Surgical cutting tool

A surgical cutting tool, such as a pair of scissors, is provided suction means which allows suction to be applied to the site of operation. In the case of scissors, the closure of the blades is used to reduce the opening of a recess formed alone one of the inboard edges of the blades, and to effectively move the opening through which suction is applied, along the blade so as to constantly juxtapose the point of cutting. Electrodes can be connected to the blades to permit the tool to also act as a cautery.

This invention relates to a surgical cutting tool. 
When using such a tool, for example surgical scissors, or a surgical 
scalpel, the surgeon normally needs to have at least one assistant who can 
carry out suctioning at the site where the surgical tool is being used, so 
as to remove blood and other body fluids which are released by the use of 
the tool and which would otherwise obscure the surgeon's field of view. 
Such an assistant may also carry out ancillary tasks, for example 
cauterization. 
However, the need to involve an assistant has a number of disadvantages. 
One of these is that the carrying out of activities by the assistant at 
the same site as that where the surgeon is working may impede the 
surgeon's activities, and thus render them more difficult, or at least 
make the operation more lengthy. Furthermore, if it were not necessary for 
the assistant to carry suctioning and cauterization, the assistant might 
be more usefully employed in other tasks to assist the surgeon, and under 
some circumstances no assistant might be required at all. 
According to the present invention there is provided a surgical cutting 
tool which is provided with means enabling suction to be applied to the 
site of operation of the tool. In two particularly preferred forms of the 
invention, the surgical tool is a pair of surgical scissors or a surgical 
scalpel. Optionally, the surgical tool may be provided with means for 
effecting cauterization. 
The surgical cutting tool according to the invention may be provided with 
means for clamping tissue on which the surgeon is operating.

Referring to the embodiment of the invention shown in FIGS. 1 to 3, this is 
in the form of pair of surgical scissors 10 having members 12 and 14 which 
are connected by a pivot 16 and which have finger openings 18 and 20 
respectively and blades 22 and 24 respectively. 
The blade 24 can be conventional in construction, but the blade 22 has a 
tip portion 26 which is modified for the purposes of the present 
invention. One form of modified tip is shown on an enlarged scale in FIG. 
2, and an alternative form of tip is shown on a similar scale in FIG. 3. 
The scissors are curved, as are the other embodiments of scissors 
described herein, and where any of the scissors are shown in plan view 
they are shown with the concave side facing the viewer. Alternatively, 
however, the invention, in its various aspects described herein, can be 
applied to scissors which are straight. 
A suction tube 28, which is preferably of metal, though it could be of some 
other material, runs up-one edge of the member 12. The tube may be an 
entity distinct from the member 12 and merely attached thereto, but it is 
preferably a tube which is implanted in the member 12. Such implantation 
could be achieved, for example, by forming a bore in the member 12 and 
inserting the tube lengthwise in it, or forming a recess in the back edge 
of the member 12 and inserting the tube into that. In the latter case the 
exposed portion of the tube might be covered, for example by solder 
material. A further possibility would be not to have a separate tube 28 as 
such and rely on a bore in the member 12 to achieve the same effect. For 
simplicity of description, such a bore is regarded in the ensuing 
description as itself constituting a tube. 
One end of the tube is attached to a flexible tube 3D which in turn is 
connected to a source of suction (not shown). The other end of the tube 
terminates in the tip 26, as is described below. The tube 28 hag a short 
branch 32 which communicates with atmosphere via an orifice 34 located in 
the finger opening 18. The orifice 34 allows a small amount of air to 
enter the tube 28, and thus, when it is open, reduces the suction effect 
applied at the tip 26. The surgeon can thus control the amount of applied 
suction by closing the orifice 34, or opening it wholly or partially, 
using that one of his fingers which is in the finger hole 18 (this being, 
under normal circumstances, the surgeon's thumb). 
In the embodiment of tip shown in FIG. 2, at least one aperture 36 (three 
such apertures are shown, though there could be a greater or lesser 
number) extends through the blade from one face to the other. The upstream 
end 38 of the suction tube 28 is positioned adjacent one edge of the 
largest of the three apertures. The tip shown in FIG. 2 provides a 
significant suction effect only when the scissors are at least partially 
closed, and control of the suction effect can therefore be achieved by 
opening and closing the scissors. Additional control, when the scissors 
are at least partially opened, can be achieved by opening and closing the 
orifice 34. 
In the embodiment of tip shown in FIG. 3, a part-conical depression is 
formed in that surface of the tip which faces towards the viewer as seen 
in FIGS. 1 and 3, i.e. the surface which faces away from the blade 24. 
Suction is here controlled solely by means of the orifice 34. 
Two further embodiments of the invention will now be described with 
reference to FIGS. 4, 5 and 6. In FIG. 4, a pair of surgical scissors is 
denoted as having a blade 101 and a blade 102, with the cutting surfaces 
of the blades being denoted below using a suffix C (1C is the cutting 
surface of blade 101 and 2C is the cutting surface of blade 102), and 
exterior surfaces of the blades (i.e those which face away from one 
another) being denoted by the suffix E (with 1E denoting the exterior 
surface of blade 101 and 2E denoting the exterior surface of blade 102). 
FIGS. 5a to 5d show one possible combination of these four surfaces. 
Surface 2C shown in FIG. 5a has a part-conical recess 50, the larger end 
of which communicates with the upstream end 38 of the suction tube 28. 
From this it will be understood that in this embodiment the suction tube 
is provided in the blade 102. This can be seen more clearly in FIG. 5c, 
which shows surface 2E. The surface 10 of blade 101 has a part-conical 
recess 52 which matches the recess 50 in surface 2C, except at the distal 
end, where a triangular aperture 54 extends through the blade and is thus 
visible also on surface 1E (see FIG. 5b). Suction is applied by the 
scissors to the operating site via the aperture 54 when the scissors are 
at least substantially closed. When they are open it is applied via the 
grooves 50 and 52. 
FIG. 6a to 6d show an alternative set of surfaces which can be used. In 
this embodiment, the suction tube 28 is provided on blade 101, with its 
upstream end 38 opening into surface 1C shown in FIG. 6d. This has the 
consequence that surface 2E is a regular blade surface, without any 
additional features resulting from the application of the present 
invention. 
FIGS. 7a to 7d show how a pair of surgical scissors may be provided with 
means for clamping the patient's tissue. For simplicity, FIGS. 7a to 7d do 
not show any means for providing the scissors with suction. It is to be 
understood, however, that such suction means could be provided in the 
structure shown in FIGS. 7a to 7d, though suction means need not provided. 
The scissors of FIGS. 7a to 7d are shown as having a pair of blades 201 and 
202, with the tip of blade 202 having a clamp member 204 which, as 
considered in the view of FIGS. 7c and 7d, overlaps the tip of the blade 
201. The blade 201 has, at its tip, a portion which is cut away to define 
a recess with which the clamp portion 204 can mate, so that when the 
scissors are closed the face 206 which is thus formed on the blade 201, 
and which is visible in FIG. 7d, bears against that face of clamp portion 
204 which, as viewed in FIG. 7d, is remote from the viewer. 
FIG. 8 shows the provision of a pair of surgical scissors with a cautery 
for effecting cauterization. One terminal (it is illustrated as being the 
positive terminal, but it could alternatively be the negative terminal) of 
an electrical supply is connected to a wire 304 which runs along one of 
the members 301 constituting the scissors (the other of the members is 
denoted by reference numeral 302) and terminates in a tip portion 306 
which is electrically isolated from the remainder of the member 301. It 
will be understood that the wire 304 is insulated from the member 301 
except where it is in electrical contact with the tip 306. The other wire 
308 is electrically connected directly to the member 301, and indirectly 
to the member 302 through the pivot 16. A bipolar cautery is thus formed. 
It a unipolar cautery were desired, one of the wires 304 and 308 would be 
omitted, and the other connection would be made to the patient's body. For 
ease of illustration FIG. 8 does not show any means for providing suction 
to the scissors. It is to be understood, however, that such suction means 
might be provided, though they need not be. It is also to be understood 
that the cautery arrangement of FIG. 8 could be combined with the clamp 
arrangement of FIGS. 7a to 7d, with or without a suction arrangement. 
FIGS. 9 and 10 illustrate an embodiment of the invention in the form of a 
scalpel. This is provided both with means for providing suction, with 
clamping means, and with a cautery. The scalpel comprises a handle 400 
having blade holder 401 which carries a blade 402. The blade has a cutting 
edge 404 and non-cutting edge 406. A suction tube 408 runs along the lower 
edge of the handle, and thence along one face of the blade 402, to 
terminate in a suction tip 410. The suction tip faces towards the adjacent 
face of the blade 402, as can be seen in FIG. 10. The downstream end of 
the tube 408 is connected to a flexible tube 410 which, in turn, is 
connected to a source of suction (not shown). 
A forceps tip 412 is positioned above, but normally spaced from, the 
non-cutting edge 406 of the blade 402. The forceps tip 412 is electrically 
isolated from the handle 400, on which it is mounted. The forceps tip is 
made of a flexible material, for example spring steel, and can thus be 
pressed resiliently towards the edge 406, to clamp tissue, for example a 
piece of tissue which is bleeding, between the forceps tip and the edge 
406. The forceps tip 412 is connected via a metallic extension 414 (which 
is electrically isolated from the handle 400) to one pole of an electrical 
supply (here shown as the positive pole). The handle 400, and hence the 
blade 402, is connected to the other pole, here shown as the negative 
pole. Accordingly, when bleeding tissue is clamped, as described above, it 
is subjected to a cauterizing action by the electrical current which 
passes through it, being clamped while cauterization is taking place. 
FIGS. 9 and 10 illustrate a bipolar cautery, but a unipolar cautery could 
be produced by omitting one or other of the electrical connections, and 
making that connection to the patient's body. 
FIG. 11 illustrates a modified scalpel blade, in which the tip thereof has 
a triangular piece 416 formed thereon. The piece 416 can be a separate 
item which is secured to the blade by suitable means, or it can be formed 
integrally therewith in the course of manufacture of the blade. The 
forceps tip preferably has a triangular piece formed at its distal end 
which is identical in shape and size to the triangular piece 416 formed on 
the blade. 
FIGS. 12 and 13 show a combined suction/cautery unit 500. This comprises a 
suction tube 502 made, for examples, from metal or a plastics material, to 
which is secured a forceps member 504 made of metal. The forceps member 
504 is resiliently flexible and can be urged towards the tube 502. One 
terminal 506 of an electrical power supply is electrically connected to 
the forceps member 504. The other pole is connected to the suction tube 
502 if the latter is of conductive material (in which case the tube and 
forceps member must be electrically isolated from one another) or, if the 
tube is not of conductive material, a conductive wire extends through the 
tube from the pole, to emerge at the tube exit 510. The other end of the 
tube 502 is connected to a suction source (not shown). 
A plurality of U-shaped guides 512 extend from the tube 502 in a direction 
away from the forceps member 504. The guides are aligned with one another, 
and define aligned openings 514 in which a surgical scalpel (not shown) 
can be received, preferably so as to be removable. In this way the surgeon 
has the option of using the scalpel alone, or combined with the suction 
and/or cautery unit, depending on the particular operation. Alternatively, 
the suction/cautery unit can be used without the scalpel. The 
suction/cautery unit is sufficiently simple that it should be economical 
for it to be manufactured, if desired, as a disposable item. 
The embodiment of FIGS. 14 to 17 is in the form of forceps 600 comprising 
first and second forceps arms 601 and 602 which are movable resiliently 
towards one another. The second forceps arm 602 has a recessed area 603 in 
which is mounted a blade holder 604. This is of a shape to be received in 
a slot 605 of a surgical blade 606. 
The forceps arm 601 is provided with a suction tube 607 formed or implanted 
therein, which can be connected at the proximal end to a source of reduced 
pressure and which terminates at the distal end in an open tip 608. 
The proximal end of the forceps carries an arm housing 610 made of plastics 
or other insulating material. (The housing 610 is drawn as though it were 
transparent, so that the structures within it are visible). The forceps 
arms 601 and 602 are held therein in fixed position and in electrical 
isolation from one another. Portions 601a and 602a are exposed for 
electrical connection to respective poles of a bipolar electrical power 
supply which enables the distal tips of the forceps members to act as a 
cautery. Alternatively, only one of the forceps arms would have an 
electrical connection made to it, for use in unipolar cauterisation. 
The embodiment of FIGS. 14 to 17 can thus be used as a pair of forceps and 
as a cutting tool, to which both suction and cauterisation can be applied. 
If in any particular situation it is desired not to use its cutting 
function the blade 606 can simply be omitted. 
It should be noted that various of the features described above may be used 
without a means for applying suction being provided. For example, the 
surgical cutting tool may be provided with the clamping and/or 
cauterisation features without suction, and a combined forceps/scalpel 
unit may be provided without suction. Also, the suction and clamping 
features may be combined in a tool which is not a cutting tool, i.e. as in 
FIGS. 12 and 13, but without the scalpel guide means.