Patent Publication Number: US-2021169482-A1

Title: Surgical clip applier

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application is a Continuation application which claims the benefit of and priority to U.S. patent application Ser. No. 16/262,073, filed on Jan. 30, 2019, which claims the benefit of and priority to U.S. Provisional Application Ser. No. 62/662,284, filed on Apr. 25, 2018, the entire content of each of which is incorporated herein by reference. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to surgical instruments. More particularly, the present disclosure relates to surgical clip appliers configured to apply surgical clips to tissue. 
     Description of Related Art 
     Surgical clip appliers are known in the art and are used for a number of distinct and useful surgical procedures. In the case of a laparoscopic surgical procedure, access to the interior of an abdomen is achieved through narrow tubes or cannulas inserted through a small entrance incision in the skin. Minimally invasive procedures performed elsewhere in the body are often generally referred to as endoscopic procedures. 
     Endoscopic surgical clip appliers having various sizes (e.g., diameters), that are configured to apply a variety of diverse surgical clips, are also known in the art, and are capable of applying a single or multiple surgical clips during an entry to the body cavity. Such surgical clips are typically fabricated from a biocompatible material and are usually compressed over tissue. Once applied to tissue, the compressed surgical clip terminates the flow of fluid therethrough. 
     SUMMARY 
     As detailed herein and shown in the drawing figures, as is traditional when referring to relative positioning on a surgical instrument, the term “proximal” refers to the end of the apparatus or component thereof which is closer to the user and the term “distal” refers to the end of the apparatus or component thereof which is further away from the user. Further, to the extent consistent, any or all of the aspects and features detailed herein may be used in conjunction with any or all of the other aspects and features detailed herein. 
     Provided in accordance with aspects of the present disclosure is a surgical clip applier including a handle assembly and an elongated assembly configured to releasably engage the handle assembly. 
     The handle assembly includes a housing, a trigger pivotably coupled to the housing, and a drive bar disposed within the housing and operably coupled to the trigger. The trigger is pivotable through a full actuation stroke from a first un-actuated position of the trigger to an actuated position of the trigger. The drive bar is translatable, in response to pivoting of the trigger, a full drive distance from a first un-actuated position of the drive bar to an actuated position of the drive bar. The drive bar includes a magnetic distal end portion. 
     The elongated assembly includes a proximal hub, an elongated shaft extending distally from the proximal hub, an end effector assembly supported at a distal end portion of the elongated shaft and including first and second jaw members, and an inner drive assembly extending through the proximal hub and the elongated shaft. The inner drive assembly is operably coupled to the end effector assembly such that translation of the inner drive assembly though the proximal hub and the elongated shaft moves the first and second jaw members from an open position to a closed position. The inner drive assembly includes a magnetic proximal end portion. 
     Upon engagement of the elongated assembly with the handle assembly, the magnetic proximal end portion of the inner drive assembly is configured to attract the magnetic distal end portion of the drive bar to move the drive bar to and retain the drive bar in a second un-actuated position of the drive bar wherein the drive bar is movable a reduced drive distance from the second un-actuated position of the drive bar to the actuated position of the drive bar. The movement and retention of the drive bar in the second un-actuated position pivots the trigger to and retains the trigger in a second un-actuated position of the trigger wherein the trigger is pivotable through a reduced actuation stroke from the second un-actuated position of the trigger to the actuated position of the trigger. 
     In an aspect of the present disclosure, with the elongated assembly engaged with the handle assembly, the trigger is movable through the reduced actuation stroke to thereby translate the drive bar through the reduced drive distance to, in turn, translate the inner drive assembly though the proximal hub and the elongated shaft to move the first and second jaw members from the open position to the closed position. 
     In another aspect of the present disclosure, the first and second jaw members are configured to retain a surgical clip therebetween such that, upon movement of the first and second jaw members from the open position to the closed position, the surgical clip is formed. 
     In still another aspect of the present disclosure, the handle assembly further includes a linkage assembly including at least one link coupling the trigger and the drive bar with one another such that pivoting of the trigger translates the drive bar. 
     In yet another aspect of the present disclosure, the inner drive assembly includes at least one actuation shaft. 
     In still yet another aspect of the present disclosure, the handle assembly further includes a latch mechanism configured to releasably engage the proximal hub of the elongated assembly with the housing of the handle assembly. 
     A surgical instrument provided in accordance with aspects of the present disclosure includes a handle assembly and an elongated assembly configured to releasably engage the handle assembly. 
     The handle assembly includes a housing, a trigger pivotably coupled to the housing, and a drive bar slidably disposed within the housing. The trigger is pivotable relative to the housing through a full actuation stroke from a first un-actuated position of the trigger to an actuated position of the trigger to translate the drive bar through the housing through a full drive distance from a first un-actuated position of the drive bar to an actuated position of the drive bar. The drive bar includes a magnetic distal end portion. 
     The elongated assembly includes a proximal hub, an elongated shaft extending distally from the proximal hub, an end effector assembly supported at a distal end portion of the elongated shaft, and an inner drive assembly operably coupled to the end effector assembly such that translation of the inner drive assembly actuates the end effector assembly. The inner drive assembly includes a magnetic proximal end portion, 
     Upon engagement of the elongated assembly with the handle assembly, the magnetic proximal end portion of the inner drive assembly attracts the magnetic distal end portion of the drive bar to pull the drive bar to a second un-actuated position of the drive bar and pivot the trigger to a second un-actuated position of the trigger. As such, the trigger is thereafter pivotable relative to the housing through a reduced actuation stroke from the second un-actuated position of the trigger to the actuated position of the trigger to translate the drive bar through the housing through a reduced drive distance from the second un-actuated position of the drive bar to the actuated position of the drive bar. 
     In an aspect of the present disclosure, with the elongated assembly engaged with the handle assembly, the trigger is movable through the reduced actuation stroke to thereby translate the drive bar through the reduced drive distance to, in turn, translate the inner drive assembly though the proximal hub and the elongated shaft to actuate the end effector assembly. 
     In another aspect of the present disclosure, actuating the end effector assembly includes moving the first and second jaw members of the end effector assembly to a closed position to form a surgical clip disposed therebetween. 
     In still another aspect of the present disclosure, the handle assembly further includes a linkage assembly including at least one link coupling the trigger and the drive bar with one another such that pivoting of the trigger translates the drive bar. 
     In yet another aspect of the present disclosure, the inner drive assembly includes at least one actuation shaft. 
     In still yet another aspect of the present disclosure, the handle assembly further includes a latch mechanism configured to releasably engage the proximal hub of the elongated assembly with the housing of the handle assembly. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Aspects and features of the present disclosure are described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical structural elements and: 
         FIG. 1  is a perspective view of a surgical clip applier provided in accordance with the present disclosure including a handle assembly having an elongated assembly engaged therewith; 
         FIG. 2  is an enlarged, longitudinal, cross-sectional view of a proximal portion of the surgical clip applier of  FIG. 1  with the elongated assembly disengaged engaged from the handle assembly; 
         FIG. 3  is an enlarged, longitudinal, cross-sectional view of the proximal portion of the surgical clip applier of  FIG. 2  with the elongated assembly moving into engagement with the handle assembly; and 
         FIG. 4  is an enlarged, longitudinal, cross-sectional view of the proximal portion of the surgical clip applier of  FIG. 2  with the elongated assembly fully engaged with the handle assembly. 
     
    
    
     DETAILED DESCRIPTION 
     Turning to  FIGS. 1-4 , a surgical clip applier embodying the aspects and features of the present disclosure is shown identified by reference numeral  10 . Surgical clip applier  10  generally includes a handle assembly  100  and one or more elongated assemblies, e.g., elongated assembly  200 , selectively connectable to handle assembly  100 . Handle assembly  100  is configured to operate an elongated assembly upon connection thereto, and may be configured as a sterilizable, reusable component or otherwise configured such that handle assembly  100  may be used with different and/or additional elongated assemblies during the course of one or more surgical procedures. The one or more elongated assemblies may be configured as single-use disposable component, limited-use disposable component, or reusable component, depending upon a particular purpose. For the purposes herein, elongated assembly  200  is described, although it is understood that handle assembly  100  is configured for use with additional and/or alternative elongated assemblies. 
     Handle assembly  100  generally includes a housing  110 , an actuation mechanism  120  operably associated with housing  110 , a latch assembly  160  operably associated with housing  110 , and a rotating receiver assembly  180  operably coupled to a distal portion of housing  110 . Housing  110  of handle assembly  100  supports and/or encloses the operating components of handle assembly  100  and defines a body portion  111  and a fixed handle portion  112  depending from body portion  111 . Body portion  111  of housing  110  includes an internal pivot post  114  extending transversely within body portion  111  and a distal opening  118  through which a proximal end portion of elongated assembly  200  extends when elongated assembly  200  is engaged with handle assembly  100 . 
     Actuation mechanism  120  is operably supported by housing  110  and includes a trigger  122 , a drive bar  130 , and a linkage assembly  140 . Trigger  122  includes a grasping portion  123 , an intermediate pivot portion  124 , and a proximal extension  125 . Grasping portion  123  of trigger  122  extends downwardly from body portion  111  of housing  110  in opposed relation relative to fixed handle portion  112  of housing  110 . Grasping portion  123  is configured to facilitate grasping and manipulation of trigger  122 . Intermediate pivot portion  124  of trigger  122  is at least partially disposed within housing  110  and defines a pivot aperture  126  that is configured to receive pivot post  114  of housing  110  so as to enable pivoting of trigger  122  about pivot post  114  and relative to housing  110 , e.g., between an un-actuated position, wherein grasping portion  123  of trigger  122  is spaced-apart relative to fixed handle portion  112 , and an actuated position, wherein grasping portion  123  of trigger  122  is approximated relative to fixed handle portion  112 . 
     Proximal extension  125  of trigger  122  is disposed on an opposite side of intermediate pivot portion  124  and, thus, pivot post  114 , as compared to grasping portion  123  of trigger  122 . As such, pivoting of grasping portion  123  to rotate in one direction, e.g., proximally towards fixed handle portion  112 , pivots proximal extension  125  to rotate in the opposite direction, e.g., distally. 
     Linkage assembly  140  includes a first linkage  142 , a second linkage  144 , and a third linkage  146 . First linkage  142  is pivotably coupled to proximal extension  125  of trigger  122  towards a first end portion of first linkage  142 . Second and third linkages  144 ,  146 , respectively, are each pivotably coupled to a second, opposite end portion of first linkage  142  at respective first end portions of second and third linkages  144 ,  146 . A second, opposite end portion of second linkage  144  is pivotably coupled to drive bar  130 , while a second, opposite end portion of third linkage  146  is pivotably coupled to body portion  111  of housing  110 . Thus, the pivot point between first linkage  142  and proximal extension  125  of trigger  122 , the pivot point between first linkage  142  and second and third linkages  144 ,  146 , respectively, and the pivot point between second linkage  144  and drive bar  130  are movable pivot points (e.g., movable relative to housing  110 ), while the pivot point between third linkage  146  and housing  110  is a fixed pivot point (e.g., fixed relative to housing  110 ). 
     Upon actuation of trigger  122 , e.g., proximal pivoting of grasping portion  123  of trigger  122  in a counterclockwise direction from the orientation illustrated in  FIGS. 1-4 , proximal extension  125  is moved in a distal, counterclockwise direction, thereby urging first linkage  142  towards drive bar  130 . This movement of first linkage  142  towards drive bar  130 , in turn, urges the first end portions of second and third linkages  144 ,  146 , respectively, towards drive bar  130  to, in turn, urge the second end portion of second linkage  144  distally such that drive bar  130  is translated distally through body portion  111  of housing  110  from a proximal, un-actuated position thereof towards a distal, actuated position thereof. A biasing spring (not shown) may be provided to bias trigger  122  in a clockwise direction towards the un-actuated position thereof, thereby biasing drive bar  130  proximally towards its un-actuated position. Trigger  122  defines a maximum actuation stroke “A1” from its un-actuated position to its actuated position to, in turn, translate drive bar  130  a maximum drive distance “D1” from its un-actuated position to its actuated position. 
     Drive bar  130  is slidably disposed within body portion  111  of housing  110 . At least a distal portion  132  of drive bar  130  includes a magnetic material  132   a . A distal end portion  132  of drive bar  130  may be formed from a magnetic material, include a magnetic material coated thereon, may engage a magnet thereon or therein, or may otherwise be configured such that distal end portion  132  of drive bar  130  is magnetic. 
     Latch assembly  160  is configured to facilitate releasable locking engagement of elongated assembly  200  with handle assembly  100 . Latch assembly  160 , more specifically, includes a pivoting lever arm  162  operably disposed on and extending into body portion  111  of housing  110 . Lever arm  162  includes an engagement finger  164  disposed towards one end thereof and a manipulatable portion  166  disposed towards the other end thereof with a pivot portion  168  disposed therebetween. Thus, upon depression of manipulatable portion  166  into housing  110  from a locked position to an unlocked position, engagement finger  164  is withdrawn upwardly and, upon release of manipulatable portion  166  and return thereof to the locked position, engagement finger  164  is returned downwardly. A torsion spring (not shown) disposed about pivot portion  168 , or other suitable biasing spring in any suitable position, may be provided to bias lever arm  162  towards the locked position, although other configurations are also contemplated. 
     Rotating receiver assembly  180  is configured to receive a proximal end portion of elongated assembly  200  and to enable selective rotation thereof relative to housing  110 . Rotating receiver assembly  180  includes a rotation knob  182  rotatably coupled to body portion  111  of housing  110  and extending distally therefrom. Rotation knob  182  defines a lumen  184  extending therethrough in communication with distal opening  118  of body portion  111  of housing  110  to enable insertion of a proximal portion of elongated assembly  200  therethrough and into operable engagement within housing  110 . 
     Elongated assembly  200  generally includes a proximal hub  220 , an elongated shaft  240  extending distally from proximal hub  220 , an end effector assembly  260  disposed towards a distal end portion of elongated shaft  240 , and an inner drive assembly  280  extending through proximal hub  220  and elongated shaft  240  and configured for operable coupling between handle assembly  100  and end effector assembly  260  when elongated assembly  200  is engaged with handle assembly  100  to enable firing of a surgical clip (not shown) about tissue. 
     Proximal hub  220  is configured for insertion through lumen  184  of rotation knob  182  and into body portion  111  of housing  110 . Proximal hub  220  defines an annular recess  222  towards the proximal end thereof and a chamfered proximal edge  224 . Thus, upon insertion of proximal hub  220  through lumen  184  of rotation knob  182  and into body portion  111  of housing  110 , chamfered proximal edge  224  cams engagement finger  164  of latch assembly  160  over the outer surface of proximal hub  220  until engagement finger  164  is disposed in alignment with annular recess  222 , wherein engagement finger  164  falls into engagement within annular recess  222  to engage proximal hub  220  and, thus, elongated assembly  200 , with handle assembly  100 . In order to disengage and remove elongated assembly  200  from handle assembly  100 , manipulatable portion  166  of latch assembly  160  is depressed into housing  110  to withdraw engagement finger  164  from annular recess  222  and enable elongated assembly  200  to be pulled distally and removed from handle assembly  100 . Proximal hub  220  and/or rotation knob  182  may further include complimentary keying features such that, upon insertion of proximal hub  220  into rotation knob  182 , elongated assembly  200  is rotationally fixed relative to rotation knob  182  and such that rotation knob  182  and elongated assembly  200  are together rotatable relative to housing  110  upon rotation of rotation knob  182  relative to housing  110 . Elongated shaft  240  extends distally from proximal hub  220  and supports end effector assembly  260  towards the distal end thereof. 
     End effector assembly  260  includes first and second jaw members  262 ,  264  pivotably engaged to one another to permit pivoting of jaw members  262 ,  264  relative to one another and elongated shaft  240  between an open position and a closed position. Jaw members  262 ,  264  are configured to receive and close, fire, or form a surgical clip about tissue, e.g., a surgical clip similar to those shown and described in U.S. Pat. No. 4,834,096, then entire contents of which are hereby incorporated herein by reference. However, it is contemplated that any suitable end effector assembly configured to close, fire, or form any suitable surgical clip(s) may be utilized with elongated assembly  200  in accordance with the present disclosure. 
     Inner drive assembly  280 , as noted above, extends through proximal hub  220  and elongated shaft  240 . Inner drive assembly  280  may include one or more actuation shafts  282  that cooperate to operably couple to jaw members  262 ,  264  of end effector assembly  260  towards a distal end portion (not shown) of inner drive assembly  280  such that translation, e.g., distal translation, of the one or more actuation shafts  282  of inner drive assembly  280  through elongated shaft  240  and relative to end effector assembly  260  pivots jaw members  262 ,  264  from the open position towards the closed position. A proximal end portion  284  of inner drive assembly  280 , e.g., the proximal portion of one of the actuation shafts  282 , is configured to couple to distal portion  132  of drive bar  130  upon engagement of elongated assembly  200  within handle assembly  100 . 
     Proximal end portion  284  of inner drive assembly  280  includes a magnetic material  280   a . Proximal end portion  284 , more specifically, may be formed from a magnetic material, include a magnetic material coated thereon, may engage a magnet thereon or therein, or may otherwise be configured such that proximal end portion  284  of inner drive assembly  280  is magnetic. 
     Upon engagement of elongated assembly  200  within handle assembly  100 , the magnetic distal end portion  132  of drive bar  130  and the magnetic proximal end portion  284  of inner drive assembly  280  attract and couple to one another in abutting, inter-fitting, or other suitable engagement to secure distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  relative to one another. As such, distal translation of drive bar  130  relative to housing  110 , e.g., in response to actuation of trigger  122 , urges inner drive assembly  280  distally through elongated shaft  240  and relative to end effector assembly  260  to pivot jaw members  262 ,  264  towards the closed position to close, fire, or form a surgical clip disposed between jaw members  262 ,  264 . On the other hand, proximal translation of drive bar  130  relative to housing  110 , in response to release or return of trigger  122 , pulls inner drive assembly  280  proximally through elongated shaft  240  and relative to end effector assembly  260  to pivot jaw members  262 ,  264  back towards the open position. 
     Referring generally to  FIGS. 1-4 , as noted above, handle assembly  100  is configured such that trigger  122  defines maximum actuation stroke “A1” that, in turn, translates drive bar  130  maximum drive distance “D1.” Inner drive assembly  280 , as also noted above, is configured to translate through elongated shaft  240  and relative to end effector assembly  260  to pivot jaw members  262 ,  264  from the open position towards the closed position to close, fire, or form a surgical clip disposed between jaw members  262 ,  264 . However, depending upon the configuration of the elongated assembly  200  utilized and/or the surgical clip (not shown) to be closed, fired, or formed, drive bar  130  may not need to translate the maximum drive distance “D1” in order to fully actuate the inner drive assembly  280  to fully close, fire, or form the surgical clip. In such instances where drive bar  130  is not required to translate the maximum drive distance “D1” in order to fully actuate inner drive assembly  280 , a dead space may be created at the beginning and/or end of the maximum actuation stroke “A1” of trigger  122  (and, thus, the maximum drive distance “D1” of drive bar  130 ) wherein trigger  122  is being actuated to translate drive bar  130  but there is no effect on end effector assembly  260 . This dead space effect may be undesirable by the user. 
     The present disclosure eliminates the aforementioned dead space effect utilizing the magnetic coupling of distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  with one another, although other suitable couplings eliminating this dead space effect are also contemplated. More specifically, distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  are configured such that, upon engagement of elongated assembly  200  within handle assembly  100 , the magnetic attraction between distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  pulls drive bar  130  distally towards inner drive assembly  280  such that the magnetic distal end portion  132  of drive bar  130  and the magnetic proximal end portion  284  of inner drive assembly  280  attract and couple to one another, thus retaining drive bar  130  in a more-distal position as compared to the un-actuated position thereof. The distal pulling and retention of drive bar  130  in the more-distal position, in turn, pivots trigger  122  in a counterclockwise direction from the un-actuated position towards the actuated position and retains trigger  122  in the more-counterclockwise position. As such, the initial starting positions of trigger  122  and drive bar  130  are shifted (while the fully actuated positions thereof remain the same) such that, in use, trigger  122  is only capable of being actuated through a reduced actuation stroke “A2” to, in turn, translate drive bar  130  a reduced drive distance “D2.” More specifically, the actuation stroke of trigger  122  and drive distance of drive bar  130  are reduced according to the actuation stroke and actuation distance required to pivot jaw members  262 ,  264  from the open position towards the closed position to close, fire, or form a surgical clip disposed between jaw members  262 ,  264 , thereby eliminating any dead space. Thus, upon actuation, trigger  122  and drive bar  130  may be actuated through the reduced actuation stroke “A2” and reduced drive distance “D2,” respectively, to the fully actuated positions thereof to pivot jaw members  262 ,  264  from the open position towards the closed position to close, fire, or form a surgical clip disposed between jaw members  262 ,  264  without the dead space effect. 
     As an alternative to the magnetic attraction between distal portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  pulling drive bar  130  distally to engage inner drive assembly  280 , or where the initial spacing between distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  is too great to enable magnetic attraction, trigger  122  may be primed by partially actuating trigger  122  until distal end portion  132  of drive bar  130  and proximal end portion  284  of inner drive assembly  280  engage one another and are held in engagement via the magnetic attraction therebetween, thereby retaining drive bar  130  and trigger  122  in their respective modified initial positions. 
     While use of a pair of magnetic materials  132   a ,  280   a  is shown and described in embodiments hereof, it is contemplated and within the scope of the present disclosure that a single magnetic material  123   a  or  280   a  may be used in combination with a complimentary ferromagnetic or magnetically attractive material (e.g., iron, nickel, cobalt, gadolinium, dysprosium and alloys such as steel that also contain specific quantities of ferromagnetic metals such as iron or nickel therein). It is further contemplated that an electromagnet may be incorporated into handle assembly  100  and/or elongated assembly  200 , as understood by one skilled in the art, to achieve the intended purpose of magnetic materials  132   a ,  280   a  described herein. 
     As can be appreciated, depending upon the particular requirements of the elongated assembly utilized with handle assembly  100 , the actuation stroke of trigger  122  and drive distance of drive bar  130  may not be reduced at all, may be reduced a relatively small amount, or may be reduced a relatively larger amount. Thus, handle assembly  100  provides a reliable feel without the dead space effect regardless of the particular configuration of the elongated assembly utilized therewith. 
     It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.