Articulating endoscopic surgical clip applier

• US 8,845,659 B2
• Filed: 02/21/2013
• Issued: 09/30/2014
• Est. Priority Date: 02/25/2010
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Whitfield, Kenneth H., Rethy, Csaba L.
• Primary Examiner(s): Tyson, Melanie
• Assistant Examiner(s): Scherbel, Todd J
• Application Number:
  US13/772,998
• Publication Number:
  US 20130172912A1
• Time in Patent Office: 586 Days
• Field of Search: None
• US Class Current: 606/143
• 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 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• 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 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00318 Steering mechanisms
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/2908 Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion

Abstract

An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly and a shaft assembly. The handle assembly includes a drive assembly; and a trigger operatively connected to the drive assembly. The shaft assembly extends from the handle assembly and includes an articulating neck assembly; and an end effector assembly supported on a distal end of the articulating neck assembly and being configured to form a surgical clip in place on the body tissue.

Claims

1. An apparatus for application of surgical clips to body tissue, the apparatus comprising:

a handle assembly including;

a housing;

a drive assembly having a clutch gear and a clutch bracket, the clutch gear defining a crown of gear teeth configured to cooperate and selectively engage a crown of teeth of a handle drive screw, the clutch bracket pivotally supported in the housing and including at least one leg extending around the clutch gear, the clutch bracket configured to approximate and separate the crown of gear teeth of the clutch gear with the crown of teeth of the handle screw;

a trigger operatively connected to the drive assembly; and

a drive block axially slidably supported in the housing, wherein the drive block is connected to the trigger and defines a helical lumen therethrough; and

a shaft assembly extending from the handle assembly, the shaft assembly including;

an articulating neck assembly; and

an end effector assembly supported on a distal end of the articulating neck assembly and being configured to form a surgical clip in place on the body tissue, the end effector including;

a plurality of clips loaded therein;

jaws supported at a distal end of the end effector, wherein the jaws are configured to serially receive and form a single clip at a time, of the plurality of clips;

a pusher bar configured to load the single clip of the plurality of clips into the jaws; and

a drive bar configured to selectively engage the pusher bar to effectuate a closure of the jaws;

wherein a single complete actuation of the trigger loads the single clip of the plurality of clips into the jaws and forms the single clip;

wherein a rotatable drive member operatively connected to the trigger and to the end effector, wherein actuation of the trigger results in a rotation of the drive member, and the rotation of the drive member results in a loading of the single clip of the plurality of clips into the jaws and in a closing of the jaws, and wherein the rotatable drive member includes the handle drive screw threadably engaged with the helical lumen of the drive block, wherein axial translation of the drive block relative to the handle drive screw of the handle assembly results in a rotation of the handle drive screw.

2. The apparatus according to claim 1, wherein the end effector assembly includes a drive sled slidably axially translatable therewithin and defines a helical lumen therethrough, and wherein the rotatable drive member includes an end effector drive screw threadably engaged with the helical lumen of the drive sled,

wherein the rotation of the handle drive screw results in a rotation of the end effector drive screw and an axial translation of the drive sled.

3. The apparatus according to claim 2, wherein the drive sled is selectively engaged with the pusher bar such that a distal advancement of the drive sled results in distal advancement of the pusher bar for a given distance and then the drive sled disconnects from the pusher bar after the given distance.

4. The apparatus according to claim 2, wherein the end effector assembly includes an advancer plate slidably disposed therewithin, wherein the advancer plate is detachably connected to the pusher bar,

wherein during a distal advancement of the pusher bar, the pusher bar engages the advancer plate to distally move the advancer plate.

5. The apparatus according to claim 4, wherein the advancer plate includes a tab extending therefrom for selective engagement by the pusher bar as the pusher bar is advanced distally.

6. The apparatus according to claim 4, wherein the end effector assembly further includes a clip follower slidably supported therewithin for urging the plurality of clips disposed within the end effect or assembly in a distal direction, the clip follower including an upper tab projecting from a first surface thereof and a lower tab projecting from a second surface thereof, wherein the upper tab of the clip follower engages the advancer plate as the advancer plate is moved distally such that the clip follower is moved distally to advance the surgical clips, and wherein the lower tab of the clip follower engages a feature as the advancer plate is moved proximally such that the clip follower remains stationary.

7. The apparatus according to claim 6, wherein the end effector assembly further includes a clip carrier disposed therewithin, wherein the clip carrier is configured to retain the surgical clips and the clip follower, wherein the lower tab of the clip follower engages features formed in the clip carrier.

8. The apparatus according to claim 7, wherein the clip follower is incrementally advanced through the clip carrier.

9. The apparatus according to claim 2, wherein the drive bar is selectively engaged by the drive sled following a loading of the single clip into the jaws by the pusher bar, and wherein distal advancement of the drive sled distally advances the drive bar to effectuate the closure of the jaws.

10. The apparatus according to claim 1, wherein the pusher bar remains in a distally advanced position during an approximation of the jaws.

11. The apparatus according to claim 1, wherein the shaft assembly is rotatable, about a longitudinal axis, with respect to the handle assembly.

12. The apparatus according to claim 1, wherein the neck assembly includes a plurality of inter-connected articulation joints.

13. The apparatus according to claim 1, wherein the handle assembly supports an articulation dial, wherein the articulation dial is operatively connected to the neck assembly such that actuation of the articulation dial results in articulation of the neck assembly.

14. The apparatus according to claim 13, wherein the handle assembly includes:

an articulation screw rotatably supported therein and connected to the articulation dial, the articulation screw defining a pair of oppositely oriented grooves formed in a surface thereof; and

a pair of articulation actuators translatably slidably supported in the handle assembly, wherein each articulation actuator is engaged with a respective helical groove of the articulation screw, wherein a proximal end of each articulation cable is secured to a respective articulation actuator;

wherein rotation of the articulation dial results in rotation of the articulation screw and opposed translation of the articulation actuators.

15. The apparatus according to claim 14 wherein the handle assembly further includes a ratchet operatively engaged with the articulation dial.