Instrument and method for unlatching surgical clips - Patents.com

Abstract

The present invention relates to a method and device for unlatching a clip. The clip may have first and second leg members, the first leg member having a hook member and the second leg member having a tip member constrained in a latched configuration by the hook member. The method may include the steps of placing the clip between first and second jaw members of the device and engaging the hook member of the first leg member with a wall of the second jaw member. The method may further include pressing an outer surface of the first leg member with the first jaw member to open the hook member and release the clip from the latched configuration and placing the tip member within a channel of the second jaw member after it has been released from the constrained state by the hook member and the tip member is spaced from the hook member.

Description

[Technical field]

[0001] FIELD OF THE DISCLOSURE The present disclosure relates generally to instruments and methods for unlatching and / or extracting (or removing) clips, and more particularly to instruments and methods for unlatching and / or extracting surgical clips from tissue.

[0002] [Citation to Related Applications] This application claims priority to U.S. Provisional Patent Application No. 63 / 185,920, filed May 7, 2021, the disclosure of which is incorporated by reference in its entirety. [Background technology]

[0003] Ligation of tissue (e.g., blood vessels, lymph nodes, nerves, fallopian tubes, or cardiac tissue) is a common procedure in many surgical procedures. Ligation of tissue may be performed by closing the vessel with a surgical clip or by suturing the vessel with a surgical thread. Using a suture for ligation requires complex manipulation of needles and sutures to create the knot required to secure the vessel. Such complex manipulations are time-consuming and difficult to perform, especially during endoscopic surgical procedures characterized by limited space and visibility. In contrast, surgical clips can be quickly secured in a temporary or permanent manner. Thus, the use of surgical clips during endoscopic as well as open surgical procedures has increased dramatically. Summary of the Invention [Problem to be solved by the invention]

[0004] The present inventors have recognized that there is a need for an improved technique to address the inefficiencies of current instruments for unlatching and / or extracting surgical clips. Current instruments are often specifically designed to unlatch one particular design of clip and often do not work with clips with curved leg members and / or clips with large radii of curvature. Current unlatching instruments also can be difficult to remove or extract from the implantation site without compressing the clip back to its closed configuration and re-latching to tissue. Additionally, current unlatching instruments require additional instruments to remove or extract the surgical clip.

[0005] One aspect of the invention relates to an instrument for unlatching a clip from a latched configuration, the clip having first and second leg members, the first leg member having a hook member and the second leg member having a tip member that is captured by the hook member in the latched configuration, the instrument having a first jaw member configured to press against an outer surface of the first leg member to release the clip from the latched configuration, and a second jaw member having a wall configured to engage the hook member and a channel configured to receive the tip member when released from capture by the hook member.

[0006] In some embodiments, the first jaw member has a length that is shorter than the length of the second jaw member. In some embodiments, at least a portion of the channel is open on both lateral sides. In some embodiments, the wall has a groove configured to receive the hook member, the groove having a distal slope configured to bias the hook member. In some embodiments, the first jaw member has a channel configured to receive an outer surface of the first leg member. In some embodiments, the first jaw member has at least one tooth configured to engage an outer surface of the first leg member. In some embodiments, the channel of the second jaw member has a distal portion with a distal slope. In some embodiments, the channel of the second jaw member has a proximal portion with a proximal slope. In some embodiments, the channel of the second jaw member has a distal portion with a first width and a proximal portion with a second width, the first width being greater than the second width. In some embodiments, at least one of the first jaw member and the second jaw member has an aperture that allows visualization of a surgical clip. In some embodiments, the first jaw member has at least one engagement member configured to removably secure the clip to the instrument after unlatching. In some embodiments, the at least one engagement member includes a first engagement member and a second engagement member configured to receive a portion of the clip therebetween. In some embodiments, the first and second engagement members have first and second hook members extending inwardly toward one another. In some embodiments, the instrument has a proximal recess formed between the first and second jaw members and configured to receive a hinge member of a surgical clip.

[0007] Another aspect of the invention relates to an instrument for unlatching a clip from a latched configuration, which may include a first jaw member configured to press against an outer surface of the first leg member to release the clip from the latched configuration, and a second jaw member configured to engage the hook member, the first jaw member having at least one engagement member configured to removably secure the clip to the instrument after unlatching.

[0008] In some embodiments, the at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip therebetween. In some embodiments, the first and second engaging members have first and second hook members extending inwardly toward one another. In some embodiments, the at least one engaging member is configured to engage first and second wing members of a surgical clip. In some embodiments, the first and second wing members have an inner surface spaced apart from an inner surface of the surgical clip and / or an outer surface spaced apart from an outer surface of the surgical clip. In some embodiments, the first and second engaging members have a substantially flat inner side. In some embodiments, the at least one engaging member has an underside that is angled, chamfered, and / or beveled to facilitate insertion of the surgical clip.

[0009] Yet another aspect of the invention relates to a method of unlatching a clip from a latched configuration, the clip having first and second leg members with distal portions that engage one another in the latched configuration, the method may include receiving the clip between first and second jaw members of an instrument, pressing an outer surface of the first leg member with the first jaw member to release the clip from the latched configuration, and receiving a distal portion of the second leg member within a channel of the second jaw member after being released from restraint by the first leg member.

[0010] In some embodiments, the first jaw member has a length that is less than the length of the second jaw member. In some embodiments, the distal portion of the first leg member has a hook member and the distal portion of the second leg member has a tip member that is restrained in a latched configuration by the hook member, the hook member deflecting when pressed to release the clip from the latched configuration and the tip member spaced apart from the hook member when received within the channel of the second jaw member. In some embodiments, at least a portion of the channel is open on both lateral sides. In some embodiments, the method further includes engaging the distal portion of the first leg member with a wall of the second jaw member. In some embodiments, engaging the distal portion of the first leg member includes receiving the distal portion of the first leg member within a groove in the wall. In some embodiments, the groove has a distal slope to open the hook member at the distal portion of the first leg member. In some embodiments, the step of pushing an outer surface of the first leg member includes pushing an intermediate portion of the outer surface of the first leg member with the first jaw member. In some embodiments, the method includes the step of receiving the outer surface of the first leg member within a channel of the first jaw member. In some embodiments, the first jaw member has at least one tooth configured to engage the first leg member. In some embodiments, the first and second leg members are curved and the outer surface of the first leg member is convex, and the step of pushing the outer surface of the first leg member includes straightening the first leg member. In some embodiments, the method further includes the step of pushing the first leg member to deflect the first leg member past a straightened configuration. In some embodiments, the step of receiving at least a portion of the second leg member within the channel of the second jaw member includes the step of receiving a distal portion of the second leg member within a distal portion of the channel with a distal slope. In some embodiments, receiving at least a portion of the second leg member within the channel of the second jaw member includes receiving a proximal portion of the second leg member within a proximal portion of the channel having a proximal slope.In some embodiments, the distal portion of the channel of the second jaw member has a width greater than a width of a proximal portion of the channel of the second jaw member. In some embodiments, the method includes visualizing the clip through an aperture in at least one of the first and second jaw members. In some embodiments, the method further includes extracting the clip from the implantation site with an instrument. In some embodiments, the method further includes receiving a hinge member of the clip within a proximal recess of the instrument formed between the first and second jaw members. In some embodiments, the method further includes receiving a portion of the first leg member between at least one engagement member of the first jaw member. In some embodiments, the at least one engagement member includes first and second engagement members. In some embodiments, the method further includes receiving a wing member extending from a side of the first leg member between the first and second engagement members.

[0011] Thus, in some embodiments, the method may involve a method of unlatching a clip from a latched configuration, the clip having first and second leg members, the first leg member having a hook member, the second leg member having a tip member restrained in the latched configuration by the hook member, the first and second leg members being curved. The method includes the steps of placing the clip between a first jaw member and a second jaw member of an instrument, engaging the hook member of the first leg member with a wall of the second jaw member, pressing a convex outer surface of the first leg member with the first jaw member to straighten the first leg member, thereby deflecting the hook member and releasing the clip from the latched configuration, and placing the tip member within a channel of the second jaw member after the tip member is released from restraint by the hook member such that the tip member is spaced apart from the hook member. Additionally, the first jaw member may have a length that is shorter than a length of the second jaw member.

[0012] In order that the invention may be readily understood, aspects thereof will now be described, by way of example only, with reference to the accompanying drawings, in which: [Brief description of the drawings]

[0013] [Figure 1] 1 is a side view of an exemplary instrument for unlatching surgical clips in accordance with one embodiment of the present invention; [Diagram 2] FIG. 2 is a side view of a first embodiment of a jaw mechanism of the instrument of FIG. 1 illustrating the jaw mechanism engaging an exemplary surgical clip. [Diagram 3] FIG. 3 is an isometric view of the device of FIGS. 1 and 2. [Figure 4] 3 is a side view of the exemplary surgical clip of FIG. 2. [Diagram 5] FIG. 4 is an isometric view of a first jaw member of the jaw mechanism of FIGS. 2 and 3; [Figure 6] FIG. 4 is an isometric view of a second jaw member of the jaw mechanism of FIGS. 2 and 3; [Figure 7] FIG. 7 illustrates a method of unlatching the surgical clip of FIGS. 2 and 4 using the instrument of FIGS. 1-3, 5 and 6. [Figure 8] FIG. 7 illustrates a method of unlatching the surgical clip of FIGS. 2 and 4 using the instrument of FIGS. 1-3, 5 and 6. [Figure 9] FIG. 7 illustrates a method of unlatching the surgical clip of FIGS. 2 and 4 using the instrument of FIGS. 1-3, 5 and 6. [Figure 10] FIG. 2 is an isometric view of a second embodiment of the jaw mechanism of the instrument of FIG. [Figure 11] 11 is a side view of the jaw mechanism of FIG. 10 engaged with an exemplary surgical clip. [Figure 12] 12 is an isometric view of the jaw mechanism of FIGS. 10 and 11 engaged with the exemplary surgical clip of FIG. 11. [Figure 13] FIG. 13 is an isometric view of a first jaw member of the jaw mechanism of FIGS. 10-12. [Figure 14]FIG. 13 is an isometric view of a second jaw member of the jaw mechanism of FIGS. 10-12. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] The invention will now be described with reference to the figures, in which like reference numerals refer to like parts throughout. In accordance with conventional practice used herein, unless otherwise specified, the term "proximal" refers to the relative positioning of an instrument or component generally closer to the user or medical staff handling or manipulating the instrument to be used, and "distal" refers to the relative positioning of an instrument or component further from the user or medical staff handling or manipulating the instrument to be used. The term "vertical" refers to the relative orientation of the instrument parallel to or along a plane that extends equally through both jaw members or to the component as well. The term "longitudinal" refers to the relative orientation along the major axis or length of the instrument or component. The term "lateral" refers to the relative orientation parallel to or along a plane that extends perpendicularly between the first and second jaw members or to the component as well.

[0015] The present invention relates to an instrument for unlatching and / or extracting a surgical clip from an implantation site within a body. The surgical clip may have first and second leg members with substantially matching curvatures, the first leg member having a convex outer surface and a hook member at a distal portion. The second leg member may have a tip member that is constrained by the hook member when the surgical clip is in a latched configuration. The instrument may have a jaw mechanism including first and second jaw members, the first jaw member being shorter than the second jaw member. One or both of the first and second jaw members may have channels, grooves, and / or teeth configured to align, secure, prevent lateral movement, unlatch and / or extract the surgical clip. The length of the first jaw member may be shortened to allow the distal end portion to press against a medial or apex portion of the convex outer surface of the first leg member. The second jaw member may have a wall configured to engage an underside of the hook member. The wall may have a groove with an inner surface that slopes away from the longitudinal axis of the instrument to aid in deflecting or opening the hook member to disengage a restraint on the tip member. The second jaw member may further have a channel and / or wall groove below or recessed from the wall for receiving the tip member upon unlatching to separate the tip member from the hook member, thereby preventing immediate re-latching of the surgical clip. Additionally, the relief provided by the channel in the second jaw member may enable the instrument to deflect the surgical clip such that the leg members are substantially parallel to one another in a substantially straightened configuration and / or deflect beyond parallel (e.g., the curvature of one or both of the leg members is reversed). The jaw mechanism can include a proximal recess formed laterally between the first and second jaw members and configured to receive a proximal portion of the surgical clip to initially align the surgical clip between the first and second jaw members.The channel of the second jaw member can have oppositely angled proximal and distal portions to receive at least a portion of the curved second leg member. The jaw mechanism can further include at least one engagement member that secures the surgical clip to the instrument prior to, during, and / or immediately after unlatching to enable the surgical clip to be extracted from the body implantation site in one fluid motion without the need for additional tools.

[0016] 1 is a side view of an instrument 100 for unlatching surgical clips in accordance with embodiments of the present invention. As shown, the instrument 100 can include a handle mechanism 110, an elongate shaft 120 extending distally from the handle mechanism 110, and a jaw mechanism 140 extending distally from the elongate shaft 120. The handle mechanism 110 can include a first handle member 112 and a second handle member 114 movably coupled to one another to actuate the jaw mechanism 140. For example, the first handle member 112 and the second handle member 114 can be pivotally attached. In a non-limiting illustrated example, the first handle member 112 can be longitudinally fixed to the elongate shaft 120, and the second handle member 114 can be longitudinally fixed to an actuator rod 122 extending through a lumen of the elongate shaft 120 (as shown in FIG. 3). In some embodiments, the proximal portion of the actuator rod 122 may have a ball that is received in a socket (not shown) of the second handle member 114, as further disclosed in U.S. Patent No. 6,733,514, the disclosure of which is incorporated by reference herein in its entirety. By rotating the second handle member 114 relative to the first handle member 112, the actuator rod 122 may longitudinally translate (e.g., retract and / or advance) the elongate shaft 120, thereby actuating or rotating the jaw mechanism 140 between an open configuration (e.g., FIG. 9) and a closed configuration (e.g., FIG. 8). A spring (not shown) disposed between the first handle member 112 and the second handle member 114 may bias the jaw mechanism 140 open from a closed configuration or to a partially open configuration.

[0017] 2 and 3, the jaw mechanism 140 can include a first jaw member 150 and a second jaw member 170 configured to receive a surgical clip 200 therebetween. The elongate shaft 120 can have first and second distal arms 124 separated by a slot 126 configured to receive overlapping proximal portions of the first and second jaw members 150, 170. The first and second jaw members 150, 170 can be pivotally coupled to a pivot pin 128 that extends through a pivot hole 130 in each of the distal arms 124. A distal end of the actuator rod 122 can be received between the overlapping proximal portions of the first and second jaw members 150, 170. The distal end of the actuator rod 122 can have one or more drive bosses 134 extending therefrom, with a first drive boss 134 extending from a first side through a drive channel 152 in the first jaw member 150 (as shown in FIG. 5) and a second drive boss 134 extending from a second side through a drive channel 172 in the second jaw member 170 (as shown in FIG. 6). Each of the drive channels 152, 172 can extend at an angle relative to a longitudinal axis of the respective jaw members 150, 170 to pivot the first and second jaw members 150, 170 between open and closed configurations when the actuator rod 122 is translated longitudinally. Distal arms 124 may each further include an elongated or substantially oval drive channel 132 along the longitudinal axis of elongate shaft 120 such that drive boss 134 may move through drive channel 132 as actuator rod 122 translates longitudinally through elongate shaft 120. Thus, jaw members 150, 170 may be oriented in an open configuration when drive boss 134 is in a distal position of drive channel 132 (e.g., as shown in FIG. 8 ), and jaw members 150, 170 may be oriented in a closed configuration when drive boss 134 is in a proximal position of drive channel 132 (e.g., as shown in FIG. 9 ).However, the instrument 100 may embody other actuation mechanisms for producing scissor-like movement of the jaw members 150, 170, such as the actuation mechanisms disclosed in International Publication No. 2021 / 062170, the disclosure of which is incorporated by reference in its entirety and made a part of this specification.

[0018] 4 is a side view of an exemplary embodiment of a surgical clip 200. The surgical clip 200 can include a first leg member 202 and a second leg member 204 having proximal end portions pivotally coupled at a hinge member 206. The surgical clip 200 can include one or more latching mechanisms. For example, the first leg member 202 can include a distal end portion with a hook member 208, and the second leg member 204 can include a distal end portion with a tip member 210. The first leg member 202 and / or the second leg member 204 can be configured to pivot relative to one another between an open configuration and a closed latched configuration via the hinge member 206. The hook member 208 can be C-shaped with a convex distal surface and a concave proximal surface. The tip member 210 can have a groove at a distal end. The surgical clip 200 may further include one or more engagement portions for interfacing with a clip applier (not shown). For example, the first leg member 202 may include one or more bosses 214 at a distal end portion proximal to the hook member 208. The second leg member 204 may include one or more bosses 212, 214 at a distal end portion at the tip member 210 that are securable to a clip applier (not shown) during attachment of the surgical clip 200 to tissue. The one or more bosses 212, 214 may extend laterally from opposite sides of the first and second leg members 202, 204. For example, the first leg member 202 may include bosses 212 extending laterally from opposite sides of the hook member 208 and connected by a bridge member that extends the width of the hook member 208. The second leg member 204 may have bosses 214 extending laterally from opposite sides of the tip member 210 and separated by grooves in the tip member 210 .

[0019] The first and second leg members 202, 204 may each have a curvature extending substantially along their entire length between their respective proximal and distal end portions. The first leg member 202 may have a convex outer surface 220 and a concave inner surface 222, and the second leg member 204 may have a concave outer surface 224 and a convex inner surface 226. The hinge member 206 may have a concave inner surface joining the inner surfaces 222, 226 and a convex outer surface joining the outer surfaces 220, 224. A clip applier (not shown) may engage the surgical clip 200 via engagement with the bosses 212, 214 to press the first and second leg members 202, 204 together. In this case, the convex outer surface of the hook member 208 may engage a camming bevel at the tip member 210, and one or both of the leg members 202, 204 may deflect as the leg members 202, 204 continue to be pressed together. The first leg member 202 may extend or straighten and / or the second leg member 204 may contract as the hook member 208 deflects and / or extends about the tip member 210. The leg members 202, 204 may revert to their curvature in the latched configuration due to the elasticity of the surgical clip 200 in its natural state. Thus, the hook member 208 may receive the tip member 210 within its concave proximal surface in the latched configuration, as shown in FIGS. 2 and 7. The radii of curvature of surfaces 220, 222 of first leg member 202 and surfaces 224, 226 of second leg member 204 may substantially match one another to provide a relatively even distribution of compressive force across the width of the clamped tissue (e.g., a ligated blood vessel). The security of the latching mechanism is assured as the clamped tissue exerts a counter force against closure of surgical clip 200, thereby causing leg members 202, 204 to deflect and extend, moving tip member 210 further into hook member 208.Exemplary features and exemplary embodiments of the surgical clip 200 are further disclosed in U.S. Pat. Nos. 4,834,096 and 5,100,416, the disclosures of which are incorporated by reference in their entireties herein.

[0020] As further shown in FIGS. 11 and 12 (not shown in FIG. 4 ), the surgical clip 200 may include wing members 230 on each side of the first leg member 202. The wing members 230 may provide stability to the first leg member 202 to prevent the surgical clip 200 from twisting during installation and / or ligation. The wing members 230 may extend at least approximately half the length of the first leg member 202. A distal end of the wing members 230 may be located proximal to the boss 212 to avoid interference with an interface of a clip applier (not shown). A proximal end of the wing members 230 may be located distal to the hinge members 206. The wing members 230 may further provide an interface with an unlatch instrument 100 to facilitate extraction of the surgical clip 200 without the use of any additional instrumentation, as will be further described herein. As shown, the wing member 230 can have a longitudinal curvature that matches the curvature of the first leg member 202. The wing member 230 can have an inner surface 232 that is spaced apart from and / or non-planar with the inner surface 222 of the first leg member 202. The wing member 230 can further have an outer surface 234 that is spaced apart from and / or non-planar with the outer surface 220 of the first leg member 202. The spaced apart and / or non-planar configuration of the inner surface 232 and / or outer surface 234 facilitates securing the wing member 230 to the unlatch device 100 to enable removal and / or extraction from the implantation site. For example, inner surface 232 may be spaced and / or non-coplanar from inner surface 222 of surgical clip 200 to provide sufficient clearance from the ligated tissue for grasping beneath wing members 230 without interference or pinching of the ligated tissue. Inner surface 232 may be a substantially flat or concave inner surface to conform and / or interface with instrument 100.Exemplary embodiments and additional features of wing member 230 and surgical clip 200 are disclosed in one or more of U.S. Patent Application Publication Nos. 2021 / 0186511 and 2021 / 0267603, the disclosures of which are incorporated by reference in their entireties. The present disclosure also contemplates providing a system including instrument 100 and surgical clip 200.

[0021] 2 and 3, the jaw members 150, 170 can be dimensioned to engage, unlatch, and / or extract the surgical clip 200 from the implantation site. The first jaw member 150 can be shorter than the second jaw member 170 and / or the first jaw member 150 can have a length that is shorter than the length of the second jaw member 170. For example, the length of a distal portion of the first jaw member 150 can be shorter than the length of a distal portion of the second jaw member 170. In another embodiment, the length from the pivot hole 154 to the distal end of the first jaw member 150 can be shorter than the length from the pivot hole 174 to the distal end of the second jaw member 170. The short length of the first jaw member 150 may be dimensioned to allow the distal end of the first jaw member 150 to push against an intermediate portion of the exterior surface 220 (e.g., at or proximal to the apex of the exterior surface 220) to straighten and / or extend the first leg member 202, as shown in Figures 7 and 8. The short length of the first jaw member 150 also allows for easier unlatching of a surgical clip 200 having a large radius of curvature (small curvature). The length of the distal portion of the second jaw member 170 may be set to be equal to or greater than the length of the surgical clip 200 (in a latched and / or straightened configuration) to engage the underside 216 of the hook member 208 opposite the second leg member 204 (as shown in Figures 2 and 7) and / or capture the second leg member 204 in the channel 182 after it has been unlatched (as shown in Figures 8 and 9).

[0022] FIG. 5 is an isometric view of the first jaw member 150, and FIG. 6 is an isometric view of the second jaw member 170. As shown, the first jaw member 150 can have a proximal portion including a drive channel 152 configured to receive one of the drive bosses 134 and a pivot hole 154 to receive the pivot pin 128. Similarly, the second jaw member 170 can have a proximal portion including a drive channel 172 to receive one of the drive bosses 134 and a pivot hole 174 to receive the pivot pin 128. The proximal portions of the jaw members 150, 170 can have a width dimensioned to be received between the distal arms 124 of the elongate shaft 120 when nested together. The proximal portions of at least one or both of the jaw members 150, 170 can have a notch 156, 176 that receives the distal end of the actuator rod 122 therebetween, as shown in FIGS. 2 and 3.

[0023] Jaw members 150, 170 can each have a distal portion configured to engage a surgical clip 200, with the distal portion of each jaw member having a greater width than the respective proximal portion. The distal portion of each jaw member 150, 170 can have an inner surface 158, 178 with one or more channels and / or grooves configured to align, secure, inhibit roll, unlatch and / or extract a surgical clip 200. For example, first jaw member 150 can have an inner channel 160 configured to receive convex outer surface 220 of first leg member 202. Channel 160 can extend longitudinally substantially the entire length of the distal portion of first jaw member 150 and can extend through a distal surface of first jaw member 150 to form an open distal end of channel 160. The open distal end of channel 160 allows first jaw member 150 to engage outer surface 220 of first leg member 202 along only a portion of its length such that first leg member 202 extends through and out of channel 160 and distally of first jaw member 150. The open distal end of channel 160 also allows the distal end of first jaw member 150 to bear against an intermediate portion of outer surface 220 of first leg member 202. Channel 160 may be recessed within inner surface 158 surrounded by proximal and side surfaces for mating with outer surface 220 to stabilize first leg member 202. First jaw member 150 may have an aperture 162 through its exterior surface and in communication with channel 160 to allow surgical clip 200 to be visible through first jaw member 150, thus providing visual confirmation to a user that surgical clip 200 has been properly loaded and / or unlatched. First jaw member 150 may optionally have at least one tooth 164 disposed within channel 160 that engages exterior surface 220 to reduce longitudinal and / or rotational movement of surgical clip 200. For example, at least one tooth 164 may include a plurality of teeth 164.

[0024] An inner surface 178 of the second jaw member 170 may include a groove 180 at a distal end thereof and configured to receive a convex outer surface (e.g., lower surface 216) of the hook member 208. The groove 180 may be generally concave to receive the convex outer surface of the hook member 208 and may have a slope that angles distally away from the longitudinal axis of the instrument 100 in at least the closed configuration and toward the outer surface of the second jaw member 170 to aid in and / or provide a ramp to facilitate deflection or release of the hook member 208. The inner surface 178 may further include a channel 182 proximal to the groove 180 and configured to receive the second leg member 204 upon unlatching of the surgical clip 200. The inner surface of the groove 180 may be elevated above and longitudinally aligned with the inner surface of the channel 182. Thus, channel 182 may provide relief to allow separation of hook member 208 and tip member 210 upon unlatching, thereby preventing relatching after unlatching and allowing subsequent extraction of surgical clip 200 from tissue. For example, groove 180 may be provided in wall 188 on channel 182 to receive second leg member 204 after unlatching. At least a portion of channel 182 may be open on both lateral sides to facilitate insertion of surgical clip 200 between first jaw member 150 and second jaw member 170 and / or to facilitate visualization of surgical clip 200 when positioned between first jaw member 150 and second jaw member 170 (as shown in FIGS. 7-9 ). The channel 182 may have communicating and longitudinally aligned distal and proximal recessed portions 184, 186, each recessed within a rim (e.g., surrounded on a lateral side) of the inner surface 178. The distal recessed portion 184 may have a width greater than that of the proximal recessed portion 186, the distal recessed portion 184 being dimensioned to receive the enlarged width portion of the boss 214 of the second leg member 204.Distal recessed portion 184 may have generally right angle corners configured to receive the generally square cross-section of boss 214, and / or proximal recessed portion 186 may be generally concave to receive the rounded cross-section of outer surface 224 of second leg member 204. Distal recessed portion 184 may have a slope extending proximally toward the outer surface of the second jaw member and away from the longitudinal axis of instrument 100 (in the closed configuration). Proximal recessed portion 186 may have a slope extending proximally away from the longitudinal axis of instrument 100 (in the closed configuration) and toward the outer surface of the second jaw member to receive the curvature of second leg member 204 and hinge member 206 within channel 182. The opposing slopes of recessed portions 184, 186 may also facilitate extension and unlatching of surgical clip 200. For example, hinge member 206 may rest within proximal recessed portion 186 to extend surgical clip 200. Thus, as shown in FIGS. 3 and 6, channel 182 may be recessed from wall 188 having groove 180 disposed at a distal portion of second jaw member 170. Channel 182 may extend longitudinally between wall 188 and a proximal portion of second jaw member 170 and / or shaft 120. Wall 188 may embody a hook- or L-shaped nose at the distal end of second jaw member 170, the nose having a height greater than the immediately proximal length of second jaw member 170. Thus, as shown in FIG. 3, channel 182 may have a transversely open notch extending proximally of wall 188 toward the proximal end of second jaw member 170. However, it is also envisioned (not shown) that wall 188 may extend substantially elevated around channel 182 surrounding the lateral sides of channel 182. In either case, surfaces of groove 180, distal recessed portion 184, and / or proximal recessed portion 186 may not be in-plane and contiguous with one another to facilitate unlatching and / or extraction of surgical clip 200.

[0025] 7-9 illustrate a method of unlatching and / or extracting the surgical clip 200 using the instrument 100. The method may be performed to unlatch and / or extract the surgical clip 200 from a surgical configuration, such as a latched condition on a ligated end of a blood vessel after hemostasis or occlusion has occurred. In use, when the surgical clip 200 is to be extracted from an implantation site, a user may gain access to the site via an appropriate surgical procedure to expose the surgical clip 200 in a latched configuration.

[0026] 7, the user may then place a surgical clip 200 between the first and second jaw members 150, 170 and engage the surgical clip 200 with the instrument 100. The user may place the surgical clip 200 in the latched configuration into the instrument 100 in the open configuration so that the jaw members 150, 170 are sufficiently spaced apart from one another (e.g., when the drive boss 134 is near or at a distal position of the drive channel 132). The instrument 100 may then align the surgical clip 200 with the jaw members 150, 170, which may be accomplished by the channels and / or grooves in the inner surfaces 158, 178 of the jaw members 150, 170. For example, surgical clip 200 may be initially aligned with instrument 100 by having underside 216 of hook member 208 nest within groove 180 of wall 188, hinge member 206 nest within proximal recessed portion 186, and / or outer surface 220 of first leg member 202 nest within channel 160 of first jaw member 150. The user may then partially close first jaw member 150 to engage first leg member 202 and / or nest outer surface 220 within channel 160. Pressure applied by instrument 100 may further seat surgical clip 200 within groove 180 and channel 160, which may further inhibit lateral rocking of surgical clip 200 during unlatching. Engaging at least one tooth 164 with exterior surface 220 provides additional security and prevents longitudinal movement (e.g., slipping off) of surgical clip 200 during unlatching. Hole 162 allows a user to view surgical clip 200 through first jaw member 150 and ensure alignment of surgical clip 200 with jaw members 150, 170. At least a portion of second leg member 204 (e.g., distal portion and / or tip member 210) may be located outside of channel 182 when restrained in the latched configuration.

[0027] 8, the instrument 100 can unlatch the surgical clip 200 by pressing on the outer surface 220 to straighten the first leg member 202 from its natural curvature. Because of the short length of the first jaw member 150, the distal end of the first jaw member 150 can apply sufficient pressure to the middle portion of the outer surface 220 to deflect or open the hook member 208 in a bending back motion to release the tip member 210 of the second leg member 204. Opening the hook member 208 can be accomplished by the distal slope of the groove 180, which transfers the compression of the first jaw member 150 to a distal force applied to the underside 216 of the hook member 208. Once second leg member 204 is no longer constrained by hook member 208, the inherent bias of surgical clip 200 may cause second leg member 204 to spin or pop out of hook member 208 with at least a portion of the second leg member (e.g., tip member 210) being received within channel 182 of second jaw member 170. At least a portion of second leg member 204 may further spin into recessed portions 184, 186 of channel 182. For example, tip member 210 and boss 214 may be received within distal recessed portion 184 and at least a portion of the remaining second leg member 204 may be received within proximal recessed portion 186. The irregularities provided by channel 182 allow first jaw member 150 to deflect leg members 202, 204 to be parallel in the substantially straightened configuration and / or to deflect beyond parallel (e.g., such that at least outer surface 220 is concave). This increased deflection allows hook member 208 to deflect more fully open, thereby allowing second leg member 204 to become unconstrained by hook member 208.The irregularities provided by channel 182 also enable tip member 210 to be separated in a spaced apart manner from hook member 208 when first and second jaw members 150, 170 are closed together and hook member 208 resumes its undeflected shape to prevent re-latching of surgical clip 200 prior to extraction.

[0028] 9, first jaw member 150 may further open to a fully open configuration to relieve pressure on first leg member 202, such that the inherent bias of surgical clip 200 causes first leg member 202 to rotate open, leg members 202, 204 to resume their natural curvature, and hook member 208 to resume its C-shape. Furthermore, engagement of surgical clip 200 within channels 160, 182 (including recessed portions 184, 186 and at least one tooth 164) provides instrument 100 with a sufficient grip of surgical clip 200 in the open configuration to permit extraction from the implantation site without the use of any additional instrument. For example, a proximal surface of wall 188 may engage tip member 210 to prevent the surgical clip from sliding distally out of jaw members 150, 170. Additionally, slight compression of first jaw member 150 can prevent relative rotation of the surgical clip (e.g., about the fulcrum of wall 188) and at least one tooth 164 can provide additional longitudinal security. First jaw member 150 can have at least one engagement member 166' to provide additional security for surgical clip 200 for extraction, as shown in and described with reference to Figures 10-14.

[0029] 10-14 illustrate a jaw mechanism 140' as a second embodiment of the instrument 100. The jaw mechanism 140' may include all of the features of the jaw mechanism 140 (which are expressly set forth herein in their entirety to avoid overloading the disclosure of the jaw members 140), and the jaw assembly 140' may be described with the same reference numerals and a prime ('). For example (as further described above), the jaw mechanism 140' may include a first jaw member 150' and a second jaw member 170' configured to receive a surgical clip 200 therebetween. As described above, the first jaw member 150' may be shorter than the second jaw member 170' and / or the first jaw member 150' may have a shorter length than the second jaw member 170'. The second jaw member 170' may have an inner surface 178' at its distal end with a groove 180' configured to receive a convex outer surface (e.g., lower surface 216) of a hook member 208 of a surgical clip. The groove 180' may have a slope extending distally away from the longitudinal axis of the second jaw member 170 and toward the outer surface of the second jaw member 170, which provides a ramp to aid in retention and ease opening of the hook member 208. The inner surface 178' may further have a channel 182' proximal to the groove 180' configured to receive the second leg member 204 when the surgical clip 200 is unlatched. The inner surface of the groove 180' may be raised above the inner surface of the channel 182'. Thus, channel 182' may provide indentations that allow separation of hook member 208 and tip member 210 upon unlatching, thereby preventing relatching after unlatching and allowing subsequent removal of surgical clip 200 from the implantation site. For example, groove 180' may be provided in upper wall 188' of channel 182' to allow channel 182' to receive second leg member 204 after unlatching, while at least a portion of channel 182' may be open on both lateral sides, as shown.

[0030] As further shown in Figures 10-14, jaw mechanism 140' may further include a proximal recess 142' configured to receive a proximal portion (e.g., hinge member 206) of surgical clip 200 to laterally stabilize surgical clip 200 during engagement, unlatching and / or extraction as shown in the method of Figures 7-9. Proximal recess 142' may be formed laterally between at least one of first jaw member 150', second jaw member 170', and / or shaft 120. For example, as further shown in Figures 13 and 14, proximal recess 142' may be formed between first notched surface 165' of first jaw member 150' and second notched surface 185' of second jaw member 170'. Each of first notch surface 165' and second notch surface 185' may be concave and / or angled, with each notch surface located on laterally opposite sides of a proximal portion of surgical clip 200 (e.g., hinge member 206) configured to provide lateral stability to surgical clip 200 during engagement, unlatching and / or extraction.

[0031] As further shown, jaw mechanism 140' can include at least one engaging member 166' configured to provide additional security of surgical clip 200 to instrument 100 for extraction after unlatching. For example, at least one engaging member 166' can be configured to create an interference fit with a portion of surgical clip 200 (e.g., wing members 230) before, during, and / or immediately after unlatching of surgical clip 200. At least one engaging member 166' can be provided at a distal portion of first jaw member 150', such as at a distal half or distal third of the distal portion of first jaw member 150'. In some embodiments (as shown), the at least one engagement member 166' may include first and second engagement members 166' extending from opposite sides of the inner surface 158' of the first jaw member 150' into a channel 160' recessed into the inner surface 158'. The first and second engagement members 166' may be configured to receive and engage the wing members 230 of the first leg member 202 between them, thereby securing the first leg member 202 to the first jaw member 150' when the first leg member 202 is received within the channel 160'. When the first jaw member 150' presses against the first leg member 202, the first and second engaging members 166' can be configured to bias away from one another when the wing members 230 contact an underside 169' (FIG. 13) of the engaging members 166', and the first and second engaging members 166' can be forced back toward one another to secure the first leg member 202 in an interference and / or latching engagement. The surgical clip 200 can additionally or alternatively be compressed when the first leg member 202 is received between the engaging members 166' in an interference and / or latching engagement.

[0032] As further shown in Figures 12 and 13, each of the first and second engaging members 166' can have a first portion 167' that extends downwardly from the inner surface 158' of the first jaw member 150' towards the second jaw member 170' in a cantilevered configuration. In some embodiments, the first and second engaging members 166' can be configured to latch and can have a second portion 168' that extends laterally inwardly towards the surgical clip 200 and a central longitudinal vertical plane of the opposing engaging members 166' to form a hook or catch structure. The hook structure second portion 168' can have a lower surface 169' that can be angled, chamfered and / or sloped to facilitate insertion and / or deflection of the engaging members 166'. Second portion 168' may be configured to fit under wing member 230 of surgical clip 200 in a secure latching and / or interference fit. As discussed above, wing member inner surface 232 may be sufficiently spaced from and / or not in the plane of inner surface 222 of first leg member 202 to provide a sufficient portion for second gap 168' to avoid interference or pinching of tissue ligated by surgical clip 200.

[0033] However, in some embodiments (not shown), the engaging member 166' may not be configured to latch or may be non-hook shaped (omitting the second portion 168'). For example, the portion 167' of the non-hook engaging member 166' may have a substantially flat or literally flat inner side (not shown) configured to exert an interference fit, frictional, pinching, and / or clamping force on a portion of the clip (e.g., the wing member 230) to secure the first leg member 202 to the first jaw member 150'. The non-hook engaging member 166' may still have a lower surface 169' that may be angled, chamfered, and / or sloped to facilitate insertion and / or deflection of the engaging member 166'.

[0034] In either case, the first and second engaging members 166' can secure or lock the surgical clip 200 to the jaw mechanism 140', thereby providing additional security for extraction of the surgical clip 200 from the implantation site after unlatching from the ligated tissue without the use of any additional instrumentation. The user can then remove the surgical clip 200 from the first and second engaging members 166', thereby allowing the surgical clip 200 to be removed from the instrument 100 (e.g., once the jaw mechanism 140' has been removed from the implantation site).

[0035] As further shown, first jaw member 150' can have a hole 162' extending through its exterior surface and in communication with channel 160' to allow surgical clip 200 to be viewed through first jaw member 150', thus providing visual confirmation to the user that surgical clip 200 has been properly loaded and / or unlatched. Second jaw member 170' can have an outer hole 189' extending through its exterior surface and in communication with channel 182' to allow surgical clip 200 to be viewed through second jaw member 170', thus providing visual confirmation to the user that surgical clip 200 has been properly loaded and / or unlatched. Second jaw member 170' can further have a distal hole 190' extending through wall 188' and in communication with channel 182' to allow visualization of surgical clip 200 through first jaw member 150'. For example, tip member 210 and / or boss 214 may be visible through distal aperture 190' to confirm unlatching of surgical clip 200.

[0036] The many features and advantages of the present invention are apparent from the detailed description, and it is, thus, intended by the appended claims to cover all such features and advantages of the present invention which fall within the true spirit and scope of the invention. Moreover, because numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation as illustrated and described, and therefore, all suitable modifications and equivalents may be employed which fall within the scope of the present invention.

Claims

1. 1. An instrument for unlatching a clip from a latched configuration, said clip having first and second leg members, said first leg member having a hook member, said second leg member having a tip member that is captured by said hook member in said latched configuration, said instrument comprising: a first jaw member configured to press an outer surface of the first leg member to release the clip from the latched configuration; a second jaw member having a wall configured to engage the hook member and a channel configured to receive the tip member when released from constrainment by the hook member.

2. The instrument of claim 1 , wherein the first jaw member has a length that is less than a length of the second jaw member.

3. 3. The device of claim 1 or claim 2, wherein at least a portion of the channel is open on both lateral sides.

4. The device of claim 1 or claim 2, wherein the wall has a groove configured to receive the hook member, the groove having a distal slope configured to bias the hook member.

5. The instrument of claim 1 or claim 2, wherein the first jaw member has a channel configured to receive the outer surface of the first leg member.

6. The instrument of claim 1 or claim 2, wherein the first jaw member has at least one tooth configured to engage the outer surface of the first leg member.

7. The instrument of claim 1 or claim 2, wherein the channel of the second jaw member has a distal portion with a distal slope.

8. The instrument of claim 1 or claim 2, wherein the channel of the second jaw member has a proximal portion with a proximal slope.

9. 3. The instrument of claim 1 or claim 2, wherein the channel of the second jaw member has a distal portion with a first width and a proximal portion with a second width, the first width being greater than the second width.

10. The instrument of claim 1 or claim 2, wherein at least one of the first and second jaw members has an aperture to allow visualization of the clip.

11. 3. The instrument of claim 1 or claim 2, wherein the first jaw member has at least one engagement member configured to removably secure the clip to the instrument after unlatching.

12. The device of claim 11 , wherein the at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip therebetween.

13. The device of claim 12 , wherein the first and second engaging members include first and second hook members extending inwardly toward one another.

14. 3. The instrument of claim 1 or claim 2, wherein the instrument has a proximal recess formed between the first and second jaw members and configured to receive a hinge member of the clip.

15. 1. An instrument for unlatching a clip from a latched configuration, said clip having first and second leg members, said first leg member having a hook member, said second leg member having a tip member that is captured by said hook member in said latched configuration, said instrument comprising: a first jaw member configured to press an outer surface of the first leg member to release the clip from the latched configuration; a second jaw member configured to engage the hook member; The first jaw member has at least one engagement member configured to removably secure the clip to the instrument after unlatching.

16. 1. A method of unlatching a clip from a latched configuration, the clip having first and second leg members with distal portions that engage one another in the latched configuration, the method comprising: receiving the clip between first and second jaw members of an instrument; pressing an outer surface of the first leg member with the first jaw member to release the clip from the latched configuration; and receiving the distal portion of the second leg member within a channel of the second jaw member after being released from restraint by the first leg member.

17. The method of claim 16 , wherein the first jaw member has a length that is less than a length of the second jaw member.

18. 18. The method of claim 16 or claim 17, wherein the distal portion of the first leg member has a hook member and the distal portion of the second leg member has a tip member restrained in the latched configuration by the hook member, the first leg member being deflected when pushed to release the clip from the latched configuration, and the tip member being spaced from the hook member when received within the channel of the second jaw member.

19. 18. The method of claim 16 or claim 17, further comprising the step of engaging the distal portion of the first leg member with a wall of the second jaw member.

20. 20. The method of claim 19, wherein the step of engaging the distal portion of the first leg member comprises receiving the distal portion of the first leg member within a groove in the wall.

21. The method of claim 20 , wherein the groove has a distal slope to open the distal portion of the first leg member.

22. 18. The method of claim 16 or claim 17, wherein the step of pressing the outer surface of the first leg member includes pressing an intermediate portion of the outer surface of the first leg member with the first jaw member.

23. 18. The method of claim 16 or claim 17, further comprising the step of receiving an outer surface of the first leg member within a channel of the first jaw member.

24. 18. The method of claim 16 or claim 17, further comprising receiving a hinged portion of the clip within a proximal recess of the instrument formed between the first and second jaw members.

25. 18. The method of claim 16 or claim 17, further comprising the step of receiving a portion of the first leg member between first and second engagement members of the first jaw member.

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