US3057355A - Vascular everter - Google Patents

Description

Oct. 9, 1962 A. J. sMlALowsKl ETAL 3,057,355

VASCULAR EVERTER Filed July 8. 1960 5l BY Mw ATTORNEY United States Patent Otilice 3,057,355 Patented Oct. 9, 1962 3,057,355 VASCULAR EVERTER Antoni J. Smialowski and Isaac J. Vogelfanger, Ottawa, Unitario, Christoph L. Fischer, Eastvew, Ontario, and Sidney H. G. Connock, ttawa, Gntario, Canada, assignors to Canadian Patent `and Development Limited, Gttawa, ntario, Canada Filed `Iuly 8, 1960, Ser. No. 41,555 7 Claims. (Cl. 12S-334) This invention relates to a device for everting the ends of blood vessels andthe like and holding them in an everted position.

For the use of peripheral suturing apparatus such as described in copending application Serial No. 717,656, led February 26, 1958 now Patent No. 2,940,451, it is desirable to provide means for facilitating the everting of the end of a blood vessel over the end o-f a bushing and for holding the everted blood vessel in that position until a suture is made.

It is an object of this invention to provide a vascular everter of simple manufacture and compact form, which is convenient to use, and which is effective to perform its function in a rapid and satisfactory manner.

The invention vwill be described with reference to the accompanying drawing, in which FIGURE l is a plan View of the device in accordance with the invention,

FIGURE 2 is a sectional side elevation of the device,

FIGURE 3 is an enlarged sectional partial side elevation of the device in one operating position thereof,

FIGURE 4 is an enlarged sectional partial side elevation of the device in another operating position thereof, and

FIGURE 5 is a sectional side elevation of a flexible washer employed in conjunction with the device.

The device comprises a hollow cylindrical member or tube 1 to which is fixed a handle 2. As shown, the handle is fixed to one end of the tube and is inclined therefrom to facilitate manipulation of the device.

A sleeve 3 is releasably mounted in the tube 1 as by means of a spring clip 4. The sleeve has a portion 5 projecting from the other end of tube 1 and an external shoulder 6 which engages the end of the tube. The sleeve portion 5 has an internal cup-shaped recess 7. A plunger 8 is reciprocally mounted in the sleeve 3. 'Ihe upper end of the plunger, i.e., the end adjacent handle 2, is provided with a flange 9 for engagement with the adjacent end edge of the sleeve to prevent the plunger from passing through the bore of the sleeve. A flat Ispring 10 resiliently urges the plunger into the position shown in FIGURE 3, i.e., with flange 9 in engagement with the sleeve. As shown, the spring 10 is removably fixed to the handle as by a screw 11 and nut 12 and is slotted at 13 to receive a projection 14 on the end of the plunger. It will be observed that the diameter of flange 9 is smaller than that of the bore of tube 1 to enable insertion of the assembly in the tube.

The plunger 8 has a small diameter end portion 15 which, in the position of FIGURE 3, lies partly within the recess 7 and extends beyond the adjacent end of the sleeve portion 5. The plunger also has a steeply tapered conical portion 16 extending from the end of portion 15 and a less steeply tapered conical portion 17 extending from the line of juncture 18 with portion 16. Conical portion 17 terminates in a rounded end 19.

The device includes a disposable and deformable exible washer 20 which is formed of a resilient material such as rubber, plastic composition or the like. The washer has an annular body section 21, a peripheral rim 22 on one side of such body section, and a conical section 23 extending inwardly from body section 21, section 23 being of thinner wall thickness than that of section 21. Conical section 23 terminates in an axial opening 24. In the form shown, the thickness of conical section 23 is gradually reduced towards opening 24 whereby the opening 24 is defined by the relatively sharp edge juncture of the converging wall surfaces of section 23.

`In use, with the end of a blood vessel 25 protruding from a bushing 26 of a suturing instrument, a washer 20 is placed over the pointed end portion 17 of plunger 8 and such end portion inserted in the opening of the blood vessel. The device is pushed into the vessel until the steep taper portion 16 pins the blood vessel against the mouth of the bushing, as shown in FIGURES 3 and 4 and thus locking the blood vessel in position to prevent it from slipping back through the bushing.

It -will be observed that the end edge of sleeve portion 5 engages the body section 21 of the washer adjoining the rim 22 which tits around the outer surface of the sleeve.

Further pressure on the handle 2 will cause the sleeve 3 to slide over plunger 8. With this movement, the rim portion of the washer and then the body section 21 are swung over the end of the bushing, the body section 21 carrying with it the end of the blood vessel.

Continuation of the movement of the sleeve 3 pulls down the thin conical section 23 of the washer and stretches it over the everted blood vessel until the edge of the washer passes a step 25a which is formed on the external surface of the bushing. The washer uow holds the blood vessel firmly in position, as sho-wn in FIG- URE 4.

The instrument may now be withdrawn, leaving the holding washer in place until the suturing operation is completed, after which the washer is severed and removed. It Will be apparent that a new washer is employed for each operation.

For satisfactory operation, the dimensions, shape, and relative positions of the sleeve, plunger, washer and bushing should be definitely related to the size of the blood vessel under treatment.

To serve the full range of blood vessel sizes, it is contemplated that a series of matching bushing and everters in small steps of sizes will be provided. Selection of the correct size of bushing and everter may be done by measuring the outside diameter and wall thickness of the blood vessel.

The diameter of the small diameter end portion 15 of the plunger should be substantially the same as the outside diameter of the blood vessel. 'I'he inside diameter of the bushing should be substantially the same as the inside diameter of the `blood vessel. The diameter of the line of juncture 18 between the conical portions 16 and 17 must be smaller than the inside diameter of the bushing. The tapered or conical portion 16 should enter only about half way into the bushing when no blood vessel is present. The tapered or conical portion 17 is such as to provide for easy insertion of the end of the plunger into the blood vessel as it protrudes yfrom the bushing.

The inside diameter of the recess 7 -should be just large enough to pass over the inverted blood vessel with the washer in holding position.

The rim 22 on the washer is desirable to prevent the washer from being pushed inside the sleeve 3. The thick body section 21 prevents the blood vessel from passing through the opening 24 in the washer. The thin conical section 23 assists in the evertion of the blood vessel and .enables it to be stretched easily and without damage We claim:

1. A vascular everter comprising a tubular member having a first end and a second end, a rigid handle fixed to said tubular member adjacent said first end, a plunger slidably mounted in said tubular member, said plunger and tubular member having engageable shoulders defining one position of said plunger in said member, and a fiat spring carried by said handle and engaging one end of said plunger to urge it into said one position, said tubular member having an interior cylindrical axial recess of greater Idiameter than Ithat of said plunger adjoining said second end, said plunger having adjacent its other end an end portion of reduced diameter protruding through said second end in said one position of said plunger, and an end conical portion extending axially outwardly from said reduced diameter portion and lying outwardly beyond said recess in said one position of said plunger, said plunger being slidable into a second position against the action of said spring in response to pressure on said end conical portion, said end conical portion in said second position lying within said recess.

2. A vascular everter comprising a tubular member having a first end and a second end, a rigid handle fixed to said tubular member adjacent said first end, a plunger slidably mounted in said tubular member, said plunger and tubular member having engageable shoulders defining one position of said plunger in said member, and a spring carried by said handle and engaging one end of said plunger to urge it into said one position, said tubular member having an interior cylindrical axial recess of greater diameter than that of said plunger adjoining said second end, said plunger having adjacent its other end a portion of reduced diameter protruding through said second end in said one position of said plunger, an intermediate conical portion extending axially outwardly from said reduced diameter portion and lying outwardly beyond said recess in said one position of said plunger, and an end conical portion extending axially outwardly from said intermediate portion, said end conical portion being tapered less steeply than said intermediate portion, said plunger being slidable into a second position against the action of said spring in response to pressure on said end conical portion, said end conical portion in said second position lying substantially wholly within said recess.

3. A vascular everter comprising a tube, a sleeve releasably fixed within said tube and having a rst end adjacent one end of said tube and a second end lying axially outwardly beyond the other end of said tube, a plunger slidably mounted in said sleeve, said plunger and sleeve having engageable shoulders defining one position of said plunger in said sleeve, a rigid handle fixed to said tube adjacent said one end thereof, a spring carried by said handle and engaging one end of said plunger to urge it into said one position, said vsleeve having an interior cylindrical axial recess of greater ldiameter than that of said plunger adjoining said second end, said plunger having adjacent its other end a portion of reduced diameter protruding through said second end in said one position of said plunger, and an end conical portion extending axially outwardly from said reduced diameter portion and lying outwardly beyond said recess in said one position of said plunger, said plunger being slidable into a second position against the action of said spring in response to pressure on said end conical portion, said end conical portion in said second position lying within said recess.

4. A vascular everter as defined in claim 3, including a deformable washer arranged for mounting on said end conical portion of said plunger, said washer having inner and outer annular portions, said outer annular portion having a thickness greater than that of said inner annular portion.

5. A vascular everter as defined in claim 3, including a unitary deformable washer arranged 4for mounting on said end conical portion of said plunger, said washer having a peripheral rim extending outwardly from one side thereof, and inner and outer annular portions, said outer annular portion having a thickness greater than that of said inner annular portion.

6r. A vascular everter as defined in claim 5, said inner annular portion of said washer being of inherently conical configuration.

7. A vascular everting washer comprising a unitary annular body of elastic deformable material having an annular body section having a central opening, said body section having an inner edge, an outer edge, and radially extending side surfaces, a peripheral rib on one of said surfaces adjoining said outer edge and extending axially outwardly therefrom, and a conical section extending axially outwardly from the other of said surfaces adjoining said inner edge, said conical section having an axial opening of smaller diameter than that of said central opening of said body section, said conical section having converging Wall surfaces meeting at a common edge and defining said axial opening.

References Cited in the file of this patent UNITED STATES PATENTS 2,088,180 Stevens July 27, 193,7 2,779,996 Tanis Feb. 5, 1957 2,940,452 Smialowski June 14, 1960

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