Two-stage hemostatic clip deployment mechanism for removal of dislodged segments
By designing an endoscopic fixture with sliding fixtures and control members, the problem of difficulty in effectively blocking or repairing wall perforations or defects in gastrointestinal surgery is solved, and the stable fixation and efficient use of fixtures are achieved.
Patent Information
- Application Number
- JP2023121813
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2019-07-24
- Filing Date
- 2023-07-26
- Publication Date
- 2025-04-30
- Estimated Expiration
- 2040-07-22
AI Technical Summary
When performing gastrointestinal surgery under endoscopy, it is difficult to effectively block or repair perforations or defects in the gastrointestinal wall, and existing fixtures are prone to fall off during use or are inconvenient for multiple use.
An endoscope fixture is designed including a slidable fixture and a control member, which consists of a capsule with a channel and two slidable fixture arms. By controlling the operation of the member, the fixture can be changed from an open state to a closed state and fixed in the closed state through a locking mechanism.
The fixture can effectively block or repair perforations or defects in the gastrointestinal wall, and ensure that the fixture is not easy to fall off during use through a locking mechanism, improving the stability and reliability of the surgery.
Smart Images

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Abstract
Description
[Technical field]
[0001] FIELD OF THEINVENTION The present invention relates to endoscopic devices, and more particularly to endoscopic clipping devices for treating tissue along the gastrointestinal tract. [Background technology]
[0002] During endoscopic gastrointestinal (GI) procedures, patients may be at risk for perforation of the GI tract wall or may need to occlude the GI tract wall as part of the procedure. Hemostatic clips may be used, for example, to occlude luminal perforations as well as to provide hemostasis for mucosal / submucosal defects, bleeding ulcers, arteries, polyps, diverticula, etc. Depending on the size of the defect, multiple clips may be used. Summary of the Invention
[0003] The present invention relates to a clip device including a clip. The clip includes a capsule including a channel extending longitudinally from a proximal end to a distal end therethrough, and a pair of clip arms. The proximal ends of the clip arms are slidably received within the channel to move the clip arms between an open configuration and a closed configuration. Each of the pair of clip arms includes a slot extending through its proximal end. The connector includes a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within each opening of the clip arms. The connector is movable from an unlocked configuration in which the pin is received within a distal portion of the slot to a locked configuration in which the pin is received within a proximal portion of the slot upon application of a predetermined force thereto. A control member extends through the proximal portion of the clip device from the proximal end to a distal end releasably coupled to the connector, such that when the connector is in the unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open configuration and the closed configuration.
[0004] In one embodiment, the capsule can include a locking tab that is biased to extend radially into the channel, such that when the pin is moved from a distal portion of the slot to a proximal portion of the slot, the pin is moved proximally past the locking tab until the pin engages the locking tab to lock the clip in a closed configuration.
[0005] In one embodiment, the distal and proximal portions of the slot may be connected via an intermediate portion having a width smaller than the width of the distal and proximal portions, thereby allowing one of the pin and a portion of the clip arm to deform and move the pin from the distal portion to the proximal portion.
[0006] In one embodiment, each of the clip arms can include a slit extending from the proximal-most end of the clip arm to the slot to define a pair of fingers that deform by spreading toward each other to allow the pin to move proximally past the intermediate portion.
[0007] In some embodiments, the connector may include overhangs extending from the pin and engaging outer surfaces of each of the clip arms. In one embodiment, the central portion of the connector can be sized and shaped such that when the connector is moved from the unlocked configuration to the locked configuration, the central portion moves an inwardly crimped tab at the proximal end of the capsule radially outward, releasing the clip from the proximal portion of the clip device.
[0008] In an embodiment, the connector may be connected to the control member via one of a weld, a rounded portion, and a ball-shaped tip of the control member, and the control member is configured to separate when a force greater than a predetermined force is applied thereto to move the connector from the unlocked configuration to the locked configuration.
[0009] The present invention relates to a clip device. The clip device includes a clip. The clip includes a capsule extending longitudinally from a proximal end to a distal end and including a channel therethrough, and a pair of clip arms. The proximal ends of the clip arms are slidably received within the channel such that the clip arms are moved between an open configuration and a closed configuration. Each of the pair of clip arms includes an opening therethrough. The connector includes a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within the respective openings of the clip arms. At least a portion of the central portion is configured to be movable relative to the pin and the clip arms from an unlocked configuration to a locked configuration upon application of a predetermined force thereto. A control member extends through a proximal portion of the clip device from the proximal end to a distal end that is releasably coupled to the connector, such that when the connector is in the unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open configuration and the closed configuration.
[0010] In one embodiment, the capsule can include a locking tab that is biased to extend radially into the channel, such that when the central portion is moved from the unlocked configuration to the locked configuration, a portion of the central portion engages the locking tab to lock the clip in the closed configuration.
[0011] In one embodiment, the central portion can include a slot therethrough, and the pin is received within the slot and is movable relative thereto from a proximal portion of the slot in the unlocked configuration to a distal portion of the slot in the locked configuration.
[0012] In one embodiment, the proximal and distal portions of the slot may be connected to one another via an intermediate portion having a width smaller than the width of the proximal and distal portions of the slot, thereby allowing the pin to deform and move from the proximal to the distal portion of the slot.
[0013] In one embodiment, the central portion can include an inner member from which the pin extends and a sliding member connected to the inner member via a shear tab, the shear tab configured to shear upon receiving a predetermined force to move the sliding member from the unlocked configuration to the locked configuration.
[0014] In some embodiments, the slide member may include a pair of slide arms extending along opposing sides of the inner member, with inwardly extending fingers at the distal ends of the slide arms engaging shear tabs at the distal end of the inner member.
[0015] In certain embodiments, the pins may engage the respective openings in the clip arms via one of a friction fit, a weld, an adhesive, and an overhang extending from the pin. In one embodiment, the central portion of the connector can be sized and shaped such that when the connector is moved from the unlocked configuration to the locked configuration, the central portion engages an inwardly crimped tab at the proximal end of the capsule and moves the crimped tab radially outward, releasing the clip from the proximal portion of the clip device.
[0016] The present invention also relates to a method of clipping tissue. A clipping device is inserted through a working channel of an endoscope to a target site within the body until a clip of the clipping device extends distally past the distal end of the working channel. The clipping device includes a capsule and a pair of clip arms slidably received therein. The clipping device is moved between an open configuration and a closed configuration using a control wire coupled to the clip arms until the target tissue is received between the distal ends as needed. The distal end of the control wire is coupled to the proximal end of the clip arms by a connector including a central portion received between the proximal ends of the clip arms and a pin extending therefrom and receivable in a slot extending through each of the proximal ends of the clip arms. The clip arms are retracted proximally into the capsule to move the clip toward the closed configuration and grasp the target tissue between the clip arms. The clip is locked in the closed configuration by pulling the control member proximally relative to the capsule until a predetermined force is applied to the connector, moving the pin from the distal portion of the slot to the proximal portion of the slot where the pin engages a locking tab radially biased into the channel of the capsule. [Brief description of the drawings]
[0017] [Figure 1A] 1 is a longitudinal side view of a clip device according to an exemplary embodiment of the present invention. [Figure 1B] FIG. 1B is a partial perspective view of a longitudinal side of a clip according to the device of FIG. 1A. [Diagram 2] 1B is a perspective close-up view of a portion of the clip device of FIG. 1A in a closed, undeployed configuration. [Diagram 3] 1B is a perspective close-up view of a portion of the clip device of FIG. 1A in a locked, deployed configuration. [Figure 4] 13 is a perspective view of a connector connected to a clip arm of a clip device according to an alternative embodiment. FIG. [Diagram 5] 1B is a perspective view of a control member and a connector according to the clip device of FIG. 1A. [Figure 6] FIG. 13 is a longitudinal side view of a control member and connector according to an alternative embodiment. [Figure 7] FIG. 13 is a perspective view of a control member and connector according to another alternative embodiment. [Figure 8] 1 is a perspective close-up view of a portion of a clip device in a closed, undeployed configuration, according to another exemplary embodiment of the present invention. [Figure 9] FIG. 2 is an enlarged perspective view of a portion of the clip device in a locked configuration. [Figure 10] FIG. 2 is a side view of a portion of a clip device in a locked, deployed configuration. [Figure 11] 9 is a perspective view of an alternative embodiment of a connector according to the clip device of FIG. 8. [Figure 12] 1 is a perspective close-up view of a portion of a clip device in a closed, undeployed configuration, according to another exemplary embodiment of the present invention. [Figure 13] 12 is a perspective close-up view of a portion of the clip device of FIG. 11 in a locked, deployed configuration. [Figure 14] 12 is a perspective view of a portion of a connector using the clip device of FIG. 11. [Figure 15] 12 is a perspective view of a portion of the connector with the clip device of FIG. 11 with the shear tab sheared; DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0018] The present invention may be further understood by reference to the following description and the accompanying drawings, in which like elements are labeled with the same reference numerals. The present invention relates to an endoscopic clipping device for treating internal tissue perforations, defects, and / or bleeding. In some cases, it may be preferable for the deployed clip to be shorter to allow for better visualization of the target site and better maneuverability when placing multiple clips. Furthermore, although the stray portion naturally migrates out of the body under normal circumstances, the stray portion may be trapped within a larger defect after closure.
[0019] An exemplary embodiment of the present invention describes a clip device comprising a clip including clip arms that are slidable within a capsule and move between an open configuration and a closed configuration that clamps tissue as needed. In particular, the clip arms are movable relative to the capsule by a control member that includes a connector at its distal end that connects the control member to the clip arms. The connector is coupled to a proximal end of the clip arms, and when the clip is clipped over the target tissue as needed, at least a portion of the connector slides proximally relative to the clip arms to lock the clip arms to the capsule and facilitate deployment of the clip from a proximal portion of the device. The sliding connector remains attached to the clip arms upon deployment. The sliding connector, including its locking mechanism, reduces the potential length of the clip arms that are inserted into the body and / or reduces the amount of material that falls off the clip. As used herein, it will be understood by those skilled in the art that the terms proximal and distal refer to directions toward and away from the user of the device, respectively.
[0020] 1A-7, the clip device 100 includes a clip 102 including a pair of clip arms 104, the proximal ends 108 of which are slidably received within a capsule 106 such that the clip arms can be moved between an open configuration in which the distal ends 110 of the clip arms 104 are separated from one another and a closed configuration in which the distal ends 110 are drawn toward one another. The clip arms 104 are moved between the open and closed configurations by proximal and distal movement of a control member 112 that is coupled to the clip arms 104 via a connector 114. The connector 114 is configured to maintain alignment between the clip arms 104, lock the clip arms 104 relative to the capsule 106 when the target tissue is clamped, and facilitate deployment of the clip from a proximal portion 116 of the clip device 100, thereby facilitating insertion of the clip 102 into the target site.
[0021] In some embodiments, once the clip 102 is clipped over the target tissue, the control member 112 is pulled proximally relative to the capsule 106 until at least a portion of the connector 114 slides proximally relative to the clip arms 104 to lock the clip 102 in the closed configuration, facilitating deployment of the clip 102 from the proximal portion 116, as described in more detail below. The proximal portion 116 may include, for example, a flexible elongate member 117 that houses the control member 112 and connects the clip 102 to a handle 119 and / or one or more actuators that remain outside the body during use and accessible to a user to allow the user to control operation and movement of the device 100 between the open and closed configurations and to deploy the clip 102 over the target tissue. The flexible elongate member may be releasably coupled to the clip 102 by a bushing 118 at a distal end of the flexible elongate member. The control member 112 extends through the elongate member from a proximal end connected to a portion of the handle member to a distal end 120 connected to the connector 114 .
[0022] The capsule 106 includes a channel 126 extending from the proximal end 122 to and through the distal end 124. In one embodiment, the proximal end 122 is configured to be releasably coupled to the bushing 118, for example, by a radially inwardly crimped tab 128 that engages a corresponding portion of the bushing 118. The proximal portion of the capsule 106 also includes a locking tab 130 that extends into the channel 126. In one example, the locking tab 130 is defined by a cut portion of a wall 132 of the capsule 106 and is angled or bent into the channel 126 such that a proximal end 134 of the locking tab 130 is biased toward a centerline of the capsule 106.
[0023] Each of the clip arms 104 extends from a proximal end 108 to a distal end 110. As mentioned above, a proximal portion of the clip arms 104 is slidably received within the channel 126 of the capsule 106. Specifically, the proximal end 108 of each of the clip arms 104 is slidably received within the channel 126 such that the clip 102 can be moved between an open configuration and a closed configuration by manipulating the control member 112. In one embodiment, the clip arms 104 are biased toward the open configuration such that when advanced distally out of the capsule 106, the clip arms 104 move away from each other under their natural bias toward the open configuration. As the arms 104 are retracted proximally into the capsule 106, the clip arms 104 are restrained by the wall 132 of the capsule 106 and are drawn together into a closed position with the distal ends 110 adjacent each other. One skilled in the art will appreciate that any number of other mechanisms for opening and closing the clip arms 104 may be used.
[0024] The clip arm 104 in this embodiment also includes an engagement feature 136 extending therefrom that is configured to engage a portion of the capsule 106 such that when the engagement feature 136 engages the capsule 106, the clip arm 104 is prevented from moving further proximally into the capsule 106. In one embodiment, the engagement feature 136 extends laterally outward and has a width greater than a width of a more proximal portion of the clip arm 104 that is sized to retract the clip arm 104 proximally into the capsule 106. Thus, when the clip arm 104 is retracted proximally into the capsule 106, the engagement feature 136 abuts the distal end 124 of the capsule 106. The engagement feature 136 is positioned along the clip arm 104 such that where the engagement feature 136 engages the capsule 106, the clip arm 104 is retracted proximally enough into the capsule 106 to draw both clip arms 104 together into a closed configuration. In one example, the engagement features 136 are configured as wings extending laterally from the longitudinal edges of the clip arms 104 .
[0025] The proximal end 108 of the clip arm 104 includes a slot 138 therethrough that receives a portion of the connector 114. The slot 138 includes a proximal portion 140 and a distal portion 142 connected to one another via an intermediate portion 144 having a width that is less than the width (e.g., diameter) of each of the proximal and distal portions 140, 142. Each of the proximal and distal portions 140, 142 is sized and shaped to receive a portion of the connector 114, such as a pin 146.
[0026] In an unlocked configuration, in which the clip arms 104 are movable relative to the capsule 106, the pin 146 is received within the distal portion 142 of the slot 138 (see, e.g., FIG. 2). In a locked configuration, in which the clip arms 104 are locked in a closed configuration relative to the capsule 106, the pin 146 is received within the proximal portion 140 of the slot 138 (see, e.g., FIG. 3). The width of the intermediate portion 144 is less than the width of the proximal and distal portions 140, 142, thereby preventing the pin 146 from inadvertently sliding from the distal portion 142 to the proximal portion 140 until it is desired to lock the clip 102 in the closed configuration. In some embodiments, the pin 146 is configured to move from the distal portion 142 to the proximal portion 140 when a predetermined force is applied by the control member 112.
[0027] As mentioned above, the control member 112 is connected to the clip arms 104 via the connector 114, whereby movement of the control member 112 controls movement of the clip 102, and in particular the movement of the clip arms 104 relative to the capsule 106. As shown in FIGURE 5, the connector 114 includes a central portion 150 that is releasably attached to the distal end 120 of the control member 112 and that is sized and shaped to be received between the proximal ends 108 of the clip arms 104, and a pin 146 extending from opposite sides of the central body 150 to be received within the slot 138. The central portion 150 extends from a proximal end 152 connected to the control member 112 to a distal end 154.
[0028] In one embodiment, the central portion is defined by opposing faces 156 that respectively contact corresponding clip arms of the clip arms 104 and sides 158 that connect to longitudinal edges 160 of the opposing faces 156. The distance between the sides 158 is selected such that when the connector 114 is slid proximally relative to the clip arms 104 from the unlocked configuration to the locked configuration, the sides 158 engage inwardly crimped tabs 128 at the proximal end 122 of the capsule 106, moving the tabs 128 radially outward to disengage from the bushings 118 of the proximal portion 116 of the device 100 and deploying the clip 102. In one embodiment, the distance between the sides 158 generally corresponds to a width (e.g., diameter) of the channel 126 of the capsule 106, thereby allowing the connector 114 to slide longitudinally therein.
[0029] The pin 146 includes a protrusion 162 extending from each of the opposing surfaces 156 for receipt within the slot 138 of a corresponding one of the clip arms 104. In one embodiment, the pin 146 may include an overhang 164 extending laterally from each protrusion 162 such that when each protrusion 162 is received within the slot 138 of the corresponding clip arm 104, the overhang 164 engages an outer surface 166 of the clip arm 104 (e.g., a face of the clip arm 104 facing away from the centerline of the capsule 106) and spaces the clip arm 104 from the channel 126 to prevent any friction that may result from sliding of the outer surface 166 of the clip arm 104 against the face of the channel 126.
[0030] As described above, the pin 146 transitions from the unlocked configuration to the locked configuration when the engagement feature 136 of the clip arm 104 engages the distal end 124 of the capsule 106 to prevent further proximal movement of the clip arm 104 relative to the capsule 106. Thus, as the control member 112 is moved further proximally relative to the capsule 106, 1.When a predetermined force is applied to the connector 114, the pin 146 moves from the distal portion 142 of the slot 138 of the clip arm 104 to the proximal portion 140 of the slot 138 via the proximal and distal portions 140, 142 and the intermediate portion 144 having a smaller width than the pin 146. In one example, the protrusion 162 of the pin 146 and / or one of the portions of the clip arm 104 extending along either side of the intermediate portion 144 deforms to allow the pin 146 to be moved proximally therethrough.
[0031] 4, the proximal end 108' of the clip arm 104' includes a slit 168' from a proximal-most end 169' of the clip arm 104' to the slot 138' to define a pair of fingers 170'. When a predetermined force is applied to a connector 114', generally similar to the connector 114 described above, to move the connector 114' from an unlocked configuration to a locked configuration, the pair of fingers 170' flex or spread apart to facilitate moving a pin 146' of the connector 114' from a distal portion 142' of the slot 138' to a proximal portion 140' of the slot 138' through an intermediate portion 144' having a width smaller than the proximal and distal portions 140', 142'. However, once the pin 146' is received within the proximal portion 140' of the slot 138', the fingers 170' return to their initial configuration, thereby retaining the pin 146' within the proximal portion 140' and locking the clip arm 104' relative to the capsule 106 by the locking tab 130, as described above.
[0032] 3, the pin 146 extends across the width (e.g., diameter) of the channel 126 of the capsule 106, such that the length of the pin 146 generally corresponds to the width of the channel 126. Thus, as the connector 114 is moved from the unlocked to the locked configuration, the pin 146 slides along and moves proximally past the locking tabs 130, thereby moving the locking tabs 130 radially outward. However, once the pin 146 proximally passes the locking tabs 130, the locking tabs 130 are permitted to return to their angled / crimped configuration, such that their proximal ends 134 extend toward the centerline of the capsule 106. In the locked configuration, the pin 146 is proximal to the proximal end 134 of the locking tab 130 such that the pin 146 engages the locking tab 130 and is prevented from moving distally past it, thereby locking the clip arm 104 thereagainst in the closed configuration.
[0033] As described above, the connector 114 is releasably coupled to the distal end 120 of the control member 112. Thus, when the connector 114 is moved to the locked configuration, whereby the central portion 150 moves the crimped tab 128 out of engagement with the bushing 118 and the pin 146 is disposed within the proximal portion 140 of the opening 138, the control member 112 is Second A predetermined force is applied thereto to move the control member 112 further proximally relative to the capsule 106 until it releases or otherwise separates the control member 112 from the connector 114. Second The predetermined force is the force required to move the connector 114 from the unlocked configuration to the locked configuration. 1. It will be understood by those skilled in the art that the predetermined force must be exceeded in order for the clip 102 to separate from the connector 114. Separation of the control member 112 from the connector 114 allows the proximal portion 116 to be removed from the body while leaving the clip 102 clipped over the target tissue within the body.
[0034] It will be appreciated by those skilled in the art that the control member 112 may be releasably coupled to the connector 114 in any of a variety of ways. In one embodiment, for example, as shown in FIG. 5, the distal end 120 of the control member 112 may be welded to the proximal end 152 of the central section 150 and configured to break or separate when a predetermined force is applied thereto. In another example, as shown in FIG. 6, the connector 114' may include a sleeve 172' extending proximally from the proximal end 152' of the central section 150' and bent over a distal portion of the control member 112'. Distal to the rounded portion 173' of the sleeve 172', the sleeve 172' includes a necked-down portion 174' configured to break or break when a predetermined force is applied thereto.
[0035] According to yet another example, as shown in FIG. 7, the control member 112'' can include a ball-shaped tip 172'' that is releasably coupled to the distal end 120'' of the control member 112''. In particular, the distal portion of the control member 112'' extends through the central portion 150'' of the connector 114'', such that the ball-shaped tip 172'' is distal to the distal end 154'' of the central portion 150''. Just proximal to the central portion 150'' of the connector 114'', the hypotube 113'' can be rolled or welded to cover the top side of the control member 112'', such that the control member 112'' is prevented from sliding distally through the central portion 150'' while opening the clip 102. When a predetermined force is applied thereto, the ball-shaped tip 172'' is separated from the remainder of the control member 112'', such that the control member 112'' can be pulled proximally from the central portion 150''.
[0036] Although FIG. 7 specifically shows and describes a hypotube 113'', it will be understood by one of ordinary skill in the art that the control member 112'' can include other elements or mechanisms that prevent distal movement of the control member 112'' relative to the connector 114''. For example, the control member 112'' can instead include an increased diameter portion just distal to the central portion 150''. Although specific examples are shown and described above, it will be understood by one of ordinary skill in the art that the control member 112 can be releasably coupled to the connector 114 in any of a number of instances, so long as the control member 112 is released from the connector 114 upon receipt of a predetermined force.
[0037] According to an exemplary method of using the clipping device 100, the clip 102 is inserted, for example, through a working channel of an endoscope to a target site within the body while the handle member remains outside the body. The clip 102 is inserted through the working channel in a closed configuration. Once the clip 102 reaches the target site, the user distally advances the control member 112 to distally advance the clip arms 104 out of the capsule 106, freeing the clip arms 104 to move under their natural bias toward an open configuration so that the target tissue may be received between the clip arms 104. The user then operates the control member 112 to move the clip 102 between the open and closed configurations as needed until the target portion of tissue is positioned between the clip arms 104 as needed.
[0038] As mentioned above, the clip arms 104 may be moved between the open and closed positions while the control connector 114 is in an unlocked configuration relative to the clip arms 104. In particular, the pin 146 of the connector 114 is received in a distal portion 142 of a slot 138 that extends through the proximal end of the clip arms 104. Once the target tissue is clamped as desired, the user pulls the control member 112 proximally (or advances the proximal portion 116 distally over the control member 112), thereby drawing the clip arms 104 toward each other to grasp the target tissue between the distal ends 110 of the clip arms 104 as the clip arms 104 are retracted into the capsule 106.
[0039] When the clip 102 is in a desired position gripping the target tissue, after the engagement feature 136 engages the capsule 106, as described above, the user applies increased force to the control member 112 in a proximal direction until the pin 146 of the connector 114 moves proximally within the slot 138 from its distal portion 142 to its proximal portion 140 through the intermediate portion 144. As described above, either the clip 104 and / or the pin 146 deforms to permit proximal movement of the pin 146 through the intermediate portion 144, which has a smaller width than the proximal and distal portions 140, 142.
[0040] When the connector 114 is moved from the unlocked position to the locked position, the pin 146 moves distally past the proximal end 134 of the locking tab 130 of the capsule 106, not only locking the clip arms 104 in the closed configuration relative to the capsule, but also moving the inwardly crimped tabs 128 at the proximal end 122 of the capsule 106 radially outwardly by the side 158 of the central portion 150 to disengage the capsule 106 from the bushing 118. When the connector 114 is moved to the locked configuration, the proximal force on the control member 112 may be increased until the control member 112 separates from the connector 114, freeing the clip 102 from the proximal portion 116 of the device 100 and leaving the clip 102 coupled to the target tissue. The proximal portion 116 including the control member 112 may then be withdrawn from the body.
[0041] 8-10, a clip device 200 according to another exemplary embodiment is generally similar to clip device 100 described above and includes a clip 202 including a pair of clip arms 204, the proximal ends 208 of which are slidably received in a capsule 206 such that the clip 202 may be moved between an open configuration in which the distal ends of the clip arms 204 are separated from one another and a closed configuration in which the distal ends are drawn toward one another. The clip arms 204 are moved between the open and closed configurations by distal and proximal movement of a control member 212, which is coupled to the clip arms 204 via a connector 214. The connector 214 is generally similar to the connector 114 and includes a central portion 250 and a pin 246. Rather than the entire connector 214 moving proximally relative to the clip arms 204 to move the clip 202 from the unlocked configuration to the locked configuration, as described in more detail below, the pin 246 remains in a fixed position relative to the clip arms 204, thereby allowing the central portion 250 to slide proximally relative to the pin 246 and the clip arms 204 to move the clip 202 from the unlocked configuration to the locked configuration.
[0042] Similar to the device 100, the connector 214 is releasably coupled to the control member 212 and includes a central portion 250 and a pin 246. The pin 246 extends from an opposing side of the central portion 250 to be received within an opening 238 through the proximal end 208 of the clip arm 204. However, the opening 238 is not elongated, but rather is sized and shaped to correspond to the size and shape of the pin 246 received therein, such that the pin 246 remains in a fixed position relative to the clip arm 204. In one embodiment, the pin 246 may be secured in the opening 238 by a friction fit. In another embodiment, the pin 246 may be secured in the opening 238 by, for example, welding or adhesive. Alternatively, the pin 246 may include an overhang generally similar to the overhang 164 described with respect to the clip device 100 for engaging the clip arm 204. Except as noted above, the clip arm 204 is generally similar to the clip arm 104.
[0043] The central portion 250 extends from a proximal end 252 to a distal end 254 and, similar to the central portion 150, is defined by opposing faces 256 that contact the inner surfaces of corresponding clip arms of the clip arms 204, and side faces 258 that connect to longitudinal edges 260 of the opposing faces from the proximal end 252 to the distal end 254. However, the central portion 250 further includes a slot 276 that extends therethrough from a first side of the opposing face 256 to a second side of the opposing face 256. The slot 276 may be configured generally similar to the slot 138 that extends through the clip arm 104 of the clip device 100. In particular, the slot 276 may include a proximal portion 240 and a distal portion 242 that are connected to one another via an intermediate portion that has a smaller width than the proximal and distal portions 240, 242. A pin 246, which will be described in more detail below, extends through the slot 276. Pin 246 is received within proximal portion 240 in an unlocked configuration (see FIG. 8) and moved into distal portion 242 in a locked configuration (see FIG. 9).
[0044] Similar to the central portion 150, the distance between the sides 258 of the central portion 250 is selected such that when the connector 214 is slid proximally relative to the pin 246 from the unlocked configuration to the locked configuration, the sides 258 engage the inwardly crimped tabs 228 at the proximal end 222 of the capsule 206, moving the tabs 228 radially outward and out of engagement with the bushing 218 of the proximal portion 216 of the device 200 and deploying the clip 202. However, the sides 258 further include a shoulder 278 for engaging the locking tab 230 of the capsule 206 in the locked configuration. Similar to the locking tab 130, the locking tab 230 extends from the wall 232 of the capsule 206 and may be angled or bent into the channel 226 of the capsule 206 such that the proximal end 234 of the locking tab 230 is biased toward the centerline of the capsule 206.
[0045] Although the pin 246 of the connector 214 remains fixed relative to the clip arm 204, the locking tabs 230 engage shoulders 278 of the central portion 250 as the central portion 250 is moved toward the locked configuration. In particular, as shown in FIG. 8 , when the connector 214 is in the unlocked configuration, the central portion 250 is positioned between the locking tabs 230, which causes the locking tabs 230 to be deformed radially outward. However, when the central portion 250 is moved proximally relative to the pin 246 such that the pin 246 is received in the distal portion 242 of the slot 276, the shoulders 278 are moved proximally past the locking tabs 230, allowing the locking tabs 230 to return to their inwardly biased configuration as shown in FIGS. 9 and 10 . Thus, the locking tabs 230 engage the shoulders 278 such that the central portion 250 can no longer move distally relative to the capsule 206 , thereby locking the clip arms 204 in the closed configuration relative to the capsule 206 .
[0046] The pin 246 extends from a first end 280 to a second end 282 in a direction transverse to the longitudinal axis of the capsule such that the first end 280 is received within the first clip arm opening 238 of the clip arm 204 and the second end 282 is received within the second clip arm opening 238 of the clip arm 204. As described above, the pin 246 is received within the slot 276 of the central portion 250 and is movable from the proximal portion 240 to the distal portion 242 when the clip 202 is moved from the unlocked configuration to the locked configuration. Similar to the pin 146, the pin 246 may deform upon receiving a predetermined force to pass through the intermediate portion 244 having a smaller width than the proximal and distal portions 240, 242.
[0047] According to an alternative embodiment, as shown in FIG. 11, the central portion 250' of the connector 214' may similarly be provided with a slot 276' through which a pin (generally similar to the pin 246) may be received. As with the connector 214, the slot 276' includes proximal and distal portions 240', 242' connected to one another via an intermediate portion 244' having a smaller width than the proximal and distal portions 242', 242'. However, the central portion 250' further includes a slot 243' extending therethrough from the distal portion 242' to the distal end 254', such that the pin need not deform as it passes through the intermediate portion 244'. In particular, when a predetermined load is applied to the connector 214', the opposing portions 255' of the central portion 250' defined by the slot 243' spread apart to allow the pin to move from the proximal portion 240' to the distal portion 242'. Once the pin is received in distal portion 242', central portion 250' returns to its initial configuration, retaining the pin within distal portion 242'.
[0048] Except as noted above, the elements of clip device 200 may be generally similar to the corresponding elements of clip device 100, and as will be understood by those skilled in the art, clip device 200 may be utilized in generally the same manner as clip device 100.
[0049] 12-15, a clip device 300 according to another exemplary embodiment of the present invention is generally similar to clip devices 100, 200, except as described below. Like clip devices 100, 200, clip device 300 includes a clip 302 including a pair of clip arms 304, the proximal ends 308 of which are slidably received in a capsule 306 such that clip 302 may be moved between an open configuration in which the distal ends of clip arms 304 are separated from one another, and a closed configuration in which the distal ends are drawn toward one another. Clip arms 304 are moved between the open and closed configurations by distal and proximal movement of a control member 312, which is coupled to clip arms 304 by connector 314.
[0050] Connector 314 may be generally similar to connector 214 and includes a central portion 350 that is movable relative to pin 346 when clip 302 is moved from an unlocked configuration, as shown in FIG 12, to a locked configuration, as shown in FIG 13. However, central portion 350 further includes a sliding member 384 that extends about internal piece 386, such that only sliding member 384 is moved relative to pin 346 when clip 302 is moved from the unlocked configuration to the locked configuration, as described in more detail below.
[0051] The inner part 386 is sized and shaped to be received between the proximal ends 308 of the clip arms 304 and includes a pin 346 extending therefrom. Similar to the pin 146, the pin 346 includes a pair of projections 362 each extending from an opposing surface 356 of the inner part 386 for receipt in an opening 338 through a corresponding clip arm of the clip arms 304. Similar to the clip 202, the opening 338 of the clip 302 is sized and shaped to correspond to the size and shape of the pin 346 received therein such that the pin 346 is in a fixed position relative thereto. Each of the opposing surfaces 356 contacts an inner surface along the proximal end 308 of the corresponding clip arm of the clip arms 304.
[0052] As shown in FIG. 14 , the inner component 386 also includes a shear tab 388. The shear tab 388 extends laterally from the distal end 354 with a stop shoulder 390 extending from the proximal end 352. The shear tab 388 is configured to be sheared by a portion of the sliding component 384 when the clip 302 is moved from the unlocked configuration to the locked configuration. The stop shoulder 390 is configured to abut a portion of the sliding component 384 to prevent the sliding component 384 from moving further proximally relative thereto, thereby preventing the sliding component 384 from disengaging from the inner component 386. When the sliding component 384 abuts the stop shoulder 390, the clip 302 is in the locked configuration.
[0053] The sliding element 384 includes a proximal end 391 releasably coupled to the control member 312 and a pair of sliding arms 392 extending distally from the proximal end 391 that are mounted over an upper side of the inner element 386 such that the pair of sliding arms 392 extend along a lateral side 358 of the inner element 386. The pair of sliding arms 392 each include a radially inwardly extending finger 394 at its distal end 398 which, in the unlocked configuration, engages the shear tab 388 by extending distally over its upper side. In an embodiment, each finger 394 may include a cutting edge 396 such that a predetermined proximal force may be applied to the sliding element 384 by the control member 312 when the clip 302 is clipped over the target tissue as required. Upon application of a predetermined proximal force, the cutting edge 396 severs / cuts the shear tab 388 from the remainder of the inner part 386, as shown in FIG. 15. Shearing the shear tab 388 allows the sliding part 384 to slide proximally relative to the inner part 386, and thereby the clip arms 304 and capsule 306, until the fingers 394 abut against the stop shoulder 390, preventing further proximal movement of the sliding part 384 relative to the inner part 386. The shearing of the shear tab 388 creates a sheared portion, but any sheared portion remains trapped within the deployed clip 302.
[0054] In the unlocked configuration, the pair of sliding arms 394 are positioned between the locking tabs 330 of the capsule 306, causing the inwardly biased locking tabs to deform radially outward. However, in the locked configuration, where the fingers 394 abut the stop shoulder 390, the distal ends 398 of the sliding arms are moved proximally past the locking tabs 330, causing the locking tabs 330 to return to their inwardly biased configuration. The locking tabs 330 thus engage the distal ends 398 of the sliding arms 394 to prevent the sliding piece 384 from being moved distally relative to the inner piece 386, thereby causing the clip arms 304 and capsule 306 to lock the clip 302 in the closed configuration. In this locked configuration, the sliding arms 392 also engage inwardly crimped tabs 328 at the proximal end 322 of the capsule 306 to move the tabs 328 radially outwardly out of engagement with the proximal portion 316 of the device 300, deploying the clip 302. It will be understood by those skilled in the art that the clip device 300 may be used in a manner generally similar to the clip devices 100, 200 to clip the clip 302 over the target tissue and subsequently lock and deploy the clip 302 as described above with respect to the devices 100, 200.
[0055] (Additional Note) As a preferred embodiment, the technical ideas that can be understood from the above embodiment will be described below. [Item 1] 1. A clip device comprising: a clip including a capsule extending longitudinally from a proximal end to a distal end and including a channel therethrough, and a pair of clip arms, the proximal ends of the pair of clip arms being slidably received within the channel such that the pair of clip arms are moved between an open configuration and a closed configuration, each of the clip arms including a slot therethrough; a connector including a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within the slots of each of the pair of clip arms, the connector being movable from an unlocked configuration in which the pin is received within a distal portion of the slot to a locked configuration in which, upon application of a predetermined force to the pin, the pin is received within a proximal portion of the slot to lock the clip arms relative to the capsule in the closed configuration; a control member extending from a proximal end to a distal end through a proximal portion of the clip device and releasably coupled to the connector such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open and closed configurations; A clip device, wherein the slot is configured to prevent the pin from moving from the proximal portion to the distal portion when the connector is in the locked configuration. [Item 2] 1. A clip device comprising: a clip including a capsule extending longitudinally from a proximal end to a distal end and including a channel therethrough, and a pair of clip arms, the proximal ends of the pair of clip arms being slidably received within the channel such that the pair of clip arms are moved between an open configuration and a closed configuration, each of the clip arms including a slot therethrough; a connector including a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within the slots of each of the pair of clip arms, the connector being movable from an unlocked configuration in which the pin is received within a distal portion of the slot to a locked configuration in which, upon application of a predetermined force to the pin, the pin is received within a proximal portion of the slot to lock the clip arms relative to the capsule in the closed configuration; a control member extending from a proximal end to a distal end through a proximal portion of the clip device and releasably coupled to the connector such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open and closed configurations; A clip device, wherein the capsule includes a locking tab biased to extend radially into the channel, whereby when the pin is moved from the distal portion of the slot to the proximal portion of the slot, the pin is moved proximally past the locking tab until the pin engages the locking tab and the connector moves to the locked configuration. [Item 3] 3. The clip device of claim 1, wherein the distal and proximal portions of the slot are connected via an intermediate portion having a width smaller than the widths of the distal and proximal portions, thereby allowing one of the pin and a portion of the clip arm to deform and move the pin from the distal portion to the proximal portion. [Item 4] 4. The clip device of claim 3, wherein each of the clip arms includes a slit extending from a proximal-most end of the clip arm to the slot to define a pair of fingers, the fingers deforming by spreading toward each other to allow the pin to move proximally past the intermediate portion. [Item 5] 5. The clip device according to any one of claims 1 to 4, wherein the connector includes an overhang extending from the pin and engaging an outer surface of each of the clip arms. [Item 6] 6. The clip device of claim 1, wherein the central portion of the connector is configured to move a pair of inwardly deformed tabs radially outward at the proximal end of the capsule to release the clip from the proximal portion of the clip device when the connector is moved from the unlocked configuration to the locked configuration. [Item 7] 7. The clip device of any one of items 1 to 6, wherein the connector is connected to the control member via a control member connection portion configured to separate when a force greater than the predetermined force is applied to the control member to move the connector from the unlocked configuration to the locked configuration, and the control member connection portion is one of a weld with the connector, a rounded portion, and a ball-shaped tip. [Item 8] 1. A clip device comprising: a clip including a capsule extending longitudinally from a proximal end to a distal end and including a channel therethrough, and a pair of clip arms, the proximal ends of the clip arms being slidably received within the channel such that the pair of clip arms are moved between an open configuration and a closed configuration, each of the clip arms including an opening therethrough; a connector including a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within the opening in each of the clip arms, at least a portion of the central portion configured to be movable relative to the pin and the clip arms from an unlocked configuration to a locked configuration upon application of a predetermined force thereto, wherein in the locked configuration the clip arms are locked relative to the capsule in the closed configuration; a control member extending from a proximal end to a distal end through a proximal portion of the clip device and releasably coupled to the connector such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open and closed configurations; A clip device, wherein the opening is configured to prevent the pin from moving from the proximal portion to the distal portion when the connector is in a locked configuration. [Item 9] 1. A clip device comprising: a clip including a capsule extending longitudinally from a proximal end to a distal end and including a channel therethrough, and a pair of clip arms, the proximal ends of the clip arms being slidably received within the channel such that the pair of clip arms are moved between an open configuration and a closed configuration, each of the clip arms including an opening therethrough; a connector including a central portion receivable between the proximal ends of the clip arms and a pin extending from the central portion and receivable within the opening in each of the clip arms, at least a portion of the central portion configured to be movable relative to the pin and the clip arms from an unlocked configuration to a locked configuration upon application of a predetermined force thereto, wherein in the locked configuration the clip arms are locked relative to the capsule in the closed configuration; a control member extending from a proximal end to a distal end through a proximal portion of the clip device and releasably coupled to the connector such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open and closed configurations; A clip device, wherein the capsule includes a locking tab biased to extend radially into the channel, such that when the central portion is moved from the unlocked configuration to the locked configuration, a portion of the central portion engages the locking tab to move the connector to the locked configuration. [Item 10] 10. The clip device of claim 8 or 9, wherein the central portion includes a slot therethrough, the pin being received within the slot and movable relative to the slot from a proximal portion of the slot in the unlocked configuration to a distal portion of the slot in the locked configuration. [Item 11] Item 11. The clip device of item 10, wherein the proximal and distal portions of the slot are connected to one another via an intermediate portion having a width less than the widths of the proximal and distal portions of the slot, thereby allowing the pin to deform and move from the proximal portion to the distal portion of the slot. [Item 12] 9. The clip device of claim 8, wherein the central portion includes an inner member through which the pin extends and a sliding member connected to the inner member via a shear tab, the shear tab configured to shear upon receiving the predetermined force to move the sliding member from the unlocked configuration to the locked configuration. [Item 13] Item 13. The clip device of item 12, wherein the sliding member includes a pair of sliding arms extending along opposing sides of the inner member, inwardly extending fingers at distal ends of the sliding arms engaging shear tabs at the distal end of the inner member. [Item 14] Item 14. The clip device of any one of items 8 to 13, wherein the pin engages the opening in each of the clip arms via one of a friction fit, a weld, an adhesive, and an overhang extending from the pin. [Item 15] Item 15. The clip device of any one of items 8 to 14, wherein the central portion of the connector is configured to engage a pair of inwardly deformed tabs at the proximal end of the capsule to move the deformed tabs radially outwardly and release the clip from the proximal portion of the clip device when the connector is moved from the unlocked configuration to the locked configuration. It will be apparent to those skilled in the art that various modifications can be made to the present invention without departing from the scope of the invention.
Claims
1. 1. A clip device comprising: a clip including a capsule and a pair of clip arms, the capsule including a channel extending longitudinally through the clip from a proximal end to a distal end, a proximal end of the pair of clip arms slidably received within the capsule such that the clip arms move proximally and extend distally from a distal opening of the channel such that the clip arms are movable between an open configuration and a closed configuration, each of the clip arms including an opening therethrough; a control member extending through a proximal portion of the clip device from a proximal end to a distal end; a connector including a central portion receivable between the proximal ends of the pair of clip arms, the connector including a pin passing through the central portion and the opening in each of the clip arms, the connector being releasably coupled to the distal end of the control member such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the clip between the open and closed configurations, whereby application of a first predetermined force to the connector via the control member moves the pin from the unlocked configuration in which the pin is received within a distal portion of the opening to a locked configuration in which the pin is received within a proximal portion of the opening.
2. 2. The clip device of claim 1, wherein the capsule includes a locking tab biased to extend radially into a channel of the capsule, such that when the pin is moved from the distal portion of the opening to the proximal portion of the opening, the pin engages and is moved past the locking tab to lock the clip in the closed configuration.
3. 2. The clip device of claim 1, wherein the distal and proximal portions of the opening are connected to one another via an intermediate portion, the intermediate portion having a width smaller than the widths of the distal and proximal portions, such that one of a portion of the pair of clip arms surrounding the pin and the intermediate portion deforms upon application of the first predetermined force, allowing the pin to move from the distal portion to the proximal portion.
4. 4. The clip device of claim 3, wherein each of the clip arms includes a slit extending from a proximal-most end of the clip arm to the opening to define a pair of fingers, the fingers deforming by spreading toward each other upon application of the first predetermined force to allow the pin to move proximally past the intermediate portion.
5. The clip device of any preceding claim, wherein the pin includes an overhang extending laterally outwardly from the pin over an outer surface of each of the clip arms.
6. 2. The clip device of claim 1, wherein the connector is sized and shaped such that when the connector is moved from an unlocked configuration to a locked configuration, the connector moves an inwardly deformed tab at a proximal end of the capsule radially outward to release the clip from the proximal portion of the clip device.
7. 2. The clip device of claim 1, wherein the connector is connected to the control member via one of a weld, a rounded portion, and a ball-shaped tip of the control member, and wherein the one of the weld, the rounded portion, and the ball-shaped tip is configured to separate from a proximal portion of the control member when a second predetermined force greater than the first predetermined force is applied to the control member.
8. 1. A clip device comprising: a clip including a capsule including a pair of clip arms, the capsule including a channel extending longitudinally through the clip from a proximal end to a distal end, proximal ends of the clip arms being slidably received within the capsule such that the clip arms are moved between an open configuration and a closed configuration, each of the clip arms including an opening therethrough; a control member extending through a proximal portion of the clip device from a proximal end to a distal end; a connector including a central portion receivable between the proximal ends of the pair of clip arms, the connector including a pin passing through the central portion and through the openings in each of the clip arms, the connector releasably coupled to the distal end of the control member such that when the connector is in an unlocked configuration, longitudinal movement of the control member relative to the capsule moves the capsule between the open and closed configurations, and when a first predetermined force is applied to the connector via the control member, at least a portion of the connector is movable relative to the pin and the clip arms from an unlocked configuration in which the pin is received in a distal portion of the opening to a locked configuration in which the pin is received in a proximal portion of the opening.
9. 9. The clip device of claim 8, wherein the capsule includes a locking tab biased to extend radially into the capsule, whereby when the connector is moved from the unlocked configuration to the locked configuration, a portion of the connector engages the locking tab to lock the clip in the closed configuration.
10. 9. The clip device of claim 8, wherein the connector includes a slot therethrough, the pin being received within the slot and movable relative to the slot from a proximal portion of the slot in the unlocked configuration to a distal portion of the slot in the locked configuration.
11. 11. The clip device of claim 10, wherein the proximal and distal portions of the slot are connected to one another via an intermediate portion having a width less than the widths of the proximal and distal portions of the slot, such that application of the first predetermined force causes the pin to deform and move from the proximal portion to the distal portion of the slot.
12. 9. The clip device of claim 8, wherein the connector includes an inner member through which the pin extends and a sliding member connected to the inner member via a shear tab, the shear tab configured to be sheared upon receiving the first predetermined force to move the sliding member from the unlocked configuration to the locked configuration.
13. 13. The clip device of claim 12, wherein the sliding member includes a pair of sliding arms extending along opposing sides of the inner member, with inwardly extending fingers at distal ends of the sliding arms engaging the shear tabs at the distal end of the inner member where the shear tabs are located.
14. The clip apparatus of claim 8 , wherein the pin engages the opening in each of the clip arms via one of a friction fit, a weld, an adhesive, and an overhang extending from the pin.
15. 9. The clip device of claim 8, wherein the connector is sized and shaped such that when the connector is moved from an unlocked configuration to a locked configuration, the connector moves an inwardly deformed tab radially outward to engage the inwardly deformed tab and release the clip from the proximal portion of the clip device.
Citation Information
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