Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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This .invention relates to a surgical clamp and partic-
ularly, to a clamp for stoppin~ the flow of blood from a blood
vessel.
In the course of vascular surgery, it is often neces-
sary to occlude temporarily a major artery in order to repair it,
to clean out its contents or to anastomose it to another blood
vessel. Usually an occluding clamp is used, and the clamp must
not only gently squeeze the vessel bu~ also must evenly compress
the vessel without injury. A spring loaded clamp with fixed ten-
sion is not satisfactory, and provision must be mad~ for adjust-
ment of the clamping pressure. Thus, the pressure must not be
more than necessary to occlude the blood vessel, and gradual re-
lease of the pressure is desirable to initially permit a small
flow of blood to test any suturing before the clamp is ully
opened. Also, after the clamp is applied, it should not have
an opening through which the vessel can be accidently dislodged
and cause a serious loss of blood.
Various types of clamps with soft, vessel engaging
surfaces and ratchet type holding mechanisms are known in the
art~ See, for example, United States Patents Nos. 3,174,754;
3,503,398; and 3,766,925~ Some of ~he prior art clamps are
cumbersome or awkward to use and/or expensive to make. After
extensive experimentation, we have discovered a clamp construc-
tion which has the features described hereinbefore and which is
both simple and inexpensive to make.
One object of the invention is a simple surgical clamp
which is readily applied to a blood vessel, which is easily ad-
justable, which will provide the desired clamping pressure with-
out injury to a vessel and which, after application, does not have
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a side opening through which the vessel can be displac-
ed.
In the preferred embodiment of the clamp of the inven-
tion at least the major portion of the clamp is made in one piece
from a plastics material~ The major portion comprises a pair of
clamping arms which are generally paralle~ when the clamp is
closed. The arms are interconnected at one end by a flexible,
resilient member which urges the arms into separated relation.
The opposite end of one arm carries a ratchet which extends toward
and engages the opposite end of the other arm so as to hold the
arms in positions at which they are set as the clamp is applied.
However, the other arm can be released from the ratchet to de-
crease clamping pressure or to open the clamp for insertion of a
blood vessel between the clamping arms.
The clamping portions of the arms have slots for re-
ceiving extensions of a soft, resilient strip for engaging the
blood vessel. The clamping portion o one arm has a projection
or tail at one end for preventing dislodgment of a blood vessel
in one direction, and the clamping portion of the other arm has
a similar projection or tail displaced from the first-mentioned
projection for preventing dislodgç~e~ of a blood vessel in the
opposite direction.
Other objects and advantages of the present invention
will be apparent from the following detailed description o
the presently preferred embodiment thereof, which description
should ~e considered in conjunction with the accompanying draw-
ings in which:
FIG. 1 is an isometric view of the preferred
embodiment of the clamp of the invention;
FIG. 2 is a side elevation view of the embodiment
shown in Fig.l with the clamp in its released
position;
FIG. 3 is a side elevation view of the embodiment
shown in Fig.l with the clamp receiving and
clamping a blood vessel;
FIG. 4 is a cross-sectional view of the embodi-
ment shown in Fig. 3 and is taken along the line
4-4 indicated in Fig. 3; and
FIG. 5 is a side elevation view of the soft
resilient strip formin~ part of the clamp of
the invention.
In the preferred embodiment of the invention illustra-
ted in the drawings, the clamp 1 has a pair of clamping arms 2
and 3 which are integral with a resilient member 4 which, when the
ratchet 5, hereinafter described, is released, causes the arms 2
and 3 to move apart and assume the positions shown in Fig. 2.
The member 4 also has sufficient elasticity to permit the arms
2 and 3 to be spread further apart than is shown in Fig. 2 so that
a blood ~essel can be inserted between the arm 3 and the upper end
of the ratchet 5 during application of the clamp 1 to a blood
vessel. Of course, it is not necessary that the blood vessel be
so inserted because the end of the vessel can be inserted directly
into the space between the arms 2 and 3 shown in Fig. 2.
The member 4 also has sufficient resiliency to permit
the arms 2 and 3 to be brought into parallel, or substantially
parallel relation, as shown in Fig. 3.
The clamping arms 2 and 3 respectively have an inter-
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mediate part engaging, clamping portion 6 and 7, the clampingportion 6 extending toward the arm 3 and the clamping portion
7 extending toward the arm 2. A strip 8 of soft, resilient
material, i.e. softer than the material of the portions 6 and
7, is on the facing surfaces of the portions 6 and 7. The
strip 8, preferably is a single strip, as illustrated in Fig. 5,
and has a pair of projections 10 and ll which are received in
slots 12 and 13 in the portions 6 and 7 and the arms 2 and 3.
The slots 12 and 13 are tapered, as shown in Fig. 4, and the
dimensions of the projections 10 and ll are such as to fill
the slots 12 and 13 as to resist dislodgement of the projec~
tions 10 and 13 from the slots 12 and 13. However, the strip
8 may be removed and replaced. Although the strip 18 is a
single strip for manufacturing and blood vessel retention reaSon
the strip 8 could be two separate and identical pieces.
The ratchet 5, having ratchet teeth 5a, extends from
the end of the arm 2 opposite from the end thereof which is
connected to the member 4 and extends toward the arm 3 which
has an opening 14 therein through which the ratchet 5 can pass.
The ratchet 5 is made of resilient material and is formed so
that it is urged toward a lip 16 at one side of the openi~g 14.
Thus, after the ratchet 5 is inserted into the opening 14, with
pressing of the arms 2 and 3 toward each other, the ratchet
teeth 5a will engage the lip 16 when the arms 2 and 3 are re-
leased and will prevent separation of the arms 2 and 3 until
the ratchet 5 is moved in a direction away from the lip 16.
It will be observed that the width of the opening 14 between
the lip 16 and the opposite side of the opening is greater than
the corresponding dimension of the ratchet 5.
A projection, or tail, 17 extends from the end of
the clamping portion 7 nearest the member 4 and a corresponding
projection, or tail, 18 extends from the end of the clamping
portion ~ farthest from the member 4. Such projections 17
and 18 prevent a blood vessel from being dislodged from
between the clarnpi~g portions 6 and 7 when the clamp is applied.
Of course, if desired, the projec~on 17 could extend from the
opposite end of the clamping portion 7 if the projection 18
extends from the opposite end of the clamping portion 6.
Preferably, all the parts of the clamp 1, except the
strip 8, are injection molded in one piece from a plastics
material, such as a polycarbonate, and the strip 8 is made
from soft, resilient material such as a soft or sponge rubber
or a celular plastics material, such as polyurethane.
In use, a blood vessel, e.g. the blood vessel 19
(Fig. 3) is inserted between the facing surfaces of the strip
8 with the clamp 1 open, as shown in Fig. 2, or with the facing
surfaces of the strip 8 otherwise far enough apart to receive
the blood vessel 19. The arms 2 and 3 are then pressed toward
each other, with the ratchet 5 received in the opening 14, until
the flow of blood from the vessel 19 is stopped and until the
desired pressure, a matter of "feel" and visual observation,
is applied to the vessel 19. The pressure may be reduced, either
if the initial pressure is too high or if it is desired to have
a small flow of blood to test suturing, by releasing the ratchet
teeth 5a from the lip 16 as previously described and by maintain-
ing gradually reduced, finger pressure on the arms 2 and 3~
The clamp 1 may be completely released by disengaging
the ratchet teeth 5a from the lip 16 and permitting the arms 2
and 3 to spring apart or by deliberately spreading the arms 2 and
3 apart manuallyO
Thus, the clamp of the invention is simple in construc-
833
tion and may be made relatively easily and inexpensively. Ablood vessel ~ay be readily inserted in the clamp and is engaged
only by relatively soft material of the strip 8. Furthermore,
the pressure on a blood vessel may be readily adjusted, and
when the clamp is at least partially closed, a blood vessel can-
not be displaced sideways out of the clamp.
Although a single embodiment of the present invention
has been described and illustrated, it will be apparent to those
skilled in the art that various modifications may be made with-
out departing from the principles of the invention.
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