US 2874384 A
Description (Le texte OCR peut contenir des erreurs.)
Feb. 24, 1959 'B. w. KRONE 2,874,334
- SURGICAL DEVICE Filed April 16, 1957 2 Sheets-Sheet 1 INVENTOR 5 %Jimw B. w. KRONE SURGICAL DEVICE! Feb. 24, 1959 2 Sheets-Sheet 2 Filed April 16, 1957 R W w W MM 3 V i m M SURGICAL DEVICE Ben W. Krone, Loves Park, 11]., assignor to Rockford hl lhedical Foundation, Rockford, 111., a corporation of nuns Application 16, 1957, Serial No. 653,143
9 Claims. ('Cl. 1-49) This invention relates to stapling devicesand particularly to a surgical instrument for applying staple-type ligatures.
An important object of this invention is to provide a staple applying device which is manipulable with one hand to first clamp an object and thereafter afiix a staple to the clamped object to maintain the latter in a clamped condition after removal of the device.
Another object of this invention is to provide a staple applying device including pivotally connected clamping jaws and a stapling apparatus for applying a staple, in which the stapling apparatus is normally spaced from the clamping jaws to permit accurate placement of thejaws on the object to be stapled and in which the stapling apparatus is movable relative to the clamping jaws to a position adjacent the clamped object.
Yet another object of this invention is to provide a hemostatic device, in accordance with the foregoing ob ject, in which a single operating lever is arranged to sequentially move the stapling device into operative position .relative to the clamping jaws and to thereafter drive a staple fromthe stapling device into the clamped tissue.
Still another object of this invention is to provide a hemostatic device having a stapling mechanism thereon for successively applying a plurality of staples, one by one.
A more particular object of this invention is to provide a hemostatic device including a pair of pivotally interconnected clamping jaws and an arm movable relative to the clamping jaws, and in which the staple magazine is yieldably supported on the arm whereby the staple driver is moved relative to the staple magazine after the latter engages the clamping jaws.
These, together with various ancillary objects and advantages of this invention, will be readily appreciated as the same becomes better understood by reference to the following detailed description when taken in connection with the accompanying drawings, wherein Figure 1 is a side elevation alview of the hem-ostatic device with the. jaws of the hemostat in a clamped position and with the ligature-applying mechanism spaced from the clamping jaws; V
Figure 2 is an enlarged fragmentary side elevational view of the hemostatic device with the stapling mechanism shown positioned on the clamping jaws preparatory to a stapling operation;
Figure 3 is an enlarged transverse sectional view through the clamping jaws and stapling mechanism, taken on the plane 33 of Figure 2; A
Figure 4 is an enlarged fragmentary longitudinal sectional view through the stapling device and clamping jaws, taken on the plane 4-4 of Figure 3;
Figure 5 is an enlarged fragmentary longitudinal sectional view through the stapling device and clamping jaws, illustrating the stapling operation;
Figure 6'is an enlarged fragmentary top plan view of the upper-clamping jaw; and
I United States Patent I 2,874,384 Patented F eb. 24, 1959 posed in sidewise overlapping relation and pivotally interconnected by means of a pin 13. The arms 11 and 12, respectively, terminate in clamping jaws 14 and 15, the registering faces of which are preferably serrated as indicated at 14-a and 15-a to facilitate clamping of tissue therebetween. Finger loops 16 and 17 are provided at the ends of the arms 11 and 12 and interengaging portions 18 and 19 are provided for locking the arms in a clamped position. As is conventional, one of the portions 18 is serrated to provide a series of rack teeth which cooperate with a pawl (not shown) on the portion 19.
In accordance with the present invention, a ligatureapplying mechanism is mounted on the hemostat so as to be normally spaced from the clamping jaws 14 and 15 to permit accurate positioning of the clamping jaws of the hemostat on the blood vessels or other tissue. The ligature-applying mechanism is selectively movable to operative position adjacent the clamping portions of the hemostat and is thereafter operable to dispense and clinch a staple around the tissue clamped by the hemostat. The ligature-applying mechanism is in the form of a stapler 21 which is mounted on the outer end of an arm 22 conveniently pivotally mounted by the pin 13 on the hemostat 10 for swinging movement relative thereto. The arm 22 terminates in a curved handle portion 23 conveniently arranged to be manipulated by one of the fingers of the hand used to operate the hemostat 10. U-shaped spring 24 is disposed around the pivot pin 13 and has laterally extending portions engaging the upper.
clamp jaw 15 and the arm 22 to yieldably urge the latter in a counterclockwise direction as viewed in Figure. 1 to thereby normally maintain the stapling device 21 in spaced relation to the clamping jaws of the hemostat. v
The stapling device 21 comprises an enlarged head 31 formed on the outer end of the arm 22 and extending generally transversely thereto. A magazine block 32 is yieldably mounted on the block 31, for movement relative thereto in the direction of movement of the arm 22. More specifically, a pair of guide pins 33 and 34 are secured to the magazine block 32, as by threaded engagement therewith and slidably extend through bores 35 and 36 in the head 31. A spring 37 is interposed between the magazine block 32 andthe head 31 and is conveniently guidably disposed around one of the guide pins such as 34 to yieldably urge the magazine block away from the head. The guide pins 33 and 34 have enlarged portions 33a and 34a, respectively, engageable with the head 31 to limit movement of the magazine block relative thereto.
The staple magazine is arranged to support a column of staples and feed the latter in a direction generally perpendicular to the plane of movement of the arm 22 relative to the hemostat. As shown, the magazine block 32 is provided with a channel 41 extending longitudinally of the block and opening at the top face and rear end thereof, The top of the block is rabbeted adjacent, opposite sides of the recess 41 to provide longitudinally extending grooves 42 therein and a cover plate 43 is positioned in the grooves and supported thereby in spaced relation to the bottom of the recess 42. A headed screw 44 is threaded into the block 32 with the head thereof overlying the cover plate 43 to releasably clamp the A generally suitable pin or the like to facilitate tightening and loosening of the screw. A depending flange 46 is provided at the rear end of the cover plate and arranged to overlie the end of the recess4l. A staple guide member 47 is slidably disposed in the recess 41, below the cover plate 43, and a spring 48 is interposed between the member 47 and the depending flange 46 to yieldably urge the member 47 to the right, as viewed in Figure 3. A column of staples 49 are disposed in the recess 41 in front of the member 47, to be advanced thereby. A plate 51 is affixed to the end of the block 32, as by brazing, and overlies an end of the recess 41 to form a stop for the staples A transverse slot 52 (see Figures 3 and 4) is formed in the block and intersects the recess 41 to slidably receive the staple driver 55. As is apparent from Figure 4, the width of the slot 52 is made equal to the width of the recess 41 and the driver 55 is dimensioned to be'snugly and slidably received in the slot 52. The staple driver blade 55 is rigidly secured to the head 31, as by a fastener 56 and arranged to drive a staple from the magazine when the head 31 is moved relative to the staple block 32.
The stapling device 21 is movable as a unit with the arm 22 until the magazine block 32 engages the upper clamping jaw 15 of the hemostat. As is apparent from Figure 2, the head 31 is slightly angularly offset from the arm 22 so that the head 31 extends generally parallel to the clamping jaws 14 and 15, when the magazine block 32 abuts against the upper clamping jaw. The upper jaw is preferably flattened, as indicated at 61, at the outer tip thereof, to provide a substantially flat surface for engagement withthe magazine block. The upper clamping jaw 15 has a slot 62 formed therein which is arranged to be aligned with the slot 52 in the magazine block, when the latter rests thereon. The width of the slot 62 corresponds to the width of the slot 52 and is arranged to receive the staple 49 as it is driven from the magazine. The upper face of the lower clamping jaw is provided with a cam surface or anvil for bending and clinching the legs of the staple inwardly to form a substantially closed loop. As shown, the upper face of the lower jaw is provided with an elongated raised boss 67 having longitudinally curved recesses formed therein for deflecting the 4 will force the driver 55 downwardly relative to the mega zine block 32 and force a staple 49 through the slot 52 and slot 62. When the prongs of the staple 49 engage the anvil 67, the prongs are deflected inwardly, as shown in Figure 5, and form a substantially closed loop which firmly clamps the tissue. The arm 22 is then released to permit the spring 24 to return the latter to its raised position and the hemostat thereafter removed from the clamped tissue. The device is then ready for a succeeding operation.
Refilling of the staple magazine is effected by loosening the screw 44 and removing the cover plate 43 and guide member 47. A plurality of staples are then positioned in the recess 41. Obviously, the staples can either be individually positioned in the recess or, if desired, can be bound together in a column, before loading, as with a soluble gelatin or the like. The guide block 47 is then reinserted into the recess 41 and the cover plate positimed to overlie the recess with the depending flange 46 thereon engaging the spring 48 to urge the guide block to the right, as viewed in Figure 3. It is apparent that by proper selection of the binder used in holding a column of staples together, the latter can be such as to be dissolved and removed during the sterilization of the instrument.
I claim: 1. A staple applying instrument comprising a clamping device having pivotally interconnected clamping porlegs of the staple, which recesses intersect and form a I cusp therebetween. a
In order to facilitate accurate positioning of the clamping jaws on the blood vessel or other tissue to be clamped, the upper jaw 15 has the side thereof recessed as indicated at 69.to facilitate viewing of the cam face on the lower jaw 14, when applying the hemostat.
In use of the device, the hemostat it is manipulated, as by inserting the thumb and the third finger of the hand through the loops 16 and 17, respectively. It is essential to proper operation of the ligature-applying mechanism that the tissue to be clamped be accurately positioned over the cam face or anvil 67 and below the slotted end portion of the upper jaw 15. Since the stapling mechanism 21 is normally spaced from the clamping jaws of the hemostat, the tips of the hemostat are always in plain view of the surgeon during application of the hemostat. The recess 69 in the side of the upper jaw 15 facilitates viewing of the anvil or cam face 67 on the lower jaw 14, as the upper jaw is moved toward its closed position, and materially assists in the accurate positioning of the hemostat on the tissue to beclamped.
After the hemostat has been clamped on the tissue such as the blood vessel 75, the handle portion 23 of the arm 22 is engaged by one of the digits, suchas the index finger, of the hand used to manipulate the hemostat 1d and the arm then moved downwardly until the magazine registers with the slot 62 in the upper clamping jaw.
Since movement of the magazine block 32 relativeto the m t tis. arre ed, u heren e flhesum 122.:
"tions, a stapling device including a staple magazine and interconnected clamping portions into and out of engagement with one of said clamping portions, and means on the other of said clamping portions for clinching the staples.
2. A staple applying instrument comprising a clamping device having pivotally interconnected clamping portions, an arm pivotally mounted on said clamping device for independent movement relative to said clamping portions, a stapling device including a staple magazine and a staple driver mounted on said arm for movement therewith relative to said pivotally interconnected clamping portions into and out of engagement with said clamping portions, said staple magazine being yieldably mounted on said arm for movement relative thereto whereby said arm is operative to initially move said magazine into engagement with said clamping portions and is thereafter operative to move said driver relative to said magazine to drive a staple therefrom, and means on one of said clamping portions for clinching the staples.
3. A staple applying instrument comprising a clamping device having pivotally interconnected clamping portions, an arm mounted on said clamping device for move- 7 said arm in the direction of movement of said arm, a
tive to said magazine to drive a staple therefrom, and
means on one of said clamping portions for clinching the staples.
4. A staple applying instrument comprising a clamping device having first and second clamping portions pivotally interconnected for relative swinging movement,
an arm pivotally mounted on said clamping device for movement relative to said clamping portions along a path paralleling the path of movement of said clamping portions, a staple magazine yieldably mounted on said arm for movement therewith toward andaway from said clamping portions and for limited movement to said arm in the direction of movement of said arm, a staple driver mounted on said arm for movement therewith and slidably received in said magazine to drive a staple there from when the driver is moved relative to said magazine, one of said clamping portions being disposed in the path of movement of said magazine whereby said arm is operative to sequentially move said magazine into engagement with said one of said clamping portions and then move said driver relative to said magazine, and means on the other clamping portion for clinching the staples.
5. The combination of claim 4 wherein said one of said clamping portions has a slot formed therein and aligned with said driver when the magazine abuts said one of said clamping portions. 1
6. A surgical instrument comprising a hemostat device having first and second pivotally interconnected members, said members having clamping portions on one end thereof moveable toward and away from each other, an arm pivotally mounted on said hemostat forv movement in a plane paralleling the plane of movement of said members, a staple magazine mounted on said arm to support and feed a column of staples in a direction transverse to said clamping portions of said members, a staple driver mounted for sliding movement relative to said magazine to drive a staple therefrom, said staple magazine being supported on said arm for sliding movement relative thereto in the direction of movement of said arm, said arm being swingable to move said magazine into engagement with one of said clamping portions whereby further movement of the arm moves the driver relative to the magazine to drive a staple therefrom, and means on the other of said clamping portions for clinching the staples.
7. The combination of claim 6 including spring means interposed between said arm and said magazine yieldably urging the magazine to an extended position away from said arm.
8. The combination of claim 7 including spring means interposed between said hemostat and said arm yieldably urging said arm to a raised position in which said magazine is spaced from said clamping portions.
9. The combination of claim 6 wherein said one of said clamping portions has a slot therein positioned to register with said staple driver when the magazine is in engagement with said one of said clamping portions, said means for clinching the staples comprising a cam face formed on the other of said clamping portions in registry with said slot to deflect the prongs on the staple inwardly to form a substantially closed loop.
References Cited in the file of this patent UNITED STATES PATENTS 452,097 Cohen May 12, 1891 1,205,634 Hubsch Nov. 21, 1916 1,369,872 Ziegler Mar. 1, 1921 1,421,265 Levinson June 27, 1922 1,905,254 Vogel ,fl. Apr. 25, 1933
Citations de brevets