Abstract:
An automatic clip applier for clamping ligating clips is disclosed, which includes: a handling unit, and two clamping means laminating with each other and connecting to the handling unit. Each clamping means respectively contains: a jaw unit containing a clipping portion to clamp a ligating clip; a magazine unit for storing plural ligating clip; a feeding unit for translating the endmost ligating clip from the magazine unit to the clipping portion of the jaw unit; and a dispensing unit for serially translating the endmost ligating clip to the end of the feeding unit. Accordingly, the automatic clip applier provided by the present invention can be used for clamping two ends of a vessel simultaneously, and the step of taking ligating clips can also be omitted. Hence, the surgical procedure can be simplified and the surgical time can be shortened by use of the automatic clip applier of the present invention.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    1. Field of the Invention 
         [0002]    The present invention relates to an automatic clip applier for clamping two ligating clips simultaneously and, more particularly, to an automatic clip applier which can be used to clamp two ligating clips simultaneously and cut a blood vessel. 
         [0003]    2. Description of Related Art 
         [0004]    During a surgical operation, a ligating of the blood vessels is usually applied to prevent bleeding of blood vessels, and some tools for such operations have been developed to assist the ligation of the blood vessels. Commonly, for example, a clip applier is used to pick up a ligating clip, and then the clip applier is clamped to deform the ligating clips to close the blood vessels. In order to save time in picking up the ligating clip, automatic clip appliers, which can provide plural ligating clips serially, are commercially available. 
         [0005]    An automatic clip applier is a clip applier, which has plural ligating clips stored therein and transmits the ligating clips sequentially to a clipping portion. Hence, a surgeon can use the automatic clip applier to close blood vessels, and does not have to pick the ligating clips up. More specifically, during the process of closing a blood vessel, the ligation clip positioned at the clipping portion is clamped to close one end of the blood vessel, then another ligating clip is transmitted automatically to the clipping portion for closing the other end of the blood vessel. Hence, the surgeon does not have to pick up another ligating clip, and can clamp the automatic clip applier directly to close the other end of the blood vessel. 
         [0006]    Although the step of picking up ligating clip can be omitted through using an automatic clip applier, there are still many complex steps such as a tool exchanging step can be simplified during the operation. For example, the automatic clip applier has to be operated two times for clamping the ligating clips to close two ends of the blood vessel, which is going to be cut. Then, a cutting tool such as a surgical blade is picked up to cut the blood vessel at an appropriate position. Hence, even though the automatic clip applier is used during the surgical performance, the step of clamping the ligating clips still has to be performed two times and the cutting tool has to be exchanged. 
         [0007]    Therefore, it is desirable to provide an automatic clip applier, which can close two ends of a blood vessel at a time. In addition, it is also desirable to provide an automatic clip applier with a function of cutting the blood vessel, in order to simplify the surgical process and save time. 
       SUMMARY OF THE INVENTION 
       [0008]    The object of the present invention is to provide an automatic clip applier for clamping two ligating clips simultaneously, which can close two ends of the blood vessel simultaneously in a single clamping step. Therefore, the operation process can be simplified and the surgical time can be reduced. 
         [0009]    To achieve the object, the automatic clip applier for clamping ligating clips comprises: a handling unit; and two clamping means laminating with each other and connecting to the handling unit. Each clamping means respectively comprises: a jaw unit containing a clipping portion to clamp a ligating clip; a jaw housing containing a cavity, wherein the jaw unit is disposed in the cavity of the jaw housing; a magazine unit for storing plural ligating clips; a feeding unit for moving the endmost ligating clip from the magazine unit to the clipping portion of the jaw unit; a dispensing unit for serially translating the endmost ligating clip to a front end of the feeding unit; and an operation unit connecting to the handling unit, the feeding unit, and the jaw housing, wherein the jaw housing is pushed and the feeding unit is drawn by operating the handling unit to move the jaw housing toward the clipping portion of the jaw unit to clamp the ligating clip positioning at the clipping portion, and to move the feeding unit in an opposite direction of the movement of the jaw housing, and the feeding unit moves back by restoring the handling unit to deliver the endmost ligating clip to the clipping portion of the jaw unit. 
         [0010]    According to the automatic clip applier for clamping ligating clips of the present invention, the handling unit connects to two clamping means, and each jaw units of the two clamping means respectively clamps a ligating clip. Hence, when a surgeon operates the handling unit, one or more ligating clips can be clamped simultaneously, and it is possible to close two ends of the blood vessel in a single clamping step. In addition, the automatic clip applier for clamping ligating clips of the present invention comprises a magazine unit for storing plural ligating clips, and the ligating clips can be moved to the jaw unit through the feeding unit. Hence, the feeding unit can move the ligating clips to the clipping portion, so the step of picking up the ligating clips can be omitted during the operation process. 
         [0011]    The automatic clip applier for clamping ligating clips of the present invention may further comprise: a cutting unit and an advancing unit, wherein, the cutting unit connects to the advancing unit, and the cutting unit is moved toward the clipping portions of the jaw units by operating the advancing unit. Preferably, one end of the cutting unit corresponds to an interval between the clipping portions of the two clamping means. After the cutting unit is moved, the cutting unit can cut a blood vessel ligated with the ligating clips. Herein, the structure of the advancing unit is not particularly limited, as long as the advancing unit can move the cutting unit toward the clipping portion of the jaw unit. 
         [0012]    Hence, after the two ends of the blood vessel are ligated by use of the automatic clip applier of the present invention, the advancing unit of the automatic clip applier of the present invention can be used to move the cutting unit toward a predetermined cutting position of the blood vessel to cut the blood vessel. Therefore, the step of picking up the cutting unit can be omitted, so the operation process can be simplified and the surgical time can be reduced. 
         [0013]    According to one aspect of the present invention, the cutting unit and the advancing unit may be disposed between the two clamping means. In addition, the automatic clip applier for clamping ligating clips may further comprise a channel cavity disposed between the two clamping means, and the advancing unit is placed inside the channel cavity. 
         [0014]    According to another aspect of the present invention, the cutting unit and the advancing unit may be disposed on a side of one of the clamping means. In addition, the automatic clip applier for clamping ligating clips may further comprise a fixing unit disposed on the side of one of the clamping means, wherein the fixing unit has a channel cavity, and the advancing unit is placed inside the channel cavity. 
         [0015]    Furthermore, according to the automatic clip applier for clamping ligating clips of the present invention, the cutting unit may comprise a cutting component and a connecting component, wherein the cutting component connects with the connecting component, and the connecting component connects with the advancing unit. In addition, the cutting component may be a blade or a hook. 
         [0016]    The automatic clip applier for clamping ligating clips of the present invention may further comprise an elastic element, wherein the connecting component is sheathed into the elastic element, and one end of the elastic element connects to the advancing unit. Hence, after the applied force on the advancing unit is removed, the elastic element can provide a restoring force to return the cutting unit and the advancing unit to its original state without a force applied thereon. Herein, the shape of the elastic element is not particularly limited, as long as it can provide a restoring force. For example, the elastic element can be a spring. 
         [0017]    In addition, according to the automatic clip applier for clamping ligating clips of the present invention, the operation unit may further comprise: a pull component and a push component. The pull component connects with the feeding unit and the handling unit and the push component connects with the jaw housing and the handling unit. When the push component is pushed and the pull component is drawn by operating the handling unit, the pushing force applied on the push component can move the jaw housing toward the clipping portion of the jaw unit to clamp the ligating clip positioned at the clipping portion, and the drawing force applied on the pull component can move the feeding unit in an opposite direction of the movement of the jaw housing. When the feeding unit is moved back by restoring the handling unit, the endmost ligating clips in the magazine unit can be delivered to the clipping portion of the jaw unit. 
         [0018]    Furthermore, according to the automatic clip applier for clamping ligating clips of the present invention, each jaw unit may further comprise an elongation part connecting with the clipping portion. The elongation part connects with the clipping portion with an angle, and the degree of the angle is not particularly limited. Preferably, the degree of the angle is 90° to 180°. More preferably, the degree of the angle is 120° to 150°. In addition, in two jaw units of the clamping means, the angles between the elongation parts and the clipping portions may be the same or different. Preferably, the angles between the elongation parts and the clipping portions of the two clamping means are the same. Hence, the jaw units can be in a straight state or a curved state, according to the requirement for the operation. For example, when a blood vessel locates in a deeper position, the automatic clip applier with a jaw unit in a curved state may be selectively used for clamping the blood vessel. Therefore, during the clamping process, the blood vessel can be easily clamped and cut with the end extended from the jaw unit in a curved state. 
         [0019]    When the automatic clip applier for clamping ligating clips of the present invention is used during the operation, two ligating clips can be clamped simultaneously to ligate two ends of a blood vessel in a single clamping step. However, when a conventional automatic clip applier is used, the clamping step has to be performed two times to ligate two ends of a blood vessel. Hence, the operation process can be simplified and the surgical time can be shortened when the automatic clip applier of the present invention is used. In addition, the automatic clip applier of the present invention further comprises a cutting unit, which can be moved toward the cutting region of a blood vessel by applying a force on an advancing unit, to cut the blood vessel. Compared to the operation process using the conventional automatic clip applier without a cutting unit, the step of picking up the cutting unit can be omitted when the automatic clip applier of the present invention is used. Therefore, the operation process can further be simplified and the surgical time can be shortened when the automatic clip applier with the cutting unit of the present invention is used. Furthermore, the automatic clip applier of the present invention further comprises a magazine unit, a feeding unit and a dispensing unit, so ligating clips stored in the magazine unit can be moved to the clipping portions of the jaw units through the feeding unit and the dispensing unit. Hence, the process of getting the ligating clips can be omitted, so the surgical time can be shortened. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0020]      FIG. 1  is a perspective view of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0021]      FIG. 2  is an exploded view of a clamping housing of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0022]      FIG. 3  is an exploded view of an operating housing of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0023]      FIG. 4  is an exploded view of a clamping mean of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0024]      FIG. 5  is an operational view of the automatic clip applier, partly removed for clarity, for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0025]      FIG. 6  is a cross-sectional view of the cutting mechanism of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0026]      FIGS. 7A to 7C  are cross-sectional views of the actuating mechanism of the feeding unit of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0027]      FIG. 8  is a partial perspective view of the automatic clip applier for clamping two ligating clips of Embodiment 2 of the present invention; 
           [0028]      FIG. 9  is a perspective view of the arrangement of the fixing unit, the advancing unit and the elastic element of the automatic clip applier for clamping two ligating clips of Embodiment 2 of the present invention; 
           [0029]      FIG. 10  is a cross-sectional view of the jaw unit of the automatic clip applier for clamping two ligating clips of Embodiment 1 of the present invention; 
           [0030]      FIG. 11  is a cross-sectional view of the jaw unit of the automatic clip applier for clamping two ligating clips of Embodiment 3 of the present invention; and 
           [0031]      FIG. 12  is a cross-sectional view of the jaw unit of the automatic clip applier for clamping two ligating clips of Embodiment 4 of the present invention. 
       
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       [0032]    The specific examples below are to be construed as merely illustrative, and not limitative of the remainder of the disclosure in any way whatsoever. Without further elaboration, it is believed that one skilled in the art can, based on the description herein, utilize the present invention to its fullest extent. All publications cited herein are hereby incorporated by reference in their entirety. 
       Embodiment 1 
       [0033]    As shown in  FIG. 1 , the automatic clip applier for clamping two ligating clips of the present embodiment comprises: an operating housing  10 , a pair of handling units  101 , and a clamping housing  11 . The clamping housing  11  longitudinally extends from the operating housing  10 , and the handling units  101  also extend from the operating housing  10 . The automatic clip applier of the present embodiment comprises two sets of clamping means, which are the same and correspond to each other. In order to clearly describe the automatic clip applier of the present embodiment, only one set of the clamping means is illustrated herein. 
         [0034]    As shown in  FIG. 1  and  FIG. 2 , the clamping housing  11  of the automatic clip applier of the present embodiment comprises: two upper caps  111  and a fixing frame  112 . Each side of the fixing frame  112  respectively has a recess  1121 , and the upper caps  111  are mounted on two sides of the fixing frame  122  to cover the recesses  1121 . Herein, the jaw unit  20 , the jaw housing  30 , the magazine unit  40 , the feeding unit  60 , the dispensing unit  70 , and the ligating clips  50  are disposed in the recesses  1121 . 
         [0035]    As shown in  FIG. 1  and  FIG. 3 , the operating housing  10  of the automatic clip applier of the present embodiment comprises: two coverings  102  and a fixing frame  103 . The fixing frame  103  is disposed between two coverings  102 , and the operation unit  80  is disposed on the fixing frame  103  and placed in the space between the coverings  102  and the fixing frame  103 . The handling unit  101  pivots on the operating unit  80  through a first lever  1011  and a second lever  1012 . More specifically, the operation unit  80  further comprises: a pull component  801  and a push component  802 . The pull component  801  comprises a pivot knob  8011  received in the hole  1014  of the second lever  1012 , and the push component  802  also comprises a pivot knob  8021  received in the hole  1013  of the first lever  1011 . Hence, when the handling unit  101  is operated, the push component  802  can be pushed and the pull component  801  can be drawn. 
         [0036]    As shown in  FIG. 2 ,  FIG. 3 , and  FIG. 4 , the automatic clip applier of the present embodiment comprises: a handling unit  101 , and two clamping means laminating with each other and connecting to the handling unit  101 . Each clamping means respectively comprises: a jaw unit  20  containing a clipping portion  201  to clamp a ligating clip  50 ; a jaw housing  30  containing a cavity  301 , wherein the jaw unit  20  is disposed in the cavity  301  of the jaw housing  30 ; a magazine unit  40  for storing plural ligating clips  50 ; a feeding unit  60  for moving the endmost ligating clip  50  from the magazine unit  40  to the clipping portion  201  of the jaw unit  20 ; a dispensing unit  70  for serially translating the endmost ligating clip  50  to the end  601  of the feeding unit  60 ; and an operation unit  80  connecting to the handling unit  101 , the feeding unit  60 , and the jaw housing  30 . When a force is applied on the handling unit  101 , the jaw housing  30  is pushed and moved toward the clipping portion  201  of the jaw unit  20  to clamp the ligating clip  50  positioning at the clipping portion  201 , and the feeding unit  60  is drawn and moved in an opposite direction of the movement of the jaw housing  30 . When the force applied on the handling unit  101  is removed, the feeding unit  60  is moved back to deliver the endmost ligating clip  50  to the clipping portion  201  of the jaw unit  20 . 
         [0037]    Hereafter, the actuating mechanism of the automatic clip applier of the present embodiment is detailed described. As shown in  FIG. 3 ,  FIG. 4  and  FIG. 5 , the jaw housing  30  of the automatic clip applier of the present embodiment further comprises a notch  302 , which is adapted to a fixing knob  8022  of the push component  802  to connect the push component  802  with the jaw housing  30 . In addition, the feeding unit  60  further comprises a fixing part  602 , which is adapted into an opening  8012  of the pull component  801  to connect the pull component  801  with the feeding unit  60 . 
         [0038]    When the handling unit  101  is operated, the push component  802  is pushed through the first lever  1011 , and the pull component  801  is drawn through the second lever  1012 . The notch  302  of the jaw housing  30  is adapted to the fixing knob  8022  of the push component  802 , so the jaw housing  30  is moved toward the clipping portion  201  of the jaw unit  20  to clamp the ligating clip (not shown in the figure) positioned at the clipping portion  20  when the handling unit  101  pushes the push component  802 . In addition, the fixing part  602  is adapted to the opening  8012  of the pull component  801 , so the feeding unit  60  can be moved in an opposite direction of the movement of the jaw housing  30  when the handling unit  101  draws the pull component  801 . 
         [0039]    As shown in  FIG. 4  and  FIG. 5 , the operation unit  80  of the automatic clip applier of the present embodiment further comprises an elastic element  803 , wherein one end of the elastic element  803  is mounted on the fixing knob  8022  of the push component  802 , and the other end is mounted on the fixing part  8013  of the pull component  801 . Therefore, the elastic element  803  can provide a restoring force to return the pull component  801  and the push component  802  back to their original state that force is not applied thereon. 
         [0040]    As shown in  FIG. 2  and  FIG. 3 , the automatic clip applier of the present embodiment further comprises: a cutting unit  901  and an advancing unit  902 , wherein the cutting unit  901  connects with the advancing unit  902 , and the cutting unit  901  and the advancing unit  902  are arranged between the clamping means. More specifically, the fixing frames  112 ,  103  respectively comprise channel cavities  1122 ,  1031 , wherein the channel cavities  1122 ,  1031  are arranged between two clamping means, and the advancing unit  902  is installed in the channel cavities  1122 ,  1031 . When force is applied on the advancing unit  902 , the cutting unit  901  is moved toward the clipping portion  201  of the jaw unit  20 . Also, the cutting unit  901  and the advancing unit  902  are installed in the channel cavities  1122 ,  1031  of the fixing frames  112 ,  103 , so the shift of the cutting unit  901  and the advancing unit  902  are limited in the space of the channel cavities  1122 ,  1031 . Therefore, the cutting unit  901  and the advancing unit  902  can be shifted in a straight route. 
         [0041]    As shown in  FIG. 2  and  FIG. 3 , the cutting unit  901  further comprises: a cutting component  9011  and a connecting component  9012 , wherein the cutting component  9011  connects with the connecting component  9012 , and the connecting component  9012  connects with the advancing unit  902 . In addition, the automatic clip applier of the present embodiment further comprises an elastic element  904 , wherein the connecting component  9012  is sheathed in the elastic element  904 , and one end of the elastic element  904  connects with the advancing unit  902 . In the present embodiment, the cutting component  9011  is a blade. 
         [0042]    As shown in  FIG. 1 ,  FIG. 3  and  FIG. 6 , when the automatic clip applier of the present embodiment is applied for cutting the blood vessel B at the cutting position B 3 , the handling unit  10  is operated for clamping the ligating clips on the clipping portions  201  to ligate two ends of the blood vessel B. Then, the advancing unit  902  is pressed to compress the elastic element  904 , so the advancing unit  902  can move the cutting unit  901  toward the cutting position B 3 . The cutting component  9011  of the cutting unit  901  corresponds to the interval H between two clip portions  201 , so the cutting component  9011  can cut the blood vessel B ligated with the ligating clips  50  after the cutting unit  901  is pushed by the advancing unit  902 . 
         [0043]    As shown in  FIG. 2 , the automatic clip applier of the present embodiment further comprises: a tab  501  and an elastic element  502 , wherein the tab  501  and the elastic element  502  are arranged in the magazine unit  40 , plural ligating clips  50  are arranged in the magazine unit  40  and connect with a front end  5011  of the tab  501 , and the tab  501  is sheathed in the elastic element  502 . The position of the tab  501  in the magazine unit  40  can be adjusted through the elastic element  502 . Hence, the storage space of the magazine unit  40  for storing the ligating clips  50  can be adjusted according to the amount of the ligating clips  50 . 
         [0044]    As shown in  FIG. 2 , the magazine unit  40  of the automatic clip applier of the present embodiment further comprises a temporary part  401 , which has a slice  4011  for introducing the endmost ligating clip  50  in the magazine unit  40  to the clipping portion  201  of the jaw unit  20 . Hereafter, the actuating mechanism for moving the ligating clip  50  to the clipping portion  201  of the jaw unit  20  is detailed described with reference to  FIGS. 7A to 7C . 
         [0045]    First,  FIG. 7A  is a perspective view showing the state that the automatic clip applier of the present embodiment is not operated. As shown in  FIG. 7A , plural ligating clips  50  are disposed at the front ends of the tabs  501 , and each clipping portion  201  is respectively disposed with a ligating clip  50 . 
         [0046]    Next, as shown in  FIG. 7B  and  FIG. 4 , when force is applied on the handling unit (not shown in the figure), the feeding unit  60  is drawn and moved in an opposite direction of the movement of the jaw housing  30 . After the feeding unit  60  is moved, a sectional difference between the ligating clip  50  positioned at the temporary part  401  and the rest of the ligating clips  50  is generated. 
         [0047]    Then, as shown in  FIG. 7C  and  FIG. 4 , when the force applied on the handling unit (not shown in the figure) is removed, the feeding unit  60  is moved back to its original state without any force applied thereon to push the ligating clip  50  positioned at the temporary part  401  of the magazine unit  40 . Hence, the endmost ligating clip  50  can be moved to the clipping portion  201 , and the automatic clip applier is in a state as shown in  FIG. 7A . 
         [0048]    In addition, as shown in  FIG. 2  and  FIG. 7A , the dispensing unit  70  is a saw-toothed (W-shaped) piece, and the pitch W of the dispensing unit  70  is the same as the length of the ligating clip  50 . When the feeding unit  60  is drawn, the dispensing unit  70  with the saw-toothed shape can deliver a single ligating clip  50  to the temporary part  401  of the magazine unit  40 . Hence, it is possible to deliver a single ligating clip  50  each time. 
         [0049]    In addition, as shown in  FIG. 2  and  FIG. 7A , each jaw unit  20  of the automatic clip applier of the present embodiment further comprises an elongating part  202 , which connects with the clipping portion  201  with an angle. Hence, the front end of each jaw units  20  is in a curved state. In the present embodiment, the jaw units  20  of the two clamping means bend inward, i.e. both the angles θ 1 , θ 2  between the clipping portions  201  and the elongation parts  202  are smaller than 180°. 
       Embodiment 2 
       [0050]    The automatic clip applier of the present embodiment is similar to that of Embodiment 1, and the difference between the automatic clip applier of the present embodiment and that of Embodiment 1 is stated as follows. 
         [0051]    According to the automatic clip applier of the present embodiment, the cutting unit  901  and the advancing unit  902  are arranged on a side of one clamping means, as shown in  FIG. 8 . In addition, the automatic clip applier further comprises a fixing unit  903  arranged at the same side that the cutting unit  901  and the advancing unit  902  arranged thereon. The fixing unit  903  has a channel cavity  9031 , and the cutting unit  901  is arranged in the channel cavity  9031  and moves with the channel cavity  9031 , as shown in  FIG. 9 . 
         [0052]    Furthermore, the cutting unit  901  of the automatic clip applier of the present embodiment further comprises a cutting component  9011  and a connecting component  9012 , wherein the cutting component  9011  connects with the connecting component  9012 , and the connecting component  9012  connects with the advancing unit  902 . In addition, the automatic clip applier of the present embodiment further comprises an elastic element  904 , wherein the connecting component  9012  is sheathed in the elastic element  904 , and one end of the elastic element  904  connects with the fixing unit  903 . In the present embodiment, the cutting component  9011  is a hook, as shown in  FIG. 9 . 
         [0053]    In addition, as shown in  FIG. 8 , according to the automatic clip applier of the present embodiment, the jaw units  20  of the two clamping means bend outward, i.e. both the angles θ 1 , θ 2  between the clipping portions  201  and the elongation parts  202  are larger than 180°. 
       Embodiment 3 
       [0054]    The automatic clip applier of the present embodiment is similar to that of Embodiment 2, except that the jaw unit  20  of one clamping means bends outward, and the jaw unit  20  of the other clamping mean bends inward. In other words, the angle θ 1  between the clipping portion  201  and the elongation part  202  in one clamping means is larger than 180°, and the angle θ 2  between the clipping portion  201  and the elongation part  202  in the other clamping means is smaller than 180°. 
       Embodiment 4 
       [0055]    The automatic clip applier of the present embodiment is similar to that of Embodiment 2, except that the jaw units  20  of both two clamping means are straight, i.e. both the angles θ 1 , θ 2  between the clipping portions  201  and the elongation parts  202  are 180°. 
         [0056]    Although the present invention has been explained in relation to its preferred embodiment, it is to be understood that many other possible modifications and variations can be made without departing from the scope of the invention as hereinafter claimed.