US 3510923 A
Description (OCR text may contain errors)
United States Patent 3,510,923 PARALLEL JAW RATCHET CLIP AND RETRACTOR Lawrence W. Blake, Huntington Beach, Calif., assignor, by mesne assignments, to American Hospital Supply Corporation, Evanston, Ill., a corporation of Illinois Filed June 20, 1968, Ser. No. 738,562 Int. Cl. A61b 17/12 US. Cl. 24263 18 Claims ABSTRACT OF THE DISCLOSURE Two embodiments of the clip and one embodiment of retractor are disclosed, made of plastic for use as disposable items. The jaws have sliding action by movement of a plunger in a barrel. A first pair of pinch grips is provided for applying the device and a second pair of pinch grips is provided for releasing the device.
BACKGROUND OF THE INVENTION This invention relates to an improved parallel jaw surgical clip and retractor having releasable ratchet means to hold the jaws in adjusted positions.
In many surgical operations, a considerable number of clips is required to occlude severed blood vessels and for other purposes. The most common type of clip has smooth surfaced swinging jaws which are parallel when closed upon themselves but which are not parallel in the partially spread position they assume on a blood vessel. The lack of parallelism of the jaws sometimes makes it difficult to completely occlude the vessel to stop bleeding. Also, the lack of parallelism and the smooth hard surfaces of the jaws creates a tendency for the clips to slip off the vessels or other tissue.
Parallel jaw clamps designed for other purposes are not adaptable to surgical use because of their size, weight and cost. Surgical clips must be small and light in weight. It is also highly desirable that they be sufliciently inexpensive to be used as disposable items. Sterilization is costly and, in the case of parallel jaw mechanisms, complete cleaning and sterilization cannot be accomplished without taking the clips apart. The taking apart and reassembling of a large number of clips after an operation is obviously to be avoided.
There is also a need for small inexpensive retractors which may be used as disposable items to obviate the time and expense of sterilizing them.
SUMMARY OF THE INVENTION The present clip accomplishes complete occlusion of the vessel, is light in weight, secure in its attachment to a vessel or other tissue and inexpensive to manufacture. It has two jaws which remain in parallelism throughout their opening and closing movements. The jaws are mounted on two relatively slidable members which are pinch closed in accordance with the clamping force desired by the surgeon. A ratchet device holds the jaws closed and pinch grips are provided to release the ratchet device and open the jaws.
Both jaws are preferably toothed to prevent slippage on the clamped tissue but either one or both jaws may be equipped with a resilient soft jaw element, if desired. The parallel action of the jaws provides complete occlusion of blood vessels with a minimum clamping force and assures secure retention thereon. Since the clips are disposable there is no problem of cleaning and sterilizing the jaw mechanisms and more reliable sterility is achieved.
The retractor is similarly constructed but has jaws equipped with hooks instead of teeth and the ratchet action is reversed to hold the jaws open instead of closed.
Objects of the invention are to provide an improved form of construction for surgical clips and retractors, to provide a clip which subjects a vessel to minimum torque and distortion for occlusion, to provide a clip having parallel jaw action, to provide a parallel jaw clip which is compact, light in weight and Well balanced, to provide a clip without springs, to provide a ratchet type clip wherein the clamping force is under the control of the surgeon, to provide a two piece construction which snaps together in assembly without requiring separate fastening means, and to provide a good quality clip and retractor of the type described which may be inexpensively constructed of plastic parts and used as a disposable item.
The invention will be better understood and the foregoing and other objetcs and advantages will become apparent from the following description of certain preferred embodiments illustrated in the accompanying drawing. Various changes may be made, however, in the details of construction and arrangement of parts and certain features may be used without others.
BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is a perspective view of a first embodiment of clip exemplifying the principles of the invention, showing the clip in open position;
FIG. 2 is a side elevation View, with parts broken away, showing the clip of FIG. 1 clamped on a blood vessel;
FIG. 3 is a side elevation view of the opposite side of the clip in FIG. 2, showing the clip in fully open position;
FIG. 4 is an end elevation view of the clip in FIG. 1;
FIG. 5 is a view on the line 5-5 in FIG. 3;
FIG. 6 is an enlarged fragmentary view showing the ratchet portion of the clip in FIG. 1;
FIG. 7 is a perspective view of a second embodiment of clip;
FIG. 8 is a side elevation view, with parts broken away, showing the clip of FIG. 7 clamped on a blood vessel;
FIG. 9 is a side elevation view of the clip in FIG. 8 with the jaws in open position;
FIG. 10 is an end elevation view of the clip in FIG. 7;
FIG. 11 is a view on the line 1111 in FIG. 9;
FIG. 12 is a side elevation view of a retractor exemplifying the principles of the invention; and
FIG. 13 is a view on the line 13-13 in FIG. 12.
DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring first to FIG. 1, the opposed jaws 10 and 11 are molded integrally with the upper ends of two telescoping member 12 and 13, respectively. Member 12 may be referred to as a plunger and member 13 as a barrel for the plunger. Th jaws extend at right angles to the plunger and barrel whereby the jaws have parallel movement toward and away from each other. The plunger and barrel are of non-circular configuration so that the plunger cannot rotate in the barrel. The jaws are shown equipped with teeth to prevent slippage on a clamped object but either one or both of the clamping faces of the jaws may be equipped with a resilient, soft pad such as rubber instead of the teeth, if desired.
The back side of barrel 13 is equipped with downwardly sloping ratchet teeth 15 as shown in FIG. 6 and a pinch grip 16 is integral with the upper end of the barrel. Pinch grip 16 is notched at 17 to slidably receive the spring arm 18 of a second pinch grip 20. The inner side of arm 18 is equipped with a pawl 21 to engage the ratchet teeth 15. Arm 18 is resilient and bendable by reason of its slender cross section. The upper end of arm 18 is integral with jaw 10 and plunger 12. A retainer tab 22 on barrel 13 overlies the side of arm 18 a short distance as shown.
Pinch grip 16 has a stiffening web 23 equipped with a tape hole 24 for securing the clip, if desired.
Plunger 12 is assembled in barrel 13 by springing the resilient arm 18 past the side of pinch grip 16 and around the end of retainer tab 22 into notch 17. The two pinch grips 16 and then hold the two parts securely in assembled relation so that the plunger is retained in the barrel.
The clip is applied to blood vessel V in FIG. 2 by pinching the jaws 10 and 11 together between the thumb and forefinger whereby the surgeon has control of the clamping pressure. For this purpose a pinch grip surface is provided over the upper end of plunger 12 and a pinch grip surface 26 is provided on the lower end of barrel 13. The thumb and forefinger may be applied either to the surfaces 25 and 26 or directly to the jaws, as desired. Since the jaws are parallel in any clamped position, complete occlusion of the vessel is obtained with a minimum clamping force. The clamped position of the jaws is retained by the engagement of pawl 21 in ratchet teeth 15.
The clip is removed by pinching together the two pinch grips 16 and 20 between the thumb and forefinger. This pinching action first causes the lower end of spring arm 18 to flex outwardly to the right in FIG. 2, to release pawl 21 from ratchet teeth 15. Then, as the grips 16 and 20 are pinched toward each other, the jaw 10 is moved upwardly away from jaw 11. In clips of very small sizes, an applicator may be provided for pinching the jaws 10 and 11 together in applying the clips and for pinching the grips 1'6 and 20 together in removing the clips.
FIGS. 7 to 11 show a clip modification wherein ratchet teeth are formed on the plunger 12. These ratchet teeth are similar to the teeth 15 in FIG. 6 except that they slope upward. Pinch grip 31 is integral with the lower end of plunger 12 and pinch grip 32 is formed on the upper end of a bifurcated spring arm 33 which is integrally connected at its lower end with the lower end of barrel 13. Pinch grip 31 has a narrow neck portion 34 which slides in slot 35 in the spring arm 33 and slot 36 in barrel 13. The inner side of the upper end of spring arm 33 is equipped with a pawl 40 to engage the ratchet teeth 30.
This clip is made in three pieces. After assembling plunger 12 in barrel 13, the lower end of spring arm 33 is adhesively secured to the barrel in a joint at 41. The two pinch grips 31 and 32 then hold the parts in assembled relation so that the plunger is retained in the barrel.
The second embodiment operates in the same manner as the first embodiment. The clip is applied either by directly pinching the jaws 10 and 11 together or by pinching the grips 25 and 26. The clip is released by pinching the grips 31 and 32 together. When grip 32 is pinched toward grip 31 in FIG. 8, the resilient spring arm 33 is flexed outwardly releasing pawl 40 from ratchet teeth 30. Continued pinching movement slides the plunger 12 upwardly in the barrel 13, as shown in FIG. 9.
Although the clamp jaws 10 and 11 in FIGS. 1 and 7 are described as parallel, it may be desired in some cases to have them converge toward their outer ends at a small angle when unstressed, so that they will assume parallelism after clamping pressure is applied. A small angle of convergence would compensate for the elasticity of the parts and the necessary looseness in the sliding fit between plunger 12 and barrel 13 whereby the jaws would become parallel in clamped position as shown in FIGS. 2 and 8.
A retractor is shown in FIGS. 12 and 13. This construction is similar to the clip in FIG. 1 except that the retractor arm or jaw is on the lower end of plunger 12 instead of its upper end. The other retractor arm or jaw 51 is integral with the upper end of barrel 13 corresponding to the clamp jaw 11 on the upper end of barrel 13 in FIG. 1. The outer ends of the retractor jaws 50 and 51 are equipped with hooks 52 on the opposite sides of the jaws.
Jaw 50 slides in a slot in barrel 13 similar to the slot 36 in FIGS. 8 and 11. This slot extends to the lower end of the barrel in FIG. 12 to permit insertion of plunger 12 and jaw 50 from the lower end of the barrel. The lower end of the barrel may be left open to form the pinch grip 26 or a cap may be adhesively secured to the lower end of the barrel to form this pinch grip, if desired. Spring arm 18 and pinch grip 20 are formed as a separate piece which is adhesively secured to plunger 12 in a joint at 53 after the plunger has been assembled in the barrel. Pinch grip 16 is integral with barrel 13 and jaw 51.
The retractor is applied by pinching together the pinch grips 25 and 26, causing the jaws 50 and 51 to spread apart. The retractor is released by pinching together the pinch grips 16 and 20, causing pawl 21 to be disengaged from teeth 15 and causing jaws 50 and 51 to move toward each other.
Having now described my invention and in what man' ner the same may be used, what I claim as new and desire to protect by Letters Patent is:
1. A pinch close-pinch open clip and retractor construction comprising a pair members connected together for relative sliding movement, a pair of jaws on the re spective members, a first pair of pinch grips on said members arranged to move said jaws to operative position, a second pair of pinch grips on said members arranged to move said jaws to inoperative position, ratchet teeth on one of said members, and a pawl on one of said pinch grips of said second pair engaging said ratchet teeth to hold said jaws in said operative position, said pawl being disengaged from said teeth by pinching said second pair of pinch grips.
2. A construction as defined in claim 1, said slidable members comprising a plunger in a barrel.
3. A construction as defined in claim 2, said ratchet teeth being on said barrel and said pawl being on said plunger.
4. A construction as defined in claim 2, said ratchet teeth being on said plunger and said pawl-being on said barrel.
5. A construction as defined in claim 1, said pinch grips retaining said sliding members in assembled relation.
6. A construction as defined in claim 1, said pawl and one pinch grip being mounted on a spring arm on one of said members.
7. A construction as defined in claim 1, said jaws being closed in operative position and spread apart in inoperative position.
8. A construction as defined in claim 1, said jaws being spread apart in operative position and closed together in inoperative position.
9. A device comprising a pair of relatively slidable members, a pair of jaws on the respective members, ratchet teeth on one of said members, a first pinch grip on said one member, a spring arm connect d at one end with the other member, said spring arm extending along said members and crossing said first pinch grip, a pawl on the other end of said spring arm engaging said ratchet teeth to hold said jaws in operative position, and a second pinch grip on said other end of said spring arm, movement of said second pinch grip toward said first pinch grip disengaging said pawl from said teeth and moving said jaws to inoperative position.
10. A device as defined in claim 9 including a second pair of pinch grips on said members for moving said jaws to operative position.
11. A device as defined in claim 9, said jaws being closed in operative position and spread apart in inoperative position.
12. A device as defined in claim 9, said jaws being spread apart in operative position and closed together in inoperative position.
13. A device as defined in claim 9, said slidable members comprising inner and outer telescoping members.
14. A device as defined in claim 13, said first pinch grip and ratchet teeth being on said outer member and said spring arm being connected with said inner member.
15. A device as defined in claim 14, said spring arm and one of said jaws being on the outer end of said inner member.
16. A device as defined in claim 14, said spring arm being on the outer end of said inner member and one of said jaws being on the inner end of said inner member.
17. A device as defined in claim 13, said first pinch grip and ratchet teeth being on said inner member and said spring arm being connected with said outer member.
18. A pinch close-pinch open clip comprising two preformed parts assembled together; the first part comprising a barrel having a first jaw, a first pinch grip and ratchet teeth; the second part comprising a plunger in said barrel having a second jaw and a spring arm carrying a pawl engaging said ratchet teeth and a second pinch grip; said spring arm crossing said first pinch gri to hold said two parts in assembled relation, the pinching together of said two pinch grips disengaging said pawl from said ratchet teeth and sliding said plunger in said barrel in a direction to open said jaws.
References Cited UNITED STATES PATENTS 1,601,035 9/1926 Nauth 128-346 2,659,371 11/1953 Schnee 128-346 3,182,373 5/1965 Strand 251-7 XR 3,320,958 5/1967 Nolan 128-346 FOREIGN PATENTS 46,956 9/1929 Norway.
DONALD A. GRIFFIN, Primary Examiner U.S. Cl. X.R. 128-346; 251-7