Endoscopic reposable surgical clip applier

• US 10,390,831 B2
• Filed: 11/02/2016
• Issued: 08/27/2019
• Est. Priority Date: 11/10/2015
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Holsten, Henry E., Lehman, Adam I., Spencer, Kathryn L.
• Primary Examiner(s): Orkin, Alexander J
• Application Number:
  US15/341,292
• Publication Number:
  US 20170128071A1
• Time in Patent Office: 1,028 Days
• 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 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• 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 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/2912 transmission of forces to actuating rod or piston
• CPC Class Codes: A61B 2017/2917 with flexible part
• CPC Class Codes: A61B 2017/2925 Pistol grips
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members

Abstract

The present disclosure relates to endoscopic reposable surgical clip appliers having a reusable handle assembly, at least one reusable shaft assembly, and at least one disposable clip cartridge assembly.

Claims

1. A reposable surgical clip applier, comprising:

a handle assembly including;

a housing defining a bore therein and which extends through a distal end thereof;

a fixed handle extending from the housing;

a trigger pivotally connected to the fixed handle, the trigger including an actuating end disposed within the bore of the housing;

a drive plunger slidably supported within the bore of the housing and axially aligned with the bore of the housing, the drive plunger having a proximal end operatively engaged by the actuating end of the trigger, and a free distal end; and

a release lever supported on the housing, wherein the release lever includes a catch for engaging and securing an endoscopic assembly that is selectively connected to the handle assembly; and

a first endoscopic assembly selectively connectable to the housing of the handle assembly, via the catch of the release lever, the first endoscopic assembly including;

a shaft assembly having;

an outer tube defining a lumen therethrough, the outer tube including a proximal end and a distal end;

a pair of jaws pivotably and fixedly supported in, and extending from the distal end of the outer tube; and

an inner shaft slidably supported within the lumen of the outer tube, the inner shaft including a proximal end and a distal end, the distal end of the inner shaft being operatively engaged with the pair of jaws to effectuate an opening and a closing of the pair of jaws upon an axial translation of the inner shaft relative to the outer tube; and

a hub assembly configured for selective insertion in the bore of the housing of the handle assembly, the hub assembly including;

an outer housing supported on the proximal end of the outer tube, the outer housing defining an open proximal end; and

a drive assembly supported within the outer housing of the hub assembly, the drive assembly including;

a cartridge cylinder slidably supported in the outer housing of the hub assembly, the cartridge cylinder including a proximal end wall, an open distal end, and a bore therein;

a cartridge plunger supported on the proximal end of the inner shaft of the shaft assembly, the cartridge plunger being slidably supported in the bore of the cartridge cylinder;

a first biasing member disposed within the bore of the cartridge cylinder, and being interposed between the proximal end wall of the cartridge cylinder and the cartridge plunger; and

a second biasing member interposed between a proximal end of the outer tube of the shaft assembly and the cartridge plunger.

2. The reposable surgical clip applier according to claim 1, wherein the first biasing member of the first endoscopic assembly is a coil spring having a first spring constant, and wherein the second biasing member of the first endoscopic assembly is a coil spring having a second spring constant, wherein the second spring constant is less than the first spring constant.

3. The reposable surgical clip applier according to claim 2, wherein during an actuation of the trigger, with the first endoscopic assembly connected to the handle assembly, the trigger distally advances the drive plunger against the proximal end wall of the cartridge cylinder of the first endoscopic assembly to distally advance the cartridge cylinder, wherein the proximal end wall of the cartridge cylinder acts on the first basing member to distally advance the first biasing member, wherein the first biasing member acts on the cartridge plunger to distally advance the cartridge plunger and the inner shaft of the first endoscopic assembly, wherein the cartridge plunger acts on the second biasing member to bias the second biasing member.

4. The reposable surgical clip applier according to claim 3, wherein the second biasing member is biased until the inner shaft of the first endoscopic assembly is stopped from distal advancement.

5. The reposable surgical clip applier according to claim 4, wherein when the inner shaft of the first endoscopic assembly is stopped from distal advancement, further actuation of the trigger further distally advances the drive plunger of the handle assembly against the proximal end wall of the cartridge cylinder of the first endoscopic assembly to further distally advance the cartridge cylinder, wherein the proximal end wall of the cartridge cylinder acts on the first basing member to bias the first biasing member.

6. The reposable surgical clip applier according to claim 5, wherein the handle assembly further comprises a ratchet assembly including:

a ratchet rack defining a length of rack teeth and having a proximal end and a distal end; and

a pawl operatively engagable with the rack teeth of the ratchet rack, wherein the pawl prohibits reversal of a direction of the trigger once the tooth of the pawl engages the rack teeth of the ratchet rack, until the tooth of the pawl is disposed beyond the proximal end or the distal end of the ratchet rack.

7. The reposable surgical clip applier according to claim 6, wherein when the inner shaft of the first endoscopic assembly is stopped from distal advancement, and when the tooth of the pawl is still engaged with the rack teeth of the ratchet rack, further actuation of the trigger further advances the rack teeth of the ratchet rack until the rack teeth of the ratchet rack clears the tooth of the pawl.

8. The reposable surgical clip applier according to claim 7, wherein the handle assembly further includes a pawl switch supported on the housing thereof, the pawl switch being operatively associated with the ratchet assembly, wherein the pawl switch includes an actuated position wherein the pawl switch acts on the pawl to disengage the pawl from the ratchet rack.

9. The reposable surgical clip applier according to claim 8, wherein the pawl switch of the handle assembly includes an un-actuated position wherein the pawl is in operative association with the ratchet rack.

10. The reposable surgical clip applier according to claim 9, wherein the pawl switch defaults to the un-actuated position upon a coupling of the first endoscopic assembly to the handle assembly.

11. The reposable surgical clip applier according to claim 10, wherein the release lever includes:

a first end operatively associated with the pawl switch, wherein actuation of the release lever, upon a connection of the first endoscopic assembly to the handle assembly, moves the first end thereof into engagement with the pawl switch to move the pawl switch to the un-actuated position; and

a second end defining the catch and being configured to selectively engage a lip of the outer housing of the first endoscopic assembly when the first endoscopic assembly is connected to the handle assembly.

12. The reposable surgical clip applier according to claim 11, wherein the release lever is actuated upon a connection of the first endoscopic assembly to the handle assembly, whereby the first end of the release lever engages the pawl switch to move the pawl switch to the un-actuated position.

13. The reposable surgical clip applier according to claim 1, further comprising:

a second endoscopic assembly selectively connectable to the housing of the handle assembly, via the catch of the release lever, the second endoscopic assembly including;

a shaft assembly having;

an outer tube defining a lumen therethrough, the outer tube including a proximal end and a distal end;

a pair of jaws fixedly supported in and extending from the distal end of the outer tube;

an elongate spindle slidably supported in the lumen of the outer tube, the spindle including a proximal end and a distal end, the spindle being translatable between a proximal position whereby the pair of jaws are opened and a distal position whereby the pair of jaws are caused to be closed by the spindle; and

an inner shaft slidably receivable within the lumen of the outer tube, the inner shaft including a proximal end and a distal end, the distal end of the inner shaft being operatively engaged the proximal end of the spindle to effectuate a translation of the spindle between the proximal and distal positions thereof; and

a hub assembly configured for selective insertion in the bore of the housing of the handle assembly, the hub assembly including;

an outer housing supported on the proximal end of the outer tube, the outer housing defining an open proximal end; and

a drive assembly supported within the outer housing of the hub assembly, the drive assembly including;

a cartridge cylinder slidably supported in the outer housing of the hub assembly, the cartridge cylinder including a cylindrical body, a proximal end wall, an open distal end, and a bore therein;

a cartridge plunger slidably supported in the bore of the cartridge cylinder, the cartridge plunger including;

 

a stem connected to the proximal end of the inner shaft of the shaft assembly; and

 

a pair of opposed fingers supported on the stem and extending through respective longitudinally extending slots formed in the cylindrical body of the cartridge cylinder, wherein the pair of opposed fingers project from the cartridge cylinder;

a first biasing member disposed about the cartridge cylinder, and being interposed between a proximal flange supported on the cartridge cylinder and the pair of opposed fingers of the cartridge plunger; and

a second biasing member supported on the stem of the cartridge plunger, and being interposed between the cartridge plunger and a proximal end of the outer tube of the shaft assembly.

14. The reposable surgical clip applier according to claim 13, wherein the first biasing member of the second endoscopic assembly is a coil spring having a first spring constant, and wherein the second biasing member of the second endoscopic assembly is a coil spring having a second spring constant, wherein the second spring constant is less than the first spring constant.

15. The reposable surgical clip applier according to claim 14, wherein during an actuation of the trigger, with the second endoscopic assembly connected to the handle assembly, the trigger distally advances the drive plunger against the proximal end wall of the cartridge cylinder of the second endoscopic assembly to distally advance the cartridge cylinder, wherein the flange of the cartridge cylinder acts on the first basing member to distally advance the first biasing member, wherein the first biasing member acts on the pair of opposed fingers of the cartridge plunger to distally advance the cartridge plunger and the inner shaft of the second endoscopic assembly, wherein the cartridge plunger acts on the second biasing member to bias the second biasing member.

16. The reposable surgical clip applier according to claim 15, wherein the second biasing member is biased until the inner shaft of the second endoscopic assembly is stopped from distal advancement.

17. The reposable surgical clip applier according to claim 16, wherein the second endoscopic assembly further comprises:

a wedge plate disposed adjacent the spindle and slidably translatable relative to the spindle, wherein a distal end of the wedge plate is interposed between a distal end of the spindle and the pair of jaws;

a filler component disposed adjacent the wedge plate and proximal of the pair of jaws;

a clip channel disposed adjacent the filler component and adjacent the pair of jaws;

a plurality of surgical clip loaded within the clip channel and slidably disposed therein;

a clip follower disposed within the clip channel at a location proximal of the plurality of clips, the clip follower being biased distally;

a clip channel cover disposed adjacent the clip channel; and

a pusher bar disposed adjacent the clip channel cover and slidably translatable relative to the pair of jaws, wherein a distal end of the pusher bar is configured to distally advance a distal-most surgical clip of the plurality of surgical clips between the pair of jaws.

18. The reposable surgical clip applier according to claim 16, wherein when the inner shaft of the second endoscopic assembly is stopped from distal advancement, further actuation of the trigger further distally advances the drive plunger of the handle assembly against the proximal end wall of the cartridge cylinder of the second endoscopic assembly to further distally advance the cartridge cylinder, wherein the flange of the cartridge cylinder acts on the first basing member to bias the first biasing member.

19. The reposable surgical clip applier according to claim 18, wherein the handle assembly further comprises a ratchet assembly including:

a ratchet rack defining a length of rack teeth and having a proximal end and a distal end; and

a pawl operatively engagable with the rack teeth of the ratchet rack, wherein the pawl prohibits reversal of a direction of the trigger once the tooth of the pawl engages the rack teeth of the ratchet rack, until the tooth of the pawl is disposed beyond the proximal end or the distal end of the ratchet rack.

20. The reposable surgical clip applier according to claim 19, wherein when the inner shaft of the second endoscopic assembly is stopped from distal advancement, and when the tooth of the pawl is still engaged with the rack teeth of the ratchet rack, further actuation of the trigger further advances the rack teeth of the ratchet rack until the rack teeth of the ratchet rack clears the tooth of the pawl.

21. The reposable surgical clip applier according to claim 20, wherein the handle assembly further includes a pawl switch supported on the housing thereof, the pawl switch being operatively associated with the ratchet assembly, wherein the pawl switch includes an actuated position wherein the pawl switch acts on the pawl to disengage the pawl from the ratchet rack.

22. The reposable surgical clip applier according to claim 21, wherein the pawl switch of the handle assembly includes an un-actuated position wherein the pawl is in operative association with the ratchet rack.

23. The reposable surgical clip applier according to claim 22, wherein the pawl switch defaults to the un-actuated position upon a coupling of the second endoscopic assembly to the handle assembly.

24. The reposable surgical clip applier according to claim 23, wherein the release lever includes:

a first end operatively associated with the pawl switch, wherein actuation of the release lever, upon a connection of the first endoscopic assembly to the handle assembly, moves the first end thereof into engagement with the pawl switch to move the pawl switch to the un-actuated position; and

a second end defining the catch and being configured to selectively engage a lip of the outer housing of the second endoscopic assembly when the second endoscopic assembly is connected to the handle assembly.

25. The reposable surgical clip applier according to claim 24, wherein the release lever is actuated upon a connection of the second endoscopic assembly to the handle assembly, whereby the first end of the release lever engages the pawl switch to move the pawl switch to the un-actuated position.