WO1990003763A1 - Automatic forceps with clips - Google Patents

Automatic forceps with clips Download PDF

Info

Publication number
WO1990003763A1
WO1990003763A1 PCT/FR1989/000514 FR8900514W WO9003763A1 WO 1990003763 A1 WO1990003763 A1 WO 1990003763A1 FR 8900514 W FR8900514 W FR 8900514W WO 9003763 A1 WO9003763 A1 WO 9003763A1
Authority
WO
WIPO (PCT)
Prior art keywords
clips
clip
blade
clamp
sheath
Prior art date
Application number
PCT/FR1989/000514
Other languages
French (fr)
Inventor
Alain Lachkar
Guy Lachkar
Franck Benssussan
Original Assignee
Alain Lachkar
Guy Lachkar
Franck Benssussan
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alain Lachkar, Guy Lachkar, Franck Benssussan filed Critical Alain Lachkar
Publication of WO1990003763A1 publication Critical patent/WO1990003763A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil

Definitions

  • the present invention relates to an automatic clamp device with surgical suture clips.
  • the end of the clamp is very thin, which allows good visibility but requires the manual positioning of each clip at the end thereof, or the loading is semi automatic, which is compatible with a fine tip, but an operation of the charger must be executed between each use, or finally the loading is automatic, but then the very large tip considerably hinders the visibility and the precision of the work.
  • the clip clamping spouts are movable relative to the operating finger, which tends to move the vessel during the operation.
  • the device according to the present invention eliminates all these drawbacks. Indeed, it allows to combine the advantages of all these previous systems by integrating into a very fine clamp tip a fully automatic loading system of suture clips. Furthermore, the clip clamping spouts are fixed relative to the control finger.
  • 11 is constituted by the combination first of all, of a double set of rods operated simultaneously by a finger-joint articulated on a double plate enclosing the mechanism, and causing each to slide in opposite directions, and with different strokes, a clip supply blade and a four ⁇ reau constituting the envelope of the clamp tip, causing the closure of the clips clamping spouts located at the end of a fixed bar relative to the plate and located itself inside the sheath, then, by a container located inside said sheath, integrated in the fixed bar, and containing the reserve of clips, these being pushed by a piston and a spring, finally, by a clip exhaust system constituted by a retaining blade releasing a clip at each opening of the clamp and allowing the blade to approach viewing push it between the clamping spouts.
  • Figure 1 shows the device as a whole.
  • Figures 2 and 3 schematically illustrate the kinematics of the clamp open (fig 2) and closed (fig 3).
  • Figure 4 is a cross section along A-A fig 1, showing the respective positions of the sleeve, the central part and the supply blade.
  • Figure 5 is a cross section along B-B fig 1, showing the container of clips.
  • Figures 6 and 7 show the upper and lower plates, seen from the inside.
  • Figures 8, 9 and 10 show the central part, the figure
  • FIG. 10 is a section along C-C in FIG. 9.
  • Figure 11 is a top view of _ the_ supply bar.
  • Figure 12 is a side view of the end of the supply bar 0.
  • FIGS. 13 to 16 relate to the container for suture clips, FIG. 13 being a top view, FIG. 14 a longitudinal section showing the spring and the piston pushing piston, as well as the operation of the retaining blade, 5 Figure 15 showing the push piston seen from above and Figure 16 the container with the holding blade, seen from below.
  • the device, Figure 1 to 16 consists of an operating finger 1, 1 ', articulated by the axes 4, 4' on its lower part 18 of the plate, actuating in one direction a sheath 11 through two lower links 3, 3 'and in the opposite direction with a much greater stroke, a supply blade 5, thanks to two upper links 2, 2' relative to a fixed central part 6 comprising two 5 nozzles 7, 7 'at its end.
  • the central part 6 has in its middle part a recess 16 (fig 8) receiving the container 8 (fig 13) of the clips 9, then that the end situated on the side of the finger-pocket 1 is hollowed out in order to allow a stud 22 to slide (integral with the supply blade 5 and held in the rest position by the return spring 10 located in the plate) lower 18.
  • the container 8 is formed of a front part consisting of a folded or machined sheet intended to contain the reserve of clips 9, and of a tubular rear part 20 serving to accommodate the push spring 12.
  • the push piston 13 is supported on the spring 12 and pushes the clips 9, which are held, at rest, by a holding piece 14 formed of a curved and elastic blade passing through the wall of the container 8 through a hole 15 provided for this purpose.
  • a hole 19 located in the bottom of the sheath coincides with the hole 15, which frees the holding blade l'4 and allows the supply blade 5 to push a clip 9 towards the internal grooves 21, 21 '(fig 9) of the spouts 7, 7' during the operation of opening of the clamp.
  • the assembly is completed by an upper plate 17 and a lower plate 18 whose role is to maintain the different parts and to provide two fixed points 4, 4 'to the rod systems.
  • the device which has just been described lends itself particularly well to the production of pliers with suture clips intended for intensive use in the operating room.
  • the positioning of the various constituent elements gives this device a maximum of useful effects which had not been obtained to date by similar devices.

Abstract

The present invention relates to an automatic forceps device with clips for surgical stitching. It is comprised of the combination first of a double set of links (2, 2', 3, 3') operated simultaneously by an articulated finger-stall (1, 1') on the double plate enclosing the mechanism and making slide into each other and in opposite directions, and with different strokes, a clip (9) supply blade (5) and a sleeve forming the envelope of the forceps end, causing the closure of the tips (7, 7') which clamp the clips (9) situated at the extremity of a bar which is fixed with respect to the plate and situated itself inside the sleeve (11), and also comprised of a container arranged inside said sleeve, integrated in the fixed bar and containing the magazine of clips which are pushed by means of a piston and a spring, and finally comprised of a clip ejection system consisting of a holding blade which releases one clip at each opening of the forceps and allowing the supply blade to push the clip between the clamping tips. The device is intended for the suture of the vessels during surgical operations.

Description

PINCE AUTOMATIQUE A CLIPSAUTOMATIC CLIPS CLIP
La présente invention a pour objet un dispositif de pince automatique à clips de suture chirurgicaux.The present invention relates to an automatic clamp device with surgical suture clips.
Il est destiné à la suture des vaisseaux au cours d'opérations chirurgicales. Dans les dispositifs réalisés à ce jour, soit l'embout de la pince est très fin, ce qui permet une bonne visibilité mais nécessite la mise en place manuelle de chaque clip à l'extrémité de celle-ci, soit le chargement est semi-automatique, ce qui est compatible avec un embout fin, mais une manoeuvre du chargeur doit être exécutée entre chaque utilisation, soit enfin le chargement est automatique, mais alors l'embout très volumineux gêne considé¬ rablement la visibilité et la précision du travail. En outre, dans ces dispositifs, les becs de serrage du clip sont mobiles par rapport au doigtier de manoeuvre, ce qui a tendance à déplacer le vaisseau durant l'opération.It is intended for suturing vessels during surgical operations. In the devices produced to date, either the end of the clamp is very thin, which allows good visibility but requires the manual positioning of each clip at the end thereof, or the loading is semi automatic, which is compatible with a fine tip, but an operation of the charger must be executed between each use, or finally the loading is automatic, but then the very large tip considerably hinders the visibility and the precision of the work. In addition, in these devices, the clip clamping spouts are movable relative to the operating finger, which tends to move the vessel during the operation.
Le dispositif suivant la présente invention supprime tous ces inconvénients. En effet, il permet de combiner les avantages de tous ces systèmes précédents en intégrant dans un embout de pince très fin un système de chargement entièrement automatique des clips de suture. Par ailleurs, les becs de serrage du clip sont fixes par rapport au doigtier de commande. 11 est constitué par la combinaison d'abord, d'un double jeu de biellettes manoeuvrées simultanément par un doigtier articulé sur une platine double enfermant le mécanisme, et faisant coulis- ser l'un dans l'autre en sens contraires, et avec des courses différentes, une lame d'approvisionnement des clips et un four¬ reau constituant l'enveloppe de l'embout de pince, provoquant la fermeture des becs de serrage des clips se trouvant à l'extré¬ mité d'une barre fixe par rapport à la platine et située elle- même à l'intérieur du fourreau, ensuite, par un conteneur situé à l'intérieur dudit fourreau, intégré dans la barre fixe, et contenant la réserve de clips, ceux-ci étant poussés par un piston et un ressort, enfin, par un système d'échappement des clips constitué par une lame de maintien libérant un clip à chaque ouverture de la pince et permettant à la lame d'appro- visionnement de le pousser entre les becs de serrage.The device according to the present invention eliminates all these drawbacks. Indeed, it allows to combine the advantages of all these previous systems by integrating into a very fine clamp tip a fully automatic loading system of suture clips. Furthermore, the clip clamping spouts are fixed relative to the control finger. 11 is constituted by the combination first of all, of a double set of rods operated simultaneously by a finger-joint articulated on a double plate enclosing the mechanism, and causing each to slide in opposite directions, and with different strokes, a clip supply blade and a four¬ reau constituting the envelope of the clamp tip, causing the closure of the clips clamping spouts located at the end of a fixed bar relative to the plate and located itself inside the sheath, then, by a container located inside said sheath, integrated in the fixed bar, and containing the reserve of clips, these being pushed by a piston and a spring, finally, by a clip exhaust system constituted by a retaining blade releasing a clip at each opening of the clamp and allowing the blade to approach viewing push it between the clamping spouts.
Sur les dessins annexés , donnés à titre d ' exemple non limitatif d' une des formes de l ' invention .In the accompanying drawings, given by way of nonlimiting example of one of the forms of the invention.
La figure 1 représente le dispositif dans son ensemble.Figure 1 shows the device as a whole.
5 Les figures 2 et 3 illustrent schématiquement la cinématique de la pince ouverte (fig 2) et fermée (fig 3) . La figure 4 est une coupe transversale suivant A-A fig 1 , montrant les positions respectives du fourreau, de la pièce centrale et de la lame d ' approvisionnement.5 Figures 2 and 3 schematically illustrate the kinematics of the clamp open (fig 2) and closed (fig 3). Figure 4 is a cross section along A-A fig 1, showing the respective positions of the sleeve, the central part and the supply blade.
-^ La figure 5 est une coupe transversale suivant B-B fig 1 , montrant le conteneur de clips.- ^ Figure 5 is a cross section along B-B fig 1, showing the container of clips.
Les figures 6 et 7 montrent les platines supérieure et inférieure, vues de l ' intérieur. Les figures 8 , 9 et 10 représentent la pièce centrale, la figureFigures 6 and 7 show the upper and lower plates, seen from the inside. Figures 8, 9 and 10 show the central part, the figure
-5 9 montrant le détail des becs et la figure 10 étant une coupe suivant C-C figure 9.-5 9 showing the detail of the spouts and FIG. 10 being a section along C-C in FIG. 9.
La figure 11 est une vue de dessus de _ la_ barre_ d ' approvisionne¬ ment. La figure 12 est une vue latérale de l 'extrémité de la barre 0 d ' approvisionnement.Figure 11 is a top view of _ the_ supply bar. Figure 12 is a side view of the end of the supply bar 0.
Les figures 13 à 16 sont relatives au conteneur de clips de suture, la figure 13 étant une vue de dessus , la figure 14 une coupe longitudinale montrant le ressort et le piston de poussée des clips, aisni que le fonctionnement de la lame de maintien , 5 la figure 15 représentant le piston de poussée vu de dessus et la figure 16 le conteneur muni de la lame de maintien , vu de dessous.FIGS. 13 to 16 relate to the container for suture clips, FIG. 13 being a top view, FIG. 14 a longitudinal section showing the spring and the piston pushing piston, as well as the operation of the retaining blade, 5 Figure 15 showing the push piston seen from above and Figure 16 the container with the holding blade, seen from below.
Le dispositif, figure 1 à 16, est constitué d'un doigtier de manoeuvre 1 , 1 ' , articulé par les axes 4, 4 ' sur sa partie 0 inférieure 18 de la platine , actionnant dans un sens un fourreau 11 par l ' intermédiaire de deux biellettes inférieures 3, 3' et en sens inverse avec une course beaucoup plus importante, une lame d' approvisionnement 5, grâce à deux biellettes supérieures 2, 2 ' par rapport à une pièce centrale fixe 6 comportant deux 5 becs 7, 7 ' à son extrémité.The device, Figure 1 to 16, consists of an operating finger 1, 1 ', articulated by the axes 4, 4' on its lower part 18 of the plate, actuating in one direction a sheath 11 through two lower links 3, 3 'and in the opposite direction with a much greater stroke, a supply blade 5, thanks to two upper links 2, 2' relative to a fixed central part 6 comprising two 5 nozzles 7, 7 'at its end.
La pièce centrale 6 comporte dans sa partie médiane un évidement 16 (fig 8) recevant le conteneur 8 (fig 13 ) des clips 9 , alors que l'extrémité située du côté du doigtier 1 est évidée pour lais¬ ser coulisser un téton 22 (fig 11) solidaire de la lame d'appro¬ visionnement 5 et maintenu en position de repos par le ressort de rappel 10 situé dans la platine inférieure 18. Le conteneur 8 est formé d'une partie avant consistant en une tôle pliée ou usinée destinée à contenir la réserve de clips 9, et d'une partie arrière tubulaire 20 servant de logement au ressort de poussée 12. Le piston de poussée 13 prend appui sur le ressort 12 et pousse les clips 9, qui sont maintenus, en repos, par une pièce de maintien 14 formée d'une lame recourbée et élastique traversant la paroi du conteneur 8 par un trou 15 prévu à cet effet. Tant que la pince est en position ouverte, l'extrémité libre de la lame 14 est maintenue à l'intérieur du conteneur 8 par le fourreau 11, lorsque la pince est fermée, un trou 19 situé dans le fond du fourreau vient coïncider avec le trou 15, ce qui libère la lame de maintien l'4 et permet à la lame d'approvisionnement 5 de pousser un clip 9 vers les rainures internes 21, 21' (fig 9) des becs 7, 7' lors de la manoeuvre d'ouverture de la pince. L'ensemble est complété par une platine supérieure 17 et une platine inférieure 18 dont le rôle est de maintenir les différentes pièces et de procurer deux points fixes 4, 4' au systèmes de biellettes.The central part 6 has in its middle part a recess 16 (fig 8) receiving the container 8 (fig 13) of the clips 9, then that the end situated on the side of the finger-pocket 1 is hollowed out in order to allow a stud 22 to slide (integral with the supply blade 5 and held in the rest position by the return spring 10 located in the plate) lower 18. The container 8 is formed of a front part consisting of a folded or machined sheet intended to contain the reserve of clips 9, and of a tubular rear part 20 serving to accommodate the push spring 12. The push piston 13 is supported on the spring 12 and pushes the clips 9, which are held, at rest, by a holding piece 14 formed of a curved and elastic blade passing through the wall of the container 8 through a hole 15 provided for this purpose. As long as the clamp is in the open position, the free end of the blade 14 is held inside the container 8 by the sheath 11, when the clamp is closed, a hole 19 located in the bottom of the sheath coincides with the hole 15, which frees the holding blade l'4 and allows the supply blade 5 to push a clip 9 towards the internal grooves 21, 21 '(fig 9) of the spouts 7, 7' during the operation of opening of the clamp. The assembly is completed by an upper plate 17 and a lower plate 18 whose role is to maintain the different parts and to provide two fixed points 4, 4 'to the rod systems.
Grâce à la finesse de son embout combiné à son automaticité totale, le dispositif qui vient d'être décrit se prête particulière¬ ment bien à la réalisation de pinces à clips de suture destinées à une utilisation intensive en bloc opératoire. Le positionnement des divers éléments constitutifs donnent à ce dispositif un maximum d'effets utiles qui n'avaient pas été obtenus à ce jour par des dispositifs similaires.Thanks to the fineness of its tip combined with its total automaticity, the device which has just been described lends itself particularly well to the production of pliers with suture clips intended for intensive use in the operating room. The positioning of the various constituent elements gives this device a maximum of useful effects which had not been obtained to date by similar devices.
Cependant, les formes et dispositions des différents éléments, ainsi que les matières utilisées pour leur fabrication pourront varier dans la limite des équivalents, sans changer pour cela, la conception générale de l'invention qui vient d'être décrite. However, the shapes and arrangements of the various elements, as well as the materials used for their manufacture may vary within the limit of equivalents, without changing the general conception of the invention which has just been described.

Claims

k k
REVENDICATIONS
1° Dispositif de pince automatique à clips de suture chirurgicaux caractérisé par la combinaison premièrement d'un double jeu de biellettes (2, 2', 3, 3') manoeuvrées simultanément par un doig¬ tier (1, 1") articulé par des axes (4, 4') sur une platine double (17, 18) enfermant le mécanisme, et faisant coulisser l'un dans l'autre en sens contraires, et avec des courses différentes, d'une part une lame d'approvisionnement (5) des clips (9) et d'autre part un fourreau (11) constituant l'enveloppe de l'embout de la pince, et provoquant la fermeture des becs (7, 7') de serrage des clips (9) se trouvant à l'extrémité d'une pièce centrale fixe (6), située elle-même à l'intérieur du fourreau (11), un ressort de rappel (10) agissant sur un téton (22) solidaire de la lame d'approvisionnement (5), et situé dans un évidement de la platine inférieure (18) maintenant la pince ouverte au repos, deuxième- ment d'une conteneur (8) situé à l'intérieur, du fourreau (11), intégré dans un évidement (16) de la pièce fixe (6), et contenant la réserve des clips (9), ceux-ci étant poussés par un piston (13) et un ressort (12) situés dans un prolongement tubulaire (20) du conteneur (8), troisièmement d'un système d'échappement des clips (9) constitué par une lame de maintien escamotable1 ° Automatic clamp device with surgical suture clips characterized by the combination first of all of a double set of rods (2, 2 ', 3, 3') operated simultaneously by a fingering (1, 1 ") articulated by axes (4, 4 ') on a double plate (17, 18) enclosing the mechanism, and sliding one in the other in opposite directions, and with different strokes, on the one hand a supply blade ( 5) clips (9) and on the other hand a sheath (11) constituting the envelope of the end of the clamp, and causing the closure of the spouts (7, 7 ') for clamping the clips (9) being at the end of a fixed central part (6), itself located inside the sheath (11), a return spring (10) acting on a stud (22) integral with the supply blade ( 5), and located in a recess in the lower plate (18) holding the clamp open at rest, secondly from a container (8) located inside, of the sheath (11), integrated rigged in a recess (16) of the fixed part (6), and containing the reserve of the clips (9), these being pushed by a piston (13) and a spring (12) situated in a tubular extension (20) of the container (8), thirdly of a clip exhaust system (9) constituted by a retractable holding blade
(14), fixée sous le conteneur (8) et pénétrant dans celui-ci par un orifice (15) pour retenir les clips (9), un autre orifice (19) situé dans le fourreau (11) permettant à la lame (14) de s'effacer pour libérer un clip à chaque fermeture de la pince et permettre à la lame d'approvisionnement (5) de le pousser dans les rainures internes (21, 21') des becs de serrage (7, 7') lors de son ouverture. (14), fixed under the container (8) and penetrating therein by an orifice (15) to retain the clips (9), another orifice (19) located in the sheath (11) allowing the blade (14 ) to be erased to release a clip each time the clamp is closed and allow the supply blade (5) to push it into the internal grooves (21, 21 ') of the clamping spouts (7, 7') when of its opening.
PCT/FR1989/000514 1988-10-07 1989-10-06 Automatic forceps with clips WO1990003763A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR8813395A FR2637489A1 (en) 1988-10-07 1988-10-07 AUTOMATIC CLIPS CLIP
FR88/13395 1988-10-07

Publications (1)

Publication Number Publication Date
WO1990003763A1 true WO1990003763A1 (en) 1990-04-19

Family

ID=9370929

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FR1989/000514 WO1990003763A1 (en) 1988-10-07 1989-10-06 Automatic forceps with clips

Country Status (5)

Country Link
EP (1) EP0396683A1 (en)
AU (1) AU4409589A (en)
FR (1) FR2637489A1 (en)
IL (1) IL91926A0 (en)
WO (1) WO1990003763A1 (en)

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US5395381A (en) * 1990-12-13 1995-03-07 United States Surgical Corporation Apparatus and method for applying latchless surgical clips
US5527319A (en) * 1992-02-13 1996-06-18 United States Surgical Corporation Surgical fastener applying instrument for ligating and dividing tissue
US5562655A (en) * 1994-08-12 1996-10-08 United States Surgical Corporation Surgical apparatus having a universal handle for actuating various attachments
US5601574A (en) * 1992-09-14 1997-02-11 Ethicon, Inc. Sterile clips and instrument for their placement
US5626585A (en) * 1994-09-16 1997-05-06 United States Surgical Corporation Ligating clip advance
US5637108A (en) * 1994-06-15 1997-06-10 United States Surgical Corporation Surgical handle having a controlled leak passage
US5700270A (en) * 1995-10-20 1997-12-23 United States Surgical Corporation Surgical clip applier
US5868759A (en) * 1997-10-10 1999-02-09 United States Surgical Corporation Surgical clip applier
US5993465A (en) * 1993-08-25 1999-11-30 Apollo Camera, Llc Method of ligating a vessel or duct
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US6599298B1 (en) 2000-10-23 2003-07-29 Vitalitec International, S.A. Automatic surgical clip applier
CN105286994A (en) * 2014-11-14 2016-02-03 镇江恒生涓恩医疗器械有限公司 Multifunctional non-stick hemostatic electric coagulation forceps
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US11253267B2 (en) 2018-08-13 2022-02-22 Covidien Lp Friction reduction mechanisms for handle assemblies
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US11298135B2 (en) 2015-11-10 2022-04-12 Covidien Lp Endoscopic reposable surgical clip applier
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US5601574A (en) * 1992-09-14 1997-02-11 Ethicon, Inc. Sterile clips and instrument for their placement
US5993465A (en) * 1993-08-25 1999-11-30 Apollo Camera, Llc Method of ligating a vessel or duct
US6607540B1 (en) 1993-08-25 2003-08-19 Surgicon, Inc. Pre-clamping method
US5637108A (en) * 1994-06-15 1997-06-10 United States Surgical Corporation Surgical handle having a controlled leak passage
US5562655A (en) * 1994-08-12 1996-10-08 United States Surgical Corporation Surgical apparatus having a universal handle for actuating various attachments
US5626585A (en) * 1994-09-16 1997-05-06 United States Surgical Corporation Ligating clip advance
US5938667A (en) * 1995-10-20 1999-08-17 United States Surgical Corporation Surgical clip applier
US5700270A (en) * 1995-10-20 1997-12-23 United States Surgical Corporation Surgical clip applier
US5868759A (en) * 1997-10-10 1999-02-09 United States Surgical Corporation Surgical clip applier
US6599298B1 (en) 2000-10-23 2003-07-29 Vitalitec International, S.A. Automatic surgical clip applier
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Also Published As

Publication number Publication date
AU4409589A (en) 1990-05-01
EP0396683A1 (en) 1990-11-14
FR2637489A1 (en) 1990-04-13
IL91926A0 (en) 1990-06-10

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