Patent GB-935490-A (GB)
Title: An instrument for suturing blood vessels and nerves
Inventor: KUKUSHKIN LEONID IVANOV
IPC: A61B17/115
Filed: 1959-09-15
Abstract: 935,490. Suturing appliances. RESEARCH INSTITUTE OF EXPERIMENTAL SURGICAL APPARATUS & INSTRUMENTS. Sept. 15, 1959, No. 31376/59. Class 81 (2). A device for suturing blood vessels and nerves with staples comprises split annular staple anvils SA, each of which can be placed around the end of an organ to be sutured, and split annular staple holders SH, each of which can be held to co-operate with one of the staple anvils, at least one staple holder and one staple anvil having flanges on to which ends of blood vessels can be folded as cuffs and at least one staple holder and one staple anvil being adapted to form bulges on ends of nerves to be sutured, two holders B1, B2 and B3, B4 for holding one staple anvil and a co-operating staple holder respectively and means for forcing staples ST from the staple holder against the anvil. Each annular staple holder (Fig. 11) is in two halves, each half having staple slots SS and a half staple punch SP with fingers for ejecting the staples. In use the two halves of the staple holder are held together around a blood vessel or nerve end between jaws SE (Fig. 4) of the pivotal arms B1, B2 of a holder, the arms then being secured together. Each arm of the holder supports a lever OL having operating portions extending outwardly from the holder and bent ends LE which engage the staple punch. Staples are ejected by the punch by rocking the operating portions of the levers about an axis parallel to the arms B1, B2. The staple anvil, which has recesses SR for bending staples ejected from the staple holder, is similarly held between the jaws of a similar holder, the staple holder and anvil holders being secured together by pins so that the staple holder and anvil are coaxially arranged. A rod (not shown) slidably fixed to one holder has cam grooves fitting over inclined ridges on the other holder so that, on sliding the rod, the distance between the holders for the staple holder and anvil may be adjusted. Haemostatic HC clamps having jaws CJ or nerve clamps NC are mounted on each of the holders for clamping the parts to be sutured adjacent the staple holder and anvil respectively. The jaws of each haemostatic clamp are carried by strips MS, one of which is slidable, under pressure of a spring LS, relative to the other, to close the jaws and is secured by a screw AS. For making an end-to-end suture between blood vessels the staple holder and anvil are secured respectively around the ends of the parts to be sutured, the cut ends being folded as cuffs over the outlets for the staples and the staplebending recesses, respectively. For making an end-to-end suture between nerve ends, the nerve ends extend through the staple holder and anvil, respectively, which hold them in abutting relation for suturing, and also extend through bushings BU (Fig. 22) which may be telescoped into the staple holder and the anvil by pivotal movement on the staple holder and anvil holders of the two nerve clamps NC towards one another, thus producing, on the cut ends of the nerves, bulges which are sutured together. For making an end-to-side suture between blood vessels, the appropriate staple anvil SA (Fig. 25) is so shaped that it extends through the staple holder into an aperture in the other blood vessel to which the cut end of the blood vessel around which the anvil is secured is to be sutured, one of the haemostatic clamps HC<SP>1</SP> having two sets of jaws for clamping the other blood vessel on each side of the aperture.