Surgical clip applier with reciprocating clip sleeve and dual ratchet mechanism

A surgical clip applier for applying a plurality of surgical clips one at a time from a clip sleeve to a tissue flap, comprising:

• a housing comprising first and second housing sections mounted together for pivotal movement about a pivot axis, each housing section having a front portion extending forwardly beyond the pivot axis to form a clip actuating jaw;
• an elongated clip sleeve mounted for longitudinal reciprocating movement relative to said housing between a forward position and a retracted position, said clip sleeve being adapted to receive a plurality of surgical clips arranged front to back in a row;
• each of said surgical clips comprising a tubular body having a pair of tissue clamping jaws defined by an elongated slit extending across the front of said body and a pair of flanges extending rearwardly from opposite sides of said body at positions remote from said slit, said tissue clamping jaws being connected by a flexible bridge at the rear of said body whereby said body may be distended from its original tubular shape by pressure applied to said flanges;
• said clip sleeve including a pair of clip retaining jaws adjacent to an open front end of said clip sleeve and positioned between said clip actuating jaws with said clip sleeve located in said forward position;
• a pusher mounted on said clip sleeve for engaging the rearmost clip in the row, said pusher being movable one step at a time along said clip sleeve to advance the row of clips toward said open front end of said clip sleeve;
• ratchet means operable each time said clip sleeve is reciprocated for advancing said pusher and the row of clips by one step along said clip sleeve, each step corresponding to the length of one surgical clip in the row;
• and
• cam means operable when said housing sections are pivoted together for a first time without a surgical clip between said clip retaining jaws for reciprocating said clip sleeve longitudinally relative to said housing between the forward position and the retracted position, said clip retaining jaws engaging the flanges of the frontmost clip in the row as said clip sleeve is moved to its retracted position and advancing the frontmost clip between said clip actuating jaws as said clip sleeve is moved to its forward position, said clip actuating jaws being movable into engagement with said clip retaining jaws when said housing sections are pivoted together for a second time with a surgical clip between said clip retaining jaws to apply pressure to the flanges and open the surgical clip to receive the tissue flap therein.

A surgical clip applier, comprising:

• a housing;
• an elongated clip sleeve adapted to receive a plurality of surgical clips arranged front to back in a row, said clip sleeve being mounted for longitudinal reciprocating movement relative to said housing;
• a pusher mounted on said clip sleeve for engaging the rearmost clip in the row, said pusher being movable one step at a time along said clip sleeve to advance the row of clips toward an open front end of said clip sleeve;
• ratchet means operable each time said clip sleeve is reciprocated for advancing said pusher and the row of clips by one step along said clip sleeve, each step corresponding to the length of one clip in the row, said ratchet means including a first ratchet mechanism operable when said clip sleeve is retracted for advancing said pusher and the row of surgical clips by one step relative to said clip sleeve and a second ratchet mechanism operable when said clip sleeve is advanced for advancing said pusher and the row of surgical clips by one step relative to said housing;
• and
• means for reciprocating said clip sleeve relative to said housing to advance the row of clips toward said front end of said clip sleeve and to move the frontmost clip in the row outward from said front end of said clip sleeve.