Source: http://www.google.com/patents/US6607542?dq=7222078
Timestamp: 2015-01-31 17:53:50
Document Index: 415925675

Matched Legal Cases: ['art 28', 'art 27', 'art 26', 'art 27', 'art 27', 'art 27', 'art 26']

Patent US6607542 - Surgical apparatus and method for occluding or encircling a body passageway - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsA surgical apparatus and method for occluding or encircling a body passageway, e.g. for haemostasis, is described. The apparatus comprises generally a delivery system for offering a temperature-dependent shape memory material clip (3′) (e.g. of Nitinol and suitably of generally U-shape in the open...http://www.google.com/patents/US6607542?utm_source=gb-gplus-sharePatent US6607542 - Surgical apparatus and method for occluding or encircling a body passagewayAdvanced Patent SearchPublication numberUS6607542 B1Publication typeGrantApplication numberUS 09/857,874Publication dateAug 19, 2003Filing dateDec 10, 1999Priority dateDec 11, 1998Fee statusPaidAlso published asDE69936353D1, EP1139885A2, EP1139885B1, WO2000035355A2, WO2000035355A3Publication number09857874, 857874, US 6607542 B1, US 6607542B1, US-B1-6607542, US6607542 B1, US6607542B1InventorsAndrew Michael WildOriginal AssigneeAndrew Michael WildExport CitationBiBTeX, EndNote, RefManPatent Citations (18), Referenced by (22), Classifications (16), Legal Events (3) External Links: USPTO, USPTO Assignment, EspacenetSurgical apparatus and method for occluding or encircling a body passagewayUS 6607542 B1Abstract A surgical apparatus and method for occluding or encircling a body passageway, e.g. for haemostasis, is described. The apparatus comprises generally a delivery system for offering a temperature-dependent shape memory material clip (3′) (e.g. of Nitinol and suitably of generally U-shape in the open (a) condition) onto the body passageway, allowing body heat to warm the clip whereby the clip closes to a closed (b) condition in which it occludes or encircles the body passageway. The apparatus is then withdrawn from the operating zone. The apparatus includes drive and control functions for moving a train of clips (3′) within a shaft (2′) of the apparatus towards a distal end port (6′), and preferably a temperature control system whereby the clips within the housing are maintained at a first temperature, substantially below body temperature.
18. The surgical clip of claim 17, wherein the Nitinol has an martensite start temperature Ms which is at least 10� C. below Af.
(a) providing a clip comprising an elongate element having first and second ends and an intermediate central portion, the clip comprising a temperature dependent shape memory material and being resiliently movable, in response to an increase in temperature from a first temperature, substantially below body temperature, to body temperature under an inherent biassing force from first configuration, in which the ends are spaced apart to allow the body passageway to pass therebetween, to a second configuration in which the clip is deformed on itself so that the clip grips or encircles the body passageway, wherein the first and second ends are legs which in the first configuration extend in the same general direction as each other from the intermediate central portion, and the intermediate central portion has at least one apex directed generally towards the legs of the clip, the clip being provided at the first temperature and in the first configuration thereof; (b) offering the clip to the body passageway so that the body passageway is received substantially between the ends of the clip; and (c) allowing the temperature of the clip to rise to approach body temperature by the proximity of the body passageway to the clip, whereby the clip deforms into its second configuration around the body passageway. 35. The surgical method of claim 34, including the steps of:
(a) utilizing a surgical apparatus having a housing for holding the clip, the housing having a port through which a clip can be released; and (b) offering the clip to the body passageway by locating the port of the surgical apparatus in proximity to the body passageway and expelling a clip through the port, whereby the clip resiliently deforms itself onto the body passageway. Description
FIELD OF THE INVENTION The present invention relates to a surgical apparatus and method for occluding or encircling a body passageway such as a blood vessel. The invention further relates to surgical clips suitable for use in such an apparatus and method. The word �surgical� herein includes human and veterinary surgery and the word �patient� herein includes human and animal patients.
The word �occluding� herein includes complete or partial closure of a body passageway and the word �encircling� herein includes prevention of expansion of a body passageway without application of a constrictive force.
DESCRIPTION OF THE PRIOR ART The surgical control of bleeding (haemostasis) by the closing of blood vessels is one of the oldest and most fundamental principles of surgery. Modern techniques such as minimally-invasive surgery cannot be performed without effective haemostasis, but there are significant difficulties in that the surgical instruments have to be controlled remotely from an operating zone within a patient and the surgeon is typically viewing the operating zone via an endoscope.
WO-A 92/13490 (Friedland), for example, describes a surgical fastening clip of a substantially U-shaped member of a shape memory metal alloy (eg Nitinol). The clip has an austenitic transformation temperature in the range of 30 to 35�, i.e just below normal body temperature. A range of clip designs is illustrated. FIG. 4, for example, shows a clip generally having two straight legs joined to form the general U-shape. In FIGS. 15 and 16, the legs are each kinked into a zig-zag shape. In FIGS. 20 and 21 the low temperature shape is straight-legged, the zig-zag shape appearing only in the austenitic state. A general feature of the clips is that in the austenitic shape the legs are tightly clamped together. The description teaches that the clips are to be squeezed down onto a vessel or tissue in the niartensitic (low temperature) state, whereupon heating to body temperature is allowed to occur to change the alloy to its austenitic state and �lock� the clip into the clamping condition (see, e.g. page 18, line 23 to page 19, line 7).
U.S. Pat. No. 5,601,572 (Middleman et al), the disclosure of which is incorporated herein by reference, describes a surgical use of pseudoelastic shape memory alloys in which the memorised physical deformation takes place without additional squeezing or other pressure, and is an essential feature of the operation of a surgical instrument. �Pseudoelasticity� is a behaviour exhibited by shape memory alloys in a stress-induced martensitic condition. The instruments disclosed include a variety of devices in which generally an elongate member formed of a shape memory alloy is housed under stress within a hollow shaft of the instrument and extended from/retracted into a distal end of the shaft at an operating zone within a patient. In its extended condition the elongate member adopts its �memorised� shape, to perform a variety of surgical tasks.
WO-A 98/58591 (Boston Scientific Corporation; filed Jun. 17, 1998; published Dec. 30, 1998), the disclosure of which is incorporated herein by reference, describes a haemostatic clip formed of a material exhibiting pseudoelastic behaviour at body temperature. Such materials include shape memory alloys when in a stress-induced martensitic condition, and this reference describes the use of generally U-shaped staple-like haemostatic clips of such alloys which are individually held under stress with the legs of the clip forced into parallel alignment, at body temperature in an applicator device described as a �hypotube� (See FIGS. 1 to 5 and associated description). Upon release from the hypotube onto a blood vessel, the legs of the clip close together as the austenitic phase predominates and the memorised shape is adopted. A corresponding circular clip is illustrated in FIGS. 8 to 11, the clip being initially held confined in a curved hypodermic needle to stress-induce the martensitic condition. The closure of the clip is triggered by release of the stress, with no change in temperature.
SUMMARY OF THE INVENTION The invention is based on the finding that a clip, comprising an elongate element having first and second ends and being resiliently movable under an inherent biassing force between a first configuration in which the ends are spaced apart to allow a body passageway to pass therebetween and a second configuration in which the elongate element is deformed, preferably generally helically wound, on itself so that the clip grips or encircles the body passageway, can be released or offered towards the body passageway in the first configuration using a clip dispensing apparatus, whereupon the clip resiliently deforms itself around the body passageway to encircle and optionally constrict and occlude the same. The expressions �helical� and �generally helically wound�, used herein, refer to at least one end of the clip bending inwardly around the body passageway, preferably to a condition where the ends are overlapping or crossing one another at least to some extent, and in particular are not to be considered as limited only to circular or cylindrical configurations
DETAILED DESCRIPTION OF THE INVENTION Thus, in a first aspect of the present invention, there is provided a surgical apparatus for occluding or encircling a body passageway, the apparatus generally comprising:
When referring to the elongate element of the clips for use in the device of the present invention, the expression �resilient� and like expressions used herein shall be taken to refer to all forms of inherent or internal (molecular) biassing of the elongate element of the clip towards its second configuration. For example, a biocompatible temperature-responsive �shape-memory� material can be used, in which the resilience is activated by a change (typically a rise) in temperature, so avoiding the need for the clip to be held in its first configuration against a restoring force. The �memorised� shape will be the second, e.g. helical, configuration. The �shape-memory� material may, for example, be a metallic alloy such as Ti�Ni, Ni�Al, Ag�Cd or Au�Cd, a norbornene polymer, a nematic liquid crystal polymer, or an advanced thermoplastic elastomer such as a homopolymer of lactide or glycolide or copolymers thereof. For further discussion of these materials, please refer to U.S. Pat. Nos. 3,442,871, 3,797,499, 3,839,297,4,505,767,4,523,591, 4,603,695 4,935,068 and 4,950,258, as well as British Patent No. 1040168 (the disclosures of all of which are incorporated herein by reference), in addition to the prior art acknowledged above.
In summary, and as will be well known to those of ordinary skill in this art, shape memory alloys are capable of transforming between martensitic and austenitic phases. This transformation between phases can be caused by a change in temperature. For example, a shape memory alloy in the martensitic phase will begin to transform to the austenitic phase when its temperature rises above the austenite start temperature As, and the transformation will be complete when the temperature rises above the austenite finish temperature Af. The transformation from austenitic to martensitic will begin when the temperature drops below the martensite start temperature Ms, and will be complete when the temperature drops below the martensite finish temperature Mf. The temperatures Ms, Mf, As and Af define the thermal transformation hysteresis loop of the shape memory alloy, and can be adjusted with a relatively high degree of precision, in the case of Ti�Ni alloys by adjustment of the relative proportions of the nickel and titanium.
The preferred material is a biocompatible and magnetic resonance imaging (MRI-) compatible temperature-dependent shape memory material having a shape transition temperature (martensite-to-austenite) in the range of approximately 20-35� C. This means that Af should be no greater than about 35� and As, should preferably be no less than about 20� C., e.g. less than about 15� C. Such a material is Nitinol, which is a nickel-titanium alloy comprising approximately 50 atomic percent nickel. For example, the alloy may be a binary alloy consisting of 50.8 atomic percent nickel and 49.2 atomic percent titanium, or it may include a quantity of a third element such as copper, cobalt, vanadium, chromium or iron. The binary alloy is preferred, as the more complex systems generally have inferior biocompatability.
Such clips should be stored in the martensite phase at a reduced temperature (preferably below about 20� C., e.g. below about 15� C.), so that, on deployment into the operating zone within the patient, the patient's body temperature rapidly heats the clip to a temperature above the martensite-to-austenite shape transition temperature, preferably above Af. This has been found to impart a closing force of up to 200 grams force onto the body passageway as the ends of the clip close to the second configuration of the clip. In this way, the closing force can be tailored to the intended end use of the clip, e.g. a crushing force (for haemostasis, for example) or a non-crushing force (for occluding body ducts, e.g. in sterilisation).
The first and second ends of the clip preferably comprise legs extending in the same general direction as each other from the intermediate central portion, the intermediate central portion being most preferably convoluted as will be described in more detail below. The term �generally the same direction� used herein refers to directions which are broadly similar, i.e. less than about 120� separated, preferably less than about 45� separated. This configuration will be referred to herein as a generally U-configuration.
It is an important preferred feature of the apparatus that the distal clip, prior to expulsion from the apparatus, is held in the port of the housing in its first (open) configuration, adjacent to the body passageway to be occluded or encircled and in such a way that the ends of the clip are free to deform onto the body passageway without external pressure to close the clip. Once the closing movement has sufficiently advanced, the apparatus can be withdrawn, without any internally driven propulsion of the clip from the housing. The expression �expulsion� or �expelled� used herein to describe the dispensing of the distal clip from the apparatus, includes all forms of release, including passive dispensing in this sense, i.e. the withdrawal of the apparatus from the operating zone so as to leave the clip in place on the body passageway.
Alternatively, the cover member may be moved into and out of position by use of a cover member control device operable externally of the housing. In a preferred form of such an arrangement, the clip control device and the cover member control device are synchronised and actuable by a single action of the surgeon. In such an arrangement, the cover member for the port of the housing preferably takes the form of a retractable shutter, movable back and forth in response to actuation of the cover member control device. The shutter preferably has a closed portion which serves to cover the port of the housing when the closed portion and port are correspondingly aligned and an open portion which serves to uncover the port when the open portion and port are correspondingly aligned. By providing a retractable cover member at the port of the housing, and by synchronising the clip control device and cover member control device so that the drive member of the apparatus can only operate on the clips when the port is covered, there is no possibility of causing more than one clip to become available to be released through the port in on �firing� (i.e. actuation) by the surgeon.
The clip control device of the apparatus are preferably manually operable by the surgeon (e.g. by finger pressure on a button or trigger). The control of clip movement and expulsion is of great importance to the success of the apparatus, as the consequences of incorrect �firing� of the apparatus would be catastrophic for a patient.
The apparatus may suitably be provided in disposable and reusable parts, which are releasably connectable together for use. The �disposable� part(s) is/are suitably provided in sterile individual packs, and the �reusable� part(s) is/are suitably provided in sterilisable materials and in an sterilisable configuration.
Where it is convenient, and where suitable laboratory or workshop facilities are available the �disposable� part(s) may in fact be made recyclable, e.g. reloadable With clips, resettable into the ready-for-use configuration, and resterilisable.
BRIEF DESCRIPTION OF THE DRAWINGS For ease of understanding the present invention, embodiments will now be described, without limitation and purely by way of example, with reference to the accompanying drawings, in which:
FIG. 5 shows schematically in transverse cross-section on the line V�V of FIG. 1 the synchronisation of the closure and clip drive means of the apparatus of FIG. 1;
FIG. 7 shows an enlarged cross-sectional view along the line VII�VII of FIG. 6, looking in the direction of the arrows;
FIG. 8 shows an enlarged cross-sectional view along the line VIII�VIII of FIG. 6, looking in the direction of the arrows;
FIG. 15b shows a vertical cross-sectional view of the distal end cover of FIG. 15a; FIG. 16 shows a vertical longitudinal cross-sectional view of the apparatus of FIG. 12, showing the separation of the handle and housing parts;
FIG. 18 shows a vertical cross-sectional view of the apparatus of FIG. 16, along the line XVIII�XVIII and looking in the direction of the arrows;
DETAILED DESCRIPTION OF THE DRAWINGS Referring firstly to FIGS. 1 to 11 of the drawings, a surgical apparatus for occluding or encircling a body passageway 1 (e.g. a vein or artery) during endoscopic surgery comprises a housing in the general form of a hollow shaft 2 holding a line of surgical clips 3. The apparatus will be described herein only with reference to at least partial occlusion of the body passageway. Encirclement of a body passageway without constriction can be achieved by selecting the appropriate tightness of winding of the helical configuration of the clip. The shaft 2 has a proximal end 4 and a distal end 5. The distal end 5 of the shaft 2 is provided with a port 6 through which an individual clip 3 can be released. The port 6 is openable and closable by means of a cover member 7 for the port, the cover member 7 being movable selectively to cover or uncover the port by means of cover member control means operable externally of the housing to control the movement of the cover member. The cover member control means will be described in more detail below.
The clip may be formed of a �shape-memory� biocompatible polymer, preferably by moulding, and if necessary the ends 14 may be provided with a coating of ultrahigh molecular weight polyethylene, although �memory� metal may, for example, alternatively be used. This provides a low-friction surface when the enlarged ends slide over one another in a cam action as the clip closes around the body passageway 1.
The �memorised� shape of the clip is a tightly wound helix or spiral, as shown in FIGS. 3 and 4, and the material of the clip is such that the clip moves rapidly into that configuration in response to the temperature rise which is associated with release from the apparatus into an operating zone within a patient's body. The inner diameter of the spiral can be predetermined by adjusting the length of the elongate element 13. In addition, the torsional force applied to the body passageway 1 can be altered by adjusting the thickness of the elongate element 13 and by altering the physical state of the material at the time of initial deformation. These modifications are routine for those of ordinary skill in the art of resilient (e.g. �shape memory�) materials.
The handle 10 is of the pencil type, as described generally in WO-97/42884, with a mid-point third finger�thumb pivot, and provision for both second and fourth finger control on the forward (right as illustrated) surface 18. On the section adjacent to the body 14 of the apparatus lies the trigger 9. This is depressed for release of a haemostatic clip 3 by opening of the port 6, whereby the end clip twists out of the shaft 2, with simultaneous release of the pressor effect of the central pressor rod 8. One haemostatic clip 3 is released when the trigger 9 is fully depressed and the mechanism then remains static until release of the trigger by the surgeon, whereupon the inner hollow shaft 2 b rotates to a 90� opposed position, so closing the distal port 6. Trigger release also causes the spring biassing to be reapplied on the pressor rod 8, thereby causing the pressor rod 8 to move forward and resume its forward effect upon the remaining haemostatic clips 3 in the apparatus.
The body 14 houses the links from the trigger 9 to the ratchet release system 15 and the cam mechanism 16. The cam mechanism 16 comprises a lightweight face-plate or cam 19, having a central aperture which receives the inner shaft 2 b whereby the cam 19 is fixedly mounted on the inner shaft 2 b. The cam is sprung via two opposed wire springs 20, 21, attached to the body casing 22. A link rod 23 from the trigger 9 is attached to one corner 19 a of the cam, and rotates the cam 90� back and forth. Owing to the lightweight nature of the cam and inner shaft and the balance spring effect, the whole mechanism flips back and forth upon respective actuation and release of the trigger 9.
In the embodiment shown, the shaft 2 is permanently closed over its distal end face 24 and fashioned from lightweight material, which is biologically inert, such as stainless steel. The outer 2a and inner 2b shafts are each provided with a side opening near the distal end thereof, forming the port 6 of the shaft. The opening of the outer shaft 2 a is generally in line with the handle 10, i.e. on the under side of the shaft of the apparatus as illustrated in FIG. 1. The inner shaft 2 b is rotatable within the outer shaft, as previously described, and the arrangement is such that the opening of the inner shaft can be aligned with the opening of the outer shaft to open the port 6 formed by the aligned openings. When the inner shaft 2 b is rotated to the release, or �open� position (FIG. 5) the two openings lie coincidental, providing an unhindered release for a haemostatic clip 3 through the port 6.
FIG. 5 shows a functional schematic diagram of this process. It shows the �opening� process upon actuation of the trigger by a surgeon's finger 25 and the �closing� process upon release of the trigger 9. These states (�open� and �closed�) refer to the condition of the port 6. With finger pressure (arrow A) the trigger 9 moves to the left as illustrated (is depressed), the two arms of the hinged mechanism move closer together within the handle 10 and thereby force the sliding mechanism down, away from the body 14 of the apparatus, so pulling the link rod 23 down, further along the handle 10. This rotates the cam 19 around, and thereby rotates the inner shaft 2 b, this rotation being against the restoring force of the opposed wire springs 20, 21. The cam 19 is square in shape and rotates, sliding as it does so against the inner wall of the body casing, which is suitably of plastic. Once it begins to rotate it assumes an unstable position and can either flip back to the stable rest position (if the surgeon inadvertently, or purposefully prematurely releases the trigger before completion of the cycle). With continued finger pressure on the trigger, however, the cam 19 springs around to the next stable position (full length side of the cam 19 against the inner casing wall), which is reached with full depression of the trigger 9. At this point the inner shaft has moved through 90�, and the two distal openings lie coincidental. The port 6 is thus open and a clip can be released by its inherent tendency to twist out of the shaft.
The ratchet part 28 includes: a central ratchet rod 33 slidably mounted coaxially upon a central ratchet rod guide pin 33 a which extends from the slidable part 27 along a significant portion of the length of the ratchet rod, internally of the ratchet rod 33; circumferential ratchet teeth 34 provided at intervals along the ratchet rod 33 in such a number and spacing that the ratchet mechanism will engage and function at generally the beginning of each trigger depression action; a pair of opposed releasable longitudinal ratchet gears 39 disposed over the ratchet rod 33 and having concave terminal teeth 39 a which can overlie the circumference of the ratchet rod 33 and engage with the teeth 34 of the ratchet rod 33 when the ratchet gears are brought into engagement with the ratchet rod 33; a pair of transverse supports 37 extending across the central space of the casing part 26 on opposed sides of the ratchet rod 33 and each serving to support the respective ratchet gear 39 in an outwardly resiliently biassed manner by means of an intermediate arched leaf spring 37 a mounted to the transverse support and further to slidingly guide the respective ratchet gear in its transverse to and fro movement into and out of engagement with the ratchet rod 33 via cooperating guide channels 37 b of the transverse supports 37 and lateral projections 39 b of the ratchet gears; (the guide channels 37 b of each transverse support 37 being in the form of mutually inwardly directed vertical slots along each of which the respective lateral projection 39 b of the ratchet gear can slide to and fro�i.e. towards and away from the ratchet rod correspondingly to the movement of the ratchet gear�and the lateral projections 39 b being smaller than the width of the guide channels 37 b so that pivotal movement of the ratchet gears is possible via the sliding pivot arrangement provided by each guide channel 37 b and lateral projection 39 b, while nevertheless the ratchet gear 39 is held captive by the guide channels 37 b as far as longitudinal movement (i.e. to left or right as viewed in FIG. 6; respectively into or out of the paper as viewed in FIG. 8) is concerned); a pair of elongate resiliently bendable ratchet adjusters 35 mounted to the slidable part 27 and extending therefrom to overlie the ratchet gears 39 and each having a terminal T-head 36 providing one terminal projection 36 a extending away from the respective ratchet gear and one terminal projection 36 b extending towards the respective ratchet gear; and a pair of angled shoulders 26 b provided on the interior wall of the casing 26 which cause a constriction between the casing wall and each ratchet gear 39 whereby the angled shoulder 26 b of the casing wall can cooperate in a cam action with the projection 36a of each ratchet adjuster 36 when the ratchet adjuster 36 is drawn into the region of constriction (to the left as illustrated; see Arrows X in FIG. 9) in response to depression of the trigger, to force the ratchet gear into engagement with the ratchet rod, against the restoring force of the leaf springs 37 a. An advance spring 40 is held under compression and overlies the ratchet rod 33 between the distal end 33 a of the ratchet rod 33, to which the distal end 40 a of the spring is mounted, and a shoulder 26 a of the casing part, against which the proximal end 40 b of the spring bears. The restoring force of the advance spring thus urges the pressor rod 8 forward (to the right as illustrated; see Arrows Y in FIG. 10) when the ratchet and pressor rods are in contact.
At the same time as the ratchet rod 33 is pulled to the left in association with the slidable part 27, the advance spring 40 is compressed. The pulling of the ratchet rod 33 out of contact with the pressor rod 8 releases the pressor effect on the haemostatic clips 3. At full depression of the trigger 9 a distal haemostatic clip is released from the apparatus, by the synchronised opening of the port 6. The remaining haemostatic clips 3 lie passively in line within the inner shaft 2 b. Upon release of the trigger 9, the port 6 closes and the trigger springs back to its resting condition. The slidable part 27 moves back (to the right) relative to the central casing part 26, and the heads 36 of the ratchet adjusters 35 move (to the right) out of the region of constriction of the casing wall (FIG. 10). Resilience of the ratchet adjusters 35 causes them to resume a parallel resting configuration out of contact with the ratchet gears 39. The pressure on the ratchet gears 39 is thus released and the ratchet gears 39 in turn lift off the central ratchet rod 33, under the restoring force of the leaf springs 37 a. In turn, the ratchet adjusters 35 are splayed out of the way by the same restoring force (FIG. 10). The ratchet rod 33, being spring loaded by the advance spring 40, is thus released, rapidly advances forward within the inner shaft 2 b, thereby re-exerting the pressor effect upon the haemostatic clips via the pressor rod 8. The line of clips then moves forward to take up the space vacated by the released clip, and the applicator is ready for the next application.
It is a feature of this apparatus that the clips are held in the shaft 2′ at a relatively constant depressed temperature. This is achieved by providing a temperature control device in the handle 10′. The temperature control device serves to maintain the temperature of the parts of the shaft within the range of about 5 to 20� C., even when the instrument is being held by a surgeon or assistant, or is being used in a hot environment.
The cooling device is therefore a Peltier effect heat pump 58 which cools on its forward surface 59 (directed towards the interior of the housing) and pumps any heat gained towards the opposing surface 60. This surface 60 is in thermal contact with a metal heat sink 61, allowing the heat to be conducted away and lost to the atmosphere via a vent 62 in the end cover 63 of the handle. The end cover 63 is conveniently adapted as an on-off rotatable switch to acuate the cooling device, the vent 62 being open in the �on� position as shown in FIG. 16. A high current battery 64 is also contained Within the handle, and the outer casing of the handle is suitable made thermally and electrically insulating. The battery 64 is connected to a conventional electronic circuit board 65 provided with electrical components which reduce the relatively high voltage from the battery and provide a suitable current. A light emitting diode (LED) 66, indicates when the device is �on�.
As shown in FIG. 20, for example, the convoluted central portion of the clip has the desirable property that it permits the central portion of the clip to flatten at least the outer curves in the second configuration (see FIG. 20), so allowing the legs 71, 72 to clasp inwards towards the central portion of the clip with a good angular presentation and therefore good mechanical advantage. This deformation is illustrated by conside ring the changes to angles α and β as shown in FIG. 19, as the clip moves from its first (a) to its second (b) configuration. As shown in FIG. 19, angle α closes from about 59� to about 57�, whereas angle β opens from about 13� to about 53�.
It is preferred that in the second configuration of the clip (see FIG. 19(b)) the ends of the legs overlap. The degree of overlap shown in FIG. 19(b), for example, is sufficient to constitute �generally helical winding� within the terms of this patent. In achieving this overlap, the wedge surfaces 75 slide across each other. For this purpose, the wedge apices 76 are slightly offset from one another in the first configuration of the clip (see FIG. 21), so that they will not meet each other precisely square-on during the closing movement.
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of nitinol for perendoscopy treatment of pedunculate polypsWO2006030204A2 *Sep 14, 2005Mar 23, 2006Andrew Michael WildApparatus for dispensing surgical clipsWO2007009099A2 *Jul 14, 2006Jan 18, 2007Idx Medical LtdApparatus and methods for occluding a hollow anatomical structureWO2012075532A1 *Dec 7, 2011Jun 14, 2012Globetek 2000 Pty LtdSurgical clip and clip manipulation device therefor* Cited by examinerClassifications U.S. Classification606/157, 606/142, 606/158, 606/139International ClassificationA61B17/00, A61B17/128, A61B17/122Cooperative ClassificationA61B17/1227, A61B17/1285, A61B17/1222, A61B2017/00867, A61B17/122European ClassificationA61B17/128E, A61B17/122, A61B17/122C, A61B17/122SLegal EventsDateCodeEventDescriptionFeb 17, 2011FPAYFee paymentYear of fee payment: 8Sep 8, 2010ASAssignmentFree format text: ASSIGNMENT OF 50% INTEREST;ASSIGNOR:WILD, ANDREW MICHAEL;REEL/FRAME:024953/0170Owner name: WILD, TERESA KATHLEEN, SAUDI ARABIAEffective date: 20100601Jan 26, 2007FPAYFee 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