Asymmetrical clip applicator and cartridge

Abstract

We provide clip applicators and cartridges for securing surgical clips to tissue. [Solution] The clip applicator preferably has a first jaw member that engages with a first leg member of a surgical clip and a second jaw member that engages with a second leg member of a surgical clip. At least one of the first jaw member and the second jaw member is asymmetrical with respect to the midplane of the clip applicator. The clip cartridge preferably has a base having a first axis and a second axis, the second axis being perpendicular to the first axis, and the clip cartridge preferably has a plurality of walls that define at least one cavity for receiving a surgical clip. At least one of the plurality of walls has a first wall portion provided on the first side of the first axis and a second wall portion provided on the second side of the first axis. The first wall portion and the second wall portion are offset from each other with respect to the second axis.

Description

Technical Field

[0001] The present disclosure (the present invention) generally relates to medical devices, and more particularly to clip applicators and cartridges for attaching surgical clips to tissue.

[0002] 〔Citation of Related Applications〕 This application claims priority to U.S. Provisional Patent Application No. 63 / 255,926, filed Oct. 14, 2021, which is hereby incorporated by reference in its entirety and made a part of this specification.

Background Art

[0003] Ligation of tissue (e.g., blood vessels, lymph nodes, nerves, bile ducts, or heart tissue) is a commonly seen technique in many surgical procedures. Current ligation systems often include surgical clips, clip applicators, and / or cartridges. A clip applicator holds a surgical clip, removes it from a cartridge, and attaches the surgical clip to tissue, thereby being used by a user to ligate, for example, a blood vessel (e.g., an artery or a vein).

Summary of the Invention

Problems to be Solved by the Invention

[0004] The inventors recognize the need to improve one or more features of the clip applicator system. For example, current clip applicators are symmetrical with respect to a midplane (plane symmetry). This can lead to improper loading of surgical clips due to a poor interface between the clip applicator and the cartridge. For example, the cartridge may result in a loose fit of the clip applicator, which may prevent the clip-holding features on the clip applicator from properly aligning with and engaging the interface on the surgical clip. As a result, the surgical clip may not be securely fixed to the clip applicator, causing it to fall out and / or fail to properly secure itself to the tissue.

[0005] The disclosed clip applicators, cartridges, and / or clip applicator systems are intended to mitigate and / or resolve one or more of these problems and / or other problems of the prior art. [Means for solving the problem]

[0006] A first aspect of the present invention relates to a clip applicator configured to fasten a surgical clip, wherein the clip applicator comprises a first jaw member configured to engage with a first leg member of the surgical clip and a second jaw member configured to engage with a second leg member of the surgical clip, and at least one of the first jaw member and the second jaw member is asymmetrical with respect to the midplane of the clip applicator.

[0007] In some embodiments, both the first jaw member and the second jaw member are asymmetrical with respect to the midplane of the clip applicator. In some embodiments, at least one of the first and second jaw members has a first width on the first side of the midplane of the clip applicator and a second width on the second side of the midplane of the clip applicator, with the first width being wider than the second width. In some embodiments, at least one of the first and second jaw members has a first longitudinal wall on the first side of the longitudinal channel and a second longitudinal wall on the second side of the longitudinal channel, with the lateral width of the first longitudinal wall being wider than the lateral width of the second longitudinal wall. In some embodiments, the first jaw member has a first longitudinal channel extending through the distal end of the first jaw member and / or the second jaw member has a second longitudinal channel extending through the distal end of the second jaw member. In some embodiments, the first jaw member has at least one first recess configured to receive at least one boss provided on the first leg member, and the second jaw member has at least one second recess configured to receive at least one boss provided on the second leg member, and at least one of the first and second jaw members is asymmetrical with respect to the midplane of the clip applicator along the first and second recesses. In some embodiments, the first jaw member has a closed lateral side of at least one first recess, and the second jaw member has a closed lateral side of at least one second recess. In some embodiments, at least one first recess of the first jaw member has an open lateral side and a closed lateral side, and at least one second recess of the second jaw member has an open lateral side and a closed lateral side. In some embodiments, each of the first and second jaw members has an angled distal surface. In some embodiments, the first jaw member and the second jaw member are radially symmetric when assembled. In some embodiments, at least one of the first and second jaw members has a stabilizing member configured to laterally stabilize the proximal portion of the surgical clip when the surgical clip is in the open position.In some embodiments, the clip applicator further has a longitudinal channel provided on at least one of the first and second jaw members, configured to receive a stabilizing member when the clip applicator is in a closed position. In some embodiments, the first jaw member has a first stabilizing member, and the second jaw member has a second stabilizing member, and the first and second stabilizing members are configured to receive the proximal portion of the surgical clip when the surgical clip is in an open position. In some embodiments, the first jaw member and the second jaw member are at least substantially identical.

[0008] The second aspect relates to a clip applicator system comprising the clip applicator described above and a clip cartridge having at least one cavity configured to receive the clip applicator for loading a surgical clip, wherein the at least one cavity is asymmetric with respect to a midplane. The at least one cavity is radially symmetric. In some embodiments, the at least one cavity is formed by an offset wall portion of the clip cartridge.

[0009] A third aspect of the present invention relates to a clip cartridge configured to store at least one surgical clip, wherein the clip cartridge has a base having a first axis and a second axis, the second axis being perpendicular to the first axis, and the clip cartridge further has a plurality of walls defining at least one cavity configured to receive at least one surgical clip, wherein at least one of the plurality of walls has a first wall portion provided on the first side of the first axis and a second wall portion provided on the second side of the second axis, and the first wall and the second wall are offset from each other with respect to the second axis.

[0010] In some embodiments, each of the plurality of walls has a first wall portion and a second wall portion offset from each other with respect to a second axis. In some embodiments, at least one of the plurality of walls has a central portion between the first wall portion and the second wall portion. In some embodiments, the first wall portion and the second wall portion have a width narrower than the central portion. In some embodiments, the second axis passing through the center of the central portion is offset with respect to the second axis passing through the center of at least one of the first wall portion and the second wall portion. In some embodiments, at least one void is asymmetric with respect to the midplane of the void. In some embodiments, at least one void is radially symmetric. In some embodiments, the clip cartridge further includes a retainer provided covering the base and configured to releasably hold at least one surgical clip in at least one void. In some embodiments, the clip cartridge further includes at least one support member extending between adjacent walls of the plurality of walls. In some embodiments, the first axis is the longitudinal axis of the base, and the second axis is the transverse axis of the base.

[0011] A fourth aspect of the present invention relates to a clip applicator system including a clip applicator and a clip cartridge as described herein.

[0012] To facilitate understanding of the present invention, it is illustrated in the accompanying drawings. [Brief explanation of the drawing]

[0013] [Figure 1] This is a side view of an exemplary embodiment of the clip applicator of the present invention. [Figure 2] This is a side view of an exemplary embodiment of the jaw mechanism of the clip applicator shown in Figure 1, into which a surgical clip is loaded according to the present invention. [Figure 3] Figures 1 and 2 are perspective views of the jaw mechanism of the clip pliers. [Figure 4]Figures 1-3 show front views of the jaw mechanism of the clip applicator with a surgical clip loaded. [Figure 5] Figure 1 is a perspective view of the clip applicator in which a surgical clip is loaded from a clip cartridge according to the present invention. [Figure 6] Figures 4 and 5 are perspective views of the clip cartridge. [Figure 7] Figures 4 to 6 are plan views of the clip cartridge. [Modes for carrying out the invention]

[0014] The same reference numerals are used in the drawings and the following detailed description to indicate identical or similar parts.

[0015] The present invention generally relates to cartridges, clip cartridges, and / or clip applicator assemblies configured to facilitate the loading and / or stability of surgical clips. In some embodiments, the clip applicator and clip cartridge may have a matching keyway interface to ensure proper and consistent loading of surgical clips. The keyway interface can be provided by the jaw members of the clip applicator being asymmetrical with respect to the midplane at least at the distal portion. The asymmetry can be made by each jaw member having a different geometric shape and / or material on opposite sides of the midplane. For example, each jaw member may have sides with different widths, located on opposite sides of the midplane and defined at least partially by the distal portion of a longitudinal wall located on the opposite side of a longitudinal channel. In some embodiments, the jaw members may be at least substantially identical, and as a result, the jaw members are radially symmetrical when assembled. The shape of the jaw members may match the corresponding shape of at least one cavity to enable secure loading of surgical clips. For example, the cartridge may be asymmetrical with respect to the intermediate plane and have a cavity formed by wall portions that are aligned with the width of the jaw member and arranged alternately.

[0016] Furthermore, asymmetric jaw members can provide relatively high structural integrity to the jaw while minimizing adverse effects on weight and / or visibility. Preferably, each jaw member has at least one clip-retaining feature (e.g., a pair of recesses) that is closed on a first lateral side of the jaw member and open on a second lateral side of the jaw member. The closed lateral side can improve the lateral stability of the surgical clip within the jaw member and help prevent the surgical clip from becoming loose, misaligned, and / or falling out when it is being manipulated to the correct position for attachment, or when it is being butted against or pressed. The open lateral side of each jaw member allows for visual confirmation of the loading of the surgical clip interface (e.g., at least one boss member) into the at least one clip-retaining feature. Thus, the jaw member does not adversely affect visibility and / or clip separation. The jaw member is further provided at the tip and may have an inclined or angled distal surface to assist in the initial introduction and in-vivo navigation of the applicator jaw by the trocar.

[0017] Figure 1 is a side view of an exemplary clip applicator 10, Figure 2 is a side view of an exemplary jaw mechanism 16 of the clip applicator 10 loaded with a surgical clip 200, and Figure 3 is a perspective view of the jaw mechanism 16. As shown in the figures, the clip applicator 10 preferably has a handle mechanism 12 connected to the proximal end of the shaft 14 and a jaw mechanism 16 connected to the distal end of the shaft 14.

[0018] The handle mechanism 12 may include a first handle member 18 and a second handle member 20 that are movably coupled to each other to actuate the jaw mechanism 16. For example, the first handle member 18 and the second handle member 20 may be rotatably mounted to each other. The first handle member 18 may be fixed longitudinally to an elongated shaft 14, and the second handle member 20 may be fixed longitudinally to an actuator rod (not shown) that passes through the lumen of the elongated shaft 14. By rotating the second handle member 20 relative to the first handle member 18, the actuator rod can be moved longitudinally through the elongated shaft 14 (for example, retracted and / or advanced), thereby allowing the jaw mechanism 16 to be actuated or rotated around the hinge pin 22 between an open position and a closed position. For example, the actuator rod may have one or more drive boss members 24 attached to opposite lateral sides of its distal end. The drive boss member 24 may slide within one or more elongated guide channels 26 provided within the elongated shaft 14 and within angled drive channels 28, 30 provided within the first and second jaw members 102, 104, respectively. A spring 32 may be provided between the first handle member 18 and the second handle member 20 to bias the jaw mechanism 16 from a closed or partially closed position to an open or partially open position. Exemplary handle and actuation mechanisms are further described in U.S. Patent No. 6,733,514, which is incorporated herein by reference and whose entire disclosure is part of this specification. However, other embodiments of the handle and / or actuation mechanism may be included.

[0019] The surgical clip 200 may have a first leg member 202 and a second leg member 204 having proximal end portions pivotally coupled at the hinge member 206. The surgical clip 200 may have one or more latching mechanisms. For example, the first leg member 202 may have a distal end portion with a hook portion 208, and the second leg member 204 may have a distal end portion with a tip member 210. The first leg member 202 and / or the second leg member 204 may be configured to pivot relative to each other between an open configuration and a closed latched configuration via the hinge member 206. The hook portion 208 may be C-shaped with a convex distal surface and a concave proximal surface. The tip member 210 may have a groove at the distal end. The surgical clip 200 may further have one or more engagement portions. For example, the first leg member 202 may have one or more boss members 212 provided at the distal end portion proximal to the hook portion 208, and the second leg member 204 may have one or more boss members 214 provided at the distal end portion at the tip member 210. The one or more boss members 212, 214 can secure the surgical clip 200 to the clip applicator 10 while the surgical clip 200 is holding tissue. The one or more boss members 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 have boss members 212 connected to each other by a bridge member extending laterally from opposite sides of the hook portion 208 and extending across the width of the hook portion 208. The second leg member 204 may have boss members 214 extending laterally from opposite sides of the tip member 210 and separated only by the groove of the tip member 210.

[0020] The first and second leg members 202 and 204 each preferably have a curvature or curved portion that extends substantially over their entire length between their proximal and distal ends. The first leg member 202 preferably has a convex outer surface and a concave inner surface, and the second leg member 204 preferably has a concave outer surface and a convex inner surface. The hinge member 206 preferably has a concave inner surface with its inner surfaces joined to each other and a convex outer surface with its outer surfaces joined to each other. When closed, the convex outer surface of the hook portion 208 preferably engages with a cam-acting oblique cutting surface provided at the tip member 210, and one or both of the leg members 202 and 204 preferably deflect when the leg members 202 and 204 continue to press against each other. As the hook portion 208 deflects and / or extends around the tip member 210, the first leg member 202 is preferably extended or straightened, and / or the second leg member 204 is preferably retracted. The leg members 202 and 204 are preferably able to revert to their curvature in the latch configuration due to the elasticity of the surgical clip 200 in its natural state. Thus, in the latch configuration, the hook portion 208 can receive the tip member 210 within its concave proximal surface. The radii of curvature of the surfaces 220, 222 of the first leg member 202 and the surfaces 224, 226 of the second leg member 204 are preferably substantially coincidental to provide a relatively uniform distribution of compressive force applied across the entire width of the clamped tissue (e.g., a ligated blood vessel). The safety of the latch mechanism is ensured when the clamped tissue exerts a reaction force against the closing of the surgical clip 200, thereby deflecting and extending the leg members 202, 204 and moving the tip member 210 further into the hook portion 208. Exemplary embodiments of the surgical clip 200 are further disclosed in U.S. Patent No. 4,834,096 and U.S. Patent No. 5,100,416, which are incorporated herein by reference and whose entirety constitutes part of this specification. However, other forms of the surgical clip may be employed.

[0021] As shown in Figures 2 to 4, the jaw mechanism 16 preferably includes a first jaw member 102 configured to engage with a first leg member 202 and a second jaw member 104 configured to engage with a second leg member 204. The first jaw member 102 and / or the second jaw member 104 preferably rotate relative to each other by a hinge pin 22 to move the surgical clip 200 between an open and a closed position. Thus, the jaw mechanism preferably is configured to load the surgical clip 200 from a cartridge 300 (e.g., Figures 5 to 7) when in the open position, and then rotate to the closed position to secure the surgical clip 200 to tissue.

[0022] As further shown in FIGS. 2 and 3, the first jaw member 102 may have a first inner surface 120 with a first longitudinal channel 122, at least one first recess 124 provided at the distal portion 106 of the jaw member 102, and a first stabilizing member 126 provided at the proximal portion 108 of the first jaw member 102. The first longitudinal channel 122 can separate the first longitudinal wall 128 and the second longitudinal wall 129 of the first jaw member 102. The second jaw member 104 may have a second inner surface 130 with a second longitudinal channel 132, at least one second recess 134 provided at the distal portion 106, and a second stabilizing member 136 provided at the proximal portion 108. The second longitudinal channel 132 can separate the third longitudinal wall 138 and the fourth longitudinal wall 139 of the second jaw member 104. In some embodiments, at least one of the first and second longitudinal channels 122, 132 may extend through the distal ends of the first and second jaw members 102, 104, thus separating the distal ends of the first and second longitudinal walls 128, 129 and / or the distal ends of the third and fourth longitudinal walls 138, 139. However, in some embodiments, at least one of the first and second jaw members 102, 104 may be closed at the distal end, such that the respective longitudinal walls 128, 129, 138, 139 are joined to each other to close the respective longitudinal channels 122, 132. Each of the first and second longitudinal walls 128, 129 may preferably have a first recess 124 separated only by the longitudinal channel 122, and each of the third and fourth longitudinal walls 138, 139 may preferably have a second recess 134 separated only by the second longitudinal channel 132.

[0023] The recesses 124 and 134 can secure the surgical clip 200 to the clip applicator 10 during loading by releasably receiving or holding the boss members 212 and 214 of the first and second leg members 202 and 204. The recesses 124 and 134 preferably have cross-sections corresponding to the boss members 212 and 214. Thus, as shown in the figure, the recesses 124 and 134 preferably are substantially semicircular grooves to receive the circular cross-section of the boss members 212 and 214. However, the recesses 124 and 134 may have other shapes oriented in other shapes of the boss members 212 and 214. During installation, the clip applicator 10 can close the surgical clip 200 by pressing the first leg member 202 and the second leg member 204 against each other through engagement with the boss members 212 and 214, which will be further described herein. The first longitudinal channel 122 can receive at least a portion of the first leg member 202 during loading and / or installation, and / or the second longitudinal channel 132 can receive at least a portion of the second leg member during loading and / or installation.

[0024] The first and second stabilizing members 126 and 136 are preferably configured to apply a lateral force to the proximal portion of the surgical clip 200 (e.g., the hinge member 206) to stabilize the surgical clip 200 laterally and / or to prevent or reduce fish-tailing. The stabilizing members 126 and 136 are preferably integrated with the respective jaw members 102 and 104. The stabilizing members 126 and 136 are preferably substantially rigid and extend substantially parallel to the longitudinal axes of the jaw members 102 and 104 in the open and closed configurations, and form a longitudinal space between these stabilizing members to receive the surgical clip 200, so that the stabilizing members 126 and 136 are positioned on opposite sides of the proximal portion of the surgical clip 200. The stabilizing members 126,136 are preferably not in contact with the surgical clip 200 proximal to allow the leg members 202,204 to become elongated when the hook portion 208 is deflected around the tip member 210 during closure. The stabilizing members 126,136 are preferably received within the wide proximal portions 123,133 of the longitudinal channels 122,132 of the opposing jaw members 102,104 when the clip applicator 10 is in the closed position. Further features and embodiments of the stabilizing members 126,136 are further disclosed in U.S. Patent Application Publication No. 2011 / 0007751, which is incorporated herein by reference and whose entire disclosure is part of this specification.

[0025] At least one (for example, both) of the first and second jaw members 102, 104 may have an inclined or angled surface 110 provided on the distal portion 106 to assist in the initial introduction of the jaw mechanism 16 by the trocar and in-vivo navigation of the jaw mechanism 16. The angled surface 110 can further assist in the loading of the surgical clip 200 by providing a cam action surface to guide the surgical clip 200 to the positions of the first jaw member 102 and the second jaw member 104. The angled surface 110 may be symmetrical with respect to the central plane of the clip applicator 10. The angled distal surface 110 may extend substantially over the entire height of each of the first and second jaw members 102, 104 in the vertical or compressive direction to form an outer distal tip portion 112 on the first and second jaw members 102, 104.

[0026] As further shown in Figure 4, it is preferable that at least one of the distal portions 106 of the first and second jaw members 102 and 104 is asymmetrical with respect to the intermediate plane (MP) of the clip applicator 10. For example, the distal portion 106 of the first jaw member 102 may have a first width (W1) between the first side surface of the first jaw member 102 and the intermediate plane (MP), and a second width (W2) between the second side surface of the first jaw member 102 and the intermediate plane (MP). Similarly, the proximal portion 106 of the second jaw member 104 may have a third width (W3) between the first side surface of the second jaw member 104 and the intermediate plane (MP), and a fourth width (W4) between the second side surface of the second jaw member 104 and the intermediate plane (MP). As shown in the figure, the first width (W1) and the fourth width (W4) are preferably aligned vertically, and the second width (W2) and the third width (W3) are preferably aligned vertically. The first width (W1) and the third width (W3) are preferably located on opposite sides of the intermediate plane (MP), and the second width (W2) and the fourth width (W4) are preferably located on opposite sides of the intermediate plane (MP). The first width (W1) is preferably wider than the second width (W2), and / or the third width (W3) is preferably wider than the fourth width (W4). In some embodiments, in order to make the first and second jaw members 102,104 radially symmetric with respect to the central point during assembly, the first width (W1) and the third width (W3) are preferably equal, and the second width (W2) and the fourth width (W4) are preferably equal. Thus, if radially symmetric, the first and second jaw members 102 and 104 can be inserted into the cartridge 300 in either a 180° orientation. Furthermore, radial symmetry facilitates the manufacture of the clip applicator 10, allowing the first and second jaw members 102 and 104 to be at least substantially identical (one is rotated and assembled) and manufactured using the same process (e.g., using the same mold). However, in some embodiments (not shown), the first jaw member 102 and the second jaw member 104 do not have to be identical.For example, the first jaw member 102 and the second jaw member 104 may be non-radially symmetric during assembly, and as a result, the first width (W1) and the third width (W3) may not be equal to each other, and / or the second width (W2) and the fourth width (W4) may not be equal to each other. If non-radially symmetric, the jaw members 102 and 104 may be keyed to the cartridge 300 in such a way that insertion of the jaw members 102 and 104 is only possible in a single orientation. For example, the clip applicator 10 may be sized so that the first jaw member 102 can be inserted into only a portion of the cartridge housing the first leg member 202, and the second jaw member 104 can be inserted into only a portion of the cartridge 300 housing the second leg member 204. Non-radiative symmetry can be used, for example, in embodiments where the first leg member 202 and the second leg member 204 have substantially different lengths and / or require different jaw structures for engagement.

[0027] The asymmetry of the first jaw member 102 and / or the second jaw member 104 with respect to the intermediate plane (MP) is preferably defined at least in part by the different widths of the distal portions of the first and second longitudinal walls 128, 129 and / or the different widths of the distal portions of the third and fourth longitudinal walls 138, 139. As shown in the figure, the first longitudinal wall 128 and the fourth longitudinal wall 139 are preferably aligned vertically, and the second longitudinal wall 129 and the third longitudinal wall 138 are preferably aligned vertically. The first longitudinal wall 128 and the third longitudinal wall 138 are preferably located on opposite sides of the intermediate plane (MP), and the second longitudinal wall 129 and the fourth longitudinal wall 139 are preferably located on opposite sides of the intermediate plane (MP). The distal portion of the first longitudinal wall 128 is preferably wider than the distal portion of the second longitudinal wall 129, and / or the distal portion of the third longitudinal wall 138 is preferably wider than the distal portion of the fourth longitudinal wall 139. Furthermore, the first jaw member 102 is preferably asymmetrical with respect to the intermediate plane (MP) along the transverse plane of at least one recess 124, and / or the second jaw member 104 is preferably asymmetrical with respect to the intermediate plane (MP) along the transverse plane of at least one recess 134. Since the first and third longitudinal walls 128 and 138 are wide, they are preferably provided on the side surface of the clip applicator 10 and have side walls or end caps 140 that close the peripheral sides of the respective recesses 124 and 134, thereby improving the retention of the boss members 212 and 214 received in these recesses and the longitudinal alignment of the surgical clip. Since the second and fourth longitudinal walls 129, 139 are narrow, they may have open lateral surfaces of the recesses 124, 134 on the sides of the clip applicator 10, thereby allowing the boss members 212, 214 received in these recesses to be visible and ensuring proper retention.

[0028] Figures 5 to 7 show a cartridge 300 configured to hold a surgical clip 200. The cartridge 300 preferably has a cartridge body 310 and a flexible retainer 350 (as shown in Figures 6 and 7).

[0029] The cartridge body 310 preferably has a base 312 and a plurality of walls 314 extending from the base 312, and preferably one or more cavities 316 are formed between adjacent walls 314. One or more surgical clips 200 are preferably supported by one or more support members 318 that are positioned within the cavities 316 and extending between adjacent walls 314. For example, the hinge member 206 of each surgical clip 200 may engage with the support member 318, and the first and second leg members 202, 204 may straddle the opposite sides of the support member 318. The support member 318 is aligned with the longitudinal axis (L) of the cartridge body 310 or the base 312. LONG It is preferable that it extends along the central portions 320 of adjacent walls 314. Figure 5 shows a surgical clip 200 with a cartridge 300 loaded into the clip applicator 10. The cartridge 300 can receive the surgical clip 200 into the cavity 316 in a storage configuration. The cartridge 300 can receive the clip applicator 10 in an open configuration and load the surgical clip 200 onto the clip applicator 10.

[0030] At least one of the walls 314 is perpendicular to the longitudinal axis, from the central portion 320 perpendicular to the longitudinal axis to the lateral axis (L LATIt is preferable to have a first wall portion 322 and a second wall portion 324 extending along the longitudinal direction. The first wall portions 322 are preferably parallel to each other when viewed laterally, and their ends preferably share a boundary with each other along the longitudinal direction. Similarly, the second wall portions 324 are preferably parallel to each other when viewed laterally, and their ends preferably share a boundary with each other along the longitudinal direction. Adjacent first wall portions 322 are preferably defining a portion of the cavity 316 that receives the first leg member 202, and adjacent second wall portions 324 are preferably defining a portion of the cavity 316 that receives the second leg member 204. With respect to at least one of the walls 314, the first wall portions 322 and the second wall portions 324 are preferably staggered and / or offset from each other and / or from the central portion 320 with respect to the transverse axis. For example, in some embodiments, it is preferable that the lateral axis passing through the center of the first wall portion 322 does not align with the lateral axis passing through the center of the second wall portion 324. Furthermore, it is preferable that the lateral axis passing through the center of the central portion 320 does not align with at least one of the lateral axes passing through the centers of the first and second wall portions 322 and 324. In some embodiments, it is preferable that the entire width of the first wall portion 322 (viewed longitudinally) does not overlap with the entire width of the second wall portion 324 (viewed longitudinally) with respect to the lateral axis. Furthermore, it is preferable that the respective widths of the first and second wall portions 322 and 324 (viewed longitudinally) are smaller than the width of the central portion 320 (viewed longitudinally). Thus, in some embodiments, it is preferable that the entirety of the first wall portion 322 and the entirety of the second wall portion 324 extend offset from each other with respect to the lateral axis of the cartridge body 310. Therefore, the cartridge body 310 and / or one or more cavities 316 are preferably asymmetrical with respect to the midplane along the transverse axis of the cartridge body 310 to facilitate keying with the clip applicator 10. The cartridge body 310 and / or one or more cavities 316 are preferably radially symmetric with respect to a central point to facilitate manufacturing. For example, the cartridge body 310 and / or one or more cavities 316 are preferably radially symmetric with respect to their respective central points.However, in some embodiments (not shown), one or more of the cavities 316 are preferably non-radially symmetric, so that the jaw members 102 and 104 can be keyed to the cartridge 300 in such a way that they can be inserted in only one orientation as described above. For example, the clip applicator 10 may be sized such that the first jaw member 102 engages only with the first leg member 202, and the second jaw member 104 engages only with the second leg member 204.

[0031] The flexible retainer 350 is preferably positioned to cover the cartridge body 310 so as to cover the base 312. The flexible retainer 350 is preferably formed separately and fixed to the base 312 such that a hole 360 ​​in the flexible retainer 350 receives a pin 340 extending from the base 312. To secure the surgical clip 204 within the cartridge 300, the flexible retainer 350 is preferably having a plurality of tabs 352, 354 extending laterally inward from the perimeter 356 of the flexible retainer 350 into the cavity 316. The tabs 352, 354 are preferably engaged with leg members 202, 204 and / or boss members 212, 214 to prevent the surgical clip 200 from falling out of the cartridge 300 during storage and / or transport. Tabs 352 and 354 can bend downward when the first and second jaw members 102 and 104 are inserted into the cavity 316, thereby allowing the surgical clip 200 to be released from the flexible retainer 350. The multiple tabs 352 and 354 may include a first tab 352 extending between adjacent first wall portions 322 located on the first side of the longitudinal axis of the cartridge 300 and a second tab 354 extending between adjacent second wall portions 324 located on the second side of the longitudinal axis of the cartridge 300. Furthermore, as shown in Figure 7, the lateral axes of the first tabs and the lateral axes of the second tabs may be offset to match and alternate with the offset configuration of the first and second wall portions 322 and 324, as described above. To enhance the safety of the mounting of the flexible retainer 350 and the cartridge body 310, the perimeter 316 is preferably formed by one or more vertical walls extending around the flexible retainer 350.

[0032] The cartridge body 310 is preferably formed as a single unit. For example, these components are preferably a single plastic body formed by injection molding. However, it is conceivable that one or more of the components may be formed separately and attached, for example, by welding or adhesive. Further descriptions relating to the retention of the surgical clip 200 and / or the manufacture of the cartridge 300 can be found in U.S. Patent No. 6,880,699, which is incorporated herein by reference and whose entire disclosure is part of this specification.

[0033] Many features and advantages of the present invention are evident from the detailed description, and thus the appended claims encompass all such features and advantages of the present invention, which belong to the true spirit and scope of the invention. Furthermore, since many modifications and variations are readily conceivable to those skilled in the art, it is not desirable to limit the present invention to the configuration and operation illustrated and described, and therefore, all suitable modifications and equivalents that fall within the scope of the present invention can be adopted.

Claims

1. A clip applicator configured to fasten a surgical clip, wherein the clip applicator is A first jaw member configured to engage with the first leg member of the surgical clip, It has a second jaw member configured to engage with the second leg member of the surgical clip, A clip pliers in which at least one of the first jaw member and the second jaw member is asymmetrical with respect to the intermediate plane of the clip pliers.

2. The clip applicator according to claim 1, wherein both the first jaw member and the second jaw member are asymmetrical with respect to the intermediate plane of the clip applicator.

3. The clip pliers according to claim 1, wherein at least one of the first and second jaw members has a first width on the first side of the intermediate plane of the clip pliers and a second width on the second side of the intermediate plane of the clip pliers, and the first width is wider than the second width.

4. The clip applicator according to claim 1, wherein at least one of the first and second jaw members has a first longitudinal wall provided on the first side of the longitudinal channel and a second longitudinal wall provided on the second side of the longitudinal channel, and the lateral width of the first longitudinal wall is wider than the lateral width of the second longitudinal wall.

5. The clip applicator according to claim 1, wherein the first jaw member has a first longitudinal channel extending through the distal end of the first jaw member and / or the second jaw member has a second longitudinal channel extending through the distal end of the second jaw member.

6. The clip applicator according to claim 1, wherein the first jaw member has at least one first recess configured to receive at least one boss provided on the first leg member, and the second jaw member has at least one second recess configured to receive at least one boss provided on the second leg member, and at least one of the first and second jaw members is asymmetrical with respect to the midplane of the clip applicator with respect to the first recess and the second recess.

7. The clip applicator according to claim 6, wherein the first jaw member has a closed lateral side of the at least one first recess, and the second jaw member has a closed lateral side of the at least one second recess.

8. The clip applicator according to claim 6, wherein the at least one first recess of the first jaw member has an open lateral side and a closed lateral side, and the at least one second recess of the second jaw member has an open lateral side and a closed lateral side.

9. The clip applicator according to claims 1 to 8, wherein each of the first and second jaw members has an angled distal surface.

10. The clip applicator according to claim 1, wherein the first jaw member and the second jaw member are radially symmetrical when assembled.

11. The clip applicator according to claim 1, wherein at least one of the first and second jaw members has a stabilizing member configured to laterally stabilize the proximal portion of the surgical clip when the surgical clip is in an open position.

12. The clip applicator according to claim 11, further comprising a longitudinal channel provided in at least one of the first and second jaw members, configured to receive the stabilizing member when the clip applicator is in a closed position.

13. The clip applicator according to claim 12, wherein the first jaw member has a first stabilizing member, the second jaw member has a second stabilizing member, and the first and second stabilizing members are configured to receive the proximal portion of the surgical clip when the surgical clip is in an open position.

14. The clip applicator according to claim 1, wherein the first jaw member and the second jaw member are at least substantially identical.

15. It is a clip applicator system, The clip applicator according to claim 1, A clip applicator system comprising: a clip cartridge having at least one cavity configured to receive the clip applicator for loading the surgical clip, wherein the at least one cavity is asymmetrical with respect to a midplane.

16. The clip applicator system according to claim 15, wherein at least one of the cavities is radially symmetric.

17. The clip applicator system according to claim 15, wherein the at least one cavity is formed by the offset wall portion of the clip cartridge.

18. A clip cartridge configured to store at least one surgical clip, wherein the clip cartridge is It has a base having a first axis and a second axis, the second axis being perpendicular to the first axis, It has a plurality of walls defining at least one cavity configured to receive the at least one surgical clip, A clip cartridge in which at least one of the plurality of walls has a first wall portion provided on the first side of the first axis and a second wall portion provided on the second side of the second axis, and the first wall and the second wall are offset from each other with respect to the second axis.

19. The clip cartridge according to claim 18, wherein each of the plurality of walls is offset from one another with respect to the second axis.

20. The clip cartridge according to claim 18, wherein at least one of the plurality of walls has a central portion between the first wall portion and the second wall portion.

21. The clip cartridge according to claim 20, wherein the first wall portion and the second wall portion have a narrower width than the central portion.

22. The clip cartridge according to claim 21, wherein the second axis passing through the center of the central portion is offset with respect to the second axis passing through the center of at least one of the first wall portion and the second wall portion.

23. The clip cartridge according to claim 18, wherein the at least one cavity is asymmetrical with respect to the midplane of the cavity.

24. The clip cartridge according to claim 18, wherein the at least one of the cavities is radially symmetric.

25. The clip cartridge according to claim 18, further comprising a retainer provided covering the base and configured to releasably hold the at least one surgical clip in the at least one cavity.

26. The clip cartridge according to claim 18, further comprising at least one support member extending between adjacent walls among the plurality of walls.

27. The clip cartridge according to claim 18, wherein the first axis is the longitudinal axis of the base, and the second axis is the transverse axis of the base.

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