Note: Descriptions are shown in the official language in which they were submitted.
.
:..
BACK~ROUND OE` THE INVENTION
~ 1. Copending Patent Applications
-
In Canadian Patent number 1,0~2,552 entitled HEMOSTATIC
CLIP APPLICATOR issued July 29, 1980, and assigned to the present
assignee, a hemostatic clip applicato.r for the strangulation OL
tubular members in a rapid and automatic manner is disclosed.
Also, in copending Canadian Patent Application serial number
291,946 entitled HENOSTATIC CLIP filed November 29, 1977, and
assigned to the present assignee, hemostatic clips adapted for
utiliæation in the present invention and similar devices is
disclosed.
6~S
1 2. Field of the Invention
2 The invention relates to the field of devices useful
3 in the application of hemostatic clips, and more specifically,
4 to devices for the application of hemostatic clips used in
the stransulation of blood vessels and other fluid ducts.
6 3. Prior Art
7 In a typical surgery procedure, a great many veins,
~ arteries, and other blood vessels must be severed and closed.
9 This is often a difficult and time consuming procedure
since many vessels are located in obscure areas where there
11 is little room in which to work. Thus, it is apparent that
12 a device which would reduce the time requied for closure
13 of blood vessels wo~ld be of great benefit to both the surgeon
14 and the patient.
One prior art atteMpt to provide a device which can
16 more rapidly close a blood vessel is disclosed by Wood, ~.S.
17 Patent No. 3,326,216. The Wood device consists of a hemo-
18 stat-like instrument which has finger loop portions coupled
19 to jaw p~tior.s. The jaw portions are adapted to hold a
~l, hemostatic clip therebetween so that the clip may be closed
~ about a vessel by bringing the finger loops together. Wood
2~ also disc70ses a separate cartridge which holds a pl~rality
23~i of clips. ~hen the Wood device is to be used, the jaw
24, portions are placed about one clip contained in the cartridge,
~5i and the clip is removed from the cartridge by the
engagement of the clip by the jaw portions. Then when
27i the ciip has been used, a new clip may be placed in
28il the device by returning to the clip cartridye and inserting
2~¦l a new clip. Two problems are apparent with the Wood ¦
301, àevice. Eirst, the hemostatic clips are not automatically
3111i
~2 1
~ q~,~S ~
1 fed into the jaws of the device, but must be individually
2 placed there. This procedure is time consuming and cumber-
3 some. In addition, the Wood device is capable of expanding
4 its jaws wider than the width of a clip contained therein.
Thus, a clip may be accidentally dropped from the device
6 causing a great deal of inconvenience and delay.
7 A second prior art attempt to provide more rapid yet
8 effective strangulation of blood vessels and the like is
9 described by Miles, U.S. Patent No. 3,082,426. Miles discloses
a surgicial stapling device which consists of finger loops
11 coupled to a pair of arms which terminate in jaw portions,
12 the jaw portions being adapated to grasp and hold a tubular
13 member. The device also has a magazine for holding a
14 plurality of clips along the length of one arm, and manually
operable clip ejector means for placing a clip about the
1 tubular member which is to be closed. In operation, the
~71 tubular member is first grasped and held by the jaw portions
~31 f the Miles device. The surgeon then places his index
19¦ finger on a button attached to the clip ejector. By
~1 urging the butt.on forward, the clip ejector places a clip about
21 1 the tubular member. Then, the clip may be deformed about the
?~ j~, blood bessel by bringing the pair of finger loops together.
~3,'1 An obvious disadvantage of the Miles device is that it is
24~,1 cumbersomer in that the surgeon must manually move a clip betwee
25~ the jaws of the device while holding the device steady so as
~6 not to loose the grasp of the tubular member. Also, as the
27ii clips are used from the cartridge, the button moves farther
28¦¦ forward so that it becomes more and more difficult to reach.
2~¦1 Also, this procedure is time consuming in that each individual
30¦¦ clip must be manually fed between the jaws of the stapling
3'l!
~2~1
l~Z46~5
~11 device. Furthermore, the construction of the Miles device,
2¦ particularly in the jaw portions, provides poor visability
31 to the surgeon since the thickness of the device obscures the
41 vessels which are to be closed.
51 Another prior art attempt to provide rapid application
6 of hemostatic clips is disclosed by DeCarlo, ~.S. Patent No.
7 3,740,944. DeCarlo discloses a gun-like device for suturing
8 and severing blood vessels in a three stage procedure.
9 ~irst, jaws of the device are closed about the blood
vessel by the actuation of the gun-like trigger mechanism.
11 Second, a pair of pushers extend through the device and come
12 forward to crimp a pair of clips, brought from an internal
13 magazine, about the vessel in two spaced locations. Third,
14 a blade comes forward from the device upon further actuation
of the gun-like handles and severes the blood vessels between
16 the two clip locations.
17 I The internal clip magazine of the DeCarlo device uses a
18 pair of leaf spring assemblies to index a plurality of
19 pairs of hemostatic clips. The clips are stored in a
pair of index guide rails where they are moved forward in unison
21¦ by opposing leaf spring assemblies. One leaf spring assembly
22¦ is attached to the moveable main body portion while the
~31 opposing lea~ spring assembly is affixed to one guide rail.
24, When the gun-like handles are actuated, the leaf spring assembly
2~ attached to the main body moves forward and contacts portions
26 of the clips contained within the magazine. ~urther
27,, movement of the main body portion moves individual clips along
28" the index guide rail and ultimately ejects a pair of clips.
29¦ ~hen a pair of clips has been ejected, the main body portion
30~ begins to return to its orginal static position. During this
1,, ~ ~.
'1 4
605
1 rearward movement of the main body portion, there is a trans-
2 ference of a pair of clips from the inaex yuide rails to the
3 ejection guide rails. This transference occurs when each leaf
4 spring assembly and its corresponding rar,lp portions guide
a clip from one index guide rail to the ejection guide
6 ¦ rail where it is available for loading into the front portion
7 I of the instrument.
8 One problem with the ~eCarlo device is that, due
9 to the three stage operation, the device is necessarily
bulky. This is a major disadvantage in that many surgical
11 procedures require severence and closure of blood vessels
12 in very limited areas so that a bulky instrument may
13 not: be able to reach the required vessel. The bulkiness
14 of the device also creates a further disadvantage in that it
produces a lack of visibility for the surgeon. Thus, the
16 very vessel that is to be severed and closed may be obscured
17 since the surgeon may not be able to see around the device.
18 A further disadvantage stems from the fact that the DeCarlo
19 device does not adapt to the application of a single clip, but
only applies a pair of clips to the vessel to be closed. In
21 a great many surgical procedures, only the application of one
22,l clip is desi~ed while the application of two clips would only
23,, ~omplicate the severance proceciure.
24', Accordingly, it is a general object of the present
~511 invention to provide an improved hemostatic clip applicator
~6 device for the strangulation of blood vessels and the like.
271, It is another object of the present invention to provide
281, an- improved hemostatic clip applicating device which automati-
29 I cally feeds clips to its forward portion and then provides
30 ¦ utomatic deformation of the clips about hlood vessels.
~21
11
li 5.
~lZ46~5
1 It is yet another object of the present invention
2 to provide an improved hemostatic clip applicator device
3 which provides high visibility to the user.
4 It is yet another object of the present invention to
provide an improved hemostatic clip applicator device which
61 has an externally coupled and replaceable clip cartridge
71 or in the alternative, a disposable hemostatic clip applicator
3 ¦ device which has an externally coupled clip cartridge.
9 ¦ It is a still further object of the present invention
10 ¦ to provide an improved hemostatic clip applicator device
11 ¦ which is incapable of accidentally dropping clips from
12 the device.
13 Summary of the Invention
____ __
14 A hemostatic clip applicator device useful for rapidly
and automatically applying clips for the strangulation of
16 blood vessels and the like is provided. The devlce has
17 a clip magazine means coupled to the exterior of a main
1~ body, the clip magazine means being adapted to hold a plurality
13 of hemostatic clips. Attached to one end of the main body is
a clip deforming means adapted to hold and crimp a hemostatic
21 clip about a blood vessel. 51ideably disposed within the
22l main body is a clip feed means which is adapted to move clips
2311 from the clip magazine means to the clip deforming means.
24!l Coupled to the clip feed means and the clip deforming means
2~i are actuating means. By a se~uential forward and rearward
2b~ movement of the actuating means, a hemostatic clip is fed
271l from the clip magazine means into the main body, where it
28!, is moved forward to the clip deforming means and there crimped
29l about a blood vessel or the like. This sequence of feeding
30¦ clips to the clip deforming means and crimping them therein,
31lj
32l
Ii.
~.
~4605 ~ ~
1 may be repeated until the plurality of clips located in the
2 clip magazine means is depleted.
3 The novel features which are believed to be characteristic
4 of the invention, both as to its organization and its method
of operation, together with further objects and advantages
6 thereof, will be better understood from the following
7 description in connection with accompanying drawings in which
a presently preferred embodiment of the invention is illus-
9 trated by way of example. It is to be expressly understood,
however, that the drawings are for purposes of illustration
11 and description only and are not intended as a definition of
12 the limits of the invention.
t3 Brief Description of the Drawings
14 FIGURE l is a side view of the clip applicating device
of the present invention;
16 FIGURE 2 is a top view of the forward portion of the
17 clip applicating device of the present invention, showing the
18 curved jaw portions;
19 FIGURE 3 is an enlarged view of the jaw portions of the
~n present invention showing a hemostatic clip closed by the
211 clip applicating device;
~ ! FIGU~E 4 is an enlarged view of the forward portion of
23¦li the clip applicating device of the present invention;
~4!~ FIGruR3 5 is an enlarged view of the top of the forward
25,, portion of the clip applicating device showing the clip magazine
2~,' in its relationship to the device;
~7j~ FIGURE 6 is an enlarged view of the forward portion nf
28¦l the clip applicating device of the present invention;
29;l FIG~RE 7 is a side view of the clip magazine of the
30¦l present invention;
'
l, 7.
1~4S~5
1 FIG~RE & is a perspective view of the clip magazine of
2 the present invention;
3 FIGURE 9 is a top view of an alternate embodiment of
4 ¦the clip magazine means of the present invention;
FIGURE 10 is a perspective view of an alternate
6 embodiment of the clip maga~ine of the present invention;
7 ¦ FIGURE 11 is a side view of an alternate embodiment of the
8 ¦clip magazine and clip magazine spring means of the present
9 ¦invention;
FIGURE 12 is a side view of an alternate embodiment of
11 the clip applicating device of the present invention;
12 ¦ FIGURE 13 is a top view of an alternate embodiment of
13 the clip applicating device of the present invention;
14 FIGURE 14 is an enlarged view of a portion of the clip
15 magazine means;
16 I FIGURE 15 is a cross-sectional view of the applicating de-
17 Ivice of the present invention taken along lines 15-15 of ~IGURE 14;
18 ¦ FIGURES 16a and 16b are a top and side view respectively
13 I¦of the lost motion link means of the present invention; and
~ol¦ FIGURES 17a, 17b and 17c illustrate the progressive
2~ novement of a clip within the clip magazine means of an
2~,alternate embodiment of the present invention.
23'Detailed 3escriE~_on of the Invention
24, A hemostatic clip applicator device is disclosed which is
25" useful in rapidly applying a hemostatic clip about blood vessels
_6 and other fluid ducts. The hemostatic clip applicator of the
~71 present invention may be used with hemostatic clips such as is
23¦ldescribed in our co-pending application, Serial No. 2~47
29~ iled on ~ entitled "Hemostatic Clip", or with
30l, any other suitably adapted hemostatic clip.
31 1, 1
32 i, 1.
,, i
il ~ ' ,
1 Referring to FIGURE 1, the hemostatic clip applying
2 device 2 of the present invention is shown in its static
3 configuration. Clip applying device 2 has an actuating
4 means comprised of an upper handle portion and a lower handle
portion. In the presently preferred embodiment, the upper
6 handle portion is comprised of upper finger loop 4, and upper
7 finger loop member 5, while the lower handle portion is
8 comprised of lower finger loop 6 and lower finger loop member
9 7. It can be seen in phantom in FIGURE 1 that upper finger
loop 4 may be brought to its forward position 8, while lower
11 finger loop 6 may be moved to an inward position 10.
12 Upper finger loop 4 and upper finger loop member 5 pivot
13 about upper finger loop pivot 12 while being biased
14 toward rear stop pin 16 by f irst spring means 14. Upper
finger loop member 5 is coupled to clip feed blade 18 by
16 feed blade pivot 17. -
17 Clip feed blade 18 is a clip feed means which in
18 the presently preferred embodiment is a blade member
19 adapted to siide through main body 20 by the forward
movement o~ upper finger loop 4. Upper finger loop 4
21 will continue to move clip feed blade 18 through main
~? ~ body 20 until upper finger loop member 5 abuts forward
23l~ stop me~ns 21. The leading edge 24 of clip feed blade
24~i 18 is adapted to correspond to the bail portion Qr trailing
25, edge of a hemostatic clip which may be placed in recess
~,, 26 by any suitably adapted means. In the presently
271~ preferred embodiment, leading edge 24 is "V" shaped.
28 ~ Thus, it can be seen from FIGURE 1 that when a hemostatic
29 I clip is placed in the clip receivin~ means formed by
30 I recess 26, the forward movement of ~pper finger loop
31 l
32 Il,
~.
ll
S
1 4 will cause clip feed blade 18 to abut the bail portlon
2 of the hemostatic clip and move the clip toward the
3 forward end of main body 20.
4 Coupled to the forward portion of main body 20 is a
5¦¦ clip deforming means adapted to deform a hemostatic clip
6 about a blood vessel or the like. In the present~y preferred
7 embodiment, the clip deforming means is comprised of upper
8 jaw portion 32 and lower jaw portion 34. Upper jaw portion
9 32 is fixedly coupled to lower finger loop member 7 and
pivotally coupled to main body 20, while lower jaw portion
11 34 is fixedly coupled to main body 20. When a hemostatic
12 clip has been fed from the clip magazine into recess
13 26 and moved forward by clip feed blade 18 to jaw portions
14 32 and 34, the clip may be squeezed about a blood vessel
by first returning upper finger loop 4 to its rearward
16 position and then raising finger loop 6 to its phantom
17 position 10 so that upper jaw portion 32 closes toward
18 lower jaw portion 34. It is important to note that the
19 outward movement of upper jaw portion 32 is limited by
the abutment of lower finger loop member 7 with lower
21 finger loop stop pin 19. Thus, if a hemostatic clip is
located in jaw portions 32 and 34, it may not be accidentally
~3,` dropped by the over expansion of upper jaw 32. Lower
24lli finger loop 6 and lower finger loop member 7 are baised
25l, toward their static configuration by second spring means
2~', 22 so that upper jaw portion 32 will return to its open
27 li position when lower finger loop 6 is no longer raised to
28¦¦ to its phantom position ]Ø Also shown in FIGURE 1 are
29 ¦ mounting holes 28 and rivets 30 adapted to couple a clip
30 I magazine, which will be more fully described hereinbelow,
311
~21 .
il 10-
llZ46~5
1I to main portion 20.
2 ~ FIGURE 2 is a top view of the forward portion of clip
31 applying device 2. Illustrated here is the relationship
4ll between main body 20, lower finger loop member 7 and
5 I upper jaw portion 32. It can be seen that lower finger loop
6 member 7 is fixedly coupled to upper jaw portion 32, while
7 the combination of member 7 and jaw portion 32 is pivotally
8 coupled to main body 20 by upper jaw pivot 36. Thus, rotation
9 of member 7 about pivot 36 by movement of lower finger loop 6
results in rotation of upper jaw 32 about pivot 36. Therefore,
11 inward and outward movement of lower finger loop 6 will result
12 in movement of upper jaw 32 toward and away from lower jaw
13 portion 34. Also shown in ~IGURE 2 is the curved configuration
14 of upper jaw portion 32 and lower jaw portion 34.
This curved forward portion of clip applying device 2 provides
16 the distinct advantage of improved visability during usage
17 since the vessel which is to be closed will be located to one
18 side or the other of the main body 20. Although the presently
19 preferred embodiment of the upper and lower jaw portions
utilizes a curved configuration, other configurations~ such
21 as straight jaw portions, may also be used.
2 FIGURE 3 illustrates the jaw portions 32 and 34 as they
23 are closed about a deformed clip 38. This configuration would
24,, have resulted from the feeding of a clip into the jaw portions
~5'~ 32 and, 34 by the forward movement of upper finger loop 4,
26l, followed by the rearward movement of upper finger loop 4 and
27 il then the inward movement of lower finger loop 6. It may be
281 noted that rearward movement of upper finger loop 4 has caused
291l feed blade 18 to return to its unactuated posit.ion, thus exiting
3011 jaw portions 32 and 34 and recess 26, so that the jaw portions
i, 11. 1
Z~605 ~ ~
1 are free to close about a clip.
2 I FIGURE 4 shows in greater detail the forward portion of
3 clip applying device 2, including clip feed blade 18 and its
4 leading edge 24 as it is disposed in groove 35 in main body
20. It can be seen that a clip 37 disposed in recess 26 will
6 be moved forward by the leading edge 24 of clip feed blade
7 18 so that the clip 37 and clip feed blade 18 slide within the
8 groove 40 in upper jaw portion 32 and groove 42 in lower jaw
9 portion 34. As noted in FIGURE 2, jaw portions 32 and 34
are curved away from main body 20. Thus, feed blad~ 18
11 must be configured so as to be capable of being moved for-
12 ward through grooves 35, 40 and 42 while simultaneously
13 bending away from main body 20 in grooves 40 and 42. In
14 the presently preferred embodiment, this capability has been
provided by constructing feed blade 18 of four layers
16 of thin blades of metal in a laminated configuration. The
17 four layers are only coupled at discrete points so that
18 feed blade 18 is able to move longitudinally through main
79 body 20 while curving around grooves 40 and 42 in jaw :
portions 32 and 34. Also shown in FIGURE 4 are rivets 30
21 and mountin~ holes 28 for coupling a clip magazine to the
22 clip ap?licator device 2.
23 FIGURE 5 is a top view of the forward portion of clip
24~ applying device 2 showing lateral clip magazine 41 replace-
~5l~ ably coupled to main body 20 by clip magazine pin 46
26¦, disposed in mounting hole 20 and clip leaf spring 48 disposed
27 under rivet 30. ~emostatic clips are disposed in clip magazine
28 housing 44 in a lateral relationship to main body 20 and
29 urged toward recess 26 of clip applying device 2 by -the spring
30l CoDtaCt 50 of central clip leaf sprlng 49. ~hus, when clip
32,
jl 12.
~ 35
1 feed blade 18 is in its fully retracted position, recess
2 26 is clear so that a clip may be fed from clip magazine
3 housing 44 into recess 26. The clip disposed in recess 26
4 is then available for movement to the jaw portions 32 and
34 when clip feed blade 18 is moved forward by the actuation
6 of upper finger loop 4. Both the clip and clip feed blade
7 18 then move through groove 35 in main body 20 and grooves
8 40 and 42 in upper jaw portions 32 and 34 respectively until
9 upper finger loop member 5 has reached its farthest forward
position. Also shown in FIGURE 5 is lower finger loop member
11 7 as it is coupled to upper jaw portion 32, so that they
12 both may rotate about upper jaw pivot 36.
13 FIGURE 6 is a top view of the forward portion of the clip
14 applying device 2, showing the lateral clip magazi.ne housing
44 and its associated clip leaf spring 48. It can be seen
16 from this illustration that clip magazine housing 44 is coupled
17 to main body 20 by a portion of clip leaf spring 48 which
1~ .lies under rivet 30, and by clip magazine pins 46 being
19 dispo~ed in mounting holes 28 in main body 20. Thus,
to mount lateral clip magazine housing 44 on main body
21 20, recesses 52 in clip leaf spring 48 are urged around
22', the shaft portion of rivet 30 until pins 46 can be located
23¦~ in mounting holes 28. When lateral clip magazine housing
~4~l 44 is so positioned, central leaf spring 49 is positioned
~6~ll over the clips 37 contained in housing 44 so that leaf
~6,i spring 49 contacts the clips 37 at point 50 and thereby
27 I urges them into the main body 20. When the clips 37 in
28 ¦ clip magazine housing 44 have been depleted, magazine
29 ¦ 41 may be removed and a new magazine installed by lifting
30¦~ housing 44 from main body 20 until pins 46 have cleared
31
3~jl
13.
1 I holes 28 so that clip leaf spring 44 may be moved longitu-
2 dinally out from under rivets 30. ~hen the depleted magazine
3 44 has been removed, a new magazine containing a supply
4 of clips 37 may be installed.
FIGURE 7 is a side cutaway view showing in greater
6 detail lateral clip magazine 41. Clip leaf spring 48
7 is disposed under rivet 30 so that central clip leaf
8 spring 49 is positioned over clips 37 eontained in magaine
9 housing 44. It ean be seen from this FIGURE that central
10 ¦ leaf spring 49 exerts a pressure on clips 37 at contact
11 ¦ point 50 so as to urge the clips individually into
12 ¦ recess 26 of main body 20. When elip feed blade 18 is in its
13 fully retraeted position, recess 26 is empty so that a clip
14 37 ma~ move into recess 26 and be held there by the urging
15 ¦ of adjacent elips 37. When a clip 37 is to be moved to
16 ¦ the jaw portions 32 and 34 of clip applying device 2,
17 ¦ elip feed blade 18 then slides laterally through body
18 ¦ portion 20 and carries clip 37 from recess 26 toward
19 ¦ the jaw portions 32 and 34.
~0 ¦ FIGURE 8 is a perspective view of lateral clip magazine
21 ¦ 41, with its associated clip leaf spring 48, eentral clip
22ll leaf spring 49 and housing 44. ~isposed in housing 44 are a
23¦i plurality of hemostatic clips 37. Central clip leaf spring
24,~ 49 is positioned so as to urge hemostatic clips 37 to
23~i exit from housing 44 through the bottom thereof. Also
26i, illustrated in FIGURE 8 are the mounting means for magazine
27l, housing 44, including pins 46, and recesses 52 disposed
23!l, in clip leaf spring 48.
2911 It can be seen from the above description and partieularly¦
30". FIGURES 1, 5 and 8 that clip applicating device 2 of the
I ,
3L~Z~6~5
1 present invention provides an automatic feeding and crimping
2 of hemostatic clips. By simply moving upper and lower finger
3 loops 4 and 6 outwardly and then inwardly, a clip is moved
4 from an external magazine 41, into a receiving means 26, and
5¦ldisposed in jaw portions 32 and 34 where it is deformed around
6 a blood vessel or the like. This process of inward and
7 ~outward movement of finger loops 4 and 6 may be repeated
8 rapidly, so that one vessel after another is closed by the
9 hemostatic clips 37, until the supply of clips in
10 magazine 41 is depleted. At this point a new magazine 41
11 may be substituted for the depleted magazine so that vessel
12 closures may be continued.
13 The clip applicating device 2 of the present invention
14 provic,es the further advantage of high visability to the
15 user. ~ecause the device 2 is of an extremely thin design,
16 essentially the width of currently used hemostats and
17 because jaw portions 32 and 34 are c-lrved away from the main
18 body 20, a surgeon using clip applying device 2 will have a
t9 clear view of the vessel he is closing and, in addition,
20 will be abl~ to reach remote and obscure regions for ~urther
~1 vessel closure. In addition, clip applying device 2 is
~ constructed ~o as to prevent a clip 37 from accidenta~lly
23'dropping from the device, thereby obivatins a great deal
24~of inconvenience and lost time.
25~ ~IGUR~ 9 illustrates an alternate embodiment oE a clip
2~l maga~ine which may be externally coupled to clip applying
27¦ldevice 2. In this embodiment, a main body spring 54 is
23llpermânently coupled to clip applyiny device 2 by rivets
29¦l56. The main body spring 54 is adapted to hold clip
30~1housing 62 in its proper alignment with main body 20
311j
~2ll
15.
' 1
il I
~t ~ I
1 in conjunction with housing pins 64. Main body spring
2 54 includes a central body spring 55 adapted to rest
3 upon the clips 37 disposed in clip housing 62. FIGURE
4 9 also illustrates a top view of protective cover 66
5 which is removed from clip housing 62 when housing 62
6 is to be utilized. Protective cover 66 prevents clips
7 37 from becoming dislodged from clip housing 6~ until
8 housing ~2 is placed properly in its relationship to
9 main body 20.
FIGURES lO and ll further illustrate the alternate
11 embodiment of a clip magazine. FIGURE 10 is a perspective
12 view of clip housing 62 showing a plurality of hemostatic
13 clips 37 disposed therein. Clip housing 62 includes
14 housing shoulders 68 and housing pins 64. FIGURE 11 is
a side view of clip housing 62 as it is held in place
16 against main body 20 by housing leaf spring 5& resting
17 1on shoulders 68. Main body spring 54 is coupled to the
18 jmain body 20 by rivet 56 so that main body spring portions
19 j 54 rest againt shoulders 68 of clip housing 62 while clip
20 1 leaf spring ~0 rests against the upper most hemostatic
211CliP 37.
~~ FIGURE 12 illustrates clip applying device 2 which
23, utilizes another alternate embodiment of a clip
24, magazine, in this case a parallel clip magazine
~5 70. Disposed in parallel clip magazine 70 is a plurality
2~ of hemostatic clips which lay parallel to main body 20
27~l, and are sequentially fed toward recess 26. Parallel clip
28¦l magazine 70 is replaceably coupled to main body 20 by
29~1 magazine couplings 72, which in the presently preferred
30l, embodiment are spring clips which snap o~er corresponding
li
321,
1,l 16.
Il I
~ 5
1 portions of main body 20. The magazine 70 is so adapted
2 that forward movement of upper finger loop 4 and the
3 corresponding movement of upper finger loop member 5
4 and clip feed blade 18 results in the sequential placement
of hemostatic clips in recess 26. Further actuation of
6 upper finger loop 4 results in movement of a clip between
7 upper jaw portion 32 and lower jaw portion 34. When
3 a clip has been so placed, upper finger loop 4 is returned
9 until it abuts rear stop pin 16 at which time lower
finger loop 6 may be moved inward so as to cause upper
11 ¦ jaw portion 32 to move toward lower jaw portion 34 and
12 1 thereby close the hemostatic clip about the blood vessel.
13 ¦ Upper finger loop 4 is biased toward stop pin 16 by first
14 spring 14, while lower finger loop 6 is biased toward
15 ¦ lower finyer loop member stop pin l9 by second spring
16 means 22.
17 FIGURE 13 is a top view of clip applying device
1~ 2 showing parallel clip magazine 70 and its coupling
1~ 72 to main body 20. Also shown in FIGURE 13 is the
~0 relationship between upper finger loop 4, lower
21 ~inger loop 6r and lower finger loop member 7 as it is
2~1, coupled to upper jaw portion 32. Lower finger loop member
23.i 7 is fixedly coupled to upper jaw portion 32, while lower
241, finger loop member 7 is pivotally coupled to main body
25~i ~0 by upper jaw pivot 36. Thus, movement of-lower finger
2S,, loop 6 results in movement of upper jaw portion 32 about
27,! upper jaw pivot 36. It can be seen from FIGURES 12 and
28~1 13 that parallel clip magazine 70 provides even greater
29! visability to the surgeon since the magazine 70 only
301l slightly increases the width of the c1ip applying device 2. `:
31i
32!1
11l 17.
.' l
1 ¦ FIGURES 14, 15, 16 and 17 generally illustrate that
2 ¦ parallel clip maga~ine 70 is comprised of a parallel clip
3 ¦ magazine housing 94, which has a plurality of inwardly
41l biased leaf springs 76, a lost motion link 82 and a clip
5 I loading blade 78 which also has a plurality of inwardly
~ I biased leaf springs 88. More specifically, FIGURE
7 14 illustrates leaf springs 76 in clip housing 94 and the
8 configuration of hemostatic clip 37 within housing 94.
9 It can be seen that each leaf spring 76 has a "V" shaped
leading edge 77 which is adapted to correspond to the
11 "V" shaped bail portion of clips 37. As will be dis~
12 cribed more fully hereinbelow, the function of each leaf
13 spring 76 is to prevent rearward movement of clips 37.
14 FIGURE 15 is a cross-sectional view of magazine 70 as it
is coupled to main body 20 by magazine couplings 72. Magazine
16 coupling 72 is adapted to spring outward around main body
17 20 until it can be positioned in notch 96 in main body 20.
18 Disposed within parallel clip mayazine 70 are inwardly biased
19 leaf springs 76 in housing 94, clip loading blade 78, with
inwardly biased leaf springs 88, along with lost motion
21 link 82. Ad~acent lost motion link 82 is clip feed blade
18 of clip applying device 2. FIGURES 16a and 16b show in
~3!1 greater detail lost motion link 82. FIGURE 16a, a top
'~, view of lost motion link 82, illustrates lost motion link
~1. ...... , . ......... . . .. . . .... . . . .
2~!, pin 86 and slot 84. FIGURE 16b is a side view of lost
2~ motion link 82 also illustrating pin 86 and slot 84.
27!1 Pin 86 is fixedly coupled to one end of lost motion link
28¦, 82, while slot 84 is an elongated aperture disposed
~9l, entirely through link 82.
30,
32'j
,; 18.
l~Z4605 (
1¦ The operation of parallel clip magazin~ 70 can be best
21 understood from the sequence illustrated in FIGURES 17a, 17b
31 and 17c. In FIGURE 17a parallel clip magazine 70 is shown
41 coupled to main body 20. Disposed within parallel clip
51 magazine 70 are leaf springs 76 extending inwardly from
6 ¦ housing 94, clip loading blade 78 with inwardly extending
7 ¦ leaf springs 88, and lost motion link 82. Adjacent lost
8 ¦ motion link 82 is the clip feed blade 18, of applying
9 ¦ device 2, which has a feed blade pin 90 attached thereto.
10 ¦ In FIGURE 17a clip feed blade 18 is in its fully retracted
11 position so that a hemostatic clip 37 is located in recess
12 26 of main body 20. Hemostatic clip 37 is held in recess 26
13 by clip guide spring 92. Disposed within parallel clip magazine
14 70 are a plurality of hemostatic clips 37 whic'n will
be sequentially moved into recess 26 by the urging of
16 leaf springs 88 coupled to clip loading blade 78 It
17 can be seen in FIGU~E 17a that feed blade pin 90 is
18 located in the extreme right hand portion of slot 84
19 in lost motion link 82 and that clip loading blade 78 is
coupled to lost motion link 82 by lost motion link pin 86.
21 In FTGU~E 17b it can be seen that clip feed blade 18,
?~ which is coupled to upper finger loop 4, has been moved
23i7 forward so that the clip 37 which was in recess 26 has
-4;~ been moved along its path toward the jaw portions.
25, Correspondingly, feed blade pin 90 has freely moved the
2~¦i length of slot 84 in lost motion link 82, the distance A,
27 ¦ so that neither lost motion link 82 nor clip loading
28 ¦ blade 78 has had a forward movement. Thus, during the
29 ! initial portion of the loading sequence of clip magazine
30 1 70, hemostatic clips 37 disposed within the magazine
31~j
32l!
Il 19.
r
~ 6
1 70 have not moved, while the clip 37 which was located
2 in the recess 26 has been moved toward the device jaws.
3 However, it can be seen in FIG~RE 17c that
4 further forward movement of clip feed blade 18 caused by the
forward movement of upper finger loop 4 has resulted
6 in a forward movement of lost motion link 82 because
7 pin 90 which was abutting the forward most portion of
8 slot 84 in lost motion link 82, has moved a distance B.
9 Thus, this subsequent forward movement of clip feed blade
18 has resulted in forward movement of lost motion link
11 82 and corresponding forward movement of pin 8~. Forward
12 movement of lost motion link pin 86, in turn, has caused
13 forward movement of clip loading blade 78 and its associated
14 leaf springs 88. Thus, the total forward movement of
pin 90 a distance C has resul-ted in hemostatic clips
16 37 being moved forward and ultimately the forward most
17 hemostatic clip 37 being guided onto the upper surface of
18 clip feed blade 18, above recess 26 by clip spring 92.
19 Nhen clip feed blade 18 is returned to its static position
by the return of upper finger loop 4, clip 37 will drop
21 into recess 26 so that it will be ready to be fed to
2~1 the jaw porLions as illustrated in FIGURE 17a.
23 1l During the later stages of the return movement of
24j, feed blade 18, clip loading blade 78 will also undergo
25ll a rearward movement. During this rearward movement of
~6¦l loading blade 78, leaf springs 88 will abut a clip 37
27 and bend outward sufficiently so that the blade 78 is
28 not impeded. When the blade leaf springs 88 have
29 cleared the clips 37, they will return to ~heir inward
31 biased position. Clips 37 are prevented from undergoing
32
~ 20.
1 a rearward movement by the protrusion of leaf springs 76
2 in housin~ 94. That is, the bail portions of clips 37
31¦abut the leading edge of leaf springs 76 and are pre-
4 vented from moving rearward. Cn the other hanc~, forward
5l'movement of clips 37 is accomplished by the abutment of
6llthe leading edge of leaf springs 88 with the bail Eortion
7lof clips 37. As springs 88 move forward due to the
8Imovement of blade 78, clips 37 bend housing leaf springs
9l 76 outward until they have passed the protruding portions
10¦ of the springs 76. In this manner, one complete forward .
11¦ movement of upper finger loop 4 will cause each clip 37
12¦ to progress to the next location just ahead of the
13 1,¦ next succeeding housin~ spring 76.
14ll, The proper alignment of both leaf springs 76 and 88
15l,in their relationship to clips 37 is accomplished by
16llthe location of rear stop pin 16 and forward stop means
171 21. The rear stop pin 16 is positioned so that abutment
181 of upper finger loop member 5 with pin 16 results in
19j sufficient movement of clip loading blade 78 so that
~0l loading blade leaf sprin~s 88 stop slightly behind each
21lladjacent clip 37. This positioning of pin 16 ensures
~ that each leaf spring 88 will be able to move the adajacent
23'~clip 37 forward. The forward stop means 21, on the other
24 handr is positioned so that abutment of upper finger
25 loop member 5 results in sufficient forward movement
',of leaf springs 88 so that each clip 37 is placed just
27,lbeyond the rearward adjacent leaf spring 76. Thus, the
28ilprevention of rearward movement of clips 37 is ensured since
29l, each leaf spring 76 is always behind the forward adjacent
30`lclip 37.
31`,
~2, ~1.
',,
~ 4605 ~
1 There has been described herein a new and novel clip
2 applying device which has special utility for applying
3 hemostatic clips to blood vessels and the like. However,
4 it is to be understood that various alternate embodiments
using the principles of the present invention may be
6 readily incorporated. Thus, while specific embodiments
7 of the present invent.ion have been disclosed and described
8 in detail herein, it will be understood by those skilled
~ in the art that various changes in form and detail may be
made therein without departing from the spirit and scope
9 f the invention.
s 19
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