|Publication number||US3833002 A|
|Publication date||Sep 3, 1974|
|Filing date||Sep 10, 1973|
|Priority date||Sep 10, 1973|
|Publication number||US 3833002 A, US 3833002A, US-A-3833002, US3833002 A, US3833002A|
|Original Assignee||J Palma|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (6), Referenced by (79), Classifications (14)|
|External Links: USPTO, USPTO Assignment, Espacenet|
United States Patent Palma 1 1 Sept. 3, 1974  APPARATUS FOR AIDING SEVERED 3,683,926 8/1972 Suzuki 128/334 R N V o O 3,786,817 l/l974 Palma 128/334 R  Inventor: James R. Palma, 1502 Curry Rd., FO EIGN TE TS OR APPLICATIONS Schenec dy, NY. 12306 591,509 8/1947 Great Britain 128/334 R l  Filed: Sept. 10, 1973 Primary Examiner-Lucie H. Laudenslager  APPI' 395,906 Attorney, Agent, or Firm-Oltman and Flynn  US. Cl. 128/334 R, 128/346 57 ABSTRACT  Int. Cl A61b 17/04  Field of Search 128/334 C 334 R 346 A surg1cal tube for aiding severed nerves to 10m, com- 128 /3 49 DIG posed primarily of a slow-dissolving material and having small, discrete areas which dissolve faster. These  References Cited discrete areas may be provided by particles of a different, faster-dissolving material that are embedded in UNITED STATES PATENTS the tube wall, or by a greatly reduced thickness of the IBdOWGII g tube wall itself at these areas yng 3,587,586 6/1971 Kronenthal 4. 128/334 R 7 Claims, 13 Drawing Figures PATENIH'JSEP 31am SHEET 1 0F 2 FIG.7
PATENTEI] SEP 3 I974 mraura FIG. 13
APPARATUS FOR AIDING SEVERED NERVES TO JOIN BACKGROUND OF THE INVENTION Severed nerves in the human body sometimes grow and heal after the nerve ends are brought into alignment and close proximity, or direct contact, with each other.
In US. Pat. No. 2,127,903 to Bowen, it has been proposed to heal a severed nerve by suturing the nerve ends and anchoring a sheath of absorbable animal membrane around them.
SUMMARY OF THE INVENTION The present invention is directed to aiding severed nerve ends to join by holding them end-to-end inside a slow-dissolving tube that, however, has small, discrete areas that dissolve relatively soon to leave small open ings which permit body fluids to contact the nerve ends inside the tube and promote the growth and healing process.
Accordingly, it is a principal object of this invention to provide a novel and improved apparatus for aiding severed nerve ends to join.
Another object of this invention is to provide such an apparatus which comprises a slow-dissolving tube for receiving the severed nerve ends which has small, discrete areas that dissolve much sooner than the rest of the tube so as to provide openings that enable body fluids to contact the nerve ends inside the tube.
Further objects and advantages of this invention will be apparent from the following detailed description of several presently-preferred embodiments, shown in the accompanying drawings in which:
FIG. I is a perspective view of a surgical tube in accordance with a first embodiment of the present invention;
FIG. 2 is a perspective view showing the FIG. 1 tube between two severed nerve ends that are to be joined;
FIG. 3 is a perspective view, partly broken away for clarity, showing the severed nerve ends inserted into the tube;
FIG. 4 is a longitudinal section taken along the line 4-4 in FIG. 3;
FIG. 5 is a view similar to FIG. 3 and showing the tube after its small, discrete, fast-dissolving areas have dissolved in the body, but before the slow-dissolving principal part of the tube has dissolved;
FIG. 6 is a perspective view of a second, T-shaped embodiment of the present surgical tube having a transverse stem for applying vacuum to the interior of the tube where the severed nerve ends are received;
FIG. 7 is a longitudinal section taken along the line 7-7 in FIG. 6;
FIG. 8 is a perspective view of a Y-shaped surgical tube receiving the severed nerve ends, with a transverse stem as one leg of the Y, in accordance with a third embodiment of this invention;
FIG. 9 is a longitudinal section through the FIG. 8 surgical tube;
FIG. 10 is a perspective view of a different form of generally Y-shaped surgical tube in accordance with a fourth embodiment of this invention;
FIG. 11 is a longitudinal section through the FIG. 10 tube;
FIG. 12 is a perspective view of a fifth embodiment of the present surgical tube, having aligned, transverse inlet and outlet stems; and
FIG. 13 is an enlarged longitudinal section through a wall of a surgical tube which has small, discrete areas which dissolve relatively rapidly because they are thin, in accordance with another embodiment of this invention.
Before explaining in detail the disclosed embodiments of the present invention, it is to be understood that the invention is not limited in its application to the details of the particular arrangements shown since the invention is capable of other embodiments. Also, the terminology used herein is for the purpose of description and not of limitation. I
DETAILED DESCRIPTION Referring first to FIGS. 1-4, the surgical tube shown there is a cylindrical tube having open opposite ends 21 and 22 into which the severed nerve ends 23 and 24 can be inserted slidably. The inside diameter of the tube is slightly greater than the diameter of the nerve ends to permit such slidable insertion to be performed quickly and easily. After the nerve ends are inserted into the tube, the opposite ends of the tube preferably are sealed with medical sealing material, as shown at 25 and 26 in FIG. 3 and 4.
For most of its extent the tube 20 has a wall thickness and a composition, such as animal tissue, such that it is dissolved, absorbed or digested in the human body relatively slowly. For example, it may take six months for the complete wall thickness of the tube to be completely dissolved.
In accordance with the present invention, the tube 20 is provided with small, localized, discrete areas that are dissolved, absorbed or digested by the body much more rapidly than the principal part of the tube. For example, these localized areas may dissolve completely in about 24 hours.
In the embodiment of FIGS. 15, these small, discrete areas are provided by discrete particles 27 of a relatively fast-dissolving material, such as sugar which are embedded in the tube wall and occupy the full thickness of the tube wall at these small areas. After a relatively short time in the body, these particles dissolve completely, leaving small discrete openings 27a in the surgical tube, as shown in FIG. 5. These small, discrete openings permit the passage of body fluids into contact with the nerve ends inside the tube to enhance the healing action as the severed nerve ends gradually join together. After this healing process is fully completed, or substantially so, the principal material of the surgical tube 20 also dissolves completely in the body.
As shown in FIG. 13, the fast-dissolving, small, discrete areas of the surgical tube may be provided by thin-walled web portions of the tube. For example, the tube wall 30 may have indentations or recesses 31 and 32 in its outside and inside faces, leaving only a thin web 33 between them that will dissolve much more rapidly than the full-thickness remainder of the tube. Alternatively or additionally, a recess or identation 34 may be formed in only one face of the tube, leaving only a fast-dissolving thin web 35 behind it. It is to be understood that these thin web, fast-dissolving portions of the tube are made of the same material as the slowdissolving much thicker remainder of the tube; they dissolve faster simply because they are thinner.
As shown in FIGS. 6 and 7, the present surgical tube may be T-shaped, with a transverse, serrated stem 40 midway between its opposite ends. This stem has a central passage 41 communicating with the interior of the tube where the nerve ends are received. The stem may be attached to a hose, indicated in phantom at 42 in FIG. 7, to enable vacuum to be applied to the interior of the tube while the nerve ends 23 and 24 are being inserted, so as to draw them into direct contact or close proximity with each other. After this has been done, the nerve-receiving opposite ends 21 and 22 of the tube are sealed by medical sealing material and 26, and after removal of the vacuum hose 42 at the end of the stem may be closed by such sealing material, also.
The stem 40 is of the same construction as the tube proper, being composed primarily of a slow-dissolving material and having small, discrete particles 27 of the fast-dissolving material.
FIGS. 8 and 9 show another embodiment of this surgical tube in which the severed nerve ends are received in straight legs 20a and 20b of the tube which are inclined at an obtuse angle to each other. The transverse, serrated stem 40 is joined to these legs 20a and 20b at the intersection between them so as to provide with them a Y-shaped surgical tube. Both legs 20a and 20b and the stem 40 have small, discrete particles 27 of the fastdissolving material embedded in them.
FIGS. 10 and 11 show another embodiment which is generally similar to that of FIGS. 8 and 9, except that it has opposite, nerve end-receiving legs 20c and 20d which curve toward each other and merge together smoothly where the stem 40 is connected to them. Both legs 20c and 20d and the stem 40 have small, discrete particles 27 of the fast-dissolving material embedded in them.
FIG. 12 shows yet another embodiment whose configuration is as disclosed and claimed in my copending US. pat. application, Ser. No. 258,737, filed June 1, I972, now US. Pat. No. 3,786,8l7. In this embodiment straight tube 20 is provided with two longitudinally spaced, transverse stems and 51 having central passages 52 and 53, respectively. which communicate with the nerve ends that are inserted into the opposite ends 21 and 22 of the tube. One of these stems serves as an inlet and the other as an outlet for filling the interior of the tube with a suitable healing ambience or substance that enhances the healing and joining together of the nerve ends during the period immediately following the insertion of the nerve ends into the tube. Both stems 50 and 51 and the remainder of the tube 20 contain small discrete particles of the fast-dissolving material. The tube ends 21 and 22 are sealed with medical sealing material after the severed nerve ends have been inserted and before the healing ambience is added. After the healing ambience has been added, the open ends of the stems 50 and 51 may be squeezed closed or closed by medical sealing material.
It is to be understood that in each of the embodiments of FIGS. 6I2, as well as in the embodiment of FIGS. 1-5, all or part of the surgical tube may have the small, discrete faster-dissolving areas provided by thin web portions of the tube wall or stem wall, in place of the particles 27 of a faster-dissolving material different from the material of which the tube is primarily composed. The slow-dissolving main body of the tube may consist of layers which dissolve successively.
1. Apparatus for aiding severed nerves to join comprising a tube having open opposite ends into which the nerve ends can be inserted, said tube being composed principally of a material that dissolves slowly in the body and having small discrete areas therein which dissolve in the body substantially faster than the remainder of the tube to provide small openings for the passage of body fluids into contact with the nerve ends inside the tube, said small, discrete areas being provided by embedded bodies of a different material than the principal material of the tube which dissolves in the body faster than the principal material of the tube.
, 2. Apparatus according to claim 1, wherein said tube has a transverse stem leading into its interior between its ends, said stem having small, discrete areas therein which dissolve in the body substantially faster than the remainder of the tube.
3. Apparatus according to claim 2, wherein said small, discrete areas in said stem are provided by em bedded bodies of a different material which dissolves in the body faster than the principal material of the tube.
4. Apparatus according to claim 2, wherein said tube and stem together are substantially T-shaped.
5. Apparatus according to claim 2, wherein said tube and stem together are substantially Y-shaped.
6. Apparatus according to claim 1, wherein said tube has a transverse inlet stem and a transverse outlet stem spaced from said inlet stern along the length of the tube and both communicating with the interior of the tube, said stems both having small discrete areas therein which dissolve in the body substantially faster than the remainder of the tube.
7. In a surgical tube for aiding severed nerves to join together, said tube being dimensioned to receive the nerve ends in its opposite ends and throughout most of its extent having a wall thickness and a composition effective to prevent the tube from completely dissolving in the body for several days, the improvement which comprises:
means providing small, discrete areas in the tube wall which dissolve in the body substantially faster than the remainder of the tube to leave small openings permitting body fluids to pass into contact with the nerve ends inside the tube,
said last mentioned means comprising small, discrete web portions of the tube wall which are substantially thinner radially than the remainder of the tube wall.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US2127903 *||May 5, 1936||Aug 23, 1938||Davis & Geck Inc||Tube for surgical purposes and method of preparing and using the same|
|US3526228 *||Mar 24, 1969||Sep 1, 1970||Ethicon Inc||Collagen lamina dural prosthesis|
|US3587586 *||Mar 15, 1968||Jun 28, 1971||Ethicon Inc||Porous collagen anastomotic cuff|
|US3683926 *||Jul 9, 1970||Aug 15, 1972||Dainippon Pharmaceutical Co||Tube for connecting blood vessels|
|US3786817 *||Jun 1, 1972||Jan 22, 1974||Palma J||Method and apparatus for aiding severed nerves to join|
|GB591509A *||Title not available|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US3916905 *||Nov 9, 1973||Nov 4, 1975||William E Kuhn||Method and means for the repair of severed peripheral nerves|
|US4013078 *||Oct 7, 1975||Mar 22, 1977||Feild James Rodney||Intervertebral protector means|
|US4306561 *||Nov 5, 1979||Dec 22, 1981||Ocean Trading Co., Ltd.||Holding apparatus for repairing severed nerves and method of using the same|
|US4350160 *||Apr 2, 1980||Sep 21, 1982||Kolesov Evgeny V||Instrument for establishing vascular anastomoses|
|US4501029 *||Apr 13, 1983||Feb 26, 1985||Mcminn Derek J W||Tendon repair|
|US4623355 *||Aug 19, 1985||Nov 18, 1986||Sawruk Stephen D||Prosthetic axon|
|US4662884 *||Apr 25, 1984||May 5, 1987||University Of Utah Research Foundation||Prostheses and methods for promoting nerve regeneration|
|US4778467 *||Jul 10, 1986||Oct 18, 1988||The University Of Utah||Prostheses and methods for promoting nerve regeneration and for inhibiting the formation of neuromas|
|US4877029 *||Mar 30, 1987||Oct 31, 1989||Brown University Research Foundation||Semipermeable nerve guidance channels|
|US4878913 *||Sep 4, 1987||Nov 7, 1989||Pfizer Hospital Products Group, Inc.||Devices for neural signal transmission|
|US5011486 *||Nov 18, 1988||Apr 30, 1991||Brown University Research Foundation||Composite nerve guidance channels|
|US5019087 *||Oct 6, 1986||May 28, 1991||American Biomaterials Corporation||Nerve regeneration conduit|
|US5026381 *||Aug 1, 1990||Jun 25, 1991||Colla-Tec, Incorporated||Multi-layered, semi-permeable conduit for nerve regeneration comprised of type 1 collagen, its method of manufacture and a method of nerve regeneration using said conduit|
|US5030225 *||Nov 30, 1990||Jul 9, 1991||Brown University Research Foundation||Electrically-charged nerve guidance channels|
|US5350388 *||Jun 3, 1992||Sep 27, 1994||Albert Einstein College Of Medicine Of Yeshiva University||Hemostasis apparatus and method|
|US5354305 *||Dec 17, 1992||Oct 11, 1994||United States Surgical Corporation||Nerve repair device|
|US5800544 *||Dec 4, 1995||Sep 1, 1998||Omeros Medical Systems, Inc.||Tendon and ligament repair system|
|US6071312 *||Aug 8, 1996||Jun 6, 2000||Lampe; Frank||Endoprosthesis, in particular an artificial hip joint|
|US6080192 *||May 28, 1998||Jun 27, 2000||Omeros Medical Systems, Inc.||Tendon and ligament repair system|
|US6106556 *||Oct 29, 1998||Aug 22, 2000||Omeros Medical Systems, Inc.||Tendon and ligament repair system|
|US6228111||Sep 27, 1996||May 8, 2001||Bionx Implants Oy||Biodegradable implant manufactured of polymer-based material and a method for manufacturing the same|
|US6740100||Mar 28, 2002||May 25, 2004||Omeros Corporation||Tendon repair using adhesive|
|US6808530 *||Jan 29, 2001||Oct 26, 2004||Karolinska Innovations Ab||Medical device for treatment of a gap or defect in the central nerve system|
|US6908470 *||Jan 10, 2002||Jun 21, 2005||Fraunhofer-Gesellschaft Zur Foderung Der Angewandten Forschung E.V.||Sieve electrode which can be connected to a nerve stump|
|US7147647||Apr 26, 2002||Dec 12, 2006||Medtronic, Inc.||Sintered titanium tube for the management of spinal cord injury|
|US8006700||Apr 2, 2002||Aug 30, 2011||Demopulos Gregory A||Soft tissue repair system|
|US8128954||Jun 7, 2005||Mar 6, 2012||California Institute Of Technology||Biodegradable drug-polymer delivery system|
|US8257372 *||Dec 29, 2009||Sep 4, 2012||Kci Licensing, Inc.||System for providing fluid flow to nerve tissues|
|US8388692||Jun 29, 2007||Mar 5, 2013||Kyoto University||Thin film multilocular structure made of collagen, member for tissue regeneration containing the same, and method for producing the same|
|US8435285||Oct 13, 2004||May 7, 2013||Boston Scientific Scimed, Inc.||Composite stent with inner and outer stent elements and method of using the same|
|US8444688||Jun 16, 2008||May 21, 2013||Boston Scientific Scimed, Inc.||Covered stents with degradable barbs|
|US8603074||Jun 25, 2009||Dec 10, 2013||Kci Licensing, Inc.||Absorbable, reduced-pressure manifolds and systems|
|US8709095||Feb 4, 2013||Apr 29, 2014||Kyoto University||Thin film multilocular structure made of collagen, member for tissue regeneration containing the same, and method for producing the same|
|US8974814||Nov 12, 2008||Mar 10, 2015||California Institute Of Technology||Layered drug delivery polymer monofilament fibers|
|US8992552 *||Apr 25, 2013||Mar 31, 2015||Kci Licensing, Inc.||System for providing fluid flow to nerve tissues|
|US9005695||May 6, 2013||Apr 14, 2015||Boston Scientific Scimed, Inc.||Composite stent with inner and outer stent elements and method of using the same|
|US9351882 *||Dec 29, 2009||May 31, 2016||Kci Licensing, Inc.||System for providing fluid flow to nerve tissues|
|US20020169477 *||Apr 2, 2002||Nov 14, 2002||Omeros Medical Systems, Inc.||Soft tissue repair system|
|US20030204197 *||Apr 26, 2002||Oct 30, 2003||Medtronic, Inc.||Sintered titanium tube for the management of spinal cord injury|
|US20040034407 *||Aug 16, 2002||Feb 19, 2004||John Sherry||Covered stents with degradable barbs|
|US20040111140 *||Jan 10, 2002||Jun 10, 2004||Thomas Stieglitz||Sieve electrode which can be connected to a nerve stump|
|US20040186488 *||Mar 17, 2003||Sep 23, 2004||Droese Karl William||Method of peripheral nerve reconstruction using a micro suction connector|
|US20040215218 *||May 24, 2004||Oct 28, 2004||Omeros Corporation||Tendon repair using internal reinforcing member|
|US20050110214 *||Oct 13, 2004||May 26, 2005||Shank Peter J.||Composite stent with inner and outer stent elements and method of using the same|
|US20050113904 *||Nov 25, 2003||May 26, 2005||Shank Peter J.||Composite stent with inner and outer stent elements and method of using the same|
|US20050276841 *||Jun 7, 2005||Dec 15, 2005||California Institute Of Technology||Biodegradable drug-polymer delivery system|
|US20070010831 *||May 5, 2006||Jan 11, 2007||Romero-Ortega Mario I||Biomimetic biosynthetic nerve implant|
|US20070100358 *||May 5, 2006||May 3, 2007||Texas Scottish Rite Hospital For Children||A Biomimetic Synthetic Nerve Implant|
|US20080125870 *||Nov 6, 2007||May 29, 2008||Carmichael Ralph W||Nerve regeneration device|
|US20080249598 *||Jun 16, 2008||Oct 9, 2008||John Sherry||Covered stents with degradable barbs|
|US20080300691 *||Nov 13, 2007||Dec 4, 2008||Texas Scottish Rite Hospital For Children||Biomimetic Synthetic Nerve Implant Casting Device|
|US20090132025 *||Jan 30, 2009||May 21, 2009||Shank Peter J||Composite stent with inner and outer stent elements and method of using the same|
|US20090155326 *||Nov 12, 2008||Jun 18, 2009||Mack Brendan C||Layered drug delivery polymer monofilament fibers|
|US20090280161 *||Jun 29, 2007||Nov 12, 2009||Tatsuo Nakamura||Thin Film Multilocular Structure Made of Collagen, Member for Tissue Regeneration Containing The Same, and Method for Producing The Same|
|US20090326515 *||Jun 25, 2009||Dec 31, 2009||Jonathan Kagan||Absorbable, reduced-pressure manifolds and systems|
|US20100023031 *||Sep 7, 2007||Jan 28, 2010||Francesco Catalano||Neural guide|
|US20100168625 *||Dec 29, 2009||Jul 1, 2010||Swain Larry D||System for providing fluid flow to nerve tissues|
|US20100168870 *||Dec 29, 2009||Jul 1, 2010||Larry Swain||System for providing fluid flow to nerve tissues|
|US20130237934 *||Apr 25, 2013||Sep 12, 2013||Kci Licensing, Inc.||System for providing fluid flow to nerve tissues|
|US20140039428 *||Oct 16, 2013||Feb 6, 2014||Kci Licensing, Inc.||Absorbable, reduced-pressure manifolds and systems|
|CN102123747B *||Jun 25, 2009||Oct 14, 2015||凯希特许有限公司||可吸收减压歧管和系统|
|DE10205997A1 *||Feb 14, 2002||Sep 4, 2003||Hm Medical Engineering Gmbh||Joint element, in particular suitable for connecting vessel or nerve sections, enveloped by barbed sleeve|
|EP0226061A2 *||Nov 20, 1986||Jun 24, 1987||United States Surgical Corporation||High molecular weight bioresorbable polymers and implantation devices thereof|
|EP0226061A3 *||Nov 20, 1986||Jul 20, 1988||Allied Corporation||High molecular weight bioresorbable polymers and implantation devices thereof|
|EP0261833A2 *||Sep 8, 1987||Mar 30, 1988||American BioInterface Corporation||Apparatus for mammalian nerve regeneration|
|EP0261833A3 *||Sep 8, 1987||Jul 18, 1990||American Biointerface Corporation||Apparatus for mammalian nerve regeneration|
|EP0370917A2 *||Nov 23, 1989||May 30, 1990||Claude Proulx||Splint-like element for use in end-to-end nerve suture|
|EP0370917A3 *||Nov 23, 1989||Jul 17, 1991||Claude Proulx||Splint-like element for use in end-to-end nerve suture|
|WO1984003035A1 *||Jan 25, 1984||Aug 16, 1984||Minnesota Mining & Mfg||Absorbable nerve repair device and method|
|WO1988004557A1 *||Dec 7, 1987||Jun 30, 1988||Allied Corporation||Implantable devices having hydrophobic component|
|WO1988006866A1 *||Mar 7, 1988||Sep 22, 1988||Brown University Research Foundation, Inc.||Piezolectric nerve guidance channels|
|WO1989010728A1 *||May 5, 1989||Nov 16, 1989||Massachusetts Institute Of Technology||Prosthesis for promotion of nerve regeneration|
|WO1993012724A1 *||Dec 30, 1992||Jul 8, 1993||Jean Berque||Optical fibre device intended to the repair of damaged nerve fibres|
|WO1997006752A1 *||Aug 8, 1996||Feb 27, 1997||Frank Lampe||Endoprosthesis, in particular an artificial hip joint|
|WO1997011724A1 *||Sep 27, 1996||Apr 3, 1997||Biocon Oy||Biodegradable implant manufactured of polymer-based material and a method for manufacturing the same|
|WO2008001952A1 *||Jun 29, 2007||Jan 3, 2008||Kyoto University||Thin film multilocular structure comprising collagen, material for tissue regeneration containing the same and method for producing the same|
|WO2009158500A2 *||Jun 25, 2009||Dec 30, 2009||Kci Licensing, Inc.||Absorbable, reduced-pressure manifolds and systems|
|WO2009158500A3 *||Jun 25, 2009||May 27, 2010||Kci Licensing, Inc.||Absorbable, reduced-pressure manifolds and systems|
|WO2011091169A1 *||Jan 20, 2011||Jul 28, 2011||University Of Rochester||Nerve and blood vessel repair systems|
|U.S. Classification||606/152, 606/154|
|International Classification||A61B17/11, A61B17/00, A61F2/00, A61B17/30|
|Cooperative Classification||A61B2017/00004, A61F2250/003, A61F2002/30032, A61B17/1128, A61F2002/30235, A61F2230/0069, A61B2017/306|