This disclosure is directed ligation clips for ligating tissue and, more particularly, to ligation clips for use in multi-fire clip appliers.
Polymeric ligation clips typically include first and second beams that are coupled together at one end by a pivotable connection, e.g., living hinge, such that the first and second beams can be moved in relation to each other between open and clamped positions. The ligation clips can be applied to tissue endoscopically through a small diameter incision or through a small diameter cannula positioned through the incision to minimize trauma to a patient during a surgical procedure.
When polymeric clips are used to ligate large vessels or ducts, extreme stress is placed on the hinge of the clip which causes fatigue. If a clinician does not select a clip of proper size, the clip can become unclamped from the vessel or duct or fracture. This is dangerous for a patient.
In one aspect of the disclosure, a polymeric ligation clip assembly includes a first beam and a second beam, and a spine. The first beam defines a first longitudinal axis and has a first end portion, a second end portion, an inner first clamping surface extending between the first and second end portions, and an outer surface. The first end portion includes first coupling structure and the second end portion includes a first locking element. The second beam defines a second longitudinal axis and has a first end portion, a second end portion, an inner second clamping surface extending between the first and second end portions, and an outer surface. The first end portion of the second beam includes a second coupling structure and the second end portion of the second beam includes a second locking element. The second coupling structure is pivotably coupled to the first coupling structure to facilitate pivotable movement of the first beam in relation to the second beam from an open position to a clamped position. The spine is received about the first and second beams when the beams are in the clamped position to reinforce the first and second beams.
In another aspect of the disclosure, a ligation clip assembly includes a first beam, a second beam, and a spine. The first beam defines a first longitudinal axis and has a first end portion, a second end portion, and an outer surface. The outer surface defines a first longitudinal groove that extends along the first longitudinal axis. The second beam defines a second longitudinal axis and has a first end portion, a second end portion, and an outer surface. The outer surface of the second beam defines a second longitudinal groove that extends along the second longitudinal axis. The second beam is coupled to the first beam such that the first and second beams are movable from an open position to a clamped position in relation to each other. The spine is received about the first and second beams when the beams are in the clamped position to reinforce the first and second beams.
In yet another aspect of the disclosure, a ligation clip assembly includes a first beam, a second beam, and a U-shaped spine. The first beam defines a first longitudinal axis and has a first end portion, a second end portion, and an outer surface. The outer surface defines a first longitudinal groove that extends along the first longitudinal axis. The first end portion of the first beam includes a first coupling structure and the second end portion of the first beam includes a first locking element. The second beam defines a second longitudinal axis and has a first end portion, a second end portion, and an outer surface. The first end portion of the second beam includes a second coupling structure and the second end portion of the second beam includes a second locking element. The outer surface of the second beam defines a second longitudinal groove that extends along the second longitudinal axis. The second beam is coupled to the first beam such that the first and the second beams are movable from an open position to a clamped position in relation to each other. The U-shaped spine is received about the first and second beams when the beams are in the clamped position to reinforce the first and second beams. The U-shaped spine is received within the first and second longitudinal grooves and includes a first leg, a second leg, and back span interconnecting the first and second legs. The second coupling structure is adapted to be pivotably coupled to the first coupling structure to facilitate pivotable movement of the first beam in relation to the second beam from the open position to the clamped position.
In aspects of the disclosure, the spine is formed of a reinforcing material selected from the group consisting of spring steels, Nitinol, and titanium.
In some aspects of the disclosure, the first and second beams each define a longitudinal groove that extends along the outer surface of the respective first and second beam and receives the spine.
In certain aspects of the disclosure, the spine is U-shaped and includes a first leg, a second leg, and back span interconnecting the first and second legs.
In aspects of the disclosure, each of the longitudinal grooves defines an indentation and each of the first and second legs of the spine includes an inwardly extending projection that is received within one of the indentations to secure the spine onto the first and second beams.
In some aspects of the disclosure, each of the first and second legs of the spine have a distal end including an inwardly extending transverse portion and each of the longitudinal grooves defines a recess that receives the inwardly extending transverse portion to secure the spine to the first and second beams.
In aspects of the disclosure, the longitudinal grooves extend from a position adjacent the respective first and second locking elements to a proximal end of the respective first end portions of the first and second beams such that the spine is positioned about the first and second coupling structures.
In some aspects of the disclosure, the first locking element includes a hook member and the second locking member includes a receiver that defines a channel that extends about a distal end of the second beam.
In certain aspects of the disclosure, the hook member and the channel extend over an arc of greater than 180 degrees.
In aspects of the disclosure, the first and second beams are formed from a polymeric material.
Other features of the disclosure will be appreciated from the following description.
Various aspects of the disclosed multi-part polymeric ligation clip assembly are described herein below with reference to the drawings, wherein:
The disclosed multi-part polymeric ligation clip assembly will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. However, it is to be understood that the aspects of the disclosed ligation clip assembly are merely exemplary of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the disclosure in virtually any appropriately detailed structure. In addition, directional terms such as front, rear, upper, lower, top, bottom, distal, proximal, and similar terms are used to assist in understanding the description and are not intended to limit the disclosure.
In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “endoscopic” is used generally to refer to endoscopic, laparoscopic, arthroscopic, and/or any other procedure conducted through a small diameter incision or cannula. Further, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel.
The disclosed multi-part ligation clip assembly includes a first beam, a second beam, and a spine, which are separate and distinct from each other. The spine is received on the first and second beams when the first and second beams are clamped about tissue after the first and the second beams are coupled together. The first beam has a first end portion including a first mating feature and the second beam has a first end portion including a second mating feature. The first and second mating features of the first and second beams can be selectively coupled together to facilitate pivotable movement of the beams of ligation clip assembly between open and clamped positions. The spine is placed about the first and second beams when the beams are moved to the clamped position to reinforce and secure the clip assembly in the clamped position.
The second beam 14 defines a longitudinal axis and has a first end portion 14a including second coupling structure 30, a second end portion 14b including a second locking element 32, an inner second clamping surface 34, and an outer surface 36. In certain aspects of the disclosure, the second coupling structure 30 includes a pair of spaced cylindrical hubs 40 that are received within the cylindrical recesses 28 defined by the arms 26 of the first coupling structure 18 to pivotably couple the first beam 12 to the second beam 14. When the cylindrical hubs 40 are received within the cylindrical recesses 28 of the arms 26 of the first coupling structure 18 (
Although not illustrated herein, the first and second clamping surfaces 22 and 34 may include tissue retention features such as protrusions and/or recesses to minimize slippage of the clip assembly 10 along tissue when the clip assembly 10 is clamped about tissue. Alternately, the first and second clamping surfaces 22, 34 can be flat or planar.
In aspects of the disclosed clip assembly 10, the first locking element 20 of the first beam 12 includes a latch member which is in the form of a hook member 44 and the second locking element 32 of the second beam 14 includes a latch member receiver in the form of a channel 46. The hook member 44 defines a circular recess 44a that receives a distal end of the second end portion 14b of the second beam 14. In some aspects of the disclosure, the hook member 44 extends along an arc of greater than 180 degrees (
Similarly, the outer surface 36 of the second beam 14 defines a longitudinal channel or groove 54 that extends along the longitudinal axis of the second beam 14 from a position adjacent the second locking element 32 on the second end portion 14b of the second beam 14 to the proximal end of the second beam 14. The groove 54 also includes at least one indentation 56 which also may be triangular in shape and positioned centrally within the groove 54. The ends of the first and second grooves 50 and 54 on the second end portion 12b and 14b of the first and second beams 12 and 14, respectively, each define a recess 58 that extends inwardly into the respective beam 12, 14 towards the respective clamping surface 22, 34.
Once the first beam 12 is pivotably coupled to the second beam 14, the first and second beams 12 and 14 are positioned about the tissue “T” (
In embodiments, the first and second beams 12 and 14 of the ligation clip assembly 10 may be made at least in part of a resilient bioabsorbable polymeric material. Examples of suitable bioabsorbable polymeric materials include acetal polyoxymethylene (POM), polyethylene terephthalate (PET), polybutylene terephthalate (PBT), polyoxymethylene, polyetheretherketone (PEEK), polypropylene, and polyethylene or other thermoplastic materials having similar properties that can be injection-molded. The ligation clip 10 may also be made at least in part of a polymeric material or materials in combination with radiolucent metal alloys. Alternately, other materials may be used to form the ligation clip 10 including biocompatible metals, plastics and composites.
Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary aspects of the disclosed ligation clip. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described aspects of the disclosed ligation clip. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.