SURGICAL CLIP APPLIER AND METHOD OF ASSEMBLY

• US 20090299382A1
• Filed: 08/11/2009
• Published: 12/03/2009
• Est. Priority Date: 08/25/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Zergiebel, Earl M.
• Granted Patent: US 8,056,565 B2
• Time in Patent Office: Days
• US Class Current: 606/142
• 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 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00464 for use with different instruments
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2090/038 during shipment
• CPC Class Codes: A61B 2090/0803 Counting the number of times an instrument is used
• 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 2090/0814 Preventing re-use
• CPC Class Codes: A61B 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: Y10T 29/49826 Assembling or joining

Abstract

Surgical clip appliers are provided and includes a channel assembly extending distally from a housing; a clip carrier disposed within said channel assembly and defining a channel and a plurality of windows therein; a plurality of clips slidably disposed within said channel of said clip carrier; a wedge plate reciprocally disposed within said channel assembly, said wedge plate being operatively connected to said handles and including a plurality of apertures formed along a length thereof; and a clip follower slidably disposed within said channel of said clip carrier and disposed proximally of said plurality of clips, said clip follower being configured and adapted for selective engagement with said windows of said clip carrier and said apertures of said wedge plate. The clip follower is configured and adapted to urge said plurality of clips, in a distal direction relative to said clip carrier, upon reciprocal movement of said wedge plate. The clip applier may be adapted to different size clips by the method of replacing modular components.

Claims

1. A method of assembling any one of a relatively small and large scaled surgical clip applier, wherein the respective clip appliers are scaled to deliver relatively small and large surgical clips, the method comprising the steps of:

providing a housing for a handle assembly;

connecting a channel assembly to the housing, wherein the channel assembly includes a plurality of respectively scaled surgical clips loaded therein;

providing a pusher bar in the channel assembly and extending to the handle assembly; and

connecting a motion multiplier system to the pusher bar, wherein the scaling member varies a stroke of the pusher bar upon a firing of either a relatively small, medium or large scaled clip applier to load the respective clip into jaws of the clip applier.

2. The method according to claim 1, further comprising the step of selecting a particular sized pusher bar.

3. The method according to claim 1, further comprising the step of placing a counter assembly in a first housing half of the housing.

4. The method according to claim 1, further comprising the step of placing a pawl and a pawl biasing member in a first housing half of the housing, wherein the pawl and the pawl biasing member are in operative association with one another.

5. The method according to claim 1, further comprising the step of placing a particularly sized motion reversing mechanism in a first housing half of the housing, wherein the motion reversing mechanism is connectable to a drive channel.

6. The method according to claim 4, further comprising the step of placing a rack member in the housing half of the housing such that the rack member is capable of axial translation relative to the housing, wherein a set of teeth of the rack member is in operative association with the pawl.

7. The method according to claim 1, further comprising the step of assembling the channel assembly, wherein the step of assembling the channel assembly includes the steps of:

providing a lower channel;

placing a drive channel in the lower channel;

placing particularly sized jaws in the lower channel and overlying the drive channel; and

placing a particularly sized wedge plate in lower channel and overlaying at least a portion of the drive channel and the jaws.

8. The method according to claim 7, wherein the step of connecting of the channel assembly to the housing includes inserting a drive pin through the drive channel such that the drive pin engages a slot in the housing, wherein axial translation of the drive pin results in axial translation of the drive channel.

9. The method according to claim 8, further comprising the steps of:

placing a pawl and a pawl biasing member in a first housing half of the housing, wherein the pawl and the pawl biasing member are in operative association with one another;

placing a rack member in the first housing half of the housing such that the rack member is capable of axial translation relative to the housing, wherein a set of teeth of the rack member is in operative association with the pawl; and

placing the drive pin through the rack member, wherein axial translation of the drive pin results in axial translation of the rack member.

10. The method according to claim 9, further comprising the step of connecting the drive channel to a particularly sized motion reversing mechanism supported in the first housing half of the housing.

11. The method according to claim 9, further comprising the step of providing a biasing member interconnecting the drive channel and the housing.

12. The method according to claim 10, wherein the motion multiplier system includes an accelerator rack and a bell crank gear, and further comprising the step of positioning the accelerator rack for slidable disposition within the housing half, and positioning the bell crank gear for pivotable disposition within the first housing half.

13. The method according to claim 9, further comprising the steps of providing at least one handle, and connecting a link arm to each of the at least handle and to the drive pin.

14. The method according to claim 9, further comprising the steps of:

providing a particularly sized clip carrying channel, a particularly sized stack of clips and a particularly sized clip follower;

loading the stack of clips into the clip carrying channel; and

inserting the clip follower in the clip carrying channel at a location proximal of the stack of clips.

15. The method according to claim 14, further comprising the step of placing the clip carrying channel in the channel assembly.

16. The method according to claim 15, further comprising the step of providing a motion multiplier system including an accelerator rack slidably positioned within the housing half, and a bell crank gear pivotally connected to the first housing half.

17. The method according to claim 16, further comprising the steps of providing at least one handle, and connecting a link arm to each of said at least one handles and to the drive pin.

18. The method according to claim 17, wherein the link arms interconnect each handle to the drive channel.

19. The method according to claim 16, further comprising the steps of providing a particularly sized pusher bar, and reciprocally placing the pusher bar at least partially over the clip carrying channel and the drive channel.

20. The method according to claim 19, further comprising the steps of providing a lockout, and placing the lockout near a distal end of the channel assembly, wherein the lockout is engaged by the clip follower upon a firing of a final clip to actuate the lockout and block movement of the pusher bar.

21. The method according to claim 20, further comprising the step of pivotally connecting the pusher bar to the bell crank gear.

22. The method according to claim 8, further comprising the step of providing at least one of an audible and a tactile indicator and connecting the indicator to the drive pin, wherein the indicator provides at least one indication upon an actuation of the clip applier during use.

23. The method according to claim 19, further comprising the steps of providing a second housing half, and securing the second housing half to the first housing half.

24. A method of assembling any one of a plurality of various scaled clip appliers, wherein the respective clip appliers are scaled to deliver relatively scaled surgical clips, the method comprising the steps of:

providing a selected housing for a handle assembly;

connecting a channel assembly to the housing, wherein the channel assembly includes a plurality of respectively scaled surgical clips loaded therein; and

connecting a motion multiplier system to a pusher bar of the clip applier, wherein the motion multiplier system varies a stroke of the pusher bar upon a firing of any scaled clip applier to load the respectively scaled surgical clip into jaws of the clip applier.

25. The method according to claim 24, further comprising the step of providing a housing having at least a housing half.

26. The method according to claim 25, further comprising the step of placing a counter assembly in the housing half of the housing.

27. The method according to claim 25, further comprising the step of placing a pawl and a pawl biasing member in the housing half of the housing, wherein the pawl and the pawl biasing member are in operative association with one another.

28. The method according to claim 25, further comprising the step of placing a motion reversing mechanism in the housing half of the housing, wherein the motion reversing mechanism is connectable to a drive channel.

29. The method according to claim 27, further comprising the step of placing a rack member in the housing half of the housing such that the rack member is capable of axial translation relative to the housing, wherein a set of teeth of the rack member is in operative association with the pawl.

30. The method according to claim 24, further comprising the step of assembling the channel assembly, wherein the step of assembling the channel assembly includes the steps of:

providing a lower channel;

placing a drive channel in the lower channel, wherein the drive channel is capable of axial reciprocation in the lower channel;

placing particularly sized jaws in the drive channel, wherein the jaws are approximated upon a distal advancement of the drive channel relative to the jaws; and

placing a particularly sized wedge plate in the lower channel and overlaying at least a portion of the drive channel and the jaws, wherein the wedge plate is capable of axial reciprocation in the lower channel, and wherein the wedge plate has a distal position in which a distal end of the wedge plate is interposed in the jaws.

31. The method according to claim 30, wherein the step of connecting of the channel assembly to the housing includes inserting a drive pin through the drive channel such that the drive pin is slidably disposed in an axial slot in the housing, wherein axial translation of the drive pin results in axial translation of the drive channel.

32. The method according to claim 31, further comprising the steps of:

placing a pawl and a pawl biasing member in the housing, wherein the pawl and the pawl biasing member are in operative association with one another;

placing a rack member in the housing such that the rack member is capable of axial translation relative to the housing, wherein a set of teeth of the rack member is in operative association with the pawl; and

placing the drive pin through the rack member, wherein axial translation of the drive pin results in axial translation of the rack member.

33. The method according to claim 32, further comprising the step of connecting the drive channel to a motion reversing mechanism supported in the housing.

34. The method according to claim 32, further comprising the steps of providing a biasing member, and interconnecting the drive channel and the housing.

35. The method according to claim 33, further comprising the step of providing a motion multiplier system including an accelerator rack slidably positioned within the housing, and a bell crank gear pivotally connected to housing.

36. The method according to claim 32, further comprising providing at least one handle and connecting link arms to each of the at least one handle and to the drive pin.

37. The method according to claim 32, further comprising the steps of:

providing a particularly sized clip carrying channel, a particularly sized stack of clips and a particularly sized clip follower;

loading the stack of clips into the clip carrying channel; and

inserting the clip follower in the clip carrying channel at a location proximal of the stack of clips, wherein the clip follower and the clip carrying channel are configured such that the clip follower engages the clip carrying channel in a manner so as to enable only distal advancement of the clip follower relative to the clip carrying channel.

38. The method according to claim 37, further comprising the step of placing the clip carrying channel in the channel assembly.

39. The method according to claim 37, further comprising the step of providing a motion multiplier system including an accelerator rack slidably positioned within the housing, and a bell crank gear pivotally connected to the half.

40. The method according to claim 39, further comprising the steps of providing at least one handle, and connecting a link arm to each of the at least one handles and to the drive pin.

41. The method according to claim 40, wherein the link arms interconnect each handle to the drive channel.

42. The method according to claim 39, further comprising the steps of providing a pusher bar, and reciprocally placing the pusher bar at least partially over the clip carrying channel and the drive channel.

43. The method according to claim 42, further comprising the steps of providing a lockout, and placing the lockout near a distal end of the channel assembly, wherein the lockout is engaged by the clip follower upon a firing of a final clip to actuate the lockout and block movement of the pusher bar.

44. The method according to claim 43, further comprising the step of pivotally connecting the pusher bar to the bell crank gear.

45. The method according to claim 31, further comprising the step of providing at least one of an audible and a tactile indicator and connecting the indicator to the drive pin, wherein the indicator provides at least one indication upon an actuation of the clip applier during use.

46. A method of firing any one of a relatively small and large scaled surgical clip applier, wherein the relative clip appliers are scaled to deliver relatively small and large surgical clips, the method comprising the steps of:

providing a relatively small and large scaled surgical clip applier, each of the relatively small and large scaled surgical clip appliers includes;

a drive channel defining a stroke having a length substantially equal for each of the relatively small and large scaled surgical clip appliers;

a pusher bar defining a stroke having a particular length for each respective relatively small and large scaled surgical clip applier;

a motion multiplier system interconnecting the drive channel and the pusher bar, wherein the motion multiplier transmits a motion of the drive channel to a motion of the pusher bar;

a wedge plate defining a stroke having a particular length for each respective relatively small and large scaled surgical clip applier; and

a motion reversing mechanism interconnecting the drive channel and the wedge plate, wherein the reversing mechanism transmits a motion of the drive channel to a motion of the wedge plate; and

actuating any one of the relatively small and large scaled surgical clip appliers to axially displace the drive channel in a first direction by an amount substantially equal to the length of the stroke thereof;

wherein the displacement of the drive channel in the first direction actuates the motion multiplier system to actuate the pusher bar in a first direction by an amount substantially equal to the particular length of the stroke thereof for the respective relatively small and large scaled surgical clip applier; and

wherein the displacement of the drive channel in the first direction actuates the motion reversing mechanism to actuate the wedge plate, in a direction opposite the first direction of drive channel, by an amount substantially equal to the particular length of the stroke thereof for the respective relatively small and large scaled surgical clip applier.

47. In a family of relatively small and large scaled surgical clip appliers, wherein each of the clip appliers includes a drive channel defining a stroke length, a pusher bar defining a corresponding stroke length and a wedge plate defining a corresponding stroke length, the improvement comprising:

a motion multiplier system interconnecting the drive channel and the pusher bar, wherein the motion multiplier transmits a motion of the drive channel to a motion of the pusher bar, wherein the displacement of the drive channel in the first direction actuates the motion multiplier system to actuate the pusher bar in a first direction by an amount substantially equal to the particular length of the stroke thereof for the respective relatively small and large scaled surgical clip applier; and

a motion reversing mechanism interconnecting the drive channel and the wedge plate, wherein the reversing mechanism transmits a motion of the drive channel to a motion of the wedge plate, wherein the displacement of the drive channel in the first direction actuates the motion reversing mechanism to actuate the wedge plate, in a direction opposite the first direction of drive channel, by an amount substantially equal to the particular length of the stroke thereof for the respective relatively small and large scaled surgical clip applier.