Multi-fire surgical clip applier

• US 20050234478A1
• Filed: 10/07/2004
• Published: 10/20/2005
• Est. Priority Date: 04/16/2004
• Status: Active Grant

• Current Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Original Assignee: Applied Medical Resources Corporation (Applied Medical Corporation)
• Inventors: Wixey, Matthew A., Wachli, Thomas D.
• Granted Patent: US 7,621,926 B2
• Time in Patent Office: Days
• US Class Current: 606/142
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• 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 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603

Abstract

Clip appliers to apply a surgical clip and methods concerning the same are provided. One provided applier has a cartridge and an actuator. The rack mechanism causes a feeder to move proximally as a closure member moves distally, such that jaw members move together to crimp a clip there between. The rack mechanism also causes the feeder to move distally as the closure member moves proximally, such that a crimped clip is released and another clip is fed into the jaw members. The rack mechanism further includes a rack connected to the closure member in which the closure member and the rack are arranged to move synchronously throughout the releasing of a crimped clip and feeding of another clip, e.g., an opening stroke.

Claims

1. A clip applier applying a surgical clip, the applier comprising:

a cartridge with a proximal end and a distal end and including;

a feeder having a proximal end and a distal end,

a closure member having a proximal end and a distal end,

a pair of opposing crimping members extending outwardly from the distal end of the closure member, and

a rack mechanism having a spur gear, a first rack connected to the feeder, and a second rack connected to the closure member; and

an actuator coupled to the proximal end of the cartridge and the proximal end of the closure member, the actuator arranged to open the opposing crimping members during an opening stroke and the closure member and the second rack arranged to move synchronously throughout the opening stroke.

2. The clip applier of claim 1 wherein the closure member and one of the feeder, the first rack and the second rack are all only movable together.

3. The clip applier of claim 1 wherein the second rack is arranged to only move at rates that substantially corresponds to rates at which the closure member moves.

4. The clip applier of claim 1 wherein the second rack moves synchronously with the closure member throughout operation of the closure member.

5. The clip applier of claim 1 wherein the feeder and the closure member arranged to travel at substantially identical rates throughout the opening stroke.

6. The clip applier of claim 1 wherein the second rack maintains constant contact with closure member.

7. The clip applier of claim 1 wherein the second rack is not prevented from moving while the closure member is moving.

8. The clip applier of claim 1 wherein the actuator is arranged to advance and retract the closure member and the rack mechanism correspondingly retract and advance the feeder at substantially identical rates at which the closure member moves.

9. The clip applier of claim 1 wherein the crimping members have jaw tips that are bone shaped.

10. The clip applier of claim 9 wherein the jaw tips are thin relative to the crimp.

11. The clip applier of claim 1 wherein the crimping members are manufactured using an electrical discharge machine.

12. The applier of claim 1 wherein the ratchet mechanism comprises a third rack including teeth and a pawl having three teeth wherein at most two of the three teeth operatively engage the teeth of the third rack.

13. The applier of claim 12 wherein the three teeth of the pawl comprises a middle tooth, a first side tooth and a second side tooth, the middle and first side tooth operatively engaging the teeth of the third rack as the third rack traverses in a first direction and the middle and second side tooth operatively engaging the teeth of the third rack as the third rack traverses a second direction, the second direction being in an opposite direction from the first direction.

14. The applier of claim 13 wherein the spur gear is operatively connected to the first and second racks to move the feeder proximally when the closure member moves distally and the third rack moves in the first direction and to move the feeder distally when the closure member moves proximally when the third rack moves in the second direction.

15. The applier of claim 13 wherein the pawl is permitted to move in one of a first direction and a second direction and prevented from moving in an opposite direction from which the pawl is permitted to move when the pawl engages the third rack.

16. The applier of claim 1 wherein the actuator comprises a trigger, a handle and a pivot link, the trigger being rotatably connected to the handle and connected to the pivot link, the pivot link being rotatably connected to the handle.

17. The applier of claim 16 further comprising a third rack disposed on the pivot link.

18. The applier of claim 17 wherein the trigger and the pivot link are permitted to move in a first direction when the pawl is engaging the third rack and the third rack is moving in the first direction and prevented from moving in a second direction, the second direction being opposite from the first direction.

19. The applier of claim 16 wherein the trigger has a proximal end and a distal end, the pivot link being connected to the proximal end of the trigger and connected to the handle by a member extending through a portion in between the distal and proximal end of the trigger.

20. The applier of claim 16 wherein the pivot link rotatably mounted to the handle defines a first stroke arc and the trigger rotatably mounted to the handle defines a second stroke arc, the first stroke arc being shorter than the second stroke arc.

21. The applier of claim 16 further comprising a swing cover rotatably mounted to the handle.

22. The applier of claim 21 wherein the swing cover when in an open position exposes portions of the ratchet mechanism and in a close position covers the ratchet mechanism.

23. The applier of claim 1 further comprising a cartridge floor including a finger with an angled portion guiding a clip towards the feeder.

24. The applier of claim 23 wherein the finger further defines a slot in the cartridge floor to further guide a clip towards the feeder.

25. The applier of claim 24 further comprising a bottom housing positioned beneath the cartridge floor and the feeder and wherein the finger holds a clip against the bottom housing.

26. The applier of claim 1 wherein the second rack is not connected to a spring.

27. A clip applier applying a surgical clip, the applier comprising:

a cartridge with a proximal end and a distal end and including;

a feeder having a proximal end and a distal end,

a closure member having a proximal end and a distal end,

a pair of opposing crimping members extending outwardly from the distal end of the closure member, and

a rack mechanism having a spur gear, a first rack connected to the feeder, and a second rack directly connected to the closure member, the closure member and the second rack only movable together; and

an actuator coupled to the proximal end of the cartridge and the proximal end of the closure member.

28. The applier of claim 27 further comprising:

a bottom housing positioned beneath the cartridge floor and the feeder;

a top cartridge mounted on a portion of the bottom housing positioned over the cartridge floor and the feeder; and

a cover housing mounted on a remaining portion of the bottom housing adjacent to the top cartridge to secure the spur gear between the cover housing and the bottom housing to permit the spur gear to operatively engage the first and second racks.

29. The applier of claim 27 further comprising:

a pusher having a front surface conforming to a shape of a clip, a proximal end and a distal end and being positioned below the feeder, the feeder being substantially flat and having a front surface conforming to a shape of a clip;

a pusher spring having a proximal end and a distal end with the distal end of the pusher spring connected to the proximal end of the pusher; and

a bottom housing being positioned below the pusher and pusher spring, connected to the proximal end of the pusher spring and the jaw members angle upwards away from the bottom housing;

wherein the closure member is positioned above the feeder.

30. The applier of claim 27 wherein the actuator further comprises a trigger, a handle and a pivot link, the trigger being rotatably connected to the handle and connected to the pivot link, the pivot link being rotatably connected to the handle and having a third rack disposed therein.

31. A method of applying a surgical clip using a clip applier having crimping members coupled to a closure member coupled to a feeder, the method comprising:

extending a feeder of a clip applier to move a clip into crimping members of a clip applier;

extending a closure member of the clip applier to close the crimping members and the clip over an object to be clipped;

retracting the feeder of the clip applier simultaneously and continuously while the closure member is extending and until the closure member closes the crimping members;

retracting the closure member to open the crimping members to release the clip; and

extending the feeder of the clip applier simultaneously and continuously while the closure member is retracting and until the closure member fully opens the crimping members.

32. The method of claim 31 further comprising preventing the closure member from retracting once the closure member starts until the crimping members and the clip are closed over the object to be clipped.

33. The method of claim 31 further comprising rotating a pivot link of the clip applier to cause extension of the closure member.

34. The method of claim 33 wherein the pivot link rotates along a first stoke arc and is connected to a handle and a trigger and further comprising rotating the trigger along a second stroke arc causing rotation of the pivot link, the first stroke arc being smaller than the second stroke arc.

35. The method of claim 33 further comprising maintaining simultaneous movement of the closure member while extending the closure member and simultaneously retracting the feeder throughout operation of the clip applier.

36. A method of manufacturing a jaw of a clip applier, the method comprising:

grinding a side profile of a jaw into a plate;

machining the plate to form an entry point for clips on a proximal end of the jaw;

machining the plate to form grooves for clips along an inner surface of each crimping member of the jaw up to substantially near a distal end of the jaw;

hardening the plate; and

cutting a top profile of the jaw by using an electrical discharge machine.

37. The method of claim 36 further comprising stamping the plate to form location holes.

38. The method of claim 36 further comprising centrifugally tumbling the jaw.

39. The method of claim 38 further comprising:

passivating the jaw;

blackening the jaw; and

baking the jaw.

40. The method of claim 36 wherein hardening the plate is performed using heat.

41. A method of manufacturing a jaw of a clip applier, the method comprising:

hardening a steel block;

cutting at least one top profile of at least one jaw into the block, leaving the at least one jaw attached in a rear portion to a portion of the block using an electrical discharge machine;

patterning a shape of interior grooves in the at least one jaw;

burning the pattern into the at least one jaw using the electrical discharge machine; and

detaching the jaw from the block using the electrical discharge machine.

42. The method of claim 41 wherein hardening the plate is performed by heating a steel block to a state of maximum hardness.