JPS5951297B2 - Hemostasis clip holder - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to hemostatic clips, and more particularly to a clip holder that securely holds a plurality of hemostatic clips before the clips are pulled out by a clip applicator.

The use of clips to ligate blood vessels during surgical procedures is well known, and there are many prior patents for specific clips and clip retainers.

For example, US Pat. No. 3,326,216 describes a particular hemostatic clip and a method for properly positioning the clip relative to a blood vessel.

This patent also shows a container or holder for supporting several clips in a convenient position for withdrawal by a clip applicator.

Since the clip is quite small, such a retainer must facilitate handling of the clip and alignment with the clip applicator lip.

Although the clip retainer described in the above-mentioned patent provides an improved device for storing and handling hemostatic clips, clips stored in this manner may become loose during shipping and handling, and the clip retainer It turns out that it is possible to completely deviate from this.

This is because the device relies entirely on frictional contact between the clip and its retainer.

Also, even slight loosening can cause the clip to shift, making it difficult for the surgeon to withdraw the clip using a clip applicator.

U.S. Pat. No. 3,270,745 describes a clip retainer that securely retains a preformed clip, but does not explicitly state how the clip can be effectively removed from the retainer. .

It appears that the internal action of the forceps jaws is necessary to effectively disengage the clip from its retainer and counteracts the outward deformation of the lips.

Additionally, the inherent spring action of the clip tends to cause it to pop off the interior surface of the clip applicator jaws after it is removed from the container.

Heretofore, there have been no known hemostatic clips that are relatively easy to withdraw with a clip applicator, yet have desirable qualities of overall retention during shipping and handling.

SUMMARY OF THE INVENTION The present invention provides a clip holder that securely secures the clip end within an opening formed in the holder.

The clip shaping element presses against the internal center of the clip and provides an anvil against which the clip must be shaped by the clip applicator before being withdrawn from the retainer.

This type of construction eliminates any risk of the clip becoming dislodged from the retainer, and the clip is always held in place for alignment with the clip applicator.

Completely forming and withdrawing the clip involves bending the partially formed clip around the clip forming anvil as necessary with a clip applicator.

It is only necessary to pull the applicator out of the holder, so that the fully formed clip can be attached to the jaws of the applicator by the outward spring action of the clip when applied to a blood vessel or other body part. retained within the body.

The present invention utilizes a positive gripping device on the hemostatic clip end that cooperates with a complementary device on the internal surface of the applicator jaws to securely withdraw the clip from the retainer. It has a further purpose.

The invention will be explained in detail below by means of preferred embodiments with reference to the accompanying drawings.

Referring to FIG. 1, the clip holder of the present invention is generally indicated at 10 and is illustrated as being held between the index finger and thumb of a surgeon or nurse.

clip applicator
11 is held in the surgeon's other hand in the optimum position to fully form the clip and withdraw it from the clip holder.

The internal structure of the clip retainer 10 is best shown in FIG. 2, in which the individual components of the retainer are shown in position for loading the clip into the retainer.

The main component of clip retainer 10 is housing 12, which is preferably constructed from a rigid plastic material.

Housing 12 has a generally rectangular opening 13;
A plurality of clips are housed therethrough which are held therein by clip-forming elements 14.

The housing 12 is shown in cross-section in FIG. 3 and has an overall box-like shape with side walls 15 and end walls 16.

The top of the housing 12 has an outwardly extending flange 17 which facilitates handling of the retainer and makes the structure more rigid.

The lower portion of the housing 12 includes inwardly extending shoulders 18.
19 are constructed and dimensioned to fit within the housing and are adapted to support a clip 20 (see FIG. 4) carried across the lower portion of the opening 13.

The detailed structure of the housing 12 is shown in more detail in FIGS. 6 to 8, in which the box-like basic structure formed by the walls 15, 16 has a central opening 13 through it and extends outwardly. Its upper edge is reinforced by an extending flange 17.

a plurality of spacer elements
ts) 21 is fixed between the walls 15 and divides the opening 13 into a plurality of spaces, each space having a shoulder 18, 19 portion extending therein.

In fact, shoulders 18 and 19 may be considered a single inwardly extending shoulder or 1. It may be thought of as a plurality of individual inwardly extending shoulders separated by spacer elements 21.

The spacer element 21 not only divides the housing 12 into a plurality of clip storage spaces, but also facilitates the assembly of the entire clip holder by providing individual pockets 1 to 24 in which clips are placed. .

To make the positioning of the clip easier, the pocket 24 tapers upwardly at the ramp 25 and is formed essentially equal to the width of the clip 20 in the bottom.

(See FIG. 9) The slot 26 is connected to each spacer element 21.
, all of which line up to form a groove 27 for receiving the clip-forming element 14.

An arcuate portion 30 of spacer element 21 extends outwardly from opening 13 and provides a guide for the tip of clip applicator 11 to ensure alignment of the applicator with clip 20.

The assembly of clip 20 within clip retainer 10 is best shown in FIGS. 3-5, which illustrate opening 1.
The steps of placing clip 20 within 3 and supporting the clip end across the opening by shoulders 18, 19 are shown in sequence.

After each clip 20 is placed in the pocket 24, the clip-forming element 14 is introduced into position within the groove 27 and then comes into contact with the clip 20 suspended across the opening 13 by shoulders 18, 19. I am made to do so.

Referring to FIG. 4, the clip-forming element 14 is generally T-shaped with an upper portion 35 matching the cross-sectional shape of the upper portion of the opening 13 and is placed within the opening surrounded by walls 15, 26. It is designed to fit under pressure.

protrusion 3 designed to fit snugly into groove 27;
6 is suspended from block 35.

The protrusion 36 forms a clip forming element or anvil around which the clip is ultimately formed by the clip applicator 11 prior to being withdrawn.

The protrusion 36 forms a pressing device.

Further, each pocket 24 forms a Krylough offshore central positioning device.

In FIG. 2, the outermost end of the protrusion 36 is more clearly shown, and a plurality of indentations 37 are shown at the end.

This uneven part is the pocket 24 and the clip 2 placed there.
It is designed to match 0.

This structure makes it easier to match the main portion of the clip retainer and ensures that the clip 20 is held in place for being pulled out by the clip applicator.

Referring again to FIG. 5, with the clip retainer 10 fully assembled, one of the clips 20 is suspended end-wise across the opening 13 and onto the shoulders 18, 19. It is shown with a clip-forming projection 36 that more or less centrally contacts the side of the clip opposite the side that contacts the book and shoulder.

Insertion of the clip-forming element 14 into the aperture 13 forces the protrusion or anvil 36 against the center of the clip, deforming the clip into a V-shape and maintaining it rigidly in this shape, causing the clip retainer 10 It will hold tightly inside.

Note that the clip has the clip forming element 14 connected to the opening 13.
It will be appreciated that prior to insertion, it must be inserted into each pocket I.24 and suspended between shoulders 18,19.

The downward movement of the anvil or protrusion 36 (as shown in FIG. 5) brings the anvil into contact with each clip and uniformly deforms it to achieve the desired result.

From the above description, it seems clear that it is not possible to remove the clip 20 from the clip retainer 10 without further deformation, either spontaneously or accidentally.

Therefore, the clip will not accidentally become loose or fall out of the clip retainer during its shipping or handling.

When the clip is not being used during a surgical procedure, the surgeon need only insert the tip of the clip applicator 11 between the individual clip applicator guide arcs 30 and bring it into contact with the intended clip 20.

The clip applicator 11 (see FIG. 11) has a jaw-like body 4.
2.43 points 40, 41 are reduced in thickness to form a clearance between adjacent guide arcs 30.
It is made to have a width approximately equal to ce).

Preferred clip applicators of the present invention each include jaws 42.
．． a pair of rotatably connected arms 45 having 43;
．． 46 in the shape of a forceps.

The operating ends of the arms 45, 46 have conventional ring-shaped gripping members 49, 50, the jaws of which are held at a predetermined distance by leaf springs 47, and the stop member 48 is a ring-shaped gripping member. It is placed between 49.50 and 50.

This arrangement will provide proper spacing for the tips 40,41 to be inserted into the clip retainer 10.

When it is desired to remove the clip from the retainer, the surgeon grasps the clip retainer and the clip applicator and inserts the tip of the applicator into one of the spaces between the guide arcs 30 to remove the clip 2.
It is sufficient to contact the suspension arm of 0.

This procedure further deforms the clip 20 into a fully formed state, while at the same time lifting the supporting ends of the clip away from the shoulders 18, 19 and removing the clip from the retainer as shown in phantom in FIG. is made possible by the clip applicator.

As shown more clearly in Figure 12.13, the tip 40.41
are each provided with a groove 52, 53 at its end, between which a gripping surface is provided for holding the clip 20 when it is withdrawn.

The arms on which the clip is suspended must be deformed inwardly to effectively release the clip from the retainer, and the arms must be deformed outwardly so as to come into contact with the inner gripping surface of the tip 40.41. The arms are held firmly between the tips because of their inherent tendency to expand elastically.

Although the structure of the tips 40, 41 is not limited to that shown in FIG. 13, grooves 52, 53 are provided so that the tips 40, 41 do not have a cutting effect on the blood vessel when the clip 20 is applied to the blood vessel. It is desirable that the thickness be shallower than the thickness of the clip 20.

The remaining clips may remain in the clip retainer 10 or be pulled from the retainer as needed during the oblique surgery.

One of the lips 20 is thus shown ligated around the blood vessel 54 in FIG.

In some cases, it has been found desirable to provide a positive gripping device at the outer end of the hemostasis clip and a complementary gripping device at the inner end of the applicator jaws.

This structure is best shown in Figures 15-17.

In FIG. 15, the clip 20a is shown in the shape it assumes when supported within the retainer 10, but has a plurality of outwardly extending saw-tooth protrusions 60a at its ends. .

When clip 20a is supported within retainer 10 between shoulders 18 and 19, as shown in FIG.
a extends outwardly at a location where it contacts complementary projections 61 on the inner end faces of the applicator jaws 40a, 41a.

Engagement of protrusions 60a and 61 occurs when the applicator is inserted into the bruising retainer and the clip 20a is held firmly between the bruising bodies as shown in FIG. The applicator is then withdrawn from the holder.

Thus, in addition to the outward spring force of the clip 20a, the positive gripping device serves to prevent accidental ejection of the clip from the applicator.

18, 19, and 20 show other embodiments of the hemostatic clip structure shown in FIG. 15.

Clips 20b, 20C, 20d each have a protrusion 60b, 60C, 60d at their outer ends, which may suitably be combined with complementary protrusions (not shown) on the inner end surface of the lip applicator. Designed to work.

All of the ridges are designed to aid in the spring action of the clip, as well as to more securely hold the clip between the applicator jaws.

Although the material of the clip of the present invention is not limited,
Preferably, it is made of surgical metal that is non-toxic and therefore can be tolerated within the body for an indefinite period of time.

Although tantalum is preferred as the clip material of the present invention, stainless steel is equally effective.

The material of the clip retainer 10 is also not limited, although it is preferred to use a sufficiently rigid, disinfectable plastic material that can be jet cast by any suitable method.

Examples of this type of plastic material include acetal and polycarbonate 1.

From the foregoing description, it should be apparent that a unique hemostatic clip retainer structure has been provided which has several advantages over any previously known devices.

The unique retention of the clip within the retainer ensures that the clip does not become detached from the retainer.

Moreover, it is nevertheless relatively easy to remove the clip from its retainer when it is desired to use it in a surgical procedure.

[Brief explanation of the drawing]

FIG. 1 is a perspective view of the clip holder of the present invention with the clip applicator in position for removing the clip from the holder; FIG. Disassemble the clip at the location where it will be installed.
The parent view, FIG. 3, is an exploded sectional view of the housing portion of FIG. 2 and the clip in a position for storage therein, and FIG.
Figure 5 is an exploded cross-sectional view of the housing similar to Figure 3 illustrating the clip supported within the housing and the clip-forming element in position for installation within the housing; 6 is a plan view of the housing portion of the clip holder shown in FIG. 2; FIG. Figure 6 housing dark 5
8 is a side view of the housing portion of the holder in FIG. 6; FIG. 9 is a partial sectional view showing the clip portion within the housing portion of the holder; 10 is a partial cross-sectional view taken along line 10-10 of FIG. 1 illustrating by dashed lines the fully formed clip portion for the clip applicator after withdrawal from the clip retainer; FIG. 12 is a partial perspective view of the clip applicator in an extended position with a clip formed thereon; FIG. 12 shows the fully formed clip located between the jaws of the clip applicator; FIG. 13 is a cross-sectional view taken along line 13-13 in FIG. 12; FIG. 14 is an exemplary perspective view of the clip portion after the clip has been applied to the blood vessel; FIG. 15 16 is a side view of another embodiment of the clip showing a device for securely gripping the ends of the hemostasis clip; FIG.
A cross-sectional view of the clip of Figure 17 and the applicator having complementary gripping surfaces at the ends of the clip applicator jaws;
Figure 18.19 shows a cross-sectional view of the end of the applicator with the clip fully formed between the jaws of the clip applicator.
．． FIG. 20 is an illustration of another embodiment of the hemostasis clip of FIG. 15. 10...Clip holder, 11...Clip applicator, 12...Housing, 13...
...Rectangular opening, 14...Clip molding element, 15, 16...Wall, 17...
Flange, 18, 19...Shoulder, 20...
... Clip, 21 ... Spacer element, 24
...Pocket (Clip center positioning device)
, 26... Thrower I, 27... Groove,
30...Clip applicator guide arc shaped part, 35...
...Block, 36...Protrusion (pressing device).

Claims (1)

[Scope of Claims] 1. A clip holder that is pulled out by a clip applicator from a clip holder that holds a plurality of hemostasis clips, which has a rectangular opening and has inward facing shoulders on both sides of one end of the opening. a plurality of clips in which both ends of the clips are supported on shoulders on both sides of the opening, and in the housing, both ends of the clips are supported on shoulders on both sides of the opening. A clip holder comprising: a clip-forming element that partially molds the clip by pressing against the clip-forming element; 2. A clip holder that is pulled out by the clip applicator from a clip holder that holds a plurality of hemostatic clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element being in contact with a side of the clip opposite to both ends of the clip. Retainer. 3. A clip holder of the type that is pulled out by the clip applicator from a clip holder holding a plurality of hemostasis clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite to both ends of the clip, and contacting a substantially central portion of the clip; A clip holder characterized in that the clip holder only makes contact with the user. 4. A clip holder of the type that is pulled out by the clip applicator from a clip holder holding a plurality of hemostatic clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite the ends of the clip, and contacting only a substantially central portion of the clip; A clip retainer having an external surface shape that contacts and matches the desired contour of a fully formed clip. 5. A clip holder that is pulled out by the clip applicator from a clip holder that holds a plurality of hemostatic clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite the ends of the clip, and contacting only a substantially central portion of the clip; contacting and having an external surface shape that corresponds to the desired contour of a fully formed clip and extending outwardly from the housing between the shoulders and forming the clip into a V-shape. 6. A clip holder of a type that is pulled out by the clip applicator from a clip holder holding a plurality of hemostasis clips, which has a rectangular opening and has a rectangular opening on both sides of one end of the opening. a housing having an inwardly facing shoulder; and within the housing;
a plurality of clips with both ends of the clips supported on shoulders on both sides of the opening; and inside the housing, both ends of the clips are pressed against the shoulders on both sides of the opening to be partially formed. a clip-forming element supporting a clip, the clip-forming element contacting a side of the clip opposite to both ends of the clip, contacting only a substantially central portion of the clip, and completely forming the clip; and extending outwardly from the housing between the shoulders and forming the clip into a V-shape; A clip holder comprising a clip central positioning device provided between said shoulders for proper positioning. 7. A clip holder that is pulled out by the clip applicator from a clip holder that holds a plurality of hemostasis clips, including a housing that has a rectangular opening and is not provided with inward facing shoulders on both sides of one end of the opening. a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite the ends of the clip, and contacting only a substantially central portion of the clip; contacting and having an external surface shape that conforms to the desired contour of a fully formed clip and extending outwardly from the housing between the shoulders and forming the clip into a V-shape; a clip central positioning device disposed between the shoulders for properly positioning the clip; and a spacer element mounted on the housing between the clip central positioning devices; A clip holder characterized in that each of said spacer elements has a groove for receiving said clip-forming element. 8. A clip holder of the type that is pulled out by the clip applicator from a clip holder holding a plurality of hemostatic clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in which both ends of the clips are supported by shoulders on both sides of the opening; and ``in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite the ends of the clip, the clip-forming element being in contact with a side of the clip opposite the ends of the clip, the clip-forming element being in contact with a side of the clip opposite to the ends of the clip; and extending outwardly from the housing between the shoulders and forming the clip into a V-shape, having an external surface shape that corresponds to the desired contour of a fully formed clip, and extending outwardly from the housing between the shoulders; The clip has a central positioning device provided between the two shoulders to appropriately position the clip, and a spacer element attached to the housing between the central positioning device. a clip applicator secured to each spacer element and extending outwardly from the housing between the shoulders, each of the spacer elements having a groove for receiving the clip forming element; A clip holder having a guide arc-shaped portion. 9. A clip holder that is pulled out by the clip applicator from a clip holder that holds a plurality of hemostatic clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips in the housing, both ends of which are supported by shoulders on both sides of the opening; and in the housing, both ends of the clips are pressed against shoulders on both sides of the opening. a clip-forming element partially molded to support the clip, the clip-forming element contacting a side of the clip opposite the ends of the clip, and contacting only a substantially central portion of the clip; contacting and having an external surface shape that conforms to the desired contour of a fully formed clip and extending outwardly from the housing between the shoulders and forming the clip into a V-shape; , a clip-forming element is provided at the center of the clip for appropriately positioning the clip, and the clip-forming element is provided at the center of the clip for appropriately positioning the clip. A clip holder having a plurality of grooves aligned with a positioning device. 10 A clip holder that is pulled out by the clip applicator from a clip holder holding a plurality of hemostasis clips, comprising: a housing having a rectangular opening and inwardly facing shoulders provided on both sides of one end of the opening; a plurality of clips within the housing, the ends of the clips being supported at shoulders on either side of the opening, and within the housing, the ends of the clips being supported against the shoulders on either side of the opening; a clip-forming element that supports the clip by pressing and partially molding the clip, the clip-forming element being in contact with a side of the clip opposite to both ends of the clip, and approximately in the center of the clip; and extending outwardly from the housing between the shoulders and forming the clip into a V-shape, having an external surface shape that corresponds to the desired contour of a fully formed clip, and extending outwardly from the housing between the shoulders; and a clip center positioning device provided between the shoulders for appropriately positioning the clip, and the clip forming element is configured to position the clip appropriately for positioning the clip. a protrusion having a plurality of grooves aligned with the central locating device and formed integrally with the rectangular block, the latter being adapted to fit tightly within the other end of the rectangular opening; A clip holder characterized by: