US 3762418 A
A surgical suture for ligating, tying or suturing two sutures simultaneously with a single maneuver. An eyeless needle is swaged to an end of a main suture section. The main suture section ends are fused portions of two separate strands of suture material. The separate strands form an intermediate portion of the main suture section between fused portions. Alternatively, the main suture section may have a plurality of intermediate separate suture strand portions connected to each other by fused portions. Marking bands are located at the junctions of the fused portions with the intermediate separate strand portions.
Description (OCR text may contain errors)
United States Patent 1 Wasson 1 1 Oct. 2, 1973 1 1 SURGICAL SUTURE 221 Filed: May 17, 1972 211 Appl. No.: 253,983
OTHER PUBLlCATlONS Bickham, Operative Surg. Vol. 1, 1924 pp. 226-269.
Digby, Surg. Gyne., Obstet., Vol. 31, 1920 pp. 410-411.
Primary Examiner-Dalton L. Truluck Attorney-John H. Bishop ct a1.
 ABSTRACT A surgical suture for ligating, tying or suturing two sutures simultaneously with a single maneuver. An eyeless needle is swaged to an end of a main suture section. The main suture section ends are fused portions of two separate strands of suture material. The separate strands form an intermediate portion of the main suture section between fused portions. Alternatively, the main suture section may have a plurality of intermediate separate suture strand portions connected to each other by fused portions. Marking bands are located at the junctions of the fused portions with the intermediate separate strand portions.
8 Claims, 7 Drawing Figures SURGICAL SUTURE BACKGROUND OF THE INVENTION l. Field of the Invention The invention relates to surgical sutures and in. particular to an improved surgicalsuture for saving the time of a surgeon in'performing suturing, ligating and closing procedures. Particularly, a double suture or ligation is provided having added strength and an increased safety factor which may be tied by a single suturing or ligating maneuver.
2. Description of the Prior Art Surgical operations usually require a considerable number of suturing and ligating maneuvers tobe performed by the surgeon for closingincisions or for tying off blood vessels, ducts and the like. It is most desirable to achieve as strong a suture or tie as possible in a minimum of timeand with a minimum amount of tissue trauma.
Increased strength of sutures and ties are obtained by variously treating the strands of suture material, or through the use of multifilament or braided filament suture strands, or by using various types of'filament material, such as wire, silk, cotton, Dacron, etc.
One known method used by surgeons to increase the strength and safety factor of sutures and ties is to use a double suture or tie. This is accomplished by suturing or tying the incision or vessel with a separate second suture or ligation, The two separate sutures or ties may be placed a short distance apart, or in adjacent side-byside fashion, or may be entwined.
The prior known use of double sutures and ligations, however, has some disadvantages. Doubling the amount of sutures required to be prepared for an operation is involved. The amount of the surgeons time to complete the suturing is doubled, since two separate maneuvers are required for making each of the two ties for the double suture.
Surgeons have attempted to avoid these problems, and yet achieve the desired results of a double suture or tie, by threading two separate sutures through an eyed needle. This arrangement also presents problems.
The pulling of the two, doubled-over strands of suture material through the opening in the tissue made by the needle causes considerable tissue trauma due to the large diameter of the combined four suture strands with respect to the smaller diameter of the needle which forms the tissue opening. The four separate suture strands become tangled, and it is difficult to rapidly tie two sutures at the same time, especially if they are of unequal length and the ends of the sutures are dangling separately and loosely. Such situations test the patience of any experienced surgeon.
The use of eyeless needles to form swaged sutures, in contrast to the use of eye needles, has increased considerably in recent years. A swaged suture is a type of suture in 'which the suture strand is attached permanently to the blunt end of a needle.
The swaged suture has many advantages over eye needles. Swaged sutures reduce tissue trama since the needle and the suture strand are approximately equal in diameter. No threading of a needle before or during an operation is required. No sterilization of the needle and suture strand is required since the swaged sutures are disposable and are supplied packagedsterile and ready for use. The suture strand is securely attached to the needle and will not unthread during use.'No wash ing, sharpening or polishing of the needle is required since a new sharp, sterile and disposable needle is provided for each suture strand.
Thus, the need has existed for a surgical suture providing the advantages of a swaged suture, and which enables a double suturing or ligating procedure to be performed by a surgeon in a single maneuver. One prior art construction is known in which the suture has two separate suture strands swaged at one end directly to an eyeless needle. The other free ends of these two suture strands are connected and sealed together by a small lead weight or shot.
Such a suture construction has some disadvantages. It does not enable the double suture strands to be pulled completely through a tissue puncture if the puncture is made at the wrong location. The needle must be backed out which is difficult, or else the lead seal must be cut off requiring a new suture to be used. This suturedoes not enable double-armed sutures to be used, that is, one in which needles are attached at both ends of the suture strand. Double-armed sutures are desirable for performing many types of suturing and ligat- -ing procedures, such as the suturing of vessels where it is necessary to suture with both ends of the suture from the inside to the outside of the vessel to prevent separation of the vessel inner lining from the vessel wall.
SUMMARY OF THE INVENTION Objectives of the invention include providing an improved surgical suture for use by a surgeon in performing suturing and ligating procedures to achieve the advantages of a double suture or tie in a single suturing or tying maneuver; providing a surgical suture for achieving double sutures or ties in which the suture strands are swaged to an eyeless needle thereby gaining the advantages of a swaged suture; providing a surgical suture for achieving double sutures or ties in a single maneuver having needles attached at both ends of the suture strand to form double armed sutures to enable usual double-armed suture procedures to be performed, and to enable two separate double sutures or ligations to be performed with one double-armed suture; providing a surgical suture having marking bands in the suture strand indicating to the surgeon the location to cut the suture strand prior to the tying of the suture or ligation; providing a surgical suture which achieves the extra strength and added safety factor of double sutures and ligations, which reduces the surgeons time in making such double sutures and ligations, and which enables each double suture and ligation to be performed in a single suturing or ligating maneuver; providing a surgical suture which may be prepackaged in sterile conditions for immediate use at the site of the operation; and providing a surgical suture which satisfies the stated objectives, which avoids difficulties heretofore present in known sutures, and which is convenient and effective to use, thereby satisfying existing needs inincluding the art.
These objectives and advantages are obtained by the construction, the general nature of which may be stated as inincluding in a surgical suture for use in suturing and ligating procedures, a needle having sharp and blunt ends; a main suture section connected or swaged to the blunt end of the needle; the main suture section including first and second fused end portions and an intermediate portion extending between the fused portions; the fused and intermediate portions each including a plurality of suture strands; the strands in the fused portions being fused together; the intermediate portion having two separate strands of suture material whereby a double suture or ligation may be made with the separate strands by a single suturing or ligating maneuver; and the main suture section having marking means located at the junctions of the fused portions and intermediate portion.
In the alternative, the main suture section may include a plurality of intermediate portions, with intervening fused portions between the intermediate portions; and a needle may be swaged to each end of the main suture section.
BRIEF DESCRIPTION OF THE DRAWINGS Preferred embodiments of the invention illustrate of the best modes in which applicant has contemplated applying the principles are set forth in the following description and shown in the drawings are particularly and distinctly pointed out and set forth in the appended claims.
FIG. 1 is a perspective view of the improved surgical suture swaged to an eyeless needle;
FIG. 2 is a diagrammatic view showing the suture being used for ligating a blood vessel;
FIG. 3 is a similar view showing the next stage in the ligation procedure after the knot has been formed and the needle removed;
FIG. 4 is a similar view showing the ligated vessel secured by double strands of ligating material and a single knot;
FIG. 5 is a diagrammatic view showing an incision being closed by a plurality of the improved surgical sutures;
FIG. 6 is a modified form of the improved surgical suture showing a double armed suture having a middle fused portion and two intermediate double strand portions; and
FIG. 7 is another modified form of the improved surgical suture having fused portions between three intermediate double strand portions.
Similar numerals refer to similar parts throughout the drawings.
DESCRIPTION OF THE PREFERRED EMBODIMENTS First Embodiment The improved surgical suture is shown generally in FIGS. 1 through 5 at 1, and comprises an eyeless needle 2, and a main suture section 3. Suture section 3 has fused end portions 4 and 6, and an intermediate portion 5 consisting of separate entwined strands 5a and 5b extending between fused portions 4 and 6. The strands 5c and 5d in the fused portions 4 and 6 are parts of the strands 5a and 5b, respectively. Strand parts 5c and 5d may extend in parallel fashion as shown, or may be entwined prior to and after fusing as a single unitary fused portion 4 or 6.
Needle 2 is a usual eyeless needle in which suture section 3 is inserted into an axial opening formed in the blunt end 7 of the needle to form a single armed swaged suture. Examples of such eyeless needles for swaged sutures are shown in US. Pat. No. 2,928,395. Such eyeless needles also are sold under the trademark Atraumatic" by David & Geck, a division of American Cyanamid Company, and may have a cutting or non-cutting tip.
The suture material or filaments forming suture section 3 and the strands 5a, 5b, 5c and 5d thereof, may be made of any one of usual suture materials, such as silver, silk, cotton, polyethylene, nylon, or many of the synthetic materials presently used for making sutures. Likewise, the suture material may be a single filament or thread (monofilament) or may be a braided filament or thread (multifilament).
Strands 5a, 5b, 5c and 5d may be either multifilament or monofilament members and separate strands 5a and 5b are fused together to form fused portions 4 and 6 by various means, such as bonding by adhesives as in US. Pat. No. 2,928,395, or by using a silicone coating as a bonding or fusing material. Strands 5a and 512 may be strands of nylon, polypropylene or other plastics, or may have a plastic coating applied to the stands which then are fused together into portions 4 and 6 by the use of ultrasonic welding such as disclosed in US. Pat. No. 3,642,010.
The examples described comprise several of various ways by which some of the numerous types of suture materials may be used for the construction of the improved suture and in which suture material strand portions are fused together to form fused portions 4 and 6.
A small marking band 8 is formed at the junctions of fused portions 4 and 6 with separate strands 5a and 5b of the intermediate double suture portion 5. Bands 8 may be formed in suture 1 by incorporating a dye into the suture material. Bands 8 preferably have a color contrasting with the color of the suture, so as to be seen readily by a surgeon or assistants during an operation, for a purpose which is discussed below.
The length of the separate strands 5a and 5b of the intermediate portion 5 may vary depending upon the particular suturing or tying procedure to be performed with suture I. The length of strands 5a and 5b of portion 5 usually will be between 16 and 18 inches for use in most suturing and tying procedures. Fused portions 4 and 6 have a shorter length than strands 5a and 5b but must have a length sufficient to be grasped by the surgeon for tying the intermediate portion 5 to form a suitable surgical knot.
An example of the use of improved suture l and the advantages achieved thereby are shown diagrammatically in FIGS. 2, 3 and 4 for tying off a blood vessel 9 before severing the vessel.
Needle 2 and main suture section 3 are looped about blood vessel 9, as shown in FIG. 2. Needle 2 may be used to puncture and extend through a section of the outer blood vessel lining if desired, depending upon the particular ligating procedure used. A suitable surgical suture knot 10 then is loosely formed in intermediate portion 5 as shown in FIG. 3. Needle 2 preferably is cut from fused portion 4 before forming knot 10, or immediately thereafter, by the surgeon or assistant using a scalpel or scissors.
One of bands 8 indicate to the surgeon or assistant the approximate location to cut main suture section 3 to remove needle 2 therefrom. The cut is made through fused portion 4 between band 8 and needle 2, preferably adjacent the end 7 of needle 2, so that portion 4 has sufficient length to be grasped by the surgeon.
The surgeon then grasps fused portions 4 and 6, one portion in each hand or instrument, and pulls knot 10 tightly about blood vessel 9 as shown in FIG. 4. Additional locking knots may be tied on top of knot 10 as necessary.
The completed tie on the severed vessel 9 (FIG. 4) has a double tic, formed by separate suture strands 5a and Sb around vessel 9 and knot 10 was tied by a single tying maneuver. Thus, the increased strength and added safety factor of a double suture tie is achieved by a single tying maneuver in approximately one-half the time that normally is required to tie two separate knots in two separate suture strands.
A further advantage is present due to the entwined strands 5a and 5b. Should either strand 5a or 5b break, the entwining prevents or lessens the possibility of the broken strand becoming loose about blood vessel 9.
After knot 10 is secured, the excess suture material is cut easily from the completed ligation to provide a compact, strong double ligation.
Suture 1 provides the same advantages in making double sutures or stitches for closing an incision that are present in the described ligation procedure.
Referring to FIG. 5, several sutures l are illustrated in various stages of closing an incision 11. Two completed double sutures l2 and 13 have closed a portion of incision 11 and a partially completed suture 14 is shown closing a further portion of incision 11. Suture 1 is shown in the bottom portion of FIG. 5, as having pierced the tissue 15 on both sides of incision 11 prior to pulling the incision closed.
Single tissue punctures 16 are made on each side of the incision through which main suture section 3 is passed. The size of puncture 16 is approximately equal to the maximum diameter of needle 2 since the combined diameters of strands 5a and 5b, and the diameter of fused portions 4 and 6 preferably are equal to or less than the needles largest diameter. This reduced diameter and reduced number of tissue punctures reduces greatly the tissue trauma. Each completed suture or stitch is a double suture comprising the two strands of suture material 50 and 5b in the intermediate portion 5 and the stitch is formed by a single suturing maneuver while the surgeon is required only to grasp a single strand at each end (fused portions 4 and 6) to tie a single retaining knot.
Second Embodiment A modified form of the improved surgical suture is indicated at 17 (FIG. 6). Suture 17 is a double armed suture having eyeless needles l8 and 19 swaged to the ends of a main suture section 20. Suture section 20 has fused end portions 21 and 22, similar to end portions 4 and 6 of suture 1, located adjacent needles l8 and 19, respectively. An intervening fused portion 23 is located between and connects together two intermediate portions 24 and 25, having separate entwined strands 24a24b and a-25b, respectively. The other ends of intermediate portions 24 and 25 are connected to fused portions 21 and 22, respectively.
Marking bands 26, similar to bands 8, are located at the junctions of the fused portion 21, 22 and 23 with intermediate double strand portions 24'and 25.
The uses and manner of use of suture l7'are similar to those of suture 1, except that two double ligations or sutures can be performed with a single suture 17. For example, needle 18 of suture 17 can be inserted through the tissue on both sides of an incision until intermediate strand portion 24 is located through the incision and punctured tissue, in a manner similar to the location of intermediate portion 5 in FIG. 5. Fused portion 23 then is cut, preferably at its center, whereby one-half of suture 17, identical to suture 1, is in place for closing the incision, and the other one-half of suture 17, also identical to suture I, is available for tying another double suture along the incision.
Third Embodiment A further modified form of the improved surgical suture is indicated at 27 and is shown in FIG. 7. Suture 27 is similar to suture 17, having eyeless needles 28 and fused end portions 29, adjacent needles 28, at both ends of a main suture section 30. Suture section 30 includes a plurality of intermediate entwined double strand portions 31, 32 and 33. Intervening fused portions 34 and 35 connect double strand portion 32 to double strand portions 31 and 33, respectively.
Marking bands 36 are located at the junctions of the fused portions and the adjacent intermediate strand portions, similar to bands 8 and 26.
Suture 27 is used in the same manner as sutures I and 17 to provide double sutures and ligations with a single suturing or ligating maneuver. Three individual double sutures may be obtained from a single suture 27 in the same manner as two double sutures are obtained from suture 17.
Other suture constructions may be provided having four or more intermediate separate double strand portions, each separated by a fused portion. Such sutures, however, may become extremely long and impractical in performing usual suturing or tying procedures.
Although improved suture l is shown and described as having an eyeless needle attached to either one or both ends of main suture section 3, the main section 3 may be produced without a needle 2 attached, for use in many ligating procedures.
As discussed above, a surgeon may or may not puncture the outer blood vessel lining with needle 2 during a ligating procedure. Therefore, a ligation construction, as shown in FIG. 3, may be produced without a needle 2 attached, the needle being surplus in many ligating procedures. Such a ligation having a main section 3, with entwined strands 5a and 5b and fused end portions 4 and 5, provides an inexpensive ligation, which enables a surgeon to form a double ligation by a single tying maneuver in approximately one-half the time required to form two separate ligations.
Accordingly, the improved surgical suture provides for forming double sutures and ligations for closing incision, tying off blood vessels, ducts and the like in a single suturing or ligating maneuver; provides needles attached to both ends of the main suture section for suturing and ligating procedures requiring a doublearmed suture; enables two separate sutures or ligations to be tied with such a double-armed suture; enables double suture strands to be used swaged to eyeless needles to reduce tissue trauma and permit sutures to be sterilized and prepackaged for immediate dispensing and use at the time of an operation; provides a suture which is simple in construction and use; and provides for the rapid discharge of suturing and ligating procedures which heretofore have been time consuming because of the double maneuver required for each double suture and ligation. Accordingly, the improved surgical suture achieves the objectives indicated and solves problems in the art.
In the foregoing description, certain terms have been used for brevity, cleamess and understanding; but no unnecessary limitations are to be implied therefrom beyond the requirements of the prior art, because such terms are used for descriptive purposes herein and are intended to be broadly construed.
Moreover, the description and illustration of the invention is by way of example, and the scope of the invention is not limited to the exact details shown or described since the features of the invention may be applied to other constructions characterized by the new concept.
Having now described the features, discoveries and principles of the invention, the manner in which the improved surgical suture is made, the characteristics of the new construction, the new uses achieved, and the advantageous results obtained; the new and useful structures, devices, elements, arrangements, parts and combinations are set forth in the appended claims.
1. A surgical suture for use in suturing and ligating procedures including a needle having sharp and blunt ends; a main suture section connected to the blunt end of the needle; the main suture section including first and second fused end portions and an intermediate portion extending between said fused portions; said fused end portions having an axial finite length of an extent sufficient to be grasped by a surgeon; the fused and intermediate portions each including a plurality of suture material strands; each strand extending integrally from the first fused end portion through the intermediate portion and to the second fused end portion; the strands in the fused portions being fused together; and the strands in the intermediate portion being separate strands; whereby the intermediate portion strands may be tied by a single suturing or ligating maneuver to form a double suture or ligation.
2. The suture defined in claim 1 in which the main suture section includes marking means; and in which said marking means are located at the junctions of the fused and intermediate portions.
3. The suture defined in claim 1 in which the main su ture section has swaged connection with the blunt end of the needle.
4. The suture defined in claim 1 in which the diameter of the fused end portion of the main suture section connected to the needle is approximately equal to the largest diameter of said needle.
5. The suture defined in claim 1 in which the main suture section includes a plurality of intermediate portions, and in which a fused portion is located between each pair of intermediate portions.
6. The suture defined in claim 5 in which needles have swaged connection to each end of said main suture section.
7. The suture defined in claim 1 in which the suture material strands in the intermediate portion are entwined.
8. A surgical ligation for use in ligating procedures including a main ligation section having first and second fused end portions and an intermediate portion extending between said fused portions; the fused end portions having an axial finite length of an extent sufficient to be grasped by a surgeon; the fused and intermediate portions each including a plurality of ligation material strands; each strand extending integrally from the first fused end portion through the intermediate portion and to the second fused end portion; the strands in the fused portion being fused together; and the strands in the intermediate portion being separate strands and entwined with respect to each other; whereby the intermediate portion strands may be tied by a single ligating maneuver to form a double ligation.