Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures

• US 5,100,420 A
• Filed: 07/18/1989
• Issued: 03/31/1992
• Est. Priority Date: 07/18/1989
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Bolanos, Henry, Ratcliff, Keith, Young, Wayne P., McGarry, Richard A., Green, David T., Heaton, Lisa W.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Jackson, Gary
• Application Number:
  US07/381,265
• Time in Patent Office: 987 Days
• Field of Search: 606/143, 606/142, 604/93, 128/4
• US Class Current: 606/143
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: Y10S 227/901 Surgical clip appliers

Abstract

An apparatus for applying surgical clips through an endoscopic tube includes an endoscopic portion housing a jaw blade, a pusher bar for feeding clips one at a time to the jaws, a channel bar for camming the jaw blades into closed position, and an array of surgical clips. The body of the apparatus comprises a frame housing an actuating mechanism and a transmission mechanism for transferrring movement to the pusher bar and channel. The endoscopic portion is rotatable relative to the frame. In one embodiment the apparatus is single disposable unit. In an alternative embodiment the endoscopic portion is detachable and disposable whereas the non-endoscopic body portion is reusable.

Claims

1. In combination:

a) a trocar having a cannula, and valve means for sealing said cannula, said cannula adapted for entry into a body cavity;

b) an endoscopic clip applier having;

i) a frame;

ii) an endoscopic portion defining a longitudinal axis and extending distally from said frame, said endoscopic portion being insertable into said cannula through said valve means in sealing engagement therewith, said endoscopic portion further including a plurality of surgical clips disposed in an array and clip closing means for sequentially closing said surgical clips; and

iii) seal means associated and adapted to cooperate with at least one of said endoscopic portion and said frame to obstruct passage of gaseous media from the body cavity.

2. An apparatus for applying surgical clips to body tissue within a body cavity, which comprises:

a) frame means;

b) endoscopic means connected to said frame means of generally elongated configuration and extending distally therefrom, said endoscopic means configured and adapted for insertion into endoscopic tubular means and including;

i) means for storing a plurality of surgical clips in an array in said endoscopic means;

ii) clip closing means including jaw means positioned at the distal end portion of said endoscopic means and arranged for individual reception of a surgical clip;

iii) means for selectively advancing said clips individually from said clip storing means into said jaw means for positioning adjacent the body tissue to be clipped;

iv) means for at least partially closing said jaw means at least sufficient to cause a clip positioned therein to grip the tissue while maintaining said clip in position adjacent the tissue; and

c) seal means associated and adapted to cooperate with at least one of said endoscopic means and said frame means to obstruct passage of gaseous media from the body cavity.

3. An apparatus for applying surgical clips to body tissue which comprises:

a) a frame configured and dimensioned to be gripped by hand;

b) an elongated endoscopic section connected at the proximal end thereof to said frame and extending distally therefrom, said endoscopic section being configured and adapted for insertion into endoscopic tubular means and including;

i) means for storing a plurality of surgical clips in a generally aligned array facing the distal portion thereof;

ii) jaw means positioned at the distal end thereof and adapted for sequential individual reception of said clips;

iii) means for advancing said clips distally from said clip storing means so as to be positioned between said jaw means for positioning adjacent the body tissue to be clipped;

iv) means for selectively at least partially closing said jaw means about each said clip after the clip is advanced therebetween, while simultaneously repositioning said clip advancing means for distal movement of the next clip; and

c) seal means positioned within at least one of said frame and said endoscopic section to obstruct passage of gaseous media from the body cavity.

4. In combination:

a) a cannula including valve means for sealing said cannula and adapted for insertion into a body cavity;

b) an endoscopic clip applier having;

i) a frame; and

ii) an endoscopic portion defining a longitudinal axis, and extending distally from said frame, said endoscopic portion being insertable into said cannula through said valve means in sealing engagement therewith so as to communicate with the body cavity, said endoscopic portion further including a plurality of surgical clips disposed in an array and clip closing means for sequentially closing said surgical clips; and

c) seal means adapted to obstruct communication of gaseous media from the body cavity through said endoscopic portion.

5. In combination:

a) a cannula adapted for insertion into a body cavity, said cannula including valve means for sealing said cannula;

b) an endoscopic clip applier having;

i) a frame;

ii) an endoscopic portion defining a longitudinal axis, and extending distally from said frame, said endoscopic portion being configured and adapted for insertion into said cannula through said valve means in sealing engagement therewith, said endoscopic portion further including a plurality of surgical clips in an array, and means for disposing at least one of said surgical clips at the end of said endoscopic portion distal to said frame, and clip closing means for closing said surgical clip; and

c) seal means positioned and adapted to obstruct passage of gaseous media from the body cavity.

6. In combination:

a) a trocar having a cannula, and valve means for sealing said cannula, said cannula adapted for insertion into a body cavity;

b) an endoscopic clip applier having;

i) a frame;

ii) an endoscopic portion defining a longitudinal axis, and extending distally from said frame, said endoscopic portion being insertable into said cannula through said valve means in sealing engagement therewith, said endoscopic portion further including a plurality of surgical clips, and means for disposing at least one of said surgical clips at the end of said endoscopic portion distal to said frame, and clip closing means for closing said surgical clip; and

c) seal means to obstruct passage of gaseous media from the body cavity.

7. A method for endoscopically applying surgical clips to body tissue within a body cavity with an apparatus having an elongated endoscopic section connected at the proximal end thereof to a frame configured and dimensioned to be gripped by hand, said endoscopic section adapted for insertion into an endoscopic cannula in gaseous sealing relation therewith and having jaw means positioned at the distal end thereof and adapted for individual reception of a surgical clip, and pusher means for advancing a surgical clip distally into said jaw means, comprising the steps of:

a) storing a plurality of surgical clips in clip storing means in said elongated endoscopic section;

b) gripping said frame in the palm of the hand;

c) selectively advancing said surgical clips individually from said clip storing means into said jaw means;

d) positioning said jaw means and the clip positioned therein adjacent the body tissue to be clipped;

e) at least partially closing said jaw means at least sufficient to cause the clip positioned therebetween to grip the tissue while maintaining the clip in position relative to the tissue;

f) positioning said pusher means to a position for advancing the next surgical clip to said jaw means; and

g) obstructing passage of gaseous media from the body cavity through said endoscopic means.

8. An apparatus for applying surgical clips to body tissue, which comprises:

a) frame means; and

b) endoscopic means defining a longitudinal axis and extending distally from said frame means, said endoscopic means comprising;

i) means for storing a plurality of surgical clips;

ii) pusher means for individually advancing the surgical clips from said storing means to jaw means;

iii) means including camming means for at least partially closing said jaw means at least sufficient to cause a clip positioned therein to grip the body tissue while maintaining said clip in position adjacent the tissue; and

iv) gaseous seal means comprising a sealing block defining an opening having an interior surface in close contiguity with said pusher means and said camming means.

9. An apparatus for applying surgical clips to body tissue, which comprises:

a) frame means; and

b) endoscopic means defining a longitudinal axis and extending distally from said frame means, said endoscopic means comprising;

i) means for storing a plurality of surgical clips;

ii) pusher means for individually advancing the surgical clips from said storing means to jaw means;

iii) means for at least partially closing said jaw means at least sufficient to cause a clip positioned therein to grip the tissue while maintaining the clip in position adjacent the tissue; and

iv) gaseous seal means comprising a sealing block defining an opening having an interior surface in close contiguity with said pusher means and said means for at least partially closing said jaw means.

10. An apparatus for applying surgical clips to body tissue within a body cavity, which comprises:

a) frame means;

b) elongated endoscopic means extending distally from said frame means, and configured and adapted for insertion into endoscopic tubular means positionable within the body cavity;

c) means for storing a plurality of surgical clips in an array in said endoscopic means;

d) clip closure means positioned at the distal end of said endoscopic means and adapted for individual reception of surgical clips;

e) means for individually advancing a surgical clip from said clip storing means to said clip closure means;

f) means for at least partially closing said clip closure means to at least partially close a clip positioned therein; and

g) seal means associated and adapted to cooperate with at least one of said endoscopic means and said frame means;

wherein communication of gaseous media from the body cavity through said endoscopic means is obstructed.

11. An apparatus for applying surgical clips to body tissue within a body cavity, which comprises:

a) frame means;

b) elongated endoscopic means extending distally from said frame means, and configured and adapted for insertion into endoscopic tubular means for communicating with the body cavity;

c) means for storing a plurality of surgical clips in an array in said endoscopic means;

d) clip closure means including jaw means positioned at the distal end of said endoscopic means and adapted for individual reception of surgical clips;

e) means for individually advancing a surgical clip from said clip storing means to said clip closure means;

f) camming means for at least partially closing said jaw means to at least partially close a clip positioned therein; and

g) seal means associated and adapted to cooperate with at least one of said endoscopic means and said frame means, said seal means defining an opening having an interior surface in close contiguity with said clip advancing means and said clip closure means;

wherein communication of gaseous media from the body cavity through said endoscopic means is obstructed.

12. An apparatus for applying surgical clips to body tissue, which comprises:

a) frame means configured for gripping with the palm of the user'"'"'s hand;

b) elongated endoscopic means extending distally from said frame means, and configured and adapted for insertion into endoscopic tubular means;

c) means for storing a plurality of surgical clips in an array in said endoscopic means;

d) clip closure means positioned at the distal end of said endoscopic means and adapted for individual reception of surgical clips;

e) means for individually advancing a surgical clip from said clip storing means to said clip closure means;

f) means for at least partially closing said clip closure means to at least partially close a clip positioned therein;

g) means connected to said frame means and configured to be gripped by the fingers of the user'"'"'s hand;

h) means associated with said finger gripping means for at least partially closing said clip closure means to at least partially close a clip positioned therein when said finger gripping means is advanced toward said frame means; and

i) seal means associated with at least one of said endoscopic means and said frame means to obstruct passage of gaseous medium.

13. The apparatus of claim 12 wherein said finger gripping means is pivotally connected to said frame means.

14. The apparatus of claim 13 wherein said finger gripping means is adapted to effect movement of first transmission means when said finger gripping means is advanced toward said frame means, said first transmission means adapted to effect at least partial closure of said clip closure means.

15. The apparatus of claim 14 wherein said seal means is positioned within said endoscopic means and defines an opening having an inner surface portion in close contiguity with said means associated with said finger gripping means for at least partially closing said clip closure means and said clip advancing means.

16. The apparatus of claim 14 wherein said seal means is positioned within said frame means.