U.S. patent number 3,576,288 [Application Number 04/766,544] was granted by the patent office on 1971-04-27 for medical instrument.
This patent grant is currently assigned to United States Surgical Corporation. Invention is credited to David T. Green.
United States Patent |
3,576,288 |
Green |
April 27, 1971 |
MEDICAL INSTRUMENT
Abstract
There is disclosed an attachment designed to be carried by a
clamping tool such as an hemostat for providing said tool with the
capability of sealing the end of a fluid carrying vessel such as a
blood vessel by means of staples. A staple cartridge is easily
secured to an hemostat; and while the hemostat temporarily clamps
and seals the end of a blood vessel, staples are smoothly ejected
thereby perfecting a more permanent seal and permitting the removal
of the hemostat.
Inventors: |
Green; David T. (Norwalk,
CT) |
Assignee: |
United States Surgical
Corporation (Baltimore, MD)
|
Family
ID: |
25076763 |
Appl.
No.: |
04/766,544 |
Filed: |
October 10, 1968 |
Current U.S.
Class: |
227/111;
227/19 |
Current CPC
Class: |
A61B
17/128 (20130101) |
Current International
Class: |
A61B
17/12 (20060101); A61B 17/128 (20060101); B25c
005/02 () |
Field of
Search: |
;227/19 ;29/212 (D)/
;128/325,334,337 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Custer, Jr.; Granville Y.
Claims
I claim:
1. A staple attachment adapted for mounting on a clamping tool of
the type having a pair of gripping jaws and comprising:
staple-carrying means in the form of a threaded screw wherein the
thread of said screw is adapted to carry a plurality of
staples;
cylindrical cam means fixedly attached to said staple-carrying
means;
a staple housing surrounding said staple-carrying means and serving
to provide a guide in which said staple-carrying means can
rotate;
a staple driver pivotally attached to said staple housing and
capable of forcing out of said staple housing a staple which is
positioned for ejection;
a cam housing in the form of a solid block of material having
therein a cylindrical bore adapted to receive said cylindrical cam,
said cam housing serving to provide a guide in which said
cylindrical cam can simultaneously rotate about its axis and slide
in the direction of its axis;
cam pin means associated with said cylindrical cam means and said
cam housing for rotating said cylindrical cam means in response to
the axial sliding of said cylindrical cam means;
staple ejecting means pivotally attached to said cam housing for
causing said staple driver to rotate about its pivot point; and
a bracket adapted to be slideably attached to said clamping tool
for supporting said staple housing and said staple driver.
2. The invention as set forth in claim 1 wherein a portion of said
bracket forms an anvil adapted to receive staples ejected from said
staple housing.
3. The invention as recited in claim 2 wherein said staple driver
is pivotally attached to said staple housing by a pin and wherein
said pin is attached to said bracket securing said driver and said
housing to said bracket.
4. The invention as recited in claim 3 wherein said cam pin means
is fixedly attached to said cam housing and extends into the bore
thereof and wherein said cylindrical cam has set thereinto a series
of grooves positively engaged by said cam pin.
5. The invention as recited in claim 4 wherein said cam housing and
its associated staple-ejecting means are mounted on said bracket
for stroking in a forward and rearward direction and wherein said
stroking causes said cam housing and said staple-ejecting means to
move relative to said staple housing, said staple driver and said
bracket.
6. The invention as recited in claim 5 wherein said staple-ejecting
means is a wedge which slides against an inside wall of said
bracket and which forces said staple driver to rotate about its
axis only after said single staple is in a position ready for
ejection, said wedge causing rotation in said staple driver as a
result of the forward stroke of said cam housing.
7. The invention as recited in claim 6 wherein said bracket has two
basic positions with respect to said clamping tool, the first being
one of readiness wherein said clamping tool can function normally
and the second being adapted for stapling wherein the clamping tool
is in engagement with the object to be stapled, said first position
being rearward of the gripping jaws of said tool and said second
position being one of engagement with said gripping jaws.
8. The invention as recited in claim 7 wherein said bracket has a
first flange portion for engaging one of the handles of said
hemostat, a second flange portion for engaging two walls of said
hemostat near its gripping jaws and a third flange portion,
intermediate said first and said second flange portions, for
engaging an additional two walls of said hemostat.
9. The invention as set forth in claim 8 and further comprising
resilient means associated with said bracket for insuring a secure
fit between said bracket and said clamping tool at the handle
portion thereof.
10. The invention as recited in claim 5 wherein the pitch of the
thread of said staple-carrying means is such that a single staple
is advanced into a position ready for ejection each time said cam
housing undergoes a forward stroke.
11. The invention are recited in claim 6 wherein said staple
housing is of a length substantially equal to that of said
staple-carrying means.
12. The invention as recited in claim 11 wherein said staple hammer
is of a length substantially equal to that of said staple
housing.
13. An attachment adapted for mounting on a clamping tool such as
an hemostat which provides said clamping tool with the additional
capability of stapling closed the end of the object being clamped,
and comprising:
stapling means for closing the end of said object being clamped by
said clamping tool, said stapling means comprising screw means for
carrying a plurality of staples, means for rotating said screw
means thereby advancing said staples, and means for singly ejecting
said staples; and
means for detachably mounting said stapling means on the body of
said clamping tool.
14. The invention as recited in claim 13 wherein said stapling
means and said mounting means form an integral unit.
15. The attachment as set forth in claim 14 wherein said mounting
means is such that said attachment is slidably mounted on the body
of said clamping tool.
Description
BACKGROUND OF THE INVENTION
Whenever the severance of a blood vessel is made necessary in the
course of a surgical operation, it is also necessary to seal the
open ends of the vessel in order that the patient does not lose an
excessive amount of blood. It is therefore general practice to use
hemostats to seal open blood vessels either for the entire duration
of the surgical procedure or until the vessels can be more
permanently sealed by means of surgical thread manually positioned
by the surgeon.
If it is the practice to employ the hemostat clamp for the duration
of the operative procedure, it is readily seen that the surgical
field can become quite cluttered if it is necessary to clamp a
large number of vessels. If, on the other hand, it is the practice
to have the surgeon tie each vessel with a suitable thread, it
becomes obvious that the duration of the surgical procedure can be
greatly increased as well as the complexity of such a
procedure.
SUMMARY OF THE INVENTION
The present invention relates to a staple cartridge which is
designed to be carried by a clamping tool. The ultimate goal of the
invention is to provide the clamping tool with the added capability
of stapling closed the object being clamped. More particularly, the
staple cartridge of the instant invention is designed for rapid
attachment to an hemostat so that while said hemostat is holding
closed the severed end of a blood vessel, a staple can be smoothly
inserted into said vessel to perfect a more permanent seal. After
the stapling action, the hemostat can be removed without breaking
the seal.
It should be obvious from the above that an attachment such as that
contemplated in the present invention greatly adds to the
efficiency of most surgical procedures. The time required for the
placement of a staple, according to the teachings of the present
invention, is far less than that required for a surgeon to manually
tie a blood vessel. As a result, fewer hands and fewer hemostats
are required in the operative arena and the duration of a given
operation is lessened to a considerable degree. Such factors are of
great import when a human life is at stake.
Accordingly, it is an object of the invention to provide an
attachment for a clamping device which gives to such device the
capability of sealing the end of the object being clamped.
It is another object of the invention to provide a staple cartridge
which attaches to a hemostat making possible the simultaneous
clamping and stapling of a blood vessel.
It is a further object of the invention to provide a simple and
inexpensive staple cartridge in order that said cartridge can be
attached to a clamping tool, employed until its staples are
exhausted and then discarded.
It is still another object of the invention to provide a stapling
attachment for a surgical tool which can be packaged in a sterile
container, attached to said tool and used without the necessity for
preoperative sterilization.
It is yet a further object of the invention to provide a staple
cartridge for use with an hemostat which can be easily and rapidly
attached to said hemostat thereby allowing the efficient
replacement of an exhausted cartridge during a surgical
operation.
These and other objects of the invention, as well as many of the
attendant advantages thereof, will become more readily apparent
when reference is made to the following description taken in
conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
In FIG. 1 there is shown a top plan view of the bracket of the
present invention when attached to an hemostat;
FIG. 2 is a side elevation taken along line 2-2 of FIG. 1;
FIG. 3 is a cross-sectional view taken along line 3-3 of FIG.
1;
FIG. 4 is a cross-sectional view taken along line 4-4 of FIG.
1;
FIG. 5 is a side elevational view taken along line 5-5 of FIG.
1;
FIG. 6 is an exploded side elevational view of the staple magazine
of the present invention;
FIG. 7(a) is a top plan view of the staple hammer shown in FIG.
6;
FIG. 7(b) is a top plan view of the staple housing shown in FIG.
6;
FIG. 8 is an enlarged top plan view of the staple hammer shown in
FIG. 7(a);
FIG. 9 is an enlarged top plan view of the staple housing shown in
FIG. 7(b);
FIG. 10 is a side elevation of the staple cartridge attached to an
hemostat before a stapling stroke;
FIG. 11 is a view similar to that shown in FIG. 10 but during a
stapling stroke;
FIG. 12 is a plan view of the cylindrical cam showing the functions
of the parts of the cam groove;
FIG. 13 is an enlarged vertical cross-sectional view of an
assembled staple magazine;
FIG. 14 is a cross-sectional view of the staple magazine taken
along line 14-14 of FIG. 13;
FIG. 15 is an enlarged end elevation of an assembled staple
magazine including the staple hammer;
FIG. 16 is an enlarged end view of the staple cartridge at the
completion of a stapling stroke; and
FIG. 17 is an enlarged side elevation, partially in section, of the
cartridge shown in FIG. 16.
DETAILED DESCRIPTION OF THE DRAWINGS
Referring first to FIGS. 1 through 5, there follows a description
of the bracket which forms a part of the present invention. The
bracket is shown generally at 10 and is attached to a hemostat 12
having a pair of handle portions 14 and 16, respectively and a set
of jaws, or gripping members, shown generally at 18. The handle
portions and the jaws rotate, in a well-known manner, about a
pivotal pin 20.
The bracket 10 is securely affixed to the hemostat 12 by the
coaction of three flange portions. The first flange portion is
shown at 22 and engages one of the handle portions 16 of the
hemostat 12. The second flange portion, best shown in FIG. 3,
comprises a first restraining wall 24 and a second restraining wall
26, these walls, respectively, engaging the near and the upper
walls of the hemostat as shown in FIG. 1. As is readily apparent
from FIGS. 1 and 3, the restraining wall 26 engages the handle
portion 16 of the hemostat 12 through the means of a resilient
spring member 28. The third flange portion, best shown in FIG. 4,
comprises a first restraining wall 30 and a second restraining wall
32, these walls, respectively, engaging the rear and lower walls of
the hemostat as shown in FIG. 1. It is thus readily seen that by
means of the three flange portions and the spring 28, the bracket
10 can be securely affixed to the hemostat 12.
Forming a part of the bracket 10, and, as will be explained below,
aiding in the attachment of the staple magazine of the present
invention, is a wall 34 extending away from the body of the
hemostat 12. As best seen in FIGS. 1, 3 and 5, both walls 32 and 34
extend from beneath the hemostat 12, with the walls 34 extending
over and partially covering the wall 32. Threaded into the wall 34
is a pin 36, the function of which will also be explained below.
Forming an integral part of the bracket 10 is a wall 38 which, in
combination with walls 30 and 32, form a chamberlike cavity shown
generally at 40. As is readily apparent when reference is made to
the FIGS., the bracket 10 can easily slide along the body of the
hemostat 12 until the flange 22 encounters a pin 42. And as is also
readily apparent, the hemostat 12 is free to operate as if
unencumbered by the bracket 10 when said bracket is in its rearward
position as shown in FIG. 1. Hereinafter, the rearward position, or
that shown in FIG. 1, will be referred to as the readiness position
while the forward position, as is shown in FIG. 11, will be
referred to as the stapling position. The reasons for such
terminology will become readily apparent when the invention is more
fully explained.
With reference now to FIGS. 6 and 7, the construction of the staple
magazine is fully explained. The magazine is shown generally at 44
and comprises a threaded screwlike member 46 fixedly attached to a
cylindrical cam 48 formed with a spiral groove 50. As is more fully
explained below, the member 46 is adapted to carry a plurality of
staples in its thread grooves. Also forming an integral part of the
staple magazine is a staple housing 52 into which the staple
carrier 46 is positioned, the housing 52 being provided with a slot
54 into which can be seated a ring 56 secured to the staple carrier
46. As seen in FIGS. 6 and 7, the rear end of the staple housing
52, adjacent the slot 54, has a relatively wide opening therein to
permit the insertion of the carrier 46 with its associated ring 56.
Associated with the staple housing 52, in a manner to be explained
below, is a staple driver 58; and positioned at the end of the
driver 58 is a staple driving blade 59 having a groove 82 (FIG. 17)
extending thereacross. The function of the blade 59 is to eject
staples from the housing 52 when the driver is depressed. Also
forming a part of the staple magazine is a cam housing 60 in the
form of a solid block of material having therein a cylindrical bore
62. Extending through the housing, and fixedly attached thereto, is
a pin 64 having an end portion 66 which extends into bore 62. As is
explained below, the function of the pin 64, and more particularly
its end portion 66, is to engage the groove 50 of the cylindrical
cam 48 and to thereby cause rotation of the staple carrier 46.
Attached to the cam housing 60 by means of a pin 68 is a
wedge-shaped member 70 which, as will be explained below, acts in
conjunction with the bracket 10 and the staple driver 58 to eject
staples from the staple housing 52.
Referring to FIGS. 8 and 9, it is readily seen that the staple
driving blade 59 is secured to the staple driver 58 at an angle A.
It is also readily seen that the staple housing 52 is terminated in
a similar manner. It should be noted that the housing 52 is
designed in such a manner that the staple driving blade 59 slides
comfortably through a slot 72 formed at the termination of the
housing 52. The reason for terminating the staple driver 58 and the
staple housing 52 in the manner described above will become obvious
when reference is made to FIGS. 13 through 15.
With reference to FIG. 13, the staple carrier 46 is shown to have a
plurality of grooves 74 machined therein, said grooves forming a
thread whose pitch angle is A. Seated in the grooves 74 are a
plurality of staples 76. As is best seen in FIG. 14, the staples
are biased in such a manner that they resiliently engage the inside
walls of the staple housing 52. In this manner, it is obvious that
when the shaft of the staple carrier 46 is rotated, the staples 76
advance, in the grooves 74, along the inside wall of the housing
52.
In view of the snug fit between the staples 76 and the housing 52,
and in view of the pitch angle of the thread, the reason for
angling the staple driving blade 59 and the slot 72 should be
readily apparent. More particularly, when a staple 76 is freed from
a groove 74 in the staple carrier 46, it snugly rests against the
walls of the staple housing 52; but because of the pitch angle
associated with the threads in the carrier 46, the staple rests at
an angle A with respect to the axis of the carrier 46. Therefore,
to most efficiently eject the staples from the housing 52, the
staple driving blade 59 and the slot 72 are both angled as shown in
FIGS. 8 and 9. The forwardmost end of the carrier 46 is also cut at
an angle so that when the carrier 46 is rotated to the position in
which the staple has just been released from its effects, there
exists alignment between the forward end of the carrier 46, the
blade 59 and the slot 72. When in this position, the front face of
the carrier is parallel to the slot 72 and is spaced from the front
wall of the housing 52 a uniform distance slightly greater than the
diameter of a staple.
With reference now to FIG. 16, there is shown a front view of the
stapling mechanism. It is there seen that a portion of the bracket
10 forms an anvil 78 into which are machined a pair of arcuate
slots 80 which serve to insure the proper contour of the staple 76
at the completion of the stapling operation. In FIG. 16, the
assembly is shown at a point in time after the end of a stapling
stroke, the staple 76 being embedded into a blood vessel 84.
With reference now to FIGS. 10 and 11, there follows a description
of the operation of the present invention. In FIG. 11 it is readily
seen that the pin 36, which is rigidly secured to the bracket 10,
serves both as the pivot point for the staple driver 58 and as the
means for fixedly attaching the staple housing 52 to the bracket
10. In FIG. 10, the staple cartridge is shown to be in its
readiness position, the bracket 10 slid away from the jaws 18 of
the hemostat 12. Further, the cam housing 60 is in its extreme
rearward position, the end portion 66 of the pin 64 engaging the
extreme rear position of the groove 50, and the staple ejecting
wedge 70, when the instrument is in the position shown in this
FIG., resting on the pin 36. In this position, the hemostat can be
operated as if totally unencumbered by the bracket 10 and its
associated staple magazine. The hemostat 12 is here shown to be
securely clamping the end of a blood vessel 84.
Once a blood vessel is sealed by means of the hemostat 12, the
bracket 10 is slid forward on the hemostat until the flange 22
encounters the pin 42. At that time, the cam housing 60 is manually
slid toward the jaws 18 of the hemostat to accomplish the stapling
of the vessel 84. When positioned as shown in FIG. 10, the staple
next ready to be ejected from the staple housing 52 is remote from
its ejection position an amount corresponding to one complete
revolution of the staple carrier 46. It therefore becomes readily
apparent that for proper operation of the assembly, the groove 50
in the cylindrical cam 48 must be such that one complete revolution
of the staple carrier 46 results each time the cam housing 60 is
stroked in a forward direction. It is also readily apparent that
for proper operation of the staple cartridge, the staple-ejecting
wedge 70 must not operate the driver 58 until a staple has reached
its proper ejection position. This is accomplished by positioning
the wedge 70 so that it engages the wall 38 only after a staple is
in position for ejection.
Referring now to FIG. 12, the functions of the cam 48 and its
groove 50 are best explained. As pictured in FIG. 12, the pin end
66 engages the groove 50 in a manner similar to that shown in FIG.
10. When the cam housing 60 is moved in the forward direction, the
pin slides in the groove 50 in a manner which causes rotation of
the staple carrier 46. After one completed revolution of the
carrier 46, that amount necessary to advance a staple into a
position ready for ejection, the cam cylinder 60 continues to move
forward without rotating the carrier 46. The interval during which
the staple carrier 46 rotates is termed the indexing period; and
the period during which the cam cylinder 60 slides forward without
a corresponding rotation in the carrier 46 is termed the
staple-driving period. As is best seen in FIG. 10, the
staple-driving period is that period between the initial engagement
of the staple-ejecting wedge 70 with the wall 38 of the bracket 10
and the completion of the stroke of the staple driving blade
59.
In FIG. 11, the assembly is shown at the end of a staple driving
interval. At this time, the cam housing 60 is at its forwardmost
position and the staple 76 is securely fastened to the blood vessel
84. At this time, the surgeon strokes the cam housing 60 in the
rearward direction and then slides the bracket 10 back from the
jaws 18 of the hemostat thus returning the apparatus to that
position shown in FIG. 10. As is evident when viewing FIG. 12, the
return stroke of the cam housing 60 leaves undisturbed the staple
carrier 46 and its associated staples. Once the forward stroke and
the rearward stroke of the cam housing 60 are completed, the
hemostat can be removed from the blood vessel 84 since a staple 76
securely closes the end of said vessel. The surgeon is then free to
clamp the jaws of the hemostat on another blood vessel and repeat
the indexing, staple driving and return operations.
It should be obvious from the above that the invention herein
described solves many of the problems noted above in regard to
surgical operations. More particularly, this invention makes
possible the clamping of a blood vessel by means of a hemostat, the
rapid sealing of said vessel by means of a staple, and the quick
removal of the hemostat in readiness for another stapling
operation.
Furthermore, the staple cartridge of the present invention is
inexpensive to manufacture and is easily secured to a hemostat.
Therefore, such a cartridge can be loaded with staples during
manufacture and can be packaged in a surgically sterile container.
In this manner, the surgeon can open the cartridge container in the
operating room, can secure said cartridge to a hemostat, can
dispose of said cartridge upon the exhaustion of its staples, and
can quickly introduce to the hemostat another presterilized staple
cartridge. As noted in the preceding paragraph, the inventive
hemostat makes it possible for the surgeon, in the operating room,
to perform a series of stapling operations and, when the staple
cartridge is exhausted, to easily replace the exhausted cartridge
with a fresh cartridge. In this regard, two alternative replacement
techniques present themselves. The first technique, the more costly
of the two, envisions that the cartridge complete with its bracket,
be replaced upon exhaustion if its staples. The second technique,
while more economical on a cost basis, results in some loss of time
in the operating room, contemplating that only the exhausted
cartridge be replaced, the bracket remaining mounted on the
hemostat.
If the first technique is employed, the surgeon, upon exhaustion of
his cartridge, opens the jaws of the hemostat 12, and slides the
bracket 10 forward until the flange 22 abuts the pin 42. Then the
bracket is moved against the bias of the spring 28 until the flange
extends over the pin. Then the bracket is further slid forward
until the jaws of the hemostat become disengaged from the cavity
40. Then, the flange 22 is easily disengaged from the hemostat 12.
A fresh cartridge, with its associated bracket, is inserted on the
hemostat 12 by first opening the hemostat, by engaging the flange
22 on the handle portion 16, by then closing the jaws of the
hemostat, and finally by sliding the bracket 10 in a rearward
direction until the cavity 40 encircles the jaws of the
hemostat.
If the second replacement technique is employed, the job of the
surgeon in the operating room is as follows. Upon exhaustion of his
staple cartridge, the surgeon removes pin 36 which is preferably
threaded into the wall 34 and removes the entire cartridge assembly
44 from the bracket 10. Then, upon opening a fresh cartridge, the
surgeon slides the same into the cavity 40 and, when the pivot of
the staple driver 58 is in alignment with the threaded opening in
the wall 34, the pin 36 is replaced, thereby securing the cartridge
44 in the housing 10.
There has been illustrated and described what is considered to be
the preferred embodiment of the invention. It will be understood,
however, that various modifications may be made without departing
from the broader scope of the invention as described by the
following claims.
* * * * *