U.S. patent number 3,771,526 [Application Number 05/223,955] was granted by the patent office on 1973-11-13 for anastomosis clamp.
Invention is credited to Peter S. Rudie.
United States Patent |
3,771,526 |
Rudie |
November 13, 1973 |
ANASTOMOSIS CLAMP
Abstract
An anastomosis clamp including a first clamping collar, a second
clamping collar, a support rod connected to the first collar with
said second collar having a support member slidable on said support
rod, each of the opposed edges of said collars being formed with
undulations which mate, and means for urging said clamping collars
together.
Inventors: |
Rudie; Peter S. (Duluth,
MN) |
Family
ID: |
22838688 |
Appl.
No.: |
05/223,955 |
Filed: |
February 7, 1972 |
Current U.S.
Class: |
606/153 |
Current CPC
Class: |
A61B
17/1114 (20130101) |
Current International
Class: |
A61B
17/11 (20060101); A61B 17/03 (20060101); A61b
017/11 () |
Field of
Search: |
;128/33R,334R,334C,346 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. An anastomosis clamp comprising:
a. a first open ended clamping collar having a substantially
constant diameter and a relatively thin wall,
b. a second open ended clamping collar having a substantially
constant diameter and a relatively thin wall,
c. a relatively narrow cross bar formed on each of said collars
adjacent one end thereof extending across the open area defined by
the collar on a diameter thereof, said collars having opposite
clamping edges on the collar ends opposite said cross bars,
d. means carried axially of said collars by said cross bars for
guiding and holding said clamping collars together in clamping
engagement, and
e. means for urging the opposed clamping edges of said clamping
collars together in clamping engagement wherein the open spaces in
collars permit flow axially through the clamping collars.
2. The device of claim 1 in which said means carried axially of
said collars by said cross bars for guiding and holding said
clamping collars includes
a. a support rod connected to said first clamping collar and
extending axially therefrom, and
b. said second clamping collar having a support member slidable on
said support rod.
3. The device of claim 2 in which said means for urging said
clamping collars together includes elastic means connected to said
first and second clamping collars.
4. The device of claim 2 in which said means for urging said
clamping collars together includes
a said support member of said first clamping collar being threaded
with draw-up means thereon adapted to act against said second
clamping collar to urge said collars together.
5. The device of claim 2 in which said support member of said
second clamping collar is flexible to allow movement of the patient
using the clamp.
6. The device of claim 4 in which said draw-up means includes a
tube slidably mounted on said threaded support member of said first
clamping collar which is drawn up against said second clamping
collar by means of a nut member.
7. The device of claim 2 further including means for maintaining
said collars in spaced apart relationship against said urging means
for allowing securement thereto of parts for clamping.
8. The device of claim 7 in which said means for maintaining said
collars in spaced apart relationship includes an opening formed in
said support member of said first clamping collar whereby said
support members may be clamped together.
Description
SUMMARY OF THE INVENTION
The invention relates generally to surgical clamps and more
particularly to an improved rectocolic anastomosis clamp. With the
removal of a portion of the bowel the ends must be joined, and it
is highly desirable to carry out bowel anastomosis by clamping
together inturned ends until agglutination occurs at the periphery
of the clamped junction. In known methods of clamping the healed
bowel ends usually form a joint that has a diameter less than that
of the original thereby resulting in a restriction in the bowel.
The amount or area of bowel ends clamped together must be as great
as possible to prevent the formation of a restriction. It is also
desirable that with the clamp in place within the bowel there may
be a ready escape of mucoid contents of the bowel.
The present invention provides a rectocolic anastomosis clamp
whereby a maximum of peripheral bowel ends are clamped whereby the
inside diameter of the healed bowel is not restricted to a
dimension less than that of the original and which allows escape of
contents of the bowel through the clamp with the clamp in clamping
position. The clamp in one form is adapted to be assembled within
the bowel with the parts being extended through the anus. The
structure is such that the positioning of the severed ends of the
bowel on the clamping faces or edges is readily and positively
accomplished. With the device the clamping pressure is established
and adjusted by manipulation of the clamp extending outwardly of
the anus in one form of the invention used to clamp the end of the
upper bowel and the rectum. A further embodiment of the clamp is
used to clamp a portion of the large or small bowel, respectively,
or to clamp a portion of the small bowel to the stomach as in a
gastroenterostomy and in this latter embodiment there is no
extension of the clamp outwardly of the anus. In either embodiment
the clamp is sluffed off in three or four days outwardly through
the anus.
In the drawings forming part of this application:
FIG. 1 is an elevational view of an anastomosis clamp embodying the
invention in position in the upper bowel and rectum prior to
clamping.
FIG. 2 is a longitudinal sectional view of the clamp in clamping
position.
FIG. 3 is an upper end view thereof.
FIG. 4 is a sectional view on the line 4--4 of FIG. 2.
FIG. 5 is a view similar to that of FIG. 2 but with the clamping
portions separated and portions broken away.
FIG. 6 is a sectional view through the clamping portions in
clamping position on the lower end of the upper bowel and the upper
end of the rectum.
FIG. 7 is an elevational view of a further embodiment of the
invention.
FIG. 8 is a view similar to that of FIG. 6 but rotated 90.degree.
.
FIG. 9 is an end view of the embodiment of FIGS. 7 and 8.
FIG. 10 is an end view opposite to that of FIG. 9.
FIG. 11 is an elevational view similar to that of FIG. 7 but with
the clamp in open position.
FIG. 12 is a sectional view of the embodiment of FIGS. 7-11 through
the clamp on the bowel ends.
Referring to the drawings in detail, the anastomosis clamp A
includes the clamping head 10. The head 10 includes the upper
clamping collar 12 to which is connected the cross bar member 14
and which lies in a plane of a diameter of the collar. The lower
peripheral edge of the upper clamping collar 12 is formed with the
undulations 16.
A rod-like support 18 extends from the inner surface of the cross
bar 14 axially of the upper clamping collar 12 and terminates in
the flexible threaded rod portion 20. Further provided is the
hollow cylindrical portion 22 connected at its lower end to the
inner surface of the cross bar 24 connected to the lower clamping
collar 26 which lies in a plane of a diameter of the collar 26 and
axially of the collar. The inside diameter of the hollow
cylindrical portion 22 is sufficient for slidable motion on the
rod-like support 18.
The numeral 28 designates a flexible tube through which the
flexible threaded rod 20 extends and threadedly mounted on the
lower end of the rod 20 is the nut 30. With the tube and rod
flexible the same can adapt to extended condition from the anus as
a result of movement of the patient. The upper peripheral edge of
the lower collar 26 is formed with undulations 32 which mate with
the undulations 16 of the upper clamping collar 12 in clamping
relation as particularly shown in FIGS. 2 and 6.
The upper and lower clamping collars 12 and 26 are brought into
clamping relation by screwing up on the nut 30 which forces the
upper end of the tube 28 against the cross bar 24 of the lower
clamping collar.
To join the lower end of the upper bowel B with the upper end of
the rectum R after cancerous portions of the bowel have been
removed, the lower open end of the upper bowel B is sewn loosely
with the thread 33. Next the clamp collar 12 is inserted into the
lower end with the end extending into and upon the undulations 16
due to the restrictiveness of the end of the bowel due to the
aforesaid sewing, particularly as in FIGS. 1, 2, and 6. Then the
upper end of the rectum R is sewn loosely by means of thread 35 and
the lower clamping collar 26 forced upwardly into the rectum to the
loosely sewn end thereof with the end extending into and upon the
undulations 32. The clamping collars 12 and 26 are then brought
together upon the lower end of the upper bowel B and the upper end
of the rectum R in clamped together relation, particularly FIGS. 2
and 6. The threads 33 and 35 are then removed. After the passing of
about three days time, the clamped bowel end and rectum end
agglutinate or grow together, and the entire clamp A is removed
through the anus as a result of a sluffing off action of the flesh
of the parts. The voids V between the collar portions and the cross
bars 12 and 24 allow bowel movement therethrough from the upper
bowel B to and through the rectum when the device A is in
place.
The complementary undulations 16 and 32 increase the extent of the
clamping edge surface of the collars 12 and 26 as compared to
purely cylindrical end surfaces of collars. With this additional
clamping edge surface the inside diameter of the bowel and rectum
at the point of joining is as large as originally and not
restricted as a result of the joining.
A further embodiment of the invention is found in FIGS. 7-12
wherein the clamp B includes the clamping head 36. The head 36
includes the first clamping collar 38 to which is connected the
first side arm 40 which terminates in the end bar 42. The end bar
42 terminates in the second side arm 44 which is connected to the
collar 38. The lower peripheral edge of the collar 38 is formed
with the undulations 46.
The numeral 48 designates a hollow support rod anchored at its
outer end to the end bar 42 and extending axially through and
outwardly of the collar 38. The wall of the rod 48 is formed with
the opening 50. Further provided is the second clamping collar 52
to which is connected the first side arm 54 which terminates in the
end bar 56. The end bar 56 terminates in the second side arm 58
which is connected to the collar 52. The peripheral edge of the
collar 52 is formed with the undulations 60 complementary to the
undulations 46 for clamping engagement therewith.
Also provided is the rod 62 anchored at its outer end to the end
bar 56 with the inner end of the rod slidably positioned within the
hollow support rod 48. The collars 38 and 52 are urged together in
clamping engagement by means of the elastic member 64 positioned
upon the end bars 42 and 56 and around the outer end of the hollow
rod 48 and the outer end of the rod 62 while extending
substantially axially through the collars 38 and 52 and parallel to
the members 48 and 62.
To join one end of a large bowel illustrated as L to the end to be
joined illustrated as La after an intermediate portion of the bowel
has been removed, the lower open end of the bowel portion L is sewn
loosely. A surgical clamp C is clamped upon the rod 62 at the
opening 50 of the hollow support rod thereby holding the collars
separated as in FIG. 11. In this condition the collars are held
apart. Then the collar 38 is inserted into the lower end of the
bowel L with the end extending into and upon the undulations 46 due
to the restrictiveness of the end of the bowel due to the aforesaid
sewing, particularly as in FIG. 12. Then the upper end of the bowel
portion La is sewn loosely and forced upon the collar with the end
extending into and upon the undulations 60. The clamp C is then
released and as a result the collars are urged together by the
elastic member 64 and upon the ends of the bowel portions.
After the passing of about three to four days time, the bowel ends
agglutinate or grow together and the entire clamp B sluffs off and
automatically passes out the anus. The voids V between the collar
portions and the bars 42 and 56 allow bowel movement therethrough
when the clamp B is in operative clamping position. As in the case
of the embodiment of clamp A the complementary undulations 46 and
60 increase the extent or length of the clamping edge surface of
the collars 38 and 52 as compared to purely cylindrical ends. With
this additional clamping edge surface, the inside diameter of the
bowel at the point of joining is substantially as large as
originally and not restricted as a result of the joining which
restrictiveness occurs where the edges of the collars are purely
cylindrical.
* * * * *