US2393910A - Universal surgical stitching instrument - Google Patents

Description

Jan. 29, 1946. J. D. KARLE UNIVERSAL SURGICAL STITCHING INSTRUMENT Filed July 8, 1945 2 Sheets-Sheet l Jan. 29, 1946. J. D. KARLE UNIVERSAL SURGICAL STITCHING INSTRUMENT Filed July 8, 1945 2 Sheets-Sheet 2 Patented Jan. 29, 1946 UNIVERSAL SURGICAL STITCHING INSTRUMENT John D. Karle, Rosellelark, N. 1., assignor to The Singer Manufacturing N. 1., a corporation of New Jersey Application July 8, 1M3, Serial No. 493,819

15 Claims.

This invention relates to surgical stitching instruments and more particularly to improvements in the instrument which forms the subject of my pending United States patent application Serial No. 438,292, filed April 9, 1942, which has matured into Patent No. 2,348,218, dated May 9, 1944.

The primary object of this invention is to provide a universal surgical stitching instrument which may be used as readily with the left hand as with the right and in which the operating conditions and the position of the thumb-releasable spool-holder relative to the thumb of the user will be precisely the same regardless of the hand in which the instrument is held.

It has been found that in the use of instruments of this nature, one surgeon will prefer to hold the instrument with his hand in one position, for example, with his thumb on top of the handle, while another will prefer to hold the instrument with his hand turned approximately ninety degrees about the handle so that his thumb will lie beside the handle. Also different operating conditions make it desirable to have the needle adjustable to a plurality of predetermined angular positions about the axis of its shank.

All of these desirable features have been obtained in a surgical stitching instrument having the improved needle-clamp actuating means and angularly adjustable needle disclosed in my above mentioned application, by mounting the thumbreleasable spool-holding means on the axis of the instrument so that it is equally accessible to the thumb of either the right or left hand; by so constructing and mounting the spool-holding and -locking means that interference between that means and the needle-clamp actuating rod, which extends lengthwise through the instrument, is

V avoided; and by so constructing the needle-holder bar that it may be secured in any one of four angular positions relative to the handle of the instrument and the thumb-releasable spool-holding means.

With the above and other objects in view, as will hereinafter ppear, the invention comprises the devices, combinations,-and arrangements of parts hereinafter set forth and illustrated in the,

accompanying drawings of a preferred embodiment of the invention, from which the several features of the invention and the advantages attained thereby will be readily understood by those skilled in the art.

In the drawings,

Fig. 1 is a top view of my improved instrument showing it held in one position in the right hand Company, Elizabethof a user with the thumb-releasable spool-holder located at the side of the instrument.

Fig. 2 is a view similar to Fig. 1 but showing the handle turned about the axis of the instrument ninety degrees relative to the needle-holding bar to bring the thumb-releasable spool-holder to the top of the instrument, as preferred by certain users.

Figs. 3 and 4 are views similar to Figs. 1 and 2 but illustrating the instrument as held in the left hand of a user.

Fig. 5 is a longitudinal sectional view taken on the line 5-'--5 of Fig. 1.

Fig. 6 is an enlarged longitudinal sectional view taken on the line 6-6 of Fig. 5 with portions of the instrument broken away.

Fig. 7 is a transverse sectional view taken on the line I-I of Fig. 6.

Fig. 8 is a transverse sectional view taken on the line 88 of Fig. 6, showing particularly the means for locating the needle-holder bar in the handle in any one of four positions.

Fig. 9 is a sectional view taken substantially on the line 9-9 of Fig. 'I.

Fig. 10 is an enlarged view of a portion of Fig. '7 showing, more clearly, the means for locking the suture-spool against rotation in the spool-holder.

' Fig. 11 is an enlarged sectional view taken on the line I l--l I of Fig. 5 showing, more clearly, the needle-clamp and the needle held therein.

Fig. 12 is a disassembled perspective view of various parts of the instrument, hereinafter to be described.

Referring more specifically to the drawings, the

invention is disclosed as embodied in a surgical stitching instrument comprising a handle I, a

receiving portion 3 and oppositely extending tubular members 4 and 5 of which the former is adapted to fit within one end of a bore 5 formed in the handle I and to be removably held therein by a screw l threaded into a hole 4" in the memher I, while the opposite member 5 is formed with a bore 8 adapted to receive the rear end of a hollow needle-holding bar 9. The rear or inner end of the bar 9 is formed with four slots or notches a, b, c and d, spaced ninety degrees apart and which are adapted selectively to receive a positioning pin Ill, carried by the member 5. In Fig. 12 the parts are shown as rotated degrees about the longitudinal axis of the instrument,

from the position shown in Fig. 5.

shaped" needle-holding notch H. A combined needle-stop and right and left thread-guiding member 5 extends over the head H, from one cheek-piece to the other. The walls of the V- shaped notch ll comprise the fixed jaw of a. needle-clamp while the movable jaw of the clamp consists of the outer semi-circular wall of an aperture l6 drilled in a head formed at one end of a needle-clamp actuating rod IS. The head i1 is slidably mounted between the cheekpieces I2 and I3. The rod l8 extends through bores in the needie-bar 3 and spool-holding section 2 and through the hollow handle I to adjacent the free end of the handle where it is threaded into a clamp-actuating nut l3 having a knurled portion which abuts the free end of the handle. A coil spring 20 surrounding the rod l8, within the hollow handle, has one end bearing against a shoulder 2| in the handle and its other end bearing against the nut I9. This spring normally urges the two jaws of the needle-clamp into yielding contact with the octagonal shank 22 of the needle 12 thereby permitting the needle to be rotated in the clamp, about the axis of its shank,

, without dropping from the needle-clamp. Rotation of the nut IS, in one direction, serves to increase the pressure of the jaws on th needle shank and causes the needle to be positively locked in its predetermined angular positions. This needle-clamp and its actuating means are fully disclosed in my above mentioned application Serial No. 438,292. The pull of the needle-clamp actuating rod l8 serves to hold the needle-bar in the portion 5 of the spool-holding section 2 and prevents accidental separation of the pin Ill from the engaged slot a, b, c or d in the needle-bar. The needle-bar 9 and the clamp-actuating rod l8 may ,be made of any desired length or bars and rods of various lengths may be provided.

When it is desired to remove the needle-bar for the purpose of cleaning or angular adjustment, the nut I3 is unscrewed from the rod l8, thereby permitting the rod and the needle-bar to be drawn outwardly from the section 2.

Suture thread t, for the needle, is wound upon a spool 23 held within the cup-like spool-case 3 of the spool-holding section 2, intermediate the needle-bar 9 and the handle The thread t runs from the spool 23 through a slot 24 in the side wall of the spool-case 3, thence through the thread-guide l5 and finally to the eye, or eyes, of the needle. The spool is rotatably journaled on the portion 25* of a spool-supporting pin or rod 25 against a collar 26 formed thereon. The spoolcase 3 is closed, to protect the suture thread and to prevent contamination thereof, by a sheet metal cover or cap 21 which is supported on the spool-pin 25 and telescopes with the spool case. A knurled nut 28 threaded, onto the portion 25 of the spool-pin holds the cap 21 in its normal operative position.

At the side of the collar 26 remote from the portion 25, on which the spool is mounted, the spool-pin has an enlarged portion 25 which is s idingly mounted in a transverse bore 29 formed.

in the section 2 and in a boss 30 projecting therefrom. A cup-nut 3|, which also serves as a thumb-button, is threaded upon the end 25 of the spool-pin and serves as means to shift the pin axially, in one direction, in opposition to a coil spring 32 surrounding the boss 30 intermediate the member 2 and the nut 3|.

Provision is made for locking the spool against rotation except when it is desired to. draw suture thread therefrom. To that end, each flange of the spool 23 is formed with a series of apertures 23" adapted to receive the head of a screw 33, located within the spool-case 3, to prevent rotation of the spool. The screw 33 also serves to hold, within the spool-case, a light C-shaped flat metal friction spring 33, adapted to bear upon the innermost flange of the. spool to prevent overrunning of the spool when it is released from the screw 33, as will now be described.

When it is desired to unlock the spool from the screw 33 so that the spool will be free to rotate to permit suture thread tobe withdrawn from the spool, the user presses on the thumb-button 3| thereby shifting the rod 25, and the spool carried thereby, axially away from the screw 33, as illustrated in dotted lines in Fig. 10. Upon release of the pressure upon the thumb-nut the spring 32 4 ts the parts in the opposite direction again 0 to bring one of the holes 23 in the spool 23, into locking engagement with the head of the screw 33. As hereinbefore stated the suture spool and its locking and unlocking means are located on the longitudinal axis of the instrument so as to be equally accessible to the thumb of either hand. When so located the axis of the spool pin intersects the axis of the clamp-actuating rod l8. To permit the parts to have this desirable location and yet toavoid interference between the spool-pin and the needle-clamp actuating rod 1 have so formed the parts that one may pass transversely through the other. Preferably the portion I 25 of the spool-pin 25 is formed with a transverse clearance aperture 25 which is of suflicient 35 width to permit the needle-clamp actuating rod I! to pass therethrough, as shown in Figs. 5, 6, 7 and 10. Also, the aperture 25 is sufliciently long to permit the spool-pin to be shifted lengthwise, under thumb-pressure applied to the thumb-button 3| or by the spring 32, to cause the spool to be released from or locked to the screw 33, as hereinbefore described. 7 I

To prevent the spool-pin from turning in the section 2 when the rod I8 is withdrawn, the collar 26 is formed with an arcuate notch 26 which fits upon a complemental rounded portion 34 of the spool-tensioning spring 34, as shown most clearly in Figs. 9 and 10.

In Fig. 1 the instrument is shown as held in the needle-bar 9 is rotated ninety degrees about its axis from the position shown in Figs. 1 and 8 so that the slot b in the free end 'of the bar engages the positioning pin Ill, thereby, in efiect, rotating the handle and the spool holder ninety degrees from the position shown in Fig. 1 in the direction indicated by the arrow :4: in that figure.

Fig. 3 shows the instrument held in the left hand of a user with the parts in the same position relative to the left hand as are the parts in Fig. 1 to the right hand. To obtain this positioning of parts, the instrument is turned end for end. the needle-bar is inserted into the section 2 with the notch c in engagement with the pin II and the needle is rotated 180 degrees about the right hand of a user with the spool-releasing 3| is above the instrument, as shown in Fig. 2,

the axis of its shank from the position e in Fig. 1 to the position i in Fig. 3.

Fig. 4 shows the handle'turned in the direction indicated by the arrow 1,: in Fig; 3 ninety degrees relative to the needle-bar and needle from the position shown in Fig. 3. This is effected by inserting the needle-bar into the section 2 with the notch d therein in engagement with the pin Hi.

It is to be understood that bec use of the octagonal cross-sectional shape of t e shank of the needle and the construction of the needleclamp, the needle may also be shifted to and positively locked in each or the other angular positions 3, g, 11,1 and l, as shown in Figs. 1 and 3 as may be required for various suturing conditions or to the safety position k, in which the needle underlies the needle-bar, for the purpose of handling or transportation.

Having thus set forth the nature of the invention, what I claim herein is:

1. A surgical stitching instrument comprising a handle; a spoolholding section secured to said handle in axial alignment therewith; a spool-case provided by said section and having its axis perpendicular to and intersecting the longitudinal axis of said section; means to lock a spool against rotation in said spool-case; a manually actuable spool-lock releasing rod arranged coaxial with said spool-case; a needle-carrying bar removably secured in said spool-holding section in axial alignment with said section and handle; a needle-clamp at 'the free end of said bar; and a needle-clamp actuating rod extending through said needle-bar, spool-holding section and handle and intersecting the axis of said spool-lock releasing rod, one of said rods having an aperture therethrough to permit passage of the other rod;

2. A surgical stitching instrument comprising a handle; a spool-holding section carried by said handle and in axial alignment therewith; a needle-carrying bar removably secured in said spoolholding section in axial alignment with said section and handle; and cooperating interengaging means provided by said needle-bar and said section to position the needle-bar in a plurality oi predetermined angular positions in said section.

3. A surgical stitching instrument comprising a handle; a spool-holding section carried by said handle and in axial alignment therewith; a needle-carrying bar having one end fitted within said spool-holding section in axial alignment with said section and handle, said end having therein a plurality of notches; and a positioning element located in said spool-holding section and adapted to enter any one of said notches to hold said needle-bar in any one of a plurality of angular positions.

4. A surgical stitching instrument comprising a handle; a spool-holding section carried by said handle and in axial alignment therewith; a needle-carrying bar having one end fitted within said spool-holding section in axial alignment with said section and handle, said end having therein a plurality of circumferentially spaced openended slots; and a positioning element carried by said section and adapted selectively to be inserted into any one of said slots to hold said needle-bar in any one of a plurality of angular positions relative to said spool-holding section and handle.

said spool-holding section in axial-alignment with said section and handle. said end having therein a plurality of circumferentially spaced open-ended slots; a positioning element carried by said section and adapted-selectively to be inserted into any one of said slots to hold said needle-bar in any one of a plurality of angular positions relative to said section and handle; a fixed needle-clamping'jaw at theouter end of said needle-bar; a movable needle-clamping jaw cooperating with said fixed jaw to clamp a needie; and means extending through said needlebar, spool-holding section and handle to draw said movable clamping jaw into needle-clamping position and to hold said needle-bar against outward movement relative to said positioning element. a

6. A surgical stitching instrument comprising a hollow handle; a spool-holding section having a cup-like spool-holding portion and. two tubular portions extending in opposite directions therefrom, one of said tubular portions being secured within the axial bore in said handle; a needle-bar having one end secured within the other tubular portion of said spool-holding section; a needle-clamp at the opposite end of said needle-bar; a needle-clamp actuating rod ex tending through said needle-bar, spool-holding section and handle; and means at the free end of said handle for actuating said needle-clamp actuating rod.

7. A surgical stitching instrument comprising a hollow handle; a spool-holding section having a central portion and two tubular portions extending in opposite directions therefrom, one of said tubular portions being secured within said handle; a cup-like spool-case provided .by said central portion having its axis perpendicular to and intersecting the axis of said tubular portions; a needle-bar having one end secured within the other tubular portion of said spool-holding section; -a spool-supporting pin mounted in said central portion coaxial with said spool-case, said spool-pin having a transverse bore therethrough; a needle-clamp at the opposite end of said needle-bar; a needle-clamp actuating rod extending through the bores in said needle-bar, spool-holding section, spool-pin, and handle; and means at the free end of said handle for actuating said needle-clamp actuating rod.

8. A surgical stitching instrument comprisin I a hollow handle; a spool-holding section having a spool-holding portion and two tubular portions extending in opposite directions therefrom, the inner of said tubular portions being secured within said handle; a cup-like spool-case provided by said central portion having its axis perpendicurotation; thumb-actuated means for shifting said 5. A surgical stitching instrument comprising die-carrying bar having one end fitted within spool-pin and spool axially to release said spoollocking means; a needle-clamp at the outer end of said needle-bar; a needle-clamp actuating rod extending through the bores in said needlebar, spool-holding section spool-pin and handle; and means at the free-end of said handle for actuating said needle-clamp actuating rod.

9. A surgical stitching instrument as set forth in claim 8 in which the side wall oi the spoolvided between the spool-pin and the spool-holding section to prevent rotation of the spool-pin while permitting axial movement thereoi'. V

11. A universal surgical stitching instrument comprising a handle; a. spool-holding section carried by said handle and having its major axis in alignment with the axis of said handle, said section including a spool-case having its axis arranged transversely of said major axis; means to look a suture spool against rotation in said spool-case; means including an endwise movable rod extending axially through said spool-case and having a thumb-button on one end thereof for releasing said spool-lock; a needle-bar adapted t have one end thereof removably secured in any one of a plurality of predetermined angular positions in said spool-holding section at'the side or said spool-case opposite said handle; a needie-clamp at the free end of said needle-bar; and a needle adapted to be secured in said needleclamp in any one of a plurality of predetermined angular positions, the angular adjustments of said needle-bar and needle permitting the instrument selectively to be assembled for, identical operating conditions whether held in the right or'left hand of a user.

12. A universal surgical stitching instrument comprising a handle; a spool-holding section carried by said handle and having its major axis in alignment with the axis of said handle, said section including a spool-case having its'axis arranged transversely of and intersecting said major axis; means to look a suture spool against rotation in said spool-case; means including a thumb-actuated endwise movable rod, having an elongated transverse aperture therethrough, extendingaxially through said spool-case for releasing said spool-lock; a needle-bar adapted to have one end thereof removably secured in any one of a plurality of predetermined angular positions in said spool-holding section; a needleclamp at the free end of said needle-bar; a needle-clamp actuating rod extending through the bores in said needle-bar, spool-holding section, spool-releasing rod and handle; a nut threaded on said clamp-actuating rod to shift it axially;

and a needle adapted to be secured in-said needleclamp in any one of a plurality or predetermined angular positions, the angular adjustments of said needle-bar and needle permitting the instrument selectively to be assembled for identical operating conditions whether held in the right or left hand oi a user. p

13. A universal surgical stitching instrument comprising a handle; a spool-holding section secured thereto and including a spool-case and thumb-controlled means for looking a suture spool therein; a needle-bar having one end removably secured in said section; a needle secured in the opposite end 01' said needle-bar; and means for efiecting relative angular adjustment between said needle-bar and said section togcause the handle and the thumb-controlled spool-locking means to have a plurality of predetermined angular positions in a hand of a user without changing the position of the needle.

14. A universal surgical stitching instrument comprising a handle; a spool-holding section secured thereto and including a spool-case and thumb-controlled means for locking 9. suture spool therein, the axes of said spool-case and thumb-controlled means being arranged perpendicular to and intersecting the axis of said handle; a needle-bar having one end secured in said section; a needle-clamp at the free end 0! said needle-bar; a needle secured in said needleclamp; a needle-clamp actuating rod extending axially through said needle-bar, spool-holding section and handle; and means for eil'ecting relative angular adjustment between said needle-bar and said section to cause the handle and the thumb controlled spool-locking means to have a plurality of predetermined angular positions in a hand of a user without changing the position of the needle-clamp and needle.

15. A universal surgical stitching instrument comprising a handle; a spool-holding section se-

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