Pre-clamping method

• US 6,607,540 B1
• Filed: 11/17/1999
• Issued: 08/19/2003
• Est. Priority Date: 08/25/1993
• Status: Expired due to Fees

• Current Assignee: Microline Surgical, Inc. (Hoya Corporation)
• Original Assignee: Surgicon, Inc.
• Inventors: Shipp, John I.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/441,898
• Time in Patent Office: 1,371 Days
• Field of Search: 606/142, 606/143, 606/157, 606/158, 128/898
• US Class Current: 606/143
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion

Abstract

The clip applier of the current invention solves the problems of prior art tools by incorporating a pre-clamp mechanism, the function of which is to pre-clamp the vessel to be ligated to a dimension such that the center leg of the spring of the ligation clip need be lifted only slightly. In this manner the spring clip can be slid over the smaller pre-clamped dimension. This insures that the clip spring material will remain within its elastic limit while allowing the tool to maintain a low profile for use in endoscopic surgery, even on large diameter vessels.

Claims

1. A method of ligating a vessel or duct having a maximum cross sectional dimension, the method comprising the steps of:

placing adjacent the vessel or duct a pre-clamping device with opposing clamping surfaces movable in relation to one another;

positioning such vessel or duct within the opposing clamping surfaces of the pre-clamping device;

closing the opposing clamping surfaces of the pre-clamping device around such vessel or duct to effectuate a compression of a portion of the vessel or duct;

positioning a ligation clip in an open position around the compressed portion of the vessel or duct using the pre-clamping device, the clip having an opening adapted to receive the vessel or duct, the size of the opening of the clip being less than the maximum cross sectional dimension of the vessel or duct prior to the compression of the duct or vessel; and

allowing the ligation clip to close due to its own internal resilience around the compressed portion of the vessel or duct resulting in ligation of the vessel or duct.

2. The method of claim 1, wherein the step of closing the opposing clamping surfaces includes pivoting the opposed clamping surfaces relative to one another.

3. The method of claim 1, wherein the step of placing the pre-clamping device includes placing a pre-clamping device having opposing clamping surfaces that are biased relative to one another to an open position.

4. The method of claim 3, further comprising the step of moving the opposing clamping surfaces of the pre-clamping device to a closed position prior to the step of placing the pre-clamping device.

5. The method of claim 1, further comprising the step of forcing the clip to the open position with the pre-clamping device prior to the step of positioning the clip.

6. The method of claim 1, wherein the pre-clamping device includes a sleeve, further comprising the step of moving the clip through the sleeve.

7. The method of claim 6, further comprising the step of moving a plurality of clips through the sleeve.

8. The method of claim 1, wherein the step of placing the pre-clamping device includes placing the pre-clamping device through a trocar having a maximum cross sectional dimension of 5 mm or less.

9. A method of ligating a vessel or duct within a body of a patient, the method comprising the steps of:

inserting a device into the body of the patient, the device having opposed clamping surfaces and being adapted to carry a ligation clip;

clamping at least a portion of the vessel or duct between the opposed clamping surfaces of the device;

placing the ligation clip in an open position around at least a portion of the vessel or duct proximate the portion of the vessel or duct clamped during said clamping step using the device, the ligation clip being resiliently biased to a closed position; and

releasing from the device the ligation clip to permit the ligation clip to move to the closed position.

10. The method of claim 9, wherein the step of closing the opposing clamping surfaces includes pivoting the opposed clamping surfaces relative to one another.

11. The method of claim 9, wherein the step of placing the clamping device includes placing a clamping device having opposed clamping surfaces that are biased relative to one another to an open position.

12. The method of claim 11, further comprising the step of moving the opposed clamping surfaces of the device to a closed position prior to the step of inserting the device.

13. The method of claim 9, wherein the device includes a sleeve, further comprising the step of moving the clip through the sleeve.

14. The method of claim 13, further comprising the step of moving a plurality of clips through the sleeve.

15. The method of claim 9, wherein the step of inserting the device includes inserting the device through a trocar having a maximum cross sectional dimension of 5 mm or less.

16. The method of claim 9, further comprising the step of forcing the clip to the open position with the device prior to the step of placing the clip.

17. A method of ligating a vessel or duct, the method comprising the steps of:

placing adjacent the vessel or duct a pre-clamping device with opposing clamping surfaces movable in relation to one another;

positioning the opposing clamping surfaces of the pre-clamping device over such vessel or duct;

closing the opposing clamping surfaces of the pre-clamping device around such vessel or duct to effectuate a compression of a portion of the vessel or duct;

positioning a ligation clip movable between an open position and a closed position in the open position around the compressed portion of the vessel or duct using the pre-clamping device, the ligation clip having a longitudinal axis and a maximum cross sectional dimension transverse to the longitudinal axis of 5 mm or less when in the closed position; and

allowing the ligation clip to close due to its own internal resilience around the compressed portion of the vessel or duct resulting in ligation of the vessel or duct.

18. The method of claim 17, further comprising the step of forcing the clip to the open position with the pre-clamping device prior to the step of positioning the clip.

19. The method of claim 17, wherein the pre-clamping device includes a sleeve, further comprising the step of moving the clip through the sleeve prior to the step of positioning the clip.

20. The method of claim 17, wherein the step of placing the pre-clamping device includes placing a pre-clamping device having opposing clamping surfaces that are biased relative to one another to an open position.

21. A method of ligating a vessel or duct during surgery comprising the steps of;

placing into a surgical field a ligation clip to be applied to such vessel or duct and a pre-clamping device with opposing clamping surfaces, the ligation clip being placed into the surgical field by a structure which carries the ligation clip;

positioning such vessel or duct within the opposing clamping surfaces of the pre-clamping device with the opposing clamping surfaces lying in a plane relative to said vessel or duct;

closing the opposing clamping surfaces of the pre-clamping device substantially in the plane around such vessel or duct to effectuate a compression of a portion of the vessel or duct;

opening the ligation clip;

positioning the opened ligation clip around the compressed portion of the vessel or duct;

closing the ligation clip around the compressed portion of the vessel or duct resulting in ligation of the vessel or duct; and

releasing the ligation clip from the structure used to carry the ligation clip into the surgical field.

22. The method of claim 21, wherein the step of opening the ligation clip includes forcing the ligation clip open with the structure that carries the ligation clip.

23. The method of claim 21, wherein the pre-clamping device includes a sleeve, further comprising the step of moving the structure that carries the ligation clip through the sleeve prior to the step of opening the clip.

24. A method of ligating a vessel or duct within a body of a patient, the method comprising the steps of:

placing a trocar through external tissue of the patient;

inserting a pre-clamping device through the trocar, the pre-clamping device having opposed clamping surfaces;

clamping at least a portion of the vessel or duct between the opposed clamping surfaces of the pre-clamping device;

placing a ligation clip in an open position around at least a portion of the vessel or duct proximate the portion of the vessel or duct clamped during said clamping step using the pre-clamping device, the ligation clip being resiliently biased to a closed position; and

releasing the ligation clip to permit the ligation clip to move to the closed position.

25. The method of claim 24, wherein the pre-clamping device includes a sleeve, further comprising the step of moving the clip through the sleeve.

26. The method of claim 25, further comprising the step of moving a plurality of clips through the sleeve.

27. The method of claim 24, wherein the step of inserting the pre-clamping device includes inserting a pre-clamping device having a maximum cross sectional dimension of 5 mm or less.

28. The method of claim 24, wherein the step of inserting the pre-clamping device includes placing a pre-clamping device having opposed clamping surfaces that are biased relative to one another to an open position.

29. The method of claim 28, further comprising the step of moving the opposed clamping surfaces of the pre-clamping device to a closed position prior to the step of inserting the pre-clamping device.

30. A method of ligating a vessel or duct within a body of a patient, the method comprising the steps of:

placing a trocar through external tissue of the patient;

clamping, through the trocar, at least a portion of the vessel or duct with a clamping device;

inserting a ligation clip through the trocar used for the clamping step, the ligation clip being resiliently biased to a closed position;

placing the ligation clip in an open position around at least a portion of the vessel or duct proximate the portion of the vessel or duct clamped during said clamping step; and

releasing the ligation clip to permit the ligation clip to move to the closed position.

31. The method of claim 30, wherein the step of placing the ligation clip includes placing the ligation clip with the clamping device.

32. The method of claim 30, wherein the clamping device includes a sleeve, further comprising the step of moving the clip through the sleeve.

33. The method of claim 32, further comprising the step of moving a plurality of clips through the sleeve.

37. A method of performing a hemostasis on tissue of the body of a patient, the method comprising the steps of:

inserting a device into the body of the patient, the device having opposed clamping surfaces and being adapted to carry a ligation clip;

applying a temporary hemostasis on at least a portion of a vessel or duct between the opposed clamping surfaces of the device;

placing the ligation clip in an open position around the vessel or duct proximate the portion of the vessel or duct under temporary hemostasis using the device, the ligation clip being resiliently biased to a closed position; and

releasing from the device the ligation clip to permit the ligation clip to move to the closed position to apply a permanent hemostasis of the vessel or duct.

34. The method of claim 38, wherein the step of clamping includes clamping with a clamping device having a maximum cross sectional dimension of 5 mm or less.

35. The method of claim 38, wherein the step of clamping includes clamping with a clamping device having opposed clamping surfaces that are biased relative to one another to an open position.

36. The method of claim 35, further comprising the step of moving the opposed clamping surfaces of the clamping device to a closed position prior to the step of clamping with the clamping device.

38. The method of claim 37, wherein the step of closing the opposing clamping surfaces includes pivoting the opposed clamping surfaces relative to one another.

39. The method of claim 37, wherein the step of placing the clamping device includes placing a clamping device having opposed clamping surfaces that are biased relative to one another to an open position.

40. The method of claim 39, further comprising the step of moving the opposed clamping surfaces of the device to a closed position prior to the step of inserting the device.

41. The method of claim 37, wherein the device includes a sleeve, further comprising the step of moving the clip through the sleeve.

42. The method of claim 41, further comprising the step of moving a plurality of clips through the sleeve.

43. The method of claim 37, wherein the step of inserting the device includes inserting the device through a trocar having a maximum cross sectional dimension of 5 mm or less.

44. The method of claim 37, further comprising the step of forcing the clip to the open position with the device prior to the step of placing the clip.