ARTICULATING ENDOSCOPIC SURGICAL CLIP APPLIER

• US 20150005790A1
• Filed: 09/15/2014
• Published: 01/01/2015
• Est. Priority Date: 02/25/2010
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Whitfield, Kenneth H., Rethy, Csaba L.
• Granted Patent: US 9,393,024 B2
• Time in Patent Office: Days
• US Class Current: 606/143
• 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 17/105 Wound clamp magazines for packaging sharps A61B50/3001
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00318 Steering mechanisms
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/2908 Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion

Abstract

An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly and a shaft assembly. The handle assembly includes a drive assembly; and a trigger operatively connected to the drive assembly. The shaft assembly extends from the handle assembly and includes an articulating neck assembly; and an end effector assembly supported on a distal end of the articulating neck assembly and being configured to form a surgical clip in place on the body tissue.

Claims

1-18. -18. (canceled)

19. An apparatus for application of surgical clips to body tissue, the apparatus comprising:

a handle assembly including;

a housing;

a drive assembly including;

a drive block axially and slidably supported in the housing, wherein the drive block defines a threaded lumen therethrough; and

a drive screw rotatably supported within the housing, the drive screw including a threaded surface configured for mating with the threaded lumen of the drive block;

a trigger operatively connected to the drive assembly such that actuation of the trigger acts on the drive block;

a ratchet mechanism supported in the housing, the ratchet mechanism including;

a pawl pivotably supported on the drive block;

a toothed-rack defined in the housing, the toothed-rack having a distal reversing recess and a proximal reversing recess configured for housing the pawl; and

a pawl spring supported on the drive block and configured to bias the pawl into operative engagement with at least one tooth of the toothed-rack to restrict longitudinal movement of the drive block in a first direction when the pawl is translated in the first direction;

wherein as the trigger is actuated, the drive block is moved in the first direction causing the drive screw to rotate and the pawl to move from the distal reversing recess to the toothed-rack such that the trigger is restricted from returning to an un-actuated position until a complete stroke is achieved.

20. The apparatus according to claim 19, further including a shaft assembly extending from the handle assembly, the shaft assembly including:

an end effector assembly having;

a plurality of clips loaded therein; and

jaws supported at a distal end of the end effector assembly, wherein the jaws are configured to serially receive and form a single clip at a time, of the plurality of clips.

21. The apparatus according to claim 20, wherein the end effector assembly includes:

a pusher bar configured to load the single clip of the plurality of clips into the jaws; and

a drive bar configured to selectively engage the pusher bar to effectuate closure of the jaws.

22. The apparatus according to claim 21, further comprising a rotatable drive member operatively connected to the trigger and to the end effector assembly, wherein actuation of the trigger results in rotation of the rotatable drive member, and rotation of the rotatable drive member results in loading of the single clip of the plurality of clips into the jaws and in a closing of the jaws.

23. The apparatus according to claim 22, wherein the drive assembly further includes a clutch gear and a clutch bracket, the clutch gear defining a crown of gear teeth configured to cooperate and selectively engage a crown of teeth of a handle drive screw, the clutch bracket pivotally supported in the housing and including at least one leg extending around the clutch gear, the clutch bracket configured to approximate and separate the clutch gear and the crown of teeth of the handle drive screw.

24. The apparatus according to claim 23, wherein the rotatable drive member includes the handle drive screw threadably engaged with the threaded lumen of the drive block, wherein axial translation of the drive block relative to the handle drive screw of the handle assembly results in rotation of the handle drive screw.

25. The apparatus according to claim 24, wherein the end effector assembly includes a drive sled slidably and axially translatable therewithin and defines a helical lumen therethrough, and wherein the rotatable drive member includes an end effector drive screw threadably engaged with the helical lumen of the drive sled,

wherein rotation of the handle drive screw results in a rotation of the end effector drive screw and axial translation of the drive sled.

26. The apparatus according to claim 25, wherein the drive sled is selectively engaged with the pusher bar such that distal advancement of the drive sled results in distal advancement of the pusher bar for a given distance and then the drive sled disconnects from the pusher bar after the given distance.

27. The apparatus according to claim 21, wherein the pusher bar remains in a distally advanced position during approximation of the jaws.

28. The apparatus according to claim 21, wherein the end effector assembly includes an advancer plate slidably disposed therewithin, wherein the advancer plate is detachably connected to the pusher bar,

wherein during distal advancement of the pusher bar, the pusher bar engages the advancer plate to distally move the advancer plate.

29. The apparatus according to claim 28, wherein the advancer plate includes a tab extending therefrom for selective engagement by the pusher bar as the pusher bar is advanced distally.

30. A method for application of surgical clips to body tissue, the method comprising:

providing a surgical instrument including;

a housing;

a drive assembly having;

a drive block axially and slidably supported in the housing, wherein the drive block defines a threaded lumen therethrough; and

a drive screw rotatably supported within the housing, the drive screw including a threaded surface configured for mating with the threaded lumen of the drive block;

a trigger operatively connected to the drive assembly such that actuation of the trigger acts on the drive block;

a ratchet mechanism supported in the housing, the ratchet mechanism including;

a pawl pivotably supported on the drive block;

a toothed-rack defined in the housing, the toothed-rack having a distal reversing recess and a proximal reversing recess configured for housing the pawl; and

a pawl spring supported on the drive block and configured to bias the pawl into operative engagement with at least one tooth of the toothed-rack to restrict longitudinal movement of the drive block in a first direction when the pawl is translated in the first direction;

actuating the trigger;

translating the drive block in a first direction;

rotating the drive screw;

translating the pawl from the distal reversing recess to the toothed-rack of the ratchet mechanism; and

engaging the pawl with the toothed-rack of the ratchet mechanism such that the trigger is restricted from returning to an un-actuated position until a complete stroke is achieved.

31. The method according to claim 30, wherein the surgical instrument provided further includes:

an end effector supporting jaws on a distal end thereof;

a pusher bar; and

a drive bar configured to selectively engage the pusher bar to effectuate closure of the jaws; and

the method further comprises

translating the drive bar to selectively engage the pusher bar to effectuate closure of the jaws.

32. The method according to claim 31 wherein the surgical instrument provided further includes:

a rotatable drive member operatively connected to the trigger and the end effector; and

the method further comprises

loading the end effector with a plurality of clips;

rotating the rotatable drive member; and

actuating the jaws to serially receive and form a single clip at a time, of the plurality of clips.