Hemostatic clipping devices and methods

Patent metadata

Field	Value
Publication number	US-11583293-B2
Application number	US-202016949118-A
Country	US
Kind code	B2
Filing date	Oct 14, 2020
Priority date	Jun 19, 2008
Publication date	Feb 21, 2023
Grant date	Feb 21, 2023

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. A tissue clipping apparatus, comprising:
a flexible insertion member extending from a proximal end which, in an operative configuration, remains outside a body accessible to a user to a distal end which is inserted into the body through a naturally occurring body lumen;
a clip including first and second clip arms, the first and second clip aiiiis bent along a curve to bias proximal and distal ends thereof radially away from one another, curves of proximal portions of the first and second clip arms forming a tissue receiving pocket between the first and second clip arms;
a capsule housing a portion of the clip therein;
a control wire extending through the insertion member from a proximal end to a distal end, the control wire operable to move the first and second clip arms between an open configuration in which distal ends of the first and second clip arms are separated from one another and a closed configuration in which the distal ends of the first and second clip arms are drawn together to grip tissue located therebetween, the first and second clip aims being configured to be moved repeatedly between the open and closed configurations until the clip is deployed;
a joint releasably coupling the distal end of the control wire to the first and second clip arms, the joint being released from the first and second clip arms to lock the first and second clip arms in the closed configuration when a pull force exerted on the control wire exceeds a predetermined level; and
a releasable coupling between the capsule and the insertion member, the coupling including at least one engagement member,
wherein, when the joint is released, the at least one engagement member is drawn radially inward through an opening in the capsule to release the capsule from the insertion member.

2. The apparatus of claim 1 , wherein the joint is configured to maintain the proximal ends of the first and second clip arms in a radially inward position out of engagement with an inner surface of the capsule, the joint configured so that, when the joint is released, the joint is separated from the first and second clip aims releasing the proximal ends of the first and second clip arms to spring radially outward to engage a portion of the capsule locking the first and second clip arms in the closed configuration.

3. The apparatus of claim 1 , wherein the joint includes a clevis extending distally from the control wire, the clevis including a first arm extending within the capsule on a first side of a proximal portion of the first and second clip arms and a second arm extending within the capsule on a second side of the proximal portions of the first and second clip arms, the first and second arms of the clevis being coupled to the first and second clip arms via a cross pin that passes through the first and second clip arms.

4. The apparatus of claim 3 , wherein the clevis is formed so that, when the joint is released, the clevis moves proximally out of the capsule disengaging the capsule from the insertion member as the engagement member is drawn radially inward through the opening in the capsule.

5. The apparatus of claim 1 , wherein the first clip atm includes a locking tab at the proximal end thereof and the capsule includes a locking feature configured to lockingly engage the locking tab when the joint is released.

6. The apparatus of claim 1 , wherein the joint includes a wire loop.

7. The apparatus of claim 6 , wherein a proximal portion of each of the first and second clip arms includes an opening through which the wire loop is passed to couple the control wire to the clip.

8. The apparatus of claim 1 , further comprising a locking mechanism configured to lock the control wire within the distal end of the flexible insertion member once the joint is separated.

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

10. The apparatus of claim 9 , wherein the flexible sheath is formed as a coil defining a lumen through which the insertion member extends, a proximal end of the hushing being coupled to a distal end of the coil.

11. A method for treating tissue, comprising:
inserting a clip to a target area within a living body adjacent target tissue, the clip including first and second clip arms bent along a curve to bias proximal and distal ends thereof radially away from one another, curves of proximal portions of the first and second clip arms forming a tissue receiving pocket therebetween;
moving a control member coupled to the clip distally to move the clip from a closed configuration to an expanded configuration, wherein the control member is coupled to the clip via a separable joint, the joint maintaining the proximal ends of the first and second clip arms in a radially inward position out of contact with an inner surface of a capsule, the joint configured to be separated from the first and second clip arms when subjected to a predetermined force by the control member;
positioning the clip so that target tissue to be clipped is positioned between the distal ends of the first and second clip arms;
moving the control member proximally to draw the first and second clip arms to the closed configuration to grip the target tissue; and
exerting an additional proximal force on the control member to separate the joint from the first and second clip arms, separating the clip from the control member.

12. The method of claim 11 , wherein the joint includes a wire loop.

13. The method of claim 12 , wherein a proximal portion of the first and second clip arms includes an opening through which the wire loop is passed to couple the control member to the clip.

14. The method of claim 11 , wherein the first clip arm includes a locking tab at the proximal end thereof.

15. The method of claim 14 , wherein the capsule includes a locking feature configured to lockingly engage the locking tab when the joint is separated from the first clip arm to lock the clip within the capsule with the first and second clip arms in the closed configuration.

Assignees

• Boston Scient 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

• A61B17/122 Primary

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

• A61B17/1285 Primary

  for minimally invasive surgery · CPC title

• A61B2090/037

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

• A61B2017/00778

  Operations on blood vessels (A61B2017/22097, A61B2017/320741 take precedence) · CPC title

• A61B17/083

  Clips, e.g. resilient · CPC title