Extract from " The St. Louis Medical and Surgical Journal," October, 1890. 
A NEW INTESTINAL CLAMP. 
BY A. V. L.*BROKAW, M.D. 
Demonstrator of Anatomy, and Operative Surgery Missouri Medical College, 
Junior Surgeon of St. John's Hospital, etc., St. Louis. 
Surgeons of experience have found a necessity for a thor- 
oughly practical and simple clamp to be used in operative 
work on the intestines. The rapid and safe application of an 
intestinal clamp is a simple yet all-important step and one 
which is fraught with much annoyance owing to the many 
deficiencies which most clamps present. In my experimantal 
and actual work in the domain of intestinal surgery, I have 
on more than one occasion felt the sore need of a clamp that 
could be speedily applied and left in situ with some assurance 
of security. 
When I first began my work in the field of intestinal sur- 
gery, I tried numerous means, but was not thoroughly satis- 
fied with any of the various appliances which our local instru- 
ment makers supplied. I have used several varieties of 
clamps and such devices as rubber tubing and strips of gauze. 
In some cases I was even fortunate enough to procure the 
"soft, dexterous fingers of an assistant" to aid me in my 
work ; but often the last mentioned aid was anything but soft 
and dexterous, sometimes, on the contrary sublimely rude 
and awkward. 
Extensive experimental study led me to the conviction that 
a clamp, made after the following manner, served its pur- 
pose well. A piece of No. 12 copper wire, 6 or 8 inches 
long, is covered with a piece of drainage tubing, by forcing the wire through its lumen. The rubber is left to overlap, 
and its ends are ligated to prevent denudation of the wire and 
disengagement of the tubing. The rubber-covered wire is 
now evenly flexed upon itself, until it presents two perfectly 
parallel blades of equal length, and the completed clamp is 
ready for use, and is applied in the same manner as the clamp 
to be described further on. While this clamp is simple and 
inexpensive, it answers admirably, and has been used by me 
since 1889; but it is devoid of that mechanical finish which, 
although not necessary, is more in harmony with the surgical 
nicety of this age. Furthermore, this clamp has one marked 
disadvantage, i. e., it can not be as thoroughly cleansed as 
modern antisepsis demands. 
For these reasons the clamp to be described and illustrated 
has been devised. Such improvements have been made, as 
to cancel all objectionable features, affording us a perfect 
means of compressing the intestine. 
A 
B 
From drawings furnished my instrument maker (A. S. 
Aloe & Co.), the instrument,shown in the cut was made. It 
consists of two parallel blades or limbs, A and J3, held in 
position by a wide piece of spring metal; the spring being so 
tempered, as to give a tendancy to seperation of the blades. 
The limbs are made of soft steel, which may be bent with the 
lingers should occasion demand. Upon the ends of either 
blade is fitted an acorn tip, which may be screwed on or off 
when necessary; each blade is covered with rubber tubing 
(drainage tubing), or, what is more desirable, with soft rub- 
ber catheter. After covering the blades, the acorn tips are 
screwed on the tubing, approximated well under the shoulders 
of the tips, and the instrument is ready to be applied. This, 
briefly, is a description of the clamp; as to the manner of 
its application, nothing could be simpler. One blade of the 
Fig. 10. Intestinal Clamp. clamp is pushed through the mesentery within a short dis" 
tance from the attached surface or concavity of the intestine. 
(See Fig. 11.) The ends of the clamp are pressed together 
Fig. 11. Intestinal Clamp Applied. 
sufficiently to compress the gut, and a ligature (figure of 
eight) is rapidly thrown round the extremities of the blades 
It is evident at a glance that the operator can regulate to a 
certainty the amount of compression upon the gut and no 
danger can accrue from undue constriction. All other spring 
clamps, which have fallen under my observation, have a tend- 
ency to compress too strongly, and thereby give rise to the 
danger of pressure gangrene, or the spring is to weak and 
does not accomplish its object. In the clamp figured in the 
illustrations, the surgeon regulates with the greatest ease and 
exactness the amount of pressure brought to bear upon the 
gut, a consideration of the greatest importance. The length 
of the parallel blades admits of an assistant holding them, 
while the operator is engaged. 
This clamp has not been presented for theoretical reasons, 
but has repeatedly been employed in intestinal work; and 
those who have used it testify to its absolute superiority over 
other contrivances. The advantages claimed for the clamp are these: 
1°. Simplicity of mechanism and the ease with which it 
is applied. 
2°. Absolute uniform compression of the bowel. 
3°. Rapidity with which applied and removed. 
4°. Precise regulation of the amount of compression. 
5°. Readiness with which the parts are separated and 
sterilized. 
The clamps that are most popular and most generally used 
are not favored with these advantages; they are, as a ride, 
expensive, and, with a few exceptions, present such a compli- 
cated arrangement, that the aim attempted is not entirely 
attained. The less complicated instruments have a more 
grevious disadvantage - they are incapable of accurate ad- 
justment and regulation in the amount of pressure, and hence 
are absolutely worthless if not directly harmful.