United States Patent Office
1
3,078,465
INSTRUMENT FOR STITCHING GASTRIC STUMP
Boris Sergueevifch Bobrov, Oktiabrskaja ul. 40, Apt. 10,
Moscow, U.S.S.R.
Filed Sept 9, 1959, Ser. No. 840,491
2 Claims. (CI. 1—50)
This invention relates to an instrument for stitching the gastric stump by means of U-shaped tantalum staples.
The existing instruments for suturing the gastric stump by means of U-shaped metal staples permit the application of only single-row shallow sutures, piercing all the layers of the gastric walls to be stitched. The jaws of these instruments unevenly grip the gastric walls because of the elastic deformation of the material of which they are made, which lowers the quality of the suture.
One of the objects of the present invention is an instrument which ensures an even gripping of the intestinal walls along the line of the suture.
This object is attained by making the operating part of the supporting jaw in the shape of a rocking arm with stops at the end.
Another object of the present invention is an instrument'which has pivotally joined clinching and supporting jaws which are provided with two rows of slots for staples brie for'each jaw, stitchers for subsequently forcing out staples from: the "slots of the first and second rows, and recesses for'clinching .sitaples. Such design allows stitching'of the "gastric stump- by means of a double row of staple sutures. This aim is attained by the provision on the clinching and supporting jaws; of projections set one against the other and' 'displaced vat 'a half pitch, and an opening in the center for needles piercing the upper layers of the gastric wall, fixing the gastric wails to the instrument jaws when driving the first~rbw of sutures into the lumen of the stump and placing the second row of sutures in the sero-muscular layers of the gastric walls.
The further objects and advantages of the present invention are seen from the following description and the attached drawings, in which the preferred embodiment of the invention is shown.
FIG. 1 is a side elevational view of the instrument;
FIG. 2 is a top plan view of the instrument;
FIG. 3 is a view of the clinching jaw without a handle and stitchers along the arrow A in FIG. 2;
FIG. 4 is a view of the supporting jaw along the arrow A in FIG. 2;
FIG. 5 is a cross-section view of the instrument along line B—B of FIG. 1;
FIG. 6 is a cross-section view of the instrument along line C—C in FIG. 1;
. FIG. 7 is a longitudinal sectional view of the stitcher;
FIGS. 8 to 10 show three types of sutures provided by the instrument of this invention;
FIG. 11 is an elevational view showing the details of the needle.
In more detail, and with further reference to the drawings, FIGURE 1 discloses the overall construction of the stitching instrument. The instrument comprises the elongated clinching jaw 1, the similarly elongated supporting jaw 2, the stitcher mechanism 3 slidably mounted on the forward portion of the clinching jaw 1, stitcher 3 being adapted to force out staples for the first row of sutures piercing all lamina of gastric walls. A similar stitcher mechanism 4 is also slidably mounted upon the forward portion of the clinching jaw, at a location laterally adjacent the stitcher mechanism 3, stitcher 4 being adapted to force out staples for the second row of sutures piercing all sero-muscular lamina. The handle 5 is provided intermediate the length of the jaws for opening and closing the clinching jaw and supporting jaw with respect to each other. The clinching jaw and supporting jaw
are pivotally connected at their rearward ends 6 by means of the pin 6', and a pair of parallel flange portions 6" having apertures therethrough for receiving and supporting the pin.
5 The handle 5 of the stitching instrument, best illustrated in FIGURES 1 and 5, for opening and closing the jaws includes a threaded portion 7 and an intermediate portion 8. The supporting jaw 2 has a hollow, threaded portion 42 for screwing the threaded portion 7 of the
jQ handle into the supporting jaw. The intermediate portion 8 of the handle is of reduced size with respect to ■the interior surface of the hollow opening in the clinching jaw, to provide a spacing 8' therebetween, and thereby accommodate the arcuate movement of the jaws rela
jg live to one another, when opening and closing the jaws. The handle 5, disposed intermediate the length of the jaws, is rotatable for screwing its lower end into the supporting jaw, with its uppermost stem portion 5' being enlarged relative to the intermediate portion 8, so that
2Q the enlarged portion will press against the clinching jaw and force it toward the supporting jaw and clamp the gastric stump therebetween.
The side surface of the elongated clinching jaw 1 (FIGS. 1 and 2), along its forward portion 13, is pro
2g vided with a pair of opposed open guideway slots 9, which extend parallel with the length of the jaws, and provide a slide support for the stitcher mechanisms 3 and 4.
Along the length of the forward portion 13 of the clinching jaw immediately beneath each stitcher mecha
30 nism, are a plurality of slots 10, for the staples. These slots 10 are formed by a pair of elongated plates 11 and 12, with vertically extending recesses in the plates forming the slots 10 at spaced intervals along the length of the plates. The elongated plates 11 and 12 are secured
35 to the housing 13 of the clinching jaw 1 by means of screws 14.
To facilitate fixing the gastric stump to the clinching jaw, a plurality of downwardly extending teeth 15 are provided adjacent plate 12, at closely spaced intervals
40 along the length of the forward portion of the clinching jaw. These projections extend toward the supporting jaw, and are each provided with an eye 16. The eye openings are aligned along a path parallel to the length of the clinching jaw. An elongated needle 17 has a
^5 rearward portion slidably secured to handle portion 19 of the clinching jaw with the forward needle portion aligned with the eyes 16 of the teeth 15 of the clinching jaw. A finger operated projection 18 is secured to the rearward portion of the needle by a screw 20 which pro
50 jects into a longitudinal slot 21 in the handle portion 19. Thus, the needle is slidably supported on the handle portion for manual movement into and out of eyes 16.
The stitcher mechanisms 3 and 4 for applying the first and second rows of stitches, respectively, are best illus
55 trated in FIGURES 1 and 7, and are of similar construction. They comprise an upright body portion 22, having grooved portions for slidably supporting the stitcher mechanism in the guideway slots 9 of the clinching jaw. A cover plate 23 is secured to the body portion by means
6Q of a plurality of screws. Between the cover plate and the body is a vertically mounted driving plunger 25, slidably mounted in a vertical direction by means of a pin 25' and slot 25". A return spring 26 for the plunger has one end connected to the plunger and its intermediate portion
65 connected to the body 22 by means of a screw 26'. An elastic stop 27 is connected to a slide 28, by suitable connecting means. The movement of the slide is limited by the length of the slot 29 in body portion 22 and which extends parallel to the length of the jaw.
70 FIGURES 1 and 4 disclose the structure of the supporting jaw 2, which consists of a rocking arm 30 pivotally mounted to the forward end of the jaw along an
