U.S. patent application number 10/715972 was filed with the patent office on 2004-07-08 for clip applying apparatuses and methods for vascular ligation.
Invention is credited to Baxter, Jeffrey Wayne.
Application Number | 20040133215 10/715972 |
Document ID | / |
Family ID | 29420741 |
Filed Date | 2004-07-08 |
United States Patent
Application |
20040133215 |
Kind Code |
A1 |
Baxter, Jeffrey Wayne |
July 8, 2004 |
Clip applying apparatuses and methods for vascular ligation
Abstract
An apparatus and method for applying ligating clips to perform
minimally invasive vascular ligation. An actuating assembly
contacts a clip applier to actuate the clip applier among at least
a first position, a second position and a third position. The clip
applier is capable of receiving a first ligating clip when the clip
applier is in the first position and a second ligating clip when
the clip applier is in the second position. The actuating assembly
actuates the clip applier to the third position to close the
ligating clip being held by the clip applier.
Inventors: |
Baxter, Jeffrey Wayne; (San
Jose, CA) |
Correspondence
Address: |
James C. Scheller, Jr.
BLAKELY, SOKOLOFF, TAYLOR & ZAFMAN LLP
Seventh Floor
12400 Wilshire Boulevard
Los Angeles
CA
90025-1026
US
|
Family ID: |
29420741 |
Appl. No.: |
10/715972 |
Filed: |
November 17, 2003 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10715972 |
Nov 17, 2003 |
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09517762 |
Mar 2, 2000 |
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6648898 |
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Current U.S.
Class: |
606/142 |
Current CPC
Class: |
A61B 17/083 20130101;
A61B 17/128 20130101 |
Class at
Publication: |
606/142 |
International
Class: |
A61B 017/10 |
Claims
What is claimed is:
1. A surgical apparatus comprising: a clip applier; and an
actuating assembly contacting said clip applier for actuating said
clip applier among at least a first position, a second position and
a third position.
2. An apparatus as in claim 1 wherein said clip applier comprises a
jaw having a first portion adjacent to a second portion.
3. An apparatus as in claim 2 wherein said first portion is
rotatably coupled to said second portion of said jaw.
4. An apparatus as in claim 3 wherein said actuating assembly is
coupled to said second portion of said jaw such that said second
portion is translatable.
5. An apparatus as in claim 2 wherein said first and second
portions are resilient.
6. An apparatus as in claim 5 wherein said actuating assembly
concurrently urges said first and second portions of said jaw
toward each other.
7. An apparatus as in claim 1 wherein said clip applier is capable
of receiving a first ligating clip when said clip applier is in
said first position, and wherein said clip applier is capable of
receiving a second ligating clip when said clip applier is in said
second position, said first and second ligating clips having
different sizes.
8. An apparatus as in claim 1 wherein said first and second
positions are open positions and said third position is a closed
position.
9. An apparatus as in claim 1 further comprising a housing disposed
around said actuating assembly.
10. A surgical apparatus comprising: a housing; a jaw having first
and second movable sections, said jaw mateable with a plurality of
ligating clips having different sizes; and an actuating mechanism
disposed substantially within said housing and contacting said
jaw.
11. An apparatus as in claim 10 wherein said housing is
tubular.
12. An apparatus as in claim 10 wherein said actuating mechanism
comprises a translatable tube disposed within said housing and
surrounding said jaw, said translatable tube concurrently urging
said first and second sections of said jaw when said translatable
tube is translated toward a distal end of said jaw.
13. An apparatus as in claim 10 wherein said actuating mechanism
comprises a rod coupled to said second movable section of said jaw,
said first moveable section of said jaw rotatably coupled to both
said second movable section and a support member fixed to said
housing.
14. An apparatus as in claim 10 wherein said actuating mechanism
comprises a handle coupled to said housing, said handle and said
jaw located at opposite ends of said housing.
15. A surgical apparatus comprising: an elongated housing having a
first end and a second end; an actuating assembly having a
translatable member extending through said housing and a handle
coupled to said translatable member adjacent to said first end of
said housing; a fixed member coupled to said housing at said second
end; and a jaw having first and second sections, said first section
rotatably coupled to said fixed member and said second section,
said second section coupled to said translatable member and
extending away from said second end of said housing, said first
section having a first range of movement and said second section
having a second range of movement, said first range of movement
dictated by said second range of movement.
16. An apparatus as in claim 15 wherein said first section of said
jaw rotates through said first range of movement as said second
section of said jaw translates through said second range of
movement.
17. A surgical apparatus comprising: an elongated outer housing
having a first end and a second end; an actuating assembly having a
translatable elongated inner housing disposed within said outer
housing and a handle coupled to said inner housing adjacent to said
first end of said outer housing; and a jaw having a first resilient
portion and a second resilient portion, said first and second
resilient portions disposed within said inner housing and extending
away from said second end of said outer housing; said inner housing
concurrently urging said first and second resilient portions of
said jaw toward each other when said inner housing translates
through said outer housing.
18. A method comprising: actuating a clip applier to a first
position; mating said clip applier with a first ligating clip such
that said first ligating clip is held by said clip applier; moving
said clip applier adjacent to a first vessel; and applying said
first ligating clip to said first vessel by actuating said clip
applier to a second position.
19. A method as in claim 18 further comprising: unmating said clip
applier from said first ligating clip after said applying;
actuating said clip applier to a third position; mating said clip
applier with a second ligating clip such that said second ligating
clip is held by said clip applier; moving said clip applier
adjacent to a second vessel; applying said second ligating clip to
said second vessel by actuating said clip applier to said second
position.
20. A method as in claim 19 wherein said first and third positions
are open positions and said second position is a closed
position.
21. A method as in claim 18 wherein actuating said clip applier to
said first position comprises translating an actuating member
toward said clip applier and wherein actuating said clip applier to
said second position comprises translating said actuating member
away from said clip applier.
22. A method as in claim 18 wherein actuating said clip applier to
said first position comprises translating an actuating member away
from said clip applier and wherein actuating said clip applier to
said second position comprises translating said actuating member
toward said clip applier.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] The present invention relates generally to vascular
ligation, and more specifically to clip appliers for vascular
ligation.
[0003] 2. Background Information
[0004] Vascular ligation is an important component of a number of
surgical procedures. For example, vascular ligation is part of the
process of endoscopic vessel harvesting, such as harvesting of the
saphenous vein to perform a coronary bypass procedure. Vascular
ligation is also an integral part of vein harvesting performed in
situ or during a femoral popliteal bypass procedure. Specifically,
the tributaries of the saphenous vein must be ligated before the
harvesting of the vein can actually occur. Common techniques for
performing vascular ligation involve the use of ligating clips and
clip appliers. However, current clip appliers are often suited for
only open surgery. In addition, ligating clips are often formed in
different sizes such that vessels of varying dimensions can be
ligated.
[0005] Vein harvesting is typically a traumatic procedure, and the
common techniques for positioning and applying ligating clips can
contribute to the invasiveness of the vein harvesting procedure.
Increased trauma to the patient's body can be dangerous and often
leads to a longer recovery period for the patient. Thus, being able
to position and apply ligating clips in a minimally invasive manner
is desirable because of the need to limit the trauma to a patient's
body.
SUMMARY OF THE INVENTION
[0006] The present invention provides in one embodiment a clip
applier in contact with an actuating assembly which actuates the
clip applier among at least a first position, a second position and
a third position. The clip applier can receive a first ligating
clip when the clip applier is in the first position, and the clip
applier can receive a second ligating clip when the clip applier is
in the second position.
[0007] In one embodiment of the present invention, the clip applier
includes a jaw having first and second movable sections adjacent to
each other. In another embodiment, the first section is rotatably
coupled to the second section, which is translatably actuated by
the actuating assembly. In yet another embodiment, the first and
second movable sections are resilient and are urged together by the
actuating assembly.
[0008] Additional features and benefits of the present invention
will become apparent from the detailed description, figures and
claims set forth below.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] Various embodiments of the present invention will be
described in detail with reference to the following drawings in
which like reference numerals refer to like elements. The present
invention is illustrated by way of example and not limitation in
the accompanying figures.
[0010] FIG. 1A shows a side view of one embodiment of a clip
applier and actuating assembly in accordance with the teachings of
the present invention.
[0011] FIG. 1B shows a partial cutaway view of the clip applier and
actuating assembly shown in FIG. 1A.
[0012] FIGS. 2A-2C show side, top and bottom views, respectively,
of a clip applier in accordance with the teachings of the present
invention.
[0013] FIGS. 3A-3C show varying positions of a clip applier in
accordance with the teachings of the present invention.
[0014] FIGS. 4A-4C show a clip applier engaging a ligating clip in
successive positions in accordance with the teachings of the
present invention.
[0015] FIG. 5A shows a side view of another embodiment of a clip
applier and actuating assembly in accordance with the teachings of
the present invention.
[0016] FIG. 5B shows a partial cutaway view of the clip applier and
actuating assembly shown in FIG. 5A.
[0017] FIGS. 6A and 6B show side and top views, respectively, of a
clip applier in accordance with the teachings of the present
invention.
[0018] FIGS. 7A-7C show varying positions of a clip applier in
accordance with the teachings of the present invention.
DETAILED DESCRIPTION
[0019] The following description provides embodiments of the
present invention. However, it will be appreciated that other
embodiments of the present invention will become apparent to those
of ordinary skill in the art upon examination of this description.
Thus, the present description and accompanying drawings are for
purposes of illustration and are not to be used to construe the
invention in a restrictive manner.
[0020] The present invention provides a clip applier that is in
actuatable contact with an actuating assembly that actuates the
clip applier among a variety of positions. Because the clip applier
can be positioned variously, it is capable of holding one at a time
ligating clips of different sizes and applying them to the target
vessel. The clip applier includes a jaw having first and second
movable sections adjacent to each other. In one embodiment of the
present invention, the first movable section is rotatably coupled
to the second movable section, which is translatably actuated by
the actuating assembly. The movement, and hence position, of the
first movable section is dictated by the movement of the second
movable section. In another embodiment of the present invention,
the first and second movable sections are resilient and are urged
by the actuating assembly to different positions.
[0021] FIGS. 1A and 1B show a side view and a partial cutaway view,
respectively, of one embodiment of a clip applier and actuating
assembly according to the present invention. A clip applier 10
includes a fixed support member 16 and a jaw having a rotating
section 12 and a translating section 14. Section 12 is rotatably
coupled to section 14 by a pin 18a. Section 12 is also rotatably
coupled to member 16 by a pin 18b. Member 16 is fixed to the inner
surface of a housing 20 via any suitable means such as, for
example, a screw or an adhesive. Member 16 could also be integrally
formed with and extending from an end of housing 20. Housing 20 is
an elongated, rigid or flexible shaft which is coupled to a handle
22. It is appreciated that housing 20 can be integrally formed with
handle 22.
[0022] Handle 22 is in a scissors-like form and includes a
stationary member 24 and an actuating member 26 which is rotatably
coupled to stationary member 24 via a pin 28. An actuating rod 30
is attached to, or integrally formed with, actuating member 26. Rod
30 extends through housing 20 and is coupled to an end of
translating section 14. In one embodiment, rod 30 is coupled to
section 14 in any suitable manner such that rod 30 can push and
pull section 14 in a translating fashion. Housing 20 not only
houses actuating rod 30 but also acts as an anchor for fixed
support member 16. Housing 20 and rod 30 can be flexible to provide
greater accessibility to target vessels, but it should be noted
that rod 30 is also rigid enough to provide a pushing force to
section 14. It is appreciated that housing 20 and rod 30 can be
formed in various lengths depending on the expected distance
between the target vessels and the insertion point on the patient's
body. Furthermore, the cross sectional shape of housing 20 can be a
variety of shapes including circular.
[0023] Sections 12 and 14 and member 16 can be made of surgical
steel, stainless steel, plastic or similar materials. Rod 30 can
also be made of surgical steel or a similar material. Housing 20
can be made of plastic, stainless steel or other appropriate
materials.
[0024] Because sections 12 and 14 can be actuated remotely via rod
30, and clip applier 10 and housing 20 are elongated with a thin
profile, the present invention can be used minimally invasively to
perform vascular ligation. This will help prevent the vascular
ligation procedure from exacerbating the invasiveness associated
with vein harvesting procedures.
[0025] FIGS. 2A-2C show side, top and bottom views, respectively of
a clip applier similar to the one shown in FIGS. 1A and 1B. The
clip applier includes a fixed support member 36 and a jaw having a
rotating section 32 and a translating section 34. A flange 39
extending from section 32 is rotatably coupled to section 34 by a
pin 38a. Flange 39 extending from section 32 is also rotatably
coupled to member 36 by a pin 38b. A gap 35 in member 36
accommodates flange 39. A gap 37 in section 34 also accommodates
flange 39. Gaps 35 and 37 are large enough to allow flange 39, and
hence section 32, to be rotated. Member 36 is attached to housing
40 as described above in conjunction with member 16 and housing 20.
Member 36 is shown extending from within housing 40, but it is
appreciated that member 36 can be integrally formed with housing 40
such that member 36 extends from an end of housing 40.
[0026] FIGS. 3A-3C show varying positions of a clip applier
according to the present invention. FIG. 3A shows a clip applier in
a closed position. The clip applier includes a fixed support member
46 and a jaw having a rotating section 42 and a translating section
44. Sections 42 and 44 are formed with notches 43 and 45,
respectively. A flange 49 extending from rotating section 42 is
rotatably coupled to section 44 by a pin 48a. Flange 49 is also
rotatably coupled to member 46 by a pin 48b. Member 46 is attached
to housing 50 as described above with respect to similar
embodiments.
[0027] FIG. 3B shows the clip applier in a slightly open position.
As translating section 44 translates away from housing 50, rotating
section 42 rotates away from section 44 due to the movement of
section 44 and the coupling of flange 49 to section 44 and member
46 via pins 48a and 48b, respectively, to create an opening between
sections 42 and 44. This opening can receive a ligating clip 52,
which is held securely by the mating of protrusions on clip 52 with
notches 43 and 45. An example of such a ligating clip with
protrusions is the ABSOLOK line of ligating clips by Ethicon, Inc.
If the ligating clip does not have protrusions or notches 43 and 45
are otherwise unnecessary, it is appreciated that the surfaces of
sections 42 and 44 can be textured to provide a better mechanical
or friction fit between the clip and sections 42 and 44.
[0028] FIG. 3C shows the clip applier in a more pronounced open
position. As translating section 44 translates farther away from
housing 50, rotating section 42 rotates farther away from section
44 to enlarge the opening between sections 42 and 44. Because of
the increased space in the opening between sections 42 and 44, a
larger ligating clip 54 can be held in the opening between sections
42 and 44. Thus, in accordance with the teachings of the present
invention, the jaw of the clip applier can be actuated to different
positions to accommodate ligating clips of different sizes.
[0029] FIGS. 4A-4C show the clip applier shown in FIG. 3C engaging
ligating clip 54 in successive positions to close ligating clip 54.
As translating section 44 moves toward housing 50, rotating section
42 rotates toward section 44 due to the movement of section 44 and
the coupling of flange 49 to section 44 and member 46 via pins 48a
and 48b, respectively. As section 42 rotates toward section 44,
section 42 applies a force to the contacted portion of clip 54 to
gradually close clip 54. Assuming clip 54 is positioned around the
target vessel (not shown) while clip 54 is open, clip 54 will be
clamped over the target vessel when it is closed. Once clip 54 is
deployed, rotating section 42 can be opened according to the above
description to allow the clip applier to be disengaged from clip
54. Once the clip applier is removed from the patient's body, the
clip applier can be engaged with another ligating clip of the same
or different size.
[0030] It is appreciated that the shape and configuration of the
jaw sections typically depends on factors such as the size and
shape of the ligating clips to be used and the desired secureness
with which the clips are held during the transit and application of
the clips. Thus, the shape and configuration of the jaw sections
shown in the figures are to be understood as examples of the
present invention.
[0031] FIGS. 5A and 5B show a side view and a partial cutaway view,
respectively, of another embodiment of a clip applier and actuating
assembly according to the present invention. A clip applier 60
includes a jaw having a first resilient section 62 and a second
resilient section 64. Sections 62 and 64 have stems 63 and 65,
respectively, that are housed within an actuating housing 66, which
is translatably housed within a main housing 70. Sections 62 and 64
and stems 63 and 65 can be made of surgical steel, stainless steel
or similar materials. Actuating housing 66 can also be made of
surgical steel or a similar material. Main housing 70 can be mad of
plastic, stainless steel or other appropriate materials. Sections
62 and 64 extend out from actuating housing 66, which is typically
in the shape of an elongated tube. Main housing 70 is also
typically in the shape of an elongated tube such that main housing
70 and actuating housing 66 are in a substantially concentric
relationship. It is appreciated that main housing 70 and actuating
housing 66 need not be tubular. Main housing 70 and actuating
housing 66 can be shaped variously to allow actuating housing 66 to
move within main housing 70. Furthermore, main housing 70 and
actuating housing 66 can be slightly flexible to provide greater
accessibility to target vessels.
[0032] Main housing 70 is coupled to a handle base 72 having a
handle 73 and a trigger 74 extending from within handle 73.
Alternatively, main housing 70 is integrally formed with handle
base 72. Trigger 74 can be part of any conventional trigger
mechanism located within handle 73 and handle base 72 such that
when trigger 74 is depressed, actuating housing 66 translates away
from handle base 72, and when trigger 74 is released, actuating
housing 66 translates toward handle base 72. The trigger mechanism
has not been shown so as not to obscure the present invention. It
should be noted that stems 63 and 65 are typically anchored within
main housing 70 or handle base 72 such that resilient sections 62
and 64 do not move back and forth as actuating housing 66 moves
back and forth.
[0033] Because sections 62 and 64 can be actuated remotely via
actuating housing 66, and clip applier 60 and housing 70 are
elongated with a thin profile, the present invention can be used
minimally invasively to perform vascular ligation. This will help
prevent the vascular ligation procedure from exacerbating the
invasiveness associated with vein harvesting procedures.
[0034] FIGS. 6A and 6B show side and top views, respectively, of a
clip applier 80 similar to the one shown in FIGS. 5A and 5B. Clip
applier 80 includes a jaw having a first resilient section 82 and a
second resilient section 84. Sections 82 and 84 have stems (not
shown) similar to stems 63 and 65 that are housed within an
actuating housing 86, which is translatably housed within a main
housing 90. The angle and shape of sections 82 and 84 can be varied
depending on factors such as the size and shape of the ligating
clips to be used and the desired secureness with which the clips
are held during the transit and application of the clips.
[0035] FIGS. 7A-7C show varying positions of the clip applier of
FIGS. 5A and 5B engaging ligating clips of different sizes. FIG. 7A
shows the clip applier in a substantially open position. When
resilient sections 82 and 84 are in their natural positions, the
space between sections 82 and 84 is large enough to accommodate
larger ligating clips such as ligating clip 92. Once ligating clip
92 is fitted between sections 82 and 84, sections 82 and 84 can be
urged (i.e., pushed) closer together by moving actuating housing 86
toward ligating clip 92 to grip ligating clip 92 more securely.
[0036] FIG. 7B shows the clip applier in a slightly closed
position. As actuating housing 86 moves out from main housing 90,
actuating housing 86 contacts sections 82 and 84 and urges them
concurrently to close the gap between sections 82 and 84. As
sections 82 and 84 are urged closer together by actuating housing
86, a smaller ligating clip such as ligating clip 94 can be held
securely by the clip applier while ligating clip 94 is positioned
around the target vessel.
[0037] FIG. 7C shows the clip applier in a more pronounced closed
position. Actuating housing 86 moves out from main housing 90 and
concurrently urges sections 82 and 84 to further close the gap
between sections 82 and 84. A ligating clip 96, which is smaller
than ligating clip 94, can then be fitted securely between sections
82 and 84. Once a ligating clip is held within sections 82 and 84
and positioned around the target vessel, actuating housing 86 is
moved in the direction indicated in FIGS. 7A-7C until the clip is
closed. It is appreciated that sections 82 and 84 can be formed
with notches to provide a more secure fit for a ligating clip by
mating with protrusions on the ligating clip. Sections 82 and 84
can also be textured to provide greater hold on a ligating clip.
Furthermore, actuating housing 86 can have a bigger or smaller
opening, depending on how much sections 82 and 84 need to be urged
together in order to close the ligating clips to be used. For
example, for more pronounced urging in conjunction with a smaller
ligating clip, the inner diameter (assuming actuating housing 86 is
in the shape of a tube) of actuating housing 86 would be
smaller.
[0038] It should be noted that actuating housing 86 typically is
not translatable to the point where actuating housing 86 completely
hides sections 82 and 84. If actuating housing 86 is capable of
moving to such a point, then actuating housing 86 could run into
and possibly damage the target vessel when a ligating clip is being
applied. Furthermore, sections 82 and 84 typically do not translate
back and forth because such movement could damage the target vessel
when a ligating clip is being applied. Thus, sections 82 and 84 are
typically anchored within main housing 90 or the handle base (see
FIGS. 5A and 5B) such that sections 82 and 84 do not engage in
translating movement when actuating housing 86 is moving back and
forth.
[0039] It is appreciated that the present invention can be used as
a stand-alone device or be used in working lumens such as the
VASOVIEW UNIPORT.RTM. by Origin Medsystems, Inc. of Menlo Park,
Calif. Furthermore, the present invention can include an actuation
limiter to lock the clip applier jaw in varying positions such that
the ligating clip is not inadvertently closed or disengaged from
the jaw.
[0040] In the foregoing detailed description, the apparatus and
method of the present invention have been described with reference
to specific exemplary embodiments. However, it will be evident that
various modifications and changes may be made without departing
from the broader scope and spirit of the present invention. The
present specification and figures are accordingly to be regarded as
illustrative rather than restrictive.
* * * * *