U.S. patent number 3,568,677 [Application Number 04/777,112] was granted by the patent office on 1971-03-09 for surgical vein stripper.
This patent grant is currently assigned to Brymill Corporation. Invention is credited to Michael D. Bryne, John O'L Nolan.
United States Patent |
3,568,677 |
Nolan , et al. |
March 9, 1971 |
SURGICAL VEIN STRIPPER
Abstract
A surgical vein stripper comprises a rod of semirigid plastic
material, such as nylon or Teflon, with means provided at the end
thereof so as to permit nonslipping engagement with a vein, which
is to be stripped, tied the end of the rod with a suture. The means
may comprise a molded or forged enlargement, a transverse pin,
suitable indentations or serrations, or a transverse annular ring
which engages a loop in the rod of material.
Inventors: |
Nolan; John O'L (Hartford,
CT), Bryne; Michael D. (Vernon, CT) |
Assignee: |
Brymill Corporation (Vernon,
CT)
|
Family
ID: |
25109327 |
Appl.
No.: |
04/777,112 |
Filed: |
November 19, 1968 |
Current U.S.
Class: |
606/159 |
Current CPC
Class: |
A61B
17/00008 (20130101); A61B 2017/00013 (20130101) |
Current International
Class: |
A61B
17/00 (20060101); A61b 017/00 () |
Field of
Search: |
;128/303--304 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Surgery Vol. 27 No. 2 Feb. 1950 p. 281 (copy in Group 335).
|
Primary Examiner: Trapp. L. W.
Claims
We claim:
1. A vein stripper comprising:
an elongated semiflexible plastic material; and
an annular ring through which said vein stripper is fed, and then
fed back as to provide a loop, said ring having a hole of a
diameter chosen so that it will not slip over said loop.
2. The vein stripper according to claim 1 wherein the inside
diameter of said ring is slightly less than twice the diameter of
said elongated semiflexible plastic material.
Description
BACKGROUND OF THE INVENTION
1. Field of The Invention
This invention relates to surgical vein apparatus, more
particularly to surgical vein strippers and cutters.
2. Description of the Prior Art
One form of vein stripper known in the prior art comprises a
surgical steel rod which is essentially not flexible. That is,
although bends of extremely large radius of curvature can be made
in the rod, the rod cannot follow tortuous routes which are
frequently required due to the anatomical condition which is one of
the primary reasons for removal of the vein. Thus, this rod cannot
follow sharp bends in the vein and, therefore, may frequently
puncture the vein. This can result in the need for multiple
incisions and taking the vein out in sections. In addition,
strippers made of surgical steel require sterilization and
additional handling so that they tend to become bent as a result of
mishandling and from coming into contact with other objects during
storage. Thus, as a result of general wear and tear, the facility
of the surgical steel vein stripper to be easily moved along the
inside of a vein is impaired with the life of the stripper. Of
course, the length of vein stripper involved requires either that
it be made in a jointed fashion or else it presents difficulties in
being processed in an autoclave.
Another form of vein stripper known to the prior art is a flexible
surgical steel stripper which may comprise either a spiral steel
wire (similar to a plumber's snake) or a cable which is composed of
braided steel wire. Strippers of this kind are too flexible and
have a tendency to become kinked, coiled and entangled in the
normal wear and tear of sterilization, handling and storage. In
addition, due to the extreme flexible nature, this flexible sort of
vein stripper also has the disadvantage of not being able to follow
tortuous routes since it has no capability of transmitting axial
compressive force: in other words, it cannot be pushed through a
vein readily. In addition, the flexibility may tend to cause
internal installment in one fashion or another, particularly where
sharp bends in the vein exist.
A procedure not heretofore practical with vein strippers known to
the prior art is a multiple vein procedure wherein not only the
great saphenous vein, but also the small saphenous and other
secondary veins exhibiting varicosity may be removed in a single
operation. In such a procedure, it may be advisable to use separate
strippers reached by different incisions at the extremity, a
smaller stripper being inserted into a secondary vein and fed along
the vein to the point where it joins the main vein (such as the
femoral vein), and thereafter fed along the main vein, side-by-side
with a larger stripper which has been fed into the main vein at the
distal end thereof. In such a procedure, the small vein may then be
inverted into the larger vein first, and then the larger vein may
be stripped in the normal fashion, bringing with it the smaller
vein. However, strippers of the prior art are either too rigid to
follow the small vein, or because of which small veins follow, too
flexible to be pushed along the tortuous route of the smaller
vein.
From the foregoing discussion, it can be seen that all of the
problems of vein strippers are compounded by the need for
maintaining the useful original character of the stripper, while at
the same time a great deal of handling and maintenance is required.
It is therefore very difficult to maintain surgical vein strippers
of the type known to the prior art at a suitable level of
proficiency so as to perform a variety of vein stripping operations
in a fashion which is consistent with high surgical standards.
Furthermore, because of the problems recited hereinbefore, vein
stripping operations currently practiced frequently encompass
excessive time, therefore requiring that the patient be subjected
to excessively long periods of anesthesia.
SUMMARY OF THE INVENTION
The object of the present invention is to provide surgical vein
strippers capable of easy insertion into veins of a variety of
sizes along tortuous routes, the performance of multiple vein
operations, avoidance of the deterioration of vein stripping
equipment as a result of sterilization, handling and storage, and
the performance of vein stripping operations in a time which is
much shorter than that required with vein strippers of the prior
art.
In accordance with the present invention, a vein stripper comprises
a length of organic material, such as a polymer or fluorocarbon,
having a characteristic that a vein tied to one end thereof will
resist slipping as the vein is inverted into itself in the process
of being stripped from the patient. In accordance with the
invention still further, a vein stripper may have a molded or
forged enlargement on one end, which enlargement prevents the
slippage of a vein tied in juxtaposition therewith. In accordance
further with the present invention, the vein stripper may have a
transverse pin disposed therethrough, which transverse pin prevents
the slippage of a vein tied in proximity thereto. In accordance
still further with the present invention, various forms of molded,
forged or machined indentations, serrations and notches may be
provided in one end of the vein stripper so as to prevent slippage
of the vein tied thereto. In still further accord with the present
invention, a plain length of suitable material may be caused to
engage a separate piece, such as an annular ring, by being threaded
therethrough and then fed back so as to form a loop which will not
pass through the object. The object then resists the tendency of a
vein to slip on the stripper when tied thereto during the stripping
operation.
A main feature of the present invention is its ease of insertion
through the vein. Because of its flexure and surface
characteristics, it progresses through the vein readily. This is
partly due to the fact that there is less adhesion between the
surfaces of vein strippers in accordance with the present invention
and the lumen surfaces of the vein than there is between said
surfaces and metal vein strippers known to the prior art.
Still another feature of the present invention is that it avoids
the necessity of multiple incisions and multipiece vein strippers.
Thus, the normal stripping operation may be performed with one
incision at the distal end, and one incision at the proximal end of
the vein, together with the use of a one piece vein stripper.
Another main feature of the present invention is that it makes
possible the use of disposable vein strippers. Thus, the need for
sterilization, handling and storage is overcome, and wear and tear
on the stripper, which impairs the capacity to perform in a
surgical fashion in subsequent stripping operations, is avoided.
Furthermore, since the stripper does not comprise a surgical steel
implement of the common type, it may be made accessible to users in
bulk form, such as in spools or long lengths, from which suitable
lengths of vein stripper may be separated. There exists also the
capacity to have vein strippers in accordance herewith
presterilized and surgically packaged, so as to be ready for use in
the operating room, and thence to be thrown away upon the
completion of an operation. In addition, because of the inherent
nature of vein strippers in accordance with the present invention,
it is possible for surgeons to have a wide variety of sizes and
configurations available without a high capital outlay or the need
to sterilize, store and handle a large number of tools. Thus, the
central supply of a surgical facility may have vein strippers in
accordance herewith with preshaped ends thereon in sterile packages
which are best suited for certain types of vein stripping
operations, and may also carry a variety of sizes of bulk vein
stripping material to be used with a loop engaging object (such as
an annular ring, as described hereinbefore), thereby to provide a
variety of vein strippers so as to permit choice of optimum
characteristics for the performance of any given vein stripping
operation. The vein strippers in accordance herewith are much less
expensive than those known to the prior art, and necessarily avoid
a great deal of personnel expense in the sterilization, handling
and storage thereof.
DESCRIPTION OF THE DRAWING
FIG. 1 is a side view of a first embodiment of the present
invention using a molded, forged or machined enlargement at one
end;
FIG. 2 is a second embodiment of the invention utilizing a
transverse pin;
FIG. 3 is a side view of a third embodiment of the invention having
indentations therein;
FIG. 4 is a modification of the embodiment of FIG. 3 in which the
indentations are accompanied by an enlargement;
FIG. 5 is a side elevation of an embodiment of the invention having
serrations, which may either be threads or parallel serrations;
FIG. 6 is an elevation of an embodiment of the present invention
where one end has a notch formed therein:
FIG. 7 is a partially sectioned, side elevation of another
embodiment of the present invention in which a plain piece of vein
stripping material is threaded back on itself through an object,
such as an annular ring;
FIG. 8 is a side elevation and partial section taken on the line
8-8 in FIG. 7;
FIG. 9 is a partially sectioned, side elevation of the embodiment
of FIGS. 7 and 8 after it has been tied to the vein prior to the
vein stripping operation; and
FIG. 10 is a sectioned side elevation of the embodiment of FIGS.
7--9 after the vein stripping operation has begun, with the vein
being inverted into itself.
The foregoing and other objects, features and advantages of the
present invention will become more apparent in the light of the
following detailed description as illustrated in the accompanying
drawing.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to FIG. 1, a first form of the invention may consist
of a suitable plastic which is sufficiently flexible so as to be
bent in following the course of a vein, but sufficiently rigid so
as to be able to transmit compressive force thereby permitting it
to be pushed along the course of a vein. Such a suitable plastic
may comprise a number of varieties of nylon or Teflon, or other
polymers and polycarbonates as well as suitable other forms of
plastic. The vein stripper in the embodiment of FIG. 1 comprises an
elongated shank portion 20 which may be of any length suitable to
the needs involved; for instance, the length should be chosen to be
in excess of the length of vein which is to be stripped, along the
route which must be threaded by the stripper through the vein,
prior to the stripping operation. At the right hand end of the
stripper in FIG. 1, an enlarged portion 22 may be formed by molding
(in the case where the entire stripper is molded); it may be formed
by machining (where a rod of larger diameter is used as the base
material) and material is removed throughout the shank portion 20;
or it may be formed by a forging process wherein the application of
a suitable, mild heat along with pressure will cause material
originally at the same diameter as the shank portion 20 to be
forged into a foreshortened but enlarged portion 22. At the left
hand end 24 of the vein stripper illustrated in FIG. 1, the
stripper may be rounded in a semispherical fashion so as to permit
easy insertion of the vein stripper as the stripper is inserted in
a leftward direction as seen in FIG. 1.
Referring now to FIG. 2, any of the materials referred to
hereinbefore may be utilized so as to provide an elongated shank
portion 26, having a hole machined therein to permit insertion of a
small pin 28. The pin may be of metal or a suitable plastic, wood,
or other material, it serving merely to supply resistance to
slippage of a vein after it is tied to the shank portion 26. Each
of the ends 30, 32 may be rounded if desired so as to permit easy
slippage of the vein stripper as it is being inserted into the vein
prior to the stripping operation. On the other hand, since the size
vs. flexibility factor, of vein strippers made in accordance with
the present invention, promotes easy insertion, it is not necessary
to provide rounded ends, the ends will be easily inserted through
the vein even though flat. In the embodiment of FIG. 2, the end 32
would be inserted into the vein without the pin 28 in place, and
after the stripper is inserted entirely through the vein and the
end 32 has emerged out of the other end of the vein, the pin 28 is
inserted through a hole in the stripper and the vein is then tied
down to the stripper close to the pin 28. The pin therefore will
resist the tendency of the vein to slip along the stripper toward
the end 32, as the stripper is moved to the left (as shown in FIG.
2) in the vein removing operation.
In the embodiment of FIG. 3, a plurality of depressions may be
formed in an end 36 of the vein stripper in such a fashion as to
not significantly lower the tensile strength of the main shank 38
of the stripper. This embodiment may be particularly advantageous
in the case of extremely small vein strippers where the provision
of holes for the insertion of pins or of notches (as in the
embodiment of FIG. 6 which is described hereinafter) would weaken a
thin vein stripper to the point where it could rupture as a vein
was being pulled. As illustrated in FIG. 3, each of the depressions
48, 50 is oriented in an opposite direction so as to maintain a
suitable cross section of material for tensile strength, the narrow
end of the depression being deep, and the wide end of the
depression being shallow. Although two depressions are shown in
FIG. 3, it is likely that three, four or more depressions might be
desired in any given embodiment, which may be chosen to suit any
implementation of the present invention. In FIG. 4 is illustrated
another modification of the embodiment of FIG. 3 wherein the
depressions 48, 50 would be forged under pressure with a little
heat, thus resulting in a slight enlargement of an end 52 of the
vein stripper. This enlargement will tend to resist slippage of the
vein after it is tied thereto, during the vein stripping
operation.
Another form of vein stripper in accordance herewith, as
illustrated in FIG. 5, includes circumferential serrations 54,
which may either be parallel or may be disposed as a single spiral
(such as threads). The serrations 54 may be provided in an end 56
of a vein stripper 58, a portion of which has been broken away for
simplicity. By tying the vein directly above the serrations, the
tendency of the suture or thread used for tying is to cause
compression of the vein into the serrations thereby providing
sufficient resistivity to slippage so that the vein follows the
stripper during the stripping operation.
An embodiment of the present invention which is best suited for use
with large vein strippers is illustrated in FIG. 6. Therein, a
notch 60 is provided near an end 62 of a vein stripper 64, most of
which is broken away for simplicity. In such a case, the vein is
tied so that the compression of the thread or suture used for tying
is within the notch 60, thus securely holding the vein against
slippage during the vein stripping operation.
A most important embodiment of the present invention is illustrated
in FIG. 7. Therein, the vein stripper comprises a length of
suitable plastic rod 66 which may be cut from a roll or long rod of
material to any desired length. In this embodiment, the stripper is
fed through the vein until the feed-end emerges from the opposite
end of the vein, and then an annular ring 68, which may be
comprised of surgical steel, plastic or other suitable material, is
slipped over an end 70 of the stripper, then the end 70 is fed back
through the ring 68. The ring 68 has a hole 72 therein which is
sufficient to permit two sections of the stripper 66 to be fed
therein, but the diameter is too small to permit a loop of the vein
stripper 66, 74 to pass therethrough. It has been found that by
selecting a ring 68 having a hole 72 with a diameter which is
slightly less than twice the diameter of the stripper 66, the above
condition is met. It can be readily seen that the embodiment of
FIG. 7 makes it quite advantageous to have a supply of preselected
diameter of vein stripper material 66 in elongated bulk, such as
long rods or on spools, with a commensurate supply of properly
sized rings 68, thereby to give the surgeon a wide variety of
choice of vein stripper sizes which are readily available and are
easily processed for the single operation and then may be thrown
away. Additionally, the outside diameter of the ring 68 may be
chosen to suit a suitable wall thickness for a particular vein
which is being removed. It is therefore possible to provide vein
strippers having various diameters with rings 68 having additional
combinations of diameters so as to provide an overall combination
of possibilities in excess of that possible with vein strippers
known to the prior art.
The vein stripper illustrated in FIGS. 7 and 8 is applied to the
vein as shown in FIG. 9. Therein, the stripper has been threaded
all the way through the vein 73 so that the end 70 has protruded
from the vein; the ring 68 has been threaded over the stripper 66,
and then the end 70 has been fed back through the ring a sufficient
distance so that it will not readily slip back through the ring,
preferably under the area of the vein which is to be tied by a
suture or thread 74. As can be seen in FIG. 9, the vein is tied
very tightly to the stripper so that it will not slip as the
stripper is pulled to the left in FIG. 9. After the vein 73 is
secured to the stripper by the suture or thread 74, the stripper 66
is moved to the left (in FIG. 9), which causes the vein to double
back on itself internally, as illustrated in FIG. 10. The vein
stripping operation proceeds in the usual fashion, so that for
every given unit of distance that the stripper 66 is moved to the
left in FIG. 10, a fold 76 in the vein 73 will move half that
increment to the left until the entire vein has been turned inside
out and is removed from the patient, in a fashion well known in the
art.
Although the invention has been shown and described with respect to
the preferred embodiments thereof, it should be understood by those
skilled in the art that the foregoing and other various changes and
omissions in the form and detail thereof may be made therein
without departing from the spirit and the scope of the
invention.
* * * * *