Sterile clips and instrument for their placement

• US 5,601,574 A
• Filed: 04/20/1995
• Issued: 02/11/1997
• Est. Priority Date: 09/14/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Biehle, Edward J. IV, Stefanchik, David
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/425,964
• Time in Patent Office: 663 Days
• Field of Search: 606/139, 606/142, 606/143, 606/151, 606/157, 606/158, 227/19, 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 surgical fastener to body tissue comprising:

providing a plurality of surgical fasteners, each said surgical fastener having facing tissue clamping portions that are movable between a normally closed tissue clamping position and an open tissue receiving position;

locating each said surgical fastener within a fastener applying instrument with the tissue clamping portions thereof in the closed position, said applying instrument having an actuation mechanism that feeds a surgical fastener to the distal end of the instrument;

positioning the distal end of said instrument adjacent the body tissue to be clamped;

operating said actuation mechanism to feed each said surgical fastener toward the distal end of said instrument, and move the tissue clamping portions of said surgical fastener from the closed position to the open position so that said tissue clamping portions diverge from each other distally of said instrument;

positioning the body tissue to be clamped between the tissue clamping portions of said surgical fastener; and

returning the tissue clamping portions of said surgical fastener to the closed position to clamp the body tissue therebetween.

2. A method as set forth in claim 1 in which said surgical fastener is an occlusion fastener, and wherein said positioning step is performed by locating a tubular vessel between the tissue clamping portions of the occlusion fastener.

3. A method as set forth in claim 1 including the step of inserting the instrument through a cannula during an endoscopic procedure.

4. A method as set forth in claim 1 wherein said body tissue is compressed prior to returning the tissue clamping portions of the surgical fastener to the closed position.

5. A method as set forth in claim 4 including the step of cutting the body tissue after it is compressed and prior to returning the tissue clamping portions of the surgical fastener to the closed position.

6. A method as set forth in claim 1 in which a plurality of generally identical surgical fasteners are located in said instrument, and wherein said actuation mechanism is operated to successively feed surgical fasteners to the distal end of the instrument.

7. A method as set forth in claim 6 wherein said actuation mechanism is operated to successively feed surgical fasteners two at a time to the distal end of the instrument.

8. A method of applying a surgical fastener to body tissue, comprising the steps of:

providing a surgical fastener having facing tissue clamping portions that are movable between a normally closed tissue clamping position and an open tissue receiving position;

locating said surgical fastener within a fastener applying instrument with the tissue clamping portions thereof in the closed position;

positioning the distal end of said instrument adjacent the body tissue to be clamped;

compressing the tissue to be clamped at the distal end of said instrument between a pair of tissue compressing surfaces by effecting relative movement of at least one of said tissue compressing surfaces toward the other;

feeding said surgical fastener toward the distal end of said instrument, and moving the tissue clamping portions of said surgical fastener from the closed position to the open position during said feeding step so that said tissue clamping portions diverge from each other distally of said instrument;

positioning the compressed body tissue to be clamped between the tissue clamping portions of said surgical fastener; and

returning the tissue clamping portions of said surgical fastener to the closed position to clamp the previously compressed body tissue therebetween.

9. A method as set forth in claim 8 in which the tissue compressing step is performed by simultaneously moving toward each other both tissue compressing surfaces of said pair of tissue compressing surfaces.

10. A method as set forth in claim 8 in which said surgical fastener is an occlusion fastener, and wherein said positioning step is performed by locating a tubular vessel between the tissue clamping portions of the occlusion fastener.

11. A method as set forth in claim 8 including the step of inserting the instrument through a cannula during an endoscopic procedure.

12. A method as set forth in claim 8 including the step of cutting the body tissue after it is compressed and prior to returning the tissue clamping portions of the surgical fastener to the closed position.

13. A method as set forth in claim 8 in which a plurality of generally identical surgical fasteners are located in said instrument, and wherein said actuation mechanism is operated to successively feed surgical fasteners to the distal end of the instrument.

14. A method as set forth in claim 13 wherein said actuation mechanism is operated to successively feed surgical fasteners two at a time to the distal end of the instrument.

15. A method of endoscopically successively applying surgical fasteners to body tissue, comprising the steps of:

providing a plurality of surgical fasteners each having a pair of tissue clamping portions movable between an open position to receive body tissue therebetween, and a closed position to grip and retain body tissue therebetween, wherein said tissue clamping portions are biased toward said closed position;

providing an instrument with a frame, and an elongated endoscopic portion extending from said frame within which said plurality of surgical fasteners are serially positioned, one behind the other, wherein the instrument includes an advancing mechanism including a manually operable handle mounted on said frame that successively distally advances said surgical fasteners one at a time to a distal end of said endoscopic portion;

moving the tissue clamping portions of the surgical fastener at the distal end of said endoscopic portion to said open position, and positioning the tissue to be clamped between the tissue clamping portions of said surgical fastener; and

releasing said tissue clamping portions after body tissue has been positioned therebetween, so that said tissue clamping portions move toward each other to grip and clamp the body tissue disposed therebetween.

16. A method as set forth in claim 15 in which said surgical fasteners are occlusion fasteners, and wherein the positioning step is performed by locating a tubular vessel between the tissue clamping portions of the occlusion fastener.

17. A method as set forth in claim 15 including the step of inserting the instrument through a cannula during an endoscopic procedure.

18. A method as set forth in claim 15 wherein said body tissue is compressed prior to returning the tissue clamping portions of the surgical fastener to the closed position.

19. A method as set forth in claim 18 including the step of cutting the body tissue after it is compressed and prior to returning the tissue clamping portions of the surgical fastener to the closed position.

20. A surgical instrument for applying a surgical fastener to body tissue, said surgical fastener having facing tissue clamping portions movable between a normally closed tissue clamping position and an open tissue receiving position, said instrument comprising:

a housing having a proximal end and a distal end;

a support within said housing that movably supports a plurality of said surgical fasteners with the tissue clamping portions thereof in said closed position;

an opener at the distal end of the housing engageable with the tissue clamping portions of each said surgical fastener to move said tissue clamping portion to said open position;

a manually operable actuating handle mounted at the proximal end of said housing;

a driver within said housing operable by said actuating handle that moves each said surgical fastener axially within said housing toward the distal end thereof and (1) into engagement with said opener so that the tissue clamping portions are moved from the closed position to the open position to receive tissue therebetween, and (2) out of engagement with said opener so that the tissue clamping portions return from the open position to the normally closed tissue clamping position.

21. A surgical instrument as set forth in claim 20 in which said plurality of surgical fasteners are movably supported within said housing, and wherein said driver cooperates with said actuating handle to feed said at least one surgical fastener axially within said housing.

22. A surgical instrument as set forth in claim 21 wherein said driver cooperates with said actuating handle to simultaneously feed two of said surgical fasteners axially within said housing.

23. A surgical instrument for applying clips to body tissue, each clip including tissue gripping portions biased toward one another, said instrument comprising:

a clip holder for storing a plurality of said clips;

a tissue compressing mechanism positioned at a distal end of said instrument;

a feed mechanism for delivering a clip from said holder to said tissue compressing mechanism, with said gripping portions of the clip being disposed in spaced relationship with compressed tissue and diverging from each other distally of said instrument; and

release means cooperating with the clip to permit the tissue gripping portions to move into gripping relationship with the compressed tissue.

24. A surgical instrument in accordance with claim 23, wherein each said clip comprises a pair of right angle members each having a pair of legs disposed at right angles to each other, and a connecting member joining said right angle members.

25. A surgical instrument in accordance with claim 23, wherein said tissue compressing mechanism comprises a pair of diverging surfaces.

26. A surgical instrument in accordance with claim 23, wherein said clip holder is configured to store a plurality of pairs of said clips, said feed mechanism being arranged to deliver each said pair of said clips from said holder to said tissue compressing mechanism.