Sterile clips and instrument for their placement

• US 5,474,567 A
• Filed: 10/28/1993
• Issued: 12/12/1995
• Est. Priority Date: 09/14/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Stefanchik, David, Biehle, Edward J. IV
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/144,926
• Time in Patent Office: 775 Days
• Field of Search: 606/142-143, 606/139, 606/141, 606/151, 227/901, 227/902
• US Class Current: 606/143
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: Y10S 227/901 Surgical clip appliers
• CPC Class Codes: Y10S 227/902 Surgical clips or staples

Abstract

An improved surgical instrument and sterile clip for ligating the vessel of a mammal. The clip has a pair of legs which are urged apart by the instrument to allow the clip to be placed on the vessel to be ligated.

Claims

1. A method of applying a sterile tissue fastener to tissue to be occluded comprising:

providing a fastener applying instrument containing a tissue fastener, said instrument having an actuating end coupled by a tubular shaft to an applying end said applying end including diverging surfaces;

positioning tissue to be occluded between diverging surfaces of said fastener applying instrument;

applying a compressing force to said tissue using said diverging surfaces;

moving said fastener toward the distal end of said diverging surfaces;

moving said fastener over a portion of said tissue that is at least partially compressed by the applied compressing force of the diverging surfaces and disassociating said fastener from the instrument; and

removing said diverging surfaces from the tissue whereby said fastener occludes said portion of said tissue.

2. The method of claim 1 wherein the diverging surfaces are placed on opposite sides of the tissue to be occluded.

3. The method of claim 1 wherein the diverging surfaces are brought to a substantially parallel position to occlude the tissue placed between the surfaces.

4. The method of claim 1 wherein said fastener is moved from a closed position to an open position to provide an opening for capturing tissue prior to disassociating said fastener from the instrument.

5. The method of claim 4 wherein the fastener is moved from its closed position to its open position as the fastener is moved towards the distal end of the diverging surfaces and wherein said diverging surfaces maintain the fastener in its open position until it is placed over tissue to be occluded.

6. The method of claim 4 wherein the fastener closes towards its closed position as said fastener is disassociated from the instrument, whereby the fastener provides a compressing force to maintain sufficient tissue occlusion provided by the diverging surfaces when said diverging surfaces are removed.

7. The method of claim 1 wherein said fastener comprises a clip having leg members in close proximity to one another, whereby leg members are spread from one another when the clip is moved towards the distal end of the diverging surfaces and said clip closes over the tissue when disassociated from the fastener applying instrument.

8. The method of claim 7 wherein said leg members are substantially parallel along at least a portion of their length when said fastener is closed.

9. The method of claim 7 wherein at least one diverging surface spreads the leg members slightly from one another to move said clip from a closed position to an open position to provide the opening for capturing tissue.

10. The method of claim 1 wherein said fastener is used to occlude tissue during an endoscopic procedure.

11. An endoscopic instrument for applying occlusion fasteners comprising:

a fastener having open and closed positions;

an actuating end and an applying end, said ends being connected by a hollow, tubular shaft;

means included with the instrument for feeding occlusion fasteners to the applying end of the instrument while the fasteners are in a closed position; and

means coupled to said shaft, for engaging and compressing tissue to provide occlusion thereof, prior to applying said fastener to the tissue.

12. The endoscopic instrument of claim 11 further comprising means for opening the fastener at the applying end of said instrument to provide an opening sufficient to capture tissue to be occluded.

13. The endoscopic instrument of claim 12 further comprising means associated with said applying end, for disassociating the fastener from said instrument.

14. The endoscopic instrument of claim 11 wherein said means for engaging and compressing comprises diverging surfaces positioned at the applying end of said instrument.

15. In combination, an endoscopic fastener applying instrument and surgical fastener comprising:

a surgical fastener adapted to occlude tissue;

said instrument including an actuating end and an applying end, said ends being connected by a hollow, tubular shaft;

means included with said instrument for feeding said fastener to the applying end of the instrument while said fastener is in a closed position;

means for opening the fastener at the applying end of said instrument to provide an opening sufficient to capture tissue to be occluded; and

wherein said means for engaging and compressing tissue includes;

diverging surfaces positioned at the applying end;

a reciprocal member disposed at the distal end of said hollow tubular portion, said reciprocal member capable of engaging and moving at least one of said diverging surfaces to cause diverging surfaces to compress tissue therebetween; and

a first drive means extending from said actuating means to said reciprocal member to move said reciprocal member and cause said diverging surfaces to compress tissue.

16. The endoscopic fastener applying instrument and surgical fastener of claim 15 wherein said instrument further comprises means to return said reciprocal member to its original position and remove said diverging surfaces from the occluded tissue.

17. In combination, an endoscopic fastener applying instrument and surgical fastening means comprising

a surgical fastener for occluding tissue;

said instrument including an actuating end and an applying end, said ends being connected by a hollow, tubular shaft;

means included with said instrument for feeding said fastener to the applying end of the instrument while said fastener is in a closed position;

means for opening the fastener at the applying end of said instrument to provide an opening sufficient to capture tissue to be occluded;

wherein said surgical fastener comprises a plurality of clips in seriatim disposed in said instrument; and

wherein said means for feeding said fastener to the applying end includes a drive means extending from said actuating end to the proximal clip of said plurality of clips to move said plurality of clips and to move the most distal clip along said diverging surfaces when said diverging surfaces are compressing tissue, to place said clip on the tissue.

18. In combination, an endoscopic fastener applying instrument and surgical fastener comprising:

a surgical fastener for occluding tissue, said fastener having an open position and a closed position, wherein said fastener is biased towards said closed position;

said instrument including an actuating end and an applying end, said ends being connected by a hollow, tubular shaft;

means included with said instrument for feeding said fastener to the applying end of the instrument while said fastener is in the closed position;

means for opening the fastener at the applying end of said instrument to the open position to provide an opening sufficient to capture tissue to be occluded; and

means at said applying end of the instrument for disassociating the fastener from said instrument, wherein said fastener is adapted to move itself from said open position towards the closed position as said fastener is disassociated from said instrument whereby said fastener provides sufficient compression to maintain occlusion of captured tissue.

19. In combination, an endoscopic fastener applying instrument and surgical fastener comprising:

a surgical fastener for occluding tissue;

said instrument including an actuating end and an applying end, said ends being connected by a hollow, tubular shaft;

means included with said instrument for feeding said fastener to the applying end of the instrument while said fastener is in a closed position; and

means for engaging and compressing tissue to occlude said tissue before applying said fastener to said tissue, said engaging and compressing means positioned at said applying end.

20. The endoscopic fastener applying instrument and surgical fastener of claim 19 wherein said means for engaging and compressing tissue includes:

diverging surfaces positioned at the applying end;

a reciprocal member disposed at the distal end of said hollow tubular portion, said reciprocal member capable of engaging and moving at least one of said diverging surfaces to cause diverging surfaces to compress tissue therebetween; and

a first drive means extending from said actuating means to said reciprocal member to move said reciprocal member and cause said diverging surfaces to compress tissue.

21. The endoscopic fastener applying instrument and surgical fastener of claim 20 wherein said instrument further comprises means to return said reciprocal member to its original position and remove said diverging surfaces from the occluded tissue.

22. The endoscopic fastener applying instrument and surgical fastener of claim 19 wherein said surgical fastener comprises a plurality of clips in seriatim disposed in said instrument.

23. The endoscopic fastener applying instrument and surgical fastener of claim 22 wherein said means for feeding said fastener to the applying end includes a drive means extending from said actuating means to the proximal clip of said plurality of clips to move said plurality of clips and to move the most distal clip along said diverging surfaces when said diverging surfaces are compressing tissue, to place said clip on the tissue.

24. The endoscopic fastener applying instrument and surgical fastener of claim 19 further comprising:

means for opening the fastener at the applying end of said instrument to provide an opening sufficient to capture tissue to be occluded.