Vascular Clamp And Forceps System

Abstract

A vascular clamp and forceps systems. The clamp has a pair of clamping blades which are spring-loaded closed, and the forceps has a pair of jaws which are also spring-loaded closed. Forceps-engaging means is connected to the blades, and clamp-engaging means is carried by the jaws. When the jaws are forced apart and then relaxed onto the clamp, the clamping blades are spread apart to receive the tissue to be clamped upon, and when the handles of the forceps are pressed together against their spring-load, the forceps is released from the clamp, and the clamp is left installed in place. The said means may be provided with multi-position arrangements whereby there is made possible a plurality of stable angular relationships between the clamp and the forceps.

Description

This invention relates to vascular clamps, to forceps for installing the same, and to the system comprising the clamp and the forceps. The words "forceps" and "applicator" are used interchangeably and have the same meaning herein.

In microvascular surgery, where small veins and aneurisms need to be clamped off, it is troublesome for the surgeon to have to maintain engagement between his forceps and the clamp by exerting a constant force on the forceps in order to hang on to the clamp. It is an object of this invention to provide a system wherein a relaxed forceps will cause the clamp to be held and held open and wherein a positive force on the forceps is required for the clamp to close and remain closed on the object, and for the forceps to be removed from the clamp. The clamp is thereby positively held by the forceps without the surgeon's efforts.

It is another drawback of prior art clamps that, in order to have a spring-actuated closure, there have customarily been provided two projecting levers for engagement by a forceps or applicator which levers intrude upon surrounding tissue. It is an object of this invention to provide a clamp wherein a pair of blades is actuated closed by a pair of arms which are biased open, all of the arm and spring-loading mechanism being enclosed in a shrouding construction of minimum bulk and without projections.

Still another disadvantage of the prior art is that it was necessary for the surgeon, in order to maintain the clamp in an opened position as needed for its application, to exert a continuing and controlled force on the forceps or applicator. The clamp is released by release of force on the forceps. This is tiring to the surgeon and requires his attention to the detail of holding the clamp open at a time when all of his energies and attention should be directed toward the problem of where and how to apply the clamp. In operations which take hours to perform, minimizing these strains and demands is an important objective. It is, therefore, an object of this invention to simplify the installation of a clamp by providing a system of clamp and forceps wherein the clamp is held open by a relaxed pair of forceps (as held by the surgeon) and is released to its closed position by force applied to the forceps.

A forceps-clamp system according to this invention comprises in combination a vascular clamp with a pair of clamping blades spring-loaded closed, a forceps having a pair of jaws also spring-loaded closed, forceps-engaging means connected to the clamping blades, and clamp-engaging means on the jaws for engagement to the forceps-engaging means. Forcing the jaws apart will enable the two means to be engaged, and releasing the jaws will enable the forceps to move the blades apart. Spreading the jaws enables the blades to move toward one another and to exert their clamping action.

According to still another preferred but optional feature of the invention, the clamping blades are joined to each other by a pair of arms which are connected thereto by joggles, whereby the blades move toward each other when the arms move apart, and the construction can be such as to shroud the region between the arms.

According to still another preferred but optional feature of the invention, springing means is connected to handles attached to the jaws of the forceps for spring-loading the jaws toward one another, said springing means comprising flexible extensions of the handles.

The above and other features of this invention will be fully understood from the following detailed description and the accompanying drawings in which:

FIG. 1 is a plan view of the system according to the invention with the forceps in its most relaxed position, and the clamp held open by the forceps;

FIG. 2 is a figure identical to FIG. 1, except that the forceps are stressed, and the clamp is closed;

FIG. 3 is a fragmentary enlarged side elevation of clamp-engaging means carried by one of the jaws;

FIG. 4 is a right-hand view of FIG. 3;

FIG. 5 is a plan view of a vascular clamp according to the invention;

FIG. 6 is a right-hand view of FIG. 5;

FIGS. 7 and 8 are fragmentary elevations showing the clamp and a portion of the forceps in two different angular positions relative to one another; and

FIG. 9 is a fragmentary view taken at line 9--9 of FIG. 5 showing a portion of the presently preferred embodiment of clamping blade.

In FIG. 1 there is shown the presently preferred embodiment of a forceps 10 according to the invention. The forceps includes jaws 11 and 12 joined by a pivot 13. The jaws are pivoted so their ends are movable toward and away from each other. At their respective tips, each jaw includes a clamp-engaging means 14. This means is shown in detail in FIGS. 3 and 4, and like means is provided on both of jaws 11 and 12. This means preferably is a projection, and its preferred embodiment is a square-based pyramid.

The square base 15 of the pyramidal projection is shown in FIG. 4, and its apex 16 is shown in FIGS. 3 and 4. The projection, therefore, has a plurality of discontinuities, these discontinuities being the edges 17 of the pyramids extending from base to apex. If desired, the point at the apex may be somewhat dulled or ground off, with only the frustum of a pyramid remaining. The frustum of a pyramid is within the scope of the term "pyramid".

On the opposite side of pivot 13 from the jaws, and rigidly attached to respective ones of the jaws is a pair of handles 18, 19. These handles are flat and rigid, and lie parallel to each other. Each has a twist 20, 21 which enables an extension 22, 23 to be formed integral with each handle which has a substantial flat area for the surgeon to grasp. Second twists 24, 25 provide transition regions connecting the extensions to respective bearings 26, 27. The bearings are pivotally joined by pin 28.

Extensions 22 and 23 and the bearings comprise "springing means". They are attached to the handles, and bias the handles apart from one another.

As can be seen in FIG. 1, each jaw is respective to and continuous with a handle and with an extension (springing means). The extension is pre-formed so that, when the jaws abut each other, or make their closest allowable approach to one another, there still remains resiliency in the extension which will spring-load or bias the jaws toward one another. It is evident that there are alternative means of so doing. For example, a blade or coil spring might be placed in opposition between the two handles, or the handles need not be tied together by pin 28, but might be in simple abutment with one another, provided other limiting means were supplied to hold the handles within proper relative range of angular motion relative to each other. However, the arrangement shown is classically simple and produces a surgical instrument which is easy to clean and to sterilize.

It will be evident from an inspection of the foregoing that the springing means spring-loads the jaws toward their closed position. The presently preferred embodiment of a vascular clamp 30, according to this invention, is shown in FIGS. 5 and 6 and takes advantage of this forceps arrangement. The clamp includes a pair of arms 31, 32 that are pivotally joined together by pivot 33. A coil spring 34, sometimes referred to as "spring means", is wrapped around pivot 33 and has tangs or tails 35, 36 which bear against arms 31 and 32 and biases them apart. The arms are identical to one another so that only arm 31 will be described in full detail.

Arm 31 includes a flange 37 and a joggle 38. Flange 37 is pivoted to the pin through joggle 38, and this joggle extends through a transition 39 to a clamping blade 40. There is also a clamping blade 41 carried by arm 32. It will thereby be seen that, by means of the joggles, the clamping blades are "crossed-over" relative to the pivot from their respective arms so that, when the arms are spread apart, the clamping blades move toward one another. Therefore, the spring means biases the clamping blades toward one another, and the arms apart from one another. The arms are separate from one another, and are joined only by the pivot. Except for structure sufficient to support the pivot, the arms lie on only one side of the pivot. The spring means lies substantially entirely between the arms. It extends on the other side of the pivot only to the extent it is wrapped around the pivot.

Each flange carries forceps-engaging means 45, 46, only means 45 being shown in detail in FIG. 6. Means 46 is identical to it. This means preferably includes an opening 47 defined by a wall 48. The wall has a plurality of discontinuities 49, in this case, 90.degree. declivities or indentations in the wall. There is a plurality of these discontinuities, at least equal in number to the number of discontinuities on the clamp-engaging means and preferably a multiple thereof, the multiple preferably being greater than one, for example two. For example, with this arrangement, as best shown in FIGS. 7 and 8, the square-based pyramid of FIGS. 3 and 4 can be inserted in the opening 47 in a number of positions enabling the clamp to be held every 45.degree. when the opening has eight discontinuities.

In FIG. 7, the clamp is held in direct alignment with the jaws. In FIG. 8, the discontinuities engage in different combinations at 45.degree. to those engaged in FIG. 7, and the clamp is held at 45.degree. to the axis of the forceps. It is equally possible for the clamp to be held at right angles to the jaws and even in backwardly directed orientations. Furthermore, different angular relationships may be provided by increasing or decreasing the number of discontinuities or of changing their relative relationships.

FIG. 9 shows the presently preferred embodiment of clamping blade 40. Both blades may be alike, and usually will be, although this is not necessary. It is a disadvantage of prior art clamping blades that they tend to slip off of slippery tissue, such as aneurisms, and it is necessary to provide means to prevent this. It has been common practice to provide declivities in the springing blades; for example, by means shown in Cogley U.S. Pat. No. 3,598,125 issued Aug. 10, 1971, for "Aneurism Clamp".

A problem encountered by some of these prior art clamps is that it is possible for the declivities themselves to abrade or cut the tissue if they are close to the edge of the blades. Accordingly, blade 40 has a substantial axial dimension of length extending in the direction of axis 50 of the blade, and a substantial dimension of width laterally relative to axis 50. It has a plurality of declivities 51 in its central section extending along the axial dimension. On both sides of this central area where the declivities are located is a pair of axially extending areas 52, 53 which are smooth, and may be polished or only slightly roughened. If desired, an area 54 may be provided at the end with the same smoothness. It will then be found that the central region can exert a powerful holding force while the clamp will not abrade or harm the tissue at its edges.

Also, as shown in the prior art, the clamping blades may be provided in such shape that their tips close before their sides in order to provide optimum clamping force on a vein.

From the foregoing, it will be noted that this invention provides a forceps-clamp system wherein the forceps in its relaxed condition holds the clamp open, and the surgeon need pay no attention to maintaining the clamp open as he seeks to place it. When the clamp is properly located, he need only squeeze the handles together in order to release the clamps at the desired location. When the clamp is closed, all interior construction is shrouded by the joggles and the flanges so that there is least disturbance to the surrounding tissue. Furthermore, the task of placing the clamp is greatly assisted by the capacity shown in FIGS. 7 and 8 to vary the angular orientation of the clamp relative to the forceps, providing a plurality of stable angular orientations.

This invention comprises not only the system, but also the unique clamp per se, and also the unique forceps per se.

It will further be noted that the declivities and smooth edges of FIG. 9 need not be used, and that also, if desired, the clamp-engaging means and forceps-engaging means might be reversed in shape, the projection being provided on the clamp and the recess or hole in the forceps. However, this will usually be less desirable because the clamps are usually left in situ after the operation and projections may be in the way.

This invention is not to be limited by the embodiments shown in the drawings and described in the description, which are given by way of example and not of limitation, but only in accordance with the scope of the appended claims.

Claims

I claim:

1. In combination: a vascular clamp comprising a pair of arms, a pivot joining said arms together for pivotal movement toward and away from one another, spring means in opposition to both of said arms biasing them apart, a clamping blade carried by each arm on the same side of the pivot as its respective arm, said clamping blades being so disposed and arranged relative to their respective arms and to each other that they tend to approach each other as the arms are spread apart, and to move apart from one another when the arms are moved toward one another, each clamping blade having a bearing surface, said bearing surfaces facing one another whereby to bear upon tissue held between the blades and to clamp onto said tissue as a consequence of the bias of the spring means when the arms are released, and forceps-engaging means on each of said arms to engage the jaws of a forceps whereby the arms may be pressed together by said forceps; and forceps for engaging said clamp and spreading the clamping blades apart by pressing said arms together, comprising a pair of jaws, a pivot joining said jaws together for a pivotal movement toward and away from one another, a handle attached to each jaw and extending on the opposite side of the pivot from its respective jaw, said jaws being so disposed and arranged relative to their respective handles and to each other that they tend to approach each other as the handles are spread apart, and to move apart from one another when the handles are moved toward each other, clamp-engaging means on each jaw removably engaged to the forceps-engaging means on the clamp, and springing means engaged to the handles biasing said handles apart, whereby with the clamp-engaging means engaged to the forceps-engaging means, the handles released, the springing means of the forceps will cause the jaws to move toward each other, compressing the spring means of the clamp, moving the arms together and the clamping blades apart, and whereby forcing the handles toward one another so as to compress the springing means, spreads the jaws apart, and enables the spring means to move the arms apart and the clamping blades toward one another.

2. A combination according to claim 1 in which each bearing surface has a substantial dimension of axial length extending in a direction away from the pivot, and of width extending laterally relative to the dimension of length, there being a substantially smooth area extending axially adjacent to both axially extending edges of the bearing surfaces, and between said smooth areas a plurality of declivities to receive and retain tissue when the bearing surfaces bear against said tissue.

3. A combination according to claim 1 in which one of said means is an opening, and the other is a projection to enter and engage in the opening.

4. A combination according to claim 3 in which the wall of the opening and the outer surface of the projection each has a plurality of discontinuities, whereby the said means can stably engage each other at a plurality of angular alignments.

5. A combination according to claim 4 in which the number of discontinuities in the wall of the opening is greater than the number carried by the projection.

6. A combination according to claim 4 in which the projection is a four-sided, square-based pyramid, and in which the number of discontinuities in the wall of the opening is a multiple of four greater than one.

7. A combination according to claim 3 in which each bearing surface has a substantial dimension of axial length extending in a direction away from the pivot, and of width extending laterally relative to the dimension of length, there being a substantially smooth area extending axially adjacent to both axially extending edges of the bearing surfaces, and between said smooth areas a plurality of declivities to receive and retain tissue when the bearing surfaces bear against said tissue.

8. A combination according to claim 6 in which each bearing surface has a substantial dimension of axial length extending in a direction away from the pivot, and of width extending laterally relative to the dimension of length, there being a substantially smooth area extending axially adjacent to both axially extending edges of the bearing surfaces, and between said smooth areas a plurality of declivities to receive and retain tissue when the bearing surfaces bear against said tissue.

9. A vascular clamp comprising a pair of arms, a pivot joining said arms together for pivotal movement toward and away from one another, spring means in opposition to both of said arms biasing them apart, a clamping blade carried by each arm on the same side of the pivot as the arm, said clamping blades being so disposed and arranged relative to their respective arms and to each other that they tend to approach each other as the arms are spread apart, and to move apart from one another when the arms are moved toward one another, each clamping blade having a bearing surface, said bearing surfaces facing one another whereby to bear upon tissue held between the blades and to clamp onto said tissue as a consequence of the bias of the spring means when the arms are released; a joggle connecting each arm to its respective blade, whereby the blades are crossed over one another with respect to said arms.

10. A vascular clamp according to claim 9 in which each blade has a bearing surface, each bearing surface having a dimension of length extending away from the pivot, and a dimension of width transverse thereto, there being a central area with a plurality of declivities, and an axially extending smooth area on both sides thereof.

11. A vascular clamp according to claim 9 in which forceps-engaging means is provided on each of said arms for compressive engagement by the jaws of a forceps.

12. A vascular clamp according to claim 10 in which forceps-engaging means is provided on each of said arms for compressive engagement by the jaws of a forceps.