CA2070465C - Disposable vascular punch - Google Patents
Disposable vascular punch Download PDFInfo
- Publication number
- CA2070465C CA2070465C CA002070465A CA2070465A CA2070465C CA 2070465 C CA2070465 C CA 2070465C CA 002070465 A CA002070465 A CA 002070465A CA 2070465 A CA2070465 A CA 2070465A CA 2070465 C CA2070465 C CA 2070465C
- Authority
- CA
- Canada
- Prior art keywords
- trigger
- punch
- blade
- housing
- mandrel
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
Abstract
A disposable punch for cutting openings in blood vessels comprises a closed pistol-shaped housing having an opening at the front end for passage of the distal ends of a punch mandrel and a blade drum out of the housing, a trigger pivot, a port in the underside of the housing through which the lower portion, or trigger arm, can extend, an engagement for a punch mandrel restraint at the front end of the housing and a trigger and blade pusher barrel receiver. The trigger itself comprises a lower portion or trigger arm which extends out of the housing, an upper portion residing within the housing and comprising a transfer member for transferring motion to the blade and pusher barrel and an engagement for the pivot of the housing. The blade pusher barrel which is movable axially and reciprocally within the housing comprises an elongated cylindrical body which itself comprises a member to receive motion transferred from the trigger upper portion, a cavity to contain a blade drum and a punch mandrel and opposing elongated longitudinal slots through which a restraint may be passed to engage the punch mandrel. The punch mandrel comprises an elongated cylindrical rod comprising a transverse hole through the rods spaced distally from the rear end to receive the restraint and a reduced stem at its distal end terminated by a circular disc normal to the rod. The blade drum comprises a hollow cylindrical body comprising a longitudinal concentric lumen for passage of the punch mandrel through the body and a blade to co-operate with the circular disc of the punch mandrel to form the opening in the blood vessel. A restraint is provided which comprises an elongated rod to engage the hole in and to prevent movement of the punch mandrel when its associated blade pusher barrel and blade drum move axially and reciprocally and a spring is provided to restore the trigger to its normal position after use.
Description
WH-85~8CA
TITLE: DISPOSABLE VASCULAR PUNCIi --- FIELD OF THE IN'vENTICN --The present izn~rerition relat=es to surgical instruments. More particularly it: relates to a vascular punch, for forming uniform open.in~.~s in body vessels :such as aortae, having decreased manua:i force requirement: and providing for sage rc~r~ention of th.e removed vessel tissue.
In cardiac s~.zrdery it is ofrten necessary to connect tubular i.tern~; with blood vessels such as arteries and veins. Numerous L,ricr a:rt inst:rl.~r~ents for that purpose haw~re been den>c:ribed, a . g . , in U. S . Pat . Nos .
3,776,237 and x,018,:;28.
The prior art:; z.nstrument~ ~.uffer, inter alia, from the follow_Lng disadT.Ta.ntages 1) large manual. for~::~e:; required to cut through the vessels; and 2) difficulty in sta:a.bilization c~f i:he instrument to form uniform smooth opena.ngs.
U.S. Pat. No. 4,018,22f3, for i.r~st.ance, describes an instrument c:ompri.sing an e_Lorigat:ed hol:Low sleeve a:nd an elongated rod, ea:tending through one end of the hollow sleeve and x~eciproc~~.lly movable therein. 'rhe elongated rod has a distal narrowed end portion comprising a fired cylindrical blade wh.i.le the hollow sleeve has a hollow cylindrical blade re:movably at:ta.c:hed thereto.
DW lief P-9A-JB ~~~~~~ ~ Jurie 6, 1991 CIP TO 07/345,995 S. N.
Tloe slidlry r'od is ai:tivatd~! t'~y a I'taridle at','t',a~l'tei!
rtot°tnally thei'ec;o arid exL~ndiri~ C,Itt"uu~l~ the sluts lri 'l:fte elorydl',ed sleeve is rilove l:ft~
t-od proxirilally am pull t.Itd bldiJ~ t,ftet-e0ri iri'to tl'te 1o011ow sleeve tloerehy 'Pol°rilirig ari operiirtg iri floe vessel tissue tlt~lwhel:Wdet°. Tloe ioollow sleeve fur.Ll.tdr' cornrrairts d spl°iry proxirilal to tl'te Itarnle of l.lte r uc~ witlci-i i5 umopi.essd~i dut iris p'rvxinal movcrneri~ of- floe.
AFl.er pUriciiirig tl'te itule irnl;u tl'te vessel. , pY'e~su'rw on the I'taridle :is t..dt.tioved arid t,lie spring expands vausiti~ Llte ft-writ of the rod, i.l~.s as5oi:iat.ed cylit'ndt"ii:~l i~lacle arid t:is5ue Safilple to exit 'FYOriI
tl'te I1G110W Sleeve .
By Vlt"t,l.le Of tf't6 f'vi°riI c;i~ '~..ftt~ 11'I~'LY'l.tfilel'l~ It 1''.a' i:llfflcrl.llt. t0 SL.ctl:i111Ze 1l:, 11'i et iairl5l,:a1"I l, d11<,~'.l'Ifliell't: Wll:f1 tl'te f~lUUd Va5Se1 .
Acoordirr~lY, 'the ir'mCnurilerrt will citarnge ivs dli~rnimrrt durirng ~.ts u5r, resul'l,irig lrn pUOrly de'fit"ieiri upatnit'ys. Lt is also rmcessar°y frlla't lat"~d rilar'IUi~l fot-oes k~e applied to floe loaridle o~f tl'te dlurya'te~i t'Ud l:u UVHY'C:iilrle Lfle pt"eSSUt"e c:of' t)le Spt~ll°I<J- c(I~Id VUt tl'tY'vu~fl f:flE~.
vessel wall. iltls Wall uuusd gi'e~al:et of ICSSe-1 eli'i'fiiwlties lti ac'<:ot°dat'iCc thd stt'arl~tf't o:f Lhe user.
Tt loiter t'.tuW kiacl'i 'fuuad t,l'~at the ai:>uve it"nicavd~l prukilefas tna-y he over"cc:~ri~e k'iy 'u5C-..,uf l:lte puriclo of Lhd itt5l,attt itiveritiori.
SUMMARY OF THE INVEfJTION
X.~; 15 ari of~ject c:rf l',fle lriveritiory to pi'ov:ic~e a sut"iU' ii:al 7.,1'iSl,t'u1'itertt, l:O 'COt"tll CJpCtiirl~s iri blood vdssels, Itav.it'ig ari irlor'eased ritaol'tatiioal at:)varrt;r~~e wi~tii:1't t°eduues ~i'te iilariual fori:e ra~Iuirerilerrts.
A~.ioi:f'tet" ohjev'l. OF t1'td it°W ernl:i01-t is t0 provide ari it-ISI;rUtimtrl,, i ~...''j ' v(1 . ~ ~ ~ : :1 r ! ; a ~? it ! ,'.i ~~'~ ~~ $~-Gocl<dt P-9A-JE Jutte 6, 1991 CZP~ ~0 07/345,995 S. N.
as desct°ibed above, wl'tet'eiit ti'te ti~aitual pressut'e is applied rtur'ri~ally to the puttcf't axis thtet'eby 5tabilizirt~ the puotclo tip dUt"ltl~J ctC:tlvdtlCU1'i.
Yet cttti:o'tl'tet' oi~jec't u~f the itlvet'ntiot'~ is to provide att irmtrwrimrtt WI'let"e11't 'tlte r'etiioved ti55ue sariyyle is retdirtdd tioere;iit 'fc>r t'eaovet'y wl'tett t'teeded.
According to arWt;l'tc~r object of tfoc ittverrtiott tfvdt'e i5 pt'c,;vic~e~I d purtcf't Wltet"eit't tf'te blade I'tas t'd~iial set'ratiuolS
to rdduce the ; d~luinec~ i:uttiry for'i:e.
Tf'te5e aitii utl'te7" uf~jcc::ts tiF floe ittveYntiori will !d itt pay-t a~Nat°et"rt ft°ori~, attd irn pdr't su~9e~ted toy, tfve detailed desoriptiorn ltt i:Ot'ijuYiCt7.Ut1 wltlt the aCCUI'fy~at'ylTt~ i.lYaWlTtgS.
Tprou~l'tout tl'ti~ aphlicdtior~ floe terrim pY"uxiri~al attd rear will k'~e used' to refer' to puirnt5 toward or' t'rear t',I'y user am Far c:~r' awdy 'frurin 't;he patiert't at'td t',I'ta terti~s distal or 'frurrt will !~e usdd to T e.F~t' to pvit'Oa 'Far ot" away ft-caiii the user at°n toward c:~r neat' the ..
patldl"rt.
BRLEF_DESGRTPT,I'ON~OF_THE DRAW,TN.~,S
TI'o irm~ortivrt i5 br~s~t de~crit~ed ~,t..t .tpte folluwir'i~ detailed ddsct'ipl;ivtn wztf~ t"e'f"dr'drtce t,o tfte dt'awit"r~s, wl'tereitv likd ..t"tur-i~k>ars y..dfdr to lit<e pat...t~r itn whiol't Fi~ur'e l is a ~ic~~ view o'f d virwt arinudititet't of ttta irtvet'rtivrt wi'tl't its trifler' iy:.t d ~f;,rwat'd 'cool<ed pvsitiort .
Fi~ut'e 2 i ~,t.:~ ~,xploded pe~'spective view o'f the puttefi u'f' ~5 F~~uY'e 1 , Z~ ~ '~,'~~ ~' DUC: ke~~t P-9A-JB June b , 1991 CIP TO 07/34 . 995 S . N .
Figure 3 is ~ le'Ft side eleva'tional view iri 5ectiurl of aloe Put'ICIv u'f Figure 1.
Figui'e 4 is a Pei'sPewtive view of a ~Fii"wt rilodi'fica'tiori o~f' aloe Nvr"'tiol't A iri Figure 3.
Figuiw 5 is d l,e~wPc~tive view o'F a second rimdi'fiuat',ion of tl~e PUr...tlGt't A irt Figut'e 3.
Figurd 6 is a le'f t side alevatiurml view o'f aloe le'f t side wall u'F thd Put'i~i~ along lima 5-5 o'f Figur'e 2.
Figur'c 7 is d side elevatic:~rlal view of tf'ia t7'igge;r wf tlw fiY"sl: erilbudil'i~et'rt.
FlgU1'6 8 7,5 c1 r°7,gftt ~li~e eltvcttlurW 1 vl6W, it'i S6i:t7,iiYl, tir tlld ~ldde Pusloer' bari'el of 'floe 'Fir's't eriil~udirilent .
Figu1'e 9 i5 a side eldva'tivrral view, ir'nsei;tivt"I, of t1'm Made ~lr"ufil o'F tl7d first enibodirilerrt:
Figures 10 is d si~fe elevatiorlal vidw u'F ~tfw Purlch rn~ndrel o1' ~tf~le ~r:l,Y"51.. fJl'1'Ihc:Ul.'I11'ilerl't .
Fi~u7°e 11 :is a vtuP view of 'tl'td rrlandrdl o'f Figur'e 10.
Figure 12 is ~ 5ide dldv~t,i<~t'ial view iri sawtiot'i wf a second dfillatidlfi16~11't wi' aloe Nur'ICl'o of Figui°c~ 1 .
Figurd 13 is ~t'i exPlvded Pe~rsPdotivd view of alnbodil'imrl'L c.f-Figure 12.
Figu',°d 14 is z~ y"iglv't side elevwt,iot"lal vidw of the t7 igger wf floe sdwrlcJ et'inoditiml"I~. v'F t;ivd irmet'rtxorn.
Figu7'd 15 is a y°igl't't s ide elevatiot'ml view iri sewtiurn wf thtj blade pusf'tei" l:r~rr'el a'f O:I'te second eriIEJOdirilerit, o'f aloe irtveritiorl.
l:.
v v ~'~ "~~ ~a DuCI<e't P-9A-J~ i June 6, 1991 CIP TO 07/345f ,995 5 ~ N
Figut-e 1E~ is a tap view itt sectiurt of tf'te blade Pusloet- hart-el o'F the purtcft u'f Figure 12.
Figut"e 17 is a sectivotal view of 'floe Made pusf'tet- bar"r"el of the ~urlc:l't o~f Figure 12 slung litre 17-17 of Figure 16.
F igut a 18 is a sec:tiottal view of tltd Made Pusften barrel ~f tl'td Put-li:h v'F Figut"e~ 12 alut'tg limb 1$'18 u'f Figure 16.
Figure 19.., is a seiaiuttal view of tVtd blade pusher- hart-cl of 't h6 punish v'f Figut°e 12 alerlg line 19-19 wf Figure 16.
Figut-a 20 is a side eleva'tiuttal view irl sdi:tiotl of a tloird ernbodirilerit of ~tlt6 purtclt of Figutwe 1.
Fzgura 21 is at-I exploe'Jed Perspective view of the erilt,odirnettt of Figure 20.
Fi~ut"e 22 is a t"igl'Yt side elevatiotlal view of tl'te ttwiggerof tf~d puit<:h u'f F'zgutwe 20.
Figurd 23 is a side alevatiurml view it-I seetiut-1 u-F
a 'fvur'tlt erilVrcsdiri~r~o-I't u~F tha Nurncf't of Figure 1.
F:lgUt"e 24 i~ a silo elcv~t~,vrlal view, itt seo'tir~ry, a u'f rrl~~iivFicr~i:iurl o'fi tfia blade druril u'f Figut"e 9.
DETAILED DESCRIPTION,- OF,.... .. .TM~.......~.R~~~RRED,--.EM~OD"I,t~ENT_ Re'fdrrl.l-~g 'to Figu7ds 1-11 tltd vascul,at- Put-tci't, by de5igrlated tfte lluriletcCl 1, C:cJfl'Ipt"l'u--',CS cl plstGl"'llfCC, 1.0 1J1U8ed, flUllUW fIVUSlIIg t::OriIPt"1s11"I<J'. tt PY'iUxlrilcll , Cat' t"sell" , P.l.stulwllat"Id (C t! f'Idt"Idle PUt"'t1.(UPI 20 a d1~tttl, G1" 'Frv1"It, poYtivrl 21. The flousin~ dlsQ f:01'IIPt-ises10r~
lwFt a1'n t-:i,gftt 10b side Walls and a 'flat't~e~--lil<e wall wtn) 33 (flat shv tf'tet-akna'twdet-I at tloe~ laeriphary of tfie housitng ettd 'ft aril its pt"oxil'ilal .' . ~ . .
DO~ket, P-9A-JB Jurte 6, 1991 CIP TO 07/345,995 S. N.
tv a disval oPertirtg 32. Tioe Puocin 1 furLlodt" cuiiyt"ises a tt"ig~dt' 3 cofi~Pr'isit'tg an upper Pot°Liurt 36, illusl:rat',ecJ ire Figures 2, 3 and 7, wi'tl'tirt vltb Itousiiy 10 am a luwai' Pct...tiort, or' t,rigJrst' a'rri~, 37 whicl't exl.~t'td5 oul.siead OF C',loe lou5irtg 10 ~I'trou~l't a lower Purl 27, L'r"mr~ir~, ~il.u~si:ir~1 al', l:lod lower jur'mLurc hct,Wcel't LIOC
PrUXiti~al 20 ~tnt:l ~Ii~Lal 21 sd~'~iort~ u'F I'tousirtg 10. Tlte Lt°igger at'rii 37 riiay u~cupy rw0 posiU:ivtW , a t~iSLdl i:~ii:l<dil PtiSitiOt'n 3a dt'td a t"ei:,rai:red PrOxirital POSiU:iort, illuwrwl:e<J 1~Y LI'td c~asl'tec~ litres 3k~ ire Figund 1.
TI°W Pu'rW 1t 1 fu'i t',1'tt~t" ~ol'itpt isds a Made drurii 6 area a Put"W I'~ tiiat'tdt"erl 7, as illusLnal:c~f ire Figure 2. Tlte i:list',al areas 0f L.loe Arum b am rnat"nYel 7, as 5ltuwtn ire Figwi cs 2 area 3; ex'trartd c~isrrally vuvside wf byte It~u~irtg 1G l,itr~uglt U:.Ite FrotnL 0t~ernirtg 32 l:ltercirt.
As sloGwrt i1'nFigut'e5 2 at°n 3 Puotult 1 'f'ur.tlodr c~ti~prises a fJlade pusiir~r hart°el 4, a t'.eW:rairtirtg Dirt 9 arid a sNrirtg 5. Figure 2 also illusvt-d'~a5 vl'ts ld'f''~. 10a, arid rigl'ot; 10b, sidc'a walls of EI'te I~tuusirtg 10 as Wdll as vitdit" as~u~idCeil 'Flat'tgc-likd POt...~ivt°ts 33a attd (nv'~, ~I',uwrt) wi'tic:li cot'inir'n, urt asserithly v'f rr!'td Put°~clo, 'to 'fut"tii the 'i"lal'tgc~-likd wall 33. Tha wall 33 wloicht exLdrt~l5 'ft'orii 1:1'te tear a'f tl'te huusir'ig 10; avuur'n ila ~dripl°~erry, atnd ti:~tvriiina~t,d~
a~L tl't~ c.list~l vPdrri.l'tg 32 at'td sdraara(:.es Lloe ~ic~e wa115 'Pt°unt each o~l'ter .
Ire Fi~u7-ds z aa~d 3 l;fWrG are al5u 5i°mwr'~ ri~eat'm 28a ore the inner sur'facd 0'F Lite 1~'F'L ~ic~e wall 10a 'Fu" al.igrtirtg C',I'te 'two side walls, by c:0uN11'it~ Said a11~~'t'triW t"rt fiW at°W wi'tl'1 COriyldfiieYnat'Y fiW a1°iS 28f~ ( rlu~
sltuwr'r) 0yt Lhd irtt'ter sur'Face wF floe rigi'tL Side wall 101 during 2g ;~sserinly G'f l:i~te Put'W I't 1. T116sC dligt'ttiieont; iiieart5 c:utiipr:lse at; li~ast;
s Dc:~c:ltwt P-9A-JB ~~~~~.~~.'.t~~) June b, 1991 CIP TO 07/345,995 ~ g, 1y.
vt'te pits 28« extettdirtg itortn«lly frorit the ittnat' surf«ce o-f the pt"uxitit«1 put"tiut't 20a of tl'te lwFt side w«11 10« «t'td «rt d~lu«1 nutither' wf cotimletitet'nt«t'y L«vities 23U ( rtvt 51'towit) oit floe iittter surf«ce of thd t'i~ltl: Side wall 10b tv reoeive s«id pitt ur pit'ts. If desit'ed, the «ligittiieit't pit'ts tiiay be utt the t igltt 5ide~ w«11 10L~ «itd ttte c:«vitids oit tl't~ ld'Ft: side w«11 10«. Otloer aligrtriter'rt iite«its, «s well kitowtt iit tlta «t't, tit«y he used itt lieu of tloa «Uove.
Tltd leFt side w«11 10a initet' surf«ce 'furtl'tat" cotitprisas pivot titer«tts 29, «5 ~Itvwt°t iit Fi~ui e~ 2,3 arid 6, i~vt eitg«gitti~
14 co~iipletimtot«ry tae«its 35 iri the upper ptirtiott 36 of 'the trigger 3 i1't « p7. vvt«1 fit«t'tt'tCt" . TI'td rite«tW 29 i:ut°W :fists v'f «
c:ylit'tc.'lrlC«1 p1t't hear the dirt«1 poi tiot't of « lower opeitirtg 27« iit 'flange-like wall pc:»"tiut'n 33«, n'f 'the loft side wall 10«, at th7a lower ,juncture v'f ti7e pt"uxitit«1 20« «t'td e~iwt«1 21« pvt°tlol'la thdt"e~u'f'.
Side w«11 101 curitprisds « sititil~at" apartirtg 27h irt 'Fldr~~r~-lilts w«11 portion 33E, TIOe opet'tity5 27« artcl 27t; cotinirte tr, fut'tin lcawer opartit'tg 27, iit i:hd l'ousit't~ 10, wl'yrt tl~t~s put'tcl't is ass~tttk'~lad, I'f desired, I'towdverr;
swirl timat"~s 29 tit«y ba ut"r floe int'ter surface c:of tltd right r«ti'tdr tlYat't irl°m leFt sidewall of 'tlod louusit'tg lo, I'f ddsit'ed, the pivc~tiry titd«t't5 ( trot sfiowt't )' tit«y c::utitpt"ise twv piot5 dxtertdit'tg rtc~t'tit«lly frurii the silo wa115 v'f t;l'td 'tri<,~'get" art~i cutitpletttcrrtdt"y i'tules yr c«vitie5 irt fi;l'td sidd walls of floe I'tou5it'W to r'ei:eive said pit'ts, Iit «dcaitiort, tIW silo walls Uf the hvusiry 10 curitprisb, irt tl'teit" distal se'rc:l.ior'~s , <:;«v:ities 31« , it't t!'te lef t side w«11 , «itd 31f; ( trot shvwit ) irt 'tf'te t'igi'rt sidd w«J.l; to rcceivb 't!'16 t'e~'tt°«lt'I1T't~'-J
p11"1 9 whic;ft 1-t«5 c o ~~'a ~e Duckwt P-9A-JB , Jutte 6, 1991 CTP TO 07/345,995 ~ S. N.
f~eetn passed tltrou~f't ttlarnrel 7 'tu rettden it irntilohile dur'it°Ig use of t~, l'te pu rtc 1't .
Tfte taist~l por'tiot't 21 of tf'te Ituusit'nc,~' 10 also corilpt ices a ~dvity (rtvt 51o0wr'I); to receive date blai:le Nusloet" bat-rel 4.
Tt"l~~j.~Ct 3, 51'tVWI"I 11"I FlgllYCB G, 3 dYIC~ 7, C:UfiINY'l~E~S ~ft'ul~lt 42c1, t"dat" 42ki ~toc~ ri~l'tt 42c:; ~st'n le'Ft 42e:! ( t'tot slouwt'n) sicJe walls ar'n uNNet: 36 arnc:l lower 37 Ptintiurt5. TI'te luwet° Por.ti0rn 37 corilprises a trigger' at"ril f0t- ef'Feirtir'y Prcaxil'iml iilovetilerld: of thte tri<~'ger' 3 'Ft-oril its i~istdl 3a to i'tS Proxitr~al 3i~ (daslte~l lines) position a5 slouwt'n iot Figure 1.
Tt"I a~~l'tiut"i, tl°te tt igger uNper pot...tiort 36 ciifilNt ices a Port 35 tl'tdt°etl'tt°ouglt, to engage aloe pivot Viol 29, when the Nut.l~lo i5 ~s~atithldd, aatd allow tl'te tt igger 3 't0 pivot 'ti'terea(~uwt wl'terl 'five 'tr'i~ger aYfin37 iS i'ilUVec~ pY"OXitilally' i~Ut'il'y ~FurfilatiUrl of ti'16 0pe1"Ill"Ig 11't the l:ilUUC:I Ve~Sel .
TI°td Uld~la pusher" k~art..el 4, sltowtt iit Figures 2, 3 at"~~! 8 , e0tilpt"i5e~~ aor alorya'tec! aylit'~drieal Lwdy eotilpt'isir~~ wt its ~list~l end; a.~dvity cotiyrisirtg a rlist~l p~t...tiurl 52, tet'tilirtatd~l . hey a disd:al apdrliry 43,' at"I~l a yroxiltal pot"tiurl' 5l tdrntinatecl ~y 20. ~ruxirilal, wall 47.
~-I'tb inrlerv wall 44 u'f the cavity Pu7wtiott 52 I'tas ~n irm~r ~ilatiletet" 5li~f'ttlY gt ea4et' tl't«rt tl'te irlrtat" cJiarr~efi,er c:of floe iitrter wall 45 o'f tiv~ cavity portiot't 51.
prc:~xitrlal wall por'.tiurl 45 i5 tdt'~tilirtaLec~, wltere it ,~uitns wall (~ur'Liott 44, by a '("lat wall 53 1°lo7°timl to wall 44. TI'te rigl7t attd lei'"t Doukdt P-9A-JB ~''~' ~~~~~u~ June 6 ~ ' 991 CIP TO 071345,995 S. N. E
side walls of E;ld~fe Pusloer hat't'dl 4, fut°'tf'tet' vOriIPrisd dlvrne',~ate~d slots 46a artd 461J (rnot sloown), resN~otivdly, spaced pr0xirilally ft i;ril wall 53.
Spring 5, SI~tUWrl irt Figures 2 & 3, is irtsetwtdd irrtu cavity ~c:~rtiorn 51 wlt~r~irn it i5 r~5trdirm~J by the r°esLrainirrg pirr 9, sl'tuwrt irt Figures 2 arnd 3, whic;lo 17a5 heart passed tlor0ugh slots 46a at'Id 461 arid t'ecerve~l icy c:avities 31a am 31b v'f huusirlg 10.
Tlne I°t0lliaw bla~ie~ druril 6, siruwrt it°I Figures 3 drtd 9, cvrnprises ait elutngatdd 1'rolluw cylirndr cornprisiry an outer wall 63, a lurilcrr 65, a 'i'ea'r° wall 62, a p7'oXitnal updrtirrg 64 artd a distal iaolluw tt"ut'o:atdd ctirnical bladd Nortiot'n 61 tar°ri~illated by atr c:~pe~nirlg 60.
The Ipl~tc;ld d'i'uril i5 irmet'tcd irrtu distal cavmty Put'tiuon 52 of tl'td ~a.i'r_el 4 urntil its real' wall 62 abuts wall P0t°'tiorl 53 theYeUf.
Tloe uWtcY didtiytej'r' v'(' 'tlrd Ejlada dviwril uu'tet" wall 63 is slightly less 'y'1a11 'tl~e int'Id~' cJiariletet" of vhd bat°rel cavity portiurl 52.
Irt ut'la aspect of" this erini;dirimrlt, illustr~at',e~J irt Figure 4, tl'ta h.lddd Not"'tiorl c:ornPt'ise;s tt sct"t..aLed krli'Fe-edge blade 61a. It'i a Sbcu,r'Id a5pr-,c't c:>'f th;is ettlf~edirnmtwrt, as i.llustra~tdd 1t'1 Figurr~ 5, ~tl'ta.
~lddti put't1iJ11 CG(IINt"iSeS ct SfIICJC:JI,I~I IC111~fe"eC.~gCE.I IJIcldt3 61~. I1'1 yet 2p &rr0'tlldT rilodz'ficatiol'n, as seem irl Figure 9, tl'td blade Potwtiorl t::UIIINT"1585 a 'flctt '~at~C ~7y WI11C:1'1 ,JV111S tIIC 11"Irr:t" sur'Facd 68 u'F t116 cJruril at i-ts di~~tdl et°n at art angle c:i'f" about 90~ ( 1 .d. , witltia s'tat"Idat"~i tol<~"arn::ds) t~ ctveate a sl'tat"P ~uttirlg ridge 69. Irt 'this ril0<:IiFi,oat;iol't tl7e c~iarnetet° c:oF 'tyre disc uF i:Ite rilartdrdl is less tivarl ~tl'te iratar diarile'ter' of tyre i~laaei i:fnuril.
i v v ~~a 'J'~ ~i,..~~
Docl<et P-9A-JB Juitd 1991 CIP TO 07/345,995 g_ M.
Ii'I ano'ti'te'r til0~l:~i":ioat',101't of tl'te hladd druril, as illustratad in F1<,1''lAt C 24 , Wlt~t e11'1 tIIC (:llcifl'ItjtGY c:U'f~ tllca dlSi.: u(' the iilaltdt"~1 15 1t35S
tiiat'i tlte~ ittnet diatimtdt° wf the blade dnuril. , the distal eitd of tiny:
l,lade drutil coiilprise5 a bellow cylindrical portion 72 wl'tose 'Front eitd i:otilNt i5cs a flat facd 75 wloii:io joitw tSte it'Irien sunfac:e 74 of tl'td cylit'tdriual partiorl 72 at ait at'IOle o'f ahout 90~ to 'FOrra a sl'tarp i:u'ttirt~ ed~e~ 75, Tio6 putsch tilatndrel 7, shown irl Fi~ure5 1-5, 10 an~i 11, is iitse'i'ted it-rto thd blade pusloer barrel 4 'througlo floe ilolloW portion 65 u'f l:~ladd ~lt'utti 6, t',I°te pt"oxitiial end of ti'te tilattdt"el 7 exterldit'Ig l;eYotnd !ltd rear wall 62 of tl'ta k~lade dt'util 6 into the hollc:~w por born of titc SNritli~. . Tine irnmi di~~tnel.et wF thte l;lade drutin cavity 65 is ~liglttly ~rr~ater that°I the outer diariietdr of the rnarldrdl so 't ha l'. ti'td tilattdrW 1 rnaY pass tlterethtruu~h.
Mat'yrel 7, near' its proxitilal ditd. 'Furtl'ter c:utilprises a ytrar'mvdy°se lovld 58,~ thv7°dt',litvouglt, througlo wlvtich tl'td t-estrairlirt~
~i~::~ 9~ pa5sb~i 'tlot'ourUh 51W!5 46a at'n 46b i5 ::~15o pa~5ec~.
. f~awtrait'fiTt~ pzrl 9 C uses tl'te sprit"m to y-ernaiit proxirital to cavity firmer wall pc:~rvtxot"t 53. Upon asseiilL>ly o'f tl'td puncl't tl'te dt'Ids u'F
'ds'l.y-~r;irtir'Ig pii'i 9 z~re r'dcdivejd key 'tf'te t:avitid5 31a attd 31L>
( toot sl'towt'n) u'1' tfld huusir~g whereby tl'td timrldrdl 7 is iiilrilobilized;
TI'te ' distal erld of rilarldrdl 7 'furrtl'tdr curilprisds a reduce!
~l~filat6r stafil 55 tdY'til7.l1a1'.6d !ay a vlrC;ular c~isC: 56. Tile disc:
filay have drn uwter diatiletet" gr'ea'ter !staff 'thte it"Itner' diarimter of floe >;ladr~
drutin lutitet'n 65, if '!ltd ~liso i5 t0 server a5 a!'! anvil.
Alter'rlativdly, Docl<dt P-9A-JS June 6, 1991 CIP TO 07/345,995 S. N.
tl'te outer' diarileter of tl'te ~lisu rilay tie less tl'tart the inner diarileter of the luiilen i'P the c,liso is to enter the lurilert iauriny the hole 'f orrilir'ig Process.
After asserilkoly u'f tlne Purtclo, witlt thte trifler 3 irl its J:LStdl, C: CU C::ItBC;I PCJ;~1'tl0l~l, ct5 Se,Nrl 1rt F1'~,JllrC~ 2 alic:a 3, I;Jlc'tf~6 Portion b1, o'f 'the Made ~It'uril 6, will ex'ter'n ~lis~tr~lly 'fruril oPe1°Ilr'IC'~ 32 Uf~ the IICiUSII'Ig 1O. It will, howeve>'; !~e sPace~f Pt"uxlrilally froth tl'te reducad 5teril 55 as°n circular iaisv 56 of rilat'tc~t"el 7. I'i iab57.re~l, t;lte ~IiSO 56 I'ilay curilpri5e a i:liwtal ptirtion 57 corilPrisiry a ~l:lstally taperei:l tnurlcated corm to facilitate irnsbrtlUlt U~ 'lira disc into tlve Mood vessel.
Irt ti'~e pt'aeti0e o'f u5iryi,~ tloc vascular Purtclo, of the irmerttiorl, arl incision is ri~a~le irt tloe bloocJ vessel tl7e lengti~ of Ll.,t~ ir'ii;is:iort l~eirt~ srildller tl-tart tlor diarile'ter u~f 'tlte Ivole to be 1'~J rl'It."-,tl:le ~'.I'16r61n; ctllC~ tllC t~IS(: 7,11SerteC".~ , 1.1y rl'leclll~ V'f C: CJI"lll:dl PUr't1V11 57 (ivf Nre~ernt) ir'rtu, 'tltd vessel. Tlae Nroxirilal silo of the c~.rculdr disc 5b i5 Pulled against the inner wall o'F the vassal.
Py~dssure is thW °r aPpl:~ed 'to thd triJ~er arrn 37 c:ausirig ttte trigger arril tv fiyive~ ~'iroXirila~.lY toward tl'te handld por'tivl'I 20 of tl'te _ Itousit°y arr~J Pi,vo't al~owt Pivot Pir'i 29 whereLty 'ty-ig~r~r uPPer Portiori 36 i5 cdu5a~l to restate Clistally arti~ fot"ward as sftGWt'I by thd arrow B ir'i Figurd5 2~ 3 ar'1~! 7:
As 'tlt~ upPdr Pot'wti0t't 36 of trigger 3 r'o'tates in tl'te direction of ~t'ruw B 'ti'te 'Front Face 42a thereof rilovds 'Forward tloeret~y causing l~lacle PUSi'~ey' t~drrel ~1, wi'tc:~sd r"aat" wall 50 at,uts the ft"orrt 'faces 42a 'r J
Duc ftc t P-9A-JB "~ ,..~~,~ ~~ r" J ~ t ie: 6 , 1991 CIP TO 07/345,995 N.
of 'thd 'tt-ig~dr 3, t~ ritove forward wi~erwhy k~la~lr~ dtwurit 6 is Pushdd 'f'Orward, ur~rtil 1:1e oNeitiitg 60 of the ~ila~le dt°uiit 6 abuts i:loe outer wall u'f 'tktd bluo~i vessdl uPPusite 'fhb ciroular disc 56 of ritattdr'dl 7. Corltirmec~ retr'actlVY'I (Uf tt'ig~er' ar'iit 37 of tt'i~gbr 3 causes k~lade 61 'to i;Wt a (:vot°tlot'n iaut Wf tltd vessel dttd Pass oven fife iitat-tdrel reduced stern 55 at-td circular disc 56 whctn ~.I'te irttter diariteter cf tlnd drurit is i,~'r'catdr 'tltat'n t1-td owtet" daarit6ter' of tl'te dl5c. A'Fter the Piece f'ta~ heart cwt owt it reiitains ort t;he reduced stein 55 of ritattdt'el 7. Tlle~ re5traitnit'y Pin 9 Prevents fimveinet°nt o'fi floe iitandrel 7, while blade druiit 6 I'lIUVeS Forward, tl'tereby causit'tg tkte reduced 5terfn 55 with i.ts dssc:~Ciatdd tissue sdritPle to be Nu5it10t'lee:~ wit:hiit tl'te cavity 65 it°i hldc~c druiii 6. As blade Pusher hart'°el 4 ritoves 'forward tlve slots 46a attd 46h also iitove forward oausit't~ rds'trairtirtg girt 9 'to t,e Posi'tiortad 'a't i:lta Proxiiital dt-td o'f' 'tfoa sluts. Sprit°y 5 is, r;urtseyudrrtly, cofnprassr~d bwtWdert tl'te rear wall 47 u'F bat'5~e1 cavity ~orLioa 51 aitd rr~strainin;~ Pirt 9. A'Fter 't!'7r~ I'told Vas heart 'forti~6d ire 'tV'ta blood vessdl, and pressurr~ ort tltd trigger arlit 37 reritovdd, sWt'irm 5 expands cdu5i,ry blade Pusher f,r~tvt.,~l 4 irit'n k~la~le drutil 6 l:o tiiove pruxzrimlly . arid tkte trigger drrit 2Q ~ 37 'tu rimve d~.5tdl 1y . Rdduc:ed s'teiit Pur'tioo 55, o'(°
ritartdrel 7 , is 'k~het'n eXPu~dcl perritit~tit"y refinval o'f tl'te tissue saritPld therefrutit.
I1: is soritetirites d~5ir>r,hle to ritore dacur>:ti:ely c:orrtrol i:lla titoverimrtt u'fi 'fife hldde Pusf'vr k'~arr'el to Prevdt'rt rnisaligttrimtrt tktdr'duf Wlldr~ i1:' i~ cau~e~i Lo iitove diwtally, dutviag the hole foriititt9 '~ 25 pt-~cdss, ot" P'roxitinlly, a'f tdr forritittg 'tl'tr~ hold. Tktis is '~11~~1 . ~ I' I i k~~ V i :;g Niti':: L
~~ ~~~ ~~~
Dui:ltc t P-9A-JB Jutte 6 , 1991 CIP TO 07/345,995 5. N.
~tc:Cvtilpli~l'te~l by 'tlte sacui'Id erilhodatiieit't, desagtta ad 1B
i~t°Id illustr'atec~ itt Figures 12-19, aF floc irnv~rntivrt wloereiit the punch 'fUr'tl'tet° cuiilpt'ises rileaits 'for it°ntei ~urw'newtit'IC~' the trigger dt'Id f~lede _ pushier barrel. Tltus, trigger 3B, as f~e5t seem il Figure 14, vorilpris6s a sworn f'tole 34, tl°lerctltruuglt, bel:Weert the side walls 42c drlc~ 42d irl its upper portion 36. The I'tole 34 Wall receive a cotilpleiilet-itat"y engaging Pitt 7G oft c! rnodificatiorl 4B of tl'te blade pusl'ter barrel 4. Tlt 'this rrlodificutiur~ blade pusher barrel 4B, a5 best reel°nlt'I FagUt"es 15-19, uofilpYases, at its pT'Gxitilal dt'td, d sl~telf 71 extdrldartg proxirilally arlia rmrrilally therwProril. A cylindrical pin 7G, 'tu little the blade pu51'ter bdrt..el 4 to tltd trigger 3B, tlOrouglt thd Rule 34 tlterditt, extet°Ids rtor'rimllY Fi uo1 Said 5ltelf 71.
Wltetn alto l;art"el dr'Id vrigge~r a~'e tltuslY liill<ed the pn-vxirilal wall 50 of this b~rt'el abuts 'tlte 'Fr01"It 'face 42a c;oP -tile upper purtiorl 36 of the .fit: i ggdt- 3B , It is, .also, oftdt't ~idsiraUla to rdtr~it't tl'td tassuc sdrnple retiiovr~tl 'Frurii the blood vassel whdn do opeoirlg is foriiled therein by use of a vascular putncl-t . Howevbr , a disadvaritagc o'f thd prior art rurlcllds, Whic:fi a~. ~lsv present irn tl'te above erilbodiriler~t at-Id 24' Ttnda'f ica'tiut't~ ofi 'tl~tl.~ ariverrta0rn, is 'tl~te pv5sibili'ty o'f loss 0f the tJ,55U6 '~'dfilple8, ft C)fll the I~)lOC:7t~ veS5c1''s, WheTl ills trlggEit S
SpYlLtg k>ctC k .
That disacavat"rt:age is cavercurne by a tl'tird erilbodirilettt, desigl'm'tecJ 1C it'1 Figure 2.0, of t',I'te irmerrtiot'1 WI'tacl't provadds rilcarts ~'uT luckat"y 'tl'te 'tt"igger aft its pToxirilal, or t"wtractad, poSitivt°I as ~i. n Docket P-9A-J8 ~°~'~'~~'~~, Jurte 6, 1991 CIP TO 07/345,995 ~ 5. N.
d C:UrtSeyLlel"I C:6 U~ wloiula~ tl'te 're~lucdc~ stern 55 wf tlod ritartdrel 7, acrd the tissue ~ari~ple, are retairte~l within the lurimrt 65 of Lhe Made drurit ~ ut"rail this tt°lgger is irrtenrtiot'ially released.
Irt tloi~ erinodiri~er'rt, a5 illuwtrdtecJ irt Fi~ure~ 20 acrd 21, the triJge'i' 3C rimy k>e lucked unto a rttt'd~~~ted pt oxirital p0sitiorn, as illuwtrated in Figure 1, !;y t,ioe dashed! lines 3b, through er'yagerimrnt o'fi locking riteat'ts tl'tetwurt wi'tl't coritplerimrltary locking ritearts in tlld I'tous.it'g 10. Tloc houSirtg 10 also c:;ori~pris65 art uppEir Pur..t .tltt"vugf't whticlt tt'igger t'.elea5e ritearts ritay er'ntet' to ur'lluck tlyte tt"igget" 3C wltet't i't is io i~lie Ywtt'actec~, lOCked position 3h, ~d t~e5t seem irt Figure 22,_ tt"ig~er 3C c:0riy>rises an drrit 38, cvpl~trW Y wj tl..t tl.tG ~:ide walls 42i: a'itd 42d tltetwo'f , wf°ticl°t desi:ernds, ar'icJ is sel~a'rdtdcl by a rt0ti:lt 41 , 'Ft"ofrl tltc upper" part of tfie rear wall 421 0'f th'te tri~get° 3C. A Prwtrusion 39, ivavirtg art aatgular tide wall 39a anal f~c:>ti:orii 'Flat 'Facd 40, wloioh cart loc:kinglY engage Witlo curiyleritert'tarY loci<it'1J riteart~ o'f the !'tou5irtg 10, extcrtds ~ft'urn alwa is c:;oNl~trnr wit:l't ar~ii 38. T1'te distal t'wtatlol"f o'f tri.gget' uppdt-~or'tic~1't 3G, ~furzrlg cu't'tinJ of tl'ta l'tc:~le'it't the blood vessel, causes dt"fit eXtet'nlut'n39 tc:~ riioVe IA~Wz~t'd ctlvYtg a c::vrii(~lel'nert~.ctt'Y
allgUlaY wall 2p'._. 2~ (a-,ut sl'towt't) of lu~kirig rneat'ns 23 (t'yt 5f'tow~'t) urn 'tl'td flangd-like Wal1 33 ('rtdt ~fluWn) of thd I~tvus:Ll'~g 10 1_.I'terelay causing I'tot~c:lo ill tv ulo~6. Ft t', tlm yi c'aatdst eXter~it 0'f (~t'ox1riml t°etraiaiurn of"
tlne tt"i~~eT' a~t.'rii 37 of 'trig~Je~r 3C, the lcwey' anti u'F arrn 38 passas the uppt~t.. eTt~l o~f' lui;kit"y riie~it"ts 23 at"it! t..tutcl't 41 sNt"it'tgs open cdusirtg 'fai:e 40 ut't at"ri~ 38 wind 'the uNPe','. Face 25 ( rtot sl'towrt ) of'' 'the lucking Doc I<t t ; ~=__9F~--JE3 June 6 , 1991 CIP T0~07/345,995 S. N.
ritearts 23, vrt foousirtg 10, to luokirtgly ertgdge, Trigger arril 37 of Lt°igger 3C, tftdreFor'a, cdnitut <;e Caused to it°mvlur'Itarily irIUVe distally. Cv~itse~udrrtly, ~la~le~ dt°urit 6 vatnr'lut kid rett'ai:'f~ed artd tlt~
distal am u'F the rilaitdn'el 7 wilt thd 'tissue sdiitNle ai:-tached tv 1:114 'rCCJuircd stctit 55 tlterGVf will rtot irxtet'td L~~yvt'nd tllr~ opet-lirtg 60 of ~lac~e~ druri~ 6. TI'tus, ~hd ti~suc s~critNle ~~tnrto~t '('~Y11 of'F and is ~rc:~i':ec't~d until its t°~cc:we~t~y is desired. T1'te angular wall 24 and up~ct" 'Face 25 of the loakirtg titeart5 25 >rtrn the 'flat'tge like wall 33 u'f tl'W Ioc:Wsit'nr,~ at'e furiited 'f"YOtil tlteiY W Y..1.C5(~ut"i~iitng patwts, e.
angular wall pot°t.iot'm 24a artd 241 (rnc>t SItVWr'I) ors floe right and left side Wa115 10a at'td 10b, t"eSpeCtlVelY, v.f tl'te itou51r1<~' , Whel'I t°etilUVal v'F tfle l:'.lSsUe saltiNle is c:~~SlT '-~''d tt"lgget- YelcaSe ritcat''IS, 5ucl°t as 'floe ti(~ 66 of a Trap 8, as 5f'tuwrl iYt Figure 20, is j;t'ISertf~~J througlo upper port, 26 of tile hvu~it"~g urrtil i~t engages arri~
- 38: Cor'n'tit-tuead dvwrtwr~ywd pr6s~uY°e o'f tlve 'tip 66 iau~es arrit 38 vtu rtioV~ l.uWard tl'td trigger 3C bc:>tiy 'faTcit'y rivtch 41, tc:> closd. Upua 41u5uY'do'fi nu'ti';I't 41 'ti'lr~ ~uli~~l;eriterrta'rY lu~kir'y rimarts ut't the 'trigger.
3C::artd l7~usirlg l0 cJisat°tg~ge, Spt-illg 5 tl'tetl expdr~d5 d;;dusirtg bl~i~e ~Eausher' E,ar7°dl 4 ~rt~l L~ldde drurir 6 to ii~ovd pr oxiritally-WI'tile rloa 2Q 'tr~,gger arfit 37 o'F trio'gget' 3C titoveS ~Ji,sl:dlly. Reduc:at:1 sten't poY'~iort 55; c~i'" rint'tdrdl 7: i5 tfOet't aXpvsed ~erriti'ttit°tg rernuval of 'tlte tissue s~ritple ~.1'terd'frurin. It'n a roost, pra'Fet~re~i erino~liri~el'rt the release riveans c:;uttipt":isc5 at't dat'rtildvaY' tywa tah 77, as saert it't Figure 23, ut't t;i~e Low v'F t116 1'tuus7.tng ctl'tc~ Wtl':dcfl6c~ t0 l;.Ple pC)twt 26 ttt 11:5 dJ.S~at~. Slde wall 78 . I'1" desird~i y 'tl'td 'taV~ 77 may tie art 1t"rtr~gt"allY timl~led pant of ~~' ~ ~'~~~:,a Docl<et P-9A-JB , Jurse 6, 1991 CIP TO 07/345,995 ~ S. N.
the housirsg. Tl~te tah 77 oars tic pressed di:~wrtwariJ thereby releasing ttl8 lOC:klrtg fiscdri5 by ~OfispYNsSirsg tile 1°scWtc:;ft 41 and c::auSlrtg tftd loe:kirtg arrn 38, ct't tile; tt"i~ger, attd floe voiitpleriteritary protrusi~ts 23 wF floe lttiusiat~ to cJiSerigage. Otfter rclaasc tttcaTtS, as krsi~wrs irt the at l:. , iitay l:» u;~ed i n l i eu of the efjove 7, tndi ~d l.ed fiiedons .
Irt d fout'tlt eiishcdiiitertt, ~i~si~rtate~i 1D artd illustrated irt Fi~ut°e 23, tf~te: vascular puttolo 1 of the fit'5t efflbodi(isers't -Further ccrispt'ise5 the trigger - blade pu5foer' >;arrel lirnkirtg cvrist~irsatiors of l:ftEJ SeCrUrl(.f etinoc,iiriiettt attd t1'te L,riO~tt' luoki'it~ a~rn release ~fcatuics of tf~e t',Itit'd eiitl:iui:,llnieat. Irt this erislpi:~diniserO:. all cF the parts ai:t~it's tine ~atise tisatttter, as iae5orit;ed ~tl:~ove, &a sitiiilat 1y dc~igl'ta'te~) paYts in tfW o(:loet' ~I'ishoc~isu~:;nts.
Cf'tat'I<J,tS (flay IJC ct~f~feU~teC.I Wl~tl~~l Y~6SpCl:~L. t0 ~L,I~tC
dC~Ldll~ V
wt'sSI,Y'Ui;I:lUrt dltd 115c u'C thd llnver7tlut't Wll.loOWt departl,rtg 'Ft'UI'it tfl6 spir'irt drtii sc~Pe rtloere6~' as de'firted lrt the appended olaitits.
TITLE: DISPOSABLE VASCULAR PUNCIi --- FIELD OF THE IN'vENTICN --The present izn~rerition relat=es to surgical instruments. More particularly it: relates to a vascular punch, for forming uniform open.in~.~s in body vessels :such as aortae, having decreased manua:i force requirement: and providing for sage rc~r~ention of th.e removed vessel tissue.
In cardiac s~.zrdery it is ofrten necessary to connect tubular i.tern~; with blood vessels such as arteries and veins. Numerous L,ricr a:rt inst:rl.~r~ents for that purpose haw~re been den>c:ribed, a . g . , in U. S . Pat . Nos .
3,776,237 and x,018,:;28.
The prior art:; z.nstrument~ ~.uffer, inter alia, from the follow_Lng disadT.Ta.ntages 1) large manual. for~::~e:; required to cut through the vessels; and 2) difficulty in sta:a.bilization c~f i:he instrument to form uniform smooth opena.ngs.
U.S. Pat. No. 4,018,22f3, for i.r~st.ance, describes an instrument c:ompri.sing an e_Lorigat:ed hol:Low sleeve a:nd an elongated rod, ea:tending through one end of the hollow sleeve and x~eciproc~~.lly movable therein. 'rhe elongated rod has a distal narrowed end portion comprising a fired cylindrical blade wh.i.le the hollow sleeve has a hollow cylindrical blade re:movably at:ta.c:hed thereto.
DW lief P-9A-JB ~~~~~~ ~ Jurie 6, 1991 CIP TO 07/345,995 S. N.
Tloe slidlry r'od is ai:tivatd~! t'~y a I'taridle at','t',a~l'tei!
rtot°tnally thei'ec;o arid exL~ndiri~ C,Itt"uu~l~ the sluts lri 'l:fte elorydl',ed sleeve is rilove l:ft~
t-od proxirilally am pull t.Itd bldiJ~ t,ftet-e0ri iri'to tl'te 1o011ow sleeve tloerehy 'Pol°rilirig ari operiirtg iri floe vessel tissue tlt~lwhel:Wdet°. Tloe ioollow sleeve fur.Ll.tdr' cornrrairts d spl°iry proxirilal to tl'te Itarnle of l.lte r uc~ witlci-i i5 umopi.essd~i dut iris p'rvxinal movcrneri~ of- floe.
AFl.er pUriciiirig tl'te itule irnl;u tl'te vessel. , pY'e~su'rw on the I'taridle :is t..dt.tioved arid t,lie spring expands vausiti~ Llte ft-writ of the rod, i.l~.s as5oi:iat.ed cylit'ndt"ii:~l i~lacle arid t:is5ue Safilple to exit 'FYOriI
tl'te I1G110W Sleeve .
By Vlt"t,l.le Of tf't6 f'vi°riI c;i~ '~..ftt~ 11'I~'LY'l.tfilel'l~ It 1''.a' i:llfflcrl.llt. t0 SL.ctl:i111Ze 1l:, 11'i et iairl5l,:a1"I l, d11<,~'.l'Ifliell't: Wll:f1 tl'te f~lUUd Va5Se1 .
Acoordirr~lY, 'the ir'mCnurilerrt will citarnge ivs dli~rnimrrt durirng ~.ts u5r, resul'l,irig lrn pUOrly de'fit"ieiri upatnit'ys. Lt is also rmcessar°y frlla't lat"~d rilar'IUi~l fot-oes k~e applied to floe loaridle o~f tl'te dlurya'te~i t'Ud l:u UVHY'C:iilrle Lfle pt"eSSUt"e c:of' t)le Spt~ll°I<J- c(I~Id VUt tl'tY'vu~fl f:flE~.
vessel wall. iltls Wall uuusd gi'e~al:et of ICSSe-1 eli'i'fiiwlties lti ac'<:ot°dat'iCc thd stt'arl~tf't o:f Lhe user.
Tt loiter t'.tuW kiacl'i 'fuuad t,l'~at the ai:>uve it"nicavd~l prukilefas tna-y he over"cc:~ri~e k'iy 'u5C-..,uf l:lte puriclo of Lhd itt5l,attt itiveritiori.
SUMMARY OF THE INVEfJTION
X.~; 15 ari of~ject c:rf l',fle lriveritiory to pi'ov:ic~e a sut"iU' ii:al 7.,1'iSl,t'u1'itertt, l:O 'COt"tll CJpCtiirl~s iri blood vdssels, Itav.it'ig ari irlor'eased ritaol'tatiioal at:)varrt;r~~e wi~tii:1't t°eduues ~i'te iilariual fori:e ra~Iuirerilerrts.
A~.ioi:f'tet" ohjev'l. OF t1'td it°W ernl:i01-t is t0 provide ari it-ISI;rUtimtrl,, i ~...''j ' v(1 . ~ ~ ~ : :1 r ! ; a ~? it ! ,'.i ~~'~ ~~ $~-Gocl<dt P-9A-JE Jutte 6, 1991 CZP~ ~0 07/345,995 S. N.
as desct°ibed above, wl'tet'eiit ti'te ti~aitual pressut'e is applied rtur'ri~ally to the puttcf't axis thtet'eby 5tabilizirt~ the puotclo tip dUt"ltl~J ctC:tlvdtlCU1'i.
Yet cttti:o'tl'tet' oi~jec't u~f the itlvet'ntiot'~ is to provide att irmtrwrimrtt WI'let"e11't 'tlte r'etiioved ti55ue sariyyle is retdirtdd tioere;iit 'fc>r t'eaovet'y wl'tett t'teeded.
According to arWt;l'tc~r object of tfoc ittverrtiott tfvdt'e i5 pt'c,;vic~e~I d purtcf't Wltet"eit't tf'te blade I'tas t'd~iial set'ratiuolS
to rdduce the ; d~luinec~ i:uttiry for'i:e.
Tf'te5e aitii utl'te7" uf~jcc::ts tiF floe ittveYntiori will !d itt pay-t a~Nat°et"rt ft°ori~, attd irn pdr't su~9e~ted toy, tfve detailed desoriptiorn ltt i:Ot'ijuYiCt7.Ut1 wltlt the aCCUI'fy~at'ylTt~ i.lYaWlTtgS.
Tprou~l'tout tl'ti~ aphlicdtior~ floe terrim pY"uxiri~al attd rear will k'~e used' to refer' to puirnt5 toward or' t'rear t',I'y user am Far c:~r' awdy 'frurin 't;he patiert't at'td t',I'ta terti~s distal or 'frurrt will !~e usdd to T e.F~t' to pvit'Oa 'Far ot" away ft-caiii the user at°n toward c:~r neat' the ..
patldl"rt.
BRLEF_DESGRTPT,I'ON~OF_THE DRAW,TN.~,S
TI'o irm~ortivrt i5 br~s~t de~crit~ed ~,t..t .tpte folluwir'i~ detailed ddsct'ipl;ivtn wztf~ t"e'f"dr'drtce t,o tfte dt'awit"r~s, wl'tereitv likd ..t"tur-i~k>ars y..dfdr to lit<e pat...t~r itn whiol't Fi~ur'e l is a ~ic~~ view o'f d virwt arinudititet't of ttta irtvet'rtivrt wi'tl't its trifler' iy:.t d ~f;,rwat'd 'cool<ed pvsitiort .
Fi~ut'e 2 i ~,t.:~ ~,xploded pe~'spective view o'f the puttefi u'f' ~5 F~~uY'e 1 , Z~ ~ '~,'~~ ~' DUC: ke~~t P-9A-JB June b , 1991 CIP TO 07/34 . 995 S . N .
Figure 3 is ~ le'Ft side eleva'tional view iri 5ectiurl of aloe Put'ICIv u'f Figure 1.
Figui'e 4 is a Pei'sPewtive view of a ~Fii"wt rilodi'fica'tiori o~f' aloe Nvr"'tiol't A iri Figure 3.
Figuiw 5 is d l,e~wPc~tive view o'F a second rimdi'fiuat',ion of tl~e PUr...tlGt't A irt Figut'e 3.
Figurd 6 is a le'f t side alevatiurml view o'f aloe le'f t side wall u'F thd Put'i~i~ along lima 5-5 o'f Figur'e 2.
Figur'c 7 is d side elevatic:~rlal view of tf'ia t7'igge;r wf tlw fiY"sl: erilbudil'i~et'rt.
FlgU1'6 8 7,5 c1 r°7,gftt ~li~e eltvcttlurW 1 vl6W, it'i S6i:t7,iiYl, tir tlld ~ldde Pusloer' bari'el of 'floe 'Fir's't eriil~udirilent .
Figu1'e 9 i5 a side eldva'tivrral view, ir'nsei;tivt"I, of t1'm Made ~lr"ufil o'F tl7d first enibodirilerrt:
Figures 10 is d si~fe elevatiorlal vidw u'F ~tfw Purlch rn~ndrel o1' ~tf~le ~r:l,Y"51.. fJl'1'Ihc:Ul.'I11'ilerl't .
Fi~u7°e 11 :is a vtuP view of 'tl'td rrlandrdl o'f Figur'e 10.
Figure 12 is ~ 5ide dldv~t,i<~t'ial view iri sawtiot'i wf a second dfillatidlfi16~11't wi' aloe Nur'ICl'o of Figui°c~ 1 .
Figurd 13 is ~t'i exPlvded Pe~rsPdotivd view of alnbodil'imrl'L c.f-Figure 12.
Figu',°d 14 is z~ y"iglv't side elevwt,iot"lal vidw of the t7 igger wf floe sdwrlcJ et'inoditiml"I~. v'F t;ivd irmet'rtxorn.
Figu7'd 15 is a y°igl't't s ide elevatiot'ml view iri sewtiurn wf thtj blade pusf'tei" l:r~rr'el a'f O:I'te second eriIEJOdirilerit, o'f aloe irtveritiorl.
l:.
v v ~'~ "~~ ~a DuCI<e't P-9A-J~ i June 6, 1991 CIP TO 07/345f ,995 5 ~ N
Figut-e 1E~ is a tap view itt sectiurt of tf'te blade Pusloet- hart-el o'F the purtcft u'f Figure 12.
Figut"e 17 is a sectivotal view of 'floe Made pusf'tet- bar"r"el of the ~urlc:l't o~f Figure 12 slung litre 17-17 of Figure 16.
F igut a 18 is a sec:tiottal view of tltd Made Pusften barrel ~f tl'td Put-li:h v'F Figut"e~ 12 alut'tg limb 1$'18 u'f Figure 16.
Figure 19.., is a seiaiuttal view of tVtd blade pusher- hart-cl of 't h6 punish v'f Figut°e 12 alerlg line 19-19 wf Figure 16.
Figut-a 20 is a side eleva'tiuttal view irl sdi:tiotl of a tloird ernbodirilerit of ~tlt6 purtclt of Figutwe 1.
Fzgura 21 is at-I exploe'Jed Perspective view of the erilt,odirnettt of Figure 20.
Fi~ut"e 22 is a t"igl'Yt side elevatiotlal view of tl'te ttwiggerof tf~d puit<:h u'f F'zgutwe 20.
Figurd 23 is a side alevatiurml view it-I seetiut-1 u-F
a 'fvur'tlt erilVrcsdiri~r~o-I't u~F tha Nurncf't of Figure 1.
F:lgUt"e 24 i~ a silo elcv~t~,vrlal view, itt seo'tir~ry, a u'f rrl~~iivFicr~i:iurl o'fi tfia blade druril u'f Figut"e 9.
DETAILED DESCRIPTION,- OF,.... .. .TM~.......~.R~~~RRED,--.EM~OD"I,t~ENT_ Re'fdrrl.l-~g 'to Figu7ds 1-11 tltd vascul,at- Put-tci't, by de5igrlated tfte lluriletcCl 1, C:cJfl'Ipt"l'u--',CS cl plstGl"'llfCC, 1.0 1J1U8ed, flUllUW fIVUSlIIg t::OriIPt"1s11"I<J'. tt PY'iUxlrilcll , Cat' t"sell" , P.l.stulwllat"Id (C t! f'Idt"Idle PUt"'t1.(UPI 20 a d1~tttl, G1" 'Frv1"It, poYtivrl 21. The flousin~ dlsQ f:01'IIPt-ises10r~
lwFt a1'n t-:i,gftt 10b side Walls and a 'flat't~e~--lil<e wall wtn) 33 (flat shv tf'tet-akna'twdet-I at tloe~ laeriphary of tfie housitng ettd 'ft aril its pt"oxil'ilal .' . ~ . .
DO~ket, P-9A-JB Jurte 6, 1991 CIP TO 07/345,995 S. N.
tv a disval oPertirtg 32. Tioe Puocin 1 furLlodt" cuiiyt"ises a tt"ig~dt' 3 cofi~Pr'isit'tg an upper Pot°Liurt 36, illusl:rat',ecJ ire Figures 2, 3 and 7, wi'tl'tirt vltb Itousiiy 10 am a luwai' Pct...tiort, or' t,rigJrst' a'rri~, 37 whicl't exl.~t'td5 oul.siead OF C',loe lou5irtg 10 ~I'trou~l't a lower Purl 27, L'r"mr~ir~, ~il.u~si:ir~1 al', l:lod lower jur'mLurc hct,Wcel't LIOC
PrUXiti~al 20 ~tnt:l ~Ii~Lal 21 sd~'~iort~ u'F I'tousirtg 10. Tlte Lt°igger at'rii 37 riiay u~cupy rw0 posiU:ivtW , a t~iSLdl i:~ii:l<dil PtiSitiOt'n 3a dt'td a t"ei:,rai:red PrOxirital POSiU:iort, illuwrwl:e<J 1~Y LI'td c~asl'tec~ litres 3k~ ire Figund 1.
TI°W Pu'rW 1t 1 fu'i t',1'tt~t" ~ol'itpt isds a Made drurii 6 area a Put"W I'~ tiiat'tdt"erl 7, as illusLnal:c~f ire Figure 2. Tlte i:list',al areas 0f L.loe Arum b am rnat"nYel 7, as 5ltuwtn ire Figwi cs 2 area 3; ex'trartd c~isrrally vuvside wf byte It~u~irtg 1G l,itr~uglt U:.Ite FrotnL 0t~ernirtg 32 l:ltercirt.
As sloGwrt i1'nFigut'e5 2 at°n 3 Puotult 1 'f'ur.tlodr c~ti~prises a fJlade pusiir~r hart°el 4, a t'.eW:rairtirtg Dirt 9 arid a sNrirtg 5. Figure 2 also illusvt-d'~a5 vl'ts ld'f''~. 10a, arid rigl'ot; 10b, sidc'a walls of EI'te I~tuusirtg 10 as Wdll as vitdit" as~u~idCeil 'Flat'tgc-likd POt...~ivt°ts 33a attd (nv'~, ~I',uwrt) wi'tic:li cot'inir'n, urt asserithly v'f rr!'td Put°~clo, 'to 'fut"tii the 'i"lal'tgc~-likd wall 33. Tha wall 33 wloicht exLdrt~l5 'ft'orii 1:1'te tear a'f tl'te huusir'ig 10; avuur'n ila ~dripl°~erry, atnd ti:~tvriiina~t,d~
a~L tl't~ c.list~l vPdrri.l'tg 32 at'td sdraara(:.es Lloe ~ic~e wa115 'Pt°unt each o~l'ter .
Ire Fi~u7-ds z aa~d 3 l;fWrG are al5u 5i°mwr'~ ri~eat'm 28a ore the inner sur'facd 0'F Lite 1~'F'L ~ic~e wall 10a 'Fu" al.igrtirtg C',I'te 'two side walls, by c:0uN11'it~ Said a11~~'t'triW t"rt fiW at°W wi'tl'1 COriyldfiieYnat'Y fiW a1°iS 28f~ ( rlu~
sltuwr'r) 0yt Lhd irtt'ter sur'Face wF floe rigi'tL Side wall 101 during 2g ;~sserinly G'f l:i~te Put'W I't 1. T116sC dligt'ttiieont; iiieart5 c:utiipr:lse at; li~ast;
s Dc:~c:ltwt P-9A-JB ~~~~~.~~.'.t~~) June b, 1991 CIP TO 07/345,995 ~ g, 1y.
vt'te pits 28« extettdirtg itortn«lly frorit the ittnat' surf«ce o-f the pt"uxitit«1 put"tiut't 20a of tl'te lwFt side w«11 10« «t'td «rt d~lu«1 nutither' wf cotimletitet'nt«t'y L«vities 23U ( rtvt 51'towit) oit floe iittter surf«ce of thd t'i~ltl: Side wall 10b tv reoeive s«id pitt ur pit'ts. If desit'ed, the «ligittiieit't pit'ts tiiay be utt the t igltt 5ide~ w«11 10L~ «itd ttte c:«vitids oit tl't~ ld'Ft: side w«11 10«. Otloer aligrtriter'rt iite«its, «s well kitowtt iit tlta «t't, tit«y he used itt lieu of tloa «Uove.
Tltd leFt side w«11 10a initet' surf«ce 'furtl'tat" cotitprisas pivot titer«tts 29, «5 ~Itvwt°t iit Fi~ui e~ 2,3 arid 6, i~vt eitg«gitti~
14 co~iipletimtot«ry tae«its 35 iri the upper ptirtiott 36 of 'the trigger 3 i1't « p7. vvt«1 fit«t'tt'tCt" . TI'td rite«tW 29 i:ut°W :fists v'f «
c:ylit'tc.'lrlC«1 p1t't hear the dirt«1 poi tiot't of « lower opeitirtg 27« iit 'flange-like wall pc:»"tiut'n 33«, n'f 'the loft side wall 10«, at th7a lower ,juncture v'f ti7e pt"uxitit«1 20« «t'td e~iwt«1 21« pvt°tlol'la thdt"e~u'f'.
Side w«11 101 curitprisds « sititil~at" apartirtg 27h irt 'Fldr~~r~-lilts w«11 portion 33E, TIOe opet'tity5 27« artcl 27t; cotinirte tr, fut'tin lcawer opartit'tg 27, iit i:hd l'ousit't~ 10, wl'yrt tl~t~s put'tcl't is ass~tttk'~lad, I'f desired, I'towdverr;
swirl timat"~s 29 tit«y ba ut"r floe int'ter surface c:of tltd right r«ti'tdr tlYat't irl°m leFt sidewall of 'tlod louusit'tg lo, I'f ddsit'ed, the pivc~tiry titd«t't5 ( trot sfiowt't )' tit«y c::utitpt"ise twv piot5 dxtertdit'tg rtc~t'tit«lly frurii the silo wa115 v'f t;l'td 'tri<,~'get" art~i cutitpletttcrrtdt"y i'tules yr c«vitie5 irt fi;l'td sidd walls of floe I'tou5it'W to r'ei:eive said pit'ts, Iit «dcaitiort, tIW silo walls Uf the hvusiry 10 curitprisb, irt tl'teit" distal se'rc:l.ior'~s , <:;«v:ities 31« , it't t!'te lef t side w«11 , «itd 31f; ( trot shvwit ) irt 'tf'te t'igi'rt sidd w«J.l; to rcceivb 't!'16 t'e~'tt°«lt'I1T't~'-J
p11"1 9 whic;ft 1-t«5 c o ~~'a ~e Duckwt P-9A-JB , Jutte 6, 1991 CTP TO 07/345,995 ~ S. N.
f~eetn passed tltrou~f't ttlarnrel 7 'tu rettden it irntilohile dur'it°Ig use of t~, l'te pu rtc 1't .
Tfte taist~l por'tiot't 21 of tf'te Ituusit'nc,~' 10 also corilpt ices a ~dvity (rtvt 51o0wr'I); to receive date blai:le Nusloet" bat-rel 4.
Tt"l~~j.~Ct 3, 51'tVWI"I 11"I FlgllYCB G, 3 dYIC~ 7, C:UfiINY'l~E~S ~ft'ul~lt 42c1, t"dat" 42ki ~toc~ ri~l'tt 42c:; ~st'n le'Ft 42e:! ( t'tot slouwt'n) sicJe walls ar'n uNNet: 36 arnc:l lower 37 Ptintiurt5. TI'te luwet° Por.ti0rn 37 corilprises a trigger' at"ril f0t- ef'Feirtir'y Prcaxil'iml iilovetilerld: of thte tri<~'ger' 3 'Ft-oril its i~istdl 3a to i'tS Proxitr~al 3i~ (daslte~l lines) position a5 slouwt'n iot Figure 1.
Tt"I a~~l'tiut"i, tl°te tt igger uNper pot...tiort 36 ciifilNt ices a Port 35 tl'tdt°etl'tt°ouglt, to engage aloe pivot Viol 29, when the Nut.l~lo i5 ~s~atithldd, aatd allow tl'te tt igger 3 't0 pivot 'ti'terea(~uwt wl'terl 'five 'tr'i~ger aYfin37 iS i'ilUVec~ pY"OXitilally' i~Ut'il'y ~FurfilatiUrl of ti'16 0pe1"Ill"Ig 11't the l:ilUUC:I Ve~Sel .
TI°td Uld~la pusher" k~art..el 4, sltowtt iit Figures 2, 3 at"~~! 8 , e0tilpt"i5e~~ aor alorya'tec! aylit'~drieal Lwdy eotilpt'isir~~ wt its ~list~l end; a.~dvity cotiyrisirtg a rlist~l p~t...tiurl 52, tet'tilirtatd~l . hey a disd:al apdrliry 43,' at"I~l a yroxiltal pot"tiurl' 5l tdrntinatecl ~y 20. ~ruxirilal, wall 47.
~-I'tb inrlerv wall 44 u'f the cavity Pu7wtiott 52 I'tas ~n irm~r ~ilatiletet" 5li~f'ttlY gt ea4et' tl't«rt tl'te irlrtat" cJiarr~efi,er c:of floe iitrter wall 45 o'f tiv~ cavity portiot't 51.
prc:~xitrlal wall por'.tiurl 45 i5 tdt'~tilirtaLec~, wltere it ,~uitns wall (~ur'Liott 44, by a '("lat wall 53 1°lo7°timl to wall 44. TI'te rigl7t attd lei'"t Doukdt P-9A-JB ~''~' ~~~~~u~ June 6 ~ ' 991 CIP TO 071345,995 S. N. E
side walls of E;ld~fe Pusloer hat't'dl 4, fut°'tf'tet' vOriIPrisd dlvrne',~ate~d slots 46a artd 461J (rnot sloown), resN~otivdly, spaced pr0xirilally ft i;ril wall 53.
Spring 5, SI~tUWrl irt Figures 2 & 3, is irtsetwtdd irrtu cavity ~c:~rtiorn 51 wlt~r~irn it i5 r~5trdirm~J by the r°esLrainirrg pirr 9, sl'tuwrt irt Figures 2 arnd 3, whic;lo 17a5 heart passed tlor0ugh slots 46a at'Id 461 arid t'ecerve~l icy c:avities 31a am 31b v'f huusirlg 10.
Tlne I°t0lliaw bla~ie~ druril 6, siruwrt it°I Figures 3 drtd 9, cvrnprises ait elutngatdd 1'rolluw cylirndr cornprisiry an outer wall 63, a lurilcrr 65, a 'i'ea'r° wall 62, a p7'oXitnal updrtirrg 64 artd a distal iaolluw tt"ut'o:atdd ctirnical bladd Nortiot'n 61 tar°ri~illated by atr c:~pe~nirlg 60.
The Ipl~tc;ld d'i'uril i5 irmet'tcd irrtu distal cavmty Put'tiuon 52 of tl'td ~a.i'r_el 4 urntil its real' wall 62 abuts wall P0t°'tiorl 53 theYeUf.
Tloe uWtcY didtiytej'r' v'(' 'tlrd Ejlada dviwril uu'tet" wall 63 is slightly less 'y'1a11 'tl~e int'Id~' cJiariletet" of vhd bat°rel cavity portiurl 52.
Irt ut'la aspect of" this erini;dirimrlt, illustr~at',e~J irt Figure 4, tl'ta h.lddd Not"'tiorl c:ornPt'ise;s tt sct"t..aLed krli'Fe-edge blade 61a. It'i a Sbcu,r'Id a5pr-,c't c:>'f th;is ettlf~edirnmtwrt, as i.llustra~tdd 1t'1 Figurr~ 5, ~tl'ta.
~lddti put't1iJ11 CG(IINt"iSeS ct SfIICJC:JI,I~I IC111~fe"eC.~gCE.I IJIcldt3 61~. I1'1 yet 2p &rr0'tlldT rilodz'ficatiol'n, as seem irl Figure 9, tl'td blade Potwtiorl t::UIIINT"1585 a 'flctt '~at~C ~7y WI11C:1'1 ,JV111S tIIC 11"Irr:t" sur'Facd 68 u'F t116 cJruril at i-ts di~~tdl et°n at art angle c:i'f" about 90~ ( 1 .d. , witltia s'tat"Idat"~i tol<~"arn::ds) t~ ctveate a sl'tat"P ~uttirlg ridge 69. Irt 'this ril0<:IiFi,oat;iol't tl7e c~iarnetet° c:oF 'tyre disc uF i:Ite rilartdrdl is less tivarl ~tl'te iratar diarile'ter' of tyre i~laaei i:fnuril.
i v v ~~a 'J'~ ~i,..~~
Docl<et P-9A-JB Juitd 1991 CIP TO 07/345,995 g_ M.
Ii'I ano'ti'te'r til0~l:~i":ioat',101't of tl'te hladd druril, as illustratad in F1<,1''lAt C 24 , Wlt~t e11'1 tIIC (:llcifl'ItjtGY c:U'f~ tllca dlSi.: u(' the iilaltdt"~1 15 1t35S
tiiat'i tlte~ ittnet diatimtdt° wf the blade dnuril. , the distal eitd of tiny:
l,lade drutil coiilprise5 a bellow cylindrical portion 72 wl'tose 'Front eitd i:otilNt i5cs a flat facd 75 wloii:io joitw tSte it'Irien sunfac:e 74 of tl'td cylit'tdriual partiorl 72 at ait at'IOle o'f ahout 90~ to 'FOrra a sl'tarp i:u'ttirt~ ed~e~ 75, Tio6 putsch tilatndrel 7, shown irl Fi~ure5 1-5, 10 an~i 11, is iitse'i'ted it-rto thd blade pusloer barrel 4 'througlo floe ilolloW portion 65 u'f l:~ladd ~lt'utti 6, t',I°te pt"oxitiial end of ti'te tilattdt"el 7 exterldit'Ig l;eYotnd !ltd rear wall 62 of tl'ta k~lade dt'util 6 into the hollc:~w por born of titc SNritli~. . Tine irnmi di~~tnel.et wF thte l;lade drutin cavity 65 is ~liglttly ~rr~ater that°I the outer diariietdr of the rnarldrdl so 't ha l'. ti'td tilattdrW 1 rnaY pass tlterethtruu~h.
Mat'yrel 7, near' its proxitilal ditd. 'Furtl'ter c:utilprises a ytrar'mvdy°se lovld 58,~ thv7°dt',litvouglt, througlo wlvtich tl'td t-estrairlirt~
~i~::~ 9~ pa5sb~i 'tlot'ourUh 51W!5 46a at'n 46b i5 ::~15o pa~5ec~.
. f~awtrait'fiTt~ pzrl 9 C uses tl'te sprit"m to y-ernaiit proxirital to cavity firmer wall pc:~rvtxot"t 53. Upon asseiilL>ly o'f tl'td puncl't tl'te dt'Ids u'F
'ds'l.y-~r;irtir'Ig pii'i 9 z~re r'dcdivejd key 'tf'te t:avitid5 31a attd 31L>
( toot sl'towt'n) u'1' tfld huusir~g whereby tl'td timrldrdl 7 is iiilrilobilized;
TI'te ' distal erld of rilarldrdl 7 'furrtl'tdr curilprisds a reduce!
~l~filat6r stafil 55 tdY'til7.l1a1'.6d !ay a vlrC;ular c~isC: 56. Tile disc:
filay have drn uwter diatiletet" gr'ea'ter !staff 'thte it"Itner' diarimter of floe >;ladr~
drutin lutitet'n 65, if '!ltd ~liso i5 t0 server a5 a!'! anvil.
Alter'rlativdly, Docl<dt P-9A-JS June 6, 1991 CIP TO 07/345,995 S. N.
tl'te outer' diarileter of tl'te ~lisu rilay tie less tl'tart the inner diarileter of the luiilen i'P the c,liso is to enter the lurilert iauriny the hole 'f orrilir'ig Process.
After asserilkoly u'f tlne Purtclo, witlt thte trifler 3 irl its J:LStdl, C: CU C::ItBC;I PCJ;~1'tl0l~l, ct5 Se,Nrl 1rt F1'~,JllrC~ 2 alic:a 3, I;Jlc'tf~6 Portion b1, o'f 'the Made ~It'uril 6, will ex'ter'n ~lis~tr~lly 'fruril oPe1°Ilr'IC'~ 32 Uf~ the IICiUSII'Ig 1O. It will, howeve>'; !~e sPace~f Pt"uxlrilally froth tl'te reducad 5teril 55 as°n circular iaisv 56 of rilat'tc~t"el 7. I'i iab57.re~l, t;lte ~IiSO 56 I'ilay curilpri5e a i:liwtal ptirtion 57 corilPrisiry a ~l:lstally taperei:l tnurlcated corm to facilitate irnsbrtlUlt U~ 'lira disc into tlve Mood vessel.
Irt ti'~e pt'aeti0e o'f u5iryi,~ tloc vascular Purtclo, of the irmerttiorl, arl incision is ri~a~le irt tloe bloocJ vessel tl7e lengti~ of Ll.,t~ ir'ii;is:iort l~eirt~ srildller tl-tart tlor diarile'ter u~f 'tlte Ivole to be 1'~J rl'It."-,tl:le ~'.I'16r61n; ctllC~ tllC t~IS(: 7,11SerteC".~ , 1.1y rl'leclll~ V'f C: CJI"lll:dl PUr't1V11 57 (ivf Nre~ernt) ir'rtu, 'tltd vessel. Tlae Nroxirilal silo of the c~.rculdr disc 5b i5 Pulled against the inner wall o'F the vassal.
Py~dssure is thW °r aPpl:~ed 'to thd triJ~er arrn 37 c:ausirig ttte trigger arril tv fiyive~ ~'iroXirila~.lY toward tl'te handld por'tivl'I 20 of tl'te _ Itousit°y arr~J Pi,vo't al~owt Pivot Pir'i 29 whereLty 'ty-ig~r~r uPPer Portiori 36 i5 cdu5a~l to restate Clistally arti~ fot"ward as sftGWt'I by thd arrow B ir'i Figurd5 2~ 3 ar'1~! 7:
As 'tlt~ upPdr Pot'wti0t't 36 of trigger 3 r'o'tates in tl'te direction of ~t'ruw B 'ti'te 'Front Face 42a thereof rilovds 'Forward tloeret~y causing l~lacle PUSi'~ey' t~drrel ~1, wi'tc:~sd r"aat" wall 50 at,uts the ft"orrt 'faces 42a 'r J
Duc ftc t P-9A-JB "~ ,..~~,~ ~~ r" J ~ t ie: 6 , 1991 CIP TO 07/345,995 N.
of 'thd 'tt-ig~dr 3, t~ ritove forward wi~erwhy k~la~lr~ dtwurit 6 is Pushdd 'f'Orward, ur~rtil 1:1e oNeitiitg 60 of the ~ila~le dt°uiit 6 abuts i:loe outer wall u'f 'tktd bluo~i vessdl uPPusite 'fhb ciroular disc 56 of ritattdr'dl 7. Corltirmec~ retr'actlVY'I (Uf tt'ig~er' ar'iit 37 of tt'i~gbr 3 causes k~lade 61 'to i;Wt a (:vot°tlot'n iaut Wf tltd vessel dttd Pass oven fife iitat-tdrel reduced stern 55 at-td circular disc 56 whctn ~.I'te irttter diariteter cf tlnd drurit is i,~'r'catdr 'tltat'n t1-td owtet" daarit6ter' of tl'te dl5c. A'Fter the Piece f'ta~ heart cwt owt it reiitains ort t;he reduced stein 55 of ritattdt'el 7. Tlle~ re5traitnit'y Pin 9 Prevents fimveinet°nt o'fi floe iitandrel 7, while blade druiit 6 I'lIUVeS Forward, tl'tereby causit'tg tkte reduced 5terfn 55 with i.ts dssc:~Ciatdd tissue sdritPle to be Nu5it10t'lee:~ wit:hiit tl'te cavity 65 it°i hldc~c druiii 6. As blade Pusher hart'°el 4 ritoves 'forward tlve slots 46a attd 46h also iitove forward oausit't~ rds'trairtirtg girt 9 'to t,e Posi'tiortad 'a't i:lta Proxiiital dt-td o'f' 'tfoa sluts. Sprit°y 5 is, r;urtseyudrrtly, cofnprassr~d bwtWdert tl'te rear wall 47 u'F bat'5~e1 cavity ~orLioa 51 aitd rr~strainin;~ Pirt 9. A'Fter 't!'7r~ I'told Vas heart 'forti~6d ire 'tV'ta blood vessdl, and pressurr~ ort tltd trigger arlit 37 reritovdd, sWt'irm 5 expands cdu5i,ry blade Pusher f,r~tvt.,~l 4 irit'n k~la~le drutil 6 l:o tiiove pruxzrimlly . arid tkte trigger drrit 2Q ~ 37 'tu rimve d~.5tdl 1y . Rdduc:ed s'teiit Pur'tioo 55, o'(°
ritartdrel 7 , is 'k~het'n eXPu~dcl perritit~tit"y refinval o'f tl'te tissue saritPld therefrutit.
I1: is soritetirites d~5ir>r,hle to ritore dacur>:ti:ely c:orrtrol i:lla titoverimrtt u'fi 'fife hldde Pusf'vr k'~arr'el to Prevdt'rt rnisaligttrimtrt tktdr'duf Wlldr~ i1:' i~ cau~e~i Lo iitove diwtally, dutviag the hole foriititt9 '~ 25 pt-~cdss, ot" P'roxitinlly, a'f tdr forritittg 'tl'tr~ hold. Tktis is '~11~~1 . ~ I' I i k~~ V i :;g Niti':: L
~~ ~~~ ~~~
Dui:ltc t P-9A-JB Jutte 6 , 1991 CIP TO 07/345,995 5. N.
~tc:Cvtilpli~l'te~l by 'tlte sacui'Id erilhodatiieit't, desagtta ad 1B
i~t°Id illustr'atec~ itt Figures 12-19, aF floc irnv~rntivrt wloereiit the punch 'fUr'tl'tet° cuiilpt'ises rileaits 'for it°ntei ~urw'newtit'IC~' the trigger dt'Id f~lede _ pushier barrel. Tltus, trigger 3B, as f~e5t seem il Figure 14, vorilpris6s a sworn f'tole 34, tl°lerctltruuglt, bel:Weert the side walls 42c drlc~ 42d irl its upper portion 36. The I'tole 34 Wall receive a cotilpleiilet-itat"y engaging Pitt 7G oft c! rnodificatiorl 4B of tl'te blade pusl'ter barrel 4. Tlt 'this rrlodificutiur~ blade pusher barrel 4B, a5 best reel°nlt'I FagUt"es 15-19, uofilpYases, at its pT'Gxitilal dt'td, d sl~telf 71 extdrldartg proxirilally arlia rmrrilally therwProril. A cylindrical pin 7G, 'tu little the blade pu51'ter bdrt..el 4 to tltd trigger 3B, tlOrouglt thd Rule 34 tlterditt, extet°Ids rtor'rimllY Fi uo1 Said 5ltelf 71.
Wltetn alto l;art"el dr'Id vrigge~r a~'e tltuslY liill<ed the pn-vxirilal wall 50 of this b~rt'el abuts 'tlte 'Fr01"It 'face 42a c;oP -tile upper purtiorl 36 of the .fit: i ggdt- 3B , It is, .also, oftdt't ~idsiraUla to rdtr~it't tl'td tassuc sdrnple retiiovr~tl 'Frurii the blood vassel whdn do opeoirlg is foriiled therein by use of a vascular putncl-t . Howevbr , a disadvaritagc o'f thd prior art rurlcllds, Whic:fi a~. ~lsv present irn tl'te above erilbodiriler~t at-Id 24' Ttnda'f ica'tiut't~ ofi 'tl~tl.~ ariverrta0rn, is 'tl~te pv5sibili'ty o'f loss 0f the tJ,55U6 '~'dfilple8, ft C)fll the I~)lOC:7t~ veS5c1''s, WheTl ills trlggEit S
SpYlLtg k>ctC k .
That disacavat"rt:age is cavercurne by a tl'tird erilbodirilettt, desigl'm'tecJ 1C it'1 Figure 2.0, of t',I'te irmerrtiot'1 WI'tacl't provadds rilcarts ~'uT luckat"y 'tl'te 'tt"igger aft its pToxirilal, or t"wtractad, poSitivt°I as ~i. n Docket P-9A-J8 ~°~'~'~~'~~, Jurte 6, 1991 CIP TO 07/345,995 ~ 5. N.
d C:UrtSeyLlel"I C:6 U~ wloiula~ tl'te 're~lucdc~ stern 55 wf tlod ritartdrel 7, acrd the tissue ~ari~ple, are retairte~l within the lurimrt 65 of Lhe Made drurit ~ ut"rail this tt°lgger is irrtenrtiot'ially released.
Irt tloi~ erinodiri~er'rt, a5 illuwtrdtecJ irt Fi~ure~ 20 acrd 21, the triJge'i' 3C rimy k>e lucked unto a rttt'd~~~ted pt oxirital p0sitiorn, as illuwtrated in Figure 1, !;y t,ioe dashed! lines 3b, through er'yagerimrnt o'fi locking riteat'ts tl'tetwurt wi'tl't coritplerimrltary locking ritearts in tlld I'tous.it'g 10. Tloc houSirtg 10 also c:;ori~pris65 art uppEir Pur..t .tltt"vugf't whticlt tt'igger t'.elea5e ritearts ritay er'ntet' to ur'lluck tlyte tt"igget" 3C wltet't i't is io i~lie Ywtt'actec~, lOCked position 3h, ~d t~e5t seem irt Figure 22,_ tt"ig~er 3C c:0riy>rises an drrit 38, cvpl~trW Y wj tl..t tl.tG ~:ide walls 42i: a'itd 42d tltetwo'f , wf°ticl°t desi:ernds, ar'icJ is sel~a'rdtdcl by a rt0ti:lt 41 , 'Ft"ofrl tltc upper" part of tfie rear wall 421 0'f th'te tri~get° 3C. A Prwtrusion 39, ivavirtg art aatgular tide wall 39a anal f~c:>ti:orii 'Flat 'Facd 40, wloioh cart loc:kinglY engage Witlo curiyleritert'tarY loci<it'1J riteart~ o'f the !'tou5irtg 10, extcrtds ~ft'urn alwa is c:;oNl~trnr wit:l't ar~ii 38. T1'te distal t'wtatlol"f o'f tri.gget' uppdt-~or'tic~1't 3G, ~furzrlg cu't'tinJ of tl'ta l'tc:~le'it't the blood vessel, causes dt"fit eXtet'nlut'n39 tc:~ riioVe IA~Wz~t'd ctlvYtg a c::vrii(~lel'nert~.ctt'Y
allgUlaY wall 2p'._. 2~ (a-,ut sl'towt't) of lu~kirig rneat'ns 23 (t'yt 5f'tow~'t) urn 'tl'td flangd-like Wal1 33 ('rtdt ~fluWn) of thd I~tvus:Ll'~g 10 1_.I'terelay causing I'tot~c:lo ill tv ulo~6. Ft t', tlm yi c'aatdst eXter~it 0'f (~t'ox1riml t°etraiaiurn of"
tlne tt"i~~eT' a~t.'rii 37 of 'trig~Je~r 3C, the lcwey' anti u'F arrn 38 passas the uppt~t.. eTt~l o~f' lui;kit"y riie~it"ts 23 at"it! t..tutcl't 41 sNt"it'tgs open cdusirtg 'fai:e 40 ut't at"ri~ 38 wind 'the uNPe','. Face 25 ( rtot sl'towrt ) of'' 'the lucking Doc I<t t ; ~=__9F~--JE3 June 6 , 1991 CIP T0~07/345,995 S. N.
ritearts 23, vrt foousirtg 10, to luokirtgly ertgdge, Trigger arril 37 of Lt°igger 3C, tftdreFor'a, cdnitut <;e Caused to it°mvlur'Itarily irIUVe distally. Cv~itse~udrrtly, ~la~le~ dt°urit 6 vatnr'lut kid rett'ai:'f~ed artd tlt~
distal am u'F the rilaitdn'el 7 wilt thd 'tissue sdiitNle ai:-tached tv 1:114 'rCCJuircd stctit 55 tlterGVf will rtot irxtet'td L~~yvt'nd tllr~ opet-lirtg 60 of ~lac~e~ druri~ 6. TI'tus, ~hd ti~suc s~critNle ~~tnrto~t '('~Y11 of'F and is ~rc:~i':ec't~d until its t°~cc:we~t~y is desired. T1'te angular wall 24 and up~ct" 'Face 25 of the loakirtg titeart5 25 >rtrn the 'flat'tge like wall 33 u'f tl'W Ioc:Wsit'nr,~ at'e furiited 'f"YOtil tlteiY W Y..1.C5(~ut"i~iitng patwts, e.
angular wall pot°t.iot'm 24a artd 241 (rnc>t SItVWr'I) ors floe right and left side Wa115 10a at'td 10b, t"eSpeCtlVelY, v.f tl'te itou51r1<~' , Whel'I t°etilUVal v'F tfle l:'.lSsUe saltiNle is c:~~SlT '-~''d tt"lgget- YelcaSe ritcat''IS, 5ucl°t as 'floe ti(~ 66 of a Trap 8, as 5f'tuwrl iYt Figure 20, is j;t'ISertf~~J througlo upper port, 26 of tile hvu~it"~g urrtil i~t engages arri~
- 38: Cor'n'tit-tuead dvwrtwr~ywd pr6s~uY°e o'f tlve 'tip 66 iau~es arrit 38 vtu rtioV~ l.uWard tl'td trigger 3C bc:>tiy 'faTcit'y rivtch 41, tc:> closd. Upua 41u5uY'do'fi nu'ti';I't 41 'ti'lr~ ~uli~~l;eriterrta'rY lu~kir'y rimarts ut't the 'trigger.
3C::artd l7~usirlg l0 cJisat°tg~ge, Spt-illg 5 tl'tetl expdr~d5 d;;dusirtg bl~i~e ~Eausher' E,ar7°dl 4 ~rt~l L~ldde drurir 6 to ii~ovd pr oxiritally-WI'tile rloa 2Q 'tr~,gger arfit 37 o'F trio'gget' 3C titoveS ~Ji,sl:dlly. Reduc:at:1 sten't poY'~iort 55; c~i'" rint'tdrdl 7: i5 tfOet't aXpvsed ~erriti'ttit°tg rernuval of 'tlte tissue s~ritple ~.1'terd'frurin. It'n a roost, pra'Fet~re~i erino~liri~el'rt the release riveans c:;uttipt":isc5 at't dat'rtildvaY' tywa tah 77, as saert it't Figure 23, ut't t;i~e Low v'F t116 1'tuus7.tng ctl'tc~ Wtl':dcfl6c~ t0 l;.Ple pC)twt 26 ttt 11:5 dJ.S~at~. Slde wall 78 . I'1" desird~i y 'tl'td 'taV~ 77 may tie art 1t"rtr~gt"allY timl~led pant of ~~' ~ ~'~~~:,a Docl<et P-9A-JB , Jurse 6, 1991 CIP TO 07/345,995 ~ S. N.
the housirsg. Tl~te tah 77 oars tic pressed di:~wrtwariJ thereby releasing ttl8 lOC:klrtg fiscdri5 by ~OfispYNsSirsg tile 1°scWtc:;ft 41 and c::auSlrtg tftd loe:kirtg arrn 38, ct't tile; tt"i~ger, attd floe voiitpleriteritary protrusi~ts 23 wF floe lttiusiat~ to cJiSerigage. Otfter rclaasc tttcaTtS, as krsi~wrs irt the at l:. , iitay l:» u;~ed i n l i eu of the efjove 7, tndi ~d l.ed fiiedons .
Irt d fout'tlt eiishcdiiitertt, ~i~si~rtate~i 1D artd illustrated irt Fi~ut°e 23, tf~te: vascular puttolo 1 of the fit'5t efflbodi(isers't -Further ccrispt'ise5 the trigger - blade pu5foer' >;arrel lirnkirtg cvrist~irsatiors of l:ftEJ SeCrUrl(.f etinoc,iiriiettt attd t1'te L,riO~tt' luoki'it~ a~rn release ~fcatuics of tf~e t',Itit'd eiitl:iui:,llnieat. Irt this erislpi:~diniserO:. all cF the parts ai:t~it's tine ~atise tisatttter, as iae5orit;ed ~tl:~ove, &a sitiiilat 1y dc~igl'ta'te~) paYts in tfW o(:loet' ~I'ishoc~isu~:;nts.
Cf'tat'I<J,tS (flay IJC ct~f~feU~teC.I Wl~tl~~l Y~6SpCl:~L. t0 ~L,I~tC
dC~Ldll~ V
wt'sSI,Y'Ui;I:lUrt dltd 115c u'C thd llnver7tlut't Wll.loOWt departl,rtg 'Ft'UI'it tfl6 spir'irt drtii sc~Pe rtloere6~' as de'firted lrt the appended olaitits.
Claims (34)
1. A vascular punch for cutting openings in blood vessels comprising a pistol-shaped housing having an opening at the front end thereof; a blade drum provided at said opening of said housing; a punch mandrel having an end thereof passing through said opening in said housing; a trigger having an arm pivot means for pivoting said trigger on said housing, said housing having port means through which said trigger arm of said trigger can extend outwardly; restraining means in said housing for engaging said punch mandrel;
and blade pusher barrel means movably mounted between said trigger and said blade drum, said trigger further comprising a lower portion extending outside of said housing; and an upper portion residing within said housing comprising means for transferring motion to said blade pusher barrel means, said blade pusher barrel means being axially and reciprocally movable within barrel receiving means of said housing, and comprising an elongated cylindrical body comprising means for receiving motion transferred from the upper portion of said trigger, cavity means to contain said blade drum and said punch mandrel, opposing elongated longitudinal slots through which said punch mandrel restraining means passes to engage said punch mandrel, said punch mandrel further comprising an elongated cylindrical rod having a transverse hole therethrough to receive said punch mandrel restraining means and a reduced stem at its distal end terminated by a circular mandrel disc normal thereto, said blade drum comprising a hollow cylindrical body having a longitudinal lumen for passage of said punch mandrel therethrough; and blade means for cooperating with said circular disc of said punch mandrel to form said opening in the blood vessel, said restraining means preventing movement of said punch mandrel when said blade pusher barrel means and said blade drum move axially and reciprocally; and restoring means for restoring raid trigger to a normal position after use.
and blade pusher barrel means movably mounted between said trigger and said blade drum, said trigger further comprising a lower portion extending outside of said housing; and an upper portion residing within said housing comprising means for transferring motion to said blade pusher barrel means, said blade pusher barrel means being axially and reciprocally movable within barrel receiving means of said housing, and comprising an elongated cylindrical body comprising means for receiving motion transferred from the upper portion of said trigger, cavity means to contain said blade drum and said punch mandrel, opposing elongated longitudinal slots through which said punch mandrel restraining means passes to engage said punch mandrel, said punch mandrel further comprising an elongated cylindrical rod having a transverse hole therethrough to receive said punch mandrel restraining means and a reduced stem at its distal end terminated by a circular mandrel disc normal thereto, said blade drum comprising a hollow cylindrical body having a longitudinal lumen for passage of said punch mandrel therethrough; and blade means for cooperating with said circular disc of said punch mandrel to form said opening in the blood vessel, said restraining means preventing movement of said punch mandrel when said blade pusher barrel means and said blade drum move axially and reciprocally; and restoring means for restoring raid trigger to a normal position after use.
2. A punch of claim 1, wherein said housing comprises a. pistol shaped side walls;
b. means for aligning said side walls during assembly;
and c. pivot means, comprising a pin normal to, and on the inner surface of, one of said side walls, to engage complementary pivoting means on the trigger.
b. means for aligning said side walls during assembly;
and c. pivot means, comprising a pin normal to, and on the inner surface of, one of said side walls, to engage complementary pivoting means on the trigger.
3. The punch of claim 1, wherein the upper portion of said trigger comprises 1) a hole passing therethrough, from one side wall to the other, to engage said pivot means of said housing around which said trigger may pivot; and 2) a front wall which abuts the rear wall of said blade pusher barrel.
4. The punch of claim 1, wherein said blade pusher barrel comprises an elongated cylindrical body comprising:
a. a front end having a cavity; comprising 1) a port at its front end;
2) a distal hollow suction to receive said blade drum;
3) a proximal hollow section, adjacent said distal hollow section, to receive raid spring means and having an inner diameter which is less than the inner diameter of said distal hollow section; and 4) a rear wall; and b. a rear end comprising 1) a wall perpendicular to the longitudinal axis of the barrel;
2) two opposing longitudinal slots through the walls of said proximal hollow section adjacent said distal hollow section, through which said restraining pin passes; and 3) a flat wall at, and normal to, said front end of the proximal hallow section which abut said rear wall of said blade drum.
a. a front end having a cavity; comprising 1) a port at its front end;
2) a distal hollow suction to receive said blade drum;
3) a proximal hollow section, adjacent said distal hollow section, to receive raid spring means and having an inner diameter which is less than the inner diameter of said distal hollow section; and 4) a rear wall; and b. a rear end comprising 1) a wall perpendicular to the longitudinal axis of the barrel;
2) two opposing longitudinal slots through the walls of said proximal hollow section adjacent said distal hollow section, through which said restraining pin passes; and 3) a flat wall at, and normal to, said front end of the proximal hallow section which abut said rear wall of said blade drum.
5. The punch of claim 1, wherein the outer diameter of said mandrel disc is slightly less than the inner diameter of said blade drum.
6. The punch of claim 1, wherein the outer diameter of said mandrel disc is slightly greater than the inner diameter of said blade drum.
7. The punch of claim 1, wherein the front portion of said blade drum comprises a truncated cone the distal portion of which forms said blade.
8. The punch of claim 7, wherein said blade is a serrated-edged knife blade.
9. The punch of claim 7, wherein said blade is a smooth bevel-edged knife blade.
10. The punch of claim 7, wherein the front wall of said blade drum comprises a flat face which joins the inner surface of said drum at an angle of about 90 degrees to form a sharp cutting edge.
11. The punch of claim 1, further comprising complementary locking means on said housing and trigger for releasably locking said trigger arm in its proximal, retracted position whereby said reduced stem of said punch mandrel, with its associated circular disc, is retained within said blade drum cavity, and releasing means to cause said complementary :locking means to disengage.
12. The punch of claim 11, wherein said complementary locking means on said trigger comprises an arm, descending from a rear wall of the upper part of the trigger, coplanar with the side walls, the lower portion of said arm being separated from said rear wall of the trigger by a compressible notch, said arm further comprising means to lockingly engage complementary means on said housing and releasing means to selectively and manually compress said locking arm notch thereby urging said complementary locking means to move apart and become disengaged.
13. The punch of claim 12, wherein said releasing means comprises a. an upper port in said housing adjacent said locking arm of said trigger; and b. an article which may be passed through said port to press upon said locking arm and compress said notch,
14. The punch of claim 12, wherein said releasing means comprises a molded portion of said upper housing wall adjacent said locking arm of said trigger which can be depressed, whereby it can press on said trigger locking arm and thereby compress said notch.
15. A vascular punch, for cutting openings in blood vessels, comprising:
a. a substantially closed pistol-shaped housing comprising:
1) two pistol shaped side walls, each comprising a pistol grip shaped descending proximal section and an approximately horizontal barrel shaped distal section;
2) a flange-like wall, extending normally to and peripherally around the edges of said side walls from the proximal end of the housing to a distal end thereof;
3) an opening at said distal end through which a punch mandrel and a blade drum pass through;
4) a lower port, near a lower juncture of said proximal and distal sections thereof, through which a trigger passes through;
5) pivot means around which an upper portion of said trigger may rotate;
6) two matching cavities, in said side walls, spaced from said front opening of said hauling, engaging a restraining pin which passes through slots in a blade pusher barrel and a transverse hole in said punch mandrel;
7) matching cavities in said distal section of said side walls which combine to form a cavity in the assembled housing to receive said blade pusher barrel;
8) at least one pin normal to the inner surface of one side wall, extending from said side wall into said housing; and 9) at least one complementary cavity on the inner surface of the other side wall to receive said at least one pin for alignment and coupling to form the assembled housing;
b. said trigger comprising;
1) a lower portion forming a trigger arm, extending outwardly from said housing;
2) an upper portion residing within said housing comprising;
a) front, rear and side walls;
b) means complementary to said pivot means in the housing around which said trigger may pivot, said front wall of said trigger abutting against a rear wall of said blade pusher barrel; and c) said blade pusher barrel, being axially movable within said housing, and comprising an elongated cylindrical body comprising;
1) at its front end a cavity comprising;
a) a front opening;
b) a distal hollow section to receive said blade drum;
and c) a proximal hollow section, adjacent said distal hollow section, whose inner diameter is less than the inner diameter of said distal hollow section;
2) a wall at its rear end perpendicular to the longitudinal axis of said barrel;
3) two opposing longitudinal slots through the walls of the proximal hollow section, adjacent its junction with the distal hollow section, through which said restraining pin passes; and 4) a flat wall at, and normal to, said distal end of said proximal hollow section to abut the rear wall of said blade drum;
d) said punch mandrel comprising an elongated cylindrical rod comprising;
1) hole therethrough spaced distally from said proximal end to receive said restraining pin;
2) a reduced stem at its distal end terminated distally by a circular disc normal thereto;
e) said blade drum means comprising a hollow cylindrical rod comprising;
1) a longitudinal concentric lumen for passage of the punch mandrel therethrough;
2) blade means to cooperate with said circular disc of said punch mandrel to form a hole in a blood vessel; and 3) at its proximal end, a flat rear wall perpendicular to the longitudinal axis of said rod, wherein the outer diameter of said wall is slightly greater than the inner diameter of said proximal cavity portion, and slightly less than the inner diameter of said distal cavity portion, of said blade pusher barrel;
f) said restraining pin comprising an elongated cylindrical rod whose outer diameter is slightly less than the inner diameter of aid transverse hole in the rear end of said punch mandrel; and g) spring means inserted in said proximal portion of said cavity of said blade pusher barrel and restrained therein by said restraining pin passing through said punch mandrel.
a. a substantially closed pistol-shaped housing comprising:
1) two pistol shaped side walls, each comprising a pistol grip shaped descending proximal section and an approximately horizontal barrel shaped distal section;
2) a flange-like wall, extending normally to and peripherally around the edges of said side walls from the proximal end of the housing to a distal end thereof;
3) an opening at said distal end through which a punch mandrel and a blade drum pass through;
4) a lower port, near a lower juncture of said proximal and distal sections thereof, through which a trigger passes through;
5) pivot means around which an upper portion of said trigger may rotate;
6) two matching cavities, in said side walls, spaced from said front opening of said hauling, engaging a restraining pin which passes through slots in a blade pusher barrel and a transverse hole in said punch mandrel;
7) matching cavities in said distal section of said side walls which combine to form a cavity in the assembled housing to receive said blade pusher barrel;
8) at least one pin normal to the inner surface of one side wall, extending from said side wall into said housing; and 9) at least one complementary cavity on the inner surface of the other side wall to receive said at least one pin for alignment and coupling to form the assembled housing;
b. said trigger comprising;
1) a lower portion forming a trigger arm, extending outwardly from said housing;
2) an upper portion residing within said housing comprising;
a) front, rear and side walls;
b) means complementary to said pivot means in the housing around which said trigger may pivot, said front wall of said trigger abutting against a rear wall of said blade pusher barrel; and c) said blade pusher barrel, being axially movable within said housing, and comprising an elongated cylindrical body comprising;
1) at its front end a cavity comprising;
a) a front opening;
b) a distal hollow section to receive said blade drum;
and c) a proximal hollow section, adjacent said distal hollow section, whose inner diameter is less than the inner diameter of said distal hollow section;
2) a wall at its rear end perpendicular to the longitudinal axis of said barrel;
3) two opposing longitudinal slots through the walls of the proximal hollow section, adjacent its junction with the distal hollow section, through which said restraining pin passes; and 4) a flat wall at, and normal to, said distal end of said proximal hollow section to abut the rear wall of said blade drum;
d) said punch mandrel comprising an elongated cylindrical rod comprising;
1) hole therethrough spaced distally from said proximal end to receive said restraining pin;
2) a reduced stem at its distal end terminated distally by a circular disc normal thereto;
e) said blade drum means comprising a hollow cylindrical rod comprising;
1) a longitudinal concentric lumen for passage of the punch mandrel therethrough;
2) blade means to cooperate with said circular disc of said punch mandrel to form a hole in a blood vessel; and 3) at its proximal end, a flat rear wall perpendicular to the longitudinal axis of said rod, wherein the outer diameter of said wall is slightly greater than the inner diameter of said proximal cavity portion, and slightly less than the inner diameter of said distal cavity portion, of said blade pusher barrel;
f) said restraining pin comprising an elongated cylindrical rod whose outer diameter is slightly less than the inner diameter of aid transverse hole in the rear end of said punch mandrel; and g) spring means inserted in said proximal portion of said cavity of said blade pusher barrel and restrained therein by said restraining pin passing through said punch mandrel.
16. The punch of claim 15, wherein said blade means comprises a distal truncated cone.
17. The punch of claim 16, wherein said blade means comprises a smooth knife-edged blade.
18. The punch of claim 6, wherein said blade means comprises a serrated blade.
19. The punch of claim 16, wherein the front wall of said blade drum comprises a flat face which joins the inner surface of said drum at an angle of about 90 degrees to form a sharp cutting edge.
20. The punch of claim 15, further comprising locking means in said housing for lockingly engaging complementary means on the side arm of the upper portion of said trigger when said trigger arm is in its proximal position, said blade drum extending outside of said housing and said reduced stem and circular disc of said punch mandrel is remained in said blade drum lumen and trigger releasing means for selectively and manually compressing said trigger arm notch, thereby urging said complementary locking means to more apart and become disengaged.
21. The punch of claim 20, wherein said locking means on said trigger comprises an arm, descending from the rear wall of the upper part of said trigger, coplanar with said side wall, the lower portion of said arm being separated from said rear wall of said trigger by a compressible notch, said arm further comprising means to lockingly engage complementary means on said housing.
22. The punch of claim 21, wherein said trigger releasing means comprises a) an upper port in said housing adjacent said locking arm of said trigger; and b) an article which may be passed through said port to press upon said locking arm and compress said notch.
23. The punch of claim 21, wherein said releasing means comprises a molded portion of the upper housing wall adjacent said locking arm of said trigger which can be depressed, whereby said molded portion presses on said trigger locking arm to thereby compress said notch.
24 . The punch of claim 15, wherein said circular disc terminating the front end of said punch mandrel has a larger outer diameter than the inner diameter of said blade drum.
25. The punch of claim 15, wherein said circular disc terminating the front end of said punch mandrel has a smaller outer diameter than the inner diameter of s aid blade drum.
26. The punch of claim 15, further comprising linking means for linking said blade pusher barrel to said trigger.
27. The punch of claim 25, wherein said linking means comprises a) a shelf whose top surface is coplanar with said trigger side walls, extending proximally from said rear wall of the blade pusher barrel, said shelf further comprising an elongated pin extending normally from said top surface to engage complementary means on said trigger; and b) a hole on said trigger upper portion, extending therethrough from ore side wall, to engage said pin.
28. The punch of claim 15, wherein the pivoting means a) on said housing comprises a pin attached to the inner surface of one side wall of said housing extending approximately normally into the housing around which the upper portion of the trigger may rotate; and b) on said trigger comprises a hole to engage said pin.
29. The punch of claim 15, wherein said pivoting means a) on said trigger comprises at least one pin extending normally from at least one side wall thereof; and b) on said housing comprises at least an equal number of complementary pin receiving means in the side walls thereof.
30. The punch of claim 1, further comprising linking means for linking said blade pusher barrel to said trigger.
31. The punch of claim 30, wherein said linking means comprises a) a shelf whose top surface is coplanar with said trigger side walls, extending proximally from the rear wall of said blade pusher barrel, said shelf further comprising an elongated pin extending normally from said top surface to engage complementary means on said trigger; and b) a hole on said trigger upper portion, extending therethrough from one side wall, to engage said pin.
32. The punch of claim 1, wherein said pivoting means a) on the housing comprises a pin attached to the inner surface of one sided wall of said housing extending approximately normally into said housing around which the upper portion of trio trigger may rotate; and b) on said trigger comprises a hole to engage said pin.
33. The punch of claim 1, wherein said pivoting mean;
a) on said trigger comprises at least one pin extending normally from at least one side wall thereof; and b) on said housing comprises at least an equal number of complementary pin receiving means in the side walls thereof.
a) on said trigger comprises at least one pin extending normally from at least one side wall thereof; and b) on said housing comprises at least an equal number of complementary pin receiving means in the side walls thereof.
34. The punch of claim 1, wherein the front portion of said blade drum comprises a cylinder, the inner diameter of which is greater than the diameter of said mandrel disc, and whose distal face joins the inner surface of the drum at an angle 90 degrees to form a sharp cutting edge.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/711,656 US5192294A (en) | 1989-05-02 | 1991-06-06 | Disposable vascular punch |
| US711,656 | 1991-06-06 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2070465A1 CA2070465A1 (en) | 1992-12-07 |
| CA2070465C true CA2070465C (en) | 2003-08-12 |
Family
ID=24858977
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002070465A Expired - Lifetime CA2070465C (en) | 1991-06-06 | 1992-06-04 | Disposable vascular punch |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US5192294A (en) |
| EP (1) | EP0517252B1 (en) |
| JP (1) | JP3172843B2 (en) |
| AU (1) | AU644570B2 (en) |
| CA (1) | CA2070465C (en) |
| DE (1) | DE69204355D1 (en) |
| MX (1) | MX9202687A (en) |
| TW (1) | TW209165B (en) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US2818852A (en) * | 1956-06-27 | 1958-01-07 | Heinz W Kugler | Spring-pressed surgical instrument |
| US3776237A (en) * | 1972-05-11 | 1973-12-04 | Tecna Corp | Surgical tool and method of providing a surgical opening |
| US3835860A (en) * | 1973-06-21 | 1974-09-17 | H Garretson | Surgical bone punch |
| US3837345A (en) * | 1973-08-31 | 1974-09-24 | A Matar | Venous valve snipper |
| US4018228A (en) * | 1975-02-24 | 1977-04-19 | Goosen Carl C | Surgical punch apparatus |
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| DE9100873U1 (en) * | 1991-01-25 | 1991-04-18 | Wisap Gesellschaft Fuer Wissenschaftlichen Apparatebau Mbh, 8029 Sauerlach, De |
-
1991
- 1991-06-06 US US07/711,656 patent/US5192294A/en not_active Expired - Lifetime
-
1992
- 1992-05-13 AU AU16208/92A patent/AU644570B2/en not_active Expired
- 1992-05-14 TW TW081103749A patent/TW209165B/zh not_active IP Right Cessation
- 1992-06-04 CA CA002070465A patent/CA2070465C/en not_active Expired - Lifetime
- 1992-06-05 DE DE69204355T patent/DE69204355D1/en not_active Expired - Lifetime
- 1992-06-05 EP EP92109557A patent/EP0517252B1/en not_active Expired - Lifetime
- 1992-06-05 MX MX9202687A patent/MX9202687A/en unknown
- 1992-06-05 JP JP14568892A patent/JP3172843B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| EP0517252A1 (en) | 1992-12-09 |
| EP0517252B1 (en) | 1995-08-30 |
| JP3172843B2 (en) | 2001-06-04 |
| MX9202687A (en) | 1992-12-01 |
| DE69204355D1 (en) | 1995-10-05 |
| AU1620892A (en) | 1992-12-10 |
| TW209165B (en) | 1993-07-11 |
| CA2070465A1 (en) | 1992-12-07 |
| AU644570B2 (en) | 1993-12-09 |
| US5192294A (en) | 1993-03-09 |
| JPH07100143A (en) | 1995-04-18 |
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