referring now to the drawings and particularly to fig1 , there is shown the present invention which comprises a medical clip applying device 10 comprises an elongated beam 12 having a proximal end ( not shown here for clarity ) and a distal end 14 fixedly secured to a stationary lower housing or brace 15 . a pistol - like handle ( not shown ) is arranged at the proximal end , with a trigger mechanism arranged with an elongated coupling connected to a pair of jaws 16 and 18 so as to permit the jaws 16 and 18 to be squeezed together as the attending physician pulls on the trigger . a pusher mechanism is arranged with the handle ( not shown for clarity ), the pusher 20 , as may be seen in fig2 , 3 b , 3 c , 4 and 7 , has a distalmost end , which sequentially pushes staples or clips 22 , as shown in phantom in fig1 , into a position between the jaws 16 and 18 before the jaws 16 and 18 are squeezed together at the distalmost end of the medical clip device 10 . the distalmost end of the pusher 20 in this invention has a generally cross - shaped member 24 , having a pair of wings 26 thereon , as may be seen in fig1 , 3 a and 3 c . the elongated cross - shaped member 24 has a pair of opposed upstanding rails 28 and 30 , on the distalmost end of the crossed - shaped member 24 , as may be seen in fig1 , 2 , 3 a and 3 c . the upstanding rails 28 and 30 each have a proximal sloping edge 32 which permits the cross shaped member 24 to be cammed downwardly and out of the way of the clip supply when the cross - shaped member 24 is retracted proximally as it moves , in order to engage a successive medical clip or staple 22 to be sequentially squeezed between the jaws 16 and 18 . the upstanding rails 28 and 30 each have a distalmost edge 34 , as best shown in fig2 , which edge 34 engages the proximal or “ bridging ” end of the u - shaped clip or staple 22 as it is pushed into an arrangement of receiving tracks 36 of the opposed jaws 16 and 18 on the distal end of the medical clip device 10 . the jaws 16 and 18 are movably supported between an upper housing half , called a “ cinch ” 42 , and a stationary lower housing half called a “ brace ” 15 . the jaws 16 and 18 each have an upstanding “ limiting ” pin 40 on each leg thereof , as may be seen in fig2 , 5 a , 5 b and 5 d . each pin 40 is arranged to slide along a respective cam track 41 disposed on an inner surface wall 43 of the cinch 42 . each pin 40 may reside at least partially in a “ pocket ” 45 at the distal end of each cam track 41 to limit or prevent inadvertent closure of the jaws 16 and 18 when they are disposed at that point ( the cinch 42 fully retracted proximally ), with the jaws 16 and 18 fully spread apart . the jaw pins 40 , when slid into and mate with the pockets 45 in the distal end of the track 41 in the cinch 42 thus prevent the jaws 16 and 18 from accidentally closing or pinching a clip or staple 22 between those jaws 16 and 18 . the pins 40 slide along the track 41 as the cinch 42 is moved proximally and distally . the pins 40 move toward and apart from one another correspondingly , as the jaws 16 and 18 move toward and apart from one another . the cinch 42 has a pair of cam surfaces 57 and 59 , which slidingly receive an outer edge 61 and 63 , as may be seen in fig5 a and 5 d . as the cinch 42 is caused to move distally , the jaws are pinched together by the effect of the cam surfaces 59 and 57 on the cinch 42 acting on the side edges 61 and 63 of the jaws 18 and 16 . the relative position of the cinch 42 with the jaws 16 and 18 closed , and its pins 40 in a rearward or proximal position is shown in fig5 d . the jaws 16 and 18 being open and the pins 40 in the distal pockets 45 , is represented in fig5 a . the cinch 42 is always proximally disposed relative to the jaws 16 and 18 before the staples or clips 22 are advanced into the tracks 36 in the jaws 16 and 18 . the cinch 42 is shown more clearly in fig5 c , with a pair of locking rails 49 , as also shown in fig4 . the rails 49 each slidably engage a shoulder 51 on the upper side of the brace 51 , as shown in fig4 . this securement arrangement permits the cinch 42 to be lockably engaged with the brace 15 and secure the jaws 16 and 18 , the pusher 20 and like components in a secure manner as the cinch 42 is slid relative to the brace 15 for squeezedly closing and permitting the biased self opening of the jaws 16 and 18 . the jaws 16 and 18 are locked into their “ open ” position when the pins 40 on those jaws 16 and 18 are engaged into the pockets 45 of the tracks 41 of the cinch 42 . the wings 26 on the elongated cross - shaped push member 24 also fit into the same track 36 in the jaws 16 and 18 as do the generally u - shaped clips 22 ( the wings 26 entering the track 36 after the staples or clips 22 are pushed therein ) do as they are being pushed distally or forwardly and prevent the jaws 16 and 18 from partially closing to undesirably squeeze a staple 22 which might fall into a patient . the jaws 16 and 18 close only after proximal withdrawal of the cross - shaped push member 24 from between the jaws 16 and 18 , and distal advance of the cinch 42 . this movement or the cinch 42 proximally permits the jaws 16 and 18 to be “ un - pinched ” and allows their self - opening by the proximally moving cinch 42 , so as to allow the jaws 16 and 18 to accept a new , open u - shaped clip member 22 , ready for a further clip actuation on a body tissue “ t ”. the wings 26 withdraw from the tracks 36 in the jaws 16 and 18 to allow closure of the jaws 16 and 18 on the clip 22 pushed therebetween . the jaws 16 and 18 are thus pushed to their “ squeezed - closed ” position by the distally directed motion of the generally u - shaped cinch 42 on the distal end of a “ closing ” pushrod 47 , as shown in fig1 , 2 , 3 a , 3 b and 5 a . the closing pushrod 47 has a proximal end ( not shown for clarity ) which is connected to the trigger mechanism in the proximal or handle end of the medical clip device 10 , which when actuated , effects the proper distal ( and subsequent proximal ) motion of that pushrod 47 . the lower housing or brace 15 which is disposed in an opposed relationship to the cinch 42 , comprises the lower side of the stationary beam 12 or support channel , as may be seen in fig1 , 2 , 3 b , 3 c , 4 and 7 . the spring 50 , shown in a separate perspective view in fig6 , is an elongated member , has a distalmost end 52 which is shaped upwardly , as seen in fig2 , to provide a biased finger on the lowermost side of the generally cross - shaped pusher member 24 , again as best seen in fig2 . the distal end 52 of the spring 50 keeps the pusher 20 right behind the clip 22 and at the proper level therewith , so that the upstanding rails 28 and 30 on the distalmost end of the cross - shaped member 26 does not slip below the bridging portion of the clip 22 , which otherwise would lead to possible misfiring or jamming of the clip 22 without binding to tissue “ t ” and possible loss of the clip 22 in the patient . the spring 50 has a proximal end 54 which is bifurcated into two parallel legs 56 and 58 , which are formed into a generally u - shaped configuration in a longitudinal direction . the legs 56 and 58 each have an inner edge 65 between which the pusher member 20 is slidably guided , as may be seen in fig2 , 3 c , 6 and 7 . the elongated arm of the clip pusher 20 extends between the bifurcated legs 56 and 58 of the spring 50 , as may be best seen however in fig3 c and 7 , to center the pusher 20 and keep it in proper alignment . the distalmost finger 52 of the elongated spring 50 adjacent the brace 15 , as may be seen in fig2 , is in rubbing , biased engagement with the underside of the generally cross - shaped pusher member 20 . the biased spring 50 keeps the elongated cross - shaped pusher member 20 in line with the back or bridging portion of the clip 22 . the jaws 16 and 18 are prevented from crossing or misaligning with respect to one another when those jaws 16 and 18 are being squeezed together by the distally directed camming force of the cinch 42 and closing in on a u - shaped clip 22 therebetween . the jaws 16 and 18 are also accurately “ opposed ” with respect to one another , because of their ultimate relationship with the alignment of the cross - shaped member 24 biased by the spring 50 arranged thereadjacent .
a medical clip dispenser apparatus for the pinching of a medical clip or staple about a portion of a mammalian body tissue . the apparatus comprises an elongated support beam having a distal end with a stationary lower housing thereon , and a distally movable hollow cinch slidably disposed on the lower housing . the cinch has a portion of a pair of closable jaws squeezably arranged therewithin . an elongated pusher has a generally cross - shaped pusher member on a distal end thereof in slidable engagement with the jaws , to keep the jaws apart from one another after a new clip has been pushed into position between the jaws .