US2944552A - Surgical instrument - Google Patents

Description

y 1960 J. A. CANNON 2,944,552

' SURGICAL INSTRUMENT Filed Dec. 29. 8

Ill/U1 INVENTOR.

JACK A. CANNON ATTORNEY Thi'sfinvention pertainsto surglcal devices and more particularly to an'arrangementlfor treating arteriosclerotic occlusivedisease. 1:":5; --i .f p :55", 5.

In thepast in treatingoccluded; rteries the app'roach I generally has beenueitherto provide t n-arterial; graft, or

to' restore the1living -artery by means of conventional have been indeterminate-and inconclusive as to the heme; iitobtained. On the other-hand, -removalio f the occlu-. sion from the living artery has been a long'and diflicult United t Cannon, Westios-Angeles, Califi, nssignor to 4 and 5gwhich are inclined with. respect tothe, axis of thc tube. In the pref'erredfembodimentthese faces are arranged so thatangle at the forwardedge of the'tubular section ,is 209. 5 :A ngle 18; between the axis Aof tubular member3 and -front' -face. 4 therefore is 70?. Outer pe ripheryg 6 ofrthe tubular 'sec tion .tapers forwardly toward face 4; so asto definei' a;relativelysharp cutting edgeat this face. lnterior surface 7 may .rfemainparallelto the axis of thetubulansection.

'- Tubular section 3 and handle both constructed of stainless steelfor durability jand corrosion resistance.

epa i hd b faces in' alignment' with. outer surfacefl. Theattachs positions the forward portionj'9qof facef toflthe tubular V 7 endarter'ectomy." The former} expedient requir 15 1 plyof vessels for use ina the: operation and,the-results.

The joint "b etw 'n-jthe h'andle andlthe' tubular section; is 'lve'rf soldering end 8 of thehan'dle to of the .t11bu1 a1 section to the handle is ;such.,tliat cutting face A inclines. from end 8 of 'ith'efhandle; .,1This section diametrically opposite- 'the connection ofthe ha'n dleto, member 3. o

. 1 using the inst I plored for collapsibility and opened to check for adequate operation, unsuitable for persons in advanced age groups. 2 I

It has been. necessary tolmake a longitudinalfin'cision in the artery throughout the entire length of the obstruction. This, mayextend for as much as 32centimeters, and in some instances even longer." After removal of thefoblqz mlcflowv from below as a result filling from'fadeq'uate collateral. It ispreferred.also tofobtain a popliteal arteriogra m,in,orderlflto' ascertain thelfexact 'status of the vessel.

If popliteal artery. ispatent and' .continuous' with at f least onemajorbranchvessel, isldefsirableto continue structing intima and secondary"thromb .1 1S, theientireli-ncision must be closed'by a'running "arterial sutufel It is necessary. to'do this -very meticulously which extg d theloperating time to what maybe unac eptabIeli nitsA;

' -According to thepresentinventioii, an instrument'is provided giving the advantages of freeing a living artery, yet drastically reducing operating time.

Therefore, it is an object of this invention to provide an instrument usable in treatment of arteriosclerotic occlusive disease.

Another object of this invention is to remove an obstruction in an artery without extensive suturing.

A further object of this invention is to materially reduce operating time in the treatment of such cases.

Yet another object of this invention is to provide an instrument having-a short tubular cutting portion on the end of a flexible handle which may be inserted within an artery for removing an occlusion therein.

These and other objects will become apparent from the followingdetailed description taken in connection with the accompanying drawing in which:

Fig. 1 is a perspective view of the surgical instrument of this invention,

Fig. 2 is an enlarged fragmentary sectional view illustrating the forward cutting portion of the instrument,

Fig. 3 is an enlarged sectional view illustratingia' po'rtion of the artery prepared for removal ofthe occlusion by theinstrument of this invention,

' Fig.4 is a fragmentary perspect ve view of the v ment used in its initial stage in freeing the interio'r of an from 'withinan artery, and Fig. 6 is an elevational view, partially broken away,

of a modified form of flexible handle for the instrumen Fig. 5 is an enlarged-sectional view showing the instrument of this inventionduring its removal of an occlusion 7 ',It 1 s. important in the next phase of the operation to start the cleavage planeproperly between the thickened intima., and,the surrounding media. "Thus, vas seen in 131g 3, beveledcut.liljis-rnade in loosening intima 11 from the interior of ,artery 12 at the. location of short longitudinal incision 13. prevents subsequent dissection of the distal intimal edge when blood flow is reestablished. After this beveled incision has been accomplished'carefully around the entire inner circumference of the artery, instrument 1 is threaded on intima 11 in the manner illustrated in Fig. 4. The intima is received by the interior of tubular member 3 with cutting face 4 at the forward edge toward the occluded section of the artery. as best seen in Fig. 5 which frees the thickened intima from the arterial wall. Tubular section 3 is gently forced forwardly by handle 2 extending through incision 13 into the artery a distance suflicient to free the entire obstruction portion. The substantially inclination of the cutting face has been found to give optimum results in advancing .the cleavage plane. Other angular relationshipswmay be used successfully if not as effectively.

When the occluding portion has been freed by the instrument'of this invention, it may be pulled fromthe artery through-incision 13, following which the instrument also is removed and the necessary sutures are made.

It can be seen from the foregoing, therefore, that. it

is possible by the use of the instrument of this invention to' remove a lengthy obstruction from within an artery whilemaking only a small incision in the wall of the that operating time is greatly reduced and that improved results are obtained. q

The instrument of this invention maybe made in various sizes so that arteries of different diameters may be successfully operated upon. Preferably a number of instruments of graduated sizes are supplied in a surgical kit so that whatever the size of the vessel encountered a properly, dimensioned instrument will be available. The outer diameter of the tubular section may vary considerably from around .110 inch to nearly one-half inch 2,944,552" Patented July 12,1960

rut-dent.'iif-Lthis inventionthe patient v is: placed supine {under a long: acting spinalnanesthesia. v An incision is made and the artery isfisolated'. It is x Instrument 1 then is advanced from incision 13 1 in size. Similarly, wall thickness may run from .060

given a slight twist as illustrated. Helically wrapped around the exterior ofportion 14 is an additional'wirelS entirely covering the central portion throughout its length. This provides a strong, flexible handle which has some rigidity in the axial direction, but which also will retain a curvature impartedto it. I V I From the foregoing, therefore, itmay be seen thatI, have. provided an. improved surgicalv instrument. readily usable in removing arterial obstructions" without requiring. long operating time or extensive suturing. Theins trumentxis comparatively simple'to construct and use, and'with the front cuttingedge inclined forwardly at approximately 70 as described above, an eflective. cleavage of the thickened intima is obtained.

H The foregoing detailed description is to be clearly un derstood as given by way of illustration andexample only, a

being limited solely lar cutting edge and' inclined with respectto the axis ofsaid tubular member, .and a flexible rod-like thrust-absorbing handle attached to the opposite end of said1rnemedge being inclined at an angle of substantially 70 with respect tothe axis of said tubular member, and a flexible handle secured to the opposite end of said tubular member.

3. A surgical instrument comprising a relatively short tubular member the ends of which are parallel and inclined with respect to the axis of said member, the outer said member being parallel and inclined with respect to the axis of said tubular. member at an angle of substantially-70", the inner surface of said tubular. rnemberbeing substantially cylindrical in shape, the outerl 'surface of said tubular 'member taperingtoward said inner surface at" one end of said member to define with said inner surface'a cutting edge, and a stainless steel wire handle silver soldered tosaid tubular member- 'in substantial alignment withthe outer surface thereof at the end of said tubular member opposite said cutting edge and positioned so that said cutting'edge inclines away from said handle.

her at. one side of the axis thereof so that said inclined References Cited in theme of thispatent;

UNITED STATES PATENTS Trace Apr. 16, 1957

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