U.S. patent number 3,762,418 [Application Number 05/253,983] was granted by the patent office on 1973-10-02 for surgical suture.
Invention is credited to William G. Wasson.
United States Patent |
3,762,418 |
Wasson |
October 2, 1973 |
SURGICAL SUTURE
Abstract
A surgical suture for ligating, tying or suturing two sutures
simultaneously with a single maneuver. An eyeless needle is swaged
to an end of a main suture section. The main suture section ends
are fused portions of two separate strands of suture material. The
separate strands form an intermediate portion of the main suture
section between fused portions. Alternatively, the main suture
section may have a plurality of intermediate separate suture strand
portions connected to each other by fused portions. Marking bands
are located at the junctions of the fused portions with the
intermediate separate strand portions.
Inventors: |
Wasson; William G. (Canton,
OH) |
Family
ID: |
22962469 |
Appl.
No.: |
05/253,983 |
Filed: |
May 17, 1972 |
Current U.S.
Class: |
606/226;
606/230 |
Current CPC
Class: |
A61B
17/06166 (20130101); A61B 90/92 (20160201); A61B
17/06004 (20130101); A61B 2017/06057 (20130101); A61B
2017/06028 (20130101); A61B 2017/06171 (20130101); A61B
2017/0619 (20130101) |
Current International
Class: |
A61B
17/06 (20060101); A61B 19/00 (20060101); A61l
017/00 () |
Field of
Search: |
;128/335,335.5,339,326
;161/172,173,175,176,177,179 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Bickham, Operative Surg. Vol. 1, 1924 pp. 226-269. .
Digby, Surg. Gyne., Obstet., Vol. 31, 1920 pp. 410-411..
|
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. A surgical suture for use in suturing and ligating procedures
including a needle having sharp and blunt ends; a main suture
section connected to the blunt end of the needle; the main suture
section including first and second fused end portions and an
intermediate portion extending between said fused portions; said
fused end portions having an axial finite length of an extent
sufficient to be grasped by a surgeon; the fused and intermediate
portions each including a plurality of suture material strands;
each strand extending integrally from the first fused end portion
through the intermediate portion and to the second fused end
portion; the strands in the fused portions being fused together;
and the strands in the intermediate portion being separate strands;
whereby the intermediate portion strands may be tied by a single
suturing or ligating maneuver to form a double suture or
ligation.
2. The suture defined in claim 1 in which the main suture section
includes marking means; and in which said marking means are located
at the junctions of the fused and intermediate portions.
3. The suture defined in claim 1 in which the main suture section
has swaged connection with the blunt end of the needle.
4. The suture defined in claim 1 in which the diameter of the fused
end portion of the main suture section connected to the needle is
approximately equal to the largest diameter of said needle.
5. The suture defined in claim 1 in which the main suture section
includes a plurality of intermediate portions, and in which a fused
portion is located between each pair of intermediate portions.
6. The suture defined in claim 5 in which needles have swaged
connection to each end of said main suture section.
7. The suture defined in claim 1 in which the suture material
strands in the intermediate portion are entwined.
8. A surgical ligation for use in ligating procedures including a
main ligation section having first and second fused end portions
and an intermediate portion extending between said fused portions;
the fused end portions having an axial finite length of an extent
sufficient to be grasped by a surgeon; the fused and intermediate
portions each including a plurality of ligation material strands;
each strand extending integrally from the first fused end portion
through the intermediate portion and to the second fused end
portion; the strands in the fused portion being fused together; and
the strands in the intermediate portion being separate strands and
entwined with respect to each other; whereby the intermediate
portion strands may be tied by a single ligating maneuver to form a
double ligation.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention relates to surgical sutures and in particular to an
improved surgical suture for saving the time of a surgeon in
performing suturing, ligating and closing procedures. Particularly,
a double suture or ligation is provided having added strength and
an increased safety factor which may be tied by a single suturing
or ligating maneuver.
2. Description of the Prior Art
Surgical operations usually require a considerable number of
suturing and ligating maneuvers to be performed by the surgeon for
closing incisions or for tying off blood vessels, ducts and the
like. It is most desirable to achieve as strong a suture or tie as
possible in a minimum of time and with a minimum amount of tissue
trauma.
Increased strength of sutures and ties are obtained by variously
treating the strands of suture material, or through the use of
multifilament or braided filament suture strands, or by using
various types of filament material, such as wire, silk, cotton,
Dacron, etc.
One known method used by surgeons to increase the strength and
safety factor of sutures and ties is to use a double suture or tie.
This is accomplished by suturing or tying the incision or vessel
with a separate second suture or ligation, The two separate sutures
or ties may be placed a short distance apart, or in adjacent
side-by-side fashion, or may be entwined.
The prior known use of double sutures and ligations, however, has
some disadvantages. Doubling the amount of sutures required to be
prepared for an operation is involved. The amount of the surgeon's
time to complete the suturing is doubled, since two separate
maneuvers are required for making each of the two ties for the
double suture.
Surgeons have attempted to avoid these problems, and yet achieve
the desired results of a double suture or tie, by threading two
separate sutures through an eyed needle. This arrangement also
presents problems.
The pulling of the two, doubled-over strands of suture material
through the opening in the tissue made by the needle causes
considerable tissue trauma due to the large diameter of the
combined four suture strands with respect to the smaller diameter
of the needle which forms the tissue opening. The four separate
suture strands become tangled, and it is difficult to rapidly tie
two sutures at the same time, especially if they are of unequal
length and the ends of the sutures are dangling separately and
loosely. Such situations test the patience of any experienced
surgeon.
The use of eyeless needles to form swaged sutures, in contrast to
the use of eye needles, has increased considerably in recent years.
A swaged suture is a type of suture in which the suture strand is
attached permanently to the blunt end of a needle.
The swaged suture has many advantages over eye needles. Swaged
sutures reduce tissue trama since the needle and the suture strand
are approximately equal in diameter. No threading of a needle
before or during an operation is required. No sterilization of the
needle and suture strand is required since the swaged sutures are
disposable and are supplied packaged sterile and ready for use. The
suture strand is securely attached to the needle and will not
unthread during use. No washing, sharpening or polishing of the
needle is required since a new sharp, sterile and disposable needle
is provided for each suture strand.
Thus, the need has existed for a surgical suture providing the
advantages of a swaged suture, and which enables a double suturing
or ligating procedure to be performed by a surgeon in a single
maneuver. One prior art construction is known in which the suture
has two separate suture strands swaged at one end directly to an
eyeless needle. The other free ends of these two suture strands are
connected and sealed together by a small lead weight or "shot".
Such a suture construction has some disadvantages. It does not
enable the double suture strands to be pulled completely through a
tissue puncture if the puncture is made at the wrong location. The
needle must be backed out which is difficult, or else the lead seal
must be cut off requiring a new suture to be used. This suture does
not enable double-armed sutures to be used, that is, one in which
needles are attached at both ends of the suture strand.
Double-armed sutures are desirable for performing many types of
suturing and ligating procedures, such as the suturing of vessels
where it is necessary to suture with both ends of the suture from
the inside to the outside of the vessel to prevent separation of
the vessel inner lining from the vessel wall.
SUMMARY OF THE INVENTION
Objectives of the invention include providing an improved surgical
suture for use by a surgeon in performing suturing and ligating
procedures to achieve the advantages of a double suture or tie in a
single suturing or tying maneuver; providing a surgical suture for
achieving double sutures or ties in which the suture strands are
swaged to an eyeless needle thereby gaining the advantages of a
swaged suture; providing a surgical suture for achieving double
sutures or ties in a single maneuver having needles attached at
both ends of the suture strand to form double armed sutures to
enable usual double-armed suture procedures to be performed, and to
enable two separate double sutures or ligations to be performed
with one double-armed suture; providing a surgical suture having
marking bands in the suture strand indicating to the surgeon the
location to cut the suture strand prior to the tying of the suture
or ligation; providing a surgical suture which achieves the extra
strength and added safety factor of double sutures and ligations,
which reduces the surgeon's time in making such double sutures and
ligations, and which enables each double suture and ligation to be
performed in a single suturing or ligating maneuver; providing a
surgical suture which may be prepackaged in sterile conditions for
immediate use at the site of the operation; and providing a
surgical suture which satisfies the stated objectives, which avoids
difficulties heretofore present in known sutures, and which is
convenient and effective to use, thereby satisfying existing needs
inincluding the art.
These objectives and advantages are obtained by the construction,
the general nature of which may be stated as inincluding in a
surgical suture for use in suturing and ligating procedures, a
needle having sharp and blunt ends; a main suture section connected
or swaged to the blunt end of the needle; the main suture section
including first and second fused end portions and an intermediate
portion extending between the fused portions; the fused and
intermediate portions each including a plurality of suture strands;
the strands in the fused portions being fused together; the
intermediate portion having two separate strands of suture material
whereby a double suture or ligation may be made with the separate
strands by a single suturing or ligating maneuver; and the main
suture section having marking means located at the junctions of the
fused portions and intermediate portion.
In the alternative, the main suture section may include a plurality
of intermediate portions, with intervening fused portions between
the intermediate portions; and a needle may be swaged to each end
of the main suture section.
BRIEF DESCRIPTION OF THE DRAWINGS
Preferred embodiments of the invention -- illustrate of the best
modes in which applicant has contemplated applying the principles
-- are set forth in the following description and shown in the
drawings are particularly and distinctly pointed out and set forth
in the appended claims.
FIG. 1 is a perspective view of the improved surgical suture swaged
to an eyeless needle;
FIG. 2 is a diagrammatic view showing the suture being used for
ligating a blood vessel;
FIG. 3 is a similar view showing the next stage in the ligation
procedure after the knot has been formed and the needle
removed;
FIG. 4 is a similar view showing the ligated vessel secured by
double strands of ligating material and a single knot;
FIG. 5 is a diagrammatic view showing an incision being closed by a
plurality of the improved surgical sutures;
FIG. 6 is a modified form of the improved surgical suture showing a
double armed suture having a middle fused portion and two
intermediate double strand portions; and
FIG. 7 is another modified form of the improved surgical suture
having fused portions between three intermediate double strand
portions.
Similar numerals refer to similar parts throughout the
drawings.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
First Embodiment
The improved surgical suture is shown generally in FIGS. 1 through
5 at 1, and comprises an eyeless needle 2, and a main suture
section 3. Suture section 3 has fused end portions 4 and 6, and an
intermediate portion 5 consisting of separate entwined strands 5a
and 5b extending between fused portions 4 and 6. The strands 5c and
5d in the fused portions 4 and 6 are parts of the strands 5a and
5b, respectively. Strand parts 5c and 5d may extend in parallel
fashion as shown, or may be entwined prior to and after fusing as a
single unitary fused portion 4 or 6.
Needle 2 is a usual eyeless needle in which suture section 3 is
inserted into an axial opening formed in the blunt end 7 of the
needle to form a single armed swaged suture. Examples of such
eyeless needles for swaged sutures are shown in U.S. Pat. No.
2,928,395. Such eyeless needles also are sold under the trademark
"Atraumatic" by David & Geck, a division of American Cyanamid
Company, and may have a cutting or non-cutting tip.
The suture material or filaments forming suture section 3 and the
strands 5a, 5b, 5c and 5d thereof, may be made of any one of usual
suture materials, such as silver, silk, cotton, polyethylene,
nylon, or many of the synthetic materials presently used for making
sutures. Likewise, the suture material may be a single filament or
thread (monofilament) or may be a braided filament or thread
(multifilament).
Strands 5a, 5b, 5c and 5d may be either multifilament or
monofilament members and separate strands 5a and 5b are fused
together to form fused portions 4 and 6 by various means, such as
bonding by adhesives as in U.S. Pat. No. 2,928,395, or by using a
silicone coating as a bonding or fusing material. Strands 5a and 5b
may be strands of nylon, polypropylene or other plastics, or may
have a plastic coating applied to the stands which then are fused
together into portions 4 and 6 by the use of ultrasonic welding
such as disclosed in U.S. Pat. No. 3,642,010.
The examples described comprise several of various ways by which
some of the numerous types of suture materials may be used for the
construction of the improved suture and in which suture material
strand portions are fused together to form fused portions 4 and
6.
A small marking band 8 is formed at the junctions of fused portions
4 and 6 with separate strands 5a and 5b of the intermediate double
suture portion 5. Bands 8 may be formed in suture 1 by
incorporating a dye into the suture material. Bands 8 preferably
have a color contrasting with the color of the suture, so as to be
seen readily by a surgeon or assistants during an operation, for a
purpose which is discussed below.
The length of the separate strands 5a and 5b of the intermediate
portion 5 may vary depending upon the particular suturing or tying
procedure to be performed with suture 1. The length of strands 5a
and 5b of portion 5 usually will be between 16 and 18 inches for
use in most suturing and tying procedures. Fused portions 4 and 6
have a shorter length than strands 5a and 5b but must have a length
sufficient to be grasped by the surgeon for tying the intermediate
portion 5 to form a suitable surgical knot.
An example of the use of improved suture 1 and the advantages
achieved thereby are shown diagrammatically in FIGS. 2, 3 and 4 for
tying off a blood vessel 9 before severing the vessel.
Needle 2 and main suture section 3 are looped about blood vessel 9,
as shown in FIG. 2. Needle 2 may be used to puncture and extend
through a section of the outer blood vessel lining if desired,
depending upon the particular ligating procedure used. A suitable
surgical suture knot 10 then is loosely formed in intermediate
portion 5 as shown in FIG. 3. Needle 2 preferably is cut from fused
portion 4 before forming knot 10, or immediately thereafter, by the
surgeon or assistant using a scalpel or scissors.
One of bands 8 indicate to the surgeon or assistant the approximate
location to cut main suture section 3 to remove needle 2 therefrom.
The cut is made through fused portion 4 between band 8 and needle
2, preferably adjacent the end 7 of needle 2, so that portion 4 has
sufficient length to be grasped by the surgeon.
The surgeon then grasps fused portions 4 and 6, one portion in each
hand or instrument, and pulls knot 10 tightly about blood vessel 9
as shown in FIG. 4. Additional locking knots may be tied on top of
knot 10 as necessary.
The completed tie on the severed vessel 9 (FIG. 4) has a double
tie, formed by separate suture strands 5a and 5b around vessel 9
and knot 10 was tied by a single tying maneuver. Thus, the
increased strength and added safety factor of a double suture tie
is achieved by a single tying maneuver in approximately one-half
the time that normally is required to tie two separate knots in two
separate suture strands.
A further advantage is present due to the entwined strands 5a and
5b. Should either strand 5a or 5b break, the entwining prevents or
lessens the possibility of the broken strand becoming loose about
blood vessel 9.
After knot 10 is secured, the excess suture material is cut easily
from the completed ligation to provide a compact, strong double
ligation.
Suture 1 provides the same advantages in making double sutures or
"stitches" for closing an incision that are present in the
described ligation procedure.
Referring to FIG. 5, several sutures 1 are illustrated in various
stages of closing an incision 11. Two completed double sutures 12
and 13 have closed a portion of incision 11 and a partially
completed suture 14 is shown closing a further portion of incision
11. Suture 1 is shown in the bottom portion of FIG. 5, as having
pierced the tissue 15 on both sides of incision 11 prior to pulling
the incision closed.
Single tissue punctures 16 are made on each side of the incision
through which main suture section 3 is passed. The size of puncture
16 is approximately equal to the maximum diameter of needle 2 since
the combined diameters of strands 5a and 5b, and the diameter of
fused portions 4 and 6 preferably are equal to or less than the
needle's largest diameter. This reduced diameter and reduced number
of tissue punctures reduces greatly the tissue trauma. Each
completed suture or stitch is a double suture comprising the two
strands of suture material 5a and 5b in the intermediate portion 5
and the stitch is formed by a single suturing maneuver while the
surgeon is required only to grasp a single strand at each end
(fused portions 4 and 6) to tie a single retaining knot.
Second Embodiment
A modified form of the improved surgical suture is indicated at 17
(FIG. 6). Suture 17 is a double armed suture having eyeless needles
18 and 19 swaged to the ends of a main suture section 20. Suture
section 20 has fused end portions 21 and 22, similar to end
portions 4 and 6 of suture 1, located adjacent needles 18 and 19,
respectively. An intervening fused portion 23 is located between
and connects together two intermediate portions 24 and 25, having
separate entwined strands 24a-24b and 25a-25b, respectively. The
other ends of intermediate portions 24 and 25 are connected to
fused portions 21 and 22, respectively.
Marking bands 26, similar to bands 8, are located at the junctions
of the fused portion 21, 22 and 23 with intermediate double strand
portions 24 and 25.
The uses and manner of use of suture 17 are similar to those of
suture 1, except that two double ligations or sutures can be
performed with a single suture 17. For example, needle 18 of suture
17 can be inserted through the tissue on both sides of an incision
until intermediate strand portion 24 is located through the
incision and punctured tissue, in a manner similar to the location
of intermediate portion 5 in FIG. 5. Fused portion 23 then is cut,
preferably at its center, whereby one-half of suture 17, identical
to suture 1, is in place for closing the incision, and the other
one-half of suture 17, also identical to suture 1, is available for
tying another double suture along the incision.
Third Embodiment
A further modified form of the improved surgical suture is
indicated at 27 and is shown in FIG. 7. Suture 27 is similar to
suture 17, having eyeless needles 28 and fused end portions 29,
adjacent needles 28, at both ends of a main suture section 30.
Suture section 30 includes a plurality of intermediate entwined
double strand portions 31, 32 and 33. Intervening fused portions 34
and 35 connect double strand portion 32 to double strand portions
31 and 33, respectively.
Marking bands 36 are located at the junctions of the fused portions
and the adjacent intermediate strand portions, similar to bands 8
and 26.
Suture 27 is used in the same manner as sutures 1 and 17 to provide
double sutures and ligations with a single suturing or ligating
maneuver. Three individual double sutures may be obtained from a
single suture 27 in the same manner as two double sutures are
obtained from suture 17.
Other suture constructions may be provided having four or more
intermediate separate double strand portions, each separated by a
fused portion. Such sutures, however, may become extremely long and
impractical in performing usual suturing or tying procedures.
Although improved suture 1 is shown and described as having an
eyeless needle attached to either one or both ends of main suture
section 3, the main section 3 may be produced without a needle 2
attached, for use in many ligating procedures.
As discussed above, a surgeon may or may not puncture the outer
blood vessel lining with needle 2 during a ligating procedure.
Therefore, a ligation construction, as shown in FIG. 3, may be
produced without a needle 2 attached, the needle being surplus in
many ligating procedures. Such a ligation having a main section 3,
with entwined strands 5a and 5b and fused end portions 4 and 5,
provides an inexpensive ligation, which enables a surgeon to form a
double ligation by a single tying maneuver in approximately
one-half the time required to form two separate ligations.
Accordingly, the improved surgical suture provides for forming
double sutures and ligations for closing incision, tying off blood
vessels, ducts and the like in a single suturing or ligating
maneuver; provides needles attached to both ends of the main suture
section for suturing and ligating procedures requiring a
double-armed suture; enables two separate sutures or ligations to
be tied with such a double-armed suture; enables double suture
strands to be used swaged to eyeless needles to reduce tissue
trauma and permit sutures to be sterilized and prepackaged for
immediate dispensing and use at the time of an operation; provides
a suture which is simple in construction and use; and provides for
the rapid discharge of suturing and ligating procedures which
heretofore have been time consuming because of the double maneuver
required for each double suture and ligation. Accordingly, the
improved surgical suture achieves the objectives indicated and
solves problems in the art.
In the foregoing description, certain terms have been used for
brevity, clearness and understanding; but no unnecessary
limitations are to be implied therefrom beyond the requirements of
the prior art, because such terms are used for descriptive purposes
herein and are intended to be broadly construed.
Moreover, the description and illustration of the invention is by
way of example, and the scope of the invention is not limited to
the exact details shown or described since the features of the
invention may be applied to other constructions characterized by
the new concept.
Having now described the features, discoveries and principles of
the invention, the manner in which the improved surgical suture is
made, the characteristics of the new construction, the new uses
achieved, and the advantageous results obtained; the new and useful
structures, devices, elements, arrangements, parts and combinations
are set forth in the appended claims.
* * * * *