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Suturing instrument

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US1822330A
US1822330A US42042930A US1822330A US 1822330 A US1822330 A US 1822330A US 42042930 A US42042930 A US 42042930A US 1822330 A US1822330 A US 1822330A
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Prior art keywords
needle
suture
provided
casing
handle
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Ainslie George
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Ainslie George
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery

Description

Sept. 8, 1931. G. AINSLIE SU'TURING INSTRUMENT 4 'sheets-sheet 1 Filed Jan. 13, 1950 grund/vwo@ drtorum* Sept 8, 1931- G. AINSLIE SUTURING INSTRUMENT Filed Jan.' l5, 1950 4 Sheets-Sheet 2 .rllilillllllllllllill Sept. 8, 1931. G. AINSLIE 1,822,330

SAUTRING INSTRUMENT Filed Jan. 13. 195o 4 Sheets-Sheet 5 :gn/vento Sept. 8, 1931. G, A|NsL|E i 1,822,33Q

SUTURING INSTRUMENT Filed Jan. 1s, 1930 4 sheets-sheet 4 ZJ Houma* Patented Sept. 8, 1931 UNTTED STATES GEORGE AINSLIE, OF IORTLAND, OREGON SUTURING INSTRUMENT Application filed January 13, 1930. Serial No. 420,429.

5 resulting from a tonsil operation, is at present a dinicult and tedious process particularly so because the cavity is in a more or less inaccessible place.

Elaborate sets of needles of various shapes 10 are required, and the needle with which the suture is to be placed is held by a pair of forceps, and auxiliary instruments are used for holding the bleeding point and directing the needle, which is awkward and requires '15 the use of both hands. Further, the needle must often be pushed through the llesli at an angle to the holding Jorcep,\so that it is frequently misdirected and the placing of the.

suture must be started over again. Also, the

' 20 needle is liable to slip out of theV holding forceps and be lost in the flesh, in which case, considerable time is consumed invsearching for the lost needle, to say nothing of the effect on the patient.

As a result, while every cavity should,in lgeneral, be sutured, it is not always done, unless there is an immediateV need, as for instance, if the cavity is bleeding, or the cavity for other reasons must be closed at once.

Therefore, the object of my invention is to provide a simple surgical vinstrumentadapted to be operated by one hand to place a suture with certainty in any cavity which can be seen, without theV use of auxiliary instruments, such as hooks, spatulas for counter pressure for the needle, and the like.

A further object of my invention is to provide a suturing instrument to which the needle is positively connected, and by which it is positively operated so that the needle can not, under any circumstances, be misdirected', or fall out of the instrument and be lost in the llesh.

A further object of my invention is to prod vide a suturing'instrument, the needle of which is adapted to first pierce the flesh on each side of the bleeding point, thus drawing the flesh more or less together, and then to engage and draw the suture through the flesh as the needle is retracted, thus preventing the possibility of the suture falling off the needle. as it pierces the flesh.

I attain my objects in a suturing instrument comprising substantially a casing provided with projecting, arcuate, a distal and proximal arms arranged to provide a fleshadmitting cavity between and forming a guide flange about said cavity, a curved suture needle slidably mounted on said guide flange within said casing. The distal arm of the casing provided at its extremity with means for holding a suture, the needle provided with means adjacent itspoint for engaging the suture, 'and simple operating means for moving the needle about said guide flange, whereby when said needle is projected from the proximal arm of the casing and through the flesh on each side the cavity to be sutured, the needle will enter said distal arm and engage the suture, and when the needleis retracted, the suture will be disengaged from said proximal arm and drawn through the sides of the cavity, thus placing the suture surely and quickly. i These and other incidental features of my invention, the details of construction, and mode of operation are hereinafter more fully described with reference to the accompanying drawings. i I

In the dra-wings:

Fig. l shows a side elevation of my suturing instrument;

Fig. 2 shows a front elevation of my instrument taken in the direction of the arrow 2 in Y Fig. l;

Fig. 3 shows a view of my instrument taken similarly to Fig. l, except the handle elements are shown partly in section;

Fig. l shows the two complementary parts of the casing containing the suture needle removed from the rest ofthe instrument;

Fig. 5 shows an y enlarged, central, longitudinal section of my instrument taken similarly to Fig. 1, with one of the needle casing halves removed, and illustrates the details of construction of the suture needle and operating means;

Fig. 6 shows a fragmentary view of the needle casing and suture needle similarly to Fig. 5, eXcept that the needle is in its projected position;

Fig. 7 shows a view similar to Fig. (3 but illustrates the needle in the operation of being retracted and drawing the suture after it;

F 8 shows, more or less diagrammatically, how the suture disengages itself from the instrument after it is placed;

F 8a shows a top end view of the instrument as shown in Fig. 7 and illustrates how the suture needle engages the suture;

Fig. 9 shows a side elevation ot the suture needle removed from the casing;

Fig. 10 shows a large scale section taken on the line 10-10 of Fig. 9;

Fig. 11 shows .a side elevation of my suture instrument embodying a modiication;

Fig. 12 shows an enlarged longitudinal section taken through Fig. 11 and illustrates the said modification, consisting in providing flexible cable element for operating the suture needle;

Fig. 13 shows further, similarly to 12, said modification of my instrument, the suture needle being shown in its projected position;

Fig. 14 shows a side elevation of a further modification of my suturing instrument;

Fig. 15 shows a fragmentary, and enlarged, cent-ral, longitudinal section of F 14 and illustrates the means provided for operating the suture needle;

Fig. 16 shows a view similar to Fig. 15, and illustrates the suture needle in its projected position;

Fig. 17 shows a side elevation of the suture needle removed from the instrument;

Fig. 18 shows a section taken. on the line 18-18 of Fig. 15; and

Fig. 19 shows a section taken on the line 19-19 of Fig. 15.

Referring now to Figures 1 to 10, my suturing instrument compi ses a needle casing a, formed in complementary halves a. a and having opposite opposed arcuate arms b, c, forming' a flesh admittin cavity between, and described for convenience as the distal and proximal arms, respectively. The casing halves are held together by a screw (Z, and the shank of the casing' is threaded .as at e and is adapted to be secured to the end of a tubular member f by means of an internally threaded collar g.

A Curbed suture needle r is provided within the said needle casing (z. with the point /L arranged so as toproject from the said proximal arm c. The other or butt end 71,2 of the needle is pivotally connected to a. curved arm j. rllhe other end of the curved arm connected to a flexible wire rod 72 by a hall Z seated in a socket Z. having an entrance slot Z2. The rod 7u is arranged in the said tubular element to Jrhe end of which a handle member m, having finger rin m is secured by means of a set screw m2.

A slide p is mounted on the said handle and provided with linger rings 79 at cach side. A flat spring q is provided in the slide and bears against the handle to prevent free movement of the slide on the handle. The end of the rod 7c, which extends through the tubular member f, is secured to the slide y) and enlarged to form a shoulder c.

By this construction, as the slide p is moved back and forth on the handle m, the needle 7i will be reciprocated in the casing a as illustrated in Figs. 5, 6, 7, and the shoulder will serve as a stop to the inward 1nove ment of the rod 7a in order to prevent the possible buckling of the rod in the tubular member The needle 7L is provided adjacent its point with a suture engaging notch 2 and the distal arm Z of the casing is provided with a suture holding notch 3, see Fig. 8a, having an entrance slot- Sa extending to the end of the said distal arm. A spring clip @l is provided on the handle m for releasably holding the free ends of a thread or suture, as ai.

The mode ot operation of my suture instrument is as follows: Assuming that the bleedin g point of a tonsular fossa is to be sutured, as illustrated in Figs. 5, 6, 7, the suture is lirst placed in the notch 3 in the distal arm at about its middle point thus forming a loop, and the ends as of the suture are releasably secured under the spring clip l on the handle for convenience in holding the suture in place on the instrument.

Then, as illustrated in Fig. 5, the instrument is held in one hand by the linger rings m and 77' and the arms Z). cv of the casing a are positioned over the sides of. the tonsular fossa, with the needle z/ in the retracted position. The wire rod 7c is then drawn outwardly from the casing a by the finger rings 77 which projects the needle zy from the proximal arm and pierces the flesh on each side of the cavity, at the same time drawing the sides of the cavity more or less closelv together. As the point 7i of the needle enters the distal arm of the casing. its notch 2 engages the suture, Figs. 6 and 8a. and then. as shown in Fig. 7. the wire rod la is operated to move inwardlv toward the casing` a and retract the needle 71.. which draws the loop .r2 ot the suture from the distal arm and through the flesh. thus the suture .is placed.

As soon as the ends of the suture are drawn from under the spring clip l ou the handle. the suture becomes loose and slips from the end of the distal arm. see Fig. 8. through the entrance slot Similarly the suture releases itself from the notch 2 in the needle. rlhe suture is then drawn together and tied inthe usual manner. i

Referring now to Figs. 11 to 13 inclusive, I have substituted a flexible cable 10 for connecting the wire rod 11 to the butt end of the suture needle 12, the latter having a groove 12a in its external periphery to accommodate the adjacent Vportion of theV cable 10. The needle casing 14 is the same as previously described except that this modification permits the outer circumference of the distal arm 15 to be annular in form, since no space need be provided within the casing to accommodate the movement of the curve arm j, shown in Figs. 1 to 10. By this construction, the arms of the casing may be more conveniently positioned for the placing oic the suture within a limited working space.

Figs. 14 to 19 inclusive show a still further modification oi my invention, having` the advantage of the external circumference of the distal arm 20, beingl annular in form but at the same time providing a positive connection between the suture needle 21, and the wire rod 22. The needle casing 23 is provided with a chord-like inner wall 2d, providing space within the casing for the movement of a straight connecting arm 25, pivotally connected with the butt end of the suture needle 21, as at 21a, which is similar to the suture needles heretofore described except that the needle is provided with an elongate, central slot 28 in which the straight arm is arranged, and in which it operates. The other end oic the straight arm 25 is secured to a separable ball and socket joint 26, as at 21?), carried by the said wire rod 22.

The modification of my instrument, illustrated in Figs. 11 to 13, is especially adapted for the construction of very small instruments where the space within which the suture is to be placed may be limited and the cavity small, such as in a rectal operation, and the modification illustrated in Figs. 14 to 19 provides al large size instrument, where large cavities are-to be sutured and consequently a more strongly constructed instrument is required.

I claim:

1. In a suturing instrument, a casing provided with projecting, arcuate, distal and proximal arms arranged to provide a fleshadmitting cavity between them, a curved suture needle slidably mounted in said casing, the distal arm provided at its extremity with means for holding a suture, the needle provided with means adjacent its point tor engaging the suture, a member located in said casing and pivotally connected to said needle, a hollow handle provided with a finger hold secured to said casing. a rod slidable within said handle and detachablv connecte-fl to said member and a slide mounted on the handle, said slide provide-d with a finder hold, and the said rod being connected to said slide.

2. In a suturing instrument, al casing having a neck and provined with prcjcctinii. arcuate, distal and proximal arms arranged to provide a flesh-admitting cavity between them, a curved suture needle slidably mounted in said casing, the distal arm provided at its extremity with a suture holding notch, the needle provided with a notch adjacent its point for engaging the suture, a member located in said casing and pivotally connected to said needle, a hollow handle provided with a finger hold secured to the neck lof vsaid casing, a rod slidable within said handle and detachably connected to said member and a slide mounted on the handle, f

extremity with a suture holding notch, the'V needle provided with a notch adjacent its point for engaging the suture, a curved member located in said head and iivotall connected to said needle, a hollow handle provided with a linger hold secured to the neck i ot said casing, a. rod slidable within said handle and detachably connected to said member and a slide mounted on the handle,

said slide provided with a iinger hold, and

the said rod being connected to said slide.

4. In a suturing instrument, a casing consisting of a divided head having a neck and provided with projecting, arcuate, distal and proximal arms arranged to provide a flesh-admitting cavity between them, a guide flange circumscribing said cavity, a curved suture needle slidably mounted on said guide flange within said casing, the distal arm provided at its extremity with a suture holding notch, the needle provided with a notch adjacent its point for engaging the suture, a hollow handle provided with a finger hold secured to the neck of said casing, a rod slidably within said handle and detachably connected to said member, a mem- `-V ber located in said head, a ball and socket separable joint connecting said rod with said member and a. slide mounted on the handle, said slide provided with a finger hold,

and the said rod being connected to said slide.

5, In a suturing instrument, a casing consisting of a divided head having a neck and provided with projecting, arcuate, distal and proximal arms arranged to provide a fleshadmitting cavity between them, a guide flange circumscribing said cavity, a curved suture needle slidably mounted on said guide flange within said casing, the distal arm provided at its extremity with a suture holding notch, the needle provided with a notch adjacent its point for engaging the suture, a hollow handle provided with a finger hold secured to the neck ot d casing, a rod slidably within said handle and detacliably connected to said member, a member located in said head, a ball and socket separable joint connecting said rod with said member and a slide mounted on the handle, said slide provided with a finger hold, and the said rod being connected to said slide.

6. In a suturing instrument, a casing provided with projecting, arcuate, distal and proximal arms arranged to provide a leshadmitting cavity between them, a guide flange circnmscribing said cavity, a curved suture needle slidably mounted in said :asing, the distal arm provided at its extremity with a sn-,tme-holdinp; notch, the needle provided wilh a notch adjacent its point for engaging the sutureq a member located in said casing; and pivotally connected to said needle, a hollow handle provided with a linger hold secured to said casina', a rod slidable within said handle and detachably connected to said member, a slide mounted on the handle, said slide provided with a linger hold, and the said rod being;- connected to said slide.

7. In a suturing instrument comprising, a casing provided witl Projecting. arcuate, distal and proximal arms arranged to provide a flesh-admitting` cavity between them, a guide flange circumscribinev said cavity, a curved suture needle slidably mounted on said guide llangge within said casina, the distal arm provided at its extremity with a suture holding notch, the needle provided with a notch adjacent its point for engaging the suture. a hollow handle provided with a finger hold secured to said casing, a flexible rod slidable within said handle and detachably connected to said member, a curved member located in said casing, a. ball and socket separable joint connecting said rod with said member and a slide mounted on the handle, said slide provided with a linger hold, and the said rod being connected to said slide.

8. ln suturinf; instrument, a easing provided with projecting arcuate distal and proximal arms arranged to provide a flesh admitting; space between them, the distal arm provided at its extremity with means for removably holdinga a suture, a curved sutureneedle slidably ca ried by said casing, and arranged to be projected trom said proximal arm. the needle provided adjacent its point with means ior engaging; the suture, operable means for moving said needle in said casing, whereby wien the needle is projected from said proximal arm and through the flesh` the needle will engage the suture held by the distal arm, and upon retraction ot the needle the suture will be disengaged from the distal arm.

9. ln sutnring inst-rnn'ient, a hollow casing; including arcuate distal and proximal arms arranged to provide a tlcsh-admittingr space between them, the distal arm provided at its extremity with means for removably holding a suture, a curved suture-needle slidably carried by said casing, the needle provided with means adjacent its point for engaging the suture, a hollow handle for said casing, a rod slidably held by said handle, a detachable articulate connection from said rod to said needle.

10. In a suturing instrument, a casing including arcuate distal and proximal arms arranged to provide a flesh-admitting space between them, the distal arm provided at its extremity with means for removably holding a suture, said casing provided with a handle, the lower end of the latter provided with a linger hold, a curved suture-needle slidably carried by said casing, the needle provided with means adjacent its point for engaging, the suture, a hollow handle for said casing, a rod slidably held by said handle, a detachable articulate connection from said rod to said needle, a slide mounted on the handle to which slide said rod is connected, said slide provided with oppositely disposed linger holds transversely of the axis of said handle.

GE ORGE AINSLIE.

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