U.S. patent number 3,802,555 [Application Number 04/830,067] was granted by the patent office on 1974-04-09 for surgical instrument package and handling procedure.
This patent grant is currently assigned to Abbott Laboratories. Invention is credited to William P. Grasty, Aldean W. Whitton, Jr..
United States Patent |
3,802,555 |
Grasty , et al. |
April 9, 1974 |
SURGICAL INSTRUMENT PACKAGE AND HANDLING PROCEDURE
Abstract
Disclosed herein is a surgical instrument package for operating
components and an instrument handling procedure incorporating
highly desirable safety features. The package of this invention
includes several trays shaped for nesting or stacking with
compartments in each tray for receiving surgical instruments. The
instruments are arranged in the trays in order of use with the
overlying tray exposing all the instruments necessary for the first
phase or sub-procedure of the operation while effectively guarding
against inadvertently picking up instruments to be used in the
subsequent sub-procedures.
Inventors: |
Grasty; William P. (Zion,
IL), Whitton, Jr.; Aldean W. (Northbrook, IL) |
Assignee: |
Abbott Laboratories (North
Chicago, IL)
|
Family
ID: |
25256229 |
Appl.
No.: |
04/830,067 |
Filed: |
June 3, 1969 |
Current U.S.
Class: |
206/572; 206/438;
206/505; 206/564; 206/370; 206/499; 206/563; 606/1 |
Current CPC
Class: |
A61B
50/30 (20160201) |
Current International
Class: |
A61B
19/02 (20060101); A61B 19/00 (20060101); A45c
011/26 () |
Field of
Search: |
;206/16S,16E,17.5,43,46FC,46FR,46PV,46ST,46SG,56K,56A,56AS,56AT,56M
;217/26.5,27 ;220/9F,23.6,97,4E,16,23.8,97C,97D ;229/2.5
;128/1,303 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Leclair; Joseph R.
Assistant Examiner: Lipman; Steven E.
Attorney, Agent or Firm: Sherman & Shalloway
Claims
What is claimed is:
1. An instrument package for use in surgical operations
comprising
a lower tray having a support surface with a plurality of recessed
compartments therein to receive surgical instruments; and
an upper tray having a lower surface, an upper surface with a
plurality of recessed compartments therein to receive surgical
instruments, and wall means depending from the periphery of said
upper surface to define with said lower surface a pocket having a
shape to mate with said lower tray, said wall means extending above
the periphery of said upper surface such that said upper surface
forms a basin with said wall means,
said upper tray being superposed over said lower tray with said
support surface of said lower tray confined in said pocket whereby
said lower tray is protected from contamination by said pocket in
said upper tray.
2. An instrument package for use in surgical operations
comprising
a lower tray having a support surface with a plurality of recessed
compartments therein to receive surgical instruments, and a
peripheral wall disposed around and extending above said support
surface such that said support surface forms a basin with said
peripheral wall; and
an upper tray having a lower surface, an upper surface with a
plurality of recessed compartments therein to receive surgical
instruments, and wall means depending from the periphery of said
upper surface to define with said lower surface a pocket having a
shape to mate with said lower tray,
said upper tray being superposed over said lower tray with said
support surface of said lower tray confined in said pocket whereby
said lower tray is protected from contamination by said pocket in
said upper tray.
3. A package for instruments used in surgical operations as defined
in claim 2 wherein said upper tray and said lower tray are each
integrally formed.
4. An instrument package for use in surgical operations
comprising
a plurality of surgical instruments;
a lower tray having a support surface with a plurality of recessed
compartments therein receiving predetermined ones of said
instruments; and
an upper tray having a lower surface, an upper surface with a
plurality of recessed compartments therein receiving the others of
said instruments, and wall means depending from the periphery of
said upper surface to define with said lower surface a pocket
having a shape to mate with said lower tray,
said upper tray being superposed over said lower tray with said
support surface of said lower tray confined in said pocket whereby
said instruments in said lower tray are protected from
contamination by said pocket in said upper tray.
5. A package for instruments used in surgical operations as defined
in claim 4 wherein said wall means of said upper tray extends above
the periphery of said upper surface such that said upper surface
forms a basin with said wall means.
6. A package for instruments used in surgical operations as defined
in claim 4 wherein said lower tray includes a peripheral wall
disposed around and extending above said support surface such that
said support surface forms a basin with said peripheral wall.
7. A package for instruments used in surgical operations as defined
in claim 4 wherein there are a plurality of said upper trays in
superposed relation, each of said plurality of upper trays having
instrument receiving recessed compartments in the upper surface
thereof and wall means defining a pocket with the lower surface
thereof to confine the upper surface of the one of said upper trays
immediately thereunder.
8. A package for instruments used in surgical operations as defined
in claim 4 wherein said recessed compartments of each of said upper
and lower trays are interconnected by a channel for assistance in
removing instruments placed therein.
9. A package for instruments used in surgical operations as defined
in claim 4 wherein said recessed compartments of said upper and
lower trays include cylindrical recesses to permit vertical
positioning of said surgical instruments.
10. A package for instruments used in surgical operations as
defined in claim 4 wherein said lower surface in said upper tray
has a plurality of recessed compartments therein which cooperate
with said recessed compartments in said support surface of said
lower tray to form instrument receiving chambers when said upper
and lower trays are in stacked superposed relation.
11. A package for instruments used in surgical operations as
defined in claim 4 wherein said upper and lower trays containing
instruments are sterilized and have a vacuum sealed material
sealing each tray separately.
12. A package for instruments used in surgical operations as
defined in claim 4 wherein said recessed compartments in said upper
tray are shaped to mate with said others of said instruments, said
others of said instruments being utilized in a first operation
subprocedure, and said recessed compartments in said lower tray are
shaped to mate with said predetermined ones of said instruments,
said predetermined ones of said instruments being utilized in a
second operation subprocedure performed after said first operation
subprocedure whereby said lower tray is bared by removal of said
upper tray to permit access to said predetermined ones of said
instruments only after said first operation subprocedure is
completed to prevent contamination of said predetermined ones of
said instruments during said first operation subprocedure.
13. A package for instruments used in surgical operations as
defined in claim 12 wherein said recessed compartments in said
lower tray are arranged along an edge of said support surface in
accordance with order of use of said predetermined ones of said
instruments during said second operation subprocedure, and said
recessed compartments in said upper tray are arranged along an edge
of said upper surface in accordance with order of use of others of
said instruments during said first operation subprocedure.
14. A package for instruments used in surgical operations as
defined in claim 4 wherein said recessed compartments in said lower
tray are shaped to mate with said predetermined ones of said
instruments and are aligned along an edge of said support surface
in arrangement in accordance with order of use of said
predetermined ones of said instruments.
Description
This invention relates to the art of special packages adapted for
receiving the instruments used in a surgical operation. The
invention also relates to the art of material handling and a
special relation of the instruments used in a surgical operation so
as to decrease the possibility of human error during the
operation.
As used herein, the term "package" is considered generic to
articles such as but not limited to "trays," "receptacles,"
"receivers," etc., which may be adapted to receive a group of
operating instruments.
As further used herein, the term "instruments" or "operating
instruments" is considered to include, but not be limited to, all
hand tools, syringes, hypodermics, needles, clamps, swabs, sponges,
scissors, scalpels, sutures, medicament containers such as vials
and ampules, forceps, cannula, razor, anteceptics, bandages,
probes, catheters, dilators, curettes, crushers, saws, shears,
ligators, scarifiers, obstetric tractors, tweezers, etc.
In the course of complex surgical operations of today, many
instruments are employed. Often times, the operation entails
several specifically delineable steps or sub-procedures such as
preparation of the area of surgery, anesthesia administration,
operation per se, sewing and finishing up steps.
It has been the practice heretofore to arrange all the instruments
in trays or loosely on a table or tables around the operating table
for access by the surgeon and his assistants. This arrangement for
handling the instruments is convenient from the standpoint that all
the instruments are readily at hand, but sometimes can cause
confusion when an assistant gets "turned around" or fails to
recognize the proper instrument or gets the proper instrument
confused with a similarly constructed instrument positioned
adjacent or near the instrument that should be used.
The instruments are usually carried on a large tray which has been
sterilized. Sterile instruments fill the tray and are ready for use
immediately upon the tray being brought into the operating room.
This arrangement has certain draw backs in that it is sometimes
desirable or necessary to perform the operation in steps wherein
either the same person would perform each of the separately
identified steps or, as is more generally the case; a nurse,
intern, or other assistant will perform the pre-operation procedure
followed by the operation per se by the surgeon and then the
finishing up procedure performed by yet another assistant or the
same nurse or intern who did the preparatory steps. In these
situations, the exposure of the instruments to the atmosphere over
an extended length of time might on infrequest occasions result in
contamination or other deleterious effects which should be avoided
if at all possible.
A yet more likely mishap would be the use of an improper
instrument, thus, not only possibly resulting in an improper
performance of the particular step, but, assuredly causing that
particular instrument not to be available when needed later on in
the operating procedure per se.
A still further possibility when all the instruments are arranged
in a single tray would be to spill any of several liquids that are
employed in the operating procedure and contaminate the entire tray
of instruments.
While some of the above-noted draw backs might be overcome by the
provision of separate trays of instruments with possibly the
location of related components in the individual trays, the
possibility of selecting an improper instrument or reaching for the
instrument from a wrong tray still exists. Further, it is also
possible to spill liquids into one of the several trays positioned
about the operating table and, thus, contaminate the instruments of
that particular tray.
Having the above-discussed state of the prior art in mind, the
present invention is designed to provide an instrument handling
procedure and packaging arrangement for instruments used in a
surgical operation and overcome the draw backs of the prior art
instrument packaging and handling.
The present invention provides a package for the instruments used
in an operating procedure and, specifically, is concerned with
arranging the associated or related instruments for each
sub-procedure of the operation together and providing a tray for
the related elements that renders inaccessible the instruments to
be employed in subsequent subprocedures of the operation.
The present invention contemplates the use of a first tray having
compartments or slots therein for receiving the instruments to be
employed in the first operating sub-procedure. These instruments
can be arranged in an order in this tray so that removal of the
instruments is sequential during the course of the first
sub-procedure to further guard against errors in selecting the
instruments used in the operation being performed. The compartment
for the associated instruments is provided in the top of the first
tray and the bottom of the first tray is hollowed so as to
telescopically fit over a second tray which contains in the upper
surface thereof compartments for the instruments to be used in the
second sub-procedure of the operation.
Each tray may be supplied with sterilized instruments and a vacuum
sealed material enclosing the tray and instruments to maintain the
instruments in their sterile condition. The instruments themselves
may be of the disposable type being employed in some advanced
hospital and operation practices. The tray itself may also be
disposable so that as each of the instruments are sequentially
removed from the tray and used, they may be disposed of and upon
finishing the particular subprocedure for which the related
compartments are provided in the first tray, the tray itself may be
removed and disposed of.
Further, in most all operating procedures today it is necessary to
count the instruments and the more advantageous and safer approach
is to return each instrument after its use to the compartment
provided therefor in the upper surface of the tray so that upon the
completion of each sub-procedure, one may look at the tray and
check to see if all the compartments are filled and avoid the
negligent leaving of an instrument or sponge, etc., in the patient.
Thereafter, the entire package may be disposed of.
The second tray telescopically positioned beneath the first tray
has the compartments in the upper surface thereof for receiving the
related instruments for the second sub-procedure. This tray itself
may also be sealed with the sterile instruments provided therein so
that even should the first tray be removed and a liquid spilled on
the second tray, same would not be contaminated because of the
sealing material provided thereover. Of course, once the sealing
material has been removed, the open upper surface of the tray
containing the related instruments of the sub-procedure could
become contaminated upon the spilling of a liquid during the course
of the operation. However, this spilling of the liquid would only
effect the one particular sub-procedure and the tray containing the
related instruments for that sub-procedure could be removed and
another placed in its stead to quickly proceed with the
operation.
If a third sub-procedure is readily delineable, the second tray
would be provided with an opening in the lower surface thereof to
telescopically receive a third tray carrying the related
instruments for a third operating sub-procedure in the compartments
of the upper surface thereof. This particular stacking arrangement
for the trays containing the associated and related instruments of
the particular sub-procedures could be extended to any number of
sub-procedures which can be properly broken out or defined for the
particular operation contemplated.
The trays may be constructed of a permanent material and supplied
to hospitals so that the instruments may be placed in the
compartments of each of the sub-procedure trays and sterilized with
each sub-procedure tray sealed to avoid contamination until use.
Also, the trays could be provided of inexpensive disposable
material (e. g., expanded foam) for hospital use. With disposable
trays, the trays themselves are sealed after sterilization, and
immediately before the operation takes place the sterile
instruments may be placed in the separate trays and then supplied
to the operating room whereupon after completion of the operation
the instruments may be removed for cleaning and sterilization while
the tray can be disposed of.
Of the several advantages of the instrument package and handling
procedure of this invention, probably the most important is the
safety factor during the operation procedure which this invention
enhances. Since the materials for a single sub-procedure are
exposed only to the person performing that sub-procedure, the
possibility of using instruments intended or designed for use in
another sub-procedure would be avoided. Providing the trays with
compartments for receiving the related instruments of a particular
sub-procedure and replacing these instruments after they have been
used enables a sure count of the instruments to avoid the
possibility of leaving an instrument or sponge, etc. in the
patient. All the instruments for the entire operation are available
and readily at hand, but, the instruments associated with one
particular sub-procedure are all that will be exposed at any given
time. When that sub-procedure is completed, the tray carrying the
instruments of that sub-procedure is removed, thus, exposing the
tray below for the next sub-procedure. Contamination from
sub-procedure to sub-procedure is eliminated since the overlying
tray completely covers the underlying tray that is used for the
subsequent sub-procedures.
Further, the underlying tray may be sealed to assure sterilization
of the instruments even though a period of time may lapse from the
completion of a first sub-procedure to the beginning of the second
sub-procedure.
Another advantage of the contemplated package of the present
invention is the provision of the instruments of each sub-procedure
in a pre-determined relation to each other, for example, aligning
each instrument along the tray in ascending or descending order of
use. The compartments or the instruments of each sub-procedure may
be aligned sequentially along the length of the tray with a channel
provided intermediate the receiving compartments to facilitate
removal of each instrument for use in the particular
sub-procedure.
Having these advantages of the invention in mind, it is a primary
object to provide a package for the instruments used in a surgical
operation.
It is another object of this invention to provide a package for
surgical instruments including a plurality of telescoping
trays.
It is still another object of this invention to provide a package
for surgical instruments including a plurality of trays having
compartments in the upper surface thereof for receiving the
surgical instruments and hollowed portions in the bottom surfaces
thereof to overly the instruments of an underlying tray.
Still a further object of this invention is to provide a package
for surgical instruments including a plurality of trays, each tray
having instrument receiving compartments in the upper surface
thereof and depending side walls for overlying a tray positioned
therebeneath.
It is still a more specific object of this invention to provide a
package for surgical instruments including a plurality of trays
having compartments in the upper surface thereof, the compartments
arranged in a linear order with a longitudinally extending channel
traversing the compartments to facilitate removal of the
instruments positioned in the compartments.
It is still a further object of this invention to provide a package
for surgical instruments including trays having compartments in the
upper surface thereof and the under surface of said trays being
shaped as covers for sequentially arranged trays positioned
therebeneath.
It is still a further object of this invention to provide a package
for surgical instruments including a plurality of trays wherein the
trays are stacked in a telescoping arrangement with the upper most
tray containing a related group of components or instruments to be
used in a delineated or clearly defined operation sub-procedure,
the underlying trays each containing related or associated
instruments to be used in subsequent surgical operation
sub-procedures so that the package exposes only those instruments
to be used in each particular sub-procedure until all of the
instruments for that sub-procedure have been used and then the tray
may be removed to expose the instruments of the underlying tray
which are to be used in the following sub-procedure.
It is yet another object of this invention to provide a material
handling process wherein all of the related components or
instruments for one sub-procedure of a surgical operation are
grouped together in such a manner as to effectively preclude
exposure of instruments to be employed in a subsequent
subprocedure.
These and other objects of the invention will become readily
apparent to those of ordinary skill in the art to which this
invention pertains when the following detailed description of an
exemplary preferred embodiment is considered along with the
accompanying drawings wherein:
FIG. 1 is an exploded perspective view of a package including a
pair of trays adapted for nesting engagement;
FIG. 2 is an exploded perspective view of a modification.
Referring now to FIG. 1, there is shown a surgical instrument
package in exploded perspective. The package is illustrated as
including three trays, an upper tray 2, middle tray 3, and lower
tray 4; but any desired or necessary number of trays is, of course,
permissible. The trays 2, 3, and 4, are shown in exploded
association to illustrate the details of each tray and the relation
of each tray to the other.
Looking first at the upper tray 2 which will contain the
instruments to be employed in the first sub-procedure of the
surgical operation, it is seen that the upper surface of the tray 2
is integrally formed to provide a basin 5 having a plurality of
instrument receiving compartments 6. These compartments are the
shape of the particular instrument which they are designed to
contain and it is often preferable to align the compartments 6 in a
row as illustrated with the compartment at one extreme end of the
row containing the first instrument to be used in the particular
sub-procedure and the compartment at the opposite end of the row
containing the last instrument to be used in the sub-procedure. The
compartments between the two extreme compartments are arranged to
receive the instruments in the order of their use starting with the
instrument that will be first used, the instrument to be used next
positioned adjacent next, etc. Of course, it is not necessary that
the compartment 6 be shaped to mate exactly with the instruments
which they are adapted to receive but this arrangement is
preferable to lessen the possibility of mistake in placing the
instruments in the trays.
The compartments 6 are interconnected by the channels 7 passing
through the basin. The channel 7 provides a convenient instrument
removing opening so that when one of the instruments in compartment
6 is needed, a person may remove same by gripping it in the area of
the exposed portion extending through the channel 7. The channel 7
may be of the same depth as most of the compartments 6 to permit
the person removing the instruments to grasp the instruments at the
exposed area extending through the channel or the channel may
extend below the depth of the compartments so that the user may
remove the instruments by reaching under the instruments in the
area of the channel and further assure that a good grip on the
instruments is had before same are passed to another or used by the
person removing it.
On the underside of the upper tray 2 is a pocket 8 which conforms
substantially to the size and shape of the middle tray 3. This
pocket 8 is defined by walls depending from the upper surface of
the tray and a planar lower surface of the tray and is adapted to
receive and overlie the middle tray 3 so that until all the
instruments for the first sub-procedure are used and the upper tray
2 is removed, the instruments to be employed in the second
sub-procedure will be inaccessible. This arrangement assures that
should something be spilled on the upper tray 2, same would not
contaminate the instruments contained in the middle tray 3.
Further, since the instruments to be used in the second
sub-procedure are not readily accessible, a safety factor is
introduced to assure that an improper instrument is not used.
The upper portion of tray 3 is integrally formed to provide a basin
9 similar to basin 5 of tray 2. The basin includes compartments 10
which may be interconnected by the channels 11 with the instruments
arranged in the compartments 10 in a manner similar to that
described in relation to the fist sub-procedure instruments
contained in the upper tray 2.
The lower surface of middle tray 3 is provided with a pocket 12
which mates with and is adapted to receive the lower tray 4. This
telescoping arrangement of middle tray 3 and lower tray 4 permits
protection of the instruments carried in the upper surface of the
lower tray 4. Until all the instruments in the compartments 10 of
middle tray 3 have been used and the tray removed, the instruments
contained in the upper surface of tray 4 are indisposed and, thus,
protected from contamination and inadvertent use by one performing
a sub-procedure using the instruments carried in the middle tray
3.
The tray 4 is similar to trays 2 and 3, previously described, and
is provided with compartments 13 which are interconnected by
channels 14. These compartments are all situated in and integrally
formed with a basin 15 which assures that the instruments within
the compartments will not bulge out of the tray and interfere with
the fit of the upper surface of the tray 4 and the pocket 12 of the
tray 3. The lower surface of tray 4 may be provided with a pocket
for receiving yet another tray containing the instruments for a
related operation sub-procedure, or, if there is no further
sub-procedure to be performed the lower portion of tray 4 may be
solid. As shown in the lower most compartments of trays 3 and 4 in
FIG. 1, cylindrical recesses 16 may be provided in the compartments
so that a syringe could be positioned vertically for easy
accessibility.
Each of trays 2, 3 and 4 may have a vacuum sealed material disposed
across the edges of the side walls after sterilized instruments are
placed in the compartments. For instance, as partially illustrated
in FIG. 1, trays 2, 3 and 4 have vacuum sealed materials 17, 18 and
19 covering the basins thereof, respectively, with the materials
extending over the trays and along the side walls sufficiently to
assure complete sealing.
Yet another arrangement within the scope of this invention is a
package similar to that previously described wherein the related
upper middle and lower trays have co-operating compartments in the
lower surface of an upper tray and the upper surface of the tray
positioned immediately therebeneath. Referring to FIG. 2, this
embodiment of the invention is illustrated with only two
co-operating trays, but any number of co-operating trays could be
provided.
The package shown includes a cover 20, an upper tray 21, and a
lower tray 22. The cover may have a flat upper surface which
overlies the upper tray 21. The lower surface of cover 20 is
provided with a pocket 23 that telescopes over the upper tray 21.
The pocket 23 is provided with compartments 24 shaped to receive
half of the instrument or group of instruments positioned in the
compartments in the upper surface of the tray 21. The tray 21 may
have a substantially planar upper surface except for the
compartments 25 which cooperate with the compartments 24 in the
lower surface of the cover to form a chamber for receiving the
instruments for a first sub-procedure of the surgical operation. It
is also possible to form the facing surfaces with basins as shown
in FIG. 2, but with the co-operating compartments forming
instrument receiving chambers, the basins are not necessary. The
chamber formed by the cooperating compartments 24 and 25 in the
cover and upper surface of tray 21 respectively may be shaped
substantially the shape necessary to accommodate the particular
instruments used in the subprocedure or the chamber may merely
receive the instruments without conforming to the shape thereof.
Channels 29 and 30 may be provided in the trays to facilitate
removal of the instrument.
The lower surface of the upper tray 21 is provided with a pocket 26
adapted to telescope over and receive the lower tray 22. The bottom
surface of the upper tray 21 contains compartments 27 which form
half a chamber and when the upper tray and lower tray are in their
stacked relation, the chamber is completed by the compartment 28 in
the upper surface of the lower tray 22. Lower tray 22 again may
have a basin or a substantially planar upper surface with the
compartments 28 which in conjunction with the compartments 27 form
the chamber for receiving the instruments for the sub-procedure
carried by the lower tray 22.
In operation, the package of instruments for the particular
surgical operation is brought into the operating room in a stacked
relation. The cover 20 is removed and placed on a table or a
position adjacent the remaining portion of the package in an
inverted position. As the instruments carried by the upper tray 21
are used in the first sub-procedure, they may be placed in the
compartments 24 of the exposed under surface of the cover 20. When
all the instruments for the first sub-procedure contained in the
upper tray 21 have been employed and, thus, removed from the upper
tray 21 and placed in the compartments of the exposed under surface
of the cover 20, the upper tray 21 is removed and inverted and
placed on the cover 20. Thus, all the instruments may be accounted
for by their placement in the cover 20 and once the instruments
have been used they are covered by the mating surface of the upper
tray 21 which is positioned in an overlying relation over the cover
20. By removing the upper tray 21, the instruments in the lower
tray 22 are exposed and, thus, the second sub-procedure may begin.
As the instruments in the compartments 28 of the lower tray 22 are
used, they are placed in the compartments 27 in the exposed pocket
26 of the upper tray 20. Since the compartments 27 mate with and
may be shaped to accommodate the instruments of the lower tray 22,
an accounting may be clearly recognized for all the instruments
being used in the second subprocedure. Once the instruments have
all been used in the lower tray 22, the tray is inverted and placed
over the upper tray 20 and into the pocket 26 covering the
instruments in the compartments 27. The package is then completed
and may be inverted in toto for removal to a cleaning and
sterilizing station for the preparation before the next
operation.
A clear extrapolation of the two illustrated preferred embodiments
is a package where the trays do not nest, but have the co-operating
compartments in the facing surface of the stacked trays. This
embodiment is less preferred, however, since without the nesting
arrangement the trays are less stable and may tend to shift in
relation to each other.
Preferred embodiments of the invention having been described, the
invention is to be limited only by the scope of the appended
claims.
* * * * *