The present invention relates to applicators and more particularly to applicators for insertion and closure of surgical clips.
Such clips may be for sterilisation or other medical, orthopaedic or surgical purposes where an intermediate position of an applicator or other appliance is required to be able to be accurately determined.
The term applicator is thus meant to include other appliances, particularly in the medical field, which involve a closure of a jaw or other similar gripping or squeezing action in which a specific intermediate position is required to be determined.
The present invention will now be described with reference to applicators for surgical clips. Except in open surgery it is necessary for the applicator to be inserted down a cannula for the more modern “key hole” surgery. Thus, the applicator or more precisely barrel portion of the applicator has to pass down the cannula loaded with a clip to be attached for occlusion of, for example a vas deferens or other tubular member.
With clips of the Filshie type such as disclosed in GB patent no. 2177748 excessive force applied to the clip during passage of the barrel down the cannula can result in clip failure. The clip could fall out of the barrel once it emerges from the cannula or alternatively the clip could fail by incorrect closure.
The present invention seeks to obviate this problem by providing a visual indication of an intermediate position of the applicator to ensure that there is no over-closure of a clip during passage of an applicator barrel down a cannula.
The present invention therefore provides an applicator, comprising a barrel portion and a handle portion attached thereto, the barrel portion comprising means for holding a surgical clip and the handle comprising trigger means, the trigger means being operative to effect closure of a surgical clip held within the barrel by movement of the trigger from a first position to a second position at which second position the applicator is operative to effect closure of the clip, and in which the trigger is provided with a visual indicator means indicative of an intermediate trigger position, at which intermediate position the surgical clip held in the barrel is closed to a half closed position.
Preferably the visual indication comprises an indentation on said trigger.
Alternatively the visual indication comprises a reduced section of the trigger.
In a further embodiment the visual indication comprises groove means in the trigger.
In a further embodiment the groove means may comprise means for engaging with a removable stop means, the removable stop means being co-operative with a portion of the handle to prevent movement of the trigger past a predetermined position.
Preferably the groove means is present on both sides of said trigger.
Preferably the stop means may comprise a U shaped member which is designed in a first locking position to sit within the groove means and to protrude from the groove means to form the stop means.
Preferably the U shaped member comprises spring steel or similar material ensuring secure engagement with the groove means.
Preferably the U shaped member comprises means for gripping by a surgeon to effect removal of the U shaped member from the trigger, enabling movement of the trigger past the predetermined position.
In a further embodiment the trigger may comprise two or more colours arranged to identify specific portions of the trigger.
In a further embodiment the handle includes a recess, the trigger being pivotally mounted within the handle, the trigger being movable into the recess when the trigger is operated, and in which the trigger is dimensioned to have minimal clearance between itself and the recess over substantially the whole pivotal movement of the trigger.
Preferably the visual indicator means is provided by a change of surface texture at a defined position across the trigger.
This change of surface texture will provide a visual indication of the defined position without any substantial variation of the surface dimension of the trigger.
The advantage of this design feature is that as the trigger is moved into and out of the handle there will be no appreciable gap between the trigger and the recess of the handle.
In surgical operation surgical gloves are worn and if there is any substantial gap between the trigger and the recess as the trigger is operated then there is a possibility of a glove catching between the trigger and the recess and being torn. This would create hygienic problems were it to occur and thus this feature is an important advantage of this embodiment.
The visual indication feature is further enhanced by the pressure felt by the surgeon on the trigger as the clip is partially closed.
The present invention also provides an applicator comprising a handle portion and a barrel portion, the barrel portion having gripping means at a distal end from the handle portion for gripping an object in which the handle portion includes trigger means operative to move into and out of a main body portion of the handle and being operative to move the gripping means to grip an object and in which the trigger means is provided with visual indication means indicating a defined intermediate position of the trigger means, the unusual indicator comprising a change in surface texture at an defined intermediate position the surface texture change being dimensioned such that the clearance between the trigger means and the main body portion is minimal, thereby removing the possibility of snagging surgical gloves on movement of the trigger.
Embodiments of the present invention will now be described by reference to the accompanying drawings in which:
a and 4b show a second embodiment with the trigger in two positions;
a and 7b showing a portion of the trigger and main body portion of the handle in cross section with an enlarged portion illustrating the change in texture feature,
With reference now to the drawings an applicator 10 for applying clips of the Filshie type (as described in European patent application no. 03075212.5) is shown. Such clips are of the hinged type and will be hereinafter referred to as Filshie clips.
The applicator 10 comprises a barrel portion 12 and a handle portion 14 including a trigger 16.
The applicator is designed to pass down a relatively small diameter cannula 18.
In order to do so it is necessary for the Filshie clip to pass down the cannula whilst in position in the applicator at the end of barrel 12. For a more detailed description reference is made to PCT application no.
A problem which arises is that if the clip is closed too far by application of trigger 16 then the clip may partially latch and the clip will not subsequently be able to be correctly attached.
To enable the surgeon to ascertain the correct position of the trigger to achieve the half closed position the trigger and handle combination is provided with visual indication means 20 as indicated in
This visual indication means preferably comprises an elongate linear feature easily discernible by a surgeon enabling the surgeon to readily set the trigger to a correct position.
The visual indicator may also comprise means for physically preventing further movement of the trigger past the correct semi-closed position of the clip this being illustrated hereinafter with reference to
With reference to
Preferably the visual indicator line 20 will exist for a substantial distance over the trigger to provide a visual indication even when the trigger is being gripped by one or more of the digits of a surgeons hand.
In
In
In
The groove can provide the visual indication itself but in a specific embodiment a U shaped member 210 (see
For illustrative purposes an edge portion 144, 146 of handle 14 is shown illustrating that when trigger 16 is pulled back the U shaped member 210 abuts the edges 144, 146 and physically prevents further movement of the trigger.
The U shaped member 210 is shown in a first embodiment in
In
The visual indication 20 may also be provided or enhanced by a change in colour of the trigger along line 20.
With reference now to
One part 162 (which could be the forward part on the rearward part) is provided with a surface texture whilst the other part 164 is a different surface texture which could for example be smooth. The advantage of this embodiment is that the trigger can be moulded from a single, preferably plastics, injection without use of a colouring agent in part of the trigger and also because the texturing can be made to raise or lower the surface by only a very small amount, possibly a few microns, the trigger can be made to slide into and out of the recess 1420 (shown exploded in
This removes the possibility of snagging or catching the surgical gloves of a surgeon whilst operating the applicator.
Additionally the amount of textured (or untextured) trigger left exposed as the trigger is pressed allows the surgeon a first appraisal of the level of clip closure and, as explained with reference to
In
As the trigger 16 moves in the direction of arrow 1610 to close the clip a feedback pressure is felt on the trigger 16 by the surgeon combining with the position of texture change line 163 to provide the surgeon with a tactile as well as visual indication.
Number | Date | Country | Kind |
---|---|---|---|
0324106.4 | Oct 2003 | GB | national |
0415796.2 | Jul 2004 | GB | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/GB2004/004360 | 10/15/2004 | WO | 00 | 8/24/2007 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2005/039422 | 5/6/2005 | WO | A |
Number | Name | Date | Kind |
---|---|---|---|
2417140 | Swanson | Mar 1947 | A |
2466714 | Kroeger et al. | Apr 1949 | A |
2735431 | Swanson | Feb 1956 | A |
3238941 | Klein et al. | Mar 1966 | A |
3402712 | Eisenhand | Sep 1968 | A |
3777538 | Weatherly et al. | Dec 1973 | A |
4157789 | Laauwe | Jun 1979 | A |
4321040 | Miller et al. | Mar 1982 | A |
4527724 | Chow et al. | Jul 1985 | A |
4632669 | Phipps et al. | Dec 1986 | A |
4998589 | Wiesendanger | Mar 1991 | A |
5137198 | Nobis et al. | Aug 1992 | A |
5356064 | Green et al. | Oct 1994 | A |
5364002 | Green et al. | Nov 1994 | A |
5486185 | Freitas et al. | Jan 1996 | A |
5591135 | Sullivan | Jan 1997 | A |
5755726 | Pratt et al. | May 1998 | A |
5868761 | Nicholas et al. | Feb 1999 | A |
5898400 | Jones et al. | Apr 1999 | A |
5902320 | Matsutani et al. | May 1999 | A |
5961494 | Hogan | Oct 1999 | A |
6610073 | Levinson | Aug 2003 | B1 |
20030029451 | Blair et al. | Feb 2003 | A1 |
20050006433 | Milliman et al. | Jan 2005 | A1 |
20070093856 | Whitfield et al. | Apr 2007 | A1 |
Number | Date | Country |
---|---|---|
0 630 612 | Dec 1994 | EP |
0 639 349 | Feb 1995 | EP |
1 304 079 | Apr 2003 | EP |
2 195 539 | Apr 1988 | GB |
Number | Date | Country | |
---|---|---|---|
20080109016 A1 | May 2008 | US |