CA1140828A - Surgical instrument for suturing organs - Google Patents
Surgical instrument for suturing organsInfo
- Publication number
- CA1140828A CA1140828A CA000322497A CA322497A CA1140828A CA 1140828 A CA1140828 A CA 1140828A CA 000322497 A CA000322497 A CA 000322497A CA 322497 A CA322497 A CA 322497A CA 1140828 A CA1140828 A CA 1140828A
- Authority
- CA
- Canada
- Prior art keywords
- staple
- longitudinal
- suturing
- staples
- jaw
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
Abstract
Abstract of the Disclosure The instrument comprises a supporting part and a staple-receiving part connected pivotally to each other, their working ends carrying opposing longitudinal jaws. The said longitudinal jaw of said staple-receiving part accom-modates staple magazines. Made in said staple magazines in opposition to the staple-clinching indentations of the longitudinal jaw of the supporting part are transverse slots adapted to accommodate the members for driving said staples and said staples, and longitudinal slots adapted to accom-modate bars with wedge-shaped ends facing said staple-driving members, adapted for cooperation with said staple-driving members, to drive out and insert said staples. The longitudinal slot of said staple-receiving part movably accommodates a knife blade movable jointly with said bars.
The instrument includes a latch-type lock for retaining the two parts in a position where they are brought together to define a suturing gap therebetween, and means for preventing substantial traumatism of the layer-by-layer sutured organs and for ensuring the rigidity of the suturing unit of the instrument in the course of a suturing operation. The instrument is operable for resection surgery of the affected portions of the spleen, lungs, liver and other organs, and also as an organ-suturing instrument.
The instrument includes a latch-type lock for retaining the two parts in a position where they are brought together to define a suturing gap therebetween, and means for preventing substantial traumatism of the layer-by-layer sutured organs and for ensuring the rigidity of the suturing unit of the instrument in the course of a suturing operation. The instrument is operable for resection surgery of the affected portions of the spleen, lungs, liver and other organs, and also as an organ-suturing instrument.
Description
SURGICAL INS~RIJ~ E'N~ FOR SUTURI:NG ORGANS
Thi~ inven-tion relates to medical instrumentation, and more particularly to a surgical instrum~nt for suturing organs.
~ he invention can be used for resection of portions o~
organs with suturing o~ the remain~n~ and removed parts o~
an organ~ e.g. of a lung and other or~ans. However, the di-sclosed instrument can oe utiliæed to utmost ef~ectivenes~
for conducting liv0r resections.
At present, liver resection surgery is performed purely manually, which takes relatively long time (thus, in a single take there is resected a liver portion 5 to 8 mm long and to lO mm thick, with ligation of the vessels and ducts to both sides of the resection area), to say nothing 0~ the ope-ration more often than not being associated with considerable loss o~ blood and po~t-operational complications of various kinds .
~here is known a surgical instrume~t or simultaneous resection of soft tissues a~d their suturing (cf. the US
Patent No. 35079,606, dated March 5~ 1963), usually employed for placing gas~ro-intestinal anastomoses. The instrument includes two pivotally connected parts, viz. the support one and ~he s-tapls-receivi~g one~ the two parts carrying at the working ends thereo~ the respective opposing longitudinally extending jaws. ~he longitudinally extending jaw of the sup-porting part has made therein a longitudi~al array o~ inde~ta--~ ~
114iV828 tions for clinching the staples, i.e., for bending over the ends of the legs of the staples. The longitudinally extend-ing jaw of the staple-receiving part carries staple magazines wherein, in opposition to the above-mentioned indentations, there are made transverse slots for staples, accommodating therein staple drivers and staples. Each staple magazine has made therein longitudinal slots accommodating bars with wedge-shaped ends facing the staple drivers and adapted for cooperation with the staple drivers when the staples are driven out. The staple-receiving part has also made therein a longitudinal slot accommodating a knife blade for tissue-dissecting purposes, which is longitudinally movable jointly with the said bars. The staple-receiving and support parts in their operating position where they are brought together to define a suturing gap therebetween are retainable with a self-actuating locking device.
The hitherto known instrument is mainly intended for placing interintestinal juice anastomoses and operates as follows. The longitudinal jaws of the instrument are inser-ted into the interior of the intestines which are to besutured, through incisions made in the walls of the intes-tines, and the walls to be sutured are positioned between the longitudinal jaws which are in the spread position.
The two parts of the instrument are connected with the pivot, and the support and staple-receiving parts are relatively rotated to bring together their longitudinal jaws :
' ' ~ ~ .
disposed on t~ working ends of these parts 9 until the 5u~u~ing gap iS defined therebetwaen~ wherea~ter the ~wo par-~s are locked with the loc~ing deviceO
The bars with the kni~e blade are moved toward the longitudinal jaws, with the bars engaging by their wedge--shaped ends the staple-driving elements or drivers, whereby the drivers are moved along the slots in the staple-receiv-ing part. Upon leaving the transverse slots, the staples pierce the tissue by their legs or prongs and engage the in-dentations or anvils in the jaw of the supporting part7 wher-eby the staples are be~t into a generally ~-shap0, firmly se-curi~g the tissue~
Simultaneously, the movin~ knife blade se~Jers the tissua between the sutures. ~ollowing the suturing procedure, the supportinæ and staple-receiving part~ are unlocked, and the instrument is removed from the suturing position. In this manner the intestinal walls have become sutured, and a clearan-ce has been provided bet~ean the sutures to ensure the permea-bility o~ tha intestine. '~he incisions in the intestinal walls, le~t a~ter the withdrawal of the lo~gitudinal jaws9 are ~utured by conventional suturing operation.
~ he structure o~ tne suturing unit of the instrument provided ~or r~pid placing of sutures on the xemaining and removing portions o~ the organ, with simultaneous severing o~
the tissue between the rows of the staples, i~e. between the su~ures. The instrume~ is operable ~ox suturin~ and resection o~ liver portions as great as 15 to 20 mm.
, ~ ~
:114()8Z8 ~lo~ever; ~-he instrum~n~ would no~v provide for perform-in~ rasection o~ a liver thicker than 20 mm, whereas the thicl~ness of the human's li~er varies, with the sectional dimension of its differen~ portions being as great as 60 to 70 mm and even greater. Should a greater thickness than 20 ~m be eng~ged by the instrument, it would result in the breakage o~ the capsule a~d of some of the vessels and duct~, bringing about intense blood loss.
~ayer-~Jise or level-wise suturing~ i.e. suturi~g of a greater thickness of the liver in several layers, with pierc-ing the capsule by the lo~gitudinal jaw of the supporting pa~t and succe~siveiy engaging each 15 to 20 mm thick layer, is impossible on account of the considerable cross-s~ctional size of the longitudinal jaw, the piercing and insertion of the longitudinal jaw resulting in substantial tra~ma and in-tense blood loss. 0~ the other hand, a reduction of the cross--sectional dimensions of the longitudinal jaw of the support-ing part of the hitherto k~own instrument canuot be attained~
since this part takes up the load at stapling, a~d its reduc-tion would brin$ about its considerable bending de~ormationyielding drastic impairmen' o~ the suture qu~lit~
~ urthermoxe, with the knife blade of the kno~n instru-ment moving, there is sometimes observed the phenomenon of the resected tissue being ~ragged along by the blade through-out the entire length o~ the longitudinal jaws, which results in the impairad quality o~ the se~ering and in trauma of the tissue adjoi~ing the suture.
, . .
~14(3828 It can be seen from the abovesaid that the hitherto known instr~ment cannot be used for performing rssections of the liver in the layer-wisc fashion when the liver is of a considerable thicXness, i.e. in the majority of the portions o~ the liver.
It is an object of the present inve~tion to provide a surgical instrument for suturing organs, which should made possible layer-by-layer suturing and resection of a parenchy- -mal organ of a considerable thickne3s, with minimized trauma-tism of ~his organ.
This object is attained in a s~rgical apparatus ~or sut-uring organs, e.g. parenchymal ones, comprisin~ two pivotally connected parts, viz. the staple-receiving one and the support-ing or clinching one, ~heir respective working ends carrying opposing longitudinal jaws, the longitudinal jaw of the supp-ort~n~ part ~aving inde~tabions made therei~ ~or bending ov~r the ends o~ the legs o~ ~aples, and the longitudinal jaw of the staple, receiving part carrying staple magazines wherein transverse staple-receiving slots are made in opposition to the- said indentations, the slots accommodating therein the staples and staple drivers, and longitudinal slots adapted to accommodate t~erein bars with wedge-shaped ends facing the staple drivers and being adapted for cooperation with the staple drivers to drive out the staples, a knife blade being accommodated in a longitudinal slot in the staple-receiviDg part ~or motion jointly with said bars, and a locking device .
.' . .
~4V828 for retaining the two parts in a position where they are brought togeth~r to define the suturing gap, in which instru-mGnt, i~ accordance with the invention, means are provided ~or preventing substantial .traumatism o~ layer-b~-la~er sut-ured organs and ensuring the rigidity of the suturing part of the apparatus in the course o~ the su~uring operation.
The herein disclosed surgical i~strument is the ~ir~t to solve the problem of layer-by-layer resection of parenchymal organs of a considerable thickness ade~uately rapidly, with a lo high quality and without blood loss; the instrument being fit for a wide field of applications at performing surgery on the liver, spleen, lungs, and other ~inds o~ surgery.
It is e~pedient that the means for preventing substantial traumatism of the layer-by-layer sutured organs and ensuring the rigldity o~ the suturing part of the apparatus i~ the cour-se of the suturing operation should include rods mounted on the longitudina~ jaw of the staple-receiving part and adapted ~or cooperation with the longitudinal aaw of the supporting part~ shaped as a bar, with aid of openings made in said bar--shaped jaw and of a locking strip accommodated in the longitu-dinal slot o~ the bar-shaped jaw and having apertures alignable .with said openings and corresponding to the spacins o~ the ~
rods, the rods haviaO grooves made therein, adapted to be e~-gaged by the apertures of the locking strip.
With the suturing unit of the instrument having the above-described structure wherein the longitudinal jaw of the staple-O~Z8 -xeceiving paxt has mou~ted therein the rods cooperating 'Ghrough the lockin~ strip with the longitudinal jaw of the supporting part, it becomes possible to minimize the cross--sectional dimensions of the last-mentioned jaw, where'by the longitudinal jaw of the supporting part can be introduced i~o a parenchymal organ without injuring the latter `and causing blood loss, with the overall rigidity of the suturing unit of the instrument adequately maintained. ~urthermore, the quality of the resection is e~hanced owing to the cooper-ation between the knife blade and the rods~ the vessels a~d ducts being sutured becoming grouped within the con~ined spa-cas intermediate the xods, so t~at no dxa~ging of the resect-ed tissue by t~e blade occurs.
The design of the instrument is simple a~d reliable, and its operation ca~ be easily mastered by a surgeon.
~he present i~vention will be further described in con-nection w.th embodiments thereo~, with reference being had to the accom~anying dra~ings, wherei~:
Fig- 1 i9 a top plan ~iew of a surgical instrument for suturing organs~ embodying the invention;
~ig. 2'is a side elevation of the surgical instrume~t for suturi~g organs, embod~ing the in~ention;
~gi. 3 is a sactional view take~ on line III-III of Fig. l;
~ig. 4 is a sectional view take~ on lina IV-IV of ~ig.l;
.
, .''' ' ~ ~ .
. .
---~ 114~828 Fig. 5 illustrates on an enlarged scale the suturing o~ the clamped tissue o~ an organ with staples and the resec-tion along the suture;
Fig. 6 is a sectional view taken on line VI-VI of ~ig~2.
Referring now to the appe~ded drawings, the surgical m -strument ~or ~uturing organs includes a supporting or`cli~ch-i~g part 1 (Fig. 1) and a staple-receiving part 2, the two parts 1 and 2 being pivotall~ connected with a screw 3. ~he working ends of t~e two parts 1 and 2 carry respective oppos-ing longitudinal jaws 4 and 5, while their opposite e~ds areprovided with rings 6. ~he longitudinal jaw 5 of the staple--receiving part 2 accommodates replaceable staple magazines 7 and 8 (Fig. 2). ~he staple magazines 7 and 8 have made therein transverse slots 9 (Fig. 1) adapted to accommodate generally U-shaped staples 10 and staple drivers 11. Uniformly spaced intermediate the staple magazines 7 and 8 throughout the le~gth of the jaw 5 are rods 12. ~he stapIe-receiving part 2 carries ~; slids 13, with screws 14 securing to this slide 13 a knife blade 15 and two bars 16 with wedge-shaped ends, reci-procable along the longitudinal slots l7 a~d l8 (~ig. 3). ~helongitudinal jaw 4 (Fig~ 1) of the supporting part 1 has made therein, in opposition to the transverse slots 9 o~ the staple magazines 7 an~ 8~ inde~tations or anvils 19 for clinching the"'~
staples 10 (Figs 1 and ~)~ Spaced longitudinally o~ the jaw 4 are openings 20 (Fig. 2), their spacing corresponding to that of the rods 12 (Fig. 1), the jaw 4 having a longitudinal slot 21 ~Fig~ 3) made therein, slidably accommodating a locking st;rip 22 (~ig. ~). The latter has apertures 23 made therein, their spacin~ corresponding to that o~ the rods 12. The sup-porting part 1 (~ig. 1) carries a pin 24 retaining a scre~l 25 with an eccentric lug 26. ~his lug 26 (~ig. 4) i8 engage-able in a slot 27 made in the locking strip 22, where~y the rotation o~ the screw 25 can be converted into reciprocation o~ the locking strip 22 (~ig. 4). ~he rotation o~ the screw 25 (~ig. 2) is limite~ vy a pin 28. The rods 12 (Fig. 5) have grooves 29 made therein, which ~rooves are positioned in the plane of reciprocation of the locking strip 22 (~ig. 5) when the ~aws 4 (~ig. 1) and 5 are brought together to define the-r~batween the suturing gap, so that the rod 12 (Fig. 5) are engageable with the locking strip 22. With the rods 12 thus ~ngaged by the locking strip 22, the suturing ef~ort is trans-mitted to and taken up by the more rigid lo~gitudinal aaw 5 (~ig. l) o~ the staple-receiving part 2. In the position of de~ining t~e suturi~g gap the supporting part 1 and ~he stap-le-receiving part 2 are locked together with a latch-type lock ~0 (~ig. 6), ~ et us illustrate the operation o~ the pre~ently disclo~-ed surgical instru~ent by an example of per~ormi~g layer-by--layer li~er resection.
The longitudinal jaws 4 and 5 (~ig. 1) are spread apart.
The longitudinal jaw 4 of the supporting part 1 is made to pierce tha capsule of the liver. ~he longitudinal jaw 4 is then inserted by its full working length, with a 15 to 2a mm thick portion of the liver being between the longitudinal jaws 4 and 5. The rings 6 are bro4ght together until the supporting part 1 and the staple-receiving part 2 are locked with the latch lock 30 (~ig. 6). l~hen ths parts 1 and 2 (~ig. 1) are thus brought together, the longitudinal ja~s 4 and 5 clamp the li~er portion therebetween, ~vith all the ves-sel and ducts therein being accommodated in the spaces bet-ween adjacent pairs of the rods 12. The scxew 25 is rotated to move the locki~g strip 22 (~ig. 5), with the apertures 23 beinæ displaced accordingly and engaging the grooYes 29 in the rods 12! so that a unitary rigid beam is formed with the longitudinal jaw 5 (~ig. 1) of the staple-r0ceiving part 2.
By moving the slide 13 with the knife blade 15 ~nA the two bars 16 with the wedge-shaped ends longitudinally of the sta-ple-receiving part 2 of the apparatus~ there is performed si=
multaneous resection throughout the e~tire length of the iongitudinal jaw~ 4 and 5, and suturing with the staples 10 of the removed portion of the liver and of the remaining one.
he slide 13 is then returned into its initial position. The screw 25 is ro~ated into its initial position to release the rods 12 ~rom the engagement with the locking strip 22. ~he longitudinal jaws are spread apart, and the instrume~t is taken o~ the sutured portion of the liver. ~he staple magaz-ines 7 and 8 (~ig. 2) are replaced, and the abovedescribed operating cycle is repeated to per~orm resection and suturing il~l)~Z8 of the entire thickness ol the liver portion. ~he liver por-tions 15 to 20 mm thick are thus resected and sutured in a si~gle cycle, ~hile liver portio~s of the maximum thickness in a human bei~g require 3 to 4 such cycles.
~ he instrument is operable for resection sur~ery of the af~ected portions of the spleen, lungs a~d other organs, and also as an organ suturing instrumen~.
-- 12 _ `
Thi~ inven-tion relates to medical instrumentation, and more particularly to a surgical instrum~nt for suturing organs.
~ he invention can be used for resection of portions o~
organs with suturing o~ the remain~n~ and removed parts o~
an organ~ e.g. of a lung and other or~ans. However, the di-sclosed instrument can oe utiliæed to utmost ef~ectivenes~
for conducting liv0r resections.
At present, liver resection surgery is performed purely manually, which takes relatively long time (thus, in a single take there is resected a liver portion 5 to 8 mm long and to lO mm thick, with ligation of the vessels and ducts to both sides of the resection area), to say nothing 0~ the ope-ration more often than not being associated with considerable loss o~ blood and po~t-operational complications of various kinds .
~here is known a surgical instrume~t or simultaneous resection of soft tissues a~d their suturing (cf. the US
Patent No. 35079,606, dated March 5~ 1963), usually employed for placing gas~ro-intestinal anastomoses. The instrument includes two pivotally connected parts, viz. the support one and ~he s-tapls-receivi~g one~ the two parts carrying at the working ends thereo~ the respective opposing longitudinally extending jaws. ~he longitudinally extending jaw of the sup-porting part has made therein a longitudi~al array o~ inde~ta--~ ~
114iV828 tions for clinching the staples, i.e., for bending over the ends of the legs of the staples. The longitudinally extend-ing jaw of the staple-receiving part carries staple magazines wherein, in opposition to the above-mentioned indentations, there are made transverse slots for staples, accommodating therein staple drivers and staples. Each staple magazine has made therein longitudinal slots accommodating bars with wedge-shaped ends facing the staple drivers and adapted for cooperation with the staple drivers when the staples are driven out. The staple-receiving part has also made therein a longitudinal slot accommodating a knife blade for tissue-dissecting purposes, which is longitudinally movable jointly with the said bars. The staple-receiving and support parts in their operating position where they are brought together to define a suturing gap therebetween are retainable with a self-actuating locking device.
The hitherto known instrument is mainly intended for placing interintestinal juice anastomoses and operates as follows. The longitudinal jaws of the instrument are inser-ted into the interior of the intestines which are to besutured, through incisions made in the walls of the intes-tines, and the walls to be sutured are positioned between the longitudinal jaws which are in the spread position.
The two parts of the instrument are connected with the pivot, and the support and staple-receiving parts are relatively rotated to bring together their longitudinal jaws :
' ' ~ ~ .
disposed on t~ working ends of these parts 9 until the 5u~u~ing gap iS defined therebetwaen~ wherea~ter the ~wo par-~s are locked with the loc~ing deviceO
The bars with the kni~e blade are moved toward the longitudinal jaws, with the bars engaging by their wedge--shaped ends the staple-driving elements or drivers, whereby the drivers are moved along the slots in the staple-receiv-ing part. Upon leaving the transverse slots, the staples pierce the tissue by their legs or prongs and engage the in-dentations or anvils in the jaw of the supporting part7 wher-eby the staples are be~t into a generally ~-shap0, firmly se-curi~g the tissue~
Simultaneously, the movin~ knife blade se~Jers the tissua between the sutures. ~ollowing the suturing procedure, the supportinæ and staple-receiving part~ are unlocked, and the instrument is removed from the suturing position. In this manner the intestinal walls have become sutured, and a clearan-ce has been provided bet~ean the sutures to ensure the permea-bility o~ tha intestine. '~he incisions in the intestinal walls, le~t a~ter the withdrawal of the lo~gitudinal jaws9 are ~utured by conventional suturing operation.
~ he structure o~ tne suturing unit of the instrument provided ~or r~pid placing of sutures on the xemaining and removing portions o~ the organ, with simultaneous severing o~
the tissue between the rows of the staples, i~e. between the su~ures. The instrume~ is operable ~ox suturin~ and resection o~ liver portions as great as 15 to 20 mm.
, ~ ~
:114()8Z8 ~lo~ever; ~-he instrum~n~ would no~v provide for perform-in~ rasection o~ a liver thicker than 20 mm, whereas the thicl~ness of the human's li~er varies, with the sectional dimension of its differen~ portions being as great as 60 to 70 mm and even greater. Should a greater thickness than 20 ~m be eng~ged by the instrument, it would result in the breakage o~ the capsule a~d of some of the vessels and duct~, bringing about intense blood loss.
~ayer-~Jise or level-wise suturing~ i.e. suturi~g of a greater thickness of the liver in several layers, with pierc-ing the capsule by the lo~gitudinal jaw of the supporting pa~t and succe~siveiy engaging each 15 to 20 mm thick layer, is impossible on account of the considerable cross-s~ctional size of the longitudinal jaw, the piercing and insertion of the longitudinal jaw resulting in substantial tra~ma and in-tense blood loss. 0~ the other hand, a reduction of the cross--sectional dimensions of the longitudinal jaw of the support-ing part of the hitherto k~own instrument canuot be attained~
since this part takes up the load at stapling, a~d its reduc-tion would brin$ about its considerable bending de~ormationyielding drastic impairmen' o~ the suture qu~lit~
~ urthermoxe, with the knife blade of the kno~n instru-ment moving, there is sometimes observed the phenomenon of the resected tissue being ~ragged along by the blade through-out the entire length o~ the longitudinal jaws, which results in the impairad quality o~ the se~ering and in trauma of the tissue adjoi~ing the suture.
, . .
~14(3828 It can be seen from the abovesaid that the hitherto known instr~ment cannot be used for performing rssections of the liver in the layer-wisc fashion when the liver is of a considerable thicXness, i.e. in the majority of the portions o~ the liver.
It is an object of the present inve~tion to provide a surgical instrument for suturing organs, which should made possible layer-by-layer suturing and resection of a parenchy- -mal organ of a considerable thickne3s, with minimized trauma-tism of ~his organ.
This object is attained in a s~rgical apparatus ~or sut-uring organs, e.g. parenchymal ones, comprisin~ two pivotally connected parts, viz. the staple-receiving one and the support-ing or clinching one, ~heir respective working ends carrying opposing longitudinal jaws, the longitudinal jaw of the supp-ort~n~ part ~aving inde~tabions made therei~ ~or bending ov~r the ends o~ the legs o~ ~aples, and the longitudinal jaw of the staple, receiving part carrying staple magazines wherein transverse staple-receiving slots are made in opposition to the- said indentations, the slots accommodating therein the staples and staple drivers, and longitudinal slots adapted to accommodate t~erein bars with wedge-shaped ends facing the staple drivers and being adapted for cooperation with the staple drivers to drive out the staples, a knife blade being accommodated in a longitudinal slot in the staple-receiviDg part ~or motion jointly with said bars, and a locking device .
.' . .
~4V828 for retaining the two parts in a position where they are brought togeth~r to define the suturing gap, in which instru-mGnt, i~ accordance with the invention, means are provided ~or preventing substantial .traumatism o~ layer-b~-la~er sut-ured organs and ensuring the rigidity of the suturing part of the apparatus in the course o~ the su~uring operation.
The herein disclosed surgical i~strument is the ~ir~t to solve the problem of layer-by-layer resection of parenchymal organs of a considerable thickness ade~uately rapidly, with a lo high quality and without blood loss; the instrument being fit for a wide field of applications at performing surgery on the liver, spleen, lungs, and other ~inds o~ surgery.
It is e~pedient that the means for preventing substantial traumatism of the layer-by-layer sutured organs and ensuring the rigldity o~ the suturing part of the apparatus i~ the cour-se of the suturing operation should include rods mounted on the longitudina~ jaw of the staple-receiving part and adapted ~or cooperation with the longitudinal aaw of the supporting part~ shaped as a bar, with aid of openings made in said bar--shaped jaw and of a locking strip accommodated in the longitu-dinal slot o~ the bar-shaped jaw and having apertures alignable .with said openings and corresponding to the spacins o~ the ~
rods, the rods haviaO grooves made therein, adapted to be e~-gaged by the apertures of the locking strip.
With the suturing unit of the instrument having the above-described structure wherein the longitudinal jaw of the staple-O~Z8 -xeceiving paxt has mou~ted therein the rods cooperating 'Ghrough the lockin~ strip with the longitudinal jaw of the supporting part, it becomes possible to minimize the cross--sectional dimensions of the last-mentioned jaw, where'by the longitudinal jaw of the supporting part can be introduced i~o a parenchymal organ without injuring the latter `and causing blood loss, with the overall rigidity of the suturing unit of the instrument adequately maintained. ~urthermore, the quality of the resection is e~hanced owing to the cooper-ation between the knife blade and the rods~ the vessels a~d ducts being sutured becoming grouped within the con~ined spa-cas intermediate the xods, so t~at no dxa~ging of the resect-ed tissue by t~e blade occurs.
The design of the instrument is simple a~d reliable, and its operation ca~ be easily mastered by a surgeon.
~he present i~vention will be further described in con-nection w.th embodiments thereo~, with reference being had to the accom~anying dra~ings, wherei~:
Fig- 1 i9 a top plan ~iew of a surgical instrument for suturing organs~ embodying the invention;
~ig. 2'is a side elevation of the surgical instrume~t for suturi~g organs, embod~ing the in~ention;
~gi. 3 is a sactional view take~ on line III-III of Fig. l;
~ig. 4 is a sectional view take~ on lina IV-IV of ~ig.l;
.
, .''' ' ~ ~ .
. .
---~ 114~828 Fig. 5 illustrates on an enlarged scale the suturing o~ the clamped tissue o~ an organ with staples and the resec-tion along the suture;
Fig. 6 is a sectional view taken on line VI-VI of ~ig~2.
Referring now to the appe~ded drawings, the surgical m -strument ~or ~uturing organs includes a supporting or`cli~ch-i~g part 1 (Fig. 1) and a staple-receiving part 2, the two parts 1 and 2 being pivotall~ connected with a screw 3. ~he working ends of t~e two parts 1 and 2 carry respective oppos-ing longitudinal jaws 4 and 5, while their opposite e~ds areprovided with rings 6. ~he longitudinal jaw 5 of the staple--receiving part 2 accommodates replaceable staple magazines 7 and 8 (Fig. 2). ~he staple magazines 7 and 8 have made therein transverse slots 9 (Fig. 1) adapted to accommodate generally U-shaped staples 10 and staple drivers 11. Uniformly spaced intermediate the staple magazines 7 and 8 throughout the le~gth of the jaw 5 are rods 12. ~he stapIe-receiving part 2 carries ~; slids 13, with screws 14 securing to this slide 13 a knife blade 15 and two bars 16 with wedge-shaped ends, reci-procable along the longitudinal slots l7 a~d l8 (~ig. 3). ~helongitudinal jaw 4 (Fig~ 1) of the supporting part 1 has made therein, in opposition to the transverse slots 9 o~ the staple magazines 7 an~ 8~ inde~tations or anvils 19 for clinching the"'~
staples 10 (Figs 1 and ~)~ Spaced longitudinally o~ the jaw 4 are openings 20 (Fig. 2), their spacing corresponding to that of the rods 12 (Fig. 1), the jaw 4 having a longitudinal slot 21 ~Fig~ 3) made therein, slidably accommodating a locking st;rip 22 (~ig. ~). The latter has apertures 23 made therein, their spacin~ corresponding to that o~ the rods 12. The sup-porting part 1 (~ig. 1) carries a pin 24 retaining a scre~l 25 with an eccentric lug 26. ~his lug 26 (~ig. 4) i8 engage-able in a slot 27 made in the locking strip 22, where~y the rotation o~ the screw 25 can be converted into reciprocation o~ the locking strip 22 (~ig. 4). ~he rotation o~ the screw 25 (~ig. 2) is limite~ vy a pin 28. The rods 12 (Fig. 5) have grooves 29 made therein, which ~rooves are positioned in the plane of reciprocation of the locking strip 22 (~ig. 5) when the ~aws 4 (~ig. 1) and 5 are brought together to define the-r~batween the suturing gap, so that the rod 12 (Fig. 5) are engageable with the locking strip 22. With the rods 12 thus ~ngaged by the locking strip 22, the suturing ef~ort is trans-mitted to and taken up by the more rigid lo~gitudinal aaw 5 (~ig. l) o~ the staple-receiving part 2. In the position of de~ining t~e suturi~g gap the supporting part 1 and ~he stap-le-receiving part 2 are locked together with a latch-type lock ~0 (~ig. 6), ~ et us illustrate the operation o~ the pre~ently disclo~-ed surgical instru~ent by an example of per~ormi~g layer-by--layer li~er resection.
The longitudinal jaws 4 and 5 (~ig. 1) are spread apart.
The longitudinal jaw 4 of the supporting part 1 is made to pierce tha capsule of the liver. ~he longitudinal jaw 4 is then inserted by its full working length, with a 15 to 2a mm thick portion of the liver being between the longitudinal jaws 4 and 5. The rings 6 are bro4ght together until the supporting part 1 and the staple-receiving part 2 are locked with the latch lock 30 (~ig. 6). l~hen ths parts 1 and 2 (~ig. 1) are thus brought together, the longitudinal ja~s 4 and 5 clamp the li~er portion therebetween, ~vith all the ves-sel and ducts therein being accommodated in the spaces bet-ween adjacent pairs of the rods 12. The scxew 25 is rotated to move the locki~g strip 22 (~ig. 5), with the apertures 23 beinæ displaced accordingly and engaging the grooYes 29 in the rods 12! so that a unitary rigid beam is formed with the longitudinal jaw 5 (~ig. 1) of the staple-r0ceiving part 2.
By moving the slide 13 with the knife blade 15 ~nA the two bars 16 with the wedge-shaped ends longitudinally of the sta-ple-receiving part 2 of the apparatus~ there is performed si=
multaneous resection throughout the e~tire length of the iongitudinal jaw~ 4 and 5, and suturing with the staples 10 of the removed portion of the liver and of the remaining one.
he slide 13 is then returned into its initial position. The screw 25 is ro~ated into its initial position to release the rods 12 ~rom the engagement with the locking strip 22. ~he longitudinal jaws are spread apart, and the instrume~t is taken o~ the sutured portion of the liver. ~he staple magaz-ines 7 and 8 (~ig. 2) are replaced, and the abovedescribed operating cycle is repeated to per~orm resection and suturing il~l)~Z8 of the entire thickness ol the liver portion. ~he liver por-tions 15 to 20 mm thick are thus resected and sutured in a si~gle cycle, ~hile liver portio~s of the maximum thickness in a human bei~g require 3 to 4 such cycles.
~ he instrument is operable for resection sur~ery of the af~ected portions of the spleen, lungs a~d other organs, and also as an organ suturing instrumen~.
-- 12 _ `
Claims (2)
1. A surgical instrument for suturing organs, such as parenchymal organs, comprising:
a supporting part having a working tip;
a staple-receiving part having a working tip and pivotally connected with said supporting part;
a first longitudinal jaw carried by the working tip of said supporting part;
a second longitudinal jaw carried by the working tip of said staple-receiving part in opposition to said first longitudinal jaw;
staples;
indentations for bending over said staples, made in said first longitudinal jaw;
staple magazines accommodated in said second longi-tudinal jaw;
members for driving said staples;
transverse slots made in said staple magazines in opposition to said indentations, adapted to accommodate therein said members for driving said staples and said staples;
longitudinal slots made in said staple magazines;
bars with wedge-shaped ends facing said members for driving said staples, accommodated in said staple magazines and adapted for cooperation with said staple-driving members, for driving out said staples;
a longitudinal slot in said staple-receiving part;
a knife blade movably accommodated in said longi-tudinal slot in said staple-receiving part for motion jointly with said bars;
a latch-type lock for securing said two parts in a position wherein they are brought together to define a suturing gap;
means for a layer-by-layer suturing of organs and for ensuring the rigidity of the working tips of the support-ing and staple-receiving parts of the instrument in the course of a suturing operation.
a supporting part having a working tip;
a staple-receiving part having a working tip and pivotally connected with said supporting part;
a first longitudinal jaw carried by the working tip of said supporting part;
a second longitudinal jaw carried by the working tip of said staple-receiving part in opposition to said first longitudinal jaw;
staples;
indentations for bending over said staples, made in said first longitudinal jaw;
staple magazines accommodated in said second longi-tudinal jaw;
members for driving said staples;
transverse slots made in said staple magazines in opposition to said indentations, adapted to accommodate therein said members for driving said staples and said staples;
longitudinal slots made in said staple magazines;
bars with wedge-shaped ends facing said members for driving said staples, accommodated in said staple magazines and adapted for cooperation with said staple-driving members, for driving out said staples;
a longitudinal slot in said staple-receiving part;
a knife blade movably accommodated in said longi-tudinal slot in said staple-receiving part for motion jointly with said bars;
a latch-type lock for securing said two parts in a position wherein they are brought together to define a suturing gap;
means for a layer-by-layer suturing of organs and for ensuring the rigidity of the working tips of the support-ing and staple-receiving parts of the instrument in the course of a suturing operation.
2. A surgical instrument as claimed in claim 1, wherein said means for the layer-by-layer suturing of organs and for ensuring the rigidity of the working tips of the supporting and staple-receiving parts comprises:
rods mounted on said second longitudinal jaw;
grooves made transversely in said rods;
a longitudinal slot made in said first longitudinal jaw being shaped as a bar;
openings made in said first longitudinal jaw for engaging said rods;
a locking strip accommodated in said longitudinal slot in said first longitudinal jaw, having apertures alignable with said openings and spaced correspondingly to the spacing of said rod, adapted to engage said grooves in said rods.
rods mounted on said second longitudinal jaw;
grooves made transversely in said rods;
a longitudinal slot made in said first longitudinal jaw being shaped as a bar;
openings made in said first longitudinal jaw for engaging said rods;
a locking strip accommodated in said longitudinal slot in said first longitudinal jaw, having apertures alignable with said openings and spaced correspondingly to the spacing of said rod, adapted to engage said grooves in said rods.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SU782595728A SU1036324A1 (en) | 1978-03-31 | 1978-03-31 | Surgical suturing device |
SU2595728 | 1978-03-31 |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1140828A true CA1140828A (en) | 1983-02-08 |
Family
ID=20755797
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000322497A Expired CA1140828A (en) | 1978-03-31 | 1979-02-28 | Surgical instrument for suturing organs |
Country Status (3)
Country | Link |
---|---|
US (1) | US4244372A (en) |
CA (1) | CA1140828A (en) |
SU (1) | SU1036324A1 (en) |
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1978
- 1978-03-31 SU SU782595728A patent/SU1036324A1/en active
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1979
- 1979-02-27 US US06/015,654 patent/US4244372A/en not_active Expired - Lifetime
- 1979-02-28 CA CA000322497A patent/CA1140828A/en not_active Expired
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SU1036324A1 (en) | 1983-08-23 |
US4244372A (en) | 1981-01-13 |
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