US 1855546 A
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A ril 26, 1932 N. w. FILE SURGICAL APPLIANCE Filed April 28, 1931 ll ul gwtnnloz Mli'ile Patented Apr. 26, 1932 UNITED: TA
" lemme. FILE, or nvircniauzae, vr'aemra suneioaii ArrLIANcn Application filed April as,
This invention relates surgical appliances, and has for its object to provide a combination of heemostat and ligator, the'latter being detachably and slidably mounted upon the haemostat in such manner as to ipermit the combined device to be brought to the bleeding point by the use ofon'e hand only,. the loop oftheligatureencompassing] the jaws'of the haemostat, and as the heemostat has been clamped upon the bleeding pointyto permit the loop to be shed from the nose: of the haemostatabout the-bleeding vesselby sliding the ligator forwardly along the haemostat'." The invention contemplates "as well a modeof operation in which the combined device is'applied to the point of-b'leeding'wby one hand asdescribed, and then Se'p arated and subsequently manipulated as separate instruments in. th'e fholding" of the vesseland tying 'it 01f..- a 1 a Another object of. theinvention; is to pr'o videa-ligator having means adapting it to be.
structurally associated with a haemostatwhil'e closing the bleeding vessel, the hae'mos'tatacting as arguide for th loop of the ligature,
leading it tothe tying off point ofthle'vessel' Figure 1 is a a plan view 'of the combined .ligatorland heemostat, parts being-broken warn" 1 315 Figure iunderneathf plan View I "of crating jaws 5 and I6.perferably formed with 1931.- serial 533,522. f
the combined instrument,' the handles of the haemosta't being omitted; Figure 3 is a side elevation partly in section' onan enlarged scale showing theworking ends of the haemostat and ligator and the slidingconnection betweenthe two instruments;and I Figure 4 is asection-taken alongthe line l iof Figure3p Referring now in detail to theseveral fig- 5 ures the numeral 1 represents a haemostat of usualconstru'ction, that is to say, it comprises 7 a pair of-handles 2 and?) pivoted scissors-like atan intermediate point-4 and having coope finely'serrated meeting faces? between which the bleedin'gvessel is adapted to be clamped The handles are made o-f re-silient material, one being provided witharatchet lug 8 and the other with a hook lug 9 engaging with the ratchet to retain thejaws of the haemost'at closed with varying degreesof pressure. 7
Thehaemostat as above described is'convention'al'and is not a part ofthe present invention"per:se,but onlyin novelcombination with the ligatorfi I I j I g The 'ligator comprises a shank l0 having az'bore-ll in its forward portion opening on'ftop ofthe s1mnk.;atthe point indicated at 12 in Figure 1', said borereceiving a ligaturelS-which protrudes-from an orifice 14: at the forward end of theligator. Rear- 'wardly of the opening 12,-the shankof the li'gator carries a slidablymounted cleat 15 about which the :free-endof the ligature is adaptedto be wound and retained; The'cle'at.
15 is mountedon a carriage 16-havinga cylindrical borethrough which the posterior is portiontof the shank '10 extends. The car; 'ria-ge 1 6 on its 'lo'wer face isprovided with "3;,
guide pins 1'1 and l8 sliding in a groove-19 formed on the "under-sidebf' the shank" 10.
The groove is provided' at its basewitha leafspring 20 orits equivalent'against'which a the'ends ofthe pinsilfand 18 bear; iSa'idOO with a channeled guide 25, the side fl'ang'esr leaf spring imposes a resilient resistance to the movement of the carriage 16 and acts as a brake.
The carriage is provided with finger rings 21 and the rearward end of the shank 10 of the ligator is provided with a finger ring 22. The latter ring is preferably formed with a socket 23 receiving the end of the shank 10 and being secured thereto by a thumb screw 24. When the finger ring 22 is removed, the end of the slot 19 is thus opened permitting the carriagel6 with itsappurtenant parts to be removed fromftheiligatorto facilitate cleansing and sterilizing of the instrument. an intermediate point the ligator is provided of which areadapted to freely embrace one ofthe handles of the haemostat. Figure 3" shows the ligator thus-mechanically associ ated with the handle 3 of the hamostat. The broken line representation of the channeled guide 25 shows thatit is; slidable upon the haernostat and when it is in its forward-most position, the forward end of the ligator is in the broken line position shown in Figure 3 in whichposition the loop 26 of the ligature is shed from the jaws of the haemostat around the stump of the. bleedingvessel. i 7
In operating the combinedappliance, the
Jigator is mounted upon the haeniostat with 1 the guide25 embracing a handle of the haemosta't andthe loop oftheligature placed about thejawsofthe haemostat as shown in Figures 1,2and-3, The haemostatis then brought to thepoint-of bleeding with the lig'ator mounted thereupon, only one of the surgeons hands beingemployed, leaving the other hand free for any other desired manipulation. The
V haemostat is clamped uponthe bleedingstump .and the ligator is then slid forward on the haemostat to the dotted line @position so that the loop of the iligature becomes [removed .fronrtheghaemostatand surrounds the bleed- ".in'g vessel below the point of application of the ha'ernostatQ It isfassumed that the knot by which the'loop of the ligature is formed is'a slip knot so; that by pulling the cleat 15 rearwardly,- -th e ligature is drawn through the; ligator' tighteningthe loop about the point of bleeding. Thewligature may then be cut oftandthe haemostat released. In
the manipulationof-the appliance as above described, the hfaemostat serves as a guidefor guiding the loop'26 oftheligature to the point of bleeding and aroundthe vessel which is to be tied off. It is 'not necessary however, that the ligator should remain slidably attached tojthje hzemostat during thetying- ,ofl'; operation.;.:If desired, as soon: as the bleeding gvessel hasbeenclamped, thetligator -:may,be lifted from the haemostat and manipulated as a separate instrument,I although in Whati I claim is:
In addition to the advantage of being able to approach the point of bleeding with both instruments, using only one hand, and having the haemostat act always as a guide for the loop of the ligature, the instrument has the additional advantage of being easy to keep clean and sterile since the bore through the ligator is but little larger than the diameter of the ligature, practically preventing the entrance of blood into said bore. The ease with which the ligator may be removed from the hzemostat andthe removable relation of the cleat and carriage 16 tothe. shank 10 of the ligator permits the'several parts to be separated facilitating the cleansing of the same.
the details ofconstruction as described are merely by way of example and are not to be construed as limitative in theirybearing upon the-scopeof the invention as claimed.
. 1. A ligator including a shank having the bore in the anterior part thereof opening in the end of :said ligator and laterally, rearwardly; of @said end, and a ,cleat slidably mountedupon said 'ligator forreoeiving the free portion of a ligature passing through the bore of said shank,'and fortautening said I 2'. Ligator'comprising a=shank, said shank being formed with a bore inits anterior por. tion opening in the end ofsaidshankand let .erally, rearwardly of 'said'end,.means on said shank adapting it to be detachably and slid- .ably mounted onahaemostat, a sliding'cleat on said shank for receivingthe free :portion of said ligature and tau'tening-the loop of said ligature, a sliding carriage on which said cleat is mounted, said shankand carriagebeing provided with; :inter-enga 'ng elements forpreventing rotation. of sai carriage.
3. Ligatoras claimed in claim 2, the shank being formed with 'a :groove and, the sliding carriage being .p-rovided'with guiding-pins extending intosaid groove, and a spring in said groove engaged by, said pins and actingas a brake forsaidcarriagei f 4 Ligator as claimed in claim 2;, saidshank 5.:
being formed with a groove'openinginto the posterior end of said shank, guiding pins extending from said carriage into said groove, a spring in said-groove engaged by saidipins forming a brake for -said carriage, and a detachable handle on the end o f-said shank normally closing the open end of said groove, said carriage being removable from said shank through' the" open end of said; groove upon removal of said handle.
5 A ligatoradapted to be slidably andidetacha bl y secured to a hsemostat, including a channeled guide adapted to slip' over a 1ongitudinal member of said haemostat, said-ligaitor comprising; a: shank having a bore in' the ago anterior part thereof opening in the end of said ligator and laterally at an intermediate point, and a eleat slidably mounted upon said ligator rearwardly of said lateral opening for receiving the free portion of a ligature assing through the bore of said shank, an for tautening said ligature.
6. Ligator as claimed in claim 2, the shank being formed with a groove and the sliding carriage including a guiding portion extending into said groove, and aspring in said I groove engag ng sald guidlng portlon and V acting as a brake for said carriage.
In testimony whereof I afiix my signature.
NORMAN W. FILE.