Surgical clip applier

• US 20130165951A1
• Filed: 03/06/2012
• Published: 06/27/2013
• Est. Priority Date: 12/21/2011
• Status: Active Grant

• Current Assignee: Joseph W. Blake III
• Original Assignee: Joseph W. Blake III
• Inventors: Blake, Joseph W. III
• Granted Patent: US 9,931,123 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 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603

Abstract

A surgical clip applier with scissor-type operating handle and clip applying cartridge in which handle has housing of upper and lower shells that defines socket for receiving cartridge, includes a lever arm actuated linear translator for linear reciprocating movement delivered to the cartridge, and an anti-backup mechanism for full forward and release strokes of the handle, and in which cartridge includes jaws for applying clips, safety means to ensure opening of jaws for each cycle, a puller bar for receiving motion from handle and timing of jaw operation to clip feed, a magazine for feeding clips to jaws in proper sequence, and a lockout mechanism to render applier inoperative after using last clip.

Claims

1. An operating handle for providing linear reciprocating movement to an instrument cartridge having means for receiving such movement, the handle comprising a housing, the housing defining a socket for receiving and holding the cartridge in the handle, a linear actuator mounted within the housing for linear reciprocation motion of fixed excursion, the linear actuator connected at one end to said cartridge whereby said motion is transmitted to the instrument, a main spring for urging the linear actuator to a normal position in which the handle is in a release operating condition, first and second lever arms, each lever arm pivotally mounted at one end to a pivot post, each lever arm at its other end having means for manual operation of the handle, each lever arm having a pivot intermediate its ends, a pair of connecting links with each link having a pivot aperture at each of its ends, each connecting link connected by one aperture to a lever arm pivot and by its other aperture to the other end of the linear actuator, the lever arms and the connecting links urged by the main spring to said normal position whereby manually squeezing the lever arms draws the linear actuator through linear motion of fixed excursion against main spring force, and by release of the lever arms spring force urges the linear actuator in return motion of fixed excursion to handle normal position.

2. An operating handle for providing linear reciprocating movement to an instrument cartridge with a cartridge cap having locking lugs and cap ribs and the cartridge further having means for receiving such movement, the handle comprising a housing of shell members joined along a median plane, the shell members together defining a socket for receiving and holding the cartridge in the handle, a linear actuator mounted within the housing for linear reciprocation motion of fixed excursion, the linear actuator positioned adjacent the socket, the linear actuator connected at one end to said cartridge positioned by the socket whereby said motion is transmitted to the instrument, a handle main spring for urging the linear actuator to a normal position in which the handle is in a release operating condition, first and second lever arms, each lever arm pivotally mounted at one end to a pivot post formed on the housing, each lever arm at its other end having means for manual operation of the handle, each lever arm having a pivot intermediate its ends, a pair of connecting links with each link having a pivot aperture at each of its ends, each connecting link connected by one aperture to a lever arm pivot and by its other aperture to the other end of the linear actuator, the lever arms and the connecting links urged by the main spring through the linear actuator to said normal position whereby manually squeezing the lever arms draws the linear actuator through linear motion of fixed excursion against main spring force, and by release of the lever arms spring force urges the linear actuator in return motion of fixed excursion to handle normal position.

3. An operating handle as defined in claim 2 in which the linear actuator has a body bar with spaced slots and with a coarsened body bar surface between the slots, a transverse compartment formed in the housing, an anti-backup spring having spring tabs positioned in the transverse compartment and the linear actuator body passing through the anti-backup spring with the spring tabs engaging body bar slots and coarsened surface as the linear actuator undergoes linear reciprocation motion of fixed excursion so that operating handle action is limited to full forward and release strokes.

4. An operating handle as defined in claim 3 in which the body bar has a links post defined by recesses in the body bar, and in which the links by their other apertures are connected to the links post.

5. An operating handle as defined in claim 3 in which the shell members define a guide channel for the linear actuator passing through the anti-backup spring.

6. An operating handle as defined in claim 2 in which the shell members define a transverse slot which receives cartridge lugs for holding cartridge to handle.

7. An operating handle as defined in claim 2 in which the shell members define a linear actuator box for positioning linear actuator and main handle spring.

8. An operating handle as defined in claim 2 in which the shell members define pivot posts for mounting handle lever arms.

9. An operating handle as defined in claim 2 in which the shell members define a cartridge socket opening defined by a front wall divided into an annular shoulder and an annular front face, the front wall having exterior notches registering with cartridge cap ribs and entry openings registering with cartridge cap lugs for receiving the cartridge by its end cap and for retaining the cartridge after rotation of the cartridge in the socket.

10. An operating handle as defined in claim 2 in which the lever arms are identical and have a closed loop for thumb and forefinger operation, each lever arm defined by a spine extending from loop to pivot end and by parallel webs extending from the spine and defining a recess opening from web inner margins, and the lever arm pivot intermediate its ends being defined by a pivot pin within each recess for securing one end of each handle connecting link.

11. An operating handle for providing anti-backup linear reciprocating motion along a path of fixed excursion to a clip applier cartridge having a puller bar, the handle comprising a housing, a pair of manually operated lever arms and connecting links mounted on the housing, the housing having an interior socket for receiving the cartridge with puller bar positioned to receive the motion, a linear actuator positioned within the housing, the linear actuator connected to one end of the links for receiving the motion from the lever arms and for transmitting the motion to the puller bar, the linear actuator having a body bar portion with recesses spaced apart a distance the same as the fixed excursion, a spring for urging the linear actuator along said path to a normal handle position, an anti-backup spring having spring tabs in confronting relation across a gap in the spring, the anti-backup spring positioned within the housing with the gap in the path so that the linear actuator passes through the gap while travelling the fixed excursion of said motion, and the spring tabs engaging the body bar portion of the linear actuator to ensure that the linear actuator completes movement in one direction before reciprocating along the path.

12. An operating handle for providing linear reciprocating movement to a surgical clip applier, the handle comprising a housing for mounting operating components of the clip applier, the components including a clip applying cartridge with a puller bar, and scissor-type handle components including a pair of lever arms, a pair of connecting links, a linear actuator, a handle main spring, and an anti-backup spring, the housing defined by upper and lower shells being joined to each other along a median plane and oriented on a central axis extending from front to rear of the housing, a socket, transverse slot, a cage, a linear actuator box, a transverse box, and guide channel all lying in sequence along the axis and defined by confronting portions of upper and lower shells, wherein the socket and transverse slot receive and position the clip applying cartridge, the cage positions cartridge puller bar in engagement with linear actuator for transfer of linear motion, the linear actuator box positions linear actuator adjacent the cage with handle main spring coiled about linear translator, the transverse box positions anti-backup spring across the path of movement of the linear actuator, the guide channel receives and guides the linear actuator passing through the anti-backup spring, pivot posts defined by upper and lower shells on opposite sides of central axis for receiving and holding lever arms, side openings between the shells for connecting links to extend between pivot points of lever arms and of linear actuator, and means for permanently securing the upper and lower shells together to define the housing.

13. An operating handle for providing linear reciprocating movement to a surgical clip applier having a scissor-type handle and removable clip applying cartridge having a puller bar and a cartridge end cap comprising cartridge end cap and handle socket for receiving cartridge end cap, the cartridge end cap having a hollow cylindrical body open at one end to receive a cartridge sleeve and closed by an wall at its other end, the end wall having a diametrical slit for passing the cartridge puller bar, locking lugs extending radially from diametrically opposed points on the body, a conical shroud affixed to end cap open end and extending over a portion of the body to a shroud open end, the shroud open end having ribs on inner surface aligned with locking lugs and aligned with end wall slit;

the handle socket formed by upper and lower shell members having a central axis and joined along a median plane, the socket having an axial opening through the front wall of the housing, the front wall being recessed to receive the shroud open end, the front wall having first and second sets of notches for registry with shroud ribs, the front wall having entry openings for receiving end cap locking lugs, the entry openings aligned with one of the first and second set of notches, locking lug channels formed in upper and lower shell members the channels extending axially into the housing, a transverse slot formed in upper and lower shell members defining the inner end point of locking lug channels, the transverse slot adapted to receive locking lugs for securing end cap to handle socket, whereby end cap is inserted into socket with locking lugs passing through entry openings and through the locking lug channels coming to rest in the transverse slot and with shroud ribs registering with one set of notches, and further wherein the end cap is rotated to lodge locking lugs within transverse slot and to register shroud ribs with the other set of notches so as to secure end cap to handle socket against both movement along or rotation about the central axis.

14. An operating handle for providing linear reciprocating movement to a surgical clip applier having a scissor-type handle and removable clip applying cartridge comprising a sleeve encasing a chassis and a cover and together defining a datum for cartridge operating components, the chassis defining a channel, the channel having a front end opening for clip applier jaws, a cam bar guide post, a jaw post, a lockout recess, a toggle cam surface, and a rear end opening for a puller bar, a jaws cam bar defined by an elongate strip body having jaw tangs for closing clip applier jaws and having first and second oblong slots, the cam bar placed in the chassis channel with first slot mounted over the guide post and the second slot mounted over the jaw post, the cam bar further having a lock out slot, recessed side edges, and an interior sinuous toggle surface, clip applying jaws mounted over the jaws post with jaws extending through the front of the chassis, the jaws having cam surfaces engaged by jaw tangs, a safety toggle having a sinuous toggle surface meshed with cam bar toggle surface, a puller bar in the form of an elongate plate positioned in the chassis overlying the cam bar, the puller bar having narrow and wide lockout slots and having depending tangs for engaging cam bar recessed edges for moving the cam bar for operating the jaws, the puller bar further having a toggle tang for actuating the safety toggle and having means for delivering linear motion to a clip magazine, and a T-end for receiving linear motion for cartridge operation, a magazine floor plate mounted along the length of the cartridge cover and overlying the jaws and the puller bar, the floor plate having means through which the puller bar delivers linear motion to a clip magazine, the floor plate further having a lock out slot, a clip capture spring, and front end ramps for guiding a clip into the jaws, a clip magazine overlying the floor plate and defining a clip magazine chamber, a clip stack and a clip advancing ladder in the clip magazine, the clip magazine having means passing by the floor plate and engaging the puller bar means for delivering linear motion for magazine operation, the magazine having a lockout slot, at least one detent spring for engaging the clip advancing ladder, a claw back spring for the clip stack, and a clip arm and clip head projecting from the front end of the magazine for engaging a clip and pushing it into the jaws, a cover detent spring mounted on the cover and adapted to pass through the magazine lockout slot for restraining movement of the ladder, the cover secured to the chassis for enclosing cartridge operating components, the cover having interior guide surface for aiding movement of clips into the jaws, and a lockout block positioned in the chassis recess and adapted pass through cam bar, puller bar, floor plate, and magazine lockout slots to arrest operation of cartridge components after all clips in clip stack have been used.

15. A surgical clip applier having operating components for operating clip applier jaws comprising a chassis defining a channel, the channel having a front for clip applier jaws, a jaw post, a toggle cam surface, and a rear end passage for a puller bar, a jaws cam bar defined by an elongate strip body having jaw tangs for closing clip applier jaws and having an oblong slot, the cam bar placed in the channel with slot mounted over jaw post, the cam bar further having recessed side edges, and an sinuous toggle surface, a safety toggle having a sinuous toggle surface positioned in the chassis toggle cam surface and meshed with cam bar toggle surface, clip applying jaws having cam surfaces, the jaws mounted on the jaw post over the cam bar with jaw tangs positioned for engaging cam surfaces, a puller bar in the form of an elongate plate positioned in the chassis overlying a portion of the cam bar, the puller bar having depending tangs for engaging cam bar recessed edges for moving the cam bar for operating the jaws, the puller bar further having a toggle tang for actuating the safety toggle, and a T-end for receiving linear motion for cartridge operation, whereby the puller bar delivers linear motion to the cam bar for closing and opening the jaws, and actuating the safety toggle to ensure the cam bar tangs disengage jaw cam surfaces when jaws are to be opened.

16. A surgical clip applier having operating components for holding and moving clips to be applied in surgery comprising clip applying jaws and a puller bar, a cartridge cover, a magazine floor plate mounted along the length of the cartridge cover and overlying the jaws and the puller bar, the floor plate having means through which the puller bar delivers linear motion to the clip magazine, the floor plate further having a lockout slot, a clip capture spring, and front end ramps for guiding clips into the jaws, a clip magazine overlying the floor plate and defining a magazine chamber, a clip stack and a clip advancing ladder in the chamber, the clip magazine having means bypassing the floor plate and engaging the puller bar to receive linear motion for magazine operation, at least one detent spring for engaging the clip advancing ladder, a claw back spring for the clip stack, and a clip arm and clip head projecting from the front end of the magazine for engaging a clip and pushing it into the jaws, a cover detent spring mounted on the cover and adapted to pass through the detent slot for restraining movement of the ladder, the cover having interior guide surface for aiding movement of clips into the jaws, whereby the puller bar delivers linear reciprocating motion to the clip magazine in a pull direction to apply a clip in surgery, capture a lead clip in the stack, claw back remaining clips in the stack, restrain movement of the ladder during claw back, move clip head into engagement with first clip in stack of clawed back clips, and on release stroke push a clip into the jaws, release restraint of ladder, and advance ensemble of magazine, clip stack and ladder.

17. A surgical clip applier having operating components including cam actuated jaws, a clip magazine having a clip stack and a clip advancing ladder for applying clips in surgery, and a lockout mechanism comprising a chassis having a channel with a recess, a spring biased lockout block mounted in the recess, a cam bar for actuating the jaws, a lockout slot in the cam bar, a puller bar for actuating the cam bar, a lockout slot in the puller bar, a floor plate, a lockout slot in the floor plate, the clip magazine adapted for reciprocating motion on the floor plate, the clip magazine having a lockout slot normally covered by clip stack and ladder when the instrument contains at least one clip whereby as the clip magazine lockout slot is uncovered by clip stack and ladder after last clip is applied the lock block moves into all lockout slots to arrest further instrument operation.

18. A surgical clip applier comprising a handle and a cartridge, the handle providing linear reciprocation motion in a cycle of pull and release strokes to the cartridge, the cartridge comprising clip applying jaws with a spring bias to jaw open position, a cam bar for camming the jaws to a closed position and for releasing the jaws to spring open, a clip magazine holding a line of clips, the clip magazine having a clip head for engaging and moving clips one-by-one into the jaws for each motion cycle, the clip magazine having a claw back spring for retracting the line of clips leaving a lead clip to be next moved into the jaws, the cartridge further comprising a puller bar connected to the handle and engaging the clip magazine and cam bar for receiving and delivering the cycle of pull and release strokes to the clip magazine and cam bar, the puller bar on the pull stroke moves the clip magazine to withdraw the clip head from the jaws, moves the claw back spring to retract line of clips and leave lead clip, and after the clip head is withdrawn from the jaws the puller bar further on the pull stroke moves the cam bar to close the jaws to apply a clip in surgery, and the puller bar on the release stroke moves the cam bar to release the jaws so the jaws spring open, and moves magazine clip head to push lead clip into the jaws for application in surgery on next motion cycle of the handle.