US3771526A

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Publication number: US3771526A
Application number: US00223955A
Authority: US
Inventors: P Rudie
Original assignee: Individual
Current assignee: Individual
Priority date: 1972-02-07
Filing date: 1972-02-07
Publication date: 1973-11-13
Anticipated expiration: 1990-11-13

Abstract

An anastomosis clamp including a first clamping collar, a second clamping collar, a support rod connected to the first collar with said second collar having a support member slidable on said support rod, each of the opposed edges of said collars being formed with undulations which mate, and means for urging said clamping collars together.

Description

United States Patent 1191 Rudie Nov. 13, 1973 ANASTOMOSIS CLAMP 1,918,890 7/1933 Bacon 128/334 c [76] Inventor: Peter S. Rudie, 302 Mid Art, FOREIGN PATENTS OR APPLICATIONS Duluth, 55802 1,057,729 5/1959 Germany 128/334 0 [22] Filed: Feb. 7, 1972 Primary Examiner-Dalton L. Truluck [21] Appl' 223955 Attorney-Jack W. Wicks et al.

[52] US. Cl. 128/334 C, 128/346 [57] ABSTRACT [51] Int. Cl A61b 17/11 [58] Field of Search 128/303 R, 334 R anasmms clamp a first clampng 128/334 C lar, a second clamping collar, a support rod connected to the first collar with said second collar having a sup- [56] References Cited port member slidable on said support rod, each of the opposed edges of said collars being formed with undu- UNITED STATES PATENTS lations which mate, and means for urging said clamp- 2,434,030 l/1948 Yeomans 128/334 C i collars together; 3,564,582 2/1971 Tjong-Joe-Wai... 2,638,901 5/1953 Sugarbaker 128/334 C 8 Claims, 12 Drawing Figures uuprsn Boa/6L 2 Patented Nov. 13,1973 3,771,526

2 Sheets-Sheet l Patented Nov. 13,1973 3,771,526

2 Sheeis-Sheet 2 l I n I ANASTOMOSIS CLAMP SUMMARY OF THE INVENTION The invention relates generally to surgical clamps and more particularly to an improved rectocolic anastomosis clamp. With the removal of a portion of the bowel the ends must be joined, and it is highly desirable to carry out bowel anastomosis by clamping together inturned ends until agglutination occurs at the periphery of the clamped junction. In known methods of clamping the healed bowel ends usually form a joint that has a diameter less than that of the original thereby resulting in a restriction in the bowel. The amount or area of bowel ends clamped together must be as great as possible to prevent the formation of a restriction. It is also desirable that with the clamp in place within the bowel there may be a ready escape of mucoid contents of the bowel.

The present invention provides a rectocolic anastomosis clamp whereby a maximum of peripheral bowel ends are clamped whereby the inside diameter of the healed bowel is not restricted to a dimension less than that of the original and which allows escape of contents of the bowel through the clamp with the clamp in clamping position. The clamp in one form is adapted to be assembled within the bowel with the parts being extended through the anus. The structure is such that the positioning of the severed ends of the bowel on the clamping faces or edges is readily and positively accomplished. With the device the clamping pressure is established and adjusted by manipulation of the clamp extending outwardly of the anus in one form of the invention used to clamp the end of the upper bowel and the rectum. A further embodiment of the clamp is used to clamp a portion of the large or small bowel, respectively, or to clamp a portion of the small bowel to the stomach as in a gastroenterostomy and in this latter embodiment there is no extension of the clamp outwardly of the anus. In either embodiment the clamp is sluffed off in three or four days outwardly through the arms. In the drawings forming part of this application: FIG. 1 is an elevational view of an anastomosis clamp embodying the invention in position in the upper bowel clamping portions separated and portions broken away.

FIG. 6 is a sectional view through the clamping portions in clamping position on the lower end. of the upper bowel and the upper end of the rectum.

FIG. 7 is an elevational view of a further embodiment of the invention.

FIG. 8 is a view similar to that of FIG. 6 but rotated 90.

FIG. 9 is an end view of the embodiment of FIGS. 7 and 8.

FIG. 10 is an end view opposite to that of FIG. 9.

FIG. 11 is an elevational view similar to that of FIG. 7 but with the clamp in open position.

FIG. 12 is a sectional view of the embodiment of FIGS. 7-11 through the clamp on the bowel ends.

Referring to the drawings in detail, the anastomosis clamp A includes theclamping head 10. Thehead 10 includes theupper clamping collar 12 to which is con-' vnected thecross bar member 14 and which lies in a plane of a diameter of the collar. The lower peripheral edge of theupper clamping collar 12 is formed with theundulations 16.

A rod-like support 18 extends from the inner surface of thecross bar 14 axially of theupper clamping collar 12 and terminates in the flexible threadedrod portion 20. Further provided is the hollowcylindrical portion 22 connected at its lower end to the inner surface of thecross bar 24 connected to thelower clamping collar 26 which lies in a plane of a diameter of thecollar 26 and axially of the collar. The inside diameter of the hollowcylindrical portion 22 is sufficient for slidable motion on the rod-like support 18.

Thenumeral 28 designates a flexible tube through which the flexiblethreaded rod 20 extends and threadedly mounted on the lower end of therod 20 is thenut 30. With the tube and rod flexible the same can adaptto extended condition from the anus as a result of movement of the patient. The upper peripheral edgeof thelower collar 26 is formed withundulations 32 which mate with theundulations 16 of theupper clamping collar 12 in clamping relation as particularly shown in FIGS. 2 and 6.

The upper and

lower clamping collars

12 and 26 are brought into clamping relation by screwing up on thenut 30 which forces the upper end of thetube 28 against thecross bar 24 of the lower clamping collar.

To join the lower end of the upper bowel B with the upper end of the rectum R after cancerous portions of the bowel have been removed, the lower open endof the upper bowel B is sewn loosely with thethread 33. Next theclamp collar 12 is inserted into the lower end with the end extending into and upon theundulations 16 due to the restrictiveness of the end of the bowel due to the aforesaid sewing, particularly as in FIGS.1, 2, and-6. Then the upper end of the rectum R is sewn loosely by means ofthread 35 and thelower clamping collar 26 forced upwardly into the rectum to the loosely sewn end thereof, with the end extending into and upon theundulations 32. The

clamping collars

12 and 26 are then brought together upon the lower end of the upper bowel B and the upper end of the rectum R in clamped together relation, particularly FIGS. 2 and 6. The

threads

33 and 35 are then removed. After the passing of about three days time, the clamped bowel end and rectum end agglutinate or grow together, and the entire clamp A is removed through the arms as a result of a sluffing off action of the flesh of the parts. The voids V between the collar portions and the

cross bars

12 and 24 allow bowel movement therethrough from the upper bowel B to and through the rectum when the device A is in place.

The

complementary undulations

16 and 32 increase the extent of the clamping edge surface of the

collars

12 and 26 as compared to purely cylindrical end surfaces of collars. With this additional clamping edge surface the inside diameter of the bowel and rectum at the point of joining is as large as originally and not restricted as a result of the joining.

A further embodiment of the invention is found in FIGS. 7-12 wherein the clamp B includes theclamping head 36. Thehead 36 includes the first clamping collar 38'to which is connected thefirst side arm 40 which terminates in theend bar 42. Theend bar 42 terminates in thesecond side arm 44 which is connected to thecollar 38. The lower peripheral edge of thecollar 38 is formed with theundulations 46.

Thenumeral 48 designates a hollow support rod anchored at its outer end to theend bar 42 and extending axially through and outwardly of thecollar 38. The wall of therod 48 is formed with the opening 50. Further provided is thesecond clamping collar 52 to which is connected thefirst side arm 54 which terminates in theend bar 56. Theend bar 56 terminates in thesecond side arm 58 which is connected to thecollar 52. The peripheral edge of thecollar 52 is formed with theundulations 60 complementary to theundulations 46 for clamping engagement therewith.

Also provided is therod 62 anchored at its outer end to theend bar 56 with the inner end of the rod slidably positioned within thehollow support rod 48. The

collars

38 and 52 are urged together in clamping engagement by means of theelastic member 64 positioned upon the

end bars

42 and 56 and around the outer end of thehollow rod 48 and the outer end of therod 62 while extending substantially axially through the

collars

38 and 52 and parallel to the

members

48 and 62.

To join one end of a large bowel illustrated as L to the end to be joined illustrated as La after an intermediate portion of the bowel has been removed, the lower open end of the bowel portion L is sewn loosely. A surgical clamp C is clamped upon therod 62 at the opening 50 of the hollow support rod thereby holding the collars separated as in FIG. 11. In this condition the collars are held apart. Then thecollar 38 is inserted into the lower end of the bowel L with the end extending into and upon theundulations 46 due to the restrictiveness of the end of the bowel due to the aforesaid sewing, particularly as in FIG. 12. Then the upper end of the bowel portion La is sewn loosely and forced upon the collar with the end extending into and upon theundulations 60. The clamp C is then released and as a result the collars are urged together by theelastic member 64 and upon the ends of the bowel portions.

After the passing of about three to four days time, the bowel ends agglutinate or grow together and the entire clamp B sluffs off and automatically passes out the anus. The voids V between the collar portions and the

bars

42 and 56 allow bowel movement therethrough when the clamp B is in operative clamping position. As in the case of the embodiment of clamp A the

complementary undulations

46 and 60 increase the extent or length of the clamping edge surface of the

collars

38 and 52 as compared to purely cylindrical ends. With this additional clamping edge surface, the inside diameter of the bowel at the point of joining is substantially as large as originally and not restricted as a result of the joining which restrictiveness occurs where the edges of the collars are purely cylindrical.

I claim:

1. An anastomosis clamp comprising:

a. a first open ended clamping collar having a substantially constant diameter and a relatively thin wall,

b. a second open ended clamping collar having a substantially constant diameter and a relatively thin wall,

c. a relatively narrow cross bar formed on each of said collars adjacent one end thereof extending across the open area defined by the collar on a diameter thereof, said collars having opposite clamping edges on the collar ends opposite said cross bars,

d. means carried axially of said collars by said cross bars for guiding and holding said clamping collars together in clamping engagement, and

e. means for urging the opposed clamping edges of said clamping collars together in clamping engagement wherein the open spaces in collars permit flow axially through the clamping collars.

2. The device of claim 1 in which said means carried axially of said collars by said cross bars for guiding and holding said clamping collars includes a. a support rod connected to said first clamping collar and extending axially therefrom, and

b. said second clamping collar having a support member slidable on said support rod.

3. The device of claim 2 in which said means for urging said clamping collars together includes elastic means connected to said first and second clamping collars.

4. The device of claim 2 in which said means for urging said clamping collars together includes a said support member of said first clamping collar being threaded with draw-up means thereon adapted to act against said second clamping collar to urge said collars together.

5. The device of claim 2 in which said support member of said second clamping collar is flexible to allow movement of the patient using the clamp.

6. The device of claim 4 in which said draw-up means includes a tube slidably mounted on said threaded support member of said first clamping collar which is drawn up against said second clamping collar by means of a nut member.

7. The device of claim 2 further including means for maintaining said collars in spaced apart relationship against said urging means for allowing securement thereto of parts for clamping.

8. The device of claim 7 in which said means for maintaining said collars in spaced apart relationship includes an opening formed in said support member of said first clamping collar whereby said support members may be clamped together.

Claims

1. An anastomosis clamp comprising: a. a first open ended clamping collar having a substantially constant diameter and a relatively thin wall, b. a second open ended clamping collar having a substantially constant diameter and a relatively thin wall, c. a relatively narrow cross bar formed on each of said collars adjacent one end thereof extending across the open area defined by the collar on a diameter thereof, said collars having opposite clamping edges on the collar ends opposite said cross bars, d. means carried axially of said collars by said cross bars for guiding and holding said clamping collars together in clamping engagement, and e. means for urging the opposed clamping edges of said clamping collars together in clamping engagement wherein the open spaces in collars permit flow axially through the clamping collars.

2. The device of claim 1 in which said means carried axially of said collars by said cross bars for guiding and holding said clamping collars includes a. a support rod connected to said first clamping collar and extending axially therefrom, and b. said second clamping collar having a support member slidable on said support rod.