US 2686521 A
Description (OCR text may contain errors)
Aug. 17, 1954 D. SHELDON ET AL 2,686,521
SURGICAL CLAMP Filed Sept. 25, 1955 N VE N TOR S 044. EA-SMUSSEN 29 05/7 SHELDON BY fiazzz. M
THE/l2 ATTO/ENE Y Patented Aug. 17, 1954 UNITED STATES RKTENT OFFICE SURGICAL CLAMP Dean Sheldon, Sandusky, and Olaf Rasmussen, Port Clinton, Ohio Application'september 25, 1953, Serial No. 382,284
8 Claims. 1
This invention relates to an improved surgical clamp.
It is among the objects of the present invention to provide a sturdy and easily manipulated clamp especially adapted for safe, convenient and substantially bloodless infant circumcision.
Circumcision of infants has become practically a universal practice by the medical profession and therefor a dependable device, easily manipulated and tending to simplify the operation while maintaining the highest degree of safety, will'be a most acceptable instrument to physicians. Such an instrument should have the followin desirable features:
1. It must be of simple design, sturdy and easily manipulated.
2. It should be so designed and constructed that the foreskin to be excised be clearly visible to the operator permittinghirn properly to gauge the amount or length to be removed.
3. The clamping portion of the instrument should be so designed and constructed that with ordinary precaution it will be practically impossible to contain and thereby injure the corona of the organ being operated upon.
4. The clamping jaws of the instrument are so fashioned that they will clamp the foreskin interposed therebetween, along a comparatively narrow line and at a predetermined, critical pressure at which the blood vessels are squeezed to form a substantially permanent adhesion of the walls of said blood vessels at the line of pressure application, thereby providing a substantially complete and satisfactory hemostasis at the line of excision.
5. The clamp should be completely operative single handed and its actuating mechanism of such a character that regardless of whether it is actuated by an operator having a comparatively weak grip, or one having a strong, vise-like grip, the clamp will be closed to exert and maintain a predetermined, critical pressure upon the foreskin contained therebetween, said critical pres sure being of a degree suiiicient to collapse and cause a substantially permanent adhesion of the Walls of the blood vessels in said foreskin along the line of pressure application without the danger of severance or shearing of the said foreskin.
'The present invention presents a surgical clamp having all of the desirable features enumerated above.
Further objects and advantages of the present invention will be apparent from the following description, reference being had to the accompanying drawings wherein a preferred embodiment of the present invention is clearly shown.
In the drawings:
Fig. 1 is a perspective, substantially full sized View of the clamp.
Fig. 2 is a side view-of the clamp in full open position.
Fig. 3 is a fragmentary view of theclamp shown in Fig.2, in another position, however.
t Fig. 4 shows the clamp in full clamping posi- Fig. 5 is a fragmentary sectional View, at enlarged scale, of the lip of theclamping jaw.
Referring to the drawings, the two levers 2 0 and 2! of the clamp, made of any suitable noncorrosive material such as stainless steel, each consists of a main fiat body portion 22 and 2-3 respectively, provided with bent-over edge portions at their longitudinal sides and at one end thereof. The bent-over longitudinal sides on lever form stiffening flanges 2 4 which merge with the transverse end flange or clamping lip at one end of lever 20. The similar bent-over sides of lever 21 form longitudinal stiffening flanges 26, said flanges merging with the end flange or clamping lip 2:! on said lever '21. As shown in Fig. 4,'fianges2 4 and "2 6 terminate short of the ends of the respective levers '20 and 2-! opposite the lip ends25 and 21. At these'opposite ends of levers 20 and 21, angular-ears 30 and 3! are provided at the sides of the respective levers, these-ears extending angularly in'a direction opposite side flanges '24 and 26. Each pair of ears is apertured toprovide aligned openings for receiving mounting pins 32 and 33 respectively. More adjacent the lip ends 25 and '21 of the respective levers 20 and 2 I, the side flanges 24 and 26 have extensions forming a pair of spaced, apertured ears 34 and 35, said ears supporting a pivot pin 31 transversely of the levers and hingedly attaching one to the other.
A toggle joint is attached to the ends of the levers opposite their lip ends .25 and 21. This toggle joint 'actuat'es .levers 2t and 2! about the pivot pin 31 .and consists of :two pairs of levers 4i) and Hi hinged togetherby :thepin 42. The other ends of levers til are hinged .to pin .32 carried :by the ears of lever 20,thereby :hingedly'securing this end of the toggle jointxto said lever 29. "The corresponding other ends-'of1levers 41 0f the "toggle joint are hinged .to pin :33 carried by the ears 3! of lever 2|, thereby hingedly securing the .toggle joint to lever 21. A trigger 45 is attachedto the toggle joint, said trigger being the means for actuating Jthe toggle joint to cause engagement and disengagement of the lip ends of the levers 20 and 2 I. In order to control movement of the toggle joint so that the clamping pressure of lips 25 and 2'! of said levers is releasably maintained at a fixed critical pressure, trigger 45 is shaped to engage lever 28 and thereby limit the movement of the toggle joint in one direction so that its over-center movement or its travel beyond the point at which pins 32, 42 and 33 are aligned or in dead-center positions, is predeterminately limited, thus positively fixing the clamping pressure at which said lips 25 and 2'! are maintained and locked against accidental release of pressure.
When the toggle joint is operated into the position as shown in Fig. 3, lips 25 and 2! will engage at substantially no pressure. Continued actuation of the toggle joint into the position in which the pins 32, 42 and 33 are at dead-center causes the said clamping lips 25 and 21 to be pressed together at maximum pressure, established by the length of the toggle joint levers 40 and ll. Levers 29 and 2! are predeterminately flexible, especially the uniianged areas 59 of said levers, said areas having a predetermined flexing characteristic and thus predeterminately relieve the maximum pressure of clamping lip engagement established by the toggle joint. The slight over-center travel of the toggle joint provided to assure locking of the clamp against accidental release does not cause any appreciable drop or reduction in the desired or necessary clamping pressure on the membrane clamped between lips 25 and 27.
A rigid pin 52 on lever 2| provides an abutment for a finger of the operator while preferably the thumb on the same hand actuates the trigger 15. Grasping and actuating the clamp with one hand releases the other hand for other necessary manipulations.
Clamping lips 25 and 21 are formed by inwardly extending bent-over ends on the respective levers 2i) and 2|. These bent-over ends incline toward the pivot pin 3'! so that when they are engaged, the outer surface of said ends present a concaved face tending to ward off any other portion or particularly the rounded end of the corona of the organ to be operated upon while the foreskin, inserted between said lips, is being properly gauged for clamping and excision. The linearly engageable edges of the oppositely disposed lips 25 and 21 are beveled as at 53 to complete the concaved contour of the said lips and also to form comparatively narrow edges linearly engageable for confining the clamping effort to a substantially narrow area. These narrow edges are sufiiciently blunt to avoid severance or shearing of the interposed foreskin at the established clamping pressure.
The inside edges of the engaged clamping lips 25 and 2! provide straight guiding edges along which the excision knife is moved for the circumcision operation. To render these guiding edges visible and accessible, each lever 2|] and 2! has an opening 55 in its body portion, adjacent the clamping end thereof. The excision instrument may easily be manipulated through these openings 55 and they also provide a full and clear view of the foreskin extending beyond said guiding edges thereby making gauging of the amount of foreskin to be excised a safe and simple operation.
To introduce the foreskin into the clamp so that it may properly beheld by said clamp for circumcision purposes, said foreskin is gripped by a forcep at its distal portion and substantially at right angles to the longitudinal axis of the organ to be operated upon. Inserting the foreskin gripping forcep through the opening provided by cut-away portions 5'! in the side flanges of the respective levers 2E and 2|, causes the foreskin to slide between the narrow edges of the clamping lips 25 and 27. When the operator has located the proper amount of foreskin inside the inner edges of the clamping lips 25 and 21, he actuates the trigger 45 into engagement with lever 29 as shown in Fig. 4, causing the foreskin to be clamped by said narrow edged lips 25 and 21, the protruding foreskin to be excised being in clear sight and readily accessible for excision purposes.
From the foregoing it may clearly be seen that the present invention provides a circumcision instrument in which all of the desirable features heretofore enumerated, are embodied.
What is claimed is as follows:
1. A surgical clamp comprising in combination, two levers pivotally secured together intermediate their ends, each lever having an angular end provided with a narrow clamping edge transversely of the lever, said edges being oppositely disposed and linearly engageable in response to separating movement of the opposite ends of said levers; a toggle joint secured between the said opposite ends of said levers, operative to actuate the levers for causing and maintaining clamping engagement of the said narrow edged ends of the levers at a predetermined critical pressure; and means attached to the toggle joint for operating it, said means being engageable with one of said levers for limiting the movement of said toggle joint in one direction.
2. A surfgical clamp comprising in combination, a pair of levers pivotally secured together, tko adjacent ends of said pair of levers being provided with narrow edges adapted linearly to be engaged one by the other in response to movement of the opposite ends of the levers; a toggle joint secured between said opposite ends of the levers, said toggle joint being operative to actuate the levers so that said narrow edges clampingly engage at a predetermined, critical pressure; and means attached to the toggle joint for operating it, said means being engageable with one of said levers for limiting the movement of the toggle joint and releasably locking said levers in their clamping positions.
3. A surgical clamp consisting of two levers pivotally secured together intermediate their ends, two adjacent ends of the respective levers being provided with transverse, linearly engageable, narrow edges; a toggle joint hingedly secured between the other two adjacent ends of said levers; and a trigger attached to toggle joint for actuating it, said trigger being engageable with one of said levers for limiting the movement of said toggle joint and releasably maintaining said narrow edges of the respective levers in clamping engagement at a predetermined, critical pressure.
4. A surgical clamp consisting of two levers each having bent-over edges providing angular flanges along the longer sides of said levers, each iiange having a perforated ear portion for receiving a pin transversely of the levers for hingedly securing said levers together; an inwardly extending flange at two adjacent ends of said levers, each flange having a narrow edge, said narrow edges being adapted to engage linearly in response to movement of the other two adjacent ends of said levers; a lever actuating toggle joint secured between said other two adjacent ends of said levers; and an operating trigger attached to said toggle joint, said trigger being engageable with one of said levers for releasably locking said levers in pressure exerting position.
5. A surgical clamp in accordance with claim 4, in which the inwardly extending, narrow edged angular flanges at two adjacent end of the respective levers both slope toward the said pin and their engageable edges are beveled to form a substantially concaved frontal surface when said flanges are engaged.
6. A surgical clamp in accordance with claim 4, in which the flanged side portions of both levers, between the pivot pin and the narrow edged end flanges of said levers are cut away to form en tranoes for the lateral introduction into the clamp of a forcep gripping a tissue to be held by the clamp.
7. A surgical clamp consisting of two levers each having their longitudinal sides bent over to provide stiiiening flanges; a pin extending through openings in said flanges and hingedly securing the levers together; a transverse flange at the two adjacent ends of said levers, said transverse flanges each having a narrow edge, one linearly engageable with the other; an opening in each lever near the transverse flange thereof, said openings rendering the inner side of the linearly engaging transverse flanges accessible; cut-away portions in the side flanges of the levers adjacent the end flanges thereof, said cut-away portions providing openings for the lateral introduotion of a membrane clasping foroep into the clamp for locating said membrane between the narrow edged flanges for clamping purposes; a toggle joint attached to the two levers for actuating them to move said narrow edged flanges into clamping engagement with the interposed membrane at a predetermined, critical pressure;-
and a toggle actuating member engageable with one of said levers for limiting the over-center movement of said toggle joint whereby the levers are releasably locked in clamping position without an appreciable decrease in their clamping pressure.
8. A surgical clamp consisting of two levers pi'votally secured together intermediate their ends, both levers being flexible in response to power application after two adjacent ends of said levers engage; narrow, linearly engageable flanges on the said adjacent ends of the levers; a toggle joint attached between the other two adjacent ends of said levers, said toggle joint, when actuated to dead-center position, causing the narrow edged flanges to be urged together at a predetermined pressure determined by the flexing of said levers, the toggle joint being operative a sufficient distance beyond dead-center to lock the levers against accidental movement to release the clamping pressure; a trigger attached to the toggle joint for operating it, said trigger being engageable with one of said levers positively to limit the overcenter movement of the toggle joint to required locking position.
References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 557,453 Thompson Mar. 31, 1896 FOREIGN PATENTS Number Country Date 47,625 Austria Apr. 25, 1911