Surgical instrumentation for blood vessels

• US 4,681,109 A
• Filed: 06/19/1986
• Issued: 07/21/1987
• Est. Priority Date: 06/12/1985
• Status: Expired due to Fees

• Current Assignee: Arroyo, Juan
• Original Assignee: Arroyo, Juan
• Inventors: Arroyo, Juan
• Primary Examiner(s): Pinkham, Richard C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US06/876,109
• Time in Patent Office: 397 Days
• Field of Search: 128/335, 128/346, 128/325, 128/326, 128/334 C
• US Class Current: 606/158
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/1103 Approximator

Abstract

Surgical instrumentation in the form of a clamp assembly specifically structured to position and maintain sections of blood vessels, including both veins and arteries, in a preferred surgical orientation such that open ends of the vessel sections are substantially adjacently positioned relative to one another and properly exposed and oriented so that such section ends may be sutured or otherwise secured together. The clamp assembly is structured such that vessel sections to be attached are adjustably positionable so that placement of the section ends may be adjusted and changed to insure proper relative positioning to one another in a preferred exposed position for attachment.

Claims

1. A surgical instrumentation assembly of the type primarily designed for the positioning of open ends of blood vessel sections in aligned relation to one another, said assembly comprising:

(a) a clamp assembly including at least one clamp each comprising two substantially elongated arms movably secured to one another,

(b) a fulcrum structure mounted on said one clamp and disposed intermediate opposite ends of said two arms and interconnected thereto and structured to define a pivotal connection between said two arms,

(c) said one clamp structured to include a positioning means at least partially mounted on each of said two arms adjacent a first of said opposite ends thereof and structured for holding and positioning a vessel section,

(d) said positioning means of each clamp including at least one gripping structure defined by a gripping surface integrally formed on an inner surface of each arm, said gripping surfaces of each clamp disposed in aligned relation to one another and cooperatively configured to engage an exterior surface of the respective blood vessel sections associated with each clamp,

(e) securement means interconnected between two of said clamps and disposed and structured for placement of said two clamps in spaced, adjacent and communicating relation to one another,

(f) said positioning means of said one clamp structured and disposed in substantially aligned relation to one another of said clamps when interconnected by said securement means and said gripping surfaces of each clamp structure terminating in an outer end and an inner end disposed on opposite longitudinal sides of said respective clamp structure, and

(h) whereby open attachable ends of the vessel sections on each one clamp are oriented to extend outwardly from said inner end of each positioning means into engageable relation with one another.

2. An assembly as in claim 1 wherein said gripping structure of each clamp comprises a sleeve integrally formed in said respective clamps, said sleeve defined by said two gripping surfaces, each including an elongated groove formed in each of said arms.

3. An assembly as in claim 2 wherein said sleeve of each clamp extends transversely between opposite longitudinal sides of said clamp and is open at opposite ends thereof to define an open inner end and an open outer end.

4. An assembly as in claim 3 wherein said open inner end of each sleeve comprises a substantially flared, enlarged configuration relative to said outer end of each sleeve and a portion of the remainder of the length thereof.

5. An assembly as in claim 2 wherein each of said gripping surfaces includes a textured finish thereon, said textured finish structured to provide at least a minimal frictional resistance to an engaged vessel section.

6. An assembly as in claim 1 wherein said gripping surfaces of each gripping structure has a substantially planar configuration disposed in coplanar relation with said inner surface of a respective one of said arms on which it is formed.

7. An assembly as in claim 6 wherein each of said gripping surfaces includes a textured finish thereon, said textured finish structured to provide at least a minimal frictional resistance to an engaged vessel section.

8. An assembly as in claim 7 wherein said positioning means of each clamp comprises a plurality of gripping structures disposed in spaced, parallel relation to one another and at least two of said plurality of gripping structures having cross-sectional dimensions which differ.

9. An assembly as in claim 1 wherein said clamp comprises a second of said opposite ends being disposed and substantially defining an opposite end of said clamp relative to said positioning means, said second ends being movably disposed in spaced relation to one another, said second ends selectively positionable towards one another upon pressure being applied thereto, said two arms pivotally connected to one another for movement of opposite ends of said clamp about said fulcrum structure.

10. An assembly as in claim 9 wherein each of said second ends include an indentation portion formed on an outer surface thereof, said indentation portions cooperatively disposed and configured to receive a tool structure therein, the tool structure designed for positioning of said two ends toward one another upon being pressed together and the resultant positioning means of said clamp being disposed away from one another.

11. An assembly as in claim 10 wherein said indentation portions include a substantially concave and hemispherical configuration.

12. An assembly as in claim 11 wherein said tool comprises projections correspondingly configured to said indentation portions and respectively disposed so as to concurrently engage said indentation portions.

13. An assembly as in claim 1 further comprising biasing means mounted on each of said clamps between said second ends of said arms and disposed and structured for biasing said second ends away from one another and biasing said first ends towards one another.

14. An assembly as in claim 13 wherein said fulcrum structure is disposed intermediate opposite ends of said clamp and said fulcrum structure of each clamp disposed in aligned substantially coaxial relation to one another.

15. An assembly as in claim 11 wherein said securement means comprises an elongated pin of sufficient longitudinal dimension for securement of a plurality of clamps thereto, said clamps connected to said pin in aligned, spaced relation to one another, said clamps movable towards and away from one another along the length of said pin for selective positioning thereof relative to one another.

16. An assembly as in claim 15 wherein said pin is disposed in interconnected relation to said fulcrum structure of adjacently positioned clamps and being disposed and structured to at least partially define a pivotal axis of each of said fulcrum structures.

17. An assembly as in claim 1 wherein said securement means comprises an elongated pin having a sufficient longitudinal dimension for movable attachment to each of said plurality of adjacently positioned clamps, said pin structured for interconnection to said fulcrum structure of said plurality of clamps, said fulcrum structure of each clamp movably disposed in substantially aligned relation to one another.

18. An assembly as in claim 17 wherein said fulcrum structure comprises a plurality of fingers secured to and extending outwardly from cooperative portions of said arms at one end of said clamp opposite to said positioning means, each arm having at least one finger secured thereto and said plurality of fingers disposed in adjacent, substantially aligned relation to one another, each of said plurality of fingers of each of said plurality of clamps movably secured to said pin.

19. An assembly as in claim 18 wherein each of said plurality of fingers comprise an aperture formed therein and dimensioned at least in part to allow passage therethrough of said pin, said pin and said apertures cooperatively dimensioned and configured to allow pivotal movement of said arms relative to one another and longitudinal movement of said plurality of adjacent clamps along the length of said pin.

20. An assembly as in claim 19 wherein said apertures of said fingers secured to a first of said arms comprise a peripheral configuration corresponding to an exterior surface configuration of said pin, whereby relative rotation is prevented therebetween;

said aperture of said fingers secured to a second of said arms comprising a peripheral configuration differing from said exterior surface of said pin, whereby relative rotation is allowed therebetween.

21. An assembly as in claim 20 wherein said exterior surface of said pin is multi-sided.

22. An assembly as in claim 21 wherein said peripheral configuration of said apertures of said other fingers is circular.

23. An assembly as in claim 19 wherein said pin comprises a head portion secured to one end thereof and having a transverse dimension sufficient to prevent passage thereof through said apertures.

24. An assembly as in claim 23 further comprising a locking portion secured to one end of said pin and structured for selective placement between a normal size and a reduced size position for passage through said aperture and maintenance in attached relaction to said fulcrum structure.

25. An assembly as in claim 1 further comprising orientation means secured to at least one of said clamps for maintaining a preferred orientation of an end portion of the vessel section engaged by said one clamp, said orientation means extending outwardly from one side of said clamp and including connecting means for attachment to the end portion protruding from said positioning means of said one clamp.

26. An assembly as in claim 25 wherein said orientation means comprises a plurality of posts secured to said clamp and including at least two of said posts disposed in spaced relation to one another on opposite sides of said positioning means and the end portion of the vessel section extending therefrom, said connecting means secured to said post and positionable relative thereto into retaining engagement with the end portio of the vessel section.

27. An assembly as in claim 26 wherein said connecting means comprises a plurality of connections at least equal in number to said posts and extending outwardly from respective ones of said posts into attachment with the end portions of said vessel sections, said plurality of connectors engaging the end portions at a plurality of spaced locations about the end portions.

28. An assembly as in claim 27 wherein at least one of said connectors comprises an elongated, semi-rigid and flexible element movably mounted and selectively positionable into and out of engagement with the end portion of the vessel section.

29. An assembly as in claim 26 wherein at least two of said plurality of posts are secured to a common longitudinal side of one arm of said clamp and extending outwardly therefrom in substantially parallel relation to one another on opposite sides of the positioning means.

30. An assembly as in claim 27 wherein at least one of said connectors comprises a thread of flexible material having one end secured to the end portion of the clamp and being secured to one of said posts and a spaced distance from the end portion.

31. An assembly as in claim 26 wherein said plurality of posts comprise at least a third post secured to said clamp substantially between said two posts and including said connecting means connected thereto and extending outwardly therefrom into attachment with the end portion.

32. An assembly as in claim 31 wherein said connecting means comprises a plurality of connectors at least equal in number to said posts and extending outwardly from respective ones of said posts into attachment with the end portions of the vessel section, said plurality of connectors engaging the end portion at a plurality of spaced locations about the end portion.

33. An assembly as in claim 31 wherein at least two of said plurality of posts are secured to a common longitudinal side of one arm of said clamp and extend outwardly therefrom in substantially parallel relation to one another on opposite sides of the positioning means, said third post secured to a longitudinal side of the other of said two arms of said clamp relative to said two posts.

34. An assembly as in claim 33 wherein said plurality of posts are integrally secured to respective ones of said arms and said two posts are substantially coplanar and said third post extending outwardly from the plane of said two posts.

35. An assembly as in claim 1 further comprising orientation means for maintaining a preferred orientation of an end portion of the vessel section engaged by said one clamp and including a base portion movably mounted adjacent one longitudinal side of at least one clamp and in communicating relation to an end portion of the vessel section engaged by said one clamp, said orientation means including a connecting means for attachment to the end portion of a vessel section protruding from said positioning means of said one clamp.

36. An assembly as in claim 35 wherein said base portion is movably connected to said securement means and selectively positionable relative thereto and between an operative position and an inoperative position relative to the vessel section engaged by said one clamp.

37. An assembly as in claim 35 wherein said orienting means comprises a plurality of posts secured to said base and including at least two of said posts disposed in spaced relation to one another on opposite sides of said positioning means and the end portion of the vessel section extending therefrom, said connecting means secured to said posts and positionable relative thereto into retaining engagement with the end portion of the vessel section.

41. An assembly as in claim 37 wherein said plurality of posts comprises at least a third post secured to said base substantially between said two posts and including said connecting means connected thereto and extending outwardly therefrom into attachment with the end portion.

42. An assembly as in claim 37 wherein said connecting means comprises a plurality of connectors at least equal in number to said posts and extending outwardly from respective ones of said posts into attachment with the end portion of said vessel section, said plurality of connectors engaging the end portion at a plurality of spaced locations thereabout.

43. An assembly as in claim 42 wherein said plurality of posts are integrally secured to said base and said two posts are disposed in substantially coplanar relation to one another and said third post extends outwardly from the plane of the two posts in a substantially angular orientation.

44. An assembly as in claim 1 wherein at least one of said clamps comprises a second of said opposite ends of said two arms being free ends defining one end of said one clamp, said free ends spaced from one another at least partially by said fulcrum structure, each of said free ends disposed at a substantially common angular orientation relative to a remainder of respective ones of said arms.

45. An assembly as in claim 44 further comprising indentation means formed in an outer surface of each of said free ends for receipt of a pressure applying instrument thereto.

46. An assembly as in claim 1 wherein at least one of said clamps comprises a substantially linearly configured longitudinal side and an opposite longitudinal side being substantially convergent towards said first opposite ends of said arms from a point along the length of said clamp.

47. An assembly as in claim 46 wherein said convergently oriented side defines in part an inner side of said one clamp.

38. An assembly as in claim 38 wherein said connecting means comprises a plurality of connectors at least equal in number to said posts and extending outwardly from respective ones of said posts into attachment with the end portion of the vessel section, said plurality of connectors engaging the end portions at a plurality of spaced locations about the end portions.

39. An assembly as in claim 38 wherein at least one of said connectors comprises an elongated, semi-rigid and flexible element movably mounted and selectively positionable into and out of an engaging position relative to the end portion of the vessel section.

40. An assembly as in claim 38 wherein at least one of said connectors comprise a thread of flexible material having one end secured to the end portions of the vessel and being secured to one of said posts a spaced distance from the end portion.