WO2013041960A1 - Clip for organ retraction during minimally invasive surgery - Google Patents

Clip for organ retraction during minimally invasive surgery Download PDF

Info

Publication number
WO2013041960A1
WO2013041960A1 PCT/IB2012/002130 IB2012002130W WO2013041960A1 WO 2013041960 A1 WO2013041960 A1 WO 2013041960A1 IB 2012002130 W IB2012002130 W IB 2012002130W WO 2013041960 A1 WO2013041960 A1 WO 2013041960A1
Authority
WO
WIPO (PCT)
Prior art keywords
clip
configuration
segments
clips
ancillary
Prior art date
Application number
PCT/IB2012/002130
Other languages
French (fr)
Inventor
David BAAS
Vincent Garitey
Frederic Mouret
Bernard Dallemagne
Silvana Perretta
Original Assignee
Surgical Perspectives Sas
Ircad
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 Surgical Perspectives Sas, Ircad filed Critical Surgical Perspectives Sas
Priority to EP12787859.3A priority Critical patent/EP2757963A1/en
Priority to CN201280057673.XA priority patent/CN104114105B/en
Priority to US14/346,703 priority patent/US9974532B2/en
Publication of WO2013041960A1 publication Critical patent/WO2013041960A1/en

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
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors 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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/083—Clips, e.g. resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227—Spring clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A61B2017/0225—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery flexible, e.g. fabrics, meshes, or membranes

Landscapes

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

Abstract

Provided herein is a clip for organ retraction or organ exposure during minimal invasive surgery wherein the clip comprises a body made of a biocompatible material wherein the body comprises at least two generally opposing first and second segments that form a jaw defined by a separation between the two segments; wherein the two segments each comprise distal and proximal ends wherein the proximal ends may be directly connected or connected through one or more segments within the body of the clip and wherein the clip defines at least four configurations a resting configuration, an open configuration, a grabbing configuration, and a sliding configuration.

Description

CLIP FOR ORGAN RETRACTION DURING MINIMALLY INVASIVE SURGERY
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S provisional patent application no. 61/538,677 entitled "CLIP FOR ORGAN RETRACTION DURING MINIMALLY INVASIVE SURGERY" filed on September 23, 2011, which is incorporated by reference in its entirety.
BACKGROUND
[0002] Minimally invasive (laparoscopic) surgery refers to a type of operation performed through small abdominal incisions in order to reduce traumatic complications and risks associated with conventional surgery. Surgical field exposure still remains a significant challenge for standard laparoscopic techniques and is important for the advancement of Single Incision Laparoscopic Surgery (SILS) and Natural Orifice Transluminal Endoscopic Surgery. Surgical risks related to poor and insufficient field exposure such as lack of visibility, limited space, poor comfort level, adjacent tissue perforation and poor control of surgical field space are still predominant in minimally invasive techniques. Surgeons are compensating for the lack of dedicated instruments by using indirect approaches and tricks to increase field space. Steep reclining position (Trendelenburg position) and high C02 levels are commonly used in surgery to augment field space. These techniques have been associated with significant peri- and post-operative complications, particularly with fragile patients and obese people. Field exposure is even more difficult to achieve in SILS procedures and impacts surgical outcome significantly. The lack of dedicated retraction instruments for SILS remains a barrier to its use and expansion.
[0003] Single use surgical retractors are instruments used to easily hold back tissues and expose underlying body parts.
[0004] Thus there is a need for a system and method for organ retraction during minimally invasive surgery. The disclosure presented herein meets this need and provides related advantages as well. There remains a need for powerful retraction means that simplify operating field access and provide increased visibility by optimizing exposure and improving control.
SUMMARY
[0005] Provided herein is a clip for organ retraction or organ exposure during minimal invasive surgery wherein the clip comprises a body made of a biocompatible material wherein the body comprises at least two generally opposing first and second segments that form a jaw defined by a separation between the two segments; wherein the two segments each comprise distal and proximal ends wherein the proximal ends may be directly connected or connected through one or more segments within the body of the clip and wherein the clip defines at least four configurations a resting configuration, an open configuration, a grabbing configuration, and a sliding configuration.
[0006] Another embodiment provides a clip wherein the resting configuration, the open configuration, the grabbing configuration, and the sliding configuration are as illustrated in Figures 2 A-D. [0007] Another embodiment provides a clip wherein the biocompatible material has an elasticity that allows changing the configuration of the clip while the clip is deployed in a cavity of a patient's body.
[0008] Another embodiment provides a clip wherein the biocompatible comprises an elastomeric material and/or metallic material.
[0009] Another embodiment provides a clip wherein changing the configuration of the clip is carried out using an ancillary.
[0010] Another embodiment provides a clip wherein the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the grabbing configuration.
[0011] Another embodiment provides a clip wherein the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the resting.
[0012] Another embodiment provides a clip wherein the ancillary allows in a single movement to change the configuration of the clip to pass from the resting configuration to the open configuration and then to the sliding configuration.
[0013] Another embodiment provides a clip wherein the ancillary allows in a single movement to change the configuration of the clip from the grabbing configuration to the open configuration and then to the sliding configuration
[0014] Another embodiment provides a clip wherein the clip is sized so it can be introduced into a mammal body cavity through a trocar having an opening having a maximum dimension of 12 mm or less
[0015] Another embodiment provides a clip wherein the clip is adapted for introduction and grabbing of an organ within five minutes or less.
[0016] Another embodiment provides a clip wherein the clip is capable of moving an organ or tissue having a weight of up to 2 kg.
[0017] Another embodiment provides a clip wherein the clip is capable of moving an organ or tissue having a weight of at least 1.5 kg.
[0018] Another embodiment provides a clip wherein the distal end of the first segment comprises a single branch and the distal end of the second segment comprises two branches that form a U-shape wherein in a closed configuration of the clip the branch of the first segment fits in the U-shape formed by the two branches of the second segments thereby allowing the two segments to cross.
[0019] Another embodiment provides a clip having a gripping strength adjustable by selection of the biocompatible material and/or the geometry of the segments forming the body of the clip.
[0020] Another embodiment provides a clip wherein the branches in the first and second segments have tips that grab tissue of the organ when the clip is in the closed or crimping configurations.
[0021] Another embodiment provides a clip wherein pressing the proximal portions opens the jaw formed by the crossed branches in the distal portions and wherein releasing the proximal portions closes the jaw formed by the branches thereby allowing grabbing of the tissue by the jaw. [0022] Another embodiment provides a clip further comprising an elastic element disposed between the two segments; wherein the elastic element that enhances the clip grabbing strength by keeping the segments apart.
[0023] Another embodiment provides a clip wherein one or both segments have a tip that is straight, pointed, round or flat.
[0024] Another embodiment provides a clip wherein one or both segments have tips wherein the tips are covered.
[0025] Another embodiment provides a clip wherein the clip is adapted for manipulation through an ancillary.
[0026] Another embodiment provides a clip wherein the ancillary allows the clip to adopt one or more configurations as the clip is pushed down by a mobile part of the ancillary.
[0027] Another embodiment provides a clip wherein movement of the clip along the length of the ancillary is effected through a button that pushes down the clip.
[0028] Another embodiment provides a clip further comprising a space in the body of the clip wherein a grabbing element (for example a hook or atraumatic grasper) can be placed through the space to withdraw the clip from a patient's body cavity.
[0029] Another embodiment provides a clip wherein the ancillary is separated from clip by releasing the hook from the clip.
[0030] Another embodiment provides a system comprising at least two clips wherein each clip comprises a hole in a segment connecting the first and second segments wherein the two clips can be attached through a flexible string or thread.
[0031] Another embodiment provides a system comprising at least three clips 2 wherein each clip comprises a hole in a segment connecting the first and second segments wherein the three clips can be attached through a flexible string or thread to form a Y shape.
[0032] Another embodiment provides a system wherein the flexible string is manipulated using a surgical ancillary comprising a stem having a grabbing element (for example a hook) at the end of the stem.
[0033] Another embodiment provides a system wherein the string or thread has at least three strands wherein the one of the three strands is a free strand that blocks movement of the string or thread when a mass is suspended through the two clips.
[0034] Another embodiment provides a system further comprising a tubular element wherein the thread or string is placed through the tubular element thereby preventing the two clips from collapsing on each other.
[0035] Another embodiment provides a system wherein the two clips and string or thread are preassembled in a charging tube having dimensions similar to the dimension of the stem of the ancillary.
[0036] Another embodiment provides a system wherein the two clips and string or thread are preassembled in a charging tube having a diameter greater than the diameter of the stem of the ancillary.
[0037] Another embodiment provides a system further comprising an element for adjusting the distance between the two clips. [0038] Another embodiment provides a system wherein one or more clips are attached to a net.
[0039] Another embodiment provides a system wherein the net allows for holding an organ.
[0040] Another embodiment provides a system wherein the net is made of transparent biocompatible material.
[0041] Another embodiment provides a system wherein the organ is a liver.
[0042] Another embodiment provides a system wherein the net is flat.
[0043] Another embodiment provides a system wherein the net has reinforced portions.
[0044] Another embodiment provides a system wherein the net has openings where portions of the organ are retained.
[0045] Another embodiment provides a system wherein the center of the net forms a cavity for retaining the organ.
[0046] Another embodiment provides a system wherein the net has a triangular geometry.
[0047] Another embodiment provides a system wherein the system comprises three clips and wherein each of the three clips is attached to one summit of the triangular net.
[0048] Another embodiment provides a system wherein the clips are attached to the net through threads with adjustable distances.
[0049] Another embodiment provides a system further comprising a mechanism for automatic deployment of the net.
[0050] Another embodiment provides a system wherein the net comprises memory alloy wire.
[0051] Another embodiment provides a system wherein the memory alloy wire maintains the net in an open position.
[0052] Another embodiment provides a system comprising one clip wherein the clip is attached to a band.
[0053] Another embodiment provides a system comprising a plurality of clips according to claim 2 wherein each clip is attached to a band and wherein the bands can attach to each other to form a net for moving an organ or tissue.
[0054] Another embodiment provides a system wherein the net is assembled within a patient's body cavity during minimal invasive surgery.
[0055] Another embodiment provides a system further comprising an element for adjusting the distance between the clip and the band
[0056] Another embodiment provides a system wherein two or more bands are attached to each other through mechanical means, magnetic means, and/or a glue.
[0057] Another embodiment provides a system wherein two or more bands form a shape suitable for moving an organ or tissue.
[0058] Another embodiment provides a system wherein at least two bands are attached to form a longer straight band.
[0059] Another embodiment provides a system wherein at least two bands are attached to form a T shape.
[0060] Another embodiment provides a system wherein at least two bands are attached to form an L shape. [0061] Another embodiment provides a system wherein at least three bands are attached to form a Y shape.
[0062] Another embodiment provides a system wherein the bands are attached to each other through hooks.
INCORPORATION BY REFERENCE
[0063] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.
BRIEF DESCRIPTION OF THE DRAWINGS
[0064] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:
[0065] FIG. 1: depicts a clip according to one embodiment as disclosed herein
[0066] FIG. 2: depicts clip configurations according to one embodiment disclosed herein resting configuration (c), open configuration (B), the crimp ing/grabbing configuration (d), and the sliding configuration (a).
[0067] FIG. 3: depicts a system with two clips according to one embodiment disclosed herein attached with a string allowing for adjustment of the distance between the two clips.
[0068] FIG. 4: depicts an ancillary according to one embodiment disclosed herein.
[0069] FIG. 5: depicts an ancillary according to one embodiment disclosed herein with a hook illustrating a grabbing element at one end for manipulating a clip as described herein.
[0070] FIG. 6: depicts an embodiment with a clip charging tube and an ancillary tube wherein the charging tube has a diameter slightly greater than the diameter of the ancillary tube.
[0071] FIG. 7: depicts a charger containing two clips.
[0072] FIG. 8: depicts a system comprising a band attached to a clip according to one embodiment as disclosed herein.
[0073] FIG. 9: depicts a system comprising two units each comprising a band and a clip wherein the bands are attached to form a longer band.
[0074] FIG. 10: depicts a system comprising three units each comprising a band and a clip wherein the three bands are attached in the form of a Y.
[0075] FIG. 11: depicts a system for introducing a clip and a net through a trocar.
[0076] FIG. 12: depicts a system comprising an element for adjusting the distance between two clips.
[0077] FIG. 13: depicts a clip according to one embodiment as disclosed herein having distal extremities of the two branches that form a U-shape, geometry which retain the single branch inside the U-shape. [0078] FIG. 14: depicts a partial view of a clip according to one embodiment as disclosed herein having distal extremities of the two branches that form a U-shape, geometry which retain the single branch inside the U-shape.
[0079] FIGs. 15 (a, b, c): depict a clip according to one embodiment within an ancillary or a grasper, wherein the grasper presents specific extremities which correspond to the clip to grab and manipulate it safely longitudinally (a, b) or transversally (c).
[0080] FIG. 16: depicts a system comprising a band attached to a clip according to one embodiment as disclosed herein wherein the system comprising a band made in a material which is elastic in one direction and inelastic on another one; a female portion which is made on the elastic direction wherein small incisions are cut; under traction of this band, the incisions are opening to offer holes enabling the connection with a male band.
[0081] FIG. 17: depicts a system comprising a band attached to a clip according to one embodiment as disclosed herein wherein the system comprising a band made in a material which is elastic in one direction and inelastic on another one; in the inelastic direction hooks are attached which enable the connection with a female bands as depicted in FIG 16.
[0082]
[0083] FIG. 18: depicts a system comprising two bands according to FIGs 16 and 17 wherein the bands are attached by connecting the bands by inserting hooks through the incisions.
[0084] FIG. 19: depicts a clip according to one embodiment as disclosed herein further comprising claws to fix the clip on a substrate.
[0085] FIG. 20: depicts a clip according to one embodiment as disclosed herein further comprising claws that fix the clip on a substrate.
[0086] FIG. 21: depicts a clip according to one embodiment as disclosed herein further comprising a claw that can be bent to form a hook enabling the connection of the body of the clip to an organ or a biological tissue.
[0087] FIGs. 22 (a, b, c, d, e, f): depict one embodiment for forming a clip according as disclosed herein.
DETAILED DESCRIPTION
[0088] Provided herein is a clip for organ retraction or organ exposure during minimal invasive surgery wherein the clip comprises a body made of a biocompatible material wherein the body comprises at least two generally opposing first and second segments that form a jaw ; wherein the two segments each comprise distal and proximal ends wherein the proximal ends may be directly connected or connected through one or more segments within the body of the clip and wherein the clip defines at least four configurations a resting configuration, an open configuration, a grabbing configuration, and a sliding configuration.
[0089] Figure 1 shows one illustration of a clip as described herein.
[0090] Figures 2 A-D illustrate a clip as depicted in Figures one in 4 configurations Figure 2-A shows the clip in a sliding configuration. Figure 2-B shows the clip in an open configuration. The open configuration can be obtained by applying pressure on the upper segments of the clip. Figure 2-C shows a clip in a resting position. The resting position can for example be obtained by releasing pressure on the upper segments of the clip.
Figure 2-D shows a clip in a grabbing position.
[0091] In one embodiment, in order to enhance the security of the clip, a U-shape geometry is added at the distal extremities of the two branches to retain the single branch inside the U-shape. FIG. 13 depicts a clip according to one embodiment as disclosed herein having distal extremities of the two branches that form a U-shape, geometry which retain the single branch inside the U-shape. FIG. 14 depicts a partial view of a clip according to one embodiment as disclosed herein having distal extremities of the two branches that form a U-shape, geometry which retain the single branch inside the U-shape.
[0092] In one embodiment an ancillary or a grasper is provided. FIGs. 15 (a, b, c) depict a clip according to one embodiment within an ancillary or a grasper, wherein the grasper presents specific extremities which correspond to the clip to grab it safely longitudinally (a, b) or transversally (c).
[0093] Another embodiment provides a clip wherein changing the configuration of the clip is carried out using an ancillary. An ancillary as described herein is illustrated in Figure 4. An embodiment wherein the ancillary comprising a grabbing element for manipulating the clip is illustrated in Figure 5. The ancillary can be separated from clip by releasing the grabbing element from the clip.
[0094] In one embodiment the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the grabbing configuration.
[0095] In another embodiment the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the resting.
[0096] In another embodiment the ancillary allows in a single movement to change the configuration of the clip to pass from the resting configuration to the open configuration and then to the sliding configuration.
[0097] In another embodiment the ancillary allows in a single movement to change the configuration of the clip from the grabbing configuration to the open configuration and then to the sliding configuration
[0098] Another embodiment provides a clip wherein the distal end of the first segment comprises a single branch and the distal end of the second segment comprises two branches that form a U-shape wherein in a closed configuration of the clip the branch of the first segment fits in the U-shape formed by the two branches of the second segments thereby allowing the two segments to cross. This embodiment is illustrated by the clip of Figure 1.
[0099] Another embodiment provides a system comprising at least two clips wherein each clip comprises a hole in a segment connecting the first and second segments wherein the two clips can be attached through a flexible string or thread. Figure 3 shows two clips attached through a string.
[00100] Another embodiment provides a system wherein the two clips and string or thread are preassembled in a charging tube having dimensions similar to the dimension of the stem of the ancillary. Figure 7 shows a charger containing two clips for deployment through the ancillary. In one embodiment as described in Figure 6 shows a charger having a diameter that is slightly greater than the diameter of the ancillary which facilitates sliding the clips through the ancillary. [00101] Another embodiment provides a system wherein the two clips and string or thread are preassembled in a charging tube having a diameter greater than the diameter of the stem of the ancillary as shown in Figure 6.
[00102] Another embodiment provides a system further comprising an element for adjusting the distance between the two clips. Figure 12
[00103] Another embodiment provides a system comprising one clip wherein the clip is attached to a band. One example of a clip attached to a band is shown in Figure 8.
[00104] Another embodiment provides a system comprising a plurality of clips wherein each clip is attached to a band and wherein the bands can attach to each other to form a net for moving an organ or tissue. One embodiment provides two kinds of bands made in a material which is elastic in one direction and inelastic on another one. For example, a female portion is formed in the elastic direction wherein small incisions are formed. Under traction of this band, the incisions may open to offer holes enabling the connection with a male band comprising a hook. A male band, made o the inelastic direction, on which hooks are connected to facilitate connection to a band having incisions. FIG. 16 depicts a system comprising a band attached to a clip according to one embodiment as disclosed herein wherein the system comprising a band made in a material which is elastic in one direction and inelastic on another one; a female portion which is made on the elastic direction wherein small incisions are cut; under traction of this band, the incisions are opening to offer holes enabling the connection with a male band. FIG. 17 depicts a system comprising a band attached to a clip according to one embodiment as disclosed herein wherein the system comprising a band made in a material which is elastic in one direction and inelastic on another one; in the inelastic direction hooks are attached which enable the connection with a female bands as depicted in FIG 16. FIG. 18 depicts a system comprising two bands according to FIGs 16 and 17 wherein the bands are attached by connecting the bands by inserting hooks through the incisions.
[00105] In one embodiment, claws may be added to the body of the clip to achieve several advantages according to the present disclosure. For example, claws are added to fix the clip on a substrate. The clip presents one or more claws which are bent around some substrate part(s). The clip is therefore linked to the substrate. This embodiment allows the fixation of the substrate on an organ or a biological tissue through the clip. This embodiment also allows preventing biological tissue damage that may be linked to direct contact between the organ and the clip. (Picture 10)FIG. 19 depicts a clip according to one embodiment as disclosed herein further comprising claws to fix the clip on a substrate. FIG. 20: depicts a clip according to one embodiment as disclosed herein further comprising claws that fix the clip on a substrate. FIG. 21 depicts a clip according to one embodiment as disclosed herein further comprising a claw that can be bent to form a hook enabling the connection of the body of the clip to an organ or a biological tissue. The claws can be used to connect different types of accessories to add an additional function to the clip
[00106] Another embodiment provides a system wherein the net is assembled within a patient's body cavity during minimal invasive surgery. [00107] One embodiment provides a system further comprising an element for adjusting the distance between the clip and the band. Figure 12
[00108] Another embodiment provides a system wherein two or more bands are attached to each other through mechanical means, magnetic means, and/or a glue.
[00109] Another embodiment provides a system wherein two or more bands form a shape suitable for moving an organ or tissue.
[00110] Another embodiment provides a system wherein at least two bands are attached to form a longer straight band. Figure 9 depicts a system comprising two units each comprising a band and a clip wherein the bands are attached to form a longer band.
[00111] Figure 10 depicts a system comprising three units each comprising a band and a clip wherein the three bands are attached in the form of a Y
[00112] Another embodiment provides a system wherein the bands are attached to each other through hooks.
[00113] While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only.
Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims

CLAIMS WHAT IS CLAIMED IS:
1. A clip for organ retraction or organ exposure during minimal invasive surgery wherein the clip comprises a body made of a biocompatible material wherein the body comprises at least two generally opposing first and second segments that form a jaw ; wherein the two segments each comprise distal and proximal ends wherein the proximal ends may be directly connected or connected through one or more segments within the body of the clip and wherein the clip defines at least four configurations a resting configuration, an open configuration, a grabbing configuration, and a sliding configuration.
2. The clip of claim 1 wherein the resting configuration, the open configuration, the
grabbing configuration, and the sliding configuration are as illustrated in Figures 2 A-D.
3. The clip of claim 2 wherein the biocompatible material has an elasticity that allows changing the configuration of the clip while the clip is deployed in a cavity of a patient's body.
4. The clip of claim 3 wherein the biocompatible comprises an elastomeric material and/or metallic material.
5. The clip of claim 3 wherein changing the configuration of the clip is carried out using an ancillary.
6. The clip of claim 5 wherein the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the grabbing configuration.
7. The clip of claim 5 wherein the ancillary allows in a single movement to change the configuration of the clip from the sliding configuration to the open configuration and then to the resting.
8. The clip of claim 5 wherein the ancillary allows in a single movement to change the configuration of the clip to pass from the resting configuration to the open configuration and then to the sliding configuration.
9. The clip of claim 5 wherein the ancillary allows in a single movement to change the configuration of the clip from the grabbing configuration to the open configuration and then to the sliding configuration
10. The clip of claim 2 wherein the clip is sized so it can be introduced into a mammal body cavity through a trocar having an opening having a maximum dimension of 12 mm or less
11. The clip of claim 2 wherein the clip is adapted for introduction and grabbing of an organ within five minutes or less.
12. The clip of claim 2 wherein the clip is capable of moving an organ or tissue having a weight of up to 2 kg.
13. The clip of claim 2 wherein the clip is capable of moving an organ or tissue having a weight of at least 1.5 kg.
14. The clip of claim 2 wherein the distal end of the first segment comprises a single branch and the distal end of the second segment comprises two branches that form a U-shape wherein in a closed configuration of the clip the branch of the first segment fits in the U- shape formed by the two branches of the second segments thereby allowing the two segments to cross.
15. The clip of claim 3 having a gripping strength adjustable by selection of the
biocompatible material and/or the geometry of the segments forming the body of the clip.
16. The clip of claim 2 wherein the branches in the first and second segments have tips that grab tissue of the organ when the clip is in the closed or crimping configurations.
17. The clip of claim 9 wherein pressing the proximal portions opens the jaw formed by the crossed branches in the distal portions and wherein releasing the proximal portions closes the jaw formed by the branches thereby allowing grabbing of the tissue by the jaw.
18. The clip of claim 3 further comprising an elastic element disposed between the two
segments; wherein the elastic element that enhances the clip grabbing strength by keeping the segments apart.
19. The clip of claim 2 wherein one or both segments have a tip that is straight, pointed, round or flat.
20. The clip of claim 2 wherein one or both segments have tips wherein the tips are covered.
21. The clip of claim 1 wherein the clip is adapted for manipulation through an ancillary.
22. The clip of claim 21 wherein the ancillary allows the clip to adopt one or more
configurations as the clip is pushed down by a mobile part of the ancillary.
23. The clip of claim 22 wherein movement of the clip along the length of the ancillary is effected through a button that pushes down the clip.
24. The clip of claim 2 further comprising a space in the body of the clip wherein a hook can be placed through the space to withdraw the clip from a patient's body cavity.
25. The clip of claim 24 wherein the ancillary is separated from clip by releasing the
grabbing element from the clip.
26. A system comprising at least two clips of claim 2 wherein each clip comprises a hole in a segment connecting the first and second segments wherein the two clips can be attached through a flexible string or thread.
27. A system comprising at least three clips of claim 2 wherein each clip comprises a hole in a segment connecting the first and second segments wherein the three clips can be attached through a flexible string or thread to form a Y shape.
28. The system of claim 26 wherein the flexible string is manipulated using a surgical
ancillary comprising a stem having a grabbing element at the end of the stem.
29. The system of claim 28 wherein the grabbing element comprises a hook.
30. The system of claim 28 wherein the grabbing element comprises an atraumatic grasper.
31. The system of claim 26 wherein the string or thread has at least three strands wherein the one of the three strands is a free strand that blocks movement of the string or thread when a mass is suspended through the two clips.
32. The system of claim 26 further comprising a tubular element wherein the thread or string is placed through the tubular element thereby preventing the two clips from collapsing on each other.
33. The system of claim 26 wherein the two clips and string or thread are preassembled in a charging tube having dimensions similar to the dimension of the stem of the ancillary.
34. The system of claim 26 wherein the two clips and string or thread are preassembled in a charging tube having a diameter greater than the diameter of the stem of the ancillary.
35. The system of claim 26 further comprising an element for adjusting the distance
between the two clips.
36. A system comprising one or more clips according to claim 2 wherein the one or more clips are attached to a net.
37. The system of claim 36 wherein the net allows for holding an organ.
38. The system of claim 37 wherein the net is made of transparent biocompatible material.
39. The system of claim 38 wherein the organ is a liver.
40. The system of claim 36 wherein the net is flat.
41. The system of claim 38 wherein the net has reinforced portions.
42. The system of claim 38 wherein the net has openings s where portions of the organ are retained.
43. The system of claim 38 wherein the center of the net forms a cavity for retaining the organ.
44. The system of claim 38 wherein the net has h a triangular geometry.
45. The system of claim 44 wherein the system comprises three clips and wherein each of the three clips is attached to one summit of the triangular net.
46. The system of claim 45 wherein the clips are attached to the net through threads with adjustable distances.
47. The system of claim 36 further comprising a mechanism for automatic deployment of the net.
48. The system of claim 47 wherein the net comprises memory alloy wire.
49. The system of claim 48 wherein the memory alloy wire maintains the net in an open position.
50. A system comprising one clip of claim 2 wherein the clip is attached to a band.
51. A system comprising a plurality of clips according to claim 2 wherein each clip is
attached to a band and wherein the bands can attach to each other to form a net for moving an organ or tissue.
52. The system of claim 51 wherein the net is assembled within a patient's body cavity during minimal invasive surgery
53. . The system of claim 48 further comprising an element for adjusting the distance
between the clip and the band
54. The system of claim 51 wherein two or more bands are attached to each other through mechanical means, magnetic means, and/or a glue.
55. The system of claim 51 wherein two or more bands form a shape suitable for moving an organ or tissue.
56. The system of claim 51 wherein at least two bands are attached to form a longer straight band.
57. The system of claim 51 wherein at least two bands are attached to form a T shape.
58. The system of claim 51 wherein at least two bands are attached to form an L shape.
59. The system of claim 51 wherein at least three bands are attached to form a Y shape.
60. The system of claim 51 wherein the bands are attached to each other through hooks.
61. The clip of claim 14 comprising at the distal ends that form a U-shape a retaining
portion to maintain the branch of the first segment inside the U-shape.
62. The clip of claim 1 comprising at the distal ends that form a U-shape a retaining portion to maintain the branch of the first segment inside the U-shape.
63. A system comprising a clip according to claim 14 and a grasper, wherein the grasper presents specific segments which correspond to the clip to grab it safely longitudinally or transversally; wherein the grasper allows to manipulate the clip.
64. A system comprising a first band made in a material which is elastic in one direction and inelastic on another one; the first band comprising a female portion which is made in the elastic direction wherein small incisions are cut; wherein under traction of the first band, the incisions open to form holes that connect to a second band.
65. The system of claim 64 further comprising a second band made in a material which is elastic in one direction and inelastic on another one; this band is made in the inelastic direction, hooks are attached to this band, which enable the connection with the first band.
66. The clip of claim 1, further comprising one or more claws to fix the clip on a substrate.
67. The clip of claim 1 wherein the clip has a configuration as illustrated in Figures 13 and 14.
PCT/IB2012/002130 2011-09-23 2012-09-21 Clip for organ retraction during minimally invasive surgery WO2013041960A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP12787859.3A EP2757963A1 (en) 2011-09-23 2012-09-21 Clip for organ retraction during minimally invasive surgery
CN201280057673.XA CN104114105B (en) 2011-09-23 2012-09-21 The folder that organ is retracted is carried out during for Minimally Invasive Surgery
US14/346,703 US9974532B2 (en) 2011-09-23 2012-09-21 Clip for organ retraction during minimally invasive surgery

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201161538677P 2011-09-23 2011-09-23
US61/538,677 2011-09-23

Publications (1)

Publication Number Publication Date
WO2013041960A1 true WO2013041960A1 (en) 2013-03-28

Family

ID=47192013

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2012/002130 WO2013041960A1 (en) 2011-09-23 2012-09-21 Clip for organ retraction during minimally invasive surgery

Country Status (4)

Country Link
US (1) US9974532B2 (en)
EP (1) EP2757963A1 (en)
CN (1) CN104114105B (en)
WO (1) WO2013041960A1 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018027113A1 (en) * 2016-08-05 2018-02-08 Boston Scientific Scimed, Inc. Systems, devices, and related methods for retracting tissue
US9974532B2 (en) 2011-09-23 2018-05-22 Surgical Perspective Sas Clip for organ retraction during minimally invasive surgery
WO2018175313A1 (en) * 2017-03-20 2018-09-27 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
WO2019070606A1 (en) * 2017-10-02 2019-04-11 Boston Scientific Scimed, Inc. Devices and methods for tissue retraction
WO2020232059A1 (en) * 2019-05-16 2020-11-19 Boston Scientific Scimed, Inc. Tissue traction bands and methods for tissue traction
US11737762B2 (en) 2018-10-31 2023-08-29 Boston Scientific Scimed, Inc. Clip devices, systems, and methods for engaging tissue
US11980355B2 (en) 2020-05-13 2024-05-14 Boston Scientific Scimed, Inc. Tissue traction bands and methods for tissue traction

Families Citing this family (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR101082762B1 (en) * 2011-02-18 2011-11-10 이정삼 Retractor system for laparoscopic surgery
CN103533900B (en) 2011-03-31 2016-12-28 佛尔蒙特·伊夫斯 The inter-tissue bridge of adjustment power
BR112014009112B1 (en) 2011-10-20 2021-06-01 Emrge, Llc. REMOVABLE COVER FOR PURPOSE
JP6649830B2 (en) * 2016-03-29 2020-02-19 小林　真 Endoscope treatment tool
SG11201809302TA (en) 2016-05-03 2018-11-29 Livac IP Co Pty Ltd Hook and fenestration retractor
CA3037999A1 (en) 2016-10-21 2018-04-26 Emrge, Llc Force modulating tissue bridges, associated tools, kits, and methods
USD876641S1 (en) 2017-10-20 2020-02-25 Emrge, Llc. Medical article for treating a wound and/or scar tissue
EP3764918B1 (en) 2018-03-14 2023-08-23 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
CN112055565A (en) 2018-05-01 2020-12-08 波士顿科学国际有限公司 Tissue retraction device and delivery system
TWI725517B (en) * 2018-09-24 2021-04-21 瑞士商瑞健醫療股份有限公司 Needle shield remover and medicament delivery device including the same
US11497526B2 (en) 2018-11-13 2022-11-15 T & J Enterprises, Llc Cervical tenaculum device
US11166710B2 (en) 2019-03-19 2021-11-09 Boehringer Technologies, Lp Intra-abdominal liver retraction device and method of use
US11246580B2 (en) 2019-04-30 2022-02-15 Boehringer Technologies, Lp Cantilever liver retraction devices and methods of use
WO2020232054A1 (en) 2019-05-14 2020-11-19 Boston Scientific Scimed, Inc. Tissue clip devices and systems
CA3129902C (en) * 2019-05-28 2024-02-13 Boston Scientific Scimed, Inc. Hemostasis clip deployment
CA3153899A1 (en) 2019-10-11 2021-04-15 Felmont F. Eaves Medical device for applying force on biological tissue, or the like
USD980434S1 (en) 2021-01-14 2023-03-07 Emrge, Llc Medical article for treating a wound and/or scar tissue

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB190513512A (en) * 1905-07-01 1906-04-19 John Ambrose Helliwell Improvements in or connected with Loom Picking Bands.
WO2003096907A1 (en) * 2002-05-17 2003-11-27 Tyco Healthcare Group, Lp Endoscopic organ retraction system and method of using the same
WO2010042844A2 (en) * 2008-10-10 2010-04-15 Surgiquest, Incorporated Internal retraction systems and devices
WO2010099327A1 (en) * 2009-02-25 2010-09-02 Scott J Stephen Apparatus and method for intra-abdominally moving a first internal organ to a position away from a second internal organ and then holding the first internal organ in the position without manual input
DE102009014292B3 (en) * 2009-03-25 2010-12-02 Eva Ryssel Device for receiving small textiles, has flat elastic body, holes or slots in pairs, where small textiles are threaded in holes or slots
EP2283778A2 (en) * 2009-08-13 2011-02-16 National Cancer Center Surgical retractor

Family Cites Families (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19809121C1 (en) * 1998-03-04 1999-08-12 Aesculap Ag & Co Kg Organ clip for aneurysm
US20040254427A1 (en) * 2003-06-16 2004-12-16 Lone Star Medical Products, Inc. Surgical stay-grip assembly and method of using same
US7520884B2 (en) * 2004-05-07 2009-04-21 Usgi Medical Inc. Methods for performing gastroplasty
MX2008011789A (en) * 2006-03-13 2009-01-22 Minilap Technologies Inc Minimally invasive surgical assembly and methods.
US7766937B2 (en) * 2006-03-13 2010-08-03 Mini-Lap Technologies, Inc. Minimally invasive surgical assembly and methods
US8133255B2 (en) * 2006-03-13 2012-03-13 Mini-Lap Technologies, Inc. Minimally invasive surgical assembly and methods
WO2010042884A2 (en) 2008-10-10 2010-04-15 Internet Services, Llc Haptic otuput device for use with haptic encoded media
KR101082762B1 (en) * 2011-02-18 2011-11-10 이정삼 Retractor system for laparoscopic surgery
DE102011001798A1 (en) * 2011-04-05 2012-10-11 Aesculap Ag Surgical clip
RU2585730C2 (en) * 2011-06-28 2016-06-10 Новатракт Серджикал, Инк. Assembly of retractor tissues
WO2013041960A1 (en) 2011-09-23 2013-03-28 Surgical Perspectives Sas Clip for organ retraction during minimally invasive surgery

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB190513512A (en) * 1905-07-01 1906-04-19 John Ambrose Helliwell Improvements in or connected with Loom Picking Bands.
WO2003096907A1 (en) * 2002-05-17 2003-11-27 Tyco Healthcare Group, Lp Endoscopic organ retraction system and method of using the same
WO2010042844A2 (en) * 2008-10-10 2010-04-15 Surgiquest, Incorporated Internal retraction systems and devices
WO2010099327A1 (en) * 2009-02-25 2010-09-02 Scott J Stephen Apparatus and method for intra-abdominally moving a first internal organ to a position away from a second internal organ and then holding the first internal organ in the position without manual input
DE102009014292B3 (en) * 2009-03-25 2010-12-02 Eva Ryssel Device for receiving small textiles, has flat elastic body, holes or slots in pairs, where small textiles are threaded in holes or slots
EP2283778A2 (en) * 2009-08-13 2011-02-16 National Cancer Center Surgical retractor

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9974532B2 (en) 2011-09-23 2018-05-22 Surgical Perspective Sas Clip for organ retraction during minimally invasive surgery
US10973506B2 (en) 2016-08-05 2021-04-13 Boston Scientific Scimed, Inc. Systems, devices, and related methods for retracting tissue
EP4233734A3 (en) * 2016-08-05 2023-09-13 Boston Scientific Scimed, Inc. Systems, devices, and related methods for retracting tissue
WO2018027113A1 (en) * 2016-08-05 2018-02-08 Boston Scientific Scimed, Inc. Systems, devices, and related methods for retracting tissue
US11109850B2 (en) 2017-03-20 2021-09-07 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
AU2018237049B2 (en) * 2017-03-20 2020-02-27 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
CN110430822A (en) * 2017-03-20 2019-11-08 波士顿科学国际有限公司 Tissue retraction device and transportation system
EP3932326A1 (en) * 2017-03-20 2022-01-05 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
WO2018175313A1 (en) * 2017-03-20 2018-09-27 Boston Scientific Scimed, Inc. Tissue retraction device and delivery system
CN110430822B (en) * 2017-03-20 2023-10-17 波士顿科学国际有限公司 Tissue retraction device and delivery system
WO2019070606A1 (en) * 2017-10-02 2019-04-11 Boston Scientific Scimed, Inc. Devices and methods for tissue retraction
JP2022009736A (en) * 2017-10-02 2022-01-14 ボストン サイエンティフィック サイムド，インコーポレイテッド Devices and methods for tissue retraction
JP7315638B2 (en) 2017-10-02 2023-07-26 ボストン サイエンティフィック サイムド，インコーポレイテッド Apparatus and method for retracting tissue
US11737762B2 (en) 2018-10-31 2023-08-29 Boston Scientific Scimed, Inc. Clip devices, systems, and methods for engaging tissue
WO2020232059A1 (en) * 2019-05-16 2020-11-19 Boston Scientific Scimed, Inc. Tissue traction bands and methods for tissue traction
CN113853166A (en) * 2019-05-16 2021-12-28 波士顿科学国际有限公司 Tissue traction band
US11980355B2 (en) 2020-05-13 2024-05-14 Boston Scientific Scimed, Inc. Tissue traction bands and methods for tissue traction

Also Published As

Publication number Publication date
US20140235936A1 (en) 2014-08-21
US9974532B2 (en) 2018-05-22
CN104114105B (en) 2017-06-30
EP2757963A1 (en) 2014-07-30
CN104114105A (en) 2014-10-22

Similar Documents

Publication Publication Date Title
US9974532B2 (en) Clip for organ retraction during minimally invasive surgery
CA2586699C (en) Remote tissue retraction device
CN106535781B (en) Method and apparatus for controlling the size of emphysema bullae
US10045842B2 (en) Systems, implants, tools, and methods for treatments of pelvic conditions
US8777849B2 (en) Expandable thoracic access port
ES2264172T3 (en) SYSTEMS AND INSTRUMENTS FOR MINIMUM ACCESS SURGERY.
CN109953800A (en) A kind of chute-type multi-arm folder
BRPI0621629A2 (en) Devices and methods for placing partitions in a hollow body organ
JP2011524753A (en) Endoscopic mesh delivery system having a mesh stabilizer and a vaginal probe integrally
JP2005103304A (en) Single lumen anastomosis applier for self-deploying fastener
BRPI0405024B1 (en) ANASTOMOTIC DEVICE
EP3777650A1 (en) Endoluminal surgery system
CN108882927A (en) Surgery pull device and operation
EP2391287B1 (en) Laparoscopic tool for a laparoscopic surgery
JP2022062923A (en) Endoscope traction clip, endoscope treatment instrument, and method of manufacturing endoscope traction clip
KR20230058497A (en) Grappling systems and methods for lumen apposition or wound defects

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 12787859

Country of ref document: EP

Kind code of ref document: A1

WWE Wipo information: entry into national phase

Ref document number: 14346703

Country of ref document: US

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 2012787859

Country of ref document: EP