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Sutureless method of rectosigmoid anastomosis and apparatus therefor

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Publication number
US2434030A
US2434030A US62801645A US2434030A US 2434030 A US2434030 A US 2434030A US 62801645 A US62801645 A US 62801645A US 2434030 A US2434030 A US 2434030A
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Prior art keywords
member
tie
cup
bolt
body
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Yeomans Theron Grover
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Yeomans Theron Grover
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus

Description

Jan. 6, 1948. 'T. G. YEOMANS 4, SUTURELESS METHOD OF RECTO-SIGMOID ANASTOMOSIS AND APPARATUS THEREFOR Filed NOV. 13, 1945 3 advanced toward each other by means of the ballheaded, square-bodied tie bolt and its nut 6.

The cup member I is provided with a round clearance hole I, through which the tie-bolt 5 may pass freely, and a spherically formed ball seat 8 is marginally constituted about the hole I.

The cup member 2 is provided with a square clearance hole; I5 through which the square bodied tie bolt 5 is adapted to be passed freely.

Surrounding the square clearance hole I5 and in the lower end of the cup member 2 is a tapered socket I4, adapted to interchangeably receive body tubes II, of varying lengths, which are provided at one end with a tapered portion I3 which mates with the tapered socket I4 and is adapted to seat 4 string suture 2|, whipped over the cut edge of the bowel and tied around the tie-bolt.

The cup member 2 is then placed in the distal segment of the rectum with the body tube I I protruding from the anus, where it is held steady by an assistant.

A purse string suture 22 is then placed in the cut edge of the rectum. The cup member 2 and tube I I' are slipped over the tie bolt 5.

The rectal purse string 22 is then tied around the tie-bolt 5, the two segments of bowel are the tube I I in the socket I4 of the cup member 2.

The opposed, in-turn, annular flanges 3 and 4 of the respective cup members I and 2 have been found satisfactory for the desired clamping purpose when not less than one quarter inch in width and the inner edges I3 and I9, as well as the outer edges I6 and H, are best adapted for the purpose when provided with smoothly rounded corners of approximately one sixty-fourth inch radius.

The square bodied tie-bolt 5 is provided with an integral spherical head 20, and the portion 9 directly adjacent the ball is necked down to a round section for a short distance in order to permit equal ball and socket action of the ball in the socket 8 in all directions. The oppositeend of the tie-bolt 5 is provided with threads Ill adapted to engage the internal threads of the hand nut 5. The total length of the tie-bolt 5 is so related to the total length of the body tube II that when the apparatus is assembled, as shown in Fig, 1, clamping pressure may be exerted between the opposed faces of the annular flanges 3 and 4.

The hand nut 6 may be provided with coarsely fluted grooves to provide more secure gripping surfaces for the fingers,

While a number of metals may be used in the construction of the apparatus, aluminum has proven very satisfactory for the cup members, the body tube and the hand nuts, on account of its light Weight, while the tie-bolt is best made from Steel in order to secure sufflcient strength in a bolt of small diameter.

The maximum diameters of the cup members I and 2 must not be too small, lest the stoma be too narrow, nor should they be too large to remove through the anus, unless the sphincter is to be divided and later repaired.

One and one-half inches has been determined in use to be a median of satisfactory diameters.

The body tube l I must be selected of such length that it will project sufficiently beyond the anus to be grasped and held against turning by suitable shaped forceps or pliers, but not enough to be clumsy.

The entire apparatus must have all exterior surfaces smooth and highly polished, but such finish is not necessary on such concealed surfaces as do not contact the bowel.

The opposing faces of the flanges 3 and 4 may be perpendicular to the longitudinal axis as shown in Fig. 2, or they may be disposed angularly with respect to the longitudinal axis, as shown in Fig. 1, in order to facilitate their concentric axial alignment.

In practice of my method the operating surgeon, having severed the bowel and removed the section containing the neoplasm, places the cup member I upon the tie-bolt 5 and inserts it into the proximal bowel where it is secured by a purse brought together, with the square portion of tiebolt 5 entering and freely engaging the square clearance hole I5 and the threaded portion extending through and beyond the body tube I I.

With the cup members I and 2 manipulated into positions of approximate alignment, the assistant screws the hand nut down against the projecting end of the body tube I I, which he at the same time restrains from any tendency to turn, by means of shaped jaw forceps, and thereby clamps the inturned bowl walls between the opposing faces of the flanges 3 and l of the cup members I and 2.

The-tightening of the nut is continued until the clamped portions of thebowel walls are sufficiently thinned and compressed so that no blood is thereafter supplied to the clamped portions between the flanges.

The apparatus and the bowel in its then condition are as shown in Fig. 1, with the serous coats in goodcontact outside the clamped area, and union proceeds at once, occuring first by adherence of the serous coats in contact within approximately six hours and then extending across the muscular coats.

In due course, union will be entirely efiected and the tissues between the opposed clamping surfaces of the flanges 3 and 4, with all of that portion within the apparatus, will have become dead and have sloughed off and separated from the living tissues.

The apparatus may then, in its entirety. be lubricated and removed through the anus and, after its removal, the mucous membrane grows across the united junction and anastomosis of the colon to the lower rectum has been completed.

The operation is rapidly and safely performed without the use of sutures other than the temporary purse strings, which can be eliminated also by the use of any satisfactory internal, expanding clamp within the inner margins of the flanges,

The appearance of a section of the rectum after anastomosis, with thickened scar tissue, is shown in section in Fig. 3.

Having thus described my invention, I claim:

1. A clamp for recto-sigmoid anastomosis for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be inserted and removed through the anus, comprising in combination, an upper cup-shaped clamping member, a lower opposed cooperating cupshaped clamping member, each'of said clamping members being provided with inwardly extending opposed clamping flanges, a hollow body member, a tie rod extending through said hollow body member and said clamping members, one end of said tie rod extending beyond the hollow body member and manually operated means cooperating with said extending: end for drawing said clamps tightly together, substantially as and for the purposes set forth.

2. A clamp for recto-sigmoid anastomosi for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be member, the opposite end of said tie rod having 10 an external ball and socket connection with the upper clamping member, and manually operated means cooperating with said extending end for drawing said clamps tightly together, substantially as and for the purposes set forth.

THERON GROVER YEQMANS.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Name Date Bacon July 18, 1933 OTHER REFERENCES Ex parte Brinkerholf, vol. 24, Commissioners Manuscript Decisions, page 349.

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US2434030A 1945-11-13 1945-11-13 Sutureless method of rectosigmoid anastomosis and apparatus therefor Expired - Lifetime US2434030A (en)

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US2434030A US2434030A (en) 1945-11-13 1945-11-13 Sutureless method of rectosigmoid anastomosis and apparatus therefor

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Cited By (31)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1057729B (en) * 1954-03-29 1959-05-21 Lameris Instr N V A surgical device for joining two intestinal parts
US3048177A (en) * 1959-06-23 1962-08-07 Takaro Timothy Blood vessel coupling device
US3472231A (en) * 1966-06-20 1969-10-14 Benjamin W Niebel Perfect circle hemorrhoidal excisor,stapler and excisor hemostatic dilator
US3771526A (en) * 1972-02-07 1973-11-13 P Rudie Anastomosis clamp
US4154241A (en) * 1977-07-29 1979-05-15 Rudie Peter S Anastomosis clamp
US4304236A (en) * 1977-05-26 1981-12-08 United States Surgical Corporation Stapling instrument having an anvil-carrying part of particular geometric shape
US4607637A (en) * 1983-07-22 1986-08-26 Anders Berggren Surgical instrument for performing anastomosis with the aid of ring-like fastening elements and the fastening elements for performing anastomosis
US4624257A (en) * 1982-06-24 1986-11-25 Anders Berggren Surgical instrument for performing anastomosis
US5709335A (en) * 1994-06-17 1998-01-20 Heartport, Inc. Surgical stapling instrument and method thereof
US5732872A (en) * 1994-06-17 1998-03-31 Heartport, Inc. Surgical stapling instrument
US5817113A (en) * 1995-02-24 1998-10-06 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US5881943A (en) * 1994-06-17 1999-03-16 Heartport, Inc. Surgical anastomosis apparatus and method thereof
US5976159A (en) * 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US6171321B1 (en) 1995-02-24 2001-01-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US20010001826A1 (en) * 1998-01-23 2001-05-24 Heartport, Inc. System for performing vascular anastomoses
WO2001043645A1 (en) * 1999-12-14 2001-06-21 Blatter Duane D Systems for intraluminally directed vascular anastomosis
US6280460B1 (en) 1998-02-13 2001-08-28 Heartport, Inc. Devices and methods for performing vascular anastomosis
US20010023354A1 (en) * 1999-04-16 2001-09-20 Blatter Duane D. Locking compression plate apparatus
US20030055441A1 (en) * 1997-10-24 2003-03-20 Suyker Wilhelmus Joseph Leonardus Mechanical anastomosis system for hollow structures
US6551334B2 (en) 1999-04-16 2003-04-22 Integrated Vascular Interventional Technologies, Lc Externally directed anastomosis systems and externally positioned anastomosis fenestra cutting apparatus
US20030191482A1 (en) * 1998-10-22 2003-10-09 Suyker Wilhelmus Joseph Leonardus Mechanical anastomosis system for hollow structures
US6726694B2 (en) 1999-04-16 2004-04-27 Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) Intraluminally directed anvil apparatus and related methods and systems
US20040092972A1 (en) * 2000-11-09 2004-05-13 Leonardus Suyker Wilhelmus Joseph Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well a auxiliary devices
US20040097994A1 (en) * 1999-04-16 2004-05-20 Blatter Duane D. Staple and anvil anastomosis system
US6743244B2 (en) 1999-04-16 2004-06-01 Integrated Vascular Interventional Technologies, L.C. Soft anvil apparatus for cutting anastomosis fenestra
US20040225306A1 (en) * 1999-12-14 2004-11-11 Blatter Duane D. Paired expandable anastomosis devices
US20070239180A1 (en) * 2006-04-06 2007-10-11 Synovis Life Technologies, Inc. Method and assembly for anastomosis
US20080051811A1 (en) * 1999-04-16 2008-02-28 Integrated Vascular Interventional Technologies, L.C. Systems for anastomosing an everted vessel with another vessel
US20090105734A1 (en) * 2006-04-21 2009-04-23 Anders Gronberg Mounting tool and a method for a device for anastomosis
US20090138030A1 (en) * 2006-04-21 2009-05-28 Anders Gronberg Device and a method for anastomosis
US20090198297A1 (en) * 2004-08-18 2009-08-06 Yongxing Zhang Transeptal lead

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1918890A (en) * 1932-08-08 1933-07-18 Joseph B Bacon Surgical device

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1918890A (en) * 1932-08-08 1933-07-18 Joseph B Bacon Surgical device

Cited By (94)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1057729B (en) * 1954-03-29 1959-05-21 Lameris Instr N V A surgical device for joining two intestinal parts
US3048177A (en) * 1959-06-23 1962-08-07 Takaro Timothy Blood vessel coupling device
US3472231A (en) * 1966-06-20 1969-10-14 Benjamin W Niebel Perfect circle hemorrhoidal excisor,stapler and excisor hemostatic dilator
US3771526A (en) * 1972-02-07 1973-11-13 P Rudie Anastomosis clamp
US4304236A (en) * 1977-05-26 1981-12-08 United States Surgical Corporation Stapling instrument having an anvil-carrying part of particular geometric shape
US4154241A (en) * 1977-07-29 1979-05-15 Rudie Peter S Anastomosis clamp
US4624257A (en) * 1982-06-24 1986-11-25 Anders Berggren Surgical instrument for performing anastomosis
US4917090A (en) * 1982-06-24 1990-04-17 Unilink, Inc. Method for performing an anastomosis
US4607637A (en) * 1983-07-22 1986-08-26 Anders Berggren Surgical instrument for performing anastomosis with the aid of ring-like fastening elements and the fastening elements for performing anastomosis
US5957363A (en) * 1994-06-17 1999-09-28 Elf Atochem S.A. Method of performing vascular anastomosis
US7122044B2 (en) 1994-06-17 2006-10-17 Heartport, Inc. Surgical stapling instrument and method thereof
US5709335A (en) * 1994-06-17 1998-01-20 Heartport, Inc. Surgical stapling instrument and method thereof
US5881943A (en) * 1994-06-17 1999-03-16 Heartport, Inc. Surgical anastomosis apparatus and method thereof
US5947363A (en) * 1994-06-17 1999-09-07 Heartport, Inc. Surgical stapling instrument and method thereof
US6659327B2 (en) 1994-06-17 2003-12-09 Heartport, Inc. Surgical anastomosis apparatus and method thereof
US6631837B1 (en) 1994-06-17 2003-10-14 Heartport, Inc. Surgical stapling instrument and method thereof
US6763993B2 (en) 1994-06-17 2004-07-20 Bolduc Lee R Surgical stapling instrument and method thereof
US6176413B1 (en) 1994-06-17 2001-01-23 Heartport, Inc. Surgical anastomosis apparatus and method thereof
US6209773B1 (en) 1994-06-17 2001-04-03 Heartport, Inc. Surgical stapling instrument and method thereof
US6588643B2 (en) 1994-06-17 2003-07-08 Hearport, Inc. Surgical stapling instrument and method thereof
US20040200876A1 (en) * 1994-06-17 2004-10-14 Bolduc Lee R. Surgical stapling instrument and method thereof
US6450390B2 (en) 1994-06-17 2002-09-17 Hearport, Inc. Surgical anastomosis apparatus and method thereof
US5732872A (en) * 1994-06-17 1998-03-31 Heartport, Inc. Surgical stapling instrument
US20110172686A1 (en) * 1995-02-24 2011-07-14 Gifford Iii Hanson S Device For Engaging Tissue Having a Preexisting Opening
US6371965B2 (en) 1995-02-24 2002-04-16 Gifford, Iii Hanson S. Devices and methods for performing a vascular anastomosis
US6443965B1 (en) * 1995-02-24 2002-09-03 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US6451034B1 (en) 1995-02-24 2002-09-17 Gifford, Iii Hanson S. Devices and methods for performing a vascular anastomosis
US6461365B2 (en) 1995-02-24 2002-10-08 Heartport, Inc. Surgical clips and methods for tissue approximation
US7935129B2 (en) 1995-02-24 2011-05-03 Heartport, Inc. Device for engaging tissue having a preexisting opening
US6491704B2 (en) 1995-02-24 2002-12-10 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US20050149077A1 (en) * 1995-02-24 2005-07-07 Gifford Hanson S.Iii Devices and methods for performing a vascular anastomosis
US7763041B2 (en) 1995-02-24 2010-07-27 Heartport, Inc. Surgical clips and methods for tissue approximation
US8617190B2 (en) 1995-02-24 2013-12-31 Heartport, Inc. Device for engaging tissue having a preexisting opening
US20030114867A1 (en) * 1995-02-24 2003-06-19 Bolduc Lee R. Surgical clips and methods for tissue approximation
US20050096676A1 (en) * 1995-02-24 2005-05-05 Gifford Hanson S.Iii Devices and methods for performing a vascular anastomosis
US20040199188A1 (en) * 1995-02-24 2004-10-07 Gifford Hanson S. Devices and methods for performing avascular anastomosis
US6171321B1 (en) 1995-02-24 2001-01-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US5976159A (en) * 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US20040186490A1 (en) * 1995-02-24 2004-09-23 Gifford Hanson S. Devices and methods for performing avascular anastomosis
US6899718B2 (en) 1995-02-24 2005-05-31 Heartport, Inc. Devices and methods for performing avascular anastomosis
US6676678B2 (en) 1995-02-24 2004-01-13 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US20050096675A1 (en) * 1995-02-24 2005-05-05 Gifford Hanson S.Iii Devices and methods for performing avascular anastomosis
US20040073240A1 (en) * 1995-02-24 2004-04-15 Bolduc Lee R. Surgical clips and methods for tissue approximation
US7112211B2 (en) 1995-02-24 2006-09-26 Heartport, Inc. Devices and methods for performing avascular anastomosis
US20050251164A1 (en) * 1995-02-24 2005-11-10 Gifford Hanson S Iii Devices and methods for performing avascular anastomosis
US6984238B2 (en) 1995-02-24 2006-01-10 Gifford Iii Hanson S Devices and methods for performing avascular anastomosis
US20040167551A1 (en) * 1995-02-24 2004-08-26 Gifford Hanson S. Devices and methods for performing a vascular anastomosis
US5817113A (en) * 1995-02-24 1998-10-06 Heartport, Inc. Devices and methods for performing a vascular anastomosis
US7022127B2 (en) 1997-10-24 2006-04-04 Innovative Interventional Technologies Bv Mechanical anastomosis system for hollow structures
US20030195534A1 (en) * 1997-10-24 2003-10-16 Suyker Wilhelmus Joseph Leonardus Mechanical anastomosis system for hollow structures
US7666198B2 (en) 1997-10-24 2010-02-23 Innovative Interventional Technologies B.V. Mechanical anastomosis system for hollow structures
US20040215221A1 (en) * 1997-10-24 2004-10-28 Suyker Wilhelmus Joseph Leonar Mechanical anastomosis system for hollow structures
US20030055441A1 (en) * 1997-10-24 2003-03-20 Suyker Wilhelmus Joseph Leonardus Mechanical anastomosis system for hollow structures
US8182498B2 (en) 1997-10-24 2012-05-22 Innovative International Technologies B.V. Mechanical anastomosis system for hollow structures
US7651510B2 (en) 1998-01-23 2010-01-26 Heartport, Inc. System for performing vascular anastomoses
US20010001826A1 (en) * 1998-01-23 2001-05-24 Heartport, Inc. System for performing vascular anastomoses
US6962596B2 (en) 1998-01-23 2005-11-08 Bolduc Lee R System for performing vascular anastomoses
US6280460B1 (en) 1998-02-13 2001-08-28 Heartport, Inc. Devices and methods for performing vascular anastomosis
US6709441B2 (en) 1998-02-13 2004-03-23 Heartport, Inc. Devices and methods for performing vascular anastomosis
US20030176878A1 (en) * 1998-02-13 2003-09-18 Bolduc Lee R. Devices and methods for performing vascular anastomosis
US7018387B2 (en) 1998-10-22 2006-03-28 Innovative Interventional Technologies B.V. Mechanical anastomosis system for hollow structures
US20030191482A1 (en) * 1998-10-22 2003-10-09 Suyker Wilhelmus Joseph Leonardus Mechanical anastomosis system for hollow structures
US7922734B2 (en) 1999-04-16 2011-04-12 Vital Access Corporation Methods for forming an anastomosis with a vessel having everted tissue
US20040097994A1 (en) * 1999-04-16 2004-05-20 Blatter Duane D. Staple and anvil anastomosis system
US8109949B2 (en) 1999-04-16 2012-02-07 Vital Access Corporation Systems for forming an anastomosis
US20060167485A1 (en) * 1999-04-16 2006-07-27 Blatter Duane D Staple and anvil anastomosis system
US6726694B2 (en) 1999-04-16 2004-04-27 Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) Intraluminally directed anvil apparatus and related methods and systems
US6551334B2 (en) 1999-04-16 2003-04-22 Integrated Vascular Interventional Technologies, Lc Externally directed anastomosis systems and externally positioned anastomosis fenestra cutting apparatus
US7160311B2 (en) 1999-04-16 2007-01-09 Integrated Vascular Interventional Technologies, L.C. (Ivit Lc) Locking compression plate anastomosis apparatus
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US8034064B2 (en) 1999-04-16 2011-10-11 Vital Access Corporation Methods for forming an anastomosis opening in a side of a blood vessel
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US20080287972A1 (en) * 1999-04-16 2008-11-20 Integrated Vascular Interventional Technologies, L.C. Systems for anastomosing an everted vessel with another vessel
US6743244B2 (en) 1999-04-16 2004-06-01 Integrated Vascular Interventional Technologies, L.C. Soft anvil apparatus for cutting anastomosis fenestra
US20010023354A1 (en) * 1999-04-16 2001-09-20 Blatter Duane D. Locking compression plate apparatus
US20080051811A1 (en) * 1999-04-16 2008-02-28 Integrated Vascular Interventional Technologies, L.C. Systems for anastomosing an everted vessel with another vessel
US7901417B2 (en) 1999-04-16 2011-03-08 Vital Access Corporation Systems for forming an anastomosis with an anvil and an apparatus having at least one guide
WO2001043644A1 (en) * 1999-12-14 2001-06-21 Blatter Duane D Compression plate anastomosis apparatus and related systems
US6569173B1 (en) * 1999-12-14 2003-05-27 Integrated Vascular Interventional Technologies, L.C. Compression plate anastomosis apparatus
WO2001043645A1 (en) * 1999-12-14 2001-06-21 Blatter Duane D Systems for intraluminally directed vascular anastomosis
US20040225306A1 (en) * 1999-12-14 2004-11-11 Blatter Duane D. Paired expandable anastomosis devices
US20040092972A1 (en) * 2000-11-09 2004-05-13 Leonardus Suyker Wilhelmus Joseph Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well a auxiliary devices
US6966917B1 (en) 2000-11-09 2005-11-22 Innovation Interventional Technologies B.V. Deformable connector for mechanically connecting hollow structures
US20050288693A1 (en) * 2000-11-09 2005-12-29 Suyker Wilhemus J L Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels
US8066723B2 (en) 2000-11-09 2011-11-29 De Vries & Metman Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well as auxiliary devices
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US20090198297A1 (en) * 2004-08-18 2009-08-06 Yongxing Zhang Transeptal lead
US20070239180A1 (en) * 2006-04-06 2007-10-11 Synovis Life Technologies, Inc. Method and assembly for anastomosis
US8313013B2 (en) 2006-04-06 2012-11-20 Synovis Life Technologies, Inc. Method and assembly for anastomosis
US8512361B2 (en) 2006-04-21 2013-08-20 Carponovum Ab Device and a method for anastomosis
US9724099B2 (en) 2006-04-21 2017-08-08 Carponovum Ab Device and method for anastomosis
US20090105734A1 (en) * 2006-04-21 2009-04-23 Anders Gronberg Mounting tool and a method for a device for anastomosis
US9155539B2 (en) * 2006-04-21 2015-10-13 Carponovum Ab Mounting tool and a method for a device for anastomosis
US20090138030A1 (en) * 2006-04-21 2009-05-28 Anders Gronberg Device and a method for anastomosis

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