Laparoscopic surgical clamp

• US 5,776,146 A
• Filed: 07/03/1996
• Issued: 07/07/1998
• Est. Priority Date: 10/20/1993
• Status: Expired due to Term

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Sackier, Jonathan M., Jones, Michael L., Dolendo, Edward E.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): TRUONG, KEVIN THAO
• Application Number:
  US08/674,925
• Time in Patent Office: 734 Days
• Field of Search: 606/142, 606/151, 606/143, 606/205, 606/206, 606/208, 606/139, 606/141
• US Class Current: 606/142
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/2837 with a locking ratchet

Abstract

A surgical clamp combination includes a clamp movable between a free state and operable state, the clamp including a pair of jaws which can be operated to occlude a body conduit. A clamp applier is adapted to releasably engage the clamp in the free state and to operate the clamp in the operable state to close the jaws. The applier has a housing disposed at a proximal end and a tube operable state. A first shaft is disposed within the tube and movable between an extended position to releasably hold the clamp in the operable state. With the clamp in the operable state, a second shaft is movable by operation of a handle, to alternatively move a pin in opposite directions, along a line normal to an axis of the second shaft, to open and close the jaws of the clamp.

Claims

1. A surgical clamp, comprising:

a first jaw having a proximal end and a distal end, the first jaw having a first fixed set of teeth located near the proximal end of the first jaw;

a second jaw having a proximal end and a distal end, the second jaw having a second fixed set of teeth located near the proximal end of the second jaw;

at least the first jaw being movable between a first position wherein the first set of teeth are spaced from the second set of teeth, and a second position wherein the first set of teeth mesh with the second set of teeth; and

at least one of the first jaw and the second jaw being movable when the first jaw is in the second position, between an open state wherein the distal end of the first jaw is spaced from the distal end of the second jaw to accept a body conduit, and a closed state wherein the distal end of the first jaw is proximate to the distal end of the second jaw to at least partially occlude the body conduit.

2. The surgical clamp recited in claim 1, the first jaw being rotatably secured to the second jaw in proximity to the respective first set of teeth and the second fixed set of teeth, so that the first fixed set of teeth and the second fixed set of teeth can be moved between the first position and the second position.

3. A surgical clamp, comprising:

a first jaw having a proximal end and a distal end, the first jaw having a first fixed set of teeth located near the proximal end of the first jaw;

a second jaw having a proximal end and a distal end, the second jaw having a second fixed set of teeth located near the proximal end of the second jaw;

moving means for moving the first jaw and the second jaw between an open state wherein the distal end of the first jaw is spaced from the distal end of the second jaw to accept a body conduit, and a closed state wherein the distal end of the first jaw and the distal end of the second jaw are proximate to at least partially occlude the body conduit, the moving means being adaptable for moving the first fixed set of teeth in and out of mesh with the second fixed set of teeth;

the moving means being configured to receive a force from an external device, the force being sufficient to move the first jaw and the second jaw between the open state and the closed state;

the first jaw being rotatably secured to the second jaw near the respective first set of teeth and the second set of teeth, so that the first set of teeth and the second set of teeth can be moved in and out of mesh;

the moving means comprising a slot disposed within the first jaw near the proximal end of the first jaw; and

the external device comprising a pin adapted for disposition within the slot, wherein application of a force within the slot by the pin in a first direction moves the first jaw and the second jaw to the open state, and application of a force within the slot by the pin in a second direction moves the first jaw and the second jaw to the closed state.

4. The surgical clamp combination recited in claim 3, the slot comprising two ramps disposed on opposing sides of the slot.

5. The surgical clamp recited in claim 3, the slot forming a flexible arm on the first jaw, and

the first fixed set of teeth being disposed on the flexible arm.

6. The surgical clamp recited in claim 5, the pin being adapted to apply a force on the flexible arm to thereby move the first fixed set of teeth out of mesh with the second fixed set of teeth, and to move the first jaw and the second jaw to one of the open state and the closed state.

7. The surgical clamp recited in claim 3, further comprising:

a flexible arm on the first jaw;

the slot in the first jaw being configured with a straight portion and a curved portion, the straight portion adapted for accommodating the pin and the curved portion providing a reduced thickness of the flexible arm near a bendable area of the flexible arm;

the first fixed set of teeth being disposed on the flexible arm; and

the pin being adapted to apply a force on the flexible arm to thereby move the first fixed set of teeth out of mesh with the second fixed set of teeth, and to move the first jaw and the second jaw to one of the open state and the closed state.

8. The surgical clamp recited in claim 3, the first set of fixed set of teeth comprising a pawl, and

the second set of fixed teeth comprising a ratchet wheel.

9. The surgical clamp recited in claim 8, the first jaw and the pawl being integrally molded together, and

the second jaw and the ratchet wheel being integrally molded together.

10. The surgical clamp recited in claim 9, the first jaw and the second jaw comprising injection molded plastic.

11. A surgical clamp, comprising:

two jaws movable between an open position and a closed position;

a ratchet wheel and pawl assembly connected to the two jaws and adapted for allowing relative rotational movement of the two jaws in a first direction and preventing relative rotational movement of the two jaws in a second direction; and

means for disengaging the pawl from the ratchet wheel, to thereby allow for relative rotational movement of the pair of jaws in the second direction.

12. A surgical clamp combination, comprising:

a pair of jaws forming a surgical clamp, the jaws being movable between an open position and a closed position;

a ratchet wheel and pawl assembly connected to the surgical clamp, the ratchet wheel and pawl assembly being adapted for allowing relative movement of the pair of jaws in a first rotational direction and preventing relative movement of the pair of jaws in a second rotational direction;

pawl-removing means for removing the pawl from mesh with the ratchet wheel, to thereby allow for relative movement of the pair of jaws in the second rotational direction;

a clamp applier having a longitudinal axis extending between a proximal end and a distal end;

a tube disposed at the distal end of the clamp applier;

engaging means disposed within the tube for engaging the surgical clamp; and

operating means disposed at the proximal end of the clamp applier for operating the engaging means to activate the pawl-removing means to thereby facilitate movement of the pair of jaws in the second rotational direction.

13. The surgical clamp combination recited in claim 12, the surgical clamp comprising an annulus, and

the engaging means comprising a hook and a pin, the hook being adapted to be placed within the annulus and the pin being adapted to contact the surgical clamp.

14. The surgical clamp combination recited in claim 13, the surgical clamp comprising a slot for accommodating the pin, the slot having ramps on opposing sides thereof.

15. The surgical clamp combination recited in claim 13, movement of the pin in a first pin direction causing the pair of jaws to move in the first rotational direction, and

movement of the pin in a second pin direction activating the pawl-removing means and also causing the pair of jaws to move in the second rotational direction.

16. The surgical clamp combination recited in claim 15, the operating means comprising a trigger for operating the hook and a handle for operating the pin.

17. The surgical clamp combination recited in claim 16, the handle comprising a scissor handle, having one stationary piece and one movable piece.

18. The surgical clamp combination recited in claim 17, further comprising a pivoting arm disposed at a distal end of the tube, the pivoting arm having the pin attached thereto.

19. The surgical clamp combination recited in claim 18, further comprising an actuator spring connected to the pivoting arm, the actuator spring accommodating the pin at a distal end of the actuator spring, the actuator spring being adapted for pivoting with the pivoting arm.

20. The surgical clamp combination recited in claim 18, movement of the movable piece of the scissor handle in a first handle direction rotating the pivoting arm disposed at the end of the tube in a first rotational direction to thereby move the pin in the first direction, and

movement of the movable piece of the scissor handle in a second handle direction rotating the pivoting arm disposed at the end of the tube in a second rotational direction to thereby move the pin in the second pin direction.

21. The surgical clamp combination recited in claim 20, wherein movement of the movable piece of the scissor handle in the first handle direction moves the pin in the first pin direction and causes the pair of jaws to close, and

wherein movement of the movable piece of the scissor handle in the second handle direction moves the pin in the second pin direction and causes the pair of jaws to open.

22. The surgical clamp combination recited in claim 19, the actuator spring being bendable in a direction approximately normal to the pivoting arm to facilitate movement of the pin on one of the ramps.

23. A surgical clamp having a longitudinal configuration and an axis extending between a proximal end and a distal end of the surgical clamp, the clamp comprising:

a first jaw having a first set of slanted teeth located near the proximal end;

a second jaw having a second set of slanted teeth adapted to be removably placed into mesh with the first set of slanted teeth, the first and second sets of slanted teeth when in mesh being adapted to slide upon one another to thereby allow the first jaw to pivot roughly about the proximal end in a first direction, the first and second sets of slanted teeth when in mesh not allowing the first jaw to pivot roughly about the proximal end in a second direction; and

a moving member for moving the first and second sets of slanted teeth out of mesh, to thereby allow the first jaw to pivot roughly about the proximal end in the second direction.

24. A surgical clamp combination, comprising:

a surgical clamp having a longitudinal axis extending between a proximal end and a distal end, and including a supporting structure;

a pair of jaws coupled to the supporting structure, the jaws being movable between an open position and a closed position;

a moving member carried by the supporting structure and operable from near the proximal end of the clamp for moving the jaws between the open position and the closed position, and comprising a ratchet wheel and pawl assembly, which can be selectively engaged and disengaged to facilitate movement of the pair of jaws between the open position and the closed position;

a clamp applier having a longitudinal axis extending between a proximal end and a distal end;

a tube disposed at the distal end of the clamp applier;

an engaging element disposed within the tube for engaging the moving means at the proximal end of the clamp, the engaging means adapted for both selectively engaging and disengaging the ratchet wheel and pawl assembly and for applying forces to the surgical clamp to facilitate movement of the pair of jaws between the open position and the closed position; and

an operating member disposed at the proximal end of the clamp applier for operating the engaging element to move the jaws of the clamp.

25. A clamp applier for selectively engaging a surgical clamp and for moving the surgical clamp between an open position and a closed position, the clamp applier having an axis extending between a proximal end and a distal end of the clamp applier, the clamp applier comprising:

a housing disposed at the proximal end;

a tube extending distally of the housing and configured to receive the surgical clamp;

engaging means disposed within the tube and adapted for releasably engaging the surgical clamp;

first moving means disposed near the proximal end and connected to the engaging means, the first moving means being adapted for moving the engaging means between an extended position wherein the engaging means can engage the surgical clamp, and a retracted position wherein the surgical clamp is releasably held in contact with the clamp applier;

operating means disposed within the tube and adapted for releasably engaging the surgical clamp, the operating means being movable in two directions along a line, which is approximately perpendicular to the axis, to thereby move the surgical clamp between the open position and the closed position; and

second moving means disposed near the proximal end and connected to the operating means, the second moving means being adapted for moving the engaging means along the line that is approximately perpendicular to the axis.

26. The clamp applier recited in claim 25, the first moving means being activated by a trigger near the proximal end, and

the second moving means being activated by a movable handle near the proximal end.

27. A surgical clamp combination, comprising:

a pair of jaws forming a surgical clamp, the jaws being movable between an open position and a closed position;

a ratchet wheel and pawl assembly connected to the surgical clamp, the ratchet wheel and pawl assembly being adapted to permit relative movement of the pair of jaws in a first rotational direction and to prevent relative movement of the pair of jaws in a second rotational direction;

the pawl being removable from the ratchet wheel to thereby allow for relative movement of the pair of jaws in the second rotational direction;

a clamp applier having a longitudinal axis extending between a proximal end and a distal end;

a tube disposed at the distal end of the clamp applier;

an engaging element disposed within the tube for engaging the surgical clamp; and

an operating member disposed at the proximal end of the clamp applier for operating the engaging element to remove the pawl from the ratchet wheel and thereby facilitate movement of the pair of jaws in the second rotational direction.

28. The surgical clamp combination recited in claim 27, wherein:

the surgical clamp includes an annulus; and

the engaging element of the clamp applier comprises a hook and a pin, the hook being adapted to engage the annulus of the clamp and the pin being adapted to engage the pawl of the clamp.

29. The surgical clamp combination recited in claim 28, further comprising:

a pivoting arm disposed at a distal end of the tube, the arm being pivotal generally in a pivot plane; and

the pin of the engaging element being attached to the pivoting arm.

30. The surgical clamp combination recited in claim 29, further comprising:

an actuator spring connected to the pivoting arm; and

the actuator spring being coupled to the pin and being adapted for pivotal movement with the pivoting arm.

31. The surgical clamp combination recited in claim 30, wherein:

the actuator spring is bendable in a direction generally normal to the pivot plane of the pivoting arm.

32. A surgical clamp, comprising:

a first jaw of the clamp having a proximal end and a distal end, the first jaw having a first set of teeth located near the proximal end of the first jaw;

a second jaw of the clamp having a proximal end and a distal end, the second jaw having a second fixed set of teeth located near the proximal end of the second jaw;

at least the first jaw being movable between a first position wherein the first set of teeth are spaced from the second set of teeth, and a second position wherein the first set of teeth mesh with the second set of teeth;

at least one of the first jaw and the second jaw being movable when the first jaw is in the second position, between an open state wherein the distal end of the first jaw is spaced from the distal end of the second jaw to accept a body conduit, and a closed state wherein the distal end of the first jaw is proximate to the distal end of the second jaw to at least partially occlude the body conduit; and

a surgical clamp actuator operable to permit movement of the surgical clamp between a disengaged position wherein the clamp is free of the clamp actuator, and an engaged position wherein the clamp is coupled to the clamp actuator, the clamp actuator being operable in the engaged position to move the clamp between the open state and the closed state.

33. The surgical clamp assembly recited in claim 32, the first jaw of the clamp being rotatably secure to the second jaw of the clamp in proximity to the first set of teeth and second set of teeth, so that the first set of teeth and the second set of teeth can be moved between the first position and the second position.

34. The surgical clamp assembly recited in claim 33 wherein at least one of the first jaw and the second jaw of the clamp defines a slot;

and

the surgical clamp actuator further comprises a pin adapted for disposition within the slot, the pin in the slot being movable in a first direction to move the first jaw relative to the second jaw toward the open state, and being movable in a second direction opposite to the first direction to move the first jaw relative to the second jaw toward the closed state.

35. The surgical clamp assembly recited in claim 34 wherein the slot of the clamp is defined by a pair of ramps disposed on opposing sides of the slot.