U.S. patent number 3,580,256 [Application Number 04/837,590] was granted by the patent office on 1971-05-25 for pre-tied suture and method of suturing.
Invention is credited to Victor G. Tahan, Jack E. Wilkinson.
United States Patent |
3,580,256 |
Wilkinson , et al. |
May 25, 1971 |
PRE-TIED SUTURE AND METHOD OF SUTURING
Abstract
A surgical suture or the like including a pair of
butterfly-loops secured in superimposed registering relation by a
casing through which the loops are visible, and a pair of tails
extending from the loops. A suturing method wherein one of the
tails is used as a suture which pierces the tissue to be sutured
and is passed through the superimposed loops, the tails then being
pulled tight to convert the interlooping formation into a square
knot.
Inventors: |
Wilkinson; Jack E. (Fresno,
CA), Tahan; Victor G. (Fresno, CA) |
Family
ID: |
25274898 |
Appl.
No.: |
04/837,590 |
Filed: |
June 30, 1969 |
Current U.S.
Class: |
606/228; 289/1.5;
289/4; 606/232 |
Current CPC
Class: |
A61B
17/04 (20130101); A61B 17/12009 (20130101); A61B
17/06166 (20130101); A61B 2017/0477 (20130101) |
Current International
Class: |
A61B
17/04 (20060101); A61B 17/12 (20060101); A61B
17/06 (20060101); A61L 017/00 () |
Field of
Search: |
;128/335,326,327,335.5
;112/156 ;289/1.5,2,4,18 ;242/159 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: McGowan; J. C.
Claims
We claim:
1. A prelooped tie element comprising:
a folded butterfly-loop formation comprising a pair of loops
superimposed one upon the other in registering relation, and a
bight connecting said loops;
a tail extending from each of the respective loops, said bight
being looped over said tails;
and a casing of frangible material in which said loops are embedded
and secured in said registering relation until broken therefrom by
pulling upon the loops in the formation of a knotted tie in which
one of said tails is first threaded through said loops.
2. A tie element as defined in claim 1, for use as a surgical
suture.
3. A suture as defined in claim 2, wherein one of said tails is a
relatively long one, of a length suitable for attachment to a
needle and for piercing tissue material, forming therewith a suture
loop around said tissue, and passing it through said butterfly
loops to start the formation of a square knot;
and wherein the other tail is relatively short, of a length
suitable for grasping to apply a pull to said butterfly loops.
4. A tie element as defined in claim 1, wherein said casing is in
the form of a thin wafer.
5. A tie element as defined in claim 1, wherein said casing is in
the form of a sheath of ring form.
6. A method of surgical suturing comprising:
utilizing a suture including a preformed folded butterfly-loop
formation comprising a pair of loops superimposed one upon the
other in registering relation, and a bight connecting said loops;
and
a tail extending from each of the respective loops, said bight
being looped over said tails;
initially securing the loops of said folded butterfly-loop
formation in said superimposed relation by means yielding to a pull
on said tails to allow the evolution into a square knot;
placing said butterfly-loop formation against a tissue member to be
sutured;
piercing said tissue with one of said tails, looping said one tail
around the tissue to form a suture loop, and passing it through
said superimposed butterfly loops;
and pulling on said tails to reduce said suture loop to
tissue-suturing size and to evolve the loop and tail formation in a
square knot.
7. The method defined in claim 6, wherein said initial securing
means is a coating of frangible, nontoxic material.
8. The method defined in claim 6, wherein the tail used to form the
suture loop is pulled in order to tighten said loop and the other
tail is then pulled to develop said square knot.
Description
BACKGROUND OF THE INVENTION
In existing surgical technique, the common practice is to hand-tie
the ends of a suture in a square knot or other nonslipping knot,
after first threading the suture through and around the cut edges
of tissues to be joined. There has been no satisfactory faster
method of securing the ends of a suture, insofar as I am aware.
OBJECTS OF THE INVENTION
The general object of the invention is to speed up the tying of a
knot by pre-execution of the preliminary stages of forming the
knot, thus eliminating the surgeon's knot-forming procedure wherein
the projecting tails of a suture are manipulated into a first
intertwined relation and then a second intertwined relation to
develop in each of the tails a loop through which two parallel arms
of the other loop are drawn. Specific objects are:
A. TO PROVIDE IN ONE END OF A SUTURE OR OTHER TIE ELEMENT A
PREFORMED LOOP STRUCTURE WHICH CAN BE QUICKLY COMBINED WITH THE
OTHER END TO FORM A KNOT;
B. TO PROVIDE IN A SURGICAL SUTURE A PREFORMED DOUBLE-LOOP
(BUTTERFLY) FORMATION WHICH CAN BE CONVERTED INTO A SQUARE KNOT
SIMPLY BY PASSING A TAIL OF THE SUTURE THROUGH THE TWO LOOPS
THEREOF AND THEN PULLING THE INTERLOOPED MEMBERS TIGHT;
C. TO PROVIDE SUCH A SUTURE INCLUDING MEANS FOR PRESERVING THE
BUTTERFLY LOOPS IN SUPERIMPOSED, REGISTERING RELATION SUCH THAT THE
TAIL CAN BE EASILY THREADED THROUGH BOTH LOOPS, USING A SUTURING
NEEDLE;
D. TO PROVIDE SUCH A SUTURE IN WHICH THE LOOPS ARE EMBEDDED AND
THUS SECURED IN A THIN, EASILY PIERCED CASING OF MATERIAL THROUGH
WHICH THE LOOPS ARE VISIBLE SO THAT A SURGEON CAN PIERCE THE CASING
WITH A SUTURING NEEDLE AT A POINT WHERE THE SUTURE WILL PASS
THROUGH THE SUPERIMPOSED LOOPS.
These and other objects will become apparent in the following
specifications and appended drawings, in which:
FIG. 1 is a plan view of a suture embodying the invention;
FIG. 2 is a fragmentary plan view of the butterfly-loop portion of
the suture on an enlarged scale, with a modified form of casing
shown in section;
FIG. 3 is a fragmentary perspective view illustrating an
intermediate step in the suturing of a pair of cut tissue edges,
using the invention;
FIG. 4 shows an early stage of evolution of the butterfly-loop
formation toward square knot form;
FIG. 5 shows a more advanced stage of such evolution;
FIG. 6 shows the evolved square knot; and
FIG. 7 is a cross-sectional view taken on line 7-7 of FIG. 1.
DESCRIPTION
Referring now to FIG. 1 in detail, the suture device of our
invention consists generally of a length of suture filament which
is looped at a point nearer one end than the other, to provide a
folded butterfly-loop formation 10, a long tail 11 and a short tail
12, and a thin casing 13 in which the butterfly 10 is embedded.
Casing 13 is essentially a thin film coating both sides of
butterfly 10, formed by dipping or spraying. It may be of wax or
plastic material and is of a nontoxic character when in contact
with the flesh of a patient. It may be in the form of a thin flat
wafer 13, as shown in FIGS. 1 and 7, or may be simply a sheath 14
of ring form as shown in FIG. 2.
Butterfly 10 comprises a pair of loops 15 and 16 which are
superimposed in registering relation in the folded butterfly of the
suture article as prepared for use (FIG. 1 or FIG. 2). The casing
13 (or 14) functions to secure the loops 15, 16 in the
superimposed, registering relation so that a suturing needle may be
easily threaded through the two loops. Loops 15 and 16 are joined
by a connecting part which, in the folded butterfly 10, is in the
form of a bight 17 and which, in the opened-out butterfly as seen
in FIGS. 4 and 5, becomes a bridge 18. In the wafer 13 of FIG. 1,
or in the sheath 14 of FIG. 2, the superimposed loops 15, 16 and
the connecting bight 17 are completely enveloped by the coating
material 13 or 14, which is sufficiently soft or frangible to tear
apart or disintegrate so as to allow the butterfly formation to
evolve into a square knot.
THE METHOD
In the practice of our improved method in the suturing of a pair of
cut edges of tissues 20, the long tail 11 is attached to a suturing
needle, the folded butterfly 10 is laid against one side of the
juxtaposed tissues, the tail 11 is looped around the tissues to
form a suturing loop 21, the tissues and then the butterfly 10 are
pierced by the needle and the tail 11 is drawn through the tissues
and the two loops of the butterfly, as shown in FIG. 3. Tail 11 is
then pulled in order to draw the loop 21 closely around the
encircled tissues (FIG. 4); and the short tail is also pulled in
order to evolve the embryonic knot formation of FIG. 3 into the
square knot formation shown in FIG. 6. In order to illustrate the
evolution of the knot, FIG. 4 shows the butterfly as it would
appear if opened up to spread the loops apart, the loop 16 being
shifted upwardly and to the left from its position seen in FIG. 3.
FIG. 4 shows the butterfly in alignment with the tail 11 when
pulled to a substantially straight position in drawing the suturing
loop 21 tight. FIG. 5 shows the initial effect of pulling on the
short tail 12 against the resistance of the suturing loop 21, an
embryonic loop 22 being developed by the tightening of loop 16 in
direct response to the pull of tail 12. In response to further pull
on tail 12, embryonic loop 22 is drawn out into the square knot
loop 23 of FIG. 6 as the loop 16 is pulled out to a substantially
straight condition at 24 in FIG. 6, and the loop 18 is evolved into
the other square knot loop 25 of FIG. 6 (shown in upwardly inverted
relation to its position in FIG. 5).
The square knot formation is obvious in FIG. 6, but the knot (as
well as suturing loop 21) are shown in a loose condition for the
purpose of clarity of illustration. It will be understood that the
finished knot and loop 21 are drawn tight in the finished suture.
The evolving formations of FIGS. 4 and 5, for clarity, are likewise
shown in a looser condition than actually exists in the evolving
knot formation. Also, it should be understood that the evolution
may proceed directly from the FIG. 3 to the FIG. 5 formation, the
FIG. 4 configuration being for the purpose of more clearly
displaying the characteristic open butterfly shape and tracing the
change from butterfly to square knot form.
As one method of prelooping the end of a suture or the like, the
invention contemplates the possibility of a surgeon's assistant
using a suitable instrument for doing the prelooping just prior to
the use of the suture by the surgeon.
Also, the invention contemplates the possibility of performing a
slip knot, double square knot or double slip knot, and fixing the
preformed loops in the manner described above, for subsequent
knot-forming use.
Further, the invention contemplates the possibility of applying a
tie element, prelooped as described above, to uses other than in
surgery, e.g., industrial applications such as the sewing of
clothes, leather, shoes, etc. and the attachment of buttons and
other fasteners. A variety of other possible applications will
suggest themselves to those who may later become familiar with the
invention.
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