CA1147228A - Surgical suturing instrument for application of a staple suture - Google Patents
Surgical suturing instrument for application of a staple sutureInfo
- Publication number
- CA1147228A CA1147228A CA000343888A CA343888A CA1147228A CA 1147228 A CA1147228 A CA 1147228A CA 000343888 A CA000343888 A CA 000343888A CA 343888 A CA343888 A CA 343888A CA 1147228 A CA1147228 A CA 1147228A
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- Canada
- Prior art keywords
- die
- staple
- guide plate
- magazine
- shape
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04S—STEREOPHONIC SYSTEMS
- H04S1/00—Two-channel systems
- H04S1/002—Non-adaptive circuits, e.g. manually adjustable or static, for enhancing the sound image or the spatial distribution
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- Physics & Mathematics (AREA)
- Engineering & Computer Science (AREA)
- Acoustics & Sound (AREA)
- Signal Processing (AREA)
- Stereophonic System (AREA)
- Circuit For Audible Band Transducer (AREA)
- Surgical Instruments (AREA)
Abstract
ABSTRACT OF THE DISCLOSURE
Disclosure is made of a surgical instrument, comprising a supporting body with a replaceable die, a magazine with staples, a carriage-holder, a staple ejector, a carriage-hol-der mechanical actuator, and a staple ejector mechanical actuator.
The replaceable die is provided with a shaped guide plate arranged square with the die and facing the magazine, the shape of said guide plate corresponding to each of the suture types.
The end surface of the magazine and of the staple ejec-tor are also shaped do as to suit the type of suture being applied and to conform to the shape of a respective die.
Disclosure is made of a surgical instrument, comprising a supporting body with a replaceable die, a magazine with staples, a carriage-holder, a staple ejector, a carriage-hol-der mechanical actuator, and a staple ejector mechanical actuator.
The replaceable die is provided with a shaped guide plate arranged square with the die and facing the magazine, the shape of said guide plate corresponding to each of the suture types.
The end surface of the magazine and of the staple ejec-tor are also shaped do as to suit the type of suture being applied and to conform to the shape of a respective die.
Description
~1~7ZZ~3 SURGIC~L SUTU~ING INST~U~T ~OR APP~IC.~ION OF A
STAP~ SUTURE
The present lnvention relates to medical equipment and more particularly to a ~urgical suturing i~strument for appli-cation of a staple su$ure, e.g., when suturing various organs and tissues with metallic staples, especially the stumps oi hollow organs, such as blood ves~els, intestines, the stomach, the bronchu~, pulmonary tis~ue, and some other organs, as well as ~or establishing an artificial filter on a blood vessel during operations for thrombus formation.
Up till now a great variety o~ surgieal suturing instru-ments ~or applying a staple suture have been developed. Said instruments are designed ~or ~uturing (closing) the stumps of hollow organs. Ae it is ~nown commonly different organs and operati~e techniques involved in suturing the stlmps oi hollo~
organs require the use of different t~pe~ o~ sutures to be appli ed. Thus, for i~stance, the linear suture is applied ior ~tuFing the intestinal stumps~ while for s~turing the bro~chial stump the palisade or the oblique (diagonal) suture i~ pl~ced;
whenever an extra staunch suture is requixed, the decussate ~ haped) suture i~ expedient to be applied. Surgical sutures are also classified by amd dif~er in length and thicknes~ o~ the ti~sues being stitched up. ~hu~, the suture established in stit-ching up the gastric stump i~ as long as 120 mm, ~here~s the suture applled in stitchin~ up the stump~ of intenstine~, the bronchus, or the vascular bundle is up to 40 mm long.
11472Z~
_ 2 --One prior-art ~urgical suturing instrument for application of a staple suture is heretofore known to u~e commonly for stit-ching up v~riou3 orga~s and ti#sues with metallic staples, e~pecially for stitchin~ up the ~tumps of ~ollow organs (cf. US
Patent ~o.3,079,606).
Said in~truments comprises a supporting body with a repla-ceable die having a number of r~ce~e~ ~or the staples to bend, a mechanically actuated carriage-holder with a change magazine, a staple ejector, a mechanical ~ctuator of the carriage-holder and a mechanical actuator oi the ~taple e~ector.
The supporting bo~y is an oblong trough provided with guides and a hook to the inner suriace o~ which a replaceable ;
die is held, h~ g a number of rece~ses for the staples to bend. The carriage-holder with a cha~ge magazine is slidable along the guide~ of the supporting body, and i~ also provided with guide#. ~he ~taple maga~ine has staple slot~ arraneed 80 as to suit the arrangement of the die rece~ee. Ea¢h of the :
staple ~lots i~ to accomodate a 3ingle metallic etRple. ~he ~taple ejector with prong~ i~ slidable along the carriage-hol-der guides, the ejector prongs being arranged to the pattern of the staple ~lot~ in the magazine.
~ he carriage-holder is screw-actuated, while the staple ejector is leYer-actuated, ~ he instrwment operates as followY. The ~oo~ i~ brought under the organ being utured. ~he carriag~-holder along with the staple ma~azine and ejector is advanced towards the die by rotating the nut of the carriage-holder actuator, with the result that the tissue being ~utured i~ compres3ed until blood ~47'~2 flow is arrested and the so-called suturing gap i~ defined between the die surface, wherein the opened staple ~lot9 are provided, and the staple magazine ~urface. Then the staple e~ector i~ al90 advanced towards the die by pre~ing the ejector actuating lever, with the result that the ejector prongs enter the ~taple slots to ~rive the staples out o~ them.
~ etallic ~taples, aiter having pierced with their leg~
the compres~ed ti~ue, catch the die rece~es ~ith ~aid legs and thrust thereagai~st to be bent into the shape of the letter ~, thus uniting the tissue firmly-However, ~aid in~trument i8 capable o~ placing a ~ingle type o~ ~uture only, e.g., the linear ~uture.
In order to apply all other type~ o~ suture~ one mu~t ha~e at his disposal such a ~umber of in~trument~ as to apply e~ery type o~ suture, which re~ult~ in a con~iderable amount of sur-gical equipment invol~ed.
- It is the ma$n object of the present invention to provide various types of suture~ applied ~ith the use o~ a ~ingle ~u-turing instrument.
It is another object of the pre3ent invention to provide a surgical suturing instrument tbat wdll preclude any error on the part of surgeon in conforming the die, magazine and staple ejector which would re~ult, at best, in breakage o~ the in~tru-ments, and at worst, in f~ lure of the suture followed by the lethal outcome.
It i9 one more object o~ the pre~ent in~ention to cut down a total cost of the equipment (i.e., suturing instrument~ and accessories) aimed at obtaining a variety of sutures needed in surgical practice.
It is a further object of the present invention to provide convenience and reliability in using the standardized units of the suturing instrument which require standard mani-pulations in order to obtain different types of sutures in practical surgery.
Said and other objects are accomplished due to the fact that in a surgical suturing instrument for application of a staple suture, comprising a supporting body with a replaceable die having a number of recesses for bending the staples fed from a change magazine provided with staple slots and mounted on a mechanically actuated carriage-holder, as well as a mechan-ically actuated ejector adapted to drive the staples out of the magazine and bring them in engagement with the replaceable die so as to establish a staple suture, according to the invention use is made of a replaceable die and of a magazine for establishing every type of suture, said replaceable die has an end guide plate situated in a plane square with the surface having staple bending recesses and jutting out from the die on its side facing the magazine, and the surface of the guide plate of every replaceable die has different shape to suit each of the suture types, while the end surface of every change maga-zine for each type of suture is shaped so as to suit the shape of the guide plate of the die for said type of suture, the staple ejector is also replaceable and its end surface is shaped similarly to the shape of the end of the magazine for the respective type of s~ture.
Owing to the provi~ion o~ a replaceable staple ejector and an end guide plate of the die ~haped similarly to the eha-pe of the end surfaces oY the magazine and e~ector, the dis-closed instx~ment assures a positive eonformity of the die, ejector and magazine, which make~ it po~ible to obtain di~e-rent types of suture~ with the same instrument, to avoid any surgeon'~ errors in 3etting the die, e~eotor and magazine which corre~pond to a definite type of ~uture and hence to lo obviate failure of the s~ture ap~lied, a~ well a3 cuts down the cost3 of the equipment adapted ~or applying diverse type~
o~ suture~ and adds to the convenience of handling the instru-ment.
It i~ expedient that the ~haped surface of the guide plate be defined by #lots opening towards the magazine, while the magazine and ejector be provided with the respective pro-~ections adapted to enter said slot~.
In what follow# the invention i~ illu#trated in a detail-ed description of ~ome ~pecific exemplary embodiments thereo~
with referonce to the attached drawing# wherein:
FIG.l is a general, fragmentarily eutaway side eleva~
tion ~iew of the in~trument, accord~ng to the invention;
~IG.2 i~ a general plan view of the in~trument, accord-ing to the invention;
FIG.3 i9 a #e~tion taken along the line III-III in ~IG.l;
FIG.4 i~ a ~ection taken along the line IV-IV in ~IG.l;
FIG.5 illustrate~ conventional symbols of various t~pes 11g~7Z'~8 -- 6 _ of ~utures made use oi in modern surgery;
~ IG.6 is a ~caled-up perspective view o~ the ejector, magazine and die for applying the linear suture;
FIG.7 is a scaled-up per~pective view of the eJector, magazine and die for applying the pali3ade suture;
~ IG.8 i~ a scaled-up per~pective view of the ejector, magazine and die ior applying the oblique (diagonal) ~uture;
and FIG.9 is a scaled-up per~pective ~iew of the ejector, lo magazine and die for applying the decu~sate (~-shaped) suture.
The surg$cal suturing in~trument for application oi a ~taple suture comprises a ~upporting body 1 (FIG.l) with a replace~ble die 2, wherein a number o~ recesses 3 (~IGS 3, 4, 6, 7, 8, 9) are provided ior staples 4 (FIG.4) to bend, a mechanically-actuated carriage-holder 5 (FIG.l) with a change magazine 6, a staple ejector 7, a mechaniaal actuator 8 o~
the carriage-holder, and a mechanical actuator 9 o~ the ~tap-le ejector.
~he supporting body i~ an oblong trough 10 having guides 11 (indicated with a dotted line) and a hook 12 held to the inner ~urface o~ which iq the die ~. A ~-~lot 13 (FIGS 6, 7, 8, 9) i~ provided in the replaceable die 2 in order to set the latter i~to the instrument, while a T-shaped projection 14 (FIG.2) is provided on the i~ner suriace of the hook 12 for the purpo~e. A tailpieoe 15 (FIG.l) of the supporting body has a lug 1~ adapted to interact with the carriage-holder mecha~i-cal actuator 8. ~he supporting body 1 ha~ a grlp 17 ior con-venience in injtrument handling.
~7;ZZ8 ~ he mechanicall-actuated carriage-holder 5 i9 shaped a~
an oblong tem h~Ying a tailpiece 18 at one end and a holder 20 carrying the change staple magazine 6, at the other end.
In order to keep the magazine 6 in place on the holder 20 a number of lugs 21 (FIG.2) are provided on the latter, whlle the same number o~ ~haped ~lot~ 22 are made in the magazine 6 (~IGS 6, 7, 8, 9)0 In additio~, ~ome through ~lots 23 for staple~ are made i~ the magazine 6, the arr~ngement pattern of said ~lot~ corre~ponding to that o~ the rece~ses 3 in the die. The mechanicall~-actuated carriage-holder 5 ha~
lug~ 24 to interact with the supporting body 1 (FIG.l). ~he tailpiece 19 of the carriage-holder is a hollow structure provided with external and internal thread.
The staple eiector 7 i~ also shaped as an oblong ~tem 25 having a T-slot (not shown) at one end, and a head ~6 with prongs ~7, at the other end.
The configuration and arrangement pattern of the prong~
27 of the ejeotor 7 corre~pond to those of the stapl.è ~lots 23 (FIGS 6, 7, 8, 9).
A~cording to the invention the e~ector 7 (FIG.l) is a replaceable compone~t; to thi~ end, the ejector i8 detachably joined, through its T-~lot, with a T-~haped projection 40 of the mechanical actuator 9 oi the ejector 7.
The mechanical actuator 8 o~ the carriage-holder 5 19 in fact a nut 28 having an annular groove 29.
The nut 28 establishes a ~crew pair align with the Exter-DP1 thread of the tailpiece 19, and with its annular groove 1147~Zl!~
29 i~ slidably engaged with the lug 16 of the supportine body 1. The mechanical actuator 9 of the eieotor 7 is essentiall~
a sCrew 30 having an annular groo~e 31.
The ~crew 30 establishe~ another screw pair along with the internal thre~d of the tailpiece 19 of the carriage-hol-der, and with its annular groove 31 is slidably engage~ with the yoke (not shown) of the e;~ctor 7.
According to the i~ention an end guide plate 32 i9 pro-~ided on the replaceable die 2 (FIGS 6, 7, 8, 9), arranged ~quare with a ~ur~ace 33, wherein the reces~es are made, said guide plate jutting out towards the magszine.
The end guide plate 32 ha~ a shape 34 which i8 imparted only to a de~inite type of ~uture ~FIG.5). O~e of the end surface~ 35 (FIGS 6, 7, 8, 9) of the magaæine 6 and one o~
the end ~urface~ 36 o~ the ejector 7 are ~hPped 90 as to 3uit the shape o~ the end guide plate 32 ~or a ~trictly de~inite type o~ suture.
- The ~hape of the end guide plate may be established by ~lots 37, while the shape of the magazine and ejeetor ends, by similar lugs 38-In order to pre~ent the ti~ue beiQg sutured from esc~p-ing beyond the zone of suture i~ the course of operation, a~
extra component i~ provided in tke i~trument, ~iz. a re~tric-tion ~trip 39 (FIG-l), capable of reckprocating between the hook 1~ and the nut ~8.
When applying a staple ~uture to the inte~tinal stump the present sur~ical ~uturing i~trume~t operates as follows.
1147~ZIg _ g _ According to the technique~ adoped in the modern ~urgery the intestinal stump i8 to be qtitched up with the linear suture.
So one must select the appropriate replaceable die 2 (FIG.6)~
the change magazine 6 Qnd the replaceable ejector 7. Then the nut 28 (FIG.l) o~ the ~arriage-holder mechanical actuator is rotated counterclockwise to retract the carriage-holder to the initial position, whereupon the carriage-holder is extract-ed from the supporting body.
The eje¢tor i9 SO set th~t its T-slot (not shown) ~hould embrace the annular groove 31 of the screw o~ the ejector me-chanioal sctuator 9 and it~ head 26 should enter the holder 20; in thi~ case the shaped end surface 36 (FIG.6) should be directed oppositely to the lug 24 (FIG.l~.
~ext the mechanically-actuated carriage-holder 5 alo~g with the e~ector 7 is placed in the troughlike portion 10 o~
the ~upporting body 1 90 that the eje¢tor 7 be at the bottom ~of said troughlike portion. Then the nut 28 of the mecha~ical actuator of the carriage-holder is given a revolution, whereby the lug~ 24 engage the guide slots 11 (shown with a dotted line) in the supporting body 1. Thu3, a slidable ~oint is obtained, capable of reciprocating lengthwi~e ~rom the hook 1~ toward~ the tailpiece 15 Or the ~upporting body 1.
The change magazine ~ (FIG.2) i~ ~itted i~to the carriage--holder in such a manner that the lugs 21 should engage the ~lots 22 in the magazine 6, whereupon the magazine is ad~anced all the way along the lugs 21.
The die 2 i~ then fitted onto the hook 12 (FIG.l) of the ~47Z:Z8 _ 10 --supporting body 1 in ~uch a manner that the T-shaped projec-tion 14 (FIG.2) of the supporting body 1 should engage the slot 13 (FIG.6) in the die 2 (~IG.2); in this case the end guide plate should face the magazine 6. ~ext the hook of the supporting body i9 brought under the organ bein~ s~tured (i.e., the intestine in this particular oase), and the res~riction strip 39 (~IG.l) i9 advanoed towards the hook so that that the organ being ~utured ~hould be confined within the die 2, the magazine 67 the hook 12 Rnd the restriction strip 39.
Thereupon the nut 28 of the carriage-holder mechanical actuator i~ rotated to advance the carriage-holder along with the magazine 6 and the ejector 7 towards the die 2, thus com-pressing the ti~sue being sutured to de~ine the suturing gap.
This done, the screw 30 of the ejector aetuator 9 i5 rota-ted clockwise to adcance the ejector towards the die, with the result that the eiector prongs 27 enter the staple ~lot~
23 of the magazine 6 to driYe the staples out o~ the magazlne slots.
Upon being expelled from the 310t5 the staples pierce with their legs the tissue being sutured~ thru3t against the die reces~es and get bent into the shape of the letter ~, thus establishing a suture.
.. ~.
~ ext the organ being sutured is cut along the plane of the instrument, and the nut 28 of the carriage.holder mechanical aotuator is rotated counterclockwise to retract the car~iage--holder 5 along with the ejector 7 into the initial position.
1147'~Z8 ~hu~, the organ is released. ~his terminates the suturing procedure.
In the instrument proposed by the present invention a positive conformity of a replacea~le die, magazine and ejector is carried out, whereby any po~sible errors of medical person-nel concerned with setting said change components into the instrument are avoided. This is a feature o~ paramount impor-tance as otherwise, should any of said component~ (die, ejec_ tor, or magazine) adapted ~or applying a de~inite type o~ ~u-ture, e.g., the li~ear euture be set to operat~ in conaunction with the change components ~or applying another type of sl~ture, such a~ the palisade suture, this will result, at best, in the ejector breakage, while at wor~t this ~ill lead in wrongly bent staples ~hich in turn might involve subsequently a ~ailure of the suture and an eventual lethal outcome.
Said errors are completely eliminated in the disclosed instrument as should only one of the change components be con-fused mistakenly the instrument will ~ail to operate at the ver~ beginning of the suture applieation prooedure, i.e., will fail to co~press the ti~sue bein~ 3utured, since the ~hape of the end guide plate 32 will not mate that of the magazine end sur~ace, whlch thereiore will prevent t~e meohanically-actuated carriage-holder from being brought together with the die.
~hus, the diæclosed instrument is capable of applying different types of sutures, obviates any errors in suture appli-cation and hence any po~sibllity of ~ailure of the applied 3U-ture, cuts down a total cost of eguipment involved in applica-tion of diverse types of sutures, and render~ the handling 1~47228 a~d manipulation with the in~trument ea~y and conYenient due to unification and standardization of the ba~ic units thereof.
STAP~ SUTURE
The present lnvention relates to medical equipment and more particularly to a ~urgical suturing i~strument for appli-cation of a staple su$ure, e.g., when suturing various organs and tissues with metallic staples, especially the stumps oi hollow organs, such as blood ves~els, intestines, the stomach, the bronchu~, pulmonary tis~ue, and some other organs, as well as ~or establishing an artificial filter on a blood vessel during operations for thrombus formation.
Up till now a great variety o~ surgieal suturing instru-ments ~or applying a staple suture have been developed. Said instruments are designed ~or ~uturing (closing) the stumps of hollow organs. Ae it is ~nown commonly different organs and operati~e techniques involved in suturing the stlmps oi hollo~
organs require the use of different t~pe~ o~ sutures to be appli ed. Thus, for i~stance, the linear suture is applied ior ~tuFing the intestinal stumps~ while for s~turing the bro~chial stump the palisade or the oblique (diagonal) suture i~ pl~ced;
whenever an extra staunch suture is requixed, the decussate ~ haped) suture i~ expedient to be applied. Surgical sutures are also classified by amd dif~er in length and thicknes~ o~ the ti~sues being stitched up. ~hu~, the suture established in stit-ching up the gastric stump i~ as long as 120 mm, ~here~s the suture applled in stitchin~ up the stump~ of intenstine~, the bronchus, or the vascular bundle is up to 40 mm long.
11472Z~
_ 2 --One prior-art ~urgical suturing instrument for application of a staple suture is heretofore known to u~e commonly for stit-ching up v~riou3 orga~s and ti#sues with metallic staples, e~pecially for stitchin~ up the ~tumps of ~ollow organs (cf. US
Patent ~o.3,079,606).
Said in~truments comprises a supporting body with a repla-ceable die having a number of r~ce~e~ ~or the staples to bend, a mechanically actuated carriage-holder with a change magazine, a staple ejector, a mechanical ~ctuator of the carriage-holder and a mechanical actuator oi the ~taple e~ector.
The supporting bo~y is an oblong trough provided with guides and a hook to the inner suriace o~ which a replaceable ;
die is held, h~ g a number of rece~ses for the staples to bend. The carriage-holder with a cha~ge magazine is slidable along the guide~ of the supporting body, and i~ also provided with guide#. ~he ~taple maga~ine has staple slot~ arraneed 80 as to suit the arrangement of the die rece~ee. Ea¢h of the :
staple ~lots i~ to accomodate a 3ingle metallic etRple. ~he ~taple ejector with prong~ i~ slidable along the carriage-hol-der guides, the ejector prongs being arranged to the pattern of the staple ~lot~ in the magazine.
~ he carriage-holder is screw-actuated, while the staple ejector is leYer-actuated, ~ he instrwment operates as followY. The ~oo~ i~ brought under the organ being utured. ~he carriag~-holder along with the staple ma~azine and ejector is advanced towards the die by rotating the nut of the carriage-holder actuator, with the result that the tissue being ~utured i~ compres3ed until blood ~47'~2 flow is arrested and the so-called suturing gap i~ defined between the die surface, wherein the opened staple ~lot9 are provided, and the staple magazine ~urface. Then the staple e~ector i~ al90 advanced towards the die by pre~ing the ejector actuating lever, with the result that the ejector prongs enter the ~taple slots to ~rive the staples out o~ them.
~ etallic ~taples, aiter having pierced with their leg~
the compres~ed ti~ue, catch the die rece~es ~ith ~aid legs and thrust thereagai~st to be bent into the shape of the letter ~, thus uniting the tissue firmly-However, ~aid in~trument i8 capable o~ placing a ~ingle type o~ ~uture only, e.g., the linear ~uture.
In order to apply all other type~ o~ suture~ one mu~t ha~e at his disposal such a ~umber of in~trument~ as to apply e~ery type o~ suture, which re~ult~ in a con~iderable amount of sur-gical equipment invol~ed.
- It is the ma$n object of the present invention to provide various types of suture~ applied ~ith the use o~ a ~ingle ~u-turing instrument.
It is another object of the pre3ent invention to provide a surgical suturing instrument tbat wdll preclude any error on the part of surgeon in conforming the die, magazine and staple ejector which would re~ult, at best, in breakage o~ the in~tru-ments, and at worst, in f~ lure of the suture followed by the lethal outcome.
It i9 one more object o~ the pre~ent in~ention to cut down a total cost of the equipment (i.e., suturing instrument~ and accessories) aimed at obtaining a variety of sutures needed in surgical practice.
It is a further object of the present invention to provide convenience and reliability in using the standardized units of the suturing instrument which require standard mani-pulations in order to obtain different types of sutures in practical surgery.
Said and other objects are accomplished due to the fact that in a surgical suturing instrument for application of a staple suture, comprising a supporting body with a replaceable die having a number of recesses for bending the staples fed from a change magazine provided with staple slots and mounted on a mechanically actuated carriage-holder, as well as a mechan-ically actuated ejector adapted to drive the staples out of the magazine and bring them in engagement with the replaceable die so as to establish a staple suture, according to the invention use is made of a replaceable die and of a magazine for establishing every type of suture, said replaceable die has an end guide plate situated in a plane square with the surface having staple bending recesses and jutting out from the die on its side facing the magazine, and the surface of the guide plate of every replaceable die has different shape to suit each of the suture types, while the end surface of every change maga-zine for each type of suture is shaped so as to suit the shape of the guide plate of the die for said type of suture, the staple ejector is also replaceable and its end surface is shaped similarly to the shape of the end of the magazine for the respective type of s~ture.
Owing to the provi~ion o~ a replaceable staple ejector and an end guide plate of the die ~haped similarly to the eha-pe of the end surfaces oY the magazine and e~ector, the dis-closed instx~ment assures a positive eonformity of the die, ejector and magazine, which make~ it po~ible to obtain di~e-rent types of suture~ with the same instrument, to avoid any surgeon'~ errors in 3etting the die, e~eotor and magazine which corre~pond to a definite type of ~uture and hence to lo obviate failure of the s~ture ap~lied, a~ well a3 cuts down the cost3 of the equipment adapted ~or applying diverse type~
o~ suture~ and adds to the convenience of handling the instru-ment.
It i~ expedient that the ~haped surface of the guide plate be defined by #lots opening towards the magazine, while the magazine and ejector be provided with the respective pro-~ections adapted to enter said slot~.
In what follow# the invention i~ illu#trated in a detail-ed description of ~ome ~pecific exemplary embodiments thereo~
with referonce to the attached drawing# wherein:
FIG.l is a general, fragmentarily eutaway side eleva~
tion ~iew of the in~trument, accord~ng to the invention;
~IG.2 i~ a general plan view of the in~trument, accord-ing to the invention;
FIG.3 i9 a #e~tion taken along the line III-III in ~IG.l;
FIG.4 i~ a ~ection taken along the line IV-IV in ~IG.l;
FIG.5 illustrate~ conventional symbols of various t~pes 11g~7Z'~8 -- 6 _ of ~utures made use oi in modern surgery;
~ IG.6 is a ~caled-up perspective view o~ the ejector, magazine and die for applying the linear suture;
FIG.7 is a scaled-up per~pective view of the eJector, magazine and die for applying the pali3ade suture;
~ IG.8 i~ a scaled-up per~pective view of the ejector, magazine and die ior applying the oblique (diagonal) ~uture;
and FIG.9 is a scaled-up per~pective ~iew of the ejector, lo magazine and die for applying the decu~sate (~-shaped) suture.
The surg$cal suturing in~trument for application oi a ~taple suture comprises a ~upporting body 1 (FIG.l) with a replace~ble die 2, wherein a number o~ recesses 3 (~IGS 3, 4, 6, 7, 8, 9) are provided ior staples 4 (FIG.4) to bend, a mechanically-actuated carriage-holder 5 (FIG.l) with a change magazine 6, a staple ejector 7, a mechaniaal actuator 8 o~
the carriage-holder, and a mechanical actuator 9 o~ the ~tap-le ejector.
~he supporting body i~ an oblong trough 10 having guides 11 (indicated with a dotted line) and a hook 12 held to the inner ~urface o~ which iq the die ~. A ~-~lot 13 (FIGS 6, 7, 8, 9) i~ provided in the replaceable die 2 in order to set the latter i~to the instrument, while a T-shaped projection 14 (FIG.2) is provided on the i~ner suriace of the hook 12 for the purpo~e. A tailpieoe 15 (FIG.l) of the supporting body has a lug 1~ adapted to interact with the carriage-holder mecha~i-cal actuator 8. ~he supporting body 1 ha~ a grlp 17 ior con-venience in injtrument handling.
~7;ZZ8 ~ he mechanicall-actuated carriage-holder 5 i9 shaped a~
an oblong tem h~Ying a tailpiece 18 at one end and a holder 20 carrying the change staple magazine 6, at the other end.
In order to keep the magazine 6 in place on the holder 20 a number of lugs 21 (FIG.2) are provided on the latter, whlle the same number o~ ~haped ~lot~ 22 are made in the magazine 6 (~IGS 6, 7, 8, 9)0 In additio~, ~ome through ~lots 23 for staple~ are made i~ the magazine 6, the arr~ngement pattern of said ~lot~ corre~ponding to that o~ the rece~ses 3 in the die. The mechanicall~-actuated carriage-holder 5 ha~
lug~ 24 to interact with the supporting body 1 (FIG.l). ~he tailpiece 19 of the carriage-holder is a hollow structure provided with external and internal thread.
The staple eiector 7 i~ also shaped as an oblong ~tem 25 having a T-slot (not shown) at one end, and a head ~6 with prongs ~7, at the other end.
The configuration and arrangement pattern of the prong~
27 of the ejeotor 7 corre~pond to those of the stapl.è ~lots 23 (FIGS 6, 7, 8, 9).
A~cording to the invention the e~ector 7 (FIG.l) is a replaceable compone~t; to thi~ end, the ejector i8 detachably joined, through its T-~lot, with a T-~haped projection 40 of the mechanical actuator 9 oi the ejector 7.
The mechanical actuator 8 o~ the carriage-holder 5 19 in fact a nut 28 having an annular groove 29.
The nut 28 establishes a ~crew pair align with the Exter-DP1 thread of the tailpiece 19, and with its annular groove 1147~Zl!~
29 i~ slidably engaged with the lug 16 of the supportine body 1. The mechanical actuator 9 of the eieotor 7 is essentiall~
a sCrew 30 having an annular groo~e 31.
The ~crew 30 establishe~ another screw pair along with the internal thre~d of the tailpiece 19 of the carriage-hol-der, and with its annular groove 31 is slidably engage~ with the yoke (not shown) of the e;~ctor 7.
According to the i~ention an end guide plate 32 i9 pro-~ided on the replaceable die 2 (FIGS 6, 7, 8, 9), arranged ~quare with a ~ur~ace 33, wherein the reces~es are made, said guide plate jutting out towards the magszine.
The end guide plate 32 ha~ a shape 34 which i8 imparted only to a de~inite type of ~uture ~FIG.5). O~e of the end surface~ 35 (FIGS 6, 7, 8, 9) of the magaæine 6 and one o~
the end ~urface~ 36 o~ the ejector 7 are ~hPped 90 as to 3uit the shape o~ the end guide plate 32 ~or a ~trictly de~inite type o~ suture.
- The ~hape of the end guide plate may be established by ~lots 37, while the shape of the magazine and ejeetor ends, by similar lugs 38-In order to pre~ent the ti~ue beiQg sutured from esc~p-ing beyond the zone of suture i~ the course of operation, a~
extra component i~ provided in tke i~trument, ~iz. a re~tric-tion ~trip 39 (FIG-l), capable of reckprocating between the hook 1~ and the nut ~8.
When applying a staple ~uture to the inte~tinal stump the present sur~ical ~uturing i~trume~t operates as follows.
1147~ZIg _ g _ According to the technique~ adoped in the modern ~urgery the intestinal stump i8 to be qtitched up with the linear suture.
So one must select the appropriate replaceable die 2 (FIG.6)~
the change magazine 6 Qnd the replaceable ejector 7. Then the nut 28 (FIG.l) o~ the ~arriage-holder mechanical actuator is rotated counterclockwise to retract the carriage-holder to the initial position, whereupon the carriage-holder is extract-ed from the supporting body.
The eje¢tor i9 SO set th~t its T-slot (not shown) ~hould embrace the annular groove 31 of the screw o~ the ejector me-chanioal sctuator 9 and it~ head 26 should enter the holder 20; in thi~ case the shaped end surface 36 (FIG.6) should be directed oppositely to the lug 24 (FIG.l~.
~ext the mechanically-actuated carriage-holder 5 alo~g with the e~ector 7 is placed in the troughlike portion 10 o~
the ~upporting body 1 90 that the eje¢tor 7 be at the bottom ~of said troughlike portion. Then the nut 28 of the mecha~ical actuator of the carriage-holder is given a revolution, whereby the lug~ 24 engage the guide slots 11 (shown with a dotted line) in the supporting body 1. Thu3, a slidable ~oint is obtained, capable of reciprocating lengthwi~e ~rom the hook 1~ toward~ the tailpiece 15 Or the ~upporting body 1.
The change magazine ~ (FIG.2) i~ ~itted i~to the carriage--holder in such a manner that the lugs 21 should engage the ~lots 22 in the magazine 6, whereupon the magazine is ad~anced all the way along the lugs 21.
The die 2 i~ then fitted onto the hook 12 (FIG.l) of the ~47Z:Z8 _ 10 --supporting body 1 in ~uch a manner that the T-shaped projec-tion 14 (FIG.2) of the supporting body 1 should engage the slot 13 (FIG.6) in the die 2 (~IG.2); in this case the end guide plate should face the magazine 6. ~ext the hook of the supporting body i9 brought under the organ bein~ s~tured (i.e., the intestine in this particular oase), and the res~riction strip 39 (~IG.l) i9 advanoed towards the hook so that that the organ being ~utured ~hould be confined within the die 2, the magazine 67 the hook 12 Rnd the restriction strip 39.
Thereupon the nut 28 of the carriage-holder mechanical actuator i~ rotated to advance the carriage-holder along with the magazine 6 and the ejector 7 towards the die 2, thus com-pressing the ti~sue being sutured to de~ine the suturing gap.
This done, the screw 30 of the ejector aetuator 9 i5 rota-ted clockwise to adcance the ejector towards the die, with the result that the eiector prongs 27 enter the staple ~lot~
23 of the magazine 6 to driYe the staples out o~ the magazlne slots.
Upon being expelled from the 310t5 the staples pierce with their legs the tissue being sutured~ thru3t against the die reces~es and get bent into the shape of the letter ~, thus establishing a suture.
.. ~.
~ ext the organ being sutured is cut along the plane of the instrument, and the nut 28 of the carriage.holder mechanical aotuator is rotated counterclockwise to retract the car~iage--holder 5 along with the ejector 7 into the initial position.
1147'~Z8 ~hu~, the organ is released. ~his terminates the suturing procedure.
In the instrument proposed by the present invention a positive conformity of a replacea~le die, magazine and ejector is carried out, whereby any po~sible errors of medical person-nel concerned with setting said change components into the instrument are avoided. This is a feature o~ paramount impor-tance as otherwise, should any of said component~ (die, ejec_ tor, or magazine) adapted ~or applying a de~inite type o~ ~u-ture, e.g., the li~ear euture be set to operat~ in conaunction with the change components ~or applying another type of sl~ture, such a~ the palisade suture, this will result, at best, in the ejector breakage, while at wor~t this ~ill lead in wrongly bent staples ~hich in turn might involve subsequently a ~ailure of the suture and an eventual lethal outcome.
Said errors are completely eliminated in the disclosed instrument as should only one of the change components be con-fused mistakenly the instrument will ~ail to operate at the ver~ beginning of the suture applieation prooedure, i.e., will fail to co~press the ti~sue bein~ 3utured, since the ~hape of the end guide plate 32 will not mate that of the magazine end sur~ace, whlch thereiore will prevent t~e meohanically-actuated carriage-holder from being brought together with the die.
~hus, the diæclosed instrument is capable of applying different types of sutures, obviates any errors in suture appli-cation and hence any po~sibllity of ~ailure of the applied 3U-ture, cuts down a total cost of eguipment involved in applica-tion of diverse types of sutures, and render~ the handling 1~47228 a~d manipulation with the in~trument ea~y and conYenient due to unification and standardization of the ba~ic units thereof.
Claims (4)
1. A surgical suturing instrument comprising:
a supporting body;
a set of replaceable dies, each of said dies adapted to be supported on said body and having a plurality of recesses for interacting with staples formed in a sur-face thereof in a particular pattern corresponding to a particular suture and further including a shaped end guide plate extending in the direction of staple ejection situ-ated in a plane substantially normal to the surface in which said recesses are formed, said guide plate having a particular shape corresponding to the respective parti-cular pattern of staple recesses formed in the die;
a set of change magazines, each of said change magazines adapted to be supported on said body and having a plurality of staple slots formed in a particular pattern corresponding to the pattern of a respective die and an end surface having a shape which conforms to the shape of the guide plate of said respective die;
mechanically actuated carriage holder means for carrying said change magazines and advancing the latter towards said die during the course of a suturing operation;
and a set of replaceable staple ejectors, each of said ejectors adapted to be supported on said body and having an end surface having a shape which conforms to the shape of the guide plate of a respective die, whereby said suturing instrument is capable of applying different types of sutures determined by the respective die, change magazine and staple ejector being utilized.
a supporting body;
a set of replaceable dies, each of said dies adapted to be supported on said body and having a plurality of recesses for interacting with staples formed in a sur-face thereof in a particular pattern corresponding to a particular suture and further including a shaped end guide plate extending in the direction of staple ejection situ-ated in a plane substantially normal to the surface in which said recesses are formed, said guide plate having a particular shape corresponding to the respective parti-cular pattern of staple recesses formed in the die;
a set of change magazines, each of said change magazines adapted to be supported on said body and having a plurality of staple slots formed in a particular pattern corresponding to the pattern of a respective die and an end surface having a shape which conforms to the shape of the guide plate of said respective die;
mechanically actuated carriage holder means for carrying said change magazines and advancing the latter towards said die during the course of a suturing operation;
and a set of replaceable staple ejectors, each of said ejectors adapted to be supported on said body and having an end surface having a shape which conforms to the shape of the guide plate of a respective die, whereby said suturing instrument is capable of applying different types of sutures determined by the respective die, change magazine and staple ejector being utilized.
2. The combination of claim 1, wherein said shaped end guide plate of each of said dies has a slot formed therein having a particular respective configuration and wherein said end surfaces of each of said change magazines and staple ejectors have lugs formed thereon having a particular respective configuration conforming to the shape of a slot of a respective guide plate.
3. The combination of claim 1, further including actuating means for moving said carriage holder means toward said die and actuating means for moving said staple ejectors with respect to said change magazine.
4. The combination of claim 2, wherein each of said actuating means includes a respective screw pair.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US2747328 | 1979-03-26 | ||
| US06/027,472 US4218585A (en) | 1979-04-05 | 1979-04-05 | Dimensional sound producing apparatus and method |
| US06/027,473 US4309570A (en) | 1979-04-05 | 1979-04-05 | Dimensional sound recording and apparatus and method for producing the same |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1147228A true CA1147228A (en) | 1983-05-31 |
Family
ID=26702522
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000343888A Expired CA1147228A (en) | 1979-03-26 | 1980-01-17 | Surgical suturing instrument for application of a staple suture |
Country Status (6)
| Country | Link |
|---|---|
| EP (1) | EP0026224A4 (en) |
| JP (1) | JPS56500477A (en) |
| CA (1) | CA1147228A (en) |
| DE (1) | DE3041429A1 (en) |
| GB (1) | GB2058524B (en) |
| WO (1) | WO1980002219A1 (en) |
Families Citing this family (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0036337B1 (en) * | 1980-03-19 | 1985-02-20 | Matsushita Electric Industrial Co., Ltd. | Sound reproducing system having sonic image localization networks |
| US4567607A (en) * | 1983-05-03 | 1986-01-28 | Stereo Concepts, Inc. | Stereo image recovery |
| JPS63224599A (en) * | 1987-03-13 | 1988-09-19 | Asa Plan:Kk | Stereo processing unit |
| JP2924710B2 (en) * | 1995-04-28 | 1999-07-26 | ヤマハ株式会社 | Stereo sound field expansion device |
| RU2106073C1 (en) * | 1996-02-12 | 1998-02-27 | Владимир Анатольевич Ефремов | Spatial sound-reproducing system |
| JP5206137B2 (en) * | 2008-06-10 | 2013-06-12 | ヤマハ株式会社 | SOUND PROCESSING DEVICE, SPEAKER DEVICE, AND SOUND PROCESSING METHOD |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3236949A (en) * | 1962-11-19 | 1966-02-22 | Bell Telephone Labor Inc | Apparent sound source translator |
| JPS51132803A (en) * | 1975-04-17 | 1976-11-18 | Nippon Hoso Kyokai <Nhk> | Sound field expander |
| JPS51163901U (en) * | 1975-06-19 | 1976-12-27 | ||
| US4118599A (en) * | 1976-02-27 | 1978-10-03 | Victor Company Of Japan, Limited | Stereophonic sound reproduction system |
| JPS52125301A (en) * | 1976-04-13 | 1977-10-21 | Victor Co Of Japan Ltd | Signal processing circuit |
| DE2640254A1 (en) * | 1976-09-03 | 1978-03-09 | Manfred Schunke | Stereophonic reproduction system - subjects channel signals to delay, phase shift and frequency change and cross-mixes signals with originals |
-
1980
- 1980-01-17 CA CA000343888A patent/CA1147228A/en not_active Expired
- 1980-04-04 WO PCT/US1980/000354 patent/WO1980002219A1/en not_active Application Discontinuation
- 1980-04-04 GB GB8038858A patent/GB2058524B/en not_active Expired
- 1980-04-04 JP JP50103280A patent/JPS56500477A/ja active Pending
- 1980-04-04 DE DE19803041429 patent/DE3041429A1/en active Granted
- 1980-10-23 EP EP19800900851 patent/EP0026224A4/en not_active Ceased
Also Published As
| Publication number | Publication date |
|---|---|
| EP0026224A4 (en) | 1981-08-27 |
| GB2058524A (en) | 1981-04-08 |
| DE3041429C2 (en) | 1992-03-12 |
| GB2058524B (en) | 1984-02-15 |
| EP0026224A1 (en) | 1981-04-08 |
| JPS56500477A (en) | 1981-04-09 |
| WO1980002219A1 (en) | 1980-10-16 |
| DE3041429A1 (en) | 1982-02-11 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| MKEX | Expiry |