USRE14923E - Surgical instrument - Google Patents

Description

H. SMIT.

SURGICAL INSTRUMENT. APPLICATION FILED NOV. 25, I919- I Reissued J uly 20, 1920. 14,923.

2 SHEETS-SHEET l.

0. ONM 4:

1m M s Reissued July 20, 1920.

mm Illl m UNITED STATES PATENT OFFICE.

HARRY .sM r; or NEW YORK, 1v. Y.

SURGICAL INSTRUMENT. 7

Specification of Reissu'ed Letters Patent. Reissued J l '20 1920 Original No. 1,293,565, dated February-4, 1919, Serial m5. 256,737, filed ctober 3, 1918. Application for reissue filed November .26,

To all whom it may concerns t Be it known that I, HARRY SMIT, a subject of the Queen of the Netherlands residing at New York, in the county of New York and State of New York, have invented certain new and useful, Improvements in Surgical Instruments, of which the followingis a specification.

This invention relates more particularly to a surgical instrument provided with a needle holder and manipulator and with fleshgripping devices adaptedto grip the edges of a wound or cut and properly position such edges 'with respect to the needle.

' The invention has for a general: object to provide an instrument whereby the labor of, the surgeon when stitching wounds, cuts, incisions or the like is materially lessened, and the p ain and inconvenience of the patient greatly reduced.

A further object of the invention is to provide an instrument which will insure a stable holding or positioning of thecdges to be stitched, with relation to the penetrating needle, and a proper positioning of the skin or flesh holders and the needle, irrespective of any outside influence such as moving of the patientyor false movement of the hand of the surgeon.

A further object'is to provide an instru ment in which the pressure of theclamps which grip the flesh ismechanically applied by means independent of the needle operating means and therefore does not vary during movement of the needle or by reason of varying pressure of the surgeons hand on the latter, the clamps also providing an abutment for the flesh which prevents the latter moving with the needle, by these features eliminating unnecessary pain and injury. a g

A further purpose of the invention is the provision of an instrument which'may be manipulated solely by one hand, both when applying the same to a wound, cut or like partto' be stitched as well as drawing the parts together and during the operation of stitching the same. r

A further purpose of the invention is the provision of an instrument embodying a minimum number of parts, the same being 1919. Serial No. 340,937.

of such construction and arrangement to admit of sterilizatlon and thorough cleaning to insure agalnst infection (of a cut or wound by the instrument. I

The invention also provides an instrument of the'character specified to which is attached a receptacle for receiving the spool or bobbin containing the thread whereby the latteris conveniently at hand andprevented from becoming infected or fouled in any manner. i

The invention also aims to provide an instrument for, the use of any type or make of needle, the latter being detachably fitted to the instrument whereby the work of the surgeon may be facilitated and different 7 to meet different conditions various changes in form, proportion, and details of construction may be resorted to without departing from the invention as defined inthe appended claims.

In the drawings Figure l is .a view in elevation of an instrument embodying the invention showing the relation of the parts when the several members are separated.

Fig. 2 is a top end view of the instrument as seen when looking down thereon with the parts in position shown in Fig. 1.

Fig. 3 is an elevation of the instrument with the several members closed together and the needle in the position which it assumes when passed through the partsto be stitched. a

Fig. 4. is a vertical section on the line 44 of Fig. 3.

Fig. 5 is a detail sectional view of the holder for the spool or bobbin taken on the line 5 5 of Fig. 4. i

Corresponding and like parts are referred to in the following description and indicated in all the'views of the drawings by like reference characters.

tion the instrument comprises a pair of main members 1n the form of arms A. and B which'cross each other toward their op- In the present embodiment of the invencrating ends and are pivotally connected together inwardly in unison, these barsbeing located intermediate of the main arms A and B as clearly shown in Figs. 1 and 3. The outer ends of the arms A andB and bars 0 and D project to a like distance from the pivot 1 so as to actjointly in the per formance of the required operation.

The outer end 0 of the bar C is flared out wardly on opposite sides to provide a pair of oppositely facing jaw members. The outer end cl of the bar D is inclined inv wardly to provide a jaw coacting with one j aw-face of the end 0, while the end b of the arm B is bent inwardly to provide a jaw coacting with the other jaw-face of the end 0.

The outer end of arm A carries the needle 2 which projects therefrom toward the arm B and is curved concentric to the pivot l.

The ends I), c and d are also formed concentric to the pivot 1 and are notched to provide clearance for the needle 2. The needle 2 is detachably connected to the arm A to admit of ready application of any -make, type or design ofneedle as maybe best suited to the requirements of the surgeon. The needle 2 has'the eye near the point whereby the thread is carried through the parts to be stitched as the point of the needle is forced through such parts.

The inner ends ofthe bars and D are of less'length than the corresponding ends of the arms A and B and the bar D has secured thereto adjacent its inner ends a curved strip 3 which is curved concentrically to the pivot 1 and extends across the arms A and B and the bar C. The strip 3 is provided with the threelongitudinal slots 1, 5 and 6 in which engage pins 7 8 and 9' fixed respectively to the arm A, bar C and arm B, these pins and slots serving to limit the outward movement of the parts as clearly shown in Fig. 1. A spring 10 of V-form is disposed between the-inner ends of the bar C and arm B and connected 'at opposite ends thereto. This spring is-of the contractile type and normally tends to draw the ends of the arm B and bar C together so as to close jaw 1) upon jaw 0. The tension of spring 10 may be regulated by means of a set screw 11 threaded through the arm A; j a

A contractile helical spring 12 connects the inner end of arm B with theinner end These arms, A and Bare adapted;

of bar D, the tension of this spring being regulated by means of a set screw 123 threaded through the arm-B, It will beapparent that the normal'action of these springs is to press the jaws b and cl against opposite sides ..of. thec'entraldouble jaw 0.

Disposed between the arms A and B and normallytending to press the latter apart is an expansile spring 14 which is mountedon a curved rod 15 attached at one end to the arm B and having its opposite end pressing freely through an "opening formed in the arm A} A casing 16 is attached to the arm B and is adapted to receive aspool-or bobbin 17 containin the thread '18. An opening 19 is found in the side wall of casing 16 and a slot 20 leads from the opening outward and facilitates the threading'of the casing when placing the spool or bobbin therein, or when it becomes necessary to pass the thread 18 through the opening 19.

A guard comprising a pair of rearwardly extending side plates 21 is applied to the outer end of the arm B and forms a shield for the needle during and subsequentto the passage of the needle through the part to be stitched. While the guard shields the point of the needle it does not obstruct the D motionless with respect to arm B. As

the arm A continues its outward movement the pin 7 reaches the left hand end of the slot 4 in strip 3 and, since the latter is mounted on barD, draws bar D outwardly, it being understood that the expansive force of spring '14: is sufficient to overcome the contractile force of springs 10 and 12. As the strip 3 continues moving the right hand end of slot 5 engages pin 8 on bar C and moves the latter outwardly until the right hand end of-slot 6 engages the pin 9 on arm B, thus stopping the outward movement of the parts and leaving them in the positionshown in Fig. 1 with the jaws b, c and d separated and the point of the needle drawn back.

In using the device the needle isthreaded and the handle portions of arms A and B grasped in a well known manner.

The jaw c is then inserteda slight distance in the wound, cut or incision to insure the jaws b and (l engaging with the skin at the sides thereof.

After the instrument has been this adjusted the 'members A and B are pressed During the initial outward movepassed through together and the parts A, B, C and D reverse the movement justdesc'ribed causing jaws b and d to close on 'the'twin jaw 0, thereby gripping the skin and drawing the same together. a

A continued closing movement of the arms A and B causes the needle 2 to pass through the edges of the skin which are thus stitched, the slot 4 being so proportioned in length as to cause the jaws to close together before the needle 2 makes any advance relatively to the aw d.

Upon relaxing the. arms A and B the ner well understood. By using a needle with a notch or open eye instead of the usual closed eye, the stitching will be continuous as will be readily understood.

As will be apparent my improved instrument may be manipulated with one hand to grip and hold the edges of the wound or in ision and pass the needle therethrough,

the clamping of the edges and penetration of the needle being performed in one continuous motion while the pressure of the clamps on the flesh is regulated entirely by the springs 10 and 12 and is entirely independent of the pressure on the arms A and B the handle portions of the latter coming together to prevent further closing movement before the needle carrying end of arm A, movesinto contact with the jaw d, as will be apparent from Fig. 3 of the drawings.

Having thus fully described my invention, what I'claim as new and desire to secure by Letters Patent is 1. In a surgical instrument of the character specified, main members pivotally connected, an intermediate pivoted member, connecting means between the intermediate member and one of the main members to limit the relative movement of the members in one direction, and a spring connection between the intermediate members and one of the main members.

2. In; a surgical instrument, main memhers pivotally connected, intermediate .pivoted members, and a spring between each of the intermediate members and-one of the main members.

- 3. In a surgical instrument of the character specified, pivoted intermediate members, a bar having connection with one of the intermediate members, and a limited play with reference to the remaining intermediate member and the main members, and a spring between pivoted main members,

each of the intermediate members and one of the main members.

' 4. A surgical instrument of the character specified, comprising main members pivotally connected, intermediate pivoted members, a bar attached to one of the intermediate members, a pin and slotconnection between said bar and the remaining intermediate member and each of the main members, and a spring between each of the inter- {)nedia-te members and one of the main memers.

5. Av surgicalinstrument of the'character specified, comprising main members pivotally connected near one of their ends, intermediate members of a less length than the main members and pivoted co-axially therewith, the outer ends of the" several members projecting to an equal distance, a curved bar attachedto one of the intermediate membersand having a pin and slot con 6. 'A surgical instrument of the character specified, comprising main members pivotally connected near one of their ends, intermediate members of a less length than the main members and pivoted co-aXially therewith, the outerends of the several members projecting to an equal distance, a curved bar attached to one of the intermediate members and having. a pin and slot connection with the remaining intermediate member and with each of the main members, a spring between each ofthe inter mediate members and one of the main members, and means for adjusting the tension of each of thesprings.

7. A surgical instrument of the character. specified, comprising main members pivotally connected, intermediate members piv-- oted co axially with the xmain members, one of the intermediate members having its outer end expansible to form a twin aw, and the adjacent ends of the main and intermediate members being bent to provide jaws to co-act with the elements of the twin jaw, a bar attached to one of the intermediate members and having a'pin and slot connection with the remaining intermediate member and with each of the main members, and a spring between each of the intermediate members and one of the main members.

'8. A surgical instrument comprising pivoted main members, a needle at the" outer end of one of the members, a guard at the outer end of the remaining member, intermediate members pivoted coa :ially with the main members, a curved bar attached to one of the intermediate members and havin a pin and slot connection with the remainlng intermediate member and with each of the.

main members, and a spring betweeneach of the intermediate member's and one of the main members.

9. The herein described surgical instrument, comprising main members crossing and pivoted at the point of crossing, the.

handle ends of such members having openings-toreceive digits ofthe hand, a needle removablyfitted to the Outer end of one of the members, a guard at the outer end of the remaining member, a thread holder mounted upon one of the members, a curved rod and expansible helicalspring between the handle ends, of the members, intermediate members of less length than. the'main members: and pivoted coaxially therewith, a curved bar attached to-one ot the intermediate members and having a pin and slot connection with the remainingintermediat'e members and with each ofthemain memhere, a spring between each of theintermediate members and one ofthe-main members, and means for adjusting thetension' of the springs;

10. In a surgical instrument, flesh gripping means, a needle driver, and a comm-onoperating mechanism for said flesh gripping means and said needle driver.

11. Ina surgical instriunent, flesh grip-- ping means, a needle driver, and a common operatingv mechanism for said fieshgripping means and said needle driver, said mechanism being adapted to first cause the flesh gripping means to act priortoengagement of the needle with the flesh;

12; In a surgical instrument, a pair of arms movable toward and away from one another,va gripping clamp jaw carried upon one of said arms, one of said arms being adapted to carrya'needle, a second gripping clamp jaw arranged intermediate of the said arms, and means'acting toccause sald second jaw to automatically move toward said firstjaw when the said armsv are moved.

toward one another;

13. In asurgical instrument, a' compound clamp adapted to grip both edges of a cut orrwound, a needle driver, and a common operating mechanism for said clamp and needle driver.

14. In-a surgical instrument," a: compound clamp adapted to grip both edges of a cut or wound, anarm'on'which one of theclamp jaws ismounted, a second arm adaptedto carry a needle, and means whereby said clamp is caused togrip the edges of the wound prior to the forward movement of the needle relatively to the adjacent arm of the clamp.

15. In a surgical instrument, a'compound clamp adapted to grip both edgesofa cut or wound, an arm on which one of the clamp jaws is mounted, a second arm adapted to carry a'needle, and means whereby a movement of the second arm to operate the needle causes the-said clamp to grip the edges: of

the wound, a said means ap plying pressure tothe clamp independently of the pressure-on the said" arm. a

16. In a surgical instrument, flesh grip-x, ping means, a needle driver, and means acting automatically with the needle driver to apply'pressure to the flesh gripping means.-

171. In, a surgical instrument, flesh grip ping means a: needle driver, and means actin g. automatically with the needle driver to apply pressure to the flesh gripping means,

said pressure'applying means being unaffectedby varying pressure on the needle driver. a

18. In a surgical instrument, a pair of relativelymovable arms one of which is adapted to carry a needle and the other a clamp-jaw,-additional clamp jaws located intermediate of said arms, springs tending to move said'additional clamp jaws toward the first mentioned clamp jaw and toward each other, and means whereby said additional clamp jaws are moved away from said first'jaw and from each other by movement of the two arms away from one another.-

19. In asurgicalinstrument, a pair of relatively movable arms one of which is adapted to carry a needle and the other a clampnjaw, additional clamp jaws located intermediate of said arms, springs tending.

to move said additional clamp jaws toward the first mentioned clamp jaw and toward each other, and means whereby said additional clamp jaws are moved away from said-first jaw and from each other by movement of the two arms away from one another, said means comprising a bar fixed on one of the said additional clamp members, and having a lost motion connection with theother member and the two arms.

20. In a surgical instrument, a pair [of arms one of which is adapted to carry a needle and the other to form an abutment movable toward and away from said intermediate jaw, and means providing an operative connection between said side clamp jaws whereby the latter may be operated in unison.

23. In a surgical instrument, an inter- .mediate clamp jaw, a-pair of side clamp jaws movable toward-and awayfrom said intermediate jaw, and means whereby said side clamp jaws may be operated in unison, said means including a pair of handle members upon one of which one of the said side clamp jaws is mounted, means whereby movement of said handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw.

24.. In a surgical instrument, an intermediate clamp jaw, a pair of side clamp jaws movable toward and away from said intermediate jaw, and means whereby said side clamp jaws may be operated in unison, said means including a pair of handle members upon one of which one of the said side clamp jaws is mounted, means whereby movement of said handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw and springs normally urging said intermediate clamp jaw and last mentioned side clamp jaw toward the other side clamp jaw.

25. In a surgical instrument, an intermediate clamp jaw, a pair of side clamp jaws movable toward and away from said intermediate jaw, a pair of handle members upon one of which one of the said side clamp jaws is mounted, and means including a slotted bar whereby movement of said handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw.

26. In a surgical instrument, an 1ntermediate clamp jaw, a pair of side clamp handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw? and springs connected at opposite ends to said handle and said side and intermediate clamp jaw and normally acting to close said jaws upon one another.

27. In a surgical instrument, an intermediate clamp jaw, a pair of side clamp jaws movable toward and away from said intermediate aw, a pair of handle members upon one of which one of the said side clamp jaws is mounted, and means including a slotted bar whereby movement of said handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw and springs connected at opposite ends to said handle and said side and intermediate clamp jaw and normally acting to close said jaws upon one another and a third spring of greater strength than the combined strength of the first mentioned springs normally urging said handle members away from one another.

28. In a surgical instrument, an intermediate clamp jaw, a pair of side clamp jaws movable toward and away from said intermediate jaw, a pair of handle members upon one of which one of the said side clamp jaws is mounted, and means including a slotted bar whereby movement of said handle members moves the intermediate clamp jaw and the other side clamp jaw away from the first mentioned jaw and springs connected at opposite ends to said handle and said side and intermediate clamp jaw and normally acting to close said jaws upon one another and a third spring of greater strength than the combined strength of the first mentioned springs normally urging said handle members away from one another said slotted bar being adapted to limit movement of said members under the influence of said spring.

13 November, 1919. v

HARRY SMIT. Witnesses:

MILTON I. MAssoN,

MARY C. 'FL GKER.

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