Surgical stitching instruments

Oct. 1, 1957

R. W. THAYER

2,808,055

SURGICAL STITCHING INSTRUMENTS

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Filed June 25, 1953

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Robert rt Thayer

INVENTOR.

BY

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United States Patent Office

2,808,055

SURGICAL STITCHING INSTRUMENTS Robert W. Thayer, Hempstead, N. Y.

Application June 25, 1953, Serial No. 363,971

Claims. (CI. 128—340) io

2,808,055

Patented Oct. 1, 1957

This.invention relates to stitching instruments and more particularly to stitching instruments of the type having characteristics making, them especially suitable to adequately meet the stringent requirements of surgery.

The instrument is designed for use by physicians, both surgeons and general practitioners, dentists, and veterinarians. An instrument made in accordance with the invention is able to use all forms of surgical suture material such as all forms of surgical catgut, all forms of surgical plastic suture material, surgical cotton sutures, surgical silk, and surgical metal sutures.

A surgical stitcher designed in accordance with this invention is useful in doing minor surgery such as emergency surgery in a doctor’s office and home, in out-patient clinics, minor operations in doctor’s office or clinics, in ligating bleeders in tonsillectomies, and other minor operations. The instrument is also useful in general surgery such as appendectomies, hernias, gall bladder operations hysterectomies, vaginal plastic operations (obstetricepisiotomy repairs), stomach and intestinal resections, thyroidectomy, neurological operations (brain and spinal cord surgery), and urological surgery.

. The design of an instrument in accordance with this invention enables a surgeon to conserve the amount of suture material used, consequently reducing the cost of the suture material per operation.

A primary object of this invention is to provide an improved stitching instrument.

Another object of the invention is to make it possible for the surgeon to cut down the operating time to a minimum so that the operating mortalities may be reduced.

Another object of the invention is to provide an improved bobbin particularly suitable for use in surgical instruments.

Another object of the invention is to provide an instrument enabling the physician to apply sutures with the proper kind of suture material, under sterile conditions, m the shortest time, in the most difficult places that the surgeon encounters, and with the least motions and effort.

Still another object of this invention is to provide conveniently operating filament-like material such as thread or other suture material feeding mechanism which gives positive action to permit suturing operations with a minimum attention to manipulation of the thread.

An additional object of the invention is to provide an instrument wherein the various elements are arranged to be easily removable for conversion and loading

According to this invention in one of its forms there is provided a needle holder consisting of a handle and extension. A bobbin is mounted in the handle and arranged to be easily removable. The bobbin contains a spring over a series of grooves to provide a holder for the end of the thread, and a friction to the thread feed to indicate the imminent end of the supply of thread. The thread is fed from the bobbin to a needle consisting of a tubular member mounted in the handle extension in such a way that it can slide back and forth. The thread is fed to the tubular member through an end which is in a readily accessible position whereby the movement of the thread with respect to the tubular member may be prevented by the operator’s thumb. According to one form of the invention, the needle is hollow and the tubular member is adapted to slide into the hollow needle.

Other incidental objects will be apparent after a reading of the following specification in connection with the accompanying drawings wherein:

Figure 1 shows an exploded view of a bobbin.

Figure 2 shows a sectional view of a surgical stitching needle constructed in accordance with this invention.

Figure 3 shows a plan view of the form of the surgical stitching needle shown in Figure 2.

Figure 4 shows a solid type needle suitable for employment in the practice of this invention.

In the several figures of the drawing the same element is designated by the same numeral.

Turning now in detail to the drawing, a hollow needle 11, of Figure 2, contains a hole through its center which is large enough at its point 13 to hold a filament-like material such as thread or other suture material. The needle 11 is carried by an extension member 15, and supported by a chuck 17 which is adapted to screw on to extension 15.

The chuck 17 engages a shoulder 19 of needle 11 which holds needle 11 firmly to extension 15. Needle 11 is made fast to shoulder 19 by a sweat fitting or in some other satisfactory manner. Shoulder 19 may have a key as shown at its top which extends a short distance into extension 15 in order to prevent the needle from turning with respect to extension 15. The extension 15 may be notched on two or more sides of its end in order that the key of the shoulder 19 may fit into any one of several notches permitting the needle 11 to be secured to the extension 15 at other angles than that shown.

Needle 11 is larger in diameter at its rear 21. The enlarged section 21 of the needle 11 permits a tubular member 23 to slide in and out of the needle 11. Tubular member 23 is mounted rigidly in a thread moving member 25 which is arranged to slide in slot 27 of the extension 15. Thread moving member 25 may consist of a plug having a diameter slightly less than the hole in extension 15. The plug of the thread moving member 25 may have an upper portion which extends out of the slot 27 in order that the upper portion of the thread moving member 25 may be engaged by the operator’s thumb The surface of thread moving member 25 is knurled as shown and contains a hole 29 which is connected to the tubular member 23. The thread is fed into the tubular member 23 at this hole 29 so that the movement of the thread with respect to the thread moving member 25 may be prevented by the thumb when it is desired to move the thread. It can be seen that by moving the thread moving member 25 toward the needle with the thumb held firmly on the upper portion of the thread moving member 25, the thread may be advanced through the needle 11.

The rear end of shoulder 19 is funnel shaped to permit tubular member 23 to enter the shoulder 19 easily. During operation it is preferred that the tubular member 23 remain in the enlarged section 21 of the needle 11 in order that the thread will not snarl in the larger diameter opening of the extension 15.

The needle 11, however, may be of the solid type as shown in Figure 4. In Figure 4, a needle 11', although shown as straight, may be curved as needle 11 of Figure 2. In this case, it is desirable to provide needle 11' with a shoulder 19' which extends a greater distance outside of the chuck 17. The reason for the extension 31 of shoulder 19' is to permit a path for the thread from the eye at the end of needle 11' through hole 33, through the

2,808,055 to the appendix. The suture material is placed properly by using the same method used in putting one stitch through the skin as described above. This stitch is applied, tied and cut. One more ligature is then used to tie around the base of the appendix, and this ligature is tied and cut.

In a hysterectomy operation a suture ligature is used to tie around each of the two round ligaments. A ligature is also used to tie around the right and left uterine arteries, and the infundibuliform ligaments are ligated with suture ligatures. The stitcher is very easy to use as a ligature carrier in placing the sutures around these various ligaments and arteries. The same technique is used for applying these suture ligatures as the one described for dealing with skin as described above.

In the stomach and intestinal resection operations,.also in thyroidectomies, and in fact in most major opeiations, the purpose is to apply suture ligatures around the veins and arteries as simply and quickly as possible. .These suture ligatures can be placed more rapidly with this type of instrument than any other type, of instrument.

In closing abdominal incisions, it is necessary to close the peritoneum, the fascia, and the skin. In using interrupted sutures or figure of eight sutures, oi. lock stitches, this instrument saves considerable time, in applying these sutures and in closing the incisions of operations.

In closing the skin of incisions, most surgeons use a simple interrupted black silk suture, or cotton, or wire, 30 the most common of which is black, silk with a simple stitch or a mattress type suture. An instrument made in accordance with this invention is designed to enable the surgeon to close the skin as easily, and as rapidly, and with as few other instruments as possible. In difficult 35 operations and neurological surgery, or in gynecological surgery where there are very large tumors and very little room to work, or in vaginal plastics where it is very difficult to apply sutures in a small place and where they have to be applied in a deep cavity or in thoracic surgei y 46 where a lung is removed and there are many small vessels deep down in a cavity to ligate, this instrument lends itself readily to apply these ligatures and sutures more easily than the ordinary ligature carriers and needle holders. Special needles of particular size, shape, and 45 length are designed for these special operations, and may be employed in the practice of the present invention.

The invention in one of its forms provides a very convenient and efficient means for tying suture material. By employing the instrument without a needle as shown 50 in Figure 3 the thread may be held taut while tying by placing the thumb firmly on the hole 29 of the thread moving member 25 and holding member 25 so that it does not slide in groove 27. .,.,.