US3482428A - Surgical apparatus for suturing tissues with metal staples - Google Patents

Surgical apparatus for suturing tissues with metal staples Download PDF

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US3482428A
US3482428A US3482428DA US3482428A US 3482428 A US3482428 A US 3482428A US 3482428D A US3482428D A US 3482428DA US 3482428 A US3482428 A US 3482428A
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magazine
guide
pusher
guides
needle
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Nikolai Nikolaevich Kapitanov
Natalia Petrovna Petrova
Nina Vasilievna Jurasova
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Nikolai Nikolaevich Kapitanov
Natalia Petrovna Petrova
Nina Vasilievna Jurasova
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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
    • A61B17/115Staplers for performing anastomosis in a single operation
    • A61B17/1152Staplers for performing anastomosis in a single operation applying the staples on the outside of the lumen
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0686Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips

Description

Dec. 9, 1969 KAPITANOV ET AL 3,482,428

SURGICAL APPARATUS FOR SUTURING TISSUES WITH METAL STAPLES Filed July 12, 1967 v 4 Sheets-Sheet 1 Dec. 9, 1969 N. N. KAPITANOV ET AL SURGICAL APPARATUS FCR SUTURING TISSUES WITH METAL STAPLES 4 Sheets-Sheet 2 Filed July 12, 1967 mm JJ N a vi ww %w\ A R Dec. 9, 1969 N. N. KAPITANOV ET AL 3,482,428

SURGICAL APPARATUS FOR SU'I'URING TISSUES WITH METAL STAPLES Filed July 12, 1967 4 Sheets-Sheet 5 a mm Q E mwfi V W E GE A 5N Q Q %T v Q &\ w L .1 My w S Dec. 9, 1969 N. N. KAPITANOV ET AL. 3,482,428

SURGICAL APPARATUS FOR SUTURING TISSUES WITH METAL STAPLES Filed July 12, 196'? 4 Sheets-Sheet 4 Q @Q &

QVAVAI/ .T Z7

\N mm r/gags z United States Patent 3,482,428 SURGICAL APPARATUS FOR SUTURING TISSUES WITH METAL STAPLES Nikolai Nikolaevich Kapitanov, 8 ulitsa Oktyabrskogo polya, 5, kv. 9; Natalia Petrovna Petrova, 1 Novokuznetskaya ulitsa, 4, kv. 44; and Nina Vasilievna Jurasova, Donskaya ulitsa, 44, kv. 40, all of Moscow, U.S.S.R.

Filed July 12, 1967, Ser. No. 652,833 Int. Cl. A61b 17/04 US. Cl. 72-410 7 Claims ABSTRACT OF THE DISCLOSURE Apparatus for suturing tissues with metal staples, employed in surgical operations, such as suturing the skin, anastomosing the bronchi, suturing the heart, intestines, vessels and other organs. The apparatus is provided with needle-shaped dies fashioned as curvilinear pointed needles having grooves for passing and bending staples, and a detachable magazine which automatically displaces when a pusher moves towards the needle-shaped dies. While moving, the pusher ejects from the magazine one staple in the direction towards the needle-shaped dies to be bent in the grooves of the latter, thereby making it possible to suture tissues approached from one side only, and particularly tissues of considerable thickness.

The present invention relates to surgical apparatus for suturing tissues with metal staples, employed in medical practice for surgical operations, such as suturing the skin, anastomosing the bronchi, suturing the heart, vessels, intestines and other organs.

There are known surgical apparatus for suturing tissues with metal staples, wherein the latter are ejected from a magazine with the aid of a pusher, the ends of the staples being subsequently bended upon cooperating with a die (cf. publication Kalendar Vracha, 1961, Moscow, pp. 418-420).

The principal disadvantage of said known surgical apparatus is that the tissues to be sutured are to be approached from two sides. The tissue being sutured should be placed between the die and the magazine with staples designed for suturing the tissue in cooperation with the die.

Another disadvantage of the known surgical apparatus for suturing tissues with metal staples is that said apparatus cannot be employed for suturing tissues of considerable thickness.

The invention is aimed at the development of a surgical apparatus that would provide for suturing tissues with metal clips only from the outside of the tissue being sutured, as well as make it possible to suture tissues of considerable thickness.

In accordance with said and other objects, the present invention consists in that the die of the present surgical apparatus is placed on the operating end of at least one guide and is fashioned as at least one curvilinear needle with a longitudinal slot on the concave side, which slot is the continuation of a groove on the guide along which groove staples are ejected from the magazine with the aid of a pusher.

It is expedient that the needle-shaped dies be mounted on the operating ends of both guides and placed with their points directed one towards the other so that, when being ejected by the pusher from the magazine, a staple slides with its ends along the grooves of the guides and the slots of the needle-shaped dies wherein the staple ends are bent, while for feeding the next staple to the dies provision is made of a magazine displacement mechanism.

It is desirable that the pusher of the present apparatus be fashioned as a carriage having a projection for inter- 3,482,428 Patented Dec. 9, 1969 linking the guides and a rod to eject staples from the magazine.

It is feasible that the magazine displacement mechanism be fashioned as a spring-loaded lever with a pin cooperating with holes in the magazine, and a spring-loaded projection cooperating with the carriage cams.

It is desirable that the cams be disposed inside the pusher carriage, one of said cams, parallelogram in crosssection, being designed for disengaging the magazine from the lock, while the other cam, a fiat one, is designed for lateral displacement of the magazine with the aid of the pusher relative the grooves of the guides.

It is likewise desirable that the magazine displacement mechanism have an immovable projection cooperating with the flat cam of magazine displacement.

The magazine of the persent apparatus may be mounted in the lateral groove of the guide with the aid of a lock entering one of the magazine holes and a spring pressing the magazine to the guide.

Other objects and advantages of the present invention will be made apparent upon examining the following description thereof and the accompanying drawings, wherem:

FIGURE 1 shows a general view of the apparatus for suturing tissues with metal staples, according to the present invention, with partial sections in places of locking the magazine with the guide and of spring-loading the regulator of the pusher movement;

FIGURE 2ditto, top view with partial section near the carriage at the location of cams;

FIGURE 3-ditto, with the guides moved apart;

FIGURE 4 shows the fixing of one of the needle-shaped dies to a guide and the position of a staple at the moment of approaching the die slots;

FIGURE 5 illustrates the staple design;

F FIGURE 6 shows the carriage in section on line II of IG. 1;

FIGURE 7 shows the guides and the pusher rod in section on line II-II of FIG. 1;

FIGURE 8 shows the apparatus magazine in section on line III-III of FIG. 2;

FIGURE 9ditto, with the guides moved apart;

FIGURE 10ditto, the magazine deflecting when acted upon by the lever of the magazine-displacement mechanlsm;

FIGURE 11ditto, the magazine displacing in the lateral groove of the guide;

FIGURE 12ditto, following the disengagement of the lever pin from the magazine hole and the locking of the magazine;

FIGURE 13ditto, the magazine being in the working position for the next staple, and the lever of the magazine displacement being in the initial position;

FIGURE 14 shows the position of the carriage cam for disengaging the magazine from the lock, section on line IVIV of FIG. 6; and

FIGURE 15 showns the flat cam for lateral displacement of the magazine in cooperation with the springloaded and immovable projections, section on line VV of FIG. 3.

When describing the exemplary embodiment of the present invention, concrete narrow terminology has been used for the sake of clarity. However, the invention is not limited by the terms adopted, and it should be borne in mind that each of these term embraces all the equivalent elements working analogously and used to solve similar problems.

The surgical apparatus according to the present invention is shaped as pincers and consists of two guides 1 and 2 (FIGS. 1, 2, 3,) with needle-shaped dies 3, a pusher 4, a magazine 5, a regulator 6 of the pusher movement, and a mechanism 7 for displacing the magazine after each suturing.

The guides 1 and 2 are interhinged with an axle 8. The connection of said guides 1 and 2 may be detachable or permanent. The guide 1 mounts a spring 9 which serves to move the guides apart.

Each guide 1, 2 is provided with a lateral groove 10 and a lock 11 for locking the magazine 5. The lateral grooves 10 are connected with the needle-shaped dies 3 by means of grooves 12 (FIG. 4) for directing staples 13 (FIG. 5) when moving the latter from the magazine 5 to the needle-shaped dies 3, each guide 1, 2 being provided with one or several dies 3. The needle-shaped dies 3 are rigidly connected to the guides 1, 2, however, they may be made detachable.

Each die 3 is fashioned as a bent needle with a longitudinal slot 14 on the concave side. At the bend the slot 14 becomes part 15 of the die 3. Each slot 14 of the needle-shaped die 3 is the continuation of a respective groove 12 of the guides 1, 2 (FIG. 4).

The magazine 5 has a longitudinal groove 16 (FIGS. 8, 9, 10, 11, 12, 13,) for the passage of the pusher 4 and lateral grooves 17 for housing ends 18 of the staples 13. On the walls of the magazine 5 provision is made of hole 19 for the connection with the locks 11 of the guides 1, 2 and for the connection with a spring-loaded lever of the mechanism 7 at the moment of automatic displacement of the magazine 5 in the lateral groove of the guide 2. The spacing of the holes 19 is the same as that of the lateral grooves 17 of the magazine 5. The magazine 5 is provided with a spring 21 which presses it to the bottom of the lateral groove 10 of the guide 2. The combustion of the magazine 5 with the lateral grooves 10 of the guides 1, 2 is such that the magazine may be placed both inclined or longitudinally with respect to said guides, which presents no technical difiiculties and depends upon the design necessity.

The pusher 4 is designed for closing the guides 1, 2 prior to suturing, feeding the staples 13 and actuating the mechanism 7 at the moment of automatic displacement of the magazine 5. The pusher 4 has a carriage 22 with a longitudinal groove 23 for movable connection with the guide 2; a projection 24 for the surgeons finger to rest against; a groove 25 for the passage of a narrow part 26 of the guide 1; projections 27 for meshing with projections 28 of the guide 1; a rod 29 or a number of rods (depending upon the number of the staples 13 fed at a time) for feeding the staples 13 from the magazine 5 to the needle-shaped dies 3 and for bending said staples when suturing; a groove 30 for the passage of the mechanism 7; and earns 31, 32 for actuating the mechanism 7.

The cam 31 is parallelogram-shaped in cross-section with working planes 33, 34, 35, 36 (FIG. 14) and is designed for disengaging the magazine 5 from the lock 11. The cam 32 is flat, has working planes 37 and 38, and is designed for lateral displacement of the magazine 5 with the aid of the pusher 4 relative the lateral groove 10 of the guide 2.

The regulator 6 of the pusher movement limits the advance of the latter towards the needle-shaped dies 3. It has an eccentric 39, a groove 40 for a spring 41, and a pin 42.

The mechanism 7 for automatic displacement of the magazine 5 consists of the spring-loaded lever with a plane 43, a spring 44, a spring 45 and an axle 46. The lever 20 has a pin 47 for cooperating with the holes 19 of the magazine 5, a groove 48 for supporting the spring 45, and an immovable projection 49 with working planes 50 and 51 for cooperating with the cam 32. The spring 45 is fixed on the guide, rests with its free end against the walls of the groove 48 of the lever 20 and presses the latters end 52 to the upper righthand corner of a movement limiter 53 secured on the guide 2. The spring 44 is secured on the lever 20 and rests with a projection 54 against a plane 55 of said levers immovable pr jection 49.

The spring-loaded projection 54 has working planes 56, 57, 58, 59 for the cooperation with the cam 31, and working planes 60, 61 for the cooperation with the cam 32.

A pin 62 is provided on the guide 2 for precluding deflection of the guides 1, 2 and for limiting the movement of the pusher 4 in the direction of the axle 8.

Following is the principle of operation of the apparatus according to the present invention.

A staple 13 is inserted into each lateral groove 17 of the magazine 5 so that, the latter being set on the guide 2, the ends 18 of the staple point in the direction of the needle-shaped dies 3. Prior to setting the magazine 5 into the lateral groove 10 of the guide 2, the pusher 4 is set to the position of separated guides 1, 2, that is, in the position at which the projections 27 are disengaged from the longitudinal projections 28 of the guide 1. The spring 9 moves the guides 1 and 2 apart. The magazine 5 is introduced into the lateral groove 10 so that the spring 21 embrace the guide 2 from the outside and the lock 11 of the guide 2 enter the extreme lower hole 19 of the magazine 5. Depending upon the thickness of tissue being sutured, the regulator 6 of the pusher movement is set to a position insuring the maximum or minimum advance of the pusher 4 in the direction of the needle-shaped dies 3. The needle-shaped dies are introduced in the edges of tissue being sutured and brought together until the guide 1 contacts the rod 29 of the pusher 4. After that the pusher 4 is advanced until the contact with its movement regulator 6. The tissue gets sutured. During the advance of the pusher 4 in the direction of the needle-shaped dies 3 the rod 29 enters the longitudinal groove 16 of the magazine 5, comes up to a staple 13 and pushes the latter forward from the lateral grooves 17 of the magazine 5 into the grooves 12 of the guides 1, 2. From the grooves 12 the staples 13 enter the longitudinal slots 14 of the needle-shaped dies 3. The ends 18 of the stables 13 are bent along the parts 15 of the needle-shaped dies 3, upon reaching the bend of the latter. The present apparatus is removed from the sutured tissue in the following manner. The pusher 4 is returned to the initial position, that is, in the position at which the projections 27 have just left the projections 28 of the guide 1. The guides 1 and 2 tend to move apart under the action of the spring 9. The needle-shaped dies 3 are taken out from the tissue.

In order to displace the magazine 5 the pusher 4 should be moved up to the pin 62. At this moment, the plane 33 of the cam 31 presses against the plane 56 of the projection 54 of the spring 44, said projection 54 resting on the projection 49 of the lever 20. The lever 20 moves down and, consequently, its end provided with the pin 47 moves from the initial position in the direction of the magazine 5. The pin 47 enters a hole 19 in the magazine 5. At the same moment, the plane 43 of the lever 20 comes up to the magazine 5 and, the lever 20 moving on, the inclined magazine 5 starts coming out of engagement with the lock 11 of the guide 2. After the plane 34 of the cam 31 coincides with the plane 57 of the projection 49, the magazine 5 is fully disengaged from the lock 11 of the guide 2, whereupon the working plane 37 of the cam 32 starts pressing against the planes 50 and 60 of the projections 49 and 54, respectively. At the same time, the pin 47 displaces the magazine 5 across the guide 2.

After the plane 38 of the cam 32 coincides with the planes 51 and 61 of the projections 49 and 54, respectively, the end of the lever 20 is pressed to the guide 2. Another opening 19 in the magazine 5 comes opposite the lock 11 of the guide 2. At the same time, the cam 31 passes the plane 57 of the projection 54 and the level 20, under the action of the spring 45, is pressed with the plane 55 to the plane 34 of the cam 31. The end of the lever 20, without leaving the guide 2, moves away from the magazine 5 until contact with the movement limiter 53.

When the pusher 4 returns from the pin 62 to the initial position, then end of the lever 20 with the pin 47 also returns to the initial position, while the plane 35 of the cam 31 acts upon the plane 58 of the projection 54 so that the plane 36 of the cam 31 slides on the plane 59 of said projection 54. The plane 38 of the cam 32 leaves the planes 51, 61 of the projections 49, 54 and the lever 20 gets into the initial position.

The surgical apparatus for suturing tissues with metal staples, according to ,-the present invention, features the following advantages. 1

The apparatus makes it possible to suture tissue by introducing into it the needle-shaped dies 3, which simultaneously serve for bending the staples 13, thus insuring mechanical suturing Without placing fiat dies under the tissue being sutured and facilitating the mechanical suturing of those organs which cannot be sutured by means of prior art apparatus (heart muscles, branchus etc.).

The present apparatus makes it possible to suture tissues at any depth, with the formation of fold or head of any size, or butt-joining the tissue edges.

The present apparatus facilitates the suturing of tissues without their pressure transfer.

Although the present invention has been described hereinabove in connection with the preferred embodiment thereof, various alterations and modifications can take place without departing from the spirit and scope of the invention, as those skilled in the art will easily understand, Such alterations and modifications are to be considered as falling within the essence and scope of the invention and the appended claims.

We claim:

1. A surgical apparatus for suturing tissues with metal staples, comprising: at least one guide with a longitudinal groove; a die fixed on said guide and fashioned as at least one curvilinear needle with a longitudinal slot on the concave side, said slot being the continuation of said longitudinal groove of said guide; a magazine placed on said guide and designed for storing staples therein; a pusher mounted on said guide and serving to eject the staples from said magazine and feed them to said die for suturing tissues.

2. A surgical apparatus in accordance with claim 1, wherein the needle-shaped dies are mounted on the operating ends of both guides, the points of said dies being directed one towards the other so that a staple being ejected by the pusher from the magazine would slide with its ends along the grooves of the guides and the slots of the needle-shaped dies wherein the staple ends are bent, while for feeding the next staple to the dies provision is made of a magazine displacement mechanism.

3. A surgical apparatus in accordance with claim 2, wherein the pusher is fashioned as a carriage having a projection for interlinking the guides and a rod for ejecting the staples from the magazine.

4. An apparatus in accordance with claim 2, wherein the magazine displacement mechanism is fashioned as a spring-loaded lever with a pin cooperating with holes in the magazine, and a spring-loaded projection cooperating with cams of the pusher carriage.

5. An apparatus in accordance with claim 4, wherein said cams are disposed inside the pusher carriage, one of said cams, parallelogram in cross-section, being designed for disengaging the magazine from a lock, while the other cam, a flat one, is designed for lateral displacement of the magazine with the aid of the pusher relative the grooves of the guides.

6. An apparatus in accordance with claim 4, wherein the magazine displacement mechanism has an immovable projection cooperating with the flat cam of magazine displacement.

7. An apparatus in accordance with claim 2, wherein the magazine is mounted in a lateral groove of the guide with the aid of a lock entering one of the magazine holes and a spring pressing the magazine to the guide.

References Cited UNITED STATES PATENTS 2,194,748 3/1940 Glaser et al. 72-410 2,744,251 5/1956 Vollmer 72410 3,047,874 8/1962 Kelsey 72410 ROBERT D. GREFE, Primary Examiner US. Cl. X.R.

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US4101063A (en) * 1973-10-30 1978-07-18 Nikolai Nikolaevich Kapitanov Surgical instrument for ligating tubular organs in deep cavities
US4122989A (en) * 1975-12-19 1978-10-31 Kapitanov Nikolai N Instrument for suturing with metal staples
US4272002A (en) * 1979-07-23 1981-06-09 Lawrence M. Smith Internal surgical stapler
US4273281A (en) * 1979-07-23 1981-06-16 Franklin G. Smith Internal surgical stapler
US4513746A (en) * 1981-10-09 1985-04-30 United States Surgical Corp. Instrument for applying plastic-like surgical fastening devices
WO2002019921A1 (en) * 2000-09-08 2002-03-14 Christy Cummins Surgical stapling instrument
US6582452B2 (en) 2000-09-08 2003-06-24 James Coleman Surgical stapler
US20040028502A1 (en) * 2001-06-07 2004-02-12 Christy Cummins Surgical staple
US20040236355A1 (en) * 2001-08-09 2004-11-25 Thomas Anthony Surgical stapling device
US20040249391A1 (en) * 2001-08-09 2004-12-09 Christy Cummins Surgical stapling device and method
US20050256537A1 (en) * 2002-07-03 2005-11-17 Christy Cummins Surgical stapling device
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US2194748A (en) * 1937-04-15 1940-03-26 Mark A Glaser Clip applicator
US2744251A (en) * 1953-06-04 1956-05-08 Vollmer Leonhard Automatic inserter for suturing clips
US3047874A (en) * 1960-10-17 1962-08-07 W D Dailey Magazine-type clip forceps

Cited By (115)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4101063A (en) * 1973-10-30 1978-07-18 Nikolai Nikolaevich Kapitanov Surgical instrument for ligating tubular organs in deep cavities
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