US 3048177 A
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Description (OCR text may contain errors)
Aug. 7, 1962 T. TAKARO BLOOD VESSEL COUPLING DEVICE 2 Sheets-Sheet 1 INVENTOR. 73m 02/; 2247mm BY/W%' l Filed June 23, 1959 Aug. 7, 1962 TAKARO BLOOD VESSEL COUPLING DEVICE 2 Sheets-Sheet 2 Filed June 23, 1959 IIIIIIIIIIIIIIIIIIIIIIv III/IIIIIIIIII/l. m
IN V EN TOR. 757770272 Eiraro 3,948,17 7 BLOOD VESSEL CUUPLHNG DEVICE Timothy Taharo, Asheville, N.C., assignor to the United States of America as represented by the Secretary of The invention described herein may be manufactured and used by or for the Government for governmental purposes without the payment of any royalty thereon.
This invention relates generally, to improvements in K lood vessel coupling devices. instant invention relates more specifically, to surgical anastomosis apparatus and method adapted for joining together and effecting the union, by anastomosis, of the severed ends of blood-vessels, intestinal canals, two or more sections of the esophagus, or other canals of the body after it is necessary to resort to surgery to remove a section of the canal and then join the ends of the canal from which the section has been removed.
instant invention may be used to facilitate the rapid coupling of a graft section between two severed canals in prosthesis or may be used in any other suitable manner deemed necessary in the art.
An object of the invention is to provide a simple, effective anastomosis device and method for effecting the approximation and healing together of severed arteries, veins, or other tubular body parts.
Another object of the invention is to provide a vessel couple designed to facilitate the rapid coupling of two blood vessels. 7
Another object of this invention is to provide an apparatus and method to facilitate the rapid coupling of two blood vessels, or a blood vessel and a graft, in such a way that blood flow through the vessels or the vessel and graft may be interrupted during surgery for only a brief period of time.
Another object of the invention is to effect a device and method whereby'the severed ends of blood vessels or body canals may be joined by suturing and healed by anastomosis after which the apparatus may be completely removed from the Wound for comfort and favora'ble psychological reaction of the patient for quick recovery after surgery.
Other objects and advantages of this invention will be apparent from the following detailed description of invention in the accompanying drawings.
in the drawings:
FIG. 1 shows a perspective view of the associated clamp members of the invention in disassembled condi-tion;
FIG. 2 shows all the members of the preferred embodimeat of the invention in associated assembly relationship;
FIG. 3 is a plan View of the invention showing the graft bean-ing portion of the couple applied to a graft portion;
FIG. 4 is a plan view of the invention showing the couple partly in section in an assembled condition joining, for example, a gnaft portion and the severed end of a blood vessel; and
FIG. 5 is a sectional view showing 'the position of the clamping members and the method of suturing after effecting the connection.
The tubular graft material used in instant invention may be of any suitable material.
One particular novelty of instant invention is that in the method and device, inventor employs an externally folded back cull-like end portion on one canal member which is received in the open end of a host canal. This United States Patent 0 arrangement eliminates the use of an internal support ring between the joined ends of the canal which remains in situ after the auastomosis joint is formed and healed.
Another particular novelty of instant device is that it may be completely removed from the anastomosis joint when once formed which adds to the patients well being and comfort after surgery.
Referring to the drawings, FIG. 1, clamping members 12 and 1% comprise twocomating semicircular halves of one component or graft bearing portion of a circular vascular clamp, and clamping members 24 and 30 comprise two comating semicircular halves of the other component or host vessel portion of a circular vascular clamp, also similarly illustrated in FIGS. 25 with like reference numbers. Clamp member 12 consists of an intermediate semicircular receiving portion 12a which terminates in teeth 15, two interdigit-ating arms 16 and 16a, each terminating in a thin portion of 17 and 17a, respectively, which are respectively pierced by openings 16b and ldc to receive threaded bolts 38 and 45, as in FIG. 2. The semicircular part 12a has two spaced external circumferential grooves 13 and E4 to receive a ligature tied about the blood vessel or graft material which are held in apposition by tying the former over the latter as hereinafter described and illustrated. Clamping rnember 18 is similarly composed of intermediate semicircular recessed portion 22 which terminates in teeth 21 and interdigitating arms 18a and 18b, each of which terminate in end portions 23a and 23 having recesses 22a and 22b which are pierced by openings 23b and 23c, respectively. Clamping member '18 has outer circumferential grooves 19 and 2a which cooperate with external grooves 13 and 14 or" clamping member 12, respectively. Recesses 22a and 22b are adapted to cooperatively receive ear members 17a and 17 of clamping member '12 and recess 22 of clamping member 18' cooperates with recess 12a of clamping member 12. Teeth 21 of clamping member 18 cooperate with teeth 15 of clamping member '12 as two portions of a sectional clamping ring of the blood vessel couple as illustrated in FIG. 5. Clamping member 24 consists of an intermediate semicircular portion 25 which terminates at one edge in teeth 26, portion 27, which has a sloping surface 270 which terminates in ear member 28 which contains a substantially centrally located aperture 29, and an oppositely extending arm member 27a which has a sloping surface 27b and terminates in ear member 2% having an aperture 2%. Clamp 30 consists similarly of an intermediate semicircular portion 31 which terminates at one edge in teeth 32, an outwardly extending arm 33 which has a sloping edge 33a and terminate in end portion 34 having therein threaded aperture 35 and slot 34a. Ear member 28 and threaded portion 46 of bolt 45 are cooperatively received in slot 34a. Arm portion 33b extends laterally from portion 31 of clamp member 30 having sloping surface 330 which terminates in end portion 34b and contains therein threaded aperture 35a and slot 340 to cooperatively receive member 29a and threaded portion 39 of bolt 38, as shown in the partial sectional view of FIG. 4
FIG. 2 is an exploded view in perspective of the parts of the present invention in preassembly relationship showing threaded bolt member 38 about to: be passed through apertures 23b, 160, 35a, and 29b, and bolt member 45 about to be passed through apertures 23c, 16b, 35, and 29 to secure comating clamping members 12 and 18in clamping assembled relationship to comating clamping members 24 and 30. The invention of FIG. 2 may be used in various ways as applied to the art to eifect a joining together and efiecting the union by anastomosis of the severed ends of blood vessels, intestinal canals, two or more sections of the esophagus, or other canals of the aoaarw '5 all body after surgery as hereinafter more specifically described and shown in FIGS. 3, 4, and 5.
FIG. 3 shows the manner in which a section of graft material is coupled to the graft bearing portion of the couple. The steps for connecting the graft member 51 into a severed blood vessel or canal are as follows:
(1) Clamping members 12 and 18 of the device are manuallyplaced externally around each end of the graft material 51;
(2) The ends of the graft material 51 are suitably folded back externally over the teeth and 21 of clamping members 12 and 18 respectively, in a cuff-like manner until the exposededges of graft material 51 overlie slots 14 and or slots 13 and 19 of clamping members 12 and 18 as desired;
(3) A ligature 60 is secured around the folded back portions of the graft material and received in one of the recesses formed by the grooves 13, 14, 19, and Zil;
(4) After the surgeon has taken the customary safeguard procedures in the art to prevent hemorrhage of the patient, the graft material 51, held by clamping members 12 and 18, may be suitably lubricated and inserted into the severed end of a blood vessel 64 until it completely receives the folded back end portion of graft member 51;
(5) Then a set of clamp members 24 and are manually placed around each severed end of the blood vessel 64 which has been positioned over the ends of the graft portion 51 and manually held in position until screw bolt member 38 is inserted through apertures 16c and 23b of clamps 12 and 18 and aperture 291) of member 24 and threaded aperture a of member 30 to engage threads 39 of member 38, and threaded bolt member 45 is similarly inserted through apertures 16b and 230 of members 12 and 18 and aperture 29 of clamping member 24 and threaded aperture 35a of member 3% to engage threads 46 of bolt member 45. The sets of clamp members 12, 18, 24, and 30 at each end of the graft portion may be suitably tightened or compressed together, as desired by the surgeon, by manually turning knurled portions and 47 of bolts 38 and 45, shown by FIGS. 2, 4, and 5;
(6) The overlapped ends of the vessel and graft are sutured (sewn) by surgical thread 70 as shown and illustrated by FIGS. 4 and 5;
(7) The clamp members may then be easily removed permitting blood flow through the vessel and graft. The blood flow is interrupted only for a brief period of time, being long enough to apply the clamp portions to the joined graft and vessel, after which blood flow may be resumed while suturing.
Referring to FIGS. 4 and 5, member 5.1a may be either of suitable graft material, another body canal or blood vessel with the foregoing method steps being applied to same.
The six members of instant device, namely, 12, 18, 26, 30, 39, and may be made of any suitable material, as desired.
Referring to FIG. 1, end portions 17 and 17a of clamp member 12 are freely and firmly received by recesses 22b and 22a of cooperating clamp member 18 to insure that there is no turning effect between clamping members 12 and 18 and to secure and hold these clamping members in assembly around a bloodvessel in such relationship that they are always substantially in longitudinal alignment with the axis of the blood vessel so that teeth 15 and 21 of members 12 and 18 are spaced substantially equidistant about the blood vessel. Surfaces 17c and 17d of member 12 in assembly are juxtaposed to surfaces 18b and 13a of member 18. Similarly, end portions 28 and 29a of member 26 are freely and firmly received by recesses 34a and 340 of cooperating clamp member 30 in assembly. Surfaces 27c and 27d of clamp member 24 during assembly are juxtaposed to surfaces 33a and 33c of cooperating clamp member 30.
Referring to FIGS. 2, 4, and 5, it is to be particularly noted that instant invention is composed of a minimum of 6 parts, being comating clamp members 12, 18, 24, j
and 30 with bolt members 33 and 45. Bolt members 338 and 45 have a novel function in that they' serve both to secure clamping members 12, 18, 24, and 36' circumferentially and longitudinally of the graft portion and host vessel 64 and to compress cooperating clamping members 12 and 18 in longitudinal alignment with cooperating clamping members 24 and 3% to contact the folded over end of the graft member 51 or 51a inserted into host vessel or canal 64. FIG. 5 shows surgical thread member "iii in position after suturing of the joint by the surgeon preparatory to removal of bolts 38 and 45 from clamping members 12, 18, 24, and 3b to release the device from the joined vessels or canals.
Although the clamping device has been described herein as particularly adapted for use in joining severed blood vessels and other anatomical cana s, it is to be understood that the principle embodied in the device may be used, without departing from the scope of the invention, in-joining any discontinuous members directly or indirectly by means of an inserted section, flexible or rigid and having various cross sections. in joining rigid materials, gasketing may be required to provide a leak-proof joint applied in ways well known to those skilled in the art.
Although the particular embodiment of this invention has been shown and described, it will be understood that this is by way of illustration only and that various changes and modifications may be made within the contemplation of this invention without departing from the broader aspects of this invention as more specifically covered by the appended claims.
1. A clamping device for joining hollow members in abutting end relation to provide a continuous path through the hollow members, comprising a plurality of pairs of clamping members for peripherally engaging the external surface of the hollow members to be joined, each pair of clamping members including longitudinally separable body portions, each said body portion having a pair of oppositely disposed arms projecting from the exterior surface of said body portion and provided with apertures adjacent to the terminal ends thereof, the terminal ends of the arms of one body portion interdigitating with the terminal ends of the arms of another body portion and having the apertures of the corresponding ends of said arms thereof in registering position, the clamping edge of each of said separable body portions parallel to the direction of projection of said arms being serrated and fastening and releasing means slidably passing longitudinally through the aligned apertures of a first pair of clamping members and threadably engaging the aligned apertures of a second pair of clamping members for maintaining said arms of adjacent longitudinally aligned pairs of said clamping members in interdigitating position and axial alignment and said pairs of clamping members in clamping engage-- ment.
2. A clamping device for joining hollow members in abutting end relation to provide a continuous path through the hollow members comprising clamping members configured to peripherally engage the external surface of the hollow members, each of said clamping members including longitudinally separable segments, each said segment having a pair of outwardly projecting arms, the arms projecting outwardly from a first segment of said clamping members terminating in a tongue having an aperture, the arms projecting outwardly from a second segment of said clamping members terminating in a notched portion having apertures in the walls of the notched portion, said notched portion receiving said tongue in interdigitating relation upon joining of said first and second segments in position to align said apertures in said tongue and notched portion in registering relation, the clamping edge of each of said longitudinally separable segments parallel to the directiton of projection of said arms being serrated and a fastening rod slidably received in the aligned apertures in the tongue and notched portion of a first pair of said clamping members and threadably received in the notch portion of the aligned apertures of a second pair of said clamping members to retain the interdigitating arms and segments in assembled condition and retain said first and second pairs of said clamping members in axial alignment and clamping engagement.
3. A clamping device as recited in claim 2 wherein the exterior surface of the segments of one of said pair of clamping members has a continuous circumferential groove adjacent the serrated edge thereof to permit securing a hollow member to be joined by the clamping device in folded over condition.
4. A clamping device as recited in claim 1 wherein the exterior surface of the separable body portions of one of said plurality of pairs of clamping members has a continuous circumferential groove adjacent the serrated edge thereof.
5. An anastomosis clamping device for joining severed ends of canal members comprising a plurality of pairs of clamping members, each said pair of clamping members adapted to peripherally engage a section of the severed canal adjacent the severed edge thereof, each pair of said clamping members including longitudinally separable body portions, each of said body portions having a pair of arms projecting exteriorly thereof, said arms provided with apertures adjacent to the terminal ends thereof, the terminal ends of the arms of one body portion interdigitating with the terminal ends of the arms of another body portion and having the apertures thereof in registering position, each of said separable body portions having an end thereof serrated and a peripheral groove on the exterior surface of the body portions of one of said pairs of clamping members to receive and permit a section of the severed canal adjacent the severed edge to be extended beyond the serrated edge and folded back upon the exterior surface of said body portion and secured in such position for insertion Within the lumen of an adjacent section of the severed canal, and fastening and releasing means slidably passing through the apertures of a first pair of said clamping members and threadably engaging the apertures of a second pair of said clamping members for maintaining the arms of said body portions in interdigitating position and said pairs of clamping members in adjacent longitudinally aligned fixed space relation.
References Cited in the file of this patent UNITED STATES PATENTS 2,434,030 Yeomans I an. 6, 1948 2,453,056 Zack Nov. 2, 1948 2,638,901 Sugarbaker May 19, 1953 2,836,181 Tapp May 27, 1958 2,880,761 Peter Apr. 7, 1959 Soresi Aug. 24, 1915