US 2834349 A
Description (OCR text may contain errors)
May 13, 1958 'H. SPRINGER FASCIA CUTTER AND CARRIER Filed Feb. 25, 1957 INVENTOR. HENRY A. SPRINGER ATTORNEY United States Patent FASCIA CUTTER AND CARRIER Henry A. Springer, Cincinnati, Ohio Application February 25, 1957, Serial No. 642,095
' 3 Claims. 01. 128-305) The invention relates to means usable by a surgeon, physician, or other person, to puncture a patients abdominal fascia, and thread and sew a fascia strip through various subcutaneous tissues, ligaments, and membranes of the human, or other live, body. The term fascia means a filet,or connective tissue which binds and supports internal organs of a human being, or other living thing.
A particular advantage of sewing together wounds or incisions with fascia is that when properly sewed and positioned among other living tissues of a human body the sewed fascia continues to live, grow and adhere to the adjacent tissues thereby making strong and dependable connections in order to maintain human tissues in close and strong contact with one another.
Heretofore, in the past, when fascia was threaded through an ordinary needle, and turned back on itself in the same manner as ordinary thread threaded in a needle, the surgeon found that when the needle was punched through fascial tissues considerable difiiculty developed because when the fascia was turned over the eye end of the needle the fascia made a bulky mass. Therefore, in order to pull the eye end of the needle, with the double fascia layers of tissue, through the tissue to be sutured considerable force was usually required which often caused the tissue to tear. Moreover, due to this excess force, the fascia often pulled out the eye of the needle. Also, only a limited thickness of fascia could be used, since it must pass through the eye of the usual and conventional needle.
An important object of the invention is to provide economical, practical and dependable means to enable a surgeon, physician or other person to quickly and efficiently puncture, thread or sew a strip of fascia through membranes, subcutaneous tissues, ligaments, and the like in the abdomen, particularly, of a human body, and without use of an ordinary and conventional needle having an eye.
Another object of the invention is to provide means to repair large inguinal (near the groin) hernias, femoral hernias, umbilical hernias, post-operative hernias, and in some instances tendons.
Further and other objects and details of the invention will be apparent from a consideration of the accompanying specification, claims, and drawings.
The invention consists in the combination of the elements, arrangement of parts and in the details of the construction, as hereinafter claimed.
In the drawings:
Fig. 1 is a perspective view of the invention shown in open position; i
Fig. 2 is the same, with parts broken away, in closed position;
Fig. 3 is a front elevational view of a portion of a human beings abdomen, with outer tissues laid back, showing a hernia with the cutter therein to cut a slit or hole in the fascia;
Fig. 4 is the same except that a fascia strip, shown Patented May 13, 1958 Fig. 5 is the same except that the hernia is sewed with itswalls together.
In the preferred "construction of the invention, I provide the surgical instrument or fascia perforator and carrier comprising the legs or strips 2 and 3, formed from steel or other suitable material. The rear or outer ends 4 and 5 of the legs or strips 2 and 3 are formed somewhat similar to the handles of ordinary scissors and have the handles or loops 6 and 7 therein for receiving an operators thumb and fingers for imparting movement to the looped ends. Near the other front or inner ends 8 and 9, of the strips 2 and 3, are the holes 10 and 11, which have received therein a pivot or rivet 12 that allows the strips to be manually pivoted with respect to each other somewhat as the handles of ordinary scissors are manipulated for cutting purposes, when a humans thumb and fingers of his hands (not shown) are received in the loops 6 and 7.
The outermost portions or jaws 13 and 14, of the inner ends 8 and 9, respectively, of the strips are bent at right angles to the bodies of the strips. The inner surfaces 15 and 16 of the jaws 13 and 14, of the ends 8 and 9, are serrated and have the usual valleys and ridges.
When the loops 6 and 7'near1y contact each other the ends 8 and '9, and the jaws 13 and 14 closely contact each other and the valleys and ridges of each serrated jaw securely meshes with the valleys and ridges of the other jaw.
The manual operation of the instrument 1 is almost the same as manipulations of ordinary cutting scissors or a hemostat in that manual movement of the loops 6 and 7 to and from each other causes pivotal movement of the legs 2 and 3 on the pivot whereby the curved ends or jaws 13 and 14 move away from and toward each other.
The extreme ends, or edges 17 and 18 of the jaws 13 and 14 of the legs 2 and 3, each are fashioned and formed somewhat as a chisel in that the rear sides 19 and 20, of the serrated ends 8 and 9, are flat and the front sides 21 and 22 are curved or inclined upwardly and rearwardly whereby 'the elongated edges 17 and '13, are sharp and have a keen cutting edge, for purposes hereinafter fully explained.
When the handles 6 and 7 are in closed position, the jaws of the instrument also are in closed position, as shown in Figs. 2 and 3 and the flat sides 19 and 20 are in alignment with each other, and the two edges 17 and 18 form a single tapered keen cutting edge 23.
The handles 6 and 7 are provided with a usual and conventional serrated lock 24 comprising the lipped lug 6 on the handle 6 and the notched lug 7 on the handle 7, whose purpose is to retain the curved jaws in firm contact with each other, for purposes hereinafter fully explained.
The operation of the invention is, as follows: First, a strip 25 of fascia is cut, with suitable cutting means, from a suitable part of the patients body, as from the fascia in the cover muscles of the lateral thigh. The length of the strip 25 depends upon the size of the hernia 26, in the fascia 27 of the abdomen 28 of the patient 29. The width of the strip 25 is not important except that it may be approximately one-half inch wide to be strong and durable. Ordinarily a strip of fascia this width cannot be threaded in the eye of a needle, but it can be conveniently and effectively used in the carrier 1. Then the handles of the carrier 1 are closed to the position shown in Figs. 2 and 3 whereby the jaws 13 and 14 are locked in close contact with each other by the lock 24 to form the keen cutting edge 23. Then the cutting edge 23 is manually used by the surgeon to puncture a hole 30 through a selected and suitable part of the patients fascia 27. Then the serrated lock 24 is manually unlocked as by operation of the handles 6 and 7 to release the lug 6 from contact with the lug 7, and the jaws 13 and 14 are separated and the end 31 of the strip 25 is placed or grasped by and between the gripping jaws when the handles are manually closed, and the lock 24 is again locked, thereby forcing the gripping jaws 13 and 14 in close and squeezing contact with the end 31 of the strip whereby the serrations retain the end 31 of the strip against release or escape from between the jaws. Then the cutting end or edge 23 is forced through the hole 30 in the fascia bringing with the end 31 of the fascia strip leaving its end 32 protruding from the hole 30. Afterward the lock 24 is unlocked and the handles 6 and 7 are manually operated to cause the jaws 13 and 14 to open, and release the end 31 of the strip 25, after which the jaws are manually closed and another hole 33 is made, by use of the cutting edge 23, in the fascia 27. Then by manual manipulation of the handles 6 and 7 the jaws are opened and the end 31 is again grasped by the jaws after which the end 31 is pulled through the hole 33. A similar procedure is followed in puncturing the holes 34, 35, 36, 37, 38, 39 and 40 through the fascia 27 and to bring therethrough the end 31 of the fascia strip 25 in desirable formation, as shown in Fig. 5, whereby the patients fascia 27 surrounding the hernia 26 is sufliciently secured by the fascia strip 25. Then the strip 25 is manually pulled tight to close the hernia to the position shown in Fig. 5. Then the protruding ends 32 and 41 of the fascia strip 25 are sewed in close contact with the adjacent fascia 27 to hold the fascia strip in fixed or immovable position with respect to the patients abdominal fascia 27. Afterward the skin and other subcutaneous tissues are brought together and sewed together over the repaired hernia.
A particular advantage of using the instrument 1 for sewing the fascia strip 25 in and out of holes punctured in the patients fascia by the elongated keen chisel shape end 23, of the jaws 13 and 14, is that the fascia strip 25 is relatively strong and after it has been sewed into the patients fascia 27 and covered by subcutaneous tissues the fascia strip 25 will continue to remain alive and it will grow and permanently adhere to and becomes an integral part of the patients abdominal fascia 27, whereby the repaired hernia, the subcutaneous tissues, and other tissues thereover and therearound are as strong and effective in holding the patients bowels and intestines in proper positions as was the original 4V abdominal wall. It is recognized that originally the bowels and intestines of the patient were held in proper position by the abdominal fascia which surrounds the abdominal muscles used generally to retract and expand the abdomen.
I believe that the form of the invention illustrated in the drawings, and referredto in the above description, is the preferred embodiment, and efficient and practicable. However, realizing that the conditions concurrent with the adoption and utilization of my invention will necessarily vary, I desire to emphasize that changes in the details and materials may be resorted to, when required, without sacrificing any of the advantages of the invention, as defined in the claims.
What I claim as new and desire to secure by Letters Patent is:
1. A fascia cutter and carrier comprising a pair of legs pivotally connected with each other and having manually operative handles on their outer ends, and having gripping jaws on their other inner ends, said jaws being bent at right angles to the legs and having their ends keenly sharp and in the form of chisels, said last mentioned ends adapted to closely contact each other when said handles are manually manipulated to form a keenly sharp cutting edge for cutting a hole in fascia, and said last mentioned ends adapted to grasp and hold tight an end of a fascia strip when said handles are manually manipulated to enable an operator to manually project said end of said fascia through said hole.
2. A surgical instrument comprising a pair of pivoted elongated metal legs each having a manually operative handle on an end, a pair of jaws on the other ends of said legs, and being bent at an angle to the main body of each of said legs, the inner surface of each of said jaws being serrated, and the outer ends of each of said jaws having a sharp outer elongated edge capable of keen cutting.
3. A surgical instrument comprising a pair of pivoted legs each having a .manually operative handle on an end, a pair of jaws on the other ends of said legs and being bent at an angle to the main body of each of said legs, the outer ends of each of said jaws having a sharp outer elongated edge capable of keen cutting.
References Cited in the file of this patent UNITED STATES PATENTS 680,119 Brewer, Jr Aug. 6, 1901 FOREIGN PATENTS 380,736 France Dec. 16, 1907