U.S. patent number 3,786,816 [Application Number 05/317,233] was granted by the patent office on 1974-01-22 for method and apparatus for occluding fluid flow through vessels.
This patent grant is currently assigned to Technibiotics, Inc.. Invention is credited to Sidney Wolvek.
United States Patent |
3,786,816 |
Wolvek |
January 22, 1974 |
METHOD AND APPARATUS FOR OCCLUDING FLUID FLOW THROUGH VESSELS
Abstract
A vascular conduit tourniquet including a sleeve having a bore
defined by a wall formed of a resilient material and a spring clip
fixed over the sleeve, preferably at the end of the sleeve opposite
from the vessel which is to be occluded. Umbilical tape is passed
under the vessel, the ends of the tape threaded through the sleeve
bore and, while holding the ends of the tape, the sleeve is
advanced against the vessel, thereby occluding the blood flow
therein. The spring clip is then pinched forcing the sleeve walls
together capturing the tape therein and maintaining the sleeve
against the vessel in occluding relationship therewith.
Inventors: |
Wolvek; Sidney (Brooklyn,
NY) |
Assignee: |
Technibiotics, Inc. (Brooklyn,
NY)
|
Family
ID: |
23232715 |
Appl.
No.: |
05/317,233 |
Filed: |
December 21, 1972 |
Current U.S.
Class: |
606/142; 606/158;
D24/143 |
Current CPC
Class: |
A61B
17/122 (20130101) |
Current International
Class: |
A61B
17/12 (20060101); A61B 17/122 (20060101); A61b
017/12 (); A61b 017/10 () |
Field of
Search: |
;128/325,346,320,326,227 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Medbery; Aldrich F.
Attorney, Agent or Firm: Darby & Darby
Claims
What is claimed is:
1. A vascular tourniquet for occluding fluid flow within a vascular
conduit vessel comprising:
a resilient sleeve having a bore defined by an interior wall, said
bore comprising a means for receiving the ends of an elongate
flexible ligating member, which member forms a loop around the
vessel portion to be occluded; and
clamping means mounted on said sleeve intermediate the end for
releasably urging opposed sections of said wall towards each other
into locking engagement with said ligating member to maintain said
tourniquet in occluding relationship with said vessel said clamping
means comprising a clip member having a pair of opposed sides
having opposed inwardly facing protuberances, each protuberance
providing means for urging said opposed wall sections towards each
other to selectively lock said ligating member therebetween
2. A vascular tourniquet as recited in claim 1 wherein said urging
means includes a spring means comprising a pair of opposed sides
resiliently spaced from each other, said clip sides adapted to be
selectively moved from a first position wherein said ligating
member is free within said sleeve bore to a second position wherein
said ligating member is in locked engagement with said wall
sections and back to said first position.
3. A vascular tourniquet as recited in claim 1 wherein said spring
clip member has a spring portion and a clip portion integrally
connected thereto, said clip portion including a first leg having a
free end movable from a first position to a second position, and a
second leg having a slot formed therein adapted to capture said
first leg free end when in said second position, said second leg
being movable to release said first leg free end.
4. A vascular tourniquet as recited in claim 1 wherein said
clamping means for releasably urging said opposed flexible wall
sections is restrained to a portion of said sleeve.
5. A vascular tourniquet as recited in claim 1 wherein the interior
surface of said sleeve has means formed thereon for positively
gripping said ligating member.
6. A vascular tourniquet as recited in claim 7 wherein said
positive gripping means includes serrations formed on said interior
surface substantially perpendicular to the longitudinal axis of
said sleeve.
7. A method of temporarily occluding the flow of blood through a
blood vessel comprising the steps of:
passing an elongate flexible ligating member under said blood
vessel;
directing the ends of said ligating member through a bore in a
resilient sleeve;
advancing said sleeve against said blood vessel to exert upon it by
tensioning the ligating member until the flow of blood therethrough
is occluded; and providing a means for
forcing opposed wall sections of said sleeve together to lock said
ligating member therebetween to cause said sleeve to remain in
position wherein said blood vessel is occluded; and
allowing said opposed wall sections to free said ligating member to
permit the flow of blood to resume in said vessel.
Description
BACKGROUND OF THE INVENTION
During surgery, it often becomes necessary to control the bleeding
from or the course of blood flow in a blood vessel without
permanently ligating it, i.e. when it is necessary to occlude a
blood vessel temporarily. It may also be necessary to hold a
cannula captured within a vessel by partially occluding it around
the cannula. In the past, such temporary occlusions have been
accomplished in various ways. A widely used procedure has been to
first free that portion of the blood vessel to be occluded from its
connective tissue. Umbilical tape or a length of suture is then
looped under the vessel by a pair of right-angled forceps. Both
ends of the tape or suture are then threaded into a large
needle-like device which draws both tape ends through a sleeve or
length of tubing. Holding the tape ends, the tube is then pushed
against the vessel thereby occluding the blood flow. At this point,
a clamp, usually a hemostat, is attached to the tape adjacent the
end of the tubing farthest from the vessel. This retains the tape
compressed against the vessel which thereby maintains the
occlusion.
In various types of surgical operations, such as in cardiac
operations, it is not unusual in the use of the above-described
method and apparatus to have six or more of these tube ends and
associated clamps extending from the incision. Clearly, the
presence of the tubes and clamps renders the operative procedure
even more difficult than normal. Further, there is always a danger
of the hemostat inadvertently opening or jamming during the
operation which may prove detrimental to the outcome of the
operation.
Several attempts have been made to deal with the above-mentioned
problem. By way of example, a vascular occluder has been designed
wherein a cap is threadedly provided on one end of a rigid tube or
sleeve, the cap having openings formed therein. The ends of
umbilical tape after having been looped around the blood vessel are
threaded through the sleeve bore through the openings in the cap
and then knotted. The cap is rotated moving it outwardly relative
to the sleeve thereby tightening the loop occluding the blood flow
through the vessel. These devices are not only relatively
complicated in structure but are quite time-consuming in their use.
Additionally physicians tend to prefer using apparatus of which
they are familiar with the "feel" and the complicated nature of the
prior devices have prevented widespread acceptance by the medical
field.
Thus, there is a need for a vascular tourniquet which will not
unduly obstruct the already limited working area of a surface
during an operation and which may be applied in a quick and
uncomplicated manner.
SUMMARY OF THE INVENTION
Accordingly, an object of this invention is to provide a new and
improved vascular tourniquet.
Another object is the provision of a new and improved vascular
tourniquet which will not unnecessarily physically obstruct the
working area of a surgeon during an operation.
An additional object is to provide a vascular tourniquet which can
be applied relatively quickly, removed easily, and with which there
is no undue danger of jamming or inadvertent release.
In accordance with a preferred embodiment of this invention, these
and other objects are attained by providing a vascular tourniquet
including a resilient sleeve having a bore formed therethrough
defined by the sleeve wall receivable of the ends of an elongate,
flexible ligating member, such as umbilical tape. A clamp is
provided over a portion of the sleeve which, subsequent to the
sleeve being moved against the blood vessel occluding the blood
flow therein, moves a pair of opposed sections of the sleeve wall
toward each other to engage and lock the tape within the
sleeve.
DESCRIPTION OF THE DRAWINGS
A more complete appreciation of the invention and many of the
attendant advantages thereof will be readily appreciated as the
same becomes better understood by reference to the following
detailed description when considered in connection with the
accompanying drawings wherein:
FIG. 1 is an elevational view of the vascular conduit tourniquet of
the present invention;
FIG. 2 is a view similar to FIG. 1 but showing the tourniquet after
occlusion of blood flow through a vessel;
FIG. 3 is a top view taken in cross-section along line 3--3 of FIG.
2;
FIG. 4 is a perspective view of a clip which forms a part of the
tourniquet; and
FIG. 5 is an elevational sectional view of a portion of the tube
taken along line 5--5 of FIG. 1.
DESCRIPTION OF A PREFERRED EMBODIMENT
Referring to the drawings the vascular tourniquet 10 includes an
elongate tubular member, or sleeve, 12 formed of a resilient
material, such as rubber, having a bore 14 extending through its
entire length. It is understood that in this context, resilient
indicates that a force applied in a direction substantially
perpendicular to the longitudinal axis of the sleeve will cause the
sleeve wall to deform in that direction and, upon removal of the
force, the sleeve wall will return to its original shape. The
sleeve may be rigid or only slightly compressible in the
longitudinal direction. The interior wall of the tubing defining
bore 14 preferably, but not necessarily, has ridges or serrations
16 (FIG. 5) formed on its surface substantially perpendicular to
the longitudinal axis of the sleeve for purposes which will become
clearer hereinbelow.
In the embodiment of the invention illustrated in the drawings, a
spring clip type clamp 28 is positioned at the end of sleeve 12
opposite the base surface 26. Referring to FIG. 4, the clip 28 is
formed preferably of a strip of spring steel or molded plastic so
as to be radiopaque formed to include an upper curvilinear spring
portion 29 integrally connected to a triangular clip portion 30
along a pair of inwardly positioned edges 31 which edges, after
assembly of the occluder, will lie adjacent to opposed wall
sections of sleeve 12. The base leg 32 of the spring portion has a
slot 33 formed therein which is adapted to receive the end 34 of
leg 35 when the latter is pinched inwardly. In order for the leg
end 34 to be locked within slot 33, leg 35 is sufficiently long so
as to interfere with base 32 prior to its end reaching the slot.
Thus, base 32 is urged downwardly under the force of leg 35 until
end 34 reaches a position opposite slot 33 at which time the base
snaps upwardly capturing the leg end and locking the clip into a
configuration wherein the edges 31 are closer together than before.
To open the spring clip, it is only necessary to depress base
extension 50 thereby freeing the leg end 34 from slot 33 at which
time the resiliency of the spring portion 29 causes leg 35 to move
outwardly. In order to receive sleeve 12, aligned openings 36 are
provided in the spring and clip portions. This spring clip design
has certain advantages when used in the present invention which
will be described in greater detail below.
Spaced, opposed shoulders 38, 40 are formed such as by molding or
attached separately on the outer surface of sleeve 12. Upper
shoulder 40 is preferably formed with beveled edges. Clip 28 is
assembled onto the sleeve by forcing upper shoulder 40 through
openings 36, the positioning being made easier by the beveled
shoulder 40 until the clip base 32 abuts shoulder 38. The spring
clip is retained on the sleeve by upper shoulder 40. Of course, the
clip may be retained on the sleeve in various other ways than as
just discussed. For example, the upper shoulder 40 need not be
provided until after the spring clip has been positioned onto the
sleeve at which time it may be molded or similarly provided on the
sleeve to permanently capture clip 28.
The tourniquet is intended to constrict a blood vessel 20 so as to
occlude the flow of blood therethrough. To do this an elongate
flexible ligating member 18, such as conventional umbilical tape or
thread made from standard suture material such as nylon, silk,
cotton or surgical gut, is passed beneath blood vessel 20. The free
ends 22 of tape 18 are threaded through bore 14 so that a noose or
loop 24 is formed around the vessel. With the free ends 22 of the
thread 18 held taut, the physician urges sleeve 12 towards vessel
20 so that its base surface 26 contacts the vessel with sufficient
force to occlude the blood flow therethrough.
According to the present invention the wall of the sleeve 12 is
itself then crimped so that the surface of bore 14 engages and
locks the thread 18 thereby maintaining the relative positions of
the sleeve against the vessel 24. The serrations 16 formed on bore
14 facilitate the grasp of the crimped sleeve on tape 18. It is
seen that although the sleeve may be formed with serrations 16
extending along the entire length of bore 14, the serrations, if
provided at all, may only be present in the vicinity of the portion
of sleeve 12 where the crimping occurs.
In operation, thread 18 is looped about a vessel 24 as shown in
FIG. 1. The physician, while holding the free ends 22 of the thread
in one hand grasps clip 28 and without exerting any inward pressure
on the clamp to crimp sleeve 12, pushes the clip against sleeve
shoulder 38 with sufficient force to cause the base surface 26 of
sleeve 12 to crimp vessel 24 occluding the blood flow therethrough.
It is desirable for the sleeve to be relatively rigid
longitudinally so that it does not become compressed during this
procedure. When the blood flow has been sufficiently occluded due
to moving the sleeve to the proper position, the physician merely
pinches side 35 of clip 28 until the leg end 34 of leg 35 is
captured in slot 33. During this procedure, inner edges 31 crimp
the adjacent sleeve wall sections together (see FIG. 2) engaging
and locking the tape therein. As mentioned above, the serrations 16
serve to facilitate the grip of the surface of bore 14 on thread
18. When it is desired to allow blood to begin to flow again, the
clip 28 is opened by depressing clip base extension 50 freeing leg
end 34.
It should be noted that the entire occluding procedure may be
accomplished using only a single hand to move sleeve 12 against
vessel 24 and clamping it in position. This feature enables a
relatively quick occlusion of the blood flow through the vessel
and, in addition, maintains the physical bulk of surgical apparatus
extending from the incision at a minimum. The particular design of
spring clip 28 is particularly suited for its use. More
particularly, the positioning of the physician's fingers on the
clip while urging it against the blood vessel to occlude the blood
flow facilitates an immediate locking of the clip after occlusion,
i.e., the fingers are in appropriate position to pinch the clip
even while the sleeve is being urged against the blood vessel.
Hemostats are now unnecessary and thus, the problems associated
therewith, are obviated. For example, there is relatively little
danger of clip 28 inadvertently opening or jamming during the
surgical operation. Further, all the edges of the clip are rounded
to discourage entanglement of suture material present in the
surgical procedure, such as during the sewing of an incision. To
further prevent suture entanglement, the clip base is recessed so
as not to extend beyond shoulder 38 (except at extension 50).
By way of example, a typical vascular tourniquet according to the
present invention may comprise a sleeve of about 6 inches in length
having a wall of about 1/16th inch thickness and a 5/32nd bore
diameter. The clip may be positioned on the upper 1 1/8 inch
portion of the sleeve. Of course, other dimensions may be used in
accordance with the present invention as determined by the
particular surgical use to which the device will be put. Of course,
the length of the sleeve may be shortened prior to or during the
operation as desired by merely cutting off an appropriate length of
the sleeve end with scissors.
Other clamping apparatus than the clip 28 may be used within the
scope of the present invention. For example, the clip may be shaped
otherwise than as shown. One alternative includes having opposed
sides extending transversely to the sleeve which are movable
towards each other to crimp the sleeve. As discussed above, other
means may be used to retain the clip on the sleeve. Other
variations and modifications of the invention may be made within
the scope of the appended claims.
* * * * *