Patent GB-1418752-A (GB)
Title: Surgical splice plate
IPC: A61B17/88
Filed: 1973-03-07
Abstract: 1418752 Suturing instrument TECHNIBIOTICS Inc 7 March 1973 [31 March 1972] 11049/73 Heading A5R [Also in Divisions B4 and F2] A surgical splice plate 52, Fig. 5A, for locking two end portions of surgical suture wire together, comprises a number formed of deformable biologically inert material having at least one passage 56, 58 formed therethrough for receiving the suture wire, and being between about 4 to 8mm long. Suturing Instrument: A suturing instrument 10, Fig. 1, comprises a first means 12 adapted for releasably fastening one end of a suture thereto, a second means 14 for releasably fastening the other end of the suture thereto in spaced relationship with the first end and cooperating means on said first and second means 10, 12 for moving them relative to each other to adjust the tension in the suture wire. The said first and second means 10, 12 consist of L-shaped members coupled together by a rack 28 integrally formed or secured to a leg 18 of the member 12 and a pinion mounted on a leg 30 of the member 14. The pinion includes a gear 36 which is rotated by a spoked wheel 44. A rotatable detent wheel 46 is threadedly mounted in the leg 30 and has a lock washer so that rotation of the wheel 46 locks the members 12 and 14 relative to each other. The other leg 16 of the member 12 has a knurled wall 22 adjacent a recessed surface 20 on which a knurled wheel 24 is mounted off-centre and is rotatable about a pivot 26 using a spoke 24a so that the wheel 24 acts as a cam to close a gap 25 between the wall 22 and the wheel 24, thereby serving as the means for releasably fastening the suture. A similar suture fastening means is formed on the end of the other leg 32 of the member 14 such that the gap 25 and a corresponding gap 43 in the leg 32 are colinear. The obverse surfaces of the members 12, 14 are flat so that the instrument may lie on a patient's body. Splice Plate: A generally rectangular splice plate 52 stainless-steel is used to splice the ends 64a, 64b of a stainless-steel wire. The bores 56, 58 have a diameter, typically 1.1mm such that the suture can slide through them. Typical dimensions of the splice plate 52 are 5mm x 4 mm x 2.5 mm. The splice plate 52 may have a transverse bore through which a silk thread or a wire is threaded to tag the splice plate 52 and to help in retrieving it should it accidentally drop into a body cavity during use. In an alternative embodiment, a splice plate 52 has a suture (64), Fig. 7, (not shown) threaded through the bore 56, a surgical needle (80) on one end of the suture (64) and the other end folded back over about # inch, thereby maintaining the splice plate 52 on the wire (64). Crimping Tool: A tool 66, Fig. 6A, for crimping the splice plate 52 is formed as a pliars tool having identical jaws 68, each formed with an inwardly projecting surface 69 integrally formed with a bevelled projection 70. The maximum separation of the jaws 68 is fixed so that the maximum space 71 between the projecting surfaces 69 is less than the width of the splice plate 52 so that it will not fall through the crimping part of the jaws 68. Operation: In closing an incision 62 in the chest, the instrument 10 is laid on the chest and the suture (64) passed through previously formed holes on either side of the incision 62 and the ends 64a, 64b of the suture (64) passed through the holes 56, 56 in the splice plate 52 in opposite directions. The ends 64a, 64b are placed in the gaps 43, 25 respectively of the instrument 10 and the spokes 24a, 42a turned to grasp the ends 64a, 64b at the ends of the members 12, 14 which are moved to tighten the suture (64). The members 12, 14 are locked using the detent wheel 46 and the splice plate is grasped between the jaws 68 of the tool 66 and crimped at 74 to a depth of about .5mm, thereby splicing the ends 64a, 64b. The excess suture is sheared off flush with the end faces of the splice plate 52. This process is repeated along the incision until it is closed.