US3533410A - Ligating hemostat - Google Patents

Description

United States Patent 172] inventors Suel Grant Shannon;

Norwood Claude Graefl', Harrisburg. Pennsylvania [21} Appl.1\o. 608,419 122 Filed Jan. 10,1967 [45] Patented 06.13.1970 [73] Assignee AMP Incorporated Harrisburg, Pennsylvania Continuation-in-part of'application Ser. No. 506,692, Nov. 8, 1965, now Patent No. 3,426,757.

[54] LIGATING HEMOSTAT 9 Claims, 7 Drawing Figs.

'21 L.S. Cl 128/326 51] 1nt.C1 ...A6lbl7/12 '0] Field olSearch 128/326. 321. 322. 334. 340. 320. 346

[56] References Cited UNITED STATES PATENTS 3,140,715 7/1964 Whitton et a1. 128/321 474,130 5/1892 Hengcr 128/322 1.816.952 8/1931 Bergman 128/334 1.855.546 4/1932 File 128/326 1.940.351 12/1933 Howard... 128/326 2,104,029 1/1938 Eshman.... 128/326 2.286578 6/1942 Sauter 128/340 3.169.526 2/1965 Wood 128/326 3.404.683 10/1968 Eizenberg 128/322 Primary E.\'uminerDalton L. Truluck A1l0rne \sCurtis. Morris and Safford, Marshall M.

Holcombe, William Hintze, William .1. Keating. Frederick W. Raring, John R. Hopkins, Adrian J. La Rue and Jay L. Seitchik ABSTRACT: A hemostat for clamping a severed blood vessel and comprising a pair of pivotal handle members formed of the nonmetallic material and having web means for strengthening the handle member and having an offset nose portion to permit minimum lateral dimension of the hemostat in the area of the hemostat which will be adjacent the blood vessel to be clamped. Ligature means are provided on the hemostat for effecting a rapid tie and include disc means forming a one way knot in the ligature.

Patented Oct. 13, 1970 Sheet Patented Oct. 13, 1970 3,533,410

Sheet 2 of 2 LIGATING HEMOSTAT CROSSREFERENCES TO RELATED APPLICATIONS This application is a continuation-in-part of our earlier filed application Ser. No. 506.692. filed Nov. 8, 1965. entitled "Ligating Hemostat". now US. Pat. No. 3.426.757.

BACKGROUND OF THE INVENTION l. Field ofthe invention The ligation of severed blood vessels during a surgical procedure.

2. Description ofthe prior art The prior art method of tying bleeders consists normally of either manually tying a surgeon's knot about the bleeder or using an electrical spark which will cause coagulation in the bleeder. Both ofthese methods have serious drawbacks. The manual tie method is time consuming and tedious and is often quite difficult when the bleeder is in an awkward location. The electrical spark method requires expensive machinery and is a potential hazard due to the presence of highly flammable anesthesia.

SUMMARY This invention provides a surgical hemostat which has loaded thereon a length of ligature adapted to be used for ligating a severed blood vessel. The ligature is preloaded on the hemostat in a manner whereby the surgeon may quickly apply a noose-like portion of the ligature to the severed vessel and may contract the noose-like portion by pulling on the ligature at an area remote from the severed vessel. The instrument is extremely simple to operate and can ligate the severed ves sel in a fraction of the time required for manual tying. The particular location of the bleeder has little or no effect on the instrument. The instrument is completely safe and thereby avoids all of the hazards incident to the use of the electrocoagulation method.

BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is a front elevational view of the preferred embodiment of the present invention;

FIG. 2 is a side elevational view of the device shown in FIG. 1;

FIG. 3 is a rear elevational view of the device of FIG. 1 shown in position to clamp a severed vessel;

FIG. 4 is a view similar to FIG. 3 but showing the device after the ligature has been applied to the vessel; FIG. 5 is a fragmentary perspective view showing the completion of a ligating operation and cutoff method;

FIG. 6 is a fragmentary perspective view showing the looping configuration of the ligature on the hemostat; and

FIG. 7 is a fragmentary perspective view showing further details of the device.

DESCRIPTION OF THE PREFERRED EMBODIMENT The attainments of the present invention will become ap parent to those skilled in the art upon a reading of the following detailed description when taken in conjunction with the drawings in which there is shown and described an illustrative embodiment of the invention; it is to be understood, however, that this embodiment is not intended to be exhaustive nor limiting of the invention but is given for purpose of illustration in order that others skilled in the art may fully understand the invention and the principles thereof and the manner of applying it in practical use so that they may modify it in various forms. each as may be best suited to the conditions of a particular use.

In US. Pat. application Ser. No. 494.l03 filed Oct. 8, 1965. by Suel 0. Shannon and entitled Surgical Device", now US. Pat. No. 3,409,0l4 issued Nov. 5, 1968, there is shown and described a ligature and disc arrangement for tying off blood vessels. The present invention is concerned with a means for applying the surgical device of the aforementioned copending application. Further the present invention constitutes an improvement over the applying device shown and described in US Pat. application Ser. No. 506.692 identified above.

With reference now to the drawings there is shown a surgical instrument 10 made inaccordance with the teachingsof the present invention. said instrument being operative to perform hemostasis and ligation of severed blood vessels. The instrument comprises a pair of handle members 12 and 14 joined at an intermediate point by pivot means 16. The pivot means may be conveniently a metallic eyelet or may be a molded extension of one of the handle members. The handle members may be made of stainless steel as is conventional for surgical hemostats. However in its preferred form the handles are made of a nonmetallic' material; for example a synthetic material such as nylon. polystyrene. etc. The handles are conveniently molded to lower the manufacturing costs of the instrument and thereby make it feasible to discard the instrument after a single use.

Handle 14 has a nose portion 18 provided with a serrated edge 20 and a finger-receiving portion 22. Handle 12 has a nose portion 24 slightly larger than the nose portion 18, the portion 24 being provided with serrations 26 which cooperate with the serrations 20. A finger-receiving portion 28 is provided on handle member 12 and locking means 30 are provided on each of the handles 12 and 14 for maintaining the instrument in a closed position while also permitting openingof the instrument by disengaging the ratchet teeth of the locking means. Such locking means are conventional in prior art hemostats.

Nose portion 24 is provided with an opening 32 therein, such opening being provided at the extreme tip of the nose portion. A metallic insert 34 is mounted within the opening 32 and has an edge 36 which constitutes a cutting surface. The insert 34 and opening 32 cooperate to form a passageway through which a ligature 38 extends.

One end of the ligature 38 is enclosed in a covering 40. The covering may take various forms such as a length of tubing through which the ligature extends or the covering may merely consist ofa coating adhesively applied to the ligature. I

As best seen in FIG. 7 the covering 40 and ligature 38 are secured to the handle 14 by a securing means 42 located adjacent the finger-receiving portion 22.v Securing means 42 comprises a series of ribs 44 through which the covering and ligature extend. The central rib is thermally deformed at 46 causing material from the central rib to flow into the channels between adjacent ribs to thereby entrap the covering and ligature.

The handle members 12 and 14 are provided with longitudinally extending webs 48, which webs serve to add additional strength and rigidity to the handles. Offset sections 50 are provided in the handle members for bringing the nose portions 18 and 24 into longitudinal alignment.

Located at the pivot means 16 is a retaining means 52. Retaining means 52 may comprise a pin-like member frictionally held within the pivot means or the retaining means may be combined as part of the pivot means and may be an integral part of one of the handle members. Retaining means 52 dle members as best seen in FIG. 2. One side of the retaining means is provided with a boss 54 (see FIG. 6) for receiving the ligature 38 as it exits from the covering 40. The ligature 38 passes around the boss 54 and then into the passageway formed by the opening 32 and the metallic insert 34. After passing through the opening 32 the ligature is formed into a noose 56, said noose being formed by the ligature being threaded through an apertured disc 58. For a complete description of the disc 58 and the manner in which the ligature is threaded through said disc reference is made to the aboveidentified application Ser. No. 494.103. Briefly the threading of the ligature through the disc provides essentially a one-way knot. that is the disc permits the noose 56 to be contracted rather easily while the disc also serves to prevent subsequent enlargement of the noose. The noose portion 56 is positioned around the handle members and is retained in position by the member 52. As is evident from FIG. 6 the noose 56 is placed outwardly on member 52 from the portion of ligature exiting from covering 40.

In use the instrument will be in the condition shown in FIGS. land 2. A bleeder such as 60 which is to be ligated will be grasped by the nose portions 18 and 24 ofthe instrument as shown in FIG. 3 and the handle members will be closed into a locked position by engagement of a locking means 30. Sufficient force is developed in the nose portions of the instrument to perform temporary hemostasis of the vessel. Considering FIGS. 3 and 6 the operator or surgeon will next grasp the covering 40 and will move the covering in a direction out of the paper and towards the reader. This movement of the covering and the ligature 38 therein will cause the ligature to be freed from the retaining means 52. This movement of the ligature off of boss 54 will also cause the noose 56 to be pulled off of the retaining member into a free position. The surgeon will then pull on the covering 40 until the covering and ligature are in the position shown in FIG. 4.

As the ligature is pulled towards the finger-receiving portion of the instrument the noose is constantly being contracted about the vessel 60. When the covering is in the position shown in FIG. 4 the noose will be in its fully contracted position about the vessel 60 and ligation of the vessel will be effected. The disc 58 will insure that the noose remains in its contracted or tightened position. As seen in FIG. the noose and disc are tightly secured about the vessel 60. The surgeon will then remove the excess portion of the ligature by grasping the ligature and applying pressure to the ligature in a direction towards the nose of the instrument, such pressure being effected conveniently by the surgeons thumb. The movement of the ligature towards the nose forces the ligature against the cutting edge 36 of the insert 34, thus severing the ligature closely adjacent the disc 58. With the tying thus effected the handle members will be moved to their open position and will be removed from the bleeder leaving only the small noose and disc around the bleeder. The noose and disc will remain on the bleeder and the wound or incision will then be closed. The material of which the ligature and disc are comprised will determine whether or not the ligature and disc are subsequently absorbed by the body. Both absorbable and nonabsorbable materials may be used safely and effectively for both the disc and ligature.

The present invention has several distinct advantages over the ligating hemostat shown and described in the above-mentioned copending application Ser. No. 506,692. The present invention provides a more rapid ligation than is possible with the hemostat of the earlier filed application and also the present invention provides an instrument which remains unitary after a ligating function has been performed. In the earlier filed application the unwanted length of ligature was not secured to the hemostat at the end of a tying operation and therefore it was necessary that both the hemostat and the ligature be counted prior to closing of the wound to insure that no unwanted objects were left in the wound. With the present device only the instrument itself need be counted and this is a relatively easy task.

Changes in construction will occur to those skilled in the art and various apparently different modifications and embodiments may be made without departing from the scope of the invention. The matter set forth in the foregoing description and accompanying drawings is offered by way of illustration only. The actual scope of the invention is intended to be defined in the following claims when viewed in their proper perspective against the prior art.

We claim:

1. A surgical instrument comprising first and second handle members, pivot means joining said members intermediate the ends thereof, each said handle member having a nose portion and a finger-receiving portion, one said nose portion being provided with an opening in its end, said opening being of sufficient size to permit the passage of a ligature therethrough, locking means provided adjacent said finger-receiving portions for maintaining said instrument in a closed position and for allowing said instrument to move to an open position. an offset section disposed in each said handle member between said nose portion and said pivot means, said offset section causing said nose portions to be in longitudinal alignment. securing means located on one said handle member adjacent the finger-receiving portion thereof. retaining means located at said pivot means. and a ligature extending through said opening in said nose portion. a noose formed in said ligature and retained in position by said retaining means, said ligature having an end secured by said securing means to said handle member.

2. A surgical instrument comprising a pair of handle members, each said handle member having a nose portion and a finger-receiving portion. pivot means connecting said handle members for pivotal movement and disposed between said nose portions and said finger-receiving portions, an opening disposed in one said nose portion, a ligature having an intermediate portion thereof passing through said opening, said ligature having a first end secured to one of said handle members adjacent the finger-receiving portion thereofand having a second end terminating in a noose, said ligature further having a portion located at said pivot means whereby the ligature extending between said portion and said first end is adapted to be manually grasped for effecting contraction of said noose. and means carried by said ligature for permitting contraction of said noose and for resisting enlargement of said noose.

3. A surgical instrument as set forth in claim 2 wherein said last named means is larger than the cross-sectional area of said opening whereby said means is incapable of passing through said opening.

4. A surgical instrument comprising a pair of handle members, each said handle member having a nose portion and a finger-receiving portion, pivot means connecting said handle members for pivotal movement and disposed between said nose portions and said finger-receiving portions, an opening disposed in one said nose portion, a ligature having an intermediate portion thereof passing through said opening, said ligature having a first end secured to one of said handle members adjacent the finger-receiving portion thereof and having a second end terminating in a noose, and disc means carried by said ligature for permitting contraction of said noose and for resisting enlargement of said noose, said disc means being larger than the cross-sectional area of said opening whereby said disc means is incapable of passing through said opening, said disc means having a plurality of apertures therethrough and wherein said noose is formed by threading said ligature through the apertures in said disc means.

5. A surgical instrument as set forth in claim 2 further comprising a metallic insert located in said opening, said insert having a cutting edge thereon adapted to sever said ligature.

6. A surgical instrument as set forth in claim 2 further comprising web means extending along each said handle member between said pivot means and said finger-receiving portion for increasing the rigidity of said handle members.

7. A surgical instrument as set forth in claim 6 wherein said handle members are formed ofa nonmetallic material.

8. A surgical instrument comprising a pair of handle members, each said handle member having a nose portion and a finger-receiving portion, pivot means connecting said handle members for pivotal movement and disposed between said nose portions and said finger-receiving portions, an opening disposed in one said nose portion, a ligature having an intermediate portion thereof passing through said opening, said ligature having a first end secured to one of said handle members adjacent the finger-receiving portion thereof and having a second end terminating in a noose, covering means surrounding said first end of said ligature, and securing means adjacent the finger-receiving portion of one said handle member for securing said covering means and said ligature first end to said handle member.

9. A surgical instrument as set forth in claim 8 wherein said securing means comprises a plurality of ribs, said ribs being thermally deformed to entrap said covering means and said ligature first end.

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