US2579192A - Suturing instrument - Google Patents

Description

Dec. 18, 1951 A. KOHL SUTURING INSTRUMENT Filed Aug. 15, 1950 8 6 a M 6 7 -1. 1 E MEME- ALEXANDER KOHL L E mm MW A TTORNEYS Patented Dec. 18,1951 g SUTURING INSTRUMENT Alexander Kohl, Fresno, Calif., assignor of onehalf to George H. Sciaroni, Fresno, Calif.

Application August 15, 1950, Serial N0.'179,439

The present invention relates generally to surgical instruments and more particularly to a stitching apparatus or surgical needle adapted to apply sutures to secure ruptured, cut, or kleft membranes, tissues, fibers and the like.

The exacting requirements of manual dexterity required of surgeons in the performance of operations is well known. One of the most ,difiicult surgical tasks is that of suturing in confined and nearly inaccessible positions. Although considerable effort has been expended in the development of improved surgical needles, the available forms thereof do not successfully overcome the difliculties encountered. For example, many conventional surgical needles are intricate and cumbersome to employ. Many are of such size and shape as to preclude their employment in restricted and/or relatively inaccessible positions. Most such needles'only are adapted to feed a suture through material being stitched and do not accomplish a looping, tying, or locking of the suture. When this type of needle is employed, the loose ends of each suture must be tied separately from other adjacent sutures to secure the stitches. This tying is frequently one of the most difficult tasks for the surgeon quickly to perform and one requiring continualpractice in order to maintain adequate proficiency. Still other conventional needles are constructed similarly to a sewing machine in their inclusion of a shuttle. These needles are inherently cumbersome instruments having use onlyin readily accessible areas where the suturing problems are not of great difiiculty.

It is an object of the present invention to provide an improved surgical needle that is easier to. employ than conventional needles and conducive to increased speed of performance of the suturing procedure.

Another object is to provide a surgical-needle adapted conveniently and speedily to stitch membranes, tissues, fibers, and the like in even confined and relatively inaccessible positions.

Another object is to provide a surgical needle of generallyslender form having a working end and a manipulating end, the working end being return-bent so that by operation of the manipulating end of the instrument a needle in the operating end may be reciprocally thrustgenerally toward the manipulating end.

Another object is to provide a surgical needle adapted simultaneously to pierce and to suture membranes, tissues, fibers, and the like.

4 Claims. (01. 128-440) Another object is to provide-a surgical needle adapted to sew or chainstitch suturing material into acontinuous series of sutures.

-A further object is to provide a semiautomatic surgical needle. a

A still further'object is to provide a surgical needle of the character described manipulatable 2 to tighten stitched thread or other suturing material.

.Other. objects and advantages of the present invention will become apparent in the subsequent description in the specification.

In the drawing: 7 Fig. 1 is a side elevation partially longitudinal section of a surgical needle embodying the principles of the present invention.

Fig. 2 is an edge elevation, partially in longitudinal section, of the surgical needle shown in Fig. I viewed from a position degrees removed from the position represented by Fig. 1.

. Fig. 3 is a fragmentary s1de elevation of the operating end of the surgical needle of the pres ent invention, as shown in Fig. 1, but with an arcuate needle thereof shown in stitching position and aretriever plate in threaded hooked position. a I

Fig. 4 is a fragmentary edge elevation of the operating end of the surgical needle showing elements thereof in the positions assumed in-Fig. 3.

Fig. 5 is a fragmentary side elevation of the portion of the needle shown in Fig. 3 illustrating a subsequent step in the operation thereof;

Fig. 6 is a fragmentary edge elevation of the subject surgical needle as viewed in Fig. 4-but showing the elements thereof in the subsequent operating step represented in Fig. 5.

Referring in greater detail to the drawing:

The surgical needle of the present invention employs an elongated hollow handle I0 conveniently formed of an inner tubular member II and an outer tubular member l2 welded, sweated, or otherwise secured in telescopic relation, as shown at IS. A guide fitting l5having a bore it formed therethrough is screw threadably mounted in the endof the outer tubular member [2 opposite to the' inner tubular member II. The guide fitting provides a shoulder ll inwardly disposed the outer tubular member l2. The fitting provides an annulus l8 integral therewith adapted for tightening against the end of the outer tubular member.

A finger. grip 2D is located about the fittingli against the annulus IS, a washer 2| positioned against 'the finger "grip, :and' a nut 22 screw threadably tightened on the fitting against the Washer and fingergrip. For convenience in subsequent discourse, the 'endof the surgical needle of the present invention mounting the finger grip 20 is referred to as the manipulating end thereof.

A hollow, arcuate, gooseneck guide 25 having a sharpened end portion 26 is welded, sweated, or otherwise rigidly mounted in the end of the inner tubular-member ll opposite to the outer member I2. The end of the surgical needle mounting the guide is for purposes of convenience hereinafter referred t .as the operating end thereof. The hollow interior of the guide 25 and in substantial alignment with the handle ID to the sharpened end portion 26 of the guide and,

as will subsequently become more clearly apparent, the groove is adapted to receive a thread or other suturing material 28.: A collar 29 is mounted on the guide in circumscribing relation to the groove 21 to assist in maintaining the thread 28 therein during operation of the needle. A thread guide 38 is provided on the outward periphery of the guide 25 in peripheral alignment with the groove 21 and is adapted to direct thread about the periphery of the guide 25 under the collar 29 into. the groove 21. The sharpened end portion 26 is provided with a V-notch 3| concentrically of the groove 21.

For convenience inv mounting a supply of thread 28 or other suturing material on the device of the present invention, a ring 34 is rigidly mounted in. circumscribing relation to the handle I adjacent to the finger grip 28. A headed post 35 is radially outwardly extended from the ring and rotatably mounts a thread reel 36 thereon. In order to resist unintentional unreeling of thread from the reel, a friction spring 37 or other braking device is provided on the post 35 in fri'o-, tional engagement with the reel 35 resistive to free rotation thereof.

A slide bushing 46 is provided within the outer I tubular member l2 in abutting relation with the end of the inner tubular member II. A plunger 4] is mounted for reciprocal longitudinal movement in the bore N5 of the guide fitting l5, the bushing 48 and the hollow interior of the guide 25-. The plunger is extended from the end of the handle l6 adjacent to the finger grip 20 and for convenience of manual manipulation is provided with a head 42 and a thumb loop 43. A .circumscribingfiange 44' is'fixedly mounted on the plunger 4| in spaced relation to the bushing and a helical spring 45 located for initial compression between the bushing and flange. M An arcuate needle 48 having a sharpened end portion 49 formed with an eye 50 is mounted for slidable reciprocal movement in the arcuate portion of the guide 25'. A flexible link chain 5| is fitted to the hollow interior of the guide 25 and interconnects the arcuate needle 48 and the plunger 4| for corresponding reciprocal movement between the needle inserting position, shown in Figs. 1 and 2 and the tying position, shown in Figs. 3 and 4. It will be obvious that thespring 45'urges the plunger to a position retracting the needle 48 onto the guide 25 referred to as the needle inserting position. In such position, the eye '50 is aligned with the groove 21' and is in registry with the V-notch 3|.

"The inner tubular member ll "of the hollow handle I0 is provided with a longitudinal slot 54. An inner drive member is rigidly mounted on the plunger 4| inwardly of the slot 54.. An outer drive member 56 is rigidly mounted on the inner drive member 55 by a pin 51 and a headed peg 58". The peg 58 has a portion of smaller diameter screw threadably engaged in the inner drive member 55' and a portion f larger diameter adjacent to its head tightened against the outer drive member 56.

A retriever plate 60 having a longitudinal slot 6|. a camway 62 and, a hooked end portion 63 is mounted on the outer drive member 56 by reception of the peg 58 through the slot 6| thereof. The camway 62 has a substantially straight portion 64 and a curved end 65 adjacent to the slot 6!. A sleeve 66 is mounted concentrically on the handle Ill adjacent to the retriever plate 60 and a headed cam 67 extended from the sleeve through the camway 62 with the hooked end portion 63 of the retriever plate disposed toward the guide 25 and arcuate. needle 48.

The arrangement of the camway 62 and cam 61 are such that movement of the "retriever plate relative to the cam toward the operating end of the device of the present invention causes the hooked end portion 630i the retriever plate to move to a position laterally adjacent to the sharpened end portion 49 of the arcuate needle 48 when in the tying position shown in Figs. 3 and 4 and by engagement of the cam in the curved end 65 of the camway to move laterally to a position radially inwardly of the needle as clearly indicated in Fig. 4. A washer 68 is employed between the retriever plate 68 and the head of the cam 61.

The lateral movement of the hooked end portion 63 of the retriever plate 60 is facilitated by a leaf spring 18 rigidly mounted on the outer drive member 56 as by a pair of bolts 1| extended alongside the retriever plate and engaged with a stud l2 rigidly mounted on'the retriever plate, as clearly indicated in each of the figures.

To urge the retriever plate 66 toward the manipulating end of the device, an ear M is extended from the outer drive member 56; A bracket I5 is provided integrally with the'retriever plate at a position laterally spaced from the ear l4 and toward the operating end of the device therefrom. A spring 16 is located under initial tension between the ear and the bracket. The spring 18 in moving the hooked end portion 63 of the retriever plate laterally for thread engagement as shown in Figs. 3 and 4 but has a component of force longitudinally of the retriever plate urging the same relative to the peg 58 toward the manipulating end of the device.

Operation The operation of the surgical needle of the present invention is believed to be clearly apparent and is briefly summarized at this point; The thread 28 or other suturing material is drawn from the reel 36 through the thread guide 30 and threaded through the groove 21 and the V-notch 3| into the eye 50. The manipulating end of the surgical needle is conveniently grasped by holding the finger grip 20 with the first and second fingers and extending the thumb through the thumb loop 43 in a position rested on the head 42. Obviously, in certain positions and under specialized conditions, a surgeon may prefer to hold and manipulate the surgicalneedle in other manners. Such departure from the operation described is within the contemplation of the subject invention.

The operating end of the needle is inserted or otherwise positioned adjacent the membrane, tissue, or fiber to be suturedwith the arcuate needle 48 in the retracted position shown in Figs. 1 and 2. ,The sharpened end portion 26 of the guide 25 is preferably held closely adjacent to the membrane or the like to be stitched.

The head 42 of the plunger is thrust toward the handle l0 moving the plunger toward the operating end of the device and driving the arcuate needle 48 into the membrane or the like, not Shown, to the position shown in Figs. 3 and 4. As

the arcuate needle is moved into the tying position shown in'Figs. 3 and4, the thread 28 is drawn into a position tensioned across the arcuate needle in chordal relation thereto. The hooked endportion 63 of the retriever plate 60 passes between. the arcuate needle and the chordally tensioned thread 28.

. Upon release of pressure on the head. 42,"the compression spring 45 returns the plunger 4! to its initial position and retracts the arcuate needle 48. The elongated slot 6| in'the retriever plate permits return travel of the inner and outer drive members 55 and 56 an appreciable distance before any return travel of the retriever plate occurs. This delayed travel of the retriever plate is assured'by operation of the spring 18 and the thread 28 dependably gathered by the hooked end portion 63 of the'retriever plate, as shown in Figs. 5 and 6.

Further return of the plunger 4| and retraction of the arcuate needle 48 returns the elements of the surgical needle to the relative positions shown in Figs. 1 and 2. When additional suturing is required, the pointed or sharpened end 26 of the guide is repositioned for subsequent operation and the performance repeated.

It will be obvious that the operation described provides successive loops of thread or other suturing material extended through the membrane or the like. A separate thread or other suturing material, not shown may be passed through the loops to lock the same quickly, conveniently, and easily providing a locked stitch. Further, the device may be employed to form chain stitches or other type of suturing, as desired. When a separate thread or other suturing material is passed a through the loops to provide a locked stitch, as

described, it is desirable to tension the thread 28, this is conveniently accomplished by positioning the surgical needle of the present invention to draw the thread to be tightened upwardly into the V-notch 3|, as shown in Fig. 3, where it wedges. Subsequent manipulation of the device with the thread so wedged readily achieves the tightening effect desired.

In surgical use the needle of the present invention has proved convenient to employ, has substantially reduced the time and difiiculties incident to such stitching particularly in constricted places, and by its effective operation in limited areas, minimized the size of accessible openings required.

Although the invention has been herein shown and described in what is conceived to be the most practical and preferred embodiment, it is recognized that departures may be made therefrom within the scope of the invention, which is not to be limited to the details disclosed herein but is to be accorded the full scope of the claims so as to embrace any and all equivalent devices and apparatus.

Having described my invention, what I claim as new and desire to secure by Letters Patent is,

1. In a surgical stitching apparatus, the combination of an arcuate needle having a sharpened end portion provided with an eye, means mounting the needle for endward arcuate reciprocal movement, means feeding thread to the eye of the needle so positioned that reciprocal movement of the needle at one of its positions draws the thread in chordal relation to the arcuate path of reciprocal movement, a hook mounted for reciprocal movement between a position in hooking relation to the thread in its chordal position and a position retracted therefrom, and synchronous drive means adapted simultaneously to move the needle to the position in which the thread is in chordal relation thereto and the hook to hooked relation to the thread.

2. Ina surgical stitching apparatus, the combination of an arcuate needle having a sharpened end-portion provided with an eye therethrough, means for reciprocating the arcuate needle longitudinally in a corresponding arcuate path between an inserting position and a tying position, means for supplying thread to the end of the needle, a thread retriever plate having a hooked end portion mounted for reciprocal movement between a position radially outwardly of the arcuate path of travel of the needle and a position radially inwardly of said arcuate path adjacent to the eye of" the needle when in tying position, and synchronous drive means for the needle and the retriever plate simultaneously thrusting the needle into typing position and the hooked end of the retriever plate to a position radially in wardly of the needle and subsequently retracting the needle to inserting position and effecting delayed retraction of the retriever plate to its position radially outwardly of the arcuate path of travel of the needle.

3. A surgical needle comprising an elongated hollow handle havinga slot formed longitudinally therein, a hollow arcuate guide extended from an end of the handle in registry with the hollow interior thereof and having a sharpened extended end portion, an arcuate needle slideably mounted in the guide and having a sharpened end portion extended from the end of the guide and formed with an eye therethrough, a plunger mounted in the handle for longitudinal slideable movement therein, a head mounted on the plunger exteriorly of the end of the handle opposite to the guide, a flexible drive linkage slideably guided in the hollow interiors of the handle and guide and interconnecting the arcuate needle and the plunger for corresponding reciprocal movement, resilient means within the handle urging the plunger in the handle in the direction of the head of the plunger, 9. thread reel mounted on the handle, a thread guide integral with the needle guide adapted to receive thread from the reel and to guide the thread to the eye of the needle, a drive member mounted on the plunger and extended through the slot in the handle, a cam member mounted on the handle intermediate the guide and the drive member, a retriever plate pivotally mounted on the drive member having a cam way fitted to the cam and a hooked end portion disposed toward the guide adjacent to the needle, the cam way being shaped so that movement of the plunger toward the guide urges the retriever plate hook toward the sharpened end of the guide and when adjacent thereto laterally to catch thread carried by the eye of the needle, and finger grips mounted on the handle adjacent to the headed end of the plunger.

4. The combination of an elongated hollow handle having a slot formed longitudinally therein, a finger grip mounted on the handle adjacent to an end thereof; a plunger slidably mounted in the handle for reciprocal longitudinal movement having a head thereon exteriorly of the handle adjacent to the end thereof provided with the finger grips; a hollow arcuate guide having a sharpened extended end portion mounted. on the end of the handle opposite to the finger grips in registry with the hollow interior thereof; an araura-1592 uate needle slidably mounted in the guide and having a' sharpened. end extended from the guide with an eye formed therethrough; a flexible chain slidably mounted in the handle and guide for reciprocal guided movement therein and interconnecting the needle and plunger for corresponding reciprocal movement; a drive block member on: the plunger adjacent to the slot in the handle; a drive peg outwardly extended from the drive member; an elongated retriever plate having a longitudinal cam way therein, a hooked end portion, and a longitudinal slot, mounted on the drive member by means of the peg engaged in the longitudinal slot thereof with the hooked end portion of the retriever plate extended toward the guide and needle; a cam extended from the handle through the cam way of the retriever plate, the cam way being shapedso that reciprocal movement of the retriever plate relative to the cam causes the hooked end portion thereof to move toward the needle when the plunger is thrust inwardly of the handle and when adjacent to'the needle to move laterally in hooked relation thereto and upon opposite movement of the plunger to move laterally away from such hooked relation' and: thence Iongitudimtlly of the handle upon further retraction of the plunger; a spring interconnecting: the retriever:- plate? and the: handle and urging the: retriever plate toward the needle relative to' the peg whereby upon retraction of the plunger therretraction of the retriever plate is delayed as accommodated by thelongitudinal slot through which the peg is: extended; a reel for a supply of thread mounted on the han dle; thread guide adapted to direct. thread from the supply to the eye of the needle around the radial periphery of the guide, said guide being formed. with a V' slot in its sharpened end portion adjacent to the needle in the radial periphery of the guide. 7

ALEXANDER, KOHL.

REFERENCES CITED The following references are of record in the file of this patent: UNITED STATES PATENTS Name Date Drake Apr. 20, 1909 Ainslie Sept. 8, 1931 Number

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