Surgical clip application assembly
An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.
1 . A surgical clip application assembly, comprising:
a surgical clip; and
a surgical clip applier having:
a hollow member having a proximal end and a distal end;
a clevis coupled to said distal end of said hollow member;
a first jaw rotatably coupled to said clevis;
a second jaw rotatably coupled to said clevis in opposed relation to said first jaw, said first and second jaws adapted to apply said surgical clip to a location;
at least one pull/push wire coupled to said first and second jaws and extending through said hollow member to said proximal end of said hollow member; and
actuation means coupled to said proximal end of said hollow member and to said proximal end of said first push/pull wire for moving said first push/pull wire through said hollow member to cause a rotation of said first and second jaws about said clevis from an open to a closed position, wherein at least one of said jaws is provided with a plurality of teeth arranged to puncture and damage tissue adjacent to said surgical clip at said location.
2 . A surgical clip applier according to claim 1 , wherein both of said jaws are provided with a plurality of teeth arranged to puncture and damage tissue adjacent two sides of the surgical clip.
3 . A surgical clip applier according to claim 1 , wherein:
at least one of said first and second jaws has:
a clip guiding channel shaped to fit a surgical clip; and
a hook shaped anvil at an end of said channel; and
said first and second jaws apply the surgical clip with said channel.
4 . A surgical clip applier according to claim 1 , wherein:
each of said first and second jaws have:
a clip guiding channel shaped to fit a surgical clip; and
a hook shaped anvil at the end of said channel;
said first and second jaws apply the surgical clip with said channel.
5 . A surgical clip applier according to claim 4 , wherein each of said anvils has a helical surface.
6 . A surgical clip applier according to claim 4 , wherein each of said anvils has a curved surface.
7 . A surgical clip applier according to claim 6 , wherein said surface is curved about a single axis.
8 . A surgical clip applier according to claim 4 , wherein:
each of said jaws has a longitudinal axis and a vertical axis perpendicular to the longitudinal axis, and
each of said channels is arranged at an angle relative to said vertical axis.
9 . A surgical clip applier according to claim 8 , wherein said angle is approximately 22 degrees.
10 . A surgical clip application assembly, comprising:
a surgical clip; and
a surgical clip applier having:
a hollow member having a proximal end and a distal end;
a clevis coupled to said distal end of said hollow member;
a first jaw rotatably coupled to said clevis;
a second jaw rotatably coupled to said clevis in opposed relation to said first jaw, said first and second jaws adapted to apply said surgical clip to a location;
at least one pull/push wire coupled to said first and second jaws and extending through said hollow member to said proximal end of said hollow member; and
an actuator coupled to said proximal end of said hollow member and to said proximal end of said first push/pull wire for moving said first push/pull wire through said hollow member to cause a rotation of said first and second jaws about said clevis from an open to a closed position, wherein at least one of said jaws is provided with a plurality of teeth arranged to puncture and damage tissue adjacent to said surgical clip at said location.
11 . A surgical clip application assembly, comprising:
a surgical clip; and
a surgical clip applier having:
a hollow member having a proximal end and a distal end;
a clevis coupled to said distal end of said hollow member;
a first jaw rotatably coupled to said clevis, said first jaw having a first clip guiding channel terminating in a first anvil;
a second jaw rotatably coupled to said clevis in opposed relation to said first jaw, said second jaw having a second clip guiding channel terminating in a second anvil, said first clip guiding channel and said second clip guiding channel guiding said surgical clip when disposed therebetween;
at least one pull/push wire coupled to said first and second jaws and extending through said hollow member to said proximal end of said hollow member; and
actuation means coupled to said proximal end of said hollow member and to said proximal end of said first push/pull wire for moving said first push/pull wire through said hollow member to cause a rotation of said first and second jaws about said clevis from an open to a closed position.
12 . A surgical clip application assembly, comprising:
a surgical clip; and
a surgical clip applier having:
a hollow member having a proximal end and a distal end;
a clevis coupled to said distal end of said hollow member;
a first jaw rotatably coupled to said clevis, said first jaw having a first clip guiding channel terminating in a first anvil;
a second jaw rotatably coupled to said clevis in opposed relation to said first jaw, said second jaw having a second clip guiding channel terminating in a second anvil, said first clip guiding channel and said second clip guiding channel guiding said surgical clip when disposed therebetween;
at least one pull/push wire coupled to said first and second jaws and extending through said hollow member to said proximal end of said hollow member; and
an actuator coupled to said proximal end of said hollow member and to said proximal end of said first push/pull wire for moving said first push/pull wire through said hollow member to cause a rotation of said first and second jaws about said clevis from an open to a closed position.
13 . A surgical clip applier according to claim 12 , wherein both of said jaws are provided with a plurality of teeth arranged to puncture and damage tissue adjacent two sides of the surgical clip.
14 . A surgical clip applier according to claim 12 , wherein:
at least one of said first and second jaws has:
a clip guiding channel shaped to fit a surgical clip; and
a hook shaped anvil at an end of said channel;
said first and second jaws apply the surgical clip with said clip guiding channel.
15 . A surgical clip applier according to claim 12 , wherein:
each of said first and second jaws have:
a clip guiding channel shaped to fit a surgical clip;
a hook shaped anvil at the end of said channel;
said first and second jaws apply the surgical clip with said channel.
16 . A surgical clip applier according to claim 15 , wherein each of said anvils has a helical surface.
17 . A surgical clip applier according to claim 15 , wherein each of said anvils has a curved surface.
18 . A surgical clip applier according to claim 17 , wherein said surface is curved about a single axis.
19 . A surgical clip applier according to claim 15 , wherein:
each of said jaws has a longitudinal axis and a vertical axis perpendicular to the longitudinal axis, and
each of said channels is arranged at an angle relative to said vertical axis.
20 . A surgical clip applier according to claim 19 , wherein said angle is approximately 22 degrees.