US 2692599 A
Description (OCR text may contain errors)
Oct. 26, 1954 R. c. CREELMAN IDENTIF YING HOLDER FOR SURGICAL LIGATURES Filed Nov. 2, 1953 Summum v il EN V EN TOR. RA W40/VD C'. cesa/11AM Patented Oct. 26, 1954 UNITED STATES OFFICE IDENTIFYING HOLDER FOR SURGICAL LIGATURESl 1D Claims.
This invention relates to a novel device useful in surgical operations for holding and identifying ligatures. The invention is herein illustratively described by reference to its presently preferred form, as devised for certain specific types of surgical operations, although it will be appreciated by those skilled in the art that various modifications and changes therein may be made without departing from the essentials of the invention.
Various surgical operations require numerous ligations, including the vaginal hysterectomy, operations for the repair of tendons and others. Certain important ligaments cut in these operations must be ligated during the course of the operation so as to render them easily accessible and identifiable for the completion stages. The practice has been to leave these ligatures relatively long. Each ligature was separately identined by fastening to it a particular type of surgical clamp. The diiferent clamps were allowed to hang suspended of their own weight over the perineum and thus maintain the various ligatures slightly taut and outwardly accessible. While this technique was basically feasible, the inconvenience and delays encountered in untangling and segregating each ligature from the others when the ligatures and clamps fastened to them were frequently jumbled together was a distinct disadvantage.
An object of the present invention is to facilitate the holding and identifying of ligatures applied in surgical operations and thereby reduce operating time.
Another object is to provide an identifying ligature holder for the described purposes affording a more positive and more reliable means of identifying particular ligatures and the ligaments or other body members to which they are connected, thereby reducing the possibility of errors in the reconstruction phases of an operation.
A related object is a ligature holder by which any desired number of ligatures may be held in an orderly arrangement minimizing the obstruction or hindrance to the activities of the surgeon, In other words, the improved ligature holder so arranges the ligatures that they do not appreciably block access to the operating area.
With these and other objects in mind, the z novel ligature identifying holder comprises in its preferred form an elongated base strip of rigid or semi-rigid material conformed or conformable to the body contour along the side of the incision or other operating area. For purposes n of the vaginal hysterectomy and similar operations two such holder devices are conveniently used, one extending transversely over and around the inner side of each leg closely adjacent to the perineum, such devices being secured in place such as by towel clips clamping to the skin through holes in each end of the base strip. The coils of a helical spring or equivalent holder means with plural gripping elements mounted on the base strip in series arrangement serve as clamps for individual ligatures. Appropriate indicia marked on the base strip adjacent the spring at different locations along its length afford a means of identifying the various ligatures pressed into the coils of the spring at such locations.
Adjustable means are also provided for placing the spring initially under a certain amount of tension so as to create the desired clamping pressure on the ligatures pressed into the spaces between spring coils. By virtue of this tension adjusting arrangement the curvature of the base strip hence of the spring is permitted to be varied in conformity with the contour of different body contact areas to which the device is applied, yet a suitable value of spring tension providing the desired gripping pressure on ligatures may be established in all such instances by a compensating adjustment of the tension control arrangement.
These and other features, objects and advantages of the invention including certain details of the presently preferred form thereof will become more fully evident from the following description by reference to the accompanying drawings.
Figure 1 is a plan view of the ligature identifying holder.
Figure 2 is a side view of the same.
Figure 3 is a simplified view illustrating application of the invention in the performance of a surgical operation.
As shown in Figures 1 and 2, the base strip l0 of the illustrated ligature identifying holder is formed of an elongated strip of sheet metal which is sufficiently thin to be bent longitudinally to different curvatures and yet has a suflicient stiifness or rigidity to prevent its buckling under the tension force of the ligature holder spring to be described. In a typical case this base strip may be approximately one and one-half inches wide and about ten inches long. Apertures i2 are provided in opposite ends of the strip lli for securing the same in place around the inside portion of the patients leg, as will be explained more fully in connection with Figure 3. A lug I6 is struck up from the body of the strip intermediate the ends thereof as an anchor for one end of the elongated helical spring I8. The opposite end of the spring is secured to one end of a screw 20. This screw passes slidably through aligned apertures in two additional lugs 22 and 24, struck up from the body of the strip near one end thereof. These latter two lugs are spaced apart lengthwise of the strip and are aligned with the lug I6 so that a nut 26 threaded on the screw 20 .may be received between the lugs 22 and 24. This nut provides a means for adjusting the tension in the spring I6.
A series of ligature identifying indicia 28 such as letters of the alphabet or numerals (illustrated) is inscribed or printed on the base strip I along the length of the holder spring I8. In the example the numbers l through 9 are marked on the base strip at spaced locations along the length of the spring to identify a possible nine different ligatures held between spring coils at the respective locations of such identifying numbers. The maximum number of identifying indicia required for different operations may, of course, vary. The spacings between successive indicia may also be varied as desired, although for most purposes a uniform spacing will be satisfactory. The spacing between any two successive indicia should not be too small, however, since it might then become awkward or difficult to press the corresponding ligatures into the spring coils for gripping purposes or to remove them later without disturbing adjacent ligatures.
It will be evident that a helical spring mounted in the illustrated manner serves as a very satisfactory and inexpensive means for releasably holding a series of threads or strings (the ligatures) extending transversely to the length of the spring, since it is a very simple matter to press these ligatures down into the spaces between adjacent spring coils at desired locations along the length of the spring. natural resilient gripping force which may be established at a desired value by adjustment of the take-up nut 26 and screw 25. The spring coils are preferably slightly separated from each other by placing the spring under tension so that the ligatures are easily inserted into the coil spaces, and yet the tension should not be excessive or it will be awkward to remove individual ligatures without disturbing others during the reconstruction phases of the surgical operation. It will, of course, be evident that the curvature of the base strip Il) assumed in order to conform to the portion of the patients body against which it is placed, will inuence the adjustment required of the spring. This is true since the spring itself assumes the curvature of the base strip when installed. The spring is on the convex side of the curved base strip, and the sharper the curvature, the greater the tendency for the coils to be separated on the outer side of the spring where they receive the ligatures. Such variations may readily by compensated, however, by take-up or opposite adjustments of the nut 26 and tensioning screw 2U, and in this manner achieve the desired gripping pressure of the spring coils on the ligatures inserted therebetween.
Figure 3 illustrates in simplified fashion application of one of the ligature-identifying holder devices in conjuncton with a surgical operation such as the vaginal hysterectomy. It will be noted in this gure that the base strip I0 has been placed against the inner. side of. the patients leg The spring provides a adjacent the perineum, and that the ends of the base strip are suitably anchored so that it will not slip out of place during the course of the operation. The lower end may be anchored to the patients skin as by a towel clip T, to the operating table or to the folds of a sheet, for instance, whereas the opposite end may also be anchored to the skin or to drapes placed over the patients body in a manner which will be readily apparent to those familiar with operating procedures and facilities. Thus positioned, the novel device serves as a highly convenient means for holding the individual ligatures Ll, L2, L3, etc. in an orderly arrangement off to the side of the opertaing area O from which the ligatures extend. Moreover, the individual ligatures placed in the coils of the spring by pressing them inwardly while extending laterally to the spring, until they are gripped between adjacent coils and thus held, are identified by the indicia on the holder so that when the reconstruction phases of the operation are reached, the surgeon may know definitely without any confusion the ligaments or other body members to which they are fastened. In this manner the former jumble of various identifying clamps and ligatures to which they were fastened is avoided and the possibility of errors in incorrectly associating a particular type of clamp with a particular ligament is reduced.
It will be appreciated, of course, that a similar ligatures identifying holder may be mounted on the other leg of the patient to receive still other ligatures extending from the opposite side of the operating area, so that the ligatures will be held completely out of the surgeons way in performing the operation most expeditiously.
It will also be appreciated that if properly held in place along the operating area a flexible base strip that is, one of fabric, leather, or other similar material, may be used in lieu of the relatively stiif metal base strip constituting the preferred and illustrated form. This substitution is possible under proper mounting conditions since all that is necessary for basic purposes is to secure the ends of the spring in the desired positions with the spring placed under the requisite tension and to provide ligature-identifying indicia at intervals along the length of the spring in accordance with the preferred mode of practicing the invention. Likewise, it will be apparent that other specific means of holding individual ligatures in place releasably at spaced locations along the base strip may be substituted for the helical spring, but again the illustrated form is the preferred arrangement.
In general, therefore, it will be seen that invention is not necessarily limited to the illustrated details since preferences or the requirements of different applications of the invention may vary and may be satisfied by different specific types of construction wtihin the principles of the invention.
I claim as my invention:
l. A ligature holder for surgical operations comprising an elongated relatively stiff base strip, anelongated helical spring, anchor elements carried by said base strip at locations on one side thereof spaced apart along the length of said base strip, opposite ends of said spring being connected to the respective anchor elements, and adjustable means associated with said spring for varying the tension thereof and thereby varying the gripping pressure of adjacent coils of said spring on surgicalzligatures inserted between said coils.
2. The ligature holder defined in claim 1, wherein the adjustable means comprises a screw connected to one end of the spring and passing slidably through an aperture in one of the anchor elements, and a nut inserted on said screw and adapted to bear against the side of said anchor element opposite the spring.
3. A ligature holder for surgical operations comprising an elongated base strip of relatively stilf material having suiicient exure to permit curving the base strip to conform to an area of a patients body adjacent a surgical operating area, an elongated helical spring, and anchor elements carried by said base strip at locations on one side thereof spaced apart along the length of said base strip, opposite ends of said spring being connected to the respective anchor elements.
4.. The ligature holder dened in claim 3, and adjustable means associated with a spring and the anchor elements placing the spring initially under predetermined tension suitable to provide desired pressure of adjacent coils of said spring on individual ligatures inserted therebetween.
5, A ligature holder for surgical operations comprising an elongated base strip conformable to the contour of a patients body at a location adjacent a surgical operating area thereon, means carried by said base strip on one side thereof providing a series of ligature-gripping elements l0- cated in successive spaced positions along a portion of the length of said base strip, and ligature identifying indicia marked on said base strip alongside said series of gripping elements to identify individual ligatures gripped by the respective gripping elements.
6. The ligature holder dened in claim 5, Wherein the gripping means comprises an elongated l6 helical spring successive adjacent coils of which constitute the ligature gripping elements.
7. The ligature holder dened in claim 6, and adjustable means associated with the spring for varying the tension thereof in variously curved shapes of the base strip for providing a desired gripping pressure of the coils of said spring on ligatures wedged therebetween.
8. A ligature holder for surgical operations comprising an elongated base strip of relatively stii sheet metal adapted for bending to the curvature of a patients body at alocation thereon adjacent a surgical operating area, an elongated helical spring, anchor elements carried by said base strip at locations spaced apart along the length thereof, opposite ends of said spring being connected to the respective anchor elements, and adjustable means connected to one end of said spring and engaging one of said anchor elements for varying the tension in said spring to establish a desired gripping pressure of adjacent spring coils on surgical ligatures inserted between such coils.
9. The ligature holder dened in claim 8, wherein the anchor elements comprise lugs struck up from the body of said base strip and adapted for connection to respectively opposite ends of the spring.
l0. A ligature holder for surgical operations comprising an elongated base strip conformable to the contour of a patients body at a location adjacent a surgical operating area thereon, and means carried by said base strip on one side thereof providing a series of ligature-gripping elements located in successive spaced positions along a portion of the length of said base strip.
No references cited.