U.S. patent number 3,867,944 [Application Number 05/301,609] was granted by the patent office on 1975-02-25 for hemostatic clip and applicator therefor.
This patent grant is currently assigned to Rene G. Le Vaux, Ernest C. Wood. Invention is credited to Peter B. Samuels.
United States Patent |
3,867,944 |
Samuels |
February 25, 1975 |
HEMOSTATIC CLIP AND APPLICATOR THEREFOR
Abstract
A hemostatic clip and an applicator therefor in which the clip
is formed of a pair of elongate strips defining spaced opposing
arms interconnected at one end and open at the other end, with each
of the arms having a plurality of teeth members on opposing faces,
with the teeth members being spaced along the lateral edges of the
faces. The invention further includes a forceps-type applicator
comprising a pair of elongate members defining jaw portions at one
end and gripping members at the other end, with one of the elongate
members having an intermediate portion defining a cam member and a
lip and the other of the elongate members having a slot
intermediate thereof and having two raised members at the lateral
edges of the slot, with the raised surfaces having profiles
corresponding to the profiles of the cam member and the lip when
the jaws of the applicator are in gripping relationship with a
hemostatic clip. The applicator also includes a cantilever spring
overlying the raised surfaces, the lip and the cam member to
thereby resiliently maintain the applicator in an intermediate open
position to grip a hemostatic clip.
Inventors: |
Samuels; Peter B. (Sherman
Oaks, CA) |
Assignee: |
Wood; Ernest C. (Beverly Hills,
CA)
Le Vaux; Rene G. (Beverly Hills, CA)
|
Family
ID: |
23164093 |
Appl.
No.: |
05/301,609 |
Filed: |
October 27, 1972 |
Current U.S.
Class: |
606/158; 24/23W;
606/142; 24/30.5R; 24/30.5W |
Current CPC
Class: |
A61B
17/122 (20130101); Y10T 24/1467 (20150115); Y10T
24/15 (20150115); Y10T 24/152 (20150115) |
Current International
Class: |
A61B
17/122 (20060101); A61B 17/12 (20060101); A61b
017/12 (); A61b 017/08 () |
Field of
Search: |
;24/23W,3.5W
;128/321,325,334R,346 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Pace; Channing L.
Claims
I claim:
1. A hemostatic clip formed of an elongate, substantially flat
strip of a non-toxic material defining a generally V-shaped clip,
said clip having spaced aims and being formed of a bail end and
open opposite the bail end, said arms having opposing faces
providing longitudinally continuous, smoothly curved surfaces a
plurality of teeth members on said faces, said teeth members being
spaced along the lateral edges of said faces, with a portion of
said surfaces extending between the teeth on opposite lateral
edges, and a rib extending longitudinally along the strip opposite
the faces.
2. A clip as defined in claim 1 wherein the teeth members are in
crosswise alignment on said faces.
3. A clip as defined in claim 1 wherein the teeth members are in
the form of substantially circular projections extending toward the
opposing faces.
4. A clip as defined in claim 1 wherein the teeth members are
positioned at intervals longitudinally over the length of said
arms.
Description
This invention relates to mechanisms useful in the strangulation of
tubular members, and more particularly to devices including
hemostatic clips and applicators therefor useful in the
strangulation of blood vessels and other fluid ducts in the human
body.
The invention will be described herein in reference to the
strangulation of blood vessels, although it will be understood by
those skilled in the art that devices embodying the concepts of the
invention are likewise adapted for closing tubular structures in
general, not only near their open ends but also on intermediate
points.
In nearly any surgical operation, one or more blood vessels must be
severed. It is generally desirable to provide means for closing the
ends of the severed vessels, at least until the end of the
operation, to stop bleeding which would otherwise interfere with
the operation and result in the loss of large amounts of blood or
other fluids. Until recently, it was the practice to employ
ligatures or the like which were tied about the vessel at the
desired point of strangulation. The customary procedure calls for
the separate clamping of each vessel after the incision has been
made; after the clamping of the vessels, a ligature is secured
about each vessel providing closure and permitting removal of the
clamps. In some instances, a great number of vessels must be
severed, requiring hours of operating time, before the operation
can proceed.
Substantial improvements in operating techniques have been provided
by improved hemostatic clip constructions and applications therefor
as are described in U.S. Pats. Nos. 3,270,745, 3,326,216,
3,363,628, 3,439,522. In the foregoing patents, the hemostatic
clips are formed of a deformable, non-toxic material and include a
pair of spaced arms adapted to be clamped about blood vessels and
the like to strangle the vessel. The foregoing patents also
describe applications for such clips in which the applicators are
of the forceps type or the pliers type and are used in the
application of the hemostatic clips to secure the clips to the
vessels.
This invention relates to further improved applicator means and
improved hemostatic clips and magazines therefor.
It is accordingly an object of this invention to provide a further
improved applicator for hemostatic clips in which the applicator is
adapted to engage a hemostatic clip to remove the clip from a
magazine therefor, in which the applicator is adapted to engage the
clip to secure the clip in the applicator and in which the
applicator includes means to provide resistance to closure of the
applicator loaded with a hemostatic clip to prevent the clip from
being inadvertently deformed prematurely through finger
pressure.
It is another object of this invention to provide a further
improved hemostatic clip and magazine therefor in which the
hemostatic clip is provided with improved means to secure the clip
onto a tubular vessel or the like without slippage, and in which
the magazine is adapted to contain the hemostatic clips to prevent
damage to or contamination thereof and to facilitate removal of the
improved hemostatic clips for rapid and simple application.
These and other objects and advantages of the invention will appear
more fully hereinafter, and, for purposes of illustration but not
of limitation, embodiments of the invention are shown in the
accompanying drawings in which:
FIG. 1 is a side view in elevation showing a clip applicator
embodying the concepts of this invention;
FIG. 2 is a top view in elevation showing the applicator of FIG.
1;
FIG. 3 is a top view of the applicator shown in FIG. 2, with spring
means displaced to expose the biasing mechanism;
FIG. 4 is a detailed view of the applicator shown in FIGS. 1 to 3,
with the clip engaged therewith;
FIG. 5 is a detailed view of the biasing mechanism illustrated in
FIG. 3, with the applicator in the closed position;
FIG. 6 is a detailed view of the applicator of this invention in
the maximum open position;
FIG. 7 is a sectional view taken along the lines 7--7 in FIG.
1;
FIG. 8 is a sectional view taken along the lines 8--8 in FIG.
1;
FIG. 9 is a detailed view of the biasing cam of the applicator of
the invention;
FIG. 10 is a detailed view of the spring assembly of the applicator
of the invention;
FIG. 11 is an end view of the hemostatic clip magazine of the
invention, having a hemostatic clip positioned therein;
FIG. 12 is an end view of the magazine shown in FIG. 11,
illustrating removal of a clip therefrom;
FIG. 13 is a sectional view taken along the lines 13--13 in FIG.
12;
FIG. 14 is a sectional view taken along the lines 14--14 in FIG.
13;
FIG. 15 illustrates the engagement of hemostatic clips in the
magazine illustrated in FIGS. 11 to 15;
FIG. 16 is a sectional view taken along the lines 16--16 in FIG.
13;
FIG. 17 is a perspective view of one embodiment of an improved
hemostatic clip of the present invention;
FIG. 18 is a perspective view of another embodiment of an improved
clip of the invention;
FIG. 19 is a sectional view taken along the lines 19--19 in FIG.
17;
FIG. 20 is a sectional view taken along the lines 20--20 in FIG.
18;
FIG. 21 is a sectional view taken along the lines 21--21 in FIG.
20; and
FIG. 22 is a view of the magazine shown in FIGS. 11 to 16,
illustrating the removal of clips therefrom with an applicator.
The hemostatic clip of the invention is adapted to be formed of a
deformable non-toxic material whereby it can safely be used in a
surgical operation. The clip, which is more fully described
hereinafter, includes a pair of arm portions with interfaces in
opposed relationship. These interfaces, when clamped, engage the
outer surface of a blood vessel or other fluid duct to effect
strangulation of the vessel or duct.
The applicator of this invention includes jaw portions with means
for receiving the outer faces of arm portions of hemostatic clips
and means to provide resistance to opening and closing the jaw
portion to securely hold the clip in the jaws of the applicator to
prevent premature, inadvertent closing of the clip and to prevent
loss of the clip from the jaw portions.
To further increase the efficiency of the invention, a suitable
magazine or holding means is provided for mounting a plurality of
clips in position to be loaded between the jaws of an applicator
for use. The magazine and associate clips can be sterilized and
packaged whereby the package can be stored indefinitely and will be
ready of use.
The accompanying drawings, in FIGS. 11 through 22, illustrate the
improved hemostatic clip of this invention. In one embodiment, as
shown in FIG. 17 of the drawing, the hemostatic clip includes an
elongate strip 10 of a deformable material having its end portions
arranged in arms 12 in spaced apart parallel relation, with the
facing or opposing inner faces 11 of the arms being formed with a
series of teeth-like projections 14 extending inwardly toward the
opposite arm along the lateral edges of the arms 12. In the
embodiment shown in FIG. 17 of the drawing, the clip is formed with
a parabolic cross-section. The teeth 14 extend along the lateral
edges of each of the opposing faces 11 and thereby prevent slippage
of the clip once it has been engaged in a clamping relationship
with the blood vessel or the like. As is shown in FIG. 17, the
teeth 14 are preferably aligned on either lateral edge of each face
11 of the arms 12; however, as will be appreciated by those skilled
in the art, the teeth 14 can be staggered along the opposite
lateral edges of each arm 12.
The clip 10 is formed of a non-toxic material, such as stainless
steel, plastics, and the like, which are capable of being deformed
and which retain the amount of deformation for clamping the blood
vessels or the like fluid ducts between the arms 12.
In accordance with another embodiment as shown in FIGS. 18, 20 and
21 of the drawing, the clip 16 can be formed of a substantially
flat strip 18 having an integral rib 20 which extends
longitudinally over substantially the entire length of the strip
18. In this embodiment, a plurality of teeth 22 can be provided on
each arm 21 of the clip 16. In the preferred practice of this
embodiment of the invention, the teeth 22 are formed from the strip
18 by punching out a portion of the metal forming the strip 18 to
thereby define the teeth 22 which extend toward the opposing
arm.
Thus, the embodiment shown in FIG. 18 provides a clip of somewhat
increased width, but nevertheless includes a plurality of teeth 22
spaced over the width of the strip 18 and extending longitudinally
along the strip to provide increased guiding means to thereby
prevent slippage of the clip in clamping engagement with a blood
vessel or the like.
The teeth 22 of the embodiment shown in FIG. 18 are somewhat
different from those illustrated in FIG. 17 in that the teeth 22
are in the form of hollow circular teeth; these teeth can simply be
formed by punching out the metal forming the strip 18 to thereby
provide a cylindrical projection having a sharp edge adapted to
engage a blood vessel or the like when the clip is closed around
the vessel to effect strangulation thereof.
In the illustration of the clips of FIGS. 17 and 18, the bail
portion of each of the clips intermediate the spaced arms 12 and
21, respectively, is bent to a substantially V-shaped
configuration, but it will be apparent to those skilled in the art
that the portions intermediate the arms may be formed to other
configurations, such as a U-shape, rounded shape or other polygonal
shape.
The magazine for use with the clips of the invention is shown in
FIGS. 11 to 16 and 22 of the invention. The magazine 30 is in the
form of a rectangular block having a pair of slots 34 extending
longitudinally over the length of the magazine 30 on either side of
a centrically disposed, longitudinally extending partition member
36. Positioned on either side of the partition member 36 are a
plurality of opposing aligned slits 32 adapted to receive clips of
the type illustrated in FIGS. 17 or 18 of the drawing and which
extend upwardly from the base 38 of the magazine to the top
opposite the base.
The bottom of slots 32 is defined in part by the inner face 42 of
the base 38 and in part by a raised surface 40. The face 42 and the
raised surface thus define a step at the bottom of the slots 34;
the arms of the clips are adapted to abut the inner face 42 of the
bottom of the slots 32 and an applicator, when inserted into the
magazine for loading and removal of a clip, abuts the raised
surface 40 as hereinafter described.
The inner face 42 of the base and the raised surface 40 define a
curved surface 44 extending upwardly from the base to the raised
surface in each slot 32. The opposing curved surfaces of opposing
slots 32 on either side of the partition member 36 are spaced each
from the other by a width slightly less than the width between the
arms of the clip. Thus, as shown in FIGS. 11 and 12, the outer
portions of the arms 12 are adapted to be engaged between the
curved surfaces 44 to securely hold the clip in the slits 32.
The longitudinally extending slots 34 communicate with the upwardly
extending slots 32, with the longitudinally extending slots having
a depth corresponding to the length of the clip.
The partition member 36 serves to further support the clips in the
magazine. In the preferred embodiment of the invention, the
partition member is provided with slits 46 extending crosswise
therein in alignment with the slots 32 whereby the bail of the
clips is received in the slits 46 to maintain a separation between
the clips in the adjacent slots 32 and thereby insure alignment of
the clips for removal by a suitable applicator as hereinafter
described.
In the use of the clips of the invention in the strangulation of
blood vessels or the like, the clips are first loaded on an
applicator as shown in FIGS. 12 and 22 of the drawing. The
applicator employed can be one of those described in the foregoing
U.S. patents or the improved applicator of this invention; the
applicator illustrated in FIG. 22 of the drawings is a forceps type
applicator as described in the above patents.
Referring to FIGS. 12 and 22, the applicator 48, which includes a
pair of opposing jaws 50 and 52 adapted to engage the arms of the
clip by means of grooves in the jaws, is inserted into the slots 32
containing a clip 49 which can be either the clip of FIG. 17 or the
clip of FIG. 18. The tips 51 of the jaws 50 and 52 are advanced to
the slot until the tips abut the raised surface 40 and the jaws are
closed slightly to disengage the arms of the clip from the curved
surfaces 44 of the magazine. After disengagement from the curved
holding surfaces, the arms of the clip spring outwardly as shown in
FIG. 12, and the clip is removed from the magazine, while secured
between the jaws of the applicator, by sliding the clip through the
slots 32 ready for use.
The clip, after removal from the magazine, can be applied to a
blood vessel or vessels by closing the jaws of the applicator with
the clip positioned about the vessel or vessels whereby the clip is
deformed about the vessel or vessels to effect strangulation
thereof. The lateral spaced teeth, which extend intermittently over
the length of the arms of the clip, serve to prevent slippage of
the clips in the closed position.
The improved applicator of this invention is illustrated in FIGS. 1
to 10 of the drawings. The applicator comprises two pivotally
joined elongate members 60 and 62, each of which includes a jaw
portion 64 or 66, respectively, adapted to engage a hemostatic clip
therebetween. For this purpose, the opposing faces of the jaw
portions are formed with elongate grooves 70 and 68, respectively,
which are adapted to engage the arms of a hemostatic clip, such as
clips of the type described in the foregoing patents or the
improved clips of this invention. Opposite the jaw portions, the
elongate members are provided with gripping members 72 and 74.
The pivoting action of the applicator of the invention is provided
by means of a slot 76 formed in one of the elongate members 60
which is adapted to receive an intermediate portion of the other
elongate member 62. As is most clearly illustrated in FIG. 8 of the
drawing, the pivotal action is provided by way of a pin 80 or the
like which extends through an opening 82 in the intermediate
portion 78 into openings 84 in the elongate member 60. Thus, the
elongate members 60 and 62 are pivotal relative to each other about
the pin 80 as an axis.
The configuration of the intermediate portion 78 of the elongate
member is shown in detail in FIG. 9 of the drawing. The
intermediate portion 78 includes a cam member 86 integral therewith
and a longitudinally spaced, raised surface or lip 88 adjacent to
the jaw portion 66 of elongate member 62.
Elongate member 60 is provided with a corresponding profile along
the lateral edges of the slot 76. As shown in FIGS. 3 and 10, the
elongate member 60 is provided with raised portions 90 on opposite
lateral edges of the central slot 76 corresponding to the cam
member 86 and longitudinally spaced raised portions 92 on the
lateral edges of the slot corresponding to the raised portion 88 on
the intermediate portion 78.
As is shown in FIG. 1 of the drawing, when the jaw portions 64 and
66 are in an intermediate open position, the cam member 86 is in a
position corresponding to that of the raised portions 90 adjacent
to the cam member; in other words, the profile of the cam member 86
matches that of the raised portions 90. Similarly, the
longitudinally spaced raised portion or lip 88 is in a position
corresponding to that of raised portions 92.
However, when the jaw portions are displaced toward a closed
position by displacing the gripping members 72 and 74 toward each
other, the cam member 86 is thrust upwardly beyond the
corresponding raised portions 90 adjacent the slot 76. Similarly,
when the jaw portions are displaced toward an open position by
displacing the gripping members 72 and 74 away from each other, the
lip 88 is thrust upwardly beyond the corresponding raised surfaces
92 along the lateral edges of the slot 76.
The applicator of this invention is provided with a substantially
flat cantilever spring member 94 which is mounted adjacent one end
to the elongate member 60 by suitable means such as a rivet or the
like. As is shown in FIGS. 1 and 4, the spring member 44 presses
downwardly on the cam member 86 and the corresponding raised
portions 90 to maintain the jaw portions in an intermediate
equilibrium position with matching profiles. This position is
preferably such that the jaw portions securely grip a hemostatic
clip 49 (FIG. 4) therebetween. Simultaneously, the spring member
depresses lip 88 so as to maintain the profile of lip 88 the same
as that of raised portion 92.
In this way, the applicator of this invention is maintained in an
equilibrium clip-gripping position. As the jaw portions are closed
by displacing the gripping members 72 and 74 toward each other, the
cam member is thrust upwardly against the spring member 94 to
thereby provide resistance to closure of the jaw portion. This
resistance to closure prevents premature inadvertent closure of the
hemostatic clip. Similarly, as the jaw portions are opened, the lip
88 is thrust against the action of the spring member 94 to prevent
unintentional loss of the clip from the jaw portions.
Thus, the applicator of the invention is biased toward an
intermediate gripping position in which a hemostatic clip is
secured between the jaws thereof. Accidental loss of the clip from
the applicator is prevented since the jaws can be opened only by
displacing the gripping members away from each other, against the
action of the spring member. Inadvertent closure of the jaws and
consequently a hemostatic clip engaged between the jaws is
prevented since the jaws can be closed only by displacing the
gripping members toward each other against the action of the spring
member.
The applicator of this invention can be used with the improved
hemostatic clips of this invention. In addition, the applicator can
also be used with the hemostatic clips described by the foregoing
patents.
It will be understood that various changes and modifications can be
made in the details of construction, operation and use without
departing from the spirit of the invention, especially as defined
in the following claims.
* * * * *