US2962024A - Hemostat - Google Patents

Description

N V- 2 1 0 M. RAYMOND 2,962,024

HEMOSTAT Filed April 8, 1958 Fl .7 Fig-9 Fig.8

g [2A 2/ BA Fig-2 Malcolm L. Raymond c796 30 INVENTOR.

33 34 BY mmqs nite Sats HEMOSTAT Malcolm L. Raymond, 88 Osborne St., Johnstown, Pa.

Filed Apr. 8, 1958, Ser. No. 727,108

4 (Jlaims. (Cl. 128-325) This invention relates in general to surgical instruments and pertains more particularly to improvements in ligating hemostats.

In using a conventional hemostat, it often occurs that the tips do not seize enough tissue for ligating purposes even though they may check the bleeding properly. Consequently, after the ligature is applied over the tips and the instrument unlocked, the knot may pull 01f when the two ends of the ligature are lifted and tautened to permit cutting of the same above the knot. This wastes time, often important in surgical operations, as well as the ligature. To prevent this, the one tying the ligature may throw it around too much tissue. Such strangulated masses of tissue may either break down, if fatty, to cause pools of liquid in the wound, or may organize into masses of undesirable excess of scar tissue. It is therefore of primary concern in connection with this invention to provide improvements in ligating hemostats which will insure the clamping or grasping of just enough more than the amount of tissue clamped by a conventional hemostat to insure the application of a proper ligature.

Another object of this invention is to provide improvements in ligating hemostats wherein the cross arms of the hemostat, while pivotally connected together in the conventional manner, are permitted a slight longitudinal movement with respect to each other so that the clamping blades or tips during the final clamping movement thereof toward each other will also be permitted of relatively longitudinal movement with respect to each so that when the tissue is clamped and the instrument locked, the clamping action will be effected between the tip of one blade and a portion of the other blade which is spaced inwardly from the tip thereof so that when the ligature is slipped down to clear the projecting tip, then tied, it will catch or include just enough more tissue than usual to insure that the ligature will not slip off.

Still another object of this invention is to provide improvements in ligating hemostats including a pair of cross arms pivotally and slidably connected together and incorporating locking means for holding the clamping tips in clamping position wherein such locking means includes mechanism for effecting relative longitudinal movement of the cross arms during engagement of the locking means and at such time as the clamping ends or tips are approaching the clamped relationship so that such tips are imparted of a compound movement, both toward each other and longitudinally with respect to each other.

These together with other objects and advantages which will become subsequently apparent reside in the details of construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part hereof, wherein like numerals refer to like parts throughout, and in which:

Figure 1 is a plan view of the improved hemostat illustrating the same in open position;

Figure 2 is a view similar to Figure 1 but showingthe instrument in locked position and illustrating the manner in which the tips thereof are longitudinally olfset with respect to each other when so disposed;

Figure 3 is a view illustrating the application of the hemostat to a mass of tissue and illustrating the initial position of a ligature;

Figure 4 is an enlarged view similar to Figure 3 but illustrating the hemostat rotated just prior to the final application of a ligature;

Figure 5 is an enlarged transverse sectional view taken substantially along the plane of section line 55 of Figure 2 and illustrating the details of the locking means;

Figure 6 is an enlarged longitudinal section taken substantially along the plane of section line 65 in Figure 2 illustrating further details of the locking mechanism;

Figure 7 is an enlarged transverse sectional view taken substantially along the plane of section line 7-7 in Figure 2 illustrating the construction of the clamping tips of the hemostat;

Figure 8 is an enlarged transverse section taken substantially along the plane in section line 88 in Figure 3 illustrating the manner in which the tissue is clamped between the tips of the hemostat; and

Figure 9 is an enlarged transverse sectional view taken substantially along the plane of section line 9-9 in Figure 2 illustrating the pivotal connection between the cross arms. 7

Referring at this time more particularly to Figure 1, the reference numerals 10 and 11 indicate the cross arms of the hemostat which are of narrow elongate construction and are provided at one end thereof with the clamping tips 12 and 13 respectively and at the opposite ends with the finger-gripping portions 14 and 15 respectively.

As can be best seen in Figures 1 and 9, an intermediate portion 16 of the cross arm 10 is narrowed and flattened on opposite sides thereof to project through the slotted intermediate portion of the other cross arm 11. The slotted portion of the cross arm 11 provides a pair of spaced, opposed portions 17 and 18 between which the portion 16 of the arm 10 is received and guided. A pin 19 is carried by and projects through the portions 17 and 18 and extends through an elongate slot 20 in the intermediate portion 16 of the cross bar 10, see particularly Figure 4.

Thus, not only are the cross arms 10 and 11 pivotally connected together for movement between the positions illustrated in Figures 1 and 2, but also the cross arms, by virtue of the pin and slot connection 19 and 20 are permitted of a slight longitudinal movement with respect to each other so that the blades or tips 12 and 13 may ultimately assume a longitudinally offset relationship with respect to each other as is illustrated most clearly in Figure 2.

In this manner, when the portion 21 of a mass of tissue see particularly Figure 3, is gripped by the blades or tips 12 and 13, the tissue will be clamped between the blades and between an end portion 22 of the blade 13 and an intermediate portion 23 of the other blade 12 offset rearwardly from the tip end 24 thereof. Thus, to grip, the blades of necessity must grasp a sufiicient amount of the tissue 23. between the effective clamping portions thereof. Consequently, when the ligature indicated generally by the reference character 25, is applied around the tips as is illustrated in Figure 3 in the initial stage of the ligature, and the instrument is turned 180 as illustrated in Figure 4 just prior to the final stage of applying the ligature, the projecting tip end 24 of blade 12 offers a guide for the final application of the ligature 25 inasmuch as the ligature must be slipped beyond thistip end 24 for application to the mass of tissue 21. In other words, the ligature Will be slipped over, beyond the tip end 24 just enough more of the mass of tissue 21 than it would were it slipped beyond the tips 22 and 24 if they were in registery with each other to insure that the ligature will be applied to a sufficient amount of tissue to hold after the instrument is removed and when the ligature is tautened to cut the free end thereof beyond the knot of the ligature. In this way, the ligature will be applied to just the right amount of tissue, neithertoo little so that the ligature will slip off when tautened to cut the free ends nor too much such as would cause strangulation of the tissue mass beyond the ligature.

Although it is conceivable that the surgeon could manipulate his fingers in such manner to effect the combined pivoting and longitudinal movement between the cross bars or arms and 11 to effect the desired clamping action as illustrated in Figures 3 and 4, due to the necessary construction of the blades 12 and 13 themselves on their opposed inner faces, it is preferred that the action be automatically effected to prevent cutting of the tissue. This can be appreciated more clearly by reference to Figures 7 and 8 wherein it will be seen that the opposed inner clamping surfaces 12A and 13A of the blades 12 and 13 respectively are longitudinally fluted or corrugated to effect a firm clamping action on the tissue 21 grasped therebetween. It will be clear from Figure 8 particularly that if the blades 12 and 13 are first brought together in clamping relationship on the tissue 21 and then the longitudinal movement imparted therebetween to project the one tip end 24 beyond the other tip end 22, there is a danger that the tissue 21 will be torn or cut by virtue of the corrugated or saw-toothed formation of the clamping surfaces 12A and 13A. Consequently, it is preferred in the final stage of closing of the instrument when the blades 12 and 13 are brought into final clamping position that a compound movement be imparted thereto in which they move toward each other and the longitudinal shifting or adjustment takes place simultaneously so as to prevent any cutting action on the tissue 21.

This is effected by means of the locking cars 30 and 31 which extend inwardly toward each other from the handle end portions 14 and of the instrument and which are provided with cooperating teeth on the overlapping surfaces thereof so as to effect the above mentioned longitudinal movement between the cross arms 10 and 11 and at the same time to lock the instrument in clamped position.

For this purpose, as can be best seen in Figures 5 and 6, the teeth 32 and 33 are cut deeper toward the tip end of the instrument as indicated by the reference character 34 and become progressively shallower therefrom toward the handle end of the instrument. Thus, when the cross arms are moved toward each other and the teeth initially engage, as shown in dotted lines in Figure 6, the progressive engagement of the several teeth with each other as the cross arms move toward the final clamping position will effect an inner engagement between the teeth 32 and 33 which, due to their construction, will impart the longitudinal relative sliding motion between the cross arms 10 and 11 so that in the final clamping stages of the instrument, as the blades 12 and 13 move toward each other, there will simultaneously be imparted a relatively longitudinal movement so that the net effect of the movement is compound, being neither purely toward each other nor purely longitudinal relative to each other but a combination of both so as to clamp the tissue 21 as gently as possible. Of course, a positive means may be provided between the cross arms 10 and 11 to positively effect the relative longitudinal movement thereof during the final clamping movement of the instrument. This could be effected by means of cam surfaces interengageable as the two cross arms 10 and 11 are moved to the final clamping position which would positively effect a longitudinal shifting therebetween.

It will be appreciated that when using a conventional hemostat, it often happens that the tips do not seize enough tissue even though they check the bleeding. Not infrequently, after the ligature is applied, and the instrument is unlocked, the knot may pull off when the two ends of the ligature are lifted and tautened to permit cutting of same above the knot. This wastes valuable time, often important in surgical operations, as well as a ligature.

As the hemostat is snapped onto the bleeding tissue, the point of one blade moves both inward and downward a fraction of an inch, say /s", through an are, as the handles are locked. When the ligature is applied, the operator or surgeon, rotates the longer tip uppermost and the assistant applies the ligature. When the ligature is necessarily slipped down to clear the projecting tip, and then tied around, it will catch or include just enough more tissue than usual to insure against accidental displacement. As the ligature is tied the operator unlocks and retracts the extended blade by the movement of his thumb.

The foregoing is considered as illustrative only of the principles of the invention. Further, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation shown and described, and accordingly all suitable modifications and equivalents may be resorted to, falling within the scope of the invention as claimed.

What is claimed as new is as follows:

1. A ligating hemostat comprising a pair of crossed pivotally connected arms having forward end portions thereof provided with clamping tips and rearward end portions provided with hand-grip portions, the connection between said arms permitting pivotal movement therebetween and a predetermined longitudinal relative shifting of the arms, whereby the clamping tips of the assembly will grasp a mass of tissue therebetween with one tip projecting beyond the other tip, and means for effecting relative longitudinal shifting movement between said arms during the final motion of the clamping tips toward each other and into clamping position with respect to each other, said means embodying cooperable ears having coacting cam teeth.

2. A ligating hemostat comprising a pair of crossed arms pivotally interconnected at intermediate portions thereof and each provided with a clamping tip at one end and a hand-grip portion at the opposite end, the pivotal connection between said arms being such as to permit predetermined longitudinal shifting therebetween, and locking means on the hand-grip ends of said arms interengageable during the final movement of said clamping tips toward each other and into clamping relationship with each other whereby to hold the instrument in locked position, said locking means being also operable to effect the longitudinal shifting between said arms during the final clamping movement thereof whereby to project the tip of one clamping element beyond the other.

3. A ligating hemostat comprising a pair of crossed pivotally connected arms having forward end portions thereof provided with clamping tips and hand-grip portrons at the rearward ends, the connection between said arms permitting both pivotal movement therebetween and a predetermined longitudinal relative shifting of the arms, whereby the clamping tips may grasp a mass of tissue therebetween with one tip projecting beyond the other tip, and means for effecting relatively longitudinal shifting between said arms during the final motion of the clamping tips toward each other and into clamping position with respect to each other, said means being interengageable to effect a locking action between said arms.

4. A ligating hemostat comprising a pair of arms crossed and pivotally connected intermediate their ends and each having a clamping end and a hand-grip end, interengaging camming means fixed to said arms adjacent the hand-grip end portions thereof and interengageable when the clamping tips of the arms are moved closely adjacent each other and into clamping relationship, said interengaging cam means being effective to impart relative longitudinal movement between said clamping tips whereby project the the tip end of one beyond the other, said interengaging means being in the form of lateral projections on said hand-grip portions of the arms and being movable into overlapping relationship with each other during the final clamping action of the instrument, the opposed overlapping surfaces of said extensions being longitudinally grooved to provide teeth and grooves being deeper at the tip end of the instrument and being progressively shallower therefrom toward the handle end of the instrument.

References Cited in the file of this patent UNITED STATES PATENTS 1,918,889 Bacon July 18, 1933 FOREIGN PATENTS 462,711 Germany July 16, 1928 516,574 Germany Jan. 24, 1931 106,809 Austria July 11, 1927

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