US2601564A - Suturing device - Google Patents

Suturing device Download PDF

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US2601564A
US2601564A US17271550A US2601564A US 2601564 A US2601564 A US 2601564A US 17271550 A US17271550 A US 17271550A US 2601564 A US2601564 A US 2601564A
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Prior art keywords
needle
holder
end
gripping
device
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David P Smith
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David P Smith
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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

June 24, 1952 MI 2,601,564

SUTURING DEVICE Filed July 8, 1950 5 Sheets-Sheet l INVENTOR. 0 W0 R .S'M/ TH H TTO/PNEY 3 Sheets-Sheet 2 Filed July 8, 1950 INVENTOR. DEV/D R 5M1 TH June 24, 1952 D. P. SMITH 2,501,564

SUTURING DEVICE Filed July 8, 1950 s Sheets-Sheet s EEEEEEQM F:- g. E U

a ilii' 38 Fig.2].

INVENTOR. H Wu F. .S'M/TH E 2 BY HTTOR Patented June 24, 1952 UNITED STATES PATENT OFFICE SUTURING DEVICE David P. Smith, Meriden, Conn.

Application July 8, 1950, Serial No. 172,715

I Claims. 1

This invention relates to instruments for use in the suturing of wounds, and more particularly to a device which is adapted to be manually held and operated for passing a surgical needle repeatedly through the tissue to be stitched while holding the needle firmly at all times.

One object of this invention is to provide a suturing device of the above nature in which the needle will be held by a pair of alternately retractable holders, each of which may be operated by a single movement of the surgeons thumb 'or forefinger.

Another object is to provide a device of the above nature in which the needle holders will be retractable in a longitudinal direction and will operate without any lateral reciprocating movements, whereby the holders will ofier ample clearance for the tissues being stitched, and interference with surrounding tissues will be minimized.

Another object is to provide a device of the above nature which will automatically grip the needle at the proper locations, which will eliminate any need for an assistant to pull the needle, and which will operate successfully in a small cavity into which it may be impossible or undesirable to insert the hand.

Another object is to provide a holder which is adapted to grip a surgical needlenby the action of a gripping element disposed entirely with said holder, thus avoiding a possibility that the tistues might be injured thereby.

Another object is to provide a suturing device of the above nature which has a minimum number of parts, and which may be quickly and easily disassembled and assembled for purposes of cleaning.

Another object is to provide a suturing device of the above nature which has few outward projections or crevices, and which is so shaped as to be easily held and operated by one hand.

ing device as it would appear during successive steps in passing the needle through the tissue for forming a stitch.

Figs. 8, 9, 10, and 11 are cross-sectional views taken on the respective lines 8-8, 99, |U-l0, and lI-ll of Figs. 4, 5, 6, and '7, but drawn on an enlarged scale.

Fig. 12 is a planview of the suturing device as it would appear with the upper body section removed and viewed substantially from the line l2-|2 of Fig. 2.

Fig. 13 is a longitudinal sectional View taken substantially on the line |3I3 of Fig. 1.

Fig. 14 is a longitudinal sectional view illustrating the inner construction of one of the needle holders.

Figs. 15, 16, and 17 are fragmentary side views, partly in section and on an enlarged scale, respectively, illustrating parts of one of the needle holders in the positions they would assume when gripping the needle, when the holder has released 3 the needle and is ready for retraction, and when A further object is to provide a device of the above nature which will be simple in construction, inexpensive to manufacture, compact, ornamental in appearance, very efiicient and durable, and which will withstand prolonged use without requiring adjustment or repair.

With these and other objects in view, there has been illustrated on the accompanying drawings one form in which the invention may conveniently be embodied in practice. 7 v

In the drawings,

Fig. 1 is a plan view of the improved suturin device, showing the curved needle ready for use.

Fig. 2 is a side view of the same. 7

Fig. 3 is a front end view of the same.

Figs. 4, 5, 6, and 7 are views showing the suturretracted.

Figs. 15A, 16A, and 17A are respective end views of the same, and also showing the relationship of the needle to the holder in the gripping and releasing positions of said holder.

Fig. 18 is a side View of an end portion of one of the gripping rods as it would appear when removed from the holder.

Fig. 19 is a cross-sectional view of the same taken on the line l9l9 of Fig. 18, looking toward the end of the gripping rod.

Fig. 20 is a side view similar to Fig. 18, but showing the rod as it would appear when rotated 90 degrees therefrom, as indicated by the line 20-20 of Fig. 18.

Fig. 21 is a longitudinal sectional view of the same, taken on the line 2l-2l of Fig. 20.

Fig. 22 is a perspective view showing an end portion of one of the holder tubes as it would appear when removed from the holder.

Referring now to the drawings, in which like reference numerals denote corresponding parts throughout the several views, the numerals 20, 2| indicate respective left and right-hand needle 7 holders of elongated, generally cylindrical shape,

which are mounted in coextensive parallel relationship in a handle 22, said needle holders being so spaced apart that the outer ends thereof may engage opposite end portions of a curved surgical needle N.

A detailed description of the needle holder 2| will suffice for a full understanding of both needle holders 20, 2|, inasmuch as said needle holders are nearly identical in construction and operation excepting for a reversed formation of the parts, as will be further described hereinafter.

The needle holder 2| comprises rearward and forward tubular casing sections 23, 24 (Fig. 14) which are detachably connected together in aligned abutting relationship by an overlapping sleeve 25 secured upon the rearward casing section 23, said sleeve 25 having an angular slot 26 adapted 'to slidably receive a screw 21 on the forward casing section 2 I.

The rearward casing section 23 is also provided with a tubular liner-28 which projects forwardly a short distance into the forward casing section 24 so as to reinforce the joint between said casing sections, the rearward end of said liner abutting a plug 29 which is secured by a screw 39 and serves as a closure for the rear end of the rearward casing section 23.

The forward casing section 24 is provided'with asmall depending anchor pin 3| for securing the holder 2| in a fixed position within the handle 22 as will be described hereinafter. g

In order to engage the needle N at a :predetermined'location forwardly of the front casing section 24, said casing section has a holder tube 32 slidably-disposed therein. The front end of the holder tube 32 is formed with a pair of oppo's'ed slots '33'which are of suitable dimensions to receive the needle N when the latter is inserted cross-wise therein, said slots being somewhat deeper than the thickness of the needle N, however, so that the needle may be spaced inwardly of the outer end of the holder tube 32 (as will be seen in Fig. 13, for example).

It will also be noted that the 'slots 33 'are slightly-offset from diametricallyopposite positions, being so "disposed that the "curvature of the needle N will cause it, when located in said slots, to intersect the axis of the holder tube 32.

While the "holder tube 32 is longitudinally retractable within the casing section 24, the end slots 33 will always be held in fixed angular relationship to the handle '22 because of a short outer pin 34 whichiis provide'don the holder tube 32 and engage in a longitudinal slot 35 in the sideof the-casing sectionj2'4. The slot35 opens through the rear end of the 'forward casing section 24 in order to permit easy assembly of theparts. The pin 34 wi1l, -however, be confined in said slot during normal "operation of the de vice, as will be described. In other words,'the holder tube 32 is longitudinally slidable for a limited distance in the holderbut can not'rotate therein.

In order to releasably grip the'needle "Nwhen it is disposed inthe slots 33, provision is made of a .g'rippi'ngrod 36 which may have limited rotatingmovement within the holder -tube'32, but which is held "against longitudinal movement with respect to said holder tube.

'Theouter end of the gripping rod 36 is-disposed in substantially flush relationship to the outer end-of the holder tube 32, and is formed with a transverse slot 31 which is curved to conform to the curvature of the needle N and which is adapted to be aligned with theslots "33 in the holder "tube 32.

Further, thesides of the curvedslot 31 are undercut at diagonally opposite locations 'so as to provide a pair of overhanding lips 39 which are adapted to engage over the outer surface of the needle N. This construction will permit the needleN to be received-in'the holder when the curvedslot 31 is aligne'd'with theslots '33, after whfch -the gri'p'ping rod-'36- may be turned #in the suitable device such as a screw 40.

holder tube to engage the lips 38 over the outer surface of the needle and thus retain it in the holder. At the same time, the rotative force applied to the gripping rod 36 will exert a firm clamping pressure upon the needle N, inasmuch as the holder tube 32 and the slots 33 therein are held against rotation.

The needle holder 21 is provided with means for operating the holder tube 32 and "the gripping rod 36, comprising a coil spring 39 (Fig. 14) which is located within the rear casing section 23, the rear end of said spring being non-rotatably anchored to the closure plug 29 by any The coil spring 39 is under resilient deformation both compressively and torsional, and the front end thereof is non-rotatably engaged in a diametrical slot 4! in the rear end of the gripping rod 36.

The compressive force in the coil spring 39 is such that the holder tube 32 and the gripping rod '36 will 'be urged to a projected position, in which position the pin 34 will engage the front end 'of the longitudinal slot 35. Further, the resilient torsional force of the coil spring 39 is exerted in a counter-clockwise direction (as viewed from the back of the. suturing device, or clockwise as seen in Fig. 15A), so that the needle Nmay be retained by the lips 38 and will be gripped-in the holder. It will also be'noted, at this point, that the angular slot '26 in the coupling sleeve 25 is formed in such a direction that the torsional force of. the coil spring 39 will tend to hold the screw 21 in engagement with the inner end of said angular slot, and the casing sections 23, 2 "will :thus beheld firmly together.

As a means for releasing the needle N and retracting the holder tube 32 and the gripping rod 36 from said needle, the gripping rod :36. is provided with a radially extending arm 42 which his vertically movable in a slot 43 .of the holder tube'32. .Vertical movement of the radial arm 42 and consequent rotation of the gripping rod 36 will be .permitted, when said gripping rod is projected to its outermost position, by virtue of a short vertical :slot 44 which extends upwardly from the longitudinal "slot 35 in :the forward ca'singsection 24.

The outer end'of the radial arm 42 is provided with an operating .knob "'45, whereby said arm may be pressed downwardly into the longitudinal slot :35, i and .then drawn rearwardly so as :to :retract both thezgrip'ping'rod :35 and the holder tube-32 at" the same time. When such retraction occurs, it will be observed that the longitudinal slot 35 will prevent any vertical movement of the radial'arm "42, so that the slots 33 at *the front end of the holderiwill be held in alignedrelationship Withthe slot 3'1. In other words, the forward end'of the'holder 2| will at all times, be in open 'COIlditiOl'lifOI' releasing and re'ceiving z-the needle J-N excepting when the holder tube and the gripping r'o'd are projected .to their :outerm'ost position.

The retracting movem'entof the parts will, 'of course, be limited by' engagement of the radial arm "42 with the forwardedge-of the outer coupling sleeve 25, while {forward projecting movement of the parts willbe'lim'ited byengagement of the pin 34 with the front .end 'of the longitudinal" slot-35, at which 'p'oint the arm 42 may removed "upwardlyin the slots 43 and 44 under the influence of the coil spring- 39.

In order to perniit the gripping rod 39 to be easily assembled with and "removed from the holder tube 32, the lower end ofthe verticalslot This construction will permit outward passage of the radial arm 42 when the needle holder is taken apart, although the entrance slot 46 will perform no function during normal operation. of the device. I

The handle 22 is so constructed as to 'detachably support the needle holders 20, 2| in parallel coextensive positions, said handle 22 comprising separable upper and lower handle sections 41, 48 which are complementary and rooved upon their inner surfaces for receiving 2| and a similar pin 53 on the holder 20 (Fig. 12)..

Opposite sides of the handle 22 are provided with respective clearance slots 54, 55 through which project the radial operating arm 42 of the needle holder 2 I, and a similar operating arm 56 on the needle holder 20, said slots being of ample size to permit free operation of saidarms.

It will be observed that the handleq22 is so formed, and the operating arms 42 and 56 are so located, that the suturing device may be easily held and operated in the right hand of the surgeon. Thus, the operating arm 42 and the knob 45 thereon occupy a laterally extending position near the front of the handle 22, and are located in such a position thatsaid knob may be readily engaged and operated by the forefinger of the surgeons hand. The operating arm 55 and the knob 51 thereon are located in a laterally extending position at the left of the handle 22, said position being opposite a central portion of the handle 22 so that the knob 51 may be readily operated by the thumb of the surgeons hand. It will also be noted that the upper handle section 41 is provided with curved depressions.

58, 59 adjacent the respective operating knobs 45,. 51 (Fig. l) said depressions being so located as to receive the thumb and forefinger and to facilitate the-operation of said knobs. 1

its hereinbefore described, the needle holder 2| is so constructed that the operating knob 45 will be returned to a forward and upward position by the action of the coil spring 39. The needle holder 20 also is constructed so that the operating knob 51 will be automatically turned .to' a, forward and upward position, this result being obtained by a construction in which'the parts have a reversed formation. The parts of the needle holder 20 also have somewhat different longitudinal proportions in order to protrated in Fig. 3, The needle N is preferably fiattenedupon its surfaces in order to permit a more eflicient gripping action by the holders 20, 2|, andmay be square in cross-section. .If desired, the outer convex surface of the needle N may be formed with a pair of shoulders 60, 6|, which areadapted to abut the outer surfaces of the holders 20, 2|, when said needle is in place therein, thus precluding any possibility that the needle N' might become longitudinally displaced in the holders.

Operation In preparing the suturing device for use,.the operating knobs 45 and 51 will be first depressed so as to alignthe slots in the front ends of the holders 2D and 2|, thus permitting the needle N to be inserted therein, a suturing thread S having previously been attached to said needle.

The operating knobs 45 and 51 will then be released so that opposite end portions of the needle N will be firmly gripped in theneedle holders .20 and 2| by the action of the spring 39. The surgeon will then hold the suturing device in his right hand in such a manner that his thumb and forefinger are engaged respectively over the operating knobs 51 and 45.

When the suturing device is held in this way. a single downward and rearward movement of the surgeons forefinger will be all that is necessary to operate the knob 45 soas to disengage and retract the needle holder 2| from the needle N, while similar operation of the needle holder 20 may be obtained by a single movement of the thumb.

In use, the suturing device will be held so that the point of the needle N is adjacent the tissue T to be stitched, whereupon'the surgeonsthumb will operate the needle holder 20 so as to disengage and withdraw said needle holder from said needle (Figs. 4 and 8), thereby permitting at least one-half of the needle N to be passed through the tissue T. While the needle holder 20 is retracted, the needle N will, of course, be firmly gripped in the needle holder 2 The surgeons thumb will then release the operating knob 51 so that the needle holder 20 will be automatically projected and will engage and grip the needle N (Figs. 5 and 9). The forefinger will then be employed to actuate the knob 45 for releasing and retracting the needle holder 2 from the needle N (Figs. 6 and 10) so that said needle, which will then be firmly gripped in the needle holder 20, may be withdrawn from the tissue T and the suturing thread S may be pulled through the tissue to form a stitch.

As soon as the needle N has been completely withdrawn from the tissue T, the operating knob 45 may be released so that the needle holder 2| will automatically engage and grip the needle (Figs. '7 and 11) and the suturing device will be in readiness for taking another stitch.

In view of the above description, it will be seen that the stitching operation may be very easily performed without any complicated movements of the surgeons hand or fingers, and that the-surgical needle will be securely held at all times.

When it is desired to clean and sterilize the suturing device, the needle holders 20 and 2| may be removed from the handle 22 after first removingthe thumbnut 50. The needle holder 2| may be taken apart after twisting the casing sections 23, 24, so as to release the screw 21 from the angular slot 26 in the outer sleeve 25. The radial 7 operating arm .42 may then he slid outwardly through :the longitud-inahslots '35 and Ii, so that the .g-ripping rod 36 and the iholdertube-fl small readily :be removed .from the casing section 24 and iron: each. other.

In vreasserribling the needle holder-:21, precaution :be taken to .twist the ,coil spring 3'9 so .as to produce the necessary rotational reflect ;upon theqgripping rod :35. This may the .done by en gaging the slot 4| in the rear end ofathe gripping rod 36 over the front .end .01 the spring 39 after said gripping rod and the holder tube 32 have sbeendnserted in the front casing section--24. The .afront casing section :24 will sthenbe rotated ,approximately 11 turns with respect to the wear :casing section 23, after which the screw -2- 1 may Ebeengaged lin-the angular slot =26 of the outer sleeve .25, *where :it will 'be held by -.the torsional sefiectrof the spring L89.

"It .will be-understoodithat the needle holder 20 :mayzzbe ta-ken apart and {reassembled-in ,the same :manner as vdescribed :above in connection with ptheneedle holder '21.

"The suturing device herein described will be "found useful not only for:thez-suturing of wounds,

but may alsobesemployed toadvantage for-other purposes such .as embroidery, tapestry, and the :ananufacture of-i'ugs.

.While there has been disclosed in this specificaitioniione form in which the invention may be embodied, it is to be understood that this :form zist shown: for the purpose of illustration only, and j-tha't the invention is not to be limited to the specific disclosure, but may be modifiedland em- ;zbodied in various other storms without departing fr-omits spirit. .In shortythe invention-includes ithe modifications and..embodiments .coming within the .scope of-the followingclaims.

:flaving .thuszfully describedthe.inv.ention,=whalt .i-i claimed a "new and fo wh i is d ired t secure Letters Patent, is:

T1. ;-In a suturing .-device, an elongated -;handle adspt ds b e di n h ndeara ineedl holders mounted vwithinsaid-handle, saidrneedle ,holders projecting ;forw ardly of saidhandle and r rc mprising gripping el m n s apt d to grip :opposite end portions of a needle at the iront .ends of said needleholderss and :means .for operating. said; gripping ,elements including .a pair of .manuallysoperable armsonsaid respective-needle holders and projecting transversely outward in opposite directions through .openings in ,said ba 'dl said arm normally be n d s o d in longitudinally-offset relation with respect to said "handle, whereby said grippingHelements may'be .qperated by d f rent fine-ems o a hsn em ac Lthejhandle.

"2. The invention as defined in claim 1,; in'which the outer surface of said handle is continuous and free of openings anderevices other thansaid *flrst*mentionedaopenings.

3. The invention as define-din c1a im1,'inwhich 'said arms *project from opposite sides of aior- *wardportion of said handleysaid arms "having ranges of movement which are located-at unzequaldistances from the-front end'of said handle,

whereby said armsinay conveniently be'operated by the thumb and forefinger of the hand.

- 4. In a suturing-device, a "handle-adapted-to' be uheldin one hand, a pair of needle holders-mounted" within said handle and projecting forwardly atherelrom, each of-saidheedle holders-comprising gripping elements relatively -movable =to releasing {and gripping positions, said-gripping elements of death of said needle holders when -in releasing positions presentingiopenings :in athe front surfaces of the needle holders adapted :to 'xecehte :opposite :end portions .of a needle. .said gripping lelementsbeing mounted forlretracting-mouements atowardsaid handle, .and mechanisms :in said re.- spective needle .holders comprising :a manually operable .arm projecting .outw.ardly :from .each 40f said needle holders for operating said gripping elements.

5. "The invention :asideflned eill claim ,4, dnwhich saidlgrippingelements :of @each'needle iholdericomr prise 1a holder tube and a rotatable gripping rod therein,saidtubeand rod hayingend slots which are aligned in :the releasing =position,=.of said ggripping elements, whereby a rotative force applied to said gripping rod lmay grip .a needle ;in said .slots.

6. The inventiomasdefined in claimeininawhich said opera-ting mechanisms :include means for maintaining said gripping elements in releasing positions while said gripping elements are retracted- "7 1 a n d e holde sflio de tub and aim .101 .p rmi mts io .o sa m A and scons training said rod ainst (longitudinal Incr m n linss i s-a u .casin smb a ins sa d ho de time a h ing s d nestles th u h which sa d ,Q sr tins arm lexteads e mov m nt sneit d' a l and transrsrs l Q ssjl w ne-wher a d a mms a tuat itq r p in and ma in apes; i sai s ot and 5:0, st as n nf ne ec in sa stubs red it r ssn gas id ea i I 4 iThs n entio a d fine i slsi 'l ln when .said.side,opening, comprises a long'itudinalsl tin wh s -.sa d. n at i a m i .s ssss ble :r

o o s p n re w en 1 b jnters ih li l z ub mana es en e in sass "lone di a s a ie ii-Pre en ng In ation ,q ub zwnsnt pr le s invs tioilmv n ql esdslln iin. sim kinzwhish p ovision; o agqi sprin h d-" 'saidtubular. as g andattached to he' rear end .pfssi ennpi a'rs r s d s r g" sin u d b fi mprs nendl ars iwhs sb sa p es iqdlmay ejrestored t soriginalpositionjaiter it has :been dis pl'aced both rotativ'ely and {longitudinall iby seq e actuation o sa a inear Q."Ijh e"invention as defined in cla-im l, in ligayside wall;o'f the end slotin' saidgripping rod s an unde r-; out portion" adjacent-one" end 'of sa d end slot, said under-cut portionflproviding alip adapted-to engageover a--needle"-in said-slot when said gripping was rotated, w hereby acci dental separation -of the needle from the-holder lmiybelprevented- 1mm PASMlTI-l.

nni ennnoesgorrnn snmmnn srraarrlsgra rnnrrs Number Name JJate 11315-16 'fiaund r. ---,-----.----;%M 1"-" E 915 aeeagam ilones Nov. 21,

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