Disposable bowel clamp and detachable applicator
United States Patent 3916908
A disposable bowel clamp is described in which the clamp can be applied quickly by means of a detachable applicator. The applicator is operated with the thumb and fingers of one hand upon two grips so that the plastic clamp can be positioned about the bowel and fastened therein by the surgeon using only one hand and having the other free for other purposes. The plastic clamp itself is comprised of two rod shaped bodies having on one end a hooking means and on the other end a corresponding aperture through which the hook-penetrates and latches into position. Each of these rods, which make up the body of the clamp, is frictionally held within the confines of one or the other jaws of the applicator in such a way that once the jaws are closed and the clamp fastened securely together, the jaws which have conducted the clamp bodies into contact can be opened and pulled away from the clamp. A presently preferred structural means for holding the clamp bodies in each of the applicator jaws is by means of a frictional U-shaped channel which runs the length of the applicator jaw and frictionally clasps each of the two portions of the clamp body.
US Patent References:
Umbilical clip and holder for same
Brandenberg - January 1948 - 2434831
Umbilical clamp and cutter
Whittaker - October 1950 - 2524337
Surgical clamp
Schnee - November 1953 - 2659371
Clothespins
Urich - June 1961 - 2988314
Device for controlling incontinence
Koessler - September 1964 - 3147754
Umbilical clip and holder for same
Brandenberg - January 1948 - 2434831
Umbilical clamp and cutter
Whittaker - October 1950 - 2524337
Surgical clamp
Schnee - November 1953 - 2659371
Clothespins
Urich - June 1961 - 2988314
Device for controlling incontinence
Koessler - September 1964 - 3147754
Application Number:
05/370955
Publication Date:
11/04/1975
Filing Date:
06/18/1973
View Patent Images:
Export Citation:
Primary Class:
Other Classes:
24/456
International Classes:
A61B17/122; A61B17/12; A61B17/08; A44B21/00
Field of Search:
24/248BB,248SL,249SL,255SL,263PJ 128/321,346
US Patent References:
Primary Examiner:
Pace, Channing L.
Claims:
We claim
1. In combination a compressive applicator means have two opposed and aligned in parallel jaws, each jaw of the applicator having releasably attached to its inner surface one half of an also opposed and aligned interlatching bowel clamp, said bowel clamp comprising a set of rod like members, each of the rod like members frictionally fitted into a receiving channel positioned in the interior surface of each jaw and having on one end thereof a latching finger and on the opposite end thereof a receptacle for the reception of the latching finger, said bowel clamp members being capable of being positioned around the periphery of a bowel and brought into register by the closure of the opposed jaws of the applicator.
2. A device according to claim 1 wherein the rod-like bowel clamp members are latched together by means of engagement of a ratchet with the latching finger.
3. A device according to claim 1 wherein each rod-like bowel clamp member has an opposed receptacle in register with the latching finger of the other rod-like bowel clamp member.
4. A device according to claim 3 wherein the receptacle has therein a set of teeth so arranged as to form a ratchet fastener with the lip of the latching finger.
1. In combination a compressive applicator means have two opposed and aligned in parallel jaws, each jaw of the applicator having releasably attached to its inner surface one half of an also opposed and aligned interlatching bowel clamp, said bowel clamp comprising a set of rod like members, each of the rod like members frictionally fitted into a receiving channel positioned in the interior surface of each jaw and having on one end thereof a latching finger and on the opposite end thereof a receptacle for the reception of the latching finger, said bowel clamp members being capable of being positioned around the periphery of a bowel and brought into register by the closure of the opposed jaws of the applicator.
2. A device according to claim 1 wherein the rod-like bowel clamp members are latched together by means of engagement of a ratchet with the latching finger.
3. A device according to claim 1 wherein each rod-like bowel clamp member has an opposed receptacle in register with the latching finger of the other rod-like bowel clamp member.
4. A device according to claim 3 wherein the receptacle has therein a set of teeth so arranged as to form a ratchet fastener with the lip of the latching finger.
Description:
BACKGROUND OF THE INVENTION
There is a constant and immediate need in the field of surgery for a truly, easily applied abdominal bowel clamp which could also be applied to the umbilical cord in obstetrical procedures. The key to practical success for such a clamp is the fact that it must be capable of being applied by one person working alone using only one hand so as to leave the other hand free to perform other functions. Clamps which have been devised in the past for the most part are metal, bulky and cumbersome in size. Other plastic clamps currently on the market require the use of both hands to close and fasten the clamp about the tissue with a sufficient compressive force to permit so tight a closure of the vessel that an incision may possibly be made within one centimeter of the situs of the clamp. A function of the plastic clamp is to provide instantaneous clasping or blocking action while utilizing a minimum amount of space in the gut. The present invention describes a structurally designed clamp applicator which is so oriented as to fit together with the clamp and act to carry the clamp into position around the bowel, fasten the same and then be removed from the operating area to be loaded with the second clamp or the third for repeated and continued use. At the present time there is not available an applicator-disposable clamp arrangement which permits the surgeon to quickly and easily load the applicator or more precisely pick up a loaded applicator, snap the clamp on the bowel and return the applicator to his assistant for loading with the second clamp which is snapped into position on the applicator and the procedure repeated. The need for surgical clamps is a diverse one and consequently the present device will vary in size from clamps which are small enough to reduce or halt the flow of major blood vessels to those which hold the flow of the contents of a bowel or larger tube. In British patent no. 972731 there is described a permanent absorbable blood vessel clamp which is employed as an implant. Essentially this clamp is employed to replace the use of a surgical forceps which is locked into position until the surgeon can ligate the vessel with surgical silk or cat gut which in time will dissolve. While this clamp is a two-piece clamp it is not intended for temporary use in the body as is the device employed by the applicant. Nor is it capable of being applied by means of a tool which generates as little force as to partially close an artery or as much force as is required to close off completly a section of the bowel. The present clamp has the capacity for adjustment and does not require the use of both the surgeon's hand and the loss of valuble time to unite the two segments of the clamp. Apart from this disclosure there is am amazing hiatus in the art of bowel clamps.
BRIEF DESCRIPTION OF THE INVENTION
Accordingly the present invention provides for the design and construction of a unique bowel clamp and applicator combination and a method for its application to the vessel to be clamped. The apparatus which comprises the device of the invention is made up of a combination of a plastic clamp formed in two rod like segments which interlatch and compress the vessel between them and a compressive applicator means for bringing the segments together in register with a sufficient amount of pressure to interlock the two rod like segments and close the clamp to the extent desired by the operator. Once the clamp has been latched in a particular position, the compressive applicator means is withdrawn leaving the clamp in position until it is removed either by excision of the clamp itself or excision of that segment of the bowel to which that clamp is attached. The structure of the device and its method of use will be more specifically explained by reference to the several figures of drawing attached hereto.
FIG. 1 of the drawing is a perspective view of the clamp-applicator assembly showing in an exploded fashion how the clamp fits into the jaws of the applicator.
FIG. 2 shows those jaws closed and the clamp segments engaged in a second perspective view.
FIG. 3 shows in cross sectional view the jaws of the applicator clamping together the clamp segments and compressing the bowel therebetween.
FIG. 4 shows the clamp itself and in perspective view the details of the ratchet like latching means for the clamp. Finally
FIG. 5 is a perspective view of the latched clamp partially closed with a segment of bowel held therein.
Referring now to FIGS. 1-5 of the drawing it can be seen in FIG. 1 that the assembly comprises a clamp applicator having two jaws 3 and 3' which are activated by a set of pivotally movable arms 4 and 4' which are connected by a set of lateral pivot pins 6 and 7 to extender legs 9 and 9' respectively and by a third pivot pin 5 to each other. The extender legs 9 and 9' are tied pivotally together by axial pivot pin 8. The movement together of arms 4 and 4' at the segment A of those arms causes a pivotal action to occur pushing segment B of the arms 4 and 4' to move apart. This closes up contraction space 26 and causes legs 9 and 9' to pivot on their pins 6, 7, and 8 and move their jaws 3 and 3' connected to those legs, together.
Each jaw of the applicator 3 and 3' has on its inner face a receiving cavity 11 and 11' wherein the clamp body 14 or 14' will frictionally fit and be held snug. Each clamp body is rod shaped and has on one end a clamp fastener hook 10 and at its opposite end a receiving cavity 11 for the said clamp fastener hook 10 and its clamp fastener guide 13 which slides into the said cavity carrying with it the fastener hook 10 and its lip 12 which slides into the receiving cavity and engages the teeth 21 contained within the receiving cavity to lock the clamp into position.
The entire operation of the device is activated by compression of the handle finger grip 1 and the thumb grip 2 which pulls the movable arms together. This is illustrated by FIG. 2 of the drawing where the device is shown in a partially closed position with no bowel caught therebetween and the gripping plates 15 and 15' grooved surfaces are lightly touching and the clamp frictional protuberance 17 for purposes of orienting the level of attachment of the gripping plates is in register with the receiving cavity end. The central ridge 18 of the grooved clamp surface is touching and the contraction slot 19 for the clamp fingers has the clamp fastener guide 13 and the clamp finger 28 inserted therein and the lip 12 caught on the teeth 21 of ratchet 22. A second friction block 20 of the clamp rod fits snugly against the side wall of the jaw 3 of the applicator hence holding the two elements together.
Turning to FIG. 3 of the drawing we see the bowel 24 squeezed between the two compression plates of the clamp and the lock compression plates 23 and 23' both in position to hold the pressure and with clamp holder friction base. The clamp finger 28 and the clamp guide 13 are locked into the receptacle 11 of each opposing clamp body and the expansion space 26 between the clamp legs 9 and 9' gone. The clamp friction base 27 is also in contact. FIGS. 4 and 5 show the clamp alone and in break away view detailing the arrangement of the receiving cavity teeth 21 and the lip of the attachment hook 12 ready for attachment by pressure from the applicator (in FIG. 4) and after the pressure has been applied (in FIG. 5).
The devices operated by placing the clamp bodies of FIGS. 4 and 5 in the receiving channel 11 for the clamp and aligning the friction blocks 17 and 20 of the clamp against the walls of the channel to insure a firm grasp of the clamp in the applicator. The jaws 3 and 3' of the clamp applicator are then set open and surround both sides of a bowel segment at right angles to it. The handles 1 and 2 are then brought together and the arms 4 and 4' forced apart, legs 9 and 9' forced together and jaws 3 and 3' closed. When these jaws are closed the clamp fastener guide 13, clamp contraction slot 19 and clamp finger 28 and clamp fastener hook 10 and 10' enter locking slots 16 and 16' and then lips 12 and 12' lock on to teeth 21 of ratch 22. This fixes the clamp in the closed position. The action of the handle grips 1 and 2 is reversed causing the arms 4 and 4' to come together forcing the legs 9 and 9' and jaws 3 and 3' to come apart which permit the clamp to ride free of the applicator. The applicator is then removed from the operating area and handed by the surgeon to his assistant who reloads the same with a second clamp for use when if necessary.
Various variations and modifications of the concept of this invention will occur to one skilled in the art upon a reading and review of this invention. It is the intention of the applicant to cover all these modifications and equivalencies although for the purpose of illustration the preferred mode or embodiment has been specifically explained.
There is a constant and immediate need in the field of surgery for a truly, easily applied abdominal bowel clamp which could also be applied to the umbilical cord in obstetrical procedures. The key to practical success for such a clamp is the fact that it must be capable of being applied by one person working alone using only one hand so as to leave the other hand free to perform other functions. Clamps which have been devised in the past for the most part are metal, bulky and cumbersome in size. Other plastic clamps currently on the market require the use of both hands to close and fasten the clamp about the tissue with a sufficient compressive force to permit so tight a closure of the vessel that an incision may possibly be made within one centimeter of the situs of the clamp. A function of the plastic clamp is to provide instantaneous clasping or blocking action while utilizing a minimum amount of space in the gut. The present invention describes a structurally designed clamp applicator which is so oriented as to fit together with the clamp and act to carry the clamp into position around the bowel, fasten the same and then be removed from the operating area to be loaded with the second clamp or the third for repeated and continued use. At the present time there is not available an applicator-disposable clamp arrangement which permits the surgeon to quickly and easily load the applicator or more precisely pick up a loaded applicator, snap the clamp on the bowel and return the applicator to his assistant for loading with the second clamp which is snapped into position on the applicator and the procedure repeated. The need for surgical clamps is a diverse one and consequently the present device will vary in size from clamps which are small enough to reduce or halt the flow of major blood vessels to those which hold the flow of the contents of a bowel or larger tube. In British patent no. 972731 there is described a permanent absorbable blood vessel clamp which is employed as an implant. Essentially this clamp is employed to replace the use of a surgical forceps which is locked into position until the surgeon can ligate the vessel with surgical silk or cat gut which in time will dissolve. While this clamp is a two-piece clamp it is not intended for temporary use in the body as is the device employed by the applicant. Nor is it capable of being applied by means of a tool which generates as little force as to partially close an artery or as much force as is required to close off completly a section of the bowel. The present clamp has the capacity for adjustment and does not require the use of both the surgeon's hand and the loss of valuble time to unite the two segments of the clamp. Apart from this disclosure there is am amazing hiatus in the art of bowel clamps.
BRIEF DESCRIPTION OF THE INVENTION
Accordingly the present invention provides for the design and construction of a unique bowel clamp and applicator combination and a method for its application to the vessel to be clamped. The apparatus which comprises the device of the invention is made up of a combination of a plastic clamp formed in two rod like segments which interlatch and compress the vessel between them and a compressive applicator means for bringing the segments together in register with a sufficient amount of pressure to interlock the two rod like segments and close the clamp to the extent desired by the operator. Once the clamp has been latched in a particular position, the compressive applicator means is withdrawn leaving the clamp in position until it is removed either by excision of the clamp itself or excision of that segment of the bowel to which that clamp is attached. The structure of the device and its method of use will be more specifically explained by reference to the several figures of drawing attached hereto.
FIG. 1 of the drawing is a perspective view of the clamp-applicator assembly showing in an exploded fashion how the clamp fits into the jaws of the applicator.
FIG. 2 shows those jaws closed and the clamp segments engaged in a second perspective view.
FIG. 3 shows in cross sectional view the jaws of the applicator clamping together the clamp segments and compressing the bowel therebetween.
FIG. 4 shows the clamp itself and in perspective view the details of the ratchet like latching means for the clamp. Finally
FIG. 5 is a perspective view of the latched clamp partially closed with a segment of bowel held therein.
Referring now to FIGS. 1-5 of the drawing it can be seen in FIG. 1 that the assembly comprises a clamp applicator having two jaws 3 and 3' which are activated by a set of pivotally movable arms 4 and 4' which are connected by a set of lateral pivot pins 6 and 7 to extender legs 9 and 9' respectively and by a third pivot pin 5 to each other. The extender legs 9 and 9' are tied pivotally together by axial pivot pin 8. The movement together of arms 4 and 4' at the segment A of those arms causes a pivotal action to occur pushing segment B of the arms 4 and 4' to move apart. This closes up contraction space 26 and causes legs 9 and 9' to pivot on their pins 6, 7, and 8 and move their jaws 3 and 3' connected to those legs, together.
Each jaw of the applicator 3 and 3' has on its inner face a receiving cavity 11 and 11' wherein the clamp body 14 or 14' will frictionally fit and be held snug. Each clamp body is rod shaped and has on one end a clamp fastener hook 10 and at its opposite end a receiving cavity 11 for the said clamp fastener hook 10 and its clamp fastener guide 13 which slides into the said cavity carrying with it the fastener hook 10 and its lip 12 which slides into the receiving cavity and engages the teeth 21 contained within the receiving cavity to lock the clamp into position.
The entire operation of the device is activated by compression of the handle finger grip 1 and the thumb grip 2 which pulls the movable arms together. This is illustrated by FIG. 2 of the drawing where the device is shown in a partially closed position with no bowel caught therebetween and the gripping plates 15 and 15' grooved surfaces are lightly touching and the clamp frictional protuberance 17 for purposes of orienting the level of attachment of the gripping plates is in register with the receiving cavity end. The central ridge 18 of the grooved clamp surface is touching and the contraction slot 19 for the clamp fingers has the clamp fastener guide 13 and the clamp finger 28 inserted therein and the lip 12 caught on the teeth 21 of ratchet 22. A second friction block 20 of the clamp rod fits snugly against the side wall of the jaw 3 of the applicator hence holding the two elements together.
Turning to FIG. 3 of the drawing we see the bowel 24 squeezed between the two compression plates of the clamp and the lock compression plates 23 and 23' both in position to hold the pressure and with clamp holder friction base. The clamp finger 28 and the clamp guide 13 are locked into the receptacle 11 of each opposing clamp body and the expansion space 26 between the clamp legs 9 and 9' gone. The clamp friction base 27 is also in contact. FIGS. 4 and 5 show the clamp alone and in break away view detailing the arrangement of the receiving cavity teeth 21 and the lip of the attachment hook 12 ready for attachment by pressure from the applicator (in FIG. 4) and after the pressure has been applied (in FIG. 5).
The devices operated by placing the clamp bodies of FIGS. 4 and 5 in the receiving channel 11 for the clamp and aligning the friction blocks 17 and 20 of the clamp against the walls of the channel to insure a firm grasp of the clamp in the applicator. The jaws 3 and 3' of the clamp applicator are then set open and surround both sides of a bowel segment at right angles to it. The handles 1 and 2 are then brought together and the arms 4 and 4' forced apart, legs 9 and 9' forced together and jaws 3 and 3' closed. When these jaws are closed the clamp fastener guide 13, clamp contraction slot 19 and clamp finger 28 and clamp fastener hook 10 and 10' enter locking slots 16 and 16' and then lips 12 and 12' lock on to teeth 21 of ratch 22. This fixes the clamp in the closed position. The action of the handle grips 1 and 2 is reversed causing the arms 4 and 4' to come together forcing the legs 9 and 9' and jaws 3 and 3' to come apart which permit the clamp to ride free of the applicator. The applicator is then removed from the operating area and handed by the surgeon to his assistant who reloads the same with a second clamp for use when if necessary.
Various variations and modifications of the concept of this invention will occur to one skilled in the art upon a reading and review of this invention. It is the intention of the applicant to cover all these modifications and equivalencies although for the purpose of illustration the preferred mode or embodiment has been specifically explained.