This disclosure relates generally to surgical clip drivers, and more specifically, to adaptors for simultaneously applying more than one surgical clip using a surgical clip driver.
In surgical operations, it is often necessary to apply hemostatic clips to blood vessels to restrict the movement of blood. Hemostatic clips are commonly used in both open surgeries, where anatomic cavities are cut open with large incisions so that the surgeon has a full view of the structures and organs involved in the surgery (e.g. without the assistance of a camera), and minimally invasive surgeries, such as but not limited to laparoscopic surgeries and thoracoscopic surgeries, where incisions in the patient are much smaller and the surgeon does not have a full view of the structures and organs involved.
Minimally invasive surgeries are becoming increasingly common procedures due to their advantages of smaller incisions, less trauma, reduced pain, shorter hospital stays, and quicker recovery when compared to open surgery.
Despite these advantages, minimally invasive surgeries commonly take longer operating time. Studies have shown that about 30% of laparoscopic surgical procedure time is spent on instrument exchange, including multiple repetitions of reloading a surgical ligation single-clip conventional driver with new clips.
Further, instrument exchange during minimally invasive surgeries may result in traumatic complications. The use of conventional clip drivers that place one clip individually at a time may therefore increase the risk of surgical complications due to trauma from repetitive instrument exchange and misplacement of the clip driver in the surgical field.
Typically, applying multiple surgical ligation clips prior to transection is safer and more common practice than applying a single clip. Two to three surgical ligation clips are typically used at each transection site, such as but not limited to a cystic duct or a small vessel. However, applying two or three surgical ligation clips can be time consuming as conventional clip drivers fire clips individually. In addition, applying multiple surgical ligation clips with conventional clip drivers often results in inaccurate placement anatomically.
Accordingly, there is a need for a new device for the accurate, simultaneous placement of more than one surgical ligation clip during a surgery.
In accordance with a broad aspect, there is provided an adaptor for a surgical clip driver for applying two or more surgical clips. The adaptor includes a first body having a first end, a second end, an inner surface extending between the first end and the second end and an outer surface opposed to the inner surface and extending between the first end and the second end. The first end has an opening extending inwardly into the first body, the opening being configured to receive a portion of a first jaw of the surgical clip driver. The first body also includes a first body retaining member configured to retain a first portion of each of the two or more surgical clips. The adaptor also includes a second body having a first end, a second end, an inner surface extending between the first end and the second end and an outer surface opposed to the inner surface and extending between the first end and the second end. The first end of the second body has an opening extending inwardly into the second body, the opening being configured to receive a portion of a second jaw of the surgical clip driver. The second body also includes a second body retaining member configured to retain a second portion of each of the two or more surgical clips. When the first body and the second body are received on the surgical clip driver, the first body retaining member and the second body retaining member face each other and are aligned with each other to receive and retain each of the two or more surgical clips.
In at least one embodiment, the first body retaining member is integral with the first body and includes two or more slots extending inwardly into the first body and the second body retaining member is integral with the second body and includes two or more slots extending inwardly into the second body.
In at least one embodiment, the two or more slots of the first body are parallel with each other and extend between the first end of the first body and the second end of the first body and the two or more slots of the second body are parallel with each other and extend between the first end of the second body and the second end of the second body.
In at least one embodiment, the two or more slots of the first body include two pairs of slots and the two or more slots of the second body include two pairs of slots.
In at least one embodiment, each the two pairs of slots are spaced apart from each other by a distance that is greater than a distance between the slots of each pair of slots.
In at least one embodiment, the two or more slots of the first body include three slots.
In at least one embodiment, the three slots include one pair of slots spaced apart from a single slot.
In at least one embodiment, the pair of slots is spaced apart from the single slot by a distance that is greater than a distance between the slots of the pair of slots.
In at least one embodiment, each slot has an inner surface shaped to correspond with an outer surface of a surgical clip such that upon applying a force on the surgical clip in a direction towards the inner surface of the slot, the surgical clip is frictionally retained in the slot.
In at least one embodiment, the first body retaining member includes at least one first slot member coupled to the inner surface of the first body, the first slot member having a slot extending inwardly into a body of the first slot member.
In at least one embodiment, the first body retaining member includes three first slot members.
In at least one embodiment, the three first slot members include one pair of first slot members spaced apart from a single first slot member.
In at least one embodiment, the pair of first slot members is spaced apart from the single first slot member by a distance that is greater than a distance between the slots of the pair of first slot members.
In at least one embodiment, the second body retaining member includes at least one second slot member coupled to the inner surface of the second body, the second slot member having a slot extending inwardly into a body of the second slot member.
In at least one embodiment, the second body retaining member includes three second slot members.
In at least one embodiment, the three second slot members include one pair of second slot members spaced apart from a single second slot member.
In at least one embodiment, the second body retaining member includes at least one second slot member coupled to the inner surface of the second body, the second slot member having a slot extending inwardly into a body of the second slot member.
In at least one embodiment, the pair of second slot members is spaced apart from the single second slot member by a distance that is greater than a distance between the slots of the pair of second slot members.
In accordance with a broad aspect, a method of applying two or more surgical clips using an adaptor described herein is described herein. The method includes placing at least a portion of a first jaw of the surgical clip driver into an opening of a first body of the adaptor; placing at least a portion of a second jaw of the surgical clip driver into an opening of a second body of the adaptor; loading at least two or more surgical clips into retaining members of the first body and the second body; positioning the first body and second body of the adaptor around a selected target clipping tissue; and actuating the surgical clip driver to simultaneously apply the two or more clips to the selected target clipping tissue.
In accordance with a broad aspect, a cartridge for supporting two or more surgical clips is described herein. The cartridge includes a clip support configured to support the two or more surgical clips. The clip support includes a hedge extending upwardly from a base to support the clips in an upside down orientation such that a rear portion of each clip is upwardly exposed. The hedge includes a separator positioned on either side of each clip to stabilize the clips from each other when the clip support is loaded with two or more clips. The cartridge also includes a cover with an opening sized and shaped to provide for a clip driver to simultaneously retrieve the two or more clips from the clip support through the opening.
In at least one embodiment, each of the separators is a flange extending outwardly from an outer surface of the hedge of the clip support.
In at least one embodiment, each of the separators of the clip support are spaced apart from each other by a same distance as a distance between the slots of the adaptor.
These and other features and advantages of the present application will become apparent from the following detailed description taken together with the accompanying drawings. It should be understood, however, that the detailed description and the specific examples, while indicating preferred embodiments of the application, are given by way of illustration only, since various changes and modifications within the spirit and scope of the application will become apparent to those skilled in the art from this detailed description.
For a better understanding of the various embodiments described herein, and to show more clearly how these various embodiments may be carried into effect, reference will be made, by way of example, to the accompanying drawings which show at least one example embodiment, and which are now described. The drawings are not intended to limit the scope of the teachings described herein.
Further aspects and features of the example embodiments described herein will appear from the following description taken together with the accompanying drawings.
Various apparatuses, methods and compositions are described below to provide an example of at least one embodiment of the claimed subject matter. No embodiment described below limits any claimed subject matter and any claimed subject matter may cover apparatuses and methods that differ from those described below. The claimed subject matter is not limited to apparatuses, methods and compositions having all of the features of any one apparatus, method or composition described below or to features common to multiple or all of the apparatuses, methods or compositions described below. It is possible that an apparatus, method or composition described below is not an embodiment of any claimed subject matter. Any subject matter that is disclosed in an apparatus, method or composition described herein that is not claimed in this document may be the subject matter of another protective instrument, for example, a continuing patent application, and the applicant(s), inventor(s) and/or owner(s) do not intend to abandon, disclaim, or dedicate to the public any such invention by its disclosure in this document.
Furthermore, it will be appreciated that for simplicity and clarity of illustration, where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements. In addition, numerous specific details are set forth in order to provide a thorough understanding of the example embodiments described herein. However, it will be understood by those of ordinary skill in the art that the example embodiments described herein may be practiced without these specific details. In other instances, well-known methods, procedures, and components have not been described in detail so as not to obscure the example embodiments described herein. Also, the description is not to be considered as limiting the scope of the example embodiments described herein.
It should be noted that terms of degree such as “substantially”, “about” and “approximately” as used herein mean a reasonable amount of deviation of the modified term such that the end result is not significantly changed. These terms of degree should be construed as including a deviation of the modified term, such as 1%, 2%, 5%, or 10%, for example, if this deviation does not negate the meaning of the term it modifies.
Furthermore, the recitation of any numerical ranges by endpoints herein includes all numbers and fractions subsumed within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.90, 4, and 5). It is also to be understood that all numbers and fractions thereof are presumed to be modified by the term “about” which means a variation up to a certain amount of the number to which reference is being made, such as 1%, 2%, 5%, or 10%, for example, if the end result is not significantly changed.
It should also be noted that, as used herein, the wording “and/or” is intended to represent an inclusive-or. That is, “X and/or Y” is intended to mean X, Y or X and Y, for example. As a further example, “X, Y, and/or Z” is intended to mean X or Y or Z or any combination thereof. Also, the expression of A, B and C means various combinations including A; B; C; A and B; A and C; B and C; or A, B and C.
The following description is not intended to limit or define any claimed or as yet unclaimed subject matter. Subject matter that may be claimed may reside in any combination or sub-combination of the elements or process steps disclosed in any part of this document including its claims and figures. Accordingly, it will be appreciated by a person skilled in the art that an apparatus, system or method disclosed in accordance with the teachings herein may embody any one or more of the features contained herein and that the features may be used in any particular combination or sub-combination that is physically feasible and realizable for its intended purpose.
Recently, there has been a growing interest in developing new tools for simultaneously applying more than one surgical clip to a selected target during a surgery.
Adaptors for a surgical clip driver are described herein. The adaptors described herein are appropriate for applying two or more surgical clips to a selected target (e.g. tissue) simultaneously during a surgery. The surgery may be an open surgery or may be a minimally invasive surgery. The adaptors described herein include a pair of bodies (or devices), e.g. made of bronze, plastic or any other appropriate material, for use inside of a human body, that are removably attachable to the tips of a surgical ligation clip driver. Each of the pair of bodies has an external surface (e.g. shaped like a hemi-oval) and an internal (or medial) surface having more than one slot (or holding groove) that is sized and shaped to match the size of and retain a typical surgical clip. The slots, or medial grooves, of each of the pair of bodies are counterpart precise to each other so the slots of the two bodies can act together to act as clip holding sites.
In at least one embodiment, when the pair of bodies (together, the adaptor) are placed on or applied to a surgical ligation clip driver and the user closes clip driver, the internal surface of each slot of each body of the adaptor closes inwardly onto a clip or clips loaded into or retained in the slots and bends each clip around a clip target (e.g. blood vessel). When the clip driver opens again, the clips are simultaneously fired and remain on the clip target.
The adaptors described herein may be adaptable to be placed on the tips of many different clip drivers and may allow for shortened surgical procedure times and reduced risk of surgical complications by reducing the need for users (e.g. surgeons) to repeatedly remove and reload the clip driver. Such improvements could lead to reduced surgical time, lower costs per surgery, better patient care, and better overall outcomes for patients.
It should be understood that although the adaptors described herein are described in the context of being used with a laparoscopic clip driver, as noted above, the adaptors described herein may also be suitable for clip drivers to be used during other types of surgeries, such as but not limited to other types of minimally invasive surgeries (e.g. thoracoscopic surgery, minimally invasive urologic and gynecologic procedures, etc.) as well as open surgeries.
Referring now to
First body 110 has a first end 111, a second end 112, a first side 113 and a second side 114 opposed to first side 113. First body 110 also includes an inner surface 115 extending between the first end 111 and the second end 112 and an outer surface 116 opposed to the inner surface 115 and extending between the first end 111 and the second end 112. In the example embodiment shown in
First end 111 of first body 110 has an opening 117 extending inwardly into the first body 110 towards the second end 112. Opening 117 is configured to receive a portion of a surgical clip driver (e.g. a portion of a first jaw of a surgical clip driver). Opening 117 extends inwardly by a distance that is sufficient to receive a portion of a first jaw of a surgical clip driver, for example, and/or is sized and shaped such that the first jaw of a surgical clip driver can be retained in the first opening 117, such as but not limited to by friction. In at least one embodiment, opening 117 passes completely through the first body 110.
First body 110 also includes a first retaining member 118. In the embodiment shown in
First retaining member 118 may include a physical mechanism for retaining each of the two or more surgical clips. For example, as shown in the embodiments of
In the embodiments shown in
It should be understood that the first body 110 may have different shapes beyond those shown in the embodiments provided herein, provided that the first opening 117 is generally positioned on an end of the first body 110 to receive at least a portion of a jaw of a surgical clip driver.
Second body 120 has a first end 121, a second end 122, a first side 123 and a second side 124 opposed to the first side 123. Second body 120 also includes an inner surface 125 extending between the first end 121 and the second end 122 and an outer surface 126 opposed to the inner surface 125 and extending between the first end 121 and the second end 122. In the example embodiment shown in
First end 121 of second body 120 has an opening 127 extending inwardly into the second body 120 towards the second end 122. Opening 127 is configured to receive a portion of a surgical clip driver (e.g. a portion of a second jaw of the surgical clip driver). Opening 127 extends inwardly by a distance that is sufficient to receive a portion of a second jaw of a surgical clip driver, for example, and/or is sized and shaped such that the second jaw of a surgical clip driver can be retained in the second opening 127 such as but not limited to by friction. In at least one embodiment, opening 127 passes completely through the second body 120.
Second retaining member 128 may include a physical mechanism for retaining each of the two or more surgical clips. For example, as shown in the embodiments of
In the embodiments shown in
It should be understood that the second body 120 may have different shapes beyond those shown in the embodiments provided herein, provided that the second opening 127 is generally positioned on an end of the second body 120 to receive at least a portion of a jaw of a surgical clip driver.
When first body 110 and second body 120 are received on a surgical clip driver, first retaining member 118 and the second retaining member 128 may face each other and be aligned with each other to receive and retain each of the two or more surgical clips.
First retaining member 118 and the second retaining member 128 may include a physical mechanism for retaining each of the two or more surgical clips. For example, as shown in the embodiments shown in both
In at least one embodiment, the slots 119 and/or the slots 129 may be grouped together. As noted above, placing two or more clips immediately adjacent to one another may offer vasculature blocking benefits. For instance, the two or more slots 119 may include two pairs of slots and the two or more slots 129 may include two pairs of slots. In at least one embodiment, each of the two pairs of slots may be spaced apart from each other by a distance AA that is greater than a distance DD between the slots of each pair of slots. An example of this can be seen in
In at least one embodiment, the two or more slots 119 of the first retaining member 118 are three slots 119a, 119b and 119c. In at least one embodiment, the three slots 119a, 119b and 119c are arranged to include one pair of slots spaced apart from a single slot. Similarly, in this embodiment, in this embodiment, the two or more slots 129 of the second retaining member 128 are three slots 129a, 129b and 129c. In at least one embodiment, the three slots 129a, 129b and 129c are arranged to include one pair of slots spaced apart from a single slot, the one pair of slots being opposed to the pair of slots of the first retaining member 118 and the single slot being opposed to the single slot of the first retaining member 118.
Each slot 119, 129 has an inner surface shaped to correspond with an outer surface of a surgical clip such that upon applying a force on the surgical clip in a direction towards the inner surface of the slot, the surgical clip is frictionally retained in the slot.
The adaptor of claim 16, wherein the second body retaining member includes at least one second slot member coupled to the inner surface of the second body, the second slot member having a slot extending inwardly into a body of the second slot member.
Turning to
In at least one embodiment, a method 500 of simultaneously applying two or more surgical clips is described herein.
At a first step 501, the method 500 includes placing at least a portion of a first jaw of the surgical clip driver into an opening of a first body of the adaptor.
At a second step 502, the method 500 includes placing at least a portion of a second jaw of the surgical clip driver into an opening of a second body of the adaptor.
At a third step 503, the method 500 includes loading at least two or more surgical clips into retaining members of the first body and the second body.
At a fourth step 504, the method 500 includes positioning the first body and second body of the adaptor around a selected target clipping tissue.
At a fifth step 505, the method 500 includes actuating the surgical clip driver to simultaneously apply the two or more clips to the selected target clipping tissue.
Surgical clip drivers need to be loaded with clips before a surgeon can use the clip driver to apply the clip on to an anatomic structure, such as a vessel or other target tissue. The adaptors described herein need to be simultaneously loaded with two or more clips before a clip driver with an adaptor can be used to simultaneously apply the two or more clips on the anatomic structure. Conventional cartridges generally do not offer the ability to simultaneously load more than one clip onto a surgical clip driver. For example,
Turning now to
Cover 620 is stationed on the base 611 of clip support 610 and includes an opening 621 that is sized and shaped to expose the clips on clip support 610 and receive the adaptor 100 therein. Opening 621 provides for the adaptor 100, when attached to a clip driver, to pass down therethrough and retrieve the clips from clip support 610. Cover 620 may also inhibit the clips from moving in anterior-posterior direction along clip support 610.
While the applicant's teachings described herein are in conjunction with various embodiments for illustrative purposes, it is not intended that the applicant's teachings be limited to such embodiments as the embodiments described herein are intended to be examples. On the contrary, the applicant's teachings described and illustrated herein encompass various alternatives, modifications, and equivalents, without departing from the embodiments described herein, the general scope of which is defined in the appended claims.
This application claims the benefit of U.S. Provisional Patent Application No. 63/072,524 filed on Aug. 31, 2021 and the entire contents of U.S. Provisional Patent Application No. 63/072,524 are hereby incorporated herein in their entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/CA2021/051202 | 8/31/2021 | WO |
Number | Date | Country | |
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63072524 | Aug 2020 | US |