US3515139A - Atraumatic clamp - Google Patents

Description

June 2, 1970 R. F. MALLINA ATRAUMATIC CLAMP INVENTOR. Pz/aaL/Qf/ /7- MMU/VA WM 1M F- .v in;

ATTORNEY June 2, 1970 R. F. MALLINA 3,515,139

ATRAUMTIC CLAMP Fi1ed.Aug. 29, 1966 2 Sheets-Sheet 2 1121.5. T1 2z 20 f fd /ZZ f7 I NVENTOR.

fi/ooz/f Mug/NA BY JM A q ATTORNE)l United States Patent O M' 3,515,139 ATRAUMATIC CLAMP Rudolph F. Malliua, Hastings-on-Hudson, N.Y., assignor to Codman & Shurtleif, Inc., a corporation of Massachusetts Filed Aug. 29, 1966, Ser. No. 575,743 Int. Cl. A61b 17/28 U.S. Cl. 128--322 10 Claims ABSTRACT F DISCLOSURE Surgical forceps are constructed with two opposing, movable jaws, one of which has at least two longitudinal grooves positioned to receive protuberances removably mounted on the opposite jaw, whereby secure clamping may be obtained by the application of uniformly distributed pressure to the tissue.

This invention relates to surgical forceps or other clamping means and particularly to clamping means adapted to clamp tubular vessels of the body or other tissues during surgery.

Surgical forceps which are in general use are made with a great -variety of types of jaws having smooth, variously grooved, serrated, perforated, or the like surfaces. Such instruments have been designed with the. intent of providing the surgeon with an instrument having a certain degree of sharpness sufficient to hold a vessel. At the same time, it is generally believed that a cutting action on the vessel is undesirable and should be minimized. The numerous designs of hemostatic clamps that are available from surgical supply houses attest the difficulty of combining the opposite effects of satisfactorily holding (gripping) and minimum trauma in a single instrument. In arterial surgery, for example, it is necessary to pro- :vide a clamp which will not slip, but, at the same time, it is desirable to prevent penetration of the tissues or other destruction thereof by, for example, excessive com pression. Similar problems arise in connection with the surgery of other tubular members of the body or various other tissues.

The general object of the present invention is the provision of forceps which provide ample clamping for arteries or other tubular members of the tbody, or the like with the least destructive action of the clamped tissues, the forceps reducing the possibility of slipping as well as aiding the secure clamping by the application of uniformly distributed pressure to the tissue.

It is also an object of the invention to so design the gripping surfaces of the clamp that maximum occlusion is obtained with a minimum of trauma.

Another object of the invention is to provide a surgica. forceps; the clamping surfaces of which have a smooth, mirror finish entirely free of burrs and other sharp irregularities that may result from the manufacturing process. These objects of the invention as well as s-ubsidiary objects having to do with particular features of construction will become apparent from the following description read in conjunction with the accompanying drawing in which:

FIG. 1 shows a face view of one form of surgical forceps, or clamp embodying the present invention, in closed condition.

FIG. 2 is an edge View thereof.

FIG. 3 is a plan view of the lower jaw member of the forceps.

FIG. 4 shows a staggered vertical cross-section partly in elevation of the operational end of the forceps taken on the lines 4--4 of FIG. 2. and further exemplified by the lines 4-4 of FIG. 3.

3,515,139 Patented June 2, 1970 ICC FIG. 8 is a view similar to FIG. 5 of the modification illustrated in FIG. 7.

FIG. 9 is a greatly enlarged view of a portion of FIG. 8 showing the clamping action on a'vessel.

FIG. l0 is a view similar to FIGS. 5 and 8 showing another modification of the upper and lower jaw members.

FIG. 11 is a fragmental vertical cross-section illustrating a modification of the upper jaw member of the forceps.

FIG. 12 is a vertical cross-section taken on the lines 12-12 of FIG. 11.

`Clamps provided in accordance with the present invention may be of any conventional construction aside from the formation of the clamping surfaces of the jaws. FIGS. 1 and 2, show, for example, forceps 10` comprising anupper scissors bar 11 and alower scissors bar 12, which are hinged at the pivot 13. Theoperational end 11 of the upper scissors bar and theoperational end 12 of the lower scissors bar extend forward of the pivot 13. Finger receiving rings 14 and 15 are provided at the ends of thebars 11 and 12, and a clamp-holding means 16 is formed with interengaging tooth projections which function to retain the forceps in a closed position.

The forceps 10' may have conventional shapes aside from the clamping surface structure, and it will be understood that the invention is quite generally applicable to a great variety of forceps and other clamps having straight or curved jaws of various dimensions depending upon the particular uses for which they are intended. The handles or other manipulating means may be of various types including springs, wedges, cam devices, screws, or the like for the purpose of closing or adjusting the forceps.

The twojaws 18 and 19 of the forceps 10 differ in construction, and there will rst be described particularly the construction of thejaw 18. This jaw is molded of a plastic material, such as Delrin, and the structure thereof will be apparent with reference to FIGS. 3-6. In its preferred form, thejaw 18 comprises a one-piece, moldedplastic sleeve 20 having on one face thereofprotuberances 22. As indicated in FIGS. 3-6, theprotuberances 22 in one row may be staggered with respect toprotuberances 22 in an adjacent row to achieve high insurance against slippage consistent with avoidance or limitation of damage to the tissues. The staggered arrangement also results in better occlusion thereby preventing leakage of the clamped vessel end. In this arrangement, the protuberances in the adjacent rows are not directly opposed to each other but rather are relatively displaced by onehalf the pitch of the protuberances, i.e., the protuberances of adjacent rows are in longitudinally staggered relationship from which it follows that each protuberance is aligned with the space between a pair of protuberances in the adjacent row. Alongitudinal slot 24 extends from one end of thesleeve 20 to a closedtip 25 at the other end of thesleeve 20, and theinterior surfaces 26, Z7, and 28 of the sleeve are dimensioned to be slidingly received by theoperational end 11 of the scissors bar. An air gap 2.9 is provided between the closed end of the plastic sleeve 20' and the lower jaw to permit the escape of air when the sleeve is placed on the jaw. A stop 30 on this bar abuts oneend 32 of thesleeve 20 when it is in operating position.

The cooperatingjaw 19 is provided with a pair of parallel,longitudinal grooves 34, 34' located betweenouter walls 35, 35 and thecentral wall 36. Thegrooves 34, `34' receive theprotuberances 22, 22 when thejaws 18 and 19 are in a closed position.

In the modification of the present invention illustrated in FIGS. 3-6, theprotuberances 22, 22' andgrooves 34 and 34 are hemispherical and may have a mirror finish as the molding process employed in the manufacture of the sleeve does not produce the burrs that would be formed if the clamping jaw were machined. The machining of even very fine teeth will leave burrs at the edges that are inherent in the milling process and cannot be removed by polishing. Such burrs may be so small that they cannot be seen by the naked eye. Yet each burr will act as a knife and, therefore, pierce or cut into the tissue. While it is impractical, if not impossible, to machine spherical protuberances of the type utilized in the present invention, it is simple and inexpensive to mold the plastic sleeves illustrated in the drawing.

FIGS. 7-9 illustrate a modification of the present invention whereinprotuberances 37 in one row are opposite protuberances 37 in an adjacent row.

The sinuous position taken by avessel 38 when clamped in the jaws of an instrument modified as shown in FIGS. 7 and 8 will be understood from FIG. 9, wherein the forceps are in the closed position. It is to be noted that a virtually uniform compression is applied through the undulating path defined by theprotuberances 37, 37', thegrooves 34, 34', thecentral wall 36, andouter walls 35, 35. Preferably, theedges 40, 40' and 41, 41 of the lower and upper jaws are rounded as shown in FIG. 9 to remove sharp edges that might damage the tissue, and provide awidened exit 42, 42 at the edge of the clamp.

Desirably, for occluding vessels having a wall thickness of 4 mils (double wall thickness 8 mils), the radius of curvature of the grooves is 16 mils, and the distance between the protuberances (pitch) may be 48 mils. Under such circumstances, the approaching surfaces of the jaws are substantially parallel, and the clearance provided prevents excessive pressure on the vessel at any point.

It will be evident that the compressed tissues limit the movement of the jaws towards each other and secure holding occurs without penetration of the tissues by the protuberances by reason of sinuous conditions imposed on the tissues in the section illustrated in FIG. 9. The holding force of the jaws illustrated in FIG. 9 may be calculated from the formula wherein f is a very small entrance friction; e is the base of natural logarithm; a is the wrapping angle and u is the coefficient of friction of the vessel being clamped.

Another modification of the present invention which results in a greater holding force is illustrated in FIG. 10. In this modification, the height of theprotuberances 43, 43 and the depth of thegrooves 44, 44 have been increased. It should be noted that the limitation in increasing the height of the protuberances is the elastic limit on tension of the vessel to be clamped. The result is secure clamping without damaging penetration by the protuberances.

FIGS. 11 and 12 illustrate yet another modification of the present invention wherein aplastic sleeve 50 is provided for theupper jaw member 12. As shown in FIG. 11, thesleeve 50 is molded wtihspherical cavities 51, 51 that complement thespherical protuberances 37, 37'. The radius of the cavities 50'r and 51 is about 8 mils greater than the radius of theprotuberances 37, 37', and the plastic sleeve is so aligned on theupper jaw member 12 that the protuberances and cavities match when the jaws of the forceps are in a closed position and provide a uniform space to accommodate the double wall thickness of a vessel as shown in FIG. 12.

It will be evident that numerous variations may be provided involving, for example, additional rows of protuberances without departing from the spirit and scope of the present invention as defined in the appended claims.

What is claimed is:

1. Surgical clamping means comprising a pair of jaws mounted for movement toward and from each other; one of said jaws having at least two longitudinal grooves, the other of said jaws having a plurality of longitudinal rows each of said rows having a plurality of convex protuberances removably mounted' thereon and each row of said protuberances being in register with one of the longitudinal grooves of the opposite jaw.

2. Clamping means according to claim 1, wherein said protuberances are arranged in parallel rows and are equally spaced from adjacent projections in the same row.

3. Clamping means according to claim 2, wherein the protuberances in one row are opposite the protuberances in another row.

4. Clamping means according to claim 2, wherein the protuberances in one row are staggered with respect to the protuberances in another row.

5. Clamping means according to claim I1, wherein said protuberances have a convex spherical dome.

6. Clamping means according to claim 1, wherein the protuberances are hemispherical in shape.

7. Clamping means according to claim 1, wherein the protuberances are slidably mounted on said other jaw.

8. Clamping means according to claim 1, wherein the protuberances are molded of plastic.

9. Surgical forceps comprising a pair of complementary jaw segments operatively connected to one another for movement into and out of gripping relation; the first of said jaw segments having a molded plastic member mounted thereon, said plastic member having protuberances of sinusoidal cross-section in a transverse and longitudinal direction on one surface thereof; the second of said jaw segments having longitudinal grooves located on that surface thereof which opposes said first jaw segment, said grooves having a sinusoidal cross-section in a transverse direction, and being so positioned as to be in registry with and partially encompass said protuberances when the forceps are closed'.

10. Surgical forceps comprising a pair of complementary jaw segments operatively connected to one another for movement into and out of gripping relation; a first molded plastic member mounted on one jaw segment; said first plastic member having protuberances of sinusoidal cross-section in a transverse and longitudinal direction onone surface thereof; and a second molded plastic member mounted on the other jaw segment, said second plastic member having cavities that complement said protuberances and mesh therewith when the jaw segments are in a closed position.

References Cited UNITED STATES PATENTS 1,982,207 1l/l934 Furniss 128-346 2,777,348 l/l957 Wraight 81-180 X 3,101,715 8/1963 Glassman 12S- 322 3,140,715 7/1964 Whitton 128-321 2,796,065 6/1957 Kapp 128--346 RICHARD A. GAUDET, Primary Examiner J. D. YASKO, Assistant Examiner

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