US1880569A - Surgical clip applying instrument - Google Patents

Description

Oct. 4, 1932. J P. WEIS 1,880,569.

SURGICAL CLIP APPLYING INSTRUMENT INVENTOR.

Patented Oct. 4, 1932 UNITED STATES JOHN P. WEIS, OF NYACK, NEW YORK SURGICAL CLIP APPLYING INSTRUMENT Application filed September 27, 1930. Serial No. 484,767.

This invention relates to surgical instruments, more particularly to surgical clip applying instruments, by means of which surglcal clips are applied to the mouths of wounds or incisions for securing the edges thereof together thereby doing away with the stitching thereof, the object of the invention being to provide a simple, inexpensive and eilicient' instrument so constructed that the clips may be automatically and quickly applied and spaced at regular predetermined intervals thereby avoiding delay especially when the patient is under an anesthetic.

Another important object is the provision of an instrument that may be rotated or rolled along the wound successively applying the clips in a regular and orderly manner while at the same time so constructed as to permit the applied clips to be visible.

Metal clips are now commonly used for the purpose of closing wounds since they are more efficient than needle stitches especially as they can be more quickly inserted and removed.

The common method of applying these metal clips has been to use a pair of tweezers or plyers to pick up each clip and apply it, this however is a slow and tedious process especially as the clips are small and difficult to pick up in just the right position to be applied, and as there is no guage or guide to assist in the application of the clips there is no regularity in the spacing thereof.

Various attempts have been made to improve upon these tweezers or plyers such as providing the tweezers with magazines but for various reasons these instruments were unsatisfactory and are not used, the old fashioned or common tweezers being employed.

0 The present improvement embodies the tweezer principle while providing means for holding a large number of clips spaced predetermined distances apart so that when the clips are applied the wound is closed in a 4 smooth and sightly manner thereby avoiding ugly figurement in the healing of the wound.

This improved instrument is not only convenient to operate and simple to load but is readily sterilized and one of the advantages thereof is that different sizes of clips may be simultaneously carried by the instrument, or difierent kinds used therewith. That is to say, the instrument is so constructed that clips all of one size or clips of different sizes may be carried in the instrument at the same time while it is also so constructed that different designs of clips may be used.

Furthermore this improved instrument can be readily and quickly loaded and efficiently sterilized in readiness for use so that the clips may be quickly applied one after another in a regular and orderly manner.

In the present instance the instrument is so constructed that it will carry 16 regularly spaced clips and is capable of closing a wound 7 inches in length.

In the drawings accompanying and forming a part of this specification Figure 1 is a side view of one form of this improved instrll ment held in the hand in position to apply a c 1p.

Figure 2 is a partly cross-sectional View of Fig. 1 lookingin the direction of the arrow and illustrates two difi'erent kinds of clips carried thereby.

Figure 3 is a detail view of one of the clip holding members.

Figure 4 is adetail partly sectional View illustrating the manner of holding the clips in place prior to the application thereof.

Figure 5 is a similar view illustrating the manner in which the clips are bent or compressed into position.

Figure 6 illustrates different sizes and 1 kinds of wound clips which may be used in the instrument.

Figure 7 illustrates a somewhat difierent construction of the instrument.

Figure 8 is a cross-sectional view taken on line 88 of Fig. 7 looking in the direction of the arrow in said Fig. 7 and illustrating a clip in place ready to be bent, and

Figure 9 is a similar sectional view to Fig. 8 illustrating the manner in which the clip is compressed or bent.

Similar characters of reference indicate corresponding parts in the several views.

Before explaining in detail the present improvement and mode of operation thereof, I desire to have it understood that the invention is not limited to the details of and arrangement of parts which are illustrated in the accompanying drawings, since the invention is capable of other embodiments, and that the phraseology which I employ is for the purpose of description and not of limitation.

In the present improvement, as shown in Figs. 1 to 5, a pair of disks or plates v1 each provided with the desired number of regular- 1y spaced arms or fingers 2 made of spring steel is clamped between a pair of disks or washers 7, 8. The outer ends of these spring arms are suitably formed as at 3, for the reception of clips and for this purpose anest is formed comprising side walls 4 and an end wall5to prevent displacement of the clips, the end wall 5 being bent over to assist in holding the clips in position. The plates 1 are secured together by screws 6 passing through the disks 7, 8 being threaded into the disk 8 and these disks are provided with openings as are also the plates 1 to form a bearing for rotary movement of the parts upon a hub or axle made in two parts 9 and 10 and secured together by screws 11, the hub members being reduced in diameter whereby the heads thereof will overlap the side walls 12 of the disks 7 and 8, and thus prevent any play of the clip holding members. These hub members 9 and 10 have laterally extending portions 15 slotted at their outer ends, as at 16, to provide side walls 17 between which are pivoted the clip bending arms or levers 18, one on each side, these levers being pivoted by pivots 19 and operate in the slots of the hub members. 2 Additional pivot holes 20 are provided in these levers whereby the position of the levers may be changed should this be necessary when using different sizes of clips. These levers have secured thereto or formed as a part thereof a U-shaped spring 22 made of very thin steel and operative to return the levers away from the clip arms and also effective to maintain the clip members in alignment when changing the pivoted position thereof. This spring is suitably shaped so that it will conveniently fit into the hand of the operator and, as stated, maintains the levers in their open position (Figures 2 and 4). The pivot-s 19 hold these levers in the slotted projecting portions of the hub and are formed by the ends of a hair-pin shaped handle or guard 23 which also fits into the hand when the instrument is in use to steady its position especially when the thumb and index finger are on the knurled portion25 of the levers. As these pivoted ends are a part of the handle or guard 23 this simplifies the shifting of the pivots and prevents displacement or loss thereof. The levers or arms 18 are provided with a pair of bent ends 24 and guiding and operating the instrument.

In Figs. 7 and 9 Ihave illustrated a similar instrument constructed, however, with one resilient member or plate 1 and a rigid member 33, the member 1 having a series of spring arms or fingers 2. In this form of instrument, however a telescopic hub is provided which is also rotatable in the central bore as at.27 of the member 2. The outermember of this hub is provided with a pin28 located in a slotted portion of the inner member of the hub so that when this pin strikes against the inside faceofthe plate 1 (see Fig. 8) further outward movement of the arm 41 and its hub 26 is prevented. The inner member 29 of the hub 26 is secured by the cross pin 30 to a. hub 31 likewise mounted for rotary movement in the central bore 32 of the rigid member 33 against the outer face of which the face 34 of the hub 31 rests and this hub 31 is formed ment of the arm 42 while permitting inward.

movement thereof against the action of .a spring 37 located between the plate 1 anda socket portion 40 carried by the lever 41 for the thumb, one end of this spring pressing against a washer.7 secured to the member 1 and the other end against a face 38 of thearm or lever 41, which is formed with a hollow thumb receiving portion or knob 40,.the arm or'lever'41 being bent at its lower end as at 42 successively to engage the resilient fingers or arms 2, thereby-to compress the same and close the clips, as shown in Fig. 9., when pressure is exerted against the concave knob 40.

The resilient member 1 and rigid member 33 are secured together by suitable spacers 44 and screws 6, which spacers may be made of different lengths so that by the mere changing of these spacers, different lengths of clips may be used in the instrument.

The rigidmember 33 and resilient'arms 2- have the same number of clip receiving'pockets or nests 45, in the present instance 16 pairs being shown, those of the rigid 'member aligning with those of the resilient member, whereby on the swinging of'the arm 41 into position 'to'engage each resilient arm or rotating the spring arms 2 relatively to the arm 41 a clip will be properly bent to close the Wound, when the arm 41 is pressed intoengagement with a spring arm or finger 2.

In this form of the instrument, all the clips are bent from one side since only one set of res'ilientarms or fingers is provided, whereas,

in the form .shownin Figs. 1 to 5, both sets of resilient arms or fingers may be compressed. 7

The clips having been properly set into the instrument and the whole sterilized, the instrument of either form may be readily and gently rolled along the wound and as each clip is brought into position, the arms or levers operated to compress or bend the clips into the wound edges so that the clips can be successively applied to the wound at equal distances apart, thereby resulting in a uniform application of the clips and thus presenting a more sightly appearance at all times while the clips are always held in proper po sition for application equally spaced, thereby insuring proper healing of the wound free from scars. The instrument is easily cleaned, easy to handle, and the rolling contact of the instrument is extremely gentle along the wound surface.

The instrument may be quickly loaded and is simple to operate and there is a uniform bending or bowing of the clips, each being bent a predetermined amount while at the same time there is clear visibility at both sides of the instrument while it is being used. It can be used with either the right or left hand or reversed in either hand and rolled forward or backward in either direction, there being only one clip in contact with the wouno surface at any time.

In the form shown in Figs. 7, 8 and 9, the rigid member 33 is provided on its periphery with a knurled surface 46 forming sufficient traction to facilitate the rolling along of the instrument with an even motion and as the clips are inserted along the sides of the wound, one at a time, the edges are drawn together from one side while, with the form of instrument shown in Figs. 1 to 5, both edges of the wound are drawn together since the clips are equally bent from both sides.

In the loading of the instrument, it is merely necessary to insert the clips in any convenient manner between the spring arms, Figs. 1 to 5, as, for instance, by inserting one end of aclip in the nest of one arm and pushing the opposite end into the nest of the other arm, and in Figs. 7 to 9, by inserting one end of a clip into the nest of the rigid member 33 and then pushing the opposite end into the nest of a resilient arm or member 2 or vice versa as found most convenient, whereupon, after the instrument is loaded it is merely necessary to press the levers or arms 18 in Figs. 1 to 5, or 41 in Fig. 1 to compress the resilient arms and thereby bend or bow the clips in a manner which will be readily understood, whereupon, when the clips are bent as these are then much shorter in length, they will readily drop from the nests of the instrument. Obviously, if it is desired to space the clips farther apart, alternate resilient arms may be loaded or the in strument can be made with differently spaced sets of clip holding arms to hold any desired number of clips.

From the foregoing, it will be seen that I have provided a very simple, readily loaded, easily sterilized, comparatively inexpensive and easily manipulated wound clip applying means in the form of a reel which may be gently rolled along the wound and which will facilitate the application of the clips in an orderly and uniform manner without injury to the wound, thereby requiring the patient to remain under the anesthetic a materially less time as compared with those cases where each clip must be separately picked up and separately applied.

It is to be understood that by describing in detail herein any particular form, structure or arrangement, it is not intended to limit the invention beyond the terms of the several claims or the requirements of the prior art.

Having thus explained the nature of my said invention and described a way of constructing and using the same, although without attempting to set forth all of the forms in which it may be made, or all of the modes of its use, I claim:

1. A surgical instrument for applying wound clips comprising spaced means for engaging and holding the opposite ends of a series of clips spaced one from another, each in readiness to be compressed, and means for compressing and thereby bowing the series of clips successively. 2. A surgical instrument for applym wound clips comprlsing resihent means for engaging and holding the opposite ends of.

a series of clips spaced one from another in readiness tobe compressed, and means for compressing and thereby bowing the series of clips successively.

3. A surgical instrument for applying wound clips comprising a reel having means for holding a series of spaced clips, and means for successively compressing the ends of the clips toward each other.

4. A surgical instrument for applying wound clips comprising rotary means for holding a series of spaced clips, and means for successively compressing the ends of the clips toward each other.

5. A surgical instrument for applying wound clips comprising rotary resilient means for holding a series of spaced clips, and compressible means for successively compressing the ends of the clips toward the other.

6'. A. surgical instrument for applying wound clips comprising rotary resilient means for holding a series of spaced clips, and sprin controlled compressible means for successively compressing the ends of the clips toward each other.

7. In a surgical instrument, the combination of a series of spaced resilient fingers constructed to hold wound clips, means for rotatively supporting said fingers, and means for successively compressing the fingers, thereby to bend the clips.

8. A surgical instrument for applying wound clips comprising a series of resilient fingers constructed to receive the clips, and means effective successively to engage the fingers to compress the ends thereor toward each other, said means and fingers having a relative rotation.

9. A surgical instrument comprising a series of pairs of spaced resilient fingers supported for rotary movement and constructed to receive wound clips, and means in position to compress the fingers and thereby the clips as the fingers are successively brought into position to be applied.

10. A surgical instrument comprising a series of resilient clip holding fingers, and means in position successively to engage said fingers, thereby to compress the same and thereby bend thewound clips.

11. A surgical instrument comprising a rigid circular member having clip receiving means, a series of resilient fingers likewise having clip receiving means, and means for compressing the fingers, thereby to bend the clips.

12. A surgical instrument comprising a rigid circular member having clip receiving means, a series of resilient fingers likewise having clip receiving means, and means for compressing the fingers, thereby to bend the clips and comprising an arm and a spring for returning the arm to its normal position.

*3. A surgical instrument comprising a rigid circular member having clip receiving means, a series of resilient fingers likewise having clip receiving means, and means for compressing the fingers, thereby to bend the clips and comprising an arm and spring means for returning the arm to its normal position, said arm and rigid member having finger rests.

14. A surgical instrument comprising a rigid circular member havingclip receiving means, a series of resilient fingers likewise having ciip receiving means, and means for compressing the fingers thereby to bend the clips and comprising an arm and spring means for returning the arm to its normal position, said arm and rigid member having fin er rests, and said arm being shittable to- C Ward and from the resilient members.

15. A surgical instrument for applying wound clips comprising two sets of spaced resilient fingers constructed to receive wound clips, means for supporting said fingers for shiftable movement, and means for compressing said fingers,- thereby to bend the clips.

16. A surgical instrument for applying wound clips comprising two sets of spaced resilien fingers constructed to receive wound clips, means for supporting said fingers for shiftable movement, and means for compress- I ing said fingers'thereby to bend the clips, said means comprising a pair of spring connected pivoted levers.

17. A surgical instrument for applying wound clips comprising two sets of spaced resilient fingers constructed to receive wound clips, means for supporting said fingers for shiftable movement, and means for compressing said fingers, thereby to bend the clips, said means comprising a pair of spring connected pivoted levers, and means for pivoting the arms for adjustment into difierent positions.

18. A surgical instrument for applying wound clips comprising two sets of spaced resilient fingers constructed to receive wound clips, means for supporting said fingers xfor shii'table movement, and means for compressing said fingers, thereby to bend the clips, said means comprising a pair of pivoted spring connected levers having pivot holes, and means for pivoting the levers for adjustment into different positions and comprising a pair of pivots adapted to co-operate with said holes and a bent guard carrying said pivots.

19. A. surgical wound clip applying i11- strument comprising spaced means for holding the opposite sides of a series of clips suspended in spaced relation one behind another in readiness to be applied, and means for successively engaging said means, thereby to bend the clips from both sides thereoftoward each other.

20. A surgical wound clip applying instru-' clips as they are successively brought into position to be applied.

21. A. surgical instrument comprising a series of resilient clip holding fingers and means in position successively to engage said fingers, thereby to compress the same and thereby bend the wound clips when pressure is exerted by the hand on said means.

22. A surgical instrument comprising a rigid circular member coupled to and spaced from a resilient circular member having nests for holding clips therebetween, and means for compressing the resilient member when pressure is exerted by the hand, thereby tose't and bend the clips.

Signed at Nyack, in the county of Rockland, and State of New York, this 24th day of September, 1930.

' JOHN P. VVEIS.

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