WO2018170822A1 - Removable drive assembly and endoscopic reposable surgical clip applier including a removable drive assembly - Google Patents

Removable drive assembly and endoscopic reposable surgical clip applier including a removable drive assembly Download PDF

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Publication number
WO2018170822A1
WO2018170822A1 PCT/CN2017/077833 CN2017077833W WO2018170822A1 WO 2018170822 A1 WO2018170822 A1 WO 2018170822A1 CN 2017077833 W CN2017077833 W CN 2017077833W WO 2018170822 A1 WO2018170822 A1 WO 2018170822A1
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WO
WIPO (PCT)
Prior art keywords
assembly
surgical clip
drive assembly
compression spring
distal
Prior art date
Application number
PCT/CN2017/077833
Other languages
French (fr)
Inventor
Zhihua Zhang
Lin Chen
Original Assignee
Covidien Lp
Covidien (China) Medical Devices Technology Co., Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien Lp, Covidien (China) Medical Devices Technology Co., Ltd. filed Critical Covidien Lp
Priority to PCT/CN2017/077833 priority Critical patent/WO2018170822A1/en
Publication of WO2018170822A1 publication Critical patent/WO2018170822A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable

Definitions

  • the present disclosure relates to surgical clip appliers and, more particularly, to a removable drive assembly for an endoscopic reposable surgical clip applier and an endoscopic reposable surgical clip applier including a removable drive assembly.
  • Endoscopic staplers and clip appliers are known in the art and used for a number of distinct and useful surgical procedures.
  • Endoscopic clip appliers that are able to apply multiple clips in endoscopic procedures during a single entry into the body cavity, for example, are described in commonly-assigned U.S. Pat. Nos. 5,084,057 and 5,100,420 to Green et al., the entire contents of which are incorporated herein by reference.
  • Another multiple endoscopic clip applier is disclosed in commonly-assigned U.S. Pat. No. 5,607,436 by Pratt et al., the entire contents of which is also hereby incorporated herein by reference.
  • the present disclosure relates to removable drive assemblies and reposable endoscopic surgical clip appliers including the same.
  • a drive assembly configured for removable positioning within a reposable endoscopic surgical clip applier.
  • the drive assembly includes an inner member, an outer member, a first compression spring, and a second compression spring.
  • the inner member includes a mandrel, an elongated shaft extending distally from the mandrel, and a pin protruding transversely from the elongated shaft.
  • the first compression spring is disposed about the mandrel.
  • the second compression spring is disposed between the mandrel and the pin.
  • the outer member includes a proximal hub and an elongated sleeve extending distally from the proximal hub.
  • the outer member is configured for removable positioning about the elongated shaft of the inner member and defines a bayonet slot configured to receive the pin to releasably engage the outer member about the elongated shaft of the inner member with the second compression spring disposed between the mandrel of the inner member and the proximal hub of the outer member.
  • the inner member further includes a distal extension rod extending distally from the elongated shaft.
  • the distal extension rod of the inner member is configured to actuate a jaw assembly of a surgical clip applier.
  • the outer member further includes a distal extension rod extending distally from the elongated sleeve.
  • the distal extension rod of the outer member is configured to load a surgical clip into a jaw assembly of a surgical clip applier.
  • the mandrel includes a body, a proximal collar disposed at a proximal end portion of the body, and a distal collar disposed at a distal end portion of the body.
  • the first compression spring is disposed about the body between the proximal and distal collars.
  • the second compression spring defines a spring constant that is greater than a spring constant of the first compression spring.
  • the bayonet slot includes an open longitudinal segment, a closed longitudinal segment, and a transverse segment extending between and connecting the open and closed longitudinal segments.
  • the pin is configured to enter the open longitudinal segment, move from the open longitudinal segment to the transverse segment, move from the transverse segment to the closed longitudinal segment, and seat within the closed longitudinal segment. More specifically, in aspects, the pin is configured to enter the open longitudinal segment upon proximal sliding of the outer member about the inner member, move from the open longitudinal segment to the transverse segment upon subsequent rotation of the outer member relative to the inner member, and seat within the closed longitudinal segment upon subsequent distal sliding of the outer member relative to the inner member.
  • compression of the second compression spring and sliding of the pin through the closed longitudinal segment of the bayonet slot enables movement of the inner member relative to the outer member.
  • a surgical clip applier provided in accordance with aspects of the present disclosure includes a handle assembly including a trigger, an outer tube assembly extending distally from the handle assembly and supporting a jaw assembly at a distal end portion thereof, a clip cartridge assembly engaged within the outer tube assembly and storing at least one surgical clip therein, and a drive assembly removably disposed within the handle assembly and outer tube assembly to operably couple the trigger with the jaw assembly and the clip cartridge assembly.
  • the drive assembly includes an inner member, an outer member, a first compression spring, and a second compression spring.
  • the inner member includes a mandrel and an elongated shaft extending distally from the mandrel.
  • the first compression spring is disposed about the mandrel.
  • the outer member includes a proximal hub and an elongated sleeve extending distally from the proximal hub.
  • the outer member is disposed about the elongated shaft of the inner member.
  • the second compression spring is disposed about the elongated shaft and positioned between the mandrel and the proximal hub.
  • actuation of the trigger through an initial portion of an actuation stroke moves the outer member distally through the outer tube assembly to urge the distal-most surgical clip of the at least one surgical clip from the clip cartridge assembly into the jaw assembly.
  • the inner member is moved distally together with the outer member upon actuation of the trigger through the initial portion of the actuation stroke.
  • the first compression spring is compressed upon actuation of the trigger through the initial portion of the actuation stroke.
  • actuation of the trigger through a subsequent portion of the actuation stroke moves the inner member distally through the outer tube assembly to actuate the jaw assembly to thereby form the distal-most surgical clip.
  • the second compression spring is compressed upon actuation of the trigger through the subsequent portion of the actuation stroke.
  • compression of the second compression spring allows the outer member to remain stationary upon actuation of the trigger through the subsequent portion of the actuation stroke.
  • the inner member includes a pin protruding therefrom and the outer member defines a bayonet slot configured to receive the pin to enable releasable engagement of the outer member about the elongated shaft of the inner member.
  • the handle assembly includes a removable proximal cap. With the removable proximal cap removed, the drive assembly is insertable through the handle assembly and into the outer tube assembly.
  • the clip cartridge assembly is removably engaged within the outer tube assembly.
  • the clip cartridge assembly stores a plurality of surgical clips therein.
  • FIG. 1 is a side view of a reposable endoscopic surgical clip applier provided in accordance with the present disclosure
  • FIG. 2 is a side view, with parts separated, of the reposable endoscopic surgical clip applier of FIG. 1;
  • FIG. 3A is an enlarged, side, longitudinal cross-sectional view of the area of detail indicated as “3A” in FIG. 1;
  • FIG. 3B is an enlarged, side, longitudinal cross-sectional view of the area of detail indicated as “3B” in FIG. 1;
  • FIG. 4 is an enlarged, perspective view, with parts separated, of a clip cartridge assembly configured for use with the reposable endoscopic surgical clip applier of FIG. 1;
  • FIG. 5 is an enlarged, perspective view of a jaw assembly of the reposable endoscopic surgical clip applier of FIG. 1;
  • FIG. 6 is a side view of a drive assembly of the reposable endoscopic surgical clip applier of FIG. 1;
  • FIG. 7 is a side, longitudinal cross-sectional view of the drive assembly of FIG. 6.
  • FIG. 8 is a side view, with parts separated, of the drive assembly of FIG. 6.
  • proximal refers to the end portion of the apparatus or component thereof which is closer to the user and the term “distal” refers to the end portion of the apparatus or component thereof which is further away from the user.
  • Surgical clip applier 10 includes a handle assembly 100, an outer tube assembly 200 extending distally from handle assembly 100, a clip cartridge assembly 300 removably and selectively mountable within a distal end portion 222 of elongated outer tube 220 of outer tube assembly 200, and a drive assembly 400 removably and selectively insertable into handle assembly 100 and outer tube assembly 200.
  • a plurality of surgical clips “C” are loaded into clip cartridge assembly 300 such that, in operation, each actuation of handle assembly 100 actuates drive assembly 400 to fire and form a single surgical clip “C” (FIG. 4) around a vessel to ligate the vessel.
  • handle assembly 100 includes a barrel 110, a rotatable nose wheel 120, a proximal cap 130, a fixed handle 140, and a trigger 150.
  • Barrel 110 is supported on fixed handle 140 and defines an open distal end portion 112, an open proximal end portion 114, and a lumen 116 extending longitudinally between the open distal and proximal end portions 112, 114, respectively, of barrel 110.
  • Rotatable nose wheel 120 is disposed about and rotatably coupled to open distal end potion 112 of barrel 110.
  • Rotatable nose wheel 120 more specifically, includes an open proximal end portion 122, an open distal end portion 124, and a lumen 126 extending longitudinally between the open proximal and distal end portions 122, 124, respectively, in communication with and coaxial arrangement relative to lumen 116 of barrel 110.
  • Open proximal end portion 122 of rotatable nose wheel 120 is disposed about and rotatably coupled to open distal end portion 112 of barrel 110 in any suitable manner.
  • Open distal end portion 124 of rotatable nose wheel 120 extends distally from barrel 110 and is configured to receive proximal end portion 212 of proximal hub 210 of outer tube assembly 200 therethrough.
  • Rotatable nose wheel 120 may be permanently affixed about proximal end portion 212 of proximal hub 210 of outer tube assembly 200 and releasably engagable about open distal end portion 112 of barrel 110, may be permanently rotatably coupled about open distal end portion 112 of barrel 110 with proximal end portion 212 of proximal hub 210 of outer tube assembly 200 being releasably engagable within open distal end portion 124 of rotatable nose wheel 120, or rotatable nose wheel 120 may be both releasably engagable about proximal end portion 212 of proximal hub 210 of outer tube assembly 200 and releasably engagable about open distal end portion 112 of barrel 110.
  • lumen 202 defined through outer tube assembly 200 is coaxially disposed relative to lumen 116 of barrel 110 and lumen 126 of rotatable nose wheel 120.
  • rotation of rotatable nose wheel 120 relative to handle assembly 100 similarly rotates outer tube assembly 200 and drive assembly 400 relative to handle assembly 100.
  • Proximal cap 130 of handle assembly 100 is configured to close the open proximal end portion 114 of barrel 110 and provide selective access to lumen 116 of barrel 110 from the open proximal end 114 thereof. More specifically, proximal cap 130 defines a threaded exterior surface 132 and open proximal end portion 114 of barrel 110 defines a threaded interior surface 118 that surrounds lumen 116, thus enabling releasable threaded engagement of proximal cap 130 within open proximal end portion 114 of barrel 110. As detailed below, with proximal cap 130 removed, drive assembly 400 may be inserted into or removed from lumen 116 of barrel 110.
  • Trigger 150 includes an actuating arm 152 that extends into lumen 116 of barrel 110, a gripping portion 154 that extends from barrel 110 adjacent fixed handle 140, and a pivoting portion 156 disposed between actuating arm 152 and gripping portion 154.
  • a pivot boss 158 pivotably couples trigger 150 with fixed handle 140, thus enabling gripping portion 154 of trigger 150 to pivot relative to fixed handle 140 between a spaced-apart position and an approximated position to drive actuating arm 152 through lumen 116 of barrel 110 from a proximal position to a distal position.
  • actuating arm 152 in response to actuation of gripping portion 154 of trigger 150 from the spaced-apart position to the approximated position, actuates drive assembly 400 to fire and form a surgical clip around a vessel to ligate the vessel.
  • outer tube assembly 200 includes a proximal hub 210, an elongated outer tube 220 extending distally from proximal hub 210, and a jaw assembly 230 operably supported at a distal end portion 222 of elongated outer tube 220.
  • Proximal hub 210 and elongated outer tube 220 cooperate to define a lumen 202 extending through outer tube assembly 200.
  • Lumen 202 communicates with and is disposed in coaxial orientation relative to lumen 116 of barrel 110 and lumen 126 of rotatable nose wheel 120.
  • outer tube assembly 200 may be configured for releasable engagement with rotatable nose wheel 120 and/or barrel 110, or may be permanently coupled to rotatable nose wheel 120 and/or barrel 110.
  • Proximal hub 210 of outer tube assembly 200 defines a greater internal diameter (and greater external diameter) as compared to elongated outer tube 220 of outer tube assembly 200. Both proximal hub 210 and elongated outer tube 220 are configured to receive drive assembly 400 through lumen 202 of outer tube assembly 200.
  • the larger-diameter proximal hub 210 enables receipt of a larger-diametered portion of drive assembly 400 while the smaller-diametered elongated outer tube 220 inhibits passage of the larger-diametered portion of drive assembly 400 therethrough such that a distal stop for drive assembly 400 is defined at the transition between the larger-diameter proximal hub 210 and smaller-diametered elongated outer tube 220.
  • Drive assembly 400 is described in greater detail below.
  • Elongated outer tube 220 defines a distal end portion 222 that operably supports jaw assembly 230.
  • Distal end portion 222 of elongated outer tube 220 further defines a window 224 that is positioned proximally of jaw assembly 230.
  • Window 224 communicates with lumen 202 of outer tube assembly 200 and is configured to permit insertion of clip cartridge assembly 300 therethrough and into lumen 202 of outer tube assembly 200 to mount clip cartridge assembly 300 at distal end portion 222 of elongated outer tube 220 in operable engagement with jaw assembly 230.
  • clip cartridge assembly 300 is selectably loadable into window 224 of elongated outer tube 220 to be in operable engagement with jaw assembly 230 of outer tube assembly 200.
  • Clip cartridge assembly 300 may be frictionally retained within window 224 or secured therein in any other suitable manner, e.g., snap-fit connection, detents, lips, wings, etc.
  • Clip cartridge assembly 300 includes a clip tray 302, a pusher bar 304, a clip follower 306, a constant force spring 310, a cartridge cover 312, and a stack of surgical clips “C. ”
  • Clip tray 302 is configured to retain the stack of surgical clips “C” therein.
  • Clip tray 302 more specifically, may include a resilient tang (not shown) configured to engage a backspan of a distal-most surgical clip “C 1 ” of the stack of surgical clips “C” to thereby retain the stack of surgical clips “C” within clip tray 302 of clip cartridge assembly 300.
  • Pusher bar 304 of clip cartridge assembly 300 is slidably disposed adjacent clip tray 302 and defines a proximal end portion 304a and a distal end portion 304b.
  • a coupling stem 304c extends proximally from proximal end portion 304a of pusher bar 304 and a pusher 304d extends distally from distal end portion 304b of pusher bar 304.
  • Pusher 304d is configured to engage a distal-most clip “C 1 ” of the stack of surgical clips “C” for loading the distal-most clip “C 1 ” into jaws 234 of jaw assembly 230, upon actuation of surgical clip applier 10.
  • Pusher bar 304 is further configured to receive a distal end portion 310b of constant force spring 310.
  • Clip follower 306 of clip cartridge assembly 300 is at least partially slidably disposed within clip tray 302 and is positioned proximally adjacent a backspan of a proximal-most clip “C p ” of the stack of surgical clips “C. ”
  • Clip follower 306 is configured to receive a coiled proximal end portion 310c of constant force spring 310 within a proximal portion thereof.
  • clip follower 306 is actuated by constant force spring 310 to help urge the remaining stack of surgical clips “C” distally into position for a subsequent actuation.
  • Constant force spring 310 is configured as a ribbon including a body portion 310a having distal end portion 310b and coiled proximal end portion 310c. Body portion 310a and distal end portion 310b of constant force spring 310 are disposed within clip tray 302. Distal end portion 310b of constant force spring 310 is secured to clip cartridge cover 312 which, in turn, is secured about clip tray 302 to enclose the components of clip cartridge assembly 300 therein. Coiled proximal end portion 310c of constant force spring 310, as noted above, is received within a proximal portion of clip follower 306. Constant force spring 310 is biased towards a more-wound-up configuration of coiled proximal end portion 310c.
  • constant force spring 310 maintains a constant distal force on clip follower 306 and, in turn, on the stack of surgical clips “C” such that the stack of surgical clips “C” is pressed against the resilient tang (not shown) of clip tray 302.
  • the stack of surgical clips “C” advances distally as clip pusher bar 304 distally advances the distal-most surgical clip “C 1 ” past the resilient tang (not shown) of clip tray 302.
  • Cartridge cover 312 of clip cartridge assembly 310 is secured about clip tray 302 to enclose the components of clip cartridge assembly 300 therein.
  • Cartridge cover 312 may include an engagement feature (not shown) configured to retain distal end portion 310b of constant force spring 310.
  • the stack of surgical clips “C” disposed within clip tray 302 may include any suitable number of surgical clips “C, ” for example, eight (8) surgical clips “C. ”
  • Surgical clips “C” may be fabricated from materials know by those skilled in the art, including and not limited to stainless steel, titanium, or other metal alloys.
  • jaw assembly 230 of outer tube assembly 200 includes a drive bar 232 slidably disposed within elongated outer tube 220 and a pair of jaws 234 extending distally from distal end portion 222 of elongated outer tube 220.
  • Drive bar 232 extends through elongated outer tube 220 opposite window 224 thereof such that, upon insertion of clip cartridge assembly 300 into window 224, clip cartridge assembly 300 is disposed atop drive bar 232.
  • Drive bar 232 defines a proximal end surface 233a (FIG. 3B) at a proximal end portion thereof and defines a V-shaped cam groove 233b at the distal end portion thereof.
  • the pair of jaws 234 of jaw assembly 230 is formed of a suitable biocompatible material such as, for example, stainless steel or titanium.
  • the pair of jaws 234 defines a channel 234c therebetween for receipt of a surgical clip “C” therein and a pair of camming wedge surfaces 234d projecting therefrom.
  • the pair of camming wedge surfaces 234d is acted upon by V-shaped cam groove 233b of the distal end portion of drive bar 232 to actuate the pair of jaws 234 to a closed position, as detailed below.
  • drive bar 232 may alternatively be part of clip cartridge assembly 300.
  • drive bar 232 may be coupled to clip tray 302, slidably supporting clip tray 302 thereon.
  • drive bar 232 may be part of drive assembly 400.
  • drive bar 232 may extend distally from distal extension rod 417 of inner shaft 410 of drive assembly 400.
  • drive assembly 400 includes an inner shaft 410, an outer shaft 420, a first compression spring 430, a second compression spring 440, and a stop washer 450. As noted above, drive assembly 400 is removably and selectively insertable into handle assembly 100 and outer tube assembly 200.
  • Inner shaft 410 of drive assembly 400 includes a mandrel 412 and an elongated shaft 414 extending distally from mandrel 412.
  • Mandrel 412 defines a larger diameter than elongated shaft 414 and includes a body 415a, a proximal collar 415b disposed at the proximal end portion of body 415a, and a distal collar 415c disposed at the distal end portion of body 415a.
  • Proximal collar 415b is affixed about body 415a of mandrel 412 in any suitable manner, e.g., via press-fitting.
  • An annular groove 416 is defined between proximal collar 415b and body 415a of mandrel 412.
  • Distal collar 415c is integrally formed (or otherwise engaged) with the distal end portion of body 415a and defines a larger diameter as compared to body 415a.
  • First compression spring 430 is disposed about body 415a of mandrel 412 between proximal collar 415b and distal collar 415c of mandrel 412. More specifically, a proximal end portion of first compression spring 430 extends at least partially into annular groove 416 and is seated therein, while a distal end portion of first compression spring 430 abuts the proximally-facing shoulder defined between the relatively smaller-diametered body 415a of mandrel 412 and the relatively larger-diametered distal collar 415c thereof.
  • Stop washer 450 of drive assembly 400 is slidably disposed about body 415a of mandrel 412 between proximal collar 415b and distal collar 415c of mandrel 412. Stop washer 450 is further engaged about a portion of first compression spring 430, inhibiting first compression spring 430 from passing proximally or distally through stop washer 450.
  • Elongated shaft 414 of inner shaft 410 extends distally from mandrel 412. More specifically, a proximal end of elongated shaft 414 may be press-fit within a bore defined within the distal end portion of mandrel 412 (or may be engaged therewith in any other suitable manner) .
  • Elongated shaft 414 includes a distal extension rod 417 extending from a distal end portion thereof. Distal extension rod 417 is offset relative to a longitudinal axis of elongated shaft 414.
  • Elongated shaft 414 further includes a recessed portion 418a defined within an outer surface of elongated shaft 414 towards the proximal end portion thereof.
  • Recessed portion 418a includes a planar base surface 418b that is recessed relative to the cylindrical outer surface of elongated shaft 414.
  • a transverse bore 418c extends from planar base surface 418b of recessed portion 418a at least partially through elongated shaft 414.
  • a pin 419 is engaged within transverse bore 418c, e.g., via press-fitting, threaded engagement, or other suitable engagement. Pin 419 extends from transverse bore 418c and recessed portion 418a and protrudes beyond the outer dimension of elongated shaft 414. As detailed below, this protruding portion of pin 419 enables releasable engagement of outer shaft 420 about inner shaft 410.
  • Second compression spring 440 of drive assembly 400 is disposed about the proximal end portion of elongated shaft 414.
  • Second compression spring 440 more specifically, is disposed between pin 419 and a distally-facing shoulder defined between the relatively larger-diametered mandrel 412 and the relatively smaller-diametered elongated shaft 414.
  • Second compression spring 440 defines a spring constant greater than that of first compression spring 430. As such, second compression spring 440 provides greater resistance to compression as compared to first compression spring 430.
  • Outer shaft 420 of drive assembly 400 is configured for releasable engagement about inner shaft 410 of drive assembly 400 and includes a proximal hub 422 and an elongated sleeve 424 extending distally from proximal hub 422. Proximal hub 422 and elongated sleeve 424 cooperate to define a lumen 425 extending longitudinally through outer shaft 420.
  • a bayonet slot 426 is defined through proximal hub 422 and a proximal end portion of elongated sleeve 424.
  • Bayonet slot 426 includes an open longitudinal portion 427a, a transverse portion 427b communicating with open longitudinal portion 427a and extending therefrom, and a closed longitudinal portion 427c communicating with and extending from transverse portion 427b.
  • Outer shaft 420 further includes a distal extension rod 428 extending from a distal end portion of elongated sleeve 424.
  • Distal extension rod 428 is engaged, e.g., pinned, to an interior surface of the distal end portion of elongated sleeve 424 and extends distally therefrom in offset relation relative to a longitudinal axis of elongated sleeve 424.
  • outer shaft 420 in order to engage outer shaft 420 about inner shaft 410, outer shaft 420, led by proximal hub 422 thereof, is inserted over the distal end portion of inner shaft 410 and slid proximally thereabout until proximal hub 422 is positioned adjacent pin 419. With proximal hub 422 position adjacent pin 419, outer shaft 420 is moved further proximally while pin 419 is guided into and through open longitudinal portion 427a of bayonet slot 426. In order to move outer shaft 420 further proximally in this manner, proximal hub 422 is urged against second compression spring 440, partially compressing second compression spring 440.
  • outer shaft 420 is rotated relative to inner shaft 410 such that pin 419 is moved from open longitudinal portion 427a of bayonet slot 426, through transverse portion 427b of bayonet slot 426 and into closed longitudinal portion 427c of bayonet slot 426.
  • outer shaft 420 may be released, allowing second compression spring 440 to urge outer shaft 420 distally relative to inner shaft 420 and move pin 419 to the closed proximal end of closed longitudinal portion 427c of bayonet slot 426, thereby releasably locking outer shaft 420 in engagement about inner shaft 410.
  • pin 419 is maintained, under the bias of second compression spring 450, at the closed proximal end of closed longitudinal portion 427c of bayonet slot 426.
  • distal extension rod 428 of outer shaft 420 extends distally from the distal end of inner shaft 410, while distal extension rod 417 of inner shaft 410 extends to the distal end of outer shaft 420.
  • Distal extension rods 417, 428 are offset in opposite direction relative to the longitudinal axis of drive assembly 400 when inner and outer shafts 410, 420 are engaged with one another.
  • outer tube assembly 200 is first engaged with handle assembly 100.
  • clip cartridge assembly 300 is installed into outer tube assembly 200 by inserting clip cartridge assembly 300 transversely through window 224 and into engagement within outer tube assembly 200.
  • drive assembly 400 may be assembled, as detailed above, and inserted through handle assembly 100 and outer tube assembly 200.
  • proximal cap 130 is removed from barrel 110 and trigger 150 is pivoted away from fixed handle 140 sufficiently such that actuating arm 152 of trigger 150 does not or minimally obstructs lumen 116 of barrel 110, thus enabling insertion of drive assembly 400 through lumen 116.
  • Drive assembly 400 led by distal extension rod 428 of outer shaft 420, is inserted through open proximal end portion 114 of barrel 110, through lumen 116 of barrel 110, and into lumen 202 of outer tube assembly 200.
  • Drive assembly 400 is inserted through handle assembly 100 and outer tube assembly 200 until distal extension rod 428 of outer shaft 420 operably engages coupling stem 304c of pusher bar 304 of clip cartridge assembly 300 (see FIG. 4) .
  • distal extension rod 417 of inner shaft 410 of drive assembly 400 is disposed proximally of proximal end surface 233a of drive bar 232 (FIG. 3B) and stop washer 450 abuts a shoulder 119 disposed within lumen 116 of barrel 110 to inhibit further distal translation of stop washer 450.
  • trigger 150 is returned to the spaced-apart position, wherein actuating arm 152 of trigger 150 abuts proximal collar 415b of mandrel 412 of inner shaft 410 of drive assembly 400.
  • Proximal cap 130 is also reengaged about open proximal end portion 114 of barrel 110 to complete assembly of surgical clip applier 10.
  • surgical clip applier 10 is manipulated and/or outer tube assembly 200 rotated using rotatable nose wheel 120 such that a vessel to be ligated is disposed between jaws 234 of jaw assembly 230.
  • griping portion 154 of trigger 150 may be actuated from the spaced-apart position towards the approximated position. Actuation of gripping portion 154 of trigger 150 proximally about pivot boss 158 pivots actuating arm 152 of trigger 150 distally about pivot boss 158, thereby urging mandrel 412 of inner shaft 410 of drive assembly 400 distally.
  • second compression spring 440 defining a greater spring constant as compared to first compression spring 430, second compression spring 440 is not initially compressed but rather, is moved distally along with inner shaft 410 to similarly move outer shaft 420 distally. That is, during the initial portion of actuation, inner and outer shafts 410 420 move together distally though barrel 110 and outer tube assembly 200.
  • pusher 304d of pusher bar 304 engages the distal-most clip “C 1 ” of the stack of surgical clips “C, ” urges the distal-most clip “C 1 ” over resilient tang (not shown) of clip tray 302, and pushes the distal-most clip “C 1 ” distally out of clip cartridge assembly 300 and into the pair of jaws 234 of jaw assembly 230.
  • each surgical clip “C” is advanced one position distally to replace the distal-most clip “C 1 ” for subsequent actuations.
  • proximal end portion 310c of constant force spring 310 is coiled up further to account for the smaller distance between proximal end portion 310c and distal end portion 310b thereof.
  • inner and outer shafts 410, 420 of drive assembly 400 are moved together with one another such that distal extension rod 428 of outer shaft 420 effects advancement of the distal-most surgical clip “C 1 ” of clip cartridge assembly 300 into jaws 234 of jaw assembly 230.
  • inner shaft 410 is moved distally during this initial portion of actuation, inner shaft 410 does not yet reach drive bar 232 of jaw assembly 230 since distal extension rod 428 of outer shaft 420 extends further distally than distal extension rod 417 of inner shaft 410.
  • inner shaft 410 may contact proximal end surface 233a (FIG. 3B) of drive bar 232 and urge drive bar 232 distally during the initial portion of actuation of griping portion 154 of trigger 150. In such embodiments, however, this initial distal urging of drive bar 232 is without effect.
  • gripping portion 154 of trigger 150 has been actuated sufficiently to move inner and outer shafts 410, 420 distally to load the distal-most surgical clip “C 1 ” into jaw assembly 230, as detailed above, further actuation of griping portion 154 of trigger 150 does not affect further distal movement of outer shaft 420. Rather, further actuation of griping portion 154 of trigger 150 moves inner shaft 410 distally and compresses second compression spring 440 such that outer shaft 420 remains stationary while inner shaft 410 is moved distally.
  • pin 419 of inner shaft 410 is moved distally through closed longitudinal portion 427c of bayonet slot 426 of outer shaft 420 from the proximal end thereof towards the distal end thereof as inner shaft 410 is moved distally relative to outer shaft 420.
  • first and second compression springs 430, 440 of drive assembly 400 bias drive assembly 400 proximally back to the initial position thereof. As such, jaws 234 of jaw assembly 230 are permitted to return to the initial, open position thereof.
  • handle assembly 100 and outer tube assembly 200 may be cleaned, sterilized, autoclaved and/or otherwise processed for reuse.
  • Handle assembly 100 and outer tube assembly 200 may be disassembled to facilitate processing for reuse.
  • Drive assembly 400 may likewise be disassembled and processed for reuse.
  • Clip cartridge assembly 300 is disposed of following a complete and/or partial use thereof.
  • surgical clip applier 10 be capable of loading different surgical clip cartridge assemblies 300 within outer tube assembly 200 thereof.
  • surgical clip applier 10 may be loaded with a clip cartridge assembly 300 having a stack of surgical clips “C” of a particular size and/or configuration.
  • a first clip cartridge assembly 300 having a stack of surgical clips “C” of a first size or a second clip cartridge assembly 300 having a stack of surgical clips “C” of a second size different than the first size may be loaded into outer tube assembly 200.
  • the user may remove the clip cartridge assembly 300 being used in favor of a different clip cartridge assembly 300.
  • the present disclosure further contemplates a surgical kit including one surgical clip applier 10 (having one handle assembly 100, one outer tube assembly 200, and one drive assembly 400) and one or more clip cartridge assemblies 300 (similar or different from one another) .
  • the kit may also include instructions for the assembly of surgical clip applier 10, the use of surgical clip applier 10, and/or the processing surgical clip applier 10 following use.
  • a package, container, or box may also be provided.

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  • Surgical Instruments (AREA)

Abstract

A removable drive assembly (400) and a reposable endoscopic surgical clip applier (10) including the same are disclosed. The drive assembly (400) includes an inner member (410), an outer member (420), and first and second compression springs (430,440). The inner member (410) includes a mandrel (412), an elongated shaft (414) extending distally from the mandrel (412), and a pin (419) protruding transversely from the elongated shaft (414). The first compression spring (430) is disposed about the mandrel (412). The outer member (420) includes a proximal hub (422) and an elongated sleeve (424) extending distally from the proximal hub (422) and is configured for removable positioning about the elongated shaft (414) of the inner member (410). The outer member (420) further defines a bayonet slot (426) configured to receive the pin (419) to releasably engage the outer member (420) about the elongated shaft (414) of the inner member (410) with the second compression spring (440) disposed between the mandrel (412) of the inner member (410) and the proximal hub (422) of the outer member (420).

Description

REMOVABLE DRIVE ASSEMBLY AND ENDOSCOPIC REPOSABLE SURGICAL CLIP APPLIER INCLUDING A REMOVABLE DRIVE ASSEMBLY BACKGROUND
Technical Field
The present disclosure relates to surgical clip appliers and, more particularly, to a removable drive assembly for an endoscopic reposable surgical clip applier and an endoscopic reposable surgical clip applier including a removable drive assembly.
Description of Related Art
Various endoscopic staplers and clip appliers are known in the art and used for a number of distinct and useful surgical procedures. Endoscopic clip appliers that are able to apply multiple clips in endoscopic procedures during a single entry into the body cavity, for example, are described in commonly-assigned U.S. Pat. Nos. 5,084,057 and 5,100,420 to Green et al., the entire contents of which are incorporated herein by reference. Another multiple endoscopic clip applier is disclosed in commonly-assigned U.S. Pat. No. 5,607,436 by Pratt et al., the entire contents of which is also hereby incorporated herein by reference. U.S. Pat. No. 5,695,502 to Pier et al., the entire contents of which is hereby incorporated herein by reference, discloses a resterilizable surgical clip applier that is configured to receive and cooperate with an interchangeable clip magazine so as to advance and form multiple clips during a single entry into a body cavity.
SUMMARY
The present disclosure relates to removable drive assemblies and reposable endoscopic surgical clip appliers including the same.
A drive assembly provided in accordance with aspects of the present disclosure is configured for removable positioning within a reposable endoscopic surgical clip applier. The drive assembly includes an inner member, an outer member, a first compression spring, and a second compression spring. The inner member includes a mandrel, an elongated shaft extending distally from the mandrel, and a pin protruding transversely from the elongated shaft. The first compression spring is disposed about the mandrel. The second compression spring is disposed between the mandrel and the pin. The outer member includes a proximal hub and an elongated sleeve extending distally from the proximal hub. The outer member is configured for removable positioning about the elongated shaft of the inner member and defines a bayonet slot configured to receive the pin to releasably engage the outer member about the elongated shaft of the inner member with the second compression spring disposed between the mandrel of the inner member and the proximal hub of the outer member.
In an aspect of the present disclosure, the inner member further includes a distal extension rod extending distally from the elongated shaft. The distal extension rod of the inner member is configured to actuate a jaw assembly of a surgical clip applier.
In another aspect of the present disclosure, the outer member further includes a distal extension rod extending distally from the elongated sleeve. The  distal extension rod of the outer member is configured to load a surgical clip into a jaw assembly of a surgical clip applier.
In another aspect of the present disclosure, the mandrel includes a body, a proximal collar disposed at a proximal end portion of the body, and a distal collar disposed at a distal end portion of the body. In such aspects, the first compression spring is disposed about the body between the proximal and distal collars.
In still another aspect of the present disclosure, the second compression spring defines a spring constant that is greater than a spring constant of the first compression spring.
In yet another aspect of the present disclosure, the bayonet slot includes an open longitudinal segment, a closed longitudinal segment, and a transverse segment extending between and connecting the open and closed longitudinal segments.
In another aspect of the present disclosure, the pin is configured to enter the open longitudinal segment, move from the open longitudinal segment to the transverse segment, move from the transverse segment to the closed longitudinal segment, and seat within the closed longitudinal segment. More specifically, in aspects, the pin is configured to enter the open longitudinal segment upon proximal sliding of the outer member about the inner member, move from the open longitudinal segment to the transverse segment upon subsequent rotation of the outer member relative to the inner member, and seat within the closed longitudinal segment upon subsequent distal sliding of the outer member relative to the inner member.
In still yet another aspect of the present disclosure, compression of the second compression spring and sliding of the pin through the closed longitudinal segment of the bayonet slot enables movement of the inner member relative to the outer member.
A surgical clip applier provided in accordance with aspects of the present disclosure includes a handle assembly including a trigger, an outer tube assembly extending distally from the handle assembly and supporting a jaw assembly at a distal end portion thereof, a clip cartridge assembly engaged within the outer tube assembly and storing at least one surgical clip therein, and a drive assembly removably disposed within the handle assembly and outer tube assembly to operably couple the trigger with the jaw assembly and the clip cartridge assembly.
In aspects of the present disclosure, the drive assembly includes an inner member, an outer member, a first compression spring, and a second compression spring. The inner member includes a mandrel and an elongated shaft extending distally from the mandrel. The first compression spring is disposed about the mandrel. The outer member includes a proximal hub and an elongated sleeve extending distally from the proximal hub. The outer member is disposed about the elongated shaft of the inner member. The second compression spring is disposed about the elongated shaft and positioned between the mandrel and the proximal hub.
In an aspect of the present disclosure, actuation of the trigger through an initial portion of an actuation stroke moves the outer member distally through the outer tube assembly to urge the distal-most surgical clip of the at least one surgical clip from the clip cartridge assembly into the jaw assembly.
In another aspect of the present disclosure, the inner member is moved distally together with the outer member upon actuation of the trigger through the initial portion of the actuation stroke.
In yet another aspect of the present disclosure, the first compression spring is compressed upon actuation of the trigger through the initial portion of the actuation stroke.
In still another aspect of the present disclosure, actuation of the trigger through a subsequent portion of the actuation stroke moves the inner member distally through the outer tube assembly to actuate the jaw assembly to thereby form the distal-most surgical clip.
In still yet another aspect of the present disclosure, the second compression spring is compressed upon actuation of the trigger through the subsequent portion of the actuation stroke.
In another aspect of the present disclosure, compression of the second compression spring allows the outer member to remain stationary upon actuation of the trigger through the subsequent portion of the actuation stroke.
In another aspect of the present disclosure, the inner member includes a pin protruding therefrom and the outer member defines a bayonet slot configured to receive the pin to enable releasable engagement of the outer member about the elongated shaft of the inner member.
In still another aspect of the present disclosure, the handle assembly includes a removable proximal cap. With the removable proximal cap removed, the drive assembly is insertable through the handle assembly and into the outer tube assembly.
In yet another aspect of the present disclosure, the clip cartridge assembly is removably engaged within the outer tube assembly.
In another aspect of the present disclosure, the clip cartridge assembly stores a plurality of surgical clips therein.
BRIEF DESCRIPTION OF THE DRAWINGS
Aspects and features of a removable drive assembly and surgical clip applier including the same are provided in accordance with the present disclosure with reference to the drawings wherein:
FIG. 1 is a side view of a reposable endoscopic surgical clip applier provided in accordance with the present disclosure；
FIG. 2 is a side view, with parts separated, of the reposable endoscopic surgical clip applier of FIG. 1；
FIG. 3A is an enlarged, side, longitudinal cross-sectional view of the area of detail indicated as “3A” in FIG. 1；
FIG. 3B is an enlarged, side, longitudinal cross-sectional view of the area of detail indicated as “3B” in FIG. 1；
FIG. 4 is an enlarged, perspective view, with parts separated, of a clip cartridge assembly configured for use with the reposable endoscopic surgical clip applier of FIG. 1；
FIG. 5 is an enlarged, perspective view of a jaw assembly of the reposable endoscopic surgical clip applier of FIG. 1；
FIG. 6 is a side view of a drive assembly of the reposable endoscopic surgical clip applier of FIG. 1；
FIG. 7 is a side, longitudinal cross-sectional view of the drive assembly of FIG. 6； and
FIG. 8 is a side view, with parts separated, of the drive assembly of FIG. 6.
DETAILED DESCRIPTION
A removable drive assembly and reposable surgical clip applier including the same in accordance with the present disclosure are described in detail below with reference to the drawing figures wherein like reference numerals identify similar or identical structural elements. As shown in the drawings and described throughout the following description, as is traditional when referring to relative positioning on a surgical instrument, the term “proximal” refers to the end portion of the apparatus or component thereof which is closer to the user and the term “distal” refers to the end portion of the apparatus or component thereof which is further away from the user.
Referring initially to FIGS. 1 and 2, a surgical clip applier provided in accordance with the present disclosure is generally designated as 10. Surgical clip applier 10 includes a handle assembly 100, an outer tube assembly 200 extending distally from handle assembly 100, a clip cartridge assembly 300 removably and selectively mountable within a distal end portion 222 of elongated outer tube 220 of outer tube assembly 200, and a drive assembly 400 removably and selectively insertable into handle assembly 100 and outer tube assembly 200. As described in detail below, a plurality of surgical clips “C”  (FIG. 4) are loaded into clip cartridge assembly 300 such that, in operation, each actuation of handle assembly 100 actuates drive assembly 400 to fire and form a single surgical clip “C” (FIG. 4) around a vessel to ligate the vessel.
With additional reference to FIG. 3A, handle assembly 100 includes a barrel 110, a rotatable nose wheel 120, a proximal cap 130, a fixed handle 140, and a trigger 150. Barrel 110 is supported on fixed handle 140 and defines an open distal end portion 112, an open proximal end portion 114, and a lumen 116 extending longitudinally between the open distal and  proximal end portions  112, 114, respectively, of barrel 110.
Rotatable nose wheel 120 is disposed about and rotatably coupled to open distal end potion 112 of barrel 110. Rotatable nose wheel 120, more specifically, includes an open proximal end portion 122, an open distal end portion 124, and a lumen 126 extending longitudinally between the open proximal and  distal end portions  122, 124, respectively, in communication with and coaxial arrangement relative to lumen 116 of barrel 110. Open proximal end portion 122 of rotatable nose wheel 120 is disposed about and rotatably coupled to open distal end portion 112 of barrel 110 in any suitable manner. Open distal end portion 124 of rotatable nose wheel 120 extends distally from barrel 110 and is configured to receive proximal end portion 212 of proximal hub 210 of outer tube assembly 200 therethrough.
Rotatable nose wheel 120 may be permanently affixed about proximal end portion 212 of proximal hub 210 of outer tube assembly 200 and releasably engagable about open distal end portion 112 of barrel 110, may be permanently rotatably coupled about open distal end portion 112 of barrel 110 with proximal end portion 212 of proximal hub 210 of outer tube assembly 200  being releasably engagable within open distal end portion 124 of rotatable nose wheel 120, or rotatable nose wheel 120 may be both releasably engagable about proximal end portion 212 of proximal hub 210 of outer tube assembly 200 and releasably engagable about open distal end portion 112 of barrel 110. In either of these configurations, with proximal end portion 212 of proximal hub 210 of outer tube assembly 200 extending into open distal end portion 124 of rotatable nose wheel 120 and rotatable nose wheel 120 rotatably coupled about open distal end portion 112 of barrel 110, lumen 202 defined through outer tube assembly 200 is coaxially disposed relative to lumen 116 of barrel 110 and lumen 126 of rotatable nose wheel 120. In use, rotation of rotatable nose wheel 120 relative to handle assembly 100 similarly rotates outer tube assembly 200 and drive assembly 400 relative to handle assembly 100.
Proximal cap 130 of handle assembly 100 is configured to close the open proximal end portion 114 of barrel 110 and provide selective access to lumen 116 of barrel 110 from the open proximal end 114 thereof. More specifically, proximal cap 130 defines a threaded exterior surface 132 and open proximal end portion 114 of barrel 110 defines a threaded interior surface 118 that surrounds lumen 116, thus enabling releasable threaded engagement of proximal cap 130 within open proximal end portion 114 of barrel 110. As detailed below, with proximal cap 130 removed, drive assembly 400 may be inserted into or removed from lumen 116 of barrel 110.
Fixed handle 140 of handle assembly 100 is engaged with barrel 110 and supports barrel 110 thereon. Trigger 150 includes an actuating arm 152 that extends into lumen 116 of barrel 110, a gripping portion 154 that extends from barrel 110 adjacent fixed handle 140, and a pivoting portion 156 disposed between actuating arm 152 and gripping portion 154. A pivot boss 158  pivotably couples trigger 150 with fixed handle 140, thus enabling gripping portion 154 of trigger 150 to pivot relative to fixed handle 140 between a spaced-apart position and an approximated position to drive actuating arm 152 through lumen 116 of barrel 110 from a proximal position to a distal position. As detailed below, distal advancement of actuating arm 152, in response to actuation of gripping portion 154 of trigger 150 from the spaced-apart position to the approximated position, actuates drive assembly 400 to fire and form a surgical clip around a vessel to ligate the vessel.
With reference to FIGS. 1, 2, and 3B, outer tube assembly 200 includes a proximal hub 210, an elongated outer tube 220 extending distally from proximal hub 210, and a jaw assembly 230 operably supported at a distal end portion 222 of elongated outer tube 220. Proximal hub 210 and elongated outer tube 220 cooperate to define a lumen 202 extending through outer tube assembly 200. Lumen 202, as noted above, communicates with and is disposed in coaxial orientation relative to lumen 116 of barrel 110 and lumen 126 of rotatable nose wheel 120. As also noted above, outer tube assembly 200 may be configured for releasable engagement with rotatable nose wheel 120 and/or barrel 110, or may be permanently coupled to rotatable nose wheel 120 and/or barrel 110.
Proximal hub 210 of outer tube assembly 200 defines a greater internal diameter (and greater external diameter) as compared to elongated outer tube 220 of outer tube assembly 200. Both proximal hub 210 and elongated outer tube 220 are configured to receive drive assembly 400 through lumen 202 of outer tube assembly 200. The larger-diameter proximal hub 210 enables receipt of a larger-diametered portion of drive assembly 400 while the smaller-diametered elongated outer tube 220 inhibits passage of the larger-diametered  portion of drive assembly 400 therethrough such that a distal stop for drive assembly 400 is defined at the transition between the larger-diameter proximal hub 210 and smaller-diametered elongated outer tube 220. Drive assembly 400 is described in greater detail below.
Elongated outer tube 220 defines a distal end portion 222 that operably supports jaw assembly 230. Distal end portion 222 of elongated outer tube 220 further defines a window 224 that is positioned proximally of jaw assembly 230. Window 224 communicates with lumen 202 of outer tube assembly 200 and is configured to permit insertion of clip cartridge assembly 300 therethrough and into lumen 202 of outer tube assembly 200 to mount clip cartridge assembly 300 at distal end portion 222 of elongated outer tube 220 in operable engagement with jaw assembly 230.
Referring also to FIG. 4, clip cartridge assembly 300, as noted above, is selectably loadable into window 224 of elongated outer tube 220 to be in operable engagement with jaw assembly 230 of outer tube assembly 200. Clip cartridge assembly 300 may be frictionally retained within window 224 or secured therein in any other suitable manner, e.g., snap-fit connection, detents, lips, wings, etc. Clip cartridge assembly 300 includes a clip tray 302, a pusher bar 304, a clip follower 306, a constant force spring 310, a cartridge cover 312, and a stack of surgical clips “C. ”
Clip tray 302 is configured to retain the stack of surgical clips “C” therein. Clip tray 302, more specifically, may include a resilient tang (not shown) configured to engage a backspan of a distal-most surgical clip “C1” of the stack of surgical clips “C” to thereby retain the stack of surgical clips “C” within clip tray 302 of clip cartridge assembly 300.
Pusher bar 304 of clip cartridge assembly 300 is slidably disposed adjacent clip tray 302 and defines a proximal end portion 304a and a distal end portion 304b. A coupling stem 304c extends proximally from proximal end portion 304a of pusher bar 304 and a pusher 304d extends distally from distal end portion 304b of pusher bar 304. Pusher 304d is configured to engage a distal-most clip “C1” of the stack of surgical clips “C” for loading the distal-most clip “C1” into jaws 234 of jaw assembly 230, upon actuation of surgical clip applier 10. Pusher bar 304 is further configured to receive a distal end portion 310b of constant force spring 310.
Clip follower 306 of clip cartridge assembly 300 is at least partially slidably disposed within clip tray 302 and is positioned proximally adjacent a backspan of a proximal-most clip “Cp” of the stack of surgical clips “C. ” Clip follower 306 is configured to receive a coiled proximal end portion 310c of constant force spring 310 within a proximal portion thereof. During an actuation of surgical clip applier 10, as pusher bar 304 urges the distal-most surgical clip “C1” of the stack of surgical clips “C” into jaws 234 of jaw assembly 230, clip follower 306 is actuated by constant force spring 310 to help urge the remaining stack of surgical clips “C” distally into position for a subsequent actuation.
Constant force spring 310 is configured as a ribbon including a body portion 310a having distal end portion 310b and coiled proximal end portion 310c. Body portion 310a and distal end portion 310b of constant force spring 310 are disposed within clip tray 302. Distal end portion 310b of constant force spring 310 is secured to clip cartridge cover 312 which, in turn, is secured about clip tray 302 to enclose the components of clip cartridge assembly 300 therein. Coiled proximal end portion 310c of constant force spring 310, as noted above, is received within a proximal portion of clip follower 306. Constant force spring  310 is biased towards a more-wound-up configuration of coiled proximal end portion 310c. As a result of this configuration, constant force spring 310 maintains a constant distal force on clip follower 306 and, in turn, on the stack of surgical clips “C” such that the stack of surgical clips “C” is pressed against the resilient tang (not shown) of clip tray 302. In this manner, as detailed below, the stack of surgical clips “C” advances distally as clip pusher bar 304 distally advances the distal-most surgical clip “C1” past the resilient tang (not shown) of clip tray 302.
Cartridge cover 312 of clip cartridge assembly 310, as noted above, is secured about clip tray 302 to enclose the components of clip cartridge assembly 300 therein. Cartridge cover 312 may include an engagement feature (not shown) configured to retain distal end portion 310b of constant force spring 310.
The stack of surgical clips “C” disposed within clip tray 302 may include any suitable number of surgical clips “C, ” for example, eight (8) surgical clips “C. ” Surgical clips “C” may be fabricated from materials know by those skilled in the art, including and not limited to stainless steel, titanium, or other metal alloys.
Referring to FIGS. 1, 2, 3B, and 5, jaw assembly 230 of outer tube assembly 200 includes a drive bar 232 slidably disposed within elongated outer tube 220 and a pair of jaws 234 extending distally from distal end portion 222 of elongated outer tube 220. Drive bar 232 extends through elongated outer tube 220 opposite window 224 thereof such that, upon insertion of clip cartridge assembly 300 into window 224, clip cartridge assembly 300 is disposed atop drive bar 232. Drive bar 232 defines a proximal end surface 233a (FIG. 3B) at a  proximal end portion thereof and defines a V-shaped cam groove 233b at the distal end portion thereof.
The pair of jaws 234 of jaw assembly 230 is formed of a suitable biocompatible material such as, for example, stainless steel or titanium. The pair of jaws 234 defines a channel 234c therebetween for receipt of a surgical clip “C” therein and a pair of camming wedge surfaces 234d projecting therefrom. The pair of camming wedge surfaces 234d is acted upon by V-shaped cam groove 233b of the distal end portion of drive bar 232 to actuate the pair of jaws 234 to a closed position, as detailed below.
As an alternative to drive bar 232 being part of jaw assembly 230 and, thus, part of outer tube assembly 200, drive bar 232 may alternatively be part of clip cartridge assembly 300. In such embodiments, drive bar 232 may be coupled to clip tray 302, slidably supporting clip tray 302 thereon. Once clip cartridge assembly 300 (including drive bar 232) is inserted into engagement within outer tube assembly 200, drive bar 232 is operably positioned relative to jaws 234 and functions similarly as detailed herein.
As another alternative, drive bar 232 may be part of drive assembly 400. In such embodiments, drive bar 232 may extend distally from distal extension rod 417 of inner shaft 410 of drive assembly 400. Once drive assembly 400 (including drive bar 232) is inserted into outer tube assembly 200, drive bar 232 is operably positioned relative to jaws 234 and functions as detailed herein.
Referring to FIGS. 2 and 6-8, drive assembly 400 includes an inner shaft 410, an outer shaft 420, a first compression spring 430, a second compression spring 440, and a stop washer 450. As noted above, drive assembly  400 is removably and selectively insertable into handle assembly 100 and outer tube assembly 200.
Inner shaft 410 of drive assembly 400 includes a mandrel 412 and an elongated shaft 414 extending distally from mandrel 412. Mandrel 412 defines a larger diameter than elongated shaft 414 and includes a body 415a, a proximal collar 415b disposed at the proximal end portion of body 415a, and a distal collar 415c disposed at the distal end portion of body 415a. Proximal collar 415b is affixed about body 415a of mandrel 412 in any suitable manner, e.g., via press-fitting. An annular groove 416 is defined between proximal collar 415b and body 415a of mandrel 412. Distal collar 415c is integrally formed (or otherwise engaged) with the distal end portion of body 415a and defines a larger diameter as compared to body 415a.
First compression spring 430 is disposed about body 415a of mandrel 412 between proximal collar 415b and distal collar 415c of mandrel 412. More specifically, a proximal end portion of first compression spring 430 extends at least partially into annular groove 416 and is seated therein, while a distal end portion of first compression spring 430 abuts the proximally-facing shoulder defined between the relatively smaller-diametered body 415a of mandrel 412 and the relatively larger-diametered distal collar 415c thereof.
Stop washer 450 of drive assembly 400 is slidably disposed about body 415a of mandrel 412 between proximal collar 415b and distal collar 415c of mandrel 412. Stop washer 450 is further engaged about a portion of first compression spring 430, inhibiting first compression spring 430 from passing proximally or distally through stop washer 450.
Elongated shaft 414 of inner shaft 410, as noted above, extends distally from mandrel 412. More specifically, a proximal end of elongated shaft 414 may be press-fit within a bore defined within the distal end portion of mandrel 412 (or may be engaged therewith in any other suitable manner) . Elongated shaft 414 includes a distal extension rod 417 extending from a distal end portion thereof. Distal extension rod 417 is offset relative to a longitudinal axis of elongated shaft 414.
Elongated shaft 414 further includes a recessed portion 418a defined within an outer surface of elongated shaft 414 towards the proximal end portion thereof. Recessed portion 418a includes a planar base surface 418b that is recessed relative to the cylindrical outer surface of elongated shaft 414. A transverse bore 418c extends from planar base surface 418b of recessed portion 418a at least partially through elongated shaft 414. A pin 419 is engaged within transverse bore 418c, e.g., via press-fitting, threaded engagement, or other suitable engagement. Pin 419 extends from transverse bore 418c and recessed portion 418a and protrudes beyond the outer dimension of elongated shaft 414. As detailed below, this protruding portion of pin 419 enables releasable engagement of outer shaft 420 about inner shaft 410.
Second compression spring 440 of drive assembly 400 is disposed about the proximal end portion of elongated shaft 414. Second compression spring 440, more specifically, is disposed between pin 419 and a distally-facing shoulder defined between the relatively larger-diametered mandrel 412 and the relatively smaller-diametered elongated shaft 414. Second compression spring 440 defines a spring constant greater than that of first compression spring 430. As such, second compression spring 440 provides greater resistance to compression as compared to first compression spring 430.
Outer shaft 420 of drive assembly 400 is configured for releasable engagement about inner shaft 410 of drive assembly 400 and includes a proximal hub 422 and an elongated sleeve 424 extending distally from proximal hub 422. Proximal hub 422 and elongated sleeve 424 cooperate to define a lumen 425 extending longitudinally through outer shaft 420. A bayonet slot 426 is defined through proximal hub 422 and a proximal end portion of elongated sleeve 424. Bayonet slot 426 includes an open longitudinal portion 427a, a transverse portion 427b communicating with open longitudinal portion 427a and extending therefrom, and a closed longitudinal portion 427c communicating with and extending from transverse portion 427b.
Outer shaft 420 further includes a distal extension rod 428 extending from a distal end portion of elongated sleeve 424. Distal extension rod 428, more specifically, is engaged, e.g., pinned, to an interior surface of the distal end portion of elongated sleeve 424 and extends distally therefrom in offset relation relative to a longitudinal axis of elongated sleeve 424.
Continuing with reference to FIGS. 2 and 6-8, in order to engage outer shaft 420 about inner shaft 410, outer shaft 420, led by proximal hub 422 thereof, is inserted over the distal end portion of inner shaft 410 and slid proximally thereabout until proximal hub 422 is positioned adjacent pin 419. With proximal hub 422 position adjacent pin 419, outer shaft 420 is moved further proximally while pin 419 is guided into and through open longitudinal portion 427a of bayonet slot 426. In order to move outer shaft 420 further proximally in this manner, proximal hub 422 is urged against second compression spring 440, partially compressing second compression spring 440.
Once pin 419 has been guided into and through open longitudinal portion 427a of bayonet slot 426, outer shaft 420 is rotated relative to inner shaft 410 such that pin 419 is moved from open longitudinal portion 427a of bayonet slot 426, through transverse portion 427b of bayonet slot 426 and into closed longitudinal portion 427c of bayonet slot 426. Once pin 419 is disposed within closed longitudinal portion 427c of bayonet slot 426, outer shaft 420 may be released, allowing second compression spring 440 to urge outer shaft 420 distally relative to inner shaft 420 and move pin 419 to the closed proximal end of closed longitudinal portion 427c of bayonet slot 426, thereby releasably locking outer shaft 420 in engagement about inner shaft 410. In this position, pin 419 is maintained, under the bias of second compression spring 450, at the closed proximal end of closed longitudinal portion 427c of bayonet slot 426.
With outer shaft 420 engaged about inner shaft 410, as detailed above, the distal end portion of second compression spring 440 abuts proximal hub 422 of outer shaft 420. Further, distal extension rod 428 of outer shaft 420 extends distally from the distal end of inner shaft 410, while distal extension rod 417 of inner shaft 410 extends to the distal end of outer shaft 420.  Distal extension rods  417, 428 are offset in opposite direction relative to the longitudinal axis of drive assembly 400 when inner and  outer shafts  410, 420 are engaged with one another.
Referring generally to FIGS. 1-8, in order to assemble surgical clip applier 10, in embodiments where handle assembly 100 and outer tube assembly 200 are releasable from one another, outer tube assembly 200 is first engaged with handle assembly 100. Next, or where handle assembly 100 and outer tube assembly 200 are permanently coupled to one another, clip cartridge assembly 300 is installed into outer tube assembly 200 by inserting clip cartridge assembly  300 transversely through window 224 and into engagement within outer tube assembly 200.
Once clip cartridge assembly 300 is engaged within outer tube assembly 200, drive assembly 400 may be assembled, as detailed above, and inserted through handle assembly 100 and outer tube assembly 200. In order to insert drive assembly 400 into position, proximal cap 130 is removed from barrel 110 and trigger 150 is pivoted away from fixed handle 140 sufficiently such that actuating arm 152 of trigger 150 does not or minimally obstructs lumen 116 of barrel 110, thus enabling insertion of drive assembly 400 through lumen 116. Drive assembly 400, led by distal extension rod 428 of outer shaft 420, is inserted through open proximal end portion 114 of barrel 110, through lumen 116 of barrel 110, and into lumen 202 of outer tube assembly 200.
Drive assembly 400, more specifically, is inserted through handle assembly 100 and outer tube assembly 200 until distal extension rod 428 of outer shaft 420 operably engages coupling stem 304c of pusher bar 304 of clip cartridge assembly 300 (see FIG. 4) . In this position, distal extension rod 417 of inner shaft 410 of drive assembly 400 is disposed proximally of proximal end surface 233a of drive bar 232 (FIG. 3B) and stop washer 450 abuts a shoulder 119 disposed within lumen 116 of barrel 110 to inhibit further distal translation of stop washer 450.
Once drive assembly 400 has been installed in the manner detailed above, trigger 150 is returned to the spaced-apart position, wherein actuating arm 152 of trigger 150 abuts proximal collar 415b of mandrel 412 of inner shaft 410 of drive assembly 400. Proximal cap 130 is also reengaged about open  proximal end portion 114 of barrel 110 to complete assembly of surgical clip applier 10.
In operation, with continued general reference to FIGS. 1-8, surgical clip applier 10 is manipulated and/or outer tube assembly 200 rotated using rotatable nose wheel 120 such that a vessel to be ligated is disposed between jaws 234 of jaw assembly 230. Once this position has been achieved, griping portion 154 of trigger 150 may be actuated from the spaced-apart position towards the approximated position. Actuation of gripping portion 154 of trigger 150 proximally about pivot boss 158 pivots actuating arm 152 of trigger 150 distally about pivot boss 158, thereby urging mandrel 412 of inner shaft 410 of drive assembly 400 distally.
Distal urging of mandrel 412 of inner shaft 410, by actuating arm 152 of trigger 150, urges inner shaft 410 distally through barrel 110 and outer tube assembly 200, compressing first compression spring 430 between proximal collar 415a and stop washer 450 which, as noted above, is inhibited from distal movement due to its abutment with shoulder 119 disposed within lumen 116 of barrel 110. Due to second compression spring 440 defining a greater spring constant as compared to first compression spring 430, second compression spring 440 is not initially compressed but rather, is moved distally along with inner shaft 410 to similarly move outer shaft 420 distally. That is, during the initial portion of actuation, inner and outer shafts 410 420 move together distally though barrel 110 and outer tube assembly 200.
The distal motion of inner and  outer shafts  410, 420 though barrel 110 and outer tube assembly 200 moves distal extension rod 428 of elongated sleeve 424 of outer shaft 420 distally. Since distal extension rod 428 is engaged  with coupling stem 304c of pusher bar 304 of clip cartridge assembly 300, this distal motion is likewise imparted to pusher bar 304 such that pusher bar 304 is moved distally. As pusher bar 304 is moved distally, pusher 304d of pusher bar 304 engages the distal-most clip “C1” of the stack of surgical clips “C, ” urges the distal-most clip “C1” over resilient tang (not shown) of clip tray 302, and pushes the distal-most clip “C1” distally out of clip cartridge assembly 300 and into the pair of jaws 234 of jaw assembly 230.
As pusher bar 304 is moved distally to load the distal-most clip “C1” into the jaws 234, the bias of constant force spring 310 to coil-up about coiled proximal end portion 310c thereof pulls coiled proximal end portion 310c and, thus, clip follower 306, distally such that clip follower 306 urges that the remaining surgical clips “C” distally. As such, each surgical clip “C” is advanced one position distally to replace the distal-most clip “C1” for subsequent actuations. Since the stack of surgical clips “C” now has one less surgical clip “C, ” coiled proximal end portion 310c of constant force spring 310 is coiled up further to account for the smaller distance between proximal end portion 310c and distal end portion 310b thereof.
As detailed above, during the initial portion of actuation of gripping portion 154 of trigger 150, inner and  outer shafts  410, 420 of drive assembly 400 are moved together with one another such that distal extension rod 428 of outer shaft 420 effects advancement of the distal-most surgical clip “C1” of clip cartridge assembly 300 into jaws 234 of jaw assembly 230. Although inner shaft 410 is moved distally during this initial portion of actuation, inner shaft 410 does not yet reach drive bar 232 of jaw assembly 230 since distal extension rod 428 of outer shaft 420 extends further distally than distal extension rod 417 of inner shaft 410. Alternatively, inner shaft 410 may contact proximal end surface 233a  (FIG. 3B) of drive bar 232 and urge drive bar 232 distally during the initial portion of actuation of griping portion 154 of trigger 150. In such embodiments, however, this initial distal urging of drive bar 232 is without effect.
Once gripping portion 154 of trigger 150 has been actuated sufficiently to move inner and  outer shafts  410, 420 distally to load the distal-most surgical clip “C1” into jaw assembly 230, as detailed above, further actuation of griping portion 154 of trigger 150 does not affect further distal movement of outer shaft 420. Rather, further actuation of griping portion 154 of trigger 150 moves inner shaft 410 distally and compresses second compression spring 440 such that outer shaft 420 remains stationary while inner shaft 410 is moved distally. To enable this relative movement between inner shaft 410 and outer shaft 420, pin 419 of inner shaft 410 is moved distally through closed longitudinal portion 427c of bayonet slot 426 of outer shaft 420 from the proximal end thereof towards the distal end thereof as inner shaft 410 is moved distally relative to outer shaft 420.
The above-detailed further distal movement of inner shaft 410 moves distal extension rod 417 of inner shaft 410 distally into contact with proximal end surface 233a (FIG. 3B) of drive bar 232 to move drive bar 232 distally. Distal movement of drive bar 232 urges V-shaped cam groove 233b of drive bar 232 about camming wedge surfaces 234d of jaw assembly 234 such that V-shaped cam groove 233b acts on camming wedge surfaces 234d to actuate the pair of jaws 234 to a closed position and form the surgical clip “C” loaded therein about the vessel to ligate the vessel.
Once surgical clip applier 10 has been fired to form the surgical clip “C” about the vessel, as detailed above, gripping portion 154 of trigger 150 may  be released. Upon release of trigger 150, first and second compression springs 430, 440 of drive assembly 400 bias drive assembly 400 proximally back to the initial position thereof. As such, jaws 234 of jaw assembly 230 are permitted to return to the initial, open position thereof.
The operation described above may then be repeated, as required, to fire and form one or more of the remaining surgical clips “C. ” After completion of a surgical procedure, handle assembly 100 and outer tube assembly 200 may be cleaned, sterilized, autoclaved and/or otherwise processed for reuse. Handle assembly 100 and outer tube assembly 200 may be disassembled to facilitate processing for reuse. Drive assembly 400 may likewise be disassembled and processed for reuse. Clip cartridge assembly 300, on the other hand, is disposed of following a complete and/or partial use thereof.
The present disclosure contemplates that surgical clip applier 10 be capable of loading different surgical clip cartridge assemblies 300 within outer tube assembly 200 thereof. Specifically, surgical clip applier 10 may be loaded with a clip cartridge assembly 300 having a stack of surgical clips “C” of a particular size and/or configuration. For example, depending upon a particular purpose, a first clip cartridge assembly 300 having a stack of surgical clips “C” of a first size or a second clip cartridge assembly 300 having a stack of surgical clips “C” of a second size different than the first size may be loaded into outer tube assembly 200. Additionally, during a surgical procedure, if the need arises to use a different size and/or configuration of surgical clip, the user may remove the clip cartridge assembly 300 being used in favor of a different clip cartridge assembly 300.
The present disclosure further contemplates a surgical kit including one surgical clip applier 10 (having one handle assembly 100, one outer tube assembly 200, and one drive assembly 400) and one or more clip cartridge assemblies 300 (similar or different from one another) . The kit may also include instructions for the assembly of surgical clip applier 10, the use of surgical clip applier 10, and/or the processing surgical clip applier 10 following use. A package, container, or box may also be provided.
It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.

Claims (20)

  1. A drive assembly configured for removable positioning within a reposable endoscopic surgical clip applier, the drive assembly comprising:
    an inner member including a mandrel, an elongated shaft extending distally from the mandrel, and a pin protruding transversely from the elongated shaft；
    a first compression spring disposed about the mandrel；
    a second compression spring disposed between the mandrel and the pin； and
    an outer member including a proximal hub and an elongated sleeve extending distally from the proximal hub, the outer member configured for removable positioning about the elongated shaft of the inner member and defining a bayonet slot configured to receive the pin to releasably engage the outer member about the elongated shaft of the inner member with the second compression spring disposed between the mandrel of the inner member and the proximal hub of the outer member.
  2. The drive assembly according to claim 1, wherein the inner member further includes a distal extension rod extending distally from the elongated shaft, the distal extension rod configured to actuate a jaw assembly of a surgical clip applier.
  3. The drive assembly according to claim 1, wherein the outer member further includes a distal extension rod extending distally from the elongated sleeve, the distal extension rod configured to load a surgical clip into a jaw assembly of a surgical clip applier.
  4. The drive assembly according to claim 1, wherein the mandrel includes a body, a proximal collar disposed at a proximal end portion of the body, and a distal collar disposed at a distal end portion of the body, and wherein the first compression spring is disposed about the body between the proximal and distal collars.
  5. The drive assembly according to claim 1, wherein the second compression spring defines a spring constant that is greater than a spring constant of the first compression spring.
  6. The drive assembly according to claim 1, wherein the bayonet slot includes an open longitudinal segment, a closed longitudinal segment, and a transverse segment extending between and connecting the open and closed longitudinal segments.
  7. The drive assembly according to claim 6, wherein the pin is configured to enter the open longitudinal segment, move from the open longitudinal segment to the transverse segment, move from the transverse segment to the closed longitudinal segment, and seat within the closed longitudinal segment.
  8. The drive assembly according to claim 7, wherein the pin is configured to enter the open longitudinal segment upon proximal sliding of the outer member about the inner member, move from the open longitudinal segment to the transverse segment upon subsequent rotation of the outer member relative to the inner member, and seat within the closed longitudinal segment upon subsequent distal sliding of the outer member relative to the inner member.
  9. The drive assembly according to claim 7, wherein compression of the second compression spring and sliding of the pin through the closed longitudinal segment of the bayonet slot enables movement of the inner member relative to the outer member.
  10. A surgical clip applier, comprising:
    a handle assembly including a trigger；
    an outer tube assembly extending distally from the handle assembly and supporting a jaw assembly at a distal end portion thereof；
    a clip cartridge assembly engaged within the outer tube assembly, the clip cartridge assembly storing at least one surgical clip therein； and
    a drive assembly removably disposed within the handle assembly and outer tube assembly to operably couple the trigger with the jaw assembly and the clip cartridge assembly, the drive assembly including:
    an inner member including a mandrel and an elongated shaft extending distally from the mandrel；
    a first compression spring disposed about the mandrel；
    an outer member including a proximal hub and an elongated sleeve extending distally from the proximal hub, the outer member disposed about the elongated shaft of the inner member； and
    a second compression spring disposed about the elongated shaft and positioned between the mandrel and the proximal hub.
  11. The surgical clip applier according to claim 10, wherein actuation of the trigger through an initial portion of an actuation stroke moves the outer member distally through the outer tube assembly to urge the distal-most surgical clip of  the at least one surgical clip from the clip cartridge assembly into the jaw assembly.
  12. The surgical clip applier according to claim 11, wherein the inner member is moved distally together with the outer member upon actuation of the trigger through the initial portion of the actuation stroke.
  13. The surgical clip applier according to claim 11, wherein the first compression spring is compressed upon actuation of the trigger through the initial portion of the actuation stroke.
  14. The surgical clip applier according to claim 11, wherein actuation of the trigger through a subsequent portion of the actuation stroke moves the inner member distally through the outer tube assembly to actuate the jaw assembly to thereby form the distal-most surgical clip.
  15. The surgical clip applier according to claim 14, wherein the second compression spring is compressed upon actuation of the trigger through the subsequent portion of the actuation stroke.
  16. The surgical clip applier according to claim 15, wherein compression of the second compression spring allows the outer member to remain stationary upon actuation of the trigger through the subsequent portion of the actuation stroke.
  17. The surgical clip applier according to claim 10, wherein the inner member includes a pin protruding therefrom and wherein the outer member defines a  bayonet slot configured to receive the pin to enable releasable engagement of the outer member about the elongated shaft of the inner member.
  18. The surgical clip applier according to claim 10, wherein the handle assembly includes a removable proximal cap and wherein, with the removable proximal cap removed, the drive assembly is insertable through the handle assembly and into the outer tube assembly.
  19. The surgical clip applier according to claim 10, wherein the clip cartridge assembly is removably engaged within the outer tube assembly.
  20. The surgical clip applier according to claim 10, wherein the clip cartridge assembly stores a plurality of surgical clips therein.
PCT/CN2017/077833 2017-03-23 2017-03-23 Removable drive assembly and endoscopic reposable surgical clip applier including a removable drive assembly WO2018170822A1 (en)

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Application Number Priority Date Filing Date Title
PCT/CN2017/077833 WO2018170822A1 (en) 2017-03-23 2017-03-23 Removable drive assembly and endoscopic reposable surgical clip applier including a removable drive assembly

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Application Number Priority Date Filing Date Title
PCT/CN2017/077833 WO2018170822A1 (en) 2017-03-23 2017-03-23 Removable drive assembly and endoscopic reposable surgical clip applier including a removable drive assembly

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WO2018170822A1 true WO2018170822A1 (en) 2018-09-27

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022057732A1 (en) * 2020-09-18 2022-03-24 苏州英途康医疗科技有限公司 Method for driving clip bin shaft of clip applier and clip applier
CN115337067A (en) * 2022-10-18 2022-11-15 苏州英途康医疗科技有限公司 Clamping mechanism and clamping device thereof

Citations (5)

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Publication number Priority date Publication date Assignee Title
US3675688A (en) * 1970-04-27 1972-07-11 United States Surgical Corp Instrument for ligating, suturing and dividing organic tubular structures
US5527320A (en) * 1994-02-10 1996-06-18 Pilling Weck Inc. Surgical clip applying instrument
US5707377A (en) * 1994-11-29 1998-01-13 American Cyanamid Company Ligation clip remover
CN105640609A (en) * 2014-12-02 2016-06-08 柯惠Lp公司 Laparoscopic surgical ligation clip applier
WO2016197350A1 (en) * 2015-06-11 2016-12-15 Covidien Lp Endoscopic reposable surgical clip applier

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3675688A (en) * 1970-04-27 1972-07-11 United States Surgical Corp Instrument for ligating, suturing and dividing organic tubular structures
US5527320A (en) * 1994-02-10 1996-06-18 Pilling Weck Inc. Surgical clip applying instrument
US5707377A (en) * 1994-11-29 1998-01-13 American Cyanamid Company Ligation clip remover
CN105640609A (en) * 2014-12-02 2016-06-08 柯惠Lp公司 Laparoscopic surgical ligation clip applier
WO2016197350A1 (en) * 2015-06-11 2016-12-15 Covidien Lp Endoscopic reposable surgical clip applier

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022057732A1 (en) * 2020-09-18 2022-03-24 苏州英途康医疗科技有限公司 Method for driving clip bin shaft of clip applier and clip applier
CN115337067A (en) * 2022-10-18 2022-11-15 苏州英途康医疗科技有限公司 Clamping mechanism and clamping device thereof
CN115337067B (en) * 2022-10-18 2022-12-20 苏州英途康医疗科技有限公司 Clamping mechanism and clamping device thereof

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