J Neurosurg 74:304-305, 1991
A new clip applier Technical note JOSEPH T. MCFADDEN, M.D. Norfolk, Virginia vs' This report describes a new applier designed to expedite clip holding, application, and release, and to improve visibility during aneurysmorrhaphy.
KEY WORDS • clip - aneurysm • applier • instrumentation
T
HE ideal applier should be a one-handed instrument that, among its other attributes: 1) reliably holds the clip until deliberately released; 2) allows clip rotation in any plane to the most advantageous angle; 3) opens the clip to maximum aperture without damage to the spring; 4) releases instantaneously without drag; 5) easily regrasps the placed clip for removal
or readjustment; and 6) never obstructs visibility in the field. In continued pursuit of these goals, we have produced a new clip applier (Fig. 1) with global approximating surfaces contoured larger than the circumference of the outer rims of the holes in the clip springs (Fig. 2). Forces between the applied ball surfaces and rim margins secure the clip (rotated to any chosen angle) for final dissection, adjustment, and release. Since the larger convex surfaces do not enter the holes with a
FIG. 1. The new long slim clip applier.
FIG. 2. Left: Head of the clip applier. Arrows point to the global approximating surfaces. Right: The ball contours are seen apposing the hole rims without entry. 304
FIG. 3. Spring and holding mechanism. A: On handle compression the sliding leaf (1) drops into the notch in the handle and is held by a leaf (2). This position secures the clip in the applier. B: On further compression the sliding leaf (1) escapes. C: The sliding leaf then recycles over the second leaf (2) for clip release, or to return to the holding position again. J. Neurosurg. / Volume 74 / February, 1991
Clip applier geometric apex, such as a point, the necessity for direct aim on seeking entry is eliminated. And, no exit being necessary, release is easy. complete, and instantaneous, free of drag and any tendency to hang up. Further, the spherical surfaces seek the clip holes without attempted aiming when the applier must he replaced deep in the wound on a positioned clip for removal or readjustment. The bayonet-shaped applier is longer and slimmer than any previous model, thus allowing better visibility during microsurgery. The manufacturer* has added a
new spring (Fig. 3) which cycles freely with one-hand
operation through the holding and releasing positions without jamming. locking, or spilling the clip.
Manuscript received June 4, 1990. * Clip applier manufactured by Codman and Shurtleff, Inc., Randolph, Massachusetts.
J. Neurosurg. Volume 74 / February, 1991
Address reprint requests to: Joseph T. McFadden, M.D., 513 Mowbray Arch, Norfolk, Virginia, 23507.
305
A new clip applier Technical note JOSEPH T. MCFADDEN, M.D. Norfolk, Virginia vs' This report describes a new applier designed to expedite clip holding, application, and release, and to improve visibility during aneurysmorrhaphy.
KEY WORDS • clip - aneurysm • applier • instrumentation
T
HE ideal applier should be a one-handed instrument that, among its other attributes: 1) reliably holds the clip until deliberately released; 2) allows clip rotation in any plane to the most advantageous angle; 3) opens the clip to maximum aperture without damage to the spring; 4) releases instantaneously without drag; 5) easily regrasps the placed clip for removal
or readjustment; and 6) never obstructs visibility in the field. In continued pursuit of these goals, we have produced a new clip applier (Fig. 1) with global approximating surfaces contoured larger than the circumference of the outer rims of the holes in the clip springs (Fig. 2). Forces between the applied ball surfaces and rim margins secure the clip (rotated to any chosen angle) for final dissection, adjustment, and release. Since the larger convex surfaces do not enter the holes with a
FIG. 1. The new long slim clip applier.
FIG. 2. Left: Head of the clip applier. Arrows point to the global approximating surfaces. Right: The ball contours are seen apposing the hole rims without entry. 304
FIG. 3. Spring and holding mechanism. A: On handle compression the sliding leaf (1) drops into the notch in the handle and is held by a leaf (2). This position secures the clip in the applier. B: On further compression the sliding leaf (1) escapes. C: The sliding leaf then recycles over the second leaf (2) for clip release, or to return to the holding position again. J. Neurosurg. / Volume 74 / February, 1991
Clip applier geometric apex, such as a point, the necessity for direct aim on seeking entry is eliminated. And, no exit being necessary, release is easy. complete, and instantaneous, free of drag and any tendency to hang up. Further, the spherical surfaces seek the clip holes without attempted aiming when the applier must he replaced deep in the wound on a positioned clip for removal or readjustment. The bayonet-shaped applier is longer and slimmer than any previous model, thus allowing better visibility during microsurgery. The manufacturer* has added a
new spring (Fig. 3) which cycles freely with one-hand
operation through the holding and releasing positions without jamming. locking, or spilling the clip.
Manuscript received June 4, 1990. * Clip applier manufactured by Codman and Shurtleff, Inc., Randolph, Massachusetts.
J. Neurosurg. Volume 74 / February, 1991
Address reprint requests to: Joseph T. McFadden, M.D., 513 Mowbray Arch, Norfolk, Virginia, 23507.
305
