Clips and applicator for tissue closure

• US 9,883,866 B2
• Filed: 11/02/2015
• Issued: 02/06/2018
• Est. Priority Date: 11/03/2014
• Status: Active Grant

• Current Assignee: Oregon Health & Science University
• Original Assignee: Oregon Health & Science University
• Inventors: Roundy, Neil, Dreilinger, Rachel
• Primary Examiner(s): Fishback, Ashley
• Application Number:
  US14/930,595
• Publication Number:
  US 20160120546A1
• Time in Patent Office: 827 Days
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/1222 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 2017/00659 located only on one side of the opening
• CPC Class Codes: A61B 2017/00668 the implement being a tack or a staple

Abstract

Surgical clips and surgical applicators used in performing rapid tissue closure in either minimally invasive surgeries or traditional open procedures are provided. In one example approach, a surgical clip comprises opposing sides extending from a top portion and terminating at tips positioned below the top portion. The resting position of the clip is its closed position. Edges of the top portion and the opposing sides form opposing faces perpendicular to the opposing sides. The opposing faces are angled inwardly towards each other at a region of the faces adjacent to the top portion. Grooves are formed in each of the opposing sides. The grooves are configured to engage inwardly turned tracks of a clip applicator such that, when a force is applied to the clip, the opposing sides bend outwardly away from each other to place the clip in an intermediate open position.

Claims

1. A surgical clip, comprising:

first and second opposing sides extending from a top portion, wherein the first and second opposing sides terminate at first and second tips positioned below the top portion with a first distance between the first and second tips, thereby placing the clip in a closed resting position;

wherein edges of the top portion and the first and second opposing sides form opposing front and back faces perpendicular to the first and second opposing sides, wherein the front and back faces are angled inwardly towards each other at a region of the faces adjacent to the top portion;

a first groove formed in the first side, the first groove extending from the front face to the back face, the first groove having a top inner surface formed by a bottom surface of a region of the top portion extending over the first side;

a second groove formed in the second side, the second groove extending from the front face to the back face, the second groove having a top inner surface formed by a bottom surface of a region of the top portion extending over the second side, where the first groove is substantially parallel to the second groove and wherein the first and second grooves are substantially perpendicular to the front and back faces at a region of the front and back faces adjacent to the first and second tips;

wherein the first and second grooves are each configured to engage inwardly turned tracks at an end of a clip applicator such that, when a force is applied to the clip, the first and second sides bend outwardly away from each other, thereby increasing the distance between the tips to a second distance between the tips, wherein the second distance between the tips is greater than the first distance between the tips, thereby placing the clip in an open position.

2. The surgical clip of claim 1, wherein the first and second grooves are each configured to engage inwardly turned tracks at the end of the clip applicator such that when a push rod of the clip applicator is used to apply pressure to the top portion, the first and second sides bend outwardly away from each other, thereby increasing the distance between the tips to the second distance between the tips.

3. The surgical clip of claim 1, wherein the first and second grooves are each configured to engage inwardly turned tracks of the clip applicator, where a distance between the inwardly turned tracks decreases at an end of the clip applicator, such that when a force is applied to the back face of the clip, the clip moves within the tracks toward the end of the clip applicator thereby increasing the distance between the tips to the second distance between the tips.

4. The surgical clip of claim 1, wherein the region of the front face adjacent to the top portion is inwardly angled by approximately 15 degrees relative to the region of the front face adjacent to the first and second tips, and wherein the region of the back face adjacent to the top portion is inwardly angled by approximately 15 degrees relative to the region of the back face adjacent to the first and second tips.

5. The surgical clip of claim 1, wherein a bottom inner surface of the first groove forms an angle of approximately 25 degrees relative to the top inner surface of the first groove and wherein a bottom inner surface of the second groove forms an angle of approximately 25 degrees relative to the top inner surface of the second groove.

6. The surgical clip of claim 5, wherein an inner flat region is formed between the bottom inner surface and the top inner surface of the first groove and the inner flat region is perpendicular to the bottom inner surface of the first groove, and wherein an inner flat region is formed between the bottom inner surface and the top inner surface of the second groove and the inner flat region is perpendicular to the bottom inner surface of the second groove.

7. The surgical clip of claim 1, wherein the region of the top portion extending over the first side forms two opposing wings extending a non-zero distance beyond the first and second sides so that a length of the top portion is greater than a length between an outer surface of the first side and an outer surface of the second side.

8. The surgical clip of claim 1, wherein a width of the clip is greater than at least 25% of a length of the clip, wherein the length of the clip is the dimension from the first side to the second side and the width of the clip is the dimension perpendicular to the length.

9. The surgical clip of claim 1, wherein the first tip converges in a direction toward the second tip to form two teeth positioned adjacent to the two opposing faces and the second tip converges in a direction toward the first tip to form a single tooth located between the two teeth formed by the first tip.

10. The surgical clip of claim 1, wherein the top portion is concave.

11. The surgical clip of claim 10, wherein a top surface of the top portion above the first side forms a first angle with a top surface of the top portion above the second side in the closed resting position, and wherein the top surface of the top portion above the first side forms a second angle with the top surface of the top portion above the second side in the open position, where the first angle is greater than the second angle.

12. The surgical clip of claim 11, wherein the first angle is greater than 90 degrees and the second angle is less than 90 degrees.

13. The surgical clip of claim 1, wherein each of the first and second opposing sides is convex.

14. The surgical clip of claim 1, wherein the clip is composed of a bioabsorbable material.

15. The surgical clip of claim 1, wherein the clip is composed of a radiolucent material.

16. The surgical clip of claim 1, wherein each of the first and second opposing sides comprises a flat portion coupled via an inner top junction to the top portion and coupled via a curved bottom junction to the tip.

17. A surgical clip array for a surgical clip applicator, comprising:

a plurality of the clips of claim 1; and

a chamber housing the plurality of surgical clips;

the chamber having inwardly turned tracks engaging the grooves of each clip to maintain the front and back faces of each clip as orientated in the same direction as the front and back faces of the other clips in the plurality of surgical clips, yet large enough to allow movement of the plurality of clips in the direction of the faces of the clips; and

wherein the plurality of clips comprises two or more clips in physical contact with one another.

18. The surgical clip array of claim 17, wherein a direction of the inwardly turned tracks transitions from a vertical direction to a horizontal direction in a transition region of the tracks and wherein the angled regions of the faces of adjacent clips in the transition region interface with each other.

19. The surgical clip array of claim 17, further comprising a top clip in the plurality of clips, wherein the back face of the top clip interfaces with a pusher element of the clip applicator.

20. A surgical clip applicator, comprising:

a clip array of claim 17, the array comprising a chamber with an open end;

a push rod configured to apply pressure on a top clip in the array.

21. The surgical applicator of claim 20, where a distance between the inwardly turned tracks decreases at an end of the applicator.

22. The surgical applicator of claim 20, further comprising a plurality of support members in a wall of the chamber, where each support member in the plurality of support members spans from one track to the opposing track.

23. The surgical applicator of claim 20, further comprising grippers at a distal end of the applicator, the grippers comprising two opposing arms held in a closed position around a bottom clip in the clip array.

24. The surgical applicator of claim 23, wherein the two opposing arms are biased away from each other, are held in a closed position around the sides of the bottom clip when opposing tabs extending from the push rod interface with outer surfaces of the grippers, and are released to an open position when a downward force is applied to the push rod to move the opposing tabs into apertures formed in opposing sides of the applicator.