A preformed ligature comprises a loop, loop forming closure and an extension which may be pulled to close the loop about a bleeder. One preformed ligature according to the invention is formed of a continuous loop of gut or synthetic suture material tied into a slip knot to form the closure and the extension is the second loop thus formed therein which may be pulled by means of a hook. Another preformed dual loop ligature is formed of a continuous loop of suture material and a narrow enveloping closure. The loop preferably has a ratchet-like surface and the closure a cooperating pawl-like surface to provide a ligature loop that may only slip one way. Repeating ligature guns for applying a plurality of such preformed ligatures comprise a tubular cartridge on which a plurality of the ligatures are preformed; the cartridge comprising a helical loop engaged track for advancing the ligatures toward the end thereof. During a surgical procedure, successive cartridges may be mounted on the instrument provided by the invention. The instrument comprises clamping jaws coaxial with the mounted cartridge for pulling a clamped bleeder into the end of the tubular cartridge and means for rotating the cartridge one revolution to advance a ligature off the end of its helical track. The cartridge preferably comprises a bar about which the second loops of the preferred forms of preformed ligatures are formed for preventing rotation of the ligatures as they are advanced by the helical track and for pushing against the slip knot or closure when the ligature is being tightened. A trigger on the ligature gun controls closure of the jaws and withdrawing of the bleeder into the end of the cartridge while rotating the cartridge one revolution by means of a cam mechanism to release a ligature. The cam track may be part of the cartridge or part of the instrument. The instrument is provided with a hook for engaging the second loop of the pretied ligature and for pulling the same to tighten the ligature about a bleeder. The hook may be actuated by the first trigger or by a second hook trigger. In one embodiment of the invention, a cutter is provided for cutting the extended loop of the pretied ligature.

A hemostatic clip applicator useful in the rapid and automatic application of hemostatic clips for the strangulation of tubular members is disclosed. The applicator consists of a main body, a clip magazine externally attached to the main body, clip deforming jaws attached to one end of the main body, a laminated clip feed blade located within the clip magazine, and an actuating mechanism attached to the feed blade and deforming jaws. In operation, one of many hemostatic clips stored in the clip magazine is fed into the deforming jaws by the interaction of the actuating mechanism and the feed blade. This feeding of a hemostatic clip into the deforming jaws is a result of the clip feed means engaging a clip from the clip magazine, sliding into the deforming jaws so as to move that clip into the deforming jaws, and the retracting of the clip feed means from the deforming jaws. When the clip is properly located about a tubular member, further actuation of the actuating mechanism results in the deformation of the clip about the tubular member. Upon further activation of the actuating mechanism, the sequential process of feeding a clip from the magazine and deforming the clip about other tubular members may be rapidly repeated until the supply of clips in the magazine is depleted.

A hemostatic clip applicator useful in the rapid and automatic application of hemostatic clips for the strangulation of tubular members is disclosed. The applicator consists of a main body, a clip magazine externally attached to the main body, clip deforming jaws attached to one end of the main body, a clip feed mechanism located within the main body and an actuating mechanism attached to the feed mechanism and deforming jaws. In operation, one of many hemostatic clips stored in the clip magazine is fed into the main body and guided to the deforming jaws by the interaction of the actuating mechanism and the feed mechanism. When the clip is properly located about a tubular member, further actuation of the actuating mechanism results in the deformation of the clip about the tubular member. Upon further activation of the actuating mechanism, the sequential process of feeding a clip from the magazine and deforming the clip about other tubular members may be rapidly repeated until the supply of clips in the magazine is depleted.