Abstract:
A dual muscle clamp used in ocular surgery. Two pairs of spaced jaws are connected to a dual element handle. The handle elements are pivotally connected together to move the jaws between clamping and spread conditions to clamp and release tissue. Spring portions on the handle elements bias the jaws to the spread condition. A spring biased hook on one handle element interlinks with the edge of an opening on the other handle element to latch the jaws in the clamping condition. Opposed pointed teeth on the jaws interfit in the clamped condition and pierce the tissue clamped between the jaws. Semi-cylindrical portions on the handle elements cooperatively define a cylinder for comfortable gripping and careful and precise control with a single hand.

Description:
BACKGROUND OF THE INVENTION 
     This invention relates to a muscle clamp and particularly a muscle clamp used in ocular surgery to hold an eye during surgery to correct a strabismus condition. 
     Strabismus is caused by lack of coordination of movement of the eyes. Movement of the eyes is controlled by eye muscles. Sometimes these eye muscles do not work together and the eyes may be non-synchronized in their movements. If the condition is severe, surgery to either shorten or lengthen an eye muscle may be necessary. To perform this surgery, the eye muscle must be severed from the eye and then re-attached at a different point. After the muscle has been cut, the eye must be held so the eye muscle can be re-attached at a precise location. A muscle clamp is used to rotate and move the eye to a desired position and then hold the eye stationary in that position during the surgery. 
     Muscle clamps have been used in the past in ocular surgery. These muscle clamps typically consist of a single pair of tiny jaws that can be moved together to clamp the schlera tissue of an eyeball and can be separated to release the tissue. The problem with these typical muscle clamps is that a single clamp does not afford enough control and leverage to rotate and move an eye to a precise position and hold it there. During a suturing operation, it is necessary for the eye to be held in such a way that the surgeon can attach an entire edge of the muscle to the eyeball. Therefore, using the existing muscle clamps, two such muscle clamps are required, to be clamped to the schlera at spaced points. Each muscle clamp must be held in a separate hand. Therefore, since one of the surgeon&#39;s hands must handle the suture needle or its holder, he has only one free hand and an assistant is required. The assistant must use both hands, one for each muscle clamp. This means the assistant does not have a free hand for doing other helpful work. 
     Also, there may be times when the surgeon would prefer or would be required to handle the muscle clamp himself and if so, in the present state of the art, he must make both of his hands available. An advantage of the present invention is that it provides a dual jaw muscle clamp that clamps and holds the tissue at two spaced points and that can be held in one hand. 
     An object of the present invention is to provide a dual muscle clamp having two separate pairs of jaws that work together to clamp tissue, such as the schlera of an eye, at spaced points. Pursuant to this object, the muscle clamp of the present invention can be handled with one hand and the one hand can manipulate both of the pairs of clamping jaws simultaneously to precisely position the clamped eyeball. Accordingly, another object of the invention is to provide a dual muscle clamp for use in ocular surgery wherein the clamping can be accomplished with only one hand thereby enabling the surgeon to handle the muscle clamp himself while the surgeon&#39;s other hand is handling a suturing needle or a needle holder; or thereby requiring only one hand of an assistant to handle the clamping means. 
     Another problem with the prior art muscle clamps is that the handles by which they are held are not comfortable or are awkward or have only one or two ways in which they can be comfortably and conveniently held. These restrictions limit the maneuverability of the muscle clamp to precisely locate the muscle clamping jaws. An object of the present invention is to provide a dual muscle clamp that has a handle that is comfortable to hold and that enables precise maneuvering of the muscle clamp. Specifically, an object of the present invention is to provide a dual muscle clamp with a cylindrical handle, the handle being substantially similar in diameter to the diameter of a mechanical pencil, the length of the handle being such that a portion of it can be gripped within the thumb and first two fingers of the hand and the rearward portion of the handle will rest against the hypothenar space of the hand. 
     Another important object of the invention is to provide a dual muscle clamp with a handle that is substantially identical to the handle on other surgical instruments used by the surgeon in sequence in the course of a single surgical operation. 
     SUMMARY OF THE INVENTION 
     This invention is directed toward an ocular dual muscle clamp. The clamp has a handle that consists of separable halves joined together at a spring loaded end. Projecting forwardly of each half of the handle is a fork-like member. Each fork-like member defines one half of a dual jaw mechanism. Accordingly, both fork-like members cooperate to define two pairs of jaws that work in unison between closed and released positions. A pre-loaded spring urges the jaws toward a normal released position. Therefore, the jaws must be subjected to an external manual force to close them to a clamping position. There is a latching mechanism for releasably latching the jaws in the clamping position. 
     The handle of the dual muscle clamp is cylindrical. A forward end of the cylindrical handle has a gripping section that is knurled. Rearwardly of the gripping section, the handle has the aforesaid pre-loaded spring. The overall length of the handle including the gripping section and the pre-sprung end is such that, with the gripping section held within the thumb and first two fingers of the hand, the rearward end, or spring end, projects far enough to rest against the hypothenar space of the hand. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a top plan view of the dual muscle clamp; 
     FIG. 2 is a right side elevation view of the dual muscle clamp in open condition; 
     FIG. 3 is a bottom view of the dual muscle clamp showing the muscle clamp in closed clamping position; 
     FIG. 4 is a right side elevation view of the dual muscle clamp in clamping condition; 
     FIG. 5 is an enlarged partial side view of the jaws of the muscle clamp shown in open condition; 
     FIG. 6 is an enlarged left end view of the muscle clamp of FIG. 2; 
     FIG. 7 is a partial view of the forward portion of one side of the muscle clamp generally as viewed along the line 7--7 of FIG. 5; 
     FIG. 8 is a partial view of the forward portion of the other side of the muscle clamp generally as viewed along the line 8--8 of FIG. 5. 
     FIG. 9 is an enlarged partial side elevation view of the muscle clamp showing the muscle clamp initiating a clamping condition. 
     FIG. 10 is an enlarged partial elevation view of the muscle clamp squeezed further toward clamping condition. 
     FIG. 11 is an enlarged partial side elevation view of the muscle clamp in the fully closed clamping condition; and 
     FIG. 12 is an enlarged front elevation view of one pair of prongs, shown clamped together generally as viewed along the line 12--12 of FIG. 10. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
     The muscle clamp 20 of this invention is preferably formed primarily as two complementary body components 22 and 24 that cooperate to provide a clamping forward end 26, a central gripping section 28, and a rearward spring section 30. The two body components 22 and 24 are joined together at the back ends 32 and 34 thereof respectively. Forward of these back ends 32 and 34, the spring section 30 comprises two leaf springs 36 and 38. These back ends 32 and 34 are thickened and cooperate with the natural bias of the leaf springs 36 and 38 to hold the body components 22 and 24 in the spaced positions relative to one another as shown in FIG. 2. An external force can squeeze the body elements 22 and 24 together to the positions shown in FIG. 4, but when the external force is released, the springs 36 and 38 will return the body components 22 and 24 to the normal spread positions shown in FIG. 2. A latching mechanism 40 releasably locks the body components together in the clamping positions illustrated in FIG. 4 as will be further described. 
     The handle section 28 comprises a semi-cylinder 42 formed on the body component 22 and a complementary semi-cylinder 44 formed on the other body component 24. These semi-cylinders are about two inches long and about 3/8 inch in diameter when pressed together to define a cylinder. 
     The clamping forward end 26 comprises a pair of flattened arms 46 and 48 extending forwardly of the semi-cylindrical handle sections 42 and 44. These arms 46 and 48 lead to opposed bifurcated jaw elements 50 and 52, respectively. The jaw element 50 thus is formed with a pair of parallel prongs 54 and 56 projecting forwardly from the arm 46, and the jaw element 52 is formed with a pair of parallel prongs 58 and 60 projecting forwardly of the arm 48. 
     The prongs 54 and 56 have individual inwardly and slightly forwardly projecting sharp points 62 and 64. The prongs 58 and 60 have inwardly and forwardly projecting pairs of sharp points 66 and 68 (on the prong 58) and 70 and 72 (on the prong 60). The points 66 and 68 define a groove 74 between them that extends across the forward end of the prong 58, and there is a similar groove 76 between the points 70 and 72. Therefore, although the points 66, 68, 70 and 72 are slightly forward of the points 62 and 64, the teeth 62 and 64 are aligned to fit within the grooves 74 and 76 when the body components 22 and 24 are squeezed together. 
     Just rearward of the points that have just been described, there are flat seats 78 and 80 on the prongs 54 and 56, and oppositely facing seats 82 and 84 on the prongs 58 and 60. When the body components 22 and 24 are squeezed together, the seats 78 and 80 contact the seats 82 and 84, respectively, and establish the limits of intersection of the teeth 62 and 64 with the teeth 66, 68, 70 and 72 (see FIG. 11). 
     The latching mechanism 40 comprises a hook 86 secured to the inner side of one of the body component 22 and an opening 88 through the other body component large enough to receive the hook 86 through it. The hook has a cam face 90 and a seat 92. The opening 88 has an actuating edge 94 (See FIG. 2). The hook 86 is spring biased to the position shown in FIG. 2 at which the cam face 90 is opposite the edge 94 of the opening 88. Therefore, to latch the muscle clamp in clamping condition, the body components 22 and 24 are squeezed toward one another at which time the cam face 90 contacts the edge 94 of the opening 88. This biases the hook 86 forwardly until, as the body components 22 and 24 are squeezed further together, the face 90 passes the edge 94 and the hook 86 snaps to the right (as viewed in FIGS. 2 and 4) pushing the seat 92 past the edge 94 into contact with the arm 48. This puts the mechanism 40 in clamping condition, holding the body components 22 and 24 in the clamped positions shown in FIG. 4. To release the clamping mechanism 40, the cam face 90 is pushed manually forward, by a thumb or finger, until the face 92 is forward of the edge 94. Then, the natural bias of the leaf springs 36 and 38 spreads the body components 22 and 24 back to the positions shown in FIG. 2. 
     This muscle clamp is preferably made of stainless steel. It weighs slightly less than one ounce. Its length from the forward end of the handle section 28 to the rearward end of the spring section 30 is preferably about 31/4 inches, enough to allow the cylindrical handle section 28 to be held between the thumb and fingers of a hand with the rear portion of the spring section 30 resting on the hypothenar space of the hand. 
     In use, the muscle clamp 20 is typically held with the gripping section between the thumb and one or two fingers. An eye E, as diagramatically illustrated in FIG. 3, is to be clamped and held. Typically, the schlera of the eye is clamped on opposite sides of the area from which the surgeon has just severed an eye muscle. Once clamped, the eye is moved and held in the exact position required to enable re-attaching the muscle to the schlera at the new location. 
     When the forward ends of the prongs 54, 56, 58 and 60 are touching or close to touching the schlera on opposite sides of the specific area to be clamped, squeezing pressure is applied to the gripping sections 42 and 44. At the desired spots, the points 62 and 64 on one side and the points 66, 68, 70 and 72 on the other side pierce the schlera. This condition is illustrated in FIG. 9. Further squeezing of the gripping sections 42 and 44 brings the faces 78 and 80 into initial contact with the faces 82 and 84, respectively. At the same time, the teeth 62 and 64 will have slid into the spaces 74 and 76, as indicated in FIG. 12, but will have reached the limits of their travel because of the initial contact between the faces 78, 80 and 82, 84. Further squeezing of the gripping sections 42 and 44 causes the face 92 of the hook 86 to clear the opening 88, and the hook 86 snaps rearwardly to latch the body elements 22 and 24 together. Now, the faces 78 and 80 may be in full contact with the faces 82 and 84, but their initial contact will have prevented the points from moving any closer together. 
     All of the foregoing clamping action will have been accomplished with just one hand holding and controlling the dual muscle clamp 20, and will have taken place rapidly once the area to be clamped is specifically located. Now the surgeon, with one hand holding the handle section 28, can rotate and move the eye E to precisely the location and orientation he wants. Since the muscle clamp 20 clamps the eye E at two spaced locations, movements of the eye E can be controlled accurately by the muscle clamp 20. 
     When clamping is no longer needed, the latching mechanism 40 is released in the manner previously described and the body components 22 and 24 are allowed to separate under the force of the spring section 30. The points 62 and 64 and 66, 68, 70 and 72 release the schlera, and therefore the eye is released. 
     This dual muscle clamp fulfills the need, objects and advantages set forth. While the preferred embodiment has been described heretofore, this invention encompasses all modifications, variations, and uses as may be covered by the following claims.