CA1124605A - Surgical stapler - Google Patents

Surgical stapler

Info

Publication number
CA1124605A
CA1124605A CA291,997A CA291997A CA1124605A CA 1124605 A CA1124605 A CA 1124605A CA 291997 A CA291997 A CA 291997A CA 1124605 A CA1124605 A CA 1124605A
Authority
CA
Canada
Prior art keywords
clip
means
main body
magazine
deforming
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.)
Expired
Application number
CA291,997A
Other languages
French (fr)
Inventor
Richard M. Densmore
Charles H. Klieman
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.)
KLIEMAN CHARLES H
Original Assignee
KLIEMAN CHARLES H
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
Priority to US82209677A priority Critical
Priority to US822,096 priority
Application filed by KLIEMAN CHARLES H filed Critical KLIEMAN CHARLES H
Application granted granted Critical
Publication of CA1124605A publication Critical patent/CA1124605A/en
Application status is Expired legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical 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

Abstract

ABSTRACT OF THE DISCLOSURE
A hemostatic clip applicator useful in the rapid and automatic application of hemostatic clips for the stangulation of tubular members is disclosed. The applicator consists of a main body, a clip magazine externally attached to the main body, clip deforming jaws attached to one end of the main body, clip feed means located within the main body and actuating means attached to the feed means and deforming jaws. In operation, one of many hemostatic clips stored in the clip magazine is fed into the main body and guided to the deforming jaws by the inter-action of the actuating means and the feed means. When the clip is properly located about a tubular member, further actuation of the actuating means results in the deformation of the clip about the tubular member. Upon further activation of the actua-ting means, the sequential process of feeding a clip from the magazine and deforming the clip about other tubular members may be rapidly repeated until the supply of clips in the magazine is depleted.

Description

.

:..

BACK~ROUND OE` THE INVENTION

~ 1. Copending Patent Applications -In Canadian Patent number 1,0~2,552 entitled HEMOSTATIC
CLIP APPLICATOR issued July 29, 1980, and assigned to the present assignee, a hemostatic clip applicato.r for the strangulation OL
tubular members in a rapid and automatic manner is disclosed.
Also, in copending Canadian Patent Application serial number 291,946 entitled HENOSTATIC CLIP filed November 29, 1977, and assigned to the present assignee, hemostatic clips adapted for utiliæation in the present invention and similar devices is disclosed.

6~S

1 2. Field of the Invention

2 The invention relates to the field of devices useful

3 in the application of hemostatic clips, and more specifically,

4 to devices for the application of hemostatic clips used in the stransulation of blood vessels and other fluid ducts.
6 3. Prior Art 7 In a typical surgery procedure, a great many veins, ~ arteries, and other blood vessels must be severed and closed.
9 This is often a difficult and time consuming procedure since many vessels are located in obscure areas where there 11 is little room in which to work. Thus, it is apparent that 12 a device which would reduce the time requied for closure 13 of blood vessels wo~ld be of great benefit to both the surgeon 14 and the patient.
One prior art atteMpt to provide a device which can 16 more rapidly close a blood vessel is disclosed by Wood, ~.S.
17 Patent No. 3,326,216. The Wood device consists of a hemo-18 stat-like instrument which has finger loop portions coupled 19 to jaw p~tior.s. The jaw portions are adapted to hold a ~l, hemostatic clip therebetween so that the clip may be closed ~ about a vessel by bringing the finger loops together. Wood 2~ also disc70ses a separate cartridge which holds a pl~rality 23~i of clips. ~hen the Wood device is to be used, the jaw 24, portions are placed about one clip contained in the cartridge, ~5i and the clip is removed from the cartridge by the engagement of the clip by the jaw portions. Then when 27i the ciip has been used, a new clip may be placed in 28il the device by returning to the clip cartridye and inserting 2~¦l a new clip. Two problems are apparent with the Wood ¦
301, àevice. Eirst, the hemostatic clips are not automatically 3111i ~2 1 ~ q~,~S ~

1 fed into the jaws of the device, but must be individually 2 placed there. This procedure is time consuming and cumber-3 some. In addition, the Wood device is capable of expanding 4 its jaws wider than the width of a clip contained therein.
Thus, a clip may be accidentally dropped from the device 6 causing a great deal of inconvenience and delay.
7 A second prior art attempt to provide more rapid yet 8 effective strangulation of blood vessels and the like is 9 described by Miles, U.S. Patent No. 3,082,426. Miles discloses a surgicial stapling device which consists of finger loops 11 coupled to a pair of arms which terminate in jaw portions, 12 the jaw portions being adapated to grasp and hold a tubular 13 member. The device also has a magazine for holding a 14 plurality of clips along the length of one arm, and manually operable clip ejector means for placing a clip about the 1 tubular member which is to be closed. In operation, the ~71 tubular member is first grasped and held by the jaw portions ~31 f the Miles device. The surgeon then places his index 19¦ finger on a button attached to the clip ejector. By ~1 urging the butt.on forward, the clip ejector places a clip about 21 1 the tubular member. Then, the clip may be deformed about the ?~ j~, blood bessel by bringing the pair of finger loops together.
~3,'1 An obvious disadvantage of the Miles device is that it is 24~,1 cumbersomer in that the surgeon must manually move a clip betwee 25~ the jaws of the device while holding the device steady so as ~6 not to loose the grasp of the tubular member. Also, as the 27ii clips are used from the cartridge, the button moves farther 28¦¦ forward so that it becomes more and more difficult to reach.
2~¦1 Also, this procedure is time consuming in that each individual 30¦¦ clip must be manually fed between the jaws of the stapling 3'l!
~2~1 l~Z46~5 ~11 device. Furthermore, the construction of the Miles device, 2¦ particularly in the jaw portions, provides poor visability 31 to the surgeon since the thickness of the device obscures the 41 vessels which are to be closed.
51 Another prior art attempt to provide rapid application 6 of hemostatic clips is disclosed by DeCarlo, ~.S. Patent No.
7 3,740,944. DeCarlo discloses a gun-like device for suturing 8 and severing blood vessels in a three stage procedure.
9 ~irst, jaws of the device are closed about the blood vessel by the actuation of the gun-like trigger mechanism.
11 Second, a pair of pushers extend through the device and come 12 forward to crimp a pair of clips, brought from an internal 13 magazine, about the vessel in two spaced locations. Third, 14 a blade comes forward from the device upon further actuation of the gun-like handles and severes the blood vessels between 16 the two clip locations.
17 I The internal clip magazine of the DeCarlo device uses a 18 pair of leaf spring assemblies to index a plurality of 19 pairs of hemostatic clips. The clips are stored in a pair of index guide rails where they are moved forward in unison 21¦ by opposing leaf spring assemblies. One leaf spring assembly 22¦ is attached to the moveable main body portion while the ~31 opposing lea~ spring assembly is affixed to one guide rail.
24, When the gun-like handles are actuated, the leaf spring assembly 2~ attached to the main body moves forward and contacts portions 26 of the clips contained within the magazine. ~urther 27,, movement of the main body portion moves individual clips along 28" the index guide rail and ultimately ejects a pair of clips.
29¦ ~hen a pair of clips has been ejected, the main body portion 30~ begins to return to its orginal static position. During this 1,, ~ ~.

'1 4 1 rearward movement of the main body portion, there is a trans-2 ference of a pair of clips from the inaex yuide rails to the 3 ejection guide rails. This transference occurs when each leaf 4 spring assembly and its corresponding rar,lp portions guide a clip from one index guide rail to the ejection guide 6 ¦ rail where it is available for loading into the front portion 7 I of the instrument.
8 One problem with the ~eCarlo device is that, due 9 to the three stage operation, the device is necessarily bulky. This is a major disadvantage in that many surgical 11 procedures require severence and closure of blood vessels 12 in very limited areas so that a bulky instrument may 13 not: be able to reach the required vessel. The bulkiness 14 of the device also creates a further disadvantage in that it produces a lack of visibility for the surgeon. Thus, the 16 very vessel that is to be severed and closed may be obscured 17 since the surgeon may not be able to see around the device.
18 A further disadvantage stems from the fact that the DeCarlo 19 device does not adapt to the application of a single clip, but only applies a pair of clips to the vessel to be closed. In 21 a great many surgical procedures, only the application of one 22,l clip is desi~ed while the application of two clips would only 23,, ~omplicate the severance proceciure.
24', Accordingly, it is a general object of the present ~511 invention to provide an improved hemostatic clip applicator ~6 device for the strangulation of blood vessels and the like.
271, It is another object of the present invention to provide 281, an- improved hemostatic clip applicating device which automati-29 I cally feeds clips to its forward portion and then provides 30 ¦ utomatic deformation of the clips about hlood vessels.

~21 li 5.

~lZ46~5 1 It is yet another object of the present invention 2 to provide an improved hemostatic clip applicator device 3 which provides high visibility to the user.
4 It is yet another object of the present invention to provide an improved hemostatic clip applicator device which 61 has an externally coupled and replaceable clip cartridge 71 or in the alternative, a disposable hemostatic clip applicator 3 ¦ device which has an externally coupled clip cartridge.
9 ¦ It is a still further object of the present invention 10 ¦ to provide an improved hemostatic clip applicator device 11 ¦ which is incapable of accidentally dropping clips from 12 the device.
13 Summary of the Invention ____ __ 14 A hemostatic clip applicator device useful for rapidly and automatically applying clips for the strangulation of 16 blood vessels and the like is provided. The devlce has 17 a clip magazine means coupled to the exterior of a main 1~ body, the clip magazine means being adapted to hold a plurality 13 of hemostatic clips. Attached to one end of the main body is a clip deforming means adapted to hold and crimp a hemostatic 21 clip about a blood vessel. 51ideably disposed within the 22l main body is a clip feed means which is adapted to move clips 2311 from the clip magazine means to the clip deforming means.
24!l Coupled to the clip feed means and the clip deforming means 2~i are actuating means. By a se~uential forward and rearward 2b~ movement of the actuating means, a hemostatic clip is fed 271l from the clip magazine means into the main body, where it 28!, is moved forward to the clip deforming means and there crimped 29l about a blood vessel or the like. This sequence of feeding 30¦ clips to the clip deforming means and crimping them therein, 31lj 32l Ii.
~.

~4605 ~ ~

1 may be repeated until the plurality of clips located in the 2 clip magazine means is depleted.
3 The novel features which are believed to be characteristic 4 of the invention, both as to its organization and its method of operation, together with further objects and advantages 6 thereof, will be better understood from the following 7 description in connection with accompanying drawings in which a presently preferred embodiment of the invention is illus-9 trated by way of example. It is to be expressly understood, however, that the drawings are for purposes of illustration 11 and description only and are not intended as a definition of 12 the limits of the invention.
t3 Brief Description of the Drawings 14 FIGURE l is a side view of the clip applicating device of the present invention;
16 FIGURE 2 is a top view of the forward portion of the 17 clip applicating device of the present invention, showing the 18 curved jaw portions;

19 FIGURE 3 is an enlarged view of the jaw portions of the ~n present invention showing a hemostatic clip closed by the 211 clip applicating device;
~ ! FIGU~E 4 is an enlarged view of the forward portion of 23¦li the clip applicating device of the present invention;
~4!~ FIGruR3 5 is an enlarged view of the top of the forward 25,, portion of the clip applicating device showing the clip magazine 2~,' in its relationship to the device;
~7j~ FIGURE 6 is an enlarged view of the forward portion nf 28¦l the clip applicating device of the present invention;

29;l FIG~RE 7 is a side view of the clip magazine of the 30¦l present invention;

' l, 7.

1~4S~5 1 FIG~RE & is a perspective view of the clip magazine of 2 the present invention;
3 FIGURE 9 is a top view of an alternate embodiment of 4 ¦the clip magazine means of the present invention;
FIGURE 10 is a perspective view of an alternate 6 embodiment of the clip maga~ine of the present invention;
7 ¦ FIGURE 11 is a side view of an alternate embodiment of the 8 ¦clip magazine and clip magazine spring means of the present 9 ¦invention;
FIGURE 12 is a side view of an alternate embodiment of 11 the clip applicating device of the present invention;
12 ¦ FIGURE 13 is a top view of an alternate embodiment of 13 the clip applicating device of the present invention;
14 FIGURE 14 is an enlarged view of a portion of the clip 15 magazine means;
16 I FIGURE 15 is a cross-sectional view of the applicating de-17 Ivice of the present invention taken along lines 15-15 of ~IGURE 14;
18 ¦ FIGURES 16a and 16b are a top and side view respectively 13 I¦of the lost motion link means of the present invention; and ~ol¦ FIGURES 17a, 17b and 17c illustrate the progressive 2~ novement of a clip within the clip magazine means of an 2~,alternate embodiment of the present invention.
23'Detailed 3escriE~_on of the Invention 24, A hemostatic clip applicator device is disclosed which is 25" useful in rapidly applying a hemostatic clip about blood vessels _6 and other fluid ducts. The hemostatic clip applicator of the ~71 present invention may be used with hemostatic clips such as is 23¦ldescribed in our co-pending application, Serial No. 2~47 29~ iled on ~ entitled "Hemostatic Clip", or with 30l, any other suitably adapted hemostatic clip.
31 1, 1 32 i, 1.
,, i il ~ ' , 1 Referring to FIGURE 1, the hemostatic clip applying 2 device 2 of the present invention is shown in its static 3 configuration. Clip applying device 2 has an actuating 4 means comprised of an upper handle portion and a lower handle portion. In the presently preferred embodiment, the upper 6 handle portion is comprised of upper finger loop 4, and upper 7 finger loop member 5, while the lower handle portion is 8 comprised of lower finger loop 6 and lower finger loop member 9 7. It can be seen in phantom in FIGURE 1 that upper finger loop 4 may be brought to its forward position 8, while lower 11 finger loop 6 may be moved to an inward position 10.
12 Upper finger loop 4 and upper finger loop member 5 pivot 13 about upper finger loop pivot 12 while being biased 14 toward rear stop pin 16 by f irst spring means 14. Upper finger loop member 5 is coupled to clip feed blade 18 by 16 feed blade pivot 17. -17 Clip feed blade 18 is a clip feed means which in 18 the presently preferred embodiment is a blade member 19 adapted to siide through main body 20 by the forward movement o~ upper finger loop 4. Upper finger loop 4 21 will continue to move clip feed blade 18 through main ~? ~ body 20 until upper finger loop member 5 abuts forward 23l~ stop me~ns 21. The leading edge 24 of clip feed blade 24~i 18 is adapted to correspond to the bail portion Qr trailing 25, edge of a hemostatic clip which may be placed in recess ~,, 26 by any suitably adapted means. In the presently 271~ preferred embodiment, leading edge 24 is "V" shaped.
28 ~ Thus, it can be seen from FIGURE 1 that when a hemostatic 29 I clip is placed in the clip receivin~ means formed by 30 I recess 26, the forward movement of ~pper finger loop 31 l 32 Il, ~.
ll S

1 4 will cause clip feed blade 18 to abut the bail portlon 2 of the hemostatic clip and move the clip toward the 3 forward end of main body 20.
4 Coupled to the forward portion of main body 20 is a

5¦¦ clip deforming means adapted to deform a hemostatic clip

6 about a blood vessel or the like. In the present~y preferred

7 embodiment, the clip deforming means is comprised of upper

8 jaw portion 32 and lower jaw portion 34. Upper jaw portion

9 32 is fixedly coupled to lower finger loop member 7 and pivotally coupled to main body 20, while lower jaw portion 11 34 is fixedly coupled to main body 20. When a hemostatic 12 clip has been fed from the clip magazine into recess 13 26 and moved forward by clip feed blade 18 to jaw portions 14 32 and 34, the clip may be squeezed about a blood vessel by first returning upper finger loop 4 to its rearward 16 position and then raising finger loop 6 to its phantom 17 position 10 so that upper jaw portion 32 closes toward 18 lower jaw portion 34. It is important to note that the 19 outward movement of upper jaw portion 32 is limited by the abutment of lower finger loop member 7 with lower 21 finger loop stop pin 19. Thus, if a hemostatic clip is located in jaw portions 32 and 34, it may not be accidentally ~3,` dropped by the over expansion of upper jaw 32. Lower 24lli finger loop 6 and lower finger loop member 7 are baised 25l, toward their static configuration by second spring means 2~', 22 so that upper jaw portion 32 will return to its open 27 li position when lower finger loop 6 is no longer raised to 28¦¦ to its phantom position ]Ø Also shown in FIGURE 1 are 29 ¦ mounting holes 28 and rivets 30 adapted to couple a clip 30 I magazine, which will be more fully described hereinbelow, ~21 .
il 10-llZ46~5 1I to main portion 20.
2 ~ FIGURE 2 is a top view of the forward portion of clip 31 applying device 2. Illustrated here is the relationship 4ll between main body 20, lower finger loop member 7 and 5 I upper jaw portion 32. It can be seen that lower finger loop 6 member 7 is fixedly coupled to upper jaw portion 32, while 7 the combination of member 7 and jaw portion 32 is pivotally 8 coupled to main body 20 by upper jaw pivot 36. Thus, rotation 9 of member 7 about pivot 36 by movement of lower finger loop 6 results in rotation of upper jaw 32 about pivot 36. Therefore, 11 inward and outward movement of lower finger loop 6 will result 12 in movement of upper jaw 32 toward and away from lower jaw 13 portion 34. Also shown in ~IGURE 2 is the curved configuration 14 of upper jaw portion 32 and lower jaw portion 34.
This curved forward portion of clip applying device 2 provides 16 the distinct advantage of improved visability during usage 17 since the vessel which is to be closed will be located to one 18 side or the other of the main body 20. Although the presently 19 preferred embodiment of the upper and lower jaw portions utilizes a curved configuration, other configurations~ such 21 as straight jaw portions, may also be used.
2 FIGURE 3 illustrates the jaw portions 32 and 34 as they 23 are closed about a deformed clip 38. This configuration would 24,, have resulted from the feeding of a clip into the jaw portions ~5'~ 32 and, 34 by the forward movement of upper finger loop 4, 26l, followed by the rearward movement of upper finger loop 4 and 27 il then the inward movement of lower finger loop 6. It may be 281 noted that rearward movement of upper finger loop 4 has caused 291l feed blade 18 to return to its unactuated posit.ion, thus exiting 3011 jaw portions 32 and 34 and recess 26, so that the jaw portions i, 11. 1 Z~605 ~ ~

1 are free to close about a clip.
2 I FIGURE 4 shows in greater detail the forward portion of 3 clip applying device 2, including clip feed blade 18 and its 4 leading edge 24 as it is disposed in groove 35 in main body 20. It can be seen that a clip 37 disposed in recess 26 will 6 be moved forward by the leading edge 24 of clip feed blade 7 18 so that the clip 37 and clip feed blade 18 slide within the 8 groove 40 in upper jaw portion 32 and groove 42 in lower jaw 9 portion 34. As noted in FIGURE 2, jaw portions 32 and 34 are curved away from main body 20. Thus, feed blad~ 18 11 must be configured so as to be capable of being moved for-12 ward through grooves 35, 40 and 42 while simultaneously 13 bending away from main body 20 in grooves 40 and 42. In 14 the presently preferred embodiment, this capability has been provided by constructing feed blade 18 of four layers 16 of thin blades of metal in a laminated configuration. The 17 four layers are only coupled at discrete points so that 18 feed blade 18 is able to move longitudinally through main 79 body 20 while curving around grooves 40 and 42 in jaw :
portions 32 and 34. Also shown in FIGURE 4 are rivets 30 21 and mountin~ holes 28 for coupling a clip magazine to the 22 clip ap?licator device 2.
23 FIGURE 5 is a top view of the forward portion of clip 24~ applying device 2 showing lateral clip magazine 41 replace-~5l~ ably coupled to main body 20 by clip magazine pin 46 26¦, disposed in mounting hole 20 and clip leaf spring 48 disposed 27 under rivet 30. ~emostatic clips are disposed in clip magazine 28 housing 44 in a lateral relationship to main body 20 and 29 urged toward recess 26 of clip applying device 2 by -the spring 30l CoDtaCt 50 of central clip leaf sprlng 49. ~hus, when clip 32, jl 12.

~ 35 1 feed blade 18 is in its fully retracted position, recess 2 26 is clear so that a clip may be fed from clip magazine 3 housing 44 into recess 26. The clip disposed in recess 26 4 is then available for movement to the jaw portions 32 and 34 when clip feed blade 18 is moved forward by the actuation 6 of upper finger loop 4. Both the clip and clip feed blade 7 18 then move through groove 35 in main body 20 and grooves 8 40 and 42 in upper jaw portions 32 and 34 respectively until 9 upper finger loop member 5 has reached its farthest forward position. Also shown in FIGURE 5 is lower finger loop member 11 7 as it is coupled to upper jaw portion 32, so that they 12 both may rotate about upper jaw pivot 36.
13 FIGURE 6 is a top view of the forward portion of the clip 14 applying device 2, showing the lateral clip magazi.ne housing 44 and its associated clip leaf spring 48. It can be seen 16 from this illustration that clip magazine housing 44 is coupled 17 to main body 20 by a portion of clip leaf spring 48 which 1~ .lies under rivet 30, and by clip magazine pins 46 being 19 dispo~ed in mounting holes 28 in main body 20. Thus, to mount lateral clip magazine housing 44 on main body 21 20, recesses 52 in clip leaf spring 48 are urged around 22', the shaft portion of rivet 30 until pins 46 can be located 23¦~ in mounting holes 28. When lateral clip magazine housing ~4~l 44 is so positioned, central leaf spring 49 is positioned ~6~ll over the clips 37 contained in housing 44 so that leaf ~6,i spring 49 contacts the clips 37 at point 50 and thereby 27 I urges them into the main body 20. When the clips 37 in 28 ¦ clip magazine housing 44 have been depleted, magazine 29 ¦ 41 may be removed and a new magazine installed by lifting 30¦~ housing 44 from main body 20 until pins 46 have cleared 3~jl 13.

1 I holes 28 so that clip leaf spring 44 may be moved longitu-2 dinally out from under rivets 30. ~hen the depleted magazine 3 44 has been removed, a new magazine containing a supply 4 of clips 37 may be installed.
FIGURE 7 is a side cutaway view showing in greater 6 detail lateral clip magazine 41. Clip leaf spring 48 7 is disposed under rivet 30 so that central clip leaf 8 spring 49 is positioned over clips 37 eontained in magaine 9 housing 44. It ean be seen from this FIGURE that central

10 ¦ leaf spring 49 exerts a pressure on clips 37 at contact

11 ¦ point 50 so as to urge the clips individually into

12 ¦ recess 26 of main body 20. When elip feed blade 18 is in its

13 fully retraeted position, recess 26 is empty so that a clip

14 37 ma~ move into recess 26 and be held there by the urging

15 ¦ of adjacent elips 37. When a clip 37 is to be moved to

16 ¦ the jaw portions 32 and 34 of clip applying device 2,

17 ¦ elip feed blade 18 then slides laterally through body

18 ¦ portion 20 and carries clip 37 from recess 26 toward

19 ¦ the jaw portions 32 and 34.
~0 ¦ FIGURE 8 is a perspective view of lateral clip magazine 21 ¦ 41, with its associated clip leaf spring 48, eentral clip 22ll leaf spring 49 and housing 44. ~isposed in housing 44 are a 23¦i plurality of hemostatic clips 37. Central clip leaf spring 24,~ 49 is positioned so as to urge hemostatic clips 37 to 23~i exit from housing 44 through the bottom thereof. Also 26i, illustrated in FIGURE 8 are the mounting means for magazine 27l, housing 44, including pins 46, and recesses 52 disposed 23!l, in clip leaf spring 48.
2911 It can be seen from the above description and partieularly¦
30". FIGURES 1, 5 and 8 that clip applicating device 2 of the I , 3L~Z~6~5 1 present invention provides an automatic feeding and crimping 2 of hemostatic clips. By simply moving upper and lower finger 3 loops 4 and 6 outwardly and then inwardly, a clip is moved 4 from an external magazine 41, into a receiving means 26, and 5¦ldisposed in jaw portions 32 and 34 where it is deformed around 6 a blood vessel or the like. This process of inward and 7 ~outward movement of finger loops 4 and 6 may be repeated 8 rapidly, so that one vessel after another is closed by the 9 hemostatic clips 37, until the supply of clips in 10 magazine 41 is depleted. At this point a new magazine 41 11 may be substituted for the depleted magazine so that vessel 12 closures may be continued.
13 The clip applicating device 2 of the present invention 14 provic,es the further advantage of high visability to the 15 user. ~ecause the device 2 is of an extremely thin design, 16 essentially the width of currently used hemostats and 17 because jaw portions 32 and 34 are c-lrved away from the main 18 body 20, a surgeon using clip applying device 2 will have a t9 clear view of the vessel he is closing and, in addition,

20 will be abl~ to reach remote and obscure regions for ~urther ~1 vessel closure. In addition, clip applying device 2 is ~ constructed ~o as to prevent a clip 37 from accidenta~lly 23'dropping from the device, thereby obivatins a great deal 24~of inconvenience and lost time.
25~ ~IGUR~ 9 illustrates an alternate embodiment oE a clip 2~l maga~ine which may be externally coupled to clip applying 27¦ldevice 2. In this embodiment, a main body spring 54 is 23llpermânently coupled to clip applyiny device 2 by rivets 29¦l56. The main body spring 54 is adapted to hold clip 30~1housing 62 in its proper alignment with main body 20 311j ~2ll 15.
' 1 il I

~t ~ I

1 in conjunction with housing pins 64. Main body spring 2 54 includes a central body spring 55 adapted to rest 3 upon the clips 37 disposed in clip housing 62. FIGURE
4 9 also illustrates a top view of protective cover 66 5 which is removed from clip housing 62 when housing 62 6 is to be utilized. Protective cover 66 prevents clips 7 37 from becoming dislodged from clip housing 6~ until 8 housing ~2 is placed properly in its relationship to 9 main body 20.
FIGURES lO and ll further illustrate the alternate 11 embodiment of a clip magazine. FIGURE 10 is a perspective 12 view of clip housing 62 showing a plurality of hemostatic 13 clips 37 disposed therein. Clip housing 62 includes 14 housing shoulders 68 and housing pins 64. FIGURE 11 is a side view of clip housing 62 as it is held in place 16 against main body 20 by housing leaf spring 5& resting 17 1on shoulders 68. Main body spring 54 is coupled to the 18 jmain body 20 by rivet 56 so that main body spring portions 19 j 54 rest againt shoulders 68 of clip housing 62 while clip 20 1 leaf spring ~0 rests against the upper most hemostatic 211CliP 37.
~~ FIGURE 12 illustrates clip applying device 2 which 23, utilizes another alternate embodiment of a clip 24, magazine, in this case a parallel clip magazine ~5 70. Disposed in parallel clip magazine 70 is a plurality 2~ of hemostatic clips which lay parallel to main body 20 27~l, and are sequentially fed toward recess 26. Parallel clip 28¦l magazine 70 is replaceably coupled to main body 20 by 29~1 magazine couplings 72, which in the presently preferred 30l, embodiment are spring clips which snap o~er corresponding li 321, 1,l 16.
Il I

~ 5 1 portions of main body 20. The magazine 70 is so adapted 2 that forward movement of upper finger loop 4 and the 3 corresponding movement of upper finger loop member 5 4 and clip feed blade 18 results in the sequential placement of hemostatic clips in recess 26. Further actuation of 6 upper finger loop 4 results in movement of a clip between 7 upper jaw portion 32 and lower jaw portion 34. When 3 a clip has been so placed, upper finger loop 4 is returned 9 until it abuts rear stop pin 16 at which time lower finger loop 6 may be moved inward so as to cause upper 11 ¦ jaw portion 32 to move toward lower jaw portion 34 and 12 1 thereby close the hemostatic clip about the blood vessel.
13 ¦ Upper finger loop 4 is biased toward stop pin 16 by first 14 spring 14, while lower finger loop 6 is biased toward 15 ¦ lower finyer loop member stop pin l9 by second spring 16 means 22.
17 FIGURE 13 is a top view of clip applying device 1~ 2 showing parallel clip magazine 70 and its coupling 1~ 72 to main body 20. Also shown in FIGURE 13 is the ~0 relationship between upper finger loop 4, lower

21 ~inger loop 6r and lower finger loop member 7 as it is 2~1, coupled to upper jaw portion 32. Lower finger loop member 23.i 7 is fixedly coupled to upper jaw portion 32, while lower 241, finger loop member 7 is pivotally coupled to main body 25~i ~0 by upper jaw pivot 36. Thus, movement of-lower finger 2S,, loop 6 results in movement of upper jaw portion 32 about 27,! upper jaw pivot 36. It can be seen from FIGURES 12 and 28~1 13 that parallel clip magazine 70 provides even greater 29! visability to the surgeon since the magazine 70 only 301l slightly increases the width of the c1ip applying device 2. `:

31i 32!1 11l 17.
.' l 1 ¦ FIGURES 14, 15, 16 and 17 generally illustrate that 2 ¦ parallel clip maga~ine 70 is comprised of a parallel clip 3 ¦ magazine housing 94, which has a plurality of inwardly 41l biased leaf springs 76, a lost motion link 82 and a clip 5 I loading blade 78 which also has a plurality of inwardly ~ I biased leaf springs 88. More specifically, FIGURE
7 14 illustrates leaf springs 76 in clip housing 94 and the 8 configuration of hemostatic clip 37 within housing 94.
9 It can be seen that each leaf spring 76 has a "V" shaped leading edge 77 which is adapted to correspond to the 11 "V" shaped bail portion of clips 37. As will be dis~
12 cribed more fully hereinbelow, the function of each leaf 13 spring 76 is to prevent rearward movement of clips 37.
14 FIGURE 15 is a cross-sectional view of magazine 70 as it is coupled to main body 20 by magazine couplings 72. Magazine 16 coupling 72 is adapted to spring outward around main body 17 20 until it can be positioned in notch 96 in main body 20.
18 Disposed within parallel clip mayazine 70 are inwardly biased 19 leaf springs 76 in housing 94, clip loading blade 78, with inwardly biased leaf springs 88, along with lost motion 21 link 82. Ad~acent lost motion link 82 is clip feed blade 18 of clip applying device 2. FIGURES 16a and 16b show in ~3!1 greater detail lost motion link 82. FIGURE 16a, a top '~, view of lost motion link 82, illustrates lost motion link ~1. ...... , . ......... . . .. . . .... . . . .
2~!, pin 86 and slot 84. FIGURE 16b is a side view of lost 2~ motion link 82 also illustrating pin 86 and slot 84.
27!1 Pin 86 is fixedly coupled to one end of lost motion link 28¦, 82, while slot 84 is an elongated aperture disposed ~9l, entirely through link 82.
30, 32'j ,; 18.

l~Z4605 ( 1¦ The operation of parallel clip magazin~ 70 can be best 21 understood from the sequence illustrated in FIGURES 17a, 17b 31 and 17c. In FIGURE 17a parallel clip magazine 70 is shown 41 coupled to main body 20. Disposed within parallel clip 51 magazine 70 are leaf springs 76 extending inwardly from 6 ¦ housing 94, clip loading blade 78 with inwardly extending 7 ¦ leaf springs 88, and lost motion link 82. Adjacent lost 8 ¦ motion link 82 is the clip feed blade 18, of applying 9 ¦ device 2, which has a feed blade pin 90 attached thereto.
10 ¦ In FIGURE 17a clip feed blade 18 is in its fully retracted 11 position so that a hemostatic clip 37 is located in recess 12 26 of main body 20. Hemostatic clip 37 is held in recess 26 13 by clip guide spring 92. Disposed within parallel clip magazine 14 70 are a plurality of hemostatic clips 37 whic'n will be sequentially moved into recess 26 by the urging of 16 leaf springs 88 coupled to clip loading blade 78 It 17 can be seen in FIGU~E 17a that feed blade pin 90 is 18 located in the extreme right hand portion of slot 84 19 in lost motion link 82 and that clip loading blade 78 is coupled to lost motion link 82 by lost motion link pin 86.
21 In FTGU~E 17b it can be seen that clip feed blade 18, ?~ which is coupled to upper finger loop 4, has been moved 23i7 forward so that the clip 37 which was in recess 26 has -4;~ been moved along its path toward the jaw portions.
25, Correspondingly, feed blade pin 90 has freely moved the 2~¦i length of slot 84 in lost motion link 82, the distance A, 27 ¦ so that neither lost motion link 82 nor clip loading 28 ¦ blade 78 has had a forward movement. Thus, during the 29 ! initial portion of the loading sequence of clip magazine 30 1 70, hemostatic clips 37 disposed within the magazine 31~j 32l!
Il 19.

r ~ 6 1 70 have not moved, while the clip 37 which was located 2 in the recess 26 has been moved toward the device jaws.
3 However, it can be seen in FIG~RE 17c that 4 further forward movement of clip feed blade 18 caused by the forward movement of upper finger loop 4 has resulted 6 in a forward movement of lost motion link 82 because 7 pin 90 which was abutting the forward most portion of 8 slot 84 in lost motion link 82, has moved a distance B.
9 Thus, this subsequent forward movement of clip feed blade 18 has resulted in forward movement of lost motion link 11 82 and corresponding forward movement of pin 8~. Forward 12 movement of lost motion link pin 86, in turn, has caused 13 forward movement of clip loading blade 78 and its associated 14 leaf springs 88. Thus, the total forward movement of pin 90 a distance C has resul-ted in hemostatic clips 16 37 being moved forward and ultimately the forward most 17 hemostatic clip 37 being guided onto the upper surface of 18 clip feed blade 18, above recess 26 by clip spring 92.
19 Nhen clip feed blade 18 is returned to its static position by the return of upper finger loop 4, clip 37 will drop 21 into recess 26 so that it will be ready to be fed to 2~1 the jaw porLions as illustrated in FIGURE 17a.
23 1l During the later stages of the return movement of 24j, feed blade 18, clip loading blade 78 will also undergo 25ll a rearward movement. During this rearward movement of ~6¦l loading blade 78, leaf springs 88 will abut a clip 37 27 and bend outward sufficiently so that the blade 78 is 28 not impeded. When the blade leaf springs 88 have 29 cleared the clips 37, they will return to ~heir inward 31 biased position. Clips 37 are prevented from undergoing ~ 20.

1 a rearward movement by the protrusion of leaf springs 76 2 in housin~ 94. That is, the bail portions of clips 37 31¦abut the leading edge of leaf springs 76 and are pre-4 vented from moving rearward. Cn the other hanc~, forward 5l'movement of clips 37 is accomplished by the abutment of 6llthe leading edge of leaf springs 88 with the bail Eortion 7lof clips 37. As springs 88 move forward due to the 8Imovement of blade 78, clips 37 bend housing leaf springs 9l 76 outward until they have passed the protruding portions 10¦ of the springs 76. In this manner, one complete forward .
11¦ movement of upper finger loop 4 will cause each clip 37 12¦ to progress to the next location just ahead of the 13 1,¦ next succeeding housin~ spring 76.
14ll, The proper alignment of both leaf springs 76 and 88 15l,in their relationship to clips 37 is accomplished by 16llthe location of rear stop pin 16 and forward stop means 171 21. The rear stop pin 16 is positioned so that abutment 181 of upper finger loop member 5 with pin 16 results in 19j sufficient movement of clip loading blade 78 so that ~0l loading blade leaf sprin~s 88 stop slightly behind each 21lladjacent clip 37. This positioning of pin 16 ensures ~ that each leaf spring 88 will be able to move the adajacent 23'~clip 37 forward. The forward stop means 21, on the other 24 handr is positioned so that abutment of upper finger 25 loop member 5 results in sufficient forward movement ',of leaf springs 88 so that each clip 37 is placed just 27,lbeyond the rearward adjacent leaf spring 76. Thus, the 28ilprevention of rearward movement of clips 37 is ensured since 29l, each leaf spring 76 is always behind the forward adjacent 30`lclip 37.

31`, ~2, ~1.

',, ~ 4605 ~

1 There has been described herein a new and novel clip 2 applying device which has special utility for applying 3 hemostatic clips to blood vessels and the like. However, 4 it is to be understood that various alternate embodiments using the principles of the present invention may be 6 readily incorporated. Thus, while specific embodiments 7 of the present invent.ion have been disclosed and described 8 in detail herein, it will be understood by those skilled ~ in the art that various changes in form and detail may be made therein without departing from the spirit and scope 9 f the invention.

s 19 ~2 .

~5 ~', ~6 '`
27~.

" 22.
.'1, 1

Claims (14)

    The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows 1. A surgical clip applying device comprising:
    (i) a main body having means for receiving clips;
    (ii) a clip magazine coupled to the exterior of said main body and having a housing adapted to store a plurality of said clips in a parallel relationship with said main body, said housing including a plurality of inwardly biased leaf springs;
    (iii) clip loading means slideably disposed within said housing for moving said clips from said magazine to said clip receiving means, said clip loading means comprising a blade member having a plurality of leaf springs disposed thereon so as to be in substantially opposed relationship with said leaf springs of said housing, said leaf springs of said housing and said leaf springs of said loading blade having a "V"-shaped leading edge so as to engage the correspondingly shaped portions of said clips, whereby said leaf springs of said loading blade sequen-tially move said clips to said clip receiving means while said leaf springs of said housing prevent movement of said clips away from said clip receiving means;
    (iv) clip deforming means coupled to said main body for deforming clips disposed therein;
    (v) clip feed means slideably disposed within said main body for moving said clips from said clip receiving means to said clip deforming means, said clip feed means adapted to slide through said main body into said clip deforming means so as to place a clip therein, and to retract from said deforming means prior to the actuation of said deforming means; and (vi) actuating means coupled to said clip feed means, said clip loading means and said clip deforming means for
  1. Claim 1 continued .....

    actuating said clip feed means, said clip loading means, and said clip deforming means.
  2. 2. The clip applying device of claim 1 wherein said magazine further includes a lost motion link member adapted to associate with said clip feed means, said link member slideably disposed within said housing and coupled to said loading means whereby initial forward movement of said feed means does not result in forward movement of said loading means while additional forward movement of said feed means results in forward movement of said loading means.
  3. 3. The clip applying device of claim 2 wherein said hous-ing further includes a guide spring coupled thereto, said guide spring adapted to urge said clips from said housing into said main body clip receiving means.
  4. 4. The clip applying device of claim 3 further including a coupling mechanism adapted such that said magazine may be coupled to and decoupled from said main body.

    5. A surgical clip applying device comprising:
    (i) a main body having a clip receiving recess;
    (ii) a clip magazine coupled to said main body and adapted to hold a plurality of clips, said magazine having a plurality of inwardly biased leaf springs adapted to prevent movement of said clips away from said clip receiving recess, (iii) clip deforming means coupled to said main body for deforming clips disposed therein;
    (iv) a clip loading blade slideably disposed in said clip magazine, said loading blade having a plurality of leaf springs adapted to engage and sequentially move said clips from said magazine to said clip receiving recess;
  5. Claim 5 continued .....
    (v) a clip feed blade slideably disposed within said main body and adapted to sequentially move said clips from said clip receiving recess to said clip deforming means, said clip feed blade adapted to slide through said main body into said clip deforming means so as to place a clip therein, and to retract from said deforming means prior to the actuation of said deform-ing means; and (vi) an actuating mechanism coupled to said clip deforming means, said clip loading blade, and said clip feed blade whereby actuation of said actuating mechanism sequentially causes said clip loading blade to slide through said clip magazine so as to sequentially move said clips to said clip receiving recess, said clip feed blade to slide through said main body into said deforming means and return therefrom so as to sequentially move said clips from said clip receiving recess to said clip deforming means, and said clip deforming means to deform said clips disposed therein.
  6. 6. The clip applying device of claim 5 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
  7. 7. The clip applying device of claim 6 wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
  8. 8. The clip applying device of claim 7 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.
  9. 9. The clip applying device of claim 5 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.
  10. 10. The clip applying device of claim 9 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
  11. 11. The clip applying device of claim in wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
  12. 12. The clip applying device of claim 5 wherein said actuating mechanism comprises an upper handle portion pivotally coupled to said main body and said clip feed blade, and a lower handle portion fixedly coupled to said deforming means, whereby movement of said upper handle portion toward said deforming means results in movement of said clip feed blade toward said deforming means while urging of said upper handle portion toward said lower handle portion results in the deforming of a clip by said clip deforming means.
  13. 13. The clip applying device of claim 12 further including coupling means for coupling said magazine to and decoupling said magazine from said main body.
  14. 14. The clip applying device of claim 5 wherein said clip magazine further includes a lost motion link slideably disposed therein, said lost motion link coupled to said clip loading blade and said clip feed blade whereby initial forward movement of said clip feed blade toward said deforming means does not result in movement of said clip loading blade while additional movement of said clip feed blade toward said deforming means results in movement of said clip loading blade toward said deforming means.
CA291,997A 1977-08-05 1977-11-29 Surgical stapler Expired CA1124605A (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US82209677A true 1977-08-05 1977-08-05
US822,096 1977-08-05

Publications (1)

Publication Number Publication Date
CA1124605A true CA1124605A (en) 1982-06-01

Family

ID=25235129

Family Applications (1)

Application Number Title Priority Date Filing Date
CA291,997A Expired CA1124605A (en) 1977-08-05 1977-11-29 Surgical stapler

Country Status (4)

Country Link
EP (1) EP0000756B1 (en)
JP (1) JPS5740775B2 (en)
CA (1) CA1124605A (en)
DE (1) DE2861194D1 (en)

Families Citing this family (182)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4480640A (en) * 1980-04-22 1984-11-06 Senco Products, Inc. Ligating device
US4509518A (en) * 1982-02-17 1985-04-09 United States Surgical Corporation Apparatus for applying surgical clips
JPS58184073U (en) * 1982-06-01 1983-12-07
US4512345A (en) * 1982-09-30 1985-04-23 United States Surgical Corporation Surgical clip applying apparatus, and clips and clip train for use therein
JPH01295087A (en) * 1988-05-21 1989-11-28 Hitachi Kaa Electron Kk Solenoid valve for hydraulic control
US8900253B2 (en) 2003-03-11 2014-12-02 Covidien Lp Clip applying apparatus with angled jaw
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US20070194082A1 (en) 2005-08-31 2007-08-23 Morgan Jerome R Surgical stapling device with anvil having staple forming pockets of varying depths
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US20070225562A1 (en) 2006-03-23 2007-09-27 Ethicon Endo-Surgery, Inc. Articulating endoscopic accessory channel
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US7665647B2 (en) 2006-09-29 2010-02-23 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
CA2605135C (en) 2006-10-17 2014-12-30 Tyco Healthcare Group Lp Apparatus for applying surgical clips
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
CN102327136B (en) 2007-04-11 2014-04-23 柯惠Lp公司 Surgical clip applier
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8408439B2 (en) 2007-06-22 2013-04-02 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US7669747B2 (en) 2007-06-29 2010-03-02 Ethicon Endo-Surgery, Inc. Washer for use with a surgical stapling instrument
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
JP5410110B2 (en) 2008-02-14 2014-02-05 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. The surgical cutting and fastening instrument with Rf electrode
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US20090206131A1 (en) 2008-02-15 2009-08-20 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
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
US7905381B2 (en) 2008-09-19 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with cutting member arrangement
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US20110006101A1 (en) 2009-02-06 2011-01-13 EthiconEndo-Surgery, Inc. Motor driven surgical fastener device with cutting member lockout arrangements
US9186136B2 (en) 2009-12-09 2015-11-17 Covidien Lp Surgical clip applier
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8608046B2 (en) 2010-01-07 2013-12-17 Ethicon Endo-Surgery, Inc. Test device for a surgical tool
US8403945B2 (en) 2010-02-25 2013-03-26 Covidien Lp Articulating endoscopic surgical clip applier
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
WO2012019063A2 (en) * 2010-08-05 2012-02-09 William Beaumont Hospital Surgical stapling and cutting system
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US8632525B2 (en) 2010-09-17 2014-01-21 Ethicon Endo-Surgery, Inc. Power control arrangements for surgical instruments and batteries
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
JP6224070B2 (en) 2012-03-28 2017-11-01 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. Retainer assembly including a tissue thickness compensator
US20120080498A1 (en) 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Curved end effector for a stapling instrument
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
BR112013007717A2 (en) 2010-09-30 2016-08-09 Ethicon Endo Surgery Inc System fasteners which comprises a retaining matrix array and an alignment
US9615826B2 (en) 2010-09-30 2017-04-11 Ethicon Endo-Surgery, Llc Multiple thickness implantable layers for surgical stapling devices
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US9433419B2 (en) 2010-09-30 2016-09-06 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of layers
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9700317B2 (en) 2010-09-30 2017-07-11 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasable tissue thickness compensator
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9016542B2 (en) 2010-09-30 2015-04-28 Ethicon Endo-Surgery, Inc. Staple cartridge comprising compressible distortion resistant components
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
RU2606493C2 (en) 2011-04-29 2017-01-10 Этикон Эндо-Серджери, Инк. Staple cartridge, containing staples, located inside its compressible part
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8632462B2 (en) 2011-03-14 2014-01-21 Ethicon Endo-Surgery, Inc. Trans-rectum universal ports
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9364239B2 (en) 2011-12-19 2016-06-14 Covidien Lp Jaw closure mechanism for a surgical clip applier
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9078653B2 (en) 2012-03-26 2015-07-14 Ethicon Endo-Surgery, Inc. Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge
RU2639857C2 (en) 2012-03-28 2017-12-22 Этикон Эндо-Серджери, Инк. Tissue thickness compensator containing capsule for medium with low pressure
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9532787B2 (en) 2012-05-31 2017-01-03 Covidien Lp Endoscopic clip applier
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US20140005678A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Rotary drive arrangements for surgical instruments
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
EP2866686A1 (en) * 2012-06-28 2015-05-06 Ethicon Endo-Surgery, Inc. Empty clip cartridge lockout
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
US9968362B2 (en) 2013-01-08 2018-05-15 Covidien Lp Surgical clip applier
BR112015021098A2 (en) 2013-03-01 2017-07-18 Ethicon Endo Surgery Inc articulated surgical instruments with conductive pathways to sign communication
US20140249557A1 (en) 2013-03-01 2014-09-04 Ethicon Endo-Surgery, Inc. Thumbwheel switch arrangements for surgical instruments
US20140263552A1 (en) 2013-03-13 2014-09-18 Ethicon Endo-Surgery, Inc. Staple cartridge tissue thickness sensor system
US9351726B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Articulation control system for articulatable surgical instruments
US9629623B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgery, Llc Drive system lockout arrangements for modular surgical instruments
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US10149680B2 (en) 2013-04-16 2018-12-11 Ethicon Llc Surgical instrument comprising a gap setting system
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
MX2016002328A (en) 2013-08-23 2016-12-14 Ethicon Endo-Surgery Llc End effector detection systems for surgical instruments.
US9987006B2 (en) 2013-08-23 2018-06-05 Ethicon Llc Shroud retention arrangement for sterilizable surgical instruments
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9642620B2 (en) 2013-12-23 2017-05-09 Ethicon Endo-Surgery, Llc Surgical cutting and stapling instruments with articulatable end effectors
US20150173749A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical staples and staple cartridges
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9757124B2 (en) 2014-02-24 2017-09-12 Ethicon Llc Implantable layer assemblies
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
US10004497B2 (en) 2014-03-26 2018-06-26 Ethicon Llc Interface systems for use with surgical instruments
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US9737301B2 (en) 2014-09-05 2017-08-22 Ethicon Llc Monitoring device degradation based on component evaluation
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US9968355B2 (en) 2014-12-18 2018-05-15 Ethicon Llc Surgical instruments with articulatable end effectors and improved firing beam support arrangements
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9931124B2 (en) 2015-01-07 2018-04-03 Covidien Lp Reposable clip applier
US10292712B2 (en) 2015-01-28 2019-05-21 Covidien Lp Surgical clip applier with integrated cutter
US10182816B2 (en) 2015-02-27 2019-01-22 Ethicon Llc Charging system that enables emergency resolutions for charging a battery
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10052044B2 (en) 2015-03-06 2018-08-21 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10159491B2 (en) 2015-03-10 2018-12-25 Covidien Lp Endoscopic reposable surgical clip applier
US20160287250A1 (en) 2015-03-31 2016-10-06 Ethicon Endo-Surgery, Llc Surgical instrument with progressive rotary drive systems
US20160367246A1 (en) 2015-06-18 2016-12-22 Ethicon Endo-Surgery, Llc Dual articulation drive system arrangements for articulatable surgical instruments
US20170056000A1 (en) 2015-08-26 2017-03-02 Ethicon Endo-Surgery, Llc Surgical stapling configurations for curved and circular stapling instruments
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US20170086832A1 (en) 2015-09-30 2017-03-30 Ethicon Endo-Surgery, Llc Tubular absorbable constructs
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US20170224335A1 (en) 2016-02-09 2017-08-10 Ethicon Endo-Surgery, Llc Articulatable surgical instruments with off-axis firing beam arrangements
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
CA2958160A1 (en) * 2016-02-24 2017-08-24 Covidien Lp Endoscopic reposable surgical clip applier
US20170281168A1 (en) 2016-04-01 2017-10-05 Ethicon Endo-Surgery, Llc Interchangeable surgical tool assembly with a surgical end effector that is selectively rotatable about a shaft axis
US20170281183A1 (en) 2016-04-01 2017-10-05 Ethicon Endo-Surgery, Llc Surgical stapling system comprising a jaw closure lockout
US20170281173A1 (en) 2016-04-01 2017-10-05 Ethicon Endo-Surgery, Llc Surgical stapling instrument
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3082426A (en) 1960-06-17 1963-03-26 George Oliver Halsted Surgical stapling device
US3326216A (en) 1964-03-30 1967-06-20 Peter B Samuels Hemostatic clip constructions
JPS4737417U (en) * 1971-05-19 1972-12-25
CH537170A (en) 1971-06-21 1973-05-31 Omega Louis Brandt & Freres S Protective case for wristwatch
JPS565538A (en) * 1979-06-27 1981-01-21 Fuji Photo Film Co Ltd Photographic mordanting layer

Also Published As

Publication number Publication date
EP0000756A1 (en) 1979-02-21
JPS5441588A (en) 1979-04-02
EP0000756B1 (en) 1981-10-21
CA1124605A1 (en)
DE2861194D1 (en) 1981-12-24
JPS5740775B2 (en) 1982-08-30

Similar Documents

Publication Publication Date Title
US3575038A (en) Surgical instrument
CA2529951C (en) Endoscopic suture systems
JP4044653B2 (en) Surgical tightening mechanism
US4179057A (en) Disposable surgical stapling instrument
US4556058A (en) Apparatus for ligation and division with fixed jaws
US5868761A (en) Surgical clip applier
US6228098B1 (en) Apparatus and method for surgical fastening
EP2777530B1 (en) Surgical stapling apparatus
US5601574A (en) Sterile clips and instrument for their placement
US10166027B2 (en) Apparatus for applying surgical clips
EP0087938B1 (en) Surgical clip applier with in-line cartridge and interruptable biased feeder
AU598920B2 (en) An improved anvil and driver assembly for a surgical skin stapling instrument
US5458279A (en) Surgical stapler with safety feature
ES2279301T3 (en) Surgical stapling instrument incorporating a keying mechanism shot.
US5207692A (en) Surgical clip applier with reciprocating clip sleeve and dual ratchet mechanism
AU627704B2 (en) Method and apparatus for storing, dispensing and applying surgical staples
AU676717B2 (en) Ligating clip applier
CA1183052A (en) Automatic hemoclip applier
US4592498A (en) Surgical stapler
CA1329088C (en) Surgical stapler
CA1240895A (en) Surgical stapling system, apparatus and staple
EP0118262B1 (en) Stapler including ratchet means for preventing double feeding of staples
US4691853A (en) Surgical stapler
CA2102346C (en) Rotatable articulating endoscopic fastening instrument
EP0442482A2 (en) Rotating head skin stapler

Legal Events

Date Code Title Description
MKEX Expiry