U.S. patent number 3,775,825 [Application Number 05/174,501] was granted by the patent office on 1973-12-04 for clip applicator.
This patent grant is currently assigned to Rene G. Levaux. Invention is credited to Peter B. Samuels, Ernest C. Wood.
United States Patent |
3,775,825 |
Wood , et al. |
December 4, 1973 |
CLIP APPLICATOR
Abstract
This application discloses apparatus for applying spaced clips
to a filament and severing the filament between the clips so as to
provide clips secured on the free ends of the severed filament. The
apparatus is disclosed in the context of a method of suturing skin
wounds wherein a suture is drawn through an edge of the wound and
the clip applicator applies the spaced clips and severs the suture
so as to provide one clip holding the suture at the edge of the
wound and another clip to the thread so that it may be used to
start the next suture.
Inventors: |
Wood; Ernest C. (Los Angeles,
CA), Samuels; Peter B. (Encino, CA) |
Assignee: |
Levaux; Rene G. (Beverly Hills,
CA)
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Family
ID: |
22636391 |
Appl.
No.: |
05/174,501 |
Filed: |
August 24, 1971 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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817496 |
Apr 18, 1969 |
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Current U.S.
Class: |
29/566.1; 29/816;
606/142 |
Current CPC
Class: |
A61B
17/0682 (20130101); A61B 17/0487 (20130101); A61B
2017/0454 (20130101); Y10T 29/53513 (20150115); A61B
2017/0488 (20130101); Y10T 29/5148 (20150115); A61B
2017/0464 (20130101) |
Current International
Class: |
A61B
17/04 (20060101); A61B 17/068 (20060101); B23q
007/10 () |
Field of
Search: |
;29/212D,211R,211C,212P |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Eager; Thomas H.
Parent Case Text
This application is a division of application Ser. No. 817,496, now
abandoned.
Claims
What we claim and desire to secure by Letters patent of the United
States is:
1. A device for applying clips to thread comprising: a body
portion; means mounted in said body portion for storing clips to be
applied to thread; a pair of normally spaced-apart jaws mounted on
said body portion for relative movement toward each other to engage
portions of a clip and move them to locking engagement around a
thread; means for moving clips stored in said first-mentioned means
to the space between said jaws and cutting means on said body
portion for severing a thread after a clip has been locked
thereon.
2. A device for applying clips to thread comprising: a body
portion; a pair of normally spaced-apart jaws pivotally mounted on
opposite sides of said body portion extending forwardly thereof and
provided with confronting portions extending toward each other for
engaging portions of a clip to be applied to a thread; an elongated
cartridge having a pair of longitudinal slots formed therein in
which clips may be stored mounted in said body portion and
extending to a point adjacent said confronting portions of said
jaws; a slide movable in said slots to force clips inbetween said
confronting portions of said jaws; cutting means pivoted coaxially
on said body portion with one of said jaws and extending to said
confronting portions of said jaws and disposed between said slots
in said cartridge; and a pair of handles pivoted on opposite sides
of said body portion, each handle having a connection to said jaws
to close said jaws in response to movement of the handles, and a
projection on said cutting means engaging one of said handles so
that continued movement of said handles after said jaws are closed
causes said cutting means to sever the thread between the clips
which have been secured thereto.
3. The device of claim 1 including cutting means on said body
portion for severing a thread after a clip has been locked
thereon.
4. The device of claim 1 wherein said first-mentioned means
comprises an elongated cartridge having a slot extending along its
length in which clips may be stored.
5. The device of claim 4 wherein said second-mentioned means
comprises a slide movable in said slot to force clips toward the
end thereof.
6. The device of claim 1 wherein said first-mentioned means
comprises an elongated cartridge having a pair of parallel slots
extending along its length in each of which slots clips may be
stored.
7. The device of claim 6 wherein said second-mentioned means
comprises a slide movable in said slots to force clips toward the
end thereof.
8. The device of claim 1 wherein said first-mentioned means extends
from the body portion to a point adjacent said jaws and is provided
with an opening at one end from which clips may be moved by said
second-mentioned means and means on said jaws to limit the movement
of the clips.
9. The device of claim 8 including cutting means carried by said
jaws for severing a thread after a clip has been locked thereon.
Description
This invention relates to surgical devices. More specifically, it
relates to a apparatus for the suturing of skin wounds.
The conventional method of closing skin wounds consists of sewing
the edges of the wound together with thread. Threads are placed and
tied separately along the wound and are termed "interrupted
sutures". Alternately, wounds may be closed by a continuous thread
anchored by tying the thread at either end of the wound. Very
frequently wounds sutured in accordance with these techniques tend
to have the edges inverted so that when healed a noticeable scar
may remain. Also, it is not uncommon that the healing may be uneven
to such an extent as to delay complete healing and to further
aggravate the scarring situation.
Therefore, it is an object of this invention to provide a novel
apparatus for closing skin wounds in which the possibility of
scarring of the wound is minimized.
It is another object of this invention to provide a novel apparatus
for suturing skin wounds which promote even healing.
It is still a further object of this invention to provide a novel
apparatus for suturing skin wounds which eliminates any encircling
thread over the wound, thus eliminating the possibility of a
cross-hatched scar.
These and other objects are achieved by the provision of a novel
applicator tool carrying a supply of clips which are applied to a
thread used to suture a wound and at the same time is capable of
severing the thread.
BRIEF DESCRIPTION OF THE DRAWINGS
These and other objects and advantages of this invention will
hereinafter appear and for purposes of illustration, but not of
limitation, an embodiment of the invention is shown in the
accompanying drawings in which:
FIG. 1 is a plan view of an applicator tool embodying the
invention;
FIG. 2 is an end view of the tool shown in FIG. 1;
FIG. 3 is a view along the line 3--3 of FIG. 2;
FIG. 4 is a plan view of a cartridge holding a supply of clips in
accordance with the invention;
FIG. 5 is an end view of the cartridge of FIG. 4;
FIG. 6a is a plan view of a clip in accordance with the invention
shown prior to its assembly on a thread;
FIG. 6b is a view of a clip in accordance with the invention
showing the position assumed upon its assembly on a thread;
FIG. 7a is a diagrammatic illustration showing the use of a thread
on which a clip has been secured in suturing a wound;
FIG. 7b is a diagrammatic figure similar to FIG. 7a in which
several sutures have been completed using the method and apparatus
of the invention;
FIG. 8 is an illustration of a tool suitable for removing clips
from a thread in accordance with the invention;
FIG. 9 is a side view, partially in section, of an alternative
embodiment of an applicator tool in accordance with the invention;
and
FIG. 10 is a front view along the line 10--10 of the embodiment of
FIG. 9.
DETAILED DESCRIPTION
The method in this application is practiced by applying a flat clip
to the end of a thread and passing the thread through the skin,
using a surgical needle, until the clip lies flat against the
surface of the skin at one edge of the wound. This is illustrated
in FIG. 7a where a clip 2 has been clamped to a thread 4 and the
thread, in turn, threaded through a suitable surgical needle 6. The
thread 4 has been drawn through the surface of the skin at one edge
8 of a wound and the clip 2 lies flat against that surface of the
skin. The needle 6 is then used to penetrate the surface of the
other edge 10 of the wound from the underside and emerge from the
upper side of that edge. At that point another clip 2 is applied to
the thread 4 and the thread is then severed. In order to facilitate
the suturing an applicator tool in accordance with the invention is
constructed to apply two clips simultaneously to the thread and to
sever the thread between the two clips. In this manner, the
emerging end of the thread is clipped and the suture secured, and
at the same time the thread is provided with a clip at its free end
to commence the next suturing operation. This sequence of
operations is repeated to the extent necessary to close the wound,
as may be seen in FIG. 7b wherein several sutures of the
interrupted variety have been applied, each suture consisting of a
pair of clips 2 and a thread 4. During each suturing operation the
thread is pulled sufficiently tight to bring the edges of the wound
together and to evert them slightly. If desired, a continuous
suture could be applied with a clip at each end.
It has been found that in addition to fixing the thread in place
the clips spread the pull exerted at the skin edge by the thread
over the entire surface of the clip and thus spread the pressure at
the point of engagement of the clip with the skin over the entire
clip, thus relieving the pressure from a restricted area. It has
also been found that the clips tend to assume a position parallel
to each other, thus contributing to the eversion of the skin edge.
By resisting the natural tendency of the skin edge to turn inward,
even healing is promoted and scarring is minimized. Another
advantage of this method results from the tendency of the clips to
immobilize the skin beneath them, that is, they, in effect, splint
the skin edge and prevent its movement. This "splinting effect"
also helps to minimize scarring of the wound by allowing healing to
proceed with the wound immobilized.
Since the practice of this method eliminates threads overlying the
wound, there is no cross-hatched scar as is seen in wounds sutured
by the prior art methods. In addition, the absence of a circular
suture relieves the wound of any circumferential compression.
In accordance with the invention, there is provided a clip
applicator tool illustrated in FIGS. 1 through 3. As seen in FIG.
1, the clip applicator comprises a body portion 14 on which the
remaining elements of the applicator are mounted for use. These
elements comprise a pair of handle portions 16 and 18 pivoted at
points 20 and 22, respectively, on the forward end of the body
portion. Passing through the body portion is a channel guide 24
which is provided at its rearward end with a spring clip 26 which
is normally urged upward from the bottom of the channel guide 24 to
hold a cartridge 28 in the channel guide. The cartridge 28 extends
through the body portion and has a front end 30 which terminates in
a pair of V-shaped openings 32 adjacent the confronting ends 34 and
36 of a pair of jaws 38 and 40, respectively, which are pivoted on
the body portion at the points 42 and 44, respectively. A pair of
outwardly bowed leaf springs 43 and 45 urge the jaws 38 and 40
outwardly from the body portion 14. The handle 16 has secured to
its undersurface a leaf spring 46 which slides at its inner end on
the surface of the channel guide 24 to normally urge the handle 16
in an outward direction. A similar leaf spring 48 is secured to the
handle 18 for the same purpose. The handles 16 and 18 are provided
with enlarged portions 47 and 49, respectively, which bear on the
jaws 38 and 40 and function as camming surfaces to cause inward
movement of the jaws when the handles are forced inwardly. A pair
of stops 50 and 52 may be provided on the body portion, engaging
with the handles 16 and 18, respectively, to limit their outward
movement.
The cartridge 28 is illustrated in greater detail in FIGS. 4 and 5.
As illustrated, it takes the form of an elongated rectangular
member provided with a pair of slots 54 and 56 extending along its
length into which clips to be applied to a thread may be stored and
from which they may be fed for compression by the jaws 38 and 40 as
required. A means to force the clips forward in the slots 54 and 56
is constituted by a slide 58 having a handle portion 60 extending
through an elongated opening 62 extending over a major portion of
the length of the cartridge 28. A notch 64 is formed in the end of
the cartridge 28 to permit passage of a thread-severing means in a
manner to be described in greater detail hereinafter. Instead of
using a handle to urge the slide forward, a spring feed could be
provided.
The thread-severing means is constituted by an arm 66 pivoted
coaxially with the jaw 40 at 44 but capable of independent movement
and carrying at its free end a cutting edge 67 and a projection 68
which acts to maintain a thread in position to be cut. Extending
from the arm 66 through an opening in the jaw 40 is a projection 70
engageable with the pivoted handle 16.
The operation of the applicator tool 14 in conjunction with the
cartridge 28 is as follows. After the cartridge 28 is caused to be
filled with an appropriate number of clips in the slots 56 and 54,
the cartridge is inserted into the channel guide 24 until its
forward motion is stopped by virtue of its contact with the
confronting surfaces 34 and 36 of the jaws 38 and 40. It is
retained in this position by the engagement of the spring clip 26
with its rear end. In order to feed clips to a position to be
applied to a thread, the slide 58 is moved forward by applying
pressure to the handle 60 so as to feed clips forward to a position
between the jaws. As may be seen in FIG. 1, the forward movement of
the slide 58 is permitted by the provision of a slotted opening 67
in the body portion 14. The forward motion of the clips is limited
by their engagement in cut-out portions 69 formed in the
confronting surfaces 34 and 36 of the jaws 38 and 40.
Referring to FIGS. 6a and 6b, it may be seen that each clip 2 is
formed as a thin, flat member having notch 72 formed at its lower
end and a pair of spread-apart legs 74 and 76 forming a wider notch
78 at its upper end. When inserted into the slots 54 and 56, the
clips nestle within each other, i.e., the narrow part of a clip
with the notch 72 rests within the wider notch 78 of each adjacent
clip. Thus, when the clips are moved forward in the cartridge 28 by
the action of the slide 58, they are positioned in the cut-out
portions 69 with the notch 78 exposed between the confronting
portions 34 and 36 of the jaws 38 and 40. With the clips so
positioned, a thread is laid between the confronting portions in
the notches 78 of the clips. The handles 16 and 18 are then
squeezed together about their pivots 20 and 22. By virtue of their
engagement with the forward ends of the jaws 38 and 40 these jaws
are caused to rotate inwardly about their pivots 42 and 44 moving
the confronting ends 34 and 36 together.
The pressure caused by the inward motion of the confronting ends 34
and 36 causes the legs 74 and 76 of the clips to be moved toward
each other securing or clamping the clip about the thread in what
was the notch 78. The dimensions are such that the legs 74 and 76
move into substantial contact with each other and are securely
fastened to the thread leaving a small notch 80 in the upper end of
the clip, as may be seen in FIG. 6b. Further compression of the
handles 16 and 18 causes the inner side of the handle 16 to bear
against the projection 70 on the arm 66 so that it continues to
move inwardly, whereby the severing edge 68 on the end of that arm
cuts the thread in between the two clips. When the thread has been
severed there results an arrangement where two clips have been
applied, one to each end of the severed thread. In practice, it has
been found desirable to dimension the clips and the applicator tool
14 so as to apply them to the thread approximately one centimeter
apart.
The clipped ends of the thread are now ready for use in the
practice of the method described above. The clipped thread which
has been severed from a longer piece may be discarded and the first
suturing operation begun using the clipped thread remaining. In the
execution of the suturing operation after the thread has been drawn
through both edges of the wound and the wound drawn together, the
applicator tool may again be used by first feeding forward another
pair of clips to a position between the confronting ends 34 and 36,
then using the applicator tool in the manner described above. This
results in a clip being applied to the emerging end of the thread,
such a clip being designated by reference numeral 12 in FIG. 7b,
and a clip has been secured to the free end of the thread so that
another suturing operation may be commenced.
After the wound has healed and it is desired to remove the sutures,
the invention provides a removing tool or opener illustrated in
FIG. 8. This is constituted by a pair of pivoted handles 82 and 84
which are provided at their free ends with a pair of pointed
projections 86 and 88, respectively. These projections may be
engaged in the notches 72 and 80 of a clip and the handles brought
together to force the projections into those notches and spread
apart or open the clip to remove it from the thread. When the clips
on each side of the wound are removed, the suturing thread may be
withdrawn in the usual manner.
FIGS. 9 and 10 illustrate an alternative embodiment in which the
cutting of the surgical thread extending between the clips is
accomplished by the provision of a scissors action. In these
figures those elements which correspond to the embodiment of FIGS.
1 through 3 have been given the same reference numerals.
In this embodiment the applicator tool has a pair of arms 66 and
66' pivoted coaxially with the jaws 40 and 38, respectively. The
arms are identical and each is provided at its forward end with
sharpened confronting scissor edges 90 and 92. Each arm 66 and 66'
is provided with projections 70 and 70' which extend through
openings in their associated jaws for engagement with the handles
16 and 18, respectively.
As may be seen in FIG. 10, a thread 4 has been placed between a
pair of clips 2 positioned between the cut-out portions 69 of the
jaws 38 and 40. As the jaws are moved toward each other when the
handles 16 and 18 are pressed together, the clips are clamped to
the thread 4. Continued compression of the handles causes them to
lean on the projections 70 and 70' moving the arms 66 and 66'
inwardly about their pivots until the scissor edges 90 and 92 cut
the thread between the two clips. As with the previously described
embodiment, the two clips have now been applied to the thread
between them severed.
The novel apparatus of this invention, thus provides a simple
method of suturing skin wounds with the advantages of promoting
even healing and minimizing scarring.
It is to be understood that changes may be made in the details of
construction, arrangement, and operation without departing from the
spirit of the invention, especially as defined in the following
claims.
* * * * *