US 3324855 A
Abstract available in
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Description (OCR text may contain errors)
June 13, 1967 H. J. HElMLlCH 3,324,855
SURGICAL SPONGE STICK Filed Jan. 12, 1965 2 Sheets-Sheet 1 INVENTOR HAM/F) J. f/E/MZ my ATTORNEYS June 13, 1967 H. J. HEIMLJCH 3,324,855
SURGICAL SPONGE STICK Filed Jan. 12, 1965 2 Sheets-Sheet 2' INVENTOR Win/k) J. f/f/Ml/(I/ ATTORNEYS United States Patent 3,324,855 SURGICAL SPONGE STICK Henry J. Heimlich, 851 Forest Ave., Rye, N.Y. 10580 Filed Jan. 12, 1%5, Ser. No. 425,013 Claims. (Cl. 128269) This invention relates to an improved surgical instrument in the form of a surgical sponge stick, capable of performing several functions during operating procedures.
Sponge sticks, as they are commonly referred to, are surgical instruments for use in prepping a patient (sterilizing an area on the body where an incision is to be made) prior to an operation and for maintaining the operating field clear of fluid by controlling the blood flow and general oozing associated therewith. Sponge sticks now in use comprise expensive metal forceps that must be presterilized, having clamping jaws into which is inserted a rectangular or square shaped surgical sponge. The sponge is usually folded and loaded into the forceps by a nurse and then handed to the physician for use. The sponge becomes rapidly saturated and must be replaced immediately. This presents a serious problem. During an operation, a large number of sponges of this type are necessary. The problem of sponge count presents itself as each sponge used during an operation must be accounted for. Many devices and systems have been developed for reducing the danger of sponge loss. Thus, sponge racks and the like have been utilized. The danger is a serious one and operations have been delayed considerably while searching for a lost sponge. An incorrect sponge count may prolong anaesthesia for the patient, bring about a need for X-rays in the operating room if the sponge is left in the patient, generally reduce operating efiiciency and endanger the patients life.
Even with the best of sponge material readily available, sponges tend to saturate very quickly. They must be discarded and new ones immediately supplied, thus prolonging measurably the operating time. In addition, care must be exercised not to bring in contact any metal of the forceps with organs when retracting, as there is a danger of inducing hematoma or lacerating an organ.
Prior to the operation, the area of incision on the body of the patient must be sterilized. The prepping procedures involve a cumbersome series of steps resulting in loss of sterilizing solution and increase in operating time.
My invention overcomes the aforementioned problems. It is an object of my invention to eliminate or reduce substantially the sponge count problem and to increase the ability of the sponge material to retain its absorbency. In addition, sponge materials, such as polyurethane, which are less absorbent than the normal gauze sponge and not practically usable, may now be utilized. The sponge material of my device may be rejuvenated by simply placing it in saline solution to free any possible clotting. It is a further object of my invention to reduce substantially the operative time'and thus decrease the danger to the patient. In this connection, the very sponging action of my device is faster and far superior to anything presently available. It is an additional object to eliminate the folding and loading time of sponges. My invention eliminates the danger of hematoma or laceration of an organ when brought in contact therewith, and accordingly, my sponge stick may be used as a retractor for overlying organs to keep the operative field unobstructed by these organs. The sponge portion itself may serve to aid in the retraction as suction is diffused throughout this portion, thus eliminating the direct application of suction to an organ. A further advantage of my sponge stick is that it may be used for prepping a patient and in this connection, eliminates the need for a sterile container of prep solution by "ice having the antiseptic solution acompanying the sponge stick, thus greatly simplifying this procedure.
My invention presents the further advantage that one hand can be used for sponging as well as suctioning thereby freeing the surgeon and his assistant for other duties. Furthermore, the operative field is kept cleaner at all times thereby increasing visibility. The operative field is kept clear of blood and other fluid, including saline, used to wet down and wash out certain areas.
My invention contemplates the provision of an improved surgical sponge stick comprising a hollow tubular handle made of a relatively rigid material and having a first end with an opening adjacent thereto, a second perforated end and a porous absorbent surgical sponge material mounted on said handle in surrounding relationship with said perforated end. The first end of the handle is formed so that it can be attached to a source of suction. In this regard, fluid, such as blood, may be aspirated through the surgical sponge and the tubular handle. The sponge is fixed to the tubular handle and the entire device may be for one time use. In addition, means such as a frangible cartridge containing an antiseptic solution may be placed within the hollow tubular handle.
Several modifications of the sponge stick and the manner of using the same are described herein with references to the drawings in which:
FIG. 1 is a partially fragmentary view of one form of my invention with a portion of the sponge being cut away to show the mounting of the sponge on the handle;
FIG. 2 is a sectional view taken along the line 22 in the direction of the arrows as indicated in FIG. 1;
FIG. 3 is a cross-section of the sponge and handle portion associated therewith taken along the line 3-3 in the direction of the arrows as indicated in FIG. 2;
FIGS. 4 and 5 are fragmentary views of the second and third embodiments of my invention in which fluid retain ing means are provided in the handle;
FIG. 6 is a view somewhat similar to FIG. 1 showing the addition of supporting means for the surgical sponge;
FIG. 7 is a cross-section of the handle portion taken along the lines 77 in the direction of the arrows as indicated in FIG. 6;
FIGS. 8, 9, 10 and 11 show in cross-section, alternate forms which the handle of my invention may assume;
FIGS. 12 and 13 are views partly in section showing suction means attached to the end of the sponge stick;
FIGS. 14 and 15 are views partly in section showing alternate means for attaching suction means to the sponge stick for swive-l movement;
FIG. 16 shows in the unassembled condition, the handle, sponge and supporting structure of yet another embodiment of my invention;
FIG. 17 is a sectional view of the parts of FIG. 16 in their assembled relationship; and
FIG. 18 is a sectional view of the sponge and handle in which the perforations of the handle provide communication between the sponge and the interior of the handle on one side only of the sponge.
Each of the forms of sponge stick shown in the drawings comprises a tubular handle having a first end with an opening adjacent thereto and a second perforated end and a sponge portion made of a porous, absorbent material which is secured to the handle in surrounding relationship to the second perforated end.
Referring to the form of sponge stick shown in FIGS. 1, 2 and 3, the tubular handle is shown at 10, and it has a first open end portion 12 and a second perforated end portion 14. The handle may be made of any suitable material which is inert and unaffected by the body fluids, antiseptics, anaesthetics and other materials with which it is used and with which it comes in contact. The material should also be such that the handle is relatively rigid, i.e.
it should be sufliciently rigid to support the sponge portion while in use and also to serve as a retractor for the retraction of organs during surgical procedures. However, it should be yieldable or flexible enough so that it can be squeezed or flexed sufficiently to rupture the frangible container shown in FIG. 4 and release the contents thereof as will be hereinafter explained. For this purpose, I have found that plastic materials, such as polyethylene, polypropylene and polystyrene serve very satisfactorily. These materials present the further advantage that they will not cause hematoma, nor laceration of overlying organs in the operative field when in contact therewith.
In the form shown in FIGS. 1-3, the second perforated end of the tubular handle is non-circular in configuration, i.e. it is partially flattened as shown. The size of this flattened portion may be varied to lend additional support to the sponge. The perforations are indicated by the numeral 16 and the number and arrangement thereof may be varied.
In the form of device illustrated in FIGS. 1-3, perforations are provided on both flattened sides and also on both of the narrow sides, as shown. Thus, communication is provided between all portions of the surrounding sponge and the interior of the tubular handle.
As previously indicated, the sponge portion 18 is attached to the tubular handle in surrounding relationship to the perforated end. The sponge portion may be made of any suitable porous, absorbent material which is inert and unaffected by the body fluids, antiseptics, anaesthetics and other fluids with which it is used and with which it comes in contact. Thus, it may be made of gauze of the type used in conventional surgical sponges or it may be made of a suitable elastomeric synthetic sponge material, such as polyurethane, polyethylene or polypropylene foam.
The sponge portion 18 is attached to the handle 10 in surrounding relationship to the perforated end. Where gauze is used for the sponge portion, the successive wrappings or layers of gauze may be stitched together or, as in the case of the surgical sponges presently used, may simply be held together by the fibers or lint of the gauze. A sponge portion made of gauze may be suitably secured to the perforated end of the tubular handle as shown as by stitching or by a suitable adhesive, which is inert t and unaffected by the fluids which come in contact therewith. A suitable adhesive for this purpose is silicone adhesive. Thus, the outer surface of the perforated end of the handle may be coated with the liquid silicone adhesive and the gauze sponge portion applied thereto.
Where the sponge portion is made of an open cell plastic foam material, the sponge portion may be held in place by friction or by a suitable adhesive of the type indicated above. 7
In using my improved sponge stick as a surgical sponge, the opening adjacent the first end of the handle is connected to a suitable source of suction, such as a vacuum pump, vacuum chamber or the like. In FIGS. 12 to 15, I have shown various illustrative coupling structures for connecting the open end 12 of the tubular handle to a vacuum line. Thus, in FIG. 12, I have shown a coupling sleeve 20 which couples the end of the tubular handle to vacuum line 22. The coupling sleeve 20 has a tight frictional fit with both the handle and the vacuum line. In this connection, both the coupling sleeve and the vacuum line should be made of a material inert to and unaffected by the fluids which come in contact therewith.
In FIG. 13, the open end of the tubular handle is fitted with a tubular plug 24, having an enlarged sleeve portion 26 which engages over the vacuum line 22. The plug portion has a tight frictional fit with the inner wall of the tubular handle and the sleeve portion 26 has a tight frictional fit with the outer surface of the vacuum line.
In FIGS. 14 and 15, I have shown couplings for providing a swivel connection to both the opening at the first end of the tubular handle and the vacuum line. Thus, in FIG. 14, I have shown a coupling sleeve 28 tightly embracing the outer end of the tubular handle and having a reduced outer end portion 30 terminating in an exterior lip portion 31. The vacuum line 32 is provided with a restricted collar portion 34 projecting therefrom at right angles and which engages the reduced end 30 of the coupling member so that it can rotate with respect thereto and will be held in place by the outer lip portion.
In FIG. 15, the vacuum line 36 is provided with a laterally projecting collar portion 38, having a plurality of circumferential interior ribs 40 which frictionally engage the exterior surface of the first end of the tubular handle to provide a sealing fit while, at the same time, permitting relative swivel or rotary motion. To help provide a sealing fit between the vacuum line and the tubular handle, I also preferably provide shoulder portions 42 in the interior of the vacuum line in engagement with the outer end of the handle.
During surgical procedures, such as surgical operations, the first end of the tubular handle is connected, as indicated, to a source of suction. The surgeon or assistant can then grasp the handle portion of the sponge stick in one hand, leaving his other hand free. The sponge portion is applied to appropriate areas to remove blood or other fluid and thereby maintain the operative area clean and visible at all times. The blood or other fluid is removed both by the aspirating action and by the absorption characteristics of the sponge portion. Most of the fluids will be aspirated through the sponge and perforations and thence, through the handle portion to a receptacle adjacent the source of vacuum. In this connection, it will be appreciated that the sponge performs afiltering action so as to prevent solid particles from clogging the perforations in the handle portion. In addition, the absorbency of the sponge material is increased measurably with the employment of suction. Thus, the sponge may, if it has solid material adhering to it to obstruct the fiow of fluids therethrough (which does not easily occur) be rejuvenated simply by dipping it in saline solution.
During the surgical procedure, the sponge stick may also be used as a retractor for retracting overlying organs in the operative field. By engaging the sponge portion with the overlying organ, at no time do sharp metal edges come in contact with tissue to cause hematoma or laceration.
For general use, it is desirable to have perforations on all sides of the second end of the handle so as to provide communication between all portions of the sponge and the source of suction. However, for certain purposes. it might be desirable to have the suction operating through only one portion of the sponge. To accomplish this result, perforations may be formed on one side only at the perforated end of the tubular handle. Alternatively, the perforated end of the handle may be perforated on all sides but may be provided with an impervious plastic shield 44 between the sponge portion and the perforated end of the handle throughout the area where it is desired to eliminate the suction, as shown in FIG. 18. The impervious shield 44 may be made of a suitable flexible plastic material which is unaffected by the fluids which come in contact therewith as, for instance, polyethylene or polypropylene. It may be secured in place by an adhesive of the type indicated above.
Under certain circumstances, it may be desirable to maintain the configuration of the sponge portion, as for instance, when it is used as a retractor as well as a sponge. For this purpose, suitable support means or frame work may be provided in the interior portion of the sponge portion in engagement therewith. Thus, as shown in FIG. 6, a support in the form of a pair of U-shaped filaments 46 may be embedded in the sponge portion on opposite sides of the perforated end portion in engagement therewith. The supports may be made of metal wire or a suitable plastic material unaffected by the fluids which come in contact therewith as, for instance, stainless steel, polyethylene or polystyrene. The end portions of the supports may be suitably secured to the sides of the perforated end portion of the handle by being embedded therein or cemented thereto.
An alternate form of supported configuration for the sponge portion is shown in FIGS. 16 and 17. In this form of device, the sponge portion is formed of two sections 18' which are secured on opposite sides of the perforated end portion of the tubular handle and are held in the desired configuration by the complementary support means 48 and 49 disposed on opposite sides of the sponge portion. The support means 48 and 49 may be made of plastic filaments inert to and unaffected by the fluids which come in contact therewith, of the type indicated above. Where the sponge portion is of rectangular configuration the support means are preferably of rectangular configuration but slightly smaller in size than the sponge portion. The support member 48 is provided with projecting stud portions 50 and the support member 49 is formed with complementary receptacle portions 51 for receiving the stud portions.
In assembling the structure in FIGS. 16 and 17, the two sections of the sponge portion 18' are arranged on opposite sides of the perforated end of the handle and the support members 48 and 49 are arranged in alignment with each other on the opposite surfaces of the two sponge portions and pressed toward each other. The receptacle members 51 and studs 50 penetrate through the sponge material and the studs engage in the receptacle members. The studs may be retained in the receptacle by friction or by a suitable bonding agent of the type indicated above. When thus assembled, the sponge portion will be maintained in substantially its original configuration by support members 43 and 49.
The cross-sectional shape of the handle portion may conveniently be circular as shown in FIG. 7. However, various other configurations of handle portion may be used to facilitate gripping and to provide strength thereto, as shown at a, 10b, 10c and 10d in FIGS. 8 to 11. In addition, the shape and size may be varied to provide for sponge sticks which may be used as retractors for large organs, such as the intestines.
As previously indicated, my improved sponge sticks may be used in prepping a patient prior to an operation. When used for this purpose, I prefer to provide a suitable antiseptic, sterilizing or prep solution or liquid in the handle portion. In this connection, the liquid or solution may be retained in the tubular handle or associated therewith in any suitable fashion so that it may be readily released to the sponge portion when desired.
Illustrative embodiments of the sponge stick having liquids or solutions of this type in the tubular handle are shown in FIGS. 4 and 5.
In FIG. 4, the liquid or solution is contained in a frangible cartridge 52 disposed in the handle and retained therein by means of a suitable stop 54 secured inside the handle adjacent the first open end thereof. The stop may be made of a plastic material similar to the handle and may be cemented in place. The cartridge or ampoule 52 may be made of a thin frangible plastic material which will break when the handle is squeezed or when it is flexed through the area Where the ampoule is disposed. For this purpose, the ampoule may be made of a thin brittle polystyrene, polypropylene or other suitable material.
In the form of device shown in FIG. 5, I provide the handle with a small dimple 56 which serves as a stop or positioner for a diaphragm 58. Spaced from the diaphragm 58 toward the first end portion of the handle is a smaller piston member 60 which may be operated by a plunger 62. Initially, the solution or liquid is contained inside the handle between the diaphragm 58 and the piston 60. Both the diaphragm and the piston may be made of a suitable plastic material inert to the material contained in the handle such as polyethylene or polypropylene. Also, both the diaphragm and piston have frictional 6 sealing engagement with the interior of the handle portion.
When it is desired to use the sponge sticks shown in FIGS. 4 and 5, in prepping a patient prior to an operation, the antiseptic or prep solution is first released into the sponge portion. In the form shown in FIG. 4, this is accomplished by breaking the frangible ampoule by squeezing or flexing the handle. In the form shown in FIG. 5, this is accomplished by shifting the plunger 62 to the left so as to cause the piston to increase the pressure of the liquid sufliciently to open or release diaphragm 58. In both instances, the liquid will flow downwardly to the perforated end of the handle and thence, through the perforations into the sponge. The antiseptic liquid is then swabbed over the surface of the skin where the incision is to be made.
In the several forms of my invention, the specific shape or configuration of the sponge portion may be varied. At the present time, surgical sponges are generally of rectangular configuration and the sponge portions of my sponge sticks may be of similar configuration. However, it should be understood that the sponge portions may be of circular or any other geometric configuration.
In addition, the specific shape or configuration of the handle 10 may also be varied. It should be long enough to be conveniently gripped by the hand and sufficiently long to eliminate or substantially reduce the chance of the sponge stick being left in the operative area when closing.
It will thus be seen that I have provided an improved sponge stick which may be used either for prepping a patient prior to an operation or for maintaining the operable field clear of fluid by controlling the blood flow and general oozing associated therewith.
Modifications may be made in the illustrated and described embodiments of my invention, as for instance, by varying the specific shape or configuration of the different parts or by varying the means used for retaining the parts in assembled relationship or by varying the structure for retaining the antiseptic or prep solution in the handle.
1. A device to be used as a surgical sponge for removing excess fluids during surgical procedures comprising: a hollow tubular handle made of relatively rigid plastic material having a first end with an opening adjacent thereto and a perforated second end with a partially flattened configuration, porous absorbent surgical sponge material mounted on said sponge handle in surrounding relationship to said partially flattened perforated end, said first end of the handle having means for connecting the opening of the first end of the tubular handle to a source of suction so that fluid may be aspirated through the sponge material and handle.
2. A device to be used as a surgical sponge for removing excess fluids during surgical procedures as set forth in claim 1 in which the perforations at the perforated end of the handle provide communication between the sponge and the interior of the handle on one side only of the device whereby aspiration will take place through the sponge material on said one side only.
3. An improved surgical sponge stick in accordance with claim 1 wherein a hollow tubular handle made of a relatively rigid material and having a first end with an opening adjacent thereto and a second perforated end, porous absorbent surgical sponge material mounted on said handle in surrounding relationship with said perforated end and means are within said tubular handle for releasably retaining a fluid therein.
4. An improved surgical sponge stick as set forth in claim 3 in which said fluid retaining means comprises a frangible cartridge and in which a stop is provided at the first end of said tubular handle to retain the cartridge within said tubular handle.
7 V v 8 5. An improved surgical sponge stick as set forth in References Cited claim 3 in which said fluid retaining means comprises 21 UNITED STATES PATENTS diaphragm positioned in the tubular handle relatively adjacent the perforated end, and also piston means posi- 1853238 4/1932 stilelds 128*269 2,294,186 8/1942 Klrschbaurn 128269 tioned in the handle and spaced from said diaphragm 5 2171070 11/1956 S 128 231 toward said first end of the handle whereby the diaphragm axon 3,179,108 4/1965 Boch et al 128-269 can be opened by shifting the piston toward the diaphragm to increase the fluid pressure. ADELE M. EAGER, Primary Examiner.