A 19th-century suturing device used to approximate cleft segments of the palate membrane, attributed to Messrs. Down Brothers of Saint Thomas Street, London.
This rare device is housed within a velvet-lined wood and leather case. Several needles of various shapes and sizes accompany the set. Silver wire is spooled at the bottom via a crank system, which may be then advanced inside the contraption and through the needle by means of a thumbwheel pulley.
“The closure of the soft palate is then processed with, fine silver wire being used, with horse hair or silk for the uvula. Mr. Smith employs a sharply curved tubular needle for the wire, which is carried on a wheel in the handle of the instrument, and can be projected when the point has traversed both sides of the palate (Braithwaite et al., 1883, p. 240).”
“The following is an outline of the steps to be taken when operating upon the soft palate. Anaesthesia, having been induced, and the hands secured to the hips, the gag is introduced and held in position, and the mouth opened to the required extent. The mucous membrane is freely pared from the margins of the cleft from below upwards. I use fine silver wire sutures, inserted from below upwards, with the aid of Mr. Smith’s tubular needle – a modification of Marion Sim’s vesical fistula needle. A small curved needle held in a holder is useful for the uvula. In simpler cases of fissured velum, neither division of the palatine muscles nor lateral incisions are required. The wire sutures, if there be no traction on the margins, will control muscular resistance (Rawdon, 1880, p. 916).”
Braithwaite, W., Braithwait, J., & Heath, C. (1883). Affections of the digestive system: Cleft palate. The Retrospect of Practical Medicine and Surgery, 86, 240.
Rawdon, H. G. (1880, June 19). The Operative Treatment Of Cleft Palate In Children. The British Medical Journal, 1(1016), 916.
- From the Lusignan collection