Instrument and method for unlatching surgical clips

Abstract

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

Description

Technical Field

[0001] The present disclosure (the present invention) generally relates to an instrument and method for unlatching and / or removing clips, and more particularly to an instrument and method for unlatching and / or removing surgical clips from tissue.

[0002] [Citation of Related Applications] This application is a claim for priority of U.S. Provisional Patent Application No. 63 / 185,920, filed on May 7, 2021, which is incorporated herein by reference in its entirety and made a part hereof.

Background Art

[0003] Ligation of tissue (e.g., blood vessels, lymph nodes, nerves, fallopian tubes, or heart tissue) is a common procedure in many surgical procedures. Ligation of tissue may be performed by closing a blood vessel with a surgical clip or by suturing a blood vessel with a surgical thread. By using a suture for ligation, a complex operation of a needle and a suture is required to create a knot necessary to fix the blood vessel. Such a complex operation is time-consuming and difficult to perform, especially during an endoscopic surgical procedure characterized by limited space and visibility. In contrast, surgical clips can be quickly stopped in a temporary or permanent manner. Therefore, the use of surgical clips during endoscopic as well as open surgical procedures has increased dramatically.

Summary of the Invention

Problems to be Solved by the Invention

[0004] The inventors recognize the need for technological improvements to address the inefficiencies of current instruments for unlatching and / or extracting surgical clips. Current instruments are often specifically designed to unlatch certain clip designs and are frequently ineffective for clips with curved leg members and / or clips with large radii of curvature. Current unlatching instruments also make it difficult to compress the clip back into its closed position and remove or extract it from the implantation site without re-latching it into the tissue. Furthermore, current unlatching instruments often require additional instruments for removing or extracting the surgical clip.

[0005] One aspect of the present invention relates to a device for unlatching a clip from a latched configuration, wherein the clip has first and second leg members, the first leg member having a hook member, and the second leg member having a tip member that is constrained by the hook member in the latched configuration. The device has a first jaw member configured to press the outer surface of the first leg member to release the clip from the latched configuration, and a second jaw member having a wall configured to engage with the hook member and a channel configured to receive the tip member when released from the constrained state by the hook member.

[0006] In some embodiments, the first jaw member has a length shorter than the length of the second jaw member. In some embodiments, at least a portion of the channel is open on both lateral sides. In some embodiments, the wall has a groove configured to receive a hook member, and the groove has a distal slope configured to deflect the hook member. In some embodiments, the first jaw member has a channel configured to receive the outer surface of the first leg member. In some embodiments, the first jaw member has at least one tooth configured to engage with the outer surface of the first leg member. In some embodiments, the channel of the second jaw member has a distal portion with a distal slope. In some embodiments, the channel of the second jaw member has a proximal portion with a proximal slope. In some embodiments, the channel of the second jaw member has a distal portion with a first width and a proximal portion with a second width, where the first width is wider than the second width. In some embodiments, at least one of the first jaw member and the second jaw member has a hole that allows visualization of the surgical clip. In some embodiments, the first jaw member has at least one engaging member configured to secure the clip to the instrument in a removable manner after the latch is released. In some embodiments, the at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip between them. In some embodiments, the first and second engaging members have a first hook member and a second hook member extending inward toward each other. In some embodiments, the instrument has a proximal recess formed between the first jaw member and the second jaw member, configured to receive the hinge member of a surgical clip.

[0007] Another aspect of the present invention relates to a device for unlatching a clip from a latched configuration. The device preferably has a first jaw member configured to press against the outer surface of a first leg member to release the clip from a latched configuration, and a second jaw member configured to engage with a hook member, wherein the first jaw member has at least one engaging member configured to secure the clip to the device so as to be removable after unlatching.

[0008] In some embodiments, at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip between them. In some embodiments, the first and second engaging members have a first hook member and a second hook member extending inward toward each other. In some embodiments, at least one engaging member is configured to engage with first and second wing members of the surgical clip. In some embodiments, the first and second wing members have an inner surface spaced apart from the inner surface of the surgical clip and / or an outer surface spaced apart from the outer surface of the surgical clip. In some embodiments, the first and second engaging members have substantially flat inner sides. In some embodiments, at least one engaging member has an angled, chamfered, and / or inclined lower surface to facilitate insertion of the surgical clip.

[0009] Another aspect of the present invention relates to a method for dislapping a clip from a latched configuration, wherein the clip has first and second leg members having distal portions that engage with each other in the latched configuration. The method preferably includes the steps of: positioning the clip between a first jaw member and a second jaw member of a device; releasing the clip from the latched configuration by pressing the outer surface of the first leg member with the first jaw member; and positioning the distal portion of the second leg member into a channel of the second jaw member after it has been released from its restraint by the first leg member.

[0010] In some embodiments, the first jaw member has a length shorter than the length of the second jaw member. In some embodiments, the distal portion of the first leg member has a hook member, and the distal portion of the second leg member has a tip member that is constrained in a latched configuration by the hook member, the hook member deflects (bends) when pressed to release the clip from the latched configuration, and the tip member is positioned at a distance from the hook member when received within the channel of the second jaw member. In some embodiments, at least a portion of the channel is open on both lateral sides. In some embodiments, the method further includes the step of engaging the distal portion of the first leg member with the wall of the second jaw member. In some embodiments, the step of engaging the distal portion of the first leg member includes the step of fitting the distal portion of the first leg member into a groove provided in the wall. In some embodiments, the groove has a distal slope for opening the hook member at the distal portion of the first leg member. In some embodiments, the step of pressing the outer surface of the first leg member includes the step of pressing the middle portion of the outer surface of the first leg member with the first jaw member. In some embodiments, the method includes the step of fitting the outer surface of the first leg member into the channel of the first jaw member. In some embodiments, the first jaw member has at least one tooth configured to engage with the first leg member. In some embodiments, the first and second leg members are curved, and the outer surface of the first leg member is convex, and the step of pressing the outer surface of the first leg member includes the step of straightening the first leg member. In some embodiments, the method further includes the step of pressing the first leg member to deflect (bend) it beyond the straightened form. In some embodiments, the step of fitting at least a portion of the second leg member into the channel of the second jaw member includes the step of fitting the distal portion of the second leg member into the distal portion of the channel which has a distal gradient. In some embodiments, the step of housing at least a portion of the second leg member within the channel of the second jaw member includes the step of housing the proximal portion of the second leg member within the proximal portion of the channel having a proximal slope.In some embodiments, the distal portion of the channel of the second jaw member has a width wider than the proximal portion of the channel of the second jaw member. In some embodiments, the method includes the step of visualizing the clip through a hole in at least one of the first jaw member and the second jaw member. In some embodiments, the method further includes the step of extracting the clip from the implantation site with an instrument. In some embodiments, the method further includes the step of housing the hinge member of the clip in a proximal recess of an instrument formed between the first jaw member and the second jaw member. In some embodiments, the method further includes the step of housing a portion of the first leg member between at least one engaging member of the first jaw member. In some embodiments, the at least one engaging member includes a first and a second engaging member. In some embodiments, the method further includes the step of housing a wing member extending from the side of the first leg member between the first engaging member and the second engaging member.

[0011] Thus, in some embodiments, there may be a method for unlatching a clip from a latched configuration, the clip having first and second leg members, the first leg member having a hook member, the second leg member having a tip member that is constrained in a latched configuration by the hook member, and the first and second leg members being curved. The method includes the steps of: positioning the clip between a first jaw member and a second jaw member of a device; engaging the hook member of the first leg member with the wall of the second jaw member; straightening the first leg member by pressing the convex outer surface of the first leg member with the first jaw member, thereby deflecting the hook member and releasing the clip from the latched configuration; and positioning the tip member within the channel of the second jaw member after the tip member has been released from its constrained state by the hook member and is positioned at a distance from the hook member. Furthermore, the first jaw member may be shorter in length than the second jaw member.

[0012] To facilitate understanding of the present invention, various aspects of the invention will be described illustratively with reference to the accompanying drawings. [Brief explanation of the drawing]

[0013] [Figure 1] This is a side view of an exemplary instrument for unlatching a surgical clip according to one embodiment of the present invention. [Figure 2] Figure 1 is a side view of a first embodiment of the jaw mechanism of the instrument, showing the jaw mechanism engaged with an example surgical clip. [Figure 3] Figures 1 and 2 are isometric views of the apparatus. [Figure 4] Figure 2 is a side view of the surgical clip shown in the example. [Figure 5] Figures 2 and 3 are isometric views of the first jaw member of the jaw mechanism. [Figure 6] Figures 2 and 3 are isometric views of the second jaw member of the jaw mechanism. [Figure 7] This diagram shows how to release the latch of the surgical clips shown in Figures 2 and 4 using the instruments shown in Figures 1-3, 5, and 6. [Figure 8] This diagram shows how to release the latch of the surgical clips shown in Figures 2 and 4 using the instruments shown in Figures 1-3, 5, and 6. [Figure 9] This diagram shows how to release the latch of the surgical clips shown in Figures 2 and 4 using the instruments shown in Figures 1-3, 5, and 6. [Figure 10] Figure 1 is an isometric view of a second embodiment of the jaw mechanism of the device shown in Figure 1. [Figure 11] This is a side view of the jaw mechanism in Figure 10, engaged with an example surgical clip. [Figure 12] Figure 11 shows isometric views of the jaw mechanism in Figures 10 and 11 engaged with the surgical clip in the example shown. [Figure 13] Figures 10 to 12 are isometric views of the first jaw member of the jaw mechanism. [Figure 14]Figures 10 to 12 are isometric views of the second jaw member of the jaw mechanism. [Modes for carrying out the invention]

[0014] Next, the present invention will be described with reference to the figures, where the same reference numerals indicate the same parts throughout the figures. In accordance with the conventional practice used herein, unless otherwise specified, the term “proximal” refers to the relative positioning of an instrument or component that is located generally close to the user or medical staff handling or manipulating the instrument to be used, and the term “distal” refers to the relative positioning of an instrument or component that is located far from the user or medical staff handling or manipulating the instrument to be used. The term “vertical” refers to the relative direction of the instrument parallel to or along a plane that equally penetrates both jaw members or similarly extends to the component. The term “longitudinal” refers to the relative direction along the long axis or length of the instrument or component. The term “lateral” refers to the relative direction parallel to or along a plane that extends perpendicularly between the first jaw member and the second jaw member or similarly extends to the component.

[0015] The present invention relates to an instrument for unlatching and / or extracting a surgical clip from an implantation site in the body. The surgical clip preferably has first and second leg members having substantially matching curvatures, the first leg member having a convex outer surface and a hook member at its distal portion. The second leg member preferably has a tip member that is restrained by the hook member when the surgical clip is in a latched configuration. The instrument preferably has a jaw mechanism including first and second jaw members, the first jaw member preferably being shorter than the second jaw member. One or both of the first and second jaw members preferably have channels, grooves, and / or teeth configured to align, fix, prevent lateral movement of, unlatching, and / or extracting the surgical clip. By shortening the length of the first jaw member, the distal end portion can press against the middle portion or apex of the convex outer surface of the first leg member. The second jaw member may have a wall configured to engage with the underside of the hook member. The wall may have a groove with an inner surface, the inner surface having a gradient extending distally from the longitudinal axis of the instrument to help deflect or open the hook member and remove the restraint on the tip member. The second jaw member may further have a channel and / or groove in the wall recessed below or from the wall to receive the tip member when the latch is released and separate the tip member from the hook member, thereby preventing the surgical clip from being immediately re-latched. Furthermore, the relief provided by the channel in the second jaw member may cause the instrument to deflect the surgical clip so that the leg members are substantially parallel to each other and / or curve beyond parallel (e.g., the curvature of one or both of the leg members is reversed). The jaw mechanism preferably includes a proximal recess formed laterally between a first jaw member and a second jaw member, which is configured to receive the proximal portion of a surgical clip and initially align the surgical clip between the first jaw member and the second jaw member.The channel of the second jaw member may have proximal and distal portions inclined in opposite directions to receive at least a portion of the curved second leg member. The jaw mechanism may further include at least one engaging member for securing the surgical clip to the instrument before, during, and / or immediately after unlatching, so that the surgical clip can be extracted from the implantation site in the body in a single, fluid motion without the need for additional tools.

[0016] FIG. 1 is a side view of an instrument 100 for unlatching a surgical clip according to embodiments of the present invention. As shown, the instrument 100 may have a handle mechanism 110, an elongated shaft 120 extending distally from the handle mechanism 110, and a jaw mechanism 140 extending distally from the elongated shaft 120. The handle mechanism 110 may include a first handle member 112 and a second handle member 114 that are movably coupled to each other to operate the jaw mechanism 140. For example, the first handle member 112 and the second handle member 114 may be rotatably attached. In the illustrated non-limiting example, the first handle member 112 may be longitudinally fixed relative to the elongated shaft 120, and the second handle member 114 may be longitudinally fixed relative to an actuator rod 122 that passes through the lumen of the elongated shaft 120 (as shown in FIG. 3). In some embodiments, the proximal portion of the actuator rod 122 may have a ball that is received within a socket (not shown) of the second handle member 114, as further disclosed in U.S. Patent No. 6,733,514, which is hereby incorporated by reference in its entirety and made part of this specification. By rotating the second handle member 114 relative to the first handle member 112, the actuator rod 122 can translate the elongated shaft 120 longitudinally (e.g., retract and / or advance), thereby operating or rotating the jaw mechanism 140 between an open configuration (e.g., FIG. 9) and a closed configuration (e.g., FIG. 8). A spring (not shown) provided between the first handle member 112 and the second handle member 114 can bias the jaw mechanism 140 from the closed configuration to the open or partially open configuration.

[0017] As further shown in Figures 2 and 3, the jaw mechanism 140 may include a first jaw member 150 and a second jaw member 170, which are configured to receive a surgical clip 200 between them. The elongated shaft 120 may have first and second distal arms 124 separated only by a slot 126 configured to receive the overlapping proximal portions of the first and second jaw members 150, 170. The first and second jaw members 150, 170 may be rotatably coupled to pivot pins 128 that pass through pivot holes 130 provided in each of the distal arms 124. The distal end of the actuator rod 122 may be received between the overlapping proximal portions of the first and second jaw members 150, 170. The distal end of the actuator rod 122 may have one or more drive bosses 134 extending from the distal end of the actuator rod 122, the first drive boss 134 may extend from the first side through the drive channel 152 of the first jaw member 150 (as shown in Figure 5), and the second drive boss 134 may extend from the second side through the drive channel 172 of the second jaw member 170 (as shown in Figure 6). Each of the drive channels 152, 172 may extend at an angle to the longitudinal axis of the respective jaw members 150, 170 so as to rotate the first and second jaw members 150, 170 between an open and a closed position when the actuator rod 122 is translated in the longitudinal direction. Each distal arm 124 may further have an elongated or substantially oval drive channel 132 along the longitudinal axis of the elongated shaft 120, so that the drive boss 134 can move through the drive channel 132 when the actuator rod 122 is translating longitudinally through the elongated shaft 120. Thus, the jaw members 150, 170 may be oriented in an open configuration when the drive boss 134 is located distal to the drive channel 132 (for example, as shown in Figure 8), and may be oriented in a closed configuration when the drive boss 134 is located proximal to the drive channel 132 (for example, as shown in Figure 9).However, the apparatus 100 may also embody other actuators for producing the scissor-like motion of the jaw members 150, 170, for example, the actuator disclosed in International Publication No. 2021 / 062170, which is incorporated herein by reference and whose entire disclosure is part of this specification.

[0018] FIG. 4 is a side view of a surgical clip 200 as an exemplary embodiment. The surgical clip 200 preferably has a first leg member 202 and a second leg member 204, and these leg members have proximal end portions rotatably coupled at a hinge member 206. The surgical clip 200 preferably has one or more latching mechanisms. For example, the first leg member 202 preferably includes a distal end portion with a hook member 208, and the second leg member 204 preferably includes a distal end portion with a tip member 210. The first leg member 202 and / or the second leg member 204 are preferably configured to rotate relative to each other between an open configuration and a closed latched configuration via the hinge member 206. The hook member 208 is preferably C-shaped with a convex distal surface and a concave proximal surface. The tip member 210 preferably has a groove at the distal end. The surgical clip 200 preferably further has one or more engagement portions that interface with a clip applicator (not shown). For example, the first leg member 202 preferably has one or more bosses 214 provided at the distal end portion on the proximal side of the hook member 208. Preferably having one or more bosses 212, the second leg member 204 has one or more bosses 212, 214 provided at the distal end portion at the tip member 210, and the bosses 212, 214 can be fixed to a clip applicator (not shown) when attaching the surgical clip 200 to tissue. The one or more bosses 212, 214 preferably extend laterally from opposite sides of the first and second leg members 202, 204. For example, the first leg member 202 preferably has a boss 212 that extends laterally from opposite sides of the hook member 208 and extends across the width of the hook member 208 and is connected by a bridge member. The second leg member 204 preferably has a boss 214 that extends laterally from opposite sides of the tip member 210 and is separated only by a groove provided in the tip member 210.

[0019] The first and second leg members 202 and 204 each preferably have a 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 220 and a concave inner surface 222, and the second leg member 204 preferably has a concave outer surface 224 and a convex inner surface 226. The hinge member 206 preferably has a concave inner surface formed by joining the inner surfaces 222 and 226 and a convex outer surface formed by joining the outer surfaces 220 and 224. A clip applicator (not shown) is preferably engaged with the surgical clip 200 via engagement with bosses 212 and 214 to press the first leg member 202 and the second leg member 204 against each other. In this case, the convex outer surface of the hook member 208 is preferably engaged with the cam-acting oblique cut surface provided at the tip member 210, and one or both of the leg members 202 and 204 are preferably deflected when the leg members 202 and 204 remain pressed against each other. The first leg member 202 is preferably extended or straightened, and / or the second leg member 204 is preferably retracted in accordance with the deflection and / or extension of the hook member 208 around the tip member 210. The leg members 202 and 204 are preferably returned to their curvature in the latch configuration due to the elasticity of the surgical clip 200 in its natural state. Thus, the hook member 208 can receive the tip member 210 within its concave proximal surface in the latch configuration, as shown in Figures 2 and 7. 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 coincide with each other to provide a relatively uniform distribution of compressive force applied across the entire width of the clamped tissue (e.g., the ligated blood vessel). The security of the latch mechanism is ensured when the clamped tissue exerts a reaction force against the closing of the surgical clip 200, thereby causing the leg members 202, 204 to deflect and extend, further moving the tip member 210 into the hook member 208.Exemplary features and 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.

[0020] As further shown in Figures 11 and 12 (not shown in Figure 4), the surgical clip 200 may have wing members 230 provided on each side of the first leg member 202. The wing members 230 can provide stability to the first leg member 202 to prevent the surgical clip 200 from twisting during attachment and / or ligation. The wing members 230 may extend over at least about half the length of the first leg member 202. The distal end of the wing member 230 may be located proximal to the boss 212 to avoid interference with the interface of a clip applicator (not shown). The proximal end of the wing member 230 may be located distal to the hinge member 206. The wing members 230 may further provide an interface with a latch release instrument 100 to facilitate the extraction of the surgical clip 200 without the use of any additional instruments, which will be further described herein. As shown in the figure, the wing member 230 preferably has a longitudinal curvature that matches the curvature of the first leg member 202. The wing member 230 preferably has an inner surface 232 that is spaced apart from and / or not located in the same plane as the inner surface 222 of the first leg member 202. The wing member 230 preferably further has an outer surface 234 that is spaced apart from and / or not located in the same plane as the outer surface 220 of the first leg member 202. By having the inner surface 232 and / or outer surface 234 spaced apart from each other and / or not located in the same plane, the wing member 230 can be easily fixed to the latch release device 100 to enable removal and / or extraction from the implantation site inside the body. For example, by having the inner surface 232 spaced apart from and / or not coplanar with the inner surface 222 of the surgical clip 200, sufficient clearance can be provided from the ligated tissue for gripping directly beneath the wing member 230 without interference or pinching of the ligated tissue. The inner surface 232 may be substantially flat or concave to match and / or interface with the instrument 100.Exemplary embodiments and additional features of the wing member 230 and the surgical clip 200 are disclosed in one or more of U.S. Patent Applications Publication No. 2021 / 0186511 and No. 2021 / 0267603, which are incorporated herein by reference and whose entirety constitutes part of this specification. This disclosure is also intended to provide a system comprising the instrument 100 and the surgical clip 200.

[0021] As further shown in Figures 2 and 3, the jaw members 150 and 170 are preferably sized to engage with the surgical clip 200, release the latch, and / or extract the surgical clip 200 from the implantation site. The first jaw member 150 is preferably shorter than the second jaw member 170, and / or the first jaw member 150 has a length shorter than the length of the second jaw member 170. For example, the distal portion of the first jaw member 150 is preferably shorter than the distal portion of the second jaw member 170. In another embodiment, the length from the pivot hole 154 to the distal end of the first jaw member 150 is preferably shorter than the length from the pivot hole 174 to the distal end of the second jaw member 170. The short length of the first jaw member 150 is preferably sized so that its distal end presses against the middle portion of the outer surface 220 (for example, at the apex or proximal to the outer surface 220), as shown in Figures 7 and 8, to straighten and / or extend the first leg member 202. The short length of the first jaw member 150 also allows for easy dislatching of surgical clips 200 having a large radius of curvature (small curvature). The length of the distal portion of the second jaw member 170 is preferably set to be greater than or equal to the length of the surgical clip 200 (in its latched and / or straightened form) in order to engage with the lower surface 216 of the hook member 208 on the opposite side of the second leg member 204 (as shown in Figures 2 and 7) and / or to capture the second leg member 204 in the channel 182 after it has been dislatched (as shown in Figures 8 and 9).

[0022] Figure 5 is an isometric view of the first jaw member 150, and Figure 6 is an isometric view of the second jaw member 170. As shown, the first jaw member 150 preferably has a proximal portion including a drive channel 152 configured to receive one of the drive bosses 134 and a pivot hole 154 for receiving a pivot pin 128. Similarly, the second jaw member 170 preferably has a proximal portion including a drive channel 172 for receiving one of the drive bosses 134 and a pivot hole 174 for receiving a pivot pin 128. The proximal portions of the jaw members 150, 170 preferably have a width that is dimensioned to be accommodated between the distal arms 124 of the elongated shaft 120 when superimposed. The proximal portions of at least one or both of the jaw members 150, 170 preferably have notches 156, 176 which accommodate the distal end of the actuator rod 122 between them, as shown in Figures 2 and 3.

[0023] Each jaw member 150, 170 may have a distal portion configured to engage with the surgical clip 200, the distal portion of each jaw member having a wider width than its proximal portion. Each distal portion of the jaw members 150, 170 may have an inner surface 158, 178 having one or more channels and / or grooves configured to align, secure, prevent lateral movement of, unlatch and / or extract the surgical clip 200. For example, the first jaw member 150 may have an inner channel 160 configured to receive the convex outer surface 220 of the first leg member 202. The channel 160 may extend longitudinally over substantially the entire length of the distal portion of the first jaw member 150 and penetrate the distal surface of the first jaw member 150 to form an open distal end of the channel 160. The open distal end of the channel 160 allows the first jaw member 150 to engage with the outer surface 220 of the first leg member 202 along only a portion of its length, so that the first leg member 202 penetrates and extends outward from the channel 160 and extends distally to the first jaw member 150. The open distal end of the channel 160 also allows the distal end of the first jaw member 150 to be pressed against the middle portion of the outer surface 220 of the first leg member 202. The channel 160 is preferably retracted into the inner surface 158, surrounded by a proximal surface and sides that fit with the outer surface 220 to stabilize the first leg member 202. The first jaw member 150 may have a hole 162 that penetrates its outer surface and communicates with the channel 160, allowing the surgical clip 200 to be seen through the first jaw member 150, thus providing the user with visual confirmation that the surgical clip 200 is properly loaded and / or unlatched. The first jaw member 150 may optionally have at least one tooth 164 located within the channel 160 that engages with the outer surface 220 to reduce the longitudinal and / or rotational movement of the surgical clip 200. For example, the at least one tooth 164 may include multiple teeth 164.

[0024] The inner surface 178 of the second jaw member 170 is preferably provided at its distal end and has a groove 180 configured to receive the convex outer surface (e.g., the lower surface 216) of the hook member 208. The groove 180 is preferably concave overall to receive the convex outer surface of the hook member 208 and has a slope that is at least angled distally away from the longitudinal axis of the closed instrument 100 and extends toward the outer surface of the second jaw member 170 to help hold a ramp to facilitate deflection or release of the hook member 208 and / or to provide this ramp. The inner surface 178 is preferably provided proximal to the groove 180 and further has a channel 182 configured to receive the second leg member 204 when the surgical clip 200 is unlatched. The inner surface of the groove 180 is preferably raised above the inner surface of the channel 182 and is preferably longitudinally aligned with the channel 182. Thus, the channel 182 preferably provides a relief that allows the hook member 208 and the tip member 210 to be separated when the latch is released, thereby preventing re-latching after the latch is released and allowing the surgical clip 200 to be subsequently extracted from the tissue. For example, the groove 180 may be provided in the wall 188 on the channel 182 to receive the second leg member 204 after the latch is released. At least a portion of the channel 182 preferably has open lateral sides to facilitate insertion of the surgical clip 200 between the first jaw member 150 and the second jaw member 170 and / or to make the surgical clip 200 more visible when positioned between the first jaw member 150 and the second jaw member 170 (as shown in Figures 7 to 9). The channel 182 preferably has a distal recessed portion 184 and a proximal recessed portion 186 that communicate with each other and are aligned longitudinally, with each recessed portion being recessed within the rim of the inner surface 178 (for example, its lateral sides are surrounded). The distal recessed portion 184 preferably has a width wider than the proximal recessed portion 186, and the distal recessed portion 184 is sized to receive the enlarged width portion of the boss 214 of the second leg member 204.The distal recessed portion 184 may have a right-angled corner overall, configured to receive the overall square cross-section of the boss 214, and / or the proximal recessed portion 186 may be concave overall, configured to receive the round cross-section of the outer surface 224 of the second leg member 204. The distal recessed portion 184 may have a slope extending proximal toward the outer surface of the second jaw member and away from the longitudinal axis of the instrument 100 (in the closed configuration). The proximal recessed portion 186 may have a slope extending proximal toward the longitudinal axis of the instrument 100 (in the closed configuration) and toward the outer surface of the second jaw member, configured to receive the curvature of the second leg member 204 and the hinge member 206 within the channel 182. The opposing slopes of the recessed portions 184 and 186 also facilitate the extension and release of the surgical clip 200. For example, the hinge member 206 may rest in a proximal recessed portion 186 to extend the surgical clip 200. Thus, as shown in Figures 3 and 6, the channel 182 may be recessed from a wall 188 having a groove 180 provided at the distal portion of the second jaw member 170. The channel 182 may extend longitudinally between the wall 188 and the proximal portion of the second jaw member 170 and / or the shaft 120. The wall 188 may embody a nose that forms a hook or L shape at the distal end of the second jaw member 170, and this nose has a height greater than the length immediately proximal to the second jaw member 170. Thus, as shown in Figure 3, the channel 182 may have a transversely open notch that extends proximal to the wall 188 toward the proximal end of the second jaw member 170. However, it is also conceivable that the wall 188 may extend substantially higher around the channel 182, enclosing the lateral side of the channel 182 (not shown). In either case, the surfaces of the groove 180, the distal recess 184, and / or the proximal recess 186 may not be in a plane with respect to each other and may not be continuous in order to facilitate the unlatching and / or extraction of the surgical clip 200.

[0025] Figures 7 to 9 illustrate a method for unlatching and / or removing a surgical clip 200 using instrument 100. This method allows for the unlatching and / or removal of the surgical clip 200 from a surgical configuration, for example, from a state where it is latched to the ligation end of a blood vessel after hemostasis or occlusion has occurred. When the surgical clip 200 is to be removed from an implantation site in the body during use, the user can access the site by performing an appropriate surgical procedure to expose the surgical clip 200 in its latched configuration.

[0026] As shown in Figure 7, the user may then place the surgical clip 200 between the first jaw member 150 and the second jaw member 170, and then engage the surgical clip 200 with the instrument 100. The user may then place the surgical clip 200 into the open instrument 100 in a latched configuration, so that the jaw members 150 and 170 are positioned sufficiently far apart from each other (for example, when the drive boss 134 is located near or at the distal position of the drive channel 132). The instrument 100 may then align the surgical clip 200 with the jaw members 150 and 170, which is made possible by the channels and / or grooves on the inner surfaces 158 and 178 of the jaw members 150 and 170. For example, the surgical clip 200 may initially be aligned with the instrument 100 by fitting the lower surface 216 of the hook member 208 into the groove 180 of the wall 188, fitting the hinge member 206 into the proximal recessed portion 186, and / or fitting the outer surface 220 of the first leg member 202 into the channel 160 of the first jaw member 150. Next, the user may partially close the first jaw member 150 to engage with the first leg member 202 and / or fit the outer surface 220 into the channel 160. The pressure applied by the instrument 100 can further engage the surgical clip 200 into the groove 180 and channel 160, thereby further preventing the surgical clip 200 from swaying during latch release. By engaging at least one tooth 164 with the outer surface 220, safety can be further enhanced, and longitudinal movement (e.g., slippage) of the surgical clip 200 can be prevented during latch release. The hole 162 allows the user to visually see the surgical clip 200 through the first jaw member 150 and ensure the alignment of the surgical clip 200 with the jaw members 150, 170. At least a portion of the second leg member 204 (e.g., the distal portion and / or the tip member 210) is preferably located outside the channel 182 when restrained in the latched configuration.

[0027] As shown in Figure 8, the instrument 100 can unlatch the surgical clip 200 by pressing the outer surface 220 and straightening the first leg member 202 from its natural curvature. Because the first jaw member 150 is short in length, the distal end of the first jaw member 150 can apply sufficient pressure to the middle portion of the outer surface 220, thereby deflecting or opening the hook member 208 in a backward bending motion and releasing the tip member 210 of the second leg member 204. Opening the hook member 208 is made possible by the distal slope of the groove 180, thereby transferring the compressed state of the first jaw member 150 to a distal force applied to the lower surface 216 of the hook member 208. Once the second leg member 204 is no longer restrained by the hook member 208, the inherent biasing force of the surgical clip 200 allows the second leg member 204 to rotate and exit or pop out from the hook member 208, with at least a portion of the second leg member (e.g., the tip member 210) being received within the channel 182 of the second jaw member 170. At least a portion of the second leg member 204 can further rotate and enter into the recessed portions 184, 186 of the channel 182. For example, the tip member 210 and the boss 214 may be received within the distal recessed portion 184, and at least a portion of the remaining second leg member 204 may be received within the proximal recessed portion 186. The irregularities provided by channel 182 allow the first jaw member 150 to be parallel and / or curve beyond parallel in a configuration in which the leg members 202, 204 are deflected and substantially straightened (for example, so that at least the outer surface 220 can become concave). This increased deflection allows the hook member 208 to be deflected and open more fully, thereby causing the second leg member 204 to become unrestrained by the hook member 208.Furthermore, the protrusions provided by the channel 182 allow the tip member 210 to be separated from the hook member 208 in a manner that creates a gap when the first and second jaw members 150, 170 close together and the hook member 208 takes on its non-deviation shape again to prevent re-latching of the surgical clip 200 prior to extraction.

[0028] As further shown in Figure 9, the first jaw member 150 can open further to a fully open configuration to release the pressure applied to the first leg member 202, and as a result, the original biasing force of the surgical clip 200 causes the first leg member 202 to rotate and open, the leg members 202, 204 to regain their natural curvature, and the hook member 208 to regain its C-shape. Furthermore, by fitting the surgical clip 200 into the channels 160, 182 (including the retractable portions 184, 186 and at least one tooth 164), the instrument 100 is provided with sufficient grip of the surgical clip 200 in the open configuration to enable extraction from the implantation site in the body without the use of any additional instruments. For example, the proximal surface of the wall 188 can engage with the tip member 210 to prevent the surgical clip from sliding distally from the jaw members 150, 170. Furthermore, slight compression of the first jaw member 150 can prevent relative rotation of the surgical clip (e.g., around the pivot point of the wall 188), and at least one tooth 164 can provide additional longitudinal safety. The first jaw member 150 may preferably have at least one engaging member 166' to provide further safety to the surgical clip 200 for extraction, which is illustrated in and will be explained with reference to Figures 10 to 14.

[0029] Figures 10 to 14 show a jaw mechanism 140' as a second embodiment of the instrument 100. The jaw mechanism 140' may include all the features of the jaw mechanism 140 (to avoid making the disclosure of the jaw members 140 complicated, the whole is explicitly described here), and the jaw assembly 140' may be described with the same reference numerals and prime symbols ('). For example (as further described above), the jaw mechanism 140' may include a first jaw member 150' and a second jaw member 170', which are configured to receive a surgical clip 200 between them. As described above, the first jaw member 150' may be shorter than the second jaw member 170' and / or the first jaw member 150' may have a shorter length than the second jaw member 170'. The second jaw member 170' is preferably provided at its distal end and has an inner surface 178' with a groove 180' configured to receive the convex outer surface (e.g., the lower surface 216) of the hook member 208 of the surgical clip. The groove 180' is preferably sloped distally away from the longitudinal axis of the second jaw member 170 and toward the outer surface of the second jaw member 170, which provides a ramp to assist in holding and facilitate opening the hook member 208. The inner surface 178' is preferably provided proximal to the groove 180' and further has a channel 182' configured to receive the second leg member 204 when the surgical clip 200 is unlatched. The inner surface of the groove 180' is preferably raised above the inner surface of the channel 182'. Thus, the channel 182' is preferably provided with grooves that allow the hook member 208 and the tip member 210 to be separated when the latch is released, thereby preventing re-latching after the latch is released and allowing the surgical clip 200 to be subsequently removed from the implantation site in the body. For example, the groove 180' is preferably provided in the upper wall 188' of the channel 182' so that the channel 182' can receive the second leg member 204 after the latch is released, but at least a portion of the channel 182' is preferably open on both lateral sides as shown in the figure.

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

[0031] As further shown, the jaw mechanism 140' may include at least one engaging member 166' configured to provide the instrument 100 with additional safety for the surgical clip 200 for extraction after latch release. For example, the at least one engaging member 166' may be configured to create an interlocking relationship with a portion of the surgical clip 200 (e.g., a wing member 230) before, during, and / or immediately after latch release of the surgical clip 200. The at least one engaging member 166' may be located on the distal portion of the first jaw member 150', for example, on the distal half or distal third of the distal portion of the first jaw member 150'. In some embodiments (as illustrated), at least one engaging member 166' may include first and second engaging members 166' extending from the inner surface 158' of the first jaw member 150' on opposite sides of a channel 160' provided recessed in the inner surface 158'. The first and second engaging members 166' may be configured to receive and engage the wing member 230 of the first leg member 202 between themselves, thereby securing the first leg member 202 to the first jaw member 150' when the first leg member 202 is received within the channel 160'. When the first jaw member 150' is pressing against the first leg member 202, the first and second engaging members 166' are preferably configured to deflect away from each other when the wing member 230 is in contact with the lower surface 169' (Figure 13) of the engaging member 166', so that the first and second engaging members 166' are pushed back toward each other to secure the first leg member 202 in an interlocking and / or latched state. The surgical clip 200 is optionally or alternatively compressed when the first leg member 202 is received in an interlocking and / or latched state between the engaging members 166'.

[0032] As further shown in Figures 12 and 13, each of the first and second engaging members 166' preferably has a first portion 167' that extends downward in a cantilevered manner from the inner surface 158' of the first jaw member 150' toward the second jaw member 170'. In some embodiments, the first and second engaging members 166' are preferably configured to latch, and these engaging members preferably have a second portion 168' that extends laterally inward toward the central longitudinal plane perpendicular to the surgical clip 200 and the engaging members 166' located opposite each other, forming a hook or catch structure. The second portion 168' of the hook structure preferably has a lower surface 169' that is angled, chamfered, and / or inclined to facilitate insertion and / or deflection of the engaging member 166'. The second portion 168' is preferably configured to fit securely in a latched and / or interlocked state under the wing member 230 of the surgical clip 200. As described above, the inner surface 232 of the wing member is preferably positioned sufficiently spaced from and / or not within the plane of the inner surface 222 of the first leg member 202, thereby providing sufficient portion for the second gap 168' to avoid interference or pinching of the tissue ligated by the surgical clip 200.

[0033] However, in some embodiments (not shown), the engaging member 166' may not be configured to latch or may be non-hooked (omitting the second portion 168'). For example, portion 167' of the non-hooked engaging member 166' may have a substantially flat or literally flat inner side surface (not shown) configured to interlock, apply friction, tightening, and / or clamping forces to the clip portion (e.g., the wing member 230) to secure the first leg member 202 to the first jaw member 150'. The non-hooked engaging member 166' may still have a lower surface 169' which may be angled, chamfered, and / or inclined to facilitate insertion and / or deflection of the engaging member 166'.

[0034] In either case, the first and second engaging members 166' may secure or lock the surgical clip 200 to the jaw mechanism 140', thereby providing additional safety for the removal of the surgical clip 200 from the implantation site after release from the ligated tissue without the use of any additional instruments. The user may then remove the surgical clip 200 from the first and second engaging members 166', thereby removing the surgical clip 200 from the instrument 100 (for example, once the jaw mechanism 140' has been removed from the implantation site).

[0035] As further shown, the first jaw member 150' preferably has a hole 162' that penetrates its outer surface and is in contact with a channel 160' so that the surgical clip 200 can be seen through the first jaw member 150', thus providing the user with visual confirmation that the surgical clip 200 is properly loaded and / or released. The second jaw member 170' preferably has an outer hole 189' that penetrates its outer surface and is in contact with a channel 182' so that the surgical clip 200 can be seen through the second jaw member 170', thus providing the user with visual confirmation that the surgical clip 200 is properly loaded and / or released. The second jaw member 170' preferably further has a distal hole 190' that penetrates the wall 188' and is in contact with a channel 182' so that the surgical clip 200 can be seen through the first jaw member 150'. For example, the tip member 210 and / or boss 214 should be visible through the distal opening 190′ so that the release of the surgical clip 200 can be confirmed.

[0036] 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 belonging to the scope of the present invention can be adopted. Other embodiments of the present invention are described below. [Embodiment 1] A device for releasing a clip from a latched configuration, wherein the clip has first and second leg members, the first leg member has a hook member, and the second leg member has a tip member that is restrained by the hook member in the latched configuration, and the device is A first jaw member configured to press the outer surface of the first leg member to release the clip from the latched position, A device comprising a wall configured to engage with the hook member and a second jaw member having a channel configured to receive the tip member when released from the restraint by the hook member. [Embodiment 2] The apparatus according to Embodiment 1, wherein the first jaw member has a length shorter than the length of the second jaw member. [Embodiment 3] The apparatus according to Embodiment 1 or Embodiment 2, wherein at least a portion of the channel has both lateral sides open. [Embodiment 4] The device according to Embodiment 1 or Embodiment 2, wherein the wall has a groove configured to receive the hook member, and the groove has a distal slope configured to deflect the hook member. [Embodiment 5] The apparatus according to Embodiment 1 or Embodiment 2, wherein the first jaw member has a channel configured to receive the outer surface of the first leg member. [Embodiment 6] The apparatus according to Embodiment 1 or Embodiment 2, wherein the first jaw member has at least one tooth configured to engage with the outer surface of the first leg member. [Embodiment 7] The apparatus according to Embodiment 1 or Embodiment 2, wherein the channel of the second jaw member has a distal portion with a distal gradient. [Embodiment 8] The apparatus according to Embodiment 1 or Embodiment 2, wherein the channel of the second jaw member has a proximal portion with a proximal gradient. [Embodiment 9] The apparatus according to Embodiment 1 or Embodiment 2, wherein the channel of the second jaw member has a distal portion having a first width and a proximal portion having a second width, the first width being wider than the second width. [Embodiment 10] The apparatus according to Embodiment 1 or Embodiment 2, wherein at least one of the first jaw member and the second jaw member has a hole that allows the clip to be visualized. [Embodiment 11] The apparatus according to Embodiment 1 or Embodiment 2, wherein the first jaw member has at least one engaging member configured to secure the clip to the apparatus in a manner that allows for removal after the latch has been released. [Embodiment 12] The device according to embodiment 11, wherein the at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip in between. [Embodiment 13] The device according to embodiment 12, wherein the first and second engaging members have a first hook member and a second hook member extending inward toward each other. [Embodiment 14] The apparatus according to Embodiment 1 or Embodiment 2, wherein the apparatus has a proximal recess formed between the first jaw member and the second jaw member, configured to receive the hinge member of the clip. [Embodiment 15] A device for releasing a clip from a latched configuration, wherein the clip has first and second leg members, the first leg member has a hook member, and the second leg member has a tip member that is restrained by the hook member in the latched configuration, and the device is A first jaw member configured to press the outer surface of the first leg member to release the clip from the latched position, It has a second jaw member configured to engage with the hook member, The first jaw member has at least one engaging member configured to secure the clip to the device in a manner that allows it to be removed after the latch is released. [Embodiment 16] A method for dislapping a clip from a latched configuration, wherein the clip has first and second leg members having distal portions that engage with each other in the latched configuration, and the method is The steps include placing the clip between the first jaw member and the second jaw member of the device, The steps include: pressing the outer surface of the first leg member with the first jaw member to release the clip from the latched position; A method comprising the step of retracting the distal portion of the second leg member into the channel of the second jaw member after it has been released from the restraint state by the first leg member. [Embodiment 17] The method according to embodiment 16, wherein the first jaw member has a length shorter than the length of the second jaw member. [Embodiment 18] The method according to Embodiment 16 or Embodiment 17, wherein the distal portion of the first leg member has a hook member, the distal portion of the second leg member has a tip member that is constrained in the latch configuration by the hook member, the first leg member is deflected when pressed to release the clip from the latch configuration, and the tip member is positioned at a distance from the hook member when received in the channel of the second jaw member. [Embodiment 19] The method according to embodiment 16 or embodiment 17, further comprising the step of engaging the distal portion of the first leg member with the wall of the second jaw member. [Embodiment 20] The method according to embodiment 19, wherein the step of engaging the distal portion of the first leg member includes the step of fitting the distal portion of the first leg member into a groove provided in the wall. [Embodiment 21] The method according to embodiment 20, wherein the groove has a distal gradient for opening the distal portion of the first leg member. [Embodiment 22] The method according to Embodiment 16 or Embodiment 17, wherein the step of pressing the outer surface of the first leg member includes the step of pressing the intermediate portion of the outer surface of the first leg member with the first jaw member. [Embodiment 23] The method according to embodiment 16 or embodiment 17, further comprising the step of fitting the outer surface of the first leg member into the channel of the first jaw member. [Embodiment 24] The method according to Embodiment 16 or Embodiment 17, further comprising the step of housing the hinge portion of the clip in a proximal recess of the device formed between the first jaw member and the second jaw member. [Embodiment 25] The method according to embodiment 16 or embodiment 17, further comprising the step of fitting a portion of the first leg member between the first engaging member and the second engaging member of the first jaw member.

Claims

1. A device for releasing a clip from a latched configuration, wherein the clip has first and second leg members, the first leg member has a hook member, and the second leg member has a tip member that is restrained by the hook member in the latched configuration, and the device is A first jaw member configured to press the outer surface of the first leg member to release the clip from the latched position, The jaw member has a wall configured to engage with the hook member and a channel configured to receive the tip member when released from the restraint by the hook member, The first jaw member has a length shorter than the length of the second jaw member.

2. The apparatus according to claim 1, wherein at least a portion of the channel has open sides on both lateral directions.

3. The device according to claim 1, wherein the wall has a groove configured to receive the hook member, and the groove has a distal slope configured to deflect the hook member.

4. The apparatus according to claim 1, wherein the first jaw member has a channel configured to receive the outer surface of the first leg member.

5. The apparatus according to claim 1, wherein the first jaw member has at least one tooth configured to engage with the outer surface of the first leg member.

6. The apparatus according to claim 1, wherein the channel of the second jaw member has a distal portion with a distal gradient.

7. The apparatus according to claim 1, wherein the channel of the second jaw member has a proximal portion with a proximal gradient.

8. The apparatus according to claim 1, wherein the channel of the second jaw member has a distal portion having a first width and a proximal portion having a second width, the first width being wider than the second width.

9. The apparatus according to claim 1, wherein at least one of the first jaw member and the second jaw member has a hole that allows the clip to be visualized.

10. The device according to claim 1, wherein the first jaw member has at least one engaging member having a hook member configured to secure the clip to the device in a manner that it can be removed after the latch is released.

11. The device according to claim 10, wherein the at least one engaging member includes a first engaging member and a second engaging member configured to receive a portion of the clip in between.

12. The device according to claim 11, wherein the first and second engaging members each have a first hook member and a second hook member extending inward toward each other.

13. The device according to claim 1, wherein the device has a proximal recess formed between the first jaw member and the second jaw member, configured to receive the hinge member of the clip.

Images