Methods of use of a clip applier

• US 9,398,914 B2
• Filed: 09/03/2013
• Issued: 07/26/2016
• Est. Priority Date: 01/30/2003
• Status: Expired due to Term

• Current Assignee: Integrated Vascular Systems, Inc. (Abbott Laboratories Incorporated)
• Original Assignee: Integrated Vascular Systems, Inc. (Abbott Laboratories Incorporated)
• Inventors: Ellingwood, Brian A., Voss, Laveille K., Gross, T. Daniel, McCrystle, Kelly
• Primary Examiner(s): BUI, VY Q
• Application Number:
  US14/017,039
• Publication Number:
  US 20140005692A1
• Time in Patent Office: 1,057 Days
• Field of Search: 606/213, 606/219, 606/139, 606/142, 606/41
• US Class Current: 1/1
• 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 2017/00637 for sealing trocar wounds through abdominal wall

Abstract

A method for closing an opening formed in a wall of a body lumen or body tissue can include positioning a splittable carrier tube adjacent to the opening, the carrier tube having a splittable distal end with an outer surface retaining a closure element in a substantially tubular configuration or having an asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile. The method including splitting a distal end of the carrier tube with a splitter and deploying the closure element from the carrier flaps of the carrier tube and over the splitter to allow the closure element to engage at least a portion of the wall of the body lumen or the body tissue and substantially close the opening.

Claims

1. A clip for closing an opening formed in a wall of a body lumen or body tissue, the clip comprising:

a shape-memory clip having a relaxed configuration with a substantially annular body defining a lumen with a plurality of tines directed inwardly from the body and being spaced apart such that a perimeter changes without changing an angle formed by proximal edges of the clip relative to a longitudinal axis, the clip further having opposing tines that are longitudinally stretched from a deploying configuration into a retaining configuration that is retained within a clip applier, wherein the clip has a substantially asymmetrically-elongated tubular shape with a substantially parallelogram longitudinal cross-sectional profile and a proximal portion having the plurality of tines being longitudinally and distally directed with a first tine of the plurality of tines being more distally oriented compared to a substantially opposite second tine being more proximal when the clip is disposed in the clip applier, with a length of the first tine being the same as a length of the second tine, and wherein the clip relaxes from the retaining configuration to the relaxed configuration when the clip is being released from the clip applier.

2. A clip as in claim 1, wherein the clip has a deploying configuration having a substantially tubular shape with a substantially rectangular longitudinal cross-sectional profile with the first tine being substantially even with the second tine, and wherein the clip relaxes from the retaining configuration to the deploying configuration before relaxing to the relaxed configuration when the clip is being released from the clip applier.

3. A clip as in claim 1, wherein the lumen in the retaining configuration has a smaller orthogonal cross-sectional profile compared to the lumen in the deploying configuration.

4. A clip as in claim 1, wherein the lumen in the retaining configuration has an oval orthogonal cross-sectional profile.

5. A clip as in claim 1, wherein the clip automatically retracts into the deploying configuration when being released from the clip applier.

6. A clip as in claim 5, wherein the clip automatically converts to the relaxed configuration from the deploying configuration after being released from the clip applier.

7. A clip as in claim 1, wherein in the relaxed configuration the first tine being more distally orientated compared to a substantially opposite second tine is substantially planar or substantially curved so as to conform with the external surface of a blood vessel.

8. A clip as in claim 1, wherein the deploying configuration is substantially symmetrical.

10. A clip as in claim 1, wherein the clip further includes a plurality of securing elements that have a magnetic force biasing the plurality of securing elements together and thereby closing an opening in the lumen wall or tissue.

9. A clip for closing an opening formed in a wall of a body lumen or body tissue, the clip comprising:

a shape-memory clip having a relaxed configuration with a substantially annular body defining a lumen with a plurality of tines directed inwardly from the body, the clip further having a retaining configuration wherein the clip has a substantially symmetrical tubular shape with a substantial rhomboid longitudinal cross-sectional profile, the plurality of tines having substantially equal length and being aligned longitudinally and distally directed with a first tine of the plurality of tines being offset longitudinally and distally compared to a substantially opposite second tine being more proximal when the clip is disposed in a clip applier, and wherein the clip relaxes from the retaining configuration to the relaxed configuration when the clip is being released from the clip applier where the first and second tines are adjacent each other, the shape memory clip is heat set so that when transitioning from the retaining configuration to the relaxed configuration the first tine transitions a shorter distance than the second tine.

11. A clip applier apparatus for closing an opening formed in a wall of a body lumen or body tissue, the clip apparatus comprising:

a pusher tube having a proximal end and a distal end, a first radial portion of the distal end extending longitudinally beyond a second radial portion of the distal end;

a shape-memory clip having a relaxed configuration with a substantially annular body defining a lumen with a plurality of tines directed inwardly from the body, the clip further having a retaining configuration wherein the clip has a substantially symmetrical elongated tubular shape with a substantially rhomboid longitudinal cross-sectional profile, the plurality of tines having substantially equal length and being longitudinally and distally directed with opposing tines that are longitudinally stretched in equal and opposite manner such that a first tine of the plurality is more distally oriented compared to a substantially opposite second tine being more proximal when the clip is disposed in a clip applier, and wherein the clip relaxes from the retaining configuration to the relaxed configuration when the clip is being released from the clip applier.

12. A clip system for closing an opening formed in a wall of a body lumen or body tissue, the clip system comprising:

a clip applier having a carrier tube that is adjacent to the opening and that has a tapered distal end; and

a pusher tube having a proximal end and a distal end, a first radial portion of the distal end extending longitudinally beyond a second radial portion of the distal end;

a shape-memory clip having a relaxed configuration with a substantially annular body defining a lumen with a plurality of tines directed inwardly from the body, the clip further having a deploying configuration wherein the clip has a substantially asymmetrically-elongated tubular shape with a substantially trapezoidal longitudinal cross-sectional profile and a proximal portion having the plurality of tines being longitudinally and distally directed with a first tine of the plurality of tines being more distally oriented compared to a substantially opposite second tine being more proximal when the clip is disposed in the clip applier, a length of the first tine is the same as a length of the second tine, the shape memory clip is heat set so that when transitioning from the retaining configuration to the relaxed configuration the first tine transitions a shorter distance than the second tine,

wherein the pusher tube within the clip applier is configured to push the clip over the tapered distal end of the carrier tube such that the clip may be ejected in the deploying configuration from the carrier tube and at least a portion of the plurality of tines engage a portion of the wall of the body lumen or the body tissue and the opening is drawn substantially closed as the clip relaxes from the deploying configuration to the relaxed configuration.