|Número de publicación||US3880166 A|
|Tipo de publicación||Concesión|
|Fecha de publicación||29 Abr 1975|
|Fecha de presentación||20 Ago 1973|
|Fecha de prioridad||20 Ago 1973|
|Número de publicación||US 3880166 A, US 3880166A, US-A-3880166, US3880166 A, US3880166A|
|Inventores||Fogarty Thomas J|
|Cesionario original||Fogarty Thomas J|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (3), Citada por (96), Clasificaciones (6)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
[451 Apr. 29, 1975 United States Patent [191 Fogarty VESSEL OCCLUDER  Inventor:
Thomas J. Fogarty, 770 Welch Rd., P 1 Alt C lif 94304 Primary E.\'aminerAldrich F. Medbery 3 Q a  Ffle Aug. 20, 973 Atrorne Agent or lrm WlllS Green & Mueth  ABSTRACT An instrument for atraumatic occlusion of small blood vessels, which includes a pad having one end thereof fastened toa length of resilient surgical tape adjacent the center portion thereof, the other end of the pad Appl. No.: 389,922
72 21 B7 81 Mb 1 BA H 2 C St um 11 21 55  Field of Search 128/325. 327, 326, 335.5.
128/339 being constructed and arranged to receive and releasably maintain one end of said tape in a selected adjusted position to entrap and occlude a blood vessel between the pad and said one end of the tape.
 References Cited UNITED STATES PATENTS 1252.260 1/1918 128/327 2 11% S14 4/1938 128/327 11 Claims, 4 Drawing Figures PATENTEDAERZQlHYS FIG. I.
VESSEL OCCLUDER BACKGROUND AND BRIEF SUMMARY OF THE INVENTION The present invention relates generally to the surgical field, and more particularly to a novel blood vessel occluder which provides for atraumatic occlusion of blood vessels without using large cumbersome clamps or clips. It is particularly useful for smaller vessels.
The necessity for an atraumatic means of occluding small vessels has greatly increased with the advent of coronary artery surgery. The anatomy, location and fragile nature of the coronary vessels precludes the use of conventional instruments such as clamps and clips for the routine occlusion of such vessels.
To obtain a secure anastomosis, the periarterial tissue must be left in place. Accordingly, the dissection of an artery in order to obtain a sufficient length of the artery to apply a conventional occluding device such as a clamp, significantly increases the technical difficulty of obtaining a secure anastomosis.
It is an object of the present invention, therefore, to provide a novel vessel occluder for the atraumatic occlusion of small vessels, which is light in weight, of low profile, and which causes no distortion of the vessel.
A further object is to provide such a novel occluder which provides for the occlusion of an artery in an anterior posterior direction without significant distortion of the arterial wall except at two points.
Yet another object is to provide a vessel occluder in which the vessel is entrapped and occluded between two resilient surfaces. whereby the trauma usually associated with unyielding materials is significantly diminished.
An additional object is to provide such a vessel occluder which includes means for manipulating vessels, as by pulling them from side to side or elevating them in order to obtain an unobstructed view of the vessel and without the necessity of pinching the structure between the fingers.
I have discovered that the above objects and advantages are achieved by a vessel occluder which includes a rigid pad which has two lengths of resilient tape extending from the top and bottom surfaces adjacent one end, a short portion of tape extending longitudinally of the pad in engagement with the bottom surface, and a slot at the other end of the pad for receiving and releasably holding one length of said tape in a selected adjusted position adjacent the short portion of tape, to occlude a vessel therebetween.
BRIEF DESCRIPTION OF THE DRAWING In the drawing:
FIG. 1 is a perspective view of a vessel occluder constructed in accordance with the teachings of the present invention, illustrating the manner in which the center portion of the tape is fastened to the occluder pad at the time of assembly;
FIG. 2 is a vertical sectional view taken on the line 22 in FIG. 1, with the tape shown in elevation;
FIG. 3 is an end view taken on the line 3-3 in FIG. 2; and
FIG. 4 is a side elevational view of the vessel occluder as it would appear in usage.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to the drawing more particularly by reference numerals, the number 10 indicates a novel vessel occluder embodying the teachings of the present invention, which includes an elongated pad 12 and a length of resilient tape 14.
The pad is made of a substantially rigid yet slightly resilient material, preferably plastic, and is elongated and generally rectangular in cross-section with top and bottom surfaces 16 and 18, respectively, opposed side walls 20, and first and second ends 22 and 24, respectively.
Each of the side walls contains a longitudinally extending groove 26 which extends from adjacent the first end 22 to the second end 24.
A first passageway 28 extends through the pad between the top and bottom surfaces, adjacent to the first end 22.
A second and similar passageway 30 extends through the pad adjacent to the second end 24. Extending from said second passageway toward the second end 24 is a slot 32 which is narrower than the diameter of the opening 30, the walls of the slot diverging outwardly as they approach the second end 24 to provide a throat 34 for a purpose to appear.
The resilient tape 14 is preferably of tubular construction and made from a conventional white silicone rubber, with opaque epoxy material in the center portion thereof.
As shown in FIG. 1, the occluder pad 12 is fastened adjacent the center portion of the tape 14 by turning the tape back upon itself and inserting the doubled portion upwardly through the opening 28 to form a bight 36. One end portion 38 of the tape containing epoxy material 40 is permitted to hang freely. The other end portion 42, which also contains epoxy material at 44, is drawn across the bottom surface 18 and pulled upwardly through the throat 34 and into the opening 30. The free end of said other end portion is then passed through the bight 36 and said one end portion 38 pulled downwardly, thereby securely fastening the pad to the tape.
As shown in FIGS. 2 and 3, the opaque, epoxy-filled portion 44 of the tape is in engagement with the bottom surface 18 of the pad, to provide an elongated resilient surface which extends longitudinally of the pad and which has an arcuate face.
Fastened to the free end of said one end portion 38 of the tape is a V2 circle blunt needle 46.
In use, after an incision has been made, the artery is identified and the blunt needle 46 carefully passed about the artery and pulled through, the one end portion 38 of the tape passing through the tissue without resistence. The needle may pass around both the coronary artery and its associated vein.
The tape is pulled through until the occluder pad 12 approaches the coronary artery. A forcep is then used to grasp the pad at the grooves 26 to maintain the pad in position, and the one end portion 38 of the tape is pulled through the throat 34 of the pad and into the opening 30.
The artery is then entrapped and occluded between two resilient surfaces, i.e.. the opaque portion 44 of the tape which is in engagement with the bottom surface 18 of the pad and the opaque portion 40 of said one end of the tape. The use of two such resilient surfaces significantly diminishes the trauma usually associated with unyielding materials.
Also, the artery is occluded in an anterior posterior direction without significant distortion of the arterial wall, except at two points.
Both of the openings 28 and 30'are preferably of a diameter which is slightly less than the outside diameter of the tubular tape 14. The size of the opening 28 is not too important. other than to be certain that the bight 36 remains in holding position, but size is important at the opening 30 because it must be such that when two thicknesses of tape are in the opening 30, the end portion 38 must be retained in its selected adjusted position so as to occlude the vessel to the particular extent required The novel vessel occluder described herein can also be used for manipulating vessels, prior or subsequent to occlusion. Thus, by passing one end of the tape about the vessel, the vessel can be moved from side to side and elevated to provide an unobstructed view of the vessel without the necessity of pinching it between the fingers. Then, when it is desired to occlude the vessel. one end of the tape is pulled so as to move the occluder pad 12 adjacent to the vessel, the pad is held in position with a forcep and the one end of the tape pulled through the throat 34 and into the opening 30, all as previously described.
It should also be noted that traction on the resilient tape can be increased to any desired level so that partial or total occlusion of a tubular structure such as a vessel; can be easily accomplished.
Thus, it is apparent that there has been provided a novel vessel occluder which fullfills all of the objects and advantages sought therefore.
1 claim l. A vessel occluder, comprising:
an elongated rigid pad having top and bottom surfaces and first and second opposed ends;
a first length of resilient tape having one end thereof secured to the pad adjacent said first end and extending from the bottom surface, a resiltent mem- [her in engagement with the bottom surface of the pad and extending longitudinally thereof; and me'ans at the second end of the pad for receiving and releasably holding said first length of the tape in a selected, adjusted position. 2. A vessel occluder according to claim 1, in which the resilient tape is of tubular shape and the resilient member in engagement with the bottom surface of the pad comprises a length of tubular tape.
3. A vessel occluder according to claim 1, in which the means for receiving and holding the other end of the tape includes a slot which terminates in a circular opening.
4. A vessel occluder according to claim 3, in which the slot and circular opening extend between the top and bottom surfaces.
5. A vessel occluder according to claim 3, in which the width of the slot is less than the diameter of the opening and the walls of the slot diverge in the direction away from the opening.
6. A vessel occluder according to claim 1, in which the elongated pad includes opposed side walls, and a longitudinally extending groove is contained in each side wall.
7. A vessel occluder according to claim 1, in which the resilient member in engagement with the bottom surface of the pad and the portion of the tape adjacent to the pad are of the same color.
8. A vessel occluder according to claim 1, which further includes a blunt needle fastened to the free end of the resilient tape.
9. A vessel occluder according to claim 1, which further includes a length of resilient tape having an end thereof secured to the pad adjacent said first end.
10. A vessel occluder according to claim 1, in which:
the first length of resilient tape is secured in a first opening adjacent to said first end;
the means for receiving and holding the other end of the tape includes a slot at said second end which terminates in a circular opening;
a second length of resilient tape extends from the top 40 surface of the pad adjacent said first opening.
11. A vessel occluder according to claim 10, in which: said lengths of tape and said member comprise a unitary piece of resilient tape of tubular configuration.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US1252260 *||5 Jul 1917||1 Ene 1918||Charles Gurtape Gilberg||Device for aiding wounded or injured persons.|
|US2113534 *||24 Oct 1936||5 Abr 1938||Burroughs Wellcome Co||Tourniquet|
|US3762418 *||17 May 1972||2 Oct 1973||W Wasson||Surgical suture|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US3993076 *||21 Abr 1975||23 Nov 1976||Fogarty Thomas J||Vessel occluding instrument|
|US4016883 *||11 Nov 1975||12 Abr 1977||Wright Jr Sanford J||Medical clamp for occluding intracranial blood vessels|
|US4140125 *||25 Feb 1976||20 Feb 1979||Med-Pro, Ltd.||Surgical tape device|
|US4611593 *||3 Dic 1984||16 Sep 1986||Thomas J. Fogarty||Vessel occluding instrument|
|US4938765 *||22 Jun 1989||3 Jul 1990||Life Centers, Inc.||Surgical silicon loops|
|US5057118 *||29 May 1990||15 Oct 1991||Applied Medical Technology, Inc.||Vessel occlusion device|
|US5693060 *||7 Jun 1995||2 Dic 1997||Smith & Nephew, Inc.||Suture securing device and method|
|US5741281 *||7 May 1996||21 Abr 1998||Smith & Nephew, Inc.||Suture securing apparatus|
|US5797959 *||13 Ago 1997||25 Ago 1998||United States Surgical Corporation||Surgical apparatus with articulating jaw structure|
|US5972009 *||7 Abr 1998||26 Oct 1999||Boston Scientific Corporation||Ligating band with rounded edges and method of use of same|
|US6001111 *||16 Ene 1998||14 Dic 1999||Cardiothoracic Systems, Inc.||Low profile vessel occluder with and without detachable applicator|
|US6007552 *||18 Dic 1997||28 Dic 1999||Minumys||Vascular clamps and surgical retractors with directional filaments for tissue engagement|
|US6099539 *||27 Jul 1998||8 Ago 2000||Thomas J. Fogarty||Surgical clamp pad with interdigitating teeth|
|US6165186 *||21 Jun 1999||26 Dic 2000||Novare Surgical Systems, Inc.||Vascular clamps and surgical retractors with directional filaments for tissue engagement|
|US6206896||27 Jul 1999||27 Mar 2001||Thomas J. Fogarty||Surgical clamp pad with interdigitating teeth|
|US6228104||18 Jun 1999||8 May 2001||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6273902||25 Ene 2000||14 Ago 2001||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6293954||21 Jun 1999||25 Sep 2001||Novare Surgical Systems, Inc.||Surgical clamp with replaceable clamp members|
|US6299621 *||18 Jun 1999||9 Oct 2001||Novare Surgical Systems, Inc.||Surgical clamp pads with elastomer impregnated mesh|
|US6312445||9 Mar 2000||6 Nov 2001||Novare Surgical Systems, Inc.||Vascular clamps and surgical retractors with directional filaments for tissue engagement|
|US6387106||25 May 2000||14 May 2002||Thomas J. Fogarty, M.D.||Surgical clamp pad with interdigitating teeth|
|US6387112||15 Jun 2000||14 May 2002||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6461368||16 Mar 2001||8 Oct 2002||Novare Surgical Systems, Inc.||Vascular clamps and surgical retractors with directional filaments for tissue engagement|
|US6527784||30 Jul 1999||4 Mar 2003||Scimed Life Systems, Inc.||Textured ligating band and method of use of same|
|US6530942||23 Jul 2001||11 Mar 2003||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6533802||16 May 2001||18 Mar 2003||Smith & Nephew, Inc.||Endobutton continuous loop for bone-tendon-bone|
|US6558408||29 Sep 2000||6 May 2003||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6613060||2 Ene 2003||2 Sep 2003||Scimed Life Systems, Inc.||Textured ligating band|
|US6692514||27 Mar 2002||17 Feb 2004||Novare Surgical Systems, Inc.||Surgical clamp having replaceable pad|
|US6719766||24 Ago 2000||13 Abr 2004||Novare Surgical Systems, Inc.||Surgical clamp pads having surface overlay|
|US6942676||21 Mar 2002||13 Sep 2005||Novare Surgical Systems, Inc.||Surgical clamp pads with deflecting elements|
|US6989017||25 Abr 2002||24 Ene 2006||Thomas J. Fogarty||Surgical clamp pad with interdigitating teeth|
|US7150757||11 Jun 2003||19 Dic 2006||Fallin T Wade||Adjustable line locks and methods|
|US7172595||2 Jun 2005||6 Feb 2007||Medicinelodge, Inc.||Bone fixation systems and related methods|
|US7530990||20 Jul 2004||12 May 2009||Smith & Nephew, Inc.||Endobutton continuous loop for bone tendon with double loop knot|
|US7566339||7 Sep 2004||28 Jul 2009||Imds.||Adjustable line locks and methods|
|US7594923||1 Dic 2004||29 Sep 2009||Medicine Lodge, Inc||Line lock suture attachment systems and methods|
|US7641694||21 Abr 2005||5 Ene 2010||IMDS, Inc.||Line lock graft retention system and method|
|US7722644||9 May 2005||25 May 2010||Medicine Lodge, Inc.||Compact line locks and methods|
|US7736308 *||16 Sep 2002||15 Jun 2010||Teleflex-Ct Devices Incorporated||Surgical retractor|
|US7806909||15 Sep 2004||5 Oct 2010||Medicine Lodge Inc.||Line lock threading systems and methods|
|US8323338||22 Dic 2005||4 Dic 2012||Smith & Nephew, Inc.||Tissue graft fixation|
|US8388655 *||6 Abr 2010||5 Mar 2013||Imds Corporation||Compact line locks and methods|
|US8454635 *||5 Abr 2001||4 Jun 2013||Coroneo, Inc.||Surgical suturing clamp|
|US8636780||23 Nov 2009||28 Ene 2014||Imds Corporation||Line lock graft retention system and method|
|US8864797||23 Sep 2011||21 Oct 2014||Coorstek Medical Llc||Systems and methods for intra-operative tension and fixation of zipknot ACL fixation|
|US8870900 *||21 Mar 2007||28 Oct 2014||Intuitive Surgical Operations, Inc.||Endoscopic beating-heart stabilizer and vessel occlusion fastener|
|US8914150||24 Ene 2014||16 Dic 2014||Intuitive Surgical Operations, Inc.||Cooperative minimally invasive telesurgical system|
|US9028547||30 Nov 2012||12 May 2015||Smith & Nephew, Inc.||Tissue graft fixation|
|US9039681||16 Jul 2008||26 May 2015||Intuitive Surgical Operations, Inc.||Minimally invasive surgical training using robotics and telecollaboration|
|US9119654||13 Ene 2012||1 Sep 2015||Intuitive Surgical Operations, Inc.||Stabilizer for robotic beating-heart surgery|
|US9220493||18 Dic 2012||29 Dic 2015||Karl Storz Gmbh & Co. Kg||Suture anchor kit|
|US9265498||4 Feb 2013||23 Feb 2016||Imds Llc||Compact line locks and methods|
|US9271798||13 Ago 2013||1 Mar 2016||Intuitive Surgical Operations, Inc.||Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures|
|US9445806||6 Dic 2012||20 Sep 2016||Karl Storz Gmbh & Co. Kg||Suture holder delivery system|
|US9636186||26 Ene 2016||2 May 2017||Intuitive Surgical Operations, Inc.||Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures|
|US9662102 *||6 Feb 2009||30 May 2017||Karl Storz Gmbh & Co. Kg||Suture holding system|
|US9666101||26 Ene 2016||30 May 2017||Intuitive Surgical Operations, Inc.||Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures|
|US9681865||6 Feb 2015||20 Jun 2017||Smith & Nephew, Inc.||Tissue graft fixation|
|US9786203||22 Abr 2015||10 Oct 2017||Intuitive Surgical Operations, Inc.||Minimally invasive surgical training using robotics and telecollaboration|
|US20020183785 *||25 Abr 2002||5 Dic 2002||Howell Thomas A.||Surgical clamp pad with interdigitatin teeth|
|US20030013941 *||16 Sep 2002||16 Ene 2003||Beth Israel Deaconess Medical Center||Surgical Retractor|
|US20030093091 *||5 Abr 2001||15 May 2003||Anthony Paolitto||Surgical suturing clamp|
|US20030208231 *||8 Nov 2001||6 Nov 2003||Williamson Warren P.||Surgical clamp devices and methods especially useful in cardiac surgery|
|US20040111103 *||3 Dic 2003||10 Jun 2004||Nixon Margaret Marie||Surgical tape tensioner|
|US20040167552 *||19 Feb 2004||26 Ago 2004||Novare Surgical Systems, Inc.||Surgical clamp pads having surface overlay|
|US20040254593 *||11 Jun 2003||16 Dic 2004||Stryker Endoscopy||Adjustable line locks and methods|
|US20050038427 *||20 Jul 2004||17 Feb 2005||Michael Perriello||Endobutton continuous loop for bone tendon with double loop knot|
|US20050288709 *||7 Sep 2004||29 Dic 2005||Fallin T W||Adjustable line locks and methods|
|US20050288710 *||15 Sep 2004||29 Dic 2005||Fallin T W||Line lock threading systems and methods|
|US20050288711 *||1 Dic 2004||29 Dic 2005||Fallin T W||Line lock suture attachment systems and methods|
|US20060190041 *||9 May 2005||24 Ago 2006||Medicinelodge, Inc.||Compact line locks and methods|
|US20060276896 *||2 Jun 2005||7 Dic 2006||Medicinelodge, Inc.||Bone implants with integrated line locks|
|US20070162125 *||22 Dic 2005||12 Jul 2007||Lebeau Jason||Tissue graft fixation|
|US20070208223 *||21 Mar 2007||6 Sep 2007||Intuitive Surgical, Inc.||Endoscopic beating-heart stabilizer and vessel occlusion fastener|
|US20080287991 *||19 May 2008||20 Nov 2008||Smith & Nephew, Inc.||Endobutton continuous loop for bone tendon with double loop knot|
|US20090099576 *||16 Jul 2008||16 Abr 2009||Intuitive Surgical, Inc.||Minimally invasive surgical training using robotics and telecollaboration|
|US20100191285 *||6 Abr 2010||29 Jul 2010||Medicinelodge, Inc. Dba Imds Co-Innovation||Compact Line Locks and Methods|
|US20100204731 *||6 Feb 2009||12 Ago 2010||Rickey Hart||Suture Holding System|
|US20100305585 *||5 Ago 2010||2 Dic 2010||Medicinelodge, Inc. Dba Imds Co-Innovation||Line lock threading systems and methods|
|US20100318126 *||5 Ago 2010||16 Dic 2010||Medicinelodge, Inc. Dba Imds Co-Innovation||Line lock threading systems and methods|
|US20110077667 *||8 Jun 2009||31 Mar 2011||Synthes Usa, Llc||Suture based tissue repair|
|US20110144699 *||15 Feb 2011||16 Jun 2011||Medicinelodge, Inc. Dba Imds Co-Innovation||Bone Implants with Integrated Line Locks|
|US20110160856 *||1 Jul 2010||30 Jun 2011||Medicinelodge, Inc. Dba Imds Co-Innovation||Systems and Methods for Zipknot ACL Fixation|
|US20120046747 *||26 Ago 2011||23 Feb 2012||Medicinelodge, Inc. Dba Imds Co-Innovation||Systems and methods for zipknot acl fixation|
|US20120277782 *||3 Jul 2012||1 Nov 2012||V.V.T. Medical Ltd.||Apparatus and method for enabling perforating vein ablation|
|US20130245686 *||6 May 2013||19 Sep 2013||Imds Corporation||Compact line locks and methods|
|DE4317328A1 *||25 May 1993||1 Dic 1994||Aesculap Ag||Ligature element for surgical purposes|
|EP0184542A2 *||27 Nov 1985||11 Jun 1986||FOGARTY, Thomas J.||Vessel occluding instrument|
|EP0184542A3 *||27 Nov 1985||24 Ago 1988||Thomas J. Fogarty||Vessel occluding instrument|
|EP0598219A2 *||14 Oct 1993||25 May 1994||Acufex Microsurgical Inc.||Suture securing device and method|
|EP0598219A3 *||14 Oct 1993||24 Ago 1994||American Cyanamid Co||Suture securing device and method.|
|EP1791475A4 *||6 Sep 2005||9 Dic 2015||Imds Llc||Adjustable line locks and methods|
|EP2441395A3 *||28 Nov 2001||18 Jun 2014||Intuitive Surgical Operations, Inc.||Endoscope beating-heart stabilizer and vessel occlusion fastener|
|WO2002091959A1 *||13 May 2002||21 Nov 2002||Smith & Nephew, Inc.||Endobutton continuous loop for bone-tendon-bone|
|WO2012040627A1 *||23 Sep 2011||29 Mar 2012||Medicinelodge, Inc. Dba Imds Co-Innovation||System for intra -operative tension and fixation of zipknot acl fixation|
|Clasificación de EE.UU.||606/158|
|Clasificación internacional||A61B17/04, A61B17/12|
|Clasificación cooperativa||A61B17/0401, A61B17/12009|