Multiple-Firing Crimp Device and Methods for Using and Manufacturing Same

• US 20150142021A1
• Filed: 11/17/2014
• Published: 05/21/2015
• Est. Priority Date: 11/18/2013
• Status: Active Grant

• Current Assignee: Edwards Lifesciences AG (Edwards Lifesciences Corporation)
• Original Assignee: Syntheon Cardiology, LLC
• Inventors: Smith, Kevin W., Mendez, Max Pierre, Palmer, Matthew A., Bales, Thomas O. Jr., Deville, Derek Dee, Cartledge, Richard, Kline, Korey, Rivera, Carlos, Nunez, George, McBrayer, M. Sean
• Granted Patent: US 10,016,193 B2
• Time in Patent Office: Days
• US Class Current: 606/148
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/0053 Loading magazines or sutures into applying tools
• CPC Class Codes: A61B 2017/00907 for light
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0438 slotted, i.e. having a longitudinal slot for enhancing their elasticity
• CPC Class Codes: A61B 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0474 Knot pushers
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/309 using white LEDs

Abstract

A multiple-firing crimp device comprises crimps, a shaft, a crimp movement assembly, and a snare. Each crimp has an internal hollow. The shaft has a distal crimping location, an exterior surface, and an interior with the clips stacked therein, the crimps moving therein along a longitudinal axis. The shaft defines a lateral opening proximal to the crimping location and communicates the interior to the environment outside the exterior surface. The crimp movement assembly within the shaft delivers the first crimp to the distal crimping location by moving the first crimp longitudinally from a first proximal position into the distal crimping location and returning to a second proximal position without the first crimp. The snare pulls at least one cord from distal of the first crimp through the first crimp and through a portion of the shaft and out the side of the shaft through the lateral opening.

Claims

1. A multiple-firing crimp device, comprising:

a plurality of crimps each having an internal hollow;

a hollow shaft;

having;

a distal crimping location;

an exterior surface; and

an interior in which is stacked the plurality of crimps to define a first crimp, the crimps moving therein along a longitudinal axis; and

defining a lateral opening proximal to the crimping location and communicating between the interior and the environment outside the exterior surface;

a crimp movement assembly within the interior of the shaft and delivering the first crimp to the distal crimping location by moving the first crimp longitudinally from a first proximal position into the distal crimping location and returning to a second proximal position without the first crimp; and

a snare that pulls at least one cord from distal of the first crimp through the first crimp and through a portion of the shaft and out the side of the shaft through the lateral opening.

2. The crimp device according to claim 1, which further comprises a snare movement assembly:

having the snare, the snare shaped;

to pass through the internal hollow of the first crimp;

to pass out of the interior of the shaft distally past the distal crimping location; and

to secure the at least one cord temporarily;

moving the snare;

to pull a portion of the at least one cord secured in the snare proximally through the first crimp; and

to present at least some of the portion of the at least one cord out through the opening for access by a user.

3. The crimp device according to claim 1, which further comprises:

a crimping assembly having a crimp control device that, when actuated, crimps the first crimp within the distal crimping location; and

a cutting assembly having a cutting control device that, when actuated, cuts the portion of the at least one cord adjacent the first crimp.

4. The device according to claim 1, wherein the at least one cord is a surgical suture.

5. The device according to claim 2, wherein:

the portion of the at least one cord secured in the snare is two free ends of a surgical suture, the end opposing the two free ends being a loop of the surgical suture secured in a surgical site;

the portion of the at least one cord secured in the snare and being pulled proximally through the first crimp is the two free ends such that, at a given time, four lengths of the surgical suture are being pulled through the first crimp; and

the at least some of the portion of the at least one cord pulled out through the opening for access by a user is the two free ends of the surgical suture.

6. The device according to claim 1, wherein the first crimp is a distal-most one of the crimps.

7. The device according to claim 1, wherein the internal hollow is one of:

a lumen; and

a slot.

8. The device according to claim 1, wherein the crimps are crimp sleeves having a hollow through bore, at least a portion of the bore being internally threaded.

9. The device according to claim 1, wherein the first proximal position is different from the second proximal position.

10. The device according to claim 1, wherein the first proximal position is the same as the second proximal position.

11. The device according to claim 1, wherein, when the crimp movement assembly returns to the second proximal position, the lateral opening is exposed to the environment outside the exterior surface.

12. The device according to claim 1, wherein, while or after the crimp movement assembly is in the process of returning to the second proximal position without the first crimp, the crimp movement assembly moves a previously second of the crimps into a crimp loading position to become a new first crimp.

13. The device according to claim 1, wherein:

the shaft has a distal cam driver; and

the crimp movement assembly comprises an exterior-threaded carriage;

movably disposed inside the shaft along the longitudinal axis towards and away from the distal cam driver; and

having a carriage distal end at which is disposed the first crimp.

14. The device according to claim 13, wherein each of the crimps has an interior thread and is threaded on the exterior threads of the carriage at a spacing from one another such that rotation of the carriage in a direction selectively carries a distal-most one of the crimps off the carriage distal end.

15. The device according to claim 14, which further comprises:

a hammer movably disposed inside the shaft adjacent the distal cam driver and having a cam follower operatively connected to the distal cam driver to move the hammer towards and away from the longitudinal axis of the shaft when the shaft is moved along the longitudinal axis;

an anvil at least partially disposed inside the shaft adjacent the distal cam driver and opposite the hammer; and

wherein the distal crimping location is between the hammer and the anvil.

16. The device according to claim 15, wherein the snare is shaped to extend through the interior of the carriage and pass through the internal hollow of the first crimp.

17. The crimp device according to claim 1, wherein the first crimp has a proximal end and which further comprises a user-movable snare movement assembly having:

the snare;

a hollow snare guide in which is disposed the snare, the snare guide being disposed external to the shaft and, when moved distally, moving through the lateral opening and up to the proximal end of the first crimp; and

a snare extension device moving the snare distally through the snare guide, through the first crimp, and past the distal crimping location of the shaft to secure the at least one cord temporarily and pull at least a portion of the at least one cord through the first crimp and out the lateral opening.

18. The crimp device according to claim 1, wherein the first crimp has a proximal end and which further comprises movable snare movement assembly having:

a cord lifter within the shaft, adjacent the snare, and shaped to lift at least one of the snare and the at least one cord; and

a snare extension device moving the snare distally along the cord lifter, through the first crimp, and past the distal crimping location of the shaft to secure the at least one cord temporarily and pull at least a portion of the at least one cord through the first crimp and past the cord lifter, the cord lifter, when actuated, presenting at least some of the portion of the at least one cord out the lateral opening for access by a user.

19. The crimp device according to claim 15, which further comprises a cutting assembly having:

a cutter within the shaft extending parallel to the longitudinal axis and shaped to cut the at least one cord adjacent the first crimp; and

a cutter control device connecting the cutter to the shaft to have the cutter move and cut the at least one cord adjacent the first crimp when the shaft is at a distal position with respect to one of the hammer and the anvil.

20. A multiple-firing crimp device, comprising:

a plurality of crimps each having an internal hollow;

a hollow shaft;

having;

a distal crimping location;

an exterior surface; and

an interior in which is stacked the plurality of crimps to define a first crimp, the crimps moving therein along a longitudinal axis; and

defining a lateral opening proximal to the crimping location and communicating between the interior and the environment outside the exterior surface;

a crimp movement assembly within the interior of the shaft and delivering the first crimp to the distal crimping location by moving the first crimp longitudinally from a first proximal position into the distal crimping location and returning to a second proximal position without the first crimp;

a snare that pulls at least one cord from distal of the first crimp through the first crimp and through a portion of the shaft and out the side of the shaft through the lateral opening; and

a snare movement assembly;

having the snare, the snare being shaped;

to pass through the internal hollow of the first crimp;

to pass out of the interior of the shaft distally past the distal crimping location; and

to secure the at least one cord temporarily; and

moving the snare;

to pull a portion of the at least one cord secured in the snare proximally through the first crimp; and

to present at least some of the portion of the at least one cord out through the opening for access by a user.