Surgical clip and surgical clip applier with reciprocating sleeve and dual rachet mechanism

摘要

A surgical clip (20) suitable for use as a scalp clip is provided. The surgical clip (20) comprises an elongated tubular body including a pair of tissue clamping jaws (22, 24) which are defined by an elongated longitudinal slit (26) across the front of the body and are connected by a flexible bridge (36) at the rear of the body. A pair of flanges (38, 40) extending rearwardly from opposite sides of the body are adapted to receive the jaws of an applier whereby pressure can be applied to the bridge (36) via the flanges (38, 40) to separate the tissue clamping jaws (22, 24) to receive a tissue flap therebetween. A surgical clip applier includes a pair of pivotal housing sections (102, 104) on which are provided a pair of clip actuating jaws (112, 114). An elongated clip sleeve (160) which receives a plurality of surgical clips (20) arranged front to back in a row is mounted for longitudinal reciprocating movement between the housing sections (102, 104). The clip sleeve (160) includes a pair of clip retaining jaws (162, 164) adjacent to its open front to receive and hold a surgical clip (20) advanced from the clip sleeve (160) between the clip actuating jaws (112, 114) on the clip sleeve (160) for engaging the rearmost clip (20) in the row. The surgical clip applier includes a ratchet mechanism which is operable each time the clip sleeve (160) is reciprocated to advance the pusher (210) and the row of clips (20) by one step corresponding to the length of one surgical clip in the row. The ratchet mechanism includes a first ratchet (188) on the clip sleeve (160) and a second ratchet (152) on one (104) of the housing sections (102, 104) which are engaged by pawls on opposite sides of the pusher (210).