U.S. patent number 3,899,914 [Application Number 05/432,052] was granted by the patent office on 1975-08-19 for apparatus for closing a cut end of a blood vessel.
Invention is credited to Taichiro Akiyama.
United States Patent |
3,899,914 |
Akiyama |
August 19, 1975 |
Apparatus for closing a cut end of a blood vessel
Abstract
A method for closing a cut end of a blood vessel comprises the
steps of nipping the cut end of the blood vessel between a pair of
closing members formed of plastic material, and of fastening the
pair of closing members to each other. An apparatus for carrying
out the above method comprises a pair of actuating members for the
pair of closing members to press the pair of closing members to
each other when the cut end of the blood vessel is inserted between
the pair of closing members, and concurrently to fasten the pair of
closing members to each other.
Inventors: |
Akiyama; Taichiro (Shinjuku-ku,
Tokyo, JA) |
Family
ID: |
27278216 |
Appl.
No.: |
05/432,052 |
Filed: |
January 9, 1974 |
Foreign Application Priority Data
|
|
|
|
|
Jan 20, 1973 [JA] |
|
|
48-8875 |
Jan 20, 1973 [JA] |
|
|
48-8876 |
Jan 20, 1973 [JA] |
|
|
48-8878 |
|
Current U.S.
Class: |
606/158;
29/243.56 |
Current CPC
Class: |
A61B
17/128 (20130101); A61B 17/0682 (20130101); A61B
17/32 (20130101); Y10T 29/53783 (20150115) |
Current International
Class: |
A61B
17/12 (20060101); A61B 17/128 (20060101); A61B
17/068 (20060101); A61B 17/32 (20060101); B21d
009/08 () |
Field of
Search: |
;128/325,326,327,346
;72/409,410 ;227/19,20,21,80 ;29/243.56 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Attorney, Agent or Firm: McDougall, Hersh & Scott
Claims
What is claimed is:
1. An apparatus for closing a cut end of a blood vessel with a pair
of closing members, comprising means for supporting and guiding a
pair of strips with each strip being formed of a series of closing
members, a pair of actuating members to press successive pairs of
closing members against one another with the cut end of a blood
vessel therebetween, said actuating members operating to
concurrently fasten said pair of closing members together, feeding
means for feeding intermittently said strips to provide successive
pairs of closing members at said actuating members, and cutting
means for automatically cutting one pair of closing members from
said pair of strips during each pressing and fastening
operation.
2. An apparatus according to claim 1 including means interlocking
the action of said pair of actuating members with said feeding
means, and an actuator for said interlocking means, operation of
said actuator achieving said pressing, fastening and cutting
operations and then automatically feeding a succeeding pair of
closure members to said actuating members.
3. An apparatus according to claim 2, wherein said actuator is a
trigger.
4. An apparatus according to claim 2, wherein said pair of
actuating members are about L-shaped in section and have openings
to pass said strips therethrough, nipping surfaces for nipping said
pair of closing members and means on one of said nipping surfaces
to fasten said pair of closing members together.
5. An apparatus according to claim 4, wherein said pair of
actuating members are rotatably supported by supporting axles at
the top end of a body containing said feeding means and said
actuating means and are urged by springs.
6. An apparatus according to claim 5, wherein said body consists of
an inner case and an outer case between which a pair of paths are
formed for feeding said pair of strips.
7. An apparatus according to claim 6 wherein said actuator
comprises an actuating shaft slidably supported in a hole extending
through said inner case, an actuator element connected to the
leading end of said actuating shaft and contacting with contact
portions formed integrally with said actuating members, a cylinder
slidably supporting the trailing end of said actuating shaft, a
disc connected to the trailing end of said actuating shaft, a disc
connected to the trailing end of said actuating shaft, a trailing
flange fixed at the trailing end of said cylinder, a spring
supported between said trailing flange and said disc, and a larger
spring surrounding said first mentioned spring and supported
between said trailing flange and the trailing end wall of said
body.
8. An apparatus according to claim 7, wherein said feeding means
comprises a pair of pins at the leading ends of a pair of elastic
rods connected to a flange fixed to the leading end of said
cylinder, said pins engaging with holes in the centres of the
closing members forming the closing member strips.
9. An apparatus according to claim 8, wherein said pair of pins are
guided by a pair of guide grooves formed on said outer case.
10. An apparatus according to claim 9, wherein said guide groove
consists of a forwardly extending straight path having an upper
face, and a curved backward path having a lower face.
11. An apparatus according to claim 10, wherein said straight path
has further a slant face for moving said pins from said lower face
to said upper face.
12. An apparatus according to claim 7 wherein an axle is fixed at
the side wall of said cylinder, said axle being engaged with an
oblong hole in an arm of said actuator pivoted at a supporting axle
fixed to said outer case.
13. Apparatus according to claim 1 in combination with a pair of
closing members formed of plastic material and adapted to nip said
cut end of a blood vessel between them and to be fastened to each
other.
14. Apparatus according to claim 1 in combination with a pair of
closing members wherein one of said closing members is rectangular
with a pair of cut-out portions on one pair of opposing edges, and
the other of said closing members has a similar rectangular base
with a pair of projections on opposing edges corresponding with
said opposing edges of said one closing member for engagement of
said projections with said cut-out portions.
15. Apparatus according to claim 1 in combination with closing
members made of a plastic material selected from the group
consisting of a titanium alloy, a tantalum alloy, an 18.6 chromium
alloy, and a polycarbonate.
16. Apparatus according to claim 1 wherein a plurality of holes are
formed in the strips corresponding with the centers of the closing
members.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention:
This invention relates to a novel method and apparatus for closing
a cut end or opening of a blood vessel, and more particularly to a
method and apparatus for closing a cut end of a blood vessel in use
of a pair of closing members.
2. Description of the Prior Art:
The conventional method for closing an opening of a blood vessel
remains as it was, in which a cut end of the blood vessel is
ligatured by a thread. It has often been said that a surgical
operation is a struggle against bleeding. Quickness and certainty
are required for ligaturing the cut end of the blood vessel. If the
surgeon is not skilled, it is difficult for him quickly and
certainly to ligature the cut end of the blood vessel by the
thread. Moreover, in the conventional method, two operators are
required for respectively nipping the cut end of the blood vessel
to stop bleeding, and ligaturing it with the thread. When the cut
end of the blood vessel is beyond the reach of the operator's hand,
it is impossible to ligature the cut end of the blood vessel.
Consequently, the conventional ligaturing is very troublesome and
difficult.
SUMMARY OF THE INVENTION
In practising the present invention a cut end of a blood vessel is
closed by nipping the cut end of the blood vessel between a pair of
closing members formed for example of plastic material, and
fastening said pair of closing members to each other.
An apparatus for carrying out the above method comprises a pair of
actuating members adapted to engage said pair of closing members to
press said pair of closing members against one another with the cut
end of the blood vessel between them, and concurrently to fasten
said pair of closing members together.
An object of the present invention is to provide a novel method for
closing a cut end of a blood vessel.
A further object of the present invention is to provide a pair of
closing members suitable for the method.
A still further object of the present invention is to provide a
pair of band plates comprising the respective groups of the closing
members which are intermittently advanced to the position of the
cut end of the blood vessel to be closed.
A still further object of the present invention is to provide a
novel apparatus for closing the cut end of the blood vessel.
A still further object of the present invention is to provide an
apparatus for closing the cut end of the blood vessel by which the
pair of the band plates are intermittently advanced to the position
of the cut end of the blood vessel.
A still further object of the present invention is to provide an
apparatus for closing the cut end of the blood vessel by which the
cut end of the blood vessel can be closed with the pair of the
closing members cut out from the pair of the band plates,
synchronously with the advance of the pair of the band plates.
A still further object of the present invention is to provide an
apparatus for closing the cut end of the blood vessel which can
simply be operated.
A still further object of the present invention is to provide an
apparatus for closing the cut end of the blood vessel which is
simple in construction.
The features and advantages of the present invention will be more
readily understood upon consideration of the following detailed
description of the preferred embodiments of the invention, taken in
conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1A is an enlarged partial cutaway view in perspective, of a
pair of strips or band plates comprising the respective groups of
closing members according to the invention;
FIG. 1B is an enlarged perspective view of a pair of the closing
members cut out from the band plates shown in FIG. 1A;
FIG. 1C is an enlarged perspective view of a cut end of a blood
vessel closed by a pair of closing members;
FIG. 1D is a cross-sectional view taken along the lines I--I of
FIG. 1C;
FIG. 2 is an elevational partial cutaway view of an apparatus
according to the invention for closing the cut end of a blood
vessel;
FIG. 3 is an enlarged cross-sectional view taken along the lines
III--III;
FIG. 4 is an enlarged fragmentary cross-sectional view, partly
cutaway, of the apparatus according to the invention;
FIG. 5 is an enlarged perspective view of a device forming part of
the apparatus according to the invention for closing the cut end of
the blood vessel;
FIG. 6A and FIG. 6B are enlarged front views of a pair of actuating
members constituting the device shown in FIG. 5;
FIG. 6C is a cross-sectional view taken along the lines VI--VI of
FIG. 6A;
FIG. 7 is an enlarged cross-sectional view of the actuating means
of the apparatus according to the invention;
FIG. 8 is an enlarged top plan view of a guide groove for a feeding
means according to the invention;
FIG. 9 is a developed cross-sectional view of FIG. 8; and
FIG. 10 is a cross-sectional view taken along the lines X--X of
FIG. 8.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Preferred embodiments of the method and apparatus for closing a cut
end or an opening of a blood vessel according to the invention will
be described in detail with reference to the drawings.
First, a closing unit or a pair of closing members will be
described with reference to FIGS. 1A to 1D. It is formed in such a
manner that each member is cut out from two kinds of strips or band
plates. FIG. 1A shows the two kinds of the band plates 11 and 12.
They are formed of a plastic material such as titanium alloy,
tantalum alloy, 18.6 chromium alloy and polycarbonate. The
thickness t, the width w.sub.1 and length l.sub.1 of the band
plates 11 and 12 are about 0.1 to 0.3 mm, about 5 to 10 mm and
about 130 to 140 mm, respectively. A plurality of, for instance,
twenty cut-out portions 13 are formed on both edges 11b of one band
plate 11 in the about half region at the side of one end 11a of the
band plate 11, at regular intervals. The cut portions 13 of one
edge 11b oppose those on the other edge 11b. A plurality of, for
instance, twenty round-ended projections 14 are formed on both the
edges 12b of another band plate 12 in the about half region at the
side of one end 12a of the band plate 12, at regular intervals. The
projections 14 of one edge 12b oppose those on the other edge 12b.
The width w.sub.2 of each projection 14 is equal to or just less
than, the width w.sub.3 of each cut portion 13. Moreover, a
plurality of, for instance, twenty holes 15 and 16 are formed along
the centre lines of the band plates 11 and 12 in the about half
regions at the sides of another ends 11c and 12c of the band plates
11 and 12, at regular intervals. The holes 15 and 16 help to
advance the band plates 11 and 12 as described below. The spacings
of the holes 15 and 16 are equal to those of the cut portions 13
and the projections 14, that is to say about 3 mm (l.sub.2 in FIG.
1B).
A pair of closing members 17 and 18 as shown in FIG. 1B are
obtained by cutting the pair of the band plates 11 and 12 at the
centre line of the adjacent cut portions 13 and projections 14 in
the direction of the width w.sub.1 of the band plates 11 and 12
(shown by dash-line in FIG. 1A). The width and the length of the
closing members 17 and 18 are w.sub.1 and l.sub.2,
respectively.
The desired closing of the cut end of the blood vessel as performed
by the pair of closing members 17 and 18, is shown in FIG. 1C and
FIG. 1D.
The projections 14 are bent to each other and fastened to each
other so that the projections 14 are fitted in the cut portions
13.
The apparatus 24 for closing the cut end of the blood vessel will
now be described with reference to FIG. 2 to FIG. 10. By this
apparatus the pair of the band plates 11 and 12 are cut to give a
pair of the closing members 17 and 18 and close the cut end of the
blood vessel as shown in FIG. 1C.
The apparatus 24 comprises a body 26 provided with a handle 25, a
device 27 attached to the leading end 26a of the body 26 for
closing the cut end of the blood vessel with the pair of the
closing members 17 and 18, feeding means 28 disposed in the body 26
for feeding the pair of the closing members 17 and 18 to the device
27, actuating means 29 disposed in the body 26 for actuating
synchronously the device 27 and the feeding means 28, and a trigger
31 pivoted at an axle 30 fixed to the side wall of the body 26 for
operating the actuating means 29.
The body 26 consists of an inner case 34 and an outer case 35 which
is open at the top end.
The device 27 for actually closing the cut end of the blood vessel
is shown in detail in FIG. 4 to FIG. 6C.
A pair of actuating members 39 and 40 are rotatably supported at
the end 26a of the body 26 by axles 41 and 42 respectively. Both of
the actuating members 39 and 40 have nipping surfaces 43 and 44 at
respective front end portions which can press the pair of the
closing members 17 and 18 forcibly to each other. A cutter 45 is
formed integrally with the actuating member 39 near the rear end of
one nipping surface 43 to cut the band plates 11 and 12 in the
direction of their width, while a V-shaped groove 46 is formed near
the rear end of the other nipping surface 44 to receive the cutter
45. Moreover, an approximately w-shaped recess 47 is formed near
the front end of the one nipping surface 43 to bend the pair of the
projections 14 opposite to each other, as shown in FIG. 6C.
Openings 48 and 49 are formed near the rear ends of the actuating
members 39 and 40 to pass the pair of the band plates 11 and 12
therethrough, respectively.
The actuating members 39 and 40 are urged in counter revolution
around the supporting axles 41 and 42 by springs 50 and 51
respectively. The upper actuating member 39 and the lower actuating
member 40 therefore normally contact with an upper edge 26b and the
lower edge 26c respectively of the top end portion 26a of the body
26. Moreover, contact portions 52 and 53 for an actuating shaft as
described below are formed integrally with the respective rear ends
of the actuating members 39 and 40.
The feeding means 28 is shown in detail in FIG. 3, FIG. 4 and FIG.
7 to FIG. 10.
A pair of paths 57 and 58 are formed along the body 26 between the
inner case 34 and the outer case 35. The band plates 11 and 12 pass
through these paths. An opening can be provided at the side of the
rear end of the paths 57 and 58 for insertion of the band plates 11
and 12. However, in this embodiment, the band plates 11 and 12 are
inserted backward into the paths 57 and 58 from the front end 26a
of the body 26. Although not shown, leaf springs or the like may be
provided in the paths 57 and 58 to press the band plates 11 and 12
against the walls of the inner case 34 to prevent undesirable
slipping of the band plates 11 and 12.
The band plates 11 and 12 are fed to the device 27 in the paths 57
and 58 in such a manner that a pair of pins 59 and 60 are engaged
with the respective holes 15 and 16 of the band plates 11 and 12.
The pins 59 and 60 are guided by guide grooves 61, as shown in FIG.
8 to FIG. 10. The guide grooves 61 are formed on the outer case 35
and consist of a straight forwardly extending path 62 in which the
pin 59 or 60 engaged with the hole 15 or 16 moves forward in the
direction of the arrow a and a curved backward path 63 in which the
pin 59 or 60 free from the hole 15 or 16 moves backward in the
direction of the arrow b. An upper face 62a is formed on the bottom
of the path 62, on which the pin 59 or 60 is advanced in engagement
with the hole 15 or 16 of the band plates 11 or 12. A lower face
63a of the curved backward path 63 is at a lower level than the
face 62a. On this lower face the pin 59 or 69 moves backward free
from the hole 15 or 16 of the band plate 11 or 12. Further, a slant
face 62a' is formed on the bottom of the path 62, on which the pin
59 or 60 is removed from the lower face 63a to the upper face 62a
for engagement with the hole 15 or 16 of the band plate 11 or 12. A
length l.sub.3 of the band plate 11 or 12 advanced by the pin 59 or
60 on the upper face 62a corresponds to the length l.sub.2 of the
closing member 17 or 18, as shown in FIG. 1B and FIG. 9. Elastic
rods 64 and 65 are connected to the pins 59 and 60 respectively, by
which the pins 59 and 60 can freely move in the upper face 62a, the
lower face 63a and the slant face 62a'.
The actuating menas 29 is shown in detail in FIG. 4 and FIG. 7.
An actuating shaft 69 is slidably supported at a hole 70 made in
the inner case 34. An actuator element 71 connected to the leading
end of the actuating shaft 69 contacts with the front faces of the
contact portions 52 and 53 of the actuating members 39 and 40. The
trailing end of the actuating shaft 69 is inserted slidably into a
cylinder 72. An axle 73 projected from the outer side of the
cylinder 72 is engaged with an oblong hole 74 made in an actuating
arm portion 31a of the trigger 31. A pair of flanges 75 and 76 are
formed on the leading and the trailing ends of the cylinder 72. The
trailing ends of the elastic rods 64 and 65 are fixed to the upper
and the lower parts of the flange 75. A coil spring 78 is supported
between the flange 76 and a disc 77 fixed to the trailing end of
the actuating shaft 69. A larger coil spring 79 surrounding the
coil spring 78 is supported between the flange 76 and a rear end
wall 26d of the body 26 to restore the trigger 31.
The operation of the apparatus 24 for closing the cut end of a
blood vessel 19 will be now described.
Before the cut end of the blood vessel 19 is closed, or the trigger
31 is drawn, the pair of actuating members 39 and 40 are open, as
shown by solid lines in FIG. 4.
The ends 11a and 12a of the band plates 11 and 12 passing through
the paths 57 and 58 are positioned at P.sub.1 or at the front ends
of the actuating members 39 and 40 when they are closed, as shown
in FIG. 2 and FIG. 4. At that time, the pin 59 or 60 is positioned
at P.sub.2 or the front end of the straight forward path 61 of the
guide groove 61, where it is free from the hole 15 or 16 of the
band plate 11 or 12.
In such a condition, as soon as the cut end of the blood vessel 19
is inserted between the pair of the actuating members 39 and 40
immediately after the blood vessel is cut, the trigger 31 is drawn
so as to rotate around the axle 30 and the axis 73, so that the
cylinder 72 is pushed backward through the oblong hole 74 and the
actuating shaft 69 slides backward through the coil spring 78. The
actuator element 71 connected to the top end of the actuating shaft
69 pushes the contact portions 52 and 53 of the actuating members
39 and 40 backward, so that the actuating members 39 and 40 are
rotated about the supporting axles 41 and 42 against the springs 50
and 51. Consequently, the actuating members 39 and 40 nip the pair
of the band plates 11 and 12 at the nipping surfaces 43 and 44
between which the cut end of the blood vessel 19 is inserted. In
the action of nipping, the pair of the band plates 11 and 12 are
cut by the cutter 45 formed on the nipping surface 43 to give the
pair of members 17 and 18 of FIG. 1B. The pair of the projections
14 are then bent opposite to each other in the recess 47, so that
the cut end of the blood vessel 19 is closed by the pair of the
closing members 17 and 18, as shown in FIG. 1C and FIG. 1D.
Furthermore when the trigger 31 is drawn the pins 59 and 60 are
moved backward with the backward movement of the cylinder 72
through the elastic rods 64 and 65 in the curved backward path 63
of the guide groove 61, so that the pins 59 and 60 are positioned
at P.sub.3 or the rear end of the straight forward path 62.
When the trigger 31 is released, it returns to the original
position by the coil spring 79. At that time, the cylinder 72 and
the actuating shaft 69 return forward to the original positions, so
that the actuator 71 is separated from the contact portions 52 and
53 of the actuating members 39 and 40, and the actuating members 39
and 40 are rotated about the axles 41 and 42 to the original
positions by the springs 50 and 51.
The band plates 11 and 12 are automatically advanced a distance
l.sub.2 in the following manner. With the forward movement of the
cylinder 72, the pins 59 and 60 are moved forward in the path 62 of
the guide groove 61 by the elastic rods 64 and 65. In the forward
movement, the pins 59 and 60 climb the slant face 62a' to move from
the lower face 63a to the upper face 62a and to engage with the
holes 15 and 16 of the band plates 11 and 12. The pins 59 and 60
move forward on the face 62a in engagement with the holes 15 and 16
to advance the band plates 11 and 12 by the spacing l.sub.2. When
the pins 59 and 60 reach the P.sub.2 -position (i.e. the front end
of the path 62) they move from the upper face 62a to the lower face
63a to become free from the holes 15 and 16 of the band plates 11
and 12. Consequently, while the pins 59 and 60 are circulated once
through the guide groove 61 consisting of the straight forwardly
extending path 62 and the curved backward path 63, the band plates
11 and 12 are intermittently advanced by the spacing l.sub.2. The
pins 59 and 60 are engaged with the holes 15 and 16 of the band
plates 11 and 12 and the band plates 11 and 12 are intermittently
advanced for the same number of times as the number of the holes
made in the band plates, that is to say, the number of the pair of
the closing members intermittently fed to the closing position
P.sub.1 is equal to that of the holes made in the band plates 11
and 12.
Although the pair of the band plates 11 and 12 are advanced in
order, and the pair of the closing members 17 and 18 are produced
by cutting the band plates 11 and 12, in the above-described
embodiment, it is possible that a number of the pair of the closing
members 17 and 18 are prepared, and the pair of the closing members
17 and 18 are set at the pair of the actuating members 39 and 40
every time the cut end of the blood vessel is closed.
In this invention, since the cut end of the blood vessel is
inserted between the pair of the closing members formed of the
plastic material and the pair of the closing members are fastened
to each other to close the cut end of the blood vessel, the closing
operation of the cut end of the blood vessel, is very simple, quick
and certain. Moreover, since the pair of the closing members are
pressed to each other by the pair of the actuating members and at
the same time the pair of the closing members are fastened to each
other, the invention has the advantage that the cut end of the
blood vessel can be closed in one action.
Moreover, while in the above embodiments band plates are used, a
pair of rolls may be used instead. These would unwind
intermittently to obtain the pair of closing members.
While preferred embodiments have been described, variations thereto
will occur to those skilled in the art within the scope of the
present inventive concepts which are delineated by the following
claims.
* * * * *