Apparatus and method for removing a clip

Abstract

An endoscopic apparatus comprises a pair of jaws pivotably connected to each other and movable between an open position and a closed position. The jaws comprise respective opposing gripper portions. Each gripper portion comprises a distal end, a proximal end, and an inside surface extending between the distal and proximal ends. At the closed position, the inside surfaces define a jaw gap therebetween. At least a portion of the jaw gap increases in distance along a direction from the distal end toward the proximal end. An actuating mechanism communicates with the jaws for moving the jaws between the open and closed position. In a surgical procedure in which a clip such as a hemostatic clip has been latched around a blood vessel or other tissue, the apparatus can be used to compress the clip and consequently unlatch the clip, thereby releasing the clip from the vessel. Thereafter, the apparatus can be rotated. After rotation, the apparatus can be used to grasp the clip and subsequently remove the clip from the surgical site.

Description

TECHNICAL FIELD [0001] The present invention generally relates to the design and use of adapted for manipulating small objects such as surgical clips. More specifically, the present invention relates to surgical endoscopic instruments that can be actuated to unlatch clips from a surgical site such as a ligature and subsequently extract such clips from the surgical site. BACKGROUND ART [0002] Many surgical procedures require vessels or other tissues of the human body to be ligated during the surgical process. For example, many surgical procedures require cutting blood vessels (e.g., veins or arteries), and these blood vessels may require ligation to reduce bleeding. In some instances, a surgeon may wish to ligate the vessel temporarily to reduce blood flow to the surgical site during the surgical procedure. In other instances a surgeon may wish to permanently ligate a vessel. Ligation of vessels or other tissues can be performed by closing the vessel with a ligating clip, or by sutur...

AI Technical Summary

Benefits of technology

The present invention provides an endoscopic apparatus for unlatching a clip that is initially provided in a latched state. The apparatus includes first and second jaws that are pivotably connected and movable between an open position and a closed position. The jaws have inside surfaces with a jaw gap therebetween that increases in distance along a direction from the distal ends of the jaws to the proximal ends. The apparatus also includes an actuating mechanism that causes the jaws to move between the open and closed positions. The invention provides a method for engaging the clip with the jaws and compressing it to separate the clip's first and second legs. The apparatus and method have advantages in manipulating clips of the type described above.

Problems solved by technology

The use of surgical thread for ligation requires complex manipulations of the needle and suture mate rial to form the knots required to secure the vessel.

Such complex manipulations are time-consuming and difficult to perform, particularly in endoscopic surgical procedures, which are characterized by limited space and visibility.

With the advent of high technology diagnostic techniques using computer tomography (CATSCAN) and magnetic resonance (MRI), metallic clips have been found to interfere with the imaging techniques.

Unlike metallic clips, which are usually symmetric, polymeric clips are usually asymmetric in design and hence lack an axis of symmetry.

As indicated above, instruments employed to install metal and polymeric clips are solely dedicated to the clip applying function, and thus cannot be reversely operated to remove the clip once applied.

In the past, a satisfactory instrument for removing latching polymeric clips had not been available.

Such removal techniques require substantial time and dexterity to safely remove the clip without adverse consequences to surrounding tissue.

As endoscopic techniques have been developed, certain inadequacies in the available surgical equipment have become apparent.

For example, the jaws of the removing instrument, which are typically used to disengage the clip from the vessel, may exert unequal pressure on the clip, resulting in a “scissoring” effect and damage to the vessel.

In addition, the jaws may impart excessive force on the clip and consequently crush the clip, thereby creating a risk that pieces of the clip are not removed from the body cavity.

In prior art devices, the force applied to the clip has been difficult to control by the surgeon using the clip removal instrument.

In other instances, the clip may not be properly oriented when it is placed within the jaws, or may slip out of alignment or even be ejected from the jaws during use of the removal instrument.

This can result in the loss and / or crushing of the clip or pieces thereof, damage to tissue, or otherwise unsuccessful use of the removal instrument.

Moreover, existing clip removal instruments have been designed primarily for manipulating symmetric clips, and therefore are not well suited to satisfy design issues unique to asymmetric clips.

Conventional clip removal instruments designed for symmetric clips may not provide the ability to adequately compress or approximate a clip.

As an additional problem, while clip removers of the prior art are capable of unlatching the clip, once the clip has been unlatched, the same instruments are not additionally capable of actually removing the clip from the surgical site and subsequently extracting the clip from the body cavity through the surgical port.

Images