Surgeon's suturing device

June 13, 1961

2,988,028

J. H. ALCAMO

SURGEON’S SUTURING DEVICE

<img file="US2988028A_D0001.tif" />

J. H. ALCAMO

SURGEON’S SUTURING DEVICE

June 13, 1961

Filed Aug. 13, 1956

2,988,028

Sheets-Sheet 2

<img file="US2988028A_D0002.tif" />

June 13, 1961

2,988,028

J. H. ALCAMO

SURGEON'S SUTURING DEVICE

Filed Aug. 13, 1956

Sheets-Sheet 3

<img file="US2988028A_D0003.tif" />

2,988,028

J. H. ALCAMO

SURGEON’S SUTURING DEVICE

June 13, 1961

Filed Aug. 13, 1956

Sheets-Sheet 4

<img file="US2988028A_D0004.tif" />

United States Patent Office

2,988,028

Patented June 13, 1961

988 028 SURGEON’S SUTURING DEVICE John H. Alcamo, Camden, N.J. (321 S. 9th St, Newark, N.J.) Filed Aug. 13,1956, Ser. No. 603,546 3 Claims. (Cl. 112—169) consists of a fixed part 2, which may be fabricated of opaque material, and a part 3, which may be fabricated of transparent material, hinged to the fixed part in order to provide easy access to the mechanical movements for ⁸ repair and cleaning purposes.

The lower portion 4 of the casing is separated from the upper portion and is held in position by a stud bolt 5 (FIG. 8). Also, there is fixed in the lower portion of the casing a pivot pin 6 to which is pivoted to swing laterally a two part needle guard 7. The parts of the guard are biased toward each other by a spring 8 (FIG. 12), which spring presses outwardly against parts of the guard which extend to the right of the pivot. Such guard is spaced from the upper part of the casing and is designed to slide under the material being sewed.

A pusher plate 9, which is provided on its lower surface with a multiplicity of serrations or knurles extends forwardly from the upper portion of the casing. Such plate is provided with cut out portions 29, 30 and 31 (FIG. therethrough, and the front and rear edges of the cut out portion 30 constituting cam surfaces, all as will later be described. The cut out portion 31 forms a guide for the pusher plate due to the engagement of the sides with an upstanding pin 38 fixed in the lower portion of the casing.

Extending laterally on both sides of the casing is a gatherer, consisting of slidable gathering plates 11 which are also knurled on their lower surfaces. The function of these plates is to draw together the edges of the material being sewed and hold the same in that relationship as the stitches are made.

A distinctive feature of my invention is the mechanism which comprises the construction of the needle 12 itself and the instrumentalities for automatically swinging the needle from side to side as the sewing progresses and for causing the needle to operate in timed sequence with the pusher and gathering plates.

Viewed in side elevation, the needle has the general form of an inverted V, although other forms would be operative. One of the legs of the V is hollow down to the needle eye 13. Unlike conventional sewing machines, the spool 14 for carrying the thread 15 is rotatably mounted on top of the needle, the thread being threaded through an opening 12—a in the hollow portion of the needle, down through such portion and through the needle eye and out the front end of the machine through a friction eyelet 16. By this arrangement, since the free end of the thread is held by such eyelet, as the needle moves downwardly the thread will be unwound from the spool and the needle will carry a double strand of the thread down through the material, leaving a loop on the bottom side thereof. On its upstroke, the strand threaded through the needle as well as the strand extending from the needle eye to the friction eyelet will remain in place and the thread then in the needle will slide through the, needle eye, the slack on the next downstroke consisting of the strand extending between the needle eye and the material being taken up as will be later explained.

The needle is pivoted in a bearing 17 formed integral with, a partially hollow post 18, which post oscillates in a .......... Such post is mounted to oscillate about the pin 6 fixed in the bottom of the casing. The pivot for the needle, which is formed integral with it, extends outwardly and rearwardly on each, side thereof to form cam followers 20 (FIG. 13)

Fixed to the upper end of the post 18 is a horizontally swingable bifurcated rocker arm 21 (FIG. 11).

* -- -----°—=----------- uul ιυ liiu _cugugciucui oi me sines alternately to opposite sides of the line of stitching and ²⁵ of a cut out portion in the rear extension of such plate to miRn (nA machina hoAtwardltr λ-Ρ+α». nnnL ___·χΐ________.___&lt;· · « . . .

My invention relates to a suturing device designed for rise by surgeons in suturing incisions especially abdominal incisions.

Much time of surgeons in completing operations is consumed by sewing together severed parts of the human body. Heretofore this necessary work has been done by hand and involved skilled techniques. My invention is designed to do this part of the work mechanically and in the shortest possible period of time, and to produce uniform results in so far as the stitches themselves and tension on the sutures are concerned. The device is adapted to be used in any location where there is a space -----„ _{vul auu M} under the, part of the body operated upon or under ²⁰ 6), the cut out portion 29 permitting the needle to pass the material being sewed. .. .. . ... In general my machine comprises a hollow needle through which the catgut or other suturing material is threaded. Mechanism is provided for swinging the needle to push the machine backwardly after each stitch thus resulting in a zig zag line of stitches. Also, gathering mechanism is provided for drawing together in abutting relationship the edges of the flesh or material being sewed and holding it in that relationship in advance of each stitch, and to release such hold as the machine is moved by the pushing mechanism to another position for the next stitch.

More particularly, my invention may be best understood by reference to the accompanying drawings in which the same reference numerals are used to designate like parts and wherein—

FIGS. 1, 2, 3 and 4 are side, front, top and rear views, respectively, of my device;

FIG. 5 is a bottom plan view of the front portion of the knurled pusher plate;

FIG. 6 is a partial sectional view, taken along the line 6—6 of FIG. 9, showing the cam for operating the pusher plate;

FIG. 7 is a sectional view, taken along the line 7—7 of FIG. 8, showing the gathering mechanism;

FIG. 8 is a vertical sectional view of my machine, showing the needle in its lowermost position;

FIG. 9 is a view similar to FIG. 8, showing the needle ₅₀in its elevated position;

• FIG. 10 is a horizontal sectional view of my machine, taken along the line 10—10 of FIG. 8;

FIG. 11 is a horizontal sectional view of my device, taken along the line 11—11 of FIG. 8;

FIG. 12 is a top horizontal sectional view of a portion of my device, taken along the line 12—12 of FIG. 1, showing the construction of the needle guard;

FIG. 13 is a top plan view of the mechanism for raising and lowering the needle;

FIGS. 14 through 21 show the type of stitches formed by my machine;

FIG. 22 is a multiple view, showing in step by step relationship how the stitches are formed; _______r________J___

FIG. 23 is a top plan view, showing a sutured incision, eg bearing 19 and is provided with a cam 44 and ·

FIG. 24 is a bottom plan view, showing the sutured incision illustrated by FIG. 23.

Referring to FIGS. 1 through 5, it will be seen that ______________ „ the mechanism is suitably housed in a casing which, as 70 for a purpose which will be described, illustrated by FIG. 11, may be provided with lights 1 —in the interior thereof. The upper portion of the casing

2,088,038

A loop engaging hook 22 is pivoted to the lower end of the post 18 which hook is connected to the needle by a spring actuated link 23. The spring is strong enough to cause the needle to penetrate the material when released from the mechanism hereinafter described for 5 raising it to its elevated position.

Extending crosswise of the casing and slightly above and parallel with the pivot for the needle is a shaft 24 having a worm wheel 25 secured intermediate the ends thereof. On each side of such wheel and keyed to. the ¹⁰shaft are cam carrying arms 26, which arms are provided on their ends with laterally extending pins 27 adapted to engage the cam arms 20 constituting a part of the needle elevating mechanism.

A worm 28 engages the worm wheel 25. Such worm is formed integral with a shaft 291. Also, keyed to such shaft is a unitary driving bevel gear and female crown clutch member 301. The male member 311 of the clutch is slidably keyed to shaft 291 and-is shiftable-into , engagement with the female member by a shifter fork 33, which fork terminates into a friction finger shifter fork control 34 slidably mounted on the side of the casing. The male member of the clutch is driven by a flexible drive cable 35 which is connected thereto and is driven from an external source of power.

The mechanism for reciprocating the gathering mechanism, pusher plates and for oscillating the needle will now be described.

For these purposes a vertical shaft 38 is provided, which shaft is journalled in an upstanding elongated bearing sleeve 39. Secured to the upper end of said shaft is a bevel gear 40 which meshes with the bevel gear 301 forming part of the crown clutch previously described. Intermediate the ends of said shaft are secured two cams: a cam 42 (FIG. 11) which is disposed between the ends of the bifurcated ends of the rocker arm 21 and functions to swing the needle back and forth, and a cam 43 (FIG. 7) which is positioned between the oppositely disposed ends of the gathering plates 11 for operating the gatherer. The gathering plates are provided with upstanding pins 11' which are engaged , by a spring ring 12' for pulling the same toward each other when the cam 43 is in inoperative position.

The operation of the machine is as follows:

Assume that the needle is in its raised position and that the material is arranged in edge to edge relationship between the pusher plate 9 and the needle guard 7; when the shaft 35 is driven and the clutch disengaged, the crown clutch element 301 keyed to shaft 291 and the shiftable clutch element 311 will become engaged upon pushing the shifter fork control 34 forwardly. Thereupon the bevel gear forming a part of the clutch 301 will drive the bevel gear 40 with which it is engaged and the shaft 38 to which the gear 40 is keyed as well as cams 42 and 43 secured to such shaft. At the same time worm 28, which is also keyed to shaft 291, will drive the worm wheel 25 and cam carrying arms 26. The pins 27 on the ends of said arms will contact the cam surfaces 20 attached to the pivot for the needle and, in cooperation with the spring actuated link 23, will cause the needle to oscillate with an up and down movement. Simultaneously therewith a swinging movement in a horizontal direction will be imparted to the needle due to the action of the cam 42 and its engagement with the rocker arm 21. The thread engaging hook 22 will swing with the needle because of its connection to the same part as the needle.

In consequence of the foregoing arrangement, when the needle reaches the limit of a lateral swing it will commence its downward movement and, due to the action Of the spring actuated link 23, will penetrate the material on one side of the line formed by the abutting edges of the material being sewed and will carry a loop of -the thread down through the material. When the needle is in its lowermost position, the hook will be in position to engage the loop on the lower side of the material, as illustrated by the first figure in the first column of FIG. 22.

The loop remains in the material upon the upstroke of the needle because of the frictional engagement of the thread with the material. It should be noted in this connection that because the free end of the thread is frictionally held in the friction eyelet 16, as the needle moves downwardly it unwinds the thread from the spool 14, and that upon the upstroke of the needle the loop of the thread forming the stitch remains in the material.

Upon the upstroke of the needle, the gathering plates 11 wifi grip the material on opposite sides of the line of stitching and draw the edges of the material together through the action of the spring 12' and because at that time the cam 43 will be in an inoperative position. Immediately after the needle clears the opening 29 in .the pusher plate and before it reaches its uppermost position, the pusher plate will engage the top surface of the material and push the machine backwardly because of the engagement of the cam 44 with the front edge of the opening 30 in such plate. During the time the pusher plate is functioning the needle will have swung to one side of the line of stitching due to the action of cam 42 on the rocker arm 21, and the needle will be in position to form the next stitch.

During the upstroke and as the machine is pushed backwardly the loop on the under side of the material will be pulled backwardly because of its engagement with the hook 22. Consequently, when the needle reaches its uppermost position it will be in position to form another stitch by carrying another loop down through the loop previously formed where the second formed loop will in turn be engaged by the hoop, as illustrated by the top figure on the right hand side of FIG. 22. After a loop has been pulled backwardly by the hook, due to backward motion of the device, as described, the loop is disengaged , from the hook by a cam 18A on post 18, which cam pushes the hook forward within the loop by acting on a collar 18B, to which the lever or hook 22 is pivoted, the downward motion of the hook or lever with the downward motion of the needle, releasing the loop from the hook.

When ready to begin its down stroke, the cam 42 will be in inoperative position, and as the needle swings downwardly the cam 44 will restore the pusher plate to its inoperative position before the needle reaches the opening in the pusher plate through which it passes. And, as the needle completes its down stroke, the cam 43 will project the gathering plates laterally and outwardly with respect to the device.

Upon forming the next stitch, the sequence of steps above described are repeated so that when the sewing is completed the material will be sewed together with a zig zag line of stitches, the stitches on top of the material consisting of single threads and those on the bottom side of double interlocked threads, as illustrated by FIGS. 23 and 24.

A barbed thread should be used, with my invention to secure the best suturing results. .

The structure of the device is claimed in accordance with its operating position in suturing an abdominal incision, with the patient in the supine position, and as shown in FIGS, 8 and 9 of the drawings.