Endoscopic hemostatic clipping apparatus

• US 9,084,604 B2
• Filed: 11/21/2011
• Issued: 07/21/2015
• Est. Priority Date: 11/07/2003
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Litscher, Eric, Turturro, Vincent A., Sullivan, Roy H.
• Primary Examiner(s): Shi, Katherine M
• Assistant Examiner(s): BACHMAN, LINDSEY MICHELE
• Application Number:
  US13/301,180
• Publication Number:
  US 20120065647A1
• Time in Patent Office: 1,338 Days
• Field of Search: 606/139, 606/142, 606/143, 606/157, 606/158, 606/219, 2271751-1821
• US Class Current: 1/1
• 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 17/128 for applying or removing clamps or clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/12004 for haemostasis, for prevention of bleeding

Abstract

An apparatus for applying clips to tissue, comprises a plurality of clips, each of the clips including a proximal end having a pair of opposed jaws and a distal end including a linking feature, where the clips are linked to one another to form a clip chain with a linking feature of a distal-most one of the clips being gripped between the jaws of an immediately proximal one of the clips and a control linkage coupled to a proximal-most one of the clips for applying tension and compression to the clip chain in combination with a magazine containing the clip chain, the magazine including an abutment surface sized to prevent passage distally therebeyond of a clip having received between its jaws a linking feature of an immediately distal clip and an opening location within which the jaws of a clip are permitted to open to release a linking feature therefrom.

Claims

1. An apparatus for applying clips to tissue, comprising:

a clip chain formed of a plurality of clips connected to one another, each of the clips including a pair of opposed jaws biased toward an open configuration and a proximal end including a linking feature received between the jaws of an immediately proximal one the clips when the proximal one of the clips is in a closed configuration, the proximal one the clips, which receives the linking feature of the distal-most one of the clips between jaws thereof, having a first cross-sectional area larger than a second cross-sectional area of the distal-most one of the clips, which does not receive a linking feature between jaws thereof;

a control linkage extending between a distal end releasably coupled to a proximal-most one of the clips and a proximal end coupled to a control handle which, when the apparatus is in an operative position, remains accessible to a user to control a tension and compression applied to the clip chain via the control linkage; and

a magazine housing the clip chain and constraining the clips in the closed configuration, the magazine including a reduced cross-section portion at a distal end thereof smaller than the first cross-sectional are and larger than the second cross-sectional area to permit distal passage therethrough of only the distal-most one of the clips such that the jaws of the distal-most one of the clips revert to the open configuration to receive a target tissue therebetween.

2. The apparatus of claim 1, wherein the magazine includes anti-pull back tabs which, when the distal-most one of the clips is drawn proximally into the magazine, engages a lock ring of the distal-most one of the clips to move the lock ring over the jaws of the distal-most one of the clips, locking the distal-most one of the clips in the closed configuration.

3. The apparatus of claim 1, wherein opposing jaws of the clip include a snap and catch mechanism to lock the jaws in the closed configuration when the distal-most one of the clips is drawn proximally into the magazine.

4. The apparatus of claim 1, wherein opposing jaws of the clip include corresponding snaps configured to engage one another and lock the jaws in the closed configuration when the distal-most one of the clips is drawn proximally into the magazine.

5. The apparatus of claim 1, wherein the magazine includes a relief portion which permits the jaws of a clip immediately proximal of the distal-most one of the clips to open, releasing the linking feature of the distal-most one of the clips to separate the distal-most one of the clips from the clip chain.

6. The apparatus of claim 5, wherein the relief portion includes one of a movable tab and an opening extending through the magazine.

7. The apparatus of claim 5, wherein the clip includes a positioning feature formed along a portion thereof to interface with a portion of the magazine and position the clip immediately proximal of the distal-most one of the clips relative to the relief portion.

8. The apparatus of claim 1, wherein the magazine is flexible for bending with respect to a longitudinal axis thereof.

9. The apparatus of claim 1, wherein the magazine includes a plurality of partially circumferential slits formed thereon to increase a flexibility thereof.

10. A method for applying clips to tissue, comprising the steps of:

inserting a magazine housing a clip chain to a target area within a body, the clip chain including a plurality of clips connected to one another, each of the clips including a pair of opposed jaws biased toward an open configuration and a proximal end including a linking feature, the magazine constraining the clips in a closed configuration such that the linking feature of a distal-most one of the clips is received between the jaws of an immediately proximal one the clips;

applying a compression to the clip chain via a control linkage coupled to a proximal-most one of the clips in the clip chain by moving the clip chain distally relative to the magazine such that the distal-most one of the clips is pushed distally past a reduced cross-section portion at a distal end of the magazine such that the jaws thereof revert to the open configuration;

positioning the jaws of the distal-most magazine over a target tissue;

applying a tension to the clip chain via the control linkage by moving the clip chain proximally and drawing the distal-most one of the clips into the magazine to close the jaws of the distal-most one of the clips over the target tissue; and

moving the clip chain farther proximally to separate the distal-most one of the clips from the immediately proximal one of the clips.

11. The method of claim 10, wherein drawing the distal-most one of the clips into the magazine locks the jaws in the closed configuration.

12. The method of claim 11, wherein the distal-most one of the clips is locked in the closed configuration via an anti-pull tab of the magazine which engages a lock ring of the distal-most one of the clips to move the lock ring over the jaws of the distal-most one of the clips.

13. The method of claim 11, wherein the distal-most one of the clips is locked in the closed configuration via a snap and catch mechanism formed on opposing jaws thereof.

14. The method of claim 11, wherein the distal-most one of the clips is locked in the closed configuration via corresponding snaps formed on the opposing jaws to engage one another.

15. The method of claim 10, wherein the distal-most one of the clip is separated from the immediately proximal one of the clips by positioning the immediately proximal one of the clips within a relief portion of the magazine which permits the jaws of the immediately proximal one of the clips to open and release the linking feature of the distal-most one of the clips.

16. The method of claim 15, wherein the relief portion includes one of a movable tab and an opening extending through the magazine.

17. The method of claim 15, wherein the immediately proximal one of the clips is positioned within the relief portion via a positioning feature formed along a portion of the clip which interface with a portion of the magazine to prevent the distal-most one of the clips from being moved any farther proximally.

18. The method of claim 10, wherein the magazine is inserted to the target area through an endoscope.

19. The method of claim 10, further comprising moving the magazine to a second target area within the body to deploy the immediately proximal one of the clips.

20. An apparatus for applying clips to tissue, comprising:

a magazine housing a clip chain formed of a plurality of clips connected to one another, each of the clips including clips including a pair of opposed jaws biased toward an open configuration and a proximal end including a linking feature, the magazine constraining the clips in a closed configuration such that the linking feature of a distal-most one of the clips is received within the between the jaws of an immediately proximal one the clips, the immediately proximal-most one of the clips, which receive the linking feature of the distal-most one of the clips between jaws thereof, having a first cross-sectional area larger than a second-cross sectional area of the distal-most clip, which does not receive a linking feature between jaws thereof, the magazine including a reduced cross-section portion at a distal end thereof which is smaller than the first cross-sectional area and larger than the second cross-sectional area to permit distal passage therethrough of only the distal-most one of the clips such that the jaws of the distal-most one of the clips revert to the open configuration to receive a target tissue therebetween; and

a control linkage extending between a distal end releasably coupled to a proximal-most one of the clips and a proximal end coupled to a control handle which, when the apparatus is in an operative position, remains accessible to a user to control a tension and compression applied to the clip chain via the control linkage.