US1460531A - Hemostatic forceps - Google Patents

Description

July 3, 1923.

1,460,531 J. F. CALLAHAN HEMOSTATI C FORCEPS Filed Feb. 18 1921 @Jamd 6M? 7% Wwggw Patented July 3, 1923.

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JOHN F. CALLAHANQDF BROCKTON,.MASSACHUSETTS.

HEMOSTATIC FOR/GEES.

Application filed February 18, 1921. Serial No. 445,949...

State of lllassachusetts, have invented new and useful Improvements in Hemostatic Forceps, of which the following is a specification.

The invention about to be described relates t forceps for closing arteries, veins, blood vessels and other bleeding points in the course of surgical operations preparatory totying a ligature about the said bleeding portions. ,1 1

My object has been to provide forceps of this character with means for so holding a ligature prepared for tying, and means for so holding the bleeding tissue, as to make certain that the ligature, when tied, will surround the artery, or other vessel orpart from which blood flows, so deeply and at such a distance back from the end of the artery, or surface of the bleeding tissue, that the ligature will not be liable to slip ofl".

Many situations occur in surgery where an artery. or blood vessel is severed and is so difficult of access that a ligature cannot be passed about the bleeding point without extreme difficulty, and then when ,tied the ligature is insecure. In. some cases it has been impossible to ,ligate the bleeding point at all. The last statement is particularly true of tonsilectomy; in which arteries are severed. but the area of the tonsilfossa is so. small audits depth so great, and the v throat cavity is so restricted, thatthe'surgeon cannot passthe loop of a ligature over the end of an ordinary hemostatic forceps which has been closed on a bleeding point, and make it secure.

In carrying out my object, above stated, I have devised a forceps by which the tis sue surrounding the blood tube, or around any other bleeding point, may be grasped, however diflicult of access the bleeding point may be; and have equipped such forceps with means for holding a ligature ready to be tied in a loop about the bleeding point, and particularly with means for so grasping the tissueand guiding the ligature that the'latter maybe tied tightly and in such a manner as to compress a narrow neck of the tissue below the original surface thereof before the forceps need to be released.

For a complete explanation of theinven- Figure 1.

tion and its utility, attention is called to the drawings forming a part of this specification, in which,

Figure l is an elevation showing one side of a particular forceps embodying the invention. I v

Figure 2 is a longitudinal sectional view between the jaws and handlesof the forceps taken on line '22 of Figure 1.

Figure 3 is a detail sectional'view taken. on line'33 of Figure 2. g I s Figure 4 is an elevation showing-the opposite side of the forceps from that shown Figure 5 is a perspective view of the jaws of the forceps in open position.

Figure (Sis an elevation. showing the jaws in their closed position view point of Figure 4.. ,1

Figure 7 is an elevation't'aken similar to Figure 6, but showing the ligature drawn tight about the tissuein thegrasp of the forceps. r v

Figure 8 is an. elevation of the jaws seen from the view point of Figure 1, but repre sented as being closed.

Figure 9 is a viewof one of, the'jaws simiand as seen from the lar to that shown in Figure 2, illustrating the manner in which the ligature is tied. about the tissue while the latter is grasped by the jaws.

. Figure 10 is a cross section taken on line 10-1O f Figure 7 illustrating. the ligating operation.

Figure 11 is a side view of a completed ligation. I i I Like reference characters indicate the same parts wherever theyoccur in all the figures. i i j TllQfOICBpS consist oftwo members 12 and 13 crossing one anotherandpivoted together by a pivot screw 14: in the .man-

ner common to forceps of various types. The jaws 15 and 16 are extensions of the members .12 and 13 respectively, and said members: have loops; or rings 17 and 18 to receive the thumb and finger of the operator. The arms or handle parts of the forcep members carry complemental latching teeth adapted tobe interengaged when the jaws are closed, there being one tooth 19 on the handle part of the member 12 and a series of teeth 20 on the handle part of member 13. Preferably the members 12 and 13, between the pivot and the 'fing'er holds, are long and springy in order that they may be latched in the closed position, even though the jaws remain more or less spread apart by the mass of interposed tissue.

In the face of each jaw and opening to ward the side of the forceps which exposed to view in Figures at, 6 and 7, is a recess 21. This recess does not extend to the extremity of the jaw nor does it extend all the way across the face of the jaw but leaves a gripping surface which is the full width of the jaw in the part 22 and is flanked by apart 23 of less than the full width. This surface may be corrugated or otherwise roughened to increase its gripping power.

' Between the parts 22 and 23 in the face of each jaw is a groove or notch 24 wide and deep enough to receive a ligature. This groove or notch 2st merges into the recess 21. There is a guard wing or lug'25 projecting from that edge of each jaw which is exposed to view in Figure 1 and located beside the recess 21. The purpose of this guard is to prevent the thread or cord which passes along the side of the jaw and through the groove 24 from slipping into the recess, wherefor the guard is given a shape and dimensions appropriate to achieve this result;

On the outer face of the member 13 is mounted a clamp or gripper 26, the purpose of which is to hold the loop or bight of the cord to be used as a ligature. This clamp is made as a stiff spring bar which is fastened at one end by a screw 27 to the member 13, and the free end of which is shaped and arranged to bear against the surface of this member when the jaws are opened. Preferably a notch 28 is formed in the inner face of the clamp to receive the cord. A pin 29 is secured to the clamp and passes thence freely through a hole in the member 13 and into contact with a cam or wedging surface 30, shown in Figure 3, formed in the adjacent face of the member 12, the arrangement and form of which is such that when the jaws are closed this surface wedges the pin outward and separates the clamp from the member 13, while when the jaws are opened the recession of the cam surface allows the clamp to close against the member 13. The separating movement thus given the clamp is great enough to permit the ligature cord to be readily slipped into and out of the space between the clamp and the opposing surface of the member 13. The pin 29 is es sentially a part of the clamp which engages the cam surface, and its function is that of a pusher for opening the. clamp when the jaws are closed.

A clip or retainer 31 is mounted on the outer side of. the member 12 to hold the ligature cord, and a similar clip may be shown in Figure 1. cord 1S then passed along the aw 15, outside mounted in a similar manner on the outer side of the other member for holding the other end of the cord; although the latter clip is not shown, and indeed, the clip 31 may be omitted without destroying the utility of the instrument.

A spring wire 32 is anchored at its end to the member 13 and is restrained from free movement by an abutment stud 34:. Its free end bears against the member 12 and tends to open the forceps, holding the jaws open when the handle parts of the instrument are unlatched.

In using the forceps for the purposes setforth, it is first threaded with the thread or cord to be used as a ligature. Such cord may be of silk, catgut, horsehair or any other material indicated in surgical practice as suitable for ligatures and sutures. To thread the forceps, the jaws and handles are first closed together, which opens the clamp 26. Then the middle part a of the cord is slipped under the clamp and the jaws are opened, whereby the clamp is caused to grip the cord. Then the cord, at one side of the gripping point, is passed along the face of the jaw 16, which is exposed to view in Figure f1, outside of the guard 25, through the groove 2a in that jaw and along the opposite side of. the instrument to the clip 31, by which it is held as The other part of the of the guard 25, and through the groove 24 in that jaw and along the handle part of the member 13, where it may be held either by a clip or by the fingers of the operator while grasping the forceps, or it may be allowed to hang free.

The cord is now clear of the gripping faces of the jaws and is so placed that it does not interfere in any way with the use of the instrument in the ordinary way as a hemostat, and it may be used to grip the end of a severed blood tube or any other bleeding point in the tonsil fossa, or any other part of the anatomy exposed in the course of a surgical operation.

Of course the instrument, or any part thereof, may be made as large or as small as may be needed in any circumstances, whereby its use as a hemostat at points most difficult of access is made possible.

-Before the jaws are closed upon the bleeding point they may be pressed into the surrounding soft tissue far enough to secure a deep bite. and when closed they are locked by the latch teeth 19 and 20, leaving the operator free to use both hands for tying the li gature. The closing of the jaws also opens the clamp 26 and leaves the loop of the cord free to be drawn tight about the gripped tissue", and the grooves 24 furnish runways through which the cord maybe drawn and by which the loop is securely guided to poalong distancef-rom thebleeding pointw Figures 6 to ll illustrate the manner; in which the tissue at the bleeding point is gripped by the forcepsland thesteps of tying the: ligature. In Figurefithe' tissue has just beengrasped, and theloop .off the cord released. Figure-7 showsthesarnerview of the jaws, after. the loop has been-drawn tight. Figure :Sshows. the manner inwhich the knot is tied. and is. drawn tight against the. tissue. Figures Qand lOshow the-manner in which theknottedloop is enabled by the formation of therjaws to compress the tissuewheresthe ligature is applied, leaving the part; of the tissue in front of the ligature as an enlarged head. which prevents the ligature from. slipping. 0E; and I Figure 11. shows-the completedligature.

. In. these figures. 36 represents. any part of the. body tissue: from which hemorrhage occurs, and 37 represents; the part which is gripped bythe jaws. The forceps are indented into the tissue far enough, to

cause this grippedspart to crossthe grooves 2%. Then the effective gripping-surfaces of the jaws are their terminal faces: .22 and the parts 23 beside the cavities 21. That part of t-hejmass of tissue which lies over the cavities is left free, Wherefore the loop of the ligature is enabled to compress I that part of the tissue at the bottom of the cavities and to leave uncompressed the we tremity of the gripped mass. The knot may be tied and the loop drawn tight while the forceps remain closed upon the tissue, because the loop is entirely contained in spaces within the jaws. Then after the tying of the ligature has been completed the forceps may be removed. Provided a deep enough bite of the tissue has been taken in the first place (which is always possible) the extremity of the gripped mass is enabled to expand after removal of the forceps and to form an enlarged head above the narrow neck where the ligature is applied, which head retains the ligature inplace.

This entire operation can be performed without need of the operator bringing his fingers near the bleeding point and is thus capable of being carried'out with respect to bleeding points in the'tonsilfossa and other spots which cannot be reached by the operators fingers.

What I claim and desire to secure by Letters Patent is:

1. Hemostatic forceps having gripping jaws, and such jaws being provided with runways in their gripping faces adjacent to but back from the extremities of the jaws, said runways being adapted to contain a ligature cord and to guide a loop formed in such a cord to the substancegripped between the jaws.

are closed.

2. Hemostatic forceps having -.gripping jawsivith runways in their opposing faces and means fontemporarily retaining at .a

point distant from the ends. of such jaws the loop of a. cord passing runways f I 3. Hemostatic forceps: having gripping jaws with runways, means for-temporarily through said leasing. .said retaining means when. the jaws 4; Hemostatic forceps comprising jaws having terminal gripping faces andad acent gripping faces of less width thantheten- I minalfaces andrunways for aligaturebord retaining-at. a-f point distant-from the ends" i v of such jaws the loop of a -cord. passing through said runways, andmeans for rIebetween said terminal and adjacent faces,

whereby the ligature contained'i'n said'runways is-enabled to be drawn tight'about-the that-part about which-the ligature iapassed.

5. l+lemostatic-forceps comprising pivoted jaws and connecting 'handlemember's, said jaws having opposed gripping surfaces at their terminals. cavities opening :at theisides of: the-jaws adjacent to said terminals, and

runways opening fromsai'd cavities between -.saidterminals and the -.jaw.;.faces beside theta cavities.

6. HGHIOStELtlC forceps comprising pivoted jaws and connecting handle members,. said aws having opposed grippmg surfaces at their terminals, cavities adjacent to the terminals, runways opening from said cavities opening at on side of the jaws and extending part way'across the jaws between said terminals and the jaw faces beside the cavi ties, and temporary clamping means on the same side of the forceps as that toward which said cavitiesopen, adapted to hold i the loop of a cord passing through the runways. v

7 Hemostatic forceps comprising pivoted jaws and connecting handle members, said jaws having opposed gripping surfaces at their terminals. cavities opening at the side of the jaws adjacent to the-terminals, runways opening fromsaid cavities. between said terminals and the jaw faces beside the cavities, guards arranged on the jaws adja cent'to the outer boundaries of said cavities in position to guide a cord passing through said runways outside of the mouths of said cavities and along the adjacent sides of the jaws, and means for holding the loop or bight of a cord so disposed.

8. Hemostatic forceps comprising complemental jaws having gripping faces and provided withguiding means for leading a cord from one side to the opposite side of said jaws, combined with a holder adapted to retain the loop of a cord engaged with said guiding means.

9. Hemostatic forceps comprising complemental gripping jaws, each of said jaws having a guideway in which a ligature cord is adapted to be placed, combined with temporary holding means for the loop of a cord, such holding means being arranged at one side of the forceps.

10. Hemostatic forceps comprising complemental gripping jaws and handle members operable to open and close said jaws together, *the forceps also having at one side a cord holder, and each of the jaws having a guideway adjacent to its extremity adapted to receive the parts of a cord running from said holder to the side of the forceps opposite thereto.

her when the aws are closed, said jaws having transverse runways opening in their gripplng faces.

12. Hemostatic forceps comprising complemental jaws having at their extremities so gripping surfaces of a certain width, and

having gripping faces of less width back from such extremities, said jaws also having runways opening in said faces of less width.

13. Hemostatic forceps comprising coinplemental jaws having at their extremities gripping surfaces of a certain width, and having gripping faces of less width back from such extremities, said jaws also having runways opening in said faces of less width, and a clamp arranged to hold the hight of a cord in such a position that the sides of said bight may extend from said clamp and through said runways.

14 Hemostatic forceps comprising complemental jaws having at their extremities gripping surfaces of a certain width, and gripping faces of less width baclr from such extremities, saidjaws also having runways opening in said faces of less-width, a clamp arranged to hold the bight of a cord in such a position that the sides of said eight may extend from said clamp and through said runways, and means for opening said clamp when the jaws are closed, the clamp being closed when the jaws are opened.

In testimony whereof I have aflixed my signature.

JOHN F. OALLAHAN.

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