Automatic laparoscopic ligation clip applicator

• US 5,904,693 A
• Filed: 11/23/1994
• Issued: 05/18/1999
• Est. Priority Date: 04/27/1993
• Status: Expired due to Term

• Current Assignee: Sherwood Services AG
• Original Assignee: American Cyanamid Co (Pfizer Inc.)
• Inventors: Stein, Jeffrey A., Dicesare, Paul C., Conners, John A., Allen, William J., Logan, Joseph N.
• Primary Examiner(s): Schmidt, Jeffrey A.
• Application Number:
  US08/346,285
• Time in Patent Office: 1,637 Days
• Field of Search: 606/139, 606/142, 606/143, 227/175.1-182.1, 227/19, 227/901
• 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

A laparoscopic ligation clip applicator for automatically applying a plurality of ligation clips includes a handle assembly having an actuator, an elongated shaft connected to the handle assembly, and an actuating mechanism disposed within the shaft. The actuating mechanism includes a clamp for engaging a first piece of the ligation clip and a slidable driver for driving a second piece of the ligation clip relative to the first piece. The actuating mechanism also includes a hold for preventing rearward movement of the ligation clips, and an advancer for sequentially feeding the ligation clips. A slidable cam, operably connected to the handle assembly, actuates the clamp, the driver and the advancer.

Claims

1. A ligation clip applicator for applying each of a plurality of sequentially fed two-piece ligation clips, comprising:

a handle assembly having an actuator;

an elongated shaft having a proximal end connected to said handle assembly, said shaft housing a plurality of two-piece ligation clips, with a distal-most ligation clip in said shaft disposed in a feed position; and

actuating means, disposed within said shaft, for assembling and sequentially feeding the ligation clips, said actuating means including a clamp for engaging a first piece of the ligation clip disposed in the feed position, a slidable driver for driving a second piece of the ligation clip disposed in the feed position, and a slidable cam operably engaged with said clamp and said driver and operable by actuating said actuator, wherein upon actuation of said cam in a cam-forward stroke said clamp engages the first piece of the ligation clip and holds it stationary and said driver drives the second piece in a forward direction to compress the first piece and close the ligation clip,

said actuating means further comprises holding means having retaining springs for preventing movement of the ligation clips in a rearward direction, and an advancer operably connected to said cam and slidable relative to the ligation clips for sequentially advancing the ligation clips in the forward direction and positioning a next-to-distal-most ligation clip in the feed position in said shaft.

2. A ligation clip applicator according to claim 1, wherein said advancer comprises a plurality of springs which are flexed by said ligation clips when said advancer slides in the rearward direction and which engage and advance the ligation clips when said advancer is moved in the forward direction.

3. A ligation clip applicator according to claim 1, further comprising a spring-loaded addrive connected to said advancer, said cam being operably engaged by said addrive and moving said addrive in the rearward direction during a cam-return stroke to charge said spring-loaded addrive, wherein said addrive disengages from said cam near the end of the cam-return stroke and discharges forwardly to drive said advancer in the forward direction to engage and advance the ligation clips.

4. A ligation clip applicator according to claim 3, wherein said addrive includes an extended shafts and a compression spring disposed around said shaft.

5. A ligation clip applicator according to claim 3, further comprising a cam spring connected to said cam and supported in said shaft, wherein said cam spring is charged during the cam-forward stroke and discharges to initiate the cam-return stroke and retract said cam and compress said compression spring to charge said spring-loaded addrive.

6. A ligation clip applicator for applying a two-piece ligation clip, comprising:

a handle assembly having an actuator;

an elongated shaft having a proximal end connected to said handle assembly and housing a plurality of two piece ligation clips, with a distal-most ligation clip in said shaft disposed in a feed position at a distal end of said shaft;

ligation clip assembling means, disposed within said shaft, for assembling and closing a designated two piece ligation clip disposed in the feed position;

ligation clip feeding means, disposed within said shaft, for advancing the ligation clips in a forward direction within said shaft and positioning a next-to-distal-most ligation clip in the feed position;

a slidable cam operably connected to said handle assembly for movement in a forward direction in a cam-forward stroke and in a rearward direction in a cam-return stroke, wherein in the cam-forward stroke said slidable cam operably engages said ligation clip assembly means to assemble and close the designated ligation clip, and in the cam-return stroke said cam actuates said ligation clip feeding means to advance the ligation clips; and

a cam spring connected to said cam and supported in said shaft, wherein said cam spring is charged during the cam-forward stroke and discharges to initiate the cam-return stroke and retract said cam in the rearward direction.

7. An automatic laparoscopic ligation clip applicator for applying two-piece ligation clips, comprising:

a handle having a squeezable trigger;

an elongated shaft assembly having a proximal end connected to said handle and housing a plurality of two-piece ligation clips arranged in an array, with a distal-most ligation clip in said shaft assembly disposed in a feed position;

a clamp disposed in shaft assembly for engaging a first piece of a designated ligation clip disposed in the feed position and holding the first piece stationary;

a driver slidably disposed in said shaft assembly for driving a second piece of the designated ligation clip in the forward direction to compress the stationary first piece and close the designated ligation clip;

a holding means disposed in said shaft assembly and having engaging portions for preventing the array of ligation clips from moving in a rearward direction in said shaft;

an advancer slidably disposed in said shaft assembly for engaging the array of ligation clips and advancing them in a forward direction;

a slidable cam disposed in said shaft assembly and actuated by said handle to slide in a forward direction in a cam-forward stroke and in a rearward direction in a cam-return stroke, said cam operably connected to said driver and said advancer; and

a cam spring connected to said cam and supported in said shaft, wherein said cam spring is charged during the cam-forward stroke and discharges to initiate the cam-return stroke and retract said cam in the rearward direction.

8. A ligation clip applicator according to claim 7, further comprising an addrive connected to said advancer and driving said advancer in the forward direction to advance the array of ligation clips.

9. A ligation clip applicator according to claim 8, wherein said addrive comprises an addrive head, an elongated shaft connected to said addrive head, and a compression spring mounted on said elongated shaft, said compression spring being compressed by movement of said addrive head in the rearward direction.

10. A ligation clip applicator according to claim 9, said addrive head having a flexible latch engagable with an addrive slot in said cam, wherein said flexible latch engages said addrive slot in the cam-return stroke and said addrive is advanced in the rearward direction to compress said addrive spring, said latch disengages from said addrive slot near the end of the cam-return stroke and said addrive spring discharges to advance said addrive and advancer in the forward direction whereupon said advancer engages the array of ligation clips and moves them in the forward direction.

11. A ligation clip applicator according to claim 7, wherein said handle includes a ratchet mechanism connected to said trigger for preventing release of said trigger until a full cam-forward stroke is completed.

12. A ligation clip applicator according to claim 7, wherein said proximal end of said shaft assembly includes a collar engagable within said handle.

13. A ligation clip applicator according to claim 12, wherein said handle includes a latch engagable with said collar to secure said shaft assembly, said latch being actuable only when said trigger is in an at-rest position.

14. A ligation clip applicator for applying two-piece ligation clips, comprising:

a handle having a squeezable trigger;

an elongated shaft assembly having a proximal end connected to said handle and housing a plurality of two-piece ligation clips arranged in an array, with a distal-most ligation clip in said shaft assembly disposed in a feed position;

a clamp disposed in said shaft assembly for engaging a first piece of a designated ligation clip disposed in the feed position and holding the first piece stationary;

a driver slidably disposed in said shaft assembly for driving a second piece of the designated ligation clip in the forward direction to compress the stationary first piece and close the designated ligation clip;

a holding means disposed in said shaft assembly and having engaging portions for preventing the array of ligation clips from moving in a rearward direction in said shaft;

an advancer slidably disposed in said shaft assembly for engaging the array of ligation clips and advancing them in a forward direction; and

a slidable cam disposed in said shaft assembly and actuated by said handle to slide in a forward direction in a cam-forward stroke and in a rearward direction in a cam-return stroke, said cam operably connected to said driver and said advancer, wherein

in the cam-forward stroke said cam actuates said clamp to engage the first piece of the designated ligation clip and actuates said driver to slide in the forward direction and engage the second piece of the designated ligation clip to assemble and close the designated ligation clip.

15. A ligation clip applicator according to claim 14, wherein said clamp and said driver each have distal ends that extend upwardly above a horizontal plane containing the array of ligation clips, and said cam actuates said clamp and said driver by advancing in the forward direction and riding down said distal ends to bias them in the horizontal plane.

16. A ligation clip applicator according to claim 15, wherein said cam actuates said clamp and said driver in the cam-return stroke by advancing in the rearward direction and allowing said distal ends of said clamp and said driver to flex upwardly out of the horizontal plane.

17. A ligation clip applicator for applying each of a plurality of sequentially fed two-piece ligation clips, comprising:

a handle assembly having an actuator;

an elongated shaft extending in a longitudinal direction and having a proximal end connected to said handle assembly, said shaft housing a plurality of two-piece ligation clips, with a distal-most ligation clip in said shaft disposed in a feed position; and

actuating means, disposed within said shaft, for assembling and sequentially feeding the ligation clips, said actuating means including a latch for engaging a first piece of the ligation clip disposed in the feed position, a slidable pusher for driving a second piece of the ligation clip disposed in the feed position substantially along the longitudinal direction, and a slidable push rod operably engaged with said pusher and operable by actuating said actuator, wherein upon actuation of said push rod in a push rod forward stroke said latch engages the first piece of the ligation clips and holds it stationary and said pusher drives the second piece in a forward direction to compress the first piece and close the ligation clip.

18. A ligation clip applicator according to claim 17, said actuating means further comprising a hold having retaining springs for preventing movement of the ligation clips in a rearward direction, and an advancer operably connected to said push rod and slidable relative to the ligation clips for sequentially advancing the ligation clips in the forward direction and positioning a next-to-distal-most ligation clip in the feed position in said shaft.

19. A ligation clip applicator according to claim 18, wherein said advancer includes a plurality of springs which are flexed by the ligation clips when said advancer slides in the rearward direction and which engage and advance the ligation clips when said advancer is moved in the forward direction.

20. A ligation clip applicator according to claim 18, said actuating means further comprising a sprocket gear rotatably disposed in said shaft, said sprocket gear engaged between a notched portion in said being rotated by sliding movement of said push rod to actuate said advancer.

21. A ligation clip applicator according to claim 20, wherein said sprocket gear includes first and second sprocket halves, with each sprocket half having circumferentially spaced teeth which are offset from each other, and said notched portions in said push rod and advancer contain first and second rows of notches offset from each other for engaging said teeth of said first and second sprocket halves.

22. A ligation clip applicator according to claim 17, further comprising locking means for ensuring that once said push rod is actuated in either the push rod forward stroke or a push rod rearward stroke that stroke will be completed before said push rod can be actuated in an opposite direction.

23. A ligation clip applicator according to claim 22, wherein said locking means includes a triangular pawl and pawl spring mounted in said shaft, and a pawl engaging portion on said push rod having a ridged portion disposed between first and second slots.

24. A ligation clip applicator according to claim 17, said actuating means further comprising a spring block operably connected to said push rod and slidably supported in said shaft and a compression spring biasing said spring block in a rearward direction, wherein said spring is charged during the push rod forward stroke and discharges to initiate a push rod return stroke and retract said push rod in the rearward direction.

25. A ligation clip applicator according to claim 17, further comprising engaging means for releasably engaging said handle assembly and said elongated shaft, said engaging means being actuable only when said actuator is in an at-rest position.

26. A ligation clip applicator according to claim 17, wherein said elongated shaft is formed to be received in a cannula thereby to be used in minimally invasive surgical procedures.

27. A ligation clip applicator for applying a two-piece ligation clip, comprising:

a handle assembly having an actuator;

an elongated shaft extending in a longitudinal direction and having a proximal end connected to said handle assembly and housing a plurality of ligation clips, with a distal-most ligation clip in said shaft disposed in a feed position at a distal end of said shaft;

ligation clip assembling means, disposed within said shaft, for assembling and closing a designated ligation clip disposed in the feed position;

ligation clip feeding means, disposed within said shaft, for advancing the ligation clips in a forward direction within said shaft and positioning a next-to-distal-most ligation clip in the feed position; and

a slidable push rod operably connected to said handle assembly for movement in a forward direction in a push rod forward stroke and in a rearward direction in a push rod return stroke, wherein in the push rod forward stroke said slidable push rod operably engages said ligation clip assembly means to assemble and close the designated ligation clip, and in the push rod return stroke said push rod actuates said ligation clip feeding means to advance the ligation clips, wherein

said ligation clip assembling means includes a latch for holding stationary a first piece of the designated ligation clip and a slidable pusher for driving a second piece of the designated ligation clip in the forward direction to compress the first piece and close the designated ligation clip.

28. A ligation clip applicator according to claim 27, wherein said pusher is engaged to said push rod and driven by said slidable push rod to slide relative to said latch in the forward and rearward directions.

29. A ligation clip applicator according to claim 27, wherein said ligation clip feeding means comprises a hold having retaining springs for preventing movement of the ligation clips in the rearward direction, and a slidable advancer operably connected to said push rod and sliding relative to the ligation clips for sequentially advancing the ligation clips in the forward direction to position the next-to-distal-most ligation clip in the feed position.

30. A ligation clip applicator according to claim 29, wherein said advancer comprises a plurality of springs which are flexed by the ligation clips when said advancer slides in the rearward direction and which engage and advance the ligation clips when said advancer is moved in the forward direction.

31. A ligation clip applicator according to claim 29, further comprising a sprocket gear rotatably disposed in said shaft, said sprocket gear engaged between a notched portion in said push rod and a notched portion in said advancer, and being rotated by sliding movement of said push rod to actuate said advancer.

32. A ligation clip applicator according to claim 31, wherein said sprocket gear includes first and second sprocket halves, with each sprocket half having circumferentially spaced teeth which are offset from each other, and said notched portions in said push rod and advancer contain first and second rows of notches offset from each other for engaging said teeth of said first and second sprocket halves.

33. A ligation clip applicator according to claim 27, further comprising locking means for ensuring that once said push rod is actuated in either the forward stroke or the rearward stroke that stroke will be completed before said push rod can be actuated in an opposite direction.

34. A ligation clip applicator according to claim 33, wherein said locking means includes a triangular pawl and a pawl spring mounted in said shaft, and a pawl engaging portion on said push rod having a ridged portion disposed between first and second slots.

35. A ligation clip applicator according to claim 27, further comprising engaging means for releasably engaging said handle assembly and said elongated shaft, said engaging means being actuable only when said actuator is in an at-rest position.

36. A ligation clip applicator according to claim 27, further comprising a slot in said shaft for receiving the ligation clips to load the ligation clips.

37. An automatic laparoscopic ligation clip applicator for applying two-piece ligation clips, comprising:

a handle having a squeezable trigger;

an elongated shaft assembly having a proximal end connected to said handle and housing a plurality of two-piece ligation clips arranged in an array, with a distal-most ligation clip in said shaft assembly disposed in a feed position;

a latch disposed in said shaft assembly for engaging a first piece of a designated ligation clip disposed in the feed position and holding the first piece stationary;

a pusher slidably disposed in said shaft assembly for driving a second piece of the designated ligation clip in the forward direction to compress the stationary first piece and close the designated ligation clip;

a hold disposed in said shaft assembly and having engaging portions for preventing the array of ligation clips from moving in a rearward direction in said shaft;

an advancer slidably disposed in said shaft assembly for engaging the array of ligation clips and advancing them in a forward direction;

a rotatable sprocket gear mounted in said shaft and engagable with said advancer; and

a slidable push rod disposed in said shaft assembly and actuated by said handle to slide in a forward direction in a push rod forward stroke and in a rearward direction in a push rod return stroke, said push rod connected at its distal end to said pusher and engagable with said sprocket gear to slide said advancer.

38. A ligation clip applicator according to claim 37, wherein in the push rod forward stroke said push rod actuates said latch to engage the first piece of the designated ligation clip and actuates said pusher to slide in the forward direction and engage the second piece of the designated ligation clip to assemble and close the designated ligation clip.

39. A ligation clip applicator according to claim 38, wherein said latch has a distal end that rests in sits unbiased position above a horizontal plane containing the array of ligation clips, and said push rod advances said pusher in the forward direction to lower the distal end of said latch into the horizontal plane.

40. A ligation clip applicator according to claim 39, wherein said push rod pulls said pusher in the push rod return stroke in the rearward direction to allow the distal end of said latch to flex upwardly out of the horizontal plane.

41. A ligation clip applicator according to claim 37, wherein said sprocket gear is engaged between a notched portion in said push rod and a notched portion in said advancer, and is rotated by sliding movement of said push rod to actuate said advancer.

42. A ligation clip applicator according to claim 41, wherein said sprocket gear includes first and second sprocket halves, with each sprocket half having circumferentially spaced teeth which are offset from each other, and said notched portions in said push rod and advancer contain first and second rows of notches offset from each other for engaging said teeth of said first and second sprocket halves.

43. A ligation clip applicator according to claim 37, further comprising a spring operably connected to said push rod and supported in said shaft, wherein said spring is charged during a push rod forward stroke and discharges in a push rod return stroke to bias said push rod in a rearward direction.

44. A ligation clip applicator according to claim 37, further comprising a spring block and an attached key slidably disposed in a proximal end of said shaft and a spring mounted on said key and abutting said spring block, with said spring block connected to said push rod and actuated by said handle, wherein said spring is charged during the push rod forward stroke and discharges in the push rod return stroke to bias said push rod in a rearward direction.

45. A ligation clip applicator according to claim 37, wherein said proximal end of said shaft assembly includes a collar engagable within said handle.

46. A ligation clip applicator according to claim 45, wherein said handle includes a latch engagable with said collar to secure said shaft assembly, said latch being actuable only when said trigger is in an at-rest position.

47. A ligation clip applicator according to claim 37, further comprising a brake for limiting forward sliding movement of the ligation clips.

48. A ligation clip applicator according to claim 37, further comprising locking means for ensuring that once said push rod is actuated in either the forward stroke or the rearward stroke that stroke will be completed before said push rod can be actuated in an opposite direction.

49. A ligation clip applicator according to claim 48, wherein said locking means includes a triangular pawl and a pawl spring mounted in said shaft, and a pawl engaging portion on said push rod having a ridged portion disposed between first and second slots.

50. A ligation clip applicator for applying each of a plurality of two-piece ligation clips, each ligation clip including a clamp and a clip body movable relative to the clamp to close it about a vessel, said clip applicator comprising:

means for storing a plurality of the ligation clips in an array with a distal-most ligation clip in an application position, with the array extending in a longitudinal direction of the clip applicator;

means, provided at a distal end of the applicator, for releasably holding the clamp of the distal-most ligation clip at the application position;

means for moving the clip body in substantially the longitudinal direction of the clip applicator and relative to the clamp, held at the application position, thereby to close the clamp, with said moving means moving relative to said holding means and said moving means and holding means housed in said storing means;

means for releasing said holding means to free the now closed distal-most ligation clip from the application position; and

means for advancing another ligation clip from the array to the application position, with said advancing means housed with said releasing means in said storing means and operably engaged with said releasing means such that the closed ligation clip is released as the another ligation clip is being advanced.