CA1261705A - Apparatus for applying surgical clips - Google Patents

Apparatus for applying surgical clips

Info

Publication number
CA1261705A
CA1261705A CA000485731A CA485731A CA1261705A CA 1261705 A CA1261705 A CA 1261705A CA 000485731 A CA000485731 A CA 000485731A CA 485731 A CA485731 A CA 485731A CA 1261705 A CA1261705 A CA 1261705A
Authority
CA
Canada
Prior art keywords
clip
distal
closing means
proximal
jaws
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000485731A
Other languages
French (fr)
Inventor
David T. Green
Richard A. Mcgarry
Graham Smith
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.)
United States Surgical Corp
Original Assignee
United States Surgical Corp
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 United States Surgical Corp filed Critical United States Surgical Corp
Application granted granted Critical
Publication of CA1261705A publication Critical patent/CA1261705A/en
Expired legal-status Critical Current

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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 Surgical clip applying apparatus in which clips are delivered to a pair of jaws one at a time for closure around body tissue. The squeezing to-gether of a pair of ring handles causes the jaws to move distally relative to the apparatus. The jaws contact a pair of inclined surfaces on the shaft of the apparatus and are thereby forced together, causing the distal-most clip in a linear array to be closed around body tissue. Release of the handles returns the jaws to the original positions so that another clip closing cycle can be initiated. An escapement mechanism interacts with the jaws to ensure that only one clip at a time from the linear array is delivered to the jaws. A clutch assembly ensures that each step in the clip closing and return cycle is completed in the proper sequence.

Description

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This invention relates to apparat~ls for applying surgical clips, especially hemostatic clips, to body tissue such as blood vessels. More particularly, the invention relates to apparatus having a reduced number oE
movable parts and which is suitable for one-handed operation to apply a plurality of clips in succession.
Surgical clip appliers typically have a pair of laterally spaced, relatively movable jaws for receiving a clip to be applied to body tissue. When clips must be inserted singly within the jaws, repeated loading may be fatiguing to the surgeon. Consequently, it has been preferred to supply a plurality of clips with the clip applier. The provision of a supply of Clip5 for repeated application by the apparatus has typically required colnplex clip storage and feed mechanisms, which can be bulky and obscure the surgeon's view of the jaws as they are placed in position to apply clips to body tissue.
After the jaws receive a clip, the jaws are brought together to close the clip around the tissue. The most cumbersome and unreliable method for bringing -the jaws together is the use of direct manual pressure. The surgeon's hand may limit the view of the clip application site and can make the application of a clip difficult in confined working areas of the body. In other methods, the 2S jaws are cammed together by interaction with a shaft or sleeve, usually in association with actuators and complex linkages~
Accordingly, one object of this invention is to improve and simplify surgical clip applying apparatus.
3~ A more particular object of this invention is to provide surgical clip applying apparatus with a reduced number of relatively movable elements for advancing and closing surgical clips.
A further object of this invention is ~o provide a simplified structure for regulating the sequential delivery of clips to the clip closing jaws oE the apparatus.

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~ ccordingly, -the invention provides apparatus for applying surgical clips one at a time to body tissue, each clip having two legs joined together at a crown, said apparatus comprising: (a) a proximal portion, (b) a distal portion having stationary camming surfaces, (c) means for holding an array of surgical clips, the array having a distal end and a proximal end, (d) clip closing means for moving between distal and proximal positions and having at the distal end jaw means for (i) receiving the distal-most clip in the array and (ii) then moving towards the distal portion of the apparatus so that the jaw means contact the camming surfaces and close the clip around the body tissue; and (e) escapement means for (i) placing the distal-most clip of the array in the jaw means when the . clip closing means has moved to the proximal position, which is towards the proximal portion o the apparatus, and (ii) preventing any of the other clips in the array from being placed in the jaw means at the same time, wherein the escapement means comprises three pairs of opposing projecting surfaces, which pairs point towards the plane of motion of the clip closing means and are spaced from one another in the longitudinal direction along the apparatus, the proximal-most pair of projecting surfaces e~tending beyond the middle pair of projecting surfaces in both the lateral and longitudinal directions, the escapement means being held stationary at its proximal end, the rest of the escapement means being able to move toward and away from the plane of motion of the clip closing means and being biased towards the plane, and the proximal-most pair of projecting surfaces resting against the clip closing means when those means are in the proximal position so that the middle and distal-most pair of projecting surfaces are out of -the plane of motion of the clip closing means.
Thusl the invention provides a clip closing element associated directly with a pair of actuating handles for longitudinal reciprocal motion relative to the clip applier. All other elements are fixed 2a ~ 7~i~
longitudinally. The clip closing element terminates in a pair of jaws which function both to close clips and to assist in the control of the feeding of clips.
The distal-most clip in a linear array of clips is pre-positioned within the jaws. Squee~ing the pair of actuating handles toge-ther directly causes distal, longitudinal motion of the clip closing means without the need for complex linkages. The jaws contact a pair of laterally spaced cam surface portions of a fixed shaft which are inclined toward one another in the dis-tal direction. The cam surface portions force the jaws toward each other to close the distal-most clip around body tissue.
The release of the actuating handles causes longitudinal motion of the jaws in the proximal direction.
During this return stroke, the jaws contact an escapement mechanism in the plane of the clip array. The jaws urge the escapement out of the plane of the clips to permit the next clip in the array to enter the jaws. During the ensuing forward stroke, the distal motion of the jaws releases the escapement so that it can return to the plane of the clip array and block the distal motion of the remaining clips in the array.
The two-stage cycle can be repeated until the supply of clips is exhausted. The simple design of the apparatus facilitates its one-handed operation, improves access to and visibility of the clip application site, and economically permits the apparatus to be made disposable.
The invention will become more apparent from the following detailed description of emboaiments of the invention with reference to the accompanying drawings, in which:

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Figure 1, which appears on the same sheet as Figures 11 and 12, is a perspective view o4 the top of a clip applier.
Figure 2, which appears on the same sheet as Figures 6 and 10, is a perspective view of ~he botto~. o4 the clip applier.
Yigures 3 throush 5 are increasingly exploded perspective views of the clip applier~
Figure 6 is a cross-section taken along line 6-5 of Figure 1.
Figure 7 is a longitudinal section tal~en along line ~-~ of Figure 1.
Figure 8 is a longitudinal section ta~en along line 8-8 of Figure 7.
Figure 9, which appears or. the sam~e sheet as Figure 3, is a per~spective view of an escapement mechanism and the surrounding portion of the clip applier.
Figure 10 is a split plan view of part of the clip applier with a portion of the bottom track surface cut away. The top portion of Figure 10 shows a portion of the clip closing means with one attached jaw. The bottom portion of Figure 10 shows a portion of the escapement mechanism.
Figure 11 is a cross-section taken along line 11-11 of Flgure 8 with the escapement mechanism cammed out of the plane of an array of clips by a pair of jaws.
Figure 12 is a view similar to Figure 11 except that distal motion of the jaws has per~itted the escapement mechanism to move into the plane of the array 3~ of clips.
Figure 13, which appears on the same sheet as Figure 5, is a perspective view of a surgical clip for use with the clip applier of Figure 1.
Figure 14 is an enlarged view of a portion of the apparatus shown in Figure ~. T~.e clip applier is shown at the initial position o. the clip closins cycle.
Figure 15 is a view si~ilar to Figure 14 except that a first intermediate clip position is shown.

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Figure 16 i8 a view similar to Figu-e 14 except that a second intermediate c'ip position is shown.
Figure 1~ is a view similar to Figure 14 except that a third intermediate clip position is shown.
Figure 18 is a view similar to Figure 14 except that the peak clip closing position is shown.
Figure 19 is a view similar to Figure 14 except that retraction from the pea~ clip clo5i~.g ~ z~
position to nearly the initial position of the clip closing cycle is shown.
Figure 20 is an enlarged view of a portion of the apparatus shown in Figure 8. The clip applier is shown at the initial position of the clip closing cycle.
Figure 21 is a view similar to Figure 20 except that a first intermediate clip position is shown.
Figure 22 is a view similar to Figure 20 except that a second intermediate clip position is shown.
Figure 23 is a view similar to Figure 20 except that a third interediate clip position is shown.
Figure 24 is a view similar to Figure 20 except that a fourth intermediate clip position is shown.
Figure 25 is a view similar to Figure 20 except that retraction from the peak clip closing position to nearly the initial position of the clip closing cycle is shown.
Figure 26 is an exploded perspective view of the clip applier showing a clutch assembly.
Figure 27 is a longitudinal section taken along line 27-27 of Figure 26.
Figure 28 is an enlarged plan view of the clutch assembly in its initial position.
Figure 29 is a view similar to Figure 28 except that the clutch assembly is shown in a irst intermediate distal position.
Figure 30 is a view similar to Figure 28 except that the clutch assembly is shown in a second intermediate distal position.
Figure 31 is a view similar to Figure 28 except that the clutch assembly is shown approaching "' - . .
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6 ~ 5 the peak distal position and then in phantom i5 shown in an intermediate proximal position.
Although this invention is also applicable to other embodiments, such as surgical clip appliers which are permanent and can be reused by inserting additional clips after the initial supply is exhausted, the invention will be fully understood from an explanation of its application to clip appliers which are totally disposable after the initial supply of clips is exhausted.
Figures 1 and 2 show clip applier 10, which includes a longitudinal shaft 20 having a distal wrap portion 22. Wrap portion 22 has a slot 24 for admitting the body tissue to be clipped. The body tissue will most frequently be a tubular structure such as blood vessel 180. Wrap portion 22 also has a pair of wrap plates 36, which define a passage bordered by cam surfaces 28 (see Figure 10). Ends 26 of wrap portion 22 may be flared to assist the surgeon in guiding tubular structure 180 into slot 24. Longitudinal shaft 20 is provided with ramp 34 for a purpose to be described below.
Longitudinal shaft 20 is operatively associated with track 40. Referring also to Figure 9, track 40 is provided with a plurality of pairs of notches 42 and longitudinal shaft 20 is provided with a plurality of pairs of tabs 30 which are bent to fit into the plurality of notches 42 to secure longitudinal shaft 20 to track 40.
The distal portion of track 40 contains opening 50 to receive and retain escapement mechanism 70, which will be described in detail below. The proximal portion of track 40 receives track insert 46.

~ t7 Longitudinal shaft 20 and track 40 are inserted and retained within the distal portions of top body part 160 and bottom body part 162. A pair of ring handles 140 are inserted and retained within the proximal portions of body parts 160 and 162.
As shown in Figure 3, body parts 160 and 162 are each provided in their proximal portions with an aperture 166. Rivet 168 is passed through apertures 166 to help hold together the proximal portions of body parts 160 and 162. Projections 164 of body part 160 are inserted in apertures 165 of body part 162. Conventional means, such as an adhe-sive, are applied to hold together the other abutting surfaces of body parts 160 and 162.
Figure 4 shows a number of the elements retained within the assembly of longitudinal shaft 20 and track 40. The proximal end of track 40 has an opening 52 with a distally projecting prong 54, which is fitted into the proximal end of compressible spring 56 ~see also Figure 7). The distal end of spring 56 is fitted into the proximal end 60 of clip follower 58. This distal end of spring 56 and clip follower 58 reciprocate within longitudinal channel 47 on the underside of track 40 ~shown in Figure 8).
Distal surface 62 of clip follower 58 contacts the rearmost clip 90 in a linear array.
Linear clip array 90 is confined within track 40 and clip cover 80. The distal end of clip cover 80 terminates in a pair of tines 82. Prong 64 projecting downwardly from track 40 fits into notch 84 in clip cover 80. This connection renders clip cover 80 stationary with respect to track 40. Prong 64 also contacts the forward end of channel 112 of clip closing means 100 (shown in Figure 5) to stop rearward motion of clip closing means 100. Cut-out 86 in the proximal portion of clip cover 80 provides clearance for the motion of the clutch assembly to be described below.

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During assembly of the clip applier, clips 90, clip follower 58, and spring 56 are inserted through an opening created by removal of track insert 46.
One end of spring 56 is fitted to prong 54 at track opening 52. Track insert 46 is then re-attached to track 40 by conventional means (e.g., snap fit).
Track 40 has two rearwardly-projecting prongs 66, which fit within a recess (not shown in Figure 4) on the underside of body part 162.
Figure 5 shows the remaining elements re-tained within the assembly of longitudinal shaft 20 and track 40. Clip closing means 100 comprises mem-ber 101 and two laterally spaced arms 102 extending from member 101. Each arm 102 terminates in a jaw 103.
Clip stop 110 also extends from member 101 and is located between arms 102.
Clip cover 80 lies between arms 102 of clip closing means 100 and the array of clips 90 (also see Figure 6). However, jaws 103 on arms 102 extend beneath the plane of the tines 82 of clip cover 80 to contact distal-most clip 90a (shown in Figure 11). Tines 82 assist the entry of a clip into the jaws 103.
A pair of oppositely spaced projecting surfaces 104 aid in fitting clip closing means 100 within lon~itudinal shaft 20 and track 40 and enable clip closing means 100 to be narrower throughout most of its length than if projecting surfaces 104 were not used. A similar function is performed by oppositely spaced projecting surfaces 88 on clip cover 80.
The rear portion of clip closing means 100 contains openings 112 and 114. Opening 112 accom-modates clutch spring 130. Opening 114 has opposing prongs 116 and 118 onto which spring 120 is positioned.
Forward end 122 of spring 120 is in constant contact with the rear surface 44 of track 40 (see Figure 3).

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The rear portion of longitudinal shaft 20 has a fit element 32 for insertion into body part 160.
Body part 160 has projection 170, which is parallel to spaced projections 170a and 170b. Projections 170 and 170a,b define the sides of trough bed 172. Slots 174 are located between projection 170 and side wall 176 on one side and between projections 170a,b and side wall 176 on the other. Fit element 32 fits into trough bed 172, is confined by rear wall 178 of body part 160, and extends into the rear portions of slots 174.
Body part 160 includes a pair of projec-tions 164 for retaining ring handles 140. Each ring handle 140 has a finger ring 142 and a shank 144.
Shank 144 terminates in knob 150, which has an aperture 152. Each ring handle 140 is fitted to body part 160 by placing each aperture 152 onto its respective projection 164.
Each shank 144 also has a slot 146. When ring handles 140 are fitted to body part 160, slots 146 will partially overlap. Different portions of slots 146 will overlap throughout the clip applica-tion cycle, during which ring handles 140 are squeezed toward each other and then are returned to their original separated position.
Recess 124 is provided in the rearmost part of clip closing means 100. Recess 124 lies between slots 146 of ring handles 140, and pin 148 passes through the slots and the recess, thereby providing a direct linkage between ring handles 140 and clip closing means 100.
The assembly of the complete clip applier may b~ summarized as follows. Referring to Figures 1-8, clip closing means 100 is placed within longi-tudinal shaft 20. Clip cover 80 is attached to track 40 and then is placed atop clip closing means 100 so that proximal surface 44 of track 40 contacts, but does not compress, spring 120 of clip closing means 100. Track 40 and longitudinal shaft 20 are attached to each other by fitting tabs 30 into slots 42. This creates a subassembly of longi-tudinal shaft 20, clip closing means 100, clip cover 80, and track 40, of which only clip closing means 100 is movable longitudinally.
Clip closing means 100 and ring handles 140 are then linked by pin 148. Apertures 152 of ring handles 140 and fit element 32 of longitudinal shaft 20 are then fitted into projections 164 and trough bed 172, respectively, of top body part 160. Bottom body part 162 is attached by passing projections 164 through apertures 165 and placing prongs 66 of track 40 within the recess of bottom body part 162. Top and bottom body parts 160 and 162 are then connected by passing rivet 168 through apertures 166. Track insert 46 is removed from track 40 to enable clips 90, clip follower 58, and spring 56 to be inserted.
Track insert 46 is then repositioned to complete the assembly.
The clip applier as shown in the drawings is substantially planar. However, in one embodiment of the invention (not shown in the drawings), the distal portion of the clip applier has an arcuate shape (that is, the left end of the device in ~igure 1 is curved downward) to provide better visibility of the operative site for the surgeon during the appli-cation of clips. In the preferred embodiment, the distal portion of longitudinal shaft 20 is permanently arced, and clip closing means 100, clip cover 80, and track 40 are produced as substantially planar elements, but are sufficiently flexible to conform to the arcuate shape of shaft 20. Preferably, longi-tudinal shaft 20, clip closing means 100, and clip cover 80 are made of stainless steel, and the track 40 is made of plastic ~e.g., LEXAN~ polycarbonate resin).

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In another preferred embodiment of this invention (not shown in the drawings), a method for indicating the number of clips remaining in the clip applier is provided. Track 40 is transparent plastic and has numbered lines corresponding to the positions of clips 90 in the linear array. A colored dot is placed on the surface of clip follower 58 behind the proximal-most clip in the linear array. The surgeon observes the colored dot in alignment with a numbered line and thereby ascertains the number of clips re-maining in the clip applier. The disposable clip applier is discarded when no clips remain.
Figure 9 shows escapement 70 and opening 50 in the distal portion of trac~ 40 which receives escapement 70. Escapement 70 is preferably made of stainless steel and includes three pairs of oppositely spaced projecting surfaces which extend outward and then downward from the axis of the escapement 70.
Each of the forwardmost pair of projections 72 has a finger 73, which projects outwardly from the vertical portion of the projecting surface. The rearmost pair of projections 76 extends beyond the middle pair of projections 74 in both the lateral an~l longi-tudinal directions. In the assembled clip applier, a lift spring 78 is proximal to the three pairs of projecting surfaces and also extends downwardly.
r~ift spring 78 has a tab 78a. The rear portions of escapement 70 and lift spring 78 have ears 79a and 79b, respectively, both of which extend to seat in recess 68 of track 40, thereby positioning escape-ment 70 in track 40 (see also Figure 20).
Figures 8, 10, and 11 show the relative positions of escapement 70, jaws 103, and clip cover tines 82 prior to the squeezing together of ring handles 140. Jaws 103 are in a different plane than escapement 70. As described below, during operation each jaw 103 contacts apex 77 of one of the rearmost :

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pair of projecting surfaces 76 of escapement 70 and cams surface 76 in the direction of track 40 and out of the plane of clip array 90.
Figure lO also shows certain features of the distal wrap portion 22 of longitudinal shaft 20.
Two wrap plates 36 project inwardly from opposing bottom surfaces of wrap portion 22 (see also Figure 4).
The space between wrap plates 36 and the remainder of wrap portion 22 defines a passage for distal motion of jaws 103. The sides of this passage comprise two laterally spaced cam surfaces 28 which are inclined toward one another in the distal direction. Distal motion of jaws 103 between wrap portion 22 and wrap plates 36 causes them to contact and traverse cam surfaces 28 so that the jaws 103 are forced toward each other to close clip 90 held in the jaws 103.
At all times, jaws 103 are confined between wrap portion 22 and wrap plates 36. Thus, jaws 103 can travel only longitudinally within the defined passage.
The distal ends of wrap portion 22 -termi-nate in flared surfaces 26 to provide a wider entry area in slot 24 for admitting the tubular structure 180 (see Figure 1~. That allows for better control of where the clip will be applied. The surgeon first places the walls of slot 24 around tubular structure 180 to provide an approximate positioning. The squeez-ing of ring handles 140 then automatically moves jaws 103 and distal most clip 90 forward, precisely around tubular structure 180. Thus, there is no need for the surgeon to perform this precise posi-tioning manually. This results in greater speed and accuracy of clip application.
Figure 11 shows a cross-section of clip applier 10 prior to the squeezing together of ring handles 140. Escapement 70 is shown cammed down, out of the plane of clips 90, by jaws 103. Distal-most clip 90 is separa-ted by clip cover tines 82 ~2~

from arms 102. However, jaws 103 extend downwardly from arms 102 to contact clip 90. Step 106 on each jaw 103, together with the respective arm 102, define groove 108 that supports one of the clip legs 94.
In Figure 12, ring handles 140 have been squeezed. Jaws 103 have moved distally carrying clip 90 forward and no longer are in contact with apexes 77 of projections 76. This enables escap-ement 70 to move up into the plane of the array of clips 90 and thus to block distal motion by all the clips behind the forwardmost one.
Figure 13 illustrates a clip that may be used with clip applier lO. Clip 90 is preferably made of metal, such as stainless steel, althou~h the use of plastics or other polymers is possible. Clip 90 has a crown 92 and two legs 94. Crown 92 is that part of clip 90 that is farthest from the ends of clip legs 94. Legs 94 are bent inward to aid in stacking clips in a linear array and to ensure safe closure around a tubular structure. Each clip in the array is in contact with the immediately adjacent clips in the array, with the ends of legs 94 of each clip touching the mid-region of the legs of the clip just ahead of it. The inner surfaces of clips 90 have grooves 96 to assist the clips in gripping body tissue during closure of the clips. The front inner surfaces 98 of clip legs 94 are rounded for safety.
The wire used for clips 90 is of generally rectan-gular cross-section, although different cross-sections may be used as long as they enable the clips to be advanced and closed properly. Various other clip features known to those skilled in the art may be added provided they do not impair operation of the clip appliers of this invention. For example, the clip crown may be curved instead of angular.
The operation of clip applier 10 in carry-ing out a complete clip closing and return stroke - ~2~ 7~3 cycle will now be described with reference to Fig-ures 14-25. Figures 14 and 20 are different views showing the position of the distal end of the clip applier prior to the squeezing together of the ring handles 140. The clip applier is positioned so that tubular structure 180 is within slot 24 of wrap sec-tion 22 of longitudinal shaft 20. In the embodiment shown, the clip applier is supplied to the surgeon with the distal-most clip 90a pre-positioned within jaws 103 ready to be closed around tubular structure 180. Alternatively, the surgeon may squeeze and release ring handles 140 to position distal-most clip 90 within jaws 103.
Each jaw 103 is in contact with an apex 77 of the respective rearmost pair of projecting sur-faces 76 of escapement 70. In this position, sur-faces 76 have been cammed by jaws 103 downward in Figure 20 so that the forwardmost and middle pairs of projecting surfaces 72 and 74 are out of the plane of the linear array of clips 90.
In Figure 21, the squeezing of the ring handles has begun. The squeezing together of ring handles 140 causes pin 148 (see Figure 8) to move forward. Because pin 148 is linked directly to clip closing means 100 at recess 124, squeezing of ring handles 140 also causes clip closing means 100 to move forward with respect to longitudinal shaft 20, track 40, and clip cover 80. In Figure 21, clip closing means 100 has moved sufficiently in the dis-tal direction so that jaws 103 are no longer in con-tact with the apexes 77 of projections 76. As a result, escapement 70 has begun to move up into the plane of clip array 90.
In Figure 15, clip closing means lO0 has continued to move in the distal direction so that forwardmost and middle pairs of projections 72 and 74 have moved into the plane of clip array 90. Por-tions of legs 94 of clip 90b are then confined be-tween pairs of projections 72 and 74 and maintained in the plane of clips 90 by fingers 73 on projec-tions 72. This blocks further distal motion of the remaining clips in the linear array and ensures that only one clip at a time can enter jaws 103. This also prevents distal motion by spring 56 and clip follower 58.
In Figure 22, there has been a small amount of additional distal motion by the jaws. Distal-most clip 90a no longer contacts clip 90b.
In Figure 23, jaws 103 and distal-most clip 90a have begun to surround tubular structure 180.
J~ws 103 are not yet in contact with cam surfaces 28 of longitudinal shaft 20.
In Figure 16, jaws 103 have just started to contact cam surfaces 28. Jaws 103 and distal-most clip 90a now surround tubular structure 180.
In Figures 17 and 24, jaws 103 are being forced toward each other as they move along cam sur-faces 28. This causes distal most clip 90a to close around tubular structure 180. The tips of the clip legs are brought together before other portions of the clip to trap tubular structure 180 within clip 90a.
The distal motion of jaws 103 tends to force tubular structure 180 towards clip crown 92 and away from the tips of clip legs 94. This action, along with the use of rounded front inner surfaces 98 of clip legs 94, ensures that the tissue is fully engaged by the clip legs, as is intended. Clip stop 110 prevents any significant proximal motion of clip 90a and thus serves to ensure that clip 90a will be confined within jaws 103 so that it may be closed. Clip stop 110 moves toward the plane of clips as it moves distally.
Bevelled block 43 of track 40 (see Figure 9~ maintains clip stop 110 in the plane of clips. Ramp 34 of -76?~

longitudinal shaft 20 provides clearance for clip stop 110 when clip closing means 100 is in the proxi~
mal portion of its receiprocal longitudinal motion.
Figure 18 shows the apparatus at the end of the clip closing stroke, that is, when the ring handles are squeezed together most completely. Clip closing means 100 is at its distal-most position and jaws 103 are nearest to each other. This causes clip 90a to close completely around tubular struc-ture 180. Jaws 103 protrude slightly beyond the distal end of longitudinal shaft 20. Thus, except for when the tips of the jaws 103 are at the end of the clip closing stroke, jaws 103 are retained within wrap plates 36 of the clip applier at all times.
This protects the jaws against damage. Although not shown in Figure 18, flaring 26 could extend suffi-ciently so that jaws 102 did not protrude beyond the distal end of longitudinal shaft 20 at any time.
Throughout the squeezing of the ring han-dles 140 during the clip closing stroke, clip closing means 100 carries with it spring 120. Distal end 122 of spring 120 contacts stationary rear surface 44 of track 40, causing spring 120 to be compressed. When the clip-closing stroke is completed, the surgeon stops squeezing together ring handles 140. Com-pressed spring 120 then tends to expand, thereby causing clip closing means 100 to move back to its original position, which in turn moves ring handles 140 apart through the linkage of pin 148.
Figures 19 and 25 are different views show-ing the condition of the apparatus when the return stroke is nearly complete. Jaws 103 move proximally and thus separate when they re-traverse the cam sur-faces 28 in the proximal direction. Closed clip 90a slides out of the retreating jaws, a motion assisted by bevels 105 on the front inner surfaces of jaws 103 which cam proximally over the closed clip. Bevels 105 , `'' ' '' '~ `

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thus ensure that the closed clip does not become snagged on jaws 103.
As clip closing means lO0 continues to move proximally, jaws 103 once more contact the apexes 77 of rearmost projections 76 of escapement 70.
Jaws 103 cam escapement 70 down, out of the plane of the array of clips 90, so that projections 72 and 74 no longer confine clip 90b. Lift spring 78 lifts clip 90b so that it clears steps 106 and enters grooves 108 of jaws 103. Clip stop llO moves proxi-mally and contacts clip 90b. Lift spring tab 78a acts as a stop to prevent rearward motion of clip 90b when clip stop 110 passes over clip 90b as it con-tinues to move proximally.
Spring 56 expands, causing clip follower 58 and clip array 90 to move distally until the appara-tus reaches the condition shown in Figures l9 and 25. Continued rearward motion of means lO0 will move clip 90b fully within jaws 103 where it is re-tained by jaw grooves 108 (comparable to the initial position of clip 90a as shown in Figures 14 and 20).
Clip applier 10 may now be withdrawn from tubular structure 180, which has been closed by com-pressed distal-most clip 90a. Cllp applier lO is then ready to be used to apply the next clip 90b to another tubular structure. This procedure can be repeated until the supply of clips has been exhausted.
In a preferred embodiment of this invention, a clutch assembly is used to ensure that each step in the clip closing and return cycle is completed before the next step is begun. Figures 26 and 27 illustrate the structure of the clutch assembly.
This clutch may be used in any type of surgical device that applies surgical fasteners (e.g., sur-gical clips, surgical staples).
The clutch assembly includes clutch leaf spring 130, which lies partially within opening 112 in clip closing means 100. Clutch spring 130 is a resilient, substantially incompressible member and may be made of spring steel or any other material suitable for springs. The distal end 131 of clutch spring 130 is attached to projection 134 on clip closing means 100. The proximal end of clutch spring 130 includes clutch prong 132 with spur 133.
One end of clutch prong 132 contacts projection 135, which extends for a short distance into opening 112 and then downward, away from the opening. Spur 133 extends over the portion of the clip closing means 100 adjacent to the proximal end of opening 112. That aids in fixing the vertical position of the proximal end of clutch spring 130. Blocks 48 and 49 extend longitudinally along and project from the inner sur-faces of opposite sides of track 40.
The operation of the clutch assembly will now be described with reference to Figures 28-31.
Figure 28 shows the condition of the clutch assembly prior to the squeezing together of the ring handles 140. Clutch prong 132 is not in contact with blocks 48 or 49.
Figure 29 shows the condition of the clutch assembly once the squeezing of the ring handles has begun. When a clip closing stroke is initiated, the clip closing means 100 moves in a distal direction.
Clutch prong 132 contacts and traverses the proximal beveled surface of block 48 and then begins to tra-verse the flat surface of block 48. This motion causes the tip of clutch prong 132 to move toward and contact block 49. This position is shown in Figure 29.
Figure 30 shows the clutch assembly after further squeezing of ring handles 140. In this draw-ing, the clutch assembly is engaged. Clutch prong 132 travels distally along and is confined by blocks 48 and 49. The length of clutch prong 132 is greater ......... ' ~

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than the lateral spacing between blocks 48 and 49.
Therefore, this ensures that the tip of clutch prong 132 remains in contact with block 49 during the period that clutch prong 132 lies between blocks 48 and 49.
Contact of clutch prong 132 with blocks 48 and 49 and projection 135 initially causes the tip of clutch prong 132 to move proximally with respect to the rest of the spring. The relative position of the tip is maintained as clutch prong 132 traverses blocks 48 and 49 during the clip closing stroke. If the surgeon ceases to squeeze ring handles 140 and thereby interrupts the clip-closing stroke, contact between spring 130 and blocks 48 and 49 will prevent return movement of the clip closing means 100. In particular, if return movement starts to occur, the tip of prong 132 digs into block 49 and stops such movement. Thus, the clutch assembly prevents partial closure of a clip.
In Figure 31, the clutch assembly is no longer engaged. Continued squeezing of ring handles 140 has caused further distal motion of clutch prong 132 so that it no longer contacts blocks 48 and 49.
That allows all the force transmitted by squeezing the handles to be utilized for completing the closure of the clip. The cut-out in the proximal portion 86 of clip cover 80 provides clearance for the distal motion of clutch spring 130.
Fiyure 31 also shows in phantom line the position of the clutch prong 132 during the return stroke when the clutch assembly is again engaged.
During that stroke, contact of clutch prong 132 with blocks 48 and 49 and projection 135 causes the tip of clutch prong 132 to move distally with respect to the rest of the spring. If the surgeon attempts to squeeze ring handles 140 during the return stroke, contact between clutch prong 132 and blocks 48 and 49 will prevent distal movement by clip closing ' , ~ , means 100. In particular, such distal movement would casue the tip of prong 132 to dig into block 49 and halt such movement. Thus, the clutch assembly pre-vents the initiation of a second clip closing stroke before the first return stroke is completed, thereby preventing clip jams.
It will be understood that the foregoing is only illustrative of the principles of the inven-tion and that various modifications can be made by those skilled in the art without departing from the scope and spirit of the invention.

Claims (13)

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. Apparatus for applying surgical clips one at a time to body tissue, each clip having two legs joined together at a crown, said apparatus comprising:
(a) a proximal portion;
(b) a distal portion having stationary camming surfaces;
(c) means for holding an array of surgical clips, the array having a distal end and a proximal end;
(d) clip closing means for moving between distal and proximal positions and having at the distal end jaw means for (i) receiving the distal-most clip in the array and (ii) then moving towards the distal portion of the apparatus so that the jaw means contact the camming surfaces and close the clip around the body tissue; and (e) escapement means for (i) placing the distal-most clip of the array in the jaw means when the clip closing means has moved to the proximal position, which is towards the proximal portion of the apparatus, and (ii) preventing any of the other clips in the array from being placed in the jaw means at the same time, wherein the escapement means comprises three pairs of opposing projecting surfaces, which pairs point towards the plane of motion of the clip closing means and are spaced from one another in the longitudinal direction along the apparatus, the proximal-most pair of projecting surfaces extending beyond the middle pair of projecting surfaces in both the lateral and longitudinal directions, the escapement means being held stationary at its proximal end, the rest of the escapement means being able to move toward and away from the plane of motion of the clip closing means and being biased towards the plane, and the proximal-most pair of projecting surfaces resting against the clip closing means when those means are in the proximal position so that the middle and distal-most pair of projecting surfaces are out of the plane of motion of the clip closing means.
2. The apparatus of claim 1, wherein as the clip closing means moves towards the distal portion of the apparatus, the proximal-most pair of protecting surfaces can no longer rest on the clip closing means, thereby allowing the movable portion of the escapement means to move towards the plane of motion of the clip closing means so that the middle and distal-most projecting surfaces confine and prevent motion of the next-to-digtal-most clip as the distal-most clip is moved towards the camming surfaces of the distal portion of the apparatus.
3. The apparatus of claim 1, further comprising activating means for moving the clip closing means towards the camming surfaces.
4. The apparatus of claim 3, wherein the activating means comprises (a) a pair of rotatably mounted handles, each handle having an arcuate slot and the handles being mounted so that the curvature of the two slots are not in the same direction, and (b) a pin attached to the clip closing means, the pin extending through both arcuate slots, the configuration being such that when the handles move toward each other, the point at which the pin extends through both slots moves in the distal direction, thereby moving the clip closing means in the distal direction.
5. The apparatus of claim 1, further comprising stop means for halting any movement in the proximal direction of the distal-most clip as it is being closed.
6. The apparatus of claim 5, wherein the stop means is attached to the clip closing means and moves along essentially the same line as the crown of the distal-most clip as that clip is moved towards the distal end of the apparatus.
7. The apparatus of claim 1, further comprising return means for moving the clip closing means towards its proximal position after the distal-most clip has been applied to body tissue.
8. The apparatus of claim 7, wherein the return means comprises a spring that is (a) normally expanded when not compressed and (b) is increasingly compressed as the clip closing means moves in a distal direction.
9. The apparatus of claim 1, further comprising clip advancing means for advancing the array of clips towards the position the jaw means occupies when the clip closing means is in its proximal position, thereby facilitating automatic feeding of the clips one at a time to the jaw means.
10. The apparatus of claim 9, wherein the clip advancing means comprises (a) a spring having proximal and distal ends, which spring is normally expanded when not compressed, the proximal end of the spring being held immovable in the apparatus, and (h) a movable clip follower that abuts the last clip in the array and is attached to the distal end of the spring, the expansion of the spring pushing the clip follower, which in turn pushes the entire array of clips.
11. The apparatus of claim 1, further comprising means for preventing significant movement of the jaw means in any but the longitudinal direction.
12. The apparatus of claim 1, further comprising a clutch which once it is engaged by the movement of the clip closing means in either the distal or proximal direction ensures that the direction of such movement is not reversed until the clutch is disengaged by sufficient movement of the clip closing means in the direction of movement that caused the clutch to engage.
13. The apparatus of claim 12, wherein the clutch comprises (a) first and second longitudinally disposed laterally spaced plastic portions, and (b) a piece of resilient metal fastened at a first end to the clip closing means and formed so that when the clutch is engaged the second end of the piece of metal is forced by contact of part of the piece of metal with the first plastic portion against the second plastic portion at an acute angle, the second end of the piece of metal (a) sliding along the second plastic portion when the clip closing means moves in the direction that caused the clutch to engage but (b) firmly engaging the second plastic portion when the clip closing means attempts to move in the other direction.
CA000485731A 1984-07-27 1985-06-27 Apparatus for applying surgical clips Expired CA1261705A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/635,262 US4616650A (en) 1984-07-27 1984-07-27 Apparatus for applying surgical clips
US635,262 1984-07-27

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CA1261705A true CA1261705A (en) 1989-09-26

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US (1) US4616650A (en)
EP (1) EP0170592B1 (en)
JP (1) JPS61501131A (en)
AT (1) ATE57464T1 (en)
AU (1) AU578481B2 (en)
BR (1) BR8506843A (en)
CA (1) CA1261705A (en)
DE (2) DE3590364C2 (en)
GB (1) GB2177302B (en)
WO (1) WO1986000794A1 (en)

Families Citing this family (272)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4712549A (en) * 1985-07-01 1987-12-15 Edward Weck & Co. Automatic hemostatic clip applier
US4967949A (en) * 1986-07-11 1990-11-06 Vastech Medical Products Inc. Apparatus for effecting occlusion of the vas deferens
US4850355A (en) * 1987-04-06 1989-07-25 Richard-Allan Medical Industries, Inc. Hemostatic clip applicator for applying multiple hemostatic clips
US5366459A (en) * 1987-05-14 1994-11-22 Inbae Yoon Surgical clip and clip application procedures
US5383881A (en) * 1989-07-18 1995-01-24 United States Surgical Corporation Safety device for use with endoscopic instrumentation
US5100420A (en) * 1989-07-18 1992-03-31 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
US5197970A (en) * 1988-01-15 1993-03-30 United States Surgical Corporation Surgical clip applicator
US5084057A (en) * 1989-07-18 1992-01-28 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
US5030226A (en) * 1988-01-15 1991-07-09 United States Surgical Corporation Surgical clip applicator
US5049152A (en) * 1989-03-07 1991-09-17 Richard-Allan Medical Industries Hemostatic clip applicator
CA2004658C (en) * 1988-06-03 1995-10-10 Michael A. Oberlander Arthroscopic clip and insertion tool
US5002562A (en) * 1988-06-03 1991-03-26 Oberlander Michael A Surgical clip
FR2637489A1 (en) * 1988-10-07 1990-04-13 Lachkar Alain AUTOMATIC CLIPS CLIP
US5104395A (en) * 1989-07-03 1992-04-14 Edward Weck Incorporated Automatic hemostatic clip applicator
US5382254A (en) * 1989-07-18 1995-01-17 United States Surgical Corporation Actuating handle for surgical instruments
USRE36720E (en) * 1990-12-13 2000-05-30 United States Surgical Corporation Apparatus and method for applying latchless surgical clips
US5366458A (en) * 1990-12-13 1994-11-22 United States Surgical Corporation Latchless surgical clip
CA2060040A1 (en) * 1991-02-08 1992-08-10 Miguel A. Velez Surgical staple and endoscopic stapler
US5171249A (en) * 1991-04-04 1992-12-15 Ethicon, Inc. Endoscopic multiple ligating clip applier
US5112343A (en) * 1991-04-05 1992-05-12 Edward Weck Incorporated Endoscopic clip appliers
US5257713A (en) * 1991-05-07 1993-11-02 United States Surgical Corporation Surgical fastening device
US5217472A (en) * 1991-05-07 1993-06-08 United States Surgical Corporation Surgical fastening device
US5497933A (en) * 1991-10-18 1996-03-12 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
US5356064A (en) * 1991-10-18 1994-10-18 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
US5289963A (en) 1991-10-18 1994-03-01 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
DE4303544A1 (en) * 1992-02-07 1993-09-23 Storz Karl Gmbh & Co Surgical instrument for applying clips to surgical incision - has reloading magazine which holds clips in sterile environment
CA2088883A1 (en) * 1992-02-13 1993-08-14 David T. Green Endoscopic ligating instrument
CA2090980C (en) * 1992-03-06 2004-11-30 David Stefanchik Ligating clip applier
US5314424A (en) * 1992-04-06 1994-05-24 United States Surgical Corporation Surgical instrument locking mechanism
US5282811A (en) * 1992-04-16 1994-02-01 Cook Pacemaker Corporation Two part surgical ligating clip, applicator and method of use
AU662407B2 (en) * 1992-05-06 1995-08-31 Ethicon Inc. Endoscopic ligation and division instrument
US5304190A (en) * 1992-05-08 1994-04-19 Ethicon, Inc. Endoscopic cutting apparatus
US5192288A (en) * 1992-05-26 1993-03-09 Origin Medsystems, Inc. Surgical clip applier
US5269792A (en) * 1992-05-26 1993-12-14 Origin Medsystems, Inc. Surgical clip
US5342373A (en) * 1992-09-14 1994-08-30 Ethicon, Inc. Sterile clips and instrument for their placement
CA2133687C (en) * 1992-10-09 2007-03-27 David T. Green Surgical clip applier
US5601224A (en) * 1992-10-09 1997-02-11 Ethicon, Inc. Surgical instrument
US5868761A (en) * 1992-10-09 1999-02-09 United States Surgical Corporation Surgical clip applier
US5626587A (en) * 1992-10-09 1997-05-06 Ethicon Endo-Surgery, Inc. Method for operating a surgical instrument
US5300081A (en) * 1992-10-09 1994-04-05 United States Surgical Corporation Surgical clip applier having clip advancement control
US5662662A (en) * 1992-10-09 1997-09-02 Ethicon Endo-Surgery, Inc. Surgical instrument and method
CA2107635C (en) * 1992-10-09 1999-08-17 David T. Green Surgical clip applier
US5725538A (en) * 1992-10-09 1998-03-10 United States Surgical Corporation Surgical clip applier
US5403327A (en) * 1992-12-31 1995-04-04 Pilling Weck Incorporated Surgical clip applier
US5382255A (en) * 1993-01-08 1995-01-17 United States Surgical Corporation Apparatus and method for assembly of surgical instruments
US5431668A (en) * 1993-04-29 1995-07-11 Ethicon, Inc. Ligating clip applier
US5431669A (en) * 1993-07-16 1995-07-11 Origin Medsystems, Inc. Surgical clip applier with distal hook
US5858018A (en) * 1993-08-25 1999-01-12 Apollo Camera, Llc Low profile tool for applying spring action ligation clips
US5441193A (en) * 1993-09-23 1995-08-15 United States Surgical Corporation Surgical fastener applying apparatus with resilient film
US5607436A (en) * 1993-10-08 1997-03-04 United States Surgical Corporation Apparatus for applying surgical clips
US5527320A (en) * 1994-02-10 1996-06-18 Pilling Weck Inc. Surgical clip applying instrument
US5833700A (en) * 1995-03-15 1998-11-10 Ethicon Endo-Surgery, Inc. Sterile occlusion fasteners and instrument and method for their placement
US5474566A (en) * 1994-05-05 1995-12-12 United States Surgical Corporation Self-contained powered surgical apparatus
US5637108A (en) * 1994-06-15 1997-06-10 United States Surgical Corporation Surgical handle having a controlled leak passage
US5562655A (en) * 1994-08-12 1996-10-08 United States Surgical Corporation Surgical apparatus having a universal handle for actuating various attachments
US5626585A (en) * 1994-09-16 1997-05-06 United States Surgical Corporation Ligating clip advance
DE4434864C2 (en) * 1994-09-29 1997-06-19 United States Surgical Corp Surgical staple applicator with interchangeable staple magazine
US5700270A (en) * 1995-10-20 1997-12-23 United States Surgical Corporation Surgical clip applier
US6425901B1 (en) 1995-12-07 2002-07-30 Loma Linda University Medical Center Vascular wound closure system
US6287322B1 (en) 1995-12-07 2001-09-11 Loma Linda University Medical Center Tissue opening locator and everter and method
US6004341A (en) * 1996-12-05 1999-12-21 Loma Linda University Medical Center Vascular wound closure device
US6524326B1 (en) 1995-12-07 2003-02-25 Loma Linda University Medical Center Tissue opening locator and everter and method
US5626608A (en) * 1996-03-29 1997-05-06 United States Surgical Corporation Surgical instrument having locking handle
US5707380A (en) * 1996-07-23 1998-01-13 United States Surgical Corporation Anastomosis instrument and method
US20020019642A1 (en) 1996-07-23 2002-02-14 Keith Milliman Anastomosis instrument and method for performing same
US6024748A (en) * 1996-07-23 2000-02-15 United States Surgical Corporation Singleshot anastomosis instrument with detachable loading unit and method
US7223273B2 (en) 1996-07-23 2007-05-29 Tyco Healthcare Group Lp Anastomosis instrument and method for performing same
US6440146B2 (en) * 1996-07-23 2002-08-27 United States Surgical Corporation Anastomosis instrument and method
US7169158B2 (en) * 1996-07-23 2007-01-30 Tyco Healthcare Group Lp Anastomosis instrument and method for performing same
US5833696A (en) * 1996-10-03 1998-11-10 United States Surgical Corporation Apparatus for applying surgical clips
US5868759A (en) * 1997-10-10 1999-02-09 United States Surgical Corporation Surgical clip applier
EP1016377B1 (en) * 1998-12-30 2006-04-26 Ethicon Inc. Suture locking device
US6896683B1 (en) * 1999-01-25 2005-05-24 Applied Material Resources Corporation Surgical instrument with improved handle assembly
US6350269B1 (en) 1999-03-01 2002-02-26 Apollo Camera, L.L.C. Ligation clip and clip applier
US6554852B1 (en) * 1999-08-25 2003-04-29 Michael A. Oberlander Multi-anchor suture
US6695854B1 (en) * 1999-11-29 2004-02-24 General Surgical Innovations, Inc. Blood vessel clip and applicator
US7153312B1 (en) 1999-12-02 2006-12-26 Smith & Nephew Inc. Closure device and method for tissue repair
US7887551B2 (en) 1999-12-02 2011-02-15 Smith & Nephew, Inc. Soft tissue attachment and repair
US6890342B2 (en) 2000-08-02 2005-05-10 Loma Linda University Method and apparatus for closing vascular puncture using hemostatic material
US6592549B2 (en) * 2001-03-14 2003-07-15 Scimed Life Systems, Inc. Rapid exchange stent delivery system and associated components
US6769594B2 (en) 2002-05-31 2004-08-03 Tyco Healthcare Group, Lp End-to-end anastomosis instrument and method for performing same
US7195142B2 (en) 2003-05-30 2007-03-27 Tyco Healthcare Group Lp End-to-end anastomosis instrument and method for performing same
US20040010274A1 (en) * 2002-07-10 2004-01-15 Manzo Scott E. Anastomosis instrument and method for performing same
US7678125B2 (en) 2002-11-12 2010-03-16 Apollo Camera, L.L.C. Surgical ligation clip
US6849079B1 (en) * 2002-12-10 2005-02-01 Joseph W. Blake, III Clip detent spring for repeating multi-clip applier
US9314235B2 (en) 2003-02-05 2016-04-19 Smith & Nephew, Inc. Tissue anchor and insertion tool
WO2004080290A2 (en) 2003-03-11 2004-09-23 Tyco Healthcare Group, Lp Clip applying apparatus with angled jaw
US8172870B2 (en) 2003-06-09 2012-05-08 Microline Surgical, Inc. Ligation clip applier
US7572266B2 (en) 2003-10-21 2009-08-11 Young Wayne P Clip applier tool having a discharge configuration
US7608092B1 (en) 2004-02-20 2009-10-27 Biomet Sports Medicince, LLC Method and apparatus for performing meniscus repair
JP2008513160A (en) 2004-09-23 2008-05-01 タイコ ヘルスケア グループ エルピー Clip application device and ligation clip
EP1805849B1 (en) 2004-10-08 2014-12-03 Covidien LP Apparatus for applying surgical clips
US8409222B2 (en) 2004-10-08 2013-04-02 Covidien Lp Endoscopic surgical clip applier
JP5103183B2 (en) 2004-10-08 2012-12-19 タイコ ヘルスケア グループ リミテッド パートナーシップ Endoscopic surgical clip applier
US9763668B2 (en) 2004-10-08 2017-09-19 Covidien Lp Endoscopic surgical clip applier
US7819886B2 (en) 2004-10-08 2010-10-26 Tyco Healthcare Group Lp Endoscopic surgical clip applier
US7749250B2 (en) 2006-02-03 2010-07-06 Biomet Sports Medicine, Llc Soft tissue repair assembly and associated method
US8088130B2 (en) 2006-02-03 2012-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8128658B2 (en) 2004-11-05 2012-03-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to bone
US9017381B2 (en) 2007-04-10 2015-04-28 Biomet Sports Medicine, Llc Adjustable knotless loops
US20060189993A1 (en) 2004-11-09 2006-08-24 Arthrotek, Inc. Soft tissue conduit device
US9801708B2 (en) 2004-11-05 2017-10-31 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8840645B2 (en) 2004-11-05 2014-09-23 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US7857830B2 (en) 2006-02-03 2010-12-28 Biomet Sports Medicine, Llc Soft tissue repair and conduit device
US8137382B2 (en) 2004-11-05 2012-03-20 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US7905904B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US7658751B2 (en) 2006-09-29 2010-02-09 Biomet Sports Medicine, Llc Method for implanting soft tissue
US8361113B2 (en) 2006-02-03 2013-01-29 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8298262B2 (en) 2006-02-03 2012-10-30 Biomet Sports Medicine, Llc Method for tissue fixation
US8303604B2 (en) 2004-11-05 2012-11-06 Biomet Sports Medicine, Llc Soft tissue repair device and method
US7909851B2 (en) 2006-02-03 2011-03-22 Biomet Sports Medicine, Llc Soft tissue repair device and associated methods
US8118836B2 (en) 2004-11-05 2012-02-21 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US7905903B2 (en) 2006-02-03 2011-03-15 Biomet Sports Medicine, Llc Method for tissue fixation
US8998949B2 (en) 2004-11-09 2015-04-07 Biomet Sports Medicine, Llc Soft tissue conduit device
US7914539B2 (en) 2004-11-09 2011-03-29 Biomet Sports Medicine, Llc Tissue fixation device
US8034090B2 (en) 2004-11-09 2011-10-11 Biomet Sports Medicine, Llc Tissue fixation device
US8038686B2 (en) 2005-04-14 2011-10-18 Ethicon Endo-Surgery, Inc. Clip applier configured to prevent clip fallout
US7740641B2 (en) 2005-04-14 2010-06-22 Ethicon Endo-Surgery, Inc. Clip applier with migrational resistance features
US7297149B2 (en) 2005-04-14 2007-11-20 Ethicon Endo-Surgery, Inc. Surgical clip applier methods
US7686820B2 (en) 2005-04-14 2010-03-30 Ethicon Endo-Surgery, Inc. Surgical clip applier ratchet mechanism
US8523882B2 (en) * 2005-04-14 2013-09-03 Ethicon Endo-Surgery, Inc. Clip advancer mechanism with alignment features
US7288098B2 (en) 2005-04-14 2007-10-30 Ethicon Endo-Surgery, Inc. Force limiting mechanism for medical instrument
US7261724B2 (en) 2005-04-14 2007-08-28 Ethicon Endo-Surgery, Inc. Surgical clip advancement mechanism
US7731724B2 (en) 2005-04-14 2010-06-08 Ethicon Endo-Surgery, Inc. Surgical clip advancement and alignment mechanism
US20060293709A1 (en) 2005-06-24 2006-12-28 Bojarski Raymond A Tissue repair device
US20070049950A1 (en) * 2005-08-25 2007-03-01 Microline Pentax Inc. Medical clip applying device
US20070049947A1 (en) * 2005-08-25 2007-03-01 Microline Pentax Inc. Cinch control device
US20070185504A1 (en) * 2005-08-25 2007-08-09 Microline Pentax, Inc. Medical clip feeding mechanism
US9326776B2 (en) * 2005-09-29 2016-05-03 Applied Medical Resources Corporation Manually actuated surgical clip applier
US20070112385A1 (en) 2005-11-15 2007-05-17 Conlon Sean P Expandable suture anchor
US9538998B2 (en) 2006-02-03 2017-01-10 Biomet Sports Medicine, Llc Method and apparatus for fracture fixation
US8562645B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8968364B2 (en) 2006-02-03 2015-03-03 Biomet Sports Medicine, Llc Method and apparatus for fixation of an ACL graft
US9468433B2 (en) 2006-02-03 2016-10-18 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US8562647B2 (en) 2006-09-29 2013-10-22 Biomet Sports Medicine, Llc Method and apparatus for securing soft tissue to bone
US7959650B2 (en) 2006-09-29 2011-06-14 Biomet Sports Medicine, Llc Adjustable knotless loops
US9271713B2 (en) 2006-02-03 2016-03-01 Biomet Sports Medicine, Llc Method and apparatus for tensioning a suture
US8251998B2 (en) 2006-08-16 2012-08-28 Biomet Sports Medicine, Llc Chondral defect repair
US8771352B2 (en) 2011-05-17 2014-07-08 Biomet Sports Medicine, Llc Method and apparatus for tibial fixation of an ACL graft
US8506597B2 (en) 2011-10-25 2013-08-13 Biomet Sports Medicine, Llc Method and apparatus for interosseous membrane reconstruction
US8652171B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Method and apparatus for soft tissue fixation
US8597327B2 (en) 2006-02-03 2013-12-03 Biomet Manufacturing, Llc Method and apparatus for sternal closure
US11311287B2 (en) 2006-02-03 2022-04-26 Biomet Sports Medicine, Llc Method for tissue fixation
US11259792B2 (en) 2006-02-03 2022-03-01 Biomet Sports Medicine, Llc Method and apparatus for coupling anatomical features
US8801783B2 (en) 2006-09-29 2014-08-12 Biomet Sports Medicine, Llc Prosthetic ligament system for knee joint
US8574235B2 (en) 2006-02-03 2013-11-05 Biomet Sports Medicine, Llc Method for trochanteric reattachment
US10517587B2 (en) 2006-02-03 2019-12-31 Biomet Sports Medicine, Llc Method and apparatus for forming a self-locking adjustable loop
US9078644B2 (en) 2006-09-29 2015-07-14 Biomet Sports Medicine, Llc Fracture fixation device
US9149267B2 (en) 2006-02-03 2015-10-06 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8652172B2 (en) 2006-02-03 2014-02-18 Biomet Sports Medicine, Llc Flexible anchors for tissue fixation
USD629101S1 (en) 2006-03-24 2010-12-14 Tyco Healthcare Group Lp Surgical clip applier
USD625009S1 (en) 2006-03-24 2010-10-05 Tyco Healthcare Group Lp Surgical clip applier
US8672969B2 (en) 2006-09-29 2014-03-18 Biomet Sports Medicine, Llc Fracture fixation device
US11259794B2 (en) 2006-09-29 2022-03-01 Biomet Sports Medicine, Llc Method for implanting soft tissue
US9918826B2 (en) 2006-09-29 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US8500818B2 (en) 2006-09-29 2013-08-06 Biomet Manufacturing, Llc Knee prosthesis assembly with ligament link
CA2605135C (en) 2006-10-17 2014-12-30 Tyco Healthcare Group Lp Apparatus for applying surgical clips
CA2868909A1 (en) 2007-03-26 2008-10-02 Tyco Healthcare Group Lp Endoscopic surgical clip applier
JP5329526B2 (en) 2007-04-11 2013-10-30 コヴィディエン リミテッド パートナーシップ Surgical clip applier
US20110208212A1 (en) 2010-02-19 2011-08-25 Zergiebel Earl M Surgical clip applier
US8465502B2 (en) 2008-08-25 2013-06-18 Covidien Lp Surgical clip applier and method of assembly
US8056565B2 (en) 2008-08-25 2011-11-15 Tyco Healthcare Group Lp Surgical clip applier and method of assembly
US8267944B2 (en) 2008-08-29 2012-09-18 Tyco Healthcare Group Lp Endoscopic surgical clip applier with lock out
US8585717B2 (en) 2008-08-29 2013-11-19 Covidien Lp Single stroke endoscopic surgical clip applier
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
US8343227B2 (en) 2009-05-28 2013-01-01 Biomet Manufacturing Corp. Knee prosthesis assembly with ligament link
US8267945B2 (en) 2009-10-09 2012-09-18 Ethicon Endo-Surgery, Inc. Clip advancer with lockout mechanism
US8262679B2 (en) 2009-10-09 2012-09-11 Ethicon Endo-Surgery, Inc. Clip advancer
US8734469B2 (en) 2009-10-13 2014-05-27 Covidien Lp Suture clip applier
US9186136B2 (en) 2009-12-09 2015-11-17 Covidien Lp Surgical clip applier
US8545486B2 (en) 2009-12-15 2013-10-01 Covidien Lp Surgical clip applier
US8403945B2 (en) 2010-02-25 2013-03-26 Covidien Lp Articulating endoscopic surgical clip applier
US8403946B2 (en) 2010-07-28 2013-03-26 Covidien Lp Articulating clip applier cartridge
US8968337B2 (en) 2010-07-28 2015-03-03 Covidien Lp Articulating clip applier
US9011464B2 (en) 2010-11-02 2015-04-21 Covidien Lp Self-centering clip and jaw
US9186153B2 (en) 2011-01-31 2015-11-17 Covidien Lp Locking cam driver and jaw assembly for clip applier
US9775623B2 (en) 2011-04-29 2017-10-03 Covidien Lp Surgical clip applier including clip relief feature
US9492170B2 (en) * 2011-08-10 2016-11-15 Ethicon Endo-Surgery, Inc. Device for applying adjunct in endoscopic procedure
JP6129859B2 (en) 2011-10-19 2017-05-17 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. Clip applier adapted for use with surgical robots
US9357991B2 (en) 2011-11-03 2016-06-07 Biomet Sports Medicine, Llc Method and apparatus for stitching tendons
US9370350B2 (en) 2011-11-10 2016-06-21 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US9381013B2 (en) 2011-11-10 2016-07-05 Biomet Sports Medicine, Llc Method for coupling soft tissue to a bone
US9314241B2 (en) 2011-11-10 2016-04-19 Biomet Sports Medicine, Llc Apparatus for coupling soft tissue to a bone
US20130131697A1 (en) 2011-11-21 2013-05-23 Covidien Lp Surgical clip applier
US9433735B2 (en) 2011-12-13 2016-09-06 Pharmajet Inc. Needle-free intradermal injection device
US9364239B2 (en) 2011-12-19 2016-06-14 Covidien Lp Jaw closure mechanism for a surgical clip applier
US9364216B2 (en) 2011-12-29 2016-06-14 Covidien Lp Surgical clip applier with integrated clip counter
US9259217B2 (en) 2012-01-03 2016-02-16 Biomet Manufacturing, Llc Suture Button
US9408610B2 (en) 2012-05-04 2016-08-09 Covidien Lp Surgical clip applier with dissector
US9532787B2 (en) 2012-05-31 2017-01-03 Covidien Lp Endoscopic clip applier
US9113892B2 (en) 2013-01-08 2015-08-25 Covidien Lp Surgical clip applier
US9968362B2 (en) 2013-01-08 2018-05-15 Covidien Lp Surgical clip applier
US9750500B2 (en) 2013-01-18 2017-09-05 Covidien Lp Surgical clip applier
US9757119B2 (en) 2013-03-08 2017-09-12 Biomet Sports Medicine, Llc Visual aid for identifying suture limbs arthroscopically
US9918827B2 (en) 2013-03-14 2018-03-20 Biomet Sports Medicine, Llc Scaffold for spring ligament repair
US9775624B2 (en) 2013-08-27 2017-10-03 Covidien Lp Surgical clip applier
US10779838B1 (en) 2013-11-13 2020-09-22 Joseph W Blake, III Instrument for serially applying clips to a surgical site
US10136886B2 (en) 2013-12-20 2018-11-27 Biomet Sports Medicine, Llc Knotless soft tissue devices and techniques
US9615822B2 (en) 2014-05-30 2017-04-11 Biomet Sports Medicine, Llc Insertion tools and method for soft anchor
US9700291B2 (en) 2014-06-03 2017-07-11 Biomet Sports Medicine, Llc Capsule retractor
US10098641B1 (en) 2014-08-21 2018-10-16 Joseph W Blake, III Jaws and cams for clip applying instruments
US10039543B2 (en) 2014-08-22 2018-08-07 Biomet Sports Medicine, Llc Non-sliding soft anchor
US9968363B2 (en) 2014-10-20 2018-05-15 Joseph W. Blake, III Multi-clip applier
US10702278B2 (en) 2014-12-02 2020-07-07 Covidien Lp Laparoscopic surgical ligation clip applier
US9931124B2 (en) 2015-01-07 2018-04-03 Covidien Lp Reposable clip applier
CN107205747B (en) 2015-01-15 2020-09-08 柯惠有限合伙公司 Reusable endoscopic surgical clip applier
US10292712B2 (en) 2015-01-28 2019-05-21 Covidien Lp Surgical clip applier with integrated cutter
US9955980B2 (en) 2015-02-24 2018-05-01 Biomet Sports Medicine, Llc Anatomic soft tissue repair
US10159491B2 (en) 2015-03-10 2018-12-25 Covidien Lp Endoscopic reposable surgical clip applier
US9974534B2 (en) 2015-03-31 2018-05-22 Biomet Sports Medicine, Llc Suture anchor with soft anchor of electrospun fibers
CN108348259B (en) 2015-11-03 2020-12-11 柯惠有限合伙公司 Endoscopic surgical clip applier
US10390831B2 (en) 2015-11-10 2019-08-27 Covidien Lp Endoscopic reposable surgical clip applier
CA2999906A1 (en) 2015-11-10 2017-05-18 Covidien Lp Endoscopic reposable surgical clip applier
AU2015414380B2 (en) 2015-11-10 2020-10-15 Covidien Lp Endoscopic reposable surgical clip applier
JP6642955B2 (en) 2016-01-11 2020-02-12 コヴィディエン リミテッド パートナーシップ Partially disposable surgical clip applier for endoscopes
US10765431B2 (en) 2016-01-18 2020-09-08 Covidien Lp Endoscopic surgical clip applier
CA2958160A1 (en) 2016-02-24 2017-08-24 Covidien Lp Endoscopic reposable surgical clip applier
CN109561897B (en) 2016-08-11 2022-03-01 柯惠有限合伙公司 Endoscopic surgical clip applier and clip application system
AU2016420481A1 (en) 2016-08-25 2019-01-17 Covidien Lp Endoscopic surgical clip applier and clip applying systems
US10639044B2 (en) 2016-10-31 2020-05-05 Covidien Lp Ligation clip module and clip applier
US10660651B2 (en) 2016-10-31 2020-05-26 Covidien Lp Endoscopic reposable surgical clip applier
US10492795B2 (en) 2016-11-01 2019-12-03 Covidien Lp Endoscopic surgical clip applier
US10426489B2 (en) 2016-11-01 2019-10-01 Covidien Lp Endoscopic reposable surgical clip applier
US10610236B2 (en) 2016-11-01 2020-04-07 Covidien Lp Endoscopic reposable surgical clip applier
JP7062662B2 (en) * 2016-12-21 2022-05-06 エシコン エルエルシー Surgical tool assembly with clutch configuration for shifting between a closure system with a closure stroke reduction mechanism and a joint motion and launch system
US10709455B2 (en) 2017-02-02 2020-07-14 Covidien Lp Endoscopic surgical clip applier
EP3576643B1 (en) 2017-02-06 2022-04-06 Covidien LP Surgical clip applier with user feedback feature
US10758244B2 (en) 2017-02-06 2020-09-01 Covidien Lp Endoscopic surgical clip applier
US10660725B2 (en) 2017-02-14 2020-05-26 Covidien Lp Endoscopic surgical clip applier including counter assembly
US10603038B2 (en) 2017-02-22 2020-03-31 Covidien Lp Surgical clip applier including inserts for jaw assembly
US11583291B2 (en) 2017-02-23 2023-02-21 Covidien Lp Endoscopic surgical clip applier
US10548602B2 (en) 2017-02-23 2020-02-04 Covidien Lp Endoscopic surgical clip applier
US10675043B2 (en) 2017-05-04 2020-06-09 Covidien Lp Reposable multi-fire surgical clip applier
US10722235B2 (en) 2017-05-11 2020-07-28 Covidien Lp Spring-release surgical clip
US10639032B2 (en) 2017-06-30 2020-05-05 Covidien Lp Endoscopic surgical clip applier including counter assembly
US10660723B2 (en) 2017-06-30 2020-05-26 Covidien Lp Endoscopic reposable surgical clip applier
US10675112B2 (en) 2017-08-07 2020-06-09 Covidien Lp Endoscopic surgical clip applier including counter assembly
US10863992B2 (en) 2017-08-08 2020-12-15 Covidien Lp Endoscopic surgical clip applier
US10932790B2 (en) 2017-08-08 2021-03-02 Covidien Lp Geared actuation mechanism and surgical clip applier including the same
US10786262B2 (en) 2017-08-09 2020-09-29 Covidien Lp Endoscopic reposable surgical clip applier
US10617429B2 (en) * 2017-08-10 2020-04-14 Ethicon Llc Surgical clip applier
US10786263B2 (en) 2017-08-15 2020-09-29 Covidien Lp Endoscopic reposable surgical clip applier
US10835341B2 (en) 2017-09-12 2020-11-17 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US10758245B2 (en) 2017-09-13 2020-09-01 Covidien Lp Clip counting mechanism for surgical clip applier
US10653429B2 (en) 2017-09-13 2020-05-19 Covidien Lp Endoscopic surgical clip applier
US10835260B2 (en) 2017-09-13 2020-11-17 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US11376015B2 (en) 2017-11-03 2022-07-05 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US10932791B2 (en) 2017-11-03 2021-03-02 Covidien Lp Reposable multi-fire surgical clip applier
US10945734B2 (en) 2017-11-03 2021-03-16 Covidien Lp Rotation knob assemblies and surgical instruments including the same
US11116513B2 (en) 2017-11-03 2021-09-14 Covidien Lp Modular surgical clip cartridge
US10828036B2 (en) 2017-11-03 2020-11-10 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US10722236B2 (en) 2017-12-12 2020-07-28 Covidien Lp Endoscopic reposable surgical clip applier
US10743887B2 (en) 2017-12-13 2020-08-18 Covidien Lp Reposable multi-fire surgical clip applier
US10959737B2 (en) 2017-12-13 2021-03-30 Covidien Lp Reposable multi-fire surgical clip applier
US10849630B2 (en) 2017-12-13 2020-12-01 Covidien Lp Reposable multi-fire surgical clip applier
US11051827B2 (en) 2018-01-16 2021-07-06 Covidien Lp Endoscopic surgical instrument and handle assemblies for use therewith
US10993721B2 (en) 2018-04-25 2021-05-04 Covidien Lp Surgical clip applier
US10786273B2 (en) 2018-07-13 2020-09-29 Covidien Lp Rotation knob assemblies for handle assemblies
US11259887B2 (en) 2018-08-10 2022-03-01 Covidien Lp Feedback mechanisms for handle assemblies
US11278267B2 (en) 2018-08-13 2022-03-22 Covidien Lp Latch assemblies and surgical instruments including the same
US11219463B2 (en) 2018-08-13 2022-01-11 Covidien Lp Bilateral spring for surgical instruments and surgical instruments including the same
US11246601B2 (en) 2018-08-13 2022-02-15 Covidien Lp Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same
US11051828B2 (en) 2018-08-13 2021-07-06 Covidien Lp Rotation knob assemblies and surgical instruments including same
US11344316B2 (en) 2018-08-13 2022-05-31 Covidien Lp Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same
US11253267B2 (en) 2018-08-13 2022-02-22 Covidien Lp Friction reduction mechanisms for handle assemblies
US11033256B2 (en) 2018-08-13 2021-06-15 Covidien Lp Linkage assembly for reusable surgical handle assemblies
US11147566B2 (en) 2018-10-01 2021-10-19 Covidien Lp Endoscopic surgical clip applier
US11524398B2 (en) 2019-03-19 2022-12-13 Covidien Lp Gear drive mechanisms for surgical instruments
CN110464412A (en) * 2019-08-09 2019-11-19 黄皆澔 Disposable tissue closure presss from both sides pedestal
US11779340B2 (en) 2020-01-02 2023-10-10 Covidien Lp Ligation clip loading device
US11723669B2 (en) 2020-01-08 2023-08-15 Covidien Lp Clip applier with clip cartridge interface

Family Cites Families (57)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2733441A (en) * 1956-02-07 white
US1203269A (en) * 1913-07-22 1916-10-31 Gustav F Richter Wound-clip forceps.
US1199653A (en) * 1916-05-10 1916-09-26 Giulio Bacolini Surgical instrument.
US2090831A (en) * 1935-12-16 1937-08-24 Harry A Burkhardt Surgical instrument
US2194748A (en) * 1937-04-15 1940-03-26 Mark A Glaser Clip applicator
US2237589A (en) * 1939-03-06 1941-04-08 Edward H Kruse Magazine for surgical ligatures
US2594102A (en) * 1950-05-03 1952-04-22 Vollmer Leonhard Automatic inserter for suturing clips
US2744251A (en) * 1953-06-04 1956-05-08 Vollmer Leonhard Automatic inserter for suturing clips
US2968041A (en) * 1958-09-25 1961-01-17 John F Skold Applicator for surgical clamps
US3086208A (en) * 1960-10-06 1963-04-23 Ethicon Inc Surgical clip assembly
US3047874A (en) * 1960-10-17 1962-08-07 W D Dailey Magazine-type clip forceps
US3234636A (en) * 1962-03-19 1966-02-15 Ernest C Wood Clip applicator
US3110899A (en) * 1962-04-12 1963-11-19 Ethicon Inc Surgical clip applier
US3152336A (en) * 1962-07-02 1964-10-13 Technical Oil Tool Corp Wound clip applicator
US3518993A (en) * 1967-05-01 1970-07-07 American Hospital Supply Corp Surgical clip applicator
CA925395A (en) * 1969-07-04 1973-05-01 Dbm Industries Limited Stapler device
IE36591B1 (en) * 1971-09-17 1976-12-08 Ici Ltd Wound clip applicator
US3777538A (en) * 1972-03-15 1973-12-11 Weck & Co Edward Surgical clip applicator
US3780416A (en) * 1972-07-10 1973-12-25 G Rider Surgical tubing clip clenching tool
USRE28932E (en) * 1972-09-29 1976-08-17 United States Surgical Corporation Surgical stapling instrument
US3882854A (en) * 1973-08-23 1975-05-13 Research Corp Surgical clip and applicator
US3873016A (en) * 1973-11-30 1975-03-25 Meyer Fishbein Pliers type surgical stapler for joining disunited skin or fascia
US4027510A (en) * 1974-05-15 1977-06-07 Siegfried Hiltebrandt Forceps
US4166466A (en) * 1976-10-08 1979-09-04 Jarvik Robert K Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
US4226242A (en) * 1977-09-13 1980-10-07 United States Surgical Corporation Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
US4412539A (en) * 1976-10-08 1983-11-01 United States Surgical Corporation Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
US4316468A (en) * 1977-08-05 1982-02-23 Charles H. Klieman Surgical stapler
US4452376A (en) * 1977-08-05 1984-06-05 Charles H. Klieman Hemostatic clip applicator
CA1082552A (en) * 1977-08-05 1980-07-29 Charles H. Klieman Hemostatic clip applicator
US4152920A (en) * 1977-10-17 1979-05-08 United States Surgical Corporation System for applying surgical clips
JPS5499386A (en) * 1977-10-17 1979-08-06 United States Surgical Corp Device for setting surgical clip
US4242902A (en) * 1978-05-11 1981-01-06 United States Surgical Corporation Surgical clip applicator
US4196836A (en) * 1978-02-14 1980-04-08 Senco Products Inc. Surgical stapling instrument
US4204623A (en) * 1978-07-17 1980-05-27 United States Surgical Corporation Manually powered surgical stapling instrument
US4202480A (en) * 1979-02-26 1980-05-13 Minnesota Mining And Manufacturing Company Stapler including means for preventing double feeding of staples
US4440170A (en) * 1979-03-06 1984-04-03 Ethicon, Inc. Surgical clip applying instrument
US4246903A (en) * 1979-04-02 1981-01-27 American Cyanamid Company Surgical instrument to apply a hemostatic clip to a vessel and method of using the same
US4299224A (en) * 1979-06-06 1981-11-10 United States Surgical Corporation Disposable clip applier
US4296751A (en) * 1979-08-02 1981-10-27 Blake Joseph W Iii Surgical device
US4396139A (en) * 1980-02-15 1983-08-02 Technalytics, Inc. Surgical stapling system, apparatus and staple
US4480640A (en) * 1980-04-22 1984-11-06 Senco Products, Inc. Ligating device
US4565199A (en) * 1980-04-22 1986-01-21 Senmed, Inc. Ligator
US4406392A (en) * 1980-05-27 1983-09-27 American Cyanamid Company Surgical stapling instrument
US4391402A (en) * 1980-05-27 1983-07-05 American Cyanamid Company Surgical stapling control means
US4452357A (en) * 1980-07-22 1984-06-05 Charles H. Klieman Surgical stapler
US4430997A (en) * 1980-11-19 1984-02-14 Ethicon, Inc. Multiple clip applier
US4500024A (en) * 1980-11-19 1985-02-19 Ethicon, Inc. Multiple clip applier
US4478220A (en) * 1982-02-05 1984-10-23 Ethicon, Inc. Ligating clip cartridge
US4480641A (en) * 1982-02-05 1984-11-06 Ethicon, Inc. Tip configuration for a ligating clip applier
US4471780A (en) * 1982-02-05 1984-09-18 Ethicon, Inc. Multiple ligating clip applier instrument
US4425915A (en) * 1982-02-26 1984-01-17 Ethicon, Inc. Surgical clip applier with in-line cartridge and interruptable biased feeder
US4427008A (en) * 1982-02-26 1984-01-24 Ethicon, Inc. Multiple ligating clip applier with rocking escapement
US4450839A (en) * 1982-02-26 1984-05-29 Ethicon, Inc. Surgical clip applier with serpentine spring clip feeder
US4478218A (en) * 1982-02-26 1984-10-23 Ethicon, Inc. Ligating clip and applier instrument therefor with clip engaging escapement
US4450840A (en) * 1982-02-26 1984-05-29 Ethicon, Inc. Ligating clip with flanged base having a recessed engaging face
US4492232A (en) * 1982-09-30 1985-01-08 United States Surgical Corporation Surgical clip applying apparatus having fixed jaws
US4512345A (en) * 1982-09-30 1985-04-23 United States Surgical Corporation Surgical clip applying apparatus, and clips and clip train for use therein

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JPH0533048B2 (en) 1993-05-18
DE3590364T1 (en) 1986-08-28
BR8506843A (en) 1986-09-23
EP0170592B1 (en) 1990-10-17
DE3590364C2 (en) 1988-01-07
WO1986000794A1 (en) 1986-02-13
AU4503585A (en) 1986-01-30
JPS61501131A (en) 1986-06-12
ATE57464T1 (en) 1990-11-15
EP0170592A2 (en) 1986-02-05
GB2177302A (en) 1987-01-21
GB2177302B (en) 1988-01-06
GB8607001D0 (en) 1986-04-23
AU578481B2 (en) 1988-10-27
US4616650A (en) 1986-10-14
EP0170592A3 (en) 1987-11-25

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