Clip applier and methods of use

• US 8,313,497 B2
• Filed: 06/28/2006
• Issued: 11/20/2012
• Est. Priority Date: 07/01/2005
• Status: Active Grant

• Current Assignee: Abbott Laboratories Incorporated
• Original Assignee: Abbott Laboratories Incorporated
• Inventors: Walberg, Erik K., Reynolds, Timothy C., Ellingwood, Brian A., Jair, Kai Y., Pantages, Anthony
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): Lauer, Christina
• Application Number:
  US11/427,297
• Publication Number:
  US 20080004636A1
• Time in Patent Office: 2,337 Days
• Field of Search: 606/213, 606/190, 606/142, 606/153, 606/151, 606/143, 606/140, 606/139
• US Class Current: 606/142
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00424 ergonomic, e.g. fitting in fist
• CPC Class Codes: A61B 2017/00672 Locating means therefor, e.g. bleed back lumen

Abstract

An apparatus for placement into an opening formed in a wall of a body lumen to deploy a closure element. The apparatus comprising a housing having a handle portion formed at a distal end, the handle portion configured to be engaged by a user when advancing the housing to deploy the closure element. A locator assembly and a carrier assembly are at least partially received in the housing. The locator assembly can have one or more expansion members that can selectably contact the wall of the body lumen and a proximal end configured to cooperate with a portion of a locator control system operable to expand the one or more expansion members. A triggering system cooperates with the locator assembly and is moveable toward the one or more expansion members of the locator assembly upon the locator control system being operated to expand the one or more expansion members.

Claims

1. An apparatus for delivering a closure element to an opening formed in a wall of a body lumen, the apparatus comprising:

a housing having a distally positioned finger grip extending in a first direction, a proximal end, and a longitudinal axis,

a locator assembly having a distal end region and a proximal end region, the distal end region having an expanded state and an unexpanded state and the proximal end being configured to cooperate with a movable plunger, the movable plunger being slidably disposed within the proximal end of said housing and distally advanceable into the proximal end of the housing,

a carrier assembly coupled with said locating assembly, said carrier assembly retaining the closure element in a substantially tubular configuration within said carrier assembly; and

a triggering system including a trigger extension, said trigger extension extending from said housing in said first direction, said triggering system, said locator assembly, and said movable plunger being operatively connected together and configured to advance distally together under movement of said movable plunger distally into said proximal end of said housing, said distal movement of said movable plunger simultaneously transitions said distal end region of said locator assembly to the expanded state and advances said trigger extension distally toward said distally positioned finger grip.

2. The apparatus as recited in claim 1, wherein said housing receives said locator assembly, said carrier assembly, and said triggering system.

3. The apparatus as recited in claim 1, wherein said locator assembly being configured to selectively control said distal end region of said locator assembly between said expanded state and said unexpanded state.

4. The apparatus as recited in claim 3, wherein said locator assembly further comprises a control member coupled to at least one expansion member and a tubular member surround said control member.

5. The apparatus as recited in claim 4, wherein said locator assembly further comprises a tubular body block mounted to said tubular member, a spring retainer receiving a portion of said tubular body block, and said movable plunger slidably cooperating with said tubular body block and said tubular member.

6. The apparatus as recited in claim 1, wherein said distal end region of said locator assembly is configured to transition from the unexpanded state to the expanded state.

7. The apparatus as recited in claim 6, wherein said triggering system moves toward said distal end region substantially simultaneously with said distal end region transitioning from said unexpanded state to said expanded state.

8. An apparatus for placement into an opening formed in a wall of a body lumen, the apparatus comprising:

a housing comprising an elongate body and a handle portion formed at a distal end and extending generally transversely from said elongate body in a first direction, said handle portion comprising a shaped grasping portion and an elongate grasping portion;

a locator assembly receivable by said housing, said locator assembly having a distal end region configured to extend into the opening and selectably contact the wall of the body lumen and a proximal end configured to cooperate with a movable plunger slidably disposed within a proximal end of said housing, cooperation of said movable plunger and said proximal end selectively moving said distal end region of said locator assembly between an expanded state and an unexpanded state;

a carrier assembly coupled with said locating assembly, said carrier assembly retaining a closure element in a substantially tubular configuration within said carrier assembly, said closure element being deployable from within a portion of said carrier assembly to close the opening formed in the wall of the body lumen, said carrier assembly including a carrier block and a trigger extension extending from said carrier block and extending from said housing in said first direction; and

a triggering system configured to deploy said closure element from said carrier assembly, said triggering system, said locator assembly, said carrier assembly, and said movable plunger being operatively connected together and configured to advance distally together under movement of said movable plunger distally into said proximal end of said housing, said distal movement of said movable plunger simultaneously transitions said distal end region of said locator assembly to the expanded state, advances said carrier assembly distally within said housing, and advances said trigger extension distally toward said distally positioned finger grip in a single step.

9. The apparatus as recited in claim 8, wherein said shaped grasping portion is spaced apart from said elongate grasping portion.

10. The apparatus as recited in claim 8, wherein said distal end of said housing further comprises at least one distal handle portion extending from said housing in a direction substantially opposite to at least one of said grasping portions.

11. The apparatus as recited in claim 8, wherein said shaped grasping portion has a generally curved configuration with a recess adapted to receive at least one of a thumb or finger during use of the apparatus.

12. The apparatus as recited in claim 8, wherein said trigger extension is coupled to and extends from said carrier assembly, said trigger extension being configured to advance the carrier assembly prior to deployment of the closure element.

13. The apparatus as recited in claim 12, wherein said trigger extension is movable toward said distal end region of said locator assembly upon activation of a locator control system to at least partially deploy at least one expansion element, disposed at said distal end region, configured to expand substantially transversely with respect to a longitudinal axis of said locator assembly.

14. An apparatus for placement into an opening formed in a wall of a body lumen to deploy a closure element, the apparatus comprising:

a housing comprising a handle portion formed at a distal end and extending in a first direction, said housing having a first stop formed within said housing;

a locator assembly receivable by said housing, said locator assembly having one or more expansion members configured to transition between an expanded state and an unexpanded state, said one or more expansion members being expanded substantially transversely with respect to a longitudinal axis of said locator assembly in the expanded state, and said locator assembly having a proximal end configured to cooperate with a portion of a locator control system of said locator assembly and with a movable plunger having two elongate structures slidably disposed within a proximal end of said housing, said locator control system being operable to transition said one or more expansion members between the expanded state and the unexpanded state and being configured to cooperate with the movable plunger;

a carrier assembly coupled with said locating assembly, said carrier assembly retaining a closure element in a substantially tubular configuration within said carrier assembly, said closure element being deployable from within a portion of said carrier assembly to close the opening formed in the wall of the body lumen, said carrier assembly including a carrier block and a trigger extension extending from said carrier block and extending from said housing in said first direction; and

a triggering system configured to deploy said closure element from said carrier assembly, said triggering system, said locator assembly, said carrier assembly, and said moveable plunger operatively connected together, a proximal portion of said carrier block engaging with one of the two elongate structures of said movable plunger, said other structure of said two elongate structures selectively engaging with the first stop to limit distal movement of the movable plunger within the housing, said trigger extension, said locator assembly, said carrier assembly, and said movable plunged being configured to advance distally together under movement of said movable plunger distally into said proximal end of said housing, said distal movement of said movable plunger simultaneously transitions said distal end region of said locator assembly to the expanded state, advances said carrier assembly distally within said housing, and advances said trigger extension distally toward said distally positioned finger grip in a single step, said trigger extension having a first orientation before said movable plunger is moved distally and longitudinally and a second orientation after said movable plunger is moved distally and longitudinally, the first orientation and the second orientation being the same and in the first direction.

15. The apparatus as recited in claim 14, wherein said housing further comprises at least one proximal handle portion configured to be engaged by the user when advancing said proximal end of said locating assembly.

16. The apparatus as recited in claim 15, wherein said trigger extension is coupled to and extending from said carrier assembly, said trigger extension being configured to advance said carrier assembly prior to deployment of said closure element.

17. The apparatus as recited in claim 14, wherein each of said one or more expansion members comprises one or more substantially flexible members.

18. The apparatus as recited in claim 14, wherein said locator control system is configured to selectively control said distal end region of said locator assembly between said expanded state and said unexpanded state.

19. The apparatus as recited in claim 18, wherein said locator assembly further comprises a control member coupled to said one or more expansion members and a tubular body surrounding said control member, said locator assembly further comprising a tubular body block mounted to said tubular member, a spring retainer receiving a portion of said tubular body block, and a movable plunger slidably cooperating with said tubular body block and said tubular member.

20. The apparatus of claim 14, wherein said carrier assembly comprises a carrier member for receiving and supporting said closure element in said substantially tubular configuration, a pusher member for distally deploying said closure element, and a cover member for retaining said closure element, said carrier member, said pusher member, and said cover member being slidably coupled.

21. The apparatus of claim 20, wherein said carrier member, said pusher member, and said cover member are provided as a plurality of nested, telescoping members with a common longitudinal axis.

22. The apparatus of claim 21, wherein said carrier member defines a lumen, said distal end region of said locator assembly being substantially axially aligned with, and at least partially slidably disposable within, said lumen of said carrier member.

23. The apparatus of claim 22, wherein said distal end region of said carrier member has a cross-section that increases distally for expanding said closure element to a cross-section that is greater than a natural cross-section of said closure element.

24. The apparatus of claim 23, wherein said distal end region of said pusher member includes one or more longitudinal extensions extending distally and being configured to expand radially as said distal end region of said pusher member moves distally and engages said distally-increasing cross-section of said distal end region of said carrier member.

25. The apparatus of claim 24, wherein said distal end region of said cover member includes one or more longitudinal extension extending distally and being configured to expand radially.

26. The apparatus of claim 20, wherein said carrier assembly further includes a support member being slidably coupled with said carrier member, said pusher member, and said cover member and being configured to provide radial support for said distal end region of said cover member.

27. The apparatus of claim 26, wherein said carrier member, said pusher member, said cover member, and said support member are provided as a plurality of nested, telescoping members with a common longitudinal axis.