US3086208A - Surgical clip assembly - Google Patents

Description

April 23, 1963 H. c. EBY

SURGICAL cup ASSEMBLY Filed Oct. 6, 1960 4 Sheets-Sheet 1 5 April 23, 1963 H, c, EBY

SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 2 Filed 001;. 6, 1960 INVENTOR AQ/P/PY 62/?042059) April 23, 1963 H. c. EBY

SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 3 Filed Oct. 6, 1960 k LII.

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SURGICAL CLIP ASSEMBLY 4 Sheets-Sheet 4 Filed Oct. 6, 1960 l N VE NTO R //4,P/Py Cza aw 5a) United States Patent 3,086,208 SURGICAL CLIP ASSEMBLY Harry Cliiford Eby, Meadville, Pa., assignor to Ethicon, Inc., a corporation of New Jersey Filed Oct. 6, 1960, Ser. No. 60,977 Claims. (Cl. 1--56) This invention relates to a skin clip assembly adapted for use in loading an applicator which may then be used by the surgeon for closing incisions or lacerations in flesh. It is a major object of my invention to provide a loader package of skin clips wherein the skin clips are held together on a carrier for loading into an applicator.

An additional object of my invention is to provide a clip holder or strip adapted to assemble a group of clips in alignmeent as a unit which can be easily inserted in an applicator.

Another object of the invention is to provide a loader package wherein a number of clips are held in alignment by a metal strip in such a manner that the metal strip may be slidably removed from the applicator after loading.

These and other objects of my invention will become apparent from the following detailed description of a preferred form thereof and from an inspection of the accompanying drawings, in which:

FIGURE 1 is a plan view of a skin clip.

FIGURE 2 is an edge elevation of the left-hand side of the skin clip illustrated in FIGURE 1.

FIGURE 3 is an edge elevation of the right-hand side of the skin clip illustrated in FIGURE 1.

FIGURE 4 is a perspective view of a clip holderand clips mounted thereon.

FIGURE 5 is an enlarged fragment of FIGURE 4.

FIGURE 6 is a perspective View of the clip holder shown in FIGURE 4. FIGURE 7 is an edge elevation of a skin clip mounted on a clip holder taken on the line 7-7 of FIGURE 5 FIGURES is an enlarged horizontal cross-section taken on line 8-8 of FIGURE 5.

FIGURE 9 shows a much enlarged transverse crosssection taken on line 99 of FIGURE 5.

FIGURE 10 is a plan view of a semi-automatic clip applicator which may be loaded with the clip assembly of the present invention.

FIGURE 11 is a plan view of the clip applicator shown in FIGURE 10, but with the body open for loading with a clip assembly and for exposure of the interior thereof.

FIGURE 12 is a side view of the clip applicator shown in FIGURE 10.

FIGURE 13 issa side view of the clip applicator shown in FIGURE 10 but opened for loading as in FIGURE 11.

FIGURE 14 is a bottom view of the clip applicator shown in FIGURE 10.

FIGURE 15 is a sectional view taken along the line 1515' of FIGURE 10.

FIGURE 16 is a side sectional view of the front portion of the clip applicator with the clip release lever out of clip retaining position.

FIGURE 17 is a sectional view taken on the line 17-17 of FIGURE -1 6.

FIGURE 18 is an elevation view taken on the line 18-1-8 of FIGURE 15.

FIGURE 19 is a sectional view taken on the line 19-19 of FIGURE 15.

FIGURE 20 is a sectional view taken on the line 2020 v of FIGURE 15.

FIGURE 22 is a sectional view taken on the line 22-22 of FIGURE 15.

contact the carrier at three different points and are held in alignment to facilitate easy insertion of the assembly into the magazine of a semi-automatic applicator. When the applicator has been loaded, the carrier may be withdrawn leaving the skin clips in position for use in the applicator magazine.

The Skin Clip An important feature of this invention resides in the clips which are assembled together to provide a loader package. As seen in FIGURES 1, 2 and 3, theclip 10 is formed of sheet material, preferably metal, and in this particular embodiment, the body is planar and generally U-shaped with a rear web portion 11 and forwardly extendingleg portions 12. The end of each leg portion :18 projects inwardly and downwardly to form thepointed tines 20. Thecenter 16 of the web portion 11 is reduced in cross-section. With these arrangements, pressure on the sides of the clip sufficient to bend theleg portions 12 would cause thetines 20 on the legs to move toward each other. When the clip is pressed onto a wound, pressure on the sides of the clip causes the tines to penetrate the skin to bring the margins together, see FIGURE 24.

The Skin Clip Assembly The clips may be assembled together on a carrier to form a unit as illustrated by FIGURE 4. As seen in FIGURE 6, thecarrier 22 is a long strip of metal formed with afinger grip 24 and alongitudinal rib 30. The width of therib 30 is slightly less than the distance between thetines 20 of the skin clip. Upturned punchedtabs 26 project beyond the top surface of the rib 3'0 and are spaced to engage the web section of consecutive skin clips. Theindividual clips 10 are spaced along the strip in a straight line in end to end relationship, with the ends of the legs of one clip slightly spaced from the rear 'of the web portion of the next clip as shown in FIGURES tains the web section in contact with thesurface 34 of the rib.

The Applicator It is necessary to describe in some detail the semi-automatic clip applicator in order to appreciate the functioning of the skin clip assembly during the loading procedure. Referring now to FIGURES 10 through 14, the instrument, indicated generally by thereference numeral 13 comprises abody 15. The body is formed from twosections 14 and 19 pivotally connected together ontrunnions 21. With this arrangement, the body sections can be pivoted apart so the instrument can be loaded with clips.

As best seen in FIGURE 12, when in use, the body is arranged so thatsection 19 overliessection 14, and these sections are releasably held together by a spring clamp assembly. This spring clamp assembly includes pivotally mountedlever members 27 and aspring clamp 33, see FIGURES 10, 14 and 17.

Thespring clamp 33 is a generally U-shaped member including aweb portion 23 and upwardly extendingleg portions 25 terminating in inturnedflanges 45. The web portion is riveted to the base ofsection 14 and theleg portions 25 embrace the sides ofsections 14 and 19, see FIGURES 12 and 13. As seen in FIGURE 10, the inturnedflanges 45 embrace the top surface ofbody section 19, and this is what holds the body sections together. To open the body,levers 27 are pressed, and as seen in FIGURE 17, this will forceleg portions 25 apart untilfianges 45 no longer embrace the top surface ofsection 19, whereuponsections 14 and 19 can be pivoted open and the instrument can be loaded with clips.

Thebody 15 is provided with a magazine for receiving a number of clips. This magazine includes a recess orguideway 28 formed in the upper surface ofsection 14, see FIGURES 11, 15 and 22. As seen in FIGURES 17, 21 and 22, theguideway 28 slidably supports the sheet surface of the body of the clips.

The body also has means for urging the clips through the guideway toward thefront end 47 of the instrument. In this particular embodiment, this comprises a spring '49 and apush member 51 slidably mounted in agroove 36 formed insurface 37 ofsection 16, see FIGURES 11 and 22. As seen in FIGURES 17 and 21, thefront end 35 of the push member is bifurcated for reasons to be described below. In addition, as seen in FIGURES 15, 16 and 17, thefront end 35 ofpush member 51 abuts against the rear edge of the rear clip in the magazine and spring pressure forces the clips toward the front of the instrument.

Section 19 ofbody 15 is provided with anenlongated slot 38 extending along a substantial portion of the length ofsection 19 with a smallbent portion 39 at the rear. 'Apin 40 with anenlarged head 41 extends throughslot 38 and is rigidly secured to pushmember 51, see FIGURES 15 and 16. This structure provides a means for holding thepush member 51 in a retracted position out of contact with the clips. This is done by pushingpin 40 to the rear end ofslot 38 and rotating it into thebent portion 39, as seen in FIGURES l1 and 23.

With thepush member 51 held in a retracted position, the instrument can be loaded by opening the body of the instrument as shown in FIGURE 11. Then an assembly of clips, see FIGURE 4 is dropped intoguideway 28 and the body is closed and thecarrier strip 22 withdrawn, leaving theclips 10 in position. Finally,pin 40 is rotated out of thebent portion 39 ofslot 38 and is released to move under pressure ofspring 49 against the rear edge of the last clip in the magazine, as shown in FIGURE 15.

The front end of thetop surface 17 ofsection 19 is beveled slightly and a spring-biased lever assembly, including a flat spring 44 and a connected clip-releaselever member 46, is mounted thereon, see FIGURES l and 16. An opening 48 extends throughsection 19 fromtop surface 17 and an abutment 50 depending fromlever member 46 extends therethrough to a point in the path of clips moving alongguideway 28. As seen in FIG- URE '16, pressure 'onlever member 46 causes the abutment 50 to rise out of the path of theclips 10 in a guideway for reasons to be described below. When pressure onlever member 46 is removed, springpressure forces lever 46 and abutment 50 back to the position shown in FIGURE 15.

A pair of forceps, indicated generally by thereference numeral 52, is mounted on the body extending out beyond the front end thereof, see FIGURES 11 and 17. The forceps include a pair of resilient metal strips 54 and 56 mounted on theopposite sides 58 and 60 of thebody section 14. The front ends of these strips are bent toward each other to formjaw abutments 62. These jaw abutments have an upwardly extending recess forming seats 63, as seen in FIGURE 15. These seats function to support and engage the front edge of the clip next to be applied by the instrument, see FIGURES 16 and 17. The jaw abutments are positioned in advance of the front end of the guideway a distance substantially equal to the length of the individual clips, for reasons to become apparent below.

Oppositely extendingcylindrical press members 64 are secured to the sides ofstrips 54 and 56 whereby pressure can be conveniently exerted on the forceps. Achannelshaped member 66 secured to the under surface ofsection 14 embraces the sides ofstrips 54 and 56 and prevents thejaw abutments 62 from moving more than a fixed distance apart against the pressure exerted by the resilience in thestrips 54 and 56, see FIGURES 14, 18 and 19. As seen in FIGURE 17, the fixed distance is equal to the width of an individual clip. This permits the forceps to hold the clip when the instrument is not in use.

The assembly of clips is conveniently installed as a unit inside the magazine of the applicator as shown in FIG-URE 25. After the housing is again closed, a gently pulling force on the metal stop is suflicient to withdraw it from the applicator, leaving the clips all properly positioned inside the instrument. It will be understood that the slight spacing between the clips contributes to the ease of removing the metal carrier. If the clips are assembled with the ends of the legs of one clip abutting against the rear of the web portion of the next clip, the force required to withdraw the carrier will be much greater than the clips may jam in the magazine.

In operation, after the clips are inserted inside the in-* strument, the pressure exerted by thespring 49 onpush member 51 forces the train of clips toward the front of the instrument until the front of the web portion of the first clip in the train engages abutment 50. Then a momentary pressure onlever member 46 is suflicient to move abutment 50 out of the guide path of the clips, permitting the push member to move the clips forwardly until the front edge 18 of the clips engage seats 63, see FIGURE 17. At the same time, it is noted that the rear edge of the web portion 11 is supported on thefront end 29 of theguideway 28. This arrangement, when coupled with the pressure exerted on the front clip byspring 49 is sufiicient to hold the body of the clip in advance of the body of the instrument, see FIGURE 17. In this position, the margin of the wound is clearly visible between thelegs 12 of theclips 10, so that the clips can be positioned more accurately.

In applying the clips, the instrument is placed against the wound with thepoints 20 of theclips 10 properly positioned. Then pressure is exerted onpress members 64. This forcesjaw abutments 62 toward each other, bending thelegs 12 of the clip. Thepoints 20 which are downwardly inclined and which extend toward each other, penetrate the skin around the wound. Then when pressure onpress members 64 is removed, thejaws 62 move apart due to the resilience instrips 54 and 56. This leaves theclips 10 embedded in the skin to hold the wound margins together and out of the instrument, as shown in FIGURE 24.

It is noted that after a clip has been used, the remainder of the clips in the magazine are prevented from moving alongguideway 28 because of the abutment 50 in their path. Consequently, in order to permit the next clip to advance into engagement with the seats 63 on thejaws 62,lever member 46 must again be pressed. This is a useful feature because it keeps all the clips enclosed in thehousing 12 until they are to be used. Otherwise, the next clip in the magazine would automatically advance to the front position, as shown in FIGURE 17, where it could be dislodged from the instrument or damaged by accidental jars or blows, while the instrument is not in use.

When the last clip in the instrument is to be used,lever member 46 is again momentarily pressed and thepush member 51 can then force this last clip into seating position on the jaws. Because thefront end 35 of thepush member 51 is forked, release oflever member 46 does not prevent the front end of thepush member 51 from moving to thefront end 29 of the guideway in order to maintain enough pressure on the last clip to keep it seated in the jaw abutments and ready for use.

As seen in FIGURE 9, thepoints 20 of theclips 10 extend downward from the surface of the body of the clip. Since the clips slide alongguideway 28 on the surface of their body, the guideway must be shaped so the points do not rub against any surface of the guideway or any other part of the body of the instrument as the clips are pushed along. This is done 'by forming a groove, recess, or opening 31 inguideway 28 designed to keep thepoints 20 out of rubbing contact with the guideway, see FIGURES 16 and 21.

The fact that thepoints 20 of theclips 10 are downwardly inclined from the body of the clip and the instrument, see FIGURES l and 16, is important because when the instrument is used to apply clips to the wound, the instrumentneed only be held at a comparatively small angle with the surface of the wound. This substantially eliminates the application of pressure on the wound which might otherwise be necessary if the points were generally in the plane of the body of the instrument so that the instrument would have to be applied to the wound at a substantial angle, e.g., in excess of 45 The invention may be embodied in other forms without departing from the spirit or essential characteristics thereof as set forth in the claims, and the present embodiment is therefore to be considered as illustrative and not restrictive and it is intended to include all changes which come within the scope and range of the claims. The applicator and skin clip described herein are claimed in copending application Serial No. 10,595, filed February 24, 1960.

What is claimed is:

1. A skin clip carrier for a series of skin clips each having a generally U-shaped body with spaced pointed leg portions and a connecting web portion, the carrier comprising a fiat strip of metal having a central upstanding rib to support the clip web portions and laterally extending side flanges to support the clip leg portions, the rib having spaced upwardly projecting spring ears extending over the clip web portions to removably retain the clips in position on the carrier.

2. A skin clip carrier for a series of skin clips each having a generally U-shaped body with spaced pointed leg portions and a connecting Web portion, the carrier comprising a flat strip of metal shaped to have a longitudinal rib and laterally extending side flanges, the width of said ri-b being slightly less than the distance between the pointed leg portions of said clip, and upwardly projecting spring ears spaced along said rib to removably retain the clips in position on the carrier.

3. A skin clip carrier for a series of skin clips each having a generally U-shaped body with spaced pointed leg portions and a connecting web portion, the carrier comprising a fiat strip of metal shaped to have a longitudinal rib and laterally extending side flanges, the width of said rib being slightly less than the distance between the pointed leg portions of said clip, and upwardly projecting spring ears spaced along said rib at distances slightly greater than the length of said clip.

4. A skin clip carrier comprising a fiat strip of metal shaped at one end to form a finger grip, a central upstanding rib extending from the finger grip to the opposite end of the strip and upwardly projecting spring ears evenly spaced along the length of said rib.

5. A skin clip carrier for a series of skin clips each having a generally U-shaped body with spaced pointed leg portions and a connecting web portion, the carrier comprising a flat strip of metal shaped at one end to form a finger grip, and extending from the finger grip to the opposite end of the strip a central upstanding rib to support the clip web portions, said rib having spaced upwardly projecting spring ears extending over the clip web portions to removably retain the clips in position on the carrier.

References Cited in the file of this patent UNITED STATES PATENTS 934,486 Walling Sept. 21, 1909 2,135,279 Dickinson Nov. 1, 1938 FOREIGN PATENTS 456,285 Great Britain Nov. 2, 1936

Claims (1)

1. A SKIN CLIP CARRIER FOR A SERIES OF SKIN CLIPS EACH HAVING A GENERALLY U-SHAPED BODY WITH SPACED POINTED LEG PORTIONS AND A CONNECTING WEB PORTION, THE CARRIER COMPRISING A FLAT STRIP OF METAL HAVING A CENTRAL UPSTANDING RIB TO SUPPORT THE CLIP WEB PORTIONS AND LATERALLY EXTENDING SIDE FLANGES TO SUPPORT THE CLIP LEG PORTIONS, THE RIB HAVING SPACED UPWARDLY PROJECTING SPRING EARS EXTENDING OVER THE CLIP WEB PORTIONS TO REMOVABLY RETAIN THE CLIPS IN POSITION ON THE CARRIER.

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