US2695616A - Circumcision clamp - Google Patents

Description

NOV. 30, 1954 HANSELL 2,695,616

CIRCUMCISION CLAMP Filed Aug. 6, 1952 IN VEN TOR. FaamM/Zazvazzg rray/10574 United States Patent O" The present invention relates to surgical instruments and more particularly to a circumcision clamp for ei'fecting hemostasis prior to amputating the distal redundant prepuce.

In the performance of acircumcision operation it is desirable that the prepuce first. be crushed in a line about the base of the glans and, after an interval of time necessary to effect hemostasis, that the prepuce be amputated adjacent, but on the distal side of, the region of hemostasis. It is desirable, also, if not essential, that the frenulum not be severed or injured during the acts of hemostasis and amputation of the prepuce. this end, it is necessary that the prepuce be properly arranged in a clamp prior to hemostasis, and therefore that the clamp be of such design as to lend itself readily to such proper arrangement by the surgeon. While clamps heretofore known and used by me have .pre-

sumablybeen constructed with these requirements in mind, none has embodied all the desirable or essential characteristics.

The primary object of the invention is, therefore, to provide an improved circumcision clamp of the type for use wherein the prepuce is clamped and crushed in a substantially circular line about the base of the glans to elfect hemostasis, such clamp being more readily applied, and with greater accuracy, than clamps heretofore known and used.

A further object of the invention is to provide a clamp, of the type herein under consideration, of such proportion and design as to guard against accidental severing of the frenulum, while, at the same time, facilitating amputation of the prepuce along a line more perfectly conforming to the base contour of the glans.

A still further object of the invention is to provide a clamp having an anvil against which a scalpel blade may be positively guided in performing the amputation of the prepuce.

Further objects of the invention will appear as the description proceeds.

To the accomplishment of the above and related objects, my invention may be embodied in the forms illustrated in the accompanying drawings, attention being called to the fact, however, that the drawings are illustrative only, and that change may be made in the specific constructions illustrated and described, so long as the scope of the appended claims is not violated.

1 is a plan view of my improved circumcision p;

Fig. 2 is a side elevationrof the clamp of Fig. 1;

Fig. 3 is a perspective view of my clamp shown in activeposition as it is intended to be used;

Fig. 4 is a sectional view through the median plane of my clamp showing the clamp in active association with the prepuce during circumcision; and

Fig. 5 is a fragmental view similar to Fig. 1 showing a modified form of my clamp.

Referring more particularly to the drawings, it will be seen that my clamp comprises a pair of mating rings 10 and 11. Both of these rings are preferably, substantially heart-shaped in plan, as seen most clearly in Fig. l; and the two rings are substantially congruent,

ring 11 having, however, an outer periphery slightly,

smaller than that of ring 10.. v

Ring .10 has a substantially uniform, radial cross-section, and, in radial cross-section, provides a substantially flat crown surface 12 and a relatively wide clamping surface 13 slopingr'adially inwardlyfand downwardly. from 2,695,616 Patented Nov. 30, 1954 crown 12. Such a cross-section defines a relatively wide, uninterrupted, inner peripheral band or surface on ring 10, sloping downwardly and inwardly similar to the frustum of a cone.

Ring 11 has a substantially uniform, radial crosssection, and, in radial cross-section, provides an anvil surface 14, which is substantially normal to the crown 12 when the rings are in mating relation. narrow clamping surface 15 slopes downwardly and radially inwardly from surface 14 at an angle substantially corresponding to that of the surface 13. Such a cross-section defines a relatively narrow, uninterrupted, outer peripheral band or surface about ring 11 sloping downwardly and inwardly similar to the frustum of a cone. When ring 11 is moved into mating relation with ring 10, clamping surfaces 13 and 15 lie in substantially parallel juxtaposition.

The peripheral contour of the base of the glans 16 is substantially oval and is slightly convex, in longitudinal cross-section, relative to the distal portion of said glans, as clearly seen in Fig. 4. The frenulum 17 lies substantially in the longitudinal median plane of the glans 16 and forms a web between the glans and the inner surface of the prepuce 18. Because of the oval shape of glans 16 and the location of frenulum 17,. I prefer to form the rings 10 and 11 each in a substantial heart shape, as clearly shown in Fig. 1. The apices 19 and 20 of the heart- shaped rings 10 and 11 act to effectually circumvest the frenulum during the clamping operation.

Additionally, because .of the convex contour of the each ring out of. asingle plane so that each will conform substantially to a cylindrical surface having its axis of rotation substantially normal to a median plane including the apices of rings 10 and 11. Thus formed, the rings will more perfectly conform to the convex base contour of glans 16. i

In use, ring 10 is slipped over glans 16, and th enveloping prepuce 18 with the apex 19 being arranged adjacent frenulum 17. .The prepuce 18 is then held away from glans 16 and ring 11 is moved over the glans to lie near the base thereof. The surgeon then grasps the prepuce and stretches it between clamping surfaces 13 and 15 of rings 10 and 11. When the prepuce 18 is properly arranged between said clamping surfaces, care being taken to see that frenulum 17 is free from between such surfaces, the rings are then forced tightly together to clamp and crush the narrow band 21 of prepuce 18, lying between surfaces 13 and 15. To facilitate proper arrangement of the prepuce between the rings, a dorsalslit 22 may be made in the prepuce.

After an interval of from ten to twenty minutes, hemostasis occursin the prepuce band 21. Using .a scalpel 23 the surgeonmay then amputate the distal redundant p'repucebyholding the side of the knife fiat against the crown surface 12 and pressing the cutting edge against the anvilsurface 14. Thus a precise, accurate cut can be made immediately adjacent the portion of the prepuce where hemostasis has taken place. After making the cut, the rings may be removed.

. Obviously, somemeans must be provided for clamping and holding rings 10 and 11 in mating relation and, to this end, I provide a pair of levers 24 and 25. Ring 10 is peripherally fixed .to an end of lever 24, preferably at a point diametrically opposite apex 19. Ring 11 is similarly fixed to an end of lever 25 at a corresponding point diametrically opposite apex 20. Levers 24 and 25 arepivoted intermediatetheir ends for oscillation about an axis 26 substantially perpendicular to the median plane through rings 10 and 11 including the apices 19 and 20. i

Such lever arrangement may preferably be aforcepstype device having finger-manipulating rings 27 and 28 on the ends of levers 24 and 25 remote from rings 10 and '11.

To enable the user to lock rings 10 and 11in clamping position relativetothe prepuce 18, after proper arrangement of the prepuce between the rings, 1 provide a bar 29 extendingfrom lever 24 towardlever 25 and a similar bar 30 extending from lever25 toward lever 24, such bars overlapping, and including ratchet teeth 31 thereon for A relatively interengagement to prevent relative oscillation between levers 24 and 25.

When the instrument is constructed as shown in Figs. 1-4, the levers and manipulating rings will project toward the patientshead after the clamp has been applied, and may rest on his abdomen. in some cases "it may be deemed preferable to construct the instrument in the manner illustrated in Fig. .5, in which the levers 2'4" and 25' are fixed to the rings and .11 substantially at their apices. With that construction, of course, the levers will project toward the patients feet after the clamp is applied and, if desired, may 'coven'i'ently be held by the surgeon during amputation.

If desired, a base or foundation element (not shown) may be permanently or removably secured to the ring 28, whereby the instrument as a -whole 'will stand alone substantially ,in the attitude illustrated in Fig. '2.

The use of a clamp, constructed in accordance with my invention, permits the performance of a circumcision operation in a more facile and "accurate fashion, and in much less time than has heretofore been possible.

I .clairn as my invention:

1. A circumcision clamp comprising a pair of substantially congruent, heart-shaped, centrally-open, mating rings, each ring being symmetrical on opposite sides of amedianplane through the apices of said heart-shaped rings, one of said rings having a relatively wide inner peripheral baud sloping downwardly and inwardly, and the other of said rings having a relatively narrow outer peripheral .band sloping upwardly and outwardly, the outerperipheral band of said other ring "being contiguous with'the inner peripheral band of said one ring when said rings are brought into mating relation, and means for releasably holding said rings in such mating relation.

2. A circumcision clamp comprising a pair of substantially congruent, heart-shaped, mating rings, each ring being symmetrical on opposite sides ofarnedian plane through the .apices of said heart-shaped rings, one of said rings having a relatively wide inner peripheral band sloping downwardly and inwardly, and the other of said rings having a relatively narrow outer peripheral band sloping upwardly and outwardly, "the outer peripheral band of said other ring being contiguous with the inner peripheral band of said one ring when said rings are brought into mating relation, and means for releasably holding said rings in such mating relation, each of said rings being curved to conform substantially to the peripheral contour of a cylinder having "its axis normal to said median plane and located on the side of said mating rings opposite from said one ring.

'3. A circumcision clamp comprising a pair of substantiallyrcongruent, heartshaped, mating rings, each ring being symmetrical on opposite sides of a median plane through the apices of said heart-shaped rings, one of said rings having a relatively wide inner peripheral band 'sloping downwardly and inwardly, and the other of said rings having a relatively narrow outer peripheral band sloping upwardly and outwardly, the outer peripheral band .of said other ring being contiguous with the inner peripheral band of said one ring when said rings are brought into mating relation, and means for releasably holding said rings in such mating relation, comprising a pair of levers pivoted intermediate their ends for oscillation about an axis substantially normal to said median plane, one of said rings being peripherally fixed to the free end of one of said levers and the other of said rings being peripherally fixed to the free end of the other of said levers, and latch means for locking said levers m adjusted position against ring-separating relative oscillation about said axis.

-4. A circumcision clamp-comprising a pair of substantially congruent, generally heart-shaped, mating rings, each ring being symmetrical on opposite sides of a median plane through the apices of said heart-shaped rings and each having a substantially uniform radial cross-section, the radial cross-section of one of said rings presenting a fiat crown surface and arelatively wide clamping "surface sloping radially inwardly and downwardly from said crown surface, and the radial cross-section of the other of said rings presenting an anvil surface substantially normal to, and intersecting the plane of, said crown surface, when said rings are in mating relation, and a relatively narrow clamping surface sloping radially inwardly and downwardly from said anvil surface, the two said clamping surfaces lying in substantially parallel juxtaposition when said rings are in mating relation, and means for releasably holding said rings in such mating relation.

5. A circumcision clamp comprising a pair of substantially congruent, generally heart-shaped, mating rings, each ring being symmetrical on opposite sides of a median plane through the apices of said heart-shaped rings and each having a substantially uniform radial cross-section, the radial cross-section of one of said rings presenting a flat crown surface .and a relatively wide clamping surface sloping radially inwardly and downwardly from said crown surface, and the radial cross-section of the other of said rings presenting an anvil surface substantially normal to said crown surface, when .said rings are in mating relation, and a relatively narrow clamping surface sloping radiallyinwardlyand downwardly from said anvil surface, the two said clamping surfaces lying in substantially parallel juxtapostion when said rings are in mating relation, and means for releasably holding said rings in such mating relation, each of said rings "being curved out of a single plane to lie in a cylindrical curve having its axis of revolution substantially perpendicular to said median plane at a point remote from said mating rings on the side thereof opposite from said one ring.

6. A circumcision clamp comprising a pair of substantially congruent, generally heart-shaped, mating rings, each ring being symmetrical on opposite sides ofa median plane through the apices of said heart-shaped rings and each having a substantially-uniform radial cross-section, the radial cross-section of one of said rings presenting a fiat crown surface and a relatively wide clamping surface sloping radially inwardly and downwardly from said crown surface, and the radial cross-section of the other of said rings "presenting an anvil surface substantially normal to said crown surface, when said rings are in mating relation, "and a relatively narrow clamping surface sloping radially inwardly and downwardly from said anvil surface, the two said clamping surfaces lying in sub-- stantially parallel juxtaposition when said rings are in mating relation, and means for rele'asably holding said rings in such mating relation, comprising 'a pair of forceps, one of said rings being peripherally fixed to the end of one of the legs of said forceps at a point diametrically opposite from the apex of said one heart-shaped ring, and the other of said rings being peripherally fixed to the end of the other of the legs of said forceps at a point diametrically opposite from the apex of said other heartshaped ring, and including latch means for preventing relative movement between said forcep legs after said rings are moved into such mating relation.

7. A circumcision clamp comprising a pair of levers, pivot means connecting said levers intermediate their ends, latch means operatively supported between adjacent legs of said levers to permit the releasable locking of said levers against relative oscillation about the pivot means, a first ring peripherally supported on an end of one of said levers, and a second mating ring peripherally supported on an end of the other of said levers, said rings being substantially congruent and heart-shaped, the outer periphery of said second ring being slightly less than that of said first ring, each of said rings being substantially uniform "in radial cross-section, said first ring presenting in radial cross-section a "flat crown surface and a relatively broad clamping surface sloping radially inwardly and downwardly from said crown surface, and said second ring presenting in radial cross-section an anvil surface, substantially normal to said crown surface when said rings are in mating relation, and .a relatively narrow clamping surface sloping radially inwardly and downwardly from said anvil surface, said clamping surface lying in substantially parallel juxtaposition when said rings are in mating relation, and each of said rings furtherbeing curved out of .a single plane to ,lie in a cylindrical curve having its axis of revolution substantially perpendicular to the median plane through said rings on the side of said rings opposite from said first ring.

8. A circumcision clamp comprising a first centrallyopen ring formed to provide aperipherally-inwardly presented clamping surface and a continuous, unobstructed axially-presented crown surface, a second centrally-open ring formed to provide a first peripherally outwardly presented clamping surface and a second peripherallyoutwardly presented unobstructed anvil surface,-anc l means supporting said rings for movement toward and away from each other, with said first peripherally-outwardly presented surface of said second ring substantially parallel with said clamping surface of said first ring and engageable thereagainst, said anvil surface of said second ring being largely located axially beyond said crown surface when said clamping surfaces are substantially in mutual engagement.

6 References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 5 2,355,209 Dwoyer Aug. 8, 1944 2,533,373 Hinckley Dec. 12, 1950

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