ENDOSCOPIC SURGICAL CLIP APPLIER

• US 20150032131A1
• Filed: 10/15/2014
• Published: 01/29/2015
• Est. Priority Date: 08/29/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Sorrentino, Gregory, Whitfield, Kenneth H.
• Granted Patent: US 10,231,735 B2
• Time in Patent Office: Days
• US Class Current: 606/143
• CPC Class Codes: A61B 1/3132 for laparoscopy
• 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 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• 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 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/1222 Packages or dispensers therefor clip magazines incorporated in a clip-applying instrument A61B17/128; for surgical articles A61B50/30
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00221 with wireless transmission of data, e.g. by infrared radiation or radiowaves
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/2902 characterized by features of the actuating rod
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• 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 90/08 : Accessories or related features not otherwise provided for

Abstract

An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Claims

1-25. -25. (canceled)

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

a handle assembly;

a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis, the housing including a fixed boss provided therein;

a plurality of surgical clips disposed within the shaft assembly;

a pair of jaws mounted adjacent a distal end portion of the shaft assembly, the pair of jaws being movable between an open spaced-apart condition and a closed approximated condition; and

a pusher bar reciprocally disposed within the housing of the shaft assembly, wherein the pusher bar includes a first spring clip fixedly supported thereon for connecting to the boss provided in the housing of the shaft assembly, the pusher bar configured to load a distal-most surgical clip into the pair of jaws during distal movement and remain connected to the boss of the housing of the shaft assembly and to remain in a distally advanced position during an approximation of the pair of jaws.

27. The apparatus according to claim 26, wherein the pusher bar includes a pusher formed at a distal end thereof, wherein the pusher has a narrow profile for contacting the loaded surgical clip at a single location.

28. The apparatus according to claim 27, wherein the pusher defines a plane that is oriented substantially orthogonal to a plane of the loaded surgical clip.

29. The apparatus according to claim 26, further comprising a connector plate reciprocally disposed within the shaft assembly, wherein the connector plate is detachably connectable to the pusher bar, wherein during an initial distal movement of the connector plate the pusher bar is distally advanced and during a further distal movement of the connector plate the connector plate is disconnected from the pusher bar.

30. The apparatus according to claim 29, wherein the pusher bar further includes a second spring clip supported thereon for engaging a first feature of the connector plate, wherein the first feature of the connector plate disengages from the second spring clip following the initial distal movement of the connector plate.

31. The apparatus according to claim 29, further comprising an advancer plate reciprocally disposed within the shaft assembly, the advancer plate including at least one fin detachably connectable to a shoulder of the pusher bar, wherein the shoulder of the pusher bar engages the at least one fin of the advancer plate during a distal and a proximal movement of the pusher bar to effectuate one of a distal and proximal movement of the advancer plate.

32. The apparatus according to claim 31, further comprising a clip follower slidably supported in the shaft assembly for urging the plurality of surgical clips in a distal direction, the clip follower including a first tab projecting from a first surface thereof and a second tab projecting from a second surface thereof, wherein the first tab of the clip follower engages the advancer plate as the advancer plate is moved distally such that the clip follower is moved distally to advance the plurality of surgical clips, and wherein the second tab of the clip follower engages a feature as the advancer plate is moved proximally such that the clip follower remains stationary.

33. The apparatus according to claim 32, further comprising a clip carrier disposed in the shaft assembly, wherein the clip carrier is configured to retain the plurality of surgical clips and the clip follower, wherein the second tab of the clip follower engages features formed in the clip carrier.

34. The apparatus according to claim 32, wherein the clip follower is incrementally advanced through the shaft assembly.

35. The apparatus according to claim 32, wherein the clip follower includes a catch extending from a surface thereof, wherein the catch engages the pusher bar following firing of a last surgical clip and prevents movement of the pusher bar in a proximal direction.

36. The apparatus according to claim 35, further comprising a ratchet assembly disposed in the handle assembly, wherein the ratchet assembly is prevented from re-setting when the pusher bar does not return to a proximal position.

37. The apparatus according to claim 26, further comprising a counter supported in the housing assembly, wherein the counter provides an indication when a surgical clip has been fired.

38. A method of applying surgical clips to body tissue, comprising the steps of:

providing an apparatus for application of surgical clips to body tissue including;

a handle assembly;

a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis, the housing including a fixed boss provided therein;

a plurality of surgical clips disposed within the shaft assembly;

a pair of jaws mounted adjacent a distal end portion of the shaft assembly, the pair of jaws being movable between an open spaced-apart condition and a closed approximated condition; and

a pusher bar reciprocally disposed within the housing of the shaft assembly, wherein the pusher bar includes a first spring clip fixedly supported thereon for connecting to the boss provided in the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the pair of jaws during distal movement and remain connected to the boss of the housing of the shaft assembly and in a distally advanced position during an approximation of the pair of jaws;

advancing the pusher bar within the housing of the shaft assembly;

loading a distal-most surgical clip into the pair of jaws;

connecting the first spring clip to the boss provided in the housing of the shaft assembly; and

approximating the pair of jaws while maintaining the connection of the first spring clip to the boss, thereby maintaining the pusher bar in the distally advanced position during approximation of the pair of jaws, wherein approximation of the pair of jaws forms the distal-most surgical clip.

39. The method according to claim 38, wherein loading the distal-most surgical clip further includes contacting a pusher formed at a distal end of the pusher bar with the loaded surgical clip at a single location.

40. The method according to claim 38, wherein advancing the pusher bar further includes:

distally advancing a connector plate that is reciprocally disposed within the shaft assembly, during an initial distal movement of the connector plate; and

disconnecting the connector plate from the pusher bar during a further distal movement of the connector plate.

41. The method according to claim 40, wherein advancing the pusher bar further includes engaging a second spring clip supported thereon with a first feature of the connector plate, and disengaging the first feature of the connector plate from the second spring clip following the initial distal movement of the connector plate.

42. The method according to claim 40, wherein advancing the pusher bar further includes reciprocating an advancer plate reciprocally within the shaft assembly, wherein the advancer plate includes at least one fin detachably connectable to a shoulder of the pusher bar, and engaging the shoulder of the pusher bar with the at least one fin of the advancer plate during a distal and a proximal movement of the pusher bar to effectuate one of a distal or proximal movement of the advancer plate.

43. The method according to claim 42, wherein advancing the pusher bar further includes a clip follower, slidably supported in the shaft assembly, urging the plurality of surgical clips in a distal direction, the clip follower including a first tab projecting from a first surface thereof and a second tab projecting from a second surface thereof, wherein during a moving of the advancer plate distally, the first tab of the clip follower engages the advancer plate such that the clip follower is moved distally to advance the plurality of surgical clips, and wherein during a moving of the advancer plate proximally, the second tab of the clip follower engages a feature as the advancer plate such that the clip follower remains stationary.

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

a handle assembly;

a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis, the housing includes a fixed boss provided therein;

a plurality of surgical clips disposed within the shaft assembly;

a pair of jaws mounted adjacent a distal end portion of the shaft assembly, the pair of jaws being movable between an open spaced-apart condition and a closed approximated condition; and

a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the boss of the housing of the shaft assembly when in a distally advanced position, the pusher bar being configured to progress to the distally advanced position to load a distal-most surgical clip into the pair of jaws during distal movement and remain connected to the boss of the housing of the shaft assembly and in the distally advanced position during an approximation of the pair of jaws.