US 2938624 A
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May 31, 1960 LA VERN E. RUNKEL ETAL 2,933,524
DISPENSER FOR SURGICAL LIGATURES Filed June 18, 1957 F IG. 4
F I G. 7
a T S Y mmms N TUEK PM MRB A EC a m C f Y. ND E mms m wu O uw w w A DISPENSER FOR SURGICAL LIGATURES LaVern E. Runkel and Richard C. Berry, Madison, Wis., and Willis C. Oaks, Rochester, N.Y., assignors to Air Reduction Company, Incorporated, New York, N.Y., a corporation of New York 7 Filed June 18, 1957, Serial No. 666,389
4 Claims. (Cl. 206- 63.3)
..This invention relates to dispensers for surgical strands, such as ligatures and the like, and particularly to a dispenser having a reel on which a strand is wound and from which the strand is supplied substantially free of kinks, waves and undue bends.
Surgical strands, such as ligatures, which are employed in surgical operations necessarily must be delivered to the site of use in a sterile condition and be otherwise physically suitable for their intended purpose. In conventional practice, the strands are sterile when brought into the operating room and are kept in readiness until required, such as by placing the sterile strands in a receptacle containing a suitable sterilizing or aseptic fluid. Commercially presterilized surgical strands, of the type now widely used, come in tubes or vessels in which the strands are contained in a suitable sterilizing and conditioning fluid. Such strands are usable directly from their Container. Regardless of the particular practice followed, however, the strand, when it is called for by the surgeon, must be taken, quickly and efiiciently, from its place of readiness and given to the surgeon for use without delay and with a minimum of handling or risk of contamination.
It has been found, however, that the prior processing of the strands during manufacture, which frequently involves coiling or winding the strands to facilitate packaging and shipment, tends to impart kinks or bends to the strands. In many cases the strands are relatively tightly coiled, such as on a spool or the like, and they furthentend to coil up on themselves when dispensed. These characteristics are especially apparent in the case of strands of the proteinaceous type which possess an inherent stiffness. Such qualities have rendered difficult the dispensing of the strands and it will be seen, not only make the handling cumbersome, but, also, increase the risk of contamination. These problems'are amplified in the case of ligatures which are in the form of elongated strands that are cut off into shorter lengths as needed at the time of dispensing.
There have been some methods and devices proposed to facilitate the dispensing of surgical strands in the operating room. However, such previously suggested means generally involve either the manipulation of an entire length of the strand in a cumbersome manner, or require the handling of the strands in a tightly wound form in which the undesired kinks and bends are exaggerated. Although the packaging of the strands in coil form has several advantages, the ordinary means heretofore available to handle these strands, readily, when .unpackaged for use have been unsatisfactory. In most instances the proposed dispensing devices have involved mechanical means, the assembly and operation of which are in themselves cumbersome and they are diflicult' to cleanse and sterilize properly for surgical use.
Accordingly, it is an object of the present invention to provide means for dispensing surgical strands, such as. ligatures, in which the handling required in delivering the strand to the surgeon and the risk of contaminanited States Patent Patented May 31, 1960 l ce tion thereof at the time of putting it to use is It is another object of the present invention to provide an improved means for dispensing surgical strands, such as ligatures andthe like, wherein a strand may be provided in coiled form and unwound as it is needed for use in a simple and expedient manner, such that the sterile condition thereof is readily maintained and the dispensed strand is free of kinks, waves or undue bends.
Another object, of the invention is to provide a dispensing means employing a flat, circular reel having spoke-like tabs forming a winding groove around its periphery within which a coiled surgical strand is wound, and a dispenser case adapted to contain such reeled strand whereby an outer end of said strand may be pulled from said dispenser and unwound from the reel in desired lengths.
A further object of the invention is the provision of such a dispenser having a wound suture carried on a reel which is freely rotatable therein, which may be readily disassembled for recharging and in which the reel is retained and guided without the requirement of complicated, auxiliary mechanical means. A further object of the invention is to provide such a dispenser wherein said dispenser case substantially completely encloses the reel, without abrasive contact between said case and the wound strand, and wherein an opening in said case through which the strand is fed is automatically oriented with respect to said reel so as to avoid any binding engagement between said case and said reel.
A still further object of the invention is to provide means in such a dispenser for affording regulation by manually imposed frictional retention means to facilitate the withdrawal and severance of desired lengths of the strand.
A still further object of the invention is to provide such a dispenser wherein said case is comprised of a substantially thin, cup-shaped member having a simple removable cover, free of crevices or operating parts such that said device may be readily cleansed and sterilized in a practical manner for operating room use.
These and other objects and advantages of the invention will be apparent from the following detailed description of a preferred form of the invention, taken in conjunction with the accompanying drawings, in which;
Fig. l is a front elevational view of a dispenser case adapted to receive a reeled surgical strand in accordance with the invention;
Fig. 2 is a vertical section taken along the line 2-2 in Fig. 1 illustrating the internal construction of the dispenser case and its removable cover portion;
Fig. 3 is a perspective view, partially in section, and broken away, illustrating a dispensing device, in accordance with the present invention, including a dispenser case and a reeled strand rotatably contained therein;
Fig. 4 is a front elevational view of the dispenser seen in Fig. 3, with the cover removed, illustrating the position of the reeled strand within the dispenser case;
Fig. 5 is a vertical sectional view taken along the line 55 in Fig. 4 illustrating the position of the reel within the assembled dispenser case and showing the relationship of the discharge opening through which the strand is withdrawn;
Fig. 6 is a detail view showing the formation of discharge opening in the wall of-the casing; and,
Fig. 7 is a perspective view, partly in section, and broken away, illustrating an alternative form of a dispensing device constructed in accordance with the invention.
Referring to the drawing, a dispenser is shown in Fig. 3, designated generally by the numeral 10, which it will be seen, includes a dispenser case 12 and a reel member 14 contained therein. A surgical strand such as a ligature 16 which is carried on the reel in the form of a coil is unwound therefrom in use and drawn through an opening 18 in the sidewall 190f the dispensercase. a 7
The dispenser case, best shown Figs. l and2, comprises a circular cup-shaped body portion 20 which open onone side. A fitted coverf22 having annular flange. 24 which. surrounds the upturned" sidewall -19 of the cup 20, and is preferably frictionally sea'ted thereon, forms a'removable closure for the chamber 25 in which a reeled strand is adapted to be contained; Thedispenser case and removable cover therefor preferably are made of a thin gauge metal whiclris suflici ently rigid to resist deformation under normal handling'and which may be sterilized by autoclaving; Oppositely disposed central openings '26 and 28 in the cover 22 and easing body 20, respectively, are provided ,for reasons which will become apparent as the description proceeds. H Referring now to Fig. 4, the manner in which the reel 14 is received in the dispenser casing will be more easily observed. The reeled strand formed by the reel blank 14'and strand 16 wound thereonis particularly adapted for use in connection with "the present invention and-is substantially identical to the reeled strands shown and described in the 'co-pending application Serial No. 666,- 390 of R. Berry'and L. Runkel for Package for Surgical Strands, assigned to the assignee of the present application and filed on the same date as the present application. The .reel 14is in the form of a thinyflat disc having a flat, substantially circular central body portion 30 around the periphery of which are provided circumferentially spaced, radially extending tabs 32. The adjacent tabs, as illustrated by the tabs 32', 32", are bent oppositely outof the plane of the central body portion to provide a substantially circular groove lying in the plane of the central body portion to receive the turns of the wound strand. The geometry of the reel is such that the strand,
members 32 against the inner surface of the side wall 19 so that it will easily revolve within the casing when the outer end of the wound strand 16 is pulled through the opening 18. It will be seen that, by the provision of this type of bearing engagement for support of the dispensing reel within the case 20, substantially no manipulation vof accessory devices for holding or securing the reeled strandwithin the dispenser is required. Once the free end of the wound strand 16 is threaded through the opening 18, the reel automaticallyaccommodates itself within the casing, allowing the strand to be pulled oif of the reel'at 'will. In withdrawing .the strand,"with the opening 18 in the position shown in Fig. 4, the reel will tend to move toward the ,right hand side of the casing such that the ends of the radial tabs 32 bear mostly against the right side and lower right side of the innersidewall 19.
The number of radial tabs and the bearing surface provided at their-outer ends is sutficient to provide a continuous sliding contact against the inner wall of the casing as the reel rotates and prevent jamming of the tabs in the casing which might result from too great a spacing therebetween. A reel, as shown, having eight equally spaced tabs, the widthfof the tabs being such'that the total circumferential extent of their outer ends corresponds approximately to one half the reel perimeter, has been found highly advantageous for the-purposes of this invention. Preferably the ends of the tabs are rounded slightly 'to provide a curvature whose radius corresponds approximately to the radial distance from the center of the reel.
The opening 18 through which the strand is withdrawn from the casing is preferably formed substantially midway'in the side of the cylindrical wall 19 as may be seen, for example, in Fig. 5. V The flange 24 of "the dis}- when wound thereon and removed therefrom for subsequent use, .is free of kinks, sharp bends and waviness, as described in the above-mentioned co-pending application Serial No. 666,390. This form of reeled strand is particularly advantageous also in that the strand, when removed therefrom, does not tend to spring back into a tightly coiled condition due to the larger diameter of its coil windings, and its handling and dispensing for use in ligating, or other purposes, is thus facilitated. The strand 16 is applied to the reel preferably by fixing its inner end at the innermost part of the coiled strand and then progressively winding the strand around the radial tabs as above described until the entire length of the strand has been received on the reel. Preferably the .outer free end of the strand is then tucked in between the side of the Wound coil and a proximate tab, the resiliency of the tab serving to retain the free end of the strand until it is desired to dispense the strand at the time of use.
The particular reel, forming a part of the dispenser device of the present invention, in addition to conveniently and compactly retaining a length .of the suture strand in a manner rendering it free from kinks, bends and tight coils at the time of use, is also highly advantageous in that it facilitates the removal of the suture strand therefrom. It will be noted also that the central body portion 30 of the reel is arranged to accommodate The reel is thus freely rotatable within the casing and is guided by'the bearing of the ends 36 of its radial tab penser cover is so related thereto that it does not over; lie the opening when the cover is in place. Such positioning of the opening 18 assists in the prevention of the ends of the peripheral tabs 32 of the reel from catching or binding on the edge of the opening. Thus, as shown in this figure, the adjacent, oppositely bent 'tabs of the reel are disposed, as a ,result ofthe construction of the reel, slightly out of the plane, and on either side, of the coiled strand. The opening 18 is of only slightly larger size than the strand 16 so that the tabs, thereby, are me; essarily prevented from coming intoalignment with the opening '18 as long as the strand 16 is threaded through the opening. It may be seen in this view that, as each tab rotates to an angular position corresponding to the location of the opening 18, the wound strand being main tained substantially in planar alignment with the open: ing causes the successive tabs to pass on either side thereof. Any possible engagement, or catching of the tabs with the edge of the opening is thereby prevented. The construction and arrangement of the reeled strand cooperate in a special way to prevent friction and possible abrasion of the strand against the interior of the case when the strand is dispensed. Thus, it will be seen, for example in Fig. 5, that the sidewise projections of the tabs-around. the periphery of the reel, on either side of the coiled strand space .the strand from the opposing end walls of the reel chamber 25. The strand, therefore, is prevented from directly bearing on the end walls as the reel rotates. Similarly, the radial projection of the tabs beyond the .coiledstrands eliminates frictionalcontact of the strands against the inside of the cylindrical wall 19 of the dispenser case.
' In order to avoid abrasion of the surgical strand .as it is passedthroughthe-opening 18 audio order further to avoid any possible binding of the reel, the cylindrical wall 19, immediately-surrounding the opening .18. is .extruded slightly in the form of a slight, outward, .conical protrusion 38 as shown in the detail view of Fig. 6. The edges of-the casing definingthe openingare preferably suitably rounded off, so as to avoid any abrasion'of the strand as it is pulled therethrough during the dispensing of the strand.
An alternative form of the casing body is shown in Fig. 7 which is identical to that above described, but wherein a slot 18', extending inwardly from the open side of the body 2%), is provided in place of the opening 18. In this form of the dispenser the cover 22 extends downwardly over the upper end of the slot 18 but not to the bottom thereof, such that an opening is provided, between the edge of the cover and the bottom of the slot, through which the strand is extracted as in the device hereinabove described.
In use, the dispenser case is sterilized by any suitable means such as autoclaving in the manner conventionally employed for the sterilization of the usual surgical instruments. The dispenser case then may be placed along with the other surgical instruments that are to be used in the operation or other surgical procedure. At the proper time, a desired size and type of suture, wound on a suitable reel as herein described, is placed within the open casing and the free end of the surgical strand threaded through the opening 18. It will be seen that the outward protrusion 38 is also effective to assist in threading the strand through the opening. In the case of the device shown in Fig. 7, the strand is simply laid in the slot 18'. The cover 22 is then placed over the casing and the strand withdrawn as it is needed. The openings 26 and 2S permit the central body portion 30 of the reel to be grasped, such as by grasping between the fingers as seen in Fig. 5, so that the rotation of the reel may be regulated at will as the strand is stripped from the reel. This greatly facilitates the holding out of the strand to allow the nurse or assistant to cut off the strand and facilitates the proper gauging or dispensing of the desired length thereof for ligating purposes. When the entire length of strand has been consumed or, if it is desired to substitute a reeled suture of a selected size or type, the dispenser is readily disassembled by pressing inwardly against the reel through either of the openings 26 and 28, while holding the opposite part of the dispenser, which thereby forces apart the cover 22 and casing body 20.
-t will be apparent that while the invention has been described in a preferred form, changes may be made without departing from the spirit and scope of the invention as defined in the following claims.
1. A dispenser case adapted to contain and dispense a surgical strand carried on a circular reel having a peripheral groove within which said strand is wound, said case comprising a cylindrical, cup-shaped body portion defining one end wall and the cylindrical side wall of said case, and a removable cup-shaped cover seated over and forming a closure for the open side of said body portion and defining therewith a cylindrical chamber within which a strand-containing, circular reel is adapted to be substantially concentrically placed so as to be freely rotatable therein, said body portion having an outward, radial protrusion in its cylindrical wall in which is formed a substantially cylindrical bore, said bore constituting a discharge port through which a strand is adapted to be dispensed, and digital receiving openings in opposing end walls of said case formed by said cover and body portion, said openings being substantially concentrically disposed in said case and in confronting relation to permit manual pressure to be applied against both sides of a reel contained in said case.
2. A dispenser case according to claim 1 wherein said cover has an annular rim bearing frictionally against the outer surface of said cylindrical side wall of said body portion to render said assembled, separable members substantially self retaining.
3. A dispenser for surgical strands comprising, in combination, a thin, flat reel having a surgical strand wound thereon, said reel comprising a substantially circular, central body portion around the periphery of which are provided circumferentially spaced, radially extending tabs, at least a plurality of which tabs are oppositely bent out of the plane of said central body portion to provide a substantially circular groove lying in the plane of said central body portion, the strand turns being disposed in said groove, and a cylindrical case within which said reel is unattachedly disposed, said case being of substantially thin cross-section, having opposing, substantially flat, end-walls, between which said reel is disposed in substantially parallel relation thereto, and a cylindrical sidewall of slightly larger diameter than said reel, said cylindrical wall portion having a discharge opening through which the outer end of said wound strand is adapted to be passed, said reel being rotatably guided within said case by the co-action of the ends of said tabs and the inner cylindrical sidewall of said case to support said wound strand in said case out of contact with said cylindrical sidewall and rotate freely when said strand is pulled through said opening, thereby permitting said strand to unwind from said reel, and said cylindrical case being provided with means forming oppositely disposed openings in said end walls in confronting relation to the central body portion of said reel, through which said reel may be frictionally engaged to regulate the rotation of said reel when said strand is unwound therefrom.
4. A dispenser according to claim 3 wherein said case comprises a shallow, cup-shaped body portion, open at one end, and a removable cover therefor, forming one of said end walls, said cover having an annular inturned edge which is received on said cylindrical side wall, and said opposed openings are formed respectively. in said cover and in said body portion.
References Cited in the file of this patent UNITED STATES PATENTS 1,123,497 Davis Jan. 5, 1915 $1,908,278 Angell May 9, 1933 2,343,064 Kjorsvik Feb. 29, 1944 2,391,301 Dukehart Dec. 18, 1945 FOREIGN PATENTS 495,109 France June 18, 1919 314,147 Italy Jan. 18, 1934