Suture needle abstract
A typical embodiment of the invention enables a surgeon to occupy
only one and in manipulating a suture needle. The instrument thumb
handle has, on one end, a freely rotatable short roller. The ring
finger handle, moreover, has a long roller that is journalled within
that handle. One end of the long roller bears against the short
roller to form a nip that engages the suture needle. The other end
of the long roller terminates near the ring finger handle grip to
enable the surgeon to rotate the long roller with another finger
of the same hand and thereby draw the needle through the nip, repositioning
the needle for another stitch.
Suture needle claims
I claim:
1. An instrument for manipulating a suture and suture needle comprising,
a thumb handle, a thumb grip on one end of said handle, a short
roller secured to the opposite end of said handle and freely rotatable
relative to the axis of said handle, a ring finger handle pivotally
jointed to said thumb handle having a lengthwise journal formed
therein and having a bight formed near one end of said handle to
expose a portion of said journal, a ring finger grip on the end
of said ring finger handle that is closest to said bight, a long
roller received in said journal for rotation relative thereto, one
end of said long roller exposed in said ring finger handle bight
and the other end of said long roller protruding from the opposite
end of said ring finger handle to selectively bear against said
short roller and to form a nip therewith, and a fulcrum for pivotally
joining said thumb and ring finger handles together to clasp the
suture needle in said nip and to advance the needle through said
nip.
2. An instrument according to claim 1 further comprising a plurality
of lengthwise oriented teeth formed in said long roller exposed
within said bight to promote rotation of said long roller, and a
roller locking finger protruding from said thumb handle in alignment
with said bight and said exposed long roller teeth, said roller
locking finger having teeth formed thereon to mesh selectively with
said long roller teeth.
3. An instrument according to claim 1 wherein said short roller
and said protruding long roller end each further comprise knurled
surfaces.
4. An instrument according to claim 1 further comprising a locking
cam protruding from said thumb handle toward said ring finger handle
and another locking cam protruding from said ring finger handle
toward said thumb handle to selectively mesh together and to prevent
said handles from moving relative to each other.
Suture needle description
BACKGROUND OF THE INVENTION
This invention relates to surgical apparatus and, more particularly,
to a suture needle holder that has rollers to grasp the needle tip
to rotate the needle into position for the next stitch, and the
like.
Suturing incisions and wounds is a demanding surgical skill. As
practiced, a curved suture needle is mounted in a simple holder
that is held in the surgeon's right hand. To complete a stitch,
frequently the needle is grasped with forceps that are held in the
surgeon's left hand and tip of the needle is released from the needle
holder. The holder then grasps the back end of the suture needle
in order to press the needle through and complete the stitch.
Clearly, this technique requires the surgeon to use both hands
in order to suture a wound or incision. The manipulations are cumbersome,
tedious and time consuming. Unquestionably, there is a need for
some technique that would not require the surgeon to use both hands
to complete a single stitch and that would take less time and physical
stress.
SUMMARY OF THE INVENTION
The invention provides an apparatus that enables a surgeon to manipulate
a suture needle with one hand. More specifically, a short, free-spinning
roller is mounted on the end of a handle. A long roller is journalled
in the body of a second handle to enable a portion of the long roller
to protrude from the end of the handle parallel with and adjacent
to the short roller. After the tip of the needle is grasped between
the rollers and the needle is removed from the tissue, the needle
is rolled forward by rotating a portion of the shank of the long
roller that is opposite to the end engaging the needle with the
middle finger of the right hand. The needle is thus rolled forward
until it is held by both rollers near the end that receives the
suture.
Held in the foregoing manner, the needle now is poised for introduction
into the patient for the next stitch. During these manipulations
the surgeon's left hand remains free for other purposes.
Thus, there is provided an improved suturing apparatus. For a more
complete appreciation of the invention, attention is invited to
the following detailed description of a preferred embodiment, taken
with the drawing. The scope of the invention, however, is limited
only through the claims.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 of the drawing is a plan view of a typical embodiment of
the invention;
FIG. 2 is a plan view of a long roller for use in the apparatus
shown in FIG. 1;
FIG. 3 is a plan view in full section of a short roller attached
to the apparatus of FIG. 1; and
FIG. 4 is a detail view of a roller locking finger for use with
the apparatus shown in FIG. 1.
DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT
These and other problems that have characterized the prior art
are overcome, to a great extent, through the practice of the invention.
As shown in FIG. 1 a thumb handle 10 has, on one end, a generally
oval thumb grip 11. The thumb grip 11 is attached to an offset,
long, slender shank 12 that has, near the end that is opposite to
the thumb grip, a transversely disposed fulcrum pin 13.
A roller locking finger 14 protrudes from the shank 12 on the side
that is opposite to the thumb grip 11 and on that portion of the
shank to which the thumb grip is joined. As best shown in FIG. 4
the locking finger 14 is a resilient, arcuate beam 15 that is cantilevered
from the shank 12. Free end 16 of the beam 15 has in its inner curved
surface, a number of teeth 17 the lengthwise axes of which are
parallel with the major axis of the shank 12 shown in FIG. 1.
A locking cam 20 also is formed integrally with the roller locking
finger. The cam 20 has the usual meshing cam surface (not shown
in the drawing) to clamp the thumb handle 10 to a ring finger handle
21 which is joined to the thumb handle by means of the fulcrum pin
13.
Continuing with the description of the thumb handle 10 the end
of the shank 12 that is opposite to the thumb grip 11 terminates
in a short roller 22. As illustrated, the short roller 22 is generally
cylindrical, the outer surface of the cylinder being finished by
knurling, or some other suitable gripping surface that enjoys an
high coefficient of friction. Turning for the moment to FIG. 3
it can be seen that the short roller 22 is an hollow cylinder, open
on the end that is oriented toward the thumb grip 11 (not shown
in FIG. 3) in order to telescope over the associated end portion
of the shank 12. Opposite end 23 of the short roller 22 terminates
in a transverse partition 24 that has a centrally disposed bore
25. The bore 25 is in general alignment with longitudinal axis 26
of the shank 12. A tapped bore 27 moreover, is formed in the end
of the shank 12. The tapped bore 27 also is in longitudinal alignment
with the axis 26 in order to receive a threaded pivot screw 30 that
joins the short roller 22 to the shank 12. In this way the short
roller 22 is free to rotate in a clockwise or counterclockwise direction
relative to the longitudinal axis 26.
In FIG. 1 the ring finger handle 21 has, at one extreme end a
generally oval ring finger grip 31 that is in the same plane as
the thumb grip 11 but is offset in the opposite direction to the
thumb grip. The shank 32 has a lengthwise journal bearing 33 that
is in general alignment with longitudinal axis 34 of the ring finger
handle 21.
In accordance with a salient feature of the invention, a bight
35 is formed in the shank to expose an end of the journal bearing
33 that is adjacent to the ring finger grip 31. A ring finger handle
locking cam 38 protrudes from the shank 32 at the junction between
the shank and the ring finger grip 31. As shown, the locking cam
38 extends toward and aligns with the corresponding locking cam
20 on the thumb handle 10 in order to selectively mate with the
cam surfaces (not shown in the drawing) on the cam 20 and thereby
to fix the relative positions of the handles 1021.
Near the tip of the ring finger handle 21 that is opposite to the
bight 35 a portion of the fulcrum pin 13 is secured in the handle
to restrict the handles 1021 to a scissors-like motion in the plane
of the grips 1131 and in the directions of arrows 3637.
A long roller 40 is mounted in the journal bearing 33 in accordance
with a further salient feature of the invention. The long roller
40 is in general longitudinal alignment with the axis 34 within
the bearing 33 and is, perhaps, best shown in FIG. 2. Thus, the
long roller 40 has, at one end, a short bearing stub 41 that has
a smoothly machined surface. Spaced immediately inward of the stub
41 is an array of short, lengthwise teeth 42. In accordance with
the invention the long roller teeth 42 have the same pitch and depth
as the teeth 17 (FIG. 4) on the arcuate beam 15 in order to mesh
selectively with the teeth on the beam.
Turning once more to FIG. 2 the long roller 40 has a smoothly
finished central portion 43 in order to rotate freely in the journal
bearing 33 (FIG. 1) in which the long roller is mounted. This rotation,
relative to the longitudinal axis 34 is in the directions of arrows
4445.
Near the end of the long roller 40 that is opposite to the stub
41 a circumferential groove 46 is formed to serve two main purposes.
Thus, the groove not only provides a clearance for the fulcrum pin
13 (FIG. 1), but also enables the fulcrum pin to act as a stop,
thereby retaining the long roller within the ring finger handle
21 and preventing the long roller from slipping out of the shank
32 during use.
Between the fulcrum groove 46 and the extreme end of the long roller
40 a further circumferential groove 47 is formed to establish a
clearance between the long roller and a terminal, angled portion
50 of the thumb handle 10.
The end portion of the long roller 40 moreover, terminates in
a cylindrical surface 51 that has a knurled, or other suitable highfriction
finish to provide a firm grip for the purpose of the invention.
In operation, the surgeon inserts thumb and ring fingers in the
respective grips 1131 and squeezes the handles 1021 together in
the direction of the arrow 37 in order to disengage the roller locking
finger 14 from the ring finger locking cam 38 and to unmesh the
locking cams 2038. The handles 1021 are then spread apart by pressing
the thumb grip 11 in the direction of the arrow 36 and the ring
finger grip 31 in the direction of the arrow 37. The handles 1021
thus are compelled to pivot about the fulcrum pin 13 and thereby
spread the rollers 2240 apart.
The tip of a suture needle (not shown in the drawing) is placed
between the knurled surfaces of the short roller 22 and the cylindrical
surface 51 of the long roller 40. After so positioning the suture
needle tip between the rollers 2240 the thumb grip 11 is pivoted
in the direction of the arrow 37 and the ring finger grip 31 is
pivoted in the direction of the arrow 36 in order to grasp the tip
of the suture needle between the knurled surfaces of the rollers
2240.
Upon so clamping the tip of the needle between the rollers 2240
the locking cams 2038 on the handles 1021 respectively, are engaged
in order to engage the needle between the rollers without requiring
any further physical effort or attention on the part of the surgeon.
The surgeon then removes the needle from the tissue.
At this point, and in accordance with one of the principles of
the invention, after the needle is free from the patient's tissue,
the surgeon presses the middle finger of the same hand used to manipulate
the thumb and ring finger grips 1131 against the teeth 42 on the
long roller 40 that are exposed in the bight 35. The middle finger
then bears against the long roller 40 to compel the roller to rotate
in the direction of arrow 52 relative to the longitudinal axis 34.
This rotation, transmitted by way of the journalled center portion
43 of the long roller 40 causes the knurled cylindrical surface
51 also to rotate in the same direction as the arrow 52. Friction
forces imposed by the knurled roller surfaces and the rotational
motion of the surface 51 in the direction of the arrow 52 and, reactively,
the movement of the freely rotating short roller 22 in the opposite
direction, force the suture needle (not shown in the drawing) to
advance through the nip of the rollers in a direction that is perpendicular
to the plane of the thumb grips 1131 toward the viewer.
The needle is advanced between the rollers 2240 until the back
end of the needle, near the suture, is reached. The long roller
locking finger 14 is then meshed with the teeth 42 on the long roller
40 in order to stop temporarily the rotation of the long roller
and the companion short roller 22 until the surgeon is prepared
to release the back of the needle and to reengage the needle tips.
From this position, with the back of the needle gripped in the
nip of the rollers 2240 the needle can be reintroduced into the
tissue for the next stitch. All of these manipulations, moreover,
are carried out in a manner that requires the surgeon to use only
one hand to complete the necessary suturing steps. In this way,
the surgeon has a free hand to press the sides of the incision together
or for other surgical purposes as the circumstances may dictate.
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