U.S. patent number 3,877,434 [Application Number 05/441,702] was granted by the patent office on 1975-04-15 for vascular tourniquet.
This patent grant is currently assigned to Sherwood Medical Industries, Inc.. Invention is credited to Norbert W. Burlis, Thomas B. Ferguson, Fred E. Satchell.
United States Patent |
3,877,434 |
Ferguson , et al. |
April 15, 1975 |
Vascular tourniquet
Abstract
A vascular tourniquet or snare for use in a surgical procedure
where it is desired to limit or restrict flow through a body vessel
or to secure a tube within such vessel. The tourniquet or snare
consists of an elongate sheath through which a rigid retractor
extends. A tape or cord wrapped about the vessel is withdrawn
through the sheath by the retractor and secured thereto by a plug
inserted in the proximal end of the sheath.
Inventors: |
Ferguson; Thomas B. (Ladue,
MO), Burlis; Norbert W. (University City, MO), Satchell;
Fred E. (Chesterfield, MO) |
Assignee: |
Sherwood Medical Industries,
Inc. (St. Louis, MO)
|
Family
ID: |
23753950 |
Appl.
No.: |
05/441,702 |
Filed: |
February 11, 1974 |
Current U.S.
Class: |
606/158; 606/139;
251/7; 606/148; 606/203 |
Current CPC
Class: |
A61B
17/0485 (20130101); A61B 17/12013 (20130101); A61B
2017/00349 (20130101) |
Current International
Class: |
A61B
17/12 (20060101); A61B 17/04 (20060101); A61B
17/00 (20060101); A61b 017/12 () |
Field of
Search: |
;128/325,326,327,349
;251/7 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Attorney, Agent or Firm: Garber; Stanley N. O'Meara; William
R.
Claims
We claim:
1. A vascular tourniquet comprising an elongate tubular sheath
having proximal and distal ends, an elongate retractor extending
through the lumen of said sheath and beyond both ends thereof, said
retractor having a handle at its proximal end and a hook at its
distal end, a cord or the like adapted to be positioned about a
body vessel and engaged by said hook for drawing the ends of the
cord through the lumen of the sheath and out its proximal end upon
withdrawal of said retractor from said lumen, and a plug axially
insertable from the exterior of said sheath into the proximal end
of said sheath to secure the cord against axial movement with
respect to said sheath.
2. The vascular tourniquet of claim 1 further comprising a tubular
collar secured within the lumen of said sheath at its proximal end,
said collar having a bore with an inner diameter generally
corresponding to the outer diameter of said plug for frictionally
receiving the same.
3. The vascular tourniquet of claim 2 further comprising an
integral strap securing said plug to said collar.
4. The vascular tourniquet of claim 1 wherein said hook comprises a
proximally directed open loop having a tip portion inclined toward
the axis of said retractor.
5. The vascular tourniquet of claim 4 wherein said handle is a
finger ring.
6. The vascular tourniquet of claim 4 further comprising a tubular
collar secured within the lumen at the proximal end of said sheath,
and an integral strap securing said plug to said collar, said
collar having a bore with an inner diameter generally corresponding
to the outer diameter of said plug for frictionally receiving the
same.
7. The vascular tourniquet of claim 1 wherein said hook comprises a
flexible loop integrally carried at the distal end of said
retractor, said loop normally having a transverse dimension greater
than the diameter of said lumen but being capable of flexing to a
smaller dimension to pass through said lumen upon withdrawal of
said retractor.
8. The vascular tourniquet of claim 7 further comprising a tubular
collar secured within the lumen at the proximal end of said tube,
and an integral strap securing said plug to said collar, said
collar having a bore with an inner diameter generally corresponding
to the outer diameter of said plug for receiving said cord and
frictionally receiving said plug.
9. The vascular tourniquet of claim 1 wherein said hook comprises a
loop at the distal end of said retractor, said loop defining an
elongate eyelet open at its proximal end and tapering toward its
distal end for receiving the cord in wedged frictional engagement
and having a tip at the open proximal end of said eyelet which is
radially inward relative to the periphery of the main portion of
said retractor to prevent snagging of the hook on the distal end of
said sheath.
10. The vascular tourniquet of claim 9 wherein said loop is an
integral part of said retractor and has a portion spaced distally
of said tip which is substantially equal to the diameter of the
main portion of said retractor.
11. The vascular tourniquet of claim 1 further including flexible
plastic connection means connecting said plug to said sheath to
allow axial insertion of said plug into the proximal end of said
sheath to frictionally engage and hold said cord and to allow axial
removal of said plug from the proximal end of said sheath.
12. The vascular tourniquet of claim 11 wherein said plug is of
plastic material.
Description
BACKGROUND OF THE INVENTION
This invention relates to a vascular tourniquet or snare, and more
particularly to a disposable device of this nature which
substantially reduces the clutter normally occurring in the
surgical field during certain operative procedures.
During certain surgical procedures it is customary to insert a
catheter or other medical tube into the lumen of a vein or artery
for various purposes. For example, in open heart surgery it is
necessary to provide an artificial means whereby the breathing
functions of the lungs and pumping functions of the heart can be
assured during the period that the heart is open. Thus, the heart
and lungs must be bypassed by diverting the venous blood returning
from the body to the right atrium into a heart-lung machine and
pumping the blood oxygenated by the machine back into the aorta,
either through one of its branches or through the aorta itself. For
this purpose, vena caval catheters are inserted into the superior
and inferior vena cavae. In the past, it has been common practice
to prevent leakage of blood at the entry site by encircling the
vessel with a snare, tourniquet or suture. For example, a
"purse-string" suture or a cord "shod" may be used, the latter
consisting of a rubber tube through which a length of umbilical
tape is passed after encircling the vessel. Once the tape is passed
through the tube, an external clamp such as hemostat is applied to
the tube to secure the tape in position therein.
The use of such prior art clamping devices provide considerable
clutter in the operative field principly due to the clamp used to
secure the umbilical tape within the rubber tube. In certain
operative procedures a relatively large number of such devices must
be used, thereby unduly limiting the surgeon's access to the
operative site.
Examples of vascular tourniquets which have been designed to
overcome these and other problems in the use of conventional
devices are illustrated in U.S. Pat. Nos. 3,043,308 and 3,507,270.
As will be readily observed, however, the devices illustrated by
these patents are relatively expensive to manufacture, and lack the
simplicity and ease of use which characterize the present
invention.
SUMMARY OF THE INVENTION
Accordingly, among the several objects of the present invention may
be noted the provision of a vascular tourniquet which substantially
reduces clutter at the operative site; the provision of such a
device which is easily manipulated for use but which securely holds
a tube or catheter within a body vessel or restricts or prohibits
flow through such vessel; and the provision of such a device which
is characterized by low cost and may be disposed of after use with
a single patient.
In general, vascular tourniquet constructed in accordance with the
present invention comprises an elongate tubular sheath having
proximal and distal ends. An elongate retractor extends through the
lumen of the sheath and beyond both ends thereof, the retractor
having a handle at its proximal end and a hook at its distal end. A
cord or other similar device is engaged by the hook after being
positioned about a body vessel for drawing the ends of the cord
through the lumen of the sheath and out its proximal end upon
withdrawal of the retractor from the sheath lumen. A plug is
frictionally received within the proximal end of the sheath to
secure the cord against movement with respect to the sheath by
binding the cord between the sheath and the plug.
These and other objects and features will be apparent
hereinafter.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a longitudinal view, partly in section, of the vascular
tourniquet of this invention with a body vessel;
FIG. 2 is a view similar to FIG. 1 but with the retractor of the
tourniquet in a changed position;
FIG. 3 is a view similar to FIG. 1 but with the tourniquet in
position of use;
FIG. 4 is a fragmentary view showing the distal end of the
retractor of the tourniquet of FIG. 1;
FIG. 5 is a fragmentary view, partly in section, of an alternate
embodiment of the invention; and
FIG. 6 is a view similar to FIG. 5 but with the retractor shown
partially withdrawn.
Corresponding reference characters indicate corresponding parts
throughout the several views of the drawings.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the drawings, and particularly to FIGS. 1-4, the
present vascular tourniquet is indicated generally at 10. While the
vascular tourniquet will be described for use in securing a
catheter within a body vessel, such as vein or artery, it will be
understood that the invention can also be used for constricting a
vessel, such as a blood vessel, urinary tract duct, etc.
The vascular tourniquet 10 is shown to comprise an elongate tubular
sheath 11 having a proximal end 12 and a distal end 14. The sheath
11, as illustrated, tapers slightly substantially from its proximal
to its distal ends although a cylindrical sheath may also be used.
The inner wall 15 of the sheath 11 defines a lumen 16 extending
throughout the length of the sheath. A relatively rigid elongate
retractor 18 is telescopically received within the lumen 16 of the
sheath 11, the retractor comprising an elongate rod 20 having an
integral handle 22 at its proximal end and an integral hook 24 at
its distal end. As illustrated in the drawings, the retractor
handle 22 comprises a circular finger ring, and the hook 24, as
seen in greater detail in FIG. 4, comprises an open loop 25 having
a proximally extending tip 27. As will be described more fully
hereinafter, the tip 27 of the hook 24 defines an open eyelet or
opening 28 for receiving a cord or tape.
A tubular collar 29 is secured within the lumen 16 of sheath 11 at
its proximal end 12. Collar 29 has a bore 30 and is secured to the
inner wall 15 of the sheath by any suitable means, such as
frictional engagement, a suitable adhesive or solvent bonding.
A plug 31 is connected to the proximal end of the collar 29 by an
integral tether or strap 32 which is formed of sufficiently
flexible material so that the plug may be readily inserted within
the bore 30 of collar 29, as seen in FIG. 3. The outer diameter of
plug 31 and inner diameter of bore 30 are sized for tight
frictional engagement of the plug within the bore.
A length of umbilical cord or tape 34 is looped about a body vessel
36 having a catheter or tube 38 therein. It should be understood,
however, that any suitable ligating material may be used in lieu of
umbilical cord to tape 34, for example, a suture type ligature or
other sterile string or cord may be used depending upon the
particular use of the tourniquet.
To use the present vascular tourniquet, for example in an operative
procedure wherein it is desired to secure the catheter 38 within
body vessel 36, the cord 34 is looped about the vessel 36 at the
desired location and the free ends of the cord 34 are grasped
within the loop 25 of the hook 24, as illustrated in FIG. 1. The
sheath 11 is then held by the user and the retractor 18 is
withdrawn through the lumen of the sheath by grasping the finger
hook 22 and moving the retractor proximally relative to the sheath.
This procedure, as illustrated in FIG. 2, draws the free ends of
the cord 34 through the lumen of the sheath until the free ends
extend beyond its proximal end 12. The retractor 18 may then be
discarded.
As will be noted, the tip 27 of the hook 24 has an upper portion
which extends proximally and is inclined downwardly toward the axis
of the retractor rod 20. The transverse dimension or height of the
hook at the tip 27 is less than the diameter of the main
cylindrical portion of the rod 20, so that the hook, with the cord
ends therein, may easily pass through the lumen 16 and bore 30 of
the sheath and collar without snagging. It will also be noted that
the opening 28 tapers from the open proximal end thereof to its
closed distal end to permit easy lateral insertion of the cord 34
into the opening 28 and to wedge the cord ends into tight
frictional engagement with the hook 25. The right end of the loop
25, as viewed in FIG. 4, is generally tapered to provide easy
insertion into the sheath 11. The loop has a maximum height or
transverse dimension at a portion indicated at 39 which has a
height substantially equal to the diameter of the main portion of
member 20 and which serves as a quide for the hook when moving in
the sheath.
The free ends of the cord 34 that now extend beyond the proximal
end 12 are grasped by one hand of the user while the sheath 11 is
held by the other hand, and tension is applied to the cord 34 until
the looped end of the cord exerts the desired degree of pressure
about vessel 36. When this is obtained, the sheath is compressed to
hold the free ends of the cord against slippage and the plug 31 is
inserted within the bore 30 of collar 20 to securely bind the cord
between the inner wall of the bore 30 and the outer surface of the
plug 31, as shown in FIG. 3. The vascular tourniquet may then be
released and will securely retain the tension applied by the cord
34 about the vessel 36. To remove the tourniquet, the plug 31 is
merely removed from bore 30 and the sheath 11 withdrawn proximally
from the cord and vessel.
As illustrated in the modified embodiment of FIGS. 5 and 6, a
tourniquet 10' includes a tubular sheath 11' which is identical to
sheath 11 of FIG. 1, and a retractor 18' which is similar to
retractor 18 except that the hook at the distal end of retractor
18' comprises a radially flexible loop or eyelet 40. As shown, the
loop 40 is continuous or closed so that the free ends of cord, such
as cord 34' , are threaded through the central opening in the loop,
indicated at 42, to withdraw the cord ends through the lumen of
sheath 11' upon withdrawal of the retractor 18'. As is apparent
from FIG. 5, the free unrestrained dimension of the loop 40 is
greater than the inner diameter of the lumen of sheath 11', but as
the retractor is withdrawn through the sheath 11', the loop 40 is
caused to flex radially inwardly to assume a transverse dimension
permitting passage thereof through the lumen with the cord
frictionally held thereby, as is apparent from FIG. 6.
The sheaths 11 and 11' are preferably made from a resiliently
flexible plastic material so that they are somewhat flexible or
compressible generally in the axial direction whereby the cord is
resiliently urged axially by the resiliency of the sheath when the
tourniquet is applied to a vessel. In this way, any forces tending
to move the sheath angularly relative to the vessel during
application and use of the tourniquet are at least partially
absorbed by the sheath thereby tending to avoid excess forces on
the vessel. The sheath should, of course, be sufficiently rigid to
avoid collapse when under the normal compressive forces encountered
in use. Sheaths of polyvinyl chloride have provided good
results.
The vascular tourniquet of the present invention may be readily
made entirely from inexpensive synthetic plastic materials so as to
be disposed of after a single use. For example, the sheath 11 may
be extruded of polyvinyl chloride while the retractor rod may be
injection molded of polypropylene. The plug 31 and collar 29,
together with tether strap 32, may be injection molded of polyvinyl
chloride.
In view of the above, it will be seen that the several objects of
the invention are achieved and other advantageous results
obtained.
As various changes could be made in the above constructions without
departing from the scope of the invention, it is intended that all
matter contained in the above description or shown in the
accompanying drawings shall be interpreted as illustrative and not
in a limiting sense.
* * * * *