US 3310199 A
Description (OCR text may contain errors)
T` J. ROBERTS ETAL. ARTICLE DISPENSING UNITS REMOVABLE March'Zl, 1967 FROM AN ENCLOSING CASING 3 Sheets-Sheet 1 Filed March 22, 1965 'r` J. ROBERTS ETAL 3,310,199 ARTICLE DISPENSING UNITS REMOVABLE FROM AN ENCLOSING CASING March 21,1967
3 Sheets-Sheet 2 Filed March 22, 1965 /A/ VEA/Top5 POBEQIZS g f2 Q Q\ Mig;
March 2l, 1967 T. J. ROBERTS ETAL Swgg ARTICLE DIsPENsING UNITS REMOVABLE FROM AN ENcLosING CASING Filed March 22, 1965 5 Sheets-Sheet 5 United States Patent O ARTICLE DISPENSING UNITS REMOVABLE FROM AN ENCLOSING CASING Tom I. Roberts and Donald lL. Paulson, Des Moines,
Iowa, assignors to Ethicon, Inc., a corporation of New Jersey Filed Mar. 22, 1965, Ser. No. 441,482
2 Claims. Cl. 221-25) This invention relates generally to sutures for stitching purposes, and particularly to individually dispensing sterile lsutures and other relatively thin elements by a machine.
A suture is a strand or fiber used to sew parts of the living body together. IIt should be sterile when used. One method of sterile pre-packaging is the placing of a sterile suture in between a pair of strips of foil or the like, the insides of which are sterile. At the time f use, the strips are separated by hand. Due to the need of sterility, however, as the outer, exposed surfaces are nonsterile, an extra pair of hands must be used, in the operating room for example, to open the suture package for removal of the sterile suture by sterile hands.
In an attempt at even more sterilization, the picture is beclouded further by the placement of the suture package in between another pair of flexible, separable strips, whereby the non-sterile hands separate .the first strips to empty out the sterile package for sterile hands. Other methods, just as cumbersome, are provided for dispensing sutures, one-by-one.
The clouded picture is made even more hazy by the fact that there are dozens and dozens of different sutures for different purposes, the sutures being of different length, thickness, strength, material, etc. The non-expert can begin to see a basis for a waste of sutures in the operating room, professional or make-shift, and the expertparticularly the hospital administrator, knows of the high amount of wastage of opened but unused sutures.
It is, therefore, an object of this invention to provide a means for dispensing one or more sutures which 1'educes substantially the waste of sutures.
It is another object of this invention to provide a means for dispensing sutures one at a time, the dispensing action literally stripping open a suture package in a sterile manner and presenting the suture for handling by sterile hands.
Yet another object of this invention is to provide a machine for individually dispensing sut-ures, whereby action of the operator, usually a nurse, results in first a stripping open of a suture package, secondly an extending of the suture outwardly of the machine toward the nurse, and thirdly in an exposure, to the nurse, of only the inner sterile surfaces of the package about the suture.
This latter object is all the more meaningful when it is realized that the mere dispensing of a suture through a hole, for example, would not accomplish all that is needed to be accomplished; As the lsuture must be grasped, were the lingers of the nurse to contact a nonsterile machine or cabinet front, not only would the suture ibe wasted, but the nurse would have to re-cleanse her hands.
Thus, an object of this invention is to expose or present to the grasping fingers of the nurse only the suture and the sterile inner portions of the package originally containing the suture. v
Still another object of this invention is the provision of a machine for automatically dispensing in sequential, operator-controlled and timed steps, any number Aof relatively thin elements, without critical regard for size or shape.
Patented Mar'.` 21, 1967 Another object of this invention is the provision of a machine capable of attainin-g these objectives which can dispense any number of different elements, the different elements .arranged in a side-by-side arrangement, whereby the operator can choose any yone of the different elements; and further wherein a plurality of elements can be st-ored in the machine in a non-used but ready condition.
Yet `another object of this invention is the provision of a machine capable of individually dispensing from a roll lor the like, a plurality of thin elements in a sequential manner, and wherein a different roll of elements can be quickly and easily -substituted for the rst roll, without any actual physical handling or contacting of any of the elements.
Still another object of this invention is to provide a machine cap-able of individually dispensing in a sterile manner a suture or the like, which suture is one of any number of like sutures packaged in an end-to-end manner in an elongated web of material comprising a pair of flexible, superimposed strips between which the sutures have been inserted.
Another object of this invention is the provision of such a machine, wherein the dispensing is obtained by ya foot actuated linkage, and the actuation being adjustable to adapt the machine to dispense elements of `different length.
It is another object of this invention to provide a machine for individually dispensing a lange number of individually wrapped sutures, the packages of which are joined end-to-end, and wherein the packaged sutures need not even be removed from the shipping carton therefor, assuming the carton is opened to permit a longitudinal withdrawal of the joined packages.
Still another object of the invention is to provide a machine capable of attaining all of the above mentioned objectives, which machine can easily be tailored to the needs of a user, is economical to manufacture, simple and rugged in construction, easily operated, and effective in operation.
These objects, and other features and advantages of this invention will become readily apparent upon reference to the following description, when taken with the accompanying drawings, wherein:
FIG. l is a perspective view of one embodiment of the present invention in the form of an enclosed machine;
FIG. 2 is a rear elevational view of the machine of this invention, with the rear broken away to show a plurality of dispensing units in place for present use, with other units stored in a ready condition for future use;
FIG. 3 is :an enlarged, foreshortened sectional view taken along the line 3 3 in FIG. 2;
FIG. 4 is an enlarged, fragmentary sectional view taken along the line 4 4 in FIG. 3;
FIG. 5 is a sectional View taken along the line 5 5 in FIG. 4;
FIG. 6 is a reduced, fragmentary view of the side of the machine opposite from that of FIG. 3;
FIG. 7 is an enlarged, perspective view of a detail of a dispensing unit;
FIG. 8 is a sectional view taken along the line 8 8 in FIG. 4; and
FIG. 9 is a sectional view taken along the Kline 9 9 in FIG. 5.
:Referring now to the drawings, one embodiment of the machine of this invention -is indicated generally at 10` in FIG. 1. Generally, the machine 10 comprises a rectangular shaped housing 11 of any size depending upon considerations not pertinent to the invention, which housing 11 :has a front panel 12, side panels 13 and 1i4, a bottom wall `16 (FIG. 3), a hinged top 17, and a hinged back 10. Casters 19 of a conductive material are mounted on the bottom wall 16 of the housing 11 for safety purposes in an operating room.
Across the front panel 12 of the housing 11, at the normal arm height for an average sized nurse are a plurality of horizontally spaced and aligned, substantially rectangular slots 21 (FIG. 1). Below the slots, a small drip pan 22 is mounted, the purpose of which is defined hereinafter. Then, at the bottom of the front panel 12 are mounted a plurality of horizontally spaced foot pedals 24, again each foot pedal being vertically aligned with one slot 21. It will be seen that the bottom front of the housing 11 is cut out at 26 whereby either foot of the nurse may easily be inserted above a foot pedal 24 for a depressing movement thereagainst.
Internally of the housing 11, a trio of vertically spaced shelves are arranged across the entire width. The upper shelf comprises a plurality of horizontally spaced and aligned guide track units 27, with each pair of adjacent units spaced on either side of a slot 21 (FIG. 4). Each unit 27 being the same, only one will be described.
Referring particularly to FIGS. 4 and 5, a guide track unit 27 comprises an upper T-bar track 28 and a lower T-bar track 29, with the horizontal flanges 28a and 29a vertically spaced a predetermined distance. Each track is welded at one end to a bracket 31 and 32 respectively, with the brackets in turn being secured to the inner surface of the housing front panel 12. A limit pin 33 (FIG. is secured between the anges 28a and 29a intermediate the ends of the tracks.
Adjacent the free ends of the tracks, a catch 34 is pivotally mounted for movement in a vertical plane through slots (not shown) provided therefor, which catch 34 is biased toward a position illustrated by a linger latch 36. It will be noted that the free end 37 of the lower track 29 extends further than the free end 38 of the upper track 28.
.Referring to FIG. 2, the tracks 27 which comprise the upper shelf are all spaced above a cross brace 39 for the rear of the housing 11, and with the top 17 hingedly moved upward, the entire upper part of the housing 11 is thereby exposed from above and to the rear of the upper part of the housing 11. Below the cross brace 39, the intermediate shelf comprises a horizontal panel 41, and with the bottom shelf comprising the upper surface of the bottom wall 16.
The three shelves are adapted to hold thirty suture dispensing units 42 of a magazine type, with each unit 42 being identical except for the type of suture held thereby. Thus, thirty different sutures lmay be held in the machine 10, with the ten units on the upper, guide track shelf held in a presently usable position, and the twenty units placed on the lower storage shelves held in a future but ready position. With the units 42 being identical, only one will be described.
Each unit 42 comprises generally a frame 43 to which is secured a container `45 for holding a web 44 of individual sutures 46 (FIG. 8), a guide unit indicated generally at 47 in FIG. 8 for guiding the web 44 through a slot 21, and a rst actuating unit indicated generally at 48 for moving the web 44 through the guide means in a manner hereinafter described to expose and extend each suture 46 outwardly of the slot 21 and the forward portion of the guide unit 47. As shown herein in FIGS. 4 and 5, for example, each suture 46 is actually a at packet easily grasped and unfolded by the hand. Within the packet 46 is found the suture of a predetermined length and material, and which is attached to a predetermined needle for stitching purposes.
The web 44 includes al pair of parallel, identical, superimposed strips 49 and 51 of preferably flexible material. The strips are secured together by any bonding agent, or by heat sealing means and with a plurality of sutures 46 arranged in a longitudinally spaced, end-to-end manner. As best illustrated in FIG. 8, pockets S2 for retaining the sutures 46 may actually be formed, and it of course will be realized that the entire inner surface area of the web 44 is sterile, as are the sutures 46.
The unit frame 43 includes a pair of vertical, parallel at panels 53 and 54 (FIG. 9) having top and bottom edges S6 and S7 (FIG. 6) and including a pair of elongated stationary arms 58 and 59 (FIG. 4). At the rear of the panels 53 and 54, the container 45 is mounted, and which also includes a pair of vertical, parallel flat panels 61 and 62 (FIGS. 4 and 5). The panels 61 and 62 are joined at their rear by a panel 63, at their base edges by a bottom panel 64, and intermediate their front edges by a short panel 66. A handle 70 is secured to the rear of the container 45 to enable the nurse to push and pull, and otherwise handle the unit 42.
Thus a box-like container is formed for supporting and holding the web 44 in an accordion folded manner. It is conceivable that were the web 44 in an open carton or box, or in a roll, for example, the container 4S could easily accommodate the web 44. IReferring to FIGS. 5 and 6, it is evident that a pair of horizontally spaced and aligned studs 65 and 65a protrude from the sides of the container 45. It is further evident that by means of the studs 65 and 65a being inserted bet-Ween the anges of the guide track units 27, the dispensing unit l42 is readily `and easily interchanged with another unit having a different type of suture.
A lead portion 44a (FIG. 8) of the web 44 extends and is led through the guide unit 47, which unit includes a pair of converging plates 67 and 68 forming thereby a gradually narrowing throat ended by a pair of rollers 69 and 71. The lower plate 68 extends between and is secured to the stationary arms 58 and 59, and the lower roller 71 also extends between and is rotatably supported by the arms 58 and 59 at their outermost limits.
Both the downwardly inclined upper plate 67 and the upper roller 69 are secured to and extended between a pair of arms 72 and 73, similar to the stationary arms 58 and 59 and pivotally mounted thereabove by pivot pins 74 (FIG. 5). The upper arms, furthermore, are biased downwardly toward an engagement between the rollers 69 and 71 'by a pair of L-type springs 76 and 77 mounted as illustrated. Thus, substantially any item of a relatively thin thickness may be passed between the stationary roller 71 and the floating roller 69. See, for example, the upwardly pivoted position in FIG. 8 of the roller 69, as illustrated in dotted lines.
The dispensing unit 42 is completed by the first actuating unit 48 which includes an upper pair of frictionally engaged, knurled rollers 78 and 79, a lower pair of frictionally engaged, knurled rollers 81 and 82, and a pair of meshed gears 83 and 84. Both sets of rollers are rotatably mounted to and extended between the frame panels 53 and 54 on stud pins (see FIG. 9) or the like, and with the gears 83 and 84 mounted on eX- tensions of the inner pair of rollers 79* and 81.
The outer pair of rollers 78 and 82 are biased downwardly and upwardly, respectively, toward their adjacent rollers 79 and 81 by a pair of U-shaped springs 86 and 87 secured to vertically spaced projections 88 and 89, and lapped over the extensions 91 of the rollers 78 and 82. To accommodate a vertical floating of the rollers 78 and 82, a pair of vertically elongated slots 92 are formed, each in a side panel 53 and 54.
Each web lead portion 44a includes a pair of tabs 44b and 44C (FIG. 5) of indeterminate length, which are threaded, respectively between the upper pair of rollers 78 and 79, and the lower pair of rollers 81 and 82. Then, in response to clockwise rotation of the upper gear 83 (FIG. 5), and counterclockwise rotation of the lower gear 84 (FIG. 5), the roller pairs 78, 79 and 81, 82 are so rotated to draw both lead tabs 44b and 44C to the right as illustrated by the arrows in FIG. 5. This movement, when the web 44 proper is guided through the throat plates 67 and 68, results in the strips 49 and 51 being separated at the guide rollers .5 69 and 71, being movably trained about the outer peripheral edges of these rollers and then being pulled themselves toward and through the rollers pairs 78, 79 and 81, 82.
This action thus results in each suture 46 (FIG. 8) being individu-ally projected fromv between the strips 49 and 51 past the rollers 69 and 71, and through the front panel slot 21 (FIG. 5) for engagement by the nurses fingers. Importantly, when the unit 42 is inserted into and between each pair of adjacent guide track units 27, the positions of the limit pin 33 (FIG. 5) and the catch 34 relative to the studs 65 and 65a, maintain the unit 42 such that at least the outer portions of the guide rollers 69 and 71 pro-ject beyond the 'outer surface of the front panel 12. It also twill be noted that the vertical (FIG. and horizontal (FIG. 4) dimensions of the slot 21 is such to permit the rollers 69 and 71 to project therethrough.
Thus, the web strips 49 and 51 (FIG. 8) extend beyond the front panel 12, and upon being separated, the inner, formerly enclosed surfaces of the strips 49 and 51 are exposed with the suture 46 for physical nger engagement in a vertical plane at least even with the front panel 12. And advantageously, formerly the outer nonsterile surfaces of the strips 49 and 51 are removed from physical engagement by the nurse, being permitted to fall into an elongated pan 93 extended across the width of the housing 11 below all the vunits 42 (FIGS. 2 and 3). A curved guide 90 is hingedly mounted on the container 45 to aid in guiding the spent upper strip 51 rearwardly to the pan 93.
To operate the iirst actuating unit 48, and to provide a variable amount of rotations to the gears 83 and 84 (FIG. 3), a second actuating unit is provided, indicated generally at 94 in FIG. 3. A single, complete unit 94 is provided for each pair of track units 27, it having been noted in FIGS. 4 -and 9 particularly that lche gears 83 and 84 are mounted on only one side of each dispensing unit 42. Thus, each second actuating unit 94 is so located as to 'be cooperably engaged by each and every dispensing unit 42 retractably inserted in between each pair of track units 27.
As the second actuating units 94 are identical, only one will be described. A foot pedal 24 (FIG. 3) is vertically slidably mounted in a bracket 96 secured to the housing 11 near the 'base area 26 thereof, and is pivotally connected to an elongated link 97 the upper end 98 (FIG. 5) of which is connected to the horizontal leg 99 of an L-shaped slide bar 100 having an upper leg 101 reciprocally mounted in a guide block 102. The block straddles and i's secured to the upper track 28.
The link 97 and foot pedal 24 are biased to their raised full line positions by a spring 103 extended between a stud 104 in a lower track 29 and a projection 106 on the leg 99. The stud 104 serves a dual purpose in that it also extends through (see FIG. 9) an elongated slot 107 formed in the leg 101 whereby to aid in retaining and guiding the slide bar 100.
Referring particularly to FIG. 5, it is seen that the upper edge 108 of the leg 101 has gear teeth formed thereon, and which are normally in mesh withthe teeth of the first actuating unit lower gear 84. Thus, in response to a full depressing movement of the pedal 24, the leg 101 acts as a rack and rotates the gear 84 a certain amount, whereby the roller pairs 78, 79 and 81, 82 are rotated to advance the web 44 sufficiently to expose another suture 46, assuming it is desired to expose one suture for every depression of a' foot pedal 24.
It is evident that upon a return of the slide bar 100 to its original position shown in FIG. 5, the leg rack 108 must be separated from the gear 84 during the return stroke. To accomplish this, a passage 109 (FIGS. 5 and 7) is formed in the guide block 102, extended from an upper entrance 111 to a lower entrance 112, and with a 6 spring urged ball 113 mounted in the block 102 at the upper entrance 111.
A pin 114 (FIGS. 5 and 9) is secured to one side of the leg 101, and engages the face 116 of the guide block 102 due to the bias of the spring 103. Thus, upon downward movement of the bar 100, when it reaches the lower end of its stroke, the pin 114 will fallagain due to the spring bias, into the lower entrance 112 of the passage 109. The slide bar 100, riding along side the guide block 102, and -capable of tilting about the stud 104 due to the articulated nature of the linkage, is thereby pulled away from the gear 84 during its return stroke by the pin 114 riding upwardly inside the passage 109. At the upper entrance 111 of the passage 109, to ensure that the leg 101 is again placed in mesh with the gear 84 for the next stroke, the biased ball 113 aids in kicking the pin 114 out of the passage 109 where it is brought back against the face 116 of the guide block 102.
In certain instances, sutures are packaged such that a small amount `of fluid is contained within each pocket 52 for storage purposes. Thus, should any of the uid not be evaporated upon exposure of the interior of the pocket 52 by the stripping action, the drip pan 22 is provided t0 prevent the uid from running down the face of the panel 12. It should also be noted herein that the second actuating unit 94 need not be limited to a foot actuated linkage. It is entirely conceivable that an electric motor or the like, energized for example by the nurses hand or foot interrupting a light ray between a pair of photoelectric cells, could be easily adapted to ladjustably reciprocate the slide bar 100.
The importance of the capability of the machine 10 to effect an extremely quick change of a stored suture dispensin-g unit 42 for a unit 42 on the top shelf, cannot be over-emphasized. Due to the structure provided, a circulating nurse in an operating room, for example, need merely depress the latch 36 (FIG. 5); pull the upper unit 42 olf the tracks 28 and 29; set the unit 42 aside; pick up a stored lower unit 42 (FIG. 2) from a lower shelf; insert the new unit in between the open pair of tracks, guided by the lead studs 65 on the protruding lower tra-ck end 37; and push the unit 42 forward until the limit pins 33 are engaged by the studs 25, whereupon the latches 36 lock.
This action automatically meshes the lower gear 84 with the slide bar rack 108, whereby the rst and second actuating units for the new unit 42 are immediately available for utilization by the scrub nurse. She depresses the correct foot pedal 24, whereupon the strips 49 and 51 of that particular web 44 are separated to expose for use the next suture 46.
Due to the web 44 between each pocket 52, or between each suture 46 or the like, being bonded transversely across the entire width, the element 46 just exposed by the scrub nurse has remained sterile for an indeiinite period of time. It thus may be appreciated that no suture 46 in the machine 10 need be exposed until absolutely necessary for use, and that no suture 46 not used need even be contacted or handled in any manner after originally being loaded, it being retained by the machine in an antiseptic condition until actually used.
In view of this description, it is believed that a means for 4automatically dispensing sutures and the like in an individual and sterile manner has been disclosed, which means is novel, practical, and economical, .and which means when placed in an operating room would be of tremendous value and savings to all concerned.
Although a preferred embodiment of this invention has been described and disclosed hereinbefore, it is to be remembered that various modications and `alternate constructions may be made thereto without departing from the true spirit and scope of the invention as defined in the appended claims.
1. A machine for individually dispensing thin elements such as sutures and the like, -comprising in combination:
.a housing having a slot formed therein through which the elements may pass;
a magazine unit containing a means for holding a plurality of the elements retractably inserted into said housing and supported thereby adjacent said slot;
said holding means including a pair of superimposed, exible, separately connected strips between which a plurality of the elements are inserted in longitudinally spaced relation;
said unit including guide means protruded outwardly through said slot for guiding said strips las a unit outwardly of said housing;
said unit including further upper and lower pairs of rollers for gripping said strips such, upon rotation, to `separate said strips and feed the elements successively through said guide means and outwardly -of said slot;
first actuating means including at least a gear mounted on said unit for rotating said rollers;
second actuating means mounted yon said housing, and including a reciprocal rack engageable by said gear upon insertion of said unit into said housing; and
in said means for reciprocating said rack includes a footoperated linkage mounted within said housing, with a foot pedal thereof exposed at the bottom front of the housing.
References Cited by the Examiner UNITED STATES PATENTS 732,337 6/1903 Clemons 221-72 778,515 12/ 1904 Trefny 221-131 1,079,996 12/1913 Stimpson 22l-l31 1,925,502 9/1933 Schaeffer 221-72 2,471,055 5 1949 Asbill 221-72 FOREIGN PATENTS 910,047 3/1945 France.
1,026,333 10/1950 France.
ROBERT B. REEVES, Primary Examiner- WALTER SOBIN, Examiner.