Surgical attachment device

Apparatus for securing one or more suction tubes, hoses, electrical and/or endoscopic cables, and intravenous and cardiovascular bypass tubing during an operation. The apparatus is a surgical attachment device that comprises a member (preferably molded plastic) having at least one opening adjacent a first surface thereof. A first portion of each opening is designed to slidably secure the tubes, hoses or cables. A second portion of each opening immediately adjacent the first surface is smaller than the dimension of the first portion. The first portion of each opening tapers from a narrow dimension at the center of the member to a wide dimension at opposite ends of the member. Each opening has a plurality of inwardly projecting tapered ribs disposed around its internal periphery that taper from their narrowest dimension at the center of the opening to their widest dimension at the ends of each opening. The inwardmost edges of the plurality of tapered ribs have a dimension nominally equal to or narrower than the narrowest dimension of the tapered opening. The tapered ribs assist in securing the tubes, hoses or cables in the opening and prevent unwanted sliding thereof. The inwardmost edges of the ribs contact the tubes, hoses or cables when they is inserted into the opening. One pair of ribs or projections are larger than the others and are initially encountered when a hose or tube is pressed into the first portion of the opening. This configuration secures the various hoses and tubes, and the like, within the second portion of the opening and prevents their inadvertent pullout. An adhesive layer is disposed on a second external surface of the member for securing it to a surgical drape during an operation. The surgical attachment device may be flexible or deformable between the first and second portions of each opening to permit passage of nonflexible tubes, hoses or cables through the second portion of the opening. This may be achieved by adding additional lower slots separated from selected openings by hinge areas that provide for easy flexing of the member at the openings to permit insertion of the tubes, hose, or cables therein. The flexible portion comprises one or more living hinge areas that flex to open each of the openings.

BACKGROUND 
The present invention relates generally to medical equipment, and more 
particularly, to a surgical attachment device that is used to secure 
tubes, wires, hoses, electrical cables, video cables and fiber optic 
cables during an operation. 
During surgical operations, it is customary for surgeons and other 
operating room personnel to employ suction tubes to remove blood, tissue 
and other cellular debris from a patient that is undergoing an operation, 
and air-driven pneumatic tools that are driven by an air source(s) coupled 
to the tools by way of pneumatic hoses. Furthermore, it is customary to 
use electrosurgical instruments that are used as cutting and coagulation 
tools during surgery. These electrosurgical instruments are connected to 
electrical equipment by way of electrical cables. Unipolar electrosurgical 
instruments transmit current through the patient to a grounding pad, while 
bipolar electrosurgical instruments transmit current between the two heads 
of bipolar forceps. The electrosurgical instruments, pneumatic tools, and 
cables are used in almost all surgeries. More recently, endoscopic surgery 
has proliferated. These surgeries require fiber optic light cables and 
video camera cables passing to and from the operative field, respectively. 
During surgery, it is common practice to store the electrosurgical 
instruments and tools in a self-adherent plastic pocket of a drape that is 
disposed over the patient when they are not in use. This also provides 
easy access for the surgeon. The cables and hoses that connect the 
electrosurgical instruments and tools to their electrical equipment, air 
sources and endoscopic equipment are loosely gathered together adjacent an 
extremity of the patient and are secured by wrapping a portion of the 
drape around the cables and then holding them in place using a surgical 
clamp. In a similar fashion, the suction tubes are also routed and clamped 
in place, typically by the same type of surgical clamp. As should be clear 
from this typical operating room scenario, the cables are not very well 
controlled and in many instances interfere with the operation, or may 
become dislodged or contaminated. 
Accordingly, and in order to overcome the limitations of conventional 
operating room practices, it is an objective of the present invention to 
provide for a surgical attachment device that is used to secure tubes, 
wires, hoses, electrical cables, video cables and fiber optic cables 
during an operation. 
SUMMARY OF THE INVENTION 
In order to meet the above and other objectives, the present invention is a 
surgical attachment device for securing one or more cylindrically shaped 
members, including tubes and/or cables, such as suction tubes, hoses, 
electrical cables, video cables and fiber optic cables during an 
operation. The surgical attachment device comprises a member, that is 
preferably comprised of molded plastic, having at least one opening or 
groove formed therein adjacent a first surface thereof. A first portion of 
each opening is designed to slidably secure a particular cylindrically 
shaped member, such as a suction tube, hose, or unipolar, bipolar, or 
endoscopic cable, for example. A second portion of each opening 
immediately adjacent the first surface is dimensioned to be slightly 
smaller than the dimension of the first portion of the opening. The first 
portion of each opening tapers from a narrow dimension adjacent the center 
of the member to a wide dimension adjacent opposite ends of the member. 
Each opening has a plurality of inwardly projecting tapered ribs disposed 
around its internal periphery that taper from their narrowest dimension 
adjacent the center of the opening to their widest dimension at the ends 
of each opening. The inwardmost edges of the plurality of tapered ribs 
have a dimension substantially equal to or narrower than the narrowest 
dimension of the tapered opening. The plurality of tapered ribs assist in 
securing the cylindrically shaped member in the opening and prevent 
unwanted sliding thereof. The inwardmost edges of the ribs contact the 
cylindrically shaped member when it is inserted into the opening. A first 
set of ribs, or projections, disposed adjacent the interface between the 
first and second portions of the opening are larger than the others and 
prevent inadvertent pull-out of the various tubes, hoses, wires and cables 
from the opening. 
An adhesive layer is disposed on a second external surface of the member so 
that it may be secured to a surgical drape during an operation. The 
adhesive layer may be affixed or otherwise coated onto the second surface 
of the member and a backing layer may be disposed thereon. The backing 
layer covers the adhesive layer prior to use, and is removed to expose the 
adhesive layer and secure the surgical attachment device to the drape. 
The surgical attachment device may comprise a member that is flexible or 
deformable between the first and second portions of each opening to permit 
passage of noncompressible or fragile cylindrically shaped members through 
the second portion of the opening into the first portion thereof. This may 
be achieved by modifying the surgical attachment device to include 
additional lower slots separated from selected openings by hinge areas 
that provide for easy flexing of the member at the openings to permit 
insertion of the tubes, hose, or cables therein. The flexible portion of 
the member comprises one or more living hinge areas that flex to open each 
opening.

DETAILED DESCRIPTION 
Referring to the drawing figures, FIG. 1 shows a typical operating room 
scenario employing surgical attachment devices 10 in accordance with the 
principles of the present invention. FIG. 1 shows an operating room table 
18 on which is disposed a surgical drape 17 the is used to cover a patient 
(not shown) during an operation. The drape has an opening 17a therein that 
exposes an area of the patient that is to be operated on. Self-adhering 
plastic pockets 16 are attached to the drape 17 in which surgical 
instruments 13 may be stored when not in use. Typical surgical instruments 
13 include electrosurgical instruments 13 used for cutting and coagulation 
of tissues, endoscopic instruments 13 used for minimally invasive surgery 
in various body cavities, or pneumatic air-driven instruments 13 of all 
types, intravenous lines and cardiovascular bypass tubes 11. Flexible 
intravenous (I-V) tubes 11 are run from I-V solution bags 14b to the 
patient. A fiber optic light source cable and video cable 12 may be 
coupled between a light source and video camera 14c and optical 
instruments 13 that are used to illuminate and view the operative field, 
for example. 
The surgical instruments 13 are connected to electrical equipment 14 
(controller 14) in a conventional manner by means of unipolar and bipolar 
electrical cables 12 for the cauterizing instruments 13, endoscopic cables 
12 for the endoscopic instruments 13, and hoses 12a for pneumatic 
air-driven instruments 13. In addition, suction tubes 11 are coupled to a 
vacuum pump 15 and are used to remove blood, tissue and other cellular 
debris from the patient during the operation. Intravenous tubes 11 passes 
to the patient and cardiovascular bypass tubes 11 pass to and from a 
cardiovascular bypass pump 14a. A compressed air pump 15a may be coupled 
to a compressed air tube 11. 
The surgical attachment devices 10 of the present invention is used to 
secure the respective suction tubes 11 and electrical or endoscopic cables 
12, and the like, in an orderly manner during the operation. FIG. 2 is an 
end view of a first embodiment of the surgical attachment device 10a in 
accordance with the present invention. FIG. 3 is a cross sectional top 
view of the surgical attachment device 10a of FIG. 2 taken along the lines 
3--3. 
The first embodiment of the surgical attachment device 10a is comprised of 
a member 21 that may be a block of plastic, such as polyethylene or 
polystyrene, for example. The member 21 is a single piece structure that 
has an outer body 23 with a plurality of inwardly extending supporting 
ribs 24 that mate with an opening 22, or groove 22. The opening 22 or 
groove 22 is formed adjacent a first surface 29a of the member 21. The 
opening 22 may have flared ends 29. 
The opening 22 has a first portion 22a that typically has a circular cross 
section, and that is sized to secure a particular suction tube 11 or cable 
12 therein. A second portion 25 of the opening 22 comprises a slot 22b 
that has a dimension that is smaller than the dimension of the first 
portion 22a. It is to be understood that while the embodiment shown in 
FIG. 2 illustrates an opening or grooves 22 for use with suction tubes 11 
and cables 12, the sizing and number of openings or grooves 22 may be 
altered to meet particular requirement for different sized tubes 11 and 
cables 12. Consequently, the embodiment of the surgical attachment device 
10a shown in FIG. 2 should not be taken as limiting. 
The surgical attachment device 10a may have a length of about 1.57 inches, 
a width of about 1.95 inches, and a thickness of about 1.00 inches, for 
example. With respect to the opening or groove 22 shown in FIG. 2, it may 
be sized for use with the pneumatic tube 11, for example, and the first or 
circular portion 22a may have a diameter of about 0.56 inches, for 
example. This diameter is outwardly tapered from the center of the 
flexible member 21 toward each end. This permits removal of the member 21 
from its mold. The width dimension of the slot 22b may be on the order of 
0.36 inches in width, for example. 
The opening 22 has a plurality of tapered ribs 27 that may be triangular, 
for example, disposed along the internal periphery of the opening 22 that 
taper from their widest dimension at respective ends of the opening 22 to 
their narrowest dimension adjacent the center of the opening 22. The 
plurality of tapered ribs 27 assist in securing the tube 11 or cable 12 in 
the groove 22 and prevent unwanted sliding and inadvertent thereof. The 
tapered ribs 27 have a diameter adjacent the respective ends of the 
opening 22 that is substantially equal to or narrower than the diameter of 
the opening 22 at its center (at the location where the tapered ribs 27 
start to taper outward). A pair of projections 26 are present at the 
interface between the first and second portions 22a, 22b of the opening 
22. The pair of projections 26 are larger than the other ribs 27 and serve 
to prevent inadvertent pull-out of the hose, cable tube or tube 12 from 
the opening 22. A surgical attachment device 10a that includes these 
projections 26 may be used to secure a pneumatic hose, for example. 
An adhesive layer 28 is disposed on a second surface 29b of the member 21 
so that it may be secured to the surgical drape 17 during an operation. 
The adhesive layer 28 may be comprised of any suitable adhesive, such as 
those commonly used in medical applications. The adhesive layer 28 is 
affixed or otherwise coated onto the second surface 29b of the flexible 
member 21 and a backing layer (not shown) such as is provided by 
wax-coated paper, for example, may be applied to the exposed surface of 
the adhesive layer 28. The backing layer is used to cover the adhesive 
layer 28 prior to use, and is peeled off to expose the adhesive layer 28, 
whereafter the surgical attachment device 10 is then secured to the drape 
17. 
Referring to FIG. 4, it is an end view of a second embodiment of the 
surgical attachment device 10b, while FIG. 5 is a cross sectional top view 
of the device 10b of FIG. 4 taken along the lines 5--5. In the surgical 
attachment device 10b shown in FIGS. 4 and 5, there are first and second 
openings 22, 31, and the first opening 22 is smaller than the opening 22 
of the device 10b of FIG. 2. The diameter of a first portion 22a of the 
first opening 22 may be on the order of 0.34 inches, for example, and is 
designed to secure a fiber optic light source cable and video cable 12, 
for example. The slot 22b of the opening 22 is smaller than the diameter 
of the first portion 22a of the opening 22 and may be on the order of 0.29 
inches, for example. The second opening 31 is formed in the member 21 and 
is sized for use with a video cable 12 and its first portion 31 a may have 
a diameter of about 0.18 inches, for example. A slot 31b of the second 
opening 31 may be on the order of 0.17 inches, for example. 
In the second embodiment of the surgical attachment device 10b, the member 
21 is flexible, and the first and second openings 22, 31 are made to open 
and close, by means of respective slots 33a, 33b that create two living 
hinges 34. The slots 33a, 33b separate two outer sections of the member 21 
from a central section and are caused to flex by squeezing them toward the 
central section, thus opening the first and second openings 22, 31. The 
living hinges 34 return to their original positions after deformation of 
the openings 22, 31. Again, in the second embodiment of the surgical 
attachment device 10b, tubes 11 and cables 12, and the like, are secured 
in the first and second openings 22, 31 by the use of the ribs 27 that 
project into the respective openings 22, 31 and make contact with the 
respective tube 11 or cable 12. 
Referring to FIGS. 6 and 7, they show first and second ends of a third 
embodiment of the surgical attachment device 10c. FIG. 8 is a cross 
sectional top view of the device 10c of FIGS. 6 and 7 taken along the 
lines 8--8. The surgical attachment device 10c is designed to have three 
substantially configured openings 22. These openings 22 are designed to 
hold flexible intravenous (I-V) tubes 11 that is connected to a 
commonly-used in-line medication port (not shown) used to add medication 
to continuously running IV fluid, for example. Each opening 22 has a first 
portion 35a that includes the plurality of triangular ribs 27 that are 
used to secure the tubing. The most superficial ribs 27 (or projections 
26) are larger than the rest of the ribs 27 and serve to restrict 
inadvertent pull-out of the tubing from the opening 22. A second portion 
35b of the opening 22 is configured to mate with and secure the I-V port. 
The second portion 35b of the opening 22 has a taper 36 that tapers from 
the outer edge of the second portion 35b of the opening 22 toward the 
center of the member 21 and generally matches a tapered portion of the IV 
port. 
Referring to FIGS. 9 and 10, they show end and cross sectional top views of 
a fourth embodiment of the surgical attachment device 10d. The fourth 
embodiment of the surgical attachment device 10d comprises three different 
sized openings 22, 31, 37. The second opening 31 is smaller than the first 
opening 22, and the third opening 37 is smaller than the second opening 
31. The diameter of the first opening 22 may be on the order of 0.34 
inches, for example, and is designed to secure suction tubing or cell 
saver suction tubing, for example. The diameter of the second opening 31 
may be on the order of 0.12 inches, for example, and is designed to secure 
a unipolar electrical cable 12, for example. The diameter of the third 
opening 37 may be on the order of 0.07 inches, for example, and is 
designed to secure a bipolar electrical cable 12, for example. The 
discussion relating to FIGS. 2, 3, 4 and 5 describe the attributes of the 
structure of the fourth embodiment of the surgical attachment device 10d, 
and additional description is not believed to be necessary in 
understanding the invention. 
The fourth embodiment of the surgical attachment device 10b includes living 
hinges 34, and the openings 31, 37 in are caused to flex by squeezing two 
outer sections of the member 21 toward a middle section thereof, thus 
opening the openings 31, 37. In the fourth embodiment of the surgical 
attachment device 10b, tubes 11 and cables 12, and the like, are secured 
in the three openings 22, 31, 37 by the use of the ribs 27 that project 
minimally into the respective openings 22, 31, 37 and make contact with 
the respective tube 11 or cable 12. 
Due to generally coincident sizes of the openings 22, 31, 37 and ribs 27 
and the cables 12, hose, or robe 11 passing through them, a certain amount 
of friction is produced. The length of the respective openings 22, 31, 37, 
in part, determines the friction or drag that is encountered by the tube 
11 or cables 12 passing through them, when they are pulled or pushed 
through their respective openings 22, 31, 37. The length of the openings 
22, 31, 37, the relative dimensions of the openings 22, 31, 37, and ribs 
27, and the tube 11, hose, or cables 12 passing through them, are 
proportioned to provide optimal control of the tube 11 and cables 12. The 
ribs 27 are sufficient to prevent easy pull-out of the tubes 11 or cables 
12, while easily allowing insertion of the tube 11 or cables 12 into their 
respective openings 22, 31, 37. The larger ribs 27 or projections 26 that 
are strategically placed, usually at the entrance to the opening 22a, 
prevent inadvertent pull-out of the tube hose, wires and cables. 
FIG. 11 is an end view of a fifth embodiment of the present surgical 
attachment device 10e. This embodiment of the device 10e is a 
cardiovascular manifold that secures multiple tubes 11 and cables 12 that 
are used in cardiovascular operations, and the like. Each of the openings 
22 of the member 21 is designed as described above and secures a specific 
type of tube 11 or cable 12 therein. 
It is to be understood that the number of openings 22 disclosed with 
reference to each of the embodiments of the device 10 may be only one 
opening 22 or may be a plurality of openings 22 as shown in the various 
disclosed embodiments. Furthermore, different variations of the disclosed 
embodiments may be constructed using the principles of the present 
invention to accommodate specific surgical situations. 
In operation, in the embodiments of the surgical attachment device 10 
having living hinges 34, the tubes 11 or cables 12 are inserted into the 
openings 22, 31, 37 by transiently deforming the narrower portion of each 
groove 22, 23, 24, deforming the tube 11, hose, or cable 12, or both, and 
pushing the tube 11, hose, or cable 12 into the openings 22, 31, 37. In 
the embodiments of the surgical attachment device 10 having openings 
without living hinges 34, the tubes 11 or cables 12 are inserted into the 
openings 22 by deforming the tube 11, hose, or cable 12, and pushing the 
tube 11, hose, or cable 12 into the openings 22. 
Once the tube 11 or cable 12 is within its openings 22, 31, 37, the 
narrower portion of the openings 22, 31, 37 restricts unintended pull-out 
of the tube 11 or cables 12 from the attachment device 10. The length of 
the openings 22, 31, 37 and the dimensions of the tubes, cables, or hoses 
11, 12 relative to their openings 22, 31, 37 and ribs 27 determines the 
drag coefficient as they are pulled therethrough. These proportions are 
designed to provide for intentional sliding through the openings 22, 31, 
37, and also provide sufficient friction to resist most unwanted motion. 
The surgical attachment devices 10 are preferably manufactured by molding 
the member 21 to form the openings 22, 31, 37 and living hinges 34. The 
adhesive layer 28 is then coated or disposed on the second surface 29b of 
the flexible member 21 and the backing layer is applied to the exposed 
surface of the adhesive layer 28. This assembly is then packaged and the 
packaged assembly is sterilized by means of gamma radiation sterilization 
procedures commonly used in the medical industry. During an operation, the 
sterilized package is opened, the surgical attachment devices 10 is 
removed from the package. The backing layer is removed from the surgical 
attachment devices 10 to expose the adhesive layer 28, and the surgical 
attachment device 10 is secured to the surgical drape 17, for example, in 
an appropriated place relative to the location of the surgery. The suction 
tube 11, hoses, and cables 12 are then inserted into the respective 
openings 22, 31, 37 to hold them in place during the surgery. 
Thus there has been described a new and improved surgical attachment 
devices that may used to secure tubes, wires, hoses, electrical cables, 
video cables and fiber optic cables during an operation. It is to be 
understood that the above-described embodiment is merely illustrative of 
some of the many specific embodiments which represent applications of the 
principles of the present invention. Clearly, numerous and other 
arrangements can be readily devised by those skilled in the art without 
departing from the scope of the invention.