US3033204A - Ligature-tier - Google Patents

Description

E. C. WOOD LIGATURE-TIER May 8, 1962 3 Sheets-Sheet 1 Filed May 5, 1958 INVENTOR. fines C. W d,

May 8, 1962 E. c. WOOD 3,033,204

LIGATURE-TIER Filed May 5, 1958 5 Sheets-Sheet 2 INVENTOR.

May 8, 1962 E. c. WOOD 3,033,204

LIGATURE-TIER Filed May 5, 1958 3 Sheets-Sheet 3 Era 15 72f} 42%4 6.6

INVENTOR.

I Lrvzesi C. 146 4 3,333,204 Patented May 8, 1962 3,033,204 LlGATURE-TIER Ernest C. Wood, 6363 Wilshire Blvd, Los Angeles, Calif.,

assignor of thirty percent to Adolph M. Brown, Beverly Hills, and thirty percent to Rene G. Le Vaux, Los

Angeles, Calif.

Filed May 5, 1958, Ser. No. 732,877 13 Claims. (Cl. 128-326) This invention relates to an instrument for stopping arterial or venous bleeding during surgical procedures.

Bleeding blood vessels are often encountered during surgical procedures, and the success of an operation is often dependent on the speed with which the bleeding can be stopped. Heretofore, when such bleeding blood vessels were encountered, they first had to be clamped with a hemostat. Then a piece of catgut, silk or cotton string had to be tied around the circumference of the blood vessel with two or three square knots. Next, the hemostat or clamp was removed, and finally the loose ends of the knot were cut away from the tied end of the blood vessels. These steps, which were performed manually, were time consuming, and when many bleeding blood vessels were encountered the time required to tie each of them was often of critical importance.

In addition, these manual procedures occupied both hands of the surgeon. This left the surgeon incapable of doing other essential work in this life-saving operation. This created severe and sometimes insurmountable difiiculties, especially when the blood vessel was located in a tiny space. Furthermore, during surgical procedures, it is oftentimes desirable and sometimes necessary to employ one hand for certain purposes while attempting to control the bleeding. Thus, the assistance of a considerable staff of trained personnel was required for operations, and the increased numbers of hands often led to confusion and interferences in the operation.

What is needed, therefore, and comprises the principal object of this invention, is an instrument which operates simply and efficiently to clamp and tie a bleeding blood vessel.

A further object of this invention is to provide an instrument for clamping and tying a blood vessel with a ligature, and for cutting the loose ends of the ligature away from the blood vessel.

Still a further object of this invention is to provide an instrument which can be conveniently operated by one hand for clamping a bleeding blood vessel, tying it with a ligature, and cutting oif the ends of the ligature knot.

Yet another object of this invention is to provide an instrument which can be used in small confining space for clamping and tying a blood vessel, and for cutting d the ends of a ligature used to tie the blood vessel.

These and other objects of this invention will become more apparent when read in the light of the accompanying drawings and specification Wherein- FIGURE 1 is a side elevational view of the combined hemostat and ligature tier;

FIGURE 2 is a plan view of the instrument shown in FIGURE 1;

FIGURE 3 is a rear elevational view of the combined hemostat and ligature tier;

FIGURE 4 is a sectional view taken on the line 44 of FIGURE 1 and looking in the direction indicated;

FIGURE 5 is a sectional view taken on the line 5--5 of FIGURE 1 and looking in the direction indicated;

FIGURE 6 is a side elevational view of a portion of the combined hemostat and ligature tier for showing the surface of a jaw opposite to the one shown in FIGURE 1;

FIGURES 7, 8, and 9 show sequential steps in the manipulation of the combined hemostat and ligature tier;

FIGURES 10 and 11 show enlarged sequential details of the operation of parts of the combined hemostat and ligature tier when tying off a bleeding blood vessel;

FIGURE 12 is a top view of the portion of the instrument disclosed in FIGURE 10;

FIGURE 13 is a sectional view taken on the line 1313 of FIGURE 11 and looking in the direction indicated; and

FIGURE 14 is a view of the ligature used in connection with the combined hemostat and ligature tier.

Referring now to FIGURE 1 of the drawing, the combined hemostat and ligature tier indicated generally by the reference numeral 10 comprises a main support bar 12. This support bar happens to be substantially rectangular in cross-section, although other shapes may also prove to be useful. A pistol grip 14 is rigidly connected to one end of the support by means of screws 15, and a fixed jaw 16 is integrally formed on the opposite end thereof and at a slight angle thereto.

A movable jaw 18 is pivotally connected to support 12 on pivot 20, and is disposed in cooperative engagement with the fixed jaw 16, so they form a pair of clamp jaws for holding a blood vessel therebetween. As seen, these clamp jaws are disposed at an angle to the support bar 12. This angular relationship is not essential, but it is useful because it makes the instrument easier to manipulate. An actuating arm 22 is integral with the movable jaw 18, and extends toward the pistol grip 14, terminating in a thumb-actuated lever 24 adjacent thereto and preferably spaced above the rearward end of the support bar 12.

A carriage, indicated generally by the reference numeral 26, comprises spaced parallel side walls 28, and top and bottom walls 30 and 31, respectively, see FIG- URES 2 and 6. The carriage walls, held together by screws 29, are arranged so they define a longitudinal opening 32, substantially rectangular in cross-section, through which the support 12 extends. The size of the opening 32 is such that its inner surfaces are in sliding engagement with the external surfaces of the support 12, see FIGURES 2 and 5. This arrangement permits the carriage 26 to move along the support 12, but because of the non-circular cross-sectional shape of the support, the carriage 26 cannot rotate on it.

As seen in FIGURES 1 and 6, the side walls 28 of the carriage 26 project below the support bar 12 and are joined together to form a dependingtrigger-shaped member 34. With this arrangement, when the instrument 10 is held in the hand of an operator by the pistol grip 14, a finger, usually the trigger finger of the same hand can be used to squeeze the trigger-shaped member 34 and thereby move the carriage 26 toward the pistol grip 14, see FIGURES 7, 8, and 9.

A leaf spring 33 is rigidly secured to the bottom wall 31 of carriage 26 by means of a screw 36. This spring extends toward jaw 18 and is biased into engagement with it for purposes to become apparent below. The top wall 30 of carriage 26 extends toward jaw 16 and terminates in a hook 38, see FIGURES 6 and 10. With this arrangement, it is apparent that the hook member 38 and the leaf spring 36 must move with the carriage 26.

The top surface 4% of support 12 is provided with a longitudinally extending T-shaped groove or guide path 42, see FIGURE 13. A flexible blade 44, substantially equal in length to the support 12, is slidably mounted in groove 42, see FIGURES 2 and 10. A cutting edge 46 is formed on one end of the blade 44, see FIGURES 10 and 11, and the opposite end 48 of this blade projects out beyond the end of groove 42 adjacent the pistol grip 14, see FIGURE 1. A first leaf spring 50 is mounted on the pistol grip 14 by means of a screw 52. This leaf spring is interlocked with the end 48 of blade 44 by any convena a tional means, see FIGURE 4, and acts to bias the blade 44 in the direction of the pistol grip 14. A second leaf spring 54 is also mounted on the pistol grip 14 by the screw 52, see FIGURE 3. As seen in FIGURE 1, one surface of this leaf spring 54 abuts against the end portion 48 of blade 44, and this leaf spring is shaped to be actuated by thumb pressure when the instrument is held by the pistol grip in the hand of the operator, see FIGURE 9. It is apparent that when thumb pressure is exerted on the leaf spring 54, the blade 44 is moved toward the jaws 16 and 18 and into a cutting position. When the pressure on leaf spring 54 is removed, it returns to its rest position and the tension in the first leaf spring 50 caused by the displacement of the blade 44 automatically retracts the blade from its advanced cutting position on support 12'.

A lock member 56, conventional in operation, is in tegral with the pistol grip 14 and projects upwardly therefrom terminating above the upper surface 40 of the support 12, see FIGURES 1 and 3. This lock member is designed to engage the actuating arm 22 of jaw 18 and releasably holds the jaws 16 and 18 in a clamping position for reasons to be described below, see FIGURES 8 and 9.

The ligature shown in FIGURE 14 and designed to be used with the instrument 10, is indicated generally by the reference numeral 60. As seen, it comprises a piece of string-like material and is usually formed from catgut, silk, or cotton. A slip knot 62 is tied in the ligature, forming an adjustable loop 64 at one end thereof. It is apparent, however, that other means for forming this adjustable loop may be used and are contemplated. A fixed loop 66 is also formed in the ligature by means of a knot 68 and is connected to the adjustable loop 64 by means of a connecting portion 70. Here also, the fixed loop in the ligature could be formed by other means than by tying a knot. The connection between portion 70 and the adjustable loop 64 is such that if the adjustable loop is surrounding a blood vessel, then a pulling force exerted on portion 70 will decrease the size of the adjustable loop 64 and cause it tightly to embrace the blood vessel to prevent it from bleeding, see FIGURE 11.

The ligature 60 is mounted on the device 10 in such a way that operation of the device causes the ligature 60 to tie a blood vessel. This requires the adjustable loop portion 64 of the ligature 60 to be initially positioned on sup port 12 so that it loosely embraces the jaw clamps 16 and 18 and with a portion of loop 64 disposed in a locating groove 72 formed in jaw clamp 18, see FIGURE 10. This part of loop 64 is held in this locating groove by the leaf spring 33 secured to the carriage 26, when the carriage is stationary and in a predetermined position on support 12. This arrangement keeps the loop 64 properly placed for effective operation of the instrument. The required position for carriage 26 can be conveniently determined by means of a positioning recess 37 formed in jaw 18. A detent 35 is located on the leaf spring 33 in such a way that it is biased into the positioning recess 37 only when the carriage is in this predetermined position. As seen, recess 37 is provided with a cam surface 39, so that when the carriage 26 is moved toward the pistol grip 14, the detent 35 will ride up on this cam surface and move the leaf spring 33 out of engagement with jaw 18 and consequently free the adjustable loop 64 and permit it to leave the locating groove 72. This movement is indicated by the dotted lines shown in FIGURE 11. Since the fixed loop 66 is also in engagement with the book 38 on the carriage 26, the same movement of carriage 26 toward the pistol grip 14 will carry the hook 38 along with it, and this will cause a pulling force to be exerted on portion 70 of the ligature 60.

When a pulling force is exerted on portion 70 of the ligature 60, the adjustable loop 64 is designed to decrease in size. The upward inclination of the clamped jaws 16 and 18 and the decreasing dimension of the jaws, coupled with the pulling force exerted by the portion 70, causes the loop to be displaced outwardly toward the ends of the clamping jaws until it is slipped off the end into engagement with the blood vessel beyond the portion clamped between the jaws. As the pull is continued, it tightly embraces the blood vessel to stop it from bleeding.

Initially, the adjustable loop 64 surrounds the jaw clamps 16 and 18 but not the blood vessel 65. Consequently, one of the functions of the instrument must be to move the adjustable loop 64 off the jaws 16 and 18 and around the periphery of the blood vessel 65. Since the pulling force on the ligature caused by the movement of the carriage 26 toward the pistol grip 14 is along the same direction, means must be provided to move the adjustable loop 64 in an opposite direction so it can move off the end of the support 12. To assist in this movement, an opening 74 is formed in jaw 16, see FIGURE 6. This opening begins at the extreme end 19 of jaw 16 and extends only partially through the jaw (half way through has been found to be practical), see FIGURE 10. This is made evident by a comparison of the opposite surfaces of jaw 16 in FIGURES 1 and 6. As seen, opening 74 extends toward the rear of jaw 16 and inclines upwardly toward its top surface 17.

With this structure, and with the adjustable loop 64 surrounding the jaws 16 and 18, as shown in FIGURE 10, the connecting portion 70 of the ligature 60 may conveniently extend from the slip knot 62 toward the extreme end 19 of jaw 16. From there, the connecting portion 70 may penetrate opening 74 and follow this opening back toward the rear upper surface 17 of the jaw 16. From there portion 70 may pass through the adjustable loop 64 and terminate in the connection between the fixed loop 66 with the hook member 38, see FIGURE 12. In this way, when a pulling force is exerted on the fixed loop 66 by the movement of the carriage 26 toward the pistol grip 14, the connecting portion 70, which is looped around the end 19 of the jaw 16, will pull the slip knot 62 and the adjustable loop 64 toward this free end and cause it to move off the jaws 16 and 18, see FIGURES 10 and 11. If this happens while the jaws are in a clamping position on a blood vessel, as shown in FIGURE 11, then this movement of the carriage will cause the adjustable loop 64 of the ligature 60 to move off the jaws of the instrument and surround the external surface of the blood vessel. Any further increase in the movement of the carriage 26 toward the pistol grip 14 will therefore cause the adjustable loop 64 to tighten around the blood vessel and stop it from bleeding.

It is noted that one of the functions of the clamping jaws 16 aind 18 is to hold the blood vessel 65 in a fixed position and to absorb the strain caused by tightening the loop 64. This is necessary to prevent the pulling force exerted on the connecting portion 70 of the ligature from being exerted directly on the blood vessel 65. Without this arrangement, the pulling force on portion 70 of the ligature which is necessary to tighten the loop 64 around the blood vessel, might be sufiicient to rip or completely tear away large portions of this blood vessel.

Once the adjustable loop 64 of the slipknot 62 is tightened around the blood vessel 65, as shown in FIG- URE 11, the ends of the knot must be cut away. As shown in FIGURES l0 and 11, the opening 74 is formed so it intersects the T-shaped groove or guide path 42 in which the blade 44 is slidably mounted. The cutting edge 46 of this blade 44, when in a retracted or non-cutting position, is comparatively near the intersection of groove 42 and opening 74, so that when portions of the ligature 60 are in opening 74, as shown, only a slight forward motion of the cutting edge 46 is necessary to cut through the connecting part 70 of the ligature adjacent the slip knot 62, see FIGURE 11. Furthermore, in this embodiment, only one end of the slip knot 62 has to be out because the slip knot is either formed so that the opposite end of the knot is initially short enough, or else this opposite end is cut before the ligature is mounted on the mstrument.

The blade 44 is flexible to permit it to conform to the arcuate portion 41 of the path 42 caused by the inclined angular relationship between the support 12 and the jaws 16 and 18. To keep the blade sliding against the bottom of the arcuate portion 41 of the guide path 42 so it can cut the ligature 60, a fixed pin 43, see FIGURE 11, is rigidly connected to the sides of the groove or guide path 42 by any convenient means. This arrangement prevents the blade 44 from leaving the arcuate portion 41 of the groove or guide path 42 as it is moved forwardly by pressure on leaf spring 54, as described above.

In operation, the instrument with the ligature 60 secured thereon as shown in FIGURE 10, is held in the hand 80 of the operator by the pistol grip 14, see FIG- URE 7. Next, the thumb 82 of the hand 80 holding the instrument engages the thumb-actuated lever 24 and pivots the connected actuating arm 22 so that the jaws 16 and 18 separate far enough to receive a blood vessel 65, see FIGURE 10. Next, the thumb 82 is used to again pivot the actuating arm 22 and clamp the jaws 16 and 18 together with the blood vessel 65 between them. To this point, the clamp jaws are acting as a temporary hemostat. Next, the actuating arm 22 is hooked under the lock member 56 to keep the clamping jaws 16 and 18 together without further thumb pressure, see FIGURE 8. Then a finger, usually the trigger finger 84 of the hand 80, encircles the trigger-shaped member 34 and exerts a pressure on it. This pressure'moves the carriage 26 toward the pistol grip 14 and, as described above, moves the adjustable loop 64 off the jaws 16 and 18 and over the outer surfaces of the blood vessel 65. Further movement of the carriage 26 toward the pistol grip tightens the loop 64 around the blood vessel and stops any bleeding, see FIGURES 9 and 11.

Then the thumb 82, freed from the necessity of holding the clamping jaws 16 and 18 in a clamping position, presses against the thumb-actuated leaf spring 54 and forces the blade 44 forward into cutting engagement with the ligature, as shown in FIGURE 11. This severs the ligature near the slipknot 62 and cuts the connection between the instrument 10 and the blood vessel 65, permitting the instrument to be removed and leaving the blood vessel securely tied.

It is apparent that through the use of this instrument blood vessels'can be tied off conveniently and quickly. Furthermore, only one hand is required to operate the instrument, leaving the other hand of the surgeon free to perform other operating procedures. Furthermore, since the clamping jaws 16 and 18- are small and narrow, the instrument can be usefully employed in tying off bleeding blood vessels which are located in confined, heretofore inaccessible, locations.

The invention may be embodied in other forms without departing from the spirit or essential characteristics thereof as set forth in the claims, and the present embodiment is therefore to be considered as illustrative and not re-' strictive, and it is intended to include all changes which come within the scope and range of the claims.

I claim:

1. An apparatus of the class described comprising a support having a locating groove therein for initially positioning a ligature, a carriage movably mounted on said support, first means connected to said carriage for holdingsaid ligature within said groove on said support when said carriage is in a predetermined stationary position, and second means connected to said carriage and adapted to be connected to said ligature for moving it out of said groove and along said support when said carriage is moved in one direction, means mounted on one end of said support and adapted to be connected to a ligature mounted on said support in such a way that when said carriage and said first and second means are moved. in one direction along said support, at least a portion of said ligature is moved in the opposite direction along said support.

determined portions of any ligature mounted on said.

support.

3. An apparatus for tying a ligature to a blood vessel comprising a support, a pistol grip rigidly connected to said support, a carriage movably mounted on said support, a first means connected to said carriage and adapted to hold a ligature in a desired position on said support when said carriage is in a predetermined stationary position, a second means connected to said carriage and adapted to be connected to said ligature for moving it along said support when said carriage is moved toward said pistol grip, means mounted on said support in spaced relation to the pistol grip and adapted to be connected to a ligature mounted on said support so that when said carriage and said first and second means are moved toward said pistol grip, at least a portion of said ligature is moved in the opposite direction along said support and into a tying position around said blood vessel, a triggershaped member rigidly connected to and depending from said carriage so that when the apparatus is held in the hand of an operator by the pistol grip a finger of the same hand can be used to squeeze the trigger-shaped member and move the carriage along said support toward the pistol grip whereby'a ligature can be tied around a blood vessel using only one hand.

4. The apparatus set forth in claim 3 including a guide track formed in said support, a cutting blade movably mounted in said guide track, and means for moving said cutting blade along said guide track into cutting engage-- ment with any ligature mounted on said support.

5. An apparatus for tying a ligature to a blood vessel comprising a support, a pistol grip rigidly connected to ,said support adjacent one end, a fixed jaw formed on the opposite end thereof, a movable jaw pivotally mounted on said support and positioned opposite said fixed jaw to form a pair of jaw clamps adapted to hold a blood vessel therebetween, an actuating rod rigidly connected to said movable jaw and extending toward said pistol grip for manipulation of said jaw clamps, a carriage movably mounted on said support, a first means connected to said carriage for holding a ligature in a desired position on said support when said carriage is in a predetermined stationary position, a second means connected to said carriage and adapted to be connected to said ligature for moving it along said support when said carriage is moved toward said pistol grip, means mounted on one of said jaws and adapted to be connected to a ligature mounted on said support so that when said carriage and said first and second means are moved toward said pistol grip, at least a portion of said ligature is moved in the opposite direction along said support and into a tying position around said blood vessel, a trigger-shaped member rigidly connected to and depending from said carriage so that when the apparatus is held in the hand of an operator by the pistol grip, a finger of the same hand can be used to squeeze the trigger-shaped member and'move the carriage along said support toward the pistol grip, whereby a ligature can be tied around a blood vessel using only one hand, a guide track formed in said support, a. cutting -blade movably mounted in said guide track, and means for moving said cutting blade along said guide track into cutting engagement with a ligature mounted on said support. I

6. An apparatus for tying a ligature to a blood vessel comprising in combination a support, a pistol grip rigidly connected to one end of'said support, a fixed jaw formed on the opposite end thereof, a movable jaw pivotally mounted on said support and positioned opposite said fixed jaw to form a pair of jaw clamps for holding a blood vessel therebetween, an actuating arm rigidly con nected to said movable jaw and extending toward and terminating near said pistol grip for convenient manipulation of said jaw clamps, a carriage movably mounted on said support, a leaf spring connected to said carriage and biased against one of said jaw clamps, a ligature made from a string-like material with a slip knot formed thereon, the loop of said slip knot loosely embracing said jaw clamps and a portion thereof held against one of said jaw clamps by said leaf spring, a hook member connected to said carriage, said hook member connected to a portion of said ligature, means mounted on the free end of one of said jaw clamps and connected to a portion of said ligature so that when said carriage and the connected leaf spring and hook member are moved toward said pistol grip the loop of said slip knot is freed from its engagement with one of said jaw clamps and moves off the free end of the jaw clamps and around any blood vessel held between them, the connection between said hook member and said ligature exerting a force on said slip knot so that continued movement of said carriage toward said pistol grip tightens the loop around said blood vessel, a trigger-shaped member rigidly connected to and depending from said carriage so that when the apparatus is held in the hand of an operator a finger of the same hand can be used to squeeze the trigger-shaped member and move the carriage toward the pistol grip whereby the slip knot of the ligature can be tightened around a blood vessel using only one hand, a guide track formed in said support and terminating near the end of said rigidly attached jaw clamp, a cutting blade movably mounted in said guide track, and means mounted on said pistol grip for moving said cutting blade along said guide track and into cutting engagement with the ligature to cut off the ends of the knot around the blood vessel.

7. An apparatus of the class described for use with a ligature having a looped end portion and a free end portion which operates to tighten the loop during relative endwise displacement of the free end portion in the direction away from the loop, comprising a support formed of a pair of elongate arms pivoted one on the other intermediate their ends to provide a clamping portion at the forward end and a handle portion at the rearward end for rocking movement of the arms about the pivot between open and clamping positions with the vessel to be tied gripped between the portions of the arm forming the clamping end portion when in clamped position, carriage means mounted on said support for lengthwise movement relative to the support between a forward position rearwardly of the clamping end portion of the support and to one side thereof and a rearward position toward the handle portion of the support, the support in the clamping end portion being formed with smooth and unobstructed surfaces on the side adjacent to the carriage and in which the clamping end portion of the arm adjacent the carriage is formed with a passage extending therethrough from the forward edge to a point on the side of the carriage and spaced rearwardly of the end but forwardly of the carriage when in the forward position, means on the carriage for releasably engaging the free end portion of the ligature when the looped end portion of the ligature is positioned about the end portion of the support and the free end portion of the ligature is threaded through the passage from the forward end to the rearward end releasably to be engaged by the carriage when in forward position whereby rearward displacement of the carriage from forward position toward rearward position operates to effect forward displacement of the looped end portion for travel off of the clamping end portion of the support and about the vessel being clamped.

8. An apparatus as claimed in claim 7 in which the clamping end portion is angled slightly from the remainder of the support in the direction towards the carriage.

9. An apparatus of the class described for use with a ligature having a looped end portion and a free end portion which operates to tighten the loop during relative endwise displacement of the free end position in the direction away from the loop, comprising a support formed of a pair of elongate arms pivoted one on the other intermediate their ends to provide a clamping portion at the forward end and a handle portion at the rearward end for rocking movement of the arms about the pivot between open and clamping positions with the vessel to be tied gripped between the portions of the arm forming the clamping end portion when in clamping position, carriage means mounted on said supported for lengthwise movement relative to the support between a forward position rearwardly of the clamping end portion of the support and to one side thereof and a rearward position toward the handle portion of the support, the support in the clamping end portion being formed with smooth and unobstructed surfaces on the side adjacent to the carriage and in which the clamping end portion of the arm adjacent the carriage is formed with a passage extending therethrough from the forward edge to a point on the side of the carriage and spaced rearwardly of the end but forwardly of the carriage when in the forward position, means on the carriage for releasably engaging the free end portion of the ligature when the looped end portion of the ligature is positioned about the end portion of the support and the free end portion of the ligature is threaded through the passage from the forward end to the rearward end releasably to be engaged by the carriage when in forward position whereby rearward displacement of the carriage from forward position toward rearward position operates to effect forward displacement of the looped end portion for travel off of the clamping end portion of the support and about the vessel being clamped and whereafter continued rearward movement of the carriage towards rearward position operates to tighten the loop about the clamped vessel for strangulation.

10. An apparatus as claimed in claim 7 in which the means on the carriage releasably to engage the free end portion of the ligature comprises a hook member.

11. An apparatus of the class described for use with a ligature having a looped end portion and a free end portion which operates to tighten the loop during relative endwise displacement of the free end portion in the direction away from the loop, comprising a support formed of a pair of elongate arms pivoted one on the other intermediate their ends to provide a clamping portion at the forward end and a handle portion at the rearward end for rocking movement of the arms about the pivot between open and clamping positions with the vessel to be tied gripped between the portions of the arm forming the clamping end portion when in clamping position, carriage means mounted on said support for lengthwise movement relative to the support between a forward position rearwardly of the clamping end portion of the support and to one side thereof and a rearward position toward the handle portion of the support, the support in the clamping end portion being formed with smooth and unobstructed surfaces on the side adjacent to the carriage and in which the clamping end portion of the arm adjacent the carriage is formed with a passage extending therethrough from the forward edge to a point on the side of the carriage and spaced rearwardly of the end but forwardly of the carriage when in the forward position, mean on the carriage for releasably engaging the free end portion of the ligature when the looped end portion of the ligature is positioned about the end portion of the support and the free end portion of the ligature is threaded through the passage from the forward end to the rearward end releasably to be engaged by the carriage when in forward position whereby rearward displacement of the carriage from forward position toward rearward position operates to effect forward displacement of the looped end portion for travel off of the clamping end portion of the support and about the vessel being clamped, and means movably mounted on direction away from the loop, comprising a support formed of a pair of elongate arms pivoted one on the other intermediate their ends to provide a clamping portion at the forward end and a handle portion at the rearward end for rocking movement of the arms about the pivot between open and clamping positions with the vessel to be tied gripped between the portions of the arm forming the clamping end portion when in clamping position, carriage means mounted on said support for lengthwise movement relative to the support between a forward position rearwardly of the clamping end portion of the support and to one side thereof and a rearward position toward the handle portion of the support, the support in the clamping end portion being formed with smooth and unobstructed surfaces on the side adjacent to the carriage and in which the clamping end portion of the arm adjacent the carriage is formed with a passage extending therethrough from the forward edge to a point on the side of the carriage and spaced rearwardly of the end but forwardly of the carriage when in the forward position, means on the carriage for releasably engaging the free end portion of the ligature when the looped end portion of the ligature is positioned about the end portion of the support and the free end portion of the ligature is threaded through the passage from the forward end to the rearward end releasably to be engaged by the carriage when in forward position whereby rearward displacement of the carriage from forward position toward rearward position operates to effect forward displacement of the looped end portion for travel off of the clamping end portion of the support and about the vessel being clamped, and a locating groove in an intermediate portion of the support for initially positioning the loop about the clamping end portion of the support.

13. An apparatus of the class described for use with a ligature having a looped end portion and a free end portion which operates to tighten the loop during relative endwise displacement of the free end portion in the direction away from the loop, comprising a support formed of a pair of elongate arms pivoted one on the other intermediate their ends to provide a clamping portion at the forward end and a handle portion at the rearward end for rocking movement of the arms about the pivot between open and clamping positions with the vessel to be tied gripped between the portions of the arm forming the clamping end portion when in clamping position, carriage means mounted on said support for lengthwise movement relative to the support between a forward position rearward-1y of the clamping end portion of the support and to one side thereof and a rearward position toward the handle portion of the support, the support in the clamping end portion being formed with smooth and unobstructed surfaces on the side adjacent to the carriage and in which the clamping end portion of the arm adjacent the carriage is formed with a passage extending therethrough from the forward edge to a point on the side of the carriage and spaced rearwardly of the end but forwardly of the carriage when in the forward position, means on the carriage for releasably engaging the free end portion of the ligature when the looped end portion of the ligature is positioned about the end portion of the support and the free end portion of the ligature is threaded through the passage from the forward end to the rearward end releasably to be engaged by the carriage when in forward position whereby rearward displacement of the carriage from forward position toward rearward position operates to effect forward displacement of the looped end portion for travel off of the clamping end portion of the support and about the vessel being clamped, and means for releasably holding the arms of the support in clamping position.

References Cited in the file of this patent UNITED STATES PATENTS 1,625,602 Gould et al. Apr. 19, 1927 1,855,546 File Apr. 26, 1932 1,940,351 Howard Dec. 19, 1933

Images