US3927660A - Lymph duct cannulator and method - Google Patents

Lymph duct cannulator and method Download PDF

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US3927660A
US3927660A US432733A US43273374A US3927660A US 3927660 A US3927660 A US 3927660A US 432733 A US432733 A US 432733A US 43273374 A US43273374 A US 43273374A US 3927660 A US3927660 A US 3927660A
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groove
holder
duct
needle
inserter
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Charles John Tegtmeyer
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North American Instrument Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0045—Devices for taking samples of body liquids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0294—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body having a specific shape matching the shape of a tool to be inserted therein, e.g. for easy introduction, for sealing purposes, guide
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00—Surgery
    • Y10S128/26—Cannula supporters

Definitions

  • ABSTRACT This invention is directed to a product for and method of lymph duct cannulation which includes surgical isolation of a lymph duct, placing the duct in a groove of a lymph duct holder, occluding the duct adjacent and proximal to the holder, distending and dilating the duct by milking same toward the cannulator from a point distal thereto until the duct fills the groove, aligning a needle inserter adjacent and distal to the holder having a channel that aligns with said groove and fixes the duct securely in said groove, and inserting the needle through the inserter channel into the duct within the groove.
  • the groove is provided with an ovoid slot through which a ligature may be placed around the duct and tightened to hold the needle in place. The occluder is then loosened and radiopaque material injected'through the needle into the duct.
  • This invention relates to the medical arts and particularly the insertion of a needle or cannula in small flaccid vessels such as a lymph duct for inserting diagnostic or treating fluids such as radiopaque medium or withdrawing fluid samples for examination.
  • the described procedure uses a lymph duct holder and cooperative elements to occlude, and guide a needle into, the duct which is securely fixed in the holder.
  • This invention relates generally to new and useful improvements in procedure and device for cannulation of small animal vessels and particularly seeks to provide a grooved lymph duct holder and a slidably cooperative aligned needle holder to direct a needle into the lymph duct held in the groove with means to occlude the duct, preferably a slidably cooperative aligned occluder at the opposite end of the holder.
  • an object of this invention is to provide a simplified procedure and device to insert a cannula into lymph ducts and similar small flaccid vessels.
  • lymph duct is dilated, then occluded and finally held in a fixed position for insertion of the cannula at a general perpendicular angle to the fixed stretched wall of the duct.
  • FIG. 1 is a perspective exploded view of the cannulator device and needle as designed in accordance with this invention
  • FIG. 2 is a perspective view of the device mounted on a patents foot after insertion of the needle and displacement of the occluder;
  • FIG. 3 is a vertical section taken along line 3-3 of FIG. 2 but after tape strips are in place.
  • the localization of the lymph vessel is a modification of the technique of Kinmonth et al mentioned hereinbefore. 0-5 ml. of a solution of Evans Blue dye mixed in a 1:1 ratio with l per cent lidocaine hydrochloride is injected introdermally and subcutaneously into each of the three web spaces between the first and fourth toes. After 10 minutes the dye-carrying lymphatics are easily identified. The same procedure is applicable to the hands.
  • a flat area on the dorsum of the foot 6 is chosen for a' transverse or vertical skin incision 7 to allow for the stable placement of the lymph duct cannulator. It is important to thoroughly isolate the duct by meticulously removing all the surrounding tissue and to keep the lymph duct moist with saline so that it can be adequately distended.
  • the cannulator consists of three basic parts as will be seen most easily in FIG. 1, namely the needle inserter 8, the lymph duct holder 9, and the lymph duct occluder 11. All three sections have a rounded superior surface and a flat inferior surface as a convenience for the physician to determine the respective surfaces by touch.
  • Holder 9 is provided with a pair of bores 14,14 at each end, an elongated groove 12, which is enlarged intermediate the ends to form an ovoid slot 13 shown closer to the distal end.
  • the ovoid slot used for the silk ligature'be closest to the toes i.e., distal.
  • the longer segment of the groove for the lymph duct is then cephalad, i.e., proximal where it can be utilized.
  • a loop of 4-0 silk 17 is placed around the vessel.
  • the duct is then placed in the groove 12 of the holder 9.
  • the silk is positioned in the ovoid slot 13 provided in the holder and a loose overhand knot tied therein. It is desirable but not essential that the ovoid slot be used in conjunction with the ligature.
  • the lymph duct occluder 11 is then slid into place by inserting pins 20,20 into associated proximal bores 14,14 to completely occlude the vessel proximally.
  • the occluder shown has been found desirable but is not necessary as a ligature could be used to occlude the duct.
  • Pins 18,20 and bores 14 insure the proper alignment of the holder 9 with both the inserter 8 and occluder 11.
  • the positions of bores and pins could be reversed or other equivalentmechanical means could be used to insure such alignment, e.g., by cooperatively recessing and offsetting the respective elements.
  • the duct 16 is now distended by distally massaging the skin over the duct toward the incision. This milks the lymph cephalad, dilating the duct 16 until it fills the groove 12 in the holder.
  • the needle inserter 8 is then slid into place by inserting pins 18,18 into associated distal bores 14,14. Now the duct 16 is fully distended and held in position, proximally by the occluder 11 and distally by the needle inserter 8.
  • a 27 or 30 gauge lymphangiographic needle 19 is attached by the connecting tubing 21 to a saline-filled syringe (not shown).
  • a loop of the tubing is taped to the patients skin.
  • the needle is gently advanced through the channel 22 in the needle inserter introducing the needle into the lumen of the duct.
  • the bevel 23 of the needle may be rotated to facilitate its placement in the duct.
  • the needle and associated channel sizes are such that there is little play so that the insertion into the duct will be at a fixed angle.
  • a small amount of saline is injected to further dilate the duct.
  • the needle 19 is then advanced past the ovoid slot holding the silk.
  • the needle length is such as to prevent the advancement of its point beyond the end of the holder.
  • the silk ligature 17 is then tightened around .the duct and the needle in a single overhand knot and the excess trimmed.
  • a strip of sterile tape 26 is placed over the cannulator assemblage and fastened to the skin.
  • Another strip 24 is placed over the needle fastening the needle to the skin to prevent recoil of the needle.
  • the occluder 11 is loosened or removed and Ethiodol, (trademark of Fougera & Co. for a radiopaque liquid of the ethyl ester of the iodized fatty acids of poppy-seed oil) is infused into the vessel. It is desirable to leave a tiny air bubble in the line to ascertain the passage position of the oil. Occasionally there is slight oil leakage from the needle 19 after the duct 16 has been cannulated.
  • the needle (which is easily seen in the groove) appears to be properly situated, it is best to leave the needle in place. Sufficient oil can be injected despite a small loss. Once a suitable duct has been isolated, the needle need only be placed in the inserter 8, which directs it into the lymph vessel and holds the needle firmly in place, preventing it from being inadvertently removed while the Ethiodol is injected. After injection, the patient is ready for radiology.
  • a small isolated vessel cannulator comprising A. a rectangular vessel holder having proximal and distal end(s) surfaces, an open groove extending between said holder end(s) surfaces, and appropriately sized to receive and permit distension of said isolated vessel,
  • a rectangular needle inserter having proximal and distal end(s) surfaces, and a channel extending between said inserter end(s) surfaces and appropriately sized to permit a needle to pass therethrough without play.
  • first means to) slidably (secure) securing in a fixed position said inserter to said holder with said channel and said groove being in continuous longitudinal alignment and with one of said proximal end surfaces having facing contact with one of said distal end surfaces.
  • the cannulator of claim 1 additionally comprising C. an occluder having proximal and distal end surfaces, and second means slidably securing in a fixed position said occluder to said holder at the holder end opposed to said inserter whereby any duct within said groove will be occluded.
  • each of said means is a plurality of aligned associated pins and bores connecting between said holder and respectively said occluder and said inserter.
  • the method of cannulating a small continuous vessel segment in situ in an animal body comprising isolating said vessel segment by removing any surrounding tissue between proximal and distal ends thereof, resting a grooved vessel holder on said body at said isolation site, placing a portion of said isolated segment in said groove, occluding said isolated segment near one of said ends beyond said groove, distending said portion in said groove by milking said vessel beyond said other end toward said occluded end, fixing said portion in said groove, bringing a needle into longitudinal alignment with said groove near said other end, and inserting (a) said needle (in) into said portion (from near said other end into) within said groove.

Abstract

This invention is directed to a product for and method of lymph duct cannulation which includes surgical isolation of a lymph duct, placing the duct in a groove of a lymph duct holder, occluding the duct adjacent and proximal to the holder, distending and dilating the duct by milking same toward the cannulator from a point distal thereto until the duct fills the groove, aligning a needle inserter adjacent and distal to the holder having a channel that aligns with said groove and fixes the duct securely in said groove, and inserting the needle through the inserter channel into the duct within the groove. The groove is provided with an ovoid slot through which a ligature may be placed around the duct and tightened to hold the needle in place. The occluder is then loosened and radiopaque material injected through the needle into the duct.

Description

[ Dec. 23, 1975 LYMPH DUCT CANNULATOR AND METHOD [75] Inventor: Charles John Tegtmeyer,
Charlottesville, Va.
[73] Assignee: North American Instrument Corporation, Hudson Falls, NY.
22 Filed: Jan. 11, 1974 21 Appl. No.: 432,733
[52] US. Cl 128/2 A; l28/DIG. 26; 128/214 R [51] Int. Cl. A61B 6/00 [58] Field of Search... 128/2 A, 346, 334 R, 334 C,
128/215, 214 R, DIG. 26
[56] References Cited UNITED STATES PATENTS 2,329,264 9/1943 Glasser 128/334 R Frankel 128/334 C Norman 128/346 X Primary Examiner-Kyle I... Howell Attorney, Agent, or FirmDayton R. Stemple, Jr.
[57] ABSTRACT This invention is directed to a product for and method of lymph duct cannulation which includes surgical isolation of a lymph duct, placing the duct in a groove of a lymph duct holder, occluding the duct adjacent and proximal to the holder, distending and dilating the duct by milking same toward the cannulator from a point distal thereto until the duct fills the groove, aligning a needle inserter adjacent and distal to the holder having a channel that aligns with said groove and fixes the duct securely in said groove, and inserting the needle through the inserter channel into the duct within the groove. The groove is provided with an ovoid slot through which a ligature may be placed around the duct and tightened to hold the needle in place. The occluder is then loosened and radiopaque material injected'through the needle into the duct.
15 Claims, 3 Drawing Figures U.S. Patent Dec. 23, 1975 LYMPH DUCT CANNULATOR AND METHOD BACKGROUND FIELD OF THE INVENTION This invention relates to the medical arts and particularly the insertion of a needle or cannula in small flaccid vessels such as a lymph duct for inserting diagnostic or treating fluids such as radiopaque medium or withdrawing fluid samples for examination. The described procedure uses a lymph duct holder and cooperative elements to occlude, and guide a needle into, the duct which is securely fixed in the holder.
BACKGROUND DESCRIPTION OF PRIOR ART SUMMARY OF THE INVENTION This invention relates generally to new and useful improvements in procedure and device for cannulation of small animal vessels and particularly seeks to provide a grooved lymph duct holder and a slidably cooperative aligned needle holder to direct a needle into the lymph duct held in the groove with means to occlude the duct, preferably a slidably cooperative aligned occluder at the opposite end of the holder.
OBJECTS OF THE INVENTION Therefore, an object of this invention is to provide a simplified procedure and device to insert a cannula into lymph ducts and similar small flaccid vessels.
It is also an object to provide a grooved holder, an occluder slidably aligned at one end thereof and an inserter slidably aligned at the opposite end of said holder whereby a needle can be easily introduced into a small flaccid vessel and fixed in that position if desired.
It is a further object to provide a procedure and device whereby lymph duct is dilated, then occluded and finally held in a fixed position for insertion of the cannula at a general perpendicular angle to the fixed stretched wall of the duct.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective exploded view of the cannulator device and needle as designed in accordance with this invention;
FIG. 2 is a perspective view of the device mounted on a patents foot after insertion of the needle and displacement of the occluder; and
FIG. 3 is a vertical section taken along line 3-3 of FIG. 2 but after tape strips are in place.
DESCRIPTION OF THE PREFERRED EMBODIMENT The localization of the lymph vessel is a modification of the technique of Kinmonth et al mentioned hereinbefore. 0-5 ml. of a solution of Evans Blue dye mixed in a 1:1 ratio with l per cent lidocaine hydrochloride is injected introdermally and subcutaneously into each of the three web spaces between the first and fourth toes. After 10 minutes the dye-carrying lymphatics are easily identified. The same procedure is applicable to the hands.
A flat area on the dorsum of the foot 6 is chosen for a' transverse or vertical skin incision 7 to allow for the stable placement of the lymph duct cannulator. It is important to thoroughly isolate the duct by meticulously removing all the surrounding tissue and to keep the lymph duct moist with saline so that it can be adequately distended.
The cannulator consists of three basic parts as will be seen most easily in FIG. 1, namely the needle inserter 8, the lymph duct holder 9, and the lymph duct occluder 11. All three sections have a rounded superior surface and a flat inferior surface as a convenience for the physician to determine the respective surfaces by touch. Holder 9 is provided with a pair of bores 14,14 at each end, an elongated groove 12, which is enlarged intermediate the ends to form an ovoid slot 13 shown closer to the distal end. When positioning the lymph duct holder it is desirable that the ovoid slot used for the silk ligature'be closest to the toes, i.e., distal. The longer segment of the groove for the lymph duct is then cephalad, i.e., proximal where it can be utilized.
' After a lymph duct segment 16 one to three centimeters preferably, or other adequate length has been isolated, a loop of 4-0 silk 17 is placed around the vessel. The duct is then placed in the groove 12 of the holder 9. The silk is positioned in the ovoid slot 13 provided in the holder and a loose overhand knot tied therein. It is desirable but not essential that the ovoid slot be used in conjunction with the ligature. The lymph duct occluder 11 is then slid into place by inserting pins 20,20 into associated proximal bores 14,14 to completely occlude the vessel proximally. The occluder shown has been found desirable but is not necessary as a ligature could be used to occlude the duct. Pins 18,20 and bores 14 insure the proper alignment of the holder 9 with both the inserter 8 and occluder 11. Obviously the positions of bores and pins could be reversed or other equivalentmechanical means could be used to insure such alignment, e.g., by cooperatively recessing and offsetting the respective elements.
The duct 16 is now distended by distally massaging the skin over the duct toward the incision. This milks the lymph cephalad, dilating the duct 16 until it fills the groove 12 in the holder. The needle inserter 8 is then slid into place by inserting pins 18,18 into associated distal bores 14,14. Now the duct 16 is fully distended and held in position, proximally by the occluder 11 and distally by the needle inserter 8.
A 27 or 30 gauge lymphangiographic needle 19 is attached by the connecting tubing 21 to a saline-filled syringe (not shown). A loop of the tubing is taped to the patients skin. The needle is gently advanced through the channel 22 in the needle inserter introducing the needle into the lumen of the duct. The bevel 23 of the needle may be rotated to facilitate its placement in the duct. The needle and associated channel sizes are such that there is little play so that the insertion into the duct will be at a fixed angle. A small amount of saline is injected to further dilate the duct. The needle 19 is then advanced past the ovoid slot holding the silk. The needle length is such as to prevent the advancement of its point beyond the end of the holder. The silk ligature 17 is then tightened around .the duct and the needle in a single overhand knot and the excess trimmed.
A strip of sterile tape 26 is placed over the cannulator assemblage and fastened to the skin. Another strip 24 is placed over the needle fastening the needle to the skin to prevent recoil of the needle. The occluder 11 is loosened or removed and Ethiodol, (trademark of Fougera & Co. for a radiopaque liquid of the ethyl ester of the iodized fatty acids of poppy-seed oil) is infused into the vessel. It is desirable to leave a tiny air bubble in the line to ascertain the passage position of the oil. Occasionally there is slight oil leakage from the needle 19 after the duct 16 has been cannulated. If the needle (which is easily seen in the groove) appears to be properly situated, it is best to leave the needle in place. Sufficient oil can be injected despite a small loss. Once a suitable duct has been isolated, the needle need only be placed in the inserter 8, which directs it into the lymph vessel and holds the needle firmly in place, preventing it from being inadvertently removed while the Ethiodol is injected. After injection, the patient is ready for radiology.
I claim:
1. A small isolated vessel cannulator comprising A. a rectangular vessel holder having proximal and distal end(s) surfaces, an open groove extending between said holder end(s) surfaces, and appropriately sized to receive and permit distension of said isolated vessel,
B. a rectangular needle inserter having proximal and distal end(s) surfaces, and a channel extending between said inserter end(s) surfaces and appropriately sized to permit a needle to pass therethrough without play.
and first means (to) slidably (secure) securing in a fixed position said inserter to said holder with said channel and said groove being in continuous longitudinal alignment and with one of said proximal end surfaces having facing contact with one of said distal end surfaces.
2. The cannulator of claim 1 wherein said groove is enlarged intermediate said holder ends by an ovoid slot.
3. The cannulator of claim 2 wherein said ovoid slot is located closer said distal than said proximal holder end 4. The cannulator of claim 3 wherein said inserter is slidably secured at said distal holder end.
5. The cannulator of claim 1 wherein said first means is a plurality of aligned associated pins and bores connecting between said holder and said inserter.
6. The cannulator of claim 1 additionally comprising C. an occluder having proximal and distal end surfaces, and second means slidably securing in a fixed position said occluder to said holder at the holder end opposed to said inserter whereby any duct within said groove will be occluded.
7. The cannulator of claim 6 wherein said inserter is slidably secured at said distal holder end.
8. The cannulator of claim 7 wherein each of said means is a plurality of aligned associated pins and bores connecting between said holder and respectively said occluder and said inserter.
9. The method of cannulating a small continuous vessel segment in situ in an animal body comprising isolating said vessel segment by removing any surrounding tissue between proximal and distal ends thereof, resting a grooved vessel holder on said body at said isolation site, placing a portion of said isolated segment in said groove, occluding said isolated segment near one of said ends beyond said groove, distending said portion in said groove by milking said vessel beyond said other end toward said occluded end, fixing said portion in said groove, bringing a needle into longitudinal alignment with said groove near said other end, and inserting (a) said needle (in) into said portion (from near said other end into) within said groove.
10. The method of claim 9 wherein said vessel is a lymph duct.
11. The method of claim 10 wherein said portion is fixed in said groove by a needle inserter having a channel in alignment with said groove and said needle is inserted in said portion through said channel.
12. The method of claim 11 wherein said inserter is slidably mounted on said holder at said other end.
13. The method of claim 12 wherein said one end is proximal and said other end is distal.
14. The method of claim 10 wherein said isolated segment is occluded by an occluder slidably mounted on said holder at said one end.
15. The method of cannulating a continuous lymph duct segment in situ in an animal body comprising isolating said duct segment by removing any surrounding tissue between proximal and distal ends thereof, placing a ligature around said duct segment, resting a slotted-grooved duct holder on a said body at said isolation site, placing a portion of said isolated segment in said groove, arranging said ligature in said slot, occluding said isolated segment near one of said ends beyond said groove, distending said portion in said groove by milking said vessel beyond said other end toward said occluded end, fixing said portion in said groove, bringing a needle into longitudinal alignment with said groove near said other end, inserting said needle into said portion within said groove past said slot, and securing said ligature around said needle and said segment. l l=

Claims (15)

1. A small isolated vessel cannulator comprising A. a rectangular vessel holder having proximal and distal end(s) surfaces, an open groove extending between said holder end(s) surfaces, and appropriately sized to receive and permit distension of said isolated vessel, B. a rectangular needle inserter having proximal and distal end(s) surfaces, and a channel extending between said inserter end(s) surfaces and appropriately sized to permit a needle to pass therethrough without play. and first means (to) slidably (secure) securing in a fixed position said inserter to said holder with said channel and said groove being in continuous longitudinal alignment and with one of said proximal end surfaces having facing contact with one of said distal end surfaces.
2. The cannulator of claim 1 wherein said groove is enlarged intermediate said holder ends by an ovoid slot.
3. The cannulator of claim 2 wherein said ovoid slot is located closer said distal than said proximal holder end
4. The cannulator of claim 3 wherein said inserter is slidably secured at said distal holder end.
5. The cannulator of claim 1 wherein said first means is a plurality of aligned associated pins and bores connecting between said holder and said inserter.
6. The cannulator of claim 1 additionally comprising C. an occluder having proximal and distal end surfaces, and second means slidably securing in a fixed position said occluder to said holder at the holder end opposed to said inserter whereby any duct within said groove will be occluded.
7. The cannulator of claim 6 wherein said inserter is slidably secured at said distal holder end.
8. The cannulator of claim 7 wherein each of said means is a plurality of aligned associated pins and bores connecting between said holder and respectively said occluder and said inserter.
9. The method of cannulating a small continuous vessel segment in situ in an animal body comprising isolating said vessel segment by removing any surrounding tissue between proximal and distal ends thereof, resting a grooved vessel holder on said body at said isolation site, placing a portion of said isolated segment in said groove, occluding said isolated segment near one of said ends beyond said groove, distending said portion in said groove by milking said vessel beyond said other end toward said occluded end, fixing said portion in said groove, bringing a needle Into longitudinal alignment with said groove near said other end, and inserting (a) said needle (in) into said portion (from near said other end into) within said groove.
10. The method of claim 9 wherein said vessel is a lymph duct.
11. The method of claim 10 wherein said portion is fixed in said groove by a needle inserter having a channel in alignment with said groove and said needle is inserted in said portion through said channel.
12. The method of claim 11 wherein said inserter is slidably mounted on said holder at said other end.
13. The method of claim 12 wherein said one end is proximal and said other end is distal.
14. The method of claim 10 wherein said isolated segment is occluded by an occluder slidably mounted on said holder at said one end.
15. The method of cannulating a continuous lymph duct segment in situ in an animal body comprising isolating said duct segment by removing any surrounding tissue between proximal and distal ends thereof, placing a ligature around said duct segment, resting a slotted-grooved duct holder on a said body at said isolation site, placing a portion of said isolated segment in said groove, arranging said ligature in said slot, occluding said isolated segment near one of said ends beyond said groove, distending said portion in said groove by milking said vessel beyond said other end toward said occluded end, fixing said portion in said groove, bringing a needle into longitudinal alignment with said groove near said other end, inserting said needle into said portion within said groove past said slot, and securing said ligature around said needle and said segment.
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Cited By (10)

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US4332248A (en) * 1980-07-31 1982-06-01 Devitis Thomas N Medical apparatus
US4911690A (en) * 1985-03-29 1990-03-27 The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Treatment or diagnosis by endoscopic administration into the lymphatics
US5139487A (en) * 1990-11-28 1992-08-18 Baber Bloomfield W Laparoscopic surgical instrument apparatus
US5167629A (en) * 1990-12-06 1992-12-01 Vertenstein Mathieu J Vein locator
EP0576555A1 (en) * 1991-03-19 1994-01-05 Ob Tech Cord cutter sampler
US5507830A (en) * 1989-02-08 1996-04-16 Smith & Nephew Richards Inc. Modular hip prosthesis
US6123690A (en) * 1998-03-20 2000-09-26 Maersk Medical A/S Subcutaneous infusion device
US20030069528A1 (en) * 2001-09-21 2003-04-10 Herz Frederick Stephan Michael Prevention and treatment of deep venous thrombosis
US20070135821A1 (en) * 2005-12-09 2007-06-14 Shabaz Martin V Guide block for biopsy or surgical devices
RU2635002C1 (en) * 2016-12-23 2017-11-08 Общество С Ограниченной Ответственностью "Вектор+" (Ооо "Вектор") Device for single and chronic cannulation of thoracic duct

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US4332248A (en) * 1980-07-31 1982-06-01 Devitis Thomas N Medical apparatus
US4911690A (en) * 1985-03-29 1990-03-27 The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Treatment or diagnosis by endoscopic administration into the lymphatics
US5507830A (en) * 1989-02-08 1996-04-16 Smith & Nephew Richards Inc. Modular hip prosthesis
US5139487A (en) * 1990-11-28 1992-08-18 Baber Bloomfield W Laparoscopic surgical instrument apparatus
US5167629A (en) * 1990-12-06 1992-12-01 Vertenstein Mathieu J Vein locator
EP0576555A1 (en) * 1991-03-19 1994-01-05 Ob Tech Cord cutter sampler
EP0576555A4 (en) * 1991-03-19 1994-07-13 Ob Tech Cord cutter sampler
US6123690A (en) * 1998-03-20 2000-09-26 Maersk Medical A/S Subcutaneous infusion device
US20030069528A1 (en) * 2001-09-21 2003-04-10 Herz Frederick Stephan Michael Prevention and treatment of deep venous thrombosis
US9433553B2 (en) 2001-09-21 2016-09-06 Fred Herz Patents, LLC Device and method for prevention and treatment of deep venous thrombosis
US8936588B2 (en) * 2001-09-21 2015-01-20 Fred Herz Patents, LLC Device and method for prevention and treatment of deep venous thrombosis
US7744543B2 (en) 2005-12-09 2010-06-29 Senorx, Inc. Guide block for biopsy or surgical devices
US9055926B2 (en) 2005-12-09 2015-06-16 Senorx, Inc. Guide block for biopsy or surgical devices
US20100256520A1 (en) * 2005-12-09 2010-10-07 Senorx, Inc. Guide block for biopsy or surgical devices
US20100256521A1 (en) * 2005-12-09 2010-10-07 Senorx, Inc. Guide block for biopsy or surgical devices
US8398565B2 (en) 2005-12-09 2013-03-19 Senorx, Inc. Guide block for biopsy or surgical devices
US8758265B2 (en) 2005-12-09 2014-06-24 Senorx, Inc. Guide block for biopsy or surgical devices
US20080132912A1 (en) * 2005-12-09 2008-06-05 Senorx, Inc. Guide block for biopsy or surgical devices
US7740593B2 (en) * 2005-12-09 2010-06-22 Senorx, Inc Guide block for biopsy or surgical devices
US20070135821A1 (en) * 2005-12-09 2007-06-14 Shabaz Martin V Guide block for biopsy or surgical devices
US9700349B2 (en) 2005-12-09 2017-07-11 Senorx, Inc. Guide block for biopsy or surgical devices
US10695086B2 (en) 2005-12-09 2020-06-30 Senorx, Inc. Guide block for biopsy or surgical devices
US9814486B2 (en) 2005-12-09 2017-11-14 Senorx, Inc. Guide block for biopsy or surgical devices
RU2635002C9 (en) * 2016-12-23 2018-04-04 Общество С Ограниченной Ответственностью "Вектор+" (Ооо "Вектор+") Device for single and chronic cannulation of thoracic duct
RU2635002C1 (en) * 2016-12-23 2017-11-08 Общество С Ограниченной Ответственностью "Вектор+" (Ооо "Вектор") Device for single and chronic cannulation of thoracic duct

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