Surgical clip applier with circular clip magazine

• US 4,448,193 A
• Filed: 02/26/1982
• Issued: 05/15/1984
• Est. Priority Date: 02/26/1982
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Ivanov, Konstantin
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): Lester, Michelle N.
• Application Number:
  US06/352,836
• Time in Patent Office: 809 Days
• Field of Search: 128/325, 128/326, 128/334 R, 128/335, 128/335.5, 128/346, 227/DIG. 1, 227/DIG. 1 A, 227/DIG. 1 B, 227/DIG. 1 C, 227/19, 227/117, 227/125, 29/243.56, 72/410
• US Class Current: 606/143
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips

Abstract

A method and a repeating instrument are provided for applying a plurality of ligating clips seriatim. Handles are provided for closing a pair of jaws which are normally biased to an open position. A circular magazine is mounted for rotation on the instrument behind the jaws and holds a plurality of clips in a spaced-apart circular array. A flexible pusher member is provided for pushing a clip out of the magazine and into the jaws when the handles are closed. The flexible pusher member is wound on a wheel which is driven by a gear engaged with a gear segment on one of the handles of the instrument. Partial closure of the handles initially withdraws a flexible pusher member from the jaws. Subsequent further closure of the handles acts through a ratchet and pawl mechanism to rotate the magazine to present a new clip in position behind the jaws and in front of the retracted flexible pusher member. At the same time, the jaws of the instrument are squeezed to latch the clip closed about tissue. Subsequent opening of the handles causes the flexible pusher member to be advanced from the magazine to position the new open clip at the jaws.

Claims

1. A repeating medical instrument for applying a plurality of ligating clips seriatim about tissue wherein each said clip is initially provided in an open state, each said open clip comprising first and second legs joined at their proximal ends by a resilient hinge and being spaced apart at their distal ends with said legs having latch means at said distal ends for holding said clip closed in clamping engagement about said tissue when said legs are squeezed together, said instrument comprising:

a frame;

first and second jaws mounted to said frame in confronting relationship for movement away from each other into an open position to receive one of said clips and toward each other into a closed position for closing and latching said one clip;

jaw biasing means for biasing said jaws outwardly away from each other and into said open position;

a pair of actuating members pivotally mounted to said frame, each said actuating member having a forward distal end portion adapted to engage one of said jaws and having a rear portion extending outwardly away from said one jaw;

first and second handles mounted to said frame for pivotal movement, each of said first and second handles including an engaging portion extending beyond its pivot axis and adapted to engage said rear portion of one of said actuating members whereby, when said first and second handles are moved toward each other, said engaging portions of each of said first and second handles move outwardly to engage said rear portions of said actuating members to force said forward distal end portions of said actuating members against said first and second jaws to move said jaws toward each other from said open position into said closed position;

a magazine and means for releasably mounting said magazine on said frame for rotation relative to said frame, said magazine defining a plurality of clip storage regions arranged in a generally circular array, each said clip storage region defining an inner access opening at an inner radius of said circular array and an outer access opening at an outer radius of said array, each said clip storage region being adapted to hold one of said clips with said clip hinge adjacent said inner access opening and with said clip leg distal ends adjacent said outer access opening, said magazine further including a circular array of ratchet teeth concentric about the axis of rotation of said magazine;

spring means carried on said frame for engaging one of said ratchet teeth when said magazine is rotated to align any one of said magazine clip storage regions with said first and second jaws;

a pawl carried on one of said handles for engaging said magazine ratchet teeth after said handles have been moved toward each other a predetermined amount;

biasing means associated with said pawl and the handle on which said pawl is carried for biasing said pawl into engagement with said magazine ratchet teeth;

said magazine clip storage regions and ratchet teeth on said magazine being arranged so that the movement said first and second handles toward each other beyond a predetermined point causes said pawl to engage said ratchet teeth and incrementally rotate said magazine to move one of said clip storage regions out of registration with said jaws and to move the next adjacent clip storage region into registration with said jaws;

a wheel mounted for rotation to said frame;

a flexible pusher member secured to and partially wound around said wheel, said flexible pusher member having at least a forward end adapted to enter into one of said magazine clip storage regions in registration with said jaws and to move said clip out of said clip storage region into said jaws;

a circular gear connected with said wheel for rotation therewith; and

a gear segment on one of said first and second handles and engaged with said circular gear for (1) rotating said wheel in a first direction when said handles are moved together to withdraw said flexible pusher member from said jaws and behind said inner access opening of one of said clip storage regions in registration with said jaws and (2) rotating said wheel in a second, opposite direction when said handles are moved apart whereby said flexible pusher member is advanced through one of said clip storage regions in registration with said jaws and between said jaws to position one of said clips at said jaws.

2. The instrument in accordance with claim 1 in which said frame includes a guide channel rearwardly of said magazine for guiding said flexible pusher member.

3. The instrument in accordance with claim 1 in which said frame includes a cover plate releasably disposed over said magazine and in which said cover plate includes a downwardly projecting guide member defining a guide channel for guiding said flexible pusher member adjacent the inner radius of said circular array of clip storage regions in registration with said jaws.

4. The instrument in accordance with claim 1 in which said jaws are fabricated from a unitary structure of resilient material, in which a rear portion of said structure has a substantially C-shaped cross section defining a channel for receiving one of said clips, and in which a forward portion of said structure includes two spaced-apart, U-shaped channel members extending forwardly of said rear portions of said structure for defining said jaws and having sufficient flexibility for the jaws to be closed by said actuating members while having sufficient resilience to move said jaws to said open position when said handles are opened a sufficient amount.

5. The instrument in accordance with claim 1 in which said magazine has a generally circular configuration, in which said ratchet teeth are integrally formed on the bottom of said magazine, in which said frame includes an upstanding post, and in which said means for releasably mounting said magazine for rotation on said frame includes a bore for receiving said upstanding post.

6. The instrument in accordance with claim 1 in which said wheel is mounted for rotation about an axis parallel to the axis of rotation of said magazine and in which said flexible pusher member is twisted through an angle of about 90 degrees.

7. A medical instrument for applying a plurality of ligating clips seriatim about tissue wherein each said clip is initially provided in an open state, each said open clip comprising first and second legs joined at their proximal ends by a resilient hinge and being apart at their distal ends with said legs having latch means at said distal ends for holding said clip closed in clamping engagement about said tissue when said legs are squeezed together, said instrument comprising:

a frame;

first and second jaws mounted to said frame in confronting relationship for movement away from each other into an open position to receive one of said clip and toward each other into a closed position for closing and latching said one clip;

jaw biasing means for biasing said jaws outwardly away from each other from said closed position and into said open position;

jaw actuating means for being operated to permit the movement of said jaws away from each other into said open position under the influence of said jaw biasing means and for being operated through a lost motion phase to effect movement of said jaws toward each other from said open position into said closed position following the termination of said lost motion phase;

a magazine and means for mounting said magazine on said frame for rotation relative to said frame, said magazine defining a plurality of clip storage regions arranged in a generally circular array, each said clip storage region defining an inner access opening at an inner radius of said circular array and an outer access opening at an outer radius of said array, each said clip storage region being adapted to hold one of said clips with said clip hinge adjacent said inner access opening and with said clip leg distal ends adjacent said outer access opening, said magazine further including a circular array of ratchet teeth concentric about the axis of rotation of said magazine;

means carried on said frame for releasably retaining said magazine against inadvertent rotational movement after said magazine has been rotated to align any one of said magazine clip storage regions with said first and second jaws;

a pawl carried on said jaw actuating means for engaging said magazine ratchet teeth when said jaw actuating means is operated to close said jaws;

biasing means associated with said pawl and with said jaw actuating means for biasing said pawl into engagement with said magazine ratchet teeth;

said magazine clip storage regions and ratchet teeth on said magazine being arranged so that operation of the said jaw actuating means to close said jaws causes said pawl to engage said ratchet teeth and incrementally rotate said magazine to move one of said clip storage regions out or registration with said jaws and to move the next adjacent clip storage region into registration with said jaws; and

clip pushing means responsive to said jaw actuating means for (1) advancing into one of said magazine clip storage regions in registration with said jaws and moving said clip out of said clip storage region and into position between said jaws when said jaw actuating means is operated to permit the opening of said jaws, and for (2) withdrawing from said jaws and behind said inner access opening of one of said clip storage regions in registration with said jaws as said jaw actuating means is operated through said lost motion phase prior to the closure of said jaws.

8. The instrument in accordance with claim 7 in which said clip pushing means includes a wheel mounted for rotation on said frame, a flexible member partially wound on said wheel, and means for rotating said wheel in either of two directions.

9. The instrument in accordance with claim 7 in which said jaws are fabricated from a unitary structure of resilient material, in which a rear portion of said structure has a substantially C-shaped cross section defining a channel for receiving one of said clips, and in which a forward portion of said structure includes two spaced-apart, U-shaped channel members extending forwardly of said rear portion of said structure for defining said jaws and having sufficient flexibility for the jaws to be closed by said jaw actuating means while having sufficient resilience to move said jaws to said open position when said jaw actuating means is operated to permit movement of said jaws away from each other.

10. The instrument in accordance with claim 7 in which said magazine has a generally circular configuration, in which said ratchet teeth are integrally formed on the bottom of said magazine, in which said frame includes an upstanding post, and in which said means for mounting said magazine for rotation on said frame includes a bore for receiving said upstanding post to permit said magazine to be removed from said instrument when desired.

11. The instrument in accordance with claim 7 in which said jaw actuating means includes:

a pair of actuating members pivotally mounted to said frame, each said actuating member having a forward distal end portion adapted to engage one of said jaws and having a rear portion extending rearwardly and outwardly away from said one jaw; and

first and second handles mounted to said frame for pivotal movement, each of said first and second handles including an engaging portion extending beyond its pivot axis and adapted to engage said rear portion of one of said actuating members whereby, when said first and second handles are moved toward each other, said engaging portions of each of said first and second handles moves outwardly to engage said rear portions of said actuating members to force said forward distal end portions of said actuating members against said first and second jaws to move said jaws toward each other from said open position into said closed position.

12. The instrument in accordance with claim 7 in which said means for releasably retaining said magazine against inadvertent rotation includes spring means carried on said frame for engaging one of said ratchet teeth when said magazine is rotated to align any one of said magazine clip storage regions with said first and second jaws.

13. The instrument in accordance with claim 11 in which said clip pushing means includes:

a wheel mounted for rotation to said frame;

a flexible pusher member secured to and partially wound around said wheel, said flexible pusher member having at least a forward end adapted to enter into one of said magazine clip storage regions in registration with said jaws and to move said clip out of said clip storage region into said jaws;

a circular gear connected with said wheel for rotation therewith; and

a gear segment mounted on one of said first and second handles and engaged with said circular gear for (1) rotating said wheel in a first direction when said handles are moved together to withdraw said flexible pusher member from said jaws and behind said inner access opening of one of said clip storage regions in registration with said jaws and (2) rotating said wheel in a second, opposite direction when said handles are moved apart whereby said flexible pusher member is advanced through one of said clip storage regions in registration with said jaws and between said jaws to push one of said clips into position at said jaws.

14. The instrument in accordance with claim 13 in which said frame includes a guide channel rearwardly of said magazine for guiding said flexible pusher member.

15. The instrument in accordance with claim 13 in which said frame includes a cover plate releasably disposed over said magazine and in which said cover plate includes a downwardly projecting guide member defining a guide channel for guiding said flexible pusher member adjacent the inner radius of said circular array of clip storage regions in registration with said jaws.

16. A medical instrument for applying a plurality of ligating clips seriatim about tissue wherein each said clip is initially provided in an open state, each said open clip comprising first and second legs joined at their proximal ends by a resilient hinge and being spaced apart at their distal ends with said legs having latch means at said distal ends for holding said clip closed in clamping engagement about said tissue when said legs are squeezed together, said instrument comprising:

a frame;

first and second jaws mounted to said frame in confronting relationship for movement away from each other into an open position to receive one of said clips and toward each other into a closed position for closing and latching said one clip;

jaw biasing means for biasing said jaws outwardly away from each other from said closed position and into said open position;

jaw actuating means for being operated to permit the movement of said jaws away from each other into said open position under the influence of said jaw biasing means and for being operated through a lost motion phase to effect movement of said jaws toward each other from said open position into said closed position following the termination of said lost motion phase;

a magazine and means for mounting said magazine on said frame for rotation relative to said frame, said magazine defining a plurality of clip storage regions arranged in a generally circular array, each said clip storage region defining an inner access opening at an inner radius of said circular array and an outer access opening at an outer radius of said array, each said clip storage region being adapted to hold one of said clips with said clip hinge adjacent said inner access opening and with said clip leg distal ends adjacent said outer access opening;

means carried on said frame for releasably retaining said magazine against inadvertent rotational movement after said magazine has been rotated to align any one of said magazine clip storage regions with said first and second jaws;

magazine rotating means responsive to the operation of the said jaw actuating means to close said jaws for incrementally rotating said magazine to move one of said clip storage regions out of registration with said jaws and to move the next adjacent clip storage region into registration with said jaws; and

clip pushing means responsive to said jaw actuating means for (1) advancing into one of said magazine clip storage regions in registration with said jaws and moving said clip out of said clip storage region and into position between said jaws when said jaw actuating means is operated to permit the opening of said jaws, and (2) withdrawing from said jaws and behind said inner access opening of one of said clip storage regions in registration with said jaws as said jaw actuating means is operated through said lost motion phase prior to the closure of said jaws.

17. The instrument in accordance with claim 16 in which said magazine rotating means includes a circular array of ratchet teeth on said magazine, a pawl carried on said jaw actuating means for engaging said ratchet teeth when said jaw actuating means is operated to close said jaws;

and biasing means associated with said pawl and with said jaw actuating means for biasing said pawl into engagement with said ratchet teeth.

18. A medical instrument for applying a plurality of ligating clips seriatim about tissue wherein each said clip is initially provided in an open state, each said open clip comprising first and second legs joined at a leg connection end of the clip and being spaced apart at their distal ends, said instrument comprising:

a frame;

first and second jaws mounted to said frame in confronting relationship for movement away from each other into an open position to receive one of said clips and toward each other into a closed position for closing said one clip;

jaw biasing means for biasing said jaws outwardly away from each other from said closed position and into said open position;

jaw actuating means for being operated to permit the movement of said jaws away from each other into said open position under the influence of said jaw biasing means and for being operated through a lost motion phase to effect movement of said jaws toward each other from said open position into said closed position following the termination of said lost motion phase;

a magazine and means for mounting said magazine on said frame for rotation relative to said frame, said magazine defining a plurality of clip storage regions arranged in a generally circular array, each said clip storage region defining an inner access opening at an inner radius of said circular array and an outer access opening at an outer radius of said array, each said clip storage region being adapted to hold one of said clips with the leg connection end of said clip adjacent said inner access opening and with said clip leg distal ends adjacent said outer access opening;

means carried on said frame for releasably retaining said magazine against inadvertent rotational movement after said magazine has been rotated to align any one of said magazine clip storage regions with said first and second jaws;

magazine rotating means responsive to the operation of the said jaw actuating means to close said jaws for incrementally rotating said magazine to move one of said clip storage regions out of registration with said jaws and to move the next adjacent clip storage region into registration with said jaws; and

clip pushing means responsive to said jaw actuating means for (1) advancing into one of said magazine clip storage regions in registration with said jaws and moving said clip out of said clip storage region and into position between said jaws when said jaw actuating means is operated to permit the opening of said jaws, and (2) withdrawing from said jaws and behind said inner access opening of one of said clip storage regions in registration with said jaws as said jaw actuating means is operated through said lost motion phase prior to the closure of said jaws.