Interoperable clamp loading device

Abstract

An intraoperative clamp loading device includes an elongated body that can be positioned at the surgical site via a cannula during endoscopic surgery to supply a ligation clamp to a clamp applicator. The elongated body includes structures for supporting and advancing the ligation clamp within the elongated body.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit and priority of U.S. Provisional Patent Application Serial No. 63 / 000,091, filed March 26, 2020, the entire contents of which are incorporated herein by reference. Technical Field

[0003] The technology generally relates to surgical clamp applicators, and more specifically, to clamp loading devices for loading ligation clamps into ligation clamp applicators during surgery. Background Technology

[0004] Endoscopic ligation clamp applicators are used to apply ligation clamps to blood vessels during surgical procedures to occlude or partially occlude them. These applicators are inserted through a small-diameter cannula or a small incision in the patient to access the surgical site within a body cavity. Performing surgery endoscopically reduces the amount of trauma to the patient during surgery, thereby minimizing patient discomfort and reducing recovery time.

[0005] Surgical clip applicators include single-firing clip applicators and multi-firing clip applicators. In a single-firing clip applicator, the ligation clip is loaded into the applicator after each use. Typically, the clip applicator is used to remove a single clip from its packaging to load the clip into the jaws of the applicator before each use. During endoscopic procedures using a single-firing clip applicator, the applicator is removed from the body cavity after each use to reload the ligation clip into the applicator. This process is time-consuming and increases the risk of infection, thus increasing trauma to the patient.

[0006] Multiple-fire clamp applicators include a clamp box coupled to an elongated body of the clamp applicator, which includes multiple ligation clamps sequentially supplied to the jaws of the clamp applicator to facilitate the placement of multiple clamps on one or more body vessels without removing the clamp applicator from the body cavity. These clamp applicators are complex, especially when a distal portion of the clamp applicator needs to be articulated. Summary of the Invention

[0007] This disclosure relates to a clamp loading device for a clamp applicator. The clamp loading device includes an elongated body that can be positioned at the surgical site during endoscopic surgery to supply a ligation clamp to the clamp applicator.

[0008] This disclosure relates to an intraoperative clamp loading device including a handle assembly, an elongated body, a guide member, a clamp retainer, a plurality of ligation clamps, a clamp locking arm, and a clamp advancing member. The handle assembly includes a handle gripper. The elongated body has a proximal portion and a distal portion, and defines a longitudinal axis. The proximal portion is coupled to the handle assembly. The elongated body includes an outer tube having a distal portion defining an opening and including an inner wall. The guide member is positioned on the distal portion of the outer tube and includes radially opposing channels configured to receive the jaws of a clamp applicator. The clamp retainer is supported on the inner wall of the outer tube and defines a clamp retaining recess positioned along the longitudinal axis of the elongated body. Each of the plurality of ligation clamps is supported within one of the clamp retaining recesses and includes a first beam, a second beam, and a hinge portion connecting the first beam to the second beam. Each of the first and second beams includes a spaced-apart boss. The clamp locking arm is supported within the distal portion of the outer tube and is formed of an elastic material. The clamp locking arm is aligned with a corresponding channel in the guide member and includes a recess configured to receive a spaced-out boss of a corresponding one of the first and second beams of the ligation clamp. The clamp advancing member includes an elongated member and a plurality of resilient fingers. Each of the resilient fingers engages a corresponding one of the plurality of ligation clamps. The clamp advancing member is movable from a retracted position to an advanced position within the outer tube, allowing the plurality of clamps to move distally within the outer tube.

[0009] Other aspects of this disclosure relate to an intraoperative clamp loading device comprising an elongated body, a clamp retainer, a plurality of ligation clamps, a clamp locking arm, and a clamp advancing member. The elongated body has a proximal portion and a distal portion, and defines a longitudinal axis. The elongated body includes an outer tube having a distal portion defining an opening and including an inner wall. The clamp retainer is supported on the inner wall of the outer tube and defines a clamp retaining recess along the longitudinal axis of the elongated body. Each of the longitudinal portions includes a flexible tab with a stop surface. Each of the plurality of ligation clamps is supported within one of the clamp retaining recesses and includes a first beam, a second beam, and a hinge portion connecting the first beam to the second beam. Each of the first beam and the second beam includes a spaced-apart boss. The stop surface of the flexible tab of the clamp retainer is positioned to engage the hinge portion of the plurality of ligation clamps to prevent proximal movement of the plurality of ligation clamps within the outer tube. The clamp locking arm is supported within the distal portion of the outer tube and is formed of an elastic material. The clamp locking arm is aligned with a corresponding channel in the guide member and includes a recess configured to receive a spaced-out boss of a corresponding one of the first and second beams of the ligation clamp. The clamp advancing member includes an elongated member and a plurality of resilient fingers. Each of the resilient fingers engages a corresponding one of the plurality of ligation clamps. The clamp advancing member is movable from a retracted position to an advanced position within the outer tube, allowing the plurality of clamps to move distally within the outer tube.

[0010] Other aspects of this disclosure relate to an intraoperative clamp loading device including a handle assembly, an elongated body, clamp retainers, a plurality of ligation clamps, clamp locking arms, and clamp advancing members. The handle assembly includes a handle gripper and an actuator. The elongated body has a proximal portion and a distal portion, and defines a longitudinal axis. The proximal portion is coupled to the handle assembly. The elongated body includes an outer tube having a distal portion defining an opening and an inner wall. The clamp retainer is supported on the inner wall of the outer tube and defines a clamp retaining recess positioned along the longitudinal axis of the elongated body. The clamp retainer is formed of an elastic material. Each of the clamp retainers includes a base portion and a longitudinal portion fixed to the inner wall of the outer tube. The clamp retainers are positioned along opposite sides of the outer tube, and each clamp retainer is aligned with another clamp retainer such that two radially opposing clamp retainers engage to define one of the clamp retaining recesses. Each of the plurality of ligation clamps is supported within one of the clamp holding recesses and includes a first beam, a second beam, and a hinge portion connecting the first beam to the second beam. Each of the first and second beams includes a spaced-apart boss. A clamp locking arm is supported within a distal portion of the outer tube and is formed of a resilient material. The clamp locking arm is aligned with an opposing channel in the guide member and includes a recess configured to receive a spaced-apart boss of a corresponding one of the first and second beams of the ligation clamp. A clamp advancing member includes an elongated member and a plurality of resilient fingers. Each of the plurality of resilient fingers engages a corresponding one of the plurality of ligation clamps. The clamp advancing member is responsive to actuation of the actuating member to move from a retracted position to an advanced position within the outer tube, thereby moving the plurality of clamps distally within the outer tube.

[0011] In various aspects of this disclosure, the handle assembly includes an actuator movable to move a clamp advance member between its retracted position and its advance position.

[0012] In some aspects of this disclosure, the clamp retainer is formed of an elastic material.

[0013] In some aspects of this disclosure, each of the clamp retainers includes a base portion and a longitudinal portion fixed to the inner wall of the outer tube, and the clamp retainer is positioned along opposite sides of the outer tube to align with another clamp retainer, such that the two radially opposite clamp retainers cooperate to define one of the clamp holding recesses.

[0014] In all aspects of this disclosure, each of the clamp holders includes a lateral portion that interconnects a base portion and a longitudinal portion.

[0015] In some aspects of this disclosure, each of the longitudinal portions includes a flexible tab positioned to engage a hinge portion of a corresponding one of a plurality of ligation clamps to prevent the corresponding ligation clamp from moving proximally within the outer tube.

[0016] In some aspects of this disclosure, each of the flexible tabs is cantilevered to a longitudinal portion of a corresponding one of the clamp holders and includes a distal stop surface.

[0017] In all aspects of this disclosure, the clamp locking arms are cantilevered to the inner wall of the outer tube, and each of the clamp locking arms includes a proximal portion and a distal portion, wherein a recess is formed in the distal portion of the clamp locking member.

[0018] In some aspects of this disclosure, the outer tube defines a cut that aligns with the distal portion of the clamp locking arm, and the distal portion of the clamp locking arm can be deflected outward into the cut to receive one of a plurality of ligation clamps.

[0019] In some aspects of this disclosure, the elastic fingers of the clamp advance member extend inwardly along the distal direction from the elongated member of the clamp advance member to engage with one of the first beams and the second beam of a respective of a plurality of ligation clamps.

[0020] Another aspect of this disclosure relates to a method for loading a ligation clamp into a clamp applicator during surgery, the method comprising inserting the clamp applicator into a patient's body cavity through a first incision in the patient's body; inserting a clamp loading device supporting a plurality of ligation clamps into the body cavity through a second incision in the patient's body; and inserting a jaw assembly of the clamp applicator into the clamp loading device within the body cavity to load a first ligation clamp of the plurality of ligation clamps from the clamp loading device into the jaw assembly of the clamp applicator.

[0021] In various aspects of this disclosure, the method includes applying a ligation clamp to tissue within a patient's body cavity, followed by inserting a jaw assembly of the clamp applicator into a clamp loading device to load a second ligation clamp of a plurality of ligation clamps from the clamp loading device into the jaw assembly of the clamp applicator.

[0022] Other features of this disclosure will be understood from the following description. Attached Figure Description

[0023] The following description, with reference to the accompanying drawings, illustrates various aspects of the disclosed intraoperative ligation clamp loading device, in which:

[0024] Figure 1 This is a side perspective view of the intraoperative ligation clamp loading device according to various aspects of this disclosure;

[0025] Figure 2 yes Figure 1A side perspective view of an exemplary ligation clamp for intraoperative ligation clamp loading device shown in the figure;

[0026] Figure 3 It is along Figure 1 A cross-sectional view of the distal portion of the slender body of the intraoperative ligation clamp loading device, which includes multiple ligation clamps, taken by section line 3-3.

[0027] Figure 4 yes Figure 3 A magnified view of the detail indicator area shown in the image;

[0028] Figure 5 It includes multiple ligation clamps. Figure 1 A cross-sectional view of the central portion of the slender body of the intraoperative ligation clamp loading device shown in the figure;

[0029] Figure 5A It is supported by Figure 1 The image shows a side perspective view of a clamp retainer within a portion of the elongated body of an intraoperative ligation clamp loading device, with a portion of the elongated body shown in dashed lines.

[0030] Figure 5B It is supported by Figure 1 The image shows a side perspective view of a clamp holder within a portion of the elongated body of an intraoperative ligation clamp loading device, wherein a portion of the elongated body is shown in dashed lines and the clamp is supported between the clamp holders;

[0031] Figure 6 This occurs when multiple ligation clamps are advanced within the main body of the intraoperative ligation clamp loading device. Figure 1 A cross-sectional view of the distal portion of the intraoperative ligation clamp loading device is shown in the figure.

[0032] Figure 7 This occurs when multiple ligation clamps are advanced within the main body of the intraoperative ligation clamp loading device. Figure 1 The image shows a cross-sectional view of the central portion of the main body of the intraoperative ligation clamp loading device.

[0033] Figure 8 When the ligation clamp applicator is inserted into the distal portion of the intraoperative ligation clamp loading device, Figure 8A The image shows a lateral perspective view of the distal portion of the intraoperative ligation clamp loading device.

[0034] Figure 8A It is the distal part of the ligation clamp applicator located near the loading device. Figure 1 The image shows a side perspective view of the intraoperative ligation clamp loading device.

[0035] Figure 9 It is along Figure 8The cross-sectional view taken by section line 9-9 shows the ligation clamp applicator located in the distal part of the intraoperative ligation clamp loading device;

[0036] Figure 10 It is along Figure 9 The cross-sectional view taken by section line 10-10; and

[0037] Figure 11 It is a side perspective view of the distal end of the ligation clamp applicator supporting the ligation clamp removed from the distal portion of the intraoperative ligation clamp loading device;

[0038] Figure 12 Is using Figure 1 The flowchart shown in the figure illustrates a method for loading intraoperative clamps.

[0039] Figure 13 It is a perspective view of the patient, in which Figure 1 The intraoperative device and shown in the figure Figure 11 The clamp applicator shown is positioned inside the patient's body;

[0040] Figure 14 yes Figure 13 The image shows a perspective view of the patient's body cavity, where a clamp is applied to the tissue. Figure 1 The intraoperative device and shown in the figure Figure 11 The clamp applicator shown is positioned inside the patient's body;

[0041] Figure 15 yes Figure 14 The image shows a perspective view of the patient's body cavity, where the second clamp is loaded into the clamp applicator. Figure 1 The intraoperative device and shown in the figure Figure 11 The clamp applicator shown is positioned inside the patient's body; and

[0042] Figure 16 yes Figure 13 The image shows a perspective view of the patient's body cavity, where the second clamp is applied to the tissue. Figure 1 The intraoperative device and shown in the figure Figure 11 The clamp applicator shown is positioned inside the patient's body. Detailed Implementation

[0043] The disclosed intraoperative clamp loading device will now be described in detail with reference to the accompanying drawings, wherein in each of the several views, the same reference numerals denote the same or corresponding elements. However, it should be understood that the aspects of this disclosure included herein are merely examples of this disclosure and can be implemented in various forms. Well-known functions or configurations have not been described in detail to avoid obscuring this disclosure with unnecessary detail. Therefore, the specific structural and functional details disclosed herein should not be construed as limiting, but rather serve only as the basis for the claims and as a representative basis for teaching those skilled in the art to adopt this disclosure differently in virtually any suitable detailed structure. Furthermore, directional terms such as front, rear, upper, lower, top, bottom, distal, proximal, and similar terms are used to aid understanding of the description and are not intended to limit this disclosure.

[0044] In this specification, the term "proximal" is generally used to refer to the portion of the device closer to the clinician, while the term "distal" is generally used to refer to the portion of the device further away from the clinician. Furthermore, the term "endoscope" is generally used to refer to endoscopy, laparoscopy, arthroscopy, and / or any other procedures performed through small-diameter incisions or cannulas. Additionally, the term "clinician" is generally used to refer to medical personnel, including physicians, nurses, and support staff.

[0045] The disclosed intraoperative clip loading device includes: an elongated body supporting a plurality of ligation clips; and a clip advancing member for advancing the plurality of ligation clips toward a distal portion of the elongated body. The distal portion of the elongated body defines an accessible opening for loading ligation clip applicators through the distal portion of the elongated body of the intraoperative clip loading device. The elongated body is sized to be positioned through a standard-sized port of a cannula to access the surgical site. The loading device can be positioned within a body cavity during endoscopic surgery to facilitate intraoperative loading of intraoperative ligation clip applicators.

[0046] Figure 1 An exemplary aspect of the disclosed intraoperative clamp loading device (generally shown as loading device 10) is illustrated. Loading device 10 includes a handle assembly 12 and an elongated body 14. The elongated body 14 includes a distal portion 14a and a proximal portion 14b fixedly connected to the handle 12. The handle assembly 12 includes a handle grip 16 and an actuator 18. Although the handle grip 16 is illustrated as a pistol-type grip, it is foreseeable that the handle grip 16 can have a variety of configurations that are ergonomically satisfactory to clinicians.

[0047] Figure 2A ligation clamp 20 is illustrated, with multiple clamps housed within an elongated body 14 of a loading device 10. Each of the ligation clamps 20 includes a first beam 22, a second beam 24, and a hinge portion 26 that interconnects the first beam 22 to the second beam 24 and allows the ligation clamp 20 to pivot between an open position and a clamped position. Each beam includes a boss 28 positioned on opposite sides of the respective beams 22 and 24. As is known in the art, the boss 28 provides an engagement surface that facilitates securing the ligation clamp 20 to the ligation clamp applicator 100. Figure 8A ).

[0048] Figures 3 to 5B An elongated body 14 of the loading device 10 is illustrated, comprising an outer tube 30, a clamp advance member 32, a clamp retainer 34, a clamp locking arm 36, and a guide member 38. The outer tube 30 is hollow and accommodates each of the components of the elongated body 14 listed above, as well as a plurality of ligation clamps 20. The outer tube 30 includes a distal portion 30a that receives or supports the guide member 38. In various aspects of this disclosure, the outer tube 30 and the guide member 38 are integrally formed, although it is contemplated that the guide member 38 may be formed separately from and attached to the outer tube 30. The guide member 38 defines a through-hole 40 and includes a radially opposing rectangular guide channel 42 extending outward from the through-hole 40. The guide channel 42 receives the jaws 112 of the end effector 114 of the clamp applicator 100. Figure 8A The jaws 112 are guided to engage with the farthest clamp 20a of a plurality of clamps 20 supported within the outer tube 30, as described in further detail below.

[0049] exist Figures 5 to 5B The clamp holder 34, best shown in the diagram, is formed of an elastic material and includes a base portion 50 and a flexible arm 52. The flexible arm 52 extends from the base portion and includes a transverse portion 52a and a longitudinal portion 52b. The base portion 50 of each of the clamp holders 34 is fixed to the inner wall 44 of the outer tube 30. Each of the clamp holders 34 is positioned opposite the other to define a clamp holding recess 56 between the two opposing clamp holders 34. The clamp holding recess 56 is defined along the outer tube 30 from the proximal end portion of the outer tube 30 to the distal end portion of the outer tube 30 between the respective opposing clamp holders 34. When the ligation clamp 20 is housed between the longitudinal portions 52b of the two opposing clamp holders 34, the flexible arms 52 of the clamp holders 34 bend outwards, and an inward force is applied to the hinge portion 26 and beams 22 and 24 of the ligation clamp 20 to support the ligation clamp 20 within the outer tube 30 of the elongated body 14 of the loading device 10. Figure 5B ).

[0050] Each of the longitudinal portions 52b of the flexible arms 52 of the clamp holder 34 includes a flexible tab 58 having a proximal end that is cantilevered to the flexible arm 52 and a distal end that defines a distal stop surface 60. When the ligation clamp 20 is housed between the flexible arms 52, the tab 58 deforms inward to allow the ligation clamp 20 to move distally through the tab 58. As the ligation clamp 20 moves past the tab 58, the tab 58 springs outward such that the stop surface 60 of the tab 58 aligns with the hinge portion 26 of a corresponding one of the ligation clamps 20 to impede proximal movement of the ligation clamp 20 within the outer tube 30.

[0051] Figure 3 and Figure 4 A clamp advance member 32 is illustrated, movable within the outer tube 30 between a retracted position and an advanced position, and includes an elongated member 64 and a plurality of resilient fingers 66. Each of the plurality of resilient fingers 66 extends distally from the elongated member 64 at an acute angle into the outer tube 30 and engages a second beam 24 of one of the ligation clamps 20. The elongated member 64 has a proximal portion (not shown) coupled to an actuator 18 of the handle assembly 12, such that actuation of the actuator 18 moves the clamp advance member 32 between its retracted and advanced positions. As the clamp advance member 32 moves from its retracted position to its advanced position, each of the ligation clamps 20 is advanced within the outer tube 30 from a first retaining recess 56 between two opposing clamp holders 34 to a next distally located retaining recess 56 within the outer tube 30.

[0052] The clamp locking arms 36 are cantilevered within the distal portion of the outer tube 30 and are made of an elastic material. Each of the clamp locking arms 36 has a proximal portion 70 fixed to the inner wall 44 of the outer tube 30 and a distal portion 72 including a recess 74. When the ligation clamp 20 is delivered to the position between the clamp locking arms 36 by the clamp advancing member 32, the recess 74 of the clamp locking arm 36 receives the boss 28 of the corresponding ligation clamp 20. The distal portion 72 of each of the clamp locking arms 36 is positioned adjacent to a cut 76 formed in the outer tube 30 of the elongated body 14. When the ligation clamp 30 is advanced to the position between the clamp locking arms 36, the cut 76 receives the distal portion of the clamp locking arm 36. More specifically, when the ligation clamp 20 is delivered by the clamp advance member 32 to the clamp locking arm 36, and when the ligation clamp 20 is removed from the elongated body 14 by the clamp applicator 100 ( Figure 8A The notch 76 allows the clamp locking arm 36 to bend outward, as described in further detail below. The clamp locking arm 36 is longitudinally aligned with the guide channel 42 formed in the guide member 38 and longitudinally aligned with the clamp holding recess 56 defined by the clamp holder 34 positioned along the length of the outer tube 30.

[0053] Figure 6 The illustration depicts the distal portion 14a of the elongated body 14 as the clamping advance member 32 moves toward its advancing position to advance the plurality of clamps 20 within the outer tube 30 of the elongated body 14. When the clamping advance member 32... Figure 6 As the clamp advance member 32 moves toward its advancing position in the direction indicated by arrow "A", each of the elastic fingers 66 engages the corresponding ligation clamp 20 and advances the corresponding ligation clamp 20 from the clamp holding recess 56 to the next distal clamp holding recess 56 defined between two opposing clamp holders 34. The distal clamp 20a of the plurality of ligation clamps 20 is advanced to a position between the clamp locking arms 36. As the distal clamp 20a moves between the clamp locking arms 36, the boss 28 on the distal clamp 20a engages the clamp locking arms 36, causing the distal portion 72 of the clamp locking arms 36 to deflect in the direction indicated by arrow "B" into the cut 76 formed in the outer tube 30. When the farthest ligation clamp 20a moves to a position where the boss 28 of the ligation clamp 20a aligns with the recess 74 in the clamp locking arm 36, the clamp locking arm 36 latches inward to position the boss 28 within the recess 74 so as to clamp the ligation clamp 20a between the clamp locking arms 36.

[0054] As the clamp advance member 32 moves toward its advance position and the ligation clamp 20 is received in the next distal clamp holding recess 56, the ligation clamp 20 passes over one of the flexible tabs 58 of the clamp holder 34. As the ligation clamp 20 passes over the flexible tab 58, the flexible tab 58 deforms inward until the hinge portion 26 of the ligation clamp 20 passes distally over the flexible tab 58. Once the ligation clamp 20 has passed the flexible tab 58, the flexible tab 58 returns to a position where the stop surface 60 of the tab 58 aligns with the hinge portion 26 of the ligation clamp 20 to prevent proximal movement of the ligation clamp 20 within the outer tube 30.

[0055] Figure 7 The diagram illustrates the clamp advance member 32 as it moves from its advance position to its retracted position along the direction of arrow "C". When the clamp advance member 32 returns to its retracted position, the angled resilient fingers 66 toward the distal end of the outer tube 30 engage the ligation clamp 30 positioned proximal to the respective resilient fingers 66. As described above, the flexible tab 58 prevents the ligation clamp 20 from moving proximally within the outer tube 30. Therefore, the resilient fingers 66 of the clamp advance member deform inward toward the elongated member 64 in the direction indicated by arrow "D" and pass beneath the respective ligation clamp 20. At the retracted position of the clamp advance member 32, the resilient fingers 66 return to their position proximal to the respective ligation clamp 20. Figure 3 The undeformed position is shown in the figure.

[0056] Figures 8 to 11 The illustration depicts the ligation clamp applicator 100 being inserted into the distal portion 14a of the elongated body 14 to remove the distal ligation clamp 20a from the loading device 10. Figure 10 The loading device 10 is used during the application of the ligation clamp 20. The clamp applicator 100 includes an end effector 114, which includes jaws 112. The jaws 112 are movable relative to each other to move the ligation clamp 20 from an open position to a clamped position, as known in the art. Each of the jaws 112 of the end effector 114 includes a distal portion, which includes a hook portion 118 defining a recess 120 that receives a boss 28 of the ligation clamp 20 to secure the ligation clamp 20 to the clamp applicator 100.

[0057] To load the ligation clamp 20 onto the clamp applicator 100, the jaws 112 of the clamp applicator 100 are inserted into the channel 42 of the guide member 38 in the distal portion 14a of the loading device 100. The channel 42 is aligned with the clamp holding recess 56 and the clamp locking arm 36 defined by the clamp holder 34, such that the jaws 112 of the clamp applicator 100 are aligned with the first beam 22 and the second beam 24 of the distal ligation clamp 20a. When the jaws 112 engage the distal portion 72 of the clamp locking arm 36, the clamp locking arm 36 moves along... Figure 10 The arrow "E" in the diagram is deflected outwards to release the distal ligation clamp 20a from the recess 74 of the clamp locking arm 36. As the jaws 112 of the clamp applicator 100 move further distally into the outer tube 30 of the loading device 10, the jaws 112 engage the beams 22 and 24 of the ligation clamp 20a, such that the boss 28 is received in the recess 120 of the hook portion 118 of the jaws 112. The stop surface 60 of the tab 58 of the clamp retainer 34 engages the ligation clamp 20a to prevent the ligation clamp 20a from moving proximally within the outer tube 30. Once the boss 28 is received in the recess 120 of the jaw member 112, the end effector 114 of the clamp applicator 100 can be removed from the loading device 10 with the ligation clamp 20 supported on the jaws 112. Figure 11 After the distal ligation clamp 20a is removed from the elongated body 14 of the loading device 10, the actuator 18 of the handle assembly 12 of the loading device 10 can be actuated to advance the ligation clamp 20 within the elongated body 14, thereby positioning the distal clamp 20a between the clamp locking arms 36 of the loading device 10.

[0058] The disclosed loading device 10 can be inserted into the surgical site within a body cavity via a cannula (not shown) to facilitate reloading of the disposable clamp applicator 100 during surgical procedures at the surgical site. The elongated body 14 has a length to access the surgical site and accommodate multiple ligation clamps 20 (e.g., five or more ligation clamps 20). The loading device 10 eliminates the need for removal of the disposable clamp applicator from the body cavity via a cannula, thus facilitating the reloading of the clamp applicator 100.

[0059] Figures 12 to 16 The illustration depicts the use of the loading device 10 and the clamp applicator 100 during a surgical procedure requiring more than one ligation clamp 20 to ligate body vessels 200. During the surgical procedure, the clamp applicator 100 and the loading device 10 are inserted into the patient's "P" through a separate incision "I" to access the body cavity "BC". Figure 14 ). ( Figure 12 Steps 300 and 302 in the process. It is foreseeable that sleeves 202a and 202b can be positioned within the cut "I", and the clamp applicator 100 and loading device 10 can be inserted through sleeves 202a and 202b. In various aspects of this disclosure, when the clamp applicator 100 is inserted through sleeve 202a, the clamp applicator 100 is loaded with the first clamp 20a (…). Figure 14 After the clamp applicator 100 is inserted through the cannula 202a, the clamp applicator 100 is manipulated to surround the body's blood vessels 200 with the jaws 112 of the clamp applicator 100. Figure 14 The clamp applicator 100 is positioned and actuated to close the ligation clamp 20a around the body's blood vessels 200. Figure 12 (Step 304). After the ligation clamp 20a is closed around the body vessel 200, the jaws 112 of the clamp applicator 100 are removed from around the closed ligation clamp 20a and inserted into the distal end of the loading device 10 in the manner described above. Figure 15 ), to retrieve the second ligation clamp 20b from the loading device 10. Figure 16 ). ( Figure 12 (Step 306). Once the second ligation clamp 20b is supported between the jaws 112 of the clamp applicator 100, the jaws 112 of the clamp applicator 100 are removed from the loading device 10, and the clamp applicator 100 is manipulated to reposition the jaws 112 of the clamp applicator 100 around the body vessel 200 (or around a different body vessel). Figure 16 ). ( Figure 12 (Step 308 in the original text). The clamp applicator 100 can now be actuated to close the second ligation clamp 20b around the body vessel 200. After each ligation clamp 20 is placed, the process can be repeated to reload the clamp applicator 100. Figure 12(Step 310 in the process). In order to advance the clamps 20a-b within the loading device 10 to allow the clamp applicator 100 to retrieve the clamps 20 within the loading device 10, the actuator 18 of the loading device 10 must be operated to advance the clamps 20a-b within the loading device 10.

[0060] It is foreseeable that the clamp applicator 10 can be inserted through the cannula 202a without the ligation clamp 20 supported between the jaws 112 of the clamp applicator 10. In such a case, the jaws 112 of the clamp applicator 100 can be inserted into the loading device 10 to retrieve the clamps 20a-b before placing the first ligation clamp 20a around the body's blood vessels 200. Inserting the clamp applicator 100 through the cannula 202a without the clamps 20a-b loaded between the jaws 112 allows the clamp applicator 100 to be inserted through a smaller diameter cannula.

[0061] Those skilled in the art will understand that the apparatuses and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary aspects of this disclosure. It is foreseeable that elements and features illustrated or described in connection with one exemplary embodiment may be combined with elements and features of another without departing from the scope of this disclosure. Similarly, those skilled in the art will understand other features and advantages of this disclosure based on the aspects of this disclosure described above. Therefore, this disclosure is not limited to what has been specifically shown and described, except as indicated by the appended claims.

Claims

1. An intraoperative clamp loading device, comprising: A handle assembly, including a handle grip; An elongated body having a proximal portion and a distal portion and defining a longitudinal axis, the proximal portion being coupled to the handle assembly, the elongated body including an outer tube having a distal portion defining an opening and including an inner wall; A guide member, positioned on the distal portion of the outer tube, the guide member including a radially opposing channel configured to receive the jaws of a clamping applicator; A clamp retainer supported on the inner wall of the outer tube, the clamp retainer defining a clamp retaining recess along the longitudinal axis of the elongated body, the clamp retainer being formed of an elastic material, each of the clamp retainers including a longitudinal portion and a base portion fixed to the inner wall of the outer tube, the clamp retainers being positioned along opposite sides of the outer tube, each of the clamp retainers being aligned with the other of the clamp retainers such that two radially opposing clamp retainers cooperate to define one of the clamp retaining recesses; A plurality of ligation clamps, each of the plurality of ligation clamps being supported within one of the clamp holding recesses, and including a first beam, a second beam, and a hinge portion connecting the first beam to the second beam, each of the first beam and the second beam including spaced-apart bosses; A clamp locking arm, supported within the distal portion of the outer tube, the clamp locking arm being formed of an elastic material and aligned with the radially opposing channel in the guide member, each clamp locking arm including a recess configured to receive a spaced-out boss of a corresponding one of the first beam and the second beam of the ligation clamp; as well as A clamp advancing member includes an elongated member and a plurality of resilient fingers, each of the plurality of resilient fingers engaging a corresponding one of the plurality of ligation clamps, the clamp advancing member being capable of moving from a retracted position to an advancing position within the outer tube to move the plurality of ligation clamps distally within the outer tube.

2. The intraoperative clamp loading device according to claim 1, wherein the handle assembly includes an actuator capable of moving the clamp advance member between its retracted position and its advance position.

3. The intraoperative clamp loading device of claim 1, wherein each of the clamp holders includes a transverse portion that interconnects the base portion and the longitudinal portion.

4. The intraoperative clamp loading device according to claim 3, wherein each of the longitudinal portions includes a flexible tab positioned to engage the hinge portion of a corresponding ligation clamp among the plurality of ligation clamps to prevent the corresponding ligation clamp from moving proximally within the outer tube.

5. The intraoperative clamp loading device of claim 4, wherein each of the flexible tabs is cantilevered to the longitudinal portion of the corresponding one of the clamp holders and includes a distal stop surface.

6. The intraoperative clamp loading device according to claim 1, wherein the clamp locking arm is cantilevered to the inner wall of the outer tube, each of the clamp locking arms including a proximal portion and a distal portion, the recess being formed in the distal portion of the clamp locking arm.

7. The intraoperative clamp loading device of claim 6, wherein the outer tube defines an incision aligned with the distal portion of the clamp locking arm, the distal portion of the clamp locking arm being deflected outward into the incision to receive one of the plurality of ligation clamps.

8. The intraoperative clamp loading device of claim 1, wherein the resilient fingers of the clamp advancing member extend distally inward from the elongated member of the clamp advancing member to engage with one of the first beam and the second beam of a respective of the plurality of ligation clamps.

9. An intraoperative clamp loading device, comprising: An elongated body having a proximal portion and a distal portion and defining a longitudinal axis, the elongated body including an outer tube having a distal portion defining an opening and including an inner wall; A clamp retainer supported on the inner wall of the outer tube, the clamp retainer defining a clamp retaining recess along the longitudinal axis of the elongated body, the clamp retainer being formed of an elastic material, each of the clamp retainers including a longitudinal portion and a base portion fixed to the inner wall of the outer tube, each of the longitudinal portions including a flexible tab having a stop surface, the clamp retainers being positioned along opposite sides of the outer tube, each of the clamp retainers being aligned with the other of the clamp retainers such that two radially opposing clamp retainers cooperate to define one of the clamp retaining recesses; A plurality of ligation clamps, each of which is supported within one of the clamp holding recesses, and includes a first beam, a second beam, and a hinge portion connecting the first beam to the second beam, each of the first beam and the second beam including a spaced-apart boss, wherein the stop surface of the flexible protrusion of the clamp holder is positioned to engage the hinge portion of the plurality of ligation clamps to prevent the plurality of ligation clamps from moving proximally within the outer tube; A clamp locking arm, supported within the distal portion of the outer tube, the clamp locking arm being formed of an elastic material and aligned with a corresponding channel in the guide member, each clamp locking arm including a recess configured to receive a spaced-out boss of a corresponding one of the first beam and the second beam of the ligation clamp; as well as A clamp advancing member includes an elongated member and a plurality of resilient fingers, each of the plurality of resilient fingers engaging a corresponding one of the plurality of ligation clamps, the clamp advancing member being capable of moving from a retracted position to an advancing position within the outer tube to move the plurality of ligation clamps distally within the outer tube.

10. The intraoperative clamp loading device of claim 9, further comprising a handle assembly including a handle gripper and an actuator coupled to the clamp advancement member such that movement of the actuator causes the clamp advancement member to move between its retracted position and its advanced position.

11. The intraoperative clamp loading device of claim 9, further comprising a guide member positioned on the distal portion of the outer tube, the guide member including a radially opposing channel configured to receive the jaws of a clamp applicator.

12. The intraoperative clamp loading device of claim 9, wherein each of the clamp holders includes a transverse portion that interconnects the base portion of the clamp holder and the longitudinal portion of the clamp holder.

13. The intraoperative clamp loading device of claim 9, wherein each of the flexible tabs is cantilevered to the longitudinal portion of a corresponding one of the clamp holders and includes a distal stop surface.

14. The intraoperative clamp loading device of claim 9, wherein the clamp locking arm is cantilevered to the inner wall of the outer tube, each of the clamp locking arms including a proximal portion and a distal portion, the recess being formed in the distal portion of the clamp locking arm.

15. The intraoperative clamp loading device of claim 14, wherein the outer tube defines an incision aligned with the distal portion of the clamp locking arm, the distal portion of the clamp locking arm being deflected outward into the incision to receive one of the plurality of ligation clamps.

16. The intraoperative clamp loading device of claim 9, wherein the resilient fingers of the clamp advancing member extend distally inward from the elongated member of the clamp advancing member to engage with one of the first beam and the second beam of a respective of the plurality of ligation clamps.

17. An intraoperative clamp loading device, comprising: A handle assembly, which includes a handle grip and an actuator; An elongated body having a proximal portion and a distal portion and defining a longitudinal axis, the proximal portion being coupled to the handle assembly, the elongated body including an outer tube having a distal portion defining an opening and an inner wall; A clamp retainer supported on the inner wall of the outer tube, the clamp retainer defining a clamp retaining recess along the longitudinal axis of the elongated body, the clamp retainer being formed of an elastic material, each of the clamp retainers including a longitudinal portion and a base portion fixed to the inner wall of the outer tube, the clamp retainers being positioned along opposite sides of the outer tube, each of the clamp retainers being aligned with the other of the clamp retainers such that two radially opposing clamp retainers cooperate to define one of the clamp retaining recesses; A plurality of ligation clamps, each of the plurality of ligation clamps being supported within one of the clamp holding recesses, and including a first beam, a second beam, and a hinge portion connecting the first beam to the second beam, each of the first beam and the second beam including spaced-apart bosses; A clamp locking arm, supported within the distal portion of the outer tube, the clamp locking arm being formed of an elastic material and aligned with a corresponding channel in the guide member, each clamp locking arm including a recess configured to receive a spaced-out boss of a corresponding one of the first beam and the second beam of the ligation clamp; as well as A clamp advancing member includes an elongated member and a plurality of resilient fingers, each of the plurality of resilient fingers engaging a corresponding one of the plurality of ligation clamps, the clamp advancing member being capable of moving from a retracted position to an advanced position within the outer tube in response to actuation of the actuator, thereby moving the plurality of ligation clamps distally within the outer tube.

18. The intraoperative clamp loading device of claim 17, wherein each of the clamp holders includes a transverse portion that interconnects the base portion and the longitudinal portion.

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