U.S. patent application number 16/445736 was filed with the patent office on 2019-10-03 for snap-on surgical clip cartridge.
The applicant listed for this patent is TELEFLEX MEDICAL INCORPORATED. Invention is credited to Salvatore CASTRO.
Application Number | 20190298377 16/445736 |
Document ID | / |
Family ID | 57885016 |
Filed Date | 2019-10-03 |
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United States Patent
Application |
20190298377 |
Kind Code |
A1 |
CASTRO; Salvatore |
October 3, 2019 |
SNAP-ON SURGICAL CLIP CARTRIDGE
Abstract
A surgical clip cartridge, assembly, and method are provided for
the storage, delivery, and loading of clips, such as those used in
a surgical ligating process. The surgical clip cartridge includes a
base portion extending in a longitudinal direction, the base
portion having a bottom surface and defining a mounting groove for
attaching the base portion onto a surgical instrument shaft. The
base portion further includes a plurality of dividers extending
from the base portion in a direction opposite of the bottom
surface, and the plurality of dividers may be used to retain
individual surgical clips therebetween for subsequent retrieval and
loading onto a clip applier. The attachment of the surgical clip
cartridge to the surgical instrument shaft enables the surgical
clip cartridge to be deployed intracorporeally for use in surgical
operations requiring applications of multiple surgical clips.
Inventors: |
CASTRO; Salvatore; (Raleigh,
NC) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
TELEFLEX MEDICAL INCORPORATED |
Morrisville |
NC |
US |
|
|
Family ID: |
57885016 |
Appl. No.: |
16/445736 |
Filed: |
June 19, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15222456 |
Jul 28, 2016 |
10383637 |
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16445736 |
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62199142 |
Jul 30, 2015 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/1285 20130101;
A61B 2017/00362 20130101; A61B 2017/12004 20130101; A61B 2090/309
20160201; A61B 17/122 20130101; A61B 17/1222 20130101 |
International
Class: |
A61B 17/128 20060101
A61B017/128; A61B 17/122 20060101 A61B017/122 |
Claims
1. A method of applying a surgical clip to a tissue, the method
comprising: releasably attaching a cartridge containing a surgical
clip to a shaft of an instrument; inserting a clip applier into a
body cavity; loading the clip applier with the surgical clip from
the cartridge while within the body cavity; and applying the
surgical clip to the tissue.
2. The method of claim 1, wherein the releasably attaching the
cartridge includes snapping the shaft into a mounting groove of the
cartridge.
3. The method of claim 2, wherein the mounting groove comprises a
concave surface extending around a longitudinal axis of the shaft
when attached.
4. The method of claim 3, wherein the concave surface extends
greater than or equal to 180.degree. around the longitudinal axis
of the shaft when attached.
5. The method of claim 2, wherein the mounting groove comprises a
radius less than or equal to an outer radius of the shaft to
provide an annular fit when the cartridge is attached to the
shaft.
6. The method of claim 1, wherein the cartridge is attached to the
shaft with at least one docking portion on a base portion of the
cartridge.
7. The method of claim 6, wherein the at least one docking portion
includes a first docking portion on a proximal end of the base
portion and a second docking portion on a distal end of the base
portion.
8. The method of claim 6, wherein the at least one docking portion
extends continuously from a proximal end of the base portion to a
distal end of the base portion.
9. The method of claim 1, wherein the cartridge is attached to the
shaft with one or more of a frictional material, knurling, notches,
and protrusions to prevent axial and/or rotational
displacement.
10. The method of claim 1, further comprising: inserting the
instrument into the body cavity through a first opening; passing
the instrument from inside the body cavity to an external
environment outside of the body cavity through a second opening,
wherein the cartridge is attached to the instrument in the external
environment; and passing the instrument and the surgical cartridge
from the external environment into the body cavity through the
second opening.
11. The method of claim 10, wherein the first opening is smaller
than the second opening, and the second opening is formed with an
access port.
12. The method of claim 10, further comprising: passing the
instrument from inside the body cavity to the external environment
through the second opening; removing the cartridge from the shaft
in the external environment; passing the instrument from the
external environment into the body cavity through the second
opening; and removing the shaft from the body cavity through the
first opening.
13. The method of claim 1, wherein the cartridge contains a
plurality of the surgical clips separated by a plurality of
dividers.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] The present application is a Continuation of U.S. patent
application Ser. No. 15/222,456, filed Jul. 28, 2016, which in turn
claims benefit of priority to U.S. Provisional Patent Application
No. 62/199,142, filed Jul. 30, 2015, the contents of which are
incorporated herein by reference in their entirety.
TECHNICAL FIELD
[0002] The present disclosure relates to storage, delivery, and
loading of clips, such as surgical ligating clips for use in
surgical procedures. In particular, the present disclosure relates
to a snap-on surgical clip cartridge configured to retain and
dispense clips intracorporeally during a surgical operation.
DESCRIPTION OF RELATED ART
[0003] Many surgical procedures require vessels or other tissues of
the human body to be ligated during the surgical process. For
example, many surgical procedures require cutting blood vessels
(e.g., veins or arteries), and these blood vessels may require
ligation to stop or reduce bleeding. In some instances, a surgeon
may wish to ligate the vessel temporarily to reduce blood flow to
the surgical site during the surgical procedure. In other
instances, a surgeon may wish to permanently ligate a vessel.
Ligation of vessels or other tissues can be performed by closing
the vessel with a ligating clip, or by suturing the vessel with
surgical thread. The use of surgical thread for ligation requires
complex manipulations of the needle and suture material to form the
knots required to secure the vessel. Such complex manipulations are
time-consuming and difficult to perform, particularly in endoscopic
surgical procedures, which are characterized by limited space and
visibility. By contrast, ligating clips are relatively easy and
quick to apply. Accordingly, the use of ligating clips in
endoscopic as well as open surgical procedures has grown
dramatically.
[0004] Various types of hemostatic and aneurysm clips are used in
surgery for ligating blood vessels or other tissues to stop the
flow of blood. Such clips have also been used for interrupting or
occluding ducts and vessels in particular surgeries, such as
sterilization procedures. Typically, a clip is applied to the
vessel or other tissue by using a dedicated mechanical instrument
commonly referred to as a surgical clip applier, ligating clip
applier, or hemostatic clip applier. The clip is permanently left
in place after application to the tissue.
[0005] Ligating clips can be classified according to their
geometric configuration (e.g., symmetric clips or asymmetric
clips), and according to the material from which they are
manufactured (e.g., metal clips or polymeric clips). Symmetric
clips are generally "C", "U", or "V" shaped and thus are
substantially symmetrical about a central, longitudinal axis
extending between the legs of the clip. Symmetric clips are usually
constructed from metals such as stainless steel, titanium,
tantalum, or alloys thereof. An example of one such clip is
disclosed in U.S. Pat. No. 5,509,920 to Phillips et al. By means of
a dedicated clip applier, the metal clip is permanently deformed
over the vessel. Asymmetric clips are usually constructed of
polymeric material.
[0006] Because clips of the type just described are small and
several clips are often used in a surgical procedure, clip holding
devices are employed to store and retain multiple clips between the
time of their manufacture and/or packaging and ultimate use in a
surgical procedure. Numerous surgical clip cartridges have been
developed, some of which strive to prevent the clips from becoming
unduly loosened or even completely dislodged during shipment and
handling. Surgical clip cartridges are intended for use with
"manual" clip appliers.
[0007] As used herein, the term "automatic" denotes the kind of
clip appliers that retain a plurality of hemostatic clips adjacent
to the jaws of a clip applier in a way such that a new clip is
automatically fed to the jaws after the previous clip has been
crimped into place. An example of an applier that dispenses a
plurality of clips for sequential application is disclosed in U.S.
Pat. No. 4,509,518 to McGarry et al.
[0008] By contrast, the term "manual" denotes the kind of clip
appliers that receive one clip at a time between the jaws, and
which have to be reloaded manually after the previous clip has been
crimped. These manual instruments usually have a forceps-type
design and the reloading operation is generally accomplished by
inserting the jaws of the applier into a clip holder or cartridge
and engaging or grasping a clip contained therein. The jaws of the
clip applier generally have longitudinal grooves to receive the
clip legs and can have end-dams at the distal end of each groove to
limit distal movement of the clip. The clip is secured in the jaws
by the natural resiliency of the clip legs and by the end-dams if
they are present. An example of a forceps-type applier having
conformal jaws used to grip and maintain alignment of the clip
during deformation is disclosed in U.S. Pat. No. 3,326,216 to
Wood.
[0009] Many types of surgical clip cartridges currently available
contain a plurality of longitudinally spaced clip retaining
chambers. A single clip is retained in each chamber by a variety of
means, and is removed from its chamber by a forceps-type clip
applier that is inserted into the selected clip chamber and secured
to the clip sufficiently to overcome whatever clip retention means
is utilized, thereby enabling the clip to be removed from the clip
chamber.
[0010] Various mechanisms are known by which clips can be retained
within the chambers of surgical clip cartridges. In all instances,
a desirable goal of such cartridges is to minimize the forces
required to load the clip into the applier and to then remove it
from the cartridge while maximizing the security with which the
clip is held in the cartridge and, subsequently, the applier jaws
prior to use. With respect to metallic clips, friction between the
clip and the side walls of its individual chamber is often
sufficient to retain the clip. The surgical clip cartridges are
generally made of molded plastic material, such that the walls of
each clip chamber are somewhat resilient and able to be pushed away
from each other when the clip applier jaws are inserted into the
chamber to retrieve the clip. An example of a cartridge holding the
clips in their respective clip chambers by means of frictional
engagement with the side walls of each chamber is shown in U.S.
Pat. No. 4,076,120 to Carroll et al. Another example of a cartridge
holding the clips in their respective clip chambers is shown in
U.S. Pat. No. 6,863,672 to Wilson, Jr.
[0011] In some surgical clip cartridges designed for metallic
clips, each individual clip chamber is provided with a central post
generally conforming to the shape of the open clip although being
slightly larger so that when the clip is pushed onto the central
post, frictional contact between the legs of the clip and the
central post retains the clip within its chamber. Cartridges of
this type are shown in U.S. Pat. Nos. 3,270,745; 3,326,216;
3,363,628; 3,439,522; and 3,439,523, all issued to Wood.
[0012] Cartridges in the related art are also known that retain
clips in a partially straightened state by maintaining each clip
under tension within its chamber, through the interaction between
the central post in the chamber and the central part of the clip
and protrusions extending into each chamber toward the central post
(from the ends). The clip is retained by having its central hinge
part pushed upwardly by the central post and its ends pushed
downwardly by the protrusions. Such a cartridge is shown in U.S.
Pat. No. 3,713,533 to Reimels and U.S. Pat. No. 4,146,130 to
Samuels et al.
[0013] U.S. Pat. No. 4,696,396 to Samuels discloses another type of
cartridge that has a plurality of ribs extending from each side
wall of each clip chamber inwardly toward the clip to retain the
clip by frictional engagement with the ribs. The aforementioned
U.S. Pat. No. 4,146,130 to Samuels et al. shows an alternative
embodiment for the situation where clips are intended to be loosely
maintained in the cartridge without frictional engagement between
the clips and the chamber, the clips in such an event being
retained in each cartridge by a covering tape which can be easily
severed by the applier as desired.
[0014] While the above cartridges for metal and polymeric clips
have been used with adequate results, there are several
disadvantages to the composition and structural design of the
cartridges that limits their functionality during use.
[0015] First, the cartridges in the related art are typically
handheld by an operator or placed on a surface, such as a table or
a tray, while the surgical clips are loaded from the clip cartridge
and loaded onto a clip applier. The result is that the cartridges
in the related art may be prone to being dropped, misplaced, or
contaminated during a surgical procedure. Second, the cartridges in
the related art are used to supply clips to a clip applier
extracorporeally. In other words, the cartridges are maintained
outside the patient and away from the operation area. In manual
ligation, a clip cartridge containing clips is set within the
operating field. The surgeon is restricted to loading a clip from
the clip cartridge onto the clip applier outside the patient. Once
the clip has been loaded from the cartridge onto the clip applier,
the clip applier together with the clip is inserted into the
patient to achieve ligation. However, this method requires the
surgeon to move back and forth from the operative site to the clip
cartridge outside of the patient for reloading, resulting in time
loss and direct visualization loss.
[0016] As such, the present disclosure contemplates an improved
surgical clip cartridge that allows quicker clip loading with no
visualization loss.
SUMMARY
[0017] According to one aspect of the present disclosure, a
surgical clip cartridge includes a base portion extending in a
longitudinal direction, and the base portion has a bottom surface.
The surgical clip cartridge further includes a plurality of
dividers extending from the base portion in a direction opposite of
the bottom surface, and the base portion defines a mounting groove
for attaching the base portion onto a surgical instrument
shaft.
[0018] In one aspect, the mounting groove extends in a direction
parallel to the longitudinal direction of the base portion. In one
aspect, the mounting groove includes at least one docking portion,
and the docking portion defines at least one concave semi-circular
surface that is configured to conform around the surgical
instrument shaft. The concave semi-circular surface has a first
radius, and the first radius is less than or equal to an outer
radius of the surgical instrument shaft to provide an annular fit
when the docking portion is attached to the surgical instrument
shaft. The concave semi-circular surface revolves about a central
longitudinal axis of the docking portion, and the revolution of the
concave semi-circular surface is greater than or equal to
180.degree.. In one aspect, a surface of the at least one docking
portion includes one or more of a friction material, knurling,
notches, and protrusions to prevent axial and/or rotational
displacement when the docking portion is attached to the surgical
instrument shaft.
[0019] In one aspect, the mounting groove defines at least two
docking portions, a first docking portion of the at least two
docking portions being located on a proximal end of the base
portion in the longitudinal direction, and the second docking
portion of the at least two docking portions being located on a
distal end of the base portion in the longitudinal direction. In
one aspect, the at least one docking portion extends continuously
from a proximal end to a distal end of the base portion.
[0020] In one aspect, at least one divider of the plurality of
dividers includes at least one wall surface extending away from the
base portion in a vertical direction perpendicular to the
longitudinal direction. In one aspect, the at least one wall
surface is a planar wall surface. In one aspect, the at least one
divider includes an upper surface, and the upper surface includes
at least a horizontally extending segment and a sloped segment
extending upwardly towards the horizontally extending segment and
towards a center of the at least one divider. In one aspect, an
upper portion of the at least one wall surface includes a latching
protrusion, the latching protrusion extending at least in the
longitudinal direction. In one aspect, the latching protrusion is
for interfacing with at least one portion of a surgical clip, the
at least one portion being one of a surface, a depression, and an
orifice of the surgical clip. In one aspect, the latching
protrusion is configured to prevent movement of a surgical clip in
directions perpendicular to the longitudinal direction of the base
portion.
[0021] In one aspect, the surgical clip cartridge further comprises
a plurality of spacer portions extending from the base portion in a
direction opposite of the bottom surface, and a spacer portion of
the plurality of spacer portions is disposed between pairs of
facing dividers of the plurality of dividers. In one aspect, the
spacer portion defines a top surface, the top surface having a
concave segment and a convex segment. In one aspect, the spacer
portion defines at least one inwardly tapering section and a depth
of the inwardly tapering section increases moving from an upper
portion of the spacer towards a lower portion of the spacer.
[0022] According to one aspect, a surgical device for storage,
delivery, and loading of surgical clips to a clip applier includes
a surgical instrument with an elongated shaft extending along a
first longitudinal axis. The surgical device further includes a
surgical clip cartridge including a base portion extending along a
second longitudinal direction. The base portion has a bottom
surface and defines a mounting groove to secure the surgical clip
cartridge onto at least a portion of the elongated shaft of the
surgical instrument.
[0023] In one aspect, the mounting groove includes at least one
docking portion, and the docking portion defines a concave
semi-circular surface configured to conform around the elongated
shaft. The concave semi-circular surface revolves about a central
longitudinal axis of the docking portion, and the revolution of the
concave semi-circular surface is greater than or equal to
180.degree.. In one aspect, the surgical clip cartridge includes a
plurality of dividers extending from the base portion in a
direction opposite of the bottom surface, and pairs of facing
dividers of the plurality of dividers are configured to receive and
retain a surgical clip of the surgical clips therebetween.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] FIG. 1 shows a front perspective view of a ligation clip in
accordance with aspects of the disclosure.
[0025] FIG. 2 shows a rear perspective view of the ligation clip of
FIG. 12 in accordance with aspects of the disclosure.
[0026] FIG. 3 shows a side view of the ligation clip of FIG. 12 in
accordance with aspects of the disclosure.
[0027] FIG. 4A shows a perspective view of a clip applier in
accordance with aspects of the disclosure.
[0028] FIG. 4B shows a perspective view of the clip applier of FIG.
4A with a ligation clip loaded in accordance with aspects of the
disclosure.
[0029] FIG. 5 shows a top perspective view of a snap-on surgical
clip cartridge in accordance with aspects of the disclosure.
[0030] FIG. 6 shows a bottom perspective view of the snap-on
surgical clip cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0031] FIG. 7 shows a front view of the snap-on surgical clip
cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0032] FIG. 8 shows a side view of the snap-on surgical clip
cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0033] FIG. 9 shows a top view of the snap-on surgical clip
cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0034] FIG. 10 shows a bottom view of the snap-on surgical clip
cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0035] FIG. 11 shows a side cross-sectional view of the snap-on
surgical clip cartridge of FIG. 9 at line 9-9 in accordance with
aspects of the disclosure.
[0036] FIG. 12 shows a perspective cross-sectional view of the
snap-on surgical clip cartridge of FIG. 9 at line 9-9 in accordance
with aspects of the disclosure.
[0037] FIG. 13 shows a close-up perspective view of the snap-on
surgical clip cartridge in accordance with aspects of the
disclosure.
[0038] FIG. 14 shows a side perspective view of a snap-on surgical
clip cartridge with clips loaded in accordance with aspects of the
disclosure.
[0039] FIG. 15 shows a side perspective view of the snap-on
surgical clip cartridge of FIG. 10, with a clip removed in
accordance with aspects of the disclosure.
[0040] FIG. 16 shows a top perspective view of a snap-on surgical
clip cartridge in accordance with aspects of the disclosure.
[0041] FIG. 17 shows a bottom perspective view of the snap-on
surgical clip cartridge of FIG. 16 in accordance with aspects of
the disclosure.
[0042] FIG. 18 shows a bottom view of the snap-on surgical clip
cartridge of FIG. 16 in accordance with aspects of the
disclosure.
[0043] FIG. 19 shows a side view of the snap-on surgical clip
cartridge of FIG. 16 in accordance with aspects of the
disclosure.
[0044] FIG. 20 shows a front view of the snap-on surgical clip
cartridge of FIG. 16 in accordance with aspects of the
disclosure.
[0045] FIG. 21 shows a rear view of the snap-on surgical clip
cartridge of FIG. 16 in accordance with aspects of the
disclosure.
[0046] FIG. 22 shows a top view of the snap-on surgical clip
cartridge of FIG. 16 in accordance with aspects of the
disclosure.
[0047] FIG. 23 shows a front perspective view of a surgical clip
cartridge in accordance with aspects of the disclosure.
[0048] FIG. 24 shows a rear perspective view of the surgical clip
cartridge of FIG. 23 in accordance with aspects of the
disclosure.
[0049] FIG. 25 shows a three-dimensional rendering of the snap-on
surgical clip cartridge of FIG. 1 in accordance with aspects of the
disclosure.
[0050] FIG. 26 shows a three-dimensional rendering of the snap-on
surgical clip cartridge of FIG. 16 in accordance with aspects of
the disclosure.
[0051] FIG. 27 shows a three-dimensional rendering of the surgical
clip cartridge of FIG. 23 in accordance with aspects of the
disclosure.
[0052] FIG. 28 shows a surgical assembly including a surgical clip
cartridge attached to a surgical instrument in accordance with
aspects of the disclosure.
[0053] FIGS. 29A-29H show an exemplary method of using the surgical
clip cartridge in a procedure in accordance with aspects of the
disclosure.
DETAILED DESCRIPTION
[0054] Now referring to the drawings, wherein like reference
numerals refer to like elements, exemplary aspects of the present
disclosure will now be discussed.
[0055] FIGS. 1-3 shows an exemplary surgical clip 100 that may be
used with the surgical clip cartridges of the present disclosure.
The surgical clip 100 may be a hemostatic clip that is capable of
being latched around a vessel or other type of tissue to ligate the
vessel and thereby stop or reduce the flow of fluid through the
vessel. The surgical clip 100 may be constructed from any suitable
biocompatible material, such as metals and/or polymers.
[0056] In one aspect, the surgical clip 100 may comprise a first
leg 110 and a second leg 120. The first leg 110 and the second leg
120 may be joined together at their proximal ends by an integral
hinge section 130. The integral hinge section 130 may define a
latching orifice 135, as will be described in further detail
below.
[0057] The first leg 110 may define an inner concave surface 112
and an outer convex surface 114. The first leg 110 may transition
to a curved, C-shaped hook section 140 at a distal end thereof. The
C-shaped hook section 140 may define a beveled surface 146. An
intersection between the beveled surface 146 and the first leg 110
may define a latching recess 148. A pair of bosses 142, 144 may
extend laterally away from the first leg 110.
[0058] The second leg 120 may define an inner convex surface 122
and an outer concave surface 124. The second leg 120 may transition
into a hook section 40 at a distal end thereof. The distal end of
the second leg 120 may further define a tip section 150. A pair of
bosses 152, 154 may extend laterally away from the second leg 120.
The pair of bosses 152, 154 may each include at least one tissue
penetrating teeth 156, 158, and the penetrating teeth 156, 158 may
be oriented towards the first leg 110.
[0059] Turning to FIGS. 4A and 4B, an exemplary clip applier 200 is
shown, and the clip applier 200 may be used to grasp and apply the
surgical clip 100 onto a target vessel or other type of tissue. In
one aspect, clip applier 200 may comprise a pair pivotable jaws
210, 220. The first jaw 210 of the pivotable jaws may include a
pair of notches 212, 214. The second jaw 220 of the pivotable jaws
may also include a pair of notches 222, 224. In one aspect, the
clip applier 200 may be used to retrieve and load the surgical
clip, for example, from a surgical clip cartridge.
[0060] The clip applier 200 may be positioned about the surgical
clip 100. The notches 212, 214 of the first jaw 210 may be
configured to receive and lock the bosses 142, 144 of the first leg
110, and the notches 222, 224 of the second jaw 220 may be
configured to receive and lock the bosses 152, 154 of the second
leg 120. Alternatively, the notches 212, 214 of the first jaw 210
may be configured to receive and lock the bosses 152, 154 of the
second leg 120, and the notches 222, 224 of the second jaw 220 may
be configured to receive and lock the bosses 142, 144 of the first
leg 110. Once secured, a distal end of the clip applier 200,
including the surgical clip 100, may be directed towards the target
vessel or tissue. The first jaw 210 and the second jaw 220 may then
be squeezed or forced closed towards each other. As this occurs,
the first leg 110 and the second leg 120 of the surgical clip 100
may close upon the target vessel or tissue between the inner
concave surface 112 and the inner convex surface 122. When
sufficient force is applied via the clip applier 200, the tip
section 150 may be forced past the beveled surface 146 and into the
latching recess 148, thereby locking the two legs 110, 120
together. As discussed above, the surgical clip cartridges in the
related art require that the surgeon move away from the operative
site to retrieve additional clips, thereby resulting in time loss
and direct visualization loss.
[0061] FIGS. 5-15 show views of a first exemplary surgical clip
cartridge 300 in accordance with aspects of the present disclosure.
FIGS. 16 and 17 further show the surgical clip cartridge 300 loaded
with clips, such as the surgical clips 100 discussed above. Of
course, other types of clips may be used with the surgical clip
cartridge 300. In one aspect, the surgical clip cartridge 300 may
include a base portion 310 extending in a longitudinal direction,
and the base portion 310 may have at least a bottom surface 312.
The surgical clip cartridge 300 may include a plurality of dividers
320 extending from the base portion 310 in a direction opposite of
the bottom surface 312.
[0062] The base portion 310 may define a mounting groove 314 for
attaching the base portion 310 onto a surgical instrument shaft, as
will be described in further detail below with reference to FIG.
26. The mounting groove 314 may extend along the longitudinal
direction. The mounting groove 314 may include at least one docking
portion 316a, 316b, the at least one docking portion 316a, 316b may
define a concave semi-circular surface configured to conform around
the surgical instrument shaft. In one aspect, the concave
semi-circular surface may have a first radius, and the first radius
may be less than or equal to an outer radius of the surgical
instrument shaft in order to provide an interference fit or an
annular fit when the docking portion 316a, 316b is attached to the
surgical instrument shaft. The interference or annular fit may
utilize the flexibility the docking portion 316a, 316b to at least
partially surround the surgical instrument shaft and maintain a
snap-on attachment utilizing a hoop-strain attribute of the docking
portion 316a, 316b.
[0063] The concave semi-circular surface may revolve about a
central longitudinal axis of the docking portion 316a, 316b, and
the revolution of the concave semi-circular surface may be greater
than or equal to 180.degree.. In one aspect, the angle of
revolution is between about 180.degree. to 270.degree.. For
example, the angle of revolution of the concave semi-circular
surface may be between about 185.degree. to 270.degree., or between
about 220.degree. to 245.degree. to ensure a secure fit about the
surgical instrument shaft, when attached, while enabling the
surgical clip cartridge 300 to be snapped-on or snapped-off of the
surgical instrument shaft using the force of a user's hands, for
example. It will be appreciated by one skilled in the art, in view
of the present disclosure, that the arc length and the revolution
of the arc may be selected based on a size or radius of the
surgical instrument shaft that the surgical clip cartridge 300 is
intended to attach on to. Additionally or alternatively, the arc
length and the revolution of the arc may be selected based on the
material properties of the surgical clip cartridge 300, such as the
resiliency, to ensure that the at least one docking portion 316a,
316b can be displaced sufficiently to engage and secure the
surgical clip cartridge 300 onto the surgical instrument shaft
without damage or failure during the product life.
[0064] In one aspect, the concave semi-circular surface of the at
least one docking portion 316a, 316b may include one or more of a
friction material, knurling, notches, and protrusions to prevent
axial or rotational displacement when the docking portion 316a,
316b is attached to the surgical instrument shaft. The addition of
one or more of the above surface features may prevent the base
portion 310 from shifting relative to the surgical instrument
shaft, thereby promoting accuracy and repeatability when a surgeon
attempts to retrieve a clip 100 from the surgical clip cartridge
300 during a surgical procedure. In one aspect, the docking portion
316a, 316b and the surgical instrument shaft may include
corresponding ribs and grooves to prevent axial and/or radial
movement of the surgical clip cartridge 300 relative to the
surgical instrument shaft once the surgical clip cartridge 300 has
been mounted to the surgical instrument shaft.
[0065] In one aspect, as best shown in FIGS. 6 and 10, the mounting
groove 314 may define at least two docking portions 316a, 316b, a
first docking portion 316a of the at least two docking portions may
be disposed on a proximal end of the base portion 310 in the
longitudinal direction, and second docking portion 316b of the at
least two docking portions being located on a distal end of the
base portion 310 in the longitudinal direction. In one aspect, the
at least one docking portion may extend continuously from a
proximal end to a distal end of the base portion.
[0066] In one aspect, as best shown in FIGS. 5, 7, 9, 11, 12, and
13, the surgical clip cartridge 300 may include a plurality of
dividers 320. Each of the plurality of dividers 320 may include at
least one wall surface 322 extending away from the base portion 310
in a vertical direction perpendicular to the longitudinal
direction. The at least one wall surface 322 may be a planar wall
surface, although other surface contours promoting the insertion
and removal of clips are of course contemplated. In one aspect, the
at least one divider 320 may include an upper surface, and the
upper surface may include a horizontally extending segment 324 and
at least one sloped segment 326 extending upwardly towards the
horizontally extending segment and towards a center of the at least
one divider 320. In one aspect, the upper surface of the at least
one divider 320 may generally define a trapezoidal shape. The
trapezoidal shape of the at least one divider 320 may provide
clearance and promote greater maneuverability of the surgical clip
100 once it has been disengaged from the surgical clip cartridge
300. For example, the sloped segments 326 may enable the C-shaped
hook section 140 and/or the tip section 150 of the surgical clip
100 to clear the at least one divider 320 more quickly and allow
the surgical clip 100 to be maneuvered along the longitudinal
direction without interference with the surgical clip cartridge
300. The increased maneuverability may be particularly beneficial
when the surgical clip cartridge 300 is used intracorporeally where
there is a limited amount of space within the body cavity of a
patient.
[0067] As shown in FIG. 14, the surgical clip 100 may be moved in
the axial direction relative to the surgical clip cartridge 300
even though portions of the surgical clip 100 overlaps with an
upper most portion of the surgical clip cartridge 300.
Additionally, the sloped segment 326 may prevent the surgical clip
100 from snagging the surgical clip cartridge 300 in the event the
surgical clip 100 is maneuvered laterally before the surgical clip
100 has completely cleared from the surgical clip cartridge 300.
The sloped segment 326 may allow the C-shaped hook section 140
and/or the tip section 150 to ride along the sloped segment 326 to
clear the surgical clip cartridge 300 without snagging during an
operation.
[0068] In one aspect, an upper portion of the at least one wall
surface 322 includes a latching protrusion 328. The latching
protrusion 328 may extend from the at least one wall surface 322.
The latching protrusion 328 may be used for interfacing with at
least a portion of a surgical clip 100, such a surface, a
depression, and/or an orifice of the surgical clip 100. In one
aspect, the interfacing portion of the surgical clip 100 may be the
latching orifice 135 disposed at the integral hinge section 130 of
the surgical clip 100. In one aspect, the latching protrusion 328
may be configured to prevent movement of a surgical clip 100 in
directions perpendicular to the longitudinal direction of the base
portion 310. For example, the surgical clip 100 may be inserted
into the surgical clip cartridge 300 such that the latching
protrusion 328 is at least partially inserted into the latching
orifice 135. In this arrangement, the latching orifice 135 and the
latching protrusion 328 may be sized to limit or prevent any play
or movement of the surgical clip 100 relative to the surgical clip
cartridge 300. However, once a predetermined threshold force is
applied to the surgical clip 100, via the clip applier 200 for
example, the surgical clip 100 may be released from the latching
protrusion 328.
[0069] As shown in FIGS. 7, 9, 11, 12, and 13, the surgical clip
cartridge 300 may further comprise a plurality of spacer portions
330. The spacer portions 330 may extend from the base portion 310
in a direction opposite of the bottom surface 312. The spacer
portion 330 of the plurality of spacer portions may be disposed
between pairs of facing dividers 320 of the plurality of dividers.
In one aspect, a width of the spacer portions 330 extending between
a pair of dividers 320 may be at least a maximum width of the
surgical clip 100. For example, the width of the spacer portions
may be at least as wide as a lateral width of the pair of bosses
152, 154 of the surgical clip 100 (as shown in FIG. 1). In one
aspect, as shown in FIG. 9, each pair of facing dividers 320 may
include at least two latching protrusion 328 to interface with the
latching orifice 135 of the surgical clip 100.
[0070] In one aspect, as best shown in FIGS. 11-13, the spacer
portion 330 may define a top surface 332, and the top surface 332
may have a concave segment 333 and a convex segment 334. The
concave segment 333 and a convex segment 334 may have a profile
complementary to the inner convex surface 122 and the inner concave
surface 112, respectively, of the surgical clip 100. The
complementary profiles may help minimize unwanted displacement or
play of the surgical clip 100, relative to the surgical clip
cartridge 300, when the surgical clip 100 is being retrieved and
withdrawn from the surgical clip cartridge 300. Additionally, or
alternatively, the complementary profiles may assist in the loading
of the surgical clips 100 onto surgical clip cartridge 300 by
providing a limit or a stop as the surgical clips 100 are inserted
downwardly towards the base portion 310.
[0071] In one aspect, as best shown in FIGS. 11 and 12, the spacer
portion 330 may define at least one inwardly tapering section 335,
336. A depth of the inwardly tapering sections 335, 336 may
increase when moving from an upper portion of the spacer towards a
lower portion of the spacer portion 330 towards the base portion
310. In other words, the depth of the inwardly tapering sections
335, 336, relative to a central axis of the respective spacer
portion 330, increases when moving from the top of the spacer
portion 330 towards the base portion 310, as shown in FIG. 11. In
one aspect, as the clip applier 200 is used to retrieve the
surgical clip 100 from the surgical clip cartridge 300 (the
trajectory of which is generally illustrated in FIGS. 14 and 15),
the legs 110, 120 of the surgical clip 100 may be biased inward in
order for the bosses 142, 144, 152, 154 to engage with the notches
212, 214, 222, 224 of the clip applier 200. The inwardly tapering
section 335, 336 may enable the legs 110, 120 to flex a sufficient
amount for the clip applier 200 to engage with the surgical clip
100. The clip applier 200 may then subsequently be maneuvered
upwardly, against the latching protrusions 328 to disengage and
release the surgical clip 100 from the surgical clip cartridge
300.
[0072] In one aspect, as shown in FIGS. 14 and 15, the surgical
clip cartridge 300 may include nine dividers 320 and two end
supporting walls 318, and the dividers 320 and supporting walls 318
may be used to retain up to ten surgical clips 100. In one aspect,
the surgical clip cartridge 300 may be configured to retain between
four to twenty surgical clips 100. In one aspect, surgical clip
cartridge 300 may be configured to retain four and twelve surgical
clips 100.
[0073] In one aspect, as shown in FIGS. 5, 7, and 9, a plurality of
ribs 319 may be provided between the end supporting walls 318 and
the docking portion 316a, 316b. The plurality of ribs 319 may
define a convex or curvilinear tapering profile that narrows
towards extreme longitudinal ends of the surgical clip cartridge
300. The tapering ribs 319 may promote insertion and removal of the
clip cartridge 300 into and out of the body cavity during a
surgical operation. The tapering ribs 319 may further promote or
enable flexing of the docking portion 316a, 316b when the surgical
clip cartridge 300 is snapped-on or snapped-off of the surgical
instrument shaft.
[0074] Referring back to FIG. 6, the surgical clip cartridge 300
may include one or more light sources 340, which may be used to
illuminate the body cavity during a surgical procedure. The one or
more light sources 340 may be in the form of light-emitted diodes,
however, other illumination sources are of course contemplated as
will be appreciated by one skilled in the art in view of the
present disclosure. For example, other illumination sources may
include, but are not limited to, incandescent light, UV light,
infrared light, and luminescence. The one or more light sources 340
may be powered by a sealed internal battery housed within the
surgical clip cartridge 300. The one or more light sources 340 may
further be connected to one or more electrical switches 350, 360
located on the surgical clip cartridge 300. Alternatively, the one
or more light sources 340 may be powered externally via electrical
contacts on the surgical clip cartridge 300 that may be connected
to corresponding electrical contacts on the surgical tool shaft
(not shown). An electric switch may further be provided on a handle
attached to the surgical tool shaft to actuate the one or more
light sources 340.
[0075] In one aspect, the one or more light sources 340 may be
primarily aimed at directions other than a direction in which the
surgical clips are retrieved and removed from the surgical clip
cartridge 300 to prevent glare. In particular, where visual sight
of the surgical clips via a camera or other visual means within the
body cavity is needed during retrieval from the surgical clip
cartridge, the orientation of the one or more light sources 340
away from a direction of retrieval may prevent light from being
directed towards the camera or other visual means. Instead, the one
or more light sources 340 may be directed in other directions to
provide general illumination within the body cavity. Additionally
or alternatively, the one or more light sources 340 may be oriented
to direct light towards a distal end of the surgical tool shaft,
when the surgical clip cartridge is mounted to the surgical tool
shaft, in order to provide illumination to a surgical area,
particularly when the surgical tool shaft is installed with an end
effector for performing a surgical procedure, as will be
appreciated by one skilled in the art in view of the present
disclosure.
[0076] In one aspect as shown in FIG. 6, the electrical switch 350
may be located on a mounting surface of the at least one docking
portion 316a, 316b. The electrical switch 350 may be actuated or
depressed as the surgical clip cartridge 300 is mounted onto the
surgical instrument shaft via the at least one docking portion
316a, 316b. Once the switch 350 is actuated or depressed, the one
or more light sources 340 may be activated to provide illumination.
The electrical switch 350 may subsequently be released by removing
the surgical clip cartridge 300 from the surgical instrument shaft
thereby deactivating the one or more light sources 340.
[0077] Additionally or alternatively, the electrical switch 360 may
be disposed on a distal or proximal end of the base portion 310.
The electrical switch 360 may be actuated manually be an operator
prior to, during, or after the surgical clip cartridge 300 has been
mounted to the surgical instrument shaft. By actuating the
electrical switch 360, the one or more light sources 340 may be
activated to provide illumination. The electrical switch 360 may be
actuated again to deactivate the one or more light sources 340.
[0078] Turning to FIGS. 16-22, a second exemplary surgical clip
cartridge 400 is shown. The surgical clip cartridge 400 may include
a generally elongated circular or elliptical body 410 extending in
a longitudinal direction. The body 410 may define a mounting groove
414 for attaching the body 410 onto a surgical instrument. The
mounting groove 414 may extend along the longitudinal direction.
The mounting groove 414 may include at least one docking portion
416a, 416b, and the at least one docking portion 416a, 416b may
define a concave semi-circular surface configured to conform around
the surgical instrument shaft. In one aspect, the concave
semi-circular surface may have a first radius, and the first radius
may be less than or equal to an outer radius of the surgical
instrument shaft in order to provide an interference fit when the
docking portion 416a, 416b is attached to the surgical instrument
shaft. The concave semi-circular surface may revolve about a
central longitudinal axis of the docking portion 416a, 416b, and
the revolution of the concave semi-circular surface may be greater
than or equal to 180.degree.. In one aspect, the angle of
revolution is between about 180.degree. to 270.degree.. For
example, the angle of revolution of the concave semi-circular
surface may be between about 185 to 270.degree., or between about
220.degree. to 245.degree. to ensure a secure fit about the
surgical instrument shaft, when attached, while enabling the
surgical clip cartridge 400 to be snapped-on or snapped-off of the
surgical instrument shaft using the force of a user's hands, for
example. It will be appreciated by one skilled in the art, in view
of the present disclosure, that the arc length and the revolution
of the arc may be selected based on a size or radius of the
surgical instrument shaft that the surgical clip cartridge 400 is
intended to attach on to. Additionally or alternatively, the arc
length and the revolution of the arc may be selected based on the
material properties of the surgical clip cartridge 400, such as the
resiliency, to ensure that the at least one docking portion 416a,
416b may displace sufficiently to engage and secure the surgical
clip cartridge 400 to the surgical instrument shaft without damage
or failure during the product life.
[0079] In one aspect, the concave semi-circular surface of the at
least one docking portion 316a, 316b may include one or more of a
friction material, knurling, notches, and protrusions to prevent
axial or rotational displacement when the docking portion 416a,
416b is attached to the surgical instrument shaft. The addition of
one or more of the above surface features may prevent the body 410
from shifting relative to the surgical instrument shaft, thereby
promoting accuracy and repeatability when a surgeon attempts to
retrieve a clip 100 from the surgical clip cartridge 400 during a
surgical procedure. In one aspect, the docking portion 416a, 416b
and the surgical instrument shaft may include corresponding ribs
and grooves to prevent axial and/or radial movement of the surgical
clip cartridge 400 relative to the surgical instrument shaft once
the surgical clip cartridge 400 has been mounted to the surgical
instrument shaft.
[0080] In one aspect, the body 410 may define a plurality of clip
slots 420 arranged end-to-end relative to one another. Each of the
clip slots 420 may be configured to receive and/or dispense the
surgical clip 100 in a direction that is perpendicular to the
longitudinal direction. In one aspect, the clip slots 420 may
include a central portion 422 and an outer portion 424. The central
portion 422 may include at least two latching protrusion 428 to
interface with the latching orifice 135 of the surgical clip 100.
In one aspect, the body 410 may include a total of four clip slots
420. However, it will be appreciated by one skilled in the art in
view of the present disclosure, that the number of clip slots 420
provided on the body 410 may be selected based on the number of
clips desired for a surgical operation and/or the available length
provided on the surgical instrument shaft. In one aspect, the body
410 may have between four and twenty clip slots. In one aspect, the
body 410 may have between four and eight clip slots.
[0081] As shown in FIGS. 16 and 20, one surgical clip 100 may be
stored within each of the clip slots 420, and the clip applier 200
may be inserted into the clip slots 420 to retrieve the surgical
clip 100 retained therein. Once the clip applier 200 has been
inserted into one of the clip slots 420, the clip applier 200 may
be positioned about the surgical clip 100. In one aspect, the
notches 212, 214 of the first jaw 210 may be configured to receive
and lock the bosses 142, 144 of the first leg 110, and the notches
222, 224 of the second jaw 220 may be configured to receive and
lock the bosses 152, 154 of the second leg 120. Alternatively, the
notches 212, 214 of the first jaw 210 may be configured to receive
and lock the bosses 152, 154 of the second leg 120, and the notches
222, 224 of the second jaw 220 may be configured to receive and
lock the bosses 142, 144 of the first leg 110. The clip applier 200
may then be withdrawn from the clip slot 420. During the withdrawal
process, the surgical clip 100 may be disengaged from the surgical
clip cartridge 400 once a predetermined threshold force is applied
to the surgical clip 100, via the clip applier 200 for example,
such that the surgical clip 100 may be released from the latching
protrusion 428.
[0082] In one aspect, as shown in FIGS. 16-19, a proximal and
distal ends 418a, 418b of the surgical clip cartridge 400 may be
rounded, filleted, and/or chamfered to promote insertion and
removal of the clip cartridge 400 into and out of the body cavity
during a surgical operation.
[0083] Referring back to FIG. 16, the surgical clip cartridge 400
may include one or more light sources 440, which may be used to
illuminate the body cavity during a surgical procedure. The one or
more light sources 435 may be in the form of light-emitted diodes,
however, other illumination sources are of course contemplated as
will be appreciated by one skilled in the art in view of the
present disclosure. For example, other illumination sources may
include, but are not limited to, incandescent light, UV light,
infrared light, and luminescence. The one or more light sources 435
may be powered by a sealed internal battery housed within the
surgical clip cartridge 400. The one or more light sources 440 may
further be connected to an electrical switch 440 located on the
surgical clip cartridge 400. Alternatively, the one or more light
sources 435 may be powered externally via electrical contacts on
the surgical clip cartridge 400 that may be connected to
corresponding electrical contacts on the surgical tool shaft (not
shown). An electric switch may further be provided on a handle
attached to the surgical tool shaft to selectively actuate the one
or more light sources 435.
[0084] In one aspect, the one or more light sources 435 may be
primarily aimed at directions other than a direction in which the
surgical clips are retrieved from the surgical clip cartridge 400
to prevent glare. As shown in FIGS. 16 and 18, the one or more
light sources 435 may be oriented to direct light towards a distal
and/or proximal end of the surgical tool shaft, when the surgical
clip cartridge is mounted to the surgical tool shaft, in order to
provide illumination to a surgical area, particularly when the
surgical tool shaft is installed with an end effector for
performing a surgical procedure, as will be appreciated by one
skilled in the art in view of the present disclosure.
[0085] In one aspect, the electrical switch 440 may be located on a
mounting surface of the at least one docking portion 416a, 416b.
The electrical switch 440 may be actuated or depressed as the
surgical clip cartridge 400 is mounted onto the surgical instrument
shaft via the at least one docking portion 416a, 416b. Once the
switch 440 is actuated or depressed, the one or more light sources
440 may be activated to provide illumination. The electrical switch
440 may subsequently be released by removing the surgical clip
cartridge 400 from the surgical instrument shaft thereby
deactivating the one or more light sources 435.
[0086] Turning to FIGS. 23 and 24, a third exemplary surgical clip
cartridge 500 is shown. The surgical clip cartridge 500 may include
a generally elongated circular or elliptical body 510 extending in
a longitudinal direction. The circular or elliptical body 510 may
include a proximal end 512 and a distal end 514. The proximal end
512 may include a tool engaging slot 516 configured to receive and
lock a distal end of a surgical tool shaft. The distal end of the
surgical tool shaft may include lateral protrusions for insertion
into the tool engaging slot 516 and to enable both the surgical
tool shaft and the surgical clip cartridge 500. The distal end 514
of the surgical clip cartridge 500 may include a clip feeding slot
518 configured to receive and dispense clips, such as but not
limited to surgical clips 100 discussed above. Of course, other
types of clips may be used with the surgical clip cartridge
500.
[0087] In one aspect, the surgical clip cartridge 500 is configured
to store a plurality of surgical clips 100, sequentially in
abutting fashion, within an interior lumen or chamber of the
surgical clip cartridge 500. A spring mechanism may be provided to
advance the surgical clips 100 toward the clip feeding slot 518 as
a preceding surgical clip 100 is removed. The surgical clips 100
may be removed from the clip feeding slot 518 by inserting the pair
pivotable jaws 210, 220 of the clip applier 200 into then clip
feeding slot 518, generally in the longitudinal direction. The pair
pivotable jaws 210, 220 may then engage the bosses 142, 144, 152,
154. The outermost surgical clip 100 may then be withdrawn from the
clip feeding slot 518 using the clip applier 200.
[0088] In one aspect, as shown in FIGS. 22 and 23, the proximal end
512 and the distal end 514 of the surgical clip cartridge 500 may
be rounded, filleted, and/or chamfered to promote insertion and
removal of the clip cartridge 500 into and out of the body cavity
during a surgical operation.
[0089] FIGS. 25, 26, and 27 show three-dimensional renderings of
the first surgical clip cartridge 300, second surgical clip
cartridge 400, and third surgical clip cartridge 500, respectively.
FIG. 28 shows a surgical assembly comprising a surgical tool 600
with an elongated shaft 610 and an end effector 620 disposed at a
distal end of the elongated shaft 610. In one aspect, the end
effector may be a grasper. In one aspect, any one or more of the
first surgical clip cartridge 300, second surgical clip cartridge
400, and third surgical clip cartridge 500, may be attached to the
elongated shaft 610. As specifically shown in FIG. 26, the first
surgical clip cartridge 300 is attached to the elongated shaft 610
via the at least one docking portion 316a, 316b, as described
above. In one aspect, a diameter of the elongated shaft 610 may be
between 1 mm and 100 mm.
[0090] A system and a method of using a surgical clip cartridge
during a surgical procedure will now be discussed. In one aspect,
the surgical procedure may be minimally invasive surgery (such as
micro-laparoscopic or needlescopic surgery) where instruments
and/or accessories may be introduced into a body cavity through
relatively small ports to reduce pain, improve recovery time, and
minimize scarring. The small ports may be less than 3 mm in
diameter, and in select aspects may be between 1 mm to 3 mm. The
use of such small ports may help minimize triangulation issues and
improve maneuverability in comparison with surgical operations
where multiple instruments are inserted in parallel through a
single larger opening. Even with the use of smaller ports, a single
larger port may be provided to pass larger components into the body
cavity, such an interchangeable end effector.
[0091] Referring to FIGS. 29A-29H, an exemplary micro-laparoscopic
system 1000 including a snap-on surgical clip cartridge, such as
the surgical clip cartridge 300, 400, 500 discussed above, is
shown. As shown in FIG. 29A, the micro-laparoscopic system 1000 may
include a surgical tool 1100 and an access port 1200. The surgical
tool 1100 may comprise a handle portion 1110 and an elongated
needle shaft 1120. The elongated needle shaft 1120 may have a
maximal outer diameter of 3 mm, and in one aspect, the diameter of
the elongated needle shaft 1120 is between 1 mm and 3 mm. The
elongated needle shaft 1120 may include a needle tip 1130 located
at a distal end thereof. The needle tip 1130 may be a beveled or
sharp needle tip configured to puncture through body tissue and may
be used to puncture through a body wall and into a body cavity.
[0092] In one aspect, the needle tip 1130 of the surgical tool 1100
may be directed adjacent to a body cavity wall. Pressure in a
distal direction may be applied to the elongated needle shaft 1120
and the needle tip 1130. As pressure is being applied to the body
cavity wall via the needle tip 1130, an incision or opening 1250
may be formed in the body cavity wall. As the incision or opening
1250 is formed, the needle tip 1130 and at least a portion of the
elongated needle shaft 1120 may be advanced to enter into the body
cavity.
[0093] The access port 1200 may be provided at a location remote
from the incision or opening 1250. In one aspect, the access port
1200 may define an interior lumen with a maximal internal diameter
of between 3 mm to 30 mm. In one aspect, the access port 1200 may
be introduced and employed through an umbilicus of the patient.
Once the access port 1200 has been positioned in and/or on the body
wall, and once the elongated needle shaft 1120 has been inserted
into the body cavity via the incision or opening 1250, the needle
tip 1130 and the elongated needle shaft 1120 may be guided from
inside the body cavity to an external environment outside the body
cavity, by entering a distal end of the access port 1200, passing
through the interior lumen of the access port 1200, and exiting a
proximal end of the access port 1200 as generally shown in FIGS.
29A and 29B.
[0094] As shown in FIG. 29B, once the distal end of the elongated
needle shaft 1120 is extended from the access port 1200 to the
external environment, the surgical clip cartridge 300, 400 may be
attached to an outer surface of the elongated needle shaft 1120.
For example, a snap-on surgical clip cartridge, such as the
surgical clip cartridge 300, 400 may be snapped onto the outer
surface of the elongated needle shaft 1120, as shown in FIG. 29C.
Alternatively, a snap-on clip cartridge, such as the surgical clip
cartridge 500 may be secured onto or over the needle tip 1130 of
the elongated needle shaft 1120. Once the snap-on clip cartridge
has been secured to the elongated needle shaft 1120, the elongated
needle shaft 1120 and the snap-on clip cartridge 300, 400 may be
withdrawn into the body cavity via the access port 1200, as shown
in FIG. 29D. The process may then be reversed, as generally shown
in FIGS. 29G and 29H, in order to remove or snap-off the clip
cartridge 300, 400 from the elongated needle shaft 1120 such that
the surgical tool 1100 can be removed from the patient, via the
initial incision or opening 1250, without creating a larger
incision.
[0095] In addition to attaching or snapping on the surgical clip
cartridge 300, 400 onto the outer surface of the elongated needle
shaft 1120, as shown generally in FIGS. 29B and 29C, an end
effector tool 700 may also be attached to the distal end of the
elongated needle shaft 1120. The end effector tool 700 may be one
of graspers, scissors, clamp, a cauterizing end, a biopsy probe, a
snare loop, a needle knife, a camera and a light source. Of course,
other tools and end effectors for the surgical tool 1100 are of
course contemplated
[0096] As shown in FIG. 29E, once the surgical clip cartridge 300,
400 mounted onto the elongated shaft 1120 has been withdrawn into
the body cavity, a clip applier such as the clip applier 200 (shown
and discussed with reference to FIGS. 4A and 4B above) may be used
within the body cavity to apply a plurality of surgical clips. In
particular, the first jaw 210 and the second jaw 220 of the clip
applier 200 may be introduced through the access port 1200 and
guided towards the surgical clip cartridge 300, 400 such that
surgical clips 100 may be retrieved from the surgical clip
cartridge 300, 400 while within the body cavity.
[0097] As generally shown in FIGS. 29E and 29F, a first surgical
clip may be retrieved using the clip applier 200 from the surgical
clip cartridge 300, 400. The first surgical clip may then be
applied to clamp at least one portion of a vessel or piece of
tissue located in at least one operation location within the body
cavity. While remaining within the body cavity, the clip applier
200 may then retrieve a second surgical clip from the surgical clip
cartridge 300, 400. The second surgical clip may then be applied to
clamp the same or another portion of the vessel or piece of tissue.
Alternatively, the second surgical clip may be applied to a
different vessel or piece of tissue within the body cavity.
Additional surgical clips may be retrieved from the surgical clip
cartridge 300, 400 and applied by the clip applier 200 without
either the clip applier 200 or the surgical clip cartridge 300, 400
from having to be removed from the body cavity.
[0098] By providing the surgical clip cartridge 300, 400 within the
body cavity, a shorter travel distance is required between
reloading of the clip applier 200, and reloading can be
accomplished intracorporeally, thereby providing a more efficient
ligation process and reducing contamination or complications that
may arise by having a surgeon repeatedly remove and re-insert a
clip applier into and out of the body cavity for reloading
purposes.
[0099] An exemplary surgical method of using the micro-laparoscopic
system 1000 will now be described. The surgical method may include
a step of providing the surgical clip cartridge 300, 400, the
surgical tool 1100 with the elongated needle shaft 1120, and the
access port 1200. The surgical clip cartridge may include between
four and eight clip slots for transporting a corresponding number
of surgical clips. The access port 1200 may be inserted into a
first opening of the body cavity wall such that at least a portion
of the access port 1200 extends into the body cavity. In one
aspect, the first opening may be created as pressure is applied
against the body cavity wall via the access port 1200. In one
aspect, the first opening may be formed at the umbilicus of the
patient. In one aspect, the access port 1200 may define a lumen
having an internal diameter of between 3 mm to 30 mm, and the first
opening may have a minimum diameter of greater than 3 mm.
[0100] The method may comprise a step of inserting the elongated
needle shaft 1120 into the body cavity via a second opening, the
second opening being remote from the first opening. In one aspect,
the needle tip 1130 of the elongated needle shaft 1120 may be used
to puncture the body cavity wall to thereby forming the second
opening. In one aspect, the maximal outer diameter of the elongated
needle shaft is 3 mm or less, and the second opening formed may
have a maximal diameter of approximately 3 mm or less.
[0101] The method may comprise a step of orienting the needle tip
1130 of the elongated needle shaft 1120 towards a distal opening of
the access port 1200 that is extended into the body cavity. The
needle tip 1130 and at least a distal portion of the elongated
needle shaft 1120 may be guided through the lumen of the access
port 1200 and out a proximal opening of the access port 1200. Once
at least the distal portion of the elongated needle shaft 1120
passes through the proximal opening of the access port 1200 and is
accessible in the external environment outside the body cavity, the
surgical clip cartridge 300, 400 may be attached to the outer
surface of the elongated needle shaft 1120. The surgical clip
cartridges 300, 400 may be secured to the elongated needle shaft
1120 via at the least one docking portion 316a, 316b, 416a, 416b
using a snap-on or annular fit. The at least one docking portion
316a, 316b, 416a, 416b may flex as it is being attached to the
elongated needle shaft 1120 and may at least partially surround the
elongated needle shaft 1120 once attached. The at least one docking
portion 316a, 316b, 416a, 416b may be slightly expanded once
attached to the elongated needle shaft 1120 and may grip the
elongated needle shaft 1120 through the presence of hoop strain or
stress.
[0102] While the distal end of the elongated needle shaft 1120
remains extended from the proximal end of the access port 1200 and
accessible to the external environment outside the body cavity, an
end effector tool 700 may be mounted to the distal end of the
elongated needle shaft 1120. In one aspect, the end effector tool
700 may be one of graspers, scissors, clamp, a cauterizing end, a
biopsy probe, a snare loop, a needle knife, a camera and a light
source.
[0103] Once the surgical clip cartridge 300, 400 has been attached
to the elongated needle shaft 1120, both the surgical clip
cartridge 300, 400 and the distal end of the elongated needle shaft
1120 may be withdrawn into the body cavity via the lumen of the
access port 1200. A plurality of surgical clips carried by the
surgical clip cartridge 300, 400 may then be retrieved from the
surgical clip cartridge 300, 400 while it is within the body
cavity.
[0104] In one aspect, a distal end of the clip applier 200 may be
inserted into the body cavity via the access port 1200. The distal
end of the clip applier 200 may include a pair of jaws or other
grasping mechanism. The pair of jaws or other grasping mechanism
may be maneuvered to at least a first slot of the surgical clip
cartridge 300, 400. The pair of jaws may then engage and retrieve a
first surgical clip retained within the first slot of the surgical
clip cartridge 300, 400. The clip applier 200 may then be directed
towards an operation location where the first surgical clip is
latched and secured around a target vessel or other type of tissue.
The pair of jaws or other grasping mechanism may then be maneuvered
to a second slot of the surgical clip cartridge 300, 400 such that
a second surgical clip may be retrieved from the second slot of the
surgical clip cartridge 300, 400. The clip applier 200 may then be
directed towards an operation location where the second surgical
clip is latched and secured around target vessel or other type of
tissue, which may be the same target vessel or tissue secured by
the first surgical clip or it may be different target vessel or
tissue as required by the procedure. This process may be repeated
such that additional surgical clips may be retrieved from the
surgical clip cartridge 300, 400 and applied without having to
remove the clip applier 200 from within the body cavity. If
present, the end effector tool 700 may be used to perform a
procedure within the body cavity while the surgical clip cartridge
300, 400 is mounted to the elongated needle shaft 1120.
[0105] Once the number of surgical clips held by the surgical clip
cartridge 300, 400 have been exhausted, or once the surgical clips
are no longer needed for the operation, the clip applier 200 may be
withdrawn from the body cavity by passing the distal end of the
clip applier 200 back through the lumen of the access port 1200 and
out to the external environment. Both the surgical clip cartridge
300, 400 and the distal end of the elongated needle shaft 1120 may
also pass through the lumen of the access port 1200 such that at
least the surgical clip cartridge 300, 400 is accessible in the
external environment. The surgical clip cartridge 300, 400 may then
be detached from the elongated needle shaft 1120. If present, the
end effector tool 700 may also be removed from the distal end of
the elongated needle shaft 1120.
[0106] The distal end of the elongated needle shaft 1120 may be
withdrawn back into the body cavity via the lumen of the access
port 1200. The surgical tool 1100, including distal end of the
elongated shaft 1120, may be completely withdrawn from the body
cavity by maneuvering the surgical tool 1100 in a proximal
direction from the body cavity wall such that the distal end of the
elongated shaft 1120 is passes through and exits via the second
opening. Although exemplary steps for a surgical method is
presented above, variations and modifications to the steps,
including rearrangement of the order and sequence, will be
appreciated by one skilled in the art in view of the present
disclosure.
[0107] The surgical clip cartridges described in the present
disclosure may be used in a variety of surgical procedure,
including intracorporeal feeding of surgical clips, to reduce
surgery time and to minimize visualization loss of the surgeon as a
result of clip reloading. The methods and systems of the present
disclosure, as described above and shown in the drawings, provide
surgical clip cartridges with superior properties to provide
surgeons with additional flexibility and maneuverability during
operation.
[0108] While the apparatus and methods of the present disclosure
have been shown and described, it will be appreciated that the
foregoing description provides examples of the surgical clip
cartridge, which may be used with a surgical instrument. However,
it is contemplated that other implementations of the disclosure may
differ in detail from the foregoing examples. Each aspect of the
disclosure may be used individually or in combination with one
another, as will be understood by one skilled in the art in view of
the present disclosure. All references to the disclosure or
examples thereof are intended to reference the particular example
being discussed at that point and are not intended to imply any
limitation as to the scope of the disclosure more generally. All
language of distinction and disparagement with respect to certain
features is intended to indicate a lack of preference for those
features, but not to exclude such from the scope of the disclosure
entirely unless otherwise indicated.
[0109] Recitation of ranges of values herein are merely intended to
serve as a shorthand method of referring individually to each
separate value falling within the range, unless otherwise indicated
herein, and each separate value is incorporated into the
specification as if it were individually recited herein. All
methods described herein can be performed in any suitable order
unless otherwise indicated herein or otherwise clearly contradicted
by context.
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