Abstract:
A pad configured to attach to a jaw of a surgical clamp includes an elongate body configured to extend over a surface of a jaw of a surgical clamp; and a flexible elongate attachment member connected to said body and configured for slidable insertion in a loading direction into an elongate cavity extending longitudinally through said jaw, wherein the elongate body has a first end and a second end, wherein the first end is configured to be inserted first into the cavity, and further comprising a direction indicator to identify which end is first inserted into said cavity. A surgical clamp utilizing the pad is also disclosed.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    The invention relates to surgical clamps and, more particularly, to an insert for a surgical clamp. 
         [0002]    Surgical clamps exist in many sizes with many different types of clamp shapes (e.g., curved jaws, straight jaws, etc.). In addition, many different types of jaw surfaces exist, as adapted to the specific function performed by the clamp. When a different function is to be performed, one must either use a different clamp, or in some circumstances replaceable pads may be added to the jaws. 
         [0003]    Many existing surgical clamps have jaws with hard clamping surfaces. Some replaceable pads for these clamps are designed to fit over the jaws to provide a softer or otherwise different clamping surface. However, these pads are often bulky, reducing the sleekness of the clamp and jaws. In addition, these pads are typically designed to fit over only straight jaws and are generally straight themselves. There is a need for other shapes such as curved or S-shaped. 
         [0004]    Other existing surgical clamps have curved, replaceable pads that are sleek, but these sleek pads are not soft and may be inappropriate for many applications. 
         [0005]    Still other existing surgical clamps have soft pads but these pads are not replaceable. This makes the pads harder to clean. Autoclaving may cause soft or delicate pads to deteriorate or wear out more quickly; with the result that the pad surfaces may become less soft or less delicate. As an alternative, the pad surfaces may be constructed to be less soft or less delicate in order to have a longer lifetime. 
         [0006]    Some surgical clamps (e.g., U.S. Pat. No. 3,503,398) have replaceable pads that are soft, but have other concerns. The pads are installed from the distal end, and may slip off from that direction. Decreasing the possibility of the pads slipping off may increase the effort necessary to install the pads. In addition, the portion of the pad that attaches to the clamp may not be flexible. 
         [0007]    Finally, some existing surgical clamps have replaceable pads that are not tightly secured to the jaws. With such clamps, the pads may move laterally after the vessel or tissue has been clamped. This lateral movement makes for an insecure clamp subject to wobbling, that may shear or tear the vessel or tissue being clamped. A solution to many of these issues is addressed in U.S. Pat. No. 6,228,104 to Fogarty et al. and related patents, all assigned to the assignee of the present application. 
         [0008]    In the above disclosures, situations arise where it is sometimes not as simple as desired to install a new pad or insert a clamp with desired capability. Further, there are additional functions which could be provided and/or enhanced with configuration of the insert. The present disclosure addresses these needs. 
       SUMMARY OF THE INVENTION 
       [0009]    In accordance with the invention, the foregoing issues have been addressed. According to the invention, a pad or insert for a surgical clamp is provided which has a direction indicator to readily indicate to a user which end is first inserted into the channel of the surgical clamp. Further, since the configuration of the pad according to the present invention allows for a front or distal loading insert, the distal end of the insert can be provided with structure to provide enhanced or additional functions, such as, preferably, rounded edges which can provide additional capability in dissection and increased visualization, for example. 
         [0010]    According to the invention, a pad is provided which is configured to attach to a jaw of a surgical clamp, and which comprises an elongate body configured to extend over a surface of a jaw of a surgical clamp; and a flexible elongate attachment member connected to said body and configured for slidable insertion in a loading direction into an elongate cavity extending longitudinally through said jaw, wherein the elongate body has a first end and a second end, wherein the first end is configured to be inserted first into the cavity, and further comprising a direction indicator at one of the first and second ends to identify which end is first inserted into said cavity. 
         [0011]    Further according to the invention, a surgical clamp is provided, which comprises a pair of elongate jaws connected together for movement toward each other, at least one of said pair of jaws, and having a distal end and a surface in opposition to the other of said jaws; and an elongate cavity adapted for slidably receiving a clamp pad, the cavity extending longitudinally within said at least one jaw, wherein and said clamp pad comprises an elongate body configured to extend over a surface of said at least one jaw, and a flexible elongate attachment member connected to said body and configured for slidable insertion in a loading direction into the cavity of said at least one jaw, wherein the elongate body has a first end and a second end, wherein the first end is configured to be inserted first into said cavity, and further comprising a direction indicator at one of the first and second ends to identify which end is first inserted into said cavity. 
         [0012]    Other objects and advantages of the present invention will be discussed further herein. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0013]    A detailed description of preferred embodiments of the invention follows, with reference to the attached drawings, wherein: 
           [0014]      FIG. 1  shows a surgical clamp with pads or inserts; 
           [0015]      FIGS. 2   a  and  2   b  show a prior art configuration of a pad for such a surgical clamp; 
           [0016]      FIGS. 3   a  and  3   b  show a pad in accordance with the present invention; 
           [0017]      FIG. 4  shows an end of a pad configured to provide additional function in dissection; and 
           [0018]      FIG. 5  is a cross sectional view of a pad according to the invention mounted in a jaw of a surgical instrument. 
       
    
    
     DETAILED DESCRIPTION 
       [0019]      FIG. 1  shows an exemplary surgical clamp  50  having jaws  66 ,  68  each including a pad  1 . The clamp  50  is shown in the process of clamping a vessel V. It may also be used to clamp organs or other bodily tissue. 
         [0020]    The clamp  50  can include finger and thumb rings  52 ,  54  for operating the clamp. A pawl  56  and ratchet teeth  58  can be provided to lock the clamp  50  when it is applied to vessel V. Handles  60 ,  62  are pivotally connected by pin  64 . Jaws  66  and  68  apply a clamping force to vessel V, as cushioned by pads  80 . 
         [0021]    Jaws  66 ,  68  can have longitudinal channels which run at least the length of the jaws which are to be cushioned by pad  80 . Pad  1  has an engaging structure which can be inserted into the channel of jaws  66 ,  68  to hold the pads securely in place for use in a surgical procedure while allowing the pad to be removed for changing the function of the clamp and/or sterilizing the clamp while disposing of a used pad. 
         [0022]      FIGS. 2   a  and  2   b  show pads  1  which are known in the art, and which have a rounded end  2  and a squared off end  3  as shown. When pad  1  is to be inserted into the channel of jaws  66 ,  68 , it is not immediately intuitive which end of the pad is first to be inserted. Further, inserting the wrong end first can result in an unstable clamp assembly, causing difficulty and potential delay during the surgical procedure. 
         [0023]    Turning to  FIGS. 3   a  and  3   b , a pad  80  according to the invention is further illustrated, in this instance installed to a jaw  66  of a surgical instrument. As shown, pad  80  as illustrated is configured as a front loading clamp. This means that the pad is inserted into the distal end  67  of the jaw  66  of the clamp. The structure for engaging pad  80  with jaw  66  is further described below with reference also to  FIG. 5 . 
         [0024]    Pad  80  has a cushion surface member  82  which is configured to provide the desired surface  84  for the surgical procedure being undertaken. Pad  80  also has an attachment member  86  ( FIG. 5 ), preferably downwardly depending from surface member  82 . Attachment member  86  preferably has a shape and size closely matching the shape and size of the channel  69  of the jaws so that attachment member  86  can be inserted into channel  69  to secure the pad relative to the jaw. Preferred materials and configurations of the attachment member and cushion surface member are discussed in the aforesaid U.S. Pat. No. 6,228,104, which is incorporated herein, in its entirety, by reference. 
         [0025]    Still referring to  FIG. 5 , the attachment member  86  of pad  80  typically has a squared structure  85  which, as shown, is desired to interact with an upward projection  71  of jaw member  66 . This engagement of features serves to hold pad  80  within jaw  66 , against inadvertent sliding of pad  80  out of jaw  66 . As also will be evident from a consideration of  FIG. 5 , the other end of attachment member  86  has a gradually curved surface  87 . This gradually curved surface helps to provide a smooth entry of pad  80  into channel  69 . It should also be appreciated, however, that in the event pad  80  is not oriented correctly for introduction into channel  69 , the squared end  85  will make such insertion much more difficult, and the rounded edge  87  would serve to facilitate unintended or undesired removal of pad  80  out of channel  69 . 
         [0026]    In order to facilitate rapid recognition of the proper insertion orientation of the pad, pad  80  according to the invention has one end  90  ( FIGS. 3   a ,  3   b ) with a direction indicator structure  92 . In the embodiment illustrated, structure  92  is provided in the form of slanted or angled end surfaces  94  which terminate in and define an end point  96  which is oriented in the direction of insertion. Thus, a person looking to install pad  80  into a jaw would intuitively know to start with the pointing end  90  entering the channel  69  first, and then continue with insertion into the channel in the same direction in which end point  96  indicates, until the attachment member  86  is fully engaged in channel  69 , preferably with structure  85  of pad  80  securely seated against structure  71  of jaw  66 . 
         [0027]    It should be appreciated that the direction indicator of the present invention is shown in  FIGS. 3   a  and  3   b  in the form of end surfaces defining a point or arrow, but numerous other configurations could be provided which could also convey the direction of orientation of pad  80  for proper insertion. Of course, the illustrated embodiment is considered to be particularly advantageous as it can be incorporated without major change in the overall shape or structure of existing pads, thereby maintaining functionality with existing clamps. 
         [0028]    Still referring to  FIGS. 3   a  and  3   b , the other end  100  of pad  80  according to the invention can be provided with additional structure to enhance functionality of the device. This is particularly true with a pad  80  and jaws  66 ,  68  configuration wherein the pad is front inserted, since such a configuration leaves end  100  as the distal facing end, where additional functionality is possible. 
         [0029]    According to the embodiment shown in  FIGS. 3   a  and  3   b , and further illustrated in  FIG. 4 , end  100  can have a series of rounded edges  102  which can help in using the distal end of the clamp for example in a dissection procedure. 
         [0030]    End  100  with rounded edges  102  is decidedly more pointed and wedge-shaped than the flat blunt end of known pads (See end  3 ,  FIGS. 2   a  and  2   b ). Further, the rounded edges increase visibility at the distal edge of the pad, which is a critical point for having maximum visibility for the surgeon. During a dissection process, the distal jaw end can frequently be used as a “wedge”, wherein the surgeon pushes the distal jaw end through tissue to separate it. When the end is more rounded, pointed or tapered, it can push more easily through tissue. In this regard, and as clearly shown in  FIGS. 3   a  and  3   b , when end  100  is also to have rounded edges to help define a dissection surface, the upper tapered surface  110  of end  100  is preferably defined and angled downwardly from surface  84  at a visible straight line  112 . This visible straight line  112  helps to distinguish end  100  with rounded edges from end  90  with a direction indicator defined thereon. 
         [0031]    It should also be appreciated that while the present invention is disclosed in terms of a front loading pad, that is, a pad which is inserted into the channel of a jaw through a distal end of the jaw, the pad configuration of the present invention is readily adaptable to rear loading jaws as well, wherein the pad is loaded into the channel of a jaw from a proximal surface of the jaw. In either configuration, end  90  of pad  80  is advantageously configured to indicate the proper direction of insertion. For rear-loading jaws, end  90  would have rounded surfaces on attachment member  86  to facilitate introduction into channel  69 , while attachment member  86  at the other end of pad  80  would have a squared off structure designed for interaction with channel  69  to hold pad  80  within jaw  66  as desired. It should also be appreciated that in this configuration, end  90  of pad  80  also serves as the distal end of the clamp, and the pointed structure defining the arrow or other type of direction indicator on the pad can also serve to enhance visibility and use of the distal end of the clamp for dissection purposes as indicated above. 
         [0032]    One or more embodiments of the present disclosure have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the disclosure. Accordingly, other embodiments are within the scope of the following claims.