U.S. patent number 3,570,497 [Application Number 04/791,708] was granted by the patent office on 1971-03-16 for suture apparatus and methods.
Invention is credited to Gerald M. Lemole.
United States Patent |
3,570,497 |
Lemole |
March 16, 1971 |
SUTURE APPARATUS AND METHODS
Abstract
The invention is a suture with needle end, cord of latch
notches, and latch collar end. The latch collar has a latch passage
therethrough. The needle followed by latch notches is pulled
through the tissue and the needle followed by a selective number of
latch notches is continued on through the collar latch passage and
severance is then made above the last notch pulled through the
latch collar as it thus is latched on the tissue surface to
complete a stitch much more quickly than can be done by
conventionally tying a suture knot.
Inventors: |
Lemole; Gerald M. (Houston,
TX) |
Family
ID: |
25154550 |
Appl.
No.: |
04/791,708 |
Filed: |
January 16, 1969 |
Current U.S.
Class: |
606/151;
24/30.5R; 606/74; 606/228; 24/16PB; 606/224 |
Current CPC
Class: |
A61B
17/12009 (20130101); A61B 17/064 (20130101); A61B
17/06 (20130101); A61B 17/04 (20130101); A61B
17/06066 (20130101); A61B 17/06004 (20130101); Y10T
24/1498 (20150115); Y10T 24/15 (20150115) |
Current International
Class: |
A61B
17/12 (20060101); A61B 17/04 (20060101); A61B
17/06 (20060101); A61B 17/064 (20060101); A61b
017/06 (); A61l 017/00 () |
Field of
Search: |
;128/334--340 ;24/16
(PB)/ ;24/30.5 (PB)/ ;24/206.1 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. A suture including a needle and a unitary, resilient,
self-latching suture cord having successively after the needle, a
series of latch notches, a connector portion, and a latch collar
from which the connector portion extends, the latch collar
providing a shaped notch passage therethrough with the latch collar
yielding resiliently to permit latch notches following the needle
to be pulled in selective number through the latch passage and with
said latch notches being resiliently yieldable and shaped so that
the last notch pulled through the latch collar returns to initial
shape and relative position to latch cord and to latch upon latch
collar upper surface.
2. A suture as claimed in claim 1 in which said suture cord between
said latch notches is easily severable whereby the needle with
leading notches may be detached by severance above said last
notch.
3. A suture as claimed in claim 1 in which said latch notches are
of truncated, tetrahedeal, pyramidal shape with bases
downwardly.
4. A suture as claimed in claim 1 in which said latch notches are
of truncated conical shape with bases downwardly.
5. A suture as claimed in claim 1 in which said latch notches are
of truncated trihedral, pyramidal shape with bases downwardly.
6. A suture as claimed in claim 1 in which said latch notches are
of flattened spheroid shape.
7. A suture as claimed in claim 1 in which said latch notches are
of substantially triangular cross section with bases downwardly and
extending on one side of the latch cord.
8. A suture as claimed in claim 1 in which said latch notches are
of substantially triangular cross section with bases downwardly and
extending on one side of the latch cord, in which the needle
puncture end is arched to the same side as that to which the notch
bases extend, and in which the base end of the needle is bonded
with the lead end of the latch cord.
9. A suture as claimed in claim 1 which is comprised of a resilient
plastic material.
10. A suture as claimed in claim 1 in which the latch cord
connector is of flattened cross section.
Description
The invention relates to suture stitches and to a suture comprised
of a needle end, a suture cord of latch notches and a latch collar
end by which suture seams may be completed, the latch collar and
last latch notch pulled therethrough completing the suture knot,
severance above said last latch notch then being made of the
leading latch notches and the needle.
Heretofore, in conventional surgery, time is required to tie the
suture knot as a stitch is completed. Especially is time saving
essential for the completion of surgery stitches and seams where,
in heart surgery, quick application of the heart lung machine is
involved. Where suture slippage can be involved, it is often
necessary to tie as many as six half hitches in each knot, and
where such time requirement per stitch can be so greatly reduced by
substituting therefor the time required to snip a latch cord
between latch notches of this invention, it can be seen how a great
contribution to surgery is herein involved.
Thus, primarily in detail the invention has object of providing a
suture and method of making sutures which involves a very
substantial time saving per stitch since the suture, comprising
latch collar from which extends the suture cord of latch notches
with needle in lead can be employed to complete a stitch with
needle from tissue, followed by latch notches, being passed through
the collar latch passage and the suture cord (and needle) then
being severed as by snipping the cord just above the last latch
notch that has been pulled through the latch collar.
Also, the invention has the broad primary object of providing a
suture, complete with needle, which self latches with its latch
collar to complete a stitch, the needle and leading notches being
detached by snipping the latch cord above the last latching notch
pulled through the latch collar.
Additionally, the invention has as its other broad primary object,
the provision of a method of suture stitching in which the suture
is latched with itself to complete a stitch, the leading part
(needle and leading latch notches) then being detached to leave a
completed stitch.
Furthermore, the invention has as an important object the provision
of a self-latching suture with needle, and with suture cord and
latch collar of resiliently yieldable material, the suture cord
severance above the selective latching notch requiring minimum time
consumption.
Additionally, the invention has as another object the provision of
a method of suture stitching in which a unitary suture is lead
through tissue and out therefrom through the suture rear to latch
therewith, the lead part beyond the latch then being severed to
leave a completed, unencumbered, firmly latched stitch.
Other and further objects will be apparent when the specification
herein is considered in connection with the drawings, in which:
FIG. 1 is an isometric view of suture apparatus as comprised in one
embodiment of the invention;
FIG. 2 is an isometric view of the latch collar end and of part of
the needle and latch notch portion of another embodiment of the
invention;
FIG. 3 is an elevational view of the latch collar end and of part
of the needle and latch notch portion of still another embodiment
of the invention;
FIG. 4 is an elevational view of the latch collar end and of part
of the needle and latch notch portion of yet another embodiment of
the invention;
FIG. 5 is an elevational view of the latch collar end and of part
of the needle and latch notch portion of still a further embodiment
of the invention;
FIG. 6 is an elevational view illustrative of the initial or needle
insertion step employing any one of the forms of the invention
disclosed in FIGS. 1--5, inclusive;
FIG. 7 is an elevational view illustrative of the following step
after that shown in FIG. 6, in which latch notches are pulled
through after the needle;
FIG. 8 is an elevational view of the following step after that
shown in FIG. 7, in which the needle is followed by latch notches
passed through the latch collar;
FIG. 9 is an elevational view of the following step after that
shown in FIG. 8, in which the latch collar is approximated over the
seam to be stitched, prior to pulling the last selective latch
notch through the latch collar;
FIG. 10 is an elevational view of the final step after that shown
in FIG. 9, with the stitch completed by latch collar and selective
latch notch, and the outer latch notches and needle removed;
and
FIG. 11 is an enlarged sectional elevational view of a portion of
the latch collar and latch cord indicative of the manner in which a
latch stitch is completed.
Referring now in detail to the drawings in which like reference
numerals are applied to like elements in the various views, suture
apparatus 10 is shown in FIG. 1 comprised of a needle 11 arched
from the plane of the latch cord 12 in direction of incision with
piercing point 13 outermost and widening to a needle base 14 which
is connected to the outermost portion of a chain 15 of successive
latch notches 16, a conventional rivet 27 being shown for this
purpose in FIG. 1. Also and additionally, the outermost portion of
the latch notch chain 15 may be bonded to the needle base.
Each latch notch 16 has a base or latch leg 17, which extends
normal to the flat latch strip 18 in the direction of incision,
with the hypotenuse side 19 of the each individual latch notch 16
extending angularly along a taper or slope to the latch strip 18 at
the base leg of the next outwardly latch notch 16. At the end of
the latch notch chain 15, the flat strip 20 extends as a connector
to a junction 23 with a latch collar 21. The latch collar 21 is
shown in FIG. 1 of block form, with a latch opening 22 formed
therethrough on the side opposite the junction 23.
Beyond the needle 11, the whole suture apparatus or cord 12 may be
integrally formed, including the latch collar 21, of a plastic
material as polyvinyl chloride, polyethylene and the like whereby
the latch cord 12 possesses some substantial degree of resiliency.
As formed, the opening 22 is of larger cross-sectional area on the
under side 24 of the latch collar 21 than on the upper or outer
side 25, or thus the sides of the opening 22 may extend with a
degree of taper from under side to outer side.
Suture apparatus 10a, FIG. 2, provides latch notches 16a in form of
truncated tetrahedral pyramids, the uppermost notch 16a being
connected by a plastic or resilient material connector 28 to a
needle base 14a. Also a connector 20a comprising an integral part
of the resilient material or plastic latch cord 12a is provided to
connect the latch notch chain 15a and the latch collar 21a. In this
view the opening 22a through the latch collar 21a may be tapered
from an opening of larger cross-sectional area on the under side,
not shown, to an area of smaller cross-sectional area at the top
side of the latch collar. Optionally the opening 22a may be of
uniform cross-sectional area from under side to top side.
Making reference now to FIG. 3, suture apparatus 10b is provided
with latch notches 16b in form of frustocones, with the upper end
of the latch notch chain 15b connected by means of a resilient
material or plastic connector 28b to the base 14b of a needle, both
connector and needle base being of the same round cross section in
area. The lower end of the latch notch chain 15b is shown connected
by a conveniently formed connector 20b, of the same resilient
material or plastic, to the latch collar 21b. Particularly, as
shown in FIG. 3, the connector portion 29a, is of round cross
section of the same diameter as the latch notch base from which it
extends, while the connector portion 29b merges to a flattened
cross section and of the contour shown.
Noticeably, in FIG. 3, the latch collar 21b is of frustoconical
shape, with the base lowermost. The opening 22b through the latch
collar may be of cylindrical shape, or tapered with the opening 22b
of slightly greater lowermost diameter than needle base 14b and
connector 28b, and of slightly lesser uppermost diameter than these
elements. In FIG. 3, the opening 22b has been expanded, thus to
receive the connector 28b therethrough, and the opening must be
further expanded to receive the frustoconical latch notches 16b
therethrough. This is possible since the latch collar 21b is of a
resilient, flexible, deformable, or plastic material, the latch
cord 12b also being of the same material.
As shown in FIG. 4, suture apparatus 10c shows needle base 14c and
connector 28c, of same outer diameter, with the latch notches 16c
of latch notch chain 15c being in the form of truncated trihedral
pyramids. A connector 20c has portion 29c, of diameter to
circumscribe latch notch base, extending from lowermost latch notch
16c; the portion 29c merging into a connector portion 29d, of
flattened cross section, and of the contour shown in FIG. 2, to
connect with the underside of the latch collar 21c. The latch
collar 21c is also shown to be in the form of a truncated trihedral
pyramid with base downwardly. The opening 22c through the latch
collar is indicated as being of round cross section, and such
opening may preferably be tapered with uppermost diameter slightly
less than the diameter of the needle base 14c and connector 28c and
with the lowermost diameter, not shown, of slightly greater
diameter than these elements.
Suture apparatus 10d, FIG. 5, is constructed and of part sizes
comparable to the suture apparatus shown in FIG. 3, with the
exception that the latch notches 16d are of spheroid shape. The
connector 20c between the lowermost spheroid center plane and the
latch collar 21d, is connected to such lowermost half-spheroid by a
round or cylindrical connector portion 29e which merges into
connector portion 29f of flattened cross section as connected with
the latch collar 21d, and of configuration shown in FIG. 5. Also,
as in FIG. 3, the latch collar 21d, FIG. 5, is shown to be in form
of a frustocone with opening 22d to receive first the needle point,
then needle base 14d, then connector 28d, and then selective latch
notches 16d of the latch notch chain 15d therethrough. Thus, it is
preferable that the opening 22d be tapered from uppermost diameter
slightly less than the diameters of connector 28d and needle base
14d, and with lowermost diameter slightly greater than the
diameters of these elements. Thus the needle point may be passed
through the latch collar opening 22d, and the opening stretched to
admit the needle base 14d, connector 28d, and the selective
spheroid latch notches 16d therethrough.
It is characteristic of all of the forms of invention shown in
FIGS. 1--5, inclusive, that all of the elements below the needle
base are of the same material, as a treated rubber, or as a
resilient, yieldable or deformable material, as a plastic, Only the
needle should be of a rigid material, and there can be plastics
capable of being hardened to form a serviceable needle to which a
connector or uppermost latch notch may be bonded or otherwise
connected. The needle bases shown in FIGS. 2--5, inclusive, may be
connected to the respective connectors therebelow, as by bonding
interfitted abutting needle base and connector ends, as by
employing fluid epoxy resin to harden as a bonding agent. In these
FIGS., structural variations made to interfit needle base and
connectors for bonding are not shown, it only sufficing to indicate
diagrammatically at 30 that bonding is made. Also minute rivets may
be used, as indicated in FIG. 1.
Noticeably, it may be possible that the entire suture apparatus or
complete stitch element or structure may be fabricated at the same
time of plastic, the plastic of the needle being adapted to harden
into, or being preformed of, a portion of rigidity and strength to
serve the function of a needle in piercing the flesh or tissue, and
in guiding or leading the suture cord through the tissue on each
side of the incision and through the latch collar. This is within
the realm of capabilities of plastics, and also such needles can be
constituted in manner not to shred off any portion thereof to leave
the wound unclean.
If reference is now made to FIGS. 6--10, successively, the steps of
making a suture stitch may be visualized. First the needle 11 is
inserted with point 13 to pierce into the skin or surface layer of
a surgery patient 31. The point 13, with the curved needle
thereafter, is moved downwardly through the flesh or tissue 32 to
extend across the incision 33 at some spaced distance below the
surface or dermic layer. Then the needle point is moved upwardly so
that the point 13, arched in direction of incision, pierces the
dermic layer of skin surface of the patient at some distance spaced
from the point of needle puncture upon entry. See FIG. 6.
Then the needle is drawn through dermic layer, tissue and/or flesh,
across incision, up through tissue and/or flesh, and out through
the dermic layer, pulling the leading latch notches 16 therewith.
Next the needle 11 and leading latch notches 16 are pulled through
the last or outward skin puncture from the tissue and/or flesh
below, and all of the needle and part of the latch notches are thus
free from the patient's body, (FIG. 7).
Next the needle, as freed, and the leading latch notches 16, are
passed through the opening 22 in the latch collar 21. As the
opening 22 is tapered, at least through one side thereof, as will
be hereinbelow described, each latch notch 16 is contracted in
passing through the upper end of the opening 22, then to extend to
normal position with the latch leg 17 to rest upon the latch collar
top surface 24, as shown in small scale in FIG. 8.
FIG. 9, to slightly larger scale than FIGS. 6--8, shows the suture
or latch cord 12 being grasped by a pliers or pulling tool type of
forceps 34 as a finger 35 pushes down upon the latch collar 21,
thus forcing the latch collar toward a flat position with under
side 25 in contact upon the dermic layer 36 of the patient 31, as
the last of the selective latch notches 16 pulled through the latch
collar 21.
Finally, FIG. 10 shows the completion of a stitch, with the latch
collar 21 bridging across the incision 33, as its under side 25
seats on the dermic layer 36 on either side of the incision. Thus
the latch or suture cord 12 extends from its junction 23 down
inwardly through the flesh or tissue 32 and across the incision 33
inwardly of the dermic layer, then outwardly through the flesh or
tissue 32 and through the dermic layer 36 and latch collar opening
22 with the last notch 16 to be pulled through the latch collar
latching upon its upper surface 24. Slightly above this latching
notch 16 the latch chain 15 has been severed, and the leading latch
notches and the needle in advance thereof are not shown. Thus these
members, not shown in FIG. 10, may be assumed to have been removed
and/or expended.
Referring now to FIG. 11, the latch collar 21 and latch notch chain
14 are shown in part, and to enlarged scale, with the relationship
of the opening 22 and latch notches 16 thus being shown in
substantially graphic detail. As the latch notches 16 are pulled
through the flesh and dermic layer, these members tend to contract.
Also, as the latch notches 16 are successively pulled into the
entrance through the under surface 25 of the latch collar 21, up
through the opening 22, as it is tapered to a smaller
cross-sectional area outlet through the top or outer surface 24 of
the latch collar, the latch notches are successively contracted.
The notch that has just been pulled clear of the opening 22 extends
outwardly to assume its original shape so that the leg 17 of the
latch notch 16 seats upon the top or outer latch collar surface 24
to complete a stitch. As the latch notches, outwardly of the latch
notch 16 atop the upper surface 24 of the latch collar 21, have no
further function, the latch chain 15 may be severed, as along the
severance line 37, FIG. 11, and the outer latch notches and needle
removed and/or expended, as aforesaid.
Noticeably in FIG. 11, each latch notch 16 is shaped so that the
leg 17 straightens out and overextends the top surface 24 of the
latch collar 21 when such particular latch collar has just been
pulled upwardly completely to pass through the opening 22. The same
theory of construction obviously applies to the forms of invention
shown in FIGS. 2--5.
It often happens that incisions of substantial length and depth
have to be made, as for instance, in heart surgery, as to install a
heart pump, or in heart replacement. Since it is so vital that
after installation, the incision must be sewed up as quickly as
possible, an invention of the kind hereinabove disclosed may be
extended into apparatus for enabling a plurality of stitches to be
completed in quickest order to extend all around a lengthy incision
as hereinabove referred to.
In this case the latch collar may be constructed to straddle the
whole, or a substantial part of, the length of an incision and have
a multiple of latch openings provided therein in spaced relation
therearound. A suture cord with expendable needle may be provided
to be passed through each opening. Apparatus of this type can thus
result in a greatest time saving where time is of the greatest
essence in sewing up the incision after an operation, as for
purposes hereinabove described.
The invention sets out to provide surgical apparatus which will
enable the quick sewing up of an incision, for the length thereof,
by use of a plurality of devices each providing the structure for a
suture stitch in such relative disposition and arrangement, as to
the parts thereof, that each suture stitch may be made in the
briefest time.
A number of separate structural embodiments are shown and
described. In this regard it is set forth that the structures shown
are greatly exaggerated in scale, whereas it is most important that
the latch notches are small enough, (not much larger in dimension
than conventional suture cords in diameter), that they do not force
too large a passage through the flesh or tissue. Still there must
be enough area of the latch notch lower surface to overextend the
latch collar outwardly of the latch chain or core of the latch
cord, that the latch chain, including the latching notch, may not
be pulled back through the latch collar.
Such a number of satisfactory forms and embodiments are shown as to
demonstrate that still other embodiments may be included within the
extent of the invention. In addition to the drawings and
hereinabove disclosure, the claims appended hereto complete the
application by claim definition.
* * * * *