Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or 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
  • A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
  • A61B2017/301—Surgical pincettes, i.e. surgical tweezers without pivotal connections with three legs
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
  • A61B2017/303—Surgical pincettes, i.e. surgical tweezers without pivotal connections with four or more legs

Definitions

• This invention relates to a surgical clip for use in endoscope clipping procedures.
• Clips of this type are known, and are employed, for example, in haemostasis (stopping bleeding) and marking medically significant sites (e.g. the sites of tumours) in the gastrointestinal tract.
• Such clips have been used for a considerable number of years with rigid endoscopes.
• they have significant shortcomings, and with the increased use of endoscopy in recent years, for example as the results of the development of flexible endoscopy, there is, and has been for some time, a need for improved clips.
• FIG. 1 of the accompanying drawings A widely used prior art clip is shown in Figure 1 of the accompanying drawings, in the configuration it has prior to use.
• this comprises a pair of arms 1 of resilient material which cross one another to form a general X-shape, the proximal ends of the arms received being in a sleeve 2 which is longitudinally slidable thereon.
• the proximal ends of the arms are connected, at a point which, in the view of Figure 1, is within the sleeve 2, to one end of a connector 3.
• the other end of the connector 3 can be connected by means of the opening 4 to a clip fixing device.
• the arms have proximal portions la which, at their maximum distance from one another, are slightly further apart than the internal diameter of the mounting 2, and distal portions lb which extend to a point where they are much further apart.
• the distal portions terminate in engaging portions lc adapted to engage body tissue.
• the sleeve 2 is slid rightwardly, by an actuating device. The initial effect of this to compress the proximal arm portions la and thereby cause the distal arm portions lb to move even further apart.
• the arms are then positioned so that the engaging portions lc are located in the correct position in relation to the tissue which is to be clipped.
• the sleeve 2 is then slid further rightwardly, so that it engages the distal arm portions lb and forces them towards one another, thus causing the tissue to be engaged by the engaging portions lc .
• An object of the present invention is to avoid this problem.
• Particular embodiments of the invention will now be described below which have additional advantages.
• a surgical clip comprising at least three arms which are secured together at their proximal ends and have distal end portions which, in the rest state thereof, form a diverging, non-coplanar array, and a sleeve movable from a first position in which the arms adopt their rest state to a second position in which the distal end portions of the arms are closer together to engage tissue which is to be clipped.
• Figure 2a and 2b are perspective and end views respectively of an embodiment of the invention.
• FIGS 3, 4 and 5 show successive stages in the use of the embodiment of Figure 2;
• Figures 6a to 6c show three types of surface pattern which may be provided at the tips of the . arms used in the clip of the invention.
• a clip 10 according to the invention comprises three resilient arms 11 which are attached at their proximal ends to a common mounting 12 and which, in the illustrated rest position, diverge towards the proximal ends.
• the diverging arm portions are non-coplanar and, as considered in an end projection, diverge approximately equiangularly, i.e. at about 120° to one another. It is to be understood, however, that equiangular divergence is not essential. It is further to be understood that there could be more than three arms, for example four arms.
• Each arm 11 has a tip portion 13 extending at an angle, for example at about 90°, to the adjoining portion of the arm.
• each arm can be a resilient metal wire, and each tip portion 13 can be an integral end portion of the respective wire.
• the tip portion 13, or the whole of each arm can be coated with a plastics material, for example by injection moulding, to reduce the risk of damage to the patient's tissue.
• the tip portions are so oriented that when the diverging arm portions are brought together (see below) the tip portions extend at least approximately parallel to one another, so that any two adjacent tip portions can form a parallel sided, tissue engaging clamp.
• each diverging arm portion has a V-shaped section 14. The purpose of these sections is explained below.
• a sleeve 15 is slidably received on the arms .
• the bore of the sleeve has a widened section 16 intermediate its length.
• the operation of the clip 10 can best be understood by consideration of Figures 3 to 5, which show the use of the clip in clamping a bleeding blood vessel 20.
• the clip is introduced into the patient's body by means of an endoscope 21, for example a flexible endoscope, having a biopsy channel 22.
• the clip 10 is held in place with respect to the endoscope by a wire 23 running in a sheath 24, both of which extend along the biopsy channel 22.
• the clip 10 is releasably attached to the wire 23.
• the endoscope with the clip mounted on the distal end thereof, as shown, is introduced into the patient's body until the clip is adjacent the location where the blood vessel is located.
• To clamp the blood vessel the clip is then moved towards the blood vessel until two of the arms- pass one side of the vessel and the third arm passes the other side. It will be appreciated that it is not necessary to rotate the clip above its longitudinal axis to achieve this. It will be achieved whatever the rotational orientation of the clip.
• the endoscope is then moved further longitudinally, i.e. towards the site where the clip is to be attached to the blood vessel, whilst a restraining rightward force is exerted on the wire clamp 26. Since the external size of the sleeve 15 is greater .than the internal size of the biopsy channel, the sleeve is thereby forced leftwardly with respect to the arms 11 until the V-shaped sections 14 of the arm engage in the widened section 16 of the sleeve bore. The situation is then as shown in Figure 4. Finally, the wire clamp 26 is released and the endoscope 21 withdrawn, leaving the clip 10 in place on the blood vessel, as shown in Figure 5.
• the function of the components 21 to 24 as regards clip installation may be taken over by a wire-wound cable (i.e. a Bowden-type cable) which is located in the biopsy channel of an endoscope.
• a wire-wound cable i.e. a Bowden-type cable

Landscapes

• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Heart & Thoracic Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Vascular Medicine (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Reproductive Health (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (3)

Publications (1)

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Family Applications (1)

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• 1997
  • 1997-10-21 GB GBGB9722203.8A patent/GB9722203D0/en not_active Ceased
• 1998
  • 1998-10-21 JP JP2000516594A patent/JP2001520069A/ja not_active Withdrawn
  • 1998-10-21 AU AU95496/98A patent/AU9549698A/en not_active Abandoned
  • 1998-10-21 EP EP98949117A patent/EP1024755A1/de not_active Withdrawn
  • 1998-10-21 WO PCT/GB1998/003147 patent/WO1999020183A1/en not_active Ceased

Non-Patent Citations (1)

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