|Publication number||US2434030 A|
|Publication date||Jan 6, 1948|
|Filing date||Nov 13, 1945|
|Priority date||Nov 13, 1945|
|Publication number||US 2434030 A, US 2434030A, US-A-2434030, US2434030 A, US2434030A|
|Inventors||Grover Yeomans Theron|
|Original Assignee||Grover Yeomans Theron|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (1), Referenced by (79), Classifications (6)|
|External Links: USPTO, USPTO Assignment, Espacenet|
Jan. 6, 1948. 'T. G. YEOMANS 4, SUTURELESS METHOD OF RECTO-SIGMOID ANASTOMOSIS AND APPARATUS THEREFOR Filed NOV. 13, 1945 3 advanced toward each other by means of the ballheaded, square-bodied tie bolt and its nut 6.
The cup member I is provided with a round clearance hole I, through which the tie-bolt 5 may pass freely, and a spherically formed ball seat 8 is marginally constituted about the hole I.
The cup member 2 is provided with a square clearance hole; I5 through which the square bodied tie bolt 5 is adapted to be passed freely.
Surrounding the square clearance hole I5 and in the lower end of the cup member 2 is a tapered socket I4, adapted to interchangeably receive body tubes II, of varying lengths, which are provided at one end with a tapered portion I3 which mates with the tapered socket I4 and is adapted to seat 4 string suture 2|, whipped over the cut edge of the bowel and tied around the tie-bolt.
The cup member 2 is then placed in the distal segment of the rectum with the body tube I I protruding from the anus, where it is held steady by an assistant.
A purse string suture 22 is then placed in the cut edge of the rectum. The cup member 2 and tube I I' are slipped over the tie bolt 5.
The rectal purse string 22 is then tied around the tie-bolt 5, the two segments of bowel are the tube I I in the socket I4 of the cup member 2.
The opposed, in-turn, annular flanges 3 and 4 of the respective cup members I and 2 have been found satisfactory for the desired clamping purpose when not less than one quarter inch in width and the inner edges I3 and I9, as well as the outer edges I6 and H, are best adapted for the purpose when provided with smoothly rounded corners of approximately one sixty-fourth inch radius.
The square bodied tie-bolt 5 is provided with an integral spherical head 20, and the portion 9 directly adjacent the ball is necked down to a round section for a short distance in order to permit equal ball and socket action of the ball in the socket 8 in all directions. The oppositeend of the tie-bolt 5 is provided with threads Ill adapted to engage the internal threads of the hand nut 5. The total length of the tie-bolt 5 is so related to the total length of the body tube II that when the apparatus is assembled, as shown in Fig, 1, clamping pressure may be exerted between the opposed faces of the annular flanges 3 and 4.
The hand nut 6 may be provided with coarsely fluted grooves to provide more secure gripping surfaces for the fingers,
While a number of metals may be used in the construction of the apparatus, aluminum has proven very satisfactory for the cup members, the body tube and the hand nuts, on account of its light Weight, while the tie-bolt is best made from Steel in order to secure sufflcient strength in a bolt of small diameter.
The maximum diameters of the cup members I and 2 must not be too small, lest the stoma be too narrow, nor should they be too large to remove through the anus, unless the sphincter is to be divided and later repaired.
One and one-half inches has been determined in use to be a median of satisfactory diameters.
The body tube l I must be selected of such length that it will project sufficiently beyond the anus to be grasped and held against turning by suitable shaped forceps or pliers, but not enough to be clumsy.
The entire apparatus must have all exterior surfaces smooth and highly polished, but such finish is not necessary on such concealed surfaces as do not contact the bowel.
The opposing faces of the flanges 3 and 4 may be perpendicular to the longitudinal axis as shown in Fig. 2, or they may be disposed angularly with respect to the longitudinal axis, as shown in Fig. 1, in order to facilitate their concentric axial alignment.
In practice of my method the operating surgeon, having severed the bowel and removed the section containing the neoplasm, places the cup member I upon the tie-bolt 5 and inserts it into the proximal bowel where it is secured by a purse brought together, with the square portion of tiebolt 5 entering and freely engaging the square clearance hole I5 and the threaded portion extending through and beyond the body tube I I.
With the cup members I and 2 manipulated into positions of approximate alignment, the assistant screws the hand nut down against the projecting end of the body tube I I, which he at the same time restrains from any tendency to turn, by means of shaped jaw forceps, and thereby clamps the inturned bowl walls between the opposing faces of the flanges 3 and l of the cup members I and 2.
The-tightening of the nut is continued until the clamped portions of thebowel walls are sufficiently thinned and compressed so that no blood is thereafter supplied to the clamped portions between the flanges.
The apparatus and the bowel in its then condition are as shown in Fig. 1, with the serous coats in goodcontact outside the clamped area, and union proceeds at once, occuring first by adherence of the serous coats in contact within approximately six hours and then extending across the muscular coats.
In due course, union will be entirely efiected and the tissues between the opposed clamping surfaces of the flanges 3 and 4, with all of that portion within the apparatus, will have become dead and have sloughed off and separated from the living tissues.
The apparatus may then, in its entirety. be lubricated and removed through the anus and, after its removal, the mucous membrane grows across the united junction and anastomosis of the colon to the lower rectum has been completed.
The operation is rapidly and safely performed without the use of sutures other than the temporary purse strings, which can be eliminated also by the use of any satisfactory internal, expanding clamp within the inner margins of the flanges,
The appearance of a section of the rectum after anastomosis, with thickened scar tissue, is shown in section in Fig. 3.
Having thus described my invention, I claim:
1. A clamp for recto-sigmoid anastomosis for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be inserted and removed through the anus, comprising in combination, an upper cup-shaped clamping member, a lower opposed cooperating cupshaped clamping member, each'of said clamping members being provided with inwardly extending opposed clamping flanges, a hollow body member, a tie rod extending through said hollow body member and said clamping members, one end of said tie rod extending beyond the hollow body member and manually operated means cooperating with said extending: end for drawing said clamps tightly together, substantially as and for the purposes set forth.
2. A clamp for recto-sigmoid anastomosi for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be member, the opposite end of said tie rod having 10 an external ball and socket connection with the upper clamping member, and manually operated means cooperating with said extending end for drawing said clamps tightly together, substantially as and for the purposes set forth.
THERON GROVER YEQMANS.
REFERENCES CITED The following references are of record in the file of this patent:
UNITED STATES PATENTS Name Date Bacon July 18, 1933 OTHER REFERENCES Ex parte Brinkerholf, vol. 24, Commissioners Manuscript Decisions, page 349.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US1918890 *||Aug 8, 1932||Jul 18, 1933||Bacon Joseph B||Surgical device|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US3048177 *||Jun 23, 1959||Aug 7, 1962||Timothy Takaro||Blood vessel coupling device|
|US3472231 *||Jun 20, 1966||Oct 14, 1969||Winner Forney D||Perfect circle hemorrhoidal excisor,stapler and excisor hemostatic dilator|
|US3771526 *||Feb 7, 1972||Nov 13, 1973||Rudie P||Anastomosis clamp|
|US4154241 *||Jul 29, 1977||May 15, 1979||Rudie Peter S||Anastomosis clamp|
|US4304236 *||Apr 10, 1980||Dec 8, 1981||United States Surgical Corporation||Stapling instrument having an anvil-carrying part of particular geometric shape|
|US4607637 *||Jul 22, 1983||Aug 26, 1986||Anders Berggren||Surgical instrument for performing anastomosis with the aid of ring-like fastening elements and the fastening elements for performing anastomosis|
|US4624257 *||Feb 21, 1984||Nov 25, 1986||Anders Berggren||Surgical instrument for performing anastomosis|
|US4917090 *||Jan 19, 1988||Apr 17, 1990||Unilink, Inc.||Method for performing an anastomosis|
|US5709335 *||Oct 31, 1995||Jan 20, 1998||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5732872 *||Feb 6, 1996||Mar 31, 1998||Heartport, Inc.||Surgical stapling instrument|
|US5817113 *||Jan 23, 1997||Oct 6, 1998||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US5881943 *||Nov 20, 1997||Mar 16, 1999||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US5947363 *||Mar 20, 1998||Sep 7, 1999||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5957363 *||Jun 19, 1997||Sep 28, 1999||Elf Atochem S.A.||Method of performing vascular anastomosis|
|US5976159 *||Feb 8, 1996||Nov 2, 1999||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6171321||May 18, 1999||Jan 9, 2001||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6176413||Jan 20, 2000||Jan 23, 2001||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6209773||Sep 7, 1999||Apr 3, 2001||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6280460||Feb 13, 1998||Aug 28, 2001||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6371965||Jan 8, 2001||Apr 16, 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6443965 *||Jan 8, 2001||Sep 3, 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6450390||Jan 8, 2001||Sep 17, 2002||Hearport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6451034||Sep 28, 2001||Sep 17, 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6461365||May 15, 2001||Oct 8, 2002||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6491704||Jul 26, 2001||Dec 10, 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6551334||Dec 14, 2000||Apr 22, 2003||Integrated Vascular Interventional Technologies, Lc||Externally directed anastomosis systems and externally positioned anastomosis fenestra cutting apparatus|
|US6569173 *||Dec 14, 1999||May 27, 2003||Integrated Vascular Interventional Technologies, L.C.||Compression plate anastomosis apparatus|
|US6588643||Feb 2, 2001||Jul 8, 2003||Hearport, Inc.||Surgical stapling instrument and method thereof|
|US6631837||Aug 28, 2001||Oct 14, 2003||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6659327||Jul 31, 2002||Dec 9, 2003||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6676678||Sep 20, 2001||Jan 13, 2004||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6709441||Apr 23, 2001||Mar 23, 2004||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6726694||Dec 14, 2000||Apr 27, 2004||Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc)||Intraluminally directed anvil apparatus and related methods and systems|
|US6743244||Oct 31, 2001||Jun 1, 2004||Integrated Vascular Interventional Technologies, L.C.||Soft anvil apparatus for cutting anastomosis fenestra|
|US6763993||May 20, 2003||Jul 20, 2004||Bolduc Lee R||Surgical stapling instrument and method thereof|
|US6899718||Apr 23, 2004||May 31, 2005||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US6962596||Mar 14, 2003||Nov 8, 2005||Bolduc Lee R||System for performing vascular anastomoses|
|US6966917||Nov 9, 2000||Nov 22, 2005||Innovation Interventional Technologies B.V.||Deformable connector for mechanically connecting hollow structures|
|US6984238||Apr 23, 2004||Jan 10, 2006||Gifford Iii Hanson S||Devices and methods for performing avascular anastomosis|
|US7018387||Apr 1, 2003||Mar 28, 2006||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7022127||Apr 1, 2003||Apr 4, 2006||Innovative Interventional Technologies Bv||Mechanical anastomosis system for hollow structures|
|US7112211||Jan 9, 2003||Sep 26, 2006||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US7122044||Apr 28, 2004||Oct 17, 2006||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US7160311||Dec 14, 2000||Jan 9, 2007||Integrated Vascular Interventional Technologies, L.C. (Ivit Lc)||Locking compression plate anastomosis apparatus|
|US7220268||Nov 12, 2003||May 22, 2007||Integrated Vascular Interventional Technologies, L.C. (Ivit Lc)||Methods for anastomosis of a graft vessel to a side of a receiving vessel|
|US7651510||Jan 12, 2001||Jan 26, 2010||Heartport, Inc.||System for performing vascular anastomoses|
|US7666198||Mar 22, 2004||Feb 23, 2010||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7763041||Jul 29, 2003||Jul 27, 2010||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US7901417||Oct 29, 2007||Mar 8, 2011||Vital Access Corporation||Systems for forming an anastomosis with an anvil and an apparatus having at least one guide|
|US7922734||Oct 29, 2007||Apr 12, 2011||Vital Access Corporation||Methods for forming an anastomosis with a vessel having everted tissue|
|US7935129||Mar 1, 2004||May 3, 2011||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US7981126||Dec 14, 2000||Jul 19, 2011||Vital Access Corporation||Locking compression plate anastomosis apparatus|
|US8034064||Mar 15, 2006||Oct 11, 2011||Vital Access Corporation||Methods for forming an anastomosis opening in a side of a blood vessel|
|US8066723||Nov 9, 2001||Nov 29, 2011||De Vries & Metman||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well as auxiliary devices|
|US8109949||Oct 29, 2007||Feb 7, 2012||Vital Access Corporation||Systems for forming an anastomosis|
|US8182498||Jun 4, 2002||May 22, 2012||Innovative International Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US8313013||Apr 6, 2006||Nov 20, 2012||Synovis Life Technologies, Inc.||Method and assembly for anastomosis|
|US8512361||Apr 23, 2007||Aug 20, 2013||Carponovum Ab||Device and a method for anastomosis|
|US8617190||Mar 28, 2011||Dec 31, 2013||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US8781604||Apr 1, 2009||Jul 15, 2014||Cardiac Pacemakers, Inc.||Method of implanting stimulation lead with biased curved section through the interatrial septum|
|US20010001826 *||Jan 12, 2001||May 24, 2001||Heartport, Inc.||System for performing vascular anastomoses|
|US20010023354 *||Dec 14, 2000||Sep 20, 2001||Blatter Duane D.||Locking compression plate apparatus|
|US20040073240 *||Jul 29, 2003||Apr 15, 2004||Bolduc Lee R.||Surgical clips and methods for tissue approximation|
|US20040092972 *||Nov 9, 2001||May 13, 2004||Leonardus Suyker Wilhelmus Joseph||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well a auxiliary devices|
|US20040097994 *||Nov 12, 2003||May 20, 2004||Blatter Duane D.||Staple and anvil anastomosis system|
|US20040167551 *||Mar 1, 2004||Aug 26, 2004||Gifford Hanson S.||Devices and methods for performing a vascular anastomosis|
|US20040186490 *||Mar 31, 2004||Sep 23, 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040199188 *||Apr 23, 2004||Oct 7, 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040200876 *||Apr 28, 2004||Oct 14, 2004||Bolduc Lee R.||Surgical stapling instrument and method thereof|
|US20040215221 *||Mar 22, 2004||Oct 28, 2004||Suyker Wilhelmus Joseph Leonar||Mechanical anastomosis system for hollow structures|
|US20040225306 *||Feb 17, 2004||Nov 11, 2004||Blatter Duane D.||Paired expandable anastomosis devices|
|US20050096675 *||Nov 29, 2004||May 5, 2005||Gifford Hanson S.Iii||Devices and methods for performing avascular anastomosis|
|US20050096676 *||Nov 29, 2004||May 5, 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050149077 *||Feb 16, 2005||Jul 7, 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050251164 *||Feb 4, 2005||Nov 10, 2005||Gifford Hanson S Iii||Devices and methods for performing avascular anastomosis|
|US20050288693 *||Aug 12, 2005||Dec 29, 2005||Suyker Wilhemus J L||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels|
|DE1057729B *||Mar 24, 1955||May 21, 1959||Lameris Instr N V||Chirurgische Vorrichtung zum Verbinden zweier Darmteile|
|WO2001043644A1 *||Dec 14, 2000||Jun 21, 2001||Duane D Blatter||Compression plate anastomosis apparatus and related systems|
|WO2001043645A1 *||Dec 14, 2000||Jun 21, 2001||Duane D Blatter||Systems for intraluminally directed vascular anastomosis|
|U.S. Classification||606/153, 227/19|
|International Classification||A61B17/03, A61B17/11|