SURGICAL CLIP APPLICATION DEVICE

A surgical clip application device for applying and crimping surgical clips to ligate a vessel.

BACKGROUND

Clip application devices or clip appliers may be used during microsurgery procedures. Microsurgery covers a variety of procedures using a microscope for operating on successively smaller blood vessels, nerves, etc. Conventional suturing techniques in microsurgery have given way to the use of surgical clips, which are applied at the end of a severed vessel or at a junction of vessels. For example, the surgical clips hold or close the tissue in a similar fashion as conventional sutures. The clips used in microsurgery are very small and are typically called microclips. An example microclip may have a size on the order of 2 mm high and 2 mm wide.

Microclips are commonly applied in surgery by forceps that load and use a single clip at a time. Single load-and-use devices are burdensome to medical professionals, as several clips may be required for a surgical procedure. The numerous reloading actions may cause handling accidents (e.g., dropping a clip on the floor, dropping an instrument, dropping a closed or partially closed clip into a wound), misloaded clips, etc. Additionally, using several sets of forceps requires cleaning and otherwise maintaining a stock of several forceps.

The present invention is directed to a surgical microclip applier for use in microsurgery that provides significant advantages over prior art instruments of the type described above.

SUMMARY

The present disclosure provides a surgical clip application device or clip applier for applying surgical clips to ligate vessels during surgery. The clip applier disclosed herein may automatically load clips, which allows a user to ligate multiple vessels during surgery. As a user aligns a vessel within the jaws of the device and squeezes the device handle, a surgical clip is crimped to ligate the vessel aligned within the jaws. Once the handle is released, another clip is automatically loaded and ready for ligating another vessel.

In an example, a surgical clip applying device includes an enclosure formed from a top housing, a bottom housing and a window cover. The clip applying device also includes a pair of handles including a left handle and a right handle, a main rail supporting a jaw closer, and a pair of clip applying jaws fixedly attached to the bottom housing and retained within the main rail. The pair of clip applying jaws has arms terminating with a pair of jaw heads. Additionally, the clip applying device includes a clip loader assembly with a clip loading tip at the clip loader assembly's distal end and a dispenser positioned above the clip loader assembly. The dispenser includes a pair of clip forks and a retention prong positioned between the pair of clip forks at the dispenser's distal end. The clip loading tip is configured to push a surgical clip supported by the pair of clip forks over the retention prong. The clip applying device also includes a clip pusher assembly configured to advance a plurality of clips towards the pair of j aw heads and a drive mechanism including a plurality of levers and at least one spring. The drive mechanism is configured to translate an actuation of the pair of handles to linear motion of the jaw closer and the clip loader assembly.

The surgical clip application device or clip applier disclosed herein is expected to offer convenience compared to devices and systems that require manually loading individual clips.

It is another advantage of the present disclosure to provide a surgical clip application device (e.g., clip applier) with automatic surgical clip reloading.

Additionally, another advantage of the present disclosure is to provide a surgical clip application device (e.g., clip applier) with a transparent window thereby allowing a user to easily ascertain a remaining clip count for surgical clips housed within the device.

It is a further advantage of the present disclosure to provide a surgical clip application device (e.g., clip applier) with multiple touch points, finger loops, and gripping surfaces for ambidextrous surgical clip application.

DETAILED DESCRIPTION OF EXAMPLE EMBODIMENTS

The surgical clip application device (e.g., clip applier) for ligating vessels described herein provides improved surgical clip application, automatic surgical clip reloading, and safety lock-out features.

FIGS.1A and1Billustrate an example embodiment of a clip applier100. The clip applier100is configured to apply clips to a surgical site. The clip applier100includes a top housing102, a bottom housing104, a left handle106a,and a right handle106bthat together form an enclosure for the clip applier100. Each of the left handle106aand right handle106b,hereinafter referred to generally as handles106, are pivotally mounted in relation to the rest of the enclosure. The enclosure for the clip applier100may be secured together by fasteners or other attachment means. Each of the top housing102, bottom housing104, left handle106aand right handle106bmay be fabricated from molded plastic. As illustrated inFIG.1A, the clip applier100has a proximal end101and a distal end103(e.g., clip applying end). Specifically, the distal end103corresponds to the portion of the clip applier100where clips are crimped and applied.

The handles106cooperate to impart linear reciprocating movement to the clip applying components housed within the enclosure. In an example, the handles106are biased to an open position. As illustrated inFIGS.1A and1B, the handles106include looped bodies with finger rings, similar to a pair of scissors. In another example, the handles106may instead include loop-less bodies, similar to a pair of pliers. In either case, the finger rings of the looped bodies or the corresponding gripping surfaces of the loop-less bodies may be made from or over-molded with a rubber-like material to improve grip and comfort.

A window cover108and a trough110sit atop the top housing102. The enclosure of the clip applier100houses a main rail120, a jaw closer130, clip applying jaws140, and a clip loader assembly150that includes a proximal clip loader154and a distal clip loader152. The clip loader assembly150cooperates with handles106and various other internal components, such that the distal clip loader152moves in a linear reciprocating motion for loading clips into the clip applying jaws140.

The enclosure of the clip applier100also houses a dispenser160and a clip pusher assembly170. The clip pusher assembly170includes a clip pusher spring172and a clip pusher bar174. Additionally, the clip applier100includes a right lever assembly180aand a left lever assembly180b.The right lever assembly180aincludes a proximal lever182a,a distal lever184aand a spring186a.The left lever assembly180bincludes a proximal lever182b,a distal lever184band a spring186b.

As discussed in more detail below, right lever assembly180aand left lever assembly180b,hereinafter referred to generally as lever assemblies180, move in conjunction with actuation of handles106to control the motion of the jaw closer130and the clip loader assembly150. In the open position, the proximal levers182and the distal levers184are nearly parallel with each other (seeFIG.1D) with the clip loader assembly150fully advanced. When the handles are transitioned from the open position to the closed position, the proximal levers182and the distal levers184create a diamond shape, pulling the clip loader assembly150back to a retracted position to grab the next surgical clip. Additionally, when the handles are transitioned from the open position to the closed position, the distal levers184push the jaw closer130forward to close the jaw heads and crimp the surgical clip that was advanced to the end of the clip applying jaws140. As the handles are again transitioned from the closed position to the open position, the jaw closer130retreats to a fully retracted position.

A jaw anchor190, such as a pin or screw (e.g., flat head cap screw) couples the clip applying jaws140to the jaw closer130and the main rail120. Additionally, the anchor190fixes the clip applying jaws140and the main rail120to the bottom housing104. As discussed in more detail below, the anchor190limits the range of motion of the jaw closer130. In another example, the jaw anchor190may instead be a post that is molded as part of the bottom housing104. As illustrated inFIG.1B, the jaw anchor190is received in a corresponding slot195in the lower housing104.

A handle anchor191, such as a pin or screw (e.g., button head cap screw) couples the top housing102to the bottom housing104near the proximal end of the clip applier100. As illustrated inFIG.1B, the handle anchor191is received in a corresponding slot197in the lower housing104.

The clip applier100also includes a ratchet pawl192that serves as an anti-backup mechanism that cooperates with the other clip handling components housed within the enclosure for the clip applier100. As illustrated inFIG.1B, the ratchet pawl192cooperates with the proximal clip loader154, such that the proximal clip loader154moves in a linear reciprocating motion. The ratchet pawl192includes a pawl pin that is positioned through corresponding openings in the jaw closer130and the main rail120before being received in a corresponding slot193in the lower housing104.

The clip applier100may also include various attachment mechanisms, such as a set of right side pins194aand a set of left side pins194bthat fixedly attach one end of the levers to their corresponding handle. For example, the set of pins194afixedly attach one end of each of the proximal lever182aand the distal lever184ato the left handle106a.Similarly, the set of pins194bfixedly attach one end of each of the proximal lever182band the distal lever184bto the right handle106b.The clip applier100may also include a set of screws196that connect the top housing102to the bottom housing104. The pins194a,194b(hereinafter generally referred to as pins193) and the screws196are example attachment mechanisms illustrated inFIG.1B. It should be appreciated that the clip applier100may include various other attachment means, including other types of fasteners, press-fit connections, adhesives, welding (e.g., electronic welding), etc.

FIG.1Cillustrates another example embodiment of a clip applier100. Many of the components illustrated inFIG.1Cmay be the same or have similar features to the components illustrated inFIG.1B. In the illustrated example, the alternate embodiment includes variations of the main rail120, jaw closer130, clip applying jaws140, clip loader assembly150(e.g., distal clip loader152and proximal clip loader154), dispenser160, etc. These variations are described in more detail and illustrated in some of the following component diagrams. The exploded view illustrated inFIG.1Calso shows a stack105of surgical clips (not pictured inFIG.1B). Furthermore, the alternate embodiment of the clip applier100shown inFIG.1Calso includes a lock-out clip185.

FIG.1Dillustrates the clip applier100in the open position andFIG.1Eillustrates the clip applier100in the closed position.

FIGS.1F,1G,1H,1I,1J, and1Killustrate yet another example embodiment of a clip applier100. Some of the components of the example embodiment of the clip applier100shown inFIGS.1F-1Kmay be the same or have similar features as corresponding components illustrated inFIGS.1B and/or1C. The alternate embodiment of the clip applier100illustrated inFIGS.1F-1Kincludes variations of the top housing102, the bottom housing104, the window cover108, the main rail120, the dispenser160, and the lock-out clip185. These variations are described and/or illustrated in more detail in within other illustrative examples of the present disclosure.

FIG.1Fillustrates a perspective view of an example clip applier100.FIG.1Gillustrates an exploded view of the example clip applier100ofFIG.1F. In the illustrated example ofFIG.1G, the clip applier100includes a left handle assembly10, a right handle assembly12, a bottom enclosure assembly14, a clip dispenser assembly16, the top housing102, and the clip loader assembly150. More generally, in some examples, one or more portions of the clip applier100are implemented as separate sub-assemblies (e.g., the left handle assembly10, the right hand assembly12, the bottom enclosure assembly14, the clip dispenser assembly150, etc.), which are then combined to assemble the clip applier100.

FIG.1Hillustrates an exploded view of the left handle assembly10. As best shown inFIG.1H, the left handle assembly10includes the left handle106a,the proximal lever182a,the distal lever184a,the spring186a,and the pins194a.In some examples, a length of the distal lever184a(e.g., “short link”) is less than a length of the proximal lever182a(e.g., “long link,” “proximal support long link,” etc.). In some examples, the left handle assembly10can be assembled by sliding the levers182aand184ainto the left handle106a,and then pressing the pins194athrough respective holes in the left handle106aand/or the levers182a,184ato attach the levers182a,184ato the left handle106a.Respective ends of the spring186acan then be connected to the levers182aand184a.

FIG.11illustrates an exploded view of the right handle assembly12. As best shown inFIG.11, the right handle assembly12includes the right handle106b,the proximal lever182b,the distal lever184b,the spring186b,and the pins194b.In some examples, a length of the distal lever184b(e.g., “short link”) is less than a length of the proximal lever182b(e.g., “long link”). In some examples, the right handle assembly12can be assembled by sliding the levers182band184binto the right handle106b,and then pressing the pins194bthrough respective holes in the right handle106band/or the levers182b,184bto attach the levers182b,184bto the right handle106b.The spring186bcan then be connected to the levers182band184b.

FIG.1Jillustrates an exploded view of the bottom enclosure assembly14. As best shown inFIG.1J, the bottom enclosure assembly14includes an insert18, the bottom housing104(which includes the slot195), the main rail120, the jaw closer130, the clip applying jaws140, and the jaw anchor190. The insert18may be a threaded insert or any other type of mechanical coupling device received in the slot195to facilitate coupling the bottom housing104with the jaw anchor190. The insert18can be formed from any suitable material, such as brass, other metal or metal oxide, plastic, or any other material. In some examples, the jaw anchor190is implemented as a screw or a flat head screw. In some examples, the bottom enclosure assembly14is assembled by inserting (e.g., sliding) the clip applying jaws140and the jaw closer130into the main rail120. The main rail120can then be placed into the bottom housing104while aligning the threaded insert18with respective holes in the jaws140, the jaw closer130, and the main rail120. As such, in the illustrated example ofFIG.1Jone or more components (i.e., the main rail120, the jaw closer130, and the jaws140) of the bottom enclosure assembly14can be attached to the bottom housing104(e.g., by coupling or torqueing the screw190into the insert18and the slot195). In alternative examples, a different attachment mechanism can be used.

FIG.1Killustrates an exploded view of the clip dispenser assembly16. As best shown inFIG.1K, the clip dispenser assembly16includes the stack105of surgical clips (exemplified by clip50), the window cover108, the dispenser160, the clip pusher spring172, the clip pusher bar174, and the lock-out clip185. In some examples, the clip dispenser assembly16is assembled by connecting the clip pusher spring172to the clip pusher bar174(e.g., sliding the spring172over the pusher bar174), then connecting the clip pusher bar174to the dispenser160(e.g., sliding the combination of the bar174and the spring172into the dispenser160), then loading the stack105of surgical clips and the lockout clip185into the dispenser160, and then attaching the window cover108to the dispenser160. Other attachment mechanisms and/or processes are possible.

As noted above, in some examples, the clip applier100can be assembled by coupling the left handle assembly10, the right handle assembly12, the bottom enclosure assembly14, the clip dispenser assembly16, the top housing102, and the clip loader assembly150to one another. In one specific example, the clip applier100ofFIGS.1F-1Kis assembled by placing the left handle assembly10into the bottom enclosure assembly14and securing the distal lever184aonto the jaw closer130. The clip loader assembly150is then attached by securing a rear hole of the clip loader assembly150over the proximal lever182a.The right handle assembly12is then placed into the assembly of the clip applier100by similarly securing the distal lever184bonto the jaw closer130. The clip dispenser assembly16is then placed into the assembly of the clip applier100by aligning the window cover108with the main rail120. In this example, the main rail120can then be crimped onto the window cover108. Then, the top housing102can be attached by pressing the top housing102onto the assembly of the clip applier100. Other example attachment mechanisms are possible.

FIGS.2A,2B,2C,2D, and2Eillustrate the movement of various drive components at the distal end103of the clip applier100while the device is dispensing and crimping surgical clips, in accordance with at least one example embodiment herein.FIG.2Fillustrates a stack of surgical clips, exemplified by clip50, which may be provide in a cartridge, at the distal end103of the clip applier100, in accordance with at least one example embodiment herein.

FIGS.3A,3B and3Cillustrate top, side and bottom views of the top housing102.

FIGS.3D and3Eillustrate another example top housing102(e.g., the top housing102fromFIG.1C). The top housing102may also include handle pegs187aand187bthat are configured to pass through handle slots (e.g., handle slots183aand183billustrated inFIG.1C, hereinafter referred to generally as handle slots183) and couple to corresponding receiving pegs (e.g., receiving pegs189aand189billustrated inFIG.4E, hereinafter referred to generally as receiving pegs189). The handle pegs187aand187b,hereinafter referred to generally as handle pegs187, the receiving pegs189and the handle slots183are configured and arranged such that the left handle106aand the right handle106bare capable of pivoting with respect to the enclosure formed by the handles106, the top housing102and the bottom housing104. In the example illustrated inFIGS.3D and3E, the top housing102may incorporate a trough portion (e.g., trough110ofFIGS.12A to12E) instead of having a separate trough component.

FIGS.3F,3G, and3Hillustrate top, side, and bottom views of yet another example top housing102(e.g., the top housing102ofFIG.1G). As best shown inFIGS.3G and3H, the example top housing102includes the handle pegs187a,187b,an anchor peg390, and a plurality of tabs exemplified by tab392. In this example, the top housing102can be attached (e.g., pressed, crimped, etc.) to other components of the clip applier100by aligning the pegs187a,187b,390, and/or the tabs392, etc. with corresponding receiving features in the bottom housing104and/or in other components of the clip applier100. For example, the handle pegs187aand187bcan be received by corresponding receiving pegs (e.g., receiving pegs189aand189billustrated inFIG.4I), the anchor peg390can be received by a corresponding receiving slot (e.g., slot197illustrated inFIG.4I), and the plurality of tabs (exemplified by tab392) can be aligned and/or received at corresponding recesses (e.g., recesses492, etc. illustrated inFIG.4I).

FIGS.4A,4B and4Cillustrate top, side and bottom views of the bottom housing104. As discussed with relation toFIG.1B, the bottom housing104includes slots193,195and197. Slot193is adapted to receive and retain a pawl pin (e.g., pawl pin1102ofFIG.11A) of the ratchet pawl192after the ratchet pawl pin passes through corresponding openings in the jaw closer130and the main rail120. Slot195is adapted to receive and retain the jaw anchor190after the jaw anchor190passes through corresponding openings in the clip applying jaws140, the jaw closer130and the main rail120. Slot197is adapted to receive and retain the handle anchor191.

FIGS.4D,4E and4Fillustrate another example bottom housing104, which may include many of the same or similar features as the bottom housing104illustrated inFIGS.4A,4B and4C. As mentioned above, the bottom housing104may include receiving pegs189aand189b.The receiving pegs189may be sized and shaped to receive and couple to the corresponding handle pegs187of the top housing102. Specifically, handle slots183may be positioned through handle pegs187before the handle pegs187are positioned within (e.g., press-fit in) receiving pegs189, which creates a pivot point for handles106. In an example, the handle pegs187and the receiving pegs189may be snap-fit gripper pins that form axes of rotation or pivot points for the handles106. In another example, the handle pegs187and the receiving pegs189may be dowel pins and bosses. Snap-fit gripper pins may advantageously provide a rotation or pivot point with fewer components.

FIGS.4G,4H, and4Iillustrate bottom, side, and top views of yet another example bottom housing104(e.g., the bottom housing104ofFIG.1J). In this illustrated example, the bottom housing104includes the receiving pegs189a,189b,the slot195, the slot197, a plurality of recesses exemplified by tab492, and a plurality of protruding edges exemplified by edge494. In this example, the bottom housing104can be attached (e.g., pressed, crimped, etc.) to other components of the clip applier100by aligning the pegs189a,189b,the slot197, the recesses492, etc., and/or the edges494, etc., with corresponding features in the top housing102and/or in other components of the clip applier100. For example, the receive pegs189aand189bcan receive corresponding handle pegs (e.g., handle pegs187aand187bofFIG.3H), the slot197can receive a corresponding anchor peg (e.g., anchor peg390ofFIG.3H), and the plurality of recesses (exemplified by tab492) can be aligned with and/or receive corresponding tabs (e.g., tabs392, etc. ofFIG.3H). Further, in this example, the edges494, etc., can be shaped to align and/or receive corresponding edge(s) of the top housing102ofFIG.3H.

FIGS.5A,5B,5C,5D and5Eillustrate various views of an example main rail120. In this example, the main rail120includes an elongate base510and side walls520aand520bthat form a channel530having a proximal end501and a distal end503.FIG.5Dillustrates a cross-sectional view of the main rail120along line A-A ofFIG.5B, which illustrates the channel530formed from the base510and sidewalls520a,520b.Near the distal end503, the side walls520aand520b,hereinafter referred to generally as side walls520, are folded over forming flanges522aand522b.The flanges, which are referred to generally as flanges522are adapted to constrain the interaction of the clip applying jaws140and the jaw closer130thereby preventing the clip applying jaws140and the jaw closer130from disengaging.

Additionally, in this example, the main rail120includes an opening or thru-hole540that accommodates jaw anchor190. Additionally, in this example, the main rail120includes an opening or thru-hole550that accommodates a pawl pin of the ratchet pawl192. In this example, the main rail120also includes a pawl slot552to accommodate a pawl flange (see pawl flange1130ofFIG.11E) of the ratchet pawl192. The pawl slot552is sized and shaped to allow the ratchet pawl192to pass through the main rail120(e.g., flanges1130aand1130bof the ratchet pawl192ofFIG.11Amay pass through slot552) while the main rail120remains fixedly coupled to the bottom housing104.

The main rail120may be fabricated from plastic or metal. In an example, the main rail120is fabricated as a stamped piece(s) of metal. As illustrated in the detail view of the example ofFIG.5E, the pawl slot552is a curved oval slot or track that allows the ratchet pawl192to rotate within the slot552.

FIG.5Fillustrates another example of the main rail120. Similar to the main rail120illustrated inFIGS.5A-5E, the main rail120illustrated inFIG.5Fincludes a base510and sidewalls520aand520bthat form channel530. Additionally, the main rail120includes flanges522aand522b.Main rail120also includes thru-holes542aand542bthat may be adapted for positioning, alignment and/or securing the main rail120. Unlike the main rail illustrated inFIGS.5A-5E, the main rail120illustrated inFIG.5Fmay be adapted for use without a ratchet pawl192.

In this example, after the main rail120is positioned in the lower housing102, the jaw closer130is positioned within the main rail120. Specifically, the channel530is configured to receive the jaw closer130, which sits atop the base510of the main rail120. The jaw closer130is further described and illustrated inFIGS.6A,6B and6C.

FIG.5Gillustrates yet another example of the main rail120(e.g., the main rail120ofFIG.1J). Similar to the main rail120ofFIG.5F, the main rail120ofFIG.5Galso includes the base510, the sidewalls520aand520bthat form channel530, and include the holes542aand542b.Additionally, in the illustrated example ofFIG.5G, the main rail120also includes a plurality of elongate members (hereinafter referred to as elongate members560) exemplified by elongate members560a,560b,and560c.In some examples, the elongate members560can be used to mechanically couple the main rail120to a window cover (e.g., the window cover108ofFIG.1K).

As illustrated inFIGS.6A,6B and6C, the jaw closer130includes an elongate base610with two drive flanges682and684that are configured to couple to respective ends of levers184band184a(seeFIG.1B), which is discussed in more detail below. The jaw closer130has a proximal end601and a distal end603. Additionally, the jaw closer130includes a slot640that accommodates jaw anchor190. The slot640is an oval slot that is adapted to limit the range of motion of the jaw closer130by providing a front-stop642and a back-stop644for the jaw anchor190. Specifically, the jaw closer130may move forward, towards the distal end103of the clip applier100, until the jaw anchor190abuts the back-stop644. Similarly, the jaw closer130may move backward, toward the proximal end101of the clip applier100, until the jaw anchor190abuts the front-stop642of the slot640.

The jaw closer130also includes a pawl track652to accommodate a positioning post1120and flanges1130aand1130bof the ratchet pawl192(seeFIG.11A). The pawl track652is sized and shaped to allow the ratchet pawl192to rotate and freely move within the pawl track652while the main rail120remains fixedly coupled to the bottom housing104.

The jaw closer130also includes an engagement indent650with cam members652aand652bthat cooperate with ramps or protrusions on the clip applying jaws140(seeFIGS.7B and7C). For example, the cam members, generally referred to as cam members652, may form the indent650, which is configured to close the clip applying jaws140as the jaw closer130is extended towards the distal end103(e.g., clip applying end) of the clip applier100. As illustrated inFIG.6C, which is an enlarged detail view of the distal end603of the jaw closer130showing the geometry of engagement indent650, the engagement indent650has a triangular shape. It should be appreciated that the engagement indent650is sized and shaped to cooperate with corresponding camming surfaces on the clip applying jaws140, and therefore other shapes, geometries or means of closing the clip applying jaws140may be implanted. Similar to the main rail120, the jaw closer130may be fabricated from plastic or metal. In an example, the jaw closer is fabricated as a stamped metal piece. In one example, the jaw closer130is made from stainless steel (e.g., half hard 304 SS).

After the jaw closer130is positioned within the main rail120, the clip applying jaws140are positioned atop the jaw closer130. Specifically, the clip applying jaws140are positioned above the main rail120and secured in place via jaw anchor190, which passes through a corresponding slot or thru-hole of the clip applying jaws140before passing through slot640of jaw closer130and thru-hole540of the main rail. The jaw anchor190secures the clip applying jaws140in place by anchoring the clip applying jaws to the corresponding slot195in the lower housing104.

FIGS.6D and6Eillustrate an alternative embodiment of the jaw closer130. In the alternate embodiment (e.g., jaw closer130ofFIG.1C), the jaw closer130includes many of the same features of the jaw closer130illustrated inFIGS.6A-6D. However, in the illustrated example, the jaw closer130is shown without a pawl track652.

The clip applying jaws140are further described and illustrated inFIGS.7A,7B,7C and7D. In the illustrated example, the clip applying jaws include a body portion710at a proximal end and arms720a,720b(e.g., right arm720aand left arm720b) that extend from the body portion710towards a distal end of the clip applying jaws140. Additionally, the clip applying jaws140includes an opening or thru-hole741that accommodates jaw anchor190. The arms720aand720b,hereinafter referred to generally as arms720terminate in cooperating jaw heads730a,730bat the distal end703.

The jaw heads730a,730b,which are referred to generally as jaw heads730, are oriented in a downward sloping position. At the end of the arms720, where the jaw heads730start, the jaw heads730are initially positioned above the arms720, such that the jaw heads730are stepped above a top surface722of the arms and slope downward such that the end of the jaw heads730at the distal end703are approximately in-line with a bottom surface724of the arms720(seeFIG.7B).

Each respective arm720includes a ramp or protrusion (e.g., ramps740aand740b) that are configured to cooperate with cam members652or indent650of the jaw closer (seeFIGS.6B and6C). When the ramps740aand740b,generally referred to herein as ramps740, cooperate with the indent650, the clip applying jaws140are transitioned to a closed position. In the closed position, the jaw heads730are moved towards each other to crimp or pinch together a surgical clip. Specifically, as the jaw closer130is extended towards the distal end103(e.g., clip applying end) of the clip applier100, the ramps740ride along the cam members652of the jaw closer, which forces the arms720and the jaw heads730closer together.

In the illustrated examples,FIG.7Cillustrates the clip applying jaws140in an open configuration with the arms720and jaw heads730spread apart. Conversely,FIG.7Aillustrates the clip applying jaws140in a closed configuration with the arms720and jaw heads730in a parallel arrangement with a smaller clip gap. For example, the clip gap760(open position) ofFIG.7Cis larger than the clip gap760(closed position) ofFIG.7A.

As illustrated inFIG.7C, the ramps740, which function as cam surfaces, are located behind the respective jaw heads730, towards the distal end703of the clip applying jaws140. The ramps740, when pressed together and viewed from above, may have a triangular shape that cooperates with the triangular shaped indent650of the jaw closer130. As the jaw closer130retreats, the arms720and their corresponding jaw heads730are released to move back to the open position. In an example, the arms720and their corresponding jaw heads730are biased (e.g., spring biased) to the open position and only close through interaction with the jaw closer130. For example, the jaws may have a natural spring bias to an open position and are forced closed when the jaw closer130is extended towards the distal end703of the clip applying jaws140for crimping a surgical clip during surgery.

As illustrated inFIG.7D, each jaw head730has a recessed channel761(e.g., recessed channel761aon jaw head730aand recessed channel761bon jaw head730b) that cooperate to form a clip track770. For example, the recessed channels760or groove is sized and shaped to allow a leg of a surgical clip to slide along the channel760. The clip track770formed between the jaw heads730is configured to provide a track that guides a surgical clip as the surgical clip travel to the distal end703of the clip applying jaws140. For example, and as discussed in more detail below, as the clip applying jaws140open, a clip pusher assembly150(seeFIGS.2A,2B,2C and8A) moves towards the distal end703of the clip applying jaws140and pushes a surgical clip into the jaw heads730. More specifically, the clip pusher pushes and positions the surgical clip into the clip track770formed by the cooperating recessed channels761of the jaw heads730. Then, the surgical clip travels along the clip track770until the surgical clip reaches the distal end703, where the clip applying jaws are transitioned to a closed position to crimp the surgical clip.

Each recessed channel761starts with an opening762and ends at a stop surface764before reaching the distal end of the clip applying jaws140. The opening762may be larger than the height or diameter of the channel761to aid in aligning and positioning the respective surgical clip leg within the channel761. The stop surface764may advantageously prevent surgical clips from traveling beyond the distal end703of the clip applying jaws140prior to application. For example, without stop surface764, surgical clips may incidentally fall out of the clip applier100before the clip applier100and the clip applying jaws140transition to a closed position to crimp and apply the surgical clip to the surgical site.

FIGS.7E and7Fillustrate another example of jaw head730. Specifically, in an alternate embodiment, the jaw head730may similarly include a recessed channel761(e.g., recessed channel761aon jaw head730aand recessed channel761bon jaw head730b) that cooperate to form a clip track770. For example, as illustrated inFIG.7F, a portion of the jaw head730may be removed thereby forming a larger opening762at the start of the channel761. The opening762may be larger than the height or diameter of the channel761to aid in aligning and positioning the respective surgical clip leg within the channel761. Additionally, the material removed from the jaw head730near region765may further aid in aligning and positioning the respective surgical clip leg within the channel761.

Once the clip applying jaws140are positioned within the enclosure, the clip loader assembly150is positioned above the clip applying jaws. As mentioned above, the clip loader assembly150includes a proximal clip loader154and a distal clip loader152. The clip loader assembly150cooperates with handles106and various other internal components, such that the distal clip loader154moves in a linear reciprocating motion for loading clips into the clip applying jaws.

FIG.8Aillustrates an example of the clip loader assembly150having a proximal end801and a distal end803. The clip loader assembly150includes a proximal clip loader154and a distal clip loader152. In an example, the proximal clip loader154and the distal clip loader152may be spot welded together at various locations or points within weld region802.

FIGS.8B,8C,8D and8Eillustrate various views of an example proximal clip loader154. The proximal clip loader154may be fabricated from plastic or metal. In an example, the proximal clip loader154is fabricated as a stamped piece(s) of metal. In one example, the proximal clip loader is made from stainless steel (e.g., 316 SS). The proximal clip loader154includes an elongate base810with two retention flanges820aand820bthat are adapted to engage corresponding structures on the top housing102to further align (e.g., align in the horizontal direction) and secure the proximal clip loader154in place. Additionally, a portion of the elongate base810has an engagement portion815that includes a plurality of teeth817. The engagement portion, and more specifically the plurality of teeth817are configured to cooperate with ratchet pawl192. For example, the proximal clip loader has an engagement portion815with teeth817and two indented notches818aand818bpositioned on opposite sides of the engagement portion815. The plurality of teeth815and indented notches818a,818b(hereinafter referred to generally as indented notches818) function as an anti-backup mechanism, which is described in more detail below. The plurality of teeth817are illustrated in more detail inFIG.8E, which is a detail view ofFIG.8D.

The proximal clip loader154also includes a drive aperture830that is configured to accommodate a drive flange (e.g., drive flange1510, seeFIG.15A) of the proximal lever182aof the right lever assembly180a.For example, proximal clip loader154is positioned over the proximal lever182a,such that the drive flange1510(seeFIG.15A) of the proximal lever182aextends upwards through the drive aperture830. Once the drive flange of the proximal lever182ais positioned through the drive aperture830, a corresponding thru-hole (e.g., thru-hole1404, seeFIG.14A) of proximal lever182bis positioned over the remaining portion of the drive flange1510that extends above the proximal clip loader154. For example, the drive aperture830is aligned with the corresponding thru-hole1404of the proximal lever182b.

FIGS.8F,8G,8H and8Jillustrate various views of an example distal clip loader152. The distal clip loader152may be fabricated from plastic or metal. In an example, the distal clip loader152is fabricated as a stamped piece(s) of metal. In one example, the proximal clip loader is made from stainless steel (e.g., 316 SS). The proximal clip loader152includes an elongate base860with two flanges862aand862bthat are adapted to engage corresponding structures on the proximal clip loader154for alignment prior to spot welding. The distal clip loader152also includes a notched window864, such that when the distal loader152is positioned over the proximal clip loader154, the window864provides access to the engagement portion815with teeth817and two indented notches818of the proximal clip loader154. It should be appreciated that instead of stacking and spot welding the proximal clip loader154to the distal clip loader152, the clip loader assembly150may instead be fabricated as a single piece.

The end of the distal clip loader (e.g., the end corresponding to the distal end803of the clip loader assembly150), includes a clip loading tip870. Prior to reaching the clip loading tip870, the elongate base860narrows at a clip loading portion866of the elongate base860. Additionally, the clip loading portion866curves upward at shoulder871until terminating at the clip loading tip870. The clip loading portion866narrows to reduce the width of the elongate base860, thereby allowing the distal clip loader152, and more specifically the clip loading tip870to engage with individual surgical clips of a clip magazine. During application, the distal clip loader152pushes a leading surgical clip from the clip magazine over a retention prong950of the dispenser160(seeFIGS.9C and9D).

In an example, and as illustrated inFIG.8J, the clip loading tip870is curved upwards and forms a U-shaped channel with base872and sidewalls874aand874b.The U-shaped channel is sized and shaped to fit around the retention prong950and between the forks940aand940bof the dispenser (seeFIGS.2A,2B,9C and9D), allowing the clip loading tip870to engage the leading surgical clip without the clip loading tip870contacting the retention prong950or forks940a,940b.For example, sidewalls874aand874bcontact respective points of the leading surgical clip50that overhang on each side of the retention prong. Pushing the leading surgical clip50over the retention prong is further illustrated inFIGS.2A and2B.

FIGS.8K,8L and8Millustrate another example clip loader assembly150. In the illustrated example, the clip loader assembly150includes a distal clip loader152and a proximal clip loader154. The detail view illustrated inFIG.8Millustrates where the proximal clip loader154and the distal clip loader152may be spot welded together. For example, the proximal clip loader154may be spot welded to the distal clip loader152at various locations or points (e.g., weld points802aand802b) within a weld region. The distal clip loader152illustrated inFIG.8Khas many of the same features as the clip loader152illustrated inFIG.8F.

FIGS.8N,8P and8Qillustrate another example of proximal clip loader154. Similar to the proximal clip loader154illustrated inFIG.8B, the proximal clip loader154illustrated inFIG.8Nincludes an elongate base810and drive aperture830that is configured to accommodate a drive flange (e.g., drive flange1510, seeFIG.15A) of the proximal lever182aof the right lever assembly180a.For example, proximal clip loader154is positioned over the proximal lever182a,such that the drive flange1510(seeFIG.15A) of the proximal lever182aextends upwards through the drive aperture830. Once the drive flange of the proximal lever182ais positioned through the drive aperture830, a corresponding thru-hole (e.g., thru-hole1404, seeFIG.14A) of proximal lever182bis positioned over the remaining portion of the drive flange1510that extends above the proximal clip loader154. For example, the drive aperture830is aligned with the corresponding thru-hole1404of the proximal lever182b.The proximal clip loader154also includes an alignment slot832as well as a vertical spacing and alignment protrusion834.

FIGS.9A,9B,9C,9D and9Eillustrate various views of an example dispenser160. The dispenser160may be fabricated from plastic or metal. In an example, the dispenser160is fabricated as a stamped piece(s) of metal. In one example, the dispenser160is made from stainless steel (e.g., half hard304SS). The dispenser160includes an elongate base910with flanges920a,920b,920cand920d,which may serve as a securing flange or snap. For example, the flanges920a-dmay form a press-fit or snap-fit with corresponding structures on bottom housing104. Additionally, the dispenser160includes two openings or thru-holes930aand930b,which may be adapted to assist with initial placement and alignment of the dispenser160. The dispenser160has a proximal end901and a distal end903.

At the distal end903, the dispenser includes forks940aand940bthat curve downward from the elongate base910at shoulder942. Additionally, the dispenser160includes a retention prong950that curves upward from the elongate base910at the shoulder942(seeFIGS.9C and9D). The forks940aand940b,hereinafter referred to generally as forks940, create both a support surface and a track for the legs of a surgical clip50. Additionally, the forks940are sized and shaped similar to the cooperating recessed channels760of the jaw heads730, which form the clip track770. For example, the forks940curve downward such that the end of forks directly lead into the cooperating recessed channels760of the jaw heads (seeFIGS.2A and2B). Therefore, the forks940curve to have the same slope (at their distal ends) as the cooperating recessed channels760.

As mentioned above, the retention prong950is curved upwards to retain the leading surgical clip50until the leading clip is pushed off of the retention prong950by the clip loading tip870. The retention prong950is adapted to have enough rigidity to support and retain a leading surgical clip50while also having enough flexibility to enable the clip loading tip870to temporarily bend the retention prong950downward to allow the leading surgical clip50to advance beyond the retention prong950, along the forks940and through the clip track770formed by the cooperating recessed channels760of the jaw heads730.

As illustrated inFIG.9E, the elongate base910may include two ridges912aand912bthat form a channel970. The channel970is adapted to receive the clip pusher assembly170, which includes a clip pusher spring172and a clip pusher bar174, described in more detail below. Additionally, the elongate base910includes two V-shaped flanges914aand914bwith a first leg of each V-shaped flange914extending downward from the ridge912below the elongate base910before the second leg of the V-shaped flange914extends back upward to the height of the top of the ridge912. The V-shaped flange(s)914may be adapted for alignment and attachment. For example, the V-shaped flange(s)914may be press-fit into a corresponding mating structure in the housing. For example, the V-shaped flange(s)914may first compress inwardly and then snap-back and hook into the corresponding mating structure in the housing.

FIGS.9F,9G,9H and9Iillustrate another example dispenser160. Similar to the dispenser160illustrated inFIG.9A, the dispenser160illustrated inFIG.9Fincludes an elongate base910. Instead of flanges (e.g., flanges920a,920b,920cand920dillustrated inFIG.9A), the dispenser160may include various attachment members925a-f,which may include square shaped thru-holes that are adapted to engage with corresponding securing features of the bottom housing104(e.g., in a snap-fit or press-fit engagement).

The dispenser160has a proximal end901and a distal end903. Similar to the embodiment illustrated inFIG.9A, the example illustrated inFIG.9Fincludes forks940aand940b(at the distal end903) that curve downward from the elongate base910. Additionally, the dispenser160includes a retention prong950that curves upward from the elongate base910to retain the leading surgical clip50until the leading clip is pushed off of the retention prong950by the clip loading tip870.

As illustrated inFIG.9GandFIG.9H, the dispenser160may include sidewalls935aand935bthat fold over to form a spring retention channel937near the proximal end901of the dispenser160. The spring retention channel937may advantageously house clip pusher spring172(seeFIG.1B) and prevent the clip pusher spring172from buckling and popping out of channel937or channel970. For example, without spring retention channel937, the clip pusher spring172may buckle and lose containment when the stack105of clips is near empty. Moving from the proximal end901towards the distal end903, and after the spring retention channel937, the attachment members (e.g., attachment members925cand925f) may be formed from sidewalls of the dispenser160and may form channel970(as illustrated inFIG.9I). The channel970is adapted to receive the clip pusher assembly170, which includes a clip pusher spring172and a clip pusher bar174, described in more detail below.

FIGS.9J,9K,9L,9M, and9Nillustrate yet another example dispenser160(e.g., the dispenser160ofFIG.1K).FIG.9Jillustrates a perspective view of an alternate embodiment of the dispenser160.FIGS.9K,9L, and9Millustrate cross-section views of the dispenser160ofFIG.9J.FIG.9Nillustrates a partial side view of the dispenser160ofFIG.9J. The example dispenser160illustrated inFIGS.9J-9Nincludes a proximal end901, a distal end903, an elongate base910, a spring retention channel937, forks940aand940b,a retention prong950, and a channel970that are similar, respectively, to the proximal end901, the distal end903, the elongate base910, the spring retention channel937, the forks940aand940b,the retention prong950, and the channel970of the example dispenser160ofFIGS.9F-9I. However, it is noted that the shapes and sizes of one or more of these components may vary. For example, the dimensions and/or shapes of channels937and/or970of the dispenser160ofFIGS.9J-9Ncould differ from the dimensions/shapes of the channels937and/or970of the dispenser ofFIGS.9F-9I. As another example, as best shown inFIG.9N, the retention prong950of this illustrated example has a different shape than the example retention prong950illustrated inFIG.9C.

In the illustrated example ofFIGS.9J-9N, the dispenser160also includes a plurality of connectors (hereinafter referred to as connectors926) exemplified by connectors926a,926b,and926c(e.g., attachment mechanisms, etc.). The connectors926can be used to mechanically couple (e.g., via a snap-fit or press-fit engagement) the dispenser160to corresponding sockets of a window cover (e.g., sockets1304a,1304b,1304c,etc. of the window cover108illustrated inFIGS.13D-13F).

As best shown inFIG.9L, a shape (e.g., width) of channel970is defined by various walls (e.g., connectors926b,926c,base910, etc.) of the dispenser160. In this example, the channel970is adapted to receive clip pusher spring172and the clip pusher bar174(e.g., seeFIGS.1G and1K). Similarly, as best shown inFIG.9M, a shape (e.g., width, etc.) of the spring retention channel937is defined by various walls of the dispenser160, including folded sidewalls936aand936b.Similar to the example dispenser160ofFIGS.9F-9I, the spring retention channel937ofFIGS.9J-9Ncould prevent and/or reduce the likelihood of clip pusher spring172popping out of the channels937and/or970.

FIGS.10A and10Billustrate an example of the clip pusher bar174. The clip pusher bar174and clip pusher spring172(seeFIG.1B) may be coupled together to form the clip pusher assembly170. For example, the proximal end1001of the clip pusher bar174may be mounted to a distal end of the clip pusher spring172. The clip pusher bar174includes an elongate shaft1010that is adapted to couple to the clip pusher spring172. At the other end of the elongate shaft1010, the clip pusher bar174includes a clip pusher head1020with a surgical clip contact notch1030. Additionally, the clip pusher bar174may include a lock-out window1040that is adapted to be grabbed by prong950to bring the clip pusher head1020into the jaws730thereby locking-out the jaws730after the last surgical clip50was applied and dispensed.FIG.10Cillustrates another example clip pusher bar174that has many of the same features as the clip pusher bar illustrated inFIGS.10A and10B, but instead of including a lock-out window1040, the clip pusher bar174ofFIG.10Cis adapted for use with a lock-out clip (e.g., lock-out clip185as illustrated inFIG.1C,FIG.1K,FIGS.16A-B, and/orFIG.16C).

The clip pusher spring172provides a constant biasing force to the clip pusher bar174thereby causing the clip pusher head1020, and more specifically the clip contact notch1030, to continually apply pressure to the clip magazine. The constant pressure ensures that a next-leading surgical clip is advanced to the retention prong950of the dispenser160. For example, both the clip pusher bar174and the clip magazine travel along the channel970of the dispenser160until the leading surgical clip50contacts the retention prong950. As discussed above, the leading surgical clip50is retained by the retention prong950until the clip is released (e.g., pushed forward) by the clip loading tip870.

In an example, a surgical clip magazine (not pictured) may carry a stack105of surgical clips50(e.g., a stack105of fifteen surgical clips50). The clip pusher assembly170provides a biasing force to the stack of surgical clips in the magazine until the magazine is empty. Referring back toFIG.2F, the stack of surgical clips are illustrated with a leading surgical clip50at the end of the clip applying jaws140.

FIGS.11A to11Eillustrate an example of ratchet pawl192. The ratchet pawl192includes a pawl pin1102. As discussed above, the pawl pin1102is adapted to fit through the opening or thru-hole550of the main rail120and into the corresponding slot193of the bottom housing104. The ratchet pawl192includes a pick1110and a positioning post1120with flanges1130aand1130b.As illustrated inFIG.11E, the flanges1130aand1130bform a curved oval-shaped flange, referred to generally as flange1130, that corresponds to the shape of the pawl slot552of the main rail120. The positioning post1120sits within the curved oval-shaped pawl slot552of the main rail120, which allows the ratchet pawl197to rotate. The positioning post1120may also be coupled to a torsion spring (not pictured) that advances ratchet pawl pick1110beyond a respective notch818aor818b(depending on movement in a forward or reverse direction) such that the ratchet pawl pick1110can engage teeth817of engagement portion815of the clip loader assembly150(seeFIGS.8B and8E). For example, the pick1110may advance forward along teeth817(towards notch818a) when pushing a clip from dispenser160and may advance backward along teeth817(towards notch818b) when retreating after a clip has been loaded into the jaws.

The ratchet pawl192also includes protrusions1140aand1140bthat are sized and shaped to extend beyond pawl slot552such that the ratchet pawl192maintains a level orientation without pivoting or tilting within the pawl slot552. As noted above, the pawl slot552is sized and shaped to allow flange1130of the ratchet pawl192to pass through the main rail120and sit below the main rail120, thereby allowing the ratchet pawl192to rotate while the main rail120remains fixedly coupled to the bottom housing104.

The main rail120may be fabricated from plastic or metal. In an example, the main rail120is fabricated as a stamped piece(s) of metal. As illustrated in the detail view ofFIG.5E, the pawl slot552is a curved oval slot or track that allows the ratchet pawl192to rotate within the slot552.

FIGS.12A to12Eillustrate an example embodiment of trough110, which is configured to cover the clip pusher spring172within the enclosure of the clip applier100. The trough110may include tabs1202a,1202b,1202cand1202d,hereinafter referred to generally as tabs1202, that are configured to snap into corresponding mating features on the top housing102.

FIGS.13A,13B and13Cillustrate an example window cover108. In this example, the window cover108and trough110are assembled onto the top housing102after the remaining surgical clip drive components (e.g., clip pusher assembly170are positioned into track or channel formed by the clip dispenser160) are installed into the clip applier100. In this example, the window cover108provides a transparent window to enable viewing of the surgical clip magazine and clip pusher assembly170. In this example, the window cover108may attach to the top housing102via tabs1302a,1302b,1302cand1302d,hereinafter referred to generally as tabs1302. The tabs1302are configured to snap into corresponding mating features on the top housing102.

The window cover108has a proximal end1301and a distal end1303. At the distal end1303, the window cover108is curved and slopes downward to further assist in retaining, guiding and directing surgical clips50into the jaw heads of the clip applying jaws140(seeFIGS.2B and2C). The transparent window also enables the user to monitor and track the motion of a surgical clip50as it travels through the clip applier100to the end of the clip applying jaws140.

FIGS.13D,13E, and13Fillustrate top, side, and cross-section views of another example window cover108(e.g., the window cover108ofFIG.1K). In this example, the window cover108includes a plurality of sockets (interchangeably referred to herein as sockets1304) exemplified by sockets1304a,1304b,and1304c.Each of the sockets1304is configured to attach and/or align with (e.g., in a snap-fit or press-fit engagement, etc.) corresponding connectors or other types of attachment members in a dispenser (e.g., the dispenser160ofFIG.1K). Alternatively or additionally, in some examples, the example window cover108is crimped or otherwise mechanically attached to a main rail (e.g., the main rail120ofFIG.1J).

FIGS.14A and14Billustrate an example embodiment of proximal lever182b,distal lever184aand distal lever184b.As illustrated inFIG.1B, proximal lever182bmay be longer than distal levers184aand184b.Each lever includes two openings or thru-holes1402and1404on each side of the lever. The levers may be made of metal. In an example, the levers are fabricated as a stamped piece(s) of metal. In one example, the levers made from stainless steel (e.g., 304 SS). Additionally, each lever may include a spring retention slot1406(also spring retention slot1506for lever182aillustrated inFIG.15A) adapted to receive and retain an end of either spring186aor spring186b,such that the levers of each lever assembly are spring biased towards each other. Specifically, once spring186ais positioned within spring retention slots1406of the proximal lever182aand distal lever184a,the ends of the levers are spring biased towards each other. Similarly, spring186bcouples levers182band184btogether.

For each of the proximal lever182b,distal lever184aand distal lever184b,the thru-holes1402are adapted to fix one end of each lever to its respective handle via pins194(seeFIG.1B). For the proximal lever182b,the thru-hole1404corresponds with the drive aperture830of the proximal clip loader154. As noted above, the drive flange1510of the proximal lever182a(seeFIGS.15A,15B and15C) passes through the bottom of the drive aperture830through the proximal clip loader154and also extends through the thru-hole1404of the proximal lever182b,which controls the linear motion of the clip loader assembly150during handle actuation.

The thru-hole1404of distal lever184bcorresponds with the left drive flange684of the jaw closer130. Similarly, the thru-hole1404of distal lever184acorresponds with the right drive flange682of the jaw closer130. The distal levers184a,184bcause the jaw closer130to move linearly towards the distal end of the clip applier100by urging the drive flanges682,684(and therefore the jaw closer130) forward during handle actuation.

FIGS.15A,15B and15Cillustrate an example embodiment of a proximal lever182aof the right lever assembly180a.As illustrated inFIG.1B, proximal lever182amay be longer than distal levers184aand184b.The proximal lever182aincludes an opening or thru-hole1502on one side of the lever and a drive flange1510on the opposite end. The proximal lever182amay be made of metal. In an example, the proximal lever182ais fabricated as a stamped piece(s) of metal. In one example, the proximal lever182ais made from stainless steel (e.g., 304 SS). Additionally, the proximal lever182amay include a spring retention slot1506adapted to receive and retain an end of the spring186, such that the levers of each lever assembly are spring biased towards each other. For example, spring retention slot1506may provide the same functionality and have the same features as spring retention slot1406described inFIG.14A.

The thru-hole1502is adapted to fix one end of the proximal lever182ato its respective handle via pin194(seeFIG.1B). As noted above, the drive flange1510of the proximal lever182a(seeFIGS.15A,15B and15C) passes through the bottom of the drive aperture830through the proximal clip loader154and also extends through the thru-hole1404of the proximal lever182b,which controls the linear motion of the clip loader assembly150during handle actuation.

FIGS.16A and16Billustrate an example lock-out clip185. The lock-out clip185may include two legs1610aand1610bthat are sized and shaped similar to the legs of a surgical clip, such that the lock-out clip185may advance through the clip applier100and into the clip track770formed by jaw heads730of the clip applying jaws140. However, the lock-out clip185also includes a resilient section1620that has sufficient rigidity and strength to prevent the clip applying jaws140from closing. For example, when the resilient section is positioned within the clip track770, the strength and stiffness of the resilient section1620advantageously prevents the clip applying jaws140from closing, thereby preventing the clinician from unintentionally closing the clip applying jaws140when a surgical clip is not present. In some examples, the lock-out clip185(including the resilient section1620) is formed from a titanium grade 5 material, and other clips (e.g., clip50or any other clip of the stack105illustrated inFIG.1K) is formed from a titanium grade 1 material. In alternative examples, the lock-out clip185, the clip50(shown inFIG.1K), and/or the stack105(shown inFIG.1K) are formed from one or more different materials.

FIG.16Cillustrates another example lock-out clip185(e.g., the lock-out clip185ofFIG.1K). Similar to the example lock-out clip185ofFIGS.16A-16B, the example lock-out clip185ofFIG.16Cincludes two legs1610a,1610band a resilient section1620. For example, a shape of the leg1610a,the1610b,and/or the resilient section1620of the lock-out clip185ofFIG.16Cmay vary from a corresponding shape of a corresponding component of the lock-out clip185ofFIGS.16A-16B.

FIGS.17A,17B,17C,17D,17E,17F and17Gillustrate the jaw portion of the clip applier100in various stages of loading a surgical clip50, crimping the surgical clip50, and applying the surgical clip50to ligate a vessel.

It should be appreciated that for each component with multiple or alternative embodiments, each or any of the embodiments may include the same or similar features as a previously described or a later described embodiment. Specifically, any of the components or features illustrated inFIG.1B, which are illustrated or described in more detail with relation to other figures, may be attributed to any of the components or features illustrated inFIG.1Cand vice versa.

Additionally, it should be appreciated that some example embodiments herein may include fewer or more components than other example embodiments. For instance, some example embodiments of the clip application device100herein can be implemented without one or more of the ratchet prawl192, the trough110, and/or any other component (e.g., pin, screw, etc.) used in other example embodiments of the clip application device100.

Aspects of the subject matter described herein may be useful alone or in combination with one or more other aspects described herein. In an example, a surgical clip applying device includes an enclosure formed from a top housing, a bottom housing and a window cover. The clip applying device also includes a pair of handles including a left handle and a right handle, a main rail supporting a jaw closer, and a pair of clip applying jaws fixedly attached to the bottom housing and retained within the main rail. The pair of clip applying jaws has arms terminating with a pair of jaw heads. Additionally, the clip applying device includes a clip loader assembly with a clip loading tip at the clip loader assembly's distal end and a dispenser positioned above the clip loader assembly. The dispenser includes a pair of clip forks and a retention prong positioned between the pair of clip forks at the dispenser's distal end. The clip loading tip is configured to push a surgical clip supported by the pair of clip forks over the retention prong. The clip applying device also includes a clip pusher assembly configured to advance a plurality of clips towards the pair of jaw heads and a drive mechanism including a plurality of levers and at least one spring. The drive mechanism is configured to translate an actuation of the pair of handles to linear motion of the jaw closer and the clip loader assembly.

In another aspect of the present disclosure, the jaw closer includes an indent with cam members at its distal end. The cam members are configured to engage and compress corresponding ramps on the arms of the clip applying jaws thereby forcing the arms and the jaw heads together as the jaw closer is advanced towards the jaw heads.

In another aspect of the present disclosure, the clip applying device includes a lock-out clip.

In another aspect of the present disclosure, the lock-out clip is sized and shaped to advance into the jaw heads.

In another aspect of the present disclosure, the lock-out clip is configured to prevent the clip applying jaws from closing once positioned within the jaw heads.

To the extent that any of these aspects are mutually exclusive, it should be understood that such mutual exclusivity shall not limit in any way the combination of such aspects with any other aspect whether or not such aspect is explicitly recited. Any of these aspects may be claimed, without limitation, as a system, method, apparatus, device, medium, etc.

The many features and advantages of the present disclosure are apparent from the written description, and thus, the appended claims are intended to cover all such features and advantages of the disclosure. Further, since numerous modifications and changes will readily occur to those skilled in the art, the present disclosure is not limited to the exact construction and operation as illustrated and described. Therefore, the described embodiments should be taken as illustrative and not restrictive, and the disclosure should not be limited to the details given herein but should be defined by the following claims and their full scope of equivalents, whether foreseeable or unforeseeable now or in the future.