Title:
CIRCUMCISION DEVICE
United States Patent 3612057


Abstract:
A circumcision clamp comprising a pair of concentric plastic rings connected by a generally radially oriented pillar or web so that the rings retain their concentricity when moved into operative position. The inner ring is uninterrupted or solid, and the outer ring is split, preferably adjacent to the pillar, to allow for expansion and contraction of the outer ring relative to the inner ring, the ends of the outer ring having means thereon for drawing them together into clamping position. The foreskin is pulled between the inner and outer rings, with the pillar engaged in the usual dorsal slit in the foreskin, to set the device proximate the base of the glans, and then the ends of the outer ring are drawn together to constrict the outer ring into clamping position. The rings preferably include opposed, complementary, annular irregularities to assist clamping and to assure that they remain aligned, as for example a V-shaped notch on the outside of the inner ring and a V-shaped projection on the inside of the outer ring.



Inventors:
FREEDMAN LAWRENCE D
Application Number:
05/004984
Publication Date:
10/12/1971
Filing Date:
01/22/1970
Assignee:
LAWRENCE D. FREEDMAN
Primary Class:
International Classes:
A61B17/326; (IPC1-7): A61B17/00
Field of Search:
128/303,303.1,305,325,346,319
View Patent Images:
US Patent References:
3111124Surgical clamp1963-11-19Rodbard
2544037Surgical device1951-03-06Mosely
2353647Apparatus for performing circumcisions1944-07-18Carmichael
2272072Circumcision ring1942-02-03Ross



Primary Examiner:
Trapp L. W.
Claims:
I claim

1. A circumcision device which comprises a continuous inner ring, a split outer ring concentric with said inner ring, and a generally radially oriented web connecting said inner and outer rings together proximate a single point on the circumference of each of the rings, said outer ring being adapted to flex between an open position wherein the foreskin may be drawn between said rings with said web engaged in a generally axial slit in the foreskin, and a closed, clamping position wherein the foreskin is clamped between said rings.

2. A circumcision device as defined in claim 1, wherein said inner and outer rings and said connecting web are a unitary molded plastic structure.

3. A circumcision device as defined in claim 1, wherein said outer ring is split proximate said web.

4. A circumcision device as defined in claim 1, wherein said inner and outer rings have opposed, complementary, generally annular irregularities thereon.

5. A circumcision device as defined in claim 4, wherein said irregularities comprise a notch in one ring and a projection on the other ring.

6. A circumcision device as defined in claim 5, wherein said notch is a generally V-shaped notch in the outside of the inner ring and said projection is a generally V-shaped projection on the inside of the outer ring.

7. A circumcision device as defined in claim 1, which includes connection means on said outer ring proximate the ends of the outer ring at the split therein for securing the outer ring in its said closed, clamping position.

8. A circumcision ring as defined in claim 7, wherein said connection means comprises a pair of generally radially outwardly projecting knobs on the respective end portions of the outer ring.

9. A circumcision device as defined in claim 1, wherein the end portions of said outer ring at the split therein are arranged to overlap to make the outer ring generally continuous in its said closed, clamping position.

Description:
BACKGROUND OF THE INVENTION

For many years it has been conventional practice in the art to employ what is commonly referred to as a circumcision ring as a surgical aid in performing circumcisions, and according to conventional prior art practice the circumcision ring is in the form of an open-ended, generally cup-shaped device which engages over the glans and under the foreskin, the device having an external annular groove providing a seat for a ligature that is tied around the foreskin, the excess foreskin usually being trimmed off. The circumcision ring would then fall off along with the devitalized tissue within a few days, leaving a healed line of excision.

An example of this type of prior art circumcision ring is shown in U.S. Pat. No. 2,272,072, issued Feb. 3, 1942 to Ross. It will be noted that the Ross device has a forwardly projecting, arcuate or curved handle employed for manipulating the circumcision ring into place and to hold the ring while the ligature is engaged and tied. Another example of this type of circumcision ring is shown in the Kariher et al. U.S. Pat. No. 3,056,407, issued Oct. 2, 1962, wherein the ring is generally similar in structure and operation to the ring disclosed in the Ross Pat. No. 2,272,072, but has a breakaway handle which can be bent back and forth so as to break it off in order to eliminate the forwardly protruding handle during the postoperative period.

However, in practice this type of prior art circumcision ring which is inserted under the foreskin and over the glans, and is adapted to be used in connection with an external ligature, is very difficult to use. For one thing, it is quite difficult to determine the exact positioning of the cup-shaped ring under the foreskin, and thus to be sure that it is properly positioned, particularly in view of the wide anatomic variety encountered in this type of operation. Further, it is very awkward to engage and tie the ligature, and to be assured that the ligature is properly placed and sufficiently tightly tied. The procedure is greatly complicated because a dorsal slit must be made in the foreskin in order to permit proper location of the circumcision ring thereunder, as shown in FIG. 7 of the Kariher et al. patent, and the resulting blood makes the area quite slippery and difficult to work with, particularly in view of the small size of the parts involved in most operations of this kind.

SUMMARY OF THE INVENTION

In view of these and other problems in the art, it is an object of the present invention to provide a novel circumcision device comprising an uninterrupted or solid inner ring adapted to be engaged under the foreskin, and a concentric, split outer ring integrally connected to the inner ring by means of a generally radially oriented pillar or web, the outer ring being engageable over the foreskin and the connecting pillar or web being disposed in the usual dorsal slit in the foreskin, and the outer ring being constrictable into clamping position about the inner ring.

It is another object of the present invention to provide a novel circumcision device of the character described wherein the concentric relationship between the inner and outer rings permits the surgeon to at all times see exactly where the circumcision ring is located, and to thereby know the exact location of the inner ring even though it is underneath the foreskin, thereby eliminating the necessity of operating blind under the foreskin. This permits uniform and predictable operative results despite wide anatomic variations.

Another object of the invention is to provide a circumcision device of the character described which is much simpler to use than conventional prior art circumcision rings, completely eliminating the necessity of tying a ligature about the foreskin, and permitting the operation to be performed without being particularly hampered by slipperiness from the presence of blood, and with substantially reduced likelihood of injury to the patient.

The presence of the exposed, outer ring as an integral part of the present invention makes the device so easy to manipulate that there is no need for the conventional forwardly projecting handle. Accordingly, there is also no need for a handle of the breakaway type, with the consequent necessity of having to grasp the installed device and bend the handle back and forth to cause it to break off as required in the device of the Kariher et al. patent referred to above.

BRIEF DESCRIPTION OF THE DRAWINGS

Further objects and advantages of the present invention will appear during the course of the following part of the specification, wherein the details of construction and mode of operation of a presently preferred embodiment are described with reference to the accompanying drawings, in which;

FIG. 1 is a top view diagrammatically illustrating the portion of the anatomy upon which a circumcision is to be performed.

FIG. 2 is a view similar to FIG. 1 after the dorsal slit has been made in the foreskin.

FIG. 3 is a view similar to FIG. 2, with the circumcision device generally operatively positioned but before the outer ring thereof has been constricted into clamping position.

FIG. 4 is a view similar to FIG. 3, but with the ends of the outer ring pulled together so that the outer ring is in its constricted clamping position.

FIG. 5 is a view similar to FIG. 4, but with the foreskin trimmed off.

FIG. 6 is a view similar to FIGS. 1 to 5, but illustrating the healed circumcision after the device of the present invention has fallen off.

FIG. 7 is an enlarged, cross-sectional view taken on the line 7--7 in FIG. 4.

FIG. 8 is a greatly enlarged, fragmentary section taken axially of the concentric rings, showing in detail the manner in which the foreskin is clamped between the inner and outer rings of the invention.

FIG. 9 is an enlarged perspective view of the invention, with a portion broken away for better illustration of the configuration of the inner and outer rings in axial section.

DETAILED DESCRIPTION

Referring to the drawing, and at first in particular to FIGS. 7, 8, and 9 thereof, the presently preferred form of the invention is generally designated 10, and includes inner and outer concentric plastic rings 12 and 14, respectively, which are joined together by means of a connecting pillar or web 16. Preferably, the two rings and connecting pillar are integrally molded as a single part. The device is made of a generally rigid or hard plastic, and the outer ring 14 is resiliently expansible and contractable to allow the foreskin to be drawn between the inner and outer rings and to permit constriction of the outer ring into the clamping position.

The inner and outer rings are provided with opposed, complementary annular irregularities to assist in the clamping action and to assure that the inner and outer rings remain concentrically aligned. These annular irregularities are preferably in the form of a V-shaped notch 18 on the outside of the inner ring 12, and a corresponding V-shaped projection 20 on the inside of the outer ring 14.

The inner ring 12 is solid or uninterrupted, forming a complete annulus which is generally rigid. On the other hand, the outer ring 14 is a split ring, having a single split therein generally designated 22 in FIG. 9. This split 22 is preferably but not necessarily located proximate the connecting pillar or web 16, and if desired the attached end of the outer ring 14 may actually terminate at the pillar or web 16. Thus, in the presently preferred form of the invention, one end portion 24 of the outer ring 14 may be considered as a fixed end portion of the outer ring, since it is generally fixedly positioned relative to the inner ring 12 through the connection of the pillar web 16, while the other end portion 26 of the outer ring may be considered as a free end portion, in that it is resiliently movable in the circumferential direction toward and away from the pillar 16 and the fixed end portion 24 for movement of the outer ring from an open position as illustrated in FIG. 9 to a closed position as illustrated in FIG. 7.

Attachment means is provided on the outer ring 14 for drawing and locking the end portions 24 and 26 of the outer ring together in the constricted position. A presently preferred attachment means comprises a pair of generally radially outwardly projecting knobs or tabs 28 and 30 on the respective end portions 24 and 26 of the outer ring 14. The knobs 28 and 30 can be readily grasped by the surgeon between a pair of fingers so as to draw the outer ring 12 into clamping position. The knobs 28 and 30 can be held together by any desired means, as for example by wire, ligature, or a built-in plastic snap lock of any desired conventional configuration. If the knobs 28 and 30 are to be held together by wire, ligature, or the like, it is preferable to provide apertures 32 therein through which the wire, ligature, or the like may be threaded to be sure that it does not slide out of position. The manner in which a wire, ligature, or the like holds the knobs or tabs 28 and 30 together with the outer ring 14 in its constricted position is best illustrated in FIG. 7.

The knob or tab 28 that is proximate the fixed end portion 24 of the outer ring is preferably, but not necessarily, radially aligned with the pillar 16 which connects the rings together.

If desired, the opposed fixed and free ends of the outer ring 14 may simply be flat or rounded opposing surfaces. On the other hand, if desired these opposed end portions of the outer ring may be notched as shown in FIGS. 3, 5, and 9, or otherwise configured in a complementary arrangement so as to overlap in the closed, constricted condition of the outer ring 14, and thereby form a substantially complete annulus of the outer ring.

While the dorsal slit that is provided on the foreskin is adequate to accommodate a pillar or web 16 of any practical thickness, if desired the pillar or web 16 may be made relatively thin in the circumferential direction so as to be somewhat bendable as illustrated in FIG. 7 for automatic adjustment of the concentricity between the inner and outer rings in the operative position of the device.

FIGS. 1 through 6 of the drawing illustrate the manner in which the invention is used. First, a hemostat clamp is placed on the dorsum of the foreskin 34 for about 2 minutes. A dorsal slit 36 is then made to within about one-half centimeter of the proximal end of the clamped area, and a blunt probe is passed around the glans 38 to remove any adhesions. The cut foreskin 34 is then pulled between the inner and outer rings 12 and 14 respectively, of the circumcision device 10, with the connecting pillar or web 16 between the rings sliding down the dorsal slit 36. The circumcision device 10 is pushed down to a position proximate the base of the glans 38, with the outer ring 14 of the device in the open position generally as shown in FIG. 3, and then the knobs 28 and 30 are pulled together to constrict the outer ring 14 and thereby clamp the foreskin 34 between the outer and inner rings as best shown in FIGS. 7 and 8. The knobs 28 and 30 are secured together by ligature 40 in the embodiment shown in the drawing, or by any other desired attachment means. The foreskin 34 is thus securely clamped between the inner and outer rings, between the V-shaped notch 18 of the inner ring and the V-shaped projection 20 of the outer ring, and these notches assure that the inner and outer rings will be brought together in concentric relationship and will remain so during the time the circumcision device 10 remains thus operatively positioned.

The foreskin may then be trimmed off as illustrated in FIG. 5, or may be left intact as shown in FIG. 4. The device 10 will fall off in several days, leaving a healed circumcision 42 as illustrated in FIG. 6.

While the instant invention has been shown and described herein in what is conceived to be the most practical and preferred embodiment, it is recognized that departures may be made therefrom within the scope of the invention, which is therefore not to be limited to the details disclosed herein.