|Publication number||US2434030 A|
|Publication date||6 Jan 1948|
|Filing date||13 Nov 1945|
|Priority date||13 Nov 1945|
|Publication number||US 2434030 A, US 2434030A, US-A-2434030, US2434030 A, US2434030A|
|Inventors||Grover Yeomans Theron|
|Original Assignee||Grover Yeomans Theron|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (1), Referenced by (94), Classifications (6)|
|External Links: USPTO, USPTO Assignment, Espacenet|
Jan. 6, 1948. 'T. G. YEOMANS 4, SUTURELESS METHOD OF RECTO-SIGMOID ANASTOMOSIS AND APPARATUS THEREFOR Filed NOV. 13, 1945 3 advanced toward each other by means of the ballheaded, square-bodied tie bolt and its nut 6.
The cup member I is provided with a round clearance hole I, through which the tie-bolt 5 may pass freely, and a spherically formed ball seat 8 is marginally constituted about the hole I.
The cup member 2 is provided with a square clearance hole; I5 through which the square bodied tie bolt 5 is adapted to be passed freely.
Surrounding the square clearance hole I5 and in the lower end of the cup member 2 is a tapered socket I4, adapted to interchangeably receive body tubes II, of varying lengths, which are provided at one end with a tapered portion I3 which mates with the tapered socket I4 and is adapted to seat 4 string suture 2|, whipped over the cut edge of the bowel and tied around the tie-bolt.
The cup member 2 is then placed in the distal segment of the rectum with the body tube I I protruding from the anus, where it is held steady by an assistant.
A purse string suture 22 is then placed in the cut edge of the rectum. The cup member 2 and tube I I' are slipped over the tie bolt 5.
The rectal purse string 22 is then tied around the tie-bolt 5, the two segments of bowel are the tube I I in the socket I4 of the cup member 2.
The opposed, in-turn, annular flanges 3 and 4 of the respective cup members I and 2 have been found satisfactory for the desired clamping purpose when not less than one quarter inch in width and the inner edges I3 and I9, as well as the outer edges I6 and H, are best adapted for the purpose when provided with smoothly rounded corners of approximately one sixty-fourth inch radius.
The square bodied tie-bolt 5 is provided with an integral spherical head 20, and the portion 9 directly adjacent the ball is necked down to a round section for a short distance in order to permit equal ball and socket action of the ball in the socket 8 in all directions. The oppositeend of the tie-bolt 5 is provided with threads Ill adapted to engage the internal threads of the hand nut 5. The total length of the tie-bolt 5 is so related to the total length of the body tube II that when the apparatus is assembled, as shown in Fig, 1, clamping pressure may be exerted between the opposed faces of the annular flanges 3 and 4.
The hand nut 6 may be provided with coarsely fluted grooves to provide more secure gripping surfaces for the fingers,
While a number of metals may be used in the construction of the apparatus, aluminum has proven very satisfactory for the cup members, the body tube and the hand nuts, on account of its light Weight, while the tie-bolt is best made from Steel in order to secure sufflcient strength in a bolt of small diameter.
The maximum diameters of the cup members I and 2 must not be too small, lest the stoma be too narrow, nor should they be too large to remove through the anus, unless the sphincter is to be divided and later repaired.
One and one-half inches has been determined in use to be a median of satisfactory diameters.
The body tube l I must be selected of such length that it will project sufficiently beyond the anus to be grasped and held against turning by suitable shaped forceps or pliers, but not enough to be clumsy.
The entire apparatus must have all exterior surfaces smooth and highly polished, but such finish is not necessary on such concealed surfaces as do not contact the bowel.
The opposing faces of the flanges 3 and 4 may be perpendicular to the longitudinal axis as shown in Fig. 2, or they may be disposed angularly with respect to the longitudinal axis, as shown in Fig. 1, in order to facilitate their concentric axial alignment.
In practice of my method the operating surgeon, having severed the bowel and removed the section containing the neoplasm, places the cup member I upon the tie-bolt 5 and inserts it into the proximal bowel where it is secured by a purse brought together, with the square portion of tiebolt 5 entering and freely engaging the square clearance hole I5 and the threaded portion extending through and beyond the body tube I I.
With the cup members I and 2 manipulated into positions of approximate alignment, the assistant screws the hand nut down against the projecting end of the body tube I I, which he at the same time restrains from any tendency to turn, by means of shaped jaw forceps, and thereby clamps the inturned bowl walls between the opposing faces of the flanges 3 and l of the cup members I and 2.
The-tightening of the nut is continued until the clamped portions of thebowel walls are sufficiently thinned and compressed so that no blood is thereafter supplied to the clamped portions between the flanges.
The apparatus and the bowel in its then condition are as shown in Fig. 1, with the serous coats in goodcontact outside the clamped area, and union proceeds at once, occuring first by adherence of the serous coats in contact within approximately six hours and then extending across the muscular coats.
In due course, union will be entirely efiected and the tissues between the opposed clamping surfaces of the flanges 3 and 4, with all of that portion within the apparatus, will have become dead and have sloughed off and separated from the living tissues.
The apparatus may then, in its entirety. be lubricated and removed through the anus and, after its removal, the mucous membrane grows across the united junction and anastomosis of the colon to the lower rectum has been completed.
The operation is rapidly and safely performed without the use of sutures other than the temporary purse strings, which can be eliminated also by the use of any satisfactory internal, expanding clamp within the inner margins of the flanges,
The appearance of a section of the rectum after anastomosis, with thickened scar tissue, is shown in section in Fig. 3.
Having thus described my invention, I claim:
1. A clamp for recto-sigmoid anastomosis for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be inserted and removed through the anus, comprising in combination, an upper cup-shaped clamping member, a lower opposed cooperating cupshaped clamping member, each'of said clamping members being provided with inwardly extending opposed clamping flanges, a hollow body member, a tie rod extending through said hollow body member and said clamping members, one end of said tie rod extending beyond the hollow body member and manually operated means cooperating with said extending: end for drawing said clamps tightly together, substantially as and for the purposes set forth.
2. A clamp for recto-sigmoid anastomosi for temporarily retaining the inturned ends of both sections of a severed bowel and adapted to be member, the opposite end of said tie rod having 10 an external ball and socket connection with the upper clamping member, and manually operated means cooperating with said extending end for drawing said clamps tightly together, substantially as and for the purposes set forth.
THERON GROVER YEQMANS.
REFERENCES CITED The following references are of record in the file of this patent:
UNITED STATES PATENTS Name Date Bacon July 18, 1933 OTHER REFERENCES Ex parte Brinkerholf, vol. 24, Commissioners Manuscript Decisions, page 349.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US1918890 *||8 Aug 1932||18 Jul 1933||Bacon Joseph B||Surgical device|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US3048177 *||23 Jun 1959||7 Aug 1962||Timothy Takaro||Blood vessel coupling device|
|US3472231 *||20 Jun 1966||14 Oct 1969||Winner Forney D||Perfect circle hemorrhoidal excisor,stapler and excisor hemostatic dilator|
|US3771526 *||7 Feb 1972||13 Nov 1973||Rudie P||Anastomosis clamp|
|US4154241 *||29 Jul 1977||15 May 1979||Rudie Peter S||Anastomosis clamp|
|US4304236 *||10 Apr 1980||8 Dec 1981||United States Surgical Corporation||Stapling instrument having an anvil-carrying part of particular geometric shape|
|US4607637 *||22 Jul 1983||26 Aug 1986||Anders Berggren||Surgical instrument for performing anastomosis with the aid of ring-like fastening elements and the fastening elements for performing anastomosis|
|US4624257 *||21 Feb 1984||25 Nov 1986||Anders Berggren||Surgical instrument for performing anastomosis|
|US4917090 *||19 Jan 1988||17 Apr 1990||Unilink, Inc.||Method for performing an anastomosis|
|US5709335 *||31 Oct 1995||20 Jan 1998||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5732872 *||6 Feb 1996||31 Mar 1998||Heartport, Inc.||Surgical stapling instrument|
|US5817113 *||23 Jan 1997||6 Oct 1998||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US5881943 *||20 Nov 1997||16 Mar 1999||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US5947363 *||20 Mar 1998||7 Sep 1999||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5957363 *||19 Jun 1997||28 Sep 1999||Elf Atochem S.A.||Method of performing vascular anastomosis|
|US5976159 *||8 Feb 1996||2 Nov 1999||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6171321||18 May 1999||9 Jan 2001||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6176413||20 Jan 2000||23 Jan 2001||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6209773||7 Sep 1999||3 Apr 2001||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6280460||13 Feb 1998||28 Aug 2001||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6371965||8 Jan 2001||16 Apr 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6443965 *||8 Jan 2001||3 Sep 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6450390||8 Jan 2001||17 Sep 2002||Hearport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6451034||28 Sep 2001||17 Sep 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6461365||15 May 2001||8 Oct 2002||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6491704||26 Jul 2001||10 Dec 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6551334||14 Dec 2000||22 Apr 2003||Integrated Vascular Interventional Technologies, Lc||Externally directed anastomosis systems and externally positioned anastomosis fenestra cutting apparatus|
|US6569173 *||14 Dec 1999||27 May 2003||Integrated Vascular Interventional Technologies, L.C.||Compression plate anastomosis apparatus|
|US6588643||2 Feb 2001||8 Jul 2003||Hearport, Inc.||Surgical stapling instrument and method thereof|
|US6631837||28 Aug 2001||14 Oct 2003||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6659327||31 Jul 2002||9 Dec 2003||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6676678||20 Sep 2001||13 Jan 2004||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6709441||23 Apr 2001||23 Mar 2004||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6726694||14 Dec 2000||27 Apr 2004||Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc)||Intraluminally directed anvil apparatus and related methods and systems|
|US6743244||31 Oct 2001||1 Jun 2004||Integrated Vascular Interventional Technologies, L.C.||Soft anvil apparatus for cutting anastomosis fenestra|
|US6763993||20 May 2003||20 Jul 2004||Bolduc Lee R||Surgical stapling instrument and method thereof|
|US6899718||23 Apr 2004||31 May 2005||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US6962596||14 Mar 2003||8 Nov 2005||Bolduc Lee R||System for performing vascular anastomoses|
|US6966917||9 Nov 2000||22 Nov 2005||Innovation Interventional Technologies B.V.||Deformable connector for mechanically connecting hollow structures|
|US6984238||23 Apr 2004||10 Jan 2006||Gifford Iii Hanson S||Devices and methods for performing avascular anastomosis|
|US7018387||1 Apr 2003||28 Mar 2006||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7022127||1 Apr 2003||4 Apr 2006||Innovative Interventional Technologies Bv||Mechanical anastomosis system for hollow structures|
|US7112211||9 Jan 2003||26 Sep 2006||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US7122044||28 Apr 2004||17 Oct 2006||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US7160311||14 Dec 2000||9 Jan 2007||Integrated Vascular Interventional Technologies, L.C. (Ivit Lc)||Locking compression plate anastomosis apparatus|
|US7220268||12 Nov 2003||22 May 2007||Integrated Vascular Interventional Technologies, L.C. (Ivit Lc)||Methods for anastomosis of a graft vessel to a side of a receiving vessel|
|US7651510||12 Jan 2001||26 Jan 2010||Heartport, Inc.||System for performing vascular anastomoses|
|US7666198||22 Mar 2004||23 Feb 2010||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7763041||29 Jul 2003||27 Jul 2010||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US7901417||29 Oct 2007||8 Mar 2011||Vital Access Corporation||Systems for forming an anastomosis with an anvil and an apparatus having at least one guide|
|US7922734||29 Oct 2007||12 Apr 2011||Vital Access Corporation||Methods for forming an anastomosis with a vessel having everted tissue|
|US7935129||1 Mar 2004||3 May 2011||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US7981126||14 Dec 2000||19 Jul 2011||Vital Access Corporation||Locking compression plate anastomosis apparatus|
|US8034064||15 Mar 2006||11 Oct 2011||Vital Access Corporation||Methods for forming an anastomosis opening in a side of a blood vessel|
|US8066723||9 Nov 2001||29 Nov 2011||De Vries & Metman||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well as auxiliary devices|
|US8109949||29 Oct 2007||7 Feb 2012||Vital Access Corporation||Systems for forming an anastomosis|
|US8182498||4 Jun 2002||22 May 2012||Innovative International Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US8313013||6 Apr 2006||20 Nov 2012||Synovis Life Technologies, Inc.||Method and assembly for anastomosis|
|US8512361||23 Apr 2007||20 Aug 2013||Carponovum Ab||Device and a method for anastomosis|
|US8617190||28 Mar 2011||31 Dec 2013||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US8781604||1 Apr 2009||15 Jul 2014||Cardiac Pacemakers, Inc.||Method of implanting stimulation lead with biased curved section through the interatrial septum|
|US9155539 *||23 Apr 2007||13 Oct 2015||Carponovum Ab||Mounting tool and a method for a device for anastomosis|
|US9724099||15 Jul 2013||8 Aug 2017||Carponovum Ab||Device and method for anastomosis|
|US20010001826 *||12 Jan 2001||24 May 2001||Heartport, Inc.||System for performing vascular anastomoses|
|US20010023354 *||14 Dec 2000||20 Sep 2001||Blatter Duane D.||Locking compression plate apparatus|
|US20030055441 *||4 Jun 2002||20 Mar 2003||Suyker Wilhelmus Joseph Leonardus||Mechanical anastomosis system for hollow structures|
|US20030114867 *||17 Jul 2002||19 Jun 2003||Bolduc Lee R.||Surgical clips and methods for tissue approximation|
|US20030176878 *||11 Apr 2003||18 Sep 2003||Bolduc Lee R.||Devices and methods for performing vascular anastomosis|
|US20030191482 *||1 Apr 2003||9 Oct 2003||Suyker Wilhelmus Joseph Leonardus||Mechanical anastomosis system for hollow structures|
|US20030195534 *||1 Apr 2003||16 Oct 2003||Suyker Wilhelmus Joseph Leonardus||Mechanical anastomosis system for hollow structures|
|US20040073240 *||29 Jul 2003||15 Apr 2004||Bolduc Lee R.||Surgical clips and methods for tissue approximation|
|US20040092972 *||9 Nov 2001||13 May 2004||Leonardus Suyker Wilhelmus Joseph||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well a auxiliary devices|
|US20040097994 *||12 Nov 2003||20 May 2004||Blatter Duane D.||Staple and anvil anastomosis system|
|US20040167551 *||1 Mar 2004||26 Aug 2004||Gifford Hanson S.||Devices and methods for performing a vascular anastomosis|
|US20040186490 *||31 Mar 2004||23 Sep 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040199188 *||23 Apr 2004||7 Oct 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040200876 *||28 Apr 2004||14 Oct 2004||Bolduc Lee R.||Surgical stapling instrument and method thereof|
|US20040215221 *||22 Mar 2004||28 Oct 2004||Suyker Wilhelmus Joseph Leonar||Mechanical anastomosis system for hollow structures|
|US20040225306 *||17 Feb 2004||11 Nov 2004||Blatter Duane D.||Paired expandable anastomosis devices|
|US20050096675 *||29 Nov 2004||5 May 2005||Gifford Hanson S.Iii||Devices and methods for performing avascular anastomosis|
|US20050096676 *||29 Nov 2004||5 May 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050149077 *||16 Feb 2005||7 Jul 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050251164 *||4 Feb 2005||10 Nov 2005||Gifford Hanson S Iii||Devices and methods for performing avascular anastomosis|
|US20050288693 *||12 Aug 2005||29 Dec 2005||Suyker Wilhemus J L||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels|
|US20060167485 *||15 Mar 2006||27 Jul 2006||Blatter Duane D||Staple and anvil anastomosis system|
|US20070239180 *||6 Apr 2006||11 Oct 2007||Synovis Life Technologies, Inc.||Method and assembly for anastomosis|
|US20080051811 *||29 Oct 2007||28 Feb 2008||Integrated Vascular Interventional Technologies, L.C.||Systems for anastomosing an everted vessel with another vessel|
|US20080287972 *||29 Oct 2007||20 Nov 2008||Integrated Vascular Interventional Technologies, L.C.||Systems for anastomosing an everted vessel with another vessel|
|US20090105734 *||23 Apr 2007||23 Apr 2009||Anders Gronberg||Mounting tool and a method for a device for anastomosis|
|US20090138030 *||23 Apr 2007||28 May 2009||Anders Gronberg||Device and a method for anastomosis|
|US20090198297 *||1 Apr 2009||6 Aug 2009||Yongxing Zhang||Transeptal lead|
|US20110172686 *||28 Mar 2011||14 Jul 2011||Gifford Iii Hanson S||Device For Engaging Tissue Having a Preexisting Opening|
|DE1057729B *||24 Mar 1955||21 May 1959||Lameris Instr N V||Chirurgische Vorrichtung zum Verbinden zweier Darmteile|
|WO2001043644A1 *||14 Dec 2000||21 Jun 2001||Blatter Duane D||Compression plate anastomosis apparatus and related systems|
|WO2001043645A1 *||14 Dec 2000||21 Jun 2001||Blatter Duane D||Systems for intraluminally directed vascular anastomosis|
|U.S. Classification||606/153, 227/19|
|International Classification||A61B17/03, A61B17/11|