Surgical clip, clip applicator and method therefor
The surgical clip includes a U or a V shaped body having clip legs extending from its apex and terminal ends having a lateral span extending outboard from the clip. The terminal ends are shaped as triangles, ovals, a T, oblong or a wide end hexagonal shape. Sometimes, the terminal ends define outboard directed hooks. The clip's inboard surface may have gripping grooves. A clip applicator includes clip carrying jaws pivotally coupled and forming a mouth. Keyways capture clip ends. If the clip is hooked, the jaws define complementary latch openings. A system for closing the clip jaws may be linked scissor-like members, cam actuators and followers or cam follower surfaces. The clip applier may include tactile response indicators for the user to indicate partial or full jaw closure and full open-clip release positions.
The present patent application is a divisional patent application based upon application Ser. No. 09/692,050 filed Oct. 19, 2000, now pending, which was a regular patent application and claiming the benefit of provisional patent application Ser. No. 60/160,387 filed Oct. 19, 1999, now pending.
The present invention relates to a surgical clip designed to be inserted into a small size access port on cannula, an associated clip applicator and a method therefor
BACKGROUND OF THE INVENTIONThe current trend in minimally invasive surgery is to utilize smaller and smaller ports for access to the surgical site via cannulae or small tubes for insertion into body cavities. Currently, 5 mm ports are being utilized instead of the original 10 mm port for instrument access in laparoscopy and other types of minimally invasive surgery. In addition, 2 to 3 mm ports are being used for access and, as a result, smaller instruments are required to operate through these smaller ports and cannulae.
A frequently used instrument in minimal access surgery is a clip applier or clip applicator. This instrument is utilized in most operations for the ligation of vessels, tubular structures and other organs or organic bodies. One of the problem encountered by the reduction in size of the clip applier is that there is an irreducible dimension between the legs of the clip which is required to enable the clip to encircle the target structure (i.e.; blood vessel or other organic body). Since most clips are applied to the blood vessel or body in an open, incipient, clip-on position (excluding springs clips), the dimension exceeds 5 mm, precluding access through a 5 mm or smaller access port on cannulae. Clips small enough to be introduced through a small port (5 mm or less) lose their utility because the small opening between the jaws or the legs of the clip minimize the usefulness or utility of the clip.
The following patent disclosures show surgical clips: U.S. Pat. No. 3,326,216 to Wood; U.S. Pat. No. 4,188,953 to Klieman et al.; U.S. Pat. No. 4,449,530 to Bendel et al.; U.S. Pat. No. 4,844,066 to Stein; U.S. Pat. No. 4,971,198 to Mericle; U.S. Pat. No. 4,972,949 to Peiffer; U.S. Pat. No. 5,192,288 to Thompson et al.; U.S. Pat. No. 5,330,442 to Green et al.
The following patent disclosures show surgical instrument handles: U.S. Pat. No. 5,582,615 to Foshee et al. and U.S. Pat. No. 5,709,706 to Kienzle et al.
OBJECTS OF THE INVENTIONIt is an object of the present invention to correct or circumvent the major problem of utilizing smaller and smaller access ports on cannulae by providing a specially designed surgical clip and an associated clip applicator.
It is another object of the present invention to provide a surgical clip which can be partially closed to reduce the clip leg span thereby permitting insertion into small access ports.
It is another object of the present invention wherein surgical clips, classified as medium, medium large, or large sizes (all currently requiring the use of larger than Smyn access ports), can be inserted into 5mm access ports (or smaller) when the clips are constructed in accordance with the principles of the present invention.
It is a farther object of the present invention to provide surgical clips having terminal ends with a lateral span being larger than the span of the clip leg body such that the flare ends coact with channels on the clip jaws of the clip applier thereby permitting the clip applier to partially close the captured clip prior to insertion through a small access port, then permitting expansion of the surgical clip after the clip and the clip jaws pass through the distal port on the cannula such that the clip can be opened to a full clip leg span and then applied, by compression, onto the blood vessel or other organic body.
It is a further object of the present invention to provide clip applier or clip applicator designs utilizing the specially designed surgical clips.
It is an additional object of the present invention to provide one tactile response to the operator indicative of a partially closed, insertion position or a fully closed position or a post deposition clip release position.
SUMMARY OF THE INVENTIONThe surgical clip includes a U or a V shaped body having clip legs extending from its apex. The clip legs lie in an imaginary clip defined plane and the terminal ends of each clip leg have a lateral span extending outboard from the clip defined plane. The terminal ends, in certain embodiments, take the shape of a triangle, an oval, a T-shape, an oblong and a wide end hexagonal shape. In another embodiment, the clip's terminal ends include outboard directed hooks. The inboard surface of the surgical clip may have gripping grooves thereon. A clip applicator is utilized to carry the surgical clip to the surgical site. The clip applicator includes a first and a second clip carrying jaw pivotally coupled together to form a clip jaw mouth therebetween. At the distal end of each clip jaw, an open ended channel is formed as a keyway. The keyway is sized to capture a respective terminal clip end therein such that the terminal clip end acts as a key for the keyway when the clip is retained in the clip jaw mouth. If the clip defines hooked terminal ends, the clip jaws define complementary latch openings. The clip applier also includes a system for closing the clip jaws onto each other. The system for closing includes a variety of structures including linked scissor-like members, cam actuators and cam follower channels or cam follower surfaces responding to longitudinal movement of the cam actuators. In a preferred embodiment, the surgical instrument or clip applier includes tactile response indicators (which may be detents on the clip jaws or proximal jaw bodies) providing an indicator to the user that the clip jaws are in a partially closed, instrument insertion position or a fully closed clip compression position or a post deposition clip release position.
BRIEF DESCRIPTION OF THE DRAWINGSFurther objects and advantages of the present invention can be found in the detailed description of the preferred embodiments when taken in conjunction with the accompanying drawings in which:
The present invention relates to a surgical clip, an associated clip applicator and a method therefor.
The present invention generally relates to a specially modified clip that has been designed for small access port insertion. The clip is constructed of the biocompatible material (titanium, stainless steel, etc.) and utilizes annealed or compressible metals or plastic materials. The distal tips of the legs of the clip are modified to a slightly expanded shape as compared to the remainder of the clip body so that a small portion of the terminal end of the legs of the clip are wider than the rest of the clip producing a slight “wedge” or “wing” configuration. This modification allows the clip to be held securely in a channel on the clip carrying jaws of the clip applier wherein the channel is slightly wider at the distal end. Utilizing this innovation, the clip can be picked up (individually or from a clip cartridge) compressed into the closed position, thereby minimizing its open clip profile and width of jaw distance, inserted through a small cannula, then opened to its incipient clip-on position and useful size by reopening the jaws of the applicator which pry the clip apart into its formerly open position.
It is in this configuration that the clip is applied to the structure (blood vessel or other organic body) and is then compressed again by the jaws of the clip applying instrument. Slight recoil of the clip applier jaws to a detent allows the applying instrument to slide off backwards from the closed clip. In order to facilitate this action, slack is provided between the expanded tip of the clip legs and its enclosing clip applier jaw channel so that no reopening of the clip occurs as the jaws recoil. The instrument is then slid backwards extricating the closed clip from the clip applier jaws and leaving it in the desired location and position.
The clip design utilizes clip shapes that can be compressed and then reopened to their previous shape and dimension. Such designs include a “U” shaped or a “V” shaped surgical clip. These designs serve this purpose well. Also, by providing appropriate detents in the clip applying instrument, partial closure only can be accomplished, thereby deforming the clip minimally to a partially open, clip insertion position prior to cannula insertion, final application and compression. Closure sufficient to reduce the clip span and instrument to the internal diameter of the required port of the cannula is all that is necessary to achieve the required results.
The invention described herein provides a unique method for applying surgical clips of any reasonable size through extremely small access ports. This development is in keeping with the trend of utilizing smaller and smaller ports for minimally invasive surgery such as laproscopy, etc. Drawings provided herewith illustrate some applicable clip and instrument designs, but other designs are encompassed by the method of inserting the malleable clip and clip applier in a closed or partially closed position until the small dimensions of the access port are cleared. The clip is then opened by the jaws of the clip applicator, applied to the appropriate site and then compressed. This principle is incorporated into several clip and instrument designs for use in minimal access surgery.
As used herein, the term “distal” refers to a feature of an item that is further removed from the surgeon or the user who operates the clip applier at a remote distance from the surgical site, that is, on a proximal end of the clip applicator or applier. As discussed later in connection with
As used herein, the term “substantially U or V-shaped body” refers to a clip which wraps upon itself such that the clip legs can be opened or closed. Further, the specific configuration of the terminal ends of the clip can take a variety of forms. One important feature with respect to the clip shown in
Clip jaws 42, 44 include distal ends 50, 52. Distal ends 50, 52 define latch openings 54, 56 which are generally complementary to outboard extending hooks 30, 32. In other words, hooks 30, 32 form hook mouths, one of which is hook mouth 33 shown in connection with hook 32. In the illustrated embodiment, latch opening 54 has a front end recess 56 generally equivalent to thickness or span 60 of hook 30 on clip leg 12 shown in
In
FIG.4 diagrammatically illustrates clip 10 shown in broken lines and retained by clip jaws 42, 44. Clip jaws 42, 44 form a clip jaw mouth 43 therebetween. The distal ends 50, 52 of jaws 42, 44 are cut-away to form open ended channels 70, 72 which define keyways sized to capture terminal clip ends 16, 18 therein. Essentially, open ended channels 70, 72 form a respective keyway for a corresponding key configuration established by terminal clip ends 16, 18. As discussed later in connection with
In
The following Closure Position Table (Operational Sequence) generally shows the sequential operation of the clip applier 40 in the present invention. The table immediately following entitled Closure Position Table (Mechanical Positions), lists the four (4) primary mechanical positions of the clip applier 40 ignoring the operational sequence shown in the earlier table.
-
- Closure Position Table (Operational Sequence)
- Full open (
FIG. 7A ) - Partially closed for insertion (
FIG. 7B ) - Full close for deposition on vessel or structure (
FIG. 7F ) - Partial release for withdrawal of clip from jaw (
FIG. 7G )
- Full open (
- Closure Position Table (Mechanical Positions)
- Full open
- Partial close for insertion
- Partial clip release position
- Full close for clip deposition
- Closure Position Table (Operational Sequence)
In
In
In
The present invention may be utilized in conjunction with surgical clips having certain gripping surfaces on the inboard side. Other surgical clip gripping surfaces may be utilized. The grip surfaces shown in
In
In
Clip 1301 includes a chamfer 1342, 1344 at its outer, opposing, lateral edges.
In a preferred embodiment, the clips are constructed in three sizes, small, medium and large. The legs of the clip are not parallel but are abducted to fit a clip holder. The X-shaped channels on the terminal planar facial segments and the longitudinal center channel provide a tire grip providing high traction for the clip on the blood vessel or organic structure. The lines of this X-shaped pattern with its coextensive vertices along the longitudinal center channel provide depressions in bas relief on the active clip faces which increase the frictional grip of the clip on the blood vessel from all angles.
The clips are constructed of titanium or tantalum. The clips are also designed with a greater angle to the diverging leg segments defining terminal planar facial segments 1304, 1306, in order to fit the clip jaws. Alternatively, the cross-sectional aspect of clip 1301 (shown as a triangle in
Surgical instrument 10 may also utilize a handle providing additional tactile responses. One such handle is shown in
Movable handle 1020 includes a tactile response surface 1604. In the illustrated embodiment, tactile response surface 1604 is an undulated or wavy surface. Other types of tactile response surfaces could be utilized. Handle 1012 includes a racket system 1011 which includes fine tooth gear 1013, swing lock bar 1015 and control button 1017. The racket locks the handle in a compressed mode and the operator releases the lock by moving control bar rearward. Tactile surface 1604 could be a plurality of nubs or protrusions which ride on and bump against tactile response wall 1606 of stationary handle member 1022.
Actuator rod 1034, in this illustrated embodiment, includes a ball and socket joint within which ball 1040 of movable rod 1026 is placed. In this manner, when actuator 1034 is retracted as shown by arrow 1614, rod 1026 is also retracted. The dimensions and the sizing of various components in
In operation, when the operator compresses handle 1020 toward stationary handle 1022 (a direction opposite arrow 1602), the user feels tactile response surface 1604 as it bumps against response wall 1606. Response wall 1606 is defined in the stationary handle member 1022. This informs the operator via tactile sensation that rod 1026 has retracted to a certain linear position which may be compressed to a first close position.
In another embodiment, cam follower channels 160, 162 are linear. In this embodiment, the closure rate of clip jaws 42, 44 based upon longitudinal movement of cam 170 in the clip follower channels is uniform. Channels 160, 162 do not bend and are exclusively linear. Cam 170 is typically a laterally positioned rod or pin for both embodiments.
As cam actuator member 2340 moves longitudinally outboard or forward, extending as shown by arrow 1830, initially jaw members 1820, 1822 close. This is shown diagrammatically in
In
Other clip jaw closure systems may be utilized.
The claims appended hereto are meant to cover modifications and changes within the scope and spirit of the present invention.
Claims
1. A surgical clip comprising a substantially U or a V shaped body defined by clip legs extending from an apex and respective terminal ends on corresponding clip legs, said clip legs lying in a clip defined plane and each said terminal end having a lateral span extending outboard from said clip plane.
2. A surgical clip as claimed in claim 1 wherein each said terminal end has a lateral end shape of a triangle, an oval, T-shape, an oblong, and wide end hexagonal shape.
3. A surgical clip as claimed in claim 2 wherein each respective said clip leg includes a inboard surface with a longitudinal center channel and at least one X-shaped channel, a vertex of said X-shaped channel being coextensive with said longitudinal center channel.
4. A surgical clip as claimed in claim 3 including a plurality of X-shaped channel formed on said inboard clip leg surfaces.
5. A surgical clip comprising a substantially U or a V shaped body defining an apex and having two terminal ends opposite said apex, said body having a length and a lateral width, each said terminal end having a lateral width which is larger than said body width.
6. A surgical clip as claimed in claim 5 wherein each said terminal end has a lateral end shape of a triangle, an oval, T-shape, an oblong, and wide end hexagonal shape.
7. A surgical clip as claimed in claim 6 wherein said body includes clip legs extending from said apex to said terminal ends, said clip legs having an inboard surface with a longitudinal center channel and at least one X-shaped channel, a vertex of said X-shaped channel being coextensive with said longitudinal center channel.
8. A surgical clip comprising a substantially U or a V shaped body having an apex and two terminal ends opposite said apex, said body having a substantially uniform lateral span and each said terminal end having a lateral span larger than said body lateral span.
9. A surgical clip as claimed in claim 8 wherein each said terminal end has a lateral end shape of a triangle, an oval, a T-shape, an oblong, and wide end hexagonal shape.
10. A surgical clip as claimed in claim 9 wherein said body includes clip legs extending from said apex to said terminal ends, said clip legs having an inboard surface with a longitudinal center channel and at least one X-shaped channel, a vertex of said X-shaped channel being coextensive with said longitudinal center channel.
11. A surgical clip comprising a substantially U or a V shaped body defined by clip legs extending from an apex and respective terminal ends on corresponding clip legs, each terminal end including a outboard hook, said clip legs, terminal ends and outboard hooks lying in a singular, clip defined plane.
12. A surgical clip as claimed in claim 11 wherein said V-shape or U-shape clip body define, with said clip legs, a wide clip mouth, each said hook defines a hook mouth disposed on opposing sides of said clip mouth and begin being open opposite said clip mouth.
13. A surgical clip as claimed in claim 12 wherein each said hook mouth is smaller than said clip mouth.
14. A surgical clip as claimed in claim 11 wherein each respective said clip leg includes a inboard surface with a longitudinal center channel and at least one X-shaped channel, a vertex of said X-shaped channel being coextensive with said longitudinal center channel.
15. A surgical clip as claimed in claim 14 including a plurality of X-shaped channel formed on said inboard clip leg surfaces.
16. A surgical instrument for applying at least one surgical clip onto a blood vessel or other organic body, said clip having a substantially U or a V shaped body defined by clip legs each having a respective terminal clip end, said clip legs lying in a clip defined plane and each said terminal clip end having a lateral span extending outboard from said clip plane, the surgical clip applying instrument comprising:
- a first and a second clip carrying jaw pivotally coupled together and forming a clip jaw mouth therebetween, each jaw having a distal end and a proximal end;
- said distal end of each said jaw having an open ended channel formed as a keyway thereon, each said keyway sized to capture a respective terminal clip end therein and a respective terminal clip end adapted to act as a key for a corresponding keyway when said clip is retained in said clip jaw mouth;
- means for closing said first and second clip carrying jaw onto each other.
17. A surgical instrument as claimed in claim 16 wherein each said keyway is open at said distal end of said corresponding jaw and each said keyway forms, in conjunction with the respective terminal clip end, a loose tongue and groove lock on opposing lateral sides of said keyway.
18. A surgical instrument as claimed in claim 17 wherein said first and second clip jaws form respective anvil surfaces in said clip mouth adapted to crush said clip legs therebetween during attachment to said blood vessel or other organic body, said anvil surfaces proximally disposed with respect to said keyways.
19. A surgical instrument as claimed in claim 16 wherein each said keyway has a corresponding roof and a floor, said clip jaws and said corresponding keyways operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said corresponding floor of said respective keyway adapted to compress said respective terminal clip end, in said post deposition release position, said corresponding floor and roof of said respective keyway adapted to be spaced apart from said terminal clip ends thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
20. A surgical instrument as claimed in claim 19 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
21. A surgical instrument as claimed in claim 20 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and a proximally disposed handle, said handle being part of said means for closing.
22. A surgical instrument as claimed in claim 16 wherein the instrument is elongated, said clip jaws being distally located on said elongated instrument, said means for closing including a user compressible handle at a proximal end of said instrument, said handle coupled to means for transferring compressive force from said handle to said clip jaws such that said clip jaws close said clip jaw mouth.
23. A surgical instrument as claimed in claim 22 wherein each said keyway has a corresponding roof and a floor, said clip jaws and said corresponding keyways operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said corresponding floor of said respective keyway adapted to compress said respective terminal clip end, in said post deposition release position, said corresponding floor and roof of said respective keyway adapted to be spaced apart from said terminal clip ends thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
24. A surgical instrument as claimed in claim 23 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
25. A surgical instrument as claimed in claim 24 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and said proximally disposed handle.
26. A surgical instrument for applying at least one surgical clip onto a blood vessel or other organic body, said clip having a substantially U or a V shaped body defined by clip legs extending from an apex and respective terminal ends on corresponding clip legs, each terminal end including a outboard clip end hook, said clip legs, terminal ends and outboard clip end hooks lying in a singular, clip defined plane, the surgical clip applying instrument comprising:
- a first and a second clip carrying jaw pivotally coupled together and forming a clip jaw mouth therebetween, each jaw having a distal end and a proximal end;
- said distal end of each said jaw having a corresponding latch opening for a respective clip end hook when said clip is retained in said clip jaw mouth;
- means for closing said first and second clip carrying jaw onto each other.
27. A surgical instrument as claimed in claim 26 wherein each said latch is defined by a cavity open at said corresponding distal end of said respective jaw.
28. A surgical instrument as claimed in claim 27 wherein first and second clip jaws form respective anvil surfaces in said clip mouth adapted to crush said clip legs therebetween during attachment to said blood vessel or other organic body, said anvil surfaces proximally disposed with respect to said latch cavities.
29. A surgical instrument as claimed in claim 26 wherein said clip end hooks have a hook mouth span, wherein each said latch cavity has a latch bar intermediate said latch cavity and said clip mouth, said latch bar having a depth less than said corresponding hook end mouth span.
30. A surgical instrument as claimed in claim 29 wherein said clip jaws and said corresponding latch cavities and latch bars operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said clip jaws adapted to compress said clip legs, and in said post deposition release position, said corresponding latch bars of said respective latch cavities adapted to be spaced intermediate said respective clip end hook mouths, thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
31. A surgical instrument as claimed in claim 30 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
32. A surgical instrument as claimed in claim 31 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and a proximally disposed handle, said handle being part of said means for closing.
33. A surgical instrument as claimed in claim 26 wherein the instrument is elongated, said clip jaws being distally located on said elongated instrument, said means for closing including a user compressible handle at a proximal end of said instrument, said handle coupled to means for transferring compressive force from said handle to said clip jaws such that said clip jaws close said clip jaw mouth.
34. A surgical instrument as claimed in claim 33,wherein each said latch is defined by a cavity open at said corresponding distal end of said respective jaw, wherein said clip end books have a hook mouth span, and wherein each said latch cavity has a latch bar intermediate said latch cavity and said clip mouth, said latch bar having a depth less than said corresponding hook end mouth span.
35. A surgical instrument as claimed in claim 34 wherein said clip jaws and said corresponding latch cavities and latch bars operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said clip jaws adapted to compress said clip legs, and in said post deposition release position, said corresponding latch bars of said respective latch cavities adapted to be spaced intermediate said respective clip end hook mouths, thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
36. A surgical instrument as claimed in claim 35 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
37. A surgical instrument as claimed in claim 36 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and said proximally disposed handle.
38. A clip applying surgical instrument for clipping a blood vessel or other organic body, comprising:
- a surgical clip having a U or a V shaped body defined by clip legs each having a respective terminal clip end, said clip legs lying in a clip defined plane and each said terminal clip end having a lateral span extending outboard from said clip plane;
- a first and a second clip carrying jaw pivotally coupled together and forming a clip jaw mouth therebetween, each jaw having a distal end and a proximal end;
- said distal end of each said jaw having an open ended channel formed as a keyway thereon, each said keyway sized to capture a respective terminal clip end therein and a respective terminal clip end adapted to act as a key for a corresponding keyway when said clip is retained in said clip jaw mouth;
- means for closing said first and second clip carrying jaw onto each other.
39. A surgical instrument as claimed in claim 38 wherein each said keyway is open at said distal end of said corresponding jaw and each said keyway forms, in conjunction with the respective terminal clip end, a loose tongue and groove lock on opposing lateral sides of said keyway.
40. A surgical instrument as claimed in claim 39 wherein said first and second clip jaws form respective anvil surfaces in said clip mouth adapted to crush said clip legs therebetween during attachment to said blood vessel or other organic body, said anvil surfaces proximally disposed with respect to said keyways.
41. A surgical instrument as claimed in claim 38 wherein each said keyway has a corresponding roof and a floor, said clip jaws and said corresponding keyways operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said corresponding floor of said respective keyway adapted to compress said respective terminal clip end, in said post deposition release position, said corresponding floor and roof of said respective keyway adapted to be spaced apart from said terminal clip ends thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
42. A surgical instrument as claimed in claim 41 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
43. A surgical instrument as claimed in claim 42 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and a proximally disposed handle, said handle being part of said means for closing.
44. A surgical instrument as claimed in claim 38 wherein the instrument is elongated, said clip jaws being distally located on said elongated instrument, said means for closing including a user compressible handle at a proximal end of said instrument, said handle coupled to means for transferring compressive force from said handle to said clip jaws such that said clip jaws close said clip jaw mouth.
45. A surgical instrument as claimed in claim 44 wherein each said keyway has a corresponding roof and a floor, said clip jaws and said corresponding keyways operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said corresponding floor of said respective keyway adapted to compress said respective terminal clip end, in said post deposition release position, said corresponding floor and roof of said respective keyway adapted to be spaced apart from said terminal-clip ends thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
46. A surgical instrument as claimed in claim 45 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
47. A surgical instrument as claimed in claim 46 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws-proximal to a pivotal axis between said first and second clip jaw, and said proximally disposed handle.
48. A clip applying surgical instrument for clipping a blood vessel or other organic body, comprising:
- a surgical clip having a substantially U or a V shaped body defined by clip legs extending from an apex and respective terminal ends on corresponding clip legs, each terminal end including a outboard clip end hook, said clip legs, terminal ends and outboard clip end hooks lying in a singular, clip defined plane;
- a first and a second clip carrying jaw pivotally coupled together and forming a clip jaw mouth therebetween, each jaw having a distal end and a proximal end;
- said distal end of each said jaw having a corresponding latch opening for a respective clip end hook when said clip is retained in said clip jaw mouth;
- means for closing said first and second clip carrying jaw onto each other.
49. A surgical instrument as claimed in claim 48 wherein each said latch is defined by a cavity open at said corresponding distal end of said respective jaw.
50. A surgical instrument as claimed in claim 49 wherein first and second clip jaws form respective anvil surfaces in said clip mouth adapted to crush said clip legs therebetween during attachment to said blood vessel or other organic body, said anvil surfaces proximally disposed with respect to said latch cavities.
51. A surgical instrument as claimed in claim 48 wherein said clip end hooks have a hook mouth span, wherein each said latch cavity has a latch bar intermediate said latch cavity and said clip mouth, said latch bar having a depth less than said corresponding hook end mouth span.
52. A surgical instrument as claimed in claim 51 wherein said clip jaws and said corresponding latch cavities and latch bars operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said clip jaws adapted to compress said clip legs, and in said post deposition release position, said corresponding latch bars of said respective latch cavities adapted to be spaced intermediate said respective clip end hook mouths, thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
53. A surgical instrument as claimed in claim 52 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
54. A surgical instrument as claimed in claim 53 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and a proximally disposed handle, said handle being part of said means for closing.
55. A surgical instrument as claimed in claim 48 wherein the instrument is elongated, said clip jaws being distally located on said elongated instrument, said means for closing including a user compressible handle at a proximal end of said instrument, said handle coupled to means for transferring compressive force from said handle to said clip jaws such that said clip jaws close said clip jaw mouth.
56. A surgical instrument as claimed in claim 55 wherein each said latch is defined by a cavity open at said corresponding distal end of said respective jaw, wherein said clip end hooks have a hook mouth span, and wherein each said latch cavity has a latch bar intermediate said latch cavity and said clip mouth, said latch bar having a depth less than said corresponding hook end mouth span.
57. A surgical instrument as claimed in claim 56 wherein said clip jaws and said corresponding latch cavities and latch bars operate in a full open position, a partially closed, instrument insertion position, a fully closed position and a post deposition clip release position, in said partially closed, instrument insertion position, said clip jaws adapted to compress said clip legs, and in said post deposition release position, said corresponding latch bars of said respective latch cavities adapted to be spaced intermediate said respective clip end hook mouths, thereby enabling proximal withdrawal of said clip jaws from the deposited clip.
58. A surgical instrument as claimed in claim 57 including tactile response indicators for said partially closed, instrument insertion position, fully closed position and post deposition clip release position.
59. A surgical instrument as claimed in claim 58 wherein said tactile response indicators are disposed on one of said clip jaws, a segment of said clip jaws proximal to a pivotal axis between said first and second clip jaw, and said proximally disposed handle.
60. A method of placing a surgical clip onto a blood vessel of other organic body via a clip applier having clip jaws on its distal end which carrying said surgical clip, said clip applier extending through a cannula, the method comprising the steps of:
- partially closing said surgical clip by compressing said clip jaws prior to insertion into said cannula;
- opening said surgical clip after exiting said cannula;
- placing said opened surgical clip about said blood vessel or other organic body;
- compressing and fully closing said surgical clip by closure of said clip jaws thereby depositing said surgical clip on said blood vessel or other organic body;
- partially opening said clip jaws and then proximally withdrawing said clip jaws from the closed surgical clip; and
- withdrawing said clip jaws proximally through said cannula.
61. A method as claimed in claim 60 wherein said step of partially closing said surgical clip prior to insertion into said cannula places said clip jaws in an instrument insertion position, and the method includes the step of further placing said clip jaws in said instrument insertion position after said step of partially opening said clip jaws and proximally withdrawing said clip jaws but before said step of withdrawing said clip jaws proximally through said cannula
Type: Application
Filed: May 27, 2003
Publication Date: Dec 15, 2005
Inventor: Melvin Levinson (Miami, FL)
Application Number: 10/446,290