US2396179A - Surgical stitching instrument - Google Patents

Description

March 5, 1946. J. D. KARLE SURGICAL STITCHING INSTRUMENT Filed July 15, 1944 Patented Mar. 5, 1946 SURGICAL STITCHING INSTRUMENT John D. Karle, Roselle Park, N. J., assigner to The Singer Manufacturing Company, Elizabeth, N. J., a corporation of New Jersey Application July 15, 1944, Serial No. 545,032

9 Claims.

, This invention relates to surgical stitching instruments and more particularly to improvements in the instrument which forms the subject of my pending United States patent application Serial No. 493,819, filed July 8, 1943.

The primary object of this invention is to provide a surgical stitching instrument which, by the substitution of suitable parts, readily may be adapted to perform various types of suturing operations under dissimilar operating conditions.

When eye, plastic surgery and other delicate suturng operations are to be performed, it is def sirable that the suturing instrument be relatively small and of light weight so that it conveniently may be held in and manipulated by the fingers of the surgeon. As such operations are usually performed with relatively small and fine needles it is also desirable that the needle-holding portion of the instrument also be small so as to be easily ,manipulated and so as not to obstruct the surgeons vision.

When general suturing is to be performed, in readily accessible places, the instrument may still be relatively small but the needle and that por tion of the instrument which holds the needle may, to advantage, be materially larger and heavier than is practical for the more delicate operations.

When performing deep suturing operations as, for example, when operating within the abdominal cavity, it is essential that the instrument be materially longer than is desirable for surface suturing.

This invention therefore has as an object to provide a surgical stitching instrument capable of having secured thereto, selectively, any one of a plurality of needle-supporting bars of various lengths and of various diameters; to provide a plurality of needle-clamp actuating rods also of various lengths and diameters each to cooperate with a complemental one of said needle-supporting bars; and to provide a single manually operatable member to actuate all of said needle-clamp actuating rods.

With the above and other objects in view, as will hereinafter appear, the invention comprises the devices, combinations and arrangements of parts hereinafter set forth and illustrated in the accompanying drawing of a preferred embodiment of the invention, from which the several features of the invention and the advantages attained thereby will be readily understood by those skilled in the art.

In the drawing, f

Fig. 1 is an enlarged central longitudinal sectional view of a surgical stitching instrument embodying the present invention, tted for deli cate suturing operations.

Fig. 2 is a sectional view substantially onthe line 2--2 of Fig. 1 on a still larger scale.

Fig. 3 is a transverse sectional View substantially on the line 3 3 of Fig. 2.

Fig. 4 is a longitudinal sectional view substantially on the line 4-4 of Fig. 2.

Fig. 5 is a perspective view of one of the larger removable needle-supporting bars and a portion of the instrument into which it is designed to be inserted and frictionally retained, a portion of the bar being shown as broken away. y

Fig. 6 is an enlarged detail sectional View of the needle-holding end of the instrument when fitted with one of the larger needle-bars, a larger needleclamp actuating rod and one of the larger size needles.

Fig. '7 is a sectional view substantially on the line 'l-l of Fig. 6.

Fig. 8 is a longitudinal sectional view of a portion of the handle-end of the instrument showing the needle-clamp actuating nut threaded upon one of the larger size needle-clamp actuating rods.

Referring more specically to the drawing, the invention is disclosed as embodied in a surgical stitching instrument comprising a handle l, a spool-holding section 2, having a cup-like spoolreceiving portion 3 and oppositely extending tubular portions 4 and 5 of which the former is fitted within one end of a bore 6 formed in the handle I and removably held therein by a screw 'l threaded into a hole la in the member 4. The opposite portion 5 is formed with a bore 8 adapted to receive the rear or shank end of any one of a plurality of hollow needle-holding bars later to be described. The portion 5 is formed with four slots or notches a. b, c and d, spaced ninety degrees 'apart and which are adapted selectively to receive a positioning tongue punched outwardly ,from the shank end of each of the needle-bars, to locate the needle-bar, and the needle carried thereby, in any one 0f four positions about the axis of the instrument.

Suture thread for the needle is wound upon a spool Il held within the cup-like spool-case 3 of the spool-holding section 2, intermediate the needle-bar and the handleI l. The thread runs from the spool l I through a slot l 2 in the sidewall of the spool-case 3, thence through a threadguiding aperture I3 in the outer end of the needleclamp, later to be described'and finally to the eye, or eyes, of the needle. The spool is rotatably journaled on the portion 14a of a spool-supporting one of the slots a, b, c, or d in the portion 5. The tongue is formed by being pressed outwardly from the shank portion 23a by means of a suitable tool projected through an aperture 23h in the diametrically opposite side of the shank.

The outside diameter of the shank Portion 23 of the needle-supporting bar corresponds to the inside diameter of the tubular portion but the latter is slightly resilient and is constricted at its outer end to cause it to grip the shank of the needle-supporting bar and hold it against acfrom. A cup-nut I9, which also serves as a thumb-button, is threaded upon the end lila of the spool-pin and serves as means to shift the pin axially, in one direction, in opposition to a coil spring 2D surrounding the boss ld intermediate the member 2 and the nut i9.

Provision is made for locking the Spool against rotation except when it is desired to draw suture thread therefrom. To that end, each ange of the spool Il is formed With a series of apertures lla adapted to receive the head vof a screw 2l, located within the spool-case 3, to prevent rotation of the spool. The screw 2l also serves to hold, within the spool-case, a light C-shaped dat metal friction spring 22, adapted to bear upon the innermost flange of the spool to prevent overrunning of the spool when it is re leased from the screw 2i, as will no-w be described.

When it is desired to unlock the spool from the screw 2l so that the spool will be free to rotate to permit suture thread to be withdrawn from the spool, the'user presses on the thumb-button I9 thereby shifting the rod I6, and the spo-ol cai'- ried thereby, axially away from the screw 2 I, thus releasing the spool. Upon release of the pressure upon the thumb-nut the spring 2li shifts the parts in the opposite direction again to bring one of the holes H2L in the spool Il, into locking engagement with the head of the screw 2l.

As in my above mentioned application, the suture spool and its locking and unlocking means are located on the longitudinal axis of the instrument so as to be equally accessible to the thumb of either hand. When so located, the axis of the spool pin l@ intersects the axis of a needle-clamp actuating rod later to be described. T0 permit the parts to have this desirable location and yet to avoid interference between the spool-pin and the needle-clamp actuating rod I have so formed the parts that one may pass transversely through the other. Preferably the portion 14C of the spool-pin lll is formed with a transverse clearance aperture lli@ which is of sufficient width to permit the needle-clamp actuating rod to pass therethrough, as shown in Figs. 1, 2 and 3. Also, the aperture Me is sufciently long to permit the spool-pin to be shifted lengthwise, under thumb-pressure applied to the thumbbutton I9 or by the spring 20, to cause the spool to be released from or lockedto the screw 2las hereinbefore described. y

Figs. l and 2 show the instrument fitted with a needle-supporting bar 23, a needle-clamp actuating rod 24 and a small needle n, all of the type used When performing delicate suturing cperations in readily accessible places such, for example, as in eye and plastic surgery. At its inner end the bar 23 is formed with an enlarged cylindrical shank po-rtion 2a adapted to nt within the bore 8 in the tubular portion 5 of .the vspool-holding section 2. The portion 'i3Ev carries the positioning tongue IB, hereinbefore men- '.tioned, which is designed to be fitted into any cidental outward movement.

The shank 23a is formed with a tapered end 23 to facilitate insertion of the shank into the bore in the portion 5. ln its outer end the bar 23 is formed with two aligned il-shaped notches 25 the walls of which afford xed jaws of a clamp for the shank s of the needle n. Cooperating with the fixed jaws in gripping the needle is a movable jaw 25 provided by the Wall of an aperture extending through the needle-clamp actuating rod 2li. Thee rod 24 extends through the bore in the bar 23,

through a bore 2a in the spool-holding section 2,

through the transverse clearance aperture lll-e in the spool-pin lil and is screwed into the smaller threaded bore 27a in a nut 2l journaled in the remote end of the handle l. The nut 2l also contains a larger threaded bore 2lb for a larger clamp-actuating rod, as later will be described.

The shank of the needle is preferably of octagonal shape in cross-section and therefore the needle may be clamped in any one of eight predetermined angular positions.

A coil spring 2S, located in a bore Ia in the handle i, has one end in engagement with the tubular portion l of the spool-holding section and its other end in contact with the inner end of the nut 2. This spring normally urges the nut 2l and rod 2% to the right, as seen in Fig. 1, thereby yieldingly gripping the needle between the jaws 25 and 26. When the needle is impositively held by the clamp jaws the needle may be rotated to any desired position Without dropping from the needle-clamp. This grip on the needle may be made positive by rotating the nut 2l. Initial turning of the nut causes it to engage the end of the handle after which a further turn of the nut will cause the rod 24 and the clamp-jaw 2t carried thereby to be urged to the right, thereby positively locking the shank of the needle between the jaws 25 and 26.

The rod 2d is provided in its outer end portion with the thread-guiding aperture I3, hereinbefore mentioned, through which the suture thread passes in its travel from the spool to the eye, or eyes, of the needle. To prevent rotating of the rod 2li in the bar 23, While permitting relative endwise movement therebetween, the outer end of the bar is provided with aligned slots 2% within which are slidingly mounted the outer ends of a pin 3G fastened in the rod. v

When it is desired to use the instrument for heavier suturing the needle-supporting bar 23 and the clamp-actuating rod 2li are removed and replaced by the needle-supporting bar E23 and the clamp-actuating bar ld, shown in Figs. 5, 6, 'i and 8 and a larger and heavier needle N, having an octagonal shank S, is secured in the needleclamp. The shank portion i232L of the bar E23 corresponds in size and shape to the shank portion 23a of the bar 23 and is adapted to be frictionally held within the slotted end portion 5 of the spool-holding section 2, with the tongue lll in a selected one of the slots a, b, c, or d. The

outer end of the bar I 23 is formed with a head |22 provided with aligned V-shaped notches |25, which correspond to the notches in the bar 23, and the wa1ls of which comprise the xed jaws of a needle-clamp. The cooperating movable jaws of the needle clamp are aiorded by the surface |26 of a bore formed in a clamp-block |27 secured upon the outer end of the clamp-actuating rod |24. The opposite end of the r'od 24 is threaded into the larger threadedbore 2lb in the nut 21, as shown in Fig. 8. The head |22 of the bar |23 is formed with aligned slots |29, which correspond to the slots 29 in the bar 23, and which slidingly' receive a cross-pin |30 secured in the clamp block |27, as for example, by solder |3|.

As shown most clearly in Fig. 7 the clamp-block |21 is provided with a thread-guiding aperture I3, parallel with the surface |26 of the movable clamp-jaw, and a portion |32 which overlies the shank of the needle and forms a stop therefor.

When deep suturing is to be performed, as for example within the abdominal cavity, a needlesupporting bar and needle-clamp actuating rod similar to those shown in Figs. 5, 6, '7 and 8 but of greater length are inserted into the instrument to materially increase the length of the instrument. Inasmuch as the longer needle-supporting bar and its complemental longer clamp-actuating bar differ from those shown in Figs. 5, 6, 7 and 8 only in length, illustration thereof is deemed unnecessary.

From the foregoing it will be perceived that this invention has provided an all-purpose surgical stitching instrument which, by a simple and convenient interchange of certain parts thereof is adapted to afford all the advantages of a plurality of single purpose instruments in the performing of a considerable number of unlike suturing operations in relatively accessible and inaccessible parts of the human body.

Having thus set forth the nature of the invention, what I claim herein is:

l. A surgical stitching instrument comprising a handle; a spool-holding section having oppositely projecting tubular portions one of which is secured to said handle, the other of said tubular portions being slotted; a needle-supporting bar having one end secured in said slotted tubular portion of said spool-holding section and having a radially projecting portion entering a slot therein to prevent relative rotation between the section and the needle-supporting bar; a fixed needle-clamping jaw formed at the outer end of said needle-supporting bar; a needle-clamp actuating rod slidingly mounted in said bar, section and handle and carrying a needle-clamping jaw adapted to cooperate with said xed jaw to clamp a needle; and means associated with said rod and handle for shifting said rod axially to effect clamping of a needle between said jaws.

2. A surgical stitching instrument comprising a handle; a spool-holding section having oppositely projecting tubular portions one of which is secured to said handle, the other of said tubular portions having therein a plurality of circumferentially spaced open-ended slots and being slightly constricted at its outer end; a needle-supporting bar having one end frictionally secured in said slotted tubular portion of said spool-holding section and having an outwardly pressed tongue adapted to be inserted into any one of the slots therein to locate the needle-supporting bar in various angular positions relative to said spoolholding section and to prevent relative rotation between the section and the bar; a ixed needleclamping jaw formed at the outer end of sald needle-supporting bar; a needle-clamp actuating rod slidingly mounted in said bar, section and handle and carrying a needle-clamping jaw adapted to cooperate with said fixed jaw to clamp a needle; and means associated with said rod and handle for shifting said rod axially to effect clamping of a needle between said jaws.

3. A. surgical stitching instrument comprising a handle; a spool-holding section having oppositely projecting tubular portions one of which is secured to said handle, the other of said tubular portions being slotted; a needle-supporting bar having one end secured in said slotted tubular portion of said spool-holding section and having an outwardly projecting portion entering a slot therein to prevent relative rotation between the section and the needle-supporting bar; a fixed needle-clamping jaw formed -at the outer end of said needle-supporting bar; a needle-clamp actuating rod`slidingly mounted in said bar, section and handle and carrying a needle-clamping jaw adapted to cooperate with said xed jaw to clamp the shank of a needle, said needle-clamp actuating rod also affording a thread-guide arranged substantially parallel to the shank of the needle; and a clamp nut threaded on said rod and engaging said handle for shifting said rod axially to effect clamping of a needle between said jaw.

4. A surgical stitching instrument comprising a handle; a spool-holding section having oppositely projecting tubular portions one of which is secured in said handle, the other of said tubular portions being slotted and slightly constricted at its outer end; a needle-supporting bar having one end frictionally secured in said slotted tubular portion of said spool-holding section and having an outwardly projecting portion entering a slot therein to prevent relative rotation between the section and the needle-supporting bar; a fixed needle-clamping jaw formed at the outer end of said needle-supporting bar; a needle-clamp actuating rod slidingly mounted in said bar, section and handle and carrying a needle clamping jaw adapted to cooperate with said fixed jaw to clamp a needle; means including a pin-and-slot connection between said needle-supporting bar and said needle-clamp actuating rod to prevent relative rotation therebetween; and means associated with said rod and handle for shifting said rod axially to effect clamping of a needle between said jaws.

5. A surgical stitching instrument comprising a handle; a spool-holding section having oppositely projecting tubular portions one of which is secured in said handle; a tubular needle-supporting bar having at one end an enlarged shank portion secured in the other tubular portion of said spoolholding section and at its other end a pair of spaced and aligned fixed needle-clamping jaws; a rod slidingly mounted in said bar, section and handle and carrying at its outer end a needleclamping jaw adapted to cooperate with said xed jaws to clamp a needle; and means associated with said rod and handle for shifting said rod axially to eect clamping of a needle between said jaws.

6. A surgical stitching instrument as set forth in claim 5 in which the overall diameter of the Secured insaid handle; a tubular needle-,support- Ving hai-'having at Lone end an enlarged shank portion secu-red in the other tubular `portion of said spoolholdingzsection and at its other end a pair of spaced and fixed needle-clamping jaws; a rod slidingly mounted in said bar, section and handle and carrying` a movable needle-clamping jaw v1ocated between said fixed jaws and adapted to cooperate therewith to clamp a needle; and a nut threaded on saidv rod and adapted to engage. said handle for shifting said rod axially to eiect, clamping of a needle between said jaws.

r8. rA surgical stitching instrument comprising ahandle; aspool-holdng section having twov oppositely projecting tubular portions of which the rst isgsecured in said handle and of which the second is adapted to receive theshank portion of anypone offa plurality of needle-supporting bars of different lengths and of diierent diameters but eachA having a shank portion adapted to t withinsaid second tubular portion and each having at its outer end a xed needle-clamping jaw; a clamp-nut rotatably mounted in the free end of said handle, said nut having a plurality of aligned threaded boresr of different diameters each adaptedto receive the threaded end of one of a plurality of diierent size clamp-actuating rods each associated with one of said needle-supporting bars,

eachof said rods :carrying a movable clamp-jaw adapted to cooperate with one of said fixed jaws to clamp a needle.

9.1 A surgical :stitching instrument .comprising a handle; a-,spool-holding section having oppositely projecting tubular portions one. of which is secured in said handle and the other of which is slotted and hasqits outer end slightly constricted, said slotted portion being adapted to receive the shank portion of any one of al plurality of needlesupporting bars of different. lengths. and of different diametersA but each having a shank portion adapted to nt within -said slotted tubular portion and having .aftongue adapted to fit within a slot insaidslotted portion to prevent relative rotation between said section and the bar, each of said bars .having at its outer end a fixed needle-clamping jaw; a clamp-nut rotatably mounted in the free end ofsaid handle, said nut having a plurality of aligned threaded bores. each adapted to receivev the threaded -end of one of a plurality of clamp-actuating rods of different diameters each associated with one of said needle-supporting bars, each of. said rods carrying a clamp-jaw adapted, Aby endwisemovement of the rod, to cooperate With one of said xed jaws to clamp a needle.

JOHN D. KARLE.

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