US2344071A - Surgical stitching apparatus - Google Patents

Description

M' tflth L4, 1944. v 3; wlLSON ETAL 2,344,071

SURGICAL STITGHING APPARATUS Filed Oct.-5, 1942 2 Sheets-Sheet 1 INVENTORS. v GERALD A. W/LsoN L YMAN E. SPENCEP THE IR Arron/var March 14, 1944. a. A. WlLSON ETAL SURGICAL STITCHING APPARATUS Fil ed Oct. 5, 1942 2 Sheets-Sheet 2 uvmvroxs.

Patented Mar. 14, 1944 SURGICAL STITCHING APPARATUS Gerald A. Wilson and Lyman E. Spencer,

Detroit, Mich.

Application October 5, 1942, Serial No. 460,740

4 Claims. (Cl. 1-491) th combination of a clamp for clamping together tissue to be dissected and a stitching head movably associated with one of the clamp members providing reliableand positive operation, and improved visibility and the parts of which are of a simplified, rugged construction convenient to i,

assemble or separate.

It is a further object of our invention to provide an improved stitching head or carriage for such apparatus.

Further objects and advantages are within the scope of my invention such as relate to the arrangement, operation and function of the related elements, to various details of construction and to combinations of parts, elements per se, and to economies of manufacture and to numerous other features as will be apparent from a consideration of the specification in conjunction with the drawings disclosing a form of my invention, in which:

Fig. 1 is a side elevationa1 view of the clamp in opened position, the stitching head being removed;

Fig. 2 is a side elevational view showing the clamp closed with the stitching head in operative position on the upper clamp member;

Fig. 3 is a cross-sectional view taken online 33 of Fig. 2;

Fig. 4 is a cross-sectional view taken along line 4-4 in Fig. 3;

Fig. 5 is a greatly enlarged fragmentary view of short portions of the two clamping members in clamped relation, showing the space provided therebetween, staples, a stapling plunger, and the staple guiding slots and clinching surfaces being represented by dotted lines; and

Fig. 6 is an enlarged fragmentary detail view, partially broken away and sectioned, to show the quick detachable clamp joint.

Referring more particularly to Fig. 1 of the drawings, our surgical stitching apparatus comprises a clamp for holding together the dissected tissues which are to be stitched together. The clamp, which is shown open in Fig. 1 consists of a, pair of clamp members II andI 3 hinged together at one end on a pivot pin I5 for relative pivotal movement. The opposite ends of the clamp members are suitably shaped to provide convenient handles I! to be gripped for swinging the members together and closing the clamp to secure the edges of tissues therebetween.

A latch I9 is provided in aslot 2| centrally disposed in the handle end of the upper clamp member II where it is pivotally journalled upon apivot pin 23. The latch I9 extends toward the lower clamp member l3 and, when the clamp is closed, it projects into aslot 25 centrally disposed in the handle end of the lower clamp member where it engages around or under alatch pin 21. Alever 29 extends from the latch I9 and projects from the upper clamp member in a convenient position for manipulation.

After the clamp members have been manually gripped togetherlever 29 and the latch I9, which are initially in the dotted line position as shown in Fig. 2, are rotated counter-clockwise to the full line position so that the latch passing under thepin 21 secures the clamp together.

An abutment 3i rises from the end of the lower clamp member I3 adjacent the handle and engages the adjacent side of the other clamp member II providing apredetermined space 33 between the two pivoted clamp members, when these are latched together as shown in Fig. 2, so that clamped tissues are firmly secured without injurious crushing. The pivot I5 at the other or hinged end of the clamp is so made that thespace 33 is uniform throughout the length of the clamp.

Secured along the upper portion of one side of the upper clamp member I l is arack tooth strip 35 which is secured snugly by rivets 31 in a recess in the upper left-hand corner of the cross section, as shown in Fig. 3. Therack teeth 39 project from thestrip 35 above the upper side of the upper clamp member I I.Guide grooves 4| are cut in both opposite sides of the upper clamp member II extending therealong from the pivot end and opening at the end adjacent the handle. Secured on and extending along opposite sides of the lower portion of the upper clamp member I I are a pair ofstaple retaining strips 43 secured as by welding, and each havingstaple receiving slots 41 in the side adjacent the clamp. Theslots 41 are of a cross-section elongated lengthwise of the clamp and are uniformly spaced and arranged in pairs on opposite sides of the clamp member, as shown in Figs. 3, 4 and 5.

A stitching head 59 is slidably mounted upon the upper clamping member H. Thishead 50 comprises a body 5| havingside plates 53 secured to the opposite sides of the body by conveniently removableknurled nuts 54 on the opposite ends ofscrews 55 extending therethrough. The upper edges of theside plates 53 are preferably arranged to be even with the upper side of the body 5|, and the lower edges of the side plates project substantially below the body for extending in guiding relation along the opposite sides of the upper clamp member Ii whereon the stitching head is movably disposed in operation.Guide pin screws 55 are passed threadably through the lower extending portions of theside plates 53 into the guide grooves M in the opposite sides of the clamp member I l. The stitching head is conveniently installed upon the handle end of the upper clamp member I i with theguide pins 55 in the guide grooves 5!, which grooves are cut open toward the handle end for this purpose.

A pair ofplungers 51 are slidably disposed on opposite sides of the head in grooves 59 cut in the inside surfaces of the side plates. To provide for reliable operation with a minimum number of parts, the plungers 5? are preferably th legs of an integral U-shaped member which is inverted in the head. The lip-turnedyoke 6!} thereof is engaged by asuitable cam 61 which is secured, as by ascrew 63, on ashaft 65 extending rotatively through ashaft bracket 61 up rising from the upper sid of the body. Theshaft bracket 63 has a pedestal flange 69 secured on the body by screws 'H. Theshaft 65 is rotated manually by means of acrank 13 attached on the upper end of the shaft by ascrew 15. As shown, the cam BI is preferably cut axially on a cylindrical shell and the cam surface engages a roller H which is disposed in aslot 19 and journalled on a pin 8! in the yoke 60 of the plungers to provide for light operation with a minimum of friction. Acompression spring 83 reacting betwen the bottom of the yoke 60 and the upper portion of the body 5i elevates theplungers 51.

As thecrank 13 is turned manually, the cam (ll is rotated and depresses theplungers 51 once in each revolution. The lower ends of the plungers pass down into the respective pairs ofstaple retaining slots 41 in succession.

In order to advance the head along the clamp and to accurately position it to insert the plungers 5'l into each pair ofstaple slots 4?, therotatable shaft 65 passes down through an aperture in the body 5| of the head, as shown in dotted lines in Fig. 3. The lower end of theshaft 55 carries akicker 85 secured or integral thereon and rotating in a recess 81 in the head and just above the upper side of the clamp member I l, as shown in Fig. 4. Thekicker 85 is of a suitable shape and length for engaging the spacedrack teeth 39 one-bY-one to advance the head one tooth for each revolution of the shaft.

To hold the head firmly in each advanced position while the plungers are being depressed, adetent disc 89 is pressed through an aperture 9| so positioned in one of the side plates that the detent rides over therack teeth 39 and lodges in the space between two teeth just as the plungers are in alignment with a pair of slots.

Thedetent disc 89 is continuously pressed toward therack teeth 39 by acompression spring 83 engaging the outer edge of the disc which is provided with atubular member 95 for receiving the end of the spring. The outer end of the spring 93 reacts against an adjusting cap '91 which adjustably screws on a tubular detent socket 59 having a flange lill secured to the side plate. Thedetent socket 99 is provided with a pair of slots I03 in diametrically opposite positions for receiving and slidably guiding the edges of thedetent disk 89.

'Fig. 6 shows the quick detachable pivot joint which provides for quick and convenient assembly or separation of the two clamp members. The pivoted end of the upper clamp member H is provided with a hinge ring I05 of a suitable thickness to be inserted between a pair of members Ill? extending in spaced relation from the end of the lower clamp member l3, and one of which is shown broken away in Fig. 6. The pivot pin E5 passes through the spaced members I01 and has on the intermediate portion two flattened areas its on opposite sides having the effect of providing a reduced diameter. The hinge ring I05 is provided with a bearing aperture III of suitable size to rotatively journal the full diameter of the journal pin IS. A pivot pin receiving slot 8 l3, having a width equal to the reduced diameter or thickness of the pivot pin, is cut through one side of the hinge ring H into the bearing aperture. The slot H3 and the flattened pivot pin l5 are so positioned as to be out of aligned relation when the clamp members I l and I3 are in clamping position. The two clamp members may be quickly hinged together, or separated, by turning the two parts to the position wherein the flattened or reduced diameter of the pivot pin [5 is aligned with the slot H3 in the 80 hinge ring H35.

35 alloy, plastics, or the like.

0 one end and handles and latch at the other end,

and also because of theuniform space 33 provided between the clamp members, the tissues are clamped with a uniform pressure and the clamp members are not bowed out of shape.

The stitching head 59, is slidably applied upon the upper clamp member i l with the guide screw pins 55 entering the guide grooves ii in opposite sides with the crank l3 turned to a suitable position to elevate theplungers 57 and to turn the kicker to a disengaging position. The stitching head is pushed along the clamp to the pivot end. The arrangement of the two rows of staple slots is such as to be clearly visible and it can be conveniently ascertained if the slots have all been correctly loaded with staples. Also the operation of the apparatus can be clearly observed.

Thecrank 13 is manually turned rotating theshaft 65, the plunger actuating cam Si, and thekicker 85. While the spring presseddetent disk 89 is lodged between two rack teeth and holds the head, the cam depresses the twoplungers 51 which simultaneously enterstaple slots 47 on opposite sidesof the clamp. As a plunger 5'! enters astaple slot 47, the staple H5, which was previously loaded therein, is pushed toward thelower clamp member 13, piercing the clamped tissues and entering the clinching depressions H1 in the lower member, as represented by dotted lines in Fig. 5. This causes the staple ends to be turned under, and is continued clinching the staples and securing the tissues H9 together. As the plungers 5-! are elevated, thekicker 85 ad vances thestitching head 53 one space, where the head is again held by the spring presseddetent disc 89 between the next pair ofrack teeth 39. Thecam 61 again depresses the pair ofplungers 51 into the next pair ofstaple slots 41, and this operation is successively repeated until the stitching head has advanced to the handle end. By releasing thelatch lever 29, the clamp is conveniently removed.

The stitching head is conveniently removed from the clamp and the clamp members are easily separated. Also it will be apparent that the parts of the head are conveniently separable so that the instrument may be cleansed and sterilized.

Although we have shown and described a certain specific embodiment of our invention, we are fully aware that many modifications thereof are possible. Our invention, therefore, is not to be restricted except insofar as necessitated by the prior art.

We claim:

1. Surgical stitching apparatus comprising, two elongated clamp members pivotally joined at one end for clamping together dissected tissues along the edges of an incision to be stitched, a row of staple slots aligned along each side of one of the clamp members, each of the staple slots being elongated parallel to the elongated dimension of the clamp member and of a size suitable for receiving a clinch staple, a stitching head for stitching tissues, cooperatively engaging means on said head and on one of the pivoted clamp members for holding the head slidably thereon, a

pair of plungers movably disposed in the head,

said plungers being shaped and positioned in each side of the head for driving staples through adjacent slots, position determining surfaces on the clamping member carrying the head for positioning the head and plungers in alignment with the staple slots, and manually operative means on said head for actuating the plungers and for controlling the movements of the head along said clamping means.

2. Surgical stitching apparatus in accordance with claim 1, and further characterized by the staple slots being arranged in evenly spaced pairs on opposite sides of the clamp member, the pair of plungers being the legs of a U-shaped member, and the manually operative means including a cam engaging the yoke of the U for simultaneously reciprocating the pair of plungers.

3. In a stitching head for use on a surgical clamp for stitching tissues held in the clamp, a body member, two side plates secured one on each side of the body, a pair of plungers, a guide recess slidably mounting one of the plungers in each side of the head, a manually rotative shaft, means journalling the shaft on the head, and cam means actuated by the shaft for depressing the plungers.

4. In a stitching head for use on a surgical clamp for stitching tissues held in the clamp, a body member, two side plates secured one on each side of the body, an inverted U-shaped element comprising, a pair of extended plungers and an interconnecting yoke, a guide recess slid ably receiving one of the plungers in each side of the head, a manually rotative shaft rising vertically above the body, means journalling the shaft on the head, and cam means actuated by the shaft for engaging the yoke and depressing the plungers.

GERALD A. WILSON. LYMAN E. SPENCER.

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