CA2541210A1 - Endoscopic hemostatic clipping apparatus - Google Patents

Endoscopic hemostatic clipping apparatus Download PDF

Info

Publication number
CA2541210A1
CA2541210A1 CA002541210A CA2541210A CA2541210A1 CA 2541210 A1 CA2541210 A1 CA 2541210A1 CA 002541210 A CA002541210 A CA 002541210A CA 2541210 A CA2541210 A CA 2541210A CA 2541210 A1 CA2541210 A1 CA 2541210A1
Authority
CA
Canada
Prior art keywords
clip
magazine
distal
clips
jaws
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.)
Granted
Application number
CA002541210A
Other languages
French (fr)
Other versions
CA2541210C (en
Inventor
Eric Litscher
Vincent Turturro
Roy Sullivan
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boston Scientific Ltd Barbados
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2541210A1 publication Critical patent/CA2541210A1/en
Application granted granted Critical
Publication of CA2541210C publication Critical patent/CA2541210C/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • 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
    • A61B2017/12004—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 haemostasis, for prevention of bleeding

Abstract

An apparatus for applying clips to tissue, comprises a plurality of clips, each of the clips including a proximal end having a pair of opposed jaws and a distal end including a linking feature, where the clips are linked to one another to form a clip chain with a linking feature of a distal-most one of the clips being gripped between the jaws of an immediately proximal one of the clips and a control linkage coupled to a proximal-most one of the clips for applying tension and compression to the clip chain in combination with a magazine containing the clip chain, the magazine including an abutment surface sized to prevent passage distally therebeyond of a clip having received between its jaws a linking feature of an immediately distal clip and an opening location within which the jaws of a clip are permitted to open to release a linking feature therefrom.

Claims (23)

1. An apparatus for applying clips to tissue, comprising:
a plurality of clips, each of the clips including a distal end having a pair of opposed jaws and a proximal end including a linking feature, where the clips are linked to one another to form a clip chain with a linking feature of a distal-most one of the clips being gripped between the jaws of an immediately proximal one of the clips;
a control linkage coupled to a proximal-most one of the clips for applying tension and compression to the clip chain; and~
a magazine containing the clip chain, the magazine including an abutment surface sized to prevent passage distally therebeyond of a clip having received between its jaws a linking feature of an immediately distal clip and an opening location within which the jaws of a clip are permitted to open to release a linking feature therefrom.
2. The apparatus according to claim 1, wherein the magazine further comprises a closing element closing and locking distal-most clip when the distal-most clip is withdrawn proximally into the magazine after having been moved distally out of the magazine to grip tissue between its jaws.
3. The apparatus according to claim 1, wherein the opening location comprises one of a flexible tab movable radially outward, an opening in a wall of the magazine, an increased inner diameter section of the magazine wall and a radially expandable section of the magazine wall.
4. The apparatus according to claim 2, wherein the closing element comprises anti-pull back tabs positioning a lock ring over the jaws of the distal-most clip.
5. The apparatus according to claim 1, wherein the closing element is formed at a distal end of the magazine as an inward projection shaped to close snaps on the jaws of the distal-most clip.
6. The apparatus according to claim 1, wherein the jaws of the clips are biased toward an open configuration.
7. An apparatus for applying clips to tissue within a body, comprising:
an elongate body extending from a proximal end which, when in an operative position, remains outside the body to a distal end which, when in the operative position extends into the body to a location adjacent to a target portion of tissue to which one or more clips are to be applied;
a control element extending through the elongate body to the distal end thereof; and a magazine formed at the distal end of the elongate body, the magazine housing therein a chain of clips with a proximal-most one of the clips being coupled to the control element to transmit force applied by the control element to the clip chain, each of the clips including a pair of opposed jaws moveable between open and closed positions, the magazine further including a clip limiting feature distally past which only a distal-most one of the clips may pass, a relief portion of the magazine permitting separation of the most distal clip from the clip chain when the distal end of a clip immediately proximal to the distal-most clip is located therein.
8. The magazine according to claim 7, wherein the magazine is flexible for bending with respect to a longitudinal axis thereof.
9. The magazine according to claim 7, wherein each of the clips comprises a proximal linking feature graspable by the jaws of an immediately proximal clip.
10. The magazine according to claim 9, wherein the distal-most clip is releasable by opening the jaws of immediately proximal clip when the immediately proximal clip is located in the relief portion of the magazine.
11. The magazine according to claim 10, wherein the relief portion comprises one of a cutout in a wall of the magazine, a flexible portion of the wall of the magazine and a moveable tab formed in the wall of the magazine.
12. The magazine according to claim 7, wherein the clip limiting feature comprises a reduced cross section portion of the magazine.
13. The magazine according to claim 12, wherein the reduced cross section portion is sized to allow translation therethrough of a clip with closed jaws and to prevent translation therethrough of a clip with partially open jaws.
14. The magazine according to claim 7, wherein the magazine comprises an anti-pull back tab limiting proximal movement of the distal-most clip.
15. The magazine according to claim 14, wherein the anti-pull back tab limits proximal movement of a lock ring of the distal-most clip.
16. The magazine according to claim 15, wherein the anti-pull back tab cooperates with the lock ring to lock the distal-most clip in a closed configuration.
17. The magazine according to claim 7, wherein the clip limiting feature sets a maximum distal displacement of the clip chain.
18. A method of deploying hemostatic clips, comprising:
inserting to a target site in a body a magazine including a plurality of hemostatic clips connected in a clip chain;
translating the clip chain distally to extend a distal-most one of the clips out of a distal end of the magazine to open clip arms of the distal-most clip into a tissue receiving configuration;

positioning the distal-most clip to receive a first target portion of tissue between the clip arms thereof;
translating the clip chain proximally to draw the distal-most clip back into the magazine and close the clip arms of the distal-most clip over the first target portion of tissue;
translating the clip chain further proximally to detach the distal-most clip from a next most distal clip of the clip chain; and moving the magazine to a second target location to deploy the next most distal clip over a second target portion of tissue.
19. The method according to claim 18, further comprising inserting the magazine to the target site through an endoscopic instrument.
20. The method according to claim 18, wherein the clip chain is translated distally and proximally by manipulating a handle coupled to a control element extending from the handle to a proximal-most one of the clips of the clip chain.
21. The method according to claim 18, further comprising placing a lock ring on the clamped most distal clip to lock clip arms of the distal-most clip closed.
22. The method according to claim 18, further comprising detaching the most distal clip by partially opening clip arms of a next most distal clip.
23. An apparatus for applying clips to tissue, comprising:
a plurality of clips linked to one another to form a clip chain;
a control linkage coupled to a proximal-most one of the clips for applying tension and compression to the clip chain; and a magazine containing the clip chain, the magazine including an abutment surface sized to permit passage distally therebeyond only of a distal-most clip of the clip chain.
CA2541210A 2003-11-07 2004-10-29 Endoscopic hemostatic clipping apparatus Active CA2541210C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US51816703P 2003-11-07 2003-11-07
US60/518,167 2003-11-07
US10/977,598 US8062311B2 (en) 2003-11-07 2004-10-29 Endoscopic hemostatic clipping apparatus
US10/977,598 2004-10-29
PCT/US2004/035953 WO2005046489A1 (en) 2003-11-07 2004-10-29 Endoscopic hemoscopic clipping apparatus

Publications (2)

Publication Number Publication Date
CA2541210A1 true CA2541210A1 (en) 2005-05-26
CA2541210C CA2541210C (en) 2012-12-11

Family

ID=34576823

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2541210A Active CA2541210C (en) 2003-11-07 2004-10-29 Endoscopic hemostatic clipping apparatus

Country Status (6)

Country Link
US (4) US8062311B2 (en)
EP (1) EP1684641B1 (en)
AT (1) ATE545373T1 (en)
AU (1) AU2004289214B2 (en)
CA (1) CA2541210C (en)
WO (1) WO2005046489A1 (en)

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US20200022705A1 (en) 2020-01-23
ATE545373T1 (en) 2012-03-15
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US20050107809A1 (en) 2005-05-19
US9084604B2 (en) 2015-07-21
US20150282813A1 (en) 2015-10-08
CA2541210C (en) 2012-12-11

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