Resection line guide for a medical procedure and method of using same

• US 10,278,707 B2
• Filed: 12/17/2014
• Issued: 05/07/2019
• Est. Priority Date: 12/17/2013
• Status: Active Grant

• Current Assignee: Standard Bariatrics, Inc. (Teleflex Incorporated)
• Original Assignee: Standard Bariatrics, Inc. (Teleflex Incorporated)
• Inventors: Thompson, Jonathan R., Weitzel, Ryan, Thompson, Bennie, Nuchols, Richard P.
• Primary Examiner(s): Eastwood, David C
• Assistant Examiner(s): Herbermann, Erich
• Application Number:
  US15/105,198
• Publication Number:
  US 20160324527A1
• Time in Patent Office: 1,602 Days
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00066 intensity
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00358 Snares for grasping
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/00991 Telescopic means
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/0807 : Indication means
• CPC Class Codes: A61B 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61F 5/0083 : Reducing the size of the stomach, e.g. gastroplasty surgical interventions A61B17/00

Abstract

The present invention relates to apparatuses and methods of using a resection line guide in various medical procedures. A resection line guide may include a first clamp member and a second clamp member configured to be positioned on a first side and a second side generally opposite that of the first side of an anatomical structure, such as, for example, a stomach. The clamp members may be configured to provide a clamping force on the stomach to secure the guide to the stomach. Further, at least one flexible member may be operatively coupled to the clamp members. The flexible member may be configured to be tensioned so as to provide at least a portion of the clamping force on the stomach.

Claims

1. A clamp for a medical procedure on a stomach, the clamp comprising:

a first clamp member configured to be positioned on a first side of the stomach, the first clamp member having a first end and a second end;

a second clamp member configured to be positioned on a second side of the stomach generally opposite that of the first side, the second clamp member having a first end and a second end; and

a hinge, the hinge coupling the first ends of the first and second clamp members such that the first clamp member is pivotable relative to the second clamp member;

a biasing member, the biasing member coupling the second ends of the first and second clamp members, wherein the biasing member is configured to apply a first clamping force in a first stage, and a second clamping force in a second stage, wherein the second clamping force is greater than the first clamping force;

a handle;

a shaft, the shaft having a proximal end and a distal end, wherein the distal end of the shaft and the biasing member are fixedly coupled with at least one of the first clamp member and the second clamp member and the proximal end of the shaft is coupled with the handle;

an actuator, the actuator being coupled with the handle and operatively coupled with the biasing member such that the actuator selectively tensions the biasing member to provide the first clamping force in the first stage and the second clamping force in the second stage

a first position in which the distal end of the shaft is fixedly coupled with at least one of the first clamp member or the second clamp member such that the clamp is operably configured for insertion into the stomach in accordance with the medical procedure;

a second position in which the distal end of the shaft is fixedly coupled with at least one of the first clamp member or the second clamp member such that the clamp is operably configured to clamp the stomach in accordance with the medical procedure;

a third position in which the distal end of the shaft is fixedly coupled with at least one of the first clamp member or the second clamp such that the clamp is operably configured for extraction from the stomach after performance of the medical procedure, and

wherein the first stage comprises the first clamping force being from about 0.5 g/mm² to about 4 g/mm².

2. The clamp of claim 1, wherein the hinge is a spring.

3. The clamp of claim 2, wherein the spring is extensible such that the first end of the first clamp member and the first end of the second clamp member are spaced apart by a variable gap.

4. The clamp of claim 1, wherein each of the first clamp member and the second clamp member have a rigid unitary construction.

5. The clamp of claim 1, wherein the second stage comprises the second clamping force being from about 4 g/mm² to about 12 g/mm².

6. The clamp of claim 1, wherein the biasing member extends through at least a portion of the first clamp member and the second clamp member.

7. The clamp of claim 1, where in the biasing member is a multi-strand stainless steel cable.

8. The clamp of claim 1, wherein at least one of the first clamp member and the second clamp member include an alignment surface operably configured to engage a stapling device.

9. The clamp of claim 1, further comprising an indicator of tissue thickness.

10. The clamp of claim 1, further comprising a spring reel tensioning device.

11. The clamp of claim 1, wherein the hinge is a living hinge.

12. A clamp for a medical procedure on a stomach, the clamp comprising:

a first rigid clamp member configured to be positioned on a first side of the stomach, the first rigid clamp member having a first end and a second end;

a second rigid clamp member configured to be positioned on a second side of the stomach generally opposite that of the first side, the second rigid clamp member having a first end and a second end; and

a hinge, the hinge being an extensible spring coupling the first ends of the first and second rigid clamp members such that the first rigid clamp member is pivotable relative to the second rigid clamp member and such that the first end of the first rigid clamp member is spaced apart from the first end of the second rigid clamp member with a variable gap;

a metal biasing member, the metal biasing member coupling the second ends of the first and second rigid clamp members, wherein the metal biasing member applies a first clamping force in a first stage, and a second clamping force in a second stage, wherein the second clamping force is greater than the first clamping force;

a handle;

a shaft, the shaft having a proximal end and a distal end, wherein the distal end of the shaft and the metal biasing member are fixedly coupled with at least one of the first rigid clamp member and the second rigid clamp member and the proximal end of the shaft is coupled with the handle;

an actuator, the actuator being coupled with the handle and operatively coupled with the metal biasing member such that the actuator selectively tensions the metal biasing member to provide the first clamping force in the first stage and the second clamping force in the second stage; and

a first position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp member such that the clamp is operably configured for insertion into the stomach in accordance with the medical procedure;

a second position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp member such that the clamp is operably configured to clamp the stomach in accordance with the medical procedure; and

a third position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp such that the clamp is operably configured for extraction from the stomach after performance of the medical procedure, and

wherein the first stage comprises the first clamping force being from about 0.5 g/mm² to about 4 g/mm².

13. The clamp of claim 12, wherein the metal biasing member is a multi-strand stainless steel cable.

14. The clamp of claim 12, wherein the metal biasing member is selected from a group consisting of a flexible member, a chain, at least one link, or combinations thereof.

15. The clamp of claim 12, wherein the second stage comprises the second clamping force being from about 4 g/mm² to about 12 g/mm².

16. The clamp of claim 12, wherein the flexible member comprises a band.

17. A clamp for a medical procedure on a stomach, the clamp comprising:

a first rigid clamp member configured to be positioned on a first side of the stomach, the first rigid clamp member having a proximal end and a distal end;

a second rigid clamp member configured to be positioned on a second side of the stomach generally opposite that of the first side, the second rigid clamp member having a proximal end and a distal end; and

a hinge, the hinge being an extensible spring coupling the distal ends of the first and second rigid clamp members such that the first rigid clamp member is pivotable relative to the second rigid clamp member and such that the proximal end of the first rigid clamp member is spaced apart from the proximal end of the second rigid clamp member with a variable gap;

a metal biasing member, the metal biasing member coupling the proximal ends of the first and second rigid clamp members, wherein the metal biasing member applies a first clamping force in a first stage, and a second clamping force in a second stage, wherein the second clamping force is greater than the first clamping force;

a handle;

a shaft, the shaft having a proximal end and a distal end, wherein the distal end of the shaft and the metal biasing member are fixedly coupled with at least one of the first rigid clamp member and the second rigid clamp member and the proximal end of the shaft is coupled with the handle;

an actuator, the actuator being coupled with the handle and operatively coupled with the metal biasing member such that the actuator selectively tensions the metal biasing member to provide the first clamping force in the first stage and the second clamping force in the second stage; and

a first position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp member such that the clamp is operably configured for insertion into the stomach in accordance with the medical procedure;

a second position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp member such that the clamp is operably configured to clamp the stomach in accordance with the medical procedure;

a third position in which the distal end of the shaft is fixedly coupled with at least one of the first rigid clamp member or the second rigid clamp such that the clamp is operably configured for extraction from the stomach after performance of the medical procedure, and

wherein the first stage comprises the first clamping force being from about 0.5 g/mm² to about 4 g/mm².

18. The clamp of claim 17, wherein the metal biasing member is a multi-strand stainless steel cable.

19. The clamp of claim 17, wherein the second stage comprises the second clamping force being from about 4 g/mm² to about 12 g/mm².

20. The clamp of claim 17, wherein at least one of the first clamp member and the second clamp member include an alignment surface operably configured to engage a stapling device.