US2733441A - white - Google Patents

Description

Feb. 7, 1956 J. w. WHITE WOUND CLIP APPLICATOR 2 Sheets-Sheet 1 Filed March 24, 1952 IN V EN TOR. c/o/m MK WW7 Feb. 7, 1956 J. w. WHITE woum: cup APPLICATOR 2 Sheets-Sheet 2 Filed March 24, 1952 JNVENTOR. g/l/IV W Ml/rs Jaime .5

lmm Eli" 7 m 3 United States Pate-ntO WOUND CLIP APPLICATOR John W. White, North Hollywood, Calif, assignor to Technical Oil Tool Corporation, Los Angeies, Calif, a corporation of California Application March 24, 1952, Serial No. 278,221

Claims. (Cl. 149.1)

My invention relates generally to wound clips for closing incisions or lacerations in the flesh, and applicators or forceps for applying clips. More specifically, the invention concerns an improved wound clip and an applicator or dispenser for use with the improved clip in a mutually cooperative manner.

Improvements in both conventional wound clips and forceps for applying the clips are greatly wanted, and I have found that changes in clip design can be correlated with a new kind of applicator in such a manner as to provide numerous advantages. At the present time, wound clips are generally designed with a single tooth or prong on each end to engage the flesh aside the incision as the clip is collapsed inwardly. These clips are of uniform and relatively narrow width, and have an edge profile characterized by a substantially fiat central portion. The accepted surgical tool for applying clips is a pair of tweezers or forceps in which the clips are grasped one at a time and applied. The procedure involved is at best slow, and because of the nature of the clips the resulting closure is imperfect.

The conventional forceps used in applying clips must be gripped with a constant and tiring hand pressure in order to hold a clip therein, and many clips are either collapsed improperly or dropped. Furthermore, the surgeon must load each clip from a separate holding device and a great amount of time is required for applying clips in even a simple operation. While magazine type applicators have been proposed to overcome the obvious disadvantages of present forceps, none of them has ever been sufficiently reliable, nor durable, to be acceptable to the medical profession. This has been partially due to the nature of conventional clips and mainly due to the nature of the applicators themselves.

It can be appreciated that as present clips are not capable of proper stacking, their use in a multiple load device is very difiicult. In order to feed clips through the applicator it is desirable to provide a feed spring or the like, and therefore it is necessary to hold the leading clip against release and in an applying position. It is also highly desirable to hold the leading clip independently of any closing pressure on the applicator jaws or forceps so that hand need not be held closed. Therefore, the only practical and safe way to hold a clip in applying position is by side lips or lugs which overhang the face of the clip at each end.

If the present narrow clip is used, the forcep jaws must be approximately equal to the clip width, and it is necessary that the holding edges must be pushed or retracted out of the way. This kind of structure is very delicate, difiicult to make, and cannot be maintained in proper adjustment. The forcep jaws for my improved clip may be less than clip width and yet sufficiently wide to clamp properly. The forcep jaws can then swing through the holding edges'positioning a clip without contact, and a very simple and durable form of head construction is possible.

It is an important object of my invention to provide a 2,733,441 7 Patented Feb. 7,

ice

, 2 clip applicator which applies the clips quickly with a positive gripping action. 1

It is a further object of my invention to provide'a clip applicator having a forcep head structure adapted to securely hold the leading clip in applying position, and to control and guide the movement of the forcep jaws.

Another object of my invention is to provide a clip applicator having feeding and holding means formed to provide a uniform and smooth feed and adapted to be easily reloaded.

It is a still further object of my invention to provide an applicator having either an integral housing magazine, or a separable chamber slide for rapid reloading and accommodation of different size clips.

Still another object of my invention is to provide an embodiment of my applicator having yieldable magazine retracting means for accurate and positiveclip feeding.

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

Fig. l is a front perspective view of a preferred form of Wound clip applicator;

Fig. 2 is a partial sectional view of the applicator head and forcep structure, in open position;

Fig. 3 is a view similar to Fig.2 showing jaws closed inwardly; r

Fig. 4 is a cross section through the clip ends taken along the line 4-4 of Fig. 2; p

Fig. 5 is an end elevation of the applicator head;

Fig. 6 is a cross section of the applicator body taken along the line 6-6 of Fig. 2;

Fig. 7 is a back perspective view of the applicator showing a stack of clips and the clip rack being inserted therein;

Fig. 7A is an elevational detail of the applicatorhead showing the clip rack preparatory to being inserted therein for removing a group of clips;

Fig. 8 is a front elevation of a modified form of applicator, having a separate magazine;

Fig. 9 is an edge elevation of the modified applicator;

Fig. 10 is a back elevation of the modified applicator with the forcep jaws in closed position;

Fig. 11 is a cross section taken along the line. 11-11 of Fig. 8;

I Fig. 12 is a perspective detail of the front structure on the magazine for the modified applicator;

Fig. 13 is a cross section of the modified applicator head showing the magazine slide retracted therein;

Fig. 14 is a cross sectional detail of an alternate form of magazine slide;

Fig. 15 is a front elevation of an alternate form of applicator providing a pivoted forcep arm mounting- Referring now to the drawings, and particularly to Fig. 1 thereof, the numeral 30 indicates generally a body or housing of a preferred embodiment of applicator. Housing 30 is of elongated rectangular shape and is internally open to take a stack of wound clips 31 therein. Clips 31 are of flat dished shape having opposed end prongs and are stacked front-to-back along housing 30 so that the front or leading clip is held at the head of the applicator in applying position. The clips 31 are made of easily deformed material permitting the central portion of the clip to yield or bend when pressure, is applied to the ends, and thus draw the prongs together in the flesh for closing the wound or incision.

In order to close clips 31 a pair of opposed forcep or tweezer arms 32 are secured to the sides of the housing and mounted for inward flexing movement, Arms 32 carry inturned forward jaw portions 33 which bracket the ends of the leading clip 31 and are adapted to clamp the forcep i l 3 pr squeeze thereagainst .to close the .clip as the arms are pressed together in the hand. As clip 31 is closed or clinched, it is released frorn the applicator and left prperly positioned on the wound. Forcep arms 3,2"are then allowed to spring outwardly, retracting jaws 33. This Ipermits'the stack'of clips 31 to slide forwardly in housing 30 and position a succeeding clip in applying position for another cycle of operation.

Housing 30 is formed as a channel member having a closed back wall and a front wall slotted longitudinally at 35 to permit inspection of the supply of clips 31. "Preferably housing 30 and other members .to be described are formed of a non-ferrous metal or stainless steel which can be sterilized without injury and chrome plated or burnished for non-oxidation appearance. The stack of clips 31 is urged upwardly in housing 30 by a plunger or follower block 36 which is supported by a spring means '37; :Feed spring 37 is formed of fiat strip material bent into a series of flat-sided corrugations or turns so as to ,have the maximum extensible length and compressibility {consistent with a uniform rate. Thus spring 37 feeds clips '31 ahead with substantially uniform pressure, regardless of the length of the stack of clips, and is adapted to yield rearwardly upon reciprocation of the stack of clips when the forward clip is closed.

As is best seen in Figs. 2 and 3, plunger block 36 has an acurate face shaped to conform to the edge curvature of clips 31 and is slidably mounted within the walls of housing 30. The length of block 36 is such that it cannot turn or twist within the housing 30 and is constrained for free sliding movement. One end of feed spring 37 "passes through an opening or split in the back of plunger 36 and is coiled and secured within an enlarged aperture 38. The other end of spring 37 bears against the rear end of'housing 30 to urge plunger 36 ahead.

The head end of housing 30 is open, and in order to hold the leading clip 31 therein I provide a yoke or collar 40 whichforms holding lugs or ears 41 (Fig. that override the front face of the clip. These lugs 41 are spaced apart at the ends of the clip 31 and prevent forward release of the clip until it has been partially closed by the forcep jaws 33. Collar 40 also provides means for guiding and limiting the movement of forcep jaws 33 to insure proper engagement with clips 31, as will be described.

"Collar 40 is shaped as a bracket bent around the head of housing 30 and secured integrally thereon by welding or the like. The end wall of collar 40 proiects laterally outwardly beyond housing 30 and is formed with an enlarged central opening 42. Thesides of collar 40 are generally U-shaped plates forming a deep cut back side opening 43 substantially equal to the depth of a closed clip for clearing the clips 31 after closing, so that the applicator can be withdrawn from the applied clip either sideways or rearwardly without danger of catching thereon or pinching the flesh.

As is best seen in Figs. 1 and 5,end opening 42 is the full thickness of a clip 31 and extends across housing 30 to the ends of the clip. However, the holding lugs 41 project forwardly and inwardly at each corner of opening 42 so as to override the front corners of clip 31 and hold it against release. Clip 31 is thus held in applying positionindependent of any pressure upon jaws 33 and is safely confined so that it cannot be prematurely released. When jaws 33 are pressed inwardly, the ends of clip 31 are brought together until they have cleared the inner limits of lugs 41. Thereafter release of pressure upon jaws 33 will clear clip 31 from the applicator regardless of whether it is in a partially or fully closed position.

Forcep or tweezer arms 32 are preferably formed of spring material having a thick rear end portion and a thinnerforward end which inclines outwardly from housing 30 and is pretensioned or sprung to urge the forward end outwardly. The rear end of each arm is'firmly secured to housing30 as by screws 45, and the forward end is bent right-angularly to extend inwardly and form .the jaw 33. The .outercentral portion .of arms 32 .has an external raised knurledsection 46 which is cast into the arm for maximum frictional contact with the fingers, and this section may also be enlarged laterally as a further gripping aid. Preferaby, arms 32 are formed of heat treated beryllium copper so as to incorporate their own spring action, and may be economically cast into the finished shape.

As is best seen in Figs. 2 and 3, jaws 33 have enlarged forwardly projecting heads 48 formed with arcuate recessed inner surfaces 49 for engagement with the ends of clips 31. The outward movement of jaw heads 48 is limited by stop bars 50 formed on the ends of collar 40, and the initial inward movement of the heads is guided by slots 51 extending inwardly from the stop bars to join the end opening 42. As is best seen in Fig. 5, the lateral thickness of slots 51 is just equal to the width of jaw heads 48 so as to hold .them against lateral movement. It should also be noted that the width of the slots 51 is equal to the lateral opening between the spaced holding lugs 41 so that as jaw heads 48 continue inwardly they slide freely between the holding lugs without interference or the necessity of springing the lugs apart.

The rear end of housing 30 is open to permit a stack of clips 31 to be inserted therein, and to complete the applicator structure I provide a swinging gate or catch 54 which normally closes the end of the housing. Gate 54 is formed as a flat transverse plate having short forwardly extending side arms 55 overlapping the outer edges of housing 30. At the free ends of arms 55 small pivot lugs 56 are turned inwardly and are rotatably engaged in apertures 57 formed in the edges of housing 30. The length of pivot lugs 56 is such that they just enter apertures 57 and clear the inner portion of housing 30 for sliding movement of the clips and feed means therein. As indicated in Fig. 1, gate 54 is swingably movable forwardly to the position shown in phantom outline for clearing the end of housing 30, and is normally positioned to extend across the end of the housing and support feed spring 37.

To prevent gate 54 from accidentally opening during the operation of the applicator I have located pivot lugs 56 so that the gate swings through an are which passes through the front edge corner of housing 30. Thus as gate 54 passes over the corner of housing 30 it rubs thereon in binding contact. Because of such frictional engagement, gate 54 will not swing forwardly unless hand pressure is intentionally applied. To prevent gate 54 from swinging rearwardly, the rear wall of housing 30 is carried slightly beyond the end thereof so that gate 54 cannot pass over it.

The specific structure ofclips 31 is described in detail in my copending continuation-in-part application, Serial No. 314,499, filed October 13, 1952, and entitled Wound Clip and Extractor Therefor, and reference is made thereto for a complete disclosure. Briefly, clips 31 have a rearwardly bowed central portion 60 and rounded jaw-engaging ends 61. Formed on the ends 61 are prongs 62 which project forwardly for engagement in the flesh and are arranged in pairs at each end. An elongated opening 65 extends along central portion 60 and defines spaced connecting webs 66 which are of reduced bending strength.

For the purpose of securing a group of clips 31 in a stack of convenient size I have provided a holding or rack means 70 which extends through a number of clips and holds them against separation. While rack means 70 is not essential, its use is very advantageous for storage of the clips, for maintaining a numerical count thereof, for sterilization of the clips, and finally for facilitating the insertion and removal of a group of clips from the applicator. The size of rack means'70 is variable, and I have chosen to illustrate a rack which holds twenty clips together as aunit, this being a practical number for insertion in an applicator of convenient hand size.

Back means 70 is formed as a generally U-shaped spring rod having generally parallel side legs 71 connected by a'flanged or outwardly projecting enlarged head 72. The free ends of legs 71 are bent arcuately to provide outwardly projecting flanges 73 of hook shape. Flanges 73 are spaced apart sufiiciently so that legs 71 may be pressed together to pull the flanges inwardly for passing through the central openings 65 in a stack of clips 31. After legs 71 have been passed rearwardly through a stack of clips 31 they are released and flanges 73 spring apart to bear against the rear surface cf the last clip in the stack. The length of le s 71 is just equal to the length of the clip stack, and as flanges 73 engage the rear clip the flanged head 72 bears against the forward clip. The secured stack of clips may then be packaged, sterilized, or otherwise treated as a unit.

An important advantage of rack 70 is that it greatly facilitates the insertion or withdrawal of a group of clips in the applicator. As is best seen in Fig. 7, a stack of clips 31 is inserted into the applicator with rack 73 in place. Because of the internal position of rack 7%, it does not in any way interfere with the operation of sliding clips 31 into applicator housing 30, but in fact facilitates it since the clips are held in a rigid elongated unit. After the clip stack has been inserted in housing 30, plunger 36 and feed spring 37 are slidably entered into the housing and gate 54 is closed. The stack of clips is now at the head of the applicator, and rack head 72 occupics the position shown in phantom outline in Fig. 1. Head 72 is then squeezed to compress legs '71 inwardly, and the rack is withdrawn forwardly from the clip stack.

Rack 71) also comes into play in removing the clips remaining in the applicator after its use has been completed. As is indicated in Fig. 7A, rack 70 is passed through applicator head 40 to enter within the clips 31. Flanged ends 73 are initially pressed together, and after rack legs 71 have passed through all of the remaining clips 31 hand pressure is released. to allow the flanged ends to spring outwardly behind the last clip in the stack. Thereafter, the stack of clips 31 is removed through the back of housing 30 with rack 70 in place so as to hold the clips together as a unit.

It is important in using a device of this nature to maintain a count of the number of clips used in the operation and check this number against the initial and remaining number of clips. Such a check is made to avoid the possibility of any clip being accidentally dropped into the wound or incision. To facilitate suchchecking I have provided index or marking means upon the face of housing 30 which indicates at all times the number of clips which have been applied from the applicator after the initial loading. Since the unit of clips loaded into the applicator is twenty clips, I provide a series of spaced indicia lines 75 which extend along the face of housing 3tl and are numbered upwardly from zero to twenty in correspondence to the spacing of the twenty clips in the unit. The plunger block 36 has a pointer-76 scribed thereon in such a position as to initially register with the zero indicia line 75 when the applicator is fully loaded. As clips 31 are applied from the device, plunger block 36 moves upwardly and pointer 76 comes into successive register with the succeeding indicia lines 75 until. the last clip is dispensed, at which time the pointer reads 20. Thus at any time pointer 76 gives a direct reading of the number of clips which have been applied.

Having thus considered the specific nature of clips 31, the operation by which the clips are held and applied in the applicator may now be fully appreciated. As will be remembered, the leading clip 31 is held against forward movement in the applicator head 40 by corner holding lugs 41. In this position the jaw-engaging ends 61 lie directly inwardly of the gripping surfaces 49 formed on the forcep jaw heads 48. Clip prongs 62 extend forwardly from the applicator head and are free to engage in the flesh. Normally, applicator housing 30 is held generally perpendicular to the skin areas in which the clips are to be applied, but it may be held either perpendicular or normal to the skin since the side openings 43 permit the clip to slide out sideways as well as forwardly, and the operating mechanism will perform equally well in any attitude. Forcep arms 32 are pressed or squeezed together and jaws 33 drive inwardly against the clip ends 61. As clip 31 is partially closed, ends 61 are drawn inwardly beyond the ends of holding lugs 41 and the clip is then held entirely by the engagement of jaw heads It should be emphasized that I have made possible an advantage in the applicator head construction through the use of the wide clips 31. With a wide clip, jaw heads 48 may be made narrow enough to pass freely between holding lugs 41 and yet wide enough to provide an adequate bearing surface for contact with clip ends 61. With a clip of conventional width, such a construction is impossible and it is necessary to spring holding lugs 41 aside to permit the passage of forcep heads 48. I avoid the use of such delicate and easily injured spring lugs and at the same time insure that the clips cannot prematurely move forwardly by the construction described. It should also be noted that jaw heads 48 are both guided and limited in movement by applicator head 40. The outer stop bars 50 come into contact with the outer edge of jaw heads 48 to limit outward movement of the forceps, and make feasible the use of a simple spring arm construction. As jaw heads 48 start to move inwardly, they are guided by the reduced slots 51 until they have contacted clip ends 61 and started the collapse of the clip. This prevents jaws 48 from sliding laterally on clip ends 61 and insures that the clip will be bent directly inwardly about a bend axis which is parallel to the plane of the clip.

As is best seen in Figs. 2 and 3, the inward pressure of forcep jaws 33 causes the central clip portion 60 to bend or buckle into a short radius turn and to elongate longitudinally so that the back of the clip is displaced rearwardly from its initial position. As the clip center 60 moves rearwardly it pushes the remaining stack of clips 31 back along housing 30, sliding plunger 36 rearwardly and forcing feed spring 37 to yield. During this time, the flesh aside the wound is engaged by prongs 62 and is drawn together in the desired manner. Because of the fact that the body flesh is drawn up at the head of the applicator, the previously mentioned cut back side openings 43 are important in preventing any pinching or tearing of the flesh.

Finally, as hand pressure is released upon forcep arms 32, jaws 33 are disengaged from the clip ends 61 and the leading clip 31 is moved forwardly under the force of feed spring 37 until the following clip is stopped by holding lugs 41. The leading clip 31 is thus properly closed on the wound and freed from the applicator, while the next following clip moves forwardly into the applying position. The operation may, of course, be repeated as many times as is necessary to close the wound or until the supply of clips is exhausted. When the final clip in a unit is used, the applicator can be quickly reloaded with another unit of clips, as has been described.

It can thus be seen that I have provided an improved wound clip and an applicator which are especially designed to provide mutually advantageous results. The closing of clips 31 is at all times controlled and a clip may be closed to any degree of partial closure depending upon the nature of wound closure which is sought. The

numerous other advantages of the invention are believed to be apparent from the foregoing description, and it can be understood that a considerable saving in time and energy is effected by the use of the clips and applicator.

In Figs. 8 to 13 I have shown a modified form of applicater which is generally similar'to the preferred form but is designed to take a separatemagazine slide. The use of a separate magazine for holding a supply of clips resent s m ts thelmost rapid reloading of the applicator, and has several other..desirable features, as will bedescribed. Clips 31 identical to those described in connection with the preferred form are applied by the modified applicator, and the ,clip rack 70 may also be advantageously usedfor loading the clip slide.

An applicator housing 89 is of elongated rectangular shape and is formed with a wide central slot 81 extending along the front face thereof for inspection of the clip supply. Both ends of housing 80 are open, and a modified collar or yoke 82 is mounted at the head of the applicator. Collar 82 overlaps the end .ofhousing 80 and is formed with generally U-shaped side plates which are cut back centrally to provide side openings 83. The end wall of collar 82 has an enlarged clip dispensing opening 84 therein which completely free of obstructions.

Forcept or tweezer .arms 32 are mounted on the sides of housing 80 and are provided with forwardly positionedinturned jaws 33 which are guided and limited in movement by collar 82. As is best seen in Fig. 13, jaws 33 have enlarged heads 43 formed with inner gripping surfaces 49 for engagement with clip ends 61. Extending outwardly beyond the ends of collar opening 84 are reduced slots which have a width equal to the width of jaw heads 48 and guide the movement thereof during the initial closing of clips 31. At the outer ends of guide slots 85', stop bars 86 are formed on collar 82 to limit the outward movement of jaw heads 48. As can be-understood, this portion of the applicator structure is quite similar to the preferred form, and the aforementioned advantages again exist.

In order to contain clips 31 I provide a rectangular magazine 95 which is similar in shape to housing 86 and is of a size to fit slidably therein. The front face of magazine 90 is slotted at 91 and the back face carries an enlarged stop bar 92 extending laterally across the rear end of the magazine and adapted to abut against the rear end of housing 39. The engagement between stop bar 92 and housing 80 limits the forward travel of vmagazine 90 within the housing and the length of the magazine is such that the head end of the slide normally extends slightly beyond the end of collar 80, as is best seen in Fig. 8.

Clips 31 are stacked within magazine 94) in frontto-back relationship and may be inserted in a unit through the use of clip rack 70, as has been described. Behind the stack of clips 31 is a plunger or follower block 36 which is urged forwardly by a feed spring 37. Theforward end of spring 37 is secured to plunger 36 as by a coiled end engaged in a plunger aperture 38. The rear end of spring 37 is fixed within magazine 90 by engagement against the inner end of a threaded screw 93 which extends through stop bar 92 into the interior of the magazine. 9, screw 93 carries a knurled head 94 on its end away from bar 92 and has an elongated undercut shank so that head 94 is spaced considerably from bar 32 even when screw 93 is extended into magazine 30 to hold spring 37. To reload magazine 90, screw 93 is f threadedly retracted out of the magazine so that spring 37 and plunger 36 may be withdrawn through the rear end of the magazine.

Plunger 36 urges the stack of clips 31 ahead within magazine 90 and the leading clip is held at the head end by holding lugs 96 which are formed on the end of the magazine. As is best seen in Fig. 12, the end of magazine 96 is formed with reduced fingers 97 that extend forwardly beyond the main body of the magazine and define front and back recesses 98 together with side openings 39 adjacent the ends of clips 31. The tipSof fingers 97 are turned inwardly to form the holding lugs .96 which overlie the front face of the leading clip'31. Thus it can be appreciated that magazine 90forms an independent container for a stack of clips As seen in Pig.

31 and properly positions the leading ,clip in an applying position within the applicator housing 80. By having a number of filled magazines 90 on hand, reloading of the applicator can be accomplished in the minimum amount of time since the reloading requires merely the removal of the magazine and the insertion of another in its place.

Magazine 90 is held against rearward movement in housing by a yieldable retraction spring means which normally holds the magazine in the forward po- SitiOn. but permits retraction of the magazine as the leading clip 31 is elongated and displaced rearwardly during the closing operation. Thus in this form of the invention the stack of clips 31 is not displaced relative to magazine upon deformation of the leading clip, but rather the entire magazine is retracted rearwardly. Because of this mode of operation, the feed of the clips is more positive, and there is less chance that the clip stack will become disarranged or jammed during the use of the applicator. However, this type of structure is more complex and is not as susceptible to positive sterilization as the preferred form of the invention. Therefore it can be understood that each form of the invention has certain advantages which can not be achieved in the other.

The retraction spring means urging magazine 99 forwardly is preferably a relatively weak coil Spring 104 which is looped around the undercut inner portion of screw head 94 and has the free ends extended forwardly and secured to housing 8%. As is best seen in Figs. 9 and 10, a pair of anchor posts projects outwardly from the back of housing 80 and is provided with annular grooves 196 in which hook ends formed on spring 104 may be removably secured. When a complete cleaning or overhaul of the instrument is desired, spring 164 may therefore be easily removed. It is important to note that the yield strength of retraction spring 164 is made substantially less than the strength of feed spring 37 in order that magazine 98 will retract rearwardly before the stack of clips 31 is pushed rearwardly within the magazine.

As is best seen in Fig. 13, when forcep arms 32 are pressed together, jaws 33 drive inwardly and engage the clip ends 61, causing the central clip portion 60 to buckle and be displaced rearwardly in the manner previously described for the preferred form. Because of the reduced width of jaw heads 48, they enter into magazine 90 through the side openings 99 behind holding lugs 96 and then pass freely between the holding lugs as the magazine is retracted rearwardly. The pressure of the leading clip center 60 upon the face of the next succeeding clip 31 forces magazine 96 to e retracted rearwardly against retraction spring 104 during the closure of the clip. Thus the importance of spring 1% being softer than feed spring 37 is seen. for if the feed spring yielded first, magazine 90 would not retract but the stack of clips 31 would merely move rearwardly and force the feed spring to compress.

As previously pointed out, by retracting magazine 90 I insure that the stack of clips 31 will not jam and the operation of the applicator is made more positive. Another advantage of using a separate magazine in the applicator is that a single applicator may be adapted to take different size clips by merely changing magazines. For normal surgical use there are several sizes of wound clips used. As an example, clips of 14, 18, and 22 millimeter length are quite common.

In order that clips of such varying'size may be applied by a single applicator, I have provided modified magazines 98a as is seen in Fig. 14. Magazine 90a is internally dimensioned to take a smaller clip than that normally used in housing 80 and is yet externally dimensioned to fit slidably in the housing with normal clearance. As illustrated, edge walls 107 are broughtforwardly from the back face of magazine 90a in a position spaced inwardly from the corresponding edges of housing 80 and at such a distance apart as to take the desired smaller clip. Walls 107 are then bent outwardly and returned inwardly to provide side flanges 108 which have a normal sliding fit Within housing 80. By this type of construction I am therefore able to supply different size clip magazines for a single applicator and a considerable economy in instrument costs may be achieved.

In Fig. 15 I have shown an alternate form of forcep arm which may be desirable for use on either form of the invention. As illustrated, the alternate forcep arm construction is shown applied to the type of applicator having the separate magazine, but it can be understood that it may be equally well applied to the preferred form of instrument. The clips 31, magazine 90, and associated elements are identical to those previously mentioned, and their description need not be repeated.

A housing 80a is generally similar to housing 80 but carries raised ribs or bosses 110 which extend along the rear portion of the housing sides. A pair of forcep arms 111 extend along the sides of housing 80a and are shaped as elongated channel members having front and rear flanges 112 projecting inwardly from an outer wall 113 and defining an inner channel or groove 114. Arms 111 are pivotally mounted to bosses 110, with the latter fitting freely within the rear portion of channels 114 and being adapted to engage outer wall 113 to limit the outward travel of the arms.

For pivotally connecting arms 111 to bosses 110 I provide pivot pins 115 which are journaled in flanges 112 and pass through the forward end of the bosses. Pins 115 are removable and are formed with an enlarged front head 116. The rear ends of pins 115 extend outwardly and serve as anchor posts for a retraction spring 104 in the same manner as the anchor posts 105 shown in Figs. 9 and 10. At the forward end of arms 111 forcep jaws 118 are secured to wall 113 and project forwardly and inwardly to bracket leading clip 31 positioned in slide 90.

Arms 111 are spring urged outwardly to hold jaws 118 open by bowed leaf springs 111 which are positioned within the forward portion of channels 114. The central portion of spring 119 bears against the side of housing 80a, and the ends are turned outwardly to bear on wall 113 and urge arms 111 to pivot outwardly about pins 115. As can be appreciated, arms 111 and springs 119 can easily be removed for cleaning or repair by removal of pivot pins 115.

By the use of this type of pivotal mounting for forcep arms 111, outward travel of the arms is limited by the engagement of bosses 111) against wall 113. Furthermore, the pivot connection allows very little lateral play in the forcep jaws 118. Thus I am able to eliminate the need for a yoke or collar at the head of the applicator for guiding and limiting the movement of the forcep jaws 118. The operation of arms 111 is quite similar to that of the previously described forcep arms, and the manner in which the clips 31 are closed and advanced is again the same and therefore need not be repeated.

While I have thus shown and described preferred and modified forms of my invention which are fully capable of providing the objects and advantages sought, it can be understood that other modifications and variations can be made without departing from the scope of my invention. Therefore I do not wish to be limited to the details described herein, except as defined in the appended claims.

I claim:

1. A wound clip applicator comprising: an elongated housing for receiving a plurality of wound clips in stacked relationship, said housing having an enlarged front opening for discharging said clips; plunger means within said housing for urging said clip stack forwardly; means mounted on the head of said housing for limiting the forward movement of said clip stack, said means including holding lugs adapted to override the front face of the leading clip and spaced a substantial lateral distance apart; a pair of spring urged forcep arms swingably mounted to the sides of said housing; and inturned forcep jaws formed on the forward ends of said arms and normally positioned to bracket the ends of said leading clips, said jaws being movable inwardly upon compression of said arms to drive said clip ends inwardly, and being of a lateral width less than the lateral spacing of said holding lugs whereby to pass freely therebetween.

2. A wound clip applicator comprising: an elongated rectangular housing for receiving a plurality of wound clips in stacked relationship, said housing having an enlarged front opening for discharging said clips; a plunger mounted for longitudinal movement within said housing to advance said clip stack; a feed spring having the forward end secured to said plunger and the rear end constrained for urging said plunger forwardly, said spring being formed of flat strip material to provide a uniform rate and maximum compressibility; means mounted on the head of said housing for limiting the forward movement of said clip stack, said means including holding lugs adapted to override the front face of the leading clip and spaced a substantial lateral distance apart; a pair of spring urged forcep arms swingably mounted to the sides of said housing; stop means for limiting the outward movement of said arms; and inturned forcep jaws formed on the forward ends of said arms and normally positioned to bracket the ends of said leading clips, said jaws being movable inwardly upon compression of said arms to drive said clip ends inwardly, and being of a lateral width less than the lateral spacing of said holding lugs whereby to pass freely therebetween.

3. A wound clip applicator comprising: an elongated rectangular housing for receiving a plurality of wound clips in stacked relationship, said housing having a closed back face and a slotted front face for inspection of the clip supply, with said faces having cut back forward openings for clip clearance upon closing of said clips and'the front end of said housing having an enlarged opening therein for discharging said clips; a plunger mounted for longitudinal movement within said housing to advance said clip stack; a feed spring having the forward end secured to said plunger and the rear end constrained for urging said plunger forwardly, said spring being formed of flat strip material bent into flat-sided turns to provide a uniform rate and maximum compressibility; holding lugs mounted on the head of said housing for limiting the forward movement of said clip stack, said lugs being mounted in spaced pairs at each end of the leading clip and overriding the front face thereof with each pair of said lugs being spaced a substantial lateral distance apart; a pair of spring urged forcep arms swingably mounted to the sides of said housing; stop means for limiting the outward movement of said arms; and forcep jaws formed on the forward ends of said arms and turned right-angularly to extend inwardly and bracket the ends of said leading clips, said jaws having arcuate inner surfaces movable inwardly upon compression of said arms to engage and drive said clip ends inwardly, and said jaws being of a lateral width less than the lateral spacing of said holding lugs whereby to pass freely therebetween.

4. A wound clip applicator comprising: an elongated rectangular housing open at both ends and adapted to slidably receive a plurality of wound clips in stacked relationship; a gate swingably mounted at the rear end of said housing; spring urged plunger means slidably mounted in said housing for urging said clip stack forwardly; a collar secured to the front end of said housing and having a central opening therein formed with corner holding lugs adapted to override the front face of the leading clip to limit the forward movement thereof, said collar having guide slots extending outwardly at the ends of said central opening and terminated by transversely extended stop bars formed on the ends of said collar; a pair of spring urged forcep arms swingably mounted to the sides smart V *11 V oflsai'djhousiing; and inturned forcep jaws formed on the forward ends of said arms and normally positioned to bracket the ends of said leading clip, said jaws being fitted within said guide slots and limited in outward movement by said stop bars, and said jaws being movable inwardly upon compression of said arms to drive said clip ends inwardly and of lateral width such as to pass freely between said holding lugs.

5. A wound clip applicator comprising: an elongated rectangular housing open at both ends and adapted to slidably receive a plurality of wound ciips in stacked relationship; a gate mounted at the rear end of said housing; spring urged plunger means slidably mounted in said housing for urging said clip stack forwardly; a collar secured to the front end of said housing and having a central opening therein formed with corner holding lugs adapted to override the front face of the leading clip to limit the forward movement thereof, said collar having guide slots extending outwardly at the ends of said central opening and terminated by transversely extended stop bars formed on the ends of said collar; a pair of spring forcep arms secured to the sides of said housing at the rear end thereof and extending divergently outwardly from the front portion of said housing; and forcep jaws formed on the forward ends of said arms and turned right-angularly to extend inwardly and bracket the ends of said leading clip, said jaws having enlarged heads fitted within said guide slots and limited in outward movement by said stop bars, the inner surfaces of said heads being arcuately recessed for gripping engagement with the ends of said clips when said jaws are moved inwardly by compression of said arms, and said heads being of a width'less than the lateral spacing of the holding lugs at each end of said collar opening whereby to pass freely therebetween.

6. A wound clip applicator comprising: an elongated rectangular housing open at both ends to slidably receive a stack of wound clips nested together in front-to-back relationship, said housing being slotted along the front face thereof for inspection of the clip supply; a gate extending across the rear end of said housing and pivotally supported thereon to swing outwardly free of said housing end; a plunger slidably mounted in said housing at the rear of said clip stack; a feed spring confined between said gate and said plunger for urging the latter forwardly; a collar secured to the front end of said hous ing and having an elongated opening in the end thereof of length and width substantially the same as that of said clip, said collar having small inturned lugs overhanging said opening and disposed in pairs at the ends thereof spaced laterally a substantial distance, and said collar having reduced guide slots extending outwardly at the ends of said openings and terminated by transversely extended stop bars formed on the ends of said collar;

a pair of spring urged forcep arms swingably mounted to the sides of said housing; and inturned forcep jaws formed on the forward ends of said arms and normally positioned to bracket theends of said leading clip, said jaws being fitted within said guide slots and limited in outward movement by said stop bars, and said jaws being movable inwardly upon compression of said arms to drive said clip ends inwardly and of lateral width such as to pass freely between said holding lugs.

7. A wound clip applicator comprising: an elongated rectangular housing open at both ends to slidably receive a stack of wound clips nested together in front-to-back relationship, said housing being slotted along the front face thereof for inspection of the clip supply; a gate extending across the rear end of said housing and pivotally supported thereon to swing outwardly free of said housing end; a plunger slidably mounted in said housing at the rear of said-clipstack; a feed spring confined between said gateand said plunger for urging the latter forwardly; a collar secured to the front end of said housing and having an elongated opening in the end thereof of length and widthsubstantially the "same as that of said clip, said collar having small inturned lugs overhanging said opening and disposed in pairs at the ends thereof spaced laterally a substantial distance,v and said collar having reduced guide slots extending outwardly at the ends of said openings and terminated by transversely extended stop bars formed on the ends of said collar; a pair of spring forcep arms secured to the sides of said housing thereof and being pretensioned to extend divergently outwardly from the front portion of said housing, the rear portions of said arms being relatively thick for rigidity and the forward portions being thinner for spring action; and forcep jaws formed on the forward ends of said arms and turned right-'angularly to extend inwardly and bracket the ends of said leading clip, said jaws having enlarged heads fitted within said guide slots and limited in outward movement by said stop bars, the inner surfaces of said heads being arcuately recessed for gripping engagement with the ends of said clips when said jaws are moved inwardly by compression of said arms, and said heads being of a width less than the lateral spacing of the holding lugs at each end of said collar opening whereby to pass freely therebetween.

8. A wound clip applicator comprising: an elongated rectangular housing open at both ends to slidably receive a stack of wound clips nested together in front-to-back relationshi said housing being slotted along the front face thereof for inspection of the clip supply; a gate extending across the rear end of said housing and pivotally supported thereon by forwardly projecting arms bracketing the sides of said housing and journaled thereon, said gate being swingable outwardly to clear said housing end and being frictionally restrained to normally remain closed; a plunger block slidably mounted in said housing at the rear of said clip stack; a feed spring having the forward end secured to said plunger block and the rear end abutting said gate to urge said plunger block forwardly, said spring being formed of flat strip material bent into flatsided coils to provide a uniform rate and maximum compressibility; a collar secured to the front end of said housing and having an elongated opening in the end thereof of length and width substantially the same as that of said clip, said collar having small inturned lugs overhanging said opening and disposed in pairs at the ends thereof spaced laterally a substantial distance, and said collar having reduced guide slots extending outwardly at the ends of said openings and terminated by transversely extended stop bars formed on the ends of said collar; a pair of spring forcep arms secured to the sides of said housing thereof and being pretensioned to extend divergently outwardly from the front portion of said housing, the rear portions of said arms being relatively thick for rigidity and the forward portions being thinner for spring action, with raised knurled surfaces extended along the center portion of said arms for hand gripping; and forcep jaws formed on the forward ends of said arms and turned right-angularly to extend inwardly and bracket the ends of said leading clip, said jaws having enlarged heads fitted within said guide slots and limited in outward movement by said stop bars, the inner surfaces of said heads being arcuately recessed for; gripping engagement with the ends of said clips when said jaws are movedinwardly by compression of said arms, and said heads being of a width less than the lateral spacing of the holding lugs at each end of said collar opening, whereby to pass freely therebetween.

9. A wound clip applicator comprising: an elongated rectangular housing open at both ends to slidably receive a stack of wound clips nested together in front-to-back relationship, said housing being slotted along the front face thereof for inspection of the clip supply and having a series of indicia lines thereon to designate thenumber 'of clips discharged therefrom; a gate extending across the rear end of said housing and pivotally supported thereon byforwardly-projecting arms'bracketing the sides 13 of said housing and journaled thereon, said gate being swingable outwardly to clear said housing endand being frictionally restrained to normally remain closed; a plunger block slidably mounted in said housing at the rear of said clip stack and having a pointer thereon to register with said housing indicia lines and indicate the number of clips discharged in accordance with the position of said plunger block; a feed spring having the forward end secured to said plunger block and the rear end abutting said gate to urge said plunger block forwardly, said spring being formed of flat strip material bent in to flat-sided coils to provide a uniform rate and maximum compressibility; a collar secured to the front end of said housing and having an elongated opening in the end thereof of length and width substantially the same as that of said clip, the sides of said collar overlapping the front and rear faces of said housing and being formed with cut back central openings for clearing said clips sideways after closure thereof, said collar having small inturned lugs overhanging said openings and disposed in pairs at the ends thereof spaced laterally a substantial distance and adapted to hold the leading clip in applying position, and said collar having reduced guide slots extending outwardly at the ends of said openings and of a width substantionally equal to the lateral spacing of said lugs, the ends of said slots being terminated by transversely extended stop bars formed on the ends of said collar; a pair of spring forcep arms secured to the sides of said housing thereof and being pretensioned to extend divergently outwardly from the front portion of said housing, the rear portions of said arms being relatively thick for rigidity and the forward portions being thinner for spring action, with raised knurled surfaces extended along the center portion of said arms for hand gripping; and forcep jaws formed on the forward ends of said arms and turned right-angularly to extend inwardly and bracket the ends of said leading clip, said jaws having enlarged heads fitted within said guide slots and limited in outward movement by said stop bars, the inner surfaces of said heads being arcuately recessed for gripping engagement with the ends of said clips when said jaws are moved inwardly by compression of said arms, and said heads being of a width less than the lateral spacing of the holding lugs at each end of said collar opening whereby to pass freely therebetween.

10. In a wound clip applicator: an elongated hollow rectangular member defining a chamber for holding a plurality of wound clips in stacked front to back relationship; spring means mounted in said member for urging said clips forwardly; holding lugs turned right angularly inwardly from the front and back walls of said member to override the end portions of the front face of the leading clip and restrain said clips against forward movement, said lugs being spaced a substantial lateral distance apart; and a pair of forcep arms swingably mounted on either side of said member and having inturned forcep jaws formed on the forward ends of said arms to engage with the ends of said leading clip, said jaws being movable inwardly to drive said clip ends inwardly and being of a lateral width less than the lateral spacing of said holding lugs whereby to pass freely therebetween.

References Cited in the file of this patent UNITED STATES PATENTS 836,662 Briggs Nov. 20, 1906 1,519,738 McGowan Dec. 16, 1921 1,671,809 Briggs May 29, 1928 2,114,795 Chabon Apr. 19, 1938 2,237,589 Dole Apr. 8, 1941 2,254,620 Miller Sept. 2, 1941 2,256,382 Dole Sept. 16, 1941 2,577,012 Hinckley Dec. 4, 1951

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