US2591063A - Surgical suture - Google Patents

Description

April 1, 1952 H. GOLDBERG 2,591,063

SURGICAL SUTURE Filed May 14, 1949 INVENTOR. HA RRY 6 R Patented Apr. 1, 1952 UNITED STATES PATENT OFFICE 8 Claims.

This invention relates to surgical sutures. More particularly, my invention pertains to surgical sutures of the type used for eye surgery, e. g., for cataract extraction.

In certain types of eye surgery, such for instance as cataract extractions with a Von Grafe knife section or with a keratome incision, it is necessary to employ a McLean preplaced suture. This type of suture involves stitching through two very closely spaced points on the eyeball and subsequently incising the. eyeball between these points while leaving the suture intact.

It is highly desirable in operations of this nature to employ a preplaced suture, since, by putting the suture in before the eyeball is opened, there is no danger when inserting a needle of pressing so hard on an opened eyeball that complications such as hemorrhage, dislocation of the lens or loss of vitreous may arise At the present time, it is conventional to employ soft, pliable filaments for preplaced eyeball sutures, these being animal or synthetic sutures such as silk, gut or nylon (polyamides). However, with such sutures, it is easy to nick or cut through the same when making the Von Grafe section or the keratome incision, or when enlarging the cut with scissors. If the suture should be cut or break because of nicking, it is necessary to insert a new suture after the incision has been made, this being attended by all the dangers mentioned above. In practice, it often is necessary to replace cut or broken sutures.

It'has been proposed to use a metallic filament for preplaced sutures so that the same cannot be cut or nicked. Most metals are injurious to the tissues of the eye if left in contact therewith for hours. However, it has been found that tantalum is not subject to this drawback and, accordingly, tantalum wires were tried as surgical eye sutures. Tantalum is Very brittle within the range of diameters used for eye sutures. Tantalum wire was found to be sufficiently flexible for stitching and could be neither broken nor nicked by an improperly directed sharp edge. But, after the operation, it is necessary to tie together the ends of the suture and when tantalum wire is thus manipulated it often breaks, necessitating placement of a new suture in the opened eyeball. Due to the frequent breakage of tantalum wire, animal and synthetic filaments still are being used at the present time.

It is an object of my invention to provide an improved surgical eye suture which avoids the foregoing drawback and has the advantages of both metal and soft flexible sutures but none of their attendant disadvantages.

It is another object of my invention to provide a suture of the character described which is simple to use and comprises relatively few and simple parts so that it can be made inexpensively and sold at a comparatively low price.

Other objects of my invention will in part be obvious and in part hereinafter pointed out.

My invention, accordingly, consists in the features of construction, combinations of elements and arrangements of parts which will be exemplifled in the constructions hereinafter described. and of which the scope of application will be indicated in the appended claims.

In the accompanying drawings, in which are shown various possible embodiments of my invention,

Fig. l is a plan view of a suture constructed in accordance with my invention:

Figs. 2 and 3 are enlarged sectional views taken substantially along the lines 2-2 and 3-3 respectively of Fig. 1; and

Figs. 4 and 5 are views similar to Fig. l of sutures embodying modified forms of my invention.

In general, I carry out my invention by providing a composite suture, that is to say, a suture having plural filaments of difierent kinds of material. One of these materials is hard and flexible, and the other material is soft and pliable. The hard filament will prevent a sharp edge from cutting the suture during the incision, while the soft filament can be tied without fear of break ing the same. More specifically, in accordance with my invention, the composite suture constitutes a metallic filament and an animal or synthetic filament, such for instance as a silk, nylon or gut filament.

The particular manner in which the two types of filament are combined is not material as long as both are present in the suture, so that each may serve its special purpose; i. e., so that the metallic filament can prevent accidental cutting of the suture and the soft pliable filament can permit the suture to be tied or sharply bent without breaking.

Referring now in detail to the drawings, and more particularly to Figs. 1 through 3, the reference numeral i0 denotes a composite suture embodying my invention. Said suture comprises a conventional semi-circular eye needle I2 having an edged cutting point 14. cludes a metallic filament I6 and a soft pliable filament [8, the latter being fabricated of silk, gut or nylon and being conventional per se.

Means also is provided to combine the two filaments. As illustrated herein such means The suture also inconstitutes a tubular sleeve which receives in its oppositeends the adjacent ends of the filaments l6, l8.

Said sleeve may be made in any suitable manner, as for example by severing from a length of extruded tubing of proper size, drilling through a metal rod and subsequently trimming the rod to a desired outer diameter, or forming from thin sheet metal. It is desirable to have the sleeve as thin-walled as possible, a suitable wall thickness being in the order of one thousandth of an inch. A satisfactory length for the sleeve is three-eighths of an inch.

The filaments have tiny diameters and should be in the order of magnitude of about one-thousandth to four-thousandths of an inch. The sleeve is of the proper internal diameter to receive the filaments. The ends of the filaments are inserted in the sleeve and the two ends of the sleeve crimped inwardly to press against the filaments.

One of thefilaments is connected to the needle $2. This may be done by providing the head of the needle with an eye through which the filament is threaded or by providing the needle with a socket 22 as shown in Fig. 2. The metal filament is next to the needle.

To use the suture lfi, the needle is passed through two closely adjacent points on an eyeball and the metallic filament drawn through these points and looped in the usual fashion. While this filament engages the eyeball, the incision is made and the operation performed. Thereafter the suture is drawn further along its length to cause the soft pliable filament to engage the eyeball and this latter filament is knotted.

In the Fig. 4 form of the invention thereare provided two eye needles 2d, 25 and two metallic filaments 26, 28, each such filament having an end thereof secured to a different one of the needles. The opposite ends of the metallic filaments are attached by sleeves 30, 32 to the ends of a soft pliable filament E l. This double-needle type of suture is useful for special techniques.

In lieu of having the two different types of filaments disposed in tandem (end-to-end), the plural filaments may be co-extensively arranged, for example as shown in Fig. 5. In this form of my invention the eye needle 38 is formed with a through opening 38, through which are threaded two filaments 40, 62, one of metal and the other of a soft pliable material, e. g. silk, gut or nylon. In using this latter form of suture, it is not necessary to shift the suture in the eyeball after the operation is completed. The metallic filament serves to protect the soft pliable filament. Should a sharp edge brush against the soft pliable filament, the latter will yield before it is damaged and in yielding will bring the sharp edge against the metallic filament through which it cannot cut. The suture is secured to the needle in a conventional manner, as by a surgical noose 44, which constitutes a means to secure the filaments to one another.

In the first two forms of the invention, i. e., in the forms of the invention shown in Figs. 1 through 4, various types of metal can be used which are not injurious to the eye tissues if left in contact therewith for comparatively short periods, about a half hour. For instance, stainless steel can be used as well as tantalum. How- Thereafter, if necessary, the ends of. the sleeve can be polished.

ever, in the latter form of the invention, wherein the two filaments are co-extensive, it is preferable to use tantalum or a metal which can be left in contact with the eye for hours and days without causing injury.

It will thus be seen that I have provided surgical sutures which achieve the several objects of my invention and are well adapted to meet the conditions of practical use.

As various possible embodiments may be made of the above invention, and as various changes might be made in the embodiments above set forth, it is to be understood that all matter herein described, or shown in the accompanying drawings, is to be interpreted as illustrative and not in a limiting sense.

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

1. A composite, surgical eye suture constituting two combined flexible filaments, one of said filaments being a fine metallic wire and the other of a soft, pliable material.

2. A composite, surgical eye suture constituting two combined flexible filaments, one of said filaments being a fine metallic wire and the other of a soft, pliable material, said filaments being of the order of magnitude of about one to fourthousandths of an inch.

3. A composite surgical eye suture constituting two tandem arranged combined flexible filaments, one of said filaments being a fine metallic Wire and the other of a soft, pliable material.

4. A composite surgical eye suture constituting two co-extensively arranged combined flexible filaments, one of said filaments being a fine metallic wire and the other of a soft, pliable material.

5. A composite surgical eye suture constituting .vo tandem arranged filaments, one of said filaments being of metal and the other of a soft, pliable material, said filaments being of the order of magnitude of about one to foui thousandths of an inch.

6. A composite, surgical eye suture comprising an eye needle and two combined fiexible filaments, one of said filaments being a fine metallic wire and the other of a soft, pliable material.

7. A composite surgical eye suture comprising an eye needle and two tandem arranged combined filaments, one of said filaments being of metal and the other of a soft, pliable material.

8. A composite surgical eye suture comprising an eye needle and two co-extensively arranged combined flexible filaments, one of said filaments being a fine metallic wire and the other of a soft, pliable material.

HARRY GOLDBERG.

REFERENSES CETED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,591,021 Davis July 6, 1926 FOREIGN PATENTS Number Country Date 425,316 Great Britain Mar. 12, 1935 OTHER REFERENCES Digby, Surgery, Gynecology, and Obstetrics, volume 31, pages 410-411 (1920).

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