CA1124605A - Surgical stapler - Google Patents

Abstract

ABSTRACT OF THE DISCLOSURE
A hemostatic clip applicator useful in the rapid and automatic application of hemostatic clips for the stangulation of tubular members is disclosed. The applicator consists of a main body, a clip magazine externally attached to the main body, clip deforming jaws attached to one end of the main body, clip feed means located within the main body and actuating means attached to the feed means and deforming jaws. In operation, one of many hemostatic clips stored in the clip magazine is fed into the main body and guided to the deforming jaws by the inter-action of the actuating means and the feed means. When the clip is properly located about a tubular member, further actuation of the actuating means results in the deformation of the clip about the tubular member. Upon further activation of the actua-ting means, the sequential process of feeding a clip from the magazine and deforming the clip about other tubular members may be rapidly repeated until the supply of clips in the magazine is depleted.

Description

.

:..

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 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 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, ~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 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 ~ 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.

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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.

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Claims (14)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows 1. A surgical clip applying device comprising:
(i) a main body having means for receiving clips;
(ii) a clip magazine coupled to the exterior of said main body and having a housing adapted to store a plurality of said clips in a parallel relationship with said main body, said housing including a plurality of inwardly biased leaf springs;
(iii) clip loading means slideably disposed within said housing for moving said clips from said magazine to said clip receiving means, said clip loading means comprising a blade member having a plurality of leaf springs disposed thereon so as to be in substantially opposed relationship with said leaf springs of said housing, said leaf springs of said housing and said leaf springs of said loading blade having a "V"-shaped leading edge so as to engage the correspondingly shaped portions of said clips, whereby said leaf springs of said loading blade sequen-tially move said clips to said clip receiving means while said leaf springs of said housing prevent movement of said clips away from said clip receiving means;
(iv) clip deforming means coupled to said main body for deforming clips disposed therein;
(v) clip feed means slideably disposed within said main body for moving said clips from said clip receiving means to said clip deforming means, said clip feed means adapted to slide through said main body into said clip deforming means so as to place a clip therein, and to retract from said deforming means prior to the actuation of said deforming means; and (vi) actuating means coupled to said clip feed means, said clip loading means and said clip deforming means for
1. Claim 1 continued .....
   
   actuating said clip feed means, said clip loading means, and said clip deforming means.
2. 2. The clip applying device of claim 1 wherein said magazine further includes a lost motion link member adapted to associate with said clip feed means, said link member slideably disposed within said housing and coupled to said loading means whereby initial forward movement of said feed means does not result in forward movement of said loading means while additional forward movement of said feed means results in forward movement of said loading means.
3. 3. The clip applying device of claim 2 wherein said hous-ing further includes a guide spring coupled thereto, said guide spring adapted to urge said clips from said housing into said main body clip receiving means.
4. 4. The clip applying device of claim 3 further including a coupling mechanism adapted such that said magazine may be coupled to and decoupled from said main body.
   
   5. A surgical clip applying device comprising:
   (i) a main body having a clip receiving recess;
   (ii) a clip magazine coupled to said main body and adapted to hold a plurality of clips, said magazine having a plurality of inwardly biased leaf springs adapted to prevent movement of said clips away from said clip receiving recess, (iii) clip deforming means coupled to said main body for deforming clips disposed therein;
   (iv) a clip loading blade slideably disposed in said clip magazine, said loading blade having a plurality of leaf springs adapted to engage and sequentially move said clips from said magazine to said clip receiving recess;
5. Claim 5 continued .....
   (v) a clip feed blade slideably disposed within said main body and adapted to sequentially move said clips from said clip receiving recess to said clip deforming means, said clip feed blade adapted to slide through said main body into said clip deforming means so as to place a clip therein, and to retract from said deforming means prior to the actuation of said deform-ing means; and (vi) an actuating mechanism coupled to said clip deforming means, said clip loading blade, and said clip feed blade whereby actuation of said actuating mechanism sequentially causes said clip loading blade to slide through said clip magazine so as to sequentially move said clips to said clip receiving recess, said clip feed blade to slide through said main body into said deforming means and return therefrom so as to sequentially move said clips from said clip receiving recess to said clip deforming means, and said clip deforming means to deform said clips disposed therein.
6. 6. The clip applying device of claim 5 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
7. 7. The clip applying device of claim 6 wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
8. 8. The clip applying device of claim 7 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.
9. 9. The clip applying device of claim 5 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.
10. 10. The clip applying device of claim 9 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
11. 11. The clip applying device of claim in wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
12. 12. The clip applying device of claim 5 wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
13. 13. The clip applying device of claim 12 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
14. 14. The clip applying device of claim 5 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.