US3166075A - Surgical clamp for circumcision - Google Patents

Description

Jan. 19, 1965 A. P. KEBEL 3,165,075

SURGICAL CLAMP FOR CIRCUMCISION Filed Aug. 3. 1962 INVENTOR. Hen/0R R K5554 United States Patent 3,166,075 SURGICAL CLAMP FQR CQQUMCKSIQN Arthur P. Kehel, 3507 N. Grant Ave, Indianapolis 13, End. Filed Aug. 3, 1962, er. No. 214,575 1 Claim. (Cl. 128-346) This application relates to a surgical clamp, particularly to a clamp useful in carrying out circumcision operations.

It has long been the practice in carrying out circumcision operations to provide a clamp which comprises as essential parts a fiat base member with a port in one end as one element and a rod-shaped member enlarged into the form of a bell at one end as another element. The latter element is frequently referred to simply as a bell. The dimensions of the two members are related so that the major portion of the bell can pass easily through the port in the base member, but the lip of the bell is made so large that it will not pass through the port. Consequently, when the smaller end of thebell member is inserted into the port and the member drawn through as far as it will go, the lip of the bell presses tightly around the circumference of the port.

In carrying out the operation of circumcision using such an apparatus the prepuce is drawn over the bellshaped end of the bell member and the member then inserted into the port of the base member as far as it will go and drawn tight by suitable means to clamp the prepuce between the lip of the bell and the rim of the port. This prevents excessive bleeding after the operation is carried out. Such clamps are available on the market, one of them being available under the trade name of Gomco clamp.

Even using clamps of the type referred to, the manipulative procedure during the operation presents certain difliculties. Thus, after the prepuce is drawn over the bell, the bell member and the excess portion of the prepuce must be passed through the port in the base member. During this procedure it is difiicult to prevent the prepuce from becoming displaced from the bell, with the result that it is generally necessary to employ forceps or tweezers inserted through the port to maintain the prepuce in its proper position on the bell until the clamp has been tightened. This is a difficult procedure for one individual to carry out and sometimes requires the assistance of a second individual. Even then there is likelihood that the. proper amount of the prepuce will not be dawn through the port, with the result that the operation will not produce the precise results desired.

The present invention is, therefore, concerned with a surgical clamp for use in carrying out circumcision operations which overcomes the major difiiculties of the clamps heretofore available. According to the present invention a member, eg a base member, having a port, herein referred to as a bellv port, and a bell member comprising an elongated rod-like portion with a bellshaped enlargement at one end is provided much as in the conventional clamp. However, the bell member is provided with an additional clamping member herein referred to as a tissue clamp arranged to clamp the prepuce in its adjusted position around the bell before the latter is inserted through the bell port. Employing this modification, any displacement of the prepuce from its desired position on the bell member during its passage through the bell port is prevented in positive fashion. Furthermore, the entire procedure can be carried out easily by one individual and the desired results accomplished with precision. The tissue clamp can be of any suitable sort, provided it will clamp the tissue securely to the bell member and provided further, that, with the tissue clamp closed, the entire bell member with the 3,166,675 Patented Jan. 19, 1965 exception of the lip of the bell can be passed readily through the bell port.

Certain advantages in the invention can be understood by reference to the accompanying drawing wherein, in the interest of clarity, certain features are shown on a somewhat exaggerated scale and wherein FIGURE 1 is a side elevation of a circumcision clam embodying features of the invention;

FIGURE 2 is a sectional elevation of the clamp of FIGURE 1; and

FIGURE 3 is an elevation, rotated of a member of FIGURES l and 2.

Referring to FIGURES l and 2, the clamp illustrated. comprises a base member 11 and a clamp arm member 12, the arm member being fulcrumed, as on a transverse rounded projection 13 located near the midpoint of the arm which lies in a transverse groove 14 in the upper surface of the base member 11. One end of the base member 11, herein referred to as its rearward end, is provided with a ventical threaded clamp post 15 which is secured to the member 11 in a suitable fashion, as by welding or by being sweated into a hole in the base member. A threaded clamping nut 16 runs on the threaded post 15. The central portion of the base member 11 can be cut away in the shape of a slot 17 in the interest of saving metal and reducing weight.

The rearward end of the arm member 12 extends approximately even with the rearward end of the base member 11 and is provided with a slot 18 throughwhich the 7 tation in the lower surface of the member and the thin. section is provided with a bell port 22 of suitable diameter.

The circular wall 23 of the bell port 22 is generally sloped inwardly and upwardly so that the upper end of the port is of smaller diameter than'the lower end. The forward end of the arm member 12 extends forwardly from the transverse projection 13 and upwardly away from the base member 11. The extreme forward end of the arm member 12 is slotted longitudinally to leave'a pair of forwardly projecting prongs 24, the upper surface'of each of which is grooved transversely as at 25 to support a transverse bell pin 26, which will be referred to. later, in a position with its midpoint between the prongs 24 centered vertically with respect to the bell port 22.

The bell member of the clamp of the invention, shown, generally, at 20, comprises an elongated rod-like section or stem 27 with a supporting pin 26, referred-to previously, extending in fixed relationship through it near its upper end. The pin 26 is sufiiciently longer than the diameter of the stem 27 to cause its ends to engage the grooves 25 in the upper surfaces of the prongs 24 when the stem is located between them. The opposite or lower end of the bell member is enlarged into a bell-shaped section 28, usually hollow, the main part of which has a diameter somewhat smaller than the diameter of the bell port 22, but the lip 29 of which is flared outwardly so that the diameter of its extreme lower end is greater than that of the bell port. It is thus seen that, when the bell member 20 is inserted upwardly through the bell port 22 with its upper end first and the pin 26 positioned in the grooves 25, the bell member is suspended with its bell-shaped.

end 28 either in or immediately below the bell port 22,

depending upon the position of the nut 16 on the post through the bell port 22 until finally any tissue surby running the nut 16 upwardly on the threaded post 15."

The bell member 20 is provided with a suitable tissue clamp, one convenient form ,of which is shown clearly in the drawing. In the modificationshown the stem 27 is slotted through its longitudinal axis: as at 32. In one preferred, but not essential, modification the slot 32 termi nates at its lower end a short distance above the interior of the bell-shaped enlargement 28, but one side of'the slot is extended downwardly as a groove until it communicates with the hollow interior of the part 28, the groove extending laterally roughly half-way through the bell member. There thus remains a shoulder portion 33 of the bell member which forms a bottom of the projected groove. Alternatively, the slot can extend to the hollow interior of the bell Z8, if desired, thus eliminating the shoulder 33.

A tissue clamp 35 is provided which is conveniently of flat, roughly S-shaped configuration, as shown in, FIG- URES 1 and 2, which is positioned in the slot 32 and is secured rotatably thereinjby means of a tissue clamp pin 36 passing through the stem 27 and through approximately the midpoint of the clamp 35. The clamp 35 can thus rotate inthe. slot 32 around the pin 36. The lower end 37 of the clamp 35 is provided with teeth 41 on its inner surface arranged, when the clamp is closed, to engage and clamp tissue between the teeth and the walls of the groove 34, as well as between the teeth and the shoulder 33 forming the bottom of the groove 34 when the apparatus is constructed in the preferred way referred to. The opposite or upper end 38 .of the tissue clamp 35 is similar in configuration to the lower end and: serves as a handle or lever for actuating the clamp. It need not, of course, be provided with teeth. The entire clamp 35 is contoured and arranged so that when it is closed, with the teeth engaging-tissue, the entire assemblage of hell member, tissue clamp and tissue can be passed upwardly through the bell port 22 until tissueis clamped between V the lip 29 and the wall 23 of the port 22. By suitable tightening of the nut 16 the parts are maintained in this position until the surgical work is completed.

It will be apparent that the tissue clamp forming an integral partof the bell member 20 can be arranged in other waysprovided it effectively clamps tissue to the bell member and retains it effectively in its desired position on the member during passage of the bell member and clamped tissue upwardly through the bell port 22 and during subsequent adjustment of the clamping nut to clamp the tissue to the desired degree between the lip 29 of the bell and the surface 23 of the bell port 22.

, I claim: 7 e g In a surgical clamp of the class described, the combination including: a

an essentially flat baseemember having forward and rearward ends;'

a bell port in the base member adjacent to the forward 7 end thereof; 1

an angular clamp arm of roughly the same length as a the base member separablyyand 'pivotally engaging the base member intermediate its ends, 'a rearward section of the arm extending from the region of the pivot in the general direction of the rearward end of the base member with its end being adjacent to the rearward end of the base member and a forward section of the arm extending from the region of the pivot in the general direction of the bell port, but

the forward end of the clamp arm to' support the bell member centered longitudinally in the bell port, the ell-shaped body comprising a hollow main body portion open at its end and a bell lip surrounding the open end of the main body portion;

a tissue clamp slot, extending longitudinally of and transversely through the bell stem with at least one side of the slot extending. into the main body portion of the bell-shaped body and intersecting the hollow interior thereof;

a roughly S-shaped tissue clamp secured rotatively near its center in the tissue clamp slot on a clamp pin secured in the bell stem and extending transversely through the slot, one end of the tissue clamp being adapted to engage tissue surrounding thebellshaped body and, in cooperation with the tissue clamp slot, to clamp tissue surrounding the main body portion of the bell-shaped body securely to the bell member and the other end of the tissue clamp being elongated beyond the clamp pin and serving as a handle Wherewith to rotate the tissue clamp around the clamp pin, the parts being dimensioned to provide for passage of the bell stem, the main body portion of the bellshaped body, the tissue clamp when clamping tissue on the bell-shaped body andthe clamped tissue through the bell port in the direction of the forward end of the clamp arm, but to prevent passage through the bell port of the bell lip and tissue surrounding it whereby, upon effecting such passage with the arm in pivotal engagement with the base member and eifecting engagement of the arm engagement means of the bell member with the forward end of the clamp arm and of the adjustable pivotal means with the rearward end of the clamp arm, and upon manipulation of the adjustable pivoting means to cause pivoting of the clamp arm on the .base member, tissue surrounding the bell lip is clamped securely between the lip and the wall of the bell port.

References Cited by the Examiner UNITED STATES PATENTS RICHARD A. GAUDET, Primary Examiner,

JORDAN FRANKLIN, Examiner.

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