The present invention is particularly concerned with, but not restricted to, a hand-held surgical tool for releasably engaging the cable of a vein stripper.

In this specification the term"cable"includes a wire, cord, thread or any generally similar member intended for use in surgery.

Background of the Invention In the operation of a previously proposed vein stripper (e. g. CH 632 659), the stripper cable is introduced into the vein in one direction, and a head is then attached to the forward end of the cable protruding from the vein to be stripped. An appropriate gripping tool is attached to the rear end of the cable, which is then pulled in the direction opposite to the direction of introduction, bringing along the cable and thus the forwardly attached head to extract and strip the vein. With this previously proposed stripping operation the surgeon cannot remain closely adjacent to the patient, particularly if the vein to be stripped is rather long.

It is the object for the present invention to provide a hand held tool which has advantages over the tools hitherto proposed in the art, in particular regarding the above identified problem.

Summary of the Invention According to the present invention there is provided a hand-held surgical tool for pulling a cable as hereinbefore defined, said tool including a gripping section adapted for releasably

gripping the cable in non slipping engagement therewith at different longitudinal locations on the cable to enable the tool to pull the cable in incremental steps and to be repositioned on the cable between successive pulling steps.

The gripping section may include a plurality of gripping teeth providing a gripping surface for the cable.

In one embodiment of the invention the gripping section may be in the form of a channel to receive the cable, and at least one of the two sides of the channel may have means to grip the cable therein. In a preferred embodiment of the invention this gripping means is in the form of a series of longitudinally spaced teeth.

The tool may also include inlet and outlet sections located upstream and downstream respectively of said gripping section.

The term downstream refers herin to the pulling direction of the cable.

The inlet and outlet sections may be spaced from the gripping section by guide paths directed to place the cable in non-slipping engagement with the gripping section when the cable is pulled tight.

The tool may be designed so that the operator's hand can grip the cable in the outlet section. In one embodiment of the invention the tool is designed to be held so that the cable is pulled in a direction along the longitudinal axis of the tool, and in another embodiment of the invention the tool is designed to be held so as to pull the cable in a direction transverse to the longitudinal direction of the tool.

According to another aspect of the invention the hand-held surgical tool is designed such that it is engageable with the cable at any position along the same, without any need to first pass a free end of the cable trough the tool.

According to yet another aspect of the invention the hand-held surgical tool further comprises means for initially guiding the cable along an open loop path about the gripping means, such that a subsequent pulling operation causes the length of said loop to decrease and, thereby, causes said cable to be brought into said non-slipping engagement with said gripping means.

Especially, the open cable loop can be U-shaped or V-shaped. When the tool is pulled, the length of the cable loop, and thus the height of the U or V, respectively, will decrease, causing the cable to be brought into said non-slipping engagement with the gripping means.

According to another aspect of the invention, the hand held sugical tool further comprises a tool body, wich defines an open loop path, in which a part of the cable is to be located, said open loop path being provided in connection to said gripping means, such that the cable is placed in non-slipping engagement with the gripping section when the cable is pulled tight by the tool.

Exemplary embodiments of the invention will now be described with reference to the accompanying drawings.

Brief Description of the Accompanying Drawings Figure 1 is a perspective view of a first embodiment of a hand-held tool according to the invention in the form of a vein stripping tool, Figure 2 is a sectional elevation of the tool of Figure 1 taken along a central longitudinal plane, Figure 3 is a perspective view of a second embodiment of a vein stripping tool according to the invention,

Figure 4 is a perspective view of a third embodiment of a vein stripping tool according to the invention, Figure 5 is a second perspective view of the vein stripping tool of fig 4, Figure 6 is a bottom view of the vein stripping tool of fig 4, and Figure 7 is a cross-sectional view of the vein stripping tool of fig 4.

Detailed Description of the Exemplary Embodiments Referring to Figures 1 and 2, the first embodiment of a vein stripper tool has an hand-held elongate body 2 injection moulded from a plastics material having the required mechanical properties and which can be sterilised. The body 2 includes an inlet guide member 4 at the front end of the body 2 and an outlet guide member 6. The guide members 4 and 6 are spaced from an intermediate cable gripping member 8 by guide paths 10 and 12, respectively. The guide paths 10 and 12 are open towards the lateral side of the body 2.

The body 2 further includes an interconnecting member 13, extending along one side of the body and interconnecting the three members 4,6 and 8. The inlet guide member 4 at the front end is shaped as a quadrant and has an arcuate grooved upper surface The outlet guide member 6 is rectangular and extends along the rear half of the body 2. The inlet and outlet guide members 4 and 6 have grooves 14 and 16, respectively in their respective upper surfaces to receive a vein stripper cable (not shown) therein.

In this embodiment, the inlet guide member 4 presents a reduced height in relation to the rest of the body 2. This results in that a larger area of the interconnecting memeber 13 becomes exposed. This area could function as an additional retaining element, in case the cable should slip out of the groove 14 in the inlet guide member 4.

The intermediate cable gripping member 8 has an upwardly tapered channel 20 therein which is open at the bottom surface of the gripping member 8 and which is in contact with

the two guide paths 10 and 12. A series of downwardly and rearwardly extending longitudinally spaced gripping teeth 18 are mounted on opposed side walls of the tapered channel 20 to provide a series of inwardly directed gripping surfaces 21.

The inlet guide path 10, the channel 20 and the outlet guide path 12, together form means for initially guiding the cable along an open loop about the gripping member 8. When the cable is slack, it will run through the inlet guide path 10, the lower part of the channel 20 and the outlet guide path 12. A subsequent pulling operation will cause the size of said cable loop to decrease, whereby a part of the loop will enter the upper part of the channel 20 and come into contact with the gripping teeth 18, which will hold the cable in non- slipping engagement.

The tool can easily be applied at any part of the cable, and there is no need to first pass a free end of the cable through the tool.

In operation, the vein stripper cable is at least partly introduced in the patient's vein and a head is then attached to the forward end of the cable protruding from the vein. An exposed slack portion of the rear end of the cable near the vein entrance point is passed under the gripping member 8, through the the guide paths 10 and 12 and placed in the grooves 14 and 16. The operator then pulls on the cable using the hand-held tool. When the cable has been pulled tight the cable enters the upper region of the tapered channel 20 to be held by the gripping surfaces 21 of the gripping teeth 18. Thereafter, when the cable has been pulled a short distance from the patient, the cable is allowed to slacken againand the tool is repositioned on the cable to a position near the vein entrance point ready for the next pulling operation. In this way, the stripper cable can be pulled out of the patient's body in incremental steps by relocating the tool to a position near the patient's body, pulling the cable a short distance, slackening the cable, relocating the tool on the cable near the patient's body, and carrying out the next pulling operation on the cable. This overcomes the problem encountered in previously proposed devices in which the operator has to move further and further away from the patient's body when stripping a vein from the patient.

The gripping tool is designed so that it is pulled in the longitudinal direction of the body 2 with the operator's thumb over the groove 16 and the fingers wrapped around the lower part of the outlet guide member 6.

For repositionning the gripping tool, the cable is slackened and released from the grip of the gripping surfaces 21 in the tapered channel 20. Parts of the cable will still be positionned in the groove 14 of the inlet guide member 4 and the inlet guide path 10. Now, the gripping tool can be moved so that the cable slides along the groove 14 and the inlet guide path 10, until a position where the next pulling operation should take place is reached. There, the gripping tool is manouevered so that the cable is again introduced into the tapered channel 20 and gripped by the gripping surface 21 in the upper part of the channel. Optionally, the cable could slide against the groove 14, the inlet guide path 10, the lower part of the channel 20 and the outlet guide path 12 during the sliding motion. In this case, care must be taken so that the cable is not unintentionally introduced into the upper part of the channel 20 and gripped by the gripping surfaces 21. This repositionning manouever could, after some practice, be made using one hand only.

Referring to Figure 3, the second embodiment of a vein stripper tool according to the invention has a hand-held elongate, slightly curved body 22 which is also injection moulded from a plastics material having the required mechanical properties and which can be sterilised. In accordance with the first embodiment in Figures 1 and 2, this body 22 also includes a holding member 24and an outlet guide member26 which are spaced from an intermediate cable gripping member 28 by guide paths 30 and 32. The body 22 further includes an interconnecting member 23, extending along one side of the body and interconnecting the three members 24,26 and 28. The outlet guide member 26 has a relatively deep channel 34 in its upper surface to receive the vein stripper cable.

The body 22 is shaped so that the upper part 30'of the inlet guide path 30 is located slightly above the concave upper surface 36 of the remainder of the body 22. This serves to place the incoming cable 46 in a way that facilitates manoevring of the tool.

The intermediate cable gripping member 28 has an upwardly tapered channel 40 therein which is open towards the bottom surface of the member 28. A series of downwardly extending longitudinally spaced gripping teeth 42 are mounted on the opposed walls of the channel 40 to provide a series of inwardly directed gripping surfaces 44.

In operation, the vein stripper cable is located in the patient's vein, and a head is attached to the forward end of the cable protruding from the vein. An exposed slack portion of the rear end of the cable near the vein entrance point is fed into the guide path 30, into the tapered channel 40, up the outlet guide path 32 and into the deep channel 34 in the outlet guide member 26. The holding member 24 functions as a practical handle for holding and manoevring the tool.

It should be appreciated that the tool is designed such that it, in the described manner, is enageable with the cable 46 at any position along the same, without any need to first pass a free end of the cable 46 trough the tool.

The cable is then pulled by the tool member, and when the cable 46 has been pulled tight the cable 46 enters the upper region of the tapered channel 40 to be held by the gripping surfaces 44 of the gripping teeth 42.

The means for initially guiding the cable 46 along an open loop path about the gripping means 28 comprises in this embodiment the inlet guide path 30, the channel 40, the outlet guide path 32 and the deep channel 34 in the outlet guide member 26. Similary to the first embodiment (fig 1 & 2), a subsequent pulling operation causes the size of said cable loop to decrease, whereby the cable 46 is brought into non-slipping engagement with the gripping means 28.

This tool body 22 is designed to be pulled in a direction transverse to its longitudinal axis so that the operator's hand is positioned as if holding a cup.

As with the tool of Figures 1 and 2, the operator uses this tool body 22 to pull the cable a short distance, the cable 46 is then allowed to slacken and be repositioned on the tool body 22 with the tool body located near the vein entrance point, and the next pulling operation

takes place. In this way, the stripper cable 46 can be pulled out of the patient's body in incremental steps and the pulling force can be maintained near the patient's body.

When repositionning this embodiment of the hand held tool, the cable 46 could preferably slide along the inlet guide path 30, the tapered channel 40, the outlet guide path 32 and the deep channel 34 in the outlet guide member 26.

A third embodiment of the invention is depicted in Figs 4-7. This embodiment is similar to the second embodiment (Fig 3), and like parts has been provided with the like reference numerals as in second embodiment, where applicable.

The third embodiment differs from the second embodiment in that the upper part 30'of the inlet guide path 30 is provided with an indentation that is adapted to receive the incoming cable and to position it laterally. The upper part 30'of the inlet guide path 30 is also, as in the second embodiment, located slightly above the concave upper surface 36 of the remainder body 22. These features are both useful to ensure that the placement of the incoming cable is controlled.

Further, the third embodiment is provided with a cable holder groove 45, provided in the side of the outlet section 26. When the cable is in engagement with the gripping section, and the cable is to be pulled, the free end of the cable could be introduced into the cable holder groove 45. This is a practical feature, since it ensures control of the location of the free end of the cable. Otherwise, there is a risk that the free end of the cable could fall out of the sterilised area, and then back in again, which would contaminate the sterilised area.

Also, a free hanging end of the cable could come in the way of the personnel involved.

In Figs 6 and 7, the construction of the gripping surfaces 44 and gripping teeth 42 is seen.

This construction is similar to the construction of the second embodiment of the invention.

Other variants and constructions are possible within the scope of the invention. The shape of the tool body 2 could of course be varied. The gripping surfaces 44 could be provided with other types of gripping means than the teeth 44, such as bars or knobs. The holding member 24 could for example be ergonomically shaped.