Endoscopic multiple ligating clip applier with rotating shaft

• US 5,171,247 A
• Filed: 10/17/1991
• Issued: 12/15/1992
• Est. Priority Date: 04/04/1991
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Murray, Michael A., Hughett, J. David
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): SCHMIDT, JEFFREY
• Application Number:
  US07/779,420
• Time in Patent Office: 425 Days
• Field of Search: 606/143, 606/142
• US Class Current: 606/142
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

An endoscopic clip applying system as described which contains a venting system and a clip applying support system which prevents closure of the mechanism before firing. The applier'"'"'s jaws are spaced apart no further than the width of the applier shaft, even when holding a clip. Also, the system ensures proper loading of the clips and prevents them from falling out during loading. Further, the system describes an easily manufacturable, positively opening system which has minimized size requirements. Furthermore, a lock-out mechanism is provided so that the mechanism may not be inadvertently fired. The shaft resists excessive torque as well as holds the clip in place during firing. There are provisions for sealant and non back-up of the clips, as well as features which make the clip properly placed for closure. In an alternate embodiment, the clip applier shaft rotates about its handle mechanism.

Claims

1. An applier mechanism for individually applying a plurality of surgical closure devices, comprises:

a shaft portion;

a handle portion;

a rotating means extending distally of said handle portion for connecting said shaft portion to said handle portion so as to permit rotation of said shaft portion about an axis extending longitudinally through said shaft portion;

applying means positioned in said shaft portion for applying a surgical closure device;

feed means positioned in said shaft portion for delivering a closure device to said applying means;

actuation means positioned in said handle portion for actuating said applying means and said feed means;

a first connection attaching said applying means to said actuation means to permit rotation of said applying means with respect to said actuation means upon rotation of said shaft portion by said rotating means;

a second connection attaching said feed means to said actuation means to permit rotation of said feed means with respect to said actuation means upon rotation of said shaft portion by said rotating means; and

wherein said first and second connections are positioned in said rotating means and rotate about a common axis extending through said shaft portion and said first and second connections are spring biased from one another within said shaft portion.

2. The device of claim 1 wherein said rotating means is connected to said handle portion at a third connection, said third connection further including detent means.

3. The device of claim 1 wherein said applying means includes a pair of jaws operated by a camming channel.

4. The device of claim 1 wherein said feed means includes a feed bar placed within said shaft in a position generally along the length of said shaft.

5. The device of claim 1 wherein said actuation means includes a feeder plate and a former plate.

6. The device of claim 5 wherein said feeder plate and said former plate each have a pair of eared connectors as part of said first and second connections.

7. The device of claim 6 wherein said feed means and said applying means are each circular in cross section, and contains notches on their outer diameter which fit within said two pairs of eared connectors.

8. A device for applying a plurality of surgical clips seriatim, said device comprising:

a) an elongated shaft assembly including;

(i) a jaw member having at its distal portion a pair of spaced apart jaws for receiving a surgical clip between said jaws, said jaws being narrowly configured so that the greatest distance between the outer surfaces of said jaws at their fully open position is relatively the same as the outer diameter of said elongated shaft assembly, said jaws having channels in a generally parallel relationship for the receipt of a surgical clip therein, and said jaw member including a pair of proximally extending spaced apart jaw arms, said jaw arms each having a primary heel located proximally of said jaws that is defined as in inner surface in each jaw arm which contacts the corresponding inner surface in the opposite jaw arm as the jaws close a surgical clip;

(ii) a clip feed mechanism for storing an array of surgical clips and delivering a clip between said jaws, said clip feed mechanism including;

(A) an elongated clip track for housing said array of surgical clips in a first path extending through a first plane with said clips arranged end-to-end with their legs facing the distal end of the device, (B) spring means for shifting the distal-most clip in said first path out of the plane of said first path and into a second path extending through a second plane generally parallel to the plane of the first path, (C) a feed bar member positioned in said second plane such that proximal movement of said feed bar member enables said spring means to shift said distal-most clip in said first path from said first path into said second path and such that distal movement of said feed bar member advances said distal-most clip into a position between said jaws, (D) an escapement member associated with said clip track which is movable between (1) a first position extending into said path so as to maintain the array of clips stationary within said first path, and (2) a second position wherein said escapement member is removed from said path to allow distal movement of said array of clips;

(iii) a jaw closure mechanism for closing a surgical clip positioned between said jaws including a cam channel having an integral jaw engaging mechanism, said can channel including a box-shaped element with a pair of lateral sides, a top and a bottom, said lateral sides capable of engaging the outer surfaces of the proximal portions of said jaws and said top having a folded member to complete said box, said folded member being formed as a dovetail joint;

(iv) a gaseous sealing structure comprising a housing which includes a sidewall, endwalls and divider walls which cooperate to define a central chamber, and end chambers at opposite ends of said central chamber, said end and divider walls including clearance openings for accommodating movement of said clip feed mechanism and said jaw closure mechanism, said sidewall having apertures for permitting sealant material to be inserted into said central chamber;

b) a handle assembly containing actuating means including a single trigger means for actuating both said jaw closure mechanism and said clip feed mechanisms;

c) rotating means extending distally of said handle assembly for connecting said shaft assembly to said handle assembly so as to permit rotation of said shaft assembly about an axis extending longitudinally through said shaft assembly;

d) a first connection attaching said jaw closure mechanism to said actuating means to permit rotation of said jaw closure mechanism with respect to said actuating means upon rotation of said shaft assembly by said rotating means; and

e) a second connection attaching said clip feed mechanism to said actuating means to permit rotation of said clip feed mechanism with respect to said actuation means upon rotation of said shaft assembly by said rotating means;

wherein said first and second connections are positioned in said rotating means and rotate about a common axis extending through said shaft assembly, and said first and second connections are spring biased from one another within said shaft assembly.