Apparatus and method for applying latchless surgical clips

• US RE36,720 E
• Filed: 03/07/1997
• Issued: 05/30/2000
• Est. Priority Date: 12/13/1990
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Zvenyatsky, Boris, McGarry, Richard, Green, David T., Shichman, Daniel
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/812,636
• Time in Patent Office: 1,180 Days
• Field of Search: 606/143, 606/142, 606/219
• US Class Current: 606/151
• 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 17/1285 for minimally invasive surgery
• CPC Class Codes: F16B 2/22 of resilient material, e.g. rubbery material F16B2/205 takes precedence

Abstract

A disposable apparatus is disclosed for applying latchless surgical clips to body tissue in endoscopic surgical procedures. The latchless clips are resiliently biased to a closed configuration. The apparatus includes a frame which is adapted to be gripped by hand, and an endoscopic section connected to the handle and capable of storing surgical clips in preparation for clipping arteries or other body tissue. The apparatus includes means for advancing each clip sequentially, temporarily opening the clip and advancing the clip further to a pair of distal jaws where the clip is positioned around the body tissue and closes around the tissue. Also included are means for closing the jaws about the clip. When the jaws are closed, the clip advancing means is simultaneously positioned to advance the next clip. The present apparatus also makes it possible to partially close a clip without interfering with the sequential movement of the clip advancing mechanism.

Claims

1. An apparatus for endoscopic application of surgical clips to body tissue, which comprises:

a) a frame,

b) endoscopic means of generally elongated configuration defining a longitudinal axis and connected to said frame and extending distally therefrom, said endoscopic means including a tubular housing defining an internal passage and having a distal end portion, and further including;

(i) means for storing a plurality of surgical clips in the internal passage of said tubular housing and a plurality of surgical clips stored in said storing means, each of said surgical clips possessing a pair of legs which are movable between a first position wherein said legs are in relatively close proximity with each other, a second open position wherein said legs are relatively spaced apart from each other, and a third closed position wherein said legs are in relatively close engaged relation with tissue gripped therebetween, said legs being resiliently biased toward said first position, said surgical clips being stored in said storing means in said first position,

(ii) clip opening means located in the internal passage of said tubular housing for moving said surgical clip legs from said first position to said second open position,

(iii) clip advancing means movable within the interior passage of said tubular housing for individually distally advancing said surgical clips to a location wherein said clips are permitted to at least partially surround body tissue when said clip legs are in said second open position; and

(iv) means positioned at said distal end portion of said tubular housing for moving said clip legs to said third position to effect closure of said surgical clips at least sufficient to grip the body tissue.

2. The apparatus of claim 1, wherein said surgical clip legs possess opposing tissue clamping surfaces and tissue clamping means on said tissue clamping surfaces, said tissue clamping means of one leg being cooperatively engageable with said tissue clamping means of the other leg to impart a tissue clamping force to body tissue positioned therebetween.

3. The apparatus of claim 1, wherein said surgical clip includes at least one projection on each of said legs.

4. The apparatus of claim 3, wherein said clip opening means comprises a track portion having at least one camming surface positioned such that upon distal advancing of said clips said projections contact said camming surface and are laterally moved to a more spaced apart configuration.

5. The apparatus of claim 1, wherein said surgical clips each have at least one projection for engagement by said advancing means.

6. The apparatus of claim 5, wherein said clip advancing means comprises a fork shaped distal end portion for engaging said projection of the clip.

7. The apparatus of claim 1, wherein said surgical clips are stored in said clip storing means in a row aligned with the longitudinal axis of the instrument.

8. The apparatus of claim 1, wherein said means for effecting closure of the surgical clip comprises jaw means positioned at the distal end of the endoscopic means.

9. The apparatus of claim 8, wherein said clip advancing means advances the surgical clips to a position between said jaw means for positioning adjacent to the body tissue to be clipped.

10. The apparatus according to claim 9, wherein said frame comprises an instrument body and an actuating handle mounted to said instrument body.

11. The apparatus according to claim 10, wherein said frame contains first transmission means for linearly transferring motion from said actuating handle to said clip advancing means.

12. The apparatus according to claim 11, wherein said frame contains second transmission means for linearly transferring motion from said actuating handle to said jaw closing means.

13. The apparatus according to claim 11, wherein said endoscopic section is rotatable independent of said handle.

14. The apparatus according to claim 11, further comprising means for locking said handle such that after actuating said handle to close said jaws, said handle cannot be actuated unless said locking means is released.

15. The apparatus according to claim 14, wherein said handle locking means comprises a first resilient catch movable in response to actuation of said handle from an unlocked position to a locked position wherein first transmission means is advanced and locked, release means adapted to release said first resilient catch, said first resilient catch being returnable to the unlocked position in response to actuation of said release means, and a second resilient catch movable in response to actuation of said handle from an unlocked position to a locked position wherein it engages and locks second transmission means, said second resilient catch being resiliently returnable to the unlocked position in response to the release of said resilient catch.

16. The apparatus according to claim 8, wherein said jaw means comprises a pair of jaws positioned in spaced relation and configured and dimensioned for reception of a surgical clip therebetween, said jaws each having a clip contacting edge adapted to engage a corresponding notch on the outer edge of the clip, said jaws being resiliently movable toward and away from each other in response to longitudinal movement of a camming means between a proximal position and a distal position.

17. The apparatus according to claim 16, wherein said camming means comprises a channel member slidably mounted within said endoscopic section and longitudinally movable in response to actuation of said handle, said channel member having at least two distal camming surfaces for biasing the jaws into said closed position.

18. The apparatus according to claim 1, wherein said means for storing surgical clips comprises a track for holding a longitudinal array of surgical clips, and spring means located proximal to the array of surgical clips for biasing said surgical clips toward the distal direction.

19. The apparatus according to claim 18, further comprising a clip follower and a clip track positioned between said jaw means and said clip follower.

20. The apparatus according to claim 1, wherein said means for advancing the surgical clips comprises a pusher bar for advancing the distal-most clip into said means for moving said clip legs to said third position, said pusher bar being longitudinally slidable in response to actuation of said handle.

21. The apparatus according to claim 1, wherein said endoscopic section includes a gaseous seal means.

22. An apparatus for endoscopic application of surgical clips to body tissue, which comprises:

a) a frame configured and dimensioned for manual gripping,

b) an endoscopic shaft of generally elongated configuration defining a longitudinal axis and connected to said frame and extending distally therefrom, said endoscopic shaft including a tubular housing defining an internal passage and having a distal end portion, and further including;

(i) means for storing a plurality of surgical clips in the internal passage of said tubular housing and a plurality of surgical clips stored in said storing means, each of said surgical clips possessing a pair of legs which are movable between a first position wherein said legs are in relatively close proximity with each other, a second open position wherein said legs are relatively spaced apart from each other, and a third closed position wherein said legs are in relatively close engaged relation with tissue gripped therebetween, said legs being resiliently biased toward said first position, said surgical clips being stored in said storing means in said first position,

(ii) clip opening means located in the internal passage of said tubular housing for moving said surgical clip legs from said first position to said second open position,

(iii) clip advancing means movable within the interior passage of said tubular housing for individually distally advancing said surgical clips to a location wherein said clips are permitted to at least partially surround body tissue when said clip legs are in said second open position; and

(iv) means positioned at said distal end portion of said tubular housing for moving said clip legs to said third position to effect closure of said surgical clips at least sufficient to grip the body tissue.

23. A disposable apparatus for endoscopic application of latchless surgical clips to body tissue, said clips each having a pair of legs normally biased toward a first position wherein said legs are in relatively close proximity with each other, and resiliently movable toward a second open position which comprises:

a) a frame adapted to be gripped by hand;

b) an elongated endoscopic section connected to said frame, said endoscopic section comprising a tubular housing with a distal end portion and further including;

i) means for storing a plurality of latchless clips in the interior of said tubular housing;

ii) a pair of jaws at the distal end portion of said tubular housing, said jaws being configured and dimensioned for reception and clamping of said latchless surgical clips;

iii) means extending through the interior of said tubular housing for advancing said latchless surgical clips into said jaws;

iv) means located in said tubular housing for causing said legs to move toward said open position to facilitate positioning of said clip about body tissue to be clipped; and

v) means for moving said jaws toward each other for closing a clip positioned therebetween.

24. A method for endoscopically applying latchless surgical clips with an apparatus having a frame adapted to be gripped by hand and an endoscopic section connected to said frame, comprising:

a) storing a plurality of said latchless surgical clips in said endoscopic section, each of Said latchless surgical clips having a pair of legs resiliently biased toward a closed position and movable away from each other to an open position;

b) distally advancing one of said latchless surgical clips to a pair of jaws positioned at a distal end of said endoscopic section by clip advancing means positioned within said endoscopic section;

c) positioning said latchless surgical clip adjacent body tissue to be clipped;

d) closing said jaws about said latchless surgical clip while permitting said clip legs to move toward the closed position, and substantially simultaneously repositioning said clip advancing means to a position proximal of the next clip to be advanced; and

e) releasably locking said clip advancing means in said proximal position until released to advance the next clip. .Iadd.

25. An apparatus for endoscopic application of surgical clips to body tissue, which comprises:

a) a frame;

b) an elongated body portion extending distally from the frame and having a distal end portion, the elongated body portion defining a longitudinal axis and an internal passage therein;

c) a storage magazine defined within the internal passage of the elongated body portion configured to retain a plurality of surgical clips;

d) a plurality of surgical clips positioned in the storage magazine, each of the surgical clips having a pair of legs movable between an approximated position wherein the legs are in approximation and an open position wherein the legs are spaced apart, the legs being biased towards the approximated position, the surgical clips being stored in the storage magazine in the approximated position;

e) a clip advancer movably mounted relative to the body portion, at least a portion of the clip advancer positioned within the internal passage;

f) first and second jaw structure mounted adjacent said distal end of the elongated body portion and defining a tissue receiving space therebetween;

g) at least one camming surface at least partially disposed adjacent the first and second jaw structure, wherein said at least one camming surface progressively cams the legs of the surgical clips towards the open position and said at least one camming surface permits the legs of the surgical clip to subsequently move towards the approximated position while said surgical clip is at least partially within the tissue receiving space. .Iaddend.