JPS6317450B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to improvements in surgical instruments, particularly suture cutters.

Such suture cutters have been known in the industry for many years and are used by surgeons to cut the ends of sutures after they have been tied. For best results, a certain length of residue must be left. If this residual portion is too short, there is a risk of the knot becoming loose. Also, if this remaining portion is too long, it will interfere with surrounding tissues. Therefore, optimizing the length of the remainder is a problem for the surgeon.

Additionally, because sutures are typically tied inside the body, there is a significant risk of cutting tissue or blood vessels. Surgeons must take great care to avoid this. This problem is complicated if the suture is deep in the body or if the patient is particularly obese.

The present invention overcomes the drawbacks of the prior art and provides a thread cutter that is simple and reliable to operate.
Proper implementation of the present invention allows even a semi-skilled assistant to cut sutures quickly, easily and safely.

In carrying out the present invention, the first handle and the second
A suture cutter is provided comprising a handle. The handles are pivotally connected to each other midway between their ends, thus creating a scissor-like configuration. One end of this pair of handles serves as a handle. The first handle terminates in a holding member at one end remote from the handle, and the second handle also terminates in a blade at one end remote from the handle. The blade is provided with a knife edge and a back portion remote from the knife edge. In this way, the blade is adapted to come into contact with the holding member in a cutting manner.

The retaining member itself has a predetermined depth and consists of arms, elements, and slots formed therebetween. The slot is large enough to receive the suture, but small enough that the suture knot cannot pass through.

The blade and knife edge contact the element at the top or leave the cut. As a result, the length of the remaining portion left uncut after cutting is determined by the depth of the holding member.

In a preferred form of the device, the arms are relatively rigid and the elements are flexible. The element can therefore move towards the arm as the blade scrapes the arm during the cutting operation.
Therefore, in the optimal device configuration, the element contacts the arm and secures the suture within the slot. For best results, the element should be spring biased away from the arm and the slot should be bored to receive the suture. This hole, like the slot itself, is too small for a suture knot to pass through.

For the best results with the simplest operation, the slot is provided with an access opening so that the thread can be easily passed through. It is particularly useful for the access opening to be flared to facilitate threading of the suture.

An advantageous form of the device provides a surface on the blade adjacent to the surface of the element. The surface is sloped toward the element such that the portion of the surface near the knife edge is further away from the element than the portion near the back surface. This results in increased pressure on the element as the knife edge moves over the element and cuts the suture. This ensures that the element closes the slot and properly retains the suture.

The handling of this tool is extremely simple and unmistakable. After the surgeon knots the suture, the free end is inserted into the slot through the flared opening. This is conveniently done near the top of the suture. The tool is then slid down the suture until the lower end of the retaining member contacts the knot. Next, align the handles together as you would normally do, and cut the sewing thread with a knife edge.

As can be readily seen, the depth of the retaining member determines the length of the remainder of the suture remaining. Therefore,
It is only necessary to design the cutter so that the retaining member has a thickness that corresponds to the desired length of the suture remainder. For example, for silk thread, 3~
3.5mm, 4.5-5mm is appropriate for guts, etc.

An alternative method of using the device is to partially close the tool before sliding it along the suture so that the blade presses against the element and causes the slot to be closed by the element. The suture is retained within the hole by this means. In this way, the thread will not slip out of the slot.

In another variant of the invention, the suture cutter is mounted on the same "tweezers" that constitute the surgical needle holder. In this way, without changing tools or loosening the knot the surgeon is attempting, the surgeon can sew, make the knot, and cut off the excess suture leaving exactly the correct amount of residual material.

As can be seen from the foregoing, it is virtually impossible for a surgeon to sever any tissue, blood vessels, organs, etc. again. As a practical matter, sutures can be safely cut even if the surgeon cannot see the knot.

Embodiments of the present invention will be described below with reference to the accompanying drawings, in which like reference numerals indicate like parts.

A suture cutter of the present invention is shown at 1. The thread cutter 1 consists of a first handle 2 and a second handle 3,
Both handles 2, 3 are pivotally connected at a midpoint 20 of their ends. A spring 4 is provided to bias the cutter 1 into the open position.

The handle 3 terminates at a midpoint 20 on the side opposite the handle 21 with a blade 8 having a knife edge 15. Pattern 2
The holding member 7 terminates at the end opposite to the handle 21.

The holding member 7 is bifurcated into an arm 9 and an element 10 near its end. Knife edge 15 is element 1
Pass over 0 and arm 9 and reach slot 11.
The sewing thread 5 inserted into the hole 14 is cut. An opening 18 is provided at the end of the slot 11 for easy insertion of the thread 5.

Referring to FIGS. 4 and 6, surface 1 of blade 8
6 is inclined with respect to the element 10. For this reason,
When the blade 8 is moved towards the suture 5, the pressure on the element 10 of the surface 16 is increased. The element 10 then moves to the position shown in FIG. 6 and holds the thread 5 in place as it is cut. A residue 19 is left on the thread 5 after cutting.

With this tool, the incision 17 is located at the seam 1 of the skin 12.
Closed by 3. A pre-cut sewing thread 5 extends from each stitch. The suture 5 is inserted through the opening 18 in the holding member 7 and into the slot 11 and hole 14.
The cutter 1 may then be partially closed so that the blade 8 and the knife edge 15 move toward the suture thread 5 without touching the suture thread 5. As a result, the element 10 mates with the arm 9 and secures the suture 5 in the hole 14. In a preferred form of the device, the inclined surface 16 allows the element 1 to
The force applied to the slot 11 is gradually increased to ensure that the slot 11 is closed.

The working end of the cutter 1 is moved along the suture 5 until the arm 9 and the underside of the element 10 come into contact with the knot 6 of the suture 5. This is done entirely by feeling and there is no need to actually see the knot 6 or the notch 17.

The cutter 1 is then fully closed and the blade 8 and knife edge 15 are used to trim the suture 5 leaving a residue 19 of the appropriate predetermined length.

A variation of the invention is shown in FIG. In this example, the slot 11 has an opening 1 facing the user.
8 is provided. To do this, insert the sewing thread 5 into the opening 1.
8 into the slot 11 from the side of the cutter facing away from the tissue. This configuration has been found to be particularly advantageous for some surgical procedures.

It will be appreciated that the method of moving the blade 8 and the holding member 7 relative to each other is not absolute. In its basic form, the invention was described as a pivoting structure similar to scissors. Another configuration is shown in FIG. The handles 2 and 3 are joined by a tweezers 23 so that the blade 8 can come into cutting contact with the element 10 and the arm 9 in a manner similar to other forms of the device. This embodiment has been found to be most useful in eye surgery and similar sensitive operations.

Sometimes the angle of use of the device is such that the head of the device obstructs the surgeon's view. In such a case, the embodiment shown schematically in FIG. 9 is useful. A handle portion 24 is on one side and a head portion 26 is on the other side. A sloped section 25 connects these two sections. In this configuration, the surgeon can clearly see what he is doing and may find this configuration more convenient to use for certain applications. Although this embodiment has been illustrated with respect to a scissor-type device, it is of course equally applicable to a tweezers-type device.

Referring in more detail to FIGS. 10 and 11, another embodiment of the invention provides a needle holder as part of a single device. The structure of this device is generally the same as other embodiments of the invention, but with needle gripping areas 26 on the blade 8 and retaining member 7, respectively.
and 27 are provided. The knife edge 15 has a slightly different shape and abuts the element 10 and the arm 9.

The handles 2 and 3 of this device are provided with a first grip 28 and a second grip 29, respectively. The first grip 28 has a first ratchet 3.
0 and the second grip 29 has a second ratchet 31 formed therein. These ratchets 30, 31 face each other and are adapted to engage with each other.

When the device is closed and the needle is gripped between gripping areas 26 and 27, latches 30 and 31 overlap and interlock with each other. This holds the device in the closed position against the tension of the spring 4. This allows the surgeon to create the knot without the risk of dislodging the needle.

After the knot is completed, the needle is released and the thread is inserted into slot 1.
1 and the device is closed. As a result, the knife edge 15 can cut the sewing thread in the same way as in the other embodiments. As a result, arm 10 and element 11
A remainder of length equal to the thickness of is left. This type of device allows the surgeon to create stitches, create knots, and cut threads without changing tools.

Another safety feature is the limit screw 32.
is provided. This adjustment screw 32 prevents the device from expanding more than desired. For best results, knife edge 15 must be in constant contact with arm 9 or element 10. In this way, no tissue is trapped between knife edge 15 and element 10.

One of the features of the present invention is that the tool is designed so that the knife edge 15 does not exceed the holding member 7 in the most preferred form. This prevents tissue from becoming trapped between the knife edge and the holding member. Moreover, due to the essential nature of the scissoring action of the tool, the blade sharpens itself. Wear on the retaining member acts to sharpen the edge and keep it sharp.

Although only a limited number of embodiments of the invention have been described above, the invention is to be broadly construed and not to be limited except by the scope of the claims.

[Brief explanation of the drawing]

In the accompanying drawings, FIG. 1 is an overall view of the device according to the present invention, partially diagrammatically shown, FIG. 2 is an enlarged bottom view perspectively showing the operating portion of the device, and FIG. 3 is a diagram showing the device in use. FIG. 4 is a cross-sectional view taken along line 4-4 in FIG. 3, FIG. 5 is a view similar to FIG. 3 after the sewing thread has been cut, and FIG.
FIG. 7 is a view similar to FIG. 2 showing another embodiment of the invention; FIG. 9 is a schematic diagram of an "offset" type device of the invention; FIG. 10 is a plan view of a combination of a suture cutter and a modified suture holder; and FIG. 11 is a view of the head of the suture cutter of FIG. 10. It is an enlarged view of. 1... Suture cutter, 2, 3... Handle, 4... Spring, 5... Sewing thread, 6... Knot, 7... Holding member,
8...blade, 9...arm, 10...element, 11...slot, 14...hole, 15...knife edge, 1
6... Surface, 17... Notch, 18... Opening, 19
...Remaining part, 20...Middle point, 21...Handle, 2
3...tweezers, 25...slanted part.

Claims (1)

Claims: 1 a suture holding member and a blade, the blade having a knife edge and a back portion remote from the knife edge, and configured to make shearing contact with the holding member; has a depth and has an arm and an element and a slot therebetween, said slot having a portion configured to receive a suture, but so small that a knot of suture cannot pass through it, thereby allowing said The suture is cut by shearing contact between the holding member and the blade, leaving a residual portion on the side away from the tissue of the human body, so that the suture is tied at a point substantially equal to the depth. Suture cutter. 2. The suture cutter of claim 1, wherein the suture holding member and the blade are elastically connected to each other at a location remote from the knife edge, thereby forming a scissor-like structure. 3 further comprising a first handle pivotally connected to a second handle at a midpoint of each end, one end of each of the first and second handles being a handle, and the first handle being a handle; The end remote from the handle terminates in the suture holding member, and the second handle terminates in the blade at the end remote from the handle, thereby forming a scissor-like structure. Claim 1
The suture cutter described in Section 1. 4 said arm is rigid and said element is flexible and configured such that said element moves towards said arm under the influence of said blade to close said slot and secure said suture therein; A suture cutter according to claim 1. 5. The suture cutter of claim 1, wherein said element is spring biased away from said arm. 6 the blade contacts the element on one side, this side being sloped towards the element from the knife edge towards the back, so that pressure on the element is reduced when the suture is cut; A suture cutter according to appended claim 4. 7. The suture cutter according to claim 1, wherein the opening for the suture is provided between the arm and the element. 8. The suture cutter of claim 1, wherein the slot is provided with an aperture configured to receive the suture, the aperture being so small that a knot cannot pass through it. 9. The suture cutter according to claim 7, wherein the opening is flared. 10. The suture cutter of claim 10, wherein the knife edge slopes toward the retaining member as it extends away from the tissue. 11. The suture cutter according to claim 3, wherein the holding member and the blade are not on the same plane as the handle. 12. The suture cutter according to claim 2, wherein the holding member and the blade are not on the same plane as the location. 13. The suture cutter according to claim 1, wherein each of the holding member and the blade is provided with a needle gripping area. 14. Claim 3, wherein each of said retaining member and blade is provided with a needle gripping area, each said area being located adjacent to an end of said first or second handle remote from said handle. The suture cutter described in Section 1. 15 a first grip is secured to the first handle, a second grip is secured to the second handle;
The first grip and the second grip are located between the point and the handle and are configured to overlap each other when the cutter is closed, and a first ratchet is provided on one side of the first grip. and a second ratchet is provided on the second grip in complementary relation to the first ratchet and configured to releasably engage the first ratchet when the cutter is closed; 15. The suture cutter of claim 14, wherein the cutter is held in a closed position by the engagement of said first and second ratchets.