Surgical clip applier and method of assembly

• US 8,465,502 B2
• Filed: 08/13/2009
• Issued: 06/18/2013
• Est. Priority Date: 08/25/2008
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Zergiebel, Earl M.
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): ORKIN, ALEXANDER J
• Application Number:
  US12/540,475
• Publication Number:
  US 20100049216A1
• Time in Patent Office: 1,405 Days
• Field of Search: 606/139, 606/142, 606/143, 606/219, 227/175.1
• US Class Current: 606/143
• CPC Class Codes: A61B 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/1222 Packages or dispensers therefor clip magazines incorporated in a clip-applying instrument A61B17/128; for surgical articles A61B50/30
• CPC Class Codes: A61B 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2090/038 during shipment

Abstract

Surgical clip appliers are provided including a channel assembly extending distally from a housing; a clip carrier disposed within the channel assembly and defining a channel and a plurality of windows therein; a plurality of clips slidably disposed within the channel of the clip carrier; a wedge plate reciprocally disposed within the channel assembly, the wedge plate being operatively connected to the handles and including a plurality of apertures formed along a length thereof; and a clip follower slidably disposed within the channel of the clip carrier and disposed proximally of the plurality of clips, the clip follower being configured and adapted for selective engagement with the windows of the clip carrier and the apertures of the wedge plate. The clip follower is configured and adapted to urge the plurality of clips, in a distal direction relative to the clip carrier, upon reciprocal movement of the wedge plate.

Claims

1. A surgical clip applier, comprising:

a housing;

at least one handle pivotably connected to the housing;

a channel assembly extending distally from the housing;

a pair of jaws supported on and extending from a distal end of the channel assembly, wherein the pair of jaws are adapted to accommodate a clip therein and operable to effect formation of a clip in response to movement of said handles;

a clip carrier disposed within said channel assembly and defining a channel and a plurality of windows therein;

a plurality of clips slidably disposed within said channel of said clip carrier;

a clip pusher bar reciprocally positioned within at least one of said housing and said channel assembly, said pusher bar having a first end operatively connected to at least one of said handles and a second end defining a pusher, said pusher bar being movable towards said jaws as said handles are approximated in a first direction by an initial amount in order to move a distal-most clip between said jaws, and said pusher bar being configured and adapted to move towards said housing as said handles are approximated an additional amount in said first direction to move said pusher behind a distal-most clip in said plurality of clips;

a wedge plate reciprocally disposed within said channel assembly, wherein a distal end of the wedge plate is selectively positionable between the pair of jaws to maintain the pair of jaws spaced apart, said wedge plate being operatively connected to said at least one handle and including a plurality of apertures formed along a length thereof; and

a clip follower slidably disposed within said channel of said clip carrier and disposed proximally of said plurality of clips, said clip follower being configured and adapted for selective engagement with said windows of said clip carrier and said apertures of said wedge plate, wherein said clip follower is configured and adapted to urge said plurality of clips, in a distal direction relative to said clip carrier, upon reciprocal movement of said wedge plate.

2. The clip applier according to claim 1, wherein the clip follower is configured to engage the wedge plate and move distally upon distal translation of the wedge plate, and is configured to engage the clip carrier and stop proximal movement thereof upon proximal translation of the wedge plate.

3. The clip applier according to claim 1, further comprising a motion multiplier system configured to distally move the pusher bar by an incremental amount upon an initial actuation of the handles, and configured to proximally move the pusher bar and the wedge plate subsequent to the initial actuation of the handles.

4. The clip applier according to claim 1, further comprising a drive channel translatably slidably disposed within at least one of said housing and said channel assembly, said drive channel having a first end operatively connected to said at least one handle and a second end configured and dimensioned to selectively engage said pair of jaws to effectuate closure of said pair of jaws, said drive channel being moved towards said pair of jaws as said at least one handle is moved actuated in a first direction to move said second end thereof against said jaws to close said jaws, said drive channel being moved away from said jaws as said at least one handle is moved a second amount to move said second end thereof away from said jaws to allow said jaws to open.

5. The clip applier according to claim 4, further comprising a motion reversing mechanism operatively connected to said wedge plate and said drive channel, wherein rotation of said motion reversing mechanism, during distal movement of said drive channel, results in proximal movement of said wedge plate.

6. The clip applier according to claim 4, further comprising a motion multiplier system including:

a bell crank gear pivotally supported in the housing and pivotally connected to the pusher bar;

an accelerator rack slidably supported in the housing and operatively joined to the bell crank gear; and

a biasing member interconnecting the drive channel and the accelerator rack,

wherein a distal translation of the drive channel causes distal translation of the accelerator rack via the biasing member, and wherein distal translation of the accelerator rack causes a first rotation of the bell crank gear and distal translation of the pusher bar.

7. The clip applier according to claim 6, wherein the bell crank gear includes an arm extending radially therefrom and an elongate slot formed in the arm, wherein the elongate slot slidably receives a boss operatively associated with the pusher bar.

8. The clip applier according to claim 6, further comprising a motion reversing mechanism operatively connected to said drive channel and said wedge plate and selectively engageable with said pusher bar, wherein rotation of said motion reversing mechanism, during said distal translation of said drive channel, results in proximal movement of said wedge plate and said pusher bar.

9. The clip applier according to claim 4, further comprising a ratchet mechanism including:

a rack, having a plurality of ratchet teeth, associated with said drive channel; and

a pawl, having at least one tooth, disposed at a location to selectively engage said rack, wherein said pawl is biased into engagement with said rack, wherein as said drive channel is longitudinally reciprocated, said plurality of teeth are passed over said pawl, and wherein said pawl prevents inadvertent return of said drive channel before full actuation of said at least one handle.

10. The clip applier according to claim 4, further comprising a lockout disposed in a distal end of said channel assembly, wherein said lockout is urged by said clip follower to extend across a path of said drive channel, thereby preventing said drive channel from moving distally.

11. The clip applier according to claim 4, wherein said drive channel is configured and dimensioned to at least partially surround said jaws and said wedge plate, wherein said drive channel includes a strap extending across a distal end thereof for maintaining said jaws and said wedge plate within said drive channel.

12. The clip applier according to claim 1, further comprising a lockout disposed in a distal end of said channel assembly.

13. The clip applier according to claim 12, wherein said lockout is actuated by said clip follower when a last clip is expelled from said clip applier.

14. The clip applier according to claim 1, further comprising a counter display mechanism supported in at least one of said housing and said channel assembly, wherein said counter display mechanism is configured and adapted to display a change in status of said clip applier upon each actuation of said at least one handle.

15. A surgical clip applier, comprising:

a housing;

at least one handle pivotably connected to opposite sides of the housing;

a channel assembly fixed to and extending from the housing;

a pair of jaws supported on and extending from a distal end of the channel assembly;

a clip carrier disposed within said channel assembly and defining a channel;

a plurality of clips slidably disposed within said channel of said clip carrier;

a clip follower slidably disposed within said channel of said clip carrier at a location proximal of said plurality of clips;

a drive channel translatably disposed within at least one of said housing and said channel assembly, said drive channel having a first end operatively connected to at least one of said handles and a second end configured and dimensioned to selectively engage said pair of jaws to effectuate closure thereof;

a pusher bar translatably disposed within at least one of said housing and said channel assembly, said pusher bar being connected to said drive channel via a motion multiplier system, a distal end of said pusher bar being configured to engage a distal-most clip of the plurality of clips;

a wedge plate reciprocally disposed within at least one of said housing and said channel assembly, wherein a distal end of said wedge plate is selectively insertable between said pair of jaws; and

a motion reversing mechanism including a first end connected to said drive channel, and a second end connected to said wedge plate and engageable by said pusher bar,

wherein distal translation of said drive channel causes said pusher bar to translate distally via said motion multiplier system; and

wherein distal translation of said drive channel causes said pusher bar and said wedge plate to translate proximally, via said motion reversing mechanism, following a dwell period.

16. The clip applier according to claim 15, further comprising a lockout disposed in a distal end of said channel assembly, wherein said lockout is actuated by said clip follower when a last clip is expelled from said clip applier, wherein said lockout is urged by said clip follower to extend across a path of said drive channel, thereby preventing said drive channel from moving distally.

17. The clip applier according to claim 16, wherein said wedge plate defines a plurality of apertures formed along a length thereof, wherein said clip carrier defines a plurality of windows formed along a length thereof, wherein said clip follower is configured and adapted for selective engagement with said windows of said clip carrier and said apertures of said wedge plate, wherein said clip follower is configured and adapted to distally incrementally urge said plurality of clips relative to said clip carrier upon a distal advancement of said wedge plate.

18. The clip applier according to claim 17, wherein said pair of jaws are adapted to accommodate a clip therein and are operable to effect formation of a clip in response to distal translation of said drive channel.

19. The clip applier according to claim 18, further comprising an indicator configured to create at least one of an audible indication and a tactile indication upon at least one of a loading of a clip into said pair of jaws and a formation of a clip by said pair of jaws.

20. The clip applier according to claim 15, wherein the motion multiplier system includes a bell crank gear having an arm extending radially therefrom and an elongate slot formed in the arm, wherein the elongate slot slidably receives a boss operatively associated with the pusher bar.

21. The clip applier according to claim 20, wherein the motion multiplier system includes an accelerator rack having a series of teeth and the bell crank gear includes a series of teeth engaged with the teeth of the accelerator rack, wherein axial translation of the accelerator rack results in rotation of the bell crank gear and axial translation of the pusher bar.

22. The clip applier according to claim 21, wherein the accelerator rack is connected to the drive channel via a biasing member.

23. The clip applier according to claim 15, further comprising a ratchet mechanism including:

a rack, having a plurality of ratchet teeth, associated with said drive channel; and

a pawl, having at least one tooth, disposed at a location to selectively engage said rack, wherein said pawl is biased into engagement with said rack, wherein as said drive channel is longitudinally reciprocated, said plurality of teeth are passed over said pawl, and wherein said pawl prevents inadvertent return of said drive channel before full actuation of said at least one handle.

24. The clip applier according to claim 15, wherein said drive channel is configured and dimensioned to at least partially surround said jaws and said wedge plate, wherein said drive channel includes a strap extending across a distal end thereof for maintaining said jaws and said wedge plate within said drive channel.

25. The clip applier according to claim 15, further comprising a counter mechanism, wherein the counter mechanism is actuatable upon one firing sequence of the clip applier, and wherein the counter mechanism provides an indication that one less clip is present in the clip applier.

26. A surgical clip applier mechanism operable to deliver at least relatively small, medium and large surgical clips, the surgical clip applier mechanism comprising:

a drive channel capable of translatable movement;

a pair of jaws engageable by a distal end of the drive channel, wherein the pair of jaws are approximated upon distal translation of the drive channel;

a wedge plate capable of reciprocal translation relative to the drive channel, wherein a distal end of the wedge plate is selectively positionable between the pair of jaws, the wedge plate defining a plurality of apertures formed along a length thereof;

a clip carrier fixedly located with respect to the drive channel, the clip carrier defining a channel and a plurality of windows formed along a length thereof;

a plurality of clips slidably disposed within said channel of said clip carrier;

a clip follower slidably disposed within said channel of said clip carrier at a location proximal of said plurality of clips;

a pusher bar capable of reciprocal translation relative to the drive channel, wherein a distal end of the pusher bar is configured for engagement with a distal-most clip of the plurality of clips;

a motion multiplier system including a bell crank gear and an accelerator rack, the accelerator rack being coupled to the drive channel via a biasing member, the bell crank gear being coupled to the accelerator rack via complementary gear teeth, and the bell crank gear being coupled to the pusher bar,

wherein distal translation of the drive channel causes the accelerator rack to translate distally, causing the bell crank gear to rotate, causing the pusher bar to translate distally; and

a motion reversing mechanism including a first end connected to the drive channel, and a second end connected to the wedge plate and engageable by the pusher bar,

wherein distal translation of the drive channel causes the first end of the pivot arm to translate distally, causing the second end of the pivot arm to translate in a proximal direction, thus causing the wedge plate to translate in a proximal direction; and

wherein distal translation of the pusher bar is stopped upon contact of the pusher bar with the second end of the motion reversing mechanism.