US3426757A - Ligating hemostat for applying a noose with a locking disc - Google Patents

Description

Feb. 11, 1969 s, NO ETAL 3,426,757

LIGATING HEMOSTAT FOR APPLYING A NOOSE WITH A LOCKING DISC Filed Nov. 8, 1965 INVENTOR. v Sum. GEHNT Summon Momma CLhuDE GRHEFF Feb. 11, 1969 s. c. SHANNON ET AL 3,426,757

LIGATING HEMOSTAT FOR APPLYING A NOOSE WITH A LOCKING DISC Filed NOV. 8, 1965 INVENTOR. Sum GPHNT Suamnom 02110000 CLfluoe GPHEFF United States Patent 13 Claims ABSTRACT OF THE DISCLOSURE A ligating device is disclosed for tying oif blood vessels during a surgical procedure and comprises a length of surgical ligature for encircling a vessel, an apertured disc carried by the ligature, the ligature being threaded through the disc in a manner to produce a one, way knot, and means for applying the ligature and disc to the severed vessel and for tightening the ligature about the vessel.

This invention relates to the art of surgery and more particularly to a new and novel means for ligating blood vessels during a surgical operation.

In the course of such an operation, the incision made by a surgeon severs a great many blood vessels, which vessels must be ligated prior to the actual surgical process. At present it is customary to ligate the blood vessels by the surgeon first clamping the vessels within a hemostat, one hemostat being used for each severed vessel, and subsequently tying the vessels closed by means of a suture material which is manipulated by hand to form a knot with the excess suture material being cut off. When the tying operation is completed, the hemostats are then unclamped and removed. This process is quite time consuming and is often done in two stages, that is all the vessels are closed by the hemostats and subsequently the tying operation is performed. The suture material used may vary and may be cotton, silk, or catgut and the material is left on the vessels after the operation is completed, the material being absorbed in whole or in part by the body.

The length of time which a patient must spend on the operating table often has a significant influence on the success of the operation. Consequently any time saved during the ligating portion of the operation would be quite beneficial to both the surgeon and the patient.

It is therefore a principal object of this invention to provide a ligating device which will materially reduce the time necessary for the ligating portion of a surgical operation.

A further object of this invention is to provide a hemostat having ligating means mounted directly thereon.

A still further object of this invention is to provide a combination hemostat-ligating means which may be disposable after each use thereof.

Another object of this invention is to provide a device whereby the severed blood vessels may be clamped and tied in a single operation prior to the clamping of a subsequent blood vessel.

A further object is to provide a combination hemostatligating means which will enable a single person to effect the clamping and tying operation, due to the fact that only two hands are necessary for performing these functions.

Other objects and attainments of the present invention will become apparent to those skilled in the art upon a reading of the following detailed description when taken in conjunction with the drawings in which there are shown and described illustrative embodiments of the invention; it is to be understood, however, that these embodiments are not intended to be exhaustive nor limiting of the invention but are given for purpose of illustration in order that others skilled in the art may fully under-stand 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 condition-s of a particular use.

In the drawings, in which like reference numerals refer to like parts:

FIGURE 1 is a perspective view of a combination hemostat-ligating means representing a preferred embodiment of the present invention;

FIGURE 2 is a side elevational view, partly broken away, of the device of FIGURE 1 clamped about a severed blood vessel.

FIGURE 3 is a view similar to FIGURE 2 showing the ligating means in a partially applied condition;

FIGURE 4 is a view similar to FIGURES 2 and 3 and showing the ligating means in its applied condition;

FIGURE 5 is a view showing a blood vessel that has been ligated in accordance with the teachings of the present invention; and

FIGURE 6 is a view partly in section of an alternative embodiment of the invention.

In U. S. patent application Ser. No. 494,103 filed Oct. 8, 1965, by Suel G. Shannon and entitled Surgical Device, 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 ligating device of the aforementioned co-pending application.

In FIGURE 1 there is shown a preferred embodiment of the present invention which comprises a hemostat 10 having a pair of arms 12 and 14, said arms terminating at one end in a pair of jaws 16 and 18 respectively having gripping surfaces 20 and 22 respectively thereon. The opposite end of arms 12 and 14 carry finger receiving portions 24 and 26 respectively and projecting inwardly from arms 12 and 14 are a pair of locking extensions 28 and 30, the extensions serving to retain the hemostat in a closed condition. The parts thus far described are preferably formed from an inexpensive plastic, such as poly-propylene, in order that the hemostat may be discarded after a single use. It is to be understood, however, that if desired, the hemostat may be repeatedly sterilized and reused and also that the hemostat may be made of stainless steel as is conventional.

The arms 12 and 14 are connected by means of a hollow pivot member 32, the pivot member being in the form of an eyelet and being coined at its ends to prevent its withdrawal from the arms 12 and 14. A removable pin 34 is slidably disposed within pivot member 32 and is frictionally held therein. The pin 34 has an abutment surface 36 thereon and terminates at one end in an enlarged section 38 for facilitating manual grasping of the pin. A slot 40 is formed in the narrow portion of pin 34, the slot serving the twofold purpose of providing resiliency in the pin for maintaining it in position within the arms 12 and 14 and also for providing a passage for a ligature to be described. The slot may optionally extend through one or both of the walls of the pin 34. The enlarged portion 38 of pin 34 has a knife slot 42 formed therein, the purpose of which will become apparent as this description proceeds.

Turning now to FIGURE 3, an elongated passageway 44 is formed in the end of one of the arms of the hemostat, in this instance the jaw 18 of arm 14. Located within passageway 44 is a hollow metallic insert 46, said insert terminating at one end in a cutting edge 48 for a purpose to be described.

As shown in the drawings, a ligature 50 is preloaded around the hemostat 10, the ligature being threaded through a disc like member 52 in a manner to form a one way knot. For a complete explanation of the manner of threading the ligature through the disc along with a description of the manner of operation of the ligature and disc, reference is again made to the above-identified eo-pending application. The ligature and disc are loaded onto the hemostat in such a way that the jaws of the hemostat are free to open and close without interference. The pin 34 serves to hold the noose portion of the ligature in position and thus prevents the ligature from interfering in any way with the operation of the hemostat. The free end of the ligature is threaded through passageway 44 and is subsequently threaded through slot 40 in pin 34 and subsequently is locked to pin 34 by passage of the ligature through the knife slot 42. A knot 51 is formed at the free end of ligature 50 to further insure that the ligature is held firmly within theknife slot 42.

FIGURE 2 shows the hemostat of the present invention in position for the ligating operation. A blood vessel 54 has been grasped between the gripping surfaces 20 and 22 and has been pulled outwardly so as to present a pyramid of flesh. The next sequence of operation is shown in FIGURE 3 wherein the pin 34 has been removed from its position in pivot member 32 to thus free the noose portion from its rest position. The movement of pin 34 causes the end of ligature 50 to be carried therewith thus contracting the noose portion of the ligature. The disc 52 is pulled into a position along the side of the blood vessel and is held there by reason of the fact that the disc is too large to pass through the passageway 44. When the noose is tight around blood vessel 54, as shown in FIGURE 4, the ligature is given a slight movement toward the flesh which causes the cutting edge 48 of the metallic insert 46 to sever the excess length of ligature and to leave a blood vessel which is securely ligated as shown in FIGURE 5.

It can be seen that the hemostat of the present invention will allow the surgeon to ligate the blood vessel immediately upon grasping of the blood vessel by the hemostat. This results in a great saving of time because the hemostat does not have to be laid aside until such time as a future tying operation would be performed. Therefore, it is not necessary to use the locking members 28 and 30 in most instances, these members only serving the purpose of giving the surgeon the option of either tying immediately or using the hemostat in the present conventional manner and laying the hemostat aside for subsequent tying. It can also be seen that the entire operation requires the use of but two hands, one to hold the hemostat in the finger receiving portions and the other to pull on the pin 34. This is contrasted by the present requirement of three hands, namely one to hold the hemostat and two to form a knot by hand of a loose piece of ligature. By requiring the use of only two hands, the entire operation can now be performed by one person, which practice was hitherto impossible.

As previously stated, the hemostat is preferably made from an inexpensive plastic whereby the hemostat may be discarded after each use. However, it can be appreciated that the hemostat could be reused and that a hospital staff member or other appropriate person could reload the hemostat with a second ligature and disc arrangement. In such instance the hemostat would preferably be made from stainless steel and could be easily resterilized.

Turning now to FIGURE 6, there is shown an alternative embodiment of the present invention. In this instance the ligature 50 and disc 52 are applied to the blood vessel 54 by means of an elongated hollow tube 56 through which the ligature passes and a cap member 58 to which the ligature is firmly secured. In this embodiment a standard hemostat may be used and the jaws 60 thereof would grasp the blood vessel at which time the cap member 58 would be moved relatively to tube 56 thus drawing the noose of the ligature tight around the blood vessel and effect the ligation. It can be seen that the tube 56 and cap 58 perform the functions of the passageway 44 and pin 34 respectively of the embodiment shown in FIG- URE 1 of the present invention. The embodiment shown in FIGURE 6 would preferably be made of an inexpensive plastic and would in most cases be a throw away item. It is further to be noted that the tube 56 could be readily secured to one jaw of a standard hemostat to thus allow the device to be used with only two hands, namely one to hold the hemostat and one to pull on cap member 58.

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 ligating device comprising a pair of arms pivotally connected intermediate the ends thereof, each said arm having a gripping surface at one end and a finger receiving portion at the opposite end, a hollow pivot member connecting said arms together, a removable pin slidably disposed within said pivot member and frictionally held therein, an elongated passageway disposed in one of said arms adjacent the gripping surface thereof, and a threadlike member passing through said elongated passageway and secured at one end to said removable pin, said threadlike member terminating at its opposite end in a loop, said loop being temporarily held in position by said pin, whereby removal of said pin will draw said loop into a position adjacent the tip of said arms.

2. A ligating device as set forth in claim 1 further comprising a disc carried by said thread-like member, said disc serving to permit the closing of said loop and to prevent the subsequent opening of said loop.

3. A ligating device as set forth in claim 1 further comprising an elongated slot in said removable pin, said thread-like member passing through said elongated slot.

4. A ligating device comprising a pair of arms pivotally connected intermediate the ends thereof, each said arm having a gripping surface at one end thereof and a finger receiving portion at the opposite end, an elongated passageway disposed in one of said arms, said passageway having an end located at the tip of said one end of the arm, a thread-like member passing through said elongated passageway and terminating at one end in a noose, a disc carried by said thread-like member, said disc serving to permit construction of said noose and to prevent subsequent expansion of said noose, means for holding said noose in position on said arms to permit free movement of said arms, and means for engaging a second end of said thread-like member for drawing said member through said passageway to constrict said noose.

5. A ligating device as set forth in claim 4 wherein said arms are formed of a non-metallic material.

6. A ligating device as set forth in claim 4 wherein said noose holding means comprises a removable pin located at the pivot point of said arms.

7. A ligating device as set forth in claim 6 wherein said removable pin has an abutment surface thereon for positioning said pin relative to said arms, said pin further having an enlarged section for facilitating manual grasping of said pin.

8. A ligating device as set forth in claim 4 further comprising a metallic insert located within said passageway, said insert having a cutting edge positioned to sever said thread-like member.

9. A ligating device for tying off blood vessels during a surgical procedure comprising in combination a length of surgical ligature for encircling a severed blood vessel, said ligature having a first end and a second end, an apertured disc carried by said ligature and fixed relative to said ligature first end, said ligature being threaded through said disc in a manner whereby said disc is readily slipable in a direction to permit constriction of said ligature about a severed vessel and whereby said disc is substantially immovable in a direction which would permit enlargement of said ligature about a severed vessel, and means for applying said ligature and disc to a severed vessel, said applying means comprising a placement portion and a tightening portion, a passageway in said placement portion through which said ligature extends, said passageway being sufiiciently small to prevent passage of 10 said disc therethrough, and said ligature second end being secured to said tightening portion of said applying means, whereby said tightening portion is operative to draw said ligature through said placement portion to constrict said ligature about a severed vessel and whereby said disc is operative to retain said ligature in its constricted condition.

10. A ligating device as set forth in claim 9 wherein said applying means comprises an elongated tubular member and wherein said passageway extends axially through said tubular member.

11. A ligating device as set forth in claim 9 wherein said applying means comprises a hemostat and wherein said passageway is disposed in the nose portion of said hemostat.

12. A ligating device as set forth in claim 11 wherein said tightening portion is also operative to temporarily retain said ligature in position on said hemostat in preparation for use.

13. A ligating device as set forth in claim 9 wherein said applying means includes mean for contacting said blood vessel to temporarily prevent the emission of blood therefrom.

References Cited UNITED STATES PATENTS 122,135 12/1871 Setchell et al. 24129 1,816,952 8/1931 Bergman 128-334 1,855,546 4/1932 File 128326 2,104,029 1/1938 Eshman 128-326 3,130,727 4/1964 Wood 128326 95,884 181924 Austria.

FOREIGN PATENTS 95,884 1/1924 Australia.

Ad. 25,656 1913 Great Britain.

OTHER REFERENCES Plaut et al., Surgery, December 1964, vol. 56, No. 6,

Hallac et al., Journal of Neurosurgery, vol. 18, 1961, pp 261-62.

DALTON L. TRULUCK, Primary Examiner.

US. Cl. X.R. 128-346 UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent No. 3,426,757 February 11, 1969 Suel Grant Shannon et al.

s certified that error appears in the above identified It i s Patent are hereby corrected as patent and that said Letter shown below:

should read constriction Column 4, line 49, "construction" Signed and sealed this 24th day of March 1970.

(SEAL) Attest:

WILLIAM E. SCHUYLER, JR.

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