CA2147757A1 - Surgical ligation clip - Google Patents
Surgical ligation clipInfo
- Publication number
- CA2147757A1 CA2147757A1 CA002147757A CA2147757A CA2147757A1 CA 2147757 A1 CA2147757 A1 CA 2147757A1 CA 002147757 A CA002147757 A CA 002147757A CA 2147757 A CA2147757 A CA 2147757A CA 2147757 A1 CA2147757 A1 CA 2147757A1
- Authority
- CA
- Canada
- Prior art keywords
- clip
- arm
- vessel
- support member
- clamping
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
Abstract
A surgical ligation clip (10) is preformed from a continuous piece of metal wire to assume a shape having a reduced cross-sectional area. A clamping arm (30) of the clip is alternately moveable from a clamped to an unclamped position above a vessel support member (14). A tension coil (34) joins the vessel support member to the clamping arm and provides the hemostatic clamping force from the clip to the targeted blood vessel.
Description
wo 95105778 ~ 1 ~ 7 7 5 7 PCT/USg4/09326 DESCRIPTION
SURGICAL LIGATION CLIP
TECHNICAL FIELD
The present invention relates generally to mechanical devices used in surgical procedures to obtain ligation or hemostasis, and more particularly, to a ligation clip used during surgery to clamp around a vessel or duct, such as the cystic duct, and thereby obtain ligation.
BACKGROUND ART
It will be a~leciated by those skilled in the art that the use of ligation clips to control bleeding during surgical procedures is well known. As described, for example, in U.S. Patent Nos. 4,976,722 and 4,979,950, prior art clips are generally formed of metal wire, usually a titanium alloy, having a "U-shaped" rectangular cross-section.
Such prior art clips often include a grooved pattern machined into the inner or clamping surfaces of the clip, in an attempt to enhance the ability of the clip to remain in position after it is closed around the vessel. Application of the clip to the vessel is normally effected by means of a crushing action produced by a clip applier, such as that disclosed in U.S. Patent No. ~,030,226. Such crushing actions, of course, permanently deform the clips, making them difficult to remove or re-position.
Prior art surgical ligation clips have several inherent problems. For example, the force applied by the clip to the vessel can be variable and inconsistent from one clip to the next, because of the variation in crushing force applied to the clip by the user.
Further, prior art clips have a tendency to slip off the end of the blood vessel stub to which it has been applied, because of the low coefficient of friction associated with the clip, and lack of adequate restraining force provide by the clip. Rec~ e of this, separation of the clip from the vessel to which it has been applied, after the wound has been closed, is not uncommon.
It is also common in the prior art to actually form and crush the clip only at the time of its application to the targeted blood vessel. Accordingly, the clip applier mechanism must be relatively large and cumbersome. This is a particular problem in laparoscopic procedures, during which both the clip and clip applier must be inserted through a trocar placed through the patient's external tissues and into the surgical field.
wo 9s/05778 2~ ~ ~ 7 7 5 7 PCT/US94/09326 Thus, prior art ligation clips used in laparoscopic procedures universally consist of a 10 mm ~ mett~r clip applier that can fit only through a trocar having a 10 to 11 mm .1i~mete~ entry port. Rec~ e one goal of laparoscopic surgery is to minimi7e the size of the entry wound, a surgical ligation clip and clip applier that can be used within a 5 mm diameter trocar port is highly desirable.
What is needed, then, is a surgical ligation clip that can be easily pre-formed into a shape that presents a minimal cross-sectional area, that can be easily applied to a vessel and that, when applied, will impart a consistent hemostatic force to the vessel while resisting separation from the vessel stub. This device is presently lacking in the prior art.
DISCLOSURE OF THE INVENTION
In order to achieve the objects of simplicity of manufacture, ease of use, consistency of clamping force, high resist~nce to lateral slil~page, and present~tion of minim~l cross-sectional area during placement of the clip inlo the surgical field, a new and improved surgical clip was designed having a vessel clamping arm, a vessel support member, and a tension coil integrally joining the arm and support member. The clip is pre-formed so that in its relaxed state, it can be easily placed within the surgical field, including through a endoscopic trocar port with as little as a five millimeter diameter. After the clip is placed proximate the blood vessel or duct to be clamped, the clamping arm is moved from its relaxed position to a position under tension,allowing positioning of the vessel between the arm and support member. When correct placement and positioning is achieved, the arm is released and, as the arm tends to move back towards its relaxed position, it clamps the vessel between the arm's curved lower surface and the supporting upper surface of the vessel support member.
To enhance the performance of the ~ension coil, in a preferred embodiment of the invention, the vessel support member includes first and second arms, one of which termin~tes in a loop section. Minimal cross-sectional area of the clip is achieved by substantially longitu~in~lly aligning the vessel support member, the clamping arm, the loop section, and the tension coil.
In a first embodiment of the clip, the clamping arm is pre-formed into a relaxed position whereby it extends slightly below the horizontal plan of the support member.
A second embodiment of the clip preloads the clamping arm into a relaxed position where the free end of the arm rests against the upper surface of the support member.
Fig. 1 is a top view of the surgical clip of the present invention with the vessel clamping member in a relaxed position.
Fig. 2 is a side view of the surgical clip of the present invention with the vessel clamping member in a relaxed position.
Fig. 3 is a top view of the surgical clip of the present invention after application to a blood vessel and with the vessel clamping arm in a clamped position.
Fig. 4 is a side view of the surgical clip of the present invention after application to a blood vessel, showing the vessel clamping arm in a clamped position.
Fig. 5 is a top view of a second embodiment of the surgical clip of the present invention having a preloaded clamping arm.
Fig. 6 is a side view of a second embodiment of the surgical clip of the presentinvention.
Fig. 7 is a top view of a third embodiment of the surgical clip of the present invention.
Fig. 8 is a side view of a third embodiment of the surgical clip of the present invention.
Fig. 9 is an end view of a third embodiment of the surgical clip of the present invention.
Fig. 10 shows the surgical clip within the jaws of a clip grasper/applier.
BEST MODE FOR CARRYING OUT THE INVENTION
Looking first at Figs. l and 2, the surgical ligation clip of the present invention is shown in its relaxed position, prior to its manipulation into a position around the target blood vessel. Surgical clip 10 comprises generally a blood vessel clamping arm 30 which is moveable in a plane perpendicular to blood vessel support member 14. As seen best in Fig. 1, support member 14 is formed of a continuous piece of surgical wire, such as titanium or stainless steel, which is bent to define a first arm 16 and a -WO 95/05778 ~ ~ ~ 7 7 ~7 PCT/US94/09326 subst~n~i~lly parallel second arm 18 joined by a one hundred eighty degree (180) bend section 20. In the preferred embodiment, the proximal free end 24 of clip 10 will be joined to first arm 16 of support member 14 by a ninety degree (90) bend section 22.
Second arm 18 termin~tes at its proximal end (away from one hundred eighty (180) bend section 20) in loop section 26, the plane of which is perpendicular to the plane of support member 14 and which loops inwardly toward clamping arm 30.
In its relaxed position as shown in Figs. 1 and 2, clamping arm 30 is longitllrlin~lly aligned with and oriented between first arm 16 and second arm 18 of support member 14, but below the horizontal plane defined by first and second arms 16 and 18. The distal free end 32 of clip 10 defines the beginning of clamping arm 30.
A curved section 36 of clamping arm 30 moves proximately away from free end 32, termin~tin~ in tension coil 34. The vertical plane established by ten~ion coil 34 is oriented in substantial alignment with the vertical plane of loop section 26, and, accordingly, perpendicular to the horizontal plane of support member 14. It will be apparent to those ~killed in the art that in this orientation ~nd by f~rmin~ clip 10 of a continuous piece of resilient material, movement of clamping arm 30 will placeclamping arm 30 under tension with respect to vessel supp~ort member 14. Further, such an orientation will minimi7e the width and cross-sectional area of clip 10 which is ~reft~l,ed, particularly in laparoscopic surgery.
Looking now at Figs. 3 and 4, application of clip ~0 to a blood vessel 40 to achieve hemostasis is shown. After clip 10 is placed in the surgical field adjacent to the targeted blood vessel 40, clamping arm 30 is moved upwardly between vessel support member arms 16 and 18 to define a gap and space between distal free end 32 and the upper surface of one hundred eighty (l80) bend section 20. For most uses, a vertical gap of approximately l.5 mm will be sufficient. Clip 10 is then maintained in this position so that blood vessel 40 can be manipulated within the space created between arm 30 and support member 14. Clamping arm 30 is then released, trappingvessel 40 within clip 10 as arm 30 moves toward its relaxe~ position. The curvature of curved section 36 of clamping arm 30 causes a relatively consistent clamping pressure to be placed over the entire surface of vessel 40, thereby achieving effective hemostasis. By placing loop section 26 physically adjacent to, and operatively in series ~ wo 95/05778 ~14 7 7 5 7 PCT/US~ 326 with tension coil 34, a smoother, more consistent application of hemostatic force is obtainable, while increasing the resistance of clip 10 to deformation.
It will be apparent to those skilled in the art that clip 10 is also effective in clamping off ducts connecting various organs, the cystic duct for example.
Accordingly, where the term "vessel" is used herein, it is intended that such reference include all fluid carrying body structures within the surgical field where ligation or clamping is needed. Where the diameter of a duct or other structure to be clamped is substantially larger than 1.5 mm, a slightly modified method of applying clip 10 is ~lc;r~lled so that the elastic limit of the material used in the construction of clip 10 is not exceeded. In such modified technique, surgical pliers of conventional design are first positioned over the area to be clamped and the duct or other structure is then compressed to approximately a two wall thickness, or 1.5 mm. The pliers are thenremoved and clip 10 applied as described above. To minimize the risk of over-con,p.ession, the pliers (not shown) will preferably include a means for limiting closure lS of its jaws to a minimum spacing of approximately 1.5 mm. The use of this technique on large structures allows clip 10 to be formed with a minimized profile suitable for use in a 5 mm trocar, even if the diameter of the duct to be clamped, for example, exceeds 5 mm.
To remove or re-position clip 10, clamping arm 30 needs merely to be moved back up into its fully unclamped position, the vessel and clip manipulated as needed, and then clamping arm 30 is released towards its relaxed position.
To counteract the tendency of clip 10 to produce a torsional force to blood vessel 40, it is ~lt;fell~d that the proximal free end of 24 of clip 10 join a ninety degree (90) bend section 22 interposed between arm 16 and proximal free end 24. As shown on Fig. 2, free end 24 and a segment of bend section 22 is centrally disposed within tension coil 34.
Adding a series of ridges, notches, burrs by machining, etching, or other treatment to the clamping surfaces of arm 30 and support member 14 can enhance the gripping force of clip 10.
To achieve the objective of minimizing the cross-sectional area of clip 10, thereby permitting it to be used in laparoscopic surgical procedures, clip 10 is pre-wo ss/0s778 PCr/us~ 5326 21477~7 formed into the position substantially as shown on Figs. l and 2. In this configuration, arms 16 and 18, clamping arm 30, tension coil 34, and loop section 26 are in substantially alignment longitudinally.
In a plcfell~d embodiment of the clip of the present invention, adaptable for placement within an endoscopic surgical field through a 5 mm diameter trocar port, the inside diameters of tension coil 34 and loop section 26 are approximately 3 mm. The length of clip 10, measured from the proximal surface of tension coil 34 to the distal surface of one hundred eighty (180) degree bend section 20 is approximately 12 mm.
The width of vessel support member 14, measured at the outside surfaces of first arm 16 and second arm 18, is approximately 2.5 mm. Clamping arm 30 is approximately 9 mm from distal free end 32 to its intersection with tension coil 34. In the ~l~fel,ed embodiment, curved section 36 of clamping arm 30 will have a radius of curvature of approximately 25 mm. A suitable material from which clip 10 can be formed is wrought titanium 6Al-4V ELI alloy wire having a nominal diameter of 0.75 mm, andwhich meets ASTM Standard F136-92. Clip 10 can also be made of wire having a non-circular cross section, or formed from wire having a combination of circular and non-circular sections. For example, tension coil 34 and/or clamping arm 30 could be stronger if formed from rectangular-shaped wire.
A second embodiment of clip 10 is shown in Figs. 5, 6, and 7, with the essential difference from the first embodiment being an extension of clamping arm 30 so that in its "relaxed" position, arm 30 rests in a preloaded condition on the upper surface of support member 14, at bend section 20. Accordingly, a l,refelled length of arm 30 in this embodiment is approximately 7.3 mm with an overall length of clip 10 of approximately 11.4 mm. By extending and preloading arm 30 so that it can assume the position shown in Fig. 6, the cross-sectional area presented by clip 10 is further minimized, rendering it more adaptable for use in small diameter trocars. Preloading arm 30, of course, helps to maintain clip 10 in a narrow profile until it is positioned for application.
As seen in Fig. 6, first arm 16 and second arm 18 of support member 14 are curved upwardly to enhance the clamping force distribution characteristics of clip 10.
It will be apparent to those skilled in the art that, as in the first embodiment of Figs.
21~7757 1-4, such cuNature could be provided alternatively or additionally within clamping arm 30. Where ease of manufacture is a prime objective, each of arms 15, 18, and 30 can be straight.
A third embodiment of the surgical clip 10 of the present invention is shown in Figs. 7, 8, and 9. Clamping arm 30 has a curved section 36 extending between distal free end 32 and tension coil 34. Vessel support member 14 is continuously formed of a first arm 16 termin~ting at proximal free end 24, joined to second arm 18 by one hundred eighty degree (180) bend section 20. Preferably, bend section 20, as shown in Fig. 9, will also have a generally concave shape so the clamping forces will be distributed more evenly across the surface of the blood vessel (not shown). The shape of curved section 36 of vessel clamping arm 30 is generally convex to provide a more secure holding force to the vessel as well. Although tests have shown that the second embodiment does not perform as well as the first embodiment described above, it does offer the advantage of being simpler to pre-form and perhaps to apply.
Fig. 10 conceptually illustrates the jaw end of a surgical grasper tool 40 whichhas been modified to function as a clip applier for the surgical clip of the present invention. Slots (not shown) have been machined into the opposing horizontal surfaces of upper jaw 41 and lower jaw 42 to accommodate therein segments of tension coil 34 and loop section 26, thereby orienting clip 10 in the vertical plane. Ret~ining pins 44 extend perpendicularly from the vertical surfaces of upper jaw 41. A tooth 43 isattached to the vertical surface of lower jaw 42 and extends above jaw 42. When clip 10 is in proper position for application, pins 44 are in contact with tension coil 34 and tooth 43 is in contact with clamping arm 30. Consequently, when jaws 41, 42 are moved toward each other (by operation of the grasper handle, not shown), pins 44 bear against tension coil 34, and tooth 43 causes clamping arm 30 to move upwardly from its relaxed position. This creates a gap between the free end 32 of arm 30 and the upper surface of support member 14. Clip 10 can then be positioned around the blood vessel (not shown). When jaws 41, 42 are then allowed to move apart, clamping arm 30 is forced downward by tension coil 34 into a clamped position around the vessel.
To remove or re-position clip 10, graspers 40 are re-positioned as shown in Fig. 9 and the process is repeated.
wo 9s/05778 ~ 2~ 47 7 57 PCT/US94/09326 Thus, although there have been described particular embodiments of the present invention of a new and useful surgical ligation clip, it is not intended that such references be construed as limitations upon the scope of this invention except as set forth in the following claims. Further, although there have been described certain dimensions used in the preferred embodiment, it is not intended that such dimensions be construed as limitations upon the scope of this invention except as set forth in the following claims.
SURGICAL LIGATION CLIP
TECHNICAL FIELD
The present invention relates generally to mechanical devices used in surgical procedures to obtain ligation or hemostasis, and more particularly, to a ligation clip used during surgery to clamp around a vessel or duct, such as the cystic duct, and thereby obtain ligation.
BACKGROUND ART
It will be a~leciated by those skilled in the art that the use of ligation clips to control bleeding during surgical procedures is well known. As described, for example, in U.S. Patent Nos. 4,976,722 and 4,979,950, prior art clips are generally formed of metal wire, usually a titanium alloy, having a "U-shaped" rectangular cross-section.
Such prior art clips often include a grooved pattern machined into the inner or clamping surfaces of the clip, in an attempt to enhance the ability of the clip to remain in position after it is closed around the vessel. Application of the clip to the vessel is normally effected by means of a crushing action produced by a clip applier, such as that disclosed in U.S. Patent No. ~,030,226. Such crushing actions, of course, permanently deform the clips, making them difficult to remove or re-position.
Prior art surgical ligation clips have several inherent problems. For example, the force applied by the clip to the vessel can be variable and inconsistent from one clip to the next, because of the variation in crushing force applied to the clip by the user.
Further, prior art clips have a tendency to slip off the end of the blood vessel stub to which it has been applied, because of the low coefficient of friction associated with the clip, and lack of adequate restraining force provide by the clip. Rec~ e of this, separation of the clip from the vessel to which it has been applied, after the wound has been closed, is not uncommon.
It is also common in the prior art to actually form and crush the clip only at the time of its application to the targeted blood vessel. Accordingly, the clip applier mechanism must be relatively large and cumbersome. This is a particular problem in laparoscopic procedures, during which both the clip and clip applier must be inserted through a trocar placed through the patient's external tissues and into the surgical field.
wo 9s/05778 2~ ~ ~ 7 7 5 7 PCT/US94/09326 Thus, prior art ligation clips used in laparoscopic procedures universally consist of a 10 mm ~ mett~r clip applier that can fit only through a trocar having a 10 to 11 mm .1i~mete~ entry port. Rec~ e one goal of laparoscopic surgery is to minimi7e the size of the entry wound, a surgical ligation clip and clip applier that can be used within a 5 mm diameter trocar port is highly desirable.
What is needed, then, is a surgical ligation clip that can be easily pre-formed into a shape that presents a minimal cross-sectional area, that can be easily applied to a vessel and that, when applied, will impart a consistent hemostatic force to the vessel while resisting separation from the vessel stub. This device is presently lacking in the prior art.
DISCLOSURE OF THE INVENTION
In order to achieve the objects of simplicity of manufacture, ease of use, consistency of clamping force, high resist~nce to lateral slil~page, and present~tion of minim~l cross-sectional area during placement of the clip inlo the surgical field, a new and improved surgical clip was designed having a vessel clamping arm, a vessel support member, and a tension coil integrally joining the arm and support member. The clip is pre-formed so that in its relaxed state, it can be easily placed within the surgical field, including through a endoscopic trocar port with as little as a five millimeter diameter. After the clip is placed proximate the blood vessel or duct to be clamped, the clamping arm is moved from its relaxed position to a position under tension,allowing positioning of the vessel between the arm and support member. When correct placement and positioning is achieved, the arm is released and, as the arm tends to move back towards its relaxed position, it clamps the vessel between the arm's curved lower surface and the supporting upper surface of the vessel support member.
To enhance the performance of the ~ension coil, in a preferred embodiment of the invention, the vessel support member includes first and second arms, one of which termin~tes in a loop section. Minimal cross-sectional area of the clip is achieved by substantially longitu~in~lly aligning the vessel support member, the clamping arm, the loop section, and the tension coil.
In a first embodiment of the clip, the clamping arm is pre-formed into a relaxed position whereby it extends slightly below the horizontal plan of the support member.
A second embodiment of the clip preloads the clamping arm into a relaxed position where the free end of the arm rests against the upper surface of the support member.
Fig. 1 is a top view of the surgical clip of the present invention with the vessel clamping member in a relaxed position.
Fig. 2 is a side view of the surgical clip of the present invention with the vessel clamping member in a relaxed position.
Fig. 3 is a top view of the surgical clip of the present invention after application to a blood vessel and with the vessel clamping arm in a clamped position.
Fig. 4 is a side view of the surgical clip of the present invention after application to a blood vessel, showing the vessel clamping arm in a clamped position.
Fig. 5 is a top view of a second embodiment of the surgical clip of the present invention having a preloaded clamping arm.
Fig. 6 is a side view of a second embodiment of the surgical clip of the presentinvention.
Fig. 7 is a top view of a third embodiment of the surgical clip of the present invention.
Fig. 8 is a side view of a third embodiment of the surgical clip of the present invention.
Fig. 9 is an end view of a third embodiment of the surgical clip of the present invention.
Fig. 10 shows the surgical clip within the jaws of a clip grasper/applier.
BEST MODE FOR CARRYING OUT THE INVENTION
Looking first at Figs. l and 2, the surgical ligation clip of the present invention is shown in its relaxed position, prior to its manipulation into a position around the target blood vessel. Surgical clip 10 comprises generally a blood vessel clamping arm 30 which is moveable in a plane perpendicular to blood vessel support member 14. As seen best in Fig. 1, support member 14 is formed of a continuous piece of surgical wire, such as titanium or stainless steel, which is bent to define a first arm 16 and a -WO 95/05778 ~ ~ ~ 7 7 ~7 PCT/US94/09326 subst~n~i~lly parallel second arm 18 joined by a one hundred eighty degree (180) bend section 20. In the preferred embodiment, the proximal free end 24 of clip 10 will be joined to first arm 16 of support member 14 by a ninety degree (90) bend section 22.
Second arm 18 termin~tes at its proximal end (away from one hundred eighty (180) bend section 20) in loop section 26, the plane of which is perpendicular to the plane of support member 14 and which loops inwardly toward clamping arm 30.
In its relaxed position as shown in Figs. 1 and 2, clamping arm 30 is longitllrlin~lly aligned with and oriented between first arm 16 and second arm 18 of support member 14, but below the horizontal plane defined by first and second arms 16 and 18. The distal free end 32 of clip 10 defines the beginning of clamping arm 30.
A curved section 36 of clamping arm 30 moves proximately away from free end 32, termin~tin~ in tension coil 34. The vertical plane established by ten~ion coil 34 is oriented in substantial alignment with the vertical plane of loop section 26, and, accordingly, perpendicular to the horizontal plane of support member 14. It will be apparent to those ~killed in the art that in this orientation ~nd by f~rmin~ clip 10 of a continuous piece of resilient material, movement of clamping arm 30 will placeclamping arm 30 under tension with respect to vessel supp~ort member 14. Further, such an orientation will minimi7e the width and cross-sectional area of clip 10 which is ~reft~l,ed, particularly in laparoscopic surgery.
Looking now at Figs. 3 and 4, application of clip ~0 to a blood vessel 40 to achieve hemostasis is shown. After clip 10 is placed in the surgical field adjacent to the targeted blood vessel 40, clamping arm 30 is moved upwardly between vessel support member arms 16 and 18 to define a gap and space between distal free end 32 and the upper surface of one hundred eighty (l80) bend section 20. For most uses, a vertical gap of approximately l.5 mm will be sufficient. Clip 10 is then maintained in this position so that blood vessel 40 can be manipulated within the space created between arm 30 and support member 14. Clamping arm 30 is then released, trappingvessel 40 within clip 10 as arm 30 moves toward its relaxe~ position. The curvature of curved section 36 of clamping arm 30 causes a relatively consistent clamping pressure to be placed over the entire surface of vessel 40, thereby achieving effective hemostasis. By placing loop section 26 physically adjacent to, and operatively in series ~ wo 95/05778 ~14 7 7 5 7 PCT/US~ 326 with tension coil 34, a smoother, more consistent application of hemostatic force is obtainable, while increasing the resistance of clip 10 to deformation.
It will be apparent to those skilled in the art that clip 10 is also effective in clamping off ducts connecting various organs, the cystic duct for example.
Accordingly, where the term "vessel" is used herein, it is intended that such reference include all fluid carrying body structures within the surgical field where ligation or clamping is needed. Where the diameter of a duct or other structure to be clamped is substantially larger than 1.5 mm, a slightly modified method of applying clip 10 is ~lc;r~lled so that the elastic limit of the material used in the construction of clip 10 is not exceeded. In such modified technique, surgical pliers of conventional design are first positioned over the area to be clamped and the duct or other structure is then compressed to approximately a two wall thickness, or 1.5 mm. The pliers are thenremoved and clip 10 applied as described above. To minimize the risk of over-con,p.ession, the pliers (not shown) will preferably include a means for limiting closure lS of its jaws to a minimum spacing of approximately 1.5 mm. The use of this technique on large structures allows clip 10 to be formed with a minimized profile suitable for use in a 5 mm trocar, even if the diameter of the duct to be clamped, for example, exceeds 5 mm.
To remove or re-position clip 10, clamping arm 30 needs merely to be moved back up into its fully unclamped position, the vessel and clip manipulated as needed, and then clamping arm 30 is released towards its relaxed position.
To counteract the tendency of clip 10 to produce a torsional force to blood vessel 40, it is ~lt;fell~d that the proximal free end of 24 of clip 10 join a ninety degree (90) bend section 22 interposed between arm 16 and proximal free end 24. As shown on Fig. 2, free end 24 and a segment of bend section 22 is centrally disposed within tension coil 34.
Adding a series of ridges, notches, burrs by machining, etching, or other treatment to the clamping surfaces of arm 30 and support member 14 can enhance the gripping force of clip 10.
To achieve the objective of minimizing the cross-sectional area of clip 10, thereby permitting it to be used in laparoscopic surgical procedures, clip 10 is pre-wo ss/0s778 PCr/us~ 5326 21477~7 formed into the position substantially as shown on Figs. l and 2. In this configuration, arms 16 and 18, clamping arm 30, tension coil 34, and loop section 26 are in substantially alignment longitudinally.
In a plcfell~d embodiment of the clip of the present invention, adaptable for placement within an endoscopic surgical field through a 5 mm diameter trocar port, the inside diameters of tension coil 34 and loop section 26 are approximately 3 mm. The length of clip 10, measured from the proximal surface of tension coil 34 to the distal surface of one hundred eighty (180) degree bend section 20 is approximately 12 mm.
The width of vessel support member 14, measured at the outside surfaces of first arm 16 and second arm 18, is approximately 2.5 mm. Clamping arm 30 is approximately 9 mm from distal free end 32 to its intersection with tension coil 34. In the ~l~fel,ed embodiment, curved section 36 of clamping arm 30 will have a radius of curvature of approximately 25 mm. A suitable material from which clip 10 can be formed is wrought titanium 6Al-4V ELI alloy wire having a nominal diameter of 0.75 mm, andwhich meets ASTM Standard F136-92. Clip 10 can also be made of wire having a non-circular cross section, or formed from wire having a combination of circular and non-circular sections. For example, tension coil 34 and/or clamping arm 30 could be stronger if formed from rectangular-shaped wire.
A second embodiment of clip 10 is shown in Figs. 5, 6, and 7, with the essential difference from the first embodiment being an extension of clamping arm 30 so that in its "relaxed" position, arm 30 rests in a preloaded condition on the upper surface of support member 14, at bend section 20. Accordingly, a l,refelled length of arm 30 in this embodiment is approximately 7.3 mm with an overall length of clip 10 of approximately 11.4 mm. By extending and preloading arm 30 so that it can assume the position shown in Fig. 6, the cross-sectional area presented by clip 10 is further minimized, rendering it more adaptable for use in small diameter trocars. Preloading arm 30, of course, helps to maintain clip 10 in a narrow profile until it is positioned for application.
As seen in Fig. 6, first arm 16 and second arm 18 of support member 14 are curved upwardly to enhance the clamping force distribution characteristics of clip 10.
It will be apparent to those skilled in the art that, as in the first embodiment of Figs.
21~7757 1-4, such cuNature could be provided alternatively or additionally within clamping arm 30. Where ease of manufacture is a prime objective, each of arms 15, 18, and 30 can be straight.
A third embodiment of the surgical clip 10 of the present invention is shown in Figs. 7, 8, and 9. Clamping arm 30 has a curved section 36 extending between distal free end 32 and tension coil 34. Vessel support member 14 is continuously formed of a first arm 16 termin~ting at proximal free end 24, joined to second arm 18 by one hundred eighty degree (180) bend section 20. Preferably, bend section 20, as shown in Fig. 9, will also have a generally concave shape so the clamping forces will be distributed more evenly across the surface of the blood vessel (not shown). The shape of curved section 36 of vessel clamping arm 30 is generally convex to provide a more secure holding force to the vessel as well. Although tests have shown that the second embodiment does not perform as well as the first embodiment described above, it does offer the advantage of being simpler to pre-form and perhaps to apply.
Fig. 10 conceptually illustrates the jaw end of a surgical grasper tool 40 whichhas been modified to function as a clip applier for the surgical clip of the present invention. Slots (not shown) have been machined into the opposing horizontal surfaces of upper jaw 41 and lower jaw 42 to accommodate therein segments of tension coil 34 and loop section 26, thereby orienting clip 10 in the vertical plane. Ret~ining pins 44 extend perpendicularly from the vertical surfaces of upper jaw 41. A tooth 43 isattached to the vertical surface of lower jaw 42 and extends above jaw 42. When clip 10 is in proper position for application, pins 44 are in contact with tension coil 34 and tooth 43 is in contact with clamping arm 30. Consequently, when jaws 41, 42 are moved toward each other (by operation of the grasper handle, not shown), pins 44 bear against tension coil 34, and tooth 43 causes clamping arm 30 to move upwardly from its relaxed position. This creates a gap between the free end 32 of arm 30 and the upper surface of support member 14. Clip 10 can then be positioned around the blood vessel (not shown). When jaws 41, 42 are then allowed to move apart, clamping arm 30 is forced downward by tension coil 34 into a clamped position around the vessel.
To remove or re-position clip 10, graspers 40 are re-positioned as shown in Fig. 9 and the process is repeated.
wo 9s/05778 ~ 2~ 47 7 57 PCT/US94/09326 Thus, although there have been described particular embodiments of the present invention of a new and useful surgical ligation clip, it is not intended that such references be construed as limitations upon the scope of this invention except as set forth in the following claims. Further, although there have been described certain dimensions used in the preferred embodiment, it is not intended that such dimensions be construed as limitations upon the scope of this invention except as set forth in the following claims.
Claims (21)
1. A clip for producing hemostasis in a blood vessel located in a surgical field, said clip comprising clamping means for applying a hemostatic force to said blood vessel, said clamping means adjustable between a clamped position and at least one unclamped position while within said surgical field.
2. The clip of Claim 1 wherein said clip is pre-formed to assume said clamped position prior to placement of said clip in said surgical field.
3. The clip of Claim 1 wherein said clip is pre-formed to assume said unclamped position prior to placement of said clip in said surgical field.
4. The clip of Claim 1, wherein said clamping means comprises a vessel clamping arm joined to a vessel support member.
5. The clip of Claim 4 further comprising integral tension means to generate said hemostatic force when said clamping means is in said clamped position.
6. A surgical ligation clip comprising:
a. an arm for clamping a blood vessel;
b. a blood vessel support member connected to said clamping arm;
c. said clamping arm moveable between a relaxed first unclamped position, a second unclamped position, and a clamped position intermediate said first and second unclamped positions; and d. means to generate and apply a hemostatic force to said blood vessel when said clamping arm is in said clamped position.
a. an arm for clamping a blood vessel;
b. a blood vessel support member connected to said clamping arm;
c. said clamping arm moveable between a relaxed first unclamped position, a second unclamped position, and a clamped position intermediate said first and second unclamped positions; and d. means to generate and apply a hemostatic force to said blood vessel when said clamping arm is in said clamped position.
7. The clip of Claim 6, said hemostatic force generation and application means comprising a tension member attached between said clamping arm and said vessel support member.
8. The clip of Claim 7 wherein said tension member comprises a tension coil connecting one end of said clamping arm to said vessel support member.
9. The clip of Claim 8 wherein said clamping arm, said tension member, and said vessel support member comprise a pre-formed continuous length of material.
10. A surgical ligation clip comprising an arm for clamping a blood vessel, said arm pre-formed into a relaxed position in which said arm is substantially aligned with an integrally pre-formed vessel support member, and said arm moveable undertension to a position above said support member whereby said blood vessel can bepositioned between said clamping arm and said support member, and whereby said clamping arm applies a hemostatic force to said blood vessel when said clamping arm is released toward said relaxed position.
11. The clip of Claim 10, said clamping arm comprising a free end joined to a first end of a tension coil by a curved clamping sectiom
12. The clip of Claim 11, said vessel support member comprising a first arm joined to a second arm by a 180 degree bent section creating a gap between said first and second arms, said second arm joined to a second end of said tension coil, and said clamping arm moveable in said gap hetween said first and second arms.
13. The clip of Claim 12, said vessel support member further comprising a loop section between said second arm and said tension coil.
14. The clip of Claim 13, said vessel support member first and second arms, said clamping section, said tension coil, and said loop section being in substantial longitudinal alignment, whereby a minimum cross-sectional area is presented during insertion of said clip into a surgical field.
15. The clip of claim 14 wherein when said clamping arm is pre-formed in said relaxed position, said arm is in a preloaded condition with said free end of said clamping arm resting above and against said support member.
16. The clip of Claim 15 further comprising means for preventing torsional movement of said blood vessel when said clip is applied.
17. The clip of Claim 16, said torsional movement prevention means comprising a 90 degree bent section joined to the free end of said first arm.
18. A method of achieving hemostasis of a blood vessel during surgery comprising the steps of:
a. placing a pre-formed surgical ligation clip having a clamping arm and a vessel support member proximate said vessel;
b. bending said clamping arm away from said vessel support member, thereby placing said clamping arm under tension;
c. placing said clip around said vessel, whereby said vessel is positioned between said arm and said support member; and d. releasing said clamping arm, thereby placing said vessel under tension between said arm and said support member.
a. placing a pre-formed surgical ligation clip having a clamping arm and a vessel support member proximate said vessel;
b. bending said clamping arm away from said vessel support member, thereby placing said clamping arm under tension;
c. placing said clip around said vessel, whereby said vessel is positioned between said arm and said support member; and d. releasing said clamping arm, thereby placing said vessel under tension between said arm and said support member.
19. The method of Claim 18 wherein said pre-formed clip is placed proximate said blood vessel by manipulating said clip through a trocar.
20. The method of Claim 19 wherein said trocar has an inner diameter of approximately 5 mm.
21. The method of Claim 18 further comprising the step of compressing said vessel to a reduced diameter prior to placing said clip around said vessel.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11163493A | 1993-08-25 | 1993-08-25 | |
US08/111,634 | 1993-08-25 |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2147757A1 true CA2147757A1 (en) | 1995-03-02 |
Family
ID=22339602
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002147757A Abandoned CA2147757A1 (en) | 1993-08-25 | 1994-08-18 | Surgical ligation clip |
Country Status (6)
Country | Link |
---|---|
US (1) | US5593414A (en) |
EP (1) | EP0673229A4 (en) |
JP (1) | JPH08504120A (en) |
AU (1) | AU7568994A (en) |
CA (1) | CA2147757A1 (en) |
WO (1) | WO1995005778A1 (en) |
Families Citing this family (336)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5342373A (en) * | 1992-09-14 | 1994-08-30 | Ethicon, Inc. | Sterile clips and instrument for their placement |
US5858018A (en) | 1993-08-25 | 1999-01-12 | Apollo Camera, Llc | Low profile tool for applying spring action ligation clips |
CA2143560C (en) * | 1994-03-02 | 2007-01-16 | Mark Fogelberg | Sterile occlusion fasteners and instrument and method for their placement |
US5681330A (en) * | 1994-03-02 | 1997-10-28 | Ethicon Endo-Surgery, Inc. | Sterile occlusion fasteners and instrument and method for their placement |
US5741274A (en) * | 1995-12-22 | 1998-04-21 | Cardio Vascular Concepts, Inc. | Method and apparatus for laparoscopically reinforcing vascular stent-grafts |
US5782844A (en) * | 1996-03-05 | 1998-07-21 | Inbae Yoon | Suture spring device applicator |
US5810851A (en) * | 1996-03-05 | 1998-09-22 | Yoon; Inbae | Suture spring device |
US5972001A (en) * | 1996-11-25 | 1999-10-26 | Yoon; Inbae | Method of ligating anatomical tissue with a suture spring device |
US6241740B1 (en) * | 1998-04-09 | 2001-06-05 | Origin Medsystems, Inc. | System and method of use for ligating and cutting tissue |
US6613059B2 (en) * | 1999-03-01 | 2003-09-02 | Coalescent Surgical, Inc. | Tissue connector apparatus and methods |
US6607541B1 (en) | 1998-06-03 | 2003-08-19 | Coalescent Surgical, Inc. | Tissue connector apparatus and methods |
US6641593B1 (en) | 1998-06-03 | 2003-11-04 | Coalescent Surgical, Inc. | Tissue connector apparatus and methods |
US6945980B2 (en) * | 1998-06-03 | 2005-09-20 | Medtronic, Inc. | Multiple loop tissue connector apparatus and methods |
US6514265B2 (en) | 1999-03-01 | 2003-02-04 | Coalescent Surgical, Inc. | Tissue connector apparatus with cable release |
US6193732B1 (en) | 1999-01-08 | 2001-02-27 | Cardiothoracic System | Surgical clips and apparatus and method for clip placement |
US6226843B1 (en) | 1999-02-25 | 2001-05-08 | Design Standards Corporation | Ligating clip |
US6350269B1 (en) | 1999-03-01 | 2002-02-26 | Apollo Camera, L.L.C. | Ligation clip and clip applier |
US8118822B2 (en) * | 1999-03-01 | 2012-02-21 | Medtronic, Inc. | Bridge clip tissue connector apparatus and methods |
US6290575B1 (en) | 1999-03-01 | 2001-09-18 | John I. Shipp | Surgical ligation clip with increased ligating force |
US6695859B1 (en) | 1999-04-05 | 2004-02-24 | Coalescent Surgical, Inc. | Apparatus and methods for anastomosis |
AUPQ090499A0 (en) | 1999-06-10 | 1999-07-01 | Peters, William S | Heart assist device and system |
US8529583B1 (en) | 1999-09-03 | 2013-09-10 | Medtronic, Inc. | Surgical clip removal apparatus |
US6926730B1 (en) * | 2000-10-10 | 2005-08-09 | Medtronic, Inc. | Minimally invasive valve repair procedure and apparatus |
US6695854B1 (en) | 1999-11-29 | 2004-02-24 | General Surgical Innovations, Inc. | Blood vessel clip and applicator |
US6293956B1 (en) * | 2000-01-26 | 2001-09-25 | Designs Standards Corporation | Ligating clips |
US6551332B1 (en) | 2000-03-31 | 2003-04-22 | Coalescent Surgical, Inc. | Multiple bias surgical fastener |
US7077851B2 (en) * | 2000-10-17 | 2006-07-18 | Aesculap Ag & Co. Kg | Aneurysm clip |
DE10054251B4 (en) * | 2000-11-02 | 2006-06-01 | Lucas Varity Gmbh | Control valve housing for a vacuum brake booster |
US20060293701A1 (en) * | 2001-05-02 | 2006-12-28 | Medtronic, Inc. | Self-closing surgical clip for tissue |
US11229472B2 (en) | 2001-06-12 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with multiple magnetic position sensors |
ES2393918T3 (en) | 2001-07-09 | 2013-01-02 | Covidien Lp | Clip or clip applier at right angles |
AUPR669001A0 (en) * | 2001-07-30 | 2001-08-23 | Sunshine Heart Company Pty Ltd | A fluid pressure generating means |
US20030199974A1 (en) * | 2002-04-18 | 2003-10-23 | Coalescent Surgical, Inc. | Annuloplasty apparatus and methods |
EP1496804A4 (en) * | 2002-04-22 | 2007-04-18 | Tyco Healthcare | Endoscopic surgical clip |
US7896896B2 (en) | 2002-04-22 | 2011-03-01 | Tyco Healthcare Group Lp | Endoscopic surgical clip |
US8066724B2 (en) | 2002-09-12 | 2011-11-29 | Medtronic, Inc. | Anastomosis apparatus and methods |
US8105345B2 (en) * | 2002-10-04 | 2012-01-31 | Medtronic, Inc. | Anastomosis apparatus and methods |
US7678125B2 (en) * | 2002-11-12 | 2010-03-16 | Apollo Camera, L.L.C. | Surgical ligation clip |
AU2002952691A0 (en) * | 2002-11-15 | 2002-11-28 | Sunshine Heart Company Pty Ltd | Heart assist device utilising aortic deformation |
EP1572010A2 (en) * | 2002-12-16 | 2005-09-14 | Edrich Vascular Devices, Inc. | Vascular suturing clip |
EP1596727A2 (en) * | 2003-02-18 | 2005-11-23 | Applied Medical Resources Corporation | Surgical clip and method for making same |
ES2616695T3 (en) * | 2003-03-11 | 2017-06-14 | Covidien Lp | Staple application device with inclined jaw |
US20040193213A1 (en) * | 2003-03-11 | 2004-09-30 | Ernest Aranyi | Clip applying apparatus with curved jaws, and clip |
US20050075659A1 (en) * | 2003-03-30 | 2005-04-07 | Fidel Realyvasquez | Apparatus and methods for minimally invasive valve surgery |
US8172870B2 (en) * | 2003-06-09 | 2012-05-08 | Microline Surgical, Inc. | Ligation clip applier |
US7862571B2 (en) * | 2003-07-25 | 2011-01-04 | Microline Surgical, Inc. | Occlusion clip and method of applying same |
US7182769B2 (en) * | 2003-07-25 | 2007-02-27 | Medtronic, Inc. | Sealing clip, delivery systems, and methods |
US20050043749A1 (en) * | 2003-08-22 | 2005-02-24 | Coalescent Surgical, Inc. | Eversion apparatus and methods |
US8394114B2 (en) * | 2003-09-26 | 2013-03-12 | Medtronic, Inc. | Surgical connection apparatus and methods |
US7572266B2 (en) * | 2003-10-21 | 2009-08-11 | Young Wayne P | Clip applier tool having a discharge configuration |
WO2005041781A1 (en) * | 2003-10-30 | 2005-05-12 | Sunshine Heart Company Pty Ltd | Methods and devices for tensioning a wrap around a blood vessel |
WO2005041783A1 (en) * | 2003-10-30 | 2005-05-12 | Sunshine Heart Company Pty Ltd | A wrap |
WO2005042082A1 (en) | 2003-10-31 | 2005-05-12 | Sunshine Heart Company Pty Ltd | Percutaneous gas-line |
DK1677872T3 (en) | 2003-10-31 | 2016-02-15 | Sunshine Heart Co Pty Ltd | synchronization Control System |
WO2005044338A1 (en) | 2003-11-11 | 2005-05-19 | Sunshine Heart Company Pty Ltd | Actuator for a heart assist device |
US7879047B2 (en) | 2003-12-10 | 2011-02-01 | Medtronic, Inc. | Surgical connection apparatus and methods |
US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
US7819886B2 (en) * | 2004-10-08 | 2010-10-26 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier |
PL1802245T3 (en) | 2004-10-08 | 2017-01-31 | Ethicon Endosurgery Llc | Ultrasonic surgical instrument |
CA2869759A1 (en) | 2004-10-08 | 2006-04-20 | Tyco Healthcare Group Lp | Apparatus for applying surgical clips |
US8409222B2 (en) * | 2004-10-08 | 2013-04-02 | Covidien Lp | Endoscopic surgical clip applier |
US9763668B2 (en) | 2004-10-08 | 2017-09-19 | Covidien Lp | Endoscopic surgical clip applier |
US7717926B2 (en) | 2004-10-08 | 2010-05-18 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier |
US20060229675A1 (en) * | 2005-04-07 | 2006-10-12 | Roberto Novoa | Anchoring System for Valve Replacement |
US20080045981A1 (en) * | 2005-04-22 | 2008-02-21 | Ilya Margolin | Ligating clip and ligating clip applicator |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
US7621930B2 (en) | 2006-01-20 | 2009-11-24 | Ethicon Endo-Surgery, Inc. | Ultrasound medical instrument having a medical ultrasonic blade |
EP2054103B1 (en) | 2006-08-21 | 2019-05-29 | Sunshine Heart Company Pty Ltd | An improved wrap for a heart assist device |
EP2314232B1 (en) | 2006-10-17 | 2015-03-25 | Covidien LP | Apparatus for applying surgical clips |
WO2008086287A2 (en) * | 2007-01-05 | 2008-07-17 | Medtronic, Inc. | Anastomosis systems and methods |
US8226675B2 (en) | 2007-03-22 | 2012-07-24 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
CA2868909A1 (en) | 2007-03-26 | 2008-10-02 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier |
WO2008127968A2 (en) | 2007-04-11 | 2008-10-23 | Tyco Healthcare Group Lp | Surgical clip applier |
JP2008302045A (en) * | 2007-06-08 | 2008-12-18 | Hoya Corp | Clip device for endoscope |
US8882791B2 (en) | 2007-07-27 | 2014-11-11 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
EP2217157A2 (en) | 2007-10-05 | 2010-08-18 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
US8663262B2 (en) | 2007-12-03 | 2014-03-04 | Covidien Ag | Battery assembly for battery-powered surgical instruments |
US8061014B2 (en) | 2007-12-03 | 2011-11-22 | Covidien Ag | Method of assembling a cordless hand-held ultrasonic cautery cutting device |
US9314261B2 (en) | 2007-12-03 | 2016-04-19 | Covidien Ag | Battery-powered hand-held ultrasonic surgical cautery cutting device |
US9017355B2 (en) | 2007-12-03 | 2015-04-28 | Covidien Ag | Battery-powered hand-held ultrasonic surgical cautery cutting device |
US8419757B2 (en) * | 2007-12-03 | 2013-04-16 | Covidien Ag | Cordless hand-held ultrasonic cautery cutting device |
US8338726B2 (en) | 2009-08-26 | 2012-12-25 | Covidien Ag | Two-stage switch for cordless hand-held ultrasonic cautery cutting device |
US9107690B2 (en) | 2007-12-03 | 2015-08-18 | Covidien Ag | Battery-powered hand-held ultrasonic surgical cautery cutting device |
US8435257B2 (en) * | 2007-12-03 | 2013-05-07 | Covidien Ag | Cordless hand-held ultrasonic cautery cutting device and method |
US8177836B2 (en) * | 2008-03-10 | 2012-05-15 | Medtronic, Inc. | Apparatus and methods for minimally invasive valve repair |
US8366726B2 (en) * | 2008-03-21 | 2013-02-05 | Gyrx Llc | Vessel occlusion clip and application thereof |
AU2009239395B2 (en) * | 2008-04-23 | 2013-08-22 | Cook Medical Technologies Llc | Tacking device |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
CA2733933C (en) * | 2008-08-19 | 2014-03-11 | Wilson-Cook Medical Inc. | Apparatus for removing lymph nodes or anchoring into tissue during a translumenal procedure |
US8465502B2 (en) | 2008-08-25 | 2013-06-18 | Covidien Lp | Surgical clip applier and method of assembly |
US20110208212A1 (en) | 2010-02-19 | 2011-08-25 | Zergiebel Earl M | Surgical clip applier |
US8056565B2 (en) * | 2008-08-25 | 2011-11-15 | Tyco Healthcare Group Lp | Surgical clip applier and method of assembly |
US8267944B2 (en) | 2008-08-29 | 2012-09-18 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier with lock out |
CA2736836C (en) * | 2008-08-29 | 2013-11-12 | Wilson-Cook Medical Inc. | Stapling device for closing perforations |
US9358015B2 (en) | 2008-08-29 | 2016-06-07 | Covidien Lp | Endoscopic surgical clip applier with wedge plate |
US8409223B2 (en) | 2008-08-29 | 2013-04-02 | Covidien Lp | Endoscopic surgical clip applier with clip retention |
US8585717B2 (en) | 2008-08-29 | 2013-11-19 | Covidien Lp | Single stroke endoscopic surgical clip applier |
US8192461B2 (en) * | 2008-09-11 | 2012-06-05 | Cook Medical Technologies Llc | Methods for facilitating closure of a bodily opening using one or more tacking devices |
US9211125B2 (en) * | 2008-10-23 | 2015-12-15 | Microline Surgical, Inc. | Flexible clip applier |
CA2746213A1 (en) * | 2008-12-09 | 2010-07-08 | Wilson-Cook Medical Inc. | Apparatus and methods for controlled release of tacking devices |
AU2009324819B2 (en) | 2008-12-09 | 2014-04-17 | Cook Medical Technologies Llc | Retractable tacking device |
CA2747233C (en) * | 2008-12-19 | 2014-08-12 | John A. Karpiel | Clip devices and methods of delivery and deployment |
AU2009335902B2 (en) * | 2008-12-19 | 2013-10-10 | Cook Medical Technologies Llc | Variable thickness tacking devices and methods of delivery and deployment |
US8142451B2 (en) * | 2009-01-26 | 2012-03-27 | Microline Surgical, Inc. | Actuator and detachable connector of flexible clip applier |
US8518060B2 (en) | 2009-04-09 | 2013-08-27 | Medtronic, Inc. | Medical clip with radial tines, system and method of using same |
US8668704B2 (en) | 2009-04-24 | 2014-03-11 | Medtronic, Inc. | Medical clip with tines, system and method of using same |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
JP2012527970A (en) * | 2009-05-28 | 2012-11-12 | クック メディカル テクノロジーズ エルエルシー | Hail-fastening device and hail-fastening device deployment method |
US8344596B2 (en) | 2009-06-24 | 2013-01-01 | Ethicon Endo-Surgery, Inc. | Transducer arrangements for ultrasonic surgical instruments |
EP2445418B1 (en) | 2009-06-26 | 2015-03-18 | Cook Medical Technologies LLC | Linear clamps for anastomosis |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US9039695B2 (en) | 2009-10-09 | 2015-05-26 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US9168054B2 (en) | 2009-10-09 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
USRE47996E1 (en) | 2009-10-09 | 2020-05-19 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US8734469B2 (en) | 2009-10-13 | 2014-05-27 | Covidien Lp | Suture clip applier |
JP5746200B2 (en) | 2009-11-03 | 2015-07-08 | クック・メディカル・テクノロジーズ・リミテッド・ライアビリティ・カンパニーCook Medical Technologies Llc | Flat clamp for anastomosis |
US9186136B2 (en) | 2009-12-09 | 2015-11-17 | Covidien Lp | Surgical clip applier |
US8545486B2 (en) | 2009-12-15 | 2013-10-01 | Covidien Lp | Surgical clip applier |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8961547B2 (en) | 2010-02-11 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with moving cutting implement |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8579928B2 (en) | 2010-02-11 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Outer sheath and blade arrangements for ultrasonic surgical instruments |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8403945B2 (en) | 2010-02-25 | 2013-03-26 | Covidien Lp | Articulating endoscopic surgical clip applier |
US10136898B2 (en) | 2010-03-09 | 2018-11-27 | Teleflex Medical Incorporated | Narrow profile surgical ligation clip |
EP2544600A4 (en) * | 2010-03-09 | 2016-07-27 | Teleflex Medical Inc | Narrow profile surgical ligation clip |
CN102939117B (en) | 2010-04-02 | 2015-12-02 | 阳光心脏有限公司 | Combination heart assist system, method and apparatus |
US8603121B2 (en) | 2010-04-14 | 2013-12-10 | Cook Medical Technologies Llc | Systems and methods for creating anastomoses |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8403946B2 (en) | 2010-07-28 | 2013-03-26 | Covidien Lp | Articulating clip applier cartridge |
US8968337B2 (en) | 2010-07-28 | 2015-03-03 | Covidien Lp | Articulating clip applier |
US9011464B2 (en) | 2010-11-02 | 2015-04-21 | Covidien Lp | Self-centering clip and jaw |
US9186153B2 (en) | 2011-01-31 | 2015-11-17 | Covidien Lp | Locking cam driver and jaw assembly for clip applier |
US9775623B2 (en) | 2011-04-29 | 2017-10-03 | Covidien Lp | Surgical clip applier including clip relief feature |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
US9271737B2 (en) | 2011-09-15 | 2016-03-01 | Teleflex Medical Incorporated | Automatic surgical ligation clip applier |
EP2755578A2 (en) | 2011-09-15 | 2014-07-23 | Teleflex Medical Incorporated | Manual surgical ligation clip applier |
US20130131697A1 (en) | 2011-11-21 | 2013-05-23 | Covidien Lp | Surgical clip applier |
US8968336B2 (en) | 2011-12-07 | 2015-03-03 | Edwards Lifesciences Corporation | Self-cinching surgical clips and delivery system |
US9364239B2 (en) | 2011-12-19 | 2016-06-14 | Covidien Lp | Jaw closure mechanism for a surgical clip applier |
US9017347B2 (en) | 2011-12-22 | 2015-04-28 | Edwards Lifesciences Corporation | Suture clip deployment devices |
US9364216B2 (en) | 2011-12-29 | 2016-06-14 | Covidien Lp | Surgical clip applier with integrated clip counter |
JP6165780B2 (en) | 2012-02-10 | 2017-07-19 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Robot-controlled surgical instrument |
US9226766B2 (en) | 2012-04-09 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Serial communication protocol for medical device |
US9724118B2 (en) | 2012-04-09 | 2017-08-08 | Ethicon Endo-Surgery, Llc | Techniques for cutting and coagulating tissue for ultrasonic surgical instruments |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US9241731B2 (en) | 2012-04-09 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Rotatable electrical connection for ultrasonic surgical instruments |
US9237921B2 (en) | 2012-04-09 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US9408610B2 (en) | 2012-05-04 | 2016-08-09 | Covidien Lp | Surgical clip applier with dissector |
US9532787B2 (en) | 2012-05-31 | 2017-01-03 | Covidien Lp | Endoscopic clip applier |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US9283045B2 (en) | 2012-06-29 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Surgical instruments with fluid management system |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
US9498202B2 (en) | 2012-07-10 | 2016-11-22 | Edwards Lifesciences Corporation | Suture securement devices |
US10016193B2 (en) | 2013-11-18 | 2018-07-10 | Edwards Lifesciences Ag | Multiple-firing crimp device and methods for using and manufacturing same |
CN104853688B (en) | 2012-09-28 | 2017-11-28 | 伊西康内外科公司 | Multifunctional bipolar tweezers |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
US10201365B2 (en) | 2012-10-22 | 2019-02-12 | Ethicon Llc | Surgeon feedback sensing and display methods |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
US9592047B2 (en) | 2012-12-21 | 2017-03-14 | Edwards Lifesciences Corporation | System for securing sutures |
US9968362B2 (en) | 2013-01-08 | 2018-05-15 | Covidien Lp | Surgical clip applier |
US9113892B2 (en) | 2013-01-08 | 2015-08-25 | Covidien Lp | Surgical clip applier |
US9750500B2 (en) | 2013-01-18 | 2017-09-05 | Covidien Lp | Surgical clip applier |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
US9241728B2 (en) | 2013-03-15 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument with multiple clamping mechanisms |
CA2902233C (en) | 2013-07-11 | 2021-01-12 | Edwards Lifesciences Corporation | Knotless suture fastener installation system |
US8986330B2 (en) | 2013-07-12 | 2015-03-24 | Miami Instruments Llc | Aortic cross clamp |
US9775624B2 (en) | 2013-08-27 | 2017-10-03 | Covidien Lp | Surgical clip applier |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
CA2903891C (en) | 2014-05-30 | 2021-01-19 | Manouchehr A. Miraki | Systems for securing sutures |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
US10702278B2 (en) | 2014-12-02 | 2020-07-07 | Covidien Lp | Laparoscopic surgical ligation clip applier |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
CN108135593B (en) | 2014-12-10 | 2020-12-11 | 爱德华兹生命科学股份公司 | Multiple fire anchor and methods of using and making same |
US9901352B2 (en) * | 2014-12-12 | 2018-02-27 | Atricure, Inc. | Occlusion clip |
SG11201705137PA (en) | 2014-12-24 | 2017-07-28 | Edwards Lifesciences Corp | Suture clip deployment devices |
US9931124B2 (en) | 2015-01-07 | 2018-04-03 | Covidien Lp | Reposable clip applier |
US10368876B2 (en) | 2015-01-15 | 2019-08-06 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10292712B2 (en) | 2015-01-28 | 2019-05-21 | Covidien Lp | Surgical clip applier with integrated cutter |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10159491B2 (en) | 2015-03-10 | 2018-12-25 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10470759B2 (en) | 2015-03-16 | 2019-11-12 | Edwards Lifesciences Corporation | Suture securement devices |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US10034684B2 (en) | 2015-06-15 | 2018-07-31 | Ethicon Llc | Apparatus and method for dissecting and coagulating tissue |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US10765470B2 (en) | 2015-06-30 | 2020-09-08 | Ethicon Llc | Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
US11058475B2 (en) | 2015-09-30 | 2021-07-13 | Cilag Gmbh International | Method and apparatus for selecting operations of a surgical instrument based on user intention |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
EP3370625B1 (en) | 2015-11-03 | 2020-07-01 | Covidien LP | Endoscopic surgical clip applier |
US10390831B2 (en) | 2015-11-10 | 2019-08-27 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10905425B2 (en) | 2015-11-10 | 2021-02-02 | Covidien Lp | Endoscopic reposable surgical clip applier |
ES2880951T3 (en) | 2015-11-10 | 2021-11-26 | Covidien Lp | Endoscopic Surgical Staple Applicator with Limited Number of Uses |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
CA3009420A1 (en) | 2016-01-11 | 2017-07-20 | Peng YI | Endoscopic reposable surgical clip applier |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US10709469B2 (en) | 2016-01-15 | 2020-07-14 | Ethicon Llc | Modular battery powered handheld surgical instrument with energy conservation techniques |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
WO2017124217A1 (en) | 2016-01-18 | 2017-07-27 | Covidien Lp | Endoscopic surgical clip applier |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
CA2958160A1 (en) | 2016-02-24 | 2017-08-24 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
US10368898B2 (en) | 2016-05-05 | 2019-08-06 | Covidien Lp | Ultrasonic surgical instrument |
US10485526B2 (en) * | 2016-05-16 | 2019-11-26 | Boston Scientific Scimed, Inc. | Devices and methods for reducing a dimension of openings in tissue |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
WO2018027788A1 (en) | 2016-08-11 | 2018-02-15 | Covidien Lp | Endoscopic surgical clip applier and clip applying systems |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US11071553B2 (en) | 2016-08-25 | 2021-07-27 | Covidien Lp | Endoscopic surgical clip applier and clip applying systems |
US10420580B2 (en) | 2016-08-25 | 2019-09-24 | Ethicon Llc | Ultrasonic transducer for surgical instrument |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
US10939905B2 (en) | 2016-08-26 | 2021-03-09 | Edwards Lifesciences Corporation | Suture clips, deployment devices therefor, and methods of use |
US10639044B2 (en) | 2016-10-31 | 2020-05-05 | Covidien Lp | Ligation clip module and clip applier |
US10660651B2 (en) | 2016-10-31 | 2020-05-26 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10492795B2 (en) | 2016-11-01 | 2019-12-03 | Covidien Lp | Endoscopic surgical clip applier |
US10426489B2 (en) | 2016-11-01 | 2019-10-01 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10610236B2 (en) | 2016-11-01 | 2020-04-07 | Covidien Lp | Endoscopic reposable surgical clip applier |
CA3043174A1 (en) | 2016-11-09 | 2018-05-17 | The United States Of America, As Represented By The Secretary, Department Of Health And Human Services | Tissue clamp and implantation method |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
US10863980B2 (en) | 2016-12-28 | 2020-12-15 | Edwards Lifesciences Corporation | Suture fastener having spaced-apart layers |
US10709455B2 (en) | 2017-02-02 | 2020-07-14 | Covidien Lp | Endoscopic surgical clip applier |
US10758244B2 (en) | 2017-02-06 | 2020-09-01 | Covidien Lp | Endoscopic surgical clip applier |
US11116514B2 (en) | 2017-02-06 | 2021-09-14 | Covidien Lp | Surgical clip applier with user feedback feature |
US10660725B2 (en) | 2017-02-14 | 2020-05-26 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US10603038B2 (en) | 2017-02-22 | 2020-03-31 | Covidien Lp | Surgical clip applier including inserts for jaw assembly |
US10548602B2 (en) | 2017-02-23 | 2020-02-04 | Covidien Lp | Endoscopic surgical clip applier |
US11583291B2 (en) | 2017-02-23 | 2023-02-21 | Covidien Lp | Endoscopic surgical clip applier |
US10675043B2 (en) | 2017-05-04 | 2020-06-09 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10722235B2 (en) | 2017-05-11 | 2020-07-28 | Covidien Lp | Spring-release surgical clip |
US10571435B2 (en) | 2017-06-08 | 2020-02-25 | Covidien Lp | Systems and methods for digital control of ultrasonic devices |
US10660723B2 (en) | 2017-06-30 | 2020-05-26 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10639032B2 (en) | 2017-06-30 | 2020-05-05 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
US10675112B2 (en) | 2017-08-07 | 2020-06-09 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US10932790B2 (en) | 2017-08-08 | 2021-03-02 | Covidien Lp | Geared actuation mechanism and surgical clip applier including the same |
US10863992B2 (en) | 2017-08-08 | 2020-12-15 | Covidien Lp | Endoscopic surgical clip applier |
US10786262B2 (en) | 2017-08-09 | 2020-09-29 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10786263B2 (en) | 2017-08-15 | 2020-09-29 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10835341B2 (en) | 2017-09-12 | 2020-11-17 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10758245B2 (en) | 2017-09-13 | 2020-09-01 | Covidien Lp | Clip counting mechanism for surgical clip applier |
US10835260B2 (en) | 2017-09-13 | 2020-11-17 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10653429B2 (en) | 2017-09-13 | 2020-05-19 | Covidien Lp | Endoscopic surgical clip applier |
WO2019089440A1 (en) | 2017-10-30 | 2019-05-09 | Teleflex Medical Incorporated | Latching wire clip |
US10945734B2 (en) | 2017-11-03 | 2021-03-16 | Covidien Lp | Rotation knob assemblies and surgical instruments including the same |
US11376015B2 (en) | 2017-11-03 | 2022-07-05 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10932791B2 (en) | 2017-11-03 | 2021-03-02 | Covidien Lp | Reposable multi-fire surgical clip applier |
US11116513B2 (en) | 2017-11-03 | 2021-09-14 | Covidien Lp | Modular surgical clip cartridge |
US10828036B2 (en) | 2017-11-03 | 2020-11-10 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10722236B2 (en) | 2017-12-12 | 2020-07-28 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10849630B2 (en) | 2017-12-13 | 2020-12-01 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10743887B2 (en) | 2017-12-13 | 2020-08-18 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10959737B2 (en) | 2017-12-13 | 2021-03-30 | Covidien Lp | Reposable multi-fire surgical clip applier |
US11051827B2 (en) | 2018-01-16 | 2021-07-06 | Covidien Lp | Endoscopic surgical instrument and handle assemblies for use therewith |
US11259832B2 (en) | 2018-01-29 | 2022-03-01 | Covidien Lp | Ultrasonic horn for an ultrasonic surgical instrument, ultrasonic surgical instrument including the same, and method of manufacturing an ultrasonic horn |
US11246617B2 (en) | 2018-01-29 | 2022-02-15 | Covidien Lp | Compact ultrasonic transducer and ultrasonic surgical instrument including the same |
US11246621B2 (en) | 2018-01-29 | 2022-02-15 | Covidien Lp | Ultrasonic transducers and ultrasonic surgical instruments including the same |
US11229449B2 (en) | 2018-02-05 | 2022-01-25 | Covidien Lp | Ultrasonic horn, ultrasonic transducer assembly, and ultrasonic surgical instrument including the same |
US10582944B2 (en) | 2018-02-23 | 2020-03-10 | Covidien Lp | Ultrasonic surgical instrument with torque assist feature |
US10993721B2 (en) | 2018-04-25 | 2021-05-04 | Covidien Lp | Surgical clip applier |
US10786273B2 (en) | 2018-07-13 | 2020-09-29 | Covidien Lp | Rotation knob assemblies for handle assemblies |
US11259887B2 (en) | 2018-08-10 | 2022-03-01 | Covidien Lp | Feedback mechanisms for handle assemblies |
US11033256B2 (en) | 2018-08-13 | 2021-06-15 | Covidien Lp | Linkage assembly for reusable surgical handle assemblies |
US11246601B2 (en) | 2018-08-13 | 2022-02-15 | Covidien Lp | Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same |
US11051828B2 (en) | 2018-08-13 | 2021-07-06 | Covidien Lp | Rotation knob assemblies and surgical instruments including same |
US11344316B2 (en) | 2018-08-13 | 2022-05-31 | Covidien Lp | Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same |
US11253267B2 (en) | 2018-08-13 | 2022-02-22 | Covidien Lp | Friction reduction mechanisms for handle assemblies |
US11278267B2 (en) | 2018-08-13 | 2022-03-22 | Covidien Lp | Latch assemblies and surgical instruments including the same |
US11219463B2 (en) | 2018-08-13 | 2022-01-11 | Covidien Lp | Bilateral spring for surgical instruments and surgical instruments including the same |
US11147566B2 (en) | 2018-10-01 | 2021-10-19 | Covidien Lp | Endoscopic surgical clip applier |
US11524398B2 (en) | 2019-03-19 | 2022-12-13 | Covidien Lp | Gear drive mechanisms for surgical instruments |
US11478268B2 (en) | 2019-08-16 | 2022-10-25 | Covidien Lp | Jaw members for surgical instruments and surgical instruments incorporating the same |
US11666357B2 (en) | 2019-09-16 | 2023-06-06 | Covidien Lp | Enclosure for electronics of a surgical instrument |
US11744636B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Electrosurgical systems with integrated and external power sources |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US20210196363A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with electrodes operable in bipolar and monopolar modes |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US20210196361A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with monopolar and bipolar energy capabilities |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11779340B2 (en) | 2020-01-02 | 2023-10-10 | Covidien Lp | Ligation clip loading device |
US11723669B2 (en) | 2020-01-08 | 2023-08-15 | Covidien Lp | Clip applier with clip cartridge interface |
US20220117623A1 (en) | 2020-10-15 | 2022-04-21 | Covidien Lp | Ultrasonic surgical instrument |
US11717312B2 (en) | 2021-10-01 | 2023-08-08 | Covidien Lp | Surgical system including blade visualization markings |
Family Cites Families (22)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2626608A (en) * | 1949-12-08 | 1953-01-27 | Garland Mather | Clamp for umbilical cords and the like |
US3056408A (en) * | 1959-04-22 | 1962-10-02 | Adolph M Brown | Ligature clip |
US3120230A (en) * | 1960-10-24 | 1964-02-04 | Jack H Sanders | Surgical clamp |
GB1021589A (en) * | 1963-12-05 | 1966-03-02 | Down Brothers And Mayer And Ph | Improvements in and relating to clamping devices |
US3476114A (en) * | 1967-01-10 | 1969-11-04 | Amp Inc | Ligating implement |
US4024868A (en) * | 1975-02-03 | 1977-05-24 | Robert W Williams | Permanent aneurysm clamp |
DE2730691C2 (en) * | 1976-07-16 | 1982-12-16 | Maruho Co. Ltd., Osaka | Surgical clip, connecting element for several surgical clips and forceps for opening and closing the same |
US4340061A (en) * | 1977-10-25 | 1982-07-20 | Mayfield Education And Research Fund | Aneurysm clip |
DE3008122C2 (en) * | 1980-03-03 | 1983-01-05 | Dieter von Dipl.-Ing. 8000 München Zeppelin | Surgical hemostat |
US4487205A (en) * | 1982-04-26 | 1984-12-11 | Ethicon, Inc. | Non-metallic, bio-compatible hemostatic clips |
US4556060A (en) * | 1982-09-30 | 1985-12-03 | Metatech Corporation | Surgical clip |
US4658822A (en) * | 1985-12-31 | 1987-04-21 | Kees Jr George | Aneurysm clip |
US4777950A (en) * | 1986-04-11 | 1988-10-18 | Kees Surgical Specialty Co. | Vascular clip |
SU1389762A1 (en) * | 1986-04-28 | 1988-04-23 | Курский Государственный Медицинский Институт | Hemostatic forceps and instrument for placing same |
US4777949A (en) * | 1987-05-08 | 1988-10-18 | Metatech Corporation | Surgical clip for clamping small blood vessels in brain surgery and the like |
DE3722311A1 (en) * | 1987-07-07 | 1989-01-19 | Braun Melsungen Ag | Vessel forceps |
JPH01310654A (en) * | 1988-06-09 | 1989-12-14 | Shigekiyo Fujita | Cerebral aneurysm clip |
KR0137223B1 (en) * | 1988-09-16 | 1998-04-24 | 페렌스 제이.슈미트 | Surgical clip |
US4961743A (en) * | 1989-01-03 | 1990-10-09 | Codman & Shurtleff, Inc. | Torsion spring |
US4966603A (en) * | 1989-07-24 | 1990-10-30 | Rms Company | Aneurysm clip |
US5342373A (en) * | 1992-09-14 | 1994-08-30 | Ethicon, Inc. | Sterile clips and instrument for their placement |
US5368600A (en) * | 1993-07-23 | 1994-11-29 | Ethicon, Inc. | Steerable bulldog clamp applier |
-
1994
- 1994-08-18 JP JP7507661A patent/JPH08504120A/en not_active Ceased
- 1994-08-18 AU AU75689/94A patent/AU7568994A/en not_active Abandoned
- 1994-08-18 CA CA002147757A patent/CA2147757A1/en not_active Abandoned
- 1994-08-18 EP EP94925934A patent/EP0673229A4/en not_active Withdrawn
- 1994-08-18 WO PCT/US1994/009326 patent/WO1995005778A1/en not_active Application Discontinuation
-
1995
- 1995-03-17 US US08/407,038 patent/US5593414A/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP0673229A4 (en) | 1996-09-11 |
WO1995005778A1 (en) | 1995-03-02 |
AU7568994A (en) | 1995-03-21 |
EP0673229A1 (en) | 1995-09-27 |
US5593414A (en) | 1997-01-14 |
JPH08504120A (en) | 1996-05-07 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA2147757A1 (en) | Surgical ligation clip | |
EP2275044B1 (en) | Surgical clip | |
US7678125B2 (en) | Surgical ligation clip | |
US6226843B1 (en) | Ligating clip | |
JP3068157B2 (en) | Surgical hemostatic clip | |
US11045206B2 (en) | Non-invasive surgical ligation clip system and method of using | |
CA1240581A (en) | Surgical clip and forceps for clamping the same | |
CA1190824A (en) | Non-metallic, bio-compatible hemostatic clips | |
JP4623450B2 (en) | Surgical clip | |
US6193732B1 (en) | Surgical clips and apparatus and method for clip placement | |
EP2389878A1 (en) | Surgical hemostatic clip including work-hardened, movement-inhibiting structure | |
US20040204724A1 (en) | Medical clip and apparatus for the application of such a clip | |
JPH0586221B2 (en) | ||
WO2019089440A1 (en) | Latching wire clip | |
WO1990002522A1 (en) | Surgical clip | |
JPH05176937A (en) | Suture clip in endoscope operation |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
EEER | Examination request | ||
FZDE | Discontinued |