Flexible surgical clip applier
A flexible clip applier includes a flat wire wound tubular coil, a pair of jaws at the end of the coil, end effector wires extending through the coil and coupled to the jaws, and a clip-advancing wire extending through the coil. A clip chamber is defined in the distal end of the coil. A clip pusher is provided at a distal end of the clip-advancing wire, and advances a clip into the jaws when the clip-advancing wire is moved distally. The jaws include channels in which a distalmost clip rides when the jaws are closed and the pusher is advanced, thereby causing the distalmost clip to be pushed over the tissue, and a distal anvil which operate to bend a portion of the clip to facilitate its retention on the clamped tissue. The device can push a clip with a force in excess of 1500 grams.
1 - 34 . (canceled)
35 . A flexible surgical device, comprising:
a) a flexible outer tubular member having proximal and distal ends;
b) a flexible advancing element extending through said tubular member and having proximal and distal ends; and
c) a handle coupled to said flexible outer tubular member and to said flexible clip-advancing element and adapted to move said advancing element distally relative to said tubular member, wherein said flexible advancing element, said tubular member, and said handle are adapted such that said handle under manual application of force can cause said advancing element to provide a distal pushing force of at least 500 grams at said distal end of said advancing element.
36 . A flexible surgical device according to claim 35 , wherein:
said advancing element provides a distal pushing force of at least 1000 grams at said distal end of said advancing element.
37 . A flexible surgical device according to claim 35 , wherein:
said advancing element provides a distal pushing force of at least 1500 grams at said distal end of said advancing element.
38 . A flexible surgical device according to claim 35 , wherein:
said advancing element provides a distal pushing force of at least 2000 grams at said distal end of said advancing element.
39 . A flexible surgical device according to claim 35 , wherein:
said outer tubular member is a flat wire wound tubular coil.
40 . A flexible surgical device according to claim 35 , further comprising:
d) an end effector assembly at said distal end of said tubular member; and
e) at least one control wire extending through said tubular member, said control wire having a proximal end coupled to said handle such that operation of said handle causes relative proximal and distal movement of said at least one control wire relative to said outer tubular member, and a distal end coupled to said end effector assembly such that movement of said at least one control wire relative to said outer tubular member causes operation of said end effector.
41 . A flexible surgical device according to claim 40 , wherein:
when said handle is operated to cause said at least one control wire to be moved proximally relative to said outer tubular member, said at least one control wire goes into tension and places a compressive force on said outer tubular member, thereby increasing an effective tensile limitation of said outer tubular member.
42 . A flexible surgical device according to claim 40 , further comprising:
f) an inner sheath extending within the outer tubular member, said sheath including a first lumen for said advancing wire, at least one second lumen for said at least one control wire, said advancing wire extending through said first lumen and said at least one control wire extending through said at least one second lumen.
43 . A flexible surgical device according to claim 42 , wherein:
said sheath has a non-circular cross-sectional shape.
44 . A flexible surgical device according to claim 40 , wherein:
said end effector assembly includes a pair of jaws.
45 . A flexible surgical device according to claim 44 , wherein:
at least one of said pair of jaws is rotatable relative to the other of said pair of jaws.
46 . A flexible surgical device according to claim 35 , wherein:
said distal end of said advancing element is provided with a structure adapted to push a surgical clip.
47 . A flexible surgical device according to claim 35 , wherein:
said distal end of said tubular member is provided with a clip chamber adapted to hold a plurality of surgical clips.
48 . A flexible surgical device according to claim 35 , wherein:
said outer tubular member has an outer diameter not exceeding 3.2 mm.
49 . A flexible surgical device according to claim 35 , wherein:
said outer tubular member has a length of 150 cm to 250 cm.