Combination subcutaneous suture remover, biopsy sampler and syringe

Claim 2

A multi-purpose surgical instrument for subcutaneous use comprising probe means in the nature of an elongate and generally slender member having a generally uniform transverse cross-section along the longitudinal axis thereof and having a bearing surface portion at the probing free end thereof; and clamping means arranged for movement in a direction generally parallel to said axis of said probe means and having an end portion thereof movable between a first clamping position wherein said end portion abuts against said bearing surface portion and a second releasing position wherein said end portion is removed or spaced from said bearing surface portion, whereby said bearing surface portion and end portion together form a clamping device in the nature of a vice which can be opened and closed by relative movement therebetween along a direction generally parallel to said axis of said probe means.

Claim 3

A surgical instrument as defined in claim 1, further comprising locking means for positively locking the relative axial positions of said prove and clamping means in said first clamping position to prevent inadvertent release of an object being clamped.

Claim 4

A surgical instrument as defined in claim 1, wherein said probe means comprises an elongate hollow tube and said clamping means comprises an elongate rod coaxially disposed within said hollow tube for slidable movement therein.

Claim 5

A surgical instrument as defined in claim 3, wherein the instrument is adapted to be hand-held and hand operated, and further comprising coaxial finger gripping means fixedly joined to said hollow tube at the hand-held end thereof remote from said probing free end, said elongate rod having a length greater than the length of said hollow tube to extend beyond the hand-held end thereof; and adjusting means mounted on said finger gripping end for engaging said rod extension and for selectively adjusting the relative axial positions of said hollow tube and elongate rod.

Claim 6

A surgical instrument as defined in claim 4, wherein said elongate rod portion extending beyond said hollow tube is provided with an engageable portion, said finger gripping means being provided with a coaxial externally threaded extension projecting in a direction away from said probing free end, said adjusting means comprising an internally threaded actuator nut threadedly engaged with said threaded extension and having a coaxial cylindrical blind cavity defining a bearing surface; and engaging means for engaging said engageable portion to maintain the same substantially in abutment against said cavity bearing surface, whereby said elongate rod axially follows said actuator nut as said threaded actuator nut moves axially on said threaded extension simultaneously with turning of said nut about said axis.

Claim 7

A surgical instrument as defined in claim 5, wherein said engageable portion comprises a cylindrical collar having a coaxial annular groove, and same engaging means comprises a radial pin on said actuator nut projecting inwardly to be received within said groove, whereby said pin causes said elongate rod to axially follow said actuator nut as said actuator nut is turned and moved axially due to the threaded engagement with said threaded extension.

Claim 8

A surgical instrument as defined in claim 6, wherein said pin is in the nature of a screw.

Claim 9

A surgical instrument as defined in claim 6, further comprising a compression spring within said blind cavity for resiliently acting between said threaded extension and said elongate rod engageable portion to bias the same against said bearing surface to minimize hysteresis during reversals of rotation of said actuator nut.

Claim 10

A surgical instrument as defined in claim 5, further comprising a stop means for limiting turning of said actuator nut beyond a predetermined axial position to prevent excessive axial movement of said actuator nut and elongate rod with respect to said hollow tube in movements from said second to said first positions.

Claim 11

A surgical instrument as defined in claim 9, wherein said stop means comprises a stop nut on said threaded extension which is selectively positionable on said threaded extension to abut against said actuator nut to prevent excessive advancement of the same at a preselected axial position on said threaded extension, whereby the maximum gripping pressures between said probing free end bearing surface and said elongate rod end portion may be controlled.

Claim 12

A surgical instrument as defined in claim 5, further comprising means for preventing rotation of said elongate rod during axial slidable movements thereof.

Claim 13

A surgical instrument as defined in claim 11, wherein said means for preventing rotation comprises a flat inside surface of said hollow tube which flat surface is generally in a plane parallel to said axis, said elongate rod end portion having a flat surface generally parallel to said axis which abuts against said flat surface of said hollow tube with clearance only to permit slidable axial movements between said flat surfaces.

Claim 14

A surgical instrument as defined in claim 3, wherein said external dimensions of said elongate rod and internal dimensions of said hollow tube are selected to be substantially similar to provide a small clearance fit therebetween, whereby fluid may be subcutaneously discharged or retrieved by suitable movement of said elongate rod within said hollow tube to thereby function as a syringe.

Claim 15

A surgical instrument as defined in claim 1, wherein said probing free end is provided with a sharply pointed tip, whereby said instrument may be used as a hypodermic needle for piercing the upper skin layers.

Claim 16

A surgical instrument as defined in claim 1, wherein the instrument is a subcutaneous suture remover, and said probe means is provided with a crochet-type hook which includes said bearing surface portion at said probing free end.

Claim 17

A surgical instrument as defined in claim 3, wherein said hollow tube is provided at the end thereof remote from said probing free end which means for receiving and introducing fluid into said hollow tube, whereby fluid may be introduced or removed subcutaneously.

Claim 18

A surgical instrument as defined in claim 1, wherein said probe means bearing surface portion and said clamping means end portion are mounted for relative movement to provide a separation therebetween which is at least comparable to the cross-sectional dimensions of said hollow tube to permit an object to be gripped by said bearing surface and end portions and be introduced or removed subcutaneously.

Claim 19

A surgical instrument as defined in claim 3, wherein said hollow tube is formed at said probing free end with a crochet-type hook suitable for engaging subcutaneous tissue, whereby at least a portion of such subcutaneous tissue may be engaged by said hook and clamped to permit removal of the same to thereby serve as a biopsy sampler.

Claim 20

A surgical instrument as defined in claim 3, wherein said hollow tube is formed at said probing free end with a crochet-type hook configurated and dimensioned to permit engagement of subcutaneous matter during probing with said hook, said hook generally being in the shape of a wedge-shaped transverse cutout which opens in a direction away from said probing free end and in the direction of the major length portion of said hollow tube.

Claim 21

A surgical instrument as defined in claim 19, wherein said wedge-shaped cutout in said hollow tube is defined by a pair of arcuate edges, each of which respectively lies in one or two planes which intersect in the region of said axis along a line substantially normal to said axis and each of which planes forms a different acute angle with said axis and the major portion of said hollow tube.

Claim 22

A surgical instrument as defined in claim 20, wherein said line of intersection of said two planes passes through said axis and is coincident with a diameter of said hollow tube.

Claim 23

A surgical instrument as defined in claim 1, further comprising cutting means for cutting an object clamped by said probe and clamping means at only one clamped point at the clamping area, whereby at least a portion of the cut object is retained after cutting to permit subcutaneous extraction of that portion of the object which remains to be clamped.

Claim 24

A surgical instrument as defined in claim 22, wherein said clamping means includes locking means for positively locking the relative axial position of said probe and clamping means to assure that at least a portion of an object to be subcutaneously extracted remains to be clamped after cutting and to prevent inadvertent release of the clamped object portion during extraction.

Claim 25

A surgical instrument as defined in claim 22, wherein said probe means comprises an elongate hollow tube, the outside surface of which is circular in cross-section along its longitudinal length, and wherein said cutting means comprises a rotary cutter element which includes a cutting edge which surrounds at least a portion of said hollow tube in the region of said probing free end thereof, said cutting edge being substantially coextensive with said outside surface to form little clearance therebetween and being mounted for rotary movement relative to said hollow tube about said axis, said cutting edge sweeping said probing free end during rotary movement thereof to cut an object clamped by said bearing surface and end portions.

Claim 26

A surgical instrument as defined in claim 24, wherein the instrument is adapted to subcutaneously extract sutures, said hollow tube being formed at said probing free end with a crochet-type hook configurated and dimensioned to permit subcutaneous engagement of sutures during probing with said hook, said hook generally being in the shape of a wedge-shaped transverse cutout which opens in a direction away from said probing free end and in the direction of the major length portion of said hollow tube.

Claim 27

A surgical instrument as defined in claim 25, wherein said wedge-shaped cutout in said hollow tube is defined by a pair of arcuate edges each of which respectively lies in one of two planes which intersect in the region of said axis along a line substantially normal to said axis and each of which planes forms a different acute angle with said axis and the major portion of said hollow tube.

Claim 28

A surgical instrument as defined in claim 24, wherein said rotary cutter element is in the nature of an elongate external sleeve which has an inside surface of circular cross-section along its longitudinal length, said inside surface having dimensions substantially corresponding to the outside surface of said hollow tube to provide little clearance therebetween said clearance being sufficient to permit relative turning between said hollow tube and external sleeve.

Claim 29

A surgical instrument as defined in claim 24, wherein said cutter element is provided with indentation means for reducing the clearance between said hollow tube probing free end and said cutting edge to substantially form an interference-fit at said cutting edge to improve the cutting characteristics thereof.

Claim 30

A surgical instrument as defined in claim 24, wherein said probe and clamping means together form a crochet-type hook clamping arrangement which extends between two opposing points on opposite sides of a plane passing through said axis, said cutter element being mounted for turning relative to said hollow tube to sweep only over a portion of said clamping arrangement between said opposing points to assure cutting of a clamped object only at one of said opposing points, whereby at least a portion of the clamped object continues to be clamped subsequent to cutting.

Claim 31

A surgical instrument as defined in claim 29, wherein the instrument is adapted to be hand-held and hand-operated, and further comprising coaxial finger gripping means fixedly joined to said hollow tube at the hand-held end thereof remote from said probing free end; and cutter actuator means connected to said cutter element and mounted on said finger gripping end for preventing undesirable relative axial movements between said hollow tube and said cutter element.

Claim 32

A surgical instrument as defined in claim 30, wherein said finger gripping means is provided with a coaxial extension projecting in the direction of said probing free end, said cutter actuator means being coaxially and rotatably mounted on said coaxial extension, said cutter actuator means including engaging means for engaging and gripping said cutter element to cause simultaneous turning of said cutter element and cutter actuating means about said axis relative to said hollow tube, and limiting means for limiting relative turning between said hook clamping arrangement and said cutter element between a first relative position wherein said cutting edge is circumferentially beyond said two opposing points to fully expose said hook clamping arrangement and a second relative position wherein at lease a portion of said cutting edge is disposed between said two opposing points to only partially cover said hook clamping arrangement, whereby a clamped object extending between said two opposing points remains clamped subsequent to movement from said first to second relative positions.

Claim 33

A surgical instrument as defined in claim 31, wherein said limiting means comprises a circumferential slot in said coaxial extension, and follower pin means on said actuator means slidably received within said slot, said slot having circumferentially opposing ends disposed to limit relative turning movements between said finger gripping means and said cutter element.

Claim 34

A surgical instrument as defined in claim 31, further comprising biasing means for normally maintaining said hook clamping arrangement and cutter element in said first relative position.

Claim 35

A surgical instrument as defined in claim 32, wherein said slot is a helical slot coaxial with said axis, whereby relative turning between said finger gripping means and said cutter element provides an axial or linear as well as an angular displacement therebetween as said pin means moves in and follows said helical slot, whereby the combination of said relative linear and angular movements enhances the cutting characteristics of the instrument.

Claim 36

A surgical instrument as defined in claim 30, wherein said cutter actuating means includes adjusting means for adjusting the normal non-cutting axial position of said cutter element relative to said hollow tube and the normal angular non-cutting position of said cutter element relative to said hook clamping arrangement.

Claim 37

A surgical instrument as defined in claim 35, wherein said adjusting means comprises a collet-lock nut arrangement which receives a portion of said cutter element in a selected position and grips said cutter portion by tightening said lock nut on said collet.

Claim 38

A subcutaneous suture extraction surgical instrument comprising: a. an elongate and generally slender circular hollow tube having a longitudinal axis and provided with a crochet-type hook at a probing end thereof, said hook having a bearing surface portion generally facing the hand-held end thereof remote from said probing end; b. a finger grip fixedly joined to said hand-held end of said hollow tube and configurated to facilitate gripping and handling of said hollow tube; c. an elongate rod having an end portion and mounted within said hollow tube for slideable axial movements relative to said hollow tube between a clamping position wherein said end portion is in abutment against said bearing surface portion and a releasing position wherein said end portion is spaced from said bearing surface portion; d. adjusting means mounted on said finger grip and coupled to said elongate rod for selectively adjusting the spacing between said bearing surface portion and said end portion to permit movement of said rod between said clamping and releasing positions, said bearing surface portion and end portion together forming a clamping device in the nature of a vice which can be opened and closed by relative movement between said hollow tube and elongate rod along a direction generally parallel to said axis; e. a rotary cutter element in the nature of an outside sleeve which is coextensive with the outside surface of said hollow tube and covers the same substantially over the entire length thereof, said outside sleeve being mounted on said hollow tube for relative angular or rotary and axial movements with respect to said hollow tube and having circular cutting edge in the region of said hook, said cutter element being movable between a non-cutting position wherein said cutting edge fully exposes said hook for probing and engaging a suture, and a cutting position wherein said cutting edge sweeps over at least a portion of said hook to cut a suture clamped by said hollow tube bearing surface portion and said rod; and f. a cutter actuator fixedly connected to said cutter element at the end thereof remote from said cutting edge and being mounted on said finger grip for movement relative thereto between first and second portions respectively corresponding to said cutting and non-cutting positions of said cutter element, whereby relative movement between said hollow tube hook and cutter element cutting edge may be effected by corresponding relative movement between said finger grip and cutter actuator to cut a suture clamped within said hook by said elongate rod, and whereby subcutaneous hooking, clamping and cutting procedures can be performed by controlling said adjusting means and cutter actuator relative to said finger grip at the hand-held end of the instrument.

Claim 39

A subcutaneous suture extraction surgical instrument comprising: a. an elongate and generally slender circular hollow tube having a longitudinal axis and provided with a crochet-type hook at a probing end thereof, said hook having a bearing surface portion generally facing the hand-held end thereof remote from said probing end; b. a finger grip fixedly joined to said hand-held end of said hollow tube and configurated to facilitate gripping and handling of said hollow tube; c. an elongate rod having an end portion and mounted within said hollow tube for slideable axial movements relative to said hollow tube between a clamping position wherein said end portion is in abutment against said bearing surface portion and a releasing position wherein said end portion is spaced from said bearing surface portion; d. adjusting means mounted on said finger grip and coupled to said elongate rod for selectively adjusting the spacing between said bearing surface portion and said end portion to permit movement of said rod between said clamping and releasing positions, said bearing surface portion and end portion together forming a clamping device in the nature of a vice which can be opened and closed by relative movement between said hollow tube and elongate rod along a direction generally parallel to said axis; e. a rotary cutter element in the nature of an outside sleeve which is coextensive with the outside surface of said hollow tube and covers the same substantially over the entire length thereof, said outside sleeve being mounted on said hollow tube for relative angular or rotary and axial movements with respect to said hollow tube and having circular cutting edge in the region of said hook, said cutter element being movable between a non-cutting position wherein said cutting edge fully exposes said hook for probing and engaging a suture, and a cutting position wherein said cutting edge sweeps over at least a portion of said hook to cut a suture clamped by said hollow tube bearing surface portion and said rod; and f. a cutter actuator fixedly connected to said cutter element at the end thereof remote from said cutting edge and being mounted on said finger grip for movement relative thereto between first and second portions respectively corresponding to said cutting and non-cutting positions of said cutter element, whereby relative movement between said hollow tube hook and cutter element cutting edge may be effected by corresponding relative movement between said finger grip and cutter actuator to cut a suture clamped within said hook by said elongate rod, and whereby subcutaneous hooking, clamping and cutting procedures can be performed by controlling said adjusting means and cutter actuator relative to said finger grip at the hand-held end of the instrument.