Vascular clamp for caesarian section

• US 20050101974A1
• Filed: 02/05/2003
• Published: 05/12/2005
• Est. Priority Date: 02/05/2003
• Status: Active Grant

• Current Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Original Assignee: Vascular Control Systems, Inc. (Johnson & Johnson)
• Inventors: Jones, Michael L., Burbank, Fred H., Uyeno, Jill, Serra, R. J., Altieri, Greig
• Granted Patent: US 7,651,511 B2
• Time in Patent Office: Days
• US Class Current: 606/151
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/489 Blood vessels
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

The invention provides devices, systems and methods for clamping arteries which are useful in reducing or abolishing blood flow in an artery, and may be used to control hemorrhage following a caesarian delivery. A clamping device embodying features of the invention includes a pair of clamping members with opposed pressure-applying members having facing pressure-applying surfaces, at least one of which is a yieldable pressure-applying surface. The yieldable pressure-applying surface is preferably resilient. The clamping members are configured to adjust the distance between pressure-applying surfaces, and a blood flow sensor is disposed on at least one of the pressure-applying members to aid in locating the target artery and also to monitor blood flow through the artery. The clamping device is particularly suitable for occluding uterine arteries by compressing the broad ligament which contains the uterine artery and which is connected to the patient'"'"'s uterus with the arterial clamp.

Claims

1. A clamping device for at least partially occluding a target vessel in a patient'"'"'s body, comprising a pair of opposed pressure-applying members configured to at least partially occlude the target vessel by applying pressure thereto, with at least one of the pressure-applying members having a yieldable pressure-applying surface.

2. The clamping device of claim 1 including a sensor on at least one of the pressure-applying members for locating the target vessel.

3. The clamping device of claim 1 wherein both pressure-applying members of the device have yieldable pressure-applying surfaces.

4. The clamping device of claim 1 wherein the yieldable pressure-applying surface is resiliently mounted onto the pressure applying member.

5. The clamping device of claim 1 wherein each of the pressure-applying members have elongated handles.

6. The clamping device of claim 5 wherein the handles of the pressure-applying members are pivotally secured.

7. The clamping device of claim 2 wherein the sensor for locating the target artery is selected from the group consisting of a blood flow sensor, a sound sensor, a pressure sensor, a strain sensor, a stress sensor, a chemical sensor, an electromagnetic radiation sensor and combinations thereof.

8. The clamping device of claim 7, wherein the blood flow sensor is a Doppler ultrasound sensor.

9. The clamping device of claim 8, wherein the Doppler ultrasound sensor is configured to sense ultrasound energy having a frequency of between about 6 MHz and about 10 MHz.

10. The clamping device of claim 7, wherein the sensor is an electromagnetic radiation sensor configured to sense electromagnetic radiation having a wavelength of between about 500 nanometers (nm) and about 2000 nm.

11. The clamping device of claim 2, wherein the sensor comprises a sensor/transducer.

12. The clamping device of claim 1, wherein the sensor is mounted onto the pressure-applying surface at a location between about 0.1 inch and about 0.6 inch proximal of the distal tip.

13. The clamping device of claim 1, wherein the yieldable pressure-applying surface is configured to move in a transverse direction when pressed into contact with tissue.

14. The clamping device of claim 13, wherein the movement in a transverse direction comprises movement of between about 0.5 mm and about 20 mm.

15. The clamping device of claim 13, wherein the movement in a transverse direction comprises movement of between about 1 and about 5 mm.

16. The clamping device of claim 3, wherein a resilient tissue-contacting surface is connected to a pressure-applying member by a resilient connection selected from the group of resilient connections consisting of spring connections, rubber layer connections, “

O”

ring connections, hydraulic connections, compressed-gas connections, and other resilient connections.

17. The clamping device of claim 5, further comprising a pair of handles with a length of between about 1 inch and about 12 inches.

18. The clamping device of claim 17, wherein the length comprises a length of between about 3 inches and about 8 inches.

19. The clamping device of claim 1, further comprising a locking mechanism configured to retain a pressure-applying member in a desired position.

20. The clamping device of claim 19, wherein the locking mechanism is releasable.

21. The clamping device of claim 1, wherein the opposed pressure-applying members are configured to apply pressure between about 1 pounds psi and about 60 psi to tissue disposed between the pressure-applying members.

22. The clamping device of claim 21, wherein the pressure-applying members are configured to apply a pressure between about 3 psi and about 30 psi to tissue disposed between the pressure-applying members.

23. The clamping device of claim 1, wherein at least one of the pressure applying surfaces has a plurality of sensors.

36. The clamping device of claim 1, wherein at least one sensor has a sensing direction effective that an artery disposed along the sensing direction will likely be detected, and wherein the at least one sensor is disposed on the pressure-applying surface effective that the sensing direction is perpendicular to the pressure-applying surface.

24. An arterial clamping system comprising:

a. a clamping device for at least partially occluding a target vessel in a patient'"'"'s body, comprising a pair of opposed pressure-applying members configured to at least partially occlude the target vessel by applying pressure thereto, with at least one of the pressure-applying members having a yieldable, pressure-applying surface; and

a sensor on at least one of the pressure-applying members for locating the target vessel; and

b. a sensor controller operatively connected to the sensor and comprising a source of power.

25. The system of claim 24, wherein the yieldable pressure-applying surface is resilient.

26. The system of claim 24, wherein the sensor comprises a Doppler ultrasound sensor and the sensor controller comprises a Doppler ultrasound controller.

27. A method of occluding an artery of a patient with a clamping device, comprising:

a. providing a clamping device comprising a sensor and having a pair of opposed pressure-applying members configured to at least partially occlude the target vessel by applying pressure thereto, with at least one of the pressure-applying members having a resilient, yieldable, pressure-applying surface;

b. contacting tissue with the resilient, yieldable, pressure-applying surface near an artery without substantially compressing the artery;

c. locating an artery with the sensor; and

d. compressing a portion of the artery by applying pressure to tissue adjacent the artery with the clamping device.

28. The method of claim 27, wherein the sensor comprises a blood flow sensor.

29. The method of claim 28, wherein the blood flow sensor is a Doppler ultrasound blood flow sensor.

30. The method of claim 28, further including detecting a change in blood flow in the artery.

31. The method of claim 27, wherein the compressing a portion of the artery comprises applying between about 1 psi of pressure and about 60 psi of pressure to body tissue.

32. The method of claim 31, wherein the compressing a portion of the artery comprises applying between about 3 psi of pressure and about 30 psi of pressure to body tissue.

33. The method of claim 27, wherein the artery is a uterine artery.

34. The method of claim 33, wherein contacting tissue near and artery comprises contacting at least a portion of a patient'"'"'s broad ligament.

35. The method of claim 29, wherein the uterine artery is located with ultrasound having a frequency of between about 6 MHz and about 10 MHz.

37. A method of controlling hemorrhaging after a caesarian birth, comprising:

a. providing a clamping device a clamping device having a pair of opposed pressure-applying members configured to at least partially occlude the target vessel by applying pressure thereto, with at least one of the pressure-applying members having a yieldable, pressure-applying surface and elongated handles extending from the pressure applying members and a locating sensor on the pressure applying surface;

b. contacting a broad ligament of the patient containing one of the patient'"'"'s uterine arteries with a yieldable, pressure-applying surface of the clamp without substantially compressing tissue;

c. locating the uterine artery with the sensor; and

d. compressing a portion of the uterine artery by applying pressure to tissue of the broad ligament adjacent the artery with the clamping device to at least partially occlude the uterine artery therein.

38. The method of claim 37 wherein the uterine artery is occluded sufficiently to stop the patient'"'"'s uterine hemorrhaging

39. A method of controlling hemorrhaging after a caesarian birth, comprising:

a. the step of providing a clamping device a clamping device having a pair of opposed pressure-applying members configured to at least partially occlude the target vessel by applying pressure thereto, with at least one of the pressure-applying members having a yieldable, pressure-applying surface and elongated handles extending from the pressure applying members and a locating sensor on the pressure applying surface;

b. the step of contacting a broad ligament of the patient containing one of the patient'"'"'s uterine arteries with a yieldable, pressure-applying surface of the clamp without substantially compressing tissue;

c. the step of locating the uterine artery with the sensor; and

d. the step of compressing a portion of the uterine artery by applying pressure to tissue of the broad ligament adjacent the artery with the clamping device to at least partially occlude the uterine artery therein.

40. A clamping device, comprising:

a. tissue-contacting means;

b. pressure-applying means for applying pressure to tissue via the tissue-contacting means;

c. compressible means for connecting the tissue-contacting means and the pressure-applying means;

d. sensor means disposed on the tissue contacting means for locating an artery to be clamped.

41. The clamping device of claim 40, wherein the compressible means comprises resilient means.

42. The clamping device of claim 40, wherein the sensor means comprises sensor/transducer means for providing signals and for sensing reflected signals for locating a uterine artery to facilitate location of the uterine artery to be occluded.