US 3518993 A
Abstract available in
Claims available in
Description (OCR text may contain errors)
L. W. BLAKE SURGICAL CLIP APPLICATOR July 1, 1970 2 Sheets-Sheet 1 Filed May 1, 1967 INVENTOR. LAWRENCE w. BLAKE A Home y July 7,1970 L. w. BLAKE 3,518,993
SURGICAL CLIP APPLICATOR Filed May 1, 1967 2 Sheets-Sheet 2 R Q Q N X Q N INVENTOR. LAWRENCE W BLAKE Aff'orney \\\\\\\K\\w\\\ 2 mm m 3 on 8 3 .m on on mm hm r lv m .EW 0 mm 0 7 n .ww m UHHM llpl l! p I Q United States Patent O US. Cl. 128-321 15 Claims ABSTRACT OF THE DISCLOSURE A device for applying vascular clips to blood vessels to pinch the vessel closed and stop the flow of blood. A barrel contains a slidable holder collet and spreader collet actuated by a thumb lever to grasp a clip, open the clip, close the clip and release the clip so that the clips do not have to be handled with the fingers.
BACKGROUND OF THE INVENTION In certain types of operations, many small blood vessels are cut and have to be closed to prevent excessive bleeding. Conventional pinch clips have long been used for this purpose. It has been the practice heretofore to apply and remove these clips with the fingers. In operations requiring a large number of clips, considerable time is expended in applying and removing the clips thereby adding to the tedious details which the surgeon must perform and lengthening the time that the patient must be kept under anesthesia. The clips are rather small and awkward to manipulate with the fingers. It would be desirable to simplify these manipulations and to reduce the time required to apply and remove the clips.
SUMMARY OF THE INVENTION The present device comprises an instrument for grasping, opening, closing and releasing conventional vascular pinch clips, all by a simple movement of a thumb lever on the handle of the instrument. Extending from the handle is a barrel containing a holder collet and a spreader collet for sliding movement in the barrel. Movement of the thumb lever in one direction projects the collets in position for picking up a clip. Reverse movement of the thumb lever to a neutral position retracts the collets partially into the barrel, closing the holder collet to grasp and hold the clip. Further movement beyond the neutral position then closes the spreader collet to pinch and open the clip.
As the clip is applied to the blood vessel, thumb movement in the first mentioned direction again projects the collets, first releasing the spreader collet so that the clip will close on the vessel by its own spring action, and then as the thumb lever moves back beyond its neutral position releasing the holder collet for withdrawal of the instrument. The instrument facilitates the handling of the clips to such an extent that a considerable amount of time and energy is saved in applying and removing a large number of clips, especially when the site of application of the clips is in an area of limited accessibility.
A further objective of the clip applicator is to provide a clip holding means which may be employed as a dissecting instrument for such functions as freeing small vessels from the loosely adhering tissue surrounding. The long slim shape, firm, four jaw collet, and blade-like shape of the clip, all contribute to this ability. This further enhances the utility of the device by providing, in one instrument, the ability to locate, isolate, and clipocclude small vessels.
Objects of the invention are to provide an instrument for applying spring clips and, particularly, for applying vascular clips to blood vessels in a surgical operation, to
3,518,993 Patented July 7,, 1970 provide a clip applicator which will apply and remove the clips with less effort and more quickly than can be done with the fingers, to provide a clip applicator which has a neutral position, in which mode, it simply holds the clips without requiring operator force, in which the successive functions of holding the clip, releasing the clip and opening the clip are performed by a single continuous movement of a control lever in convenient position on the handle of the instrument, to provide a clip applicator having a holder collet and a spreader collet operable in sequence by sliding movement of the collets, and to provide an instrument of the type described which may be readily disassembled for cleaning and sterilizing.
Other objects and advantages will become apparent and the invention will be better understood from the following detailed description of the preferred embodiment illustrated in the accompanying drawings. Various changes may be made, however, in the details of construction and arrangement of parts and certain features may be employed without others. All such modifications within the scope of the appended claims are included in the invention.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a longitudinal sectional view of a clip applicator embodying the principles of the invention, showing the parts in clip-holding and spreading position;
FIG. 2 is a side elevation view, with parts broken away, showing the parts in clip-releasing position;
FIG. 3 is an exploded fragmentary perspective view of the thumb lever and control rod in FIG. 1;
FIG. 4 is an enlarged view, with parts in section, showing the holder and spreader collets in extended position as in FIG. 2;
FIG. 5 is a view similar to FIG. 4, showing the collets in partially retracted position with the holder collet closed and the spreader collet still open;
FIG. 6 is a view approximately on the line 6-6 in FIG. 5, showing the collets in the same positions as in FIG. 5; and
FIG. 7 is a view similar to FIG. 6 but showing the collets in fully retracted position for holding and spreading the clip, as in FIG. 1.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring first to FIG. 1, the instrument comprises, essentially, a handle body 10 having a cylindrical barrel 11 extending from one end thereof. The handle body contains a longitudinal bore 12 in alignment with the bore of barrel 11. A cylindrical control rod 13 is slidable in these bores to open and close in sequence a holder collet 14 and a spreader collet 15, which are connected with the distal end of the control rod and project from the distal end of barrel 11.
Control rod 13 is reciprocated by a control member preferably in the form of a longitudinally extending thumb lever 20 which is pivotally mounted on a transverse pin 21 in a pair of parallel ears 22 on the upper side of body 10. The thumb lever is biased to a neutral position intermediate between its FIG. 1 and FIG. 2 positions by a cantilever leaf spring 23 secured at one end to the proximal end of body 10 by a screw 24. The free end of spring 23 bears against a flat surface 25 on the end of thumb lever 20.
The under side of handle body 10 is equipped with an elongated loop 26 to encircle the fingers of the operators hand when the handle is grasped with the thumb lying along the top side of thumb lever 20. The end of the thumb lever is equipped with a thumb loop 27 to encircle the end of the operators thumb so that he can lift the thumb lever or squeeze it down against body 10 with equal facility.
Such lifting and squeezing movements of the thumb are transmitted to control rod 13 by a rounded bell crank end 28 on thumb lever which is received in a notch 29 in the proximal end of the control rod. Thus, by applying lifting movement to thumb loop 27, the collets 14 and 15 may be projected from the end of barrel 11 as shown in FIG. 2. Then by applying downward squeezing pressure to thumb lever 20, the thumb lever is moved to its FIG. 1 position to retract the collets partially into the barrel.
As seen in FIGS. 4 to 7, holder collet 14 has a flat transverse base portion from opposite sides of which extend a pair of longitudinal spring arms 36 in the U- shaped configuration of a tuning fork. Similarly, spreader collet 15 has a transverse flat base portion 37 from the opposite sides of which extend a pair of longitudinal spring arms 38 in the U-shaped configuration of a tuning fork. The two collets are turned at right angles to each other relative to the axis of barrel 11, and base 35 of holder collet 14 fits between the arms 38 of spreader collet 15. The two collets are held in assembled relation by a threaded stud 40 on holder collet 14 which extends through a smooth bore hole 41 in base 37 of the spreader collet and is engaged in a threaded hole 42 in the distal end of control rod 13 as shown in FIG. 6.
The arms 36 of holder collet 14 terminate in a pair of opposed clamp jaws 45 equipped with confronting projections 46. Abutments 47 are spaced a short distance behind these projections. The outer sides of jaws 45 have sloping cam surfaces 50 which are engageable with the rounded end 51 of barrel 11. When the collets are fully extended as shown in FIGS. 2 and 4, the cam surfaces 50 are at, or slightly beyond, the end of the barrel whereby the outward spring action of arms 36 holds the jaws open as to grasp a clip shown in FIG. 4. When the collets are retracted into the barrel, the cam surfaces 50 slide on the rounded end 51 of the barrel causing jaws 45 to be cammed toward each other and assume a closed position as shown in FIG. 5 to clamp and hold the clip. This corresponds to the neutral position of thumb lever 20.
In a similar manner, the spreader collet spring arms 38 terminate in a pair of opposed jaws 55 and these arms and jaws are formed with sloping cam surfaces 56 on their outer sides as shown in FIG. 6. Cam surfaces 56 are spaced longitudinally in a distal direction from the cam surfaces 50 so that the spreader collet jaws will not close until after the holder collet jaws have been closed when the collets are retracted. FIG. 7 shows the closed position of jaws 55 wherein the collets are retracted to their inward limit of movement as shown in FIG. 1.
The conventional vascular pinch clip C, which is to be used with the present applicator, is made of a single strip of spring metal having a pair of fiat overlapping fingers 60 which are normally held flatly together as shown in FIG. 6 by the spring loop 61. Loop 61 is formed with two spaced apart side portions 62 which are adapted to be gripped and pinched together to open or spread the clip as shown in FIG. 7. Hence, the collet 15 which spreads the clip is referred to as a spreader collet.
FIGS. 4 to 7 illustrate the sequence of jaw movements in picking up and spreading the clip C. In FIG. 4 the collets are fully extended as in FIG. 2 and both the holder collet jasw 45 and the spreader collet jaws 55 are open to receive the clip. The clip is picked up by applying the holder collet jaws 45 to the opposite open sides of spring loop 61 with the spreader collet jaws 55 overlying the opposite sides 62 of the spring loop. Abutments 47 limit the depth of insertion of the clip in the collet jaws whereby the clip is properly positioned for gripping by the holder collet and squeezing by the spreader collet. Then, as the thumb lever is allowed to return to its neutral position, the collets are drawn into barrel 11 by control rod 13 and cam surfaces 50 close the jaws 45 of the holder collet causing projections 46 to enter the opposite open sides of spring loop 61 and provide retention for the clip as shown in FIGS. 5 and 6. The two sets of jaws are in the same relative positions in FIGS. 5 and 6.
Further retractive movement of the collets pulls cam surfaces 56 into the end of the barrel, closing the jaws 55 and pinching the opposite sides of spring loop 61 together to spread the clip fingers 60 apart as shown in FIG. 7.
FIG. 7 shows the cam surface 56 withdrawn entirely within the end 51 of the barrel 11. The clip applicator can be adapted to clips of smaller size, or to adjust the maximum opening of the clip jaws 60 by adjustably unscrewing the stud 40 from control rod 13. This will cause the maximum retracted position of control rod 13 to occur when cam surface 56 is only partially within the end 51 of the barrel 11, thus, limiting clip spreading.
When a blood vessel is placed between clip fingers 60 and control rod 13 is moved outward, or toward the right in FIG. 7, the spreader collet jaws 55 are opened first, allowing the clip to close itself on the vessel. In a similar manner, further outward movement of the control rod opens the holder collet jaws 45 so that the applicator may be removed from the clip, leaving the clip pinched on the vessel to stop the flow of blood in the vessel.
When the clip is later to be removed from the vessel, the applicator is applied to the clip as shown in FIG. 4 and the sequence of operations in FIGS. 4 to 7 is repeated. The convenience and speed afforded by this instrument will be appreciated from the fact that the sequence of movements shown in FIGS. 4 to 7 is produced by merely squeezing thumb lever 20 in one continuous movement from its FIG. 2 position to its FIG. 1 position.
The instrument is easy to take apart for cleaning and sterilizing. Removal of screw 24 and pin 21 releases spring 23 and thumb lever 20. Then control rod 13 and the two collets may be withdrawn. The collets are detached by unscrewing stud 40 from the control rod.
Having now described my invention and in what manner the same may be used, what I claim as new and desire to protect by Letters Patent is:
1. A clip applicator comprising a handle member, a pair of opposed gripping members in said handle member arranged to grip a spring clip from its opposite sides to hold the clip, a pair of opposed squeezing members in said handle member operating at right angles to said gripping members for squeezing the held portion of the clip to open the clip, a movable control member on said handle member arranged to open and close said gripping members and squeezing members, said handle member comprising a barrel, and said gripping and squeezing members being slidable in said barrel by said control member, said gripping and squeezing members having cam means thereon arranged to cooperate with said barrel for opening and closing said gripping and squeezing members in response to sliding movement in said barrel, and a control rod slidable in said barrel interconnecting said control member and said gripping and squeezing members to produce said sliding movement, said control member comprising a bell crank lever.
2. A clip applicator as defined in claim 1, including a thumb loop on said lever, said lever being movable in one direction by a squeezing movement of the operators thumb and movable in the opposite direction by a lifting movement of the operators thumb.
3. A clip applicator as defined in claim 2, including a spring arranged to bias said lever toward an intermediate portion in its range of movement.
4. A clip applicator comprising a handle, a clip holder on said handle having a pair of jaws, a clip spreader on said handle having a pair of jaws operating at right angles to said holder jaws, a movable control member on said handle arranged to open said holder and spreader jaws in sequence in one continuous movement of said control member in one direction and close said holder and spreader jaws in sequence in one continuous movement of said control member in the opposite direction, and means to bias said control member toward an intermediate position holding said holder jaws closed and said spreader jaws open.
5. A clip applicator as defined in claim 4, said holder jaws having opposed gripping faces and a pair of confronting central projections on said faces.
6. A clip applicator as defined in claim 4, said handle member comprising a barrel, and a control rod slidable in said barrel and connected with said control member for opening and closing said holder jaws and spreader aws.
7. A clip applicator as defined in claim 4, said handle member comprising a barrel, and said holder and spreader jaws being slidable in said barrel by said control member.
8. A clip applicator as defined in claim 7, said holder and spreader jaws having cam means thereon arranged to cooperate with said barrel for opening and closing said holder and spreader jaws in response to sliding movement in said barrel.
9. A clip applicator as defined in claim 8, including a control rod slidable in said barrel interconnecting said control member and said holder and spreader jaws to produce said sliding movement.
10. A clip applicator comprising a barrel, a clip holder collet having a pair of jaws slidable in one end of said barrel, a clip spreader collet having a pair of jaws at right angles to said holder jaws slidable in said one end of said barrel, means on said collets for opening and closing the collets in sequence by sliding movement in unison in said barrel, a handle on the opposite end of said barrel, and a control member on said handle for sliding said collets in said barrel.
11. A clip applicator as defined in claim 10, including a control rod slidable in said barrel, one end of said control rod being connected with said collets and the opposite end being connected with said control member.
12. A clip applicator as defined in claim 11, including a means for adjusting said collets lengthwise on said control rod.
13. A clip applicator as defined in claim 10, said opening and closing means comprising cam surfaces on the collets engageable with said barrel in different positions in said sliding movement, and means to bias said collets to a position holding said holder collet closed and said spreader collet open.
14. A clip applicator as defined in claim 11, each collet comprising a U-shaped member having a base portion connected with said control rod and a pair of spring arms having opposed jaws on their outer ends, said U-shaped members being disposed at right angles to each other relative to the axis of said rod.
15. A clip applicator comprising a barrel, a clip holder collet slidable in one end of said barrel, a clip spreader collet slidable in said one end of said barrel, means on said collets for opening and closing the collets by sliding movement in said barrel, a handle on the opposite end of said barrel, a control member on said handle for sliding said collets in said barrel, a control rod slidable in said barrel, one end of said control rod being connected with said collets and the opposite end being connected with said control member, each collet comprising a U-shaped member having a base portion connected with said control rod and a pair of spring arms having opposed jaws on their outer ends, said U-shaped members being disposed at right angles to each other relative to the axis of said rod, said means for opening and closing said collets comprising cam surfaces on the spring arms of said holder collet engageable with the end of said barrel to close the holder collet upon initial retractive movement of the collets into the barrel from an extended position, and cam surfaces on the spring arms of said spreader collet engageable with the end of said barrel to close the spreader collet upon fnrther retractive movement.
References Cited UNITED STATES PATENTS 2/1941 Jensen 294-20 3/1948 Bagge 279-51 U.S. Cl. X.R.