WO2023039467A1

WO2023039467A1 - Medical clamp having a blade

Info

Publication number: WO2023039467A1
Application number: PCT/US2022/076104
Authority: WO
Inventors: Hubert SWANA; Riham M. HANNA; Evan C. GOMEZ; Thomas Hartmann; Sang-Eun Song
Original assignee: University Of Central Florida Research Foundation, Inc.; Orlando Health Inc.
Priority date: 2021-09-08
Filing date: 2022-09-08
Publication date: 2023-03-16

Abstract

A medical instrument may include a first elongated arm and a second elongated arm, the first elongated arm and the second elongated arm being coupled at a pivot joint. Thus, pivoting of the first elongated arm relative to the second elongated arm about the pivot joint causes a distal end of the first elongated arm to move relative to a distal end of the second elongated arm. A blade may be fixed to the distal end of at least one of the first elongated arm and the second elongated arm such that the blade moves when the respective elongated arm pivots.

Description

MEDICAL CLAMP HAVING A BLADE

RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Application No. 63/241,717, filed September 8, 2021, and entitled “Meatome: A novel clamp for single step urethral meatal stenosis surgery,” which is hereby incorporated by reference in its entirety.

BACKGROUND

[0002] Meatal stenosis is a condition that occurs in boys after circumcision or urethral surgery. Scar tissue forms around the opening of the urethra at the tip of the penis (meatus) and obstructs the urinary flow. Symptoms can include deviation of the urinary stream, pain with urination and bleeding from the tip of the penis. Meatal stenosis can also interfere with complete bladder emptying. If left untreated, meatal stenosis can lead to further complications such as bladder and urinary tract infections. Meatotomy is a surgical procedure performed to correct meatal stenosis by widening the urethral opening, also called the meatus.

[0003] The two most popular methods used to today to fix a meatal stenosis are a meatotomy or meatoplasty. These procedures are very similar but do have unique indications. In general, meatoplasty is a more complex procedure reserved for extensive scarring and obstruction of the meatus. Meatoplasty is performed in the operating room with general anesthetic support. During meatoplasty, excision of scar tissue is performed, occasionally tissue is grafted to replace portions of the urethra at the tip of the penis and the edges of the surgically opened penis are sutured. Meatotomy is indicated when the obstructive tissue is generally thinner and is amenable to a more simple incision. Meatotomy can be performed as an in-office procedure with local anesthesia for an awake patient. Currently meatotomy requires multiple instruments deployed in a variable number of steps. In general meatotomy procedure is as follows: stabilization of the penis, dilation of the urethral meatus, placing an instrument to crimp the edges of tissue causing obstruction, crimping of the tissue followed by incision of the overlying obstructive tissue covering the meatus using surgical scissors or a scalpel. For patients (especially children) the use of multiple instruments, surgical draping, and visible blood can cause anxiety. Reduction in the number of instruments, the steps involved, and the time required for meatotomy is therefore very desirable.

BRIEF DESCRIPTION OF THE DRAWINGS

[0004] The present embodiments are illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings.

[0005] The following figures are illustrative only, and are not intended to be limiting

[0006] FIG. 1 shows side perspective view of an embodiment of a multi-functional surgical device.

[0007] FIG. 2 shows a perspective view of the proximal end of the embodiment shown in FIG. 1

[0008] FIG. 3 shows a perspective view of the blade on a face of a clamp member of the embodiment shown in FIG. 1

[0009] FIG. 4 shows a perspective view of the slit on a face of a clamp member of the embodiment shown in FIG. 1

[0010] FIG. 5 shows a perspective view of the interlocking portion of the embodiment shown in FIG. 1.

[0011] FIG. 6 shows a side perspective view of the embodiment shown in FIG. 1 [0012] FIG. 7 shows the measurements of the first clamp member of the embodiment shown in FIG. 1. Dimensions are shown in centimeters.

[0013] FIG. 8 shows the pre-incision crimping and post-incision crimping of the device compared to the industry-standard devices.

[0014] FIG. 9 shows the measurements of the embodiment shown in FIG. 1. Dimensions are shown in centimeters.

[0015] FIG. 10 shows measurements of the blade and ridges on a face of a clamp member of the embodiment shown in FIG. 1.

[0016] FIG. 11 shows an embodiment of a medical instrument having an angled blade, non- engageable locking device, and finger loops, where the medical instrument is in a closed state without deformation in its elongated arms.

[0017] FIG. 12 shows the medical instrument from FIG. 11 in an open state.

[0018] FIG. 13 shows a magnified view of the angled blade from the embodiment of FIGS. 11- 12.

[0019] FIG. 14 shows an alternative blade embodiment, which is also included in the embodiment(s) of FIGS. 1-10.

DEFINITIONS

[0020] For the purposes of promoting an understanding of the principles and operation of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated container and method, and such further applications of the principles of the invention as illustrated therein being contemplated as would normally occur to those skilled in the art to which the invention pertains.

[0021] It is to be noted that the terms "first," "second," and the like as used herein do not denote any order, quantity, or importance, but rather are used to distinguish one element from another, unless otherwise specifically stated herein. The terms "a" and "an" do not denote a limitation of quantity, but rather denote the presence of at least one of the referenced item. The modifier "about" used in connection with a quantity is inclusive of the stated value and has the meaning dictated by the context. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). About can be understood as within 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.1%, 0.05%, or 0.01% of the stated value. Unless otherwise clear from context, all numerical values provided herein are modified by the term about. In a specific embodiment, the term “about” includes a stated numerical value as well as a value that is +/— 30% of the stated numerical value. For example, about 40 degrees includes 40 degrees as well as angles of 36 degrees and 44 degrees, and all values in between. In many instances, the term “about” may include numbers that are rounded to the nearest significant figure. Furthermore, to the extent that the terms "including," "includes," "having," "has," "with," or variants thereof are used in either the detailed description and/or the claims, such terms are intended to be inclusive in a manner similar to the term "comprising."

[0022] It is to be noted that all ranges disclosed within this specification are inclusive and are independently combinable. Notwithstanding that the numerical ranges and parameters setting forth the broad scope are approximations, the numerical values set forth in specific non-limiting examples are reported as precisely as possible. Any numerical value, however, inherently contains certain errors necessarily resulting from the standard deviation found in their respective testing measurements. Moreover, all ranges disclosed herein are to be understood to encompass any and all sub-ranges subsumed therein. As a non-limiting example, a range of "less than 10" can include any and all sub-ranges between (and including) the minimum value of zero and the maximum value of 10, that is, any and all sub-ranges having a minimum value of equal to or greater than zero and a maximum value of equal to or less than 10, e.g., 1 to 7.

[0023] Ranges provided herein are understood to be shorthand for all of the values within the range. For example, a range of 1 to 50 is understood to include any number, combination of numbers, or sub-range from the group consisting 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50.

[0024] As used herein, the terms "subject", "user" and "patient" are used interchangeably. As used herein, the term "subject" refers to an animal, preferably a mammal such as a non-primate (e.g., cows, pigs, horses, cats, dogs, rats etc.) and a primate (e.g., monkey and human), and most preferably a human.

[0025] The term “meatal stenosis” refers to a condition that occurs in subjects after circumcision or urethral surgery. Scar tissue forms around the opening of the urethra at the tip of the penis (meatus) and obstructs the urinary flow. Symptoms can include deviation of the urinary stream, pain with urination and bleeding from the tip of the penis. Meatal stenosis can also interfere with complete bladder emptying. If left untreated, meatal stenosis can lead to further complications such as bladder and urinary tract infections. Meatotomy is a surgical procedure performed to correct meatal stenosis by widening the urethral opening, also called the meatus. DETAILED DESCRIPTION

[0026] This disclosure describes a novel and inventive device that can perform a meatotomy procedure unaccompanied by additional surgical devices which will in turn improve patient cooperation. The cutting and crimping functionality of the novel device was compared with an industry-standard tool.

[0027] For the fabrication of the novel meatotomy device, SolidWorks was used as the 3D- design platform for modeling the device. Following design creation, each model was 3D-printed in plastic using Selective Laser Sintering (SLS)/ Nylon 12 for analysis. Following team deliberation of the 3D-printed plastic model, improvements and modifications were made in SolidWorks on each subsequent design until a finished model was approved upon. The finished model was 3D-printed in Direct Metal Laser Sintering / Stainless 17-4 for testing. All models were printed by the company “Xometry”.

[0028] The final design was compared with industry-standard surgical tools. Comparative qualitative analysis of crimping and cutting ability was performed with the final 3D-printed model against a current industry-standard device using chicken skin as the testing sample. Devices were tested as followed to maintain consistency:

1. Device clamped down into 3rd notch of locking mechanism;

2. Device held in place for five seconds following closure;

3. Device released from cutting site and imaging obtained.

[0029] Following successful experimentation, analysis of each site was obtained by the researchers.

[0030] The device was fabricated with a centrally located blade, flanked on both sides by ridged grooves to act as a simultaneous crimping tool. This ensures that during incision of the obstructed urethral opening by the blade the adjacent skin is simultaneously crimped to prevent bleeding. The device showed similar crimping ability when compared to a current industrystandard device, as well as an additional ability to cut the chicken skin (FIG. 8). This simultaneous action, allowing for less surgical devices, is addresses the poor patient cooperation seen during the current meatotomy procedures.

[0031] According to a first general embodiment, a medical instrument may include one or more of the following: a first elongated arm and a second elongated arm, the first elongated arm and the second elongated arm being coupled at a pivot joint; a clamp formed by a distal end of the first elongated arm and a distal end of the second elongated arm, where pivoting of the first elongated arm relative to the second elongated arm about the pivot joint opens and closes the clamp; and a blade fixed to the distal end of the first elongated arm, the blade being configured to perform a cutting action when the clamp closes.

[0032] In certain implementations, the distal end of the first elongated arm includes a first clamp face, and where the blade is angled relative to the first clamp face, and a protrusion distance of the blade from the first clamp face may decrease along a length of the blade in a distal direction. The angle of the blade relative to the first clamp face may be between about 5 degrees and about 20 degrees, for example. The second elongated arm may include a second clamp face, the second clamp face approaching the first clamp face as the medical instrument closes. The second clamp face may include a cavity for receiving the blade when the medical instrument closes. Optionally, the second clamp face lacks a blade completely (unlike the first clamp face in this implementation).

[0033] In certain implementations, the medical instrument further includes a first locking protrusion extending from the first elongated arm and a second locking protrusion extending from the second elongated arm, where the first locking protrusion is configured to engage the second locking protrusion to prevent the medical instrument from opening. The first locking protrusion and the second locking protrusion may remain out of engagement when the clamp is in a closed state and the first elongated arm and the second elongated arm are undeformed. The first locking protrusion may be configured to engage the second locking protrusion when the medical instrument is in the closed state and a force is applied to deform one of the first elongated arm and the second elongated arm towards the other of the first elongated arm and the second elongated arm.

[0034] In certain implementations, the medical instrument further includes a first finger loop at a proximal end of the first elongated arm and a second finger loop at a proximal end of the second elongated arm. The medical instrument may also comprising a third finger loop at or near a proximal end of the first elongated arm and located adjacent to the first finger loop, where the first finger loop and the third finger loop are configured to accommodate adjacent fingers, and where the second finger loop are configured to accommodate a thumb.

[0035] According to a second general embodiment, a medical instrument may include one or more of the following: a first elongated arm and a second elongated arm, the first elongated arm and the second elongated arm being coupled at a pivot joint, where pivoting of the first elongated arm relative to the second elongated arm about the pivot joint causes a distal end of the first elongated arm to move relative to a distal end of the second elongated arm; and a blade fixed to the distal end of the first elongated arm such that the blade moves when the first elongated arm pivots.

[0036] In certain implementations, the blade is angled relative to a longitudinal direction of the distal end of the first elongated arm. For example, a protrusion distance of the blade decreases along a length of the blade in a distal direction. E.g., the angle of the blade relative to the longitudinal direction is between about 5 degrees and about 20 degrees.

[0037] In certain implementations, a first clamp face is located at the distal end of the first elongated arm, where the blade extends from the first clamp face, and where the first clamp face includes a convex curve. Additionally or alternatively, a second clamp face is located at the distal end of the second elongated arm, and the second clamp face includes a convex curve.

[0038] According to a third general embodiment, a medical instrument may include a first clamp member and a second clamp member that are pivotably coupled to one another at a pivoting joint. The first and second claim members comprising a distal end and a proximal end, and the first and second clamp members comprise first and second faces, respectively, that are urged toward each other as the first and second clamp members pivot. The first and second clamp members are 7.92 cm to 14.72 cm long. In a specific embodiment, the first and second clamp members are about 11.32 cm long.

[0039] The first clamp member includes a blade extending from the first face, and the blade, in some embodiments, is .65 cm to 1.21 cm long. In a specific embodiment, the blade is about .93 cm long. The blade is flanked by ridges on the first face allowing it to crimp after making a cut. The ridges are .11 cm to .20 cm wide, and in a specific embodiment, the ridges are about .152 cm wide. The second face has a slit flanked by ridges, and the slit, in some embodiments, in some embodiments, is .65 cm to 1.21 cm long. In a specific embodiment, the slit is about .93 cm long. The blade inserts into the slit when the first and second faces come together.

[0040] The proximal end of the first and second clamp members comprise first and second interlocking portions that allow for constant application of pressure following the incision. The first and second interlocking portions have interlocking that engage together to secure the clamp in a closed position and then can be released to have the clamp in an open position. In certain embodiments, the first and second interlocking portions are 2.31 cm to 4.23 cm long. In specific embodiments the first and second interlocking portions are about 3.30 cm long.

[0041 ] According to a fourth general embodiment, disclosed is a method for fixing a meatal stenosis in a subject. The method includes obtaining a medical clamp embodiment described herein; stabilization and anesthetization of a penis; and then simultaneously crimping and incising an obstructive tissue with the medical clamp; where the penis is no longer obstructed. [0042] Turning to the drawings, FIG. 1 shows a side perspective view of a medical instrument embodiment 100. The medical instrument 100 includes a first elongated arm 102a and a second elongated arm 102b. The elongated arms 102 a,b are 7.92 cm to 14.72 cm long. In a specific embodiment, the elongated arms 102 a,b are about 11.32 cm long. The first and second elongated arms each comprise a distal end 104a, 104b and a proximal end 106a, 106b. In some embodiments, the distal ends 104 a,b are 1.78 cm to 3.30 cm long. In a specific embodiment, the distal ends 104 a,b are about 2.54 cm long. The first and second elongated arms 102a, 102b pivot about a pivoting joint 103. One example of a pivoting joint is a mortise and tenon arrangement, where one of the elongated arms has a hole and the other has a peg that fits in the hole.

[0043] FIGs 2, 3 and 4 show an end nonplanar (FIG. 2 and 4) and planar view (FIG. 3) of the instrument 100. As shown, one of the distal ends 104a shows a blade 105 flanked by ridges 107b. In some embodiments, the ridges are .22 cm to .41 cm wide. In a specific embodiment, the ridges are about .318 cm wide. The distal end 104b comprises a slit 108 flanked by ridges 107a. In some embodiments, the blade 105 and slit 108 are .65 cm to 1.21 cm long. In a specific embodiment, the blade 105 and slit 108 are about .93 cm long. When the distal ends 104 a,b are urged together, the blade 105 inserts into the slit 108. The ridges 107 a,b interlace when the distal ends are urged together.

[0044] Shown in FIG. 5 are the proximal ends 106 a,b releasably locked together. In some embodiments, the proximal ends 106 a,b are 2.31 cm to 4.29 cm long. In a specific embodiment, the proximal ends 106 a,b are about 3.30 cm long. The proximal ends 106a, b releasably lock together which locks the instrument 100 in a closed position, where the distal ends 104a, b are urged together.

[0045]

[0046] FIGS. 11-13 shows another example of a medical instrument 200. Like the embodiments discussed above, the medical instrument 200 may be used to perform a meatotomy procedure, and it will be appreciated that certain features of the medical instrument 200, and associated advantages, may be used for other functions. Referring to FIGS. 11-12, the medical instrument 200 includes a first elongated arm 202a (or first clamp member) and a second elongated arm 202b (or second clamp member) that pivot about a pivot joint 203. Proximal ends 206 of the elongated arms 202 may be generally configured to be manipulated by a medical professional controlling/performing the medical procedure to rotate the elongated arms 202 about the pivot joint 203 (thereby opening and closing a clamp 112 at the distal end of the medical instrument 200). The clamp 112 is generally formed by distal ends 204 of the device, which may be urged together in a manner similar to as described above with reference to the distal ends 104 a,b of FIGS. 2-4.

[0047] As shown in FIG. 11, two locking protrusions 212 extend from the elongated arms 202 and are configured to releasably lock together in a manner similar to as described above with reference to the proximal ends 106a, 106b of FIG. 5. E.g., a first locking protrusion 212a depicted in FIG. 11 has a set of interlocking teeth 214a, and a second locking protrusion 212b has a second set of interlocking teeth 214b that engage the first set of interlocking teeth 214a in a releasable manner. A “locked state” of the medical instrument, as defined herein, occurs when the interlocking teeth 214 are engaged with one another (e.g., in an interlocking manner) such that they remain in engagement by default and do not release from one another without external manipulation.

[0048] A unique feature of the medical instrument 200, depicted in FIG. 11, is that the first locking protrusion 212a and the second locking protrusion 212b remain in an unlocked/released state when the clamp 112 initially closes (i.e., when the first distal end 204a and the second distal end 204b first make contact as they pivot towards one another). For example, when initially reaching the locked state (without further pressure/force to deform the elongated arms towards one another, hereafter referred to as an “inward” force or pressure), the first elongated arm 202a may remain angled relative to the second elongated arm 202b (e.g., at an angle 225 of FIG. 11) such that a gap remains therebetween. The depicted first and second locking protrusions 212 sized such that, absent bending or other structural deformation of the elongated arms 202, the interlocking teeth 214 do not reach each other for locking engagement.

[0049] Once the clamp 210 closes, additionally inward pressure may be placed on the elongated arms 202 by a medical professional, particularly by creating torque about the pivot joint 203 due to approximately-tangent force applied to the proximal ends 206 of the elongated arms 202. This additional inward pressure may cause the elongated arms 202 to bend and/or otherwise deform, which may cause the locking protrusions 212 to move closer together and eventually into locking engagement. In some embodiments, the initial engagement may begin nearly immediately upon application of such force, meaning that the device is designed such that the limit of non-engagement occurs where the clamp is initially closed. Advantageously, the medical instrument 200 may allow a medical professional to perform certain procedures (e.g., meatotomy) with a high degree of precision since the device can fully close without interference from locking functionality, but locking may occur with additional force. Additionally, when a clamping action is desired, the present embodiment provides a wide-range of available clamping pressure (with higher relative clamping pressures being lockable), which may enhance the ability to manipulate target tissue during the medical procedure.

[0050] Referring to FIG. 13, the medical instrument 200 may include a blade 205 that extends from the first distal end 204a, and towards the second distal end 204b, when the clamp 112 is open. More particularly, the blade 205 extends away from a first clamp face 220a of the first clamp member, and generally towards a second clamp face 220b of the second clamp member. The blade 205 may be similar in structure and functionality to the blade 105 shown in FIG. 1 and FIG. 14 (e.g., the blade 205 may be associated with a slit located within the second distal end 204b), but it does have a primary difference: the blade 205 of FIG. 13 is angled relative to a first clamp face 220a defined by the first distal end 204a, whereas the blade 105 of the prior embodiment is generally parallel to the first clamp face 220a (with the exception of a relatively small distal angled portion 109 of the blade 105, which may prevent undesirable “poking” as the device is moved distally towards its target). In particular, the blade 205 may be angled such that its elevation (i.e., the protrusion distance from the first clamp face 120a) decreases moving in the distal direction, meaning the taller or higher-protruding portion of the blade 205 is closest to the pivot joint 203 and the shortest, lowest-protruding portion of the blade 205 is at the blade’s distal end. In other embodiments, it is contemplated that the blade could be angled the opposite direction (i.e., tallest on its distal side), but this is not shown. It is also contemplated that the blade could have an irregular shape rather than a constant, linear edge as shown.

[0051] Without limitation, the depicted blade angle 230 for the blade 205 may be between about 3 degrees and about 45 degrees, such as between about 5 degrees and about 20 degrees, and such as about 10 to 15 degrees in one exemplary embodiment. The angled nature of the blade 205 enhances the shear angle when the blade 205 makes a cut (thereby increasing the local cutting force at different locations along the blade when initially engaging the target tissue), simultaneously decreasing overall compression force acting on the target tissue. Advantageously, the blade 205 may produce a cleaner cut in certain circumstances, particularly under enhanced control provided by the non-engaging locking protrusions 212 discussed above. While not shown, a corresponding angled slit or cavity may be defined by the second distal end 204b, although it is not a requirement that such a slit be angled to fit the angled blade 205.

[0052] It is also contemplated that at least one of the clamp faces 220 may not be planar, e.g., the first clamp face 220a and/or the second clamp face 220b may be slightly curved in a convex manner (which is depicted in FIG. 13). When this feature is included, the above- specified “blade angle” may be an angle of the blade relative to an elongated-lengthwise direction of the distal end of the respective elongated arm. This curved-face feature may be advantageous for further enhancing the level of engagement of the clamp faces, particularly in view of the precisely- controllable instrument provided by the non-engaging locking protrusions 212 discussed above. [0053] Referring again to FIGS. 11-12, the medical instrument 200 may include at least one finger loop at the proximal end of the device. In the present embodiment, a first finger loop 240 is located at the first proximal end 206a and a second finger loop 242 is located at the second proximal end 206b. These finger loops 240,242 may advantageously enhance the gripping capabilities of a medical professional, position the medical professional’s hand to concentrate tangential force at the proximal end fo the device (thereby increasing torque about the pivot joint 203), as well as prevent hand slippage during a medical procedure. A third finger loop 244 may also be included at the first proximal end 206a and configured for recovering a second finger (e.g., where the first and third loops 240, 244 receives the index and middle finger, and the second finger loop 242 receives a thumb). In addition to the above-mentioned advantages, the third finger loop 244 may ensure proper orientation of the device (e.g., preventing upside-down operation), particularly when the medical instrument 200 is used in locations such that the distal end of the device is not clearly visible, which may advantageously prevent unwanted incisions/cuts by the blade 205.

[0054] In the depicted embodiment, the blade 205 extends from the first elongated arm 202a, meaning that the blade 205 is operable directly by force via the first finger loop 240 and/or the third finger loop 244. In other embodiments, the blade 205 or finger loops may be switched such that the opposite orientation is included, particular where the blade’s movement is desired to be thumb-actuated. It is also contemplated that two blades may be included, one blade being on each side of the clamp 112, although that embodiment is not shown. Any other suitable variation may also be included.

[0055] While one or more embodiments of the present invention have been shown and described herein, such embodiments are provided by way of example only. Variations, changes and substitutions may be made without departing from the invention herein. Accordingly, it is intended that the invention be limited only by the spirit and scope of the appended claims. The teachings of all references cited herein are incorporated in their entirety to the extent not inconsistent with the teachings herein.

Claims

CLAIMS What is claimed is:

1. A medical instrument, comprising: a first elongated arm and a second elongated arm, the first elongated arm and the second elongated arm being coupled at a pivot joint; a clamp formed by a distal end of the first elongated arm and a distal end of the second elongated arm, wherein pivoting of the first elongated arm relative to the second elongated arm about the pivot joint opens and closes the clamp; and a blade fixed to the distal end of the first elongated arm, the blade being configured to perform a cutting action when the clamp closes.

2. The medical instrument of claim 1, wherein the distal end of the first elongated arm includes a first clamp face, and wherein the blade is angled relative to the first clamp face.

3. The medical instrument of claim 2, wherein a protrusion distance of the blade from the first clamp face decreases along a length of the blade in a distal direction.

4. The medical instrument of any of claims 2-3, wherein the angle of the blade relative to the first clamp face is between about 5 degrees and about 20 degrees.

5. The medical instrument of any of claims 2-3, wherein the second elongated arm includes a second clamp face, the second clamp face approaching the first clamp face as the clamp closes.

6. The medical instrument of claim 5, wherein the second clamp face includes a cavity for receiving the blade when the clamp closes.

7. The medical instrument of any of claims 5-6, wherein the second clamp face lacks a blade. The medical instrument of any of the preceding claims, further comprising: a first locking protrusion extending from the first elongated arm and a second locking protrusion extending from the second elongated arm, wherein the first locking protrusion is configured to engage the second locking protrusion to prevent the clamp from opening. The medical instrument of claim 8, wherein the first locking protrusion and the second locking protrusion remain out of engagement when the clamp is in a closed state and the first elongated arm and the second elongated arm are undeformed. The medical instrument of claim 9, wherein the first locking protrusion is configured to engage the second locking protrusion when the clamp is in the closed state and a force is applied to deform one of the first elongated arm and the second elongated arm towards the other of the first elongated arm and the second elongated arm. The medical instrument of any of the preceding claims, further comprising a first finger loop at a proximal end of the first elongated arm and a second finger loop at a proximal end of the second elongated arm. The medical instrument of claim 11, further comprising a third finger loop at or near a proximal end of the first elongated arm and located adjacent to the first finger loop, wherein the first finger loop and the third finger loop are configured to accommodate adjacent fingers, and wherein the second finger loop are configured to accommodate a thumb. A method for fixing a meatal stenosis in a subject comprised of i) stabilization of a penis and ii) simultaneously crimping and incising an obstructive tissue with the clamp of claims 1-12, wherein the penis is no longer obstructed. A method for constructing the medical instrument of claims 1-12. 18 A medical instrument, comprising: a first elongated arm and a second elongated arm, the first elongated arm and the second elongated arm being coupled at a pivot joint, wherein pivoting of the first elongated arm relative to the second elongated arm about the pivot joint causes a distal end of the first elongated arm to move relative to a distal end of the second elongated arm; and a blade fixed to the distal end of the first elongated arm such that the blade moves when the first elongated arm pivots. The medical instrument of claim 15, wherein the blade is angled relative to a longitudinal direction of the distal end of the first elongated arm. The medical instrument of claim 16, wherein a protrusion distance of the blade decreases along a length of the blade in a distal direction. The medical instrument of any of claims 16-17, wherein the angle of the blade relative to the longitudinal direction is between about 5 degrees and about 20 degrees. The medical instrument of any of claims 15-17, wherein a first clamp face is located at the distal end of the first elongated arm, wherein the blade extends from the first clamp face, and wherein the first clamp face includes a convex curve. The medical instrument of any of claims 15-19, wherein a second clamp face is located at the distal end of the second elongated arm, and wherein the second clamp face includes a convex curve.

19 A medical clamp comprising: a first clamp member and a second clamp member that are pivotably coupled to one another at a pivoting joint, the first clamp member and the second clamp member each comprising a distal end and a proximal end, and the first clamp member and the second clamp member comprising first and second faces, respectively, that are urged toward each other as the first and second clamp members pivot. The medical clamp of claim 21, wherein the first and second clamp members comprise a length of 7.92 cm to 14.72 cm. The medical clamp of claim 22, wherein the first and second clamp members comprise a length of about 11.32 cm. The medical clamp of claim 21, wherein the first clamp member comprises a blade extending from the first face. The medical clamp of claim 24, wherein the blade comprises a length of 0.65 cm to 1.21 cm. The medical clamp of claim 21, wherein the blade comprises a length of about 0.93 cm. The medical clamp of any of claims 24-26, wherein the blade is flanked by ridges on the first face. The medical clamp of claim 21, wherein the second face comprises a slit defined therein. The medical clamp of claim 28, wherein the slit comprises a length of 0.65 cm to 1.21 cm. The medical clamp of claim 29, wherein the slit comprises a length of about 0.93 cm. 20 The medial clamp of any of claims 28-30, wherein the slit is flanked by ridges on the second face. The medical clamp of any of claims 21-31, wherein the blade inserts into the slit when the first and second faces come together. The medical clamp of claim 21, wherein the proximal end of the first and second clamp members comprise first and second interlocking portions. The medical clamp of claim 33, wherein the first and second interlocking portions comprise interlocking ridges and releasable engage together to secure the clamp in a closed position. The medical clamp of any of claims 33-34, wherein the first and second interlocking portions comprise lengths of 2.31 cm to 4.29 cm. The medical clamp of claim 35, wherein the first and second interlocking portions comprise lengths of about 3.30 cm. A method for fixing a meatal stenosis in a subject comprised of i) stabilization of a penis and ii) simultaneously crimping and incising an obstructive tissue with the clamp of claims 21-36, wherein the penis is no longer obstructed.