US 3326217 A
Description (OCR text may contain errors)
June 20, 1967 s KE HEMOSTATIC CLAMP Filed April 27, 1964 2 Sheets-Sheet 24 INVENTOR HARRY SYDNEY KERR BY A fi llPJ ATTORNEYS June 20, 1967 H. s. KERR HEMOSTATIC CLAMP 2 Sheets-Sheet 2 Filed April 27, 1964 FIG. 4
IN VE/VTOR HAKRY SYDNEY K RR HTTOKN'Y United States Patent M 3,326,217 HEMOSTATIC CLAMP Harry Sydney Kerr, 184 Clark Ave., Thornhill, Ontario, Canada Filed Apr. 27, 1964, Ser. No. 364,883 7 Claims. (Cl. 128325) This application is a continuation in part of my copending application Ser. No. 314,918 (now abandoned) filed Oct. 9, 1963.
My invention relates to an instrument which is particularly useful as a surgical instrument for shutting off the flow of blood through an artery or vein past the point at which the clip is aflixed to the artery or vein.
An object of my invention is to provide a surgical instrument for clamping blood vessels and the like comprising a pair of opposed members each member having a body portion and an elongated reduced portion; pivot means between said body portions permitting relative pivotal movement between said members; variable pressure means acting on the members urging the reduced elongated portions toward each other in substantially aligned contacting relationship, whereby, when the instrument is applied to a blood vessel, such as a vein or an artery, the degree of compression on the blood vessel may be adjusted by the surgeon without risk or injury to that tissue.
A disadvantage of the type of clip presently in use is that it is not adjustable relative to the degree of compression which is to be applied to the blood vessel and, in the past, this has been overcome by providing an assortment of clips, each clip being tempered to exert a different compression, from which assortment the surgeon could select a clip exerting the desired compression. It is an object of my invention to overcome this disadvantage by providing a clip with means for varying the compression exerted by each clip to the desired degree. This not only reduces the cost of manufacture but also avoids the serious risk of the surgeon, inadvertently, selecting a clip of too great a compression which would hence injure the blood vessel.
Another disadvantage of blood vessel clips presently in use is that the clamping members of the clip tend to have a shearing action which, unless extreme care is taken 'when closing such clips on the blood vessel, may sever the blood vessel or do like irrepairable damage.
Therefore, another object of my invention is to provide a surgical instrument which avoids the foregoing disadvantage by providing means on the instrument which assure that, at least, the members which compress the blood vessel remain in parallel, aligned relationship without shearing action.
For a complete disclosure of particular embodiments of my invention reference will be had to the appended drawings wherein like numerals refer to like parts and wherein. a particular embodiment is shown:
FIGURE 1 is an exploded side perspective View of my invention, enlarged about seven times to show details of construction;
FIGURE 2 is a side perspective assembled view of my invention showing it in use, i.e., clamping a blood vessel;
FIGURE 3 is an end elevation of my invention;
FIGURE 4 is an exploded side perspective view of an alternate embodiment of my invention;
FIGURE 5 is a side perspective view of two members of a further embodiment of my invention showing the members in contacting relationship as they would appear in assembled form; and
FIGURE 6 is a side perspective view of a member of a still further embodiment of my invention.
Referring to the drawings, the instrument, generally 3,3262 1 7 Patented June 20, 1967 designated as 10, comprises an upper member 11 and a lower member 12 each having a flat surface 13, 14 respectively, facing one another. Each member 11, 12 is reduced at one end so as to present facing, fiat blades 15, 16. The ends 17 and 18 of the blades 15 and 16 may have any of several shapes, depending on the requirements of the particular application. For example they may be snub-nosed as illustrated in FIGURES 1 and 2 to allow the blades to be readily worked above and below the blood vessel. Alternately the outer surfaces of the blades may be tapered towards the ends 17 and 18 as shown in FIGURES 4 and 6 to provide relatively pointed ends to facilitate inserting the clamp into areas of limited space. The ends 17 and 18 may also be bent away from each other as illustrated in FIGURE 5 so that blood vessel may be more readily worked between the blades 15 and 16.
The surfaces 13 and 14 of the blades 15, 16 which contact each other may be smooth. However it is preferable that facing surfaces 13 and 14 have very fine serrations to improve the grip as illustrated in FIGURE 4.
In the embodiment illustrated in FIGURES 1 and 2 the remainder of the members 11, 12 hereinafter referred to as the body portions 19, 20 respectively, each have a longitudinal groove 21, 22 respectively, equally cut lengthwise into the respective outer waces of the body portions 19, 20. The configuration of these grooves is such as to receive and retain the free ends 23, 24 of a tempered C type spring 25 hereinafter referred to as the circlip. The circlip 25 is, however, slidable along the horizontal axis of the grooves 21, 22 which may be correspondingly calibrated to show the degree of movement of the circlip.
Each groove is provided with a means for ensuring that circlip 25 does not slide right through the grooves 21, 22 and off the ends of the respective body portions 19, 20
nearest the blades 15, 16 respectively. There are several ways in which this can be done and an expedient method is to simply not groove the body portions for their full length but to leave a short section at the end, as shown at 26 to serve as a limit of the grooves.
Also, as will be hereinafter explained, it is preferred that the dimensions of the circlip 25 be such that the circlip may pivot on its free ends 23, 24 and be swung around the ends of the members 11, 12 remote from the blades 15, 16.
In an alternative embodiment illustrated in FIGURES 4 and 5 the grooves 21 and 22 may be replaced by a series of circular depressions 38 in the outer faces of the body portions 19, 20. The depressions 38 may be produced by any known method such as drilling and are disposed in a line along the body portions 19 and 20 from the end nearest the blades 15 and 16 to a point nearly corresponding to the transverse grooves 27 and 28 referred to below. The depressions 38 are preferable to the grooves 21 and 22 in that they prevent the ends of the circlip from inadvertently slipping out of place and thus changing the compression of the clamp when it is in use. It has been found in practice that 3 or 4 depressions 38 in each of the body members 19 and 20 provide a sufiicient range in the degree of compression.
In a still further embodiment illustrated at FIGURE 6 the depressions 38 may be located on the outer faces of the blades 15 and 16. This embodiment is desired when a very small surgical clip is required as it allows for a considerable reduction in the size of the body portions 19 and 20.
Grooves.27 and 28 are transversely cut into the facing surfaces 13, 14 of the body portions 19, 20 respectively. As will be hereinafter explained, one or more pairs of such transverse grooves may be cut as illustrated in FIGURE 1 at 27a, 28a.
For reasons which will be hereinafter explained the end of the body portion 19 most remote from end 17 is bevelled, or otherwise reduced, in the direction of the body portion 20 as shown at 32.
My invention, in the illustrated and described embodiments is assembled by taking the member 12 in one hand and inserting the roller 29 into the transverse groove 28, the flanges 30, 31 hanging below the groove 28 and abutting the sides of the body portion 20. Member 11 is then taken and positioned so that its corresponding groove 27 engages with the roller 29. In the embodiment illustrated in FIGURES 1 and 2 each groove 27, 28 accommodates less than half of the diameter of the roller 29. The roller 29 acts as a spacer between the members 11, 12 and as a point about which such members may pivot. The point of pivot may be rendered adjustable by, as before suggested, providing more than one pair of grooves the same as grooves 27, 28 but at different points along the body portions 19, 20.
In the embodiment illustrated in FIGURES 4, and 6, the grooves 27 and 28 together accommodate the whole roller 29 to allow the surfaces 13 and 14 to come into substantially complete contact. In order to allow the members 11 and 12 to pivot about the roller 29 the ends of the body portions 19 and 20 remote from the blades 15 and 16 are undercut from the grooves 27, 28 at 32 and 32a. Consequently in this embodiment only one pair of grooves 27, 28 may be used.
The next step in assembly of the embodiment illustrated in FIGURES l and 2 is to take the circlip 25 and, by manually pivoting the blades 15, 16 into the fully open position, sliding ends 23, 24 into grooves 21, 22, at the ends of the grooves most remote from the blades 15, 16 respectively. The spacing between the ends 23, 24 is preferably such that the circlip 25 does not frictionally engage with the grooves 21, 22 until it is moved along the groove to approximately a point corresponding to the transverse grooves 27 and 28. This facilitates sliding the ends 23, 24 into grooves 21, 22. In the embodiments illustrated in FIGURES 4, 5 and 6 the ends 23 and 24 of the circlip 25 are inserted in respective corresponding depressions 38 in each of the members 11 and 12. This may be done most readily while the blades 15 and 16 are in the closed position.
In the use of my invention, the surgeon first prepares the area about the blood vessel 33 to which one or more of my invention is to be applied and then sufliciently increasing the space between the blades 15, 16 by squeezing the ends of the members 11, 12 remote therefrom a relative amount toward each other, works the blood vessel 33 between the blades 15, 16. The reduced portion 32 permits the members 11, 12 to be squeezed closer together, while still providing a stop, with a consequential pivot about the roller 29 and spreading apart of the blades 16, 17.
Once the blood vessel is between the blades 15, 16 the squeeze on the remote ends of the members 11, 12 is released and, as a result, the blades engage the blood vessel in what can be described as a position of rest which does not normally create sufficient compression to shut off the flow of blood past the point at which the blades lie. To create the desired compression in the embodiment shown in FIGURES .l and 2 the circlip 25 is slid down the grooves 21, 22 in the direction of the ends 17, 18. This movement allows the free ends 23, 24 to come closer together and force the blades 15, 16 closer together. This downward movement of the circlip is continued until the desired compression is obtained. When the circlip is moved between the pivot point and the ends of the body portions 19, 20 near and remote from the blades 15, 16 respectively compression between the blades is released and the said ends are urged towards each other in a closing action.
In the embodiment illustrated in FIGURES 4, 5 and 6 the degree of compression is adjusted by moving the ends 23 and 24 of the circlip 25 from one depression 38 to the adjacent depression in a step-wise manner. For example, if end 23 is in a depression 38 of member 11 and the end 24 is in the corresponding depression in member 12 the degree of compression may be increased by firstly withdrawing end 23 from its depression and sliding it into the next depression nearer the blade 15 and then moving the end 24 to the corresponding depression in a similar mannet. This process may be repeated or reversed to obtain the desired degree of compression.
In the embodiment shown in FIGURES 1 and 2, there should preferably be an inclination and declination of the blades 15, 16 relative to each other. The degree to which this inclination and declination is implemented is such that the blades will be parallel to one another when they are in the position of rest and it will be relative to the degree of spacing of the body portions 19, 20 caused by the roller 29. This parallelism is preferred to avoid an irritating shearing action which would otherwise be created when the blades 15, 16 were being released into a position of rest. In the embodiments shown in FIGURES 4, 5 and 6 the inclination and declination of the blades 15, 16 are not necessary as the members 11 and 12 are not spaced by the roller 31 and the blades 15, 16 are thus parallel when in a position of rest.
In my disclosure I have mentioned that the blades 15, 16 are formed of a reduced portion of the member 11, 12. This reduction decreases the amount of force required of the circlip to create the desired amount of compression and contributes to the sensitivity of the instrument preferred by the surgeon. In my invention I prefer blades having a thickness of approximately 7 of an inch.
In use it has been found practical to be able to pivotally swing the circlip on its ends 23, 24 about the end of the members 11, 12 remote from the blood vessel so that the surgeon may, if necessary, clear his line of sight to the area on which he is operating.
If desired, a depression 34, 35 can be provided in each of the body portions 19 and 20, respectively, near the end of their outer faces most remote from the blades 15, 16 such depressions being of such a size as to snugly accommodate a pin (shown at 36 in FIGURE 2) extending from each of the forward end of facing pincers of a forceps 37, in a direction toward each other. This added feature gives the surgeon additional control of my invention but, of course, it may be used efficiently with or without such feature.
While I have described and illustrated specific embodiments of my invention it is to be expected that those skilled in the art will be able to construct variations and modifications of my invention without departing from the spirit of the invention and, therefore, I intend to include such variations and modifications within the scope of the appended claims.
What I claim as new and desire to protect by Letters Patent of the United States is:
1. A surgical instrument for clamping blood vessels and the like comprising a pair of opposed members, each member having a body portion and an elongated reduced portion; pivot means between said body portions permitting relative pivotal movement between said members; variable pressure means acting on the members urging the reduced elongated portions toward each other in substantially aligned and contacting relationship, said variable pressure means comprising a series of circular depressions located in longitudinal linear relationship in each of the outwardly facing surfaces of the opposed members, and a tempered circlip, the open ends of said circlip engaging in respective depressions in the opposed members.
2. A surgical instrument for clamping blood vessels and the like comprising a pair of opposed members, each member having a body portion and an elongated reduced portion; pivot means between said body portions permitting relative pivotal movement between said members; variable pressure means acting on the members urging the reduced elongated portions toward each other in substantially aligned and contacting relationship, said variable pressure means comprising a series of circular depressions located in longitudinal linear relationship in each of the outwardly facing surfaces of the body portions, and a tempered circlip, the open ends of said circlip engaging in respective depressions in the body portions.
3. A surgical instrument as defined in claim 1 wherein the series of depressions extend along the outwardly facing surfaces of each body portion from the end adjacent the reduced portion to a point adjacent said pivot means.
4. A surgical instrument as defined in claim 1 wherein the inner surface of at least one body portion remote from the corresponding reduced elongated portion is undercut to permit the opposed members to pivot about said pivot means.
5. A surgical instrument as defined in claim 4 wherein the pivot means comprises a roller seated in respective grooves formed in the opposed body portions; said roller being provided with a peripheral, radially extending flange at each end thereof to substantially preclude lateral move' ment of the opposed members with respect to each other.
6. A surgical instrument as defined in claim 5 wherein the ends of the reduced portions remote from the body portions are divergent with respect to each other.
7. A surgical instrument as defined in claim 1 wherein the ends of each body portion remote from the reduced portions are grooved to provide seating means for clampadjusting tool means.
References Cited UNITED STATES PATENTS 1,684,721 9/1928 Wood 24l37.5 2,467,864 4/1949 Sisk 24-137 2,593,201 4/1952 Saunders 24-252 3,103,727 9/1963 Carr 24137.5
RICHARD A. GAUDET, Primary Examiner.
G. MCNEILL, Assistant Examiner.