Abstract:
A surgical clamp includes a first member having a first handle, a first jaw, and a first pivot point intermediate the first handle and the first jaw; a second handle member having a second handle, a second jaw, and a second pivot point intermediate the second handle and the second jaw. The second handle member is pivotally connected to the first handle member at their respective pivot points. The first jaw and the second jaw cooperate to define a clamping element and a cutting element.

Description:
CROSS-REFERENCE TO RELATED APPLICATION  
       [0001]     None.  
       STATEMENT REGARDING FEDERALLY-SPONSORED RESEARCH OR DEVELOPMENT  
       [0002]     None.  
       BACKGROUND OF THE INVENTION  
       [0003]     The present invention relates to a surgical clamp and cutting device. More particularly, the present invention relates to a surgical clamp and cutting device for use in connection with a wire sternotomy suture.  
         [0004]     A sternotomy is an incision into or through the sternum and is typically part of the open heart surgery procedure. During such open heart surgery, the sternum is split to provide access to the inside of the patient&#39;s chest. After the surgery, the patient&#39;s sternum must be sutured back together. Typically, the sternum is sutured back together by passing a needle attached to a stainless steel wire through either side of the sternum, drawing the opposed sides of the sternum together so that the sternum may heal properly. In such a suturing procedure, it is typical to use a needle to lace the stainless steel wire through the sternum such that when the stainless steel wire is fully laced, the needle end of the wire and the tail end of the wire can be joined and pulled collectively to close the opposed sides of the sternum together. The typical stainless steel wire used in such suturing procedures has a diameter of about 0.75 to about 1 millimeter; typically several such wires are used to close the sternum.  
         [0005]     Once the opposed sides of the sternum have been laced, the distal end and needle end of the wire are clamped or otherwise joined and the needle is cut off as close to the clamp as possible. Typically, the resulting short section of wire is very sharp. The clamps are used to grasp the wire ends to draw the opposed sections of the sternum back together and to twist tie the wire to firmly hold the sternum in place to enable the sternum to heal. The short section of wire protruding from the needle end is sharp and may often times tear the surgeon&#39;s gloves, actually cut the surgeon&#39;s hands, or cause damage to the patient if not effectively addressed.  
         [0006]     Typically, a surgeon will use a standard surgical clamp to grasp the ends of the stainless steel wire. The surgeon may then use this same standard surgical clamp to twist the wires together. Finally, the surgeon will typically use a different cutting instrument to cut off the excess portions of the stainless steel wire.  
         [0007]     Accordingly, it is one object of the present invention to provide a tool that combines in one device (1) the cutting functions necessary with the needle end of the stainless steal suturing wires and (2) the clamping function necessary for grasping and twisting of the stainless steel suturing wires.  
         [0008]     A further object of the present invention is to provide a surgical tool that provides for an accurate cut of the stainless steel wire upon clamping and twisting of the wire.  
         [0009]     These and other desirable characteristics of the present invention will become apparent in view of the present specification, including the claims and drawings.  
       SUMMARY OF THE INVENTION  
       [0010]     The present invention is directed to a surgical clamp and cutting device, and more particularly, to a surgical clamp for use in grasping stainless steel wire sutures typically used to repair the sternum after open heart surgery. The surgical clamp and cutting device of the present invention further includes a cutting feature for cutting the stainless steel wire suture at a designated and beneficial location for eliminating excess stainless steel wire protrusions.  
         [0011]     The surgical clamp and cutting device of the present invention includes two members pivotally attached adjacent one end of each member in typical pliers fashion. Each member has at one end a jaw. At the opposite end of each member is a handle that includes locking components such that when the two handles of the surgical clamp and cutting device are biased together, the locking components engage to lock both handles in a relatively compressed position, thereby biasing the jaws of the members together. Also, each handle includes a spring component for biasing the handles away from each other such that when the locking components are not engaged, the handles are separated by the spring components, thereby separating the jaws as well.  
         [0012]     The jaw of each segment includes an element that when biased together with the element of the opposed jaw will cooperate to grip the stainless steel wire such that it may be firmly held, pulled, and twisted, and cut the wire at the desired predetermined and beneficial location. In a preferred embodiment, the elements constitute a set of teeth that are offset from one another, thereby bending the wire, as well as biting into the wire, for a firm grip of the stainless steel wire. Additionally, in a preferred embodiment, each of the elements includes a tooth which when biased together cut from both sides of the stainless steel wire. The elements enclose the cut end of the wire, thus protecting the surgeon. Of course, alternate element embodiments are contemplated, several of which are described below. The elements may be integral with the jaws of the surgical clamp and cutting device, however, it is preferred that each jaw include a slot such that the elements may be removably inserted in the slots and may be replaced at the end of their useful life. In this way, only the elements need be replaced instead of the entire device. The surgical clamp and cutting device of the present invention is preferably made of a material typically used for surgical instruments, such as stainless steel. The elements may also be made of such materials, such as stainless steel and preferably tungsten carbide.  
     
    
     BRIEF DESCRIPTION OF THE FIGURES  
       [0013]      FIG. 1  is an elevated, partial cross-section view of a surgical clamp.  
         [0014]      FIG. 2  is an elevated end view of one embodiment of the cutting element for use with a surgical clamp.  
         [0015]      FIG. 3  is an elevated end view of one embodiment of the cutting element for use with a surgical clamp.  
         [0016]      FIG. 4  is an elevated end view of one embodiment of the cutting element for use with a surgical clamp.  
         [0017]      FIG. 5  is an elevated perspective view of the jaws of a clamp.  
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0018]      FIG. 1  is an elevated, partial cross-sectional view of a surgical clamp  10  of the present invention. The surgical clamp  10  has a first member  20  and a second member  22 .  
         [0019]     The first member  20  includes a first member jaw  30 , a first member handle  32 , a first member locking component  34 , a first member spring component  36 , a first member hand seat  38 , and a first member slot  40  positioned within the jaw  30 . The second member  22  includes a second member jaw  50 , a second member handle  52 , a second member locking component  54 , a second member spring component  56 , a second member little finger seat  58 , and a second member slot  60  located within the second member jaw  50 .  
         [0020]     The first member  20  and the second member  22  are pivotally connected at pivot  66  in a manner conventionally used for prior art surgical clamps. The locking component  34  and the spring component  36  are fixedly attached to the handle  32  of the first member  20  by conventional screws  68 . Handle  32  will have apertures adapted to receive conventional screws  68  for secure attachment of locking component  34  and spring component  36 . As understood by those skilled in the art, any other conventional methods of fixedly attaching locking component  34  and spring component  36  to handle  32  may be employed. Also as understood by those skilled in the art, locking components  54  and  34  may be integral features of handles  22  and  20 . Similarly, locking component  54  and spring component  56  are fixedly attached to the handle  52  of the second member  22 . Spring component  56  and locking component  54  are fixedly attached to handle  52  with conventional screws  68 . Handle  52  is adapted to receive conventional screws  68  in such a manner that locking component  54  and spring component  56  are securely attached to handle  52 .  
         [0021]     As can be seen in  FIG. 1 , first member spring component  36  cooperates with second member spring component  56  in a conventional manner to bias first member handle  32  away from second member handle  52 . This spring mechanism provides the outward force often employed in a surgical clamp or pliers generally. Those skilled in the art will readily recognize that any other conventional spring separating mechanism may be similarly employed to provide the outward force separating handle  32  and handle  52 .  
         [0022]     As further shown in  FIG. 1 , first member locking component  34  cooperates with second member locking component  54  to maintain handle  32  and handle  52  in a locked position in opposition to the forces created by the cooperating first member spring component  36  and second member spring component  56 . The first member locking component  34  includes a base  76  and a latch  78 . The base  76  and latch  78  are pivotally connected by pivot pin  74 . The latch  78  includes a spring seat  84  and a locking leg  80  that has locking teeth  82 . The spring seat  84  extends away from the pivot point between the base  76  and the latch  78  providing a seat for the distal end  86  of the first member spring component  36 .  
         [0023]     Locking component  54  of the second member  22  also includes a locking leg  90  with locking teeth  92 . When the handles  32  and  52  are compressed, locking teeth  82  of locking component  34  engage and cooperate with locking teeth  92  of locking component  54  to hold handle  32  and handle  52  in a locked position. The cooperation between distal end  86  of the spring component  36  and spring seat  84  of the latch  78  biases locking leg  80  of the locking component  34  towards locking leg  90  of the locking component  54  such that when the handles  32  and  52  are compressed the locking legs  80 ,  90  engage and cannot disengage without further interaction. In order to disengage locking leg  80  from locking leg  90 , spring seat  84  of the latch  78  must be rotated away from locking leg  90  of locking component  54 , thereby also rotating locking leg  80  away from locking leg  90 . Although the locking mechanism as described herein is the preferred locking mechanism for use with the present invention, those skilled in the art will readily recognize the application of other conventional locking mechanisms that may also be suitably employed in the present invention.  
         [0024]     When handle  32  and handle  52  are compressed such that locking leg  80  engages locking leg  90 , jaw  30  and jaw  50  are similarly closed by virtue of the pivoting arrangement between the first member  20  and the second member  22 . Naturally, when the locking legs  80  and  90  are disengaged permitting handle  32  and handle  52  to separate as a result of the cooperating spring force of spring components  36  and  56 , jaw  30  and jaw  50  similarly separate.  
         [0025]     As noted above, jaw  30  includes slot  40  and jaw  50  includes slot  60  into which elements ( FIGS. 2-4 ) may be inserted. It is the elements that grip and cut the stainless steel wire suture.  
         [0026]     The surgical clamp  10  of the present invention is ergonomically designed such that the user must position the surgical clamp  10  in the correct orientation within the hand for use. Specifically, handle  32  of the first member  20  includes a hand seat  38  which is configured to be positioned between the thumb and index finger of the user while the handle  52  includes a little finger seat  58  to provide a positioning ledge for the user&#39;s little finger. In this way, the clamp is certain to be used in the correct orientation by the user. Another possibility to ensure correct orientation is to utilize indents for the fingers on the handles.  
         [0027]      FIG. 2  is an elevated end view of one embodiment of the cutting element  100  of the present invention. The cutting element  100  consists of an upper element or grip  102  and a lower element or pull  104 . The grip  102  is adapted to fit within slot  40  of the jaw  30  ( FIG. 1 ) of the first member  20 . The pull  104  is adapted to fit within slot  60  of the jaw  50  ( FIG. 1 ) of the second member  22 . In the embodiment shown in  FIG. 2 , the grip  102  includes a first tooth  106 , a second tooth  108  and a cutting blade  110 . The pull  104  includes a third tooth  112  and a cutting blade  114 . As noted above,  FIG. 2  is an end view of the element  100 . Thus, blade  110  and blade  114  run longitudinally along grip  102  and pull  104 , respectively. In other words, the plane  116  passing vertically through the middle of blade  110  and the middle of blade  114  as shown in  FIG. 2  is generally parallel to the plane defined by first member  20  and second member  22  ( FIG. 1 ).  
         [0028]     Similarly, teeth  106 ,  108  run longitudinally along inner surface of the grip  102  and tooth  112  runs longitudinally along the inner surface of the pull  104 .  
         [0029]     When the handle  32  and the handle  52  of the surgical clamp  10  are compressed, thereby closing jaws  30  and  50 , the grip  102  and pull  104  are similarly compressed being located within the slot  40  and slot  60  ( FIG. 1 ), respectively. The action of simultaneously cutting and clamping the stainless steel wire suture demands that the jaws of a surgical clamp be designed to hold the stainless steel wire suture forcefully but not require so much pressure that it is difficult to cut the wire suture. The cutting element  100 , as illustrated in  FIG. 2 , accomplishes this goal by utilizing, in a preferred embodiment, a clamping means that has teeth that are offset from one another, thereby bending the wire as well as biting into the wire. Specifically, when the wire is placed between the grip  102  and the pull  102  and the jaws  30 ,  50  are closed, the third tooth  112  is generally disposed between the first tooth  106  and the second tooth  108 , thereby bending the wire suture into a slight “S” shape providing for a secure grip on the wire suture. Simultaneously cutting blade  110  cooperates with cutting blade  114  to cut the wire suture at a pre-determined and beneficial distance from second tooth  108 . In this way, the sharp cut end of the wire is contained within the grip and pull elements.  
         [0030]     As noted above, the standard diameter of the stainless steel wire suture commonly used in typical surgical applications is about 0.75 to about 1 millimeter. For typical wires, one configuration of the element  100  may be a distance of about 1.2 mm (dimension a) between the inner surfaces of the grip  102  and pull  104 , the height of each blades  110 ,  114  may be about 0.6 mm (dimension b), and the height of each of teeth  106 ,  108 ,  112  may be about 0.4 mm (dimension c).  
         [0031]     As will be understood by those skilled in the art, the teeth  106 ,  108  and cutting blade  110  of the grip may be integrally formed with the jaw  30  of the first member  20  ( FIG. 1 ), and similarly the third tooth  112  and cutting blade  114  of the pull  104  may be formed integrally with the jaw  50  of the second member  22  ( FIG. 1 ). It is preferred, however, to provide the jaw  30  with slot  40  and jaw  50  with slot  60  to accommodate the cutting element  100  so that when the cutting element  100  has reached the end of its useful life, only the cutting element  100  need be replaced. The cutting element  100  may be made of materials typically used for surgical instruments such as stainless steel. The preferred material for the cutting element  100  is tungsten carbide.  
         [0032]     A better understanding of the operation of the surgical clamp  10  may be had by reference to  FIG. 5 . The longitudinal alignment of the teeth and blades of the cutting element  100  can be seen in  FIG. 5  which is an elevated perspective view of the surgical clamp  10  in an opened position. As described above, the needle end of the stainless steel wire suture passes through the jaws  30 ,  50  such that the needle exits the area between the jaws at the blade  114  side of the surgical clamp  10 . When the handles  20 ,  22  are biased together, jaws  30 ,  50  are also biased together bringing the teeth  106 ,  108  of the grip  102  into cooperating position with tooth  112 . Simultaneously, blade  110  is brought into cooperating position with blade  114  to cut the needle from the stainless steel wire suture leaving the wire suture clamped by the cooperating clamping force of teeth  106 ,  108  of the grip  102  and tooth  112  of the pull  104 .  
         [0033]      FIG. 3  is an elevated end view of another embodiment of the cutting element  120  of the present invention. The cutting element  120  includes a grip  122  and a pull  124 . The grip  122  includes teeth  128  and cutting blade  130 . The pull  124  includes teeth  132  and cutting blade  124 . The cutting element  120 , as shown in  FIG. 3 , provides an alternative gripping arrangement to that shown in  FIG. 2 .  
         [0034]      FIG. 4  is an elevated end view of another embodiment of the cutting element  140  of the present invention. In this embodiment, the grip  142  includes teeth  148 . The pull  144  includes teeth  152 . In this embodiment, only one of the elements includes a blade. Specifically, the pull  144  includes blade  154 . Alternatively, the blade may be deployed on grip  142 . Those skilled in the art will understand that the various teeth and blade arrangements disclosed can be interchanged to provide the desired configuration.  
         [0035]     While the present invention has been illustrated in some detail according to the preferred embodiment shown in the foregoing drawings and descriptions, it will be understood that the invention is not limited thereto since modifications may be made by those skilled in the art, particularly in light of the foregoing teaching. It is therefore contemplated by the appended claims to cover such modifications as incorporate those features that come within the spirit and scope of the invention.