Endoscopic surgical clip applier

• US 20060085015A1
• Filed: 10/07/2005
• Published: 04/20/2006
• Est. Priority Date: 10/08/2004
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Whitfield, Kenneth H., Sorrentino, Greg
• Granted Patent: US 7,637,917 B2
• Time in Patent Office: Days
• US Class Current: 606/142
• 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 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• 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 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/12004 for haemostasis, for prevention of bleeding
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2090/0803 Counting the number of times an instrument is used
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 90/08 Accessories or related features not otherwise provided for

Abstract

A surgical clip applying apparatus is disclosed which has a handle portion, a body extending distally from the handle portion defining a longitudinal axis and a number of surgical clips disposed within the body. The apparatus has a movable member biased in the housing adjacent the wedge plate. An actuator longitudinally advances the wedge plate a predetermined distance to a distal most position. The wedge plate has an end being disposed between first and second jaw portions at the distal most position. The wedge plate end is configured to maintain the jaw assembly in the spaced apart position during loading of the surgical clip and the wedge plate end reduces torque and external forces on the jaw assembly during the loading. The movable member holds the wedge plate in the distal most position during the loading and the movable member is deflected at a conclusion of the loading. The movable member releases the wedge plate upon deflection. The movable member allows a longitudinal proximal retraction of the wedge plate from the distal most position.

Claims

1. An apparatus for application of surgical clips to body tissue comprising:

a handle portion;

a body extending distally from the handle portion and defining a longitudinal axis;

a plurality of surgical clips disposed within the body;

a jaw assembly mounted adjacent a distal end portion of the body, said jaw assembly further comprising first and second jaw portions movable between a spaced apart and an approximated position;

a wedge plate longitudinally movable between said first and said second jaw portions;

a clip pusher configured to individually distally advance a surgical clip to said jaw assembly while said jaw portions are in the spaced apart position;

an actuator at least partially disposed within said body and longitudinally movable in response to actuation of said handle portion;

a jaw closure member positioned adjacent said first and said second jaw portions to move said jaw portions to the approximated position;

a movable member being biased in said housing adjacent said wedge plate;

wherein said actuator longitudinally advances said wedge plate a predetermined distance to a distal most position;

wherein said wedge plate has an end being disposed between said first and said second jaw portions at said distal most position, said wedge plate end configured to maintain said jaw assembly in said spaced apart position during loading of said surgical clip, said wedge plate end reducing torque and external forces on said jaw assembly during said loading;

wherein said movable member holds said wedge plate in said distal most position during said loading of said jaw assembly with said surgical clip; and

wherein said movable member is deflected at a conclusion of said loading, said movable member releasing said wedge plate upon deflection, said movable member allowing a longitudinal proximal retraction of said wedge plate from said distal most position.

2. The apparatus of claim 1, wherein said actuator comprises a cam, and wherein said wedge plate has a cam slot, said cam being engageable with a camming surface in said cam slot, said cam contacting said camming surface to move said wedge plate distally between said first jaw portion and said second jaw portion of said jaw assembly.

3. The apparatus of claim 2, further comprising a component being substantially aligned with said wedge plate, said component having a component cam slot and a camming feature, said camming feature being in said component cam slot, said component cam slot being aligned with said cam slot of said wedge plate, wherein when said camming feature contacts said cam said camming feature of said component drives said cam laterally out of engagement with said camming surface of said wedge plate, wherein said component terminates distal movement of said wedge plate.

4. The apparatus of claim 3, wherein said wedge plate further comprises a proximal window, said proximal window having a member extending from a lateral side of said window forming a first proximal window section and a second proximal window section, said movable member having a first portion moving from said first proximal window section to said second proximal window section, said movable member configured to retain said wedge plate at said distal most position with said first portion retaining at least one of said first and said second proximal window sections.

5. The apparatus of claim 4, further comprising a biasing component for biasing a second portion of said movable member to retain said wedge plate at said distal most position.

6. The apparatus of claim 5, wherein said movable member moves from a first position to a second position, wherein in said first position said first portion of movable member retains said wedge plate, and wherein in said second position said movable member is deflected and does not retain said wedge plate, said movable member permitting said wedge plate end to be retracted proximally from said jaw assembly.

7. The apparatus of claim 6, wherein said movable member deflects from said first position to said second position by a second camming feature, said actuator configured to deflect said movable member out of engagement with said wedge plate and permitting retraction of said wedge plate.

8. The apparatus of claim 7, wherein said wedge plate has a rounded distal end configured to compress at least a portion of said jaw assembly.

9. The apparatus of claim 1, further comprising a lockout mechanism having a pawl that mates with a corresponding notch in at least one of a trigger and said handle portion, said pawl preventing said at least one of said trigger and said handle portion from longitudinally moving said actuator when said lockout mechanism is actuated.

10. The apparatus of claim 9, wherein said lockout mechanism comprises a first rotatable member with said pawl, a second rotatable member having a notch and a plurality of teeth disposed around substantially an inner circumference of an inner surface of said second rotatable member, said lockout mechanism further comprising a third rotatable member having a post, said post configured to mount said lockout mechanism with said handle portion.

11. The apparatus of claim 10, wherein said pawl rotates in said inner surface of said second rotatable member to mesh with said plurality of teeth, and wherein the apparatus has a number of clips that are at least as many as a number of said plurality of teeth, wherein when said plurality of clips are exhausted said pawl advances to said notch, and wherein said further rotation of said first rotatable member traverses said pawl out from said second rotatable member through said notch, said pawl configured to mate with said corresponding notch in said handle portion.

12. The apparatus of claim 1, further comprising a rotatable member having a free portion and a biased portion, wherein said handle portion has a rib, wherein when said actuator longitudinally moves in response to actuation of the handle portion, said actuator rotates said rotatable member, said rotatable member rotating said free portion to contact said rib, said contact audibly indicating that said surgical clip has fired.

48. The apparatus of claim 5, wherein said biasing component is a spring bar member.

13. An apparatus for application of surgical clips to body tissue comprising:

a handle portion;

a body extending distally from said handle portion and defining a longitudinal axis;

a plurality of surgical clips disposed within said body;

a jaw assembly mounted adjacent a distal end portion of said body, said jaw assembly further comprising first and second jaw portions movable between a spaced apart and an approximated position;

a wedge plate longitudinally movable between said first and said second jaw portions;

a clip pusher configured to individually distally advance a surgical clip to said jaw assembly while said jaw portions are in said spaced apart position;

an actuator at least partially disposed within said body and longitudinally movable in response to actuation of said handle portion;

a jaw closure member positioned adjacent said first and said second jaw portions to move said jaw portions to said approximated position;

wherein said actuator longitudinally advances said wedge plate a predetermined distance to a distal most position;

wherein said wedge plate has an end being disposed between said first and said second jaw portions at said distal most position, said wedge plate end configured to maintain said jaw assembly in said spaced apart position during loading of said surgical clip, said wedge plate end reducing torque and external forces on said jaw assembly during said loading; and

wherein said actuator further actuates a signal device, said signal device providing an identification that at least one of said plurality of clips has fired.

14. The apparatus of claim 13, wherein said signal device is a visual display.

15. The apparatus of claim 14, wherein said visual display is an a liquid crystal display, a light emitting diode, an electronic device, an electronic display, a changeable display, a black and white display, a color display, a colored backlight, and any combinations thereof.

16. The apparatus of claim 14, wherein said visual display has an electrical contact, said electrical contact configured to modulate a displayed parameter to a current parameter based on toggling said electrical contact, and further comprising a movable member having a free end and a fixed end, said fixed end connected to said handle portion and said actuator, wherein when said actuator longitudinally moves in response to actuation of said handle portion, said actuator moves said movable member, said movable member moving said free end to contact with said electrical contact, said contact modulating said visual display from said displayed parameter to said current parameter.

33. The apparatus of claim 13, wherein said signal device is an audible device and emits a chime in response to said clip being fired.

34. The apparatus of claim 13, wherein said signal device is an audible device and emits a recorded characteristic sound in response to said clip being fired.

35. The apparatus of claim 13, wherein said signal device is an audible device is a visual indicator that is battery powered.

36. The apparatus of claim 35, wherein said battery powered visual indicator comprises a tab, said tab being disposed between an electrical contact of a battery and said visual indicator, said tab being removably connected between said battery and said visual indicator to prevent drain of said battery, said removal of said tab energizing said visual indicator at an initial use.

37. The apparatus of claim 36, wherein said tab is made from a non conductive material.

38. The apparatus of claim 37, wherein said tab is made from an insulating polymeric material.

40. The apparatus of claim 13, wherein said signal device is an audible device and emits a characteristic sound in response to a predetermined deflection of said handle portion.

41. The apparatus of claim 13, wherein said signal device is an audible device and emits a characteristic sound in response to a compression of said clip.

42. The apparatus of claim 13, wherein said signal device is an audible device and emits a characteristic sound in response to a loading of said clip.

43. The apparatus of claim 13, said signal device is an audible device and emits a first characteristic sound in response to a loading of said clip, a second characteristic sound in response to a compression of said clip, a third characteristic sound in response to a loading of another clip of said plurality of clips, wherein said first through third characteristic sounds are different.

44. The apparatus of claim 13, wherein said signal device is an audible device and emits a characteristic sound in response to an exhaustion of said plurality of clips in said body.

45. The apparatus of claim 13, wherein said signal device is powered by a manner selected from the group consisting of battery powered, solar powered, electrically powered, and any combinations thereof.

46. The apparatus of claim 13, wherein said signal device provides a plurality of different signals for a number of different clip applying events.

47. The apparatus of claim 13, wherein said signal device is a visual device comprising a lens and a display, said lens magnifying said display.

17. An apparatus for application of surgical clips to body tissue, which comprises:

a) a handle assembly having a handle and a trigger movable relative to the handle, said trigger having a trigger lockout notch;

b) a body extending distally from said handle and defining a longitudinal axis;

c) a plurality of surgical clips disposed within said body;

d) a jaw assembly mounted adjacent a distal end portion of the body, said jaw assembly including first and second jaw portions movable between a spaced apart and an approximated position;

e) a clip pusher configured to individually distally advance a surgical clip to said jaw assembly while said jaw portions are in said spaced apart position;

f) an actuator at least partially disposed within said body and longitudinally movable in response to actuation of said handle assembly;

g) a link connected at a first end to said actuator and connected at a second end to said trigger;

h) a jaw closure member positioned adjacent said first and said second jaw portions to move said jaw portions to the approximated position; and

i) a lockout mechanism comprising;

a first rotatable member with a first shaft and a first arm having a first pawl, said first shaft fixedly engaging said handle assembly;

a second rotatable member having an escape notch on a radial position of said second rotatable member with a second post, and a plurality of teeth disposed around substantially an inner circumference of an inner surface of said second rotatable member;

a third rotatable member having an aperture for receiving said second post in said second rotatable member, said third rotatable member configured to engage with said trigger;

wherein said first pawl rotates in said inner surface of said second rotatable member, said first pawl configured to mesh with said plurality of teeth, said pawl advancing to a next tooth of said plurality of teeth each time said trigger is fired;

wherein a number of said plurality of clips are least as many as a number of said teeth;

wherein when said plurality of clips are exhausted said first pawl is advanced to said escape notch, and wherein when said trigger is further fired and said plurality of clips are exhausted, said first pawl traverses out from said second rotatable member through said escape notch to said trigger notch, said first pawl preventing firing of the apparatus.

18. The apparatus of claim 17, wherein said first rotatable member is a lockout arm.

19. The apparatus of claim 17, wherein said second rotatable member is a lockout wheel.

20. The apparatus of claim 17, wherein said third rotatable member is an indexer wheel.

21. The apparatus of claim 17, wherein said first pawl has a nose member connected at an end thereof, said nose member for mating with said trigger notch.

22. The apparatus of claim 17, further comprising a signaling device for alerting the surgeon that at least one clip of said plurality of surgical clips has fired.

23. An apparatus for application of surgical clips to body tissue comprising:

a handle portion;

a body extending distally from said handle portion and defining a longitudinal axis;

a plurality of surgical clips disposed within said body;

a jaw assembly mounted adjacent a distal end portion of said body, said jaw assembly further comprising first and second jaw portions movable between a spaced apart and an approximated position;

a wedge plate longitudinally movable between said first and said second jaw portions;

a clip pusher configured to individually distally advance a surgical clip to said jaw assembly while said jaw portions are in the spaced apart position;

an actuator at least partially disposed within said body and longitudinally movable in response to actuation of said handle portion;

a jaw closure member positioned adjacent said first and said second jaw portions to move said jaw portions to said approximated position;

wherein said actuator longitudinally advances said wedge plate a predetermined distance to a distal most position;

wherein said wedge plate has an end being disposed between said first and said second jaw portions at said distal most position, said wedge plate end configured to maintain said jaw assembly in said spaced apart position during loading of said surgical clip, said wedge plate end reducing torque on said jaw assembly during said loading; and

wherein said actuator further actuates an audible device configured to indicate that at least one of said plurality of clips has fired.

24. The apparatus of claim 23, wherein said audible device comprises a click lever, said click lever being linked to said actuator, said audible device further comprises a rib connected to an interior housing of said handle portion, wherein when said actuator moves distally said actuator urges rotation of said click lever, wherein said click lever rotates at a full stroke to contact said rib at said full stroke, said contact emanating an acoustic wave, said acoustic wave configured to indicate that at least one of said plurality of clips has fired.

25. The apparatus of claim 24, further comprising a visual indicator configured to visually indicate that at least one clip of said plurality of surgical clips has fired.

26. The apparatus of claim 25, wherein said visual indicator comprises a display having an electrical contact plate, said display displaying a parameter, wherein when said actuator moves distally, said actuator moves a lever, said lever contacting said electrical contact plate, said contact causing said display to change from said parameter to a current displayed parameter.

27. The apparatus of claim 26, wherein said parameter is selected from the group consisting of a number of fired clips, a number of remaining clips, a display time of the procedure, surgical data, hemostatic clip information, an image and any combinations thereof.

28. The apparatus of claim 23, further comprising a cam slot in said wedge plate with a wedge plate camming surface in said cam slot, said wedge plate having a distal rounded end, and a proximal window, and further comprising a filler component having a filler component cam slot being aligned with said cam slot and having a filler component camming feature, a proximal window and a spring bar member in said window, said filler component being fixed in said body, the apparatus further comprising a movable member connected to said filler component, said movable member having a first arm and a second arm, said second arm being biased by said spring bar member;

wherein said actuator has a cam link, said cam link being driven distally in said cam slot, said cam contacting said wedge plate camming surface and moving said wedge plate distally, wherein said rounded distal end is moved between said jaws for loading.

29. The apparatus of claim 28, wherein said cam link contacts said filler component camming feature and is cammed out of engagement with said wedge plate camming surface.

30. The apparatus of claim 29, wherein when said cam link is cammed out of engagement with said wedge plate camming surface, said second arm of said movable member retains said distal rounded end of said wedge plate between said jaws for loading.

31. The apparatus of claim 30, wherein when said actuator is driven further distally, said actuator deflects said first arm, said first arm rotating said second arm, said second arm releasing said wedge plate, and wherein said wedge plate distal end retracts from between said jaws.

32. An apparatus for application of surgical clips to body tissue comprising:

a handle portion;

a body extending distally from said handle portion and defining a longitudinal axis;

a plurality of surgical clips disposed within said body;

a jaw assembly mounted adjacent a distal end portion of said body, said jaw assembly further comprising first and second jaw portions movable between a spaced-apart and an approximated position;

a wedge plate longitudinally movable between said first and said second jaw portions;

a clip pusher configured to individually distally advance a surgical clip to said jaw assembly while said jaw portions are in said spaced apart position;

an actuator at least partially disposed within said body and longitudinally movable in response to actuation of said handle portion;

a jaw closure member positioned adjacent said first and said second jaw portions to move said jaw portions to said approximated position;

wherein said actuator longitudinally advances said wedge plate a predetermined distance to a distal most position;

wherein said wedge plate has an end being disposed between said first and said second jaw portions at said distal most position, said wedge plate end configured to maintain said jaw assembly in said spaced apart position during loading of said surgical clip, said wedge plate end reducing torque on said jaw assembly during said loading;

wherein said body is connected to said handle by a rotatable member, said rotatable member fixedly connected to said handle and said body, wherein upon rotation of said rotatable member said body rotates and said jaw portions rotate;

wherein said rotatable member is a plurality of members having a first elongated knob housing and a second knob with a plurality of notches being disposed therearound, said second knob being disposed over said knob housing; and

wherein at least one of said plurality of members is adapted to be rotated by an index finger for rotating said body.