Hemostatic clipping devices and methods

Patent metadata

Field	Value
Publication number	US-10166028-B2
Application number	US-201615097896-A
Country	US
Kind code	B2
Filing date	Apr 13, 2016
Priority date	Jun 19, 2008
Publication date	Jan 1, 2019
Grant date	Jan 1, 2019

Abstract

A tissue clipping apparatus, comprises a flexible, elongate member, a proximal end of which remains external to the body accessible to a user while a distal end of the flexible member is inserted into the body to a location adjacent to target tissue to be clipped and a control wire extending through the flexible member in combination with a capsule releasably coupled to a distal end of the flexible member and a clip a proximal portion of which is received within the capsule. A joint releasably coupling the clip to the control wire, includes a yoke extending around a proximal end of the clip and a frangible link which fails when subject to a predetermined force to separate the clip from the control wire.

First claim

What is claimed is:

1. An apparatus for applying clips to tissue, comprising:
a flexible sheath extending from a proximal end which, in an operative configuration, extends into a living body to a target portion of tissue to be clipped;
a capsule extending from a proximal end to a distal end and having an opening formed in the proximal end;
a clip assembly provided in the capsule and configured to be operably movable between a closed configuration in which first and second arms of the clip assembly are drawn toward one another and an expanded configuration in which the first and second arms extend distally from the capsule and are separated from one another to receive target tissue therebetween;
a control member including a distal end releasably coupled to the clip assembly to transmit to the clip assembly forces applied thereto to move the clip assembly between the closed and expanded configurations; and
a separable clevis connecting the control member to the clip assembly, the clevis including first and second members extending distally from the control member on opposite sides of the clip assembly and including a cross-pin extending between the first and second members coupling the clevis to the clip assembly, the first and second members being configured to be separated from the cross-pin when subjected to a predetermined force by the control member to uncouple the control member from the clip assembly.

2. The apparatus of claim 1 , further comprising a bushing coupled to the distal end of the flexible sheath and releasably coupled to the proximal end of the capsule.

3. The apparatus of claim 2 , wherein the flexible sheath is formed as a coil shaft defining a lumen through which the control member extends and wherein a proximal end of the bushing is coupled to a distal end of the coil shaft and a distal end of the bushing is coupled to the proximal end of the capsule.

4. The apparatus of claim 1 , wherein the capsule includes at least one locking tab extending radially into the capsule, the locking tabs being positioned to engage a proximal portion of the clip assembly when it has been drawn proximally into the capsule to a predetermined position, so that when the clip assembly reaches the predetermined position, the locking tab mechanically interlocks with a corresponding structure of the clip assembly preventing the clip assembly from being moved distally out of the capsule.

5. The apparatus of claim 1 , wherein the clip assembly includes a member contacting a surface of one of the first and second arms to define a proximal-most position beyond which the clip assembly may not be dawn further proximally into the capsule so that, when the clip assembly has reached the proximal-most position, proximally directed force applied to the control member increases a tension force applied by the control member to the separable clevis until the predetermined force is reached.

6. The apparatus of claim 1 , wherein first member couples to a first end of the cross-pin on a first side of the first and second arms and the second member couples to a second end of the cross-pin on a second side of the first and second arms.

7. The apparatus of claim 6 , wherein the first and second members are located in the capsule when the first and second arms are connected to the cross-pin.

8. The apparatus of claim 1 , wherein the first and second members extend distally from a coupling member coupled to a distal end of the control member.

9. The apparatus of claim 8 , wherein the first and second members extend distally from a radially outermost surface of the coupling member.

10. The apparatus of claim 9 , wherein a distal end of the control member is received within the coupling member.

11. A method for treating tissue, comprising:
inserting a clip to a target area within a living body adjacent a target tissue, the clip including a capsule extending from a proximal end to a distal end and having an opening formed in the proximal end and first and second arms movably received in the capsule for movement between a closed configuration in which the first and second arms are drawn toward one another and an expanded configuration in which the first and second arms extend distally from the capsule and are separated from one another to receive target tissue therebetween;
inserting the clip to a target site within a living body;
moving a control member coupled to the clip distally to move the clip from the closed configuration to the expanded configuration, wherein the control member is coupled to the clip via a separable clevis including two members that engage a cross pin of the clip;
positioning the clip so that target tissue to be clipped is positioned between distal ends of the first and second legs; and
moving the control member proximally to draw the first and second arms to the closed configuration to grip the target tissue;
exerting additional proximally directed force on the control member to separate the members of the clevis from the cross-pin separating the clip from the control member.

12. The method according to claim 11 , wherein the capsule includes at least one locking tab extending radially into the capsule toward a longitudinal axis thereof, the locking tab being positioned to lockingly engage a corresponding feature of one of the first and second arms when the clip is separated from the control member to lock the clip within the capsule with the first and second arms in the closed configuration.

13. The method according to claim 12 , wherein the control wire is surrounded by a flexible sheath that extends to a distal end coupled to a proximal end of a bushing, wherein a distal end of the bushing is releasably coupled to the capsule, the method further comprising separating the bushing from the capsule when the clip is separated from the control member.

Assignees

• Boston Scient Scimed Inc
• Boston Scientfic Scimed Inc

Inventors

• Menn Dmitri
• Durgin Russell F
• Wells Brian Keith
• Wolf Lance Alan
• Furnish Gregory R
• Abramov Vasiliy P
• Kelly William C Mers

Classifications

• A61B17/1285 Primary

  for minimally invasive surgery · CPC title

• A61B17/10

  for applying or removing wound clamps {, e.g. containing only one clamp or staple (A61B17/076 takes precedence; containing multiple wound clamps A61B17/068)}; Wound clamp magazines · CPC title

• A61B17/122 Primary

  Clamps or clips, e.g. for the umbilical cord {(for the vas deferens A61F6/206)} · CPC title

• A61B2090/037

  with a frangible part, e.g. by reduced diameter · CPC title

• A61B17/00234

  for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title