Left Atrial Appendage Clip Delivery with Dual-Axis Jaw Articulation
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Solution Overview
Problem
Current surgical methods for externally occluding the left atrial appendage (LAA) face challenges such as the need for precise placement of exclusion clips, potential for bleeding, risk of clot dislodgement, and limitations in open-ended clip designs, particularly in ensuring complete closure and stability during minimally invasive procedures.
Innovation Solution
The development of a self-motivating exclusion clip system with tissue-crossing sensors and a delivery device that provides a positive indication of complete clip placement, allowing for one-handed operation and reduced need for separate stabilization instruments, along with a design that enhances surface interaction and grip without damaging tissue.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If open-ended exclusion clips are used for LAA occlusion, then the device can be delivered through minimally invasive approaches, but the clip may not provide complete closure and lacks stability during the procedure
Solution Approach 1:
The exclusion clip is divided into two separate struts (first and second struts) that can be delivered independently through the delivery device. Each strut has its own biasing member that provides independent force, allowing the struts to converge and close the LAA opening completely while maintaining stability through coordinated action of both segments
Solution Approach 2:
The two struts are combined within a single delivery device that delivers them simultaneously or sequentially to the LAA. The biasing members on both struts work together to provide combined closing force, ensuring complete and stable occlusion of the LAA opening that neither strut could achieve alone
2Manufacturing precision
If surgical methods require precise placement of exclusion clips, then complete LAA closure can be achieved, but the procedure becomes more complex and time-consuming
Solution Approach 1:
Each strut is equipped with its own biasing member that automatically provides the force needed to close the LAA opening. The struts self-align and self-close without requiring complex manual manipulation or additional stabilization instruments, reducing surgical complexity while maintaining precise placement
Solution Approach 2:
The delivery device includes sensors that detect when the struts have properly converged and closed the LAA opening. This feedback mechanism confirms complete closure to the operator, eliminating the need for complex visual assessment techniques and simplifying the surgical procedure
3Measurement precision
If separate stabilization instruments are used during clip placement, then precise positioning can be achieved, but the number of instruments and procedural steps increases
Solution Approach 1:
The delivery device performs multiple functions: it delivers both struts, positions them accurately at the LAA opening, and detects when closure is complete. This multi-functional device replaces the need for separate stabilization instruments, reducing the total number of instruments while maintaining positioning accuracy
Solution Approach 2:
The delivery device acts as an intermediary that guides the struts to the correct position and monitors closure. It mediates between the surgeon's control and the clip placement process, providing automated positioning and detection without requiring additional stabilization tools
Data Source
AI summary
A surgical clip delivery device end effector that is configured to implant a clip having a pair of opposing clip struts each having a proximal end and a distal end includes a clevis, a pair of jaws connected to the clevis, and a pair of clip-connecting ends configured to removably connect respectively to the pair of clip struts, at least one of the pair of clip-connecting ends connected to at least one of the pair of jaws with two angular degrees of freedom such that, responsive to connection of the clip struts of the clip to the clip-connecting ends, a movement of the jaws in an initial opening action separates the proximal ends of the clip struts before separating the distal ends of the clip struts.