Surgical Instrument. Page: 3 of 4
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709,367
of the meeting lacerated edges for the pur-
pose hereinafter appearing.
e represents notches or grooves formed
transversely in the opposite sides or lengths
5 of each part of the instrument to receive and
hold the sutures against slipping and to main-
tain the same in proper position.
Where a lacerated perineum is to be oper-
ated on, the sutures are inserted through the
io vaginal wall about three-eighths of an inch
from the lacerated edge and passed in through
the rectal wall about the same distance from
the lacerated edge therein and then across
the lacerated rectal wall and through the
r5 same about three-eighths of an inch on the
other side of the lacerated edges from which
the sutures entered the rectal wall and back
through the vaginal wall on the opposite side
of the laceration from where the sutures were
20 first entered. The necessary number of su-
tures are inserted and passed through the
vaginal and rectal walls and left loose with
long ends in the vagina. The rupture is then
pressed apart and the curved blade is placed
25 in the vagina and the other blade in the rec-
tum between the sutures and the lacerated
side of the wall. The blades of the instru-
ment are then adjusted toward each other to
the necessary positions to properly hold the
30 parts, and the clamping device is locked to
firmly hold the blades and body portion in
the desired positions. The sutures f, Fig.
5, after the instrument has thus been in-
serted and properly adjusted with the su-
35 tures fitting in the grooves or notches, are
properly tied. The body portion of the in-
strument rests and bears against the exter-
nal wall of the perineum, and sutures f are
passed through the said exterior wall, in at
40 one side of the laceration and out at the other
side and around the body portion of the in-
strument, and tied at the exterior, as indi-
cated in Fig. 5. Also, if need be, certain
sutures can be inserted through the vaginal
45 wall and around the curved blade therein
and through the exterior wall and around and
tied over the body portion of the instrument,
as shown. It will be noted that the sutures
on each side of the laceration pass over or
So across the opposite lengths of each portion of
the instrument, so that the instrument, in
effect, forms a framework on which the su-
tures are stretched and which takes the strain
and relieves the body of the patient from
55 the strain of the sutures. The instrument
also clamps or holds the ruptured parts to-
gether and against strain, as the instrument,
in effect, forms a triangle between the three
walls of which the ruptured perineum is held
60 or clamped, while the longitudinal openings
of the instrument expose the lacerated edges,
so that they can be inspected and treated.
After the lacerated edges have properly
united the sutures are cut and removed, the
65 connecting or clamping device of the instru-
ment is loosened, and the body portion is re-
moved, drawing the blade from the rectum,and then the curved blade is drawn from the
vagina. When the instrument is inserted,
before the sutures are tightened and tied 70
around the same, it is desirable that the two
blades extend into the vagina and rectum to
points above the lacerations in the walls of
said parts. When the sutures are drawn
and tied around the instrument, the lacer- 75
ated edges are properly brought together and
thus held without strain on the parts until
union is complete.
The instrument can be made of well-plated
steel of sufficient stiffness to prevent spring- 8o
ing when the sutures are drawn over the same
and tied.
It is obvious that in accordance with my
invention stiff open-work frames can be em-
ployed to rest against a part of the body and 85
around a wound or rupture, so that the su-
tures can pass over the portions of the frame
on opposite sides of the lacerated edges and
receive the strain thereof when the sutures
are tightened and tied to draw the lacerated 90
edges together.
Having thus fully described my invention,
what I claim as new, and desire to secure by
Letters Patent of the United States, is-
1. A surgical instrument formed to.codper- 95
ate with sutures in drawing and holding to-
gether the edges of a wound, rupture or lacer-
ation, and comprising a stiff open suture-re-
ceiving frame formed to rest against the lacer-
ated portion surrounding the cut and with the 10o
lacerated edges exposed in the opening of the
frame, so that the sutures can be stretched
transversely around the frame from one side
of the laceration to the other, for the purposes
stated, the frame having transverse suture- 1o5
holding notches along the outer edges of the
opposite longitudinal portions.
2. In a device of the character described,
the combination of a member having adjacent
parallel angular portions; and a member hav- 110
ing adjacent curved portions lying in parallel
planes; the members being secured together
at one extremity and inclosing a free open
space substantially triangular in outline.
3. In a device of the character described, 115
the combination of a member having adjacent
parallel angular portions; and a member hav-
ing adjacent curved portions lying in parallel
planes; the members being adjustably se-
cured together at one extremity and inclosing 120
a free open space substantially triangular in
outline.
4. In a device of the character described,
the combination of a member having adjacent
parallel angular portions; and a member hav- 125
ing adjacent curved portions lying in parallel
planes; the several portions having notches
in their outer sides; the members being se-
cured together at their extremities.
5. In a device of the character described, 130
the combination of a member having adjacent
angular portions; and a member having ad-
jacent curved portions; each of the curved
portions lying in the same plane with one of2
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Simpson, Richard H. Surgical Instrument., patent, September 16, 1902; [Washington D.C.]. (https://texashistory.unt.edu/ark:/67531/metapth509799/m1/3/: accessed July 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.