ENDOSCOPIC SURGICAL CLIP APPLIER

• US 20080243145A1
• Filed: 03/26/2008
• Published: 10/02/2008
• Est. Priority Date: 03/26/2007
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Whitfield, Kenneth H., Sorrentino, Gregory
• Granted Patent: US 8,382,773 B2
• Time in Patent Office: Days
• US Class Current: 606/143
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 2090/0814 Preventing re-use
• CPC Class Codes: A61B 90/08 Accessories or related features not otherwise provided for

Abstract

An apparatus for application of surgical clips is provided and includes a lockout system selectively engageable with a pusher bar to prevent the pusher bar from returning to a home position and to prevent a trigger from completing a full stroke when a plurality of clips are substantially exhausted. The apparatus may include a trip mechanism including a trip lever biased into contact with the pusher bar, wherein distal movement of the drive bar moves the trip mechanism until the trip lever engages a lip of the pusher bar and in turn distally moves the pusher bar. The apparatus may include a wedge plate including a distal end placeable between spaced-apart jaw members, wherein the wedge plate is moved proximally to withdraw the distal end thereof from between the jaw members when a drive channel is moved in a distal direction.

Claims

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

a) a handle assembly;

b) a shaft assembly extending distally from the handle assembly and defining a longitudinal axis;

c) a plurality of surgical clips disposed within the shaft assembly;

d) jaws mounted adjacent a distal end portion of the shaft assembly, the jaws including a pair of jaw members movable between a spaced-apart and an approximated position;

e) a clip pusher bar configured to individually distally advance a surgical clip to the jaws while the jaw members are in the spaced apart position;

f) a drive bar at least partially disposed within the handle assembly and the shaft assembly, the drive bar being longitudinally movable in response to actuation of a trigger of the handle assembly;

g) a drive channel positioned adjacent the first and second jaw members to move the jaw members to the approximated position; and

h) a lockout system configured to selectively engage the clip pusher bar to prevent the clip pusher bar from returning to a home position and to prevent the trigger from completing a full stroke when the plurality of clips are substantially exhausted.

2. The apparatus according to claim 1, wherein the lockout system includes a pusher-bar latch mechanism supported in the shaft assembly, wherein a lock-out bar of the latch mechanism is actuated to engage the clip pusher bar when a final clip is exhausted, whereby the lock-out bar prevents the clip pusher bar from returning to the home position.

3. The apparatus according to claim 2, further comprising a clip follower slidably disposed within the shaft assembly at a location proximal of the plurality of clips, wherein the clip follower urges the lock-out bar of the pusher-bar latch mechanism into engagement with the clip pusher bar when the final clip is exhausted.

4. The apparatus according to claim 2, wherein the lockout system includes:

a rack having a plurality of ratchet teeth and being secured to the drive channel; and

a pawl having at least one tooth and being disposed at a location to selectively engage the rack, wherein the pawl is biased into engagement with the rack, wherein as the drive channel is longitudinally reciprocated, the plurality of teeth are passed over the pawl, and wherein the pawl prevents inadvertent return of the drive channel before full actuation of the apparatus.

5. The apparatus according to claim 4, wherein the lockout system includes:

a latch member operatively engageable by the clip pusher bar and the drive channel, wherein the latch member includes a position that is out of engagement with the drive channel when the clip pusher bar is in the home position, and a position that is engaged with the drive channel when the clip pusher bar is in a non-home position,

wherein when the clip pusher bar is prevented from returning to the home position by the lock-out bar, the latch member is engaged with drive channel and prevents the drive channel from moving proximally, whereby the plurality of teeth of the rack are maintained in engagement with the pawl.

6. The apparatus according to claim 1, further comprising a wedge plate slidably supported in the shaft assembly, the wedge plate includes a distal end configured and dimensioned for placement between the jaw members when the jaw members are in the spaced-apart position, wherein the wedge plate is moved in a proximal direction to withdraw the distal end thereof from between the jaw members when the drive channel is moved in a distal direction.

7. The apparatus according to claim 6, further comprising a gear operatively disposed between the wedge plate and the drive channel, wherein the gear translates distal movement of the drive channel into proximal movement of the wedge plate and proximal movement of the drive channel into distal movement of the wedge plate.

8. The apparatus according to claim 6, wherein a delay is provided between the distal advancement of the drive bar and the distal advancement of the drive channel.

9. The apparatus according to claim 1, further comprising a trip mechanism supported on the drive bar, the trip mechanism includes a trip lever biased into contact with the clip pusher bar, wherein distal movement of the drive bar moves the trip mechanism until the trip lever thereof engages a lip of the clip pusher bar and in turn distally moves the clip pusher bar.

10. The apparatus according to claim 1, further comprising a shear pin operatively connected to the drive bar to transmit axial forces to the drive bar during movement of the trigger, wherein the shear pin includes at least one region of reduced strength.

11. The apparatus according to claim 10, wherein the shear pin will fail at the at least one region of reduced strength when a minimum predetermined shear force is exerted on the shear pin.

12. The apparatus according to claim 1, wherein the jaws are mounted adjacent a distal end portion of the shaft assembly in a manner capable of splaying in an outward direction in order to accommodate a clip between the pair of jaw members.

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

a) a handle assembly;

b) a shaft assembly extending distally from the handle assembly and defining a longitudinal axis;

c) a plurality of surgical clips disposed within the shaft assembly;

d) jaws mounted adjacent a distal end portion of the shaft assembly, the jaws including a pair of jaw members movable between a spaced-apart and an approximated position;

e) a clip pusher bar configured to individually distally advance a surgical clip to the jaws while the jaw members are in the spaced apart position;

f) a drive bar at least partially disposed within the handle assembly and the shaft assembly, the drive bar being longitudinally movable in response to actuation of a trigger of the handle assembly;

g) a drive channel positioned adjacent the first and second jaw members to move the jaw members to the approximated position; and

h) a trip mechanism supported on the drive bar, the trip mechanism includes a trip lever biased into contact with the clip pusher bar, wherein distal movement of the drive bar moves the trip mechanism until the trip lever thereof engages a lip of the clip pusher bar and in turn distally moves the clip pusher bar.

14. The apparatus according to claim 13, further comprising:

a lockout system configured to selectively engage the clip pusher bar to prevent the clip pusher bar from returning to a home position and to prevent the trigger from completing a full stroke when the plurality of clips are substantially exhausted.

15. The apparatus according to claim 14, wherein the lockout system includes a pusher-bar latch mechanism supported in the shaft assembly, wherein a lock-out bar of the latch mechanism is actuated to engage the clip pusher bar when a final clip is exhausted, whereby the lock-out bar prevents the clip pusher bar from returning to the home position.

16. The apparatus according to claim 15, wherein the lockout system includes:

a rack having a plurality of ratchet teeth and being secured to the drive channel; and

a pawl having at least one tooth and being disposed at a location to selectively engage the rack, wherein the pawl is biased into engagement with the rack, wherein as the drive channel is longitudinally reciprocated, the plurality of teeth are passed over the pawl, and wherein the pawl prevents inadvertent return of the drive channel before full actuation of the apparatus.

17. The apparatus according to claim 16, wherein the lockout system includes:

a latch member operatively engageable by the clip pusher bar and the drive channel, wherein the latch member includes a position that is out of engagement with the drive channel when the clip pusher bar is in the home position, and a position that is engaged with the drive channel when the clip pusher bar is in a non-home position,

wherein when the clip pusher bar is prevented from returning to the home position by the lock-out bar, the latch member is engaged with drive channel and prevents the drive channel from moving proximally, whereby the plurality of teeth of the rack are maintained in engagement with the pawl.

18. The apparatus according to claim 15, further comprising a clip follower slidably disposed within the shaft assembly at a location proximal of the plurality of clips, wherein the clip follower urges the lock-out bar of the pusher-bar latch mechanism into engagement with the clip pusher bar when the final clip is exhausted.

19. The apparatus according to claim 13, further comprising a wedge plate slidably supported in the shaft assembly, the wedge plate includes a distal end configured and dimensioned for placement between the jaw members when the jaw members are in the spaced-apart position, wherein the wedge plate is moved in a proximal direction to withdraw the distal end thereof from between the jaw members when the drive channel is moved in a distal direction.

20. The apparatus according to claim 19, further comprising a gear operatively disposed between the wedge plate and the drive channel, wherein the gear translates distal movement of the drive channel into proximal movement of the wedge plate and proximal movement of the drive channel into distal movement of the wedge plate.

21. The apparatus according to claim 13, wherein a delay is provided between the distal advancement of the drive bar and the distal advancement of the drive channel.

22. The apparatus according to claim 13, further comprising a shear pin operatively connected to the drive bar to transmit axial forces to the drive bar during movement of the trigger, wherein the shear pin includes at least one region of reduced strength.

23. The apparatus according to claim 22, wherein the shear pin will fail at the at least one region of reduced strength when a minimum predetermined shear force is exerted on the shear pin.

24. An apparatus for application of surgical clips to body tissue, the apparatus comprising:

a) a handle assembly;

b) a shaft assembly extending distally from the handle assembly and defining a longitudinal axis;

c) a plurality of surgical clips disposed within the shaft assembly;

d) jaws mounted adjacent a distal end portion of the shaft assembly, the jaws including a pair of jaw members movable between a spaced-apart and an approximated position;

e) a clip pusher bar configured to individually distally advance a surgical clip to the jaws while the jaw members are in the spaced apart position;

f) a drive bar at least partially disposed within the handle assembly and the shaft assembly, the drive bar being longitudinally movable in response to actuation of a trigger of the handle assembly;

g) a drive channel positioned adjacent the first and second jaw members to move the jaw members to the approximated position; and

h) a wedge plate slidably supported in the shaft assembly, the wedge plate includes a distal end configured and dimensioned for placement between the jaw members when the jaw members are in the spaced-apart position, wherein the wedge plate is moved in a proximal direction to withdraw the distal end thereof from between the jaw members when the drive channel is moved in a distal direction.

25. The apparatus according to claim 24, further comprising a gear operatively disposed between the wedge plate and the drive channel, wherein the gear translates distal movement of the drive channel into proximal movement of the wedge plate and proximal movement of the drive channel into distal movement of the wedge plate.

26. The apparatus according to claim 24, wherein a delay is provided between the distal advancement of the drive bar and the distal advancement of the drive channel.

27. The apparatus according to claim 24, further comprising:

a lockout system configured to selectively engage the clip pusher bar to prevent the clip pusher bar from returning to a home position and to prevent the trigger from completing a full stroke when the plurality of clips are substantially exhausted.

28. The apparatus according to claim 27, wherein the lockout system includes a pusher-bar latch mechanism supported in the shaft assembly, wherein a lock-out bar of the latch mechanism is actuated to engage the clip pusher bar when a final clip is exhausted, whereby the lock-out bar prevents the clip pusher bar from returning to the home position.

29. The apparatus according to claim 28, further comprising a clip follower slidably disposed within the shaft assembly at a location proximal of the plurality of clips, wherein the clip follower urges the lock-out bar of the pusher-bar latch mechanism into engagement with the clip pusher bar when the final clip is exhausted.

30. The apparatus according to claim 29, wherein the lockout system includes:

a rack having a plurality of ratchet teeth and being secured to the drive channel; and

a pawl having at least one tooth and being disposed at a location to selectively engage the rack, wherein the pawl is biased into engagement with the rack, wherein as the drive channel is longitudinally reciprocated, the plurality of teeth are passed over the pawl, and wherein the pawl prevents inadvertent return of the drive channel before full actuation of the apparatus.

31. The apparatus according to claim 30, wherein the lockout system includes:

a latch member operatively engageable by the clip pusher bar and the drive channel, wherein the latch member includes a position that is out of engagement with the drive channel when the clip pusher bar is in the home position, and a position that is engaged with the drive channel when the clip pusher bar is in a non-home position,

wherein when the clip pusher bar is prevented from returning to the home position by the lock-out bar, the latch member is engaged with drive channel and prevents the drive channel from moving proximally, whereby the plurality of teeth of the rack are maintained in engagement with the pawl.

32. The apparatus according to claim 24, further comprising a trip mechanism supported on the drive bar, the trip mechanism includes a trip lever biased into contact with the clip pusher bar, wherein distal movement of the drive bar moves the trip mechanism until the trip lever thereof engages a lip of the clip pusher bar and in turn distally moves the clip pusher bar.

33. The apparatus according to claim 24, further comprising a shear pin operatively connected to the drive bar to transmit axial forces to the drive bar during movement of the trigger, wherein the shear pin includes at least one region of reduced strength.

34. The apparatus according to claim 33, wherein the shear pin will fail at the at least one region of reduced strength when a minimum predetermined shear force is exerted on the shear pin.

35. An apparatus for application of surgical clips to body tissue, the apparatus comprising:

a) a handle assembly;

b) a shaft assembly extending distally from the handle assembly;

c) a plurality of surgical clips disposed within the shaft assembly, each clip having an outer width; and

d) jaws mounted adjacent a distal end portion of the shaft assembly, the jaws including a pair of jaw members movable between a spaced-apart and an approximated position, wherein when the pair of jaw members are in the spaced-apart position the pair of jaw members have an outer width, wherein a ratio of the outer width of the clip to the outer width of the pair of jaw members when in the spaced-apart position in less than or equal to 1;

1.8.

36. A method of applying surgical clips from a surgical clip applier, the method comprising the steps of:

providing a surgical clip applier comprising at least a plurality of clips, jaws configured to receive and form said clips, and a trigger configured to actuate the jaws between an open position for receiving said clips and a closed position for forming said clips;

actuating the trigger from an open position to a closed position to load a first clip into the jaws and to move the jaws from the open position to the closed position to form said first clip; and

then

releasing the trigger to return the trigger to the open position and to return the jaws to the open position.

37. The method according to claim 36, wherein the trigger can only return to the open position after the trigger has been actuated to a fully closed position.

38. The method according to claim 36, further comprising the step of providing a drive bar connected to the trigger, and wherein the step of actuating the trigger from the open position to the closed position then causes the drive bar to move distally.

39. The method according to claim 38, further comprising the step of providing a pusher bar selectively connected to the drive bar, and wherein the step of actuating the trigger from the open position to the closed position then causes the pusher bar to move distally.

40. The method according to claim 39, wherein the step of moving the pusher bar distally includes the step of a distal end of the pusher bar contacting a backspan of a distalmost clip and then moving the distalmost clip to a position between into the jaws.

41. The method according to claim 40, further comprising the step of then disengaging the drive bar from the pusher bar, whereby the drive bar continues to move distally.

42. The method according to claim 41, further comprising the step of simultaneously moving a remainder of clips in a distal direction as said distalmost clip is moved into the jaws.

43. The method according to claim 42, further comprising the step of the drive bar then engaging a drive channel to move the drive channel in a distal direction.

44. The method according to claim 43, further comprising the step of then moving the pusher bar in a proximal direction.

45. The method according to claim 44, further comprising the step of then moving a wedge plate in a proximal direction such that a distal end of the wedge plate is withdrawn from between the jaws.

46. The method according to claim 45, further comprising the step of then engaging a distal end of the drive channel against the jaws to move the jaws from the open position to the closed position to form the clip disposed therein.

47. The method according to claim 46, further comprising the step of actuating a counter mechanism to indicate that an event has occurred.

48. The method according to claim 46, further comprising the step of then releasing the trigger to move the drive bar and drive channel in a proximal direction and to move the wedge plate in a distal direction.

49. The method according to claim 48, further comprising the step of actuating a lock member, following placement of a final clip into the jaws, that engages the pusher bar and prevents the pusher bar from moving to a fully proximal position.