Medical devices with detachable pivotable jaws
View Patent ↗Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.
1. A medical device for engaging tissue, the medical device comprising:
a housing defining an internal passageway and a longitudinal axis extending between proximal and distal ends of the housing, the housing defining first and second guide surfaces along the internal passageway;
a first jaw slidably and pivotally connected to the housing, the first jaw having proximal and distal ends, the first jaw slidably received within the internal passageway for longitudinal movement along the first guide surface between an extended position and a retracted position;
a second jaw slidably and pivotally connected to the housing, the second jaw having proximal and distal ends, the second jaw slidably received within the internal passageway for longitudinal movement along the second guide surface between an extended position and a retracted position;
the housing structured to block rotation of the first and second jaws when in their retracted positions, the housing structured to permit rotation of the first and second jaws when in their extended positions; and
a driver engaged with the proximal ends of the first and second jaws, the proximal ends of the first and second jaws including geared teeth, and wherein the driver includes corresponding teeth that mesh with the geared teeth of the jaws, longitudinal movement of the driver moving the first and second jaws longitudinally along the first and second guide surfaces between their retracted and extended positions, longitudinal movement of the driver rotating the first and second jaws relative to the housing when the first and second jaws are in their extended positions.
2. The medical device of claim 1 , wherein the proximal ends of the first and second jaws are located adjacent the distal end of the housing when the first and second jaws are in their extended positions.
3. The medical device of claim 2 , wherein the proximal ends of the first and second jaws are slidably and pivotally attached to the housing.
4. The medical device of claim 1 , wherein the housing defines a shoulder within the internal passageway, and wherein the driver includes a locking tab positioned to engage the shoulder to limit longitudinal movement of the driver and the first and second jaws.
5. The medical device of claim 4 , wherein the shoulder moves the locking tab to a position out of engagement with the shoulder when a distally directed longitudinal force on the driver reaches a predetermined level to permit longitudinal movement of the driver and the first and second jaws in a distal direction.
6. The medical device of claim 5 , further comprising an elongate drive wire selectively connected to the driver for longitudinal movement therewith, and wherein the locking tab firmly engages the drive wire when the locking tab is positioned distal to the shoulder, and wherein the locking tab does not firmly engage the drive wire when the locking tab is positioned proximal to the shoulder to permit the drive wire to be disconnected from the driver.
7. The medical device of claim 5 , wherein the housing defines a third guide surface, the third guide surface guiding longitudinal movement of the driver within the housing, the third guide surface defining the shoulder.
8. The medical device of claim 1 , further comprising an elongate drive wire having an enlarged distal head, and wherein the driver includes a socket facing proximally, the driver constructed of a resilient material that flexes to adjust the size of the socket, the socket sized to selectively receive the enlarged distal head of the drive wire.
9. The medical device of claim 1 , wherein the proximal ends of the first and second jaws are formed as pinions, and wherein the driver is formed as a rack, wherein longitudinal movement of the driver and rack rotates the pinions and first and second jaws in their extended positions.
10. The medical device of claim 9 , wherein the driver includes a central spine extending longitudinally and teeth extending laterally from the central spine.
11. The medical device of claim 10 , wherein the driver includes pairs of teeth extending in laterally opposite directions from the spine to form two sets of teeth, one of the two sets of teeth engaged with the pinion of the first jaw, the other of the two sets of teeth engaged with the pinion of the second jaw.
12. The medical device of claim 1 , further comprising an elongated drive wire selectively connected to the driver for longitudinal movement therewith, the driver defining a locking tab positioned between the drive wire and the housing, the housing defining a driver guide surface that guides longitudinal movement of the driver, the driver guide surface maintaining the locking tab in a position firmly engaging the drive wire such that the drive wire cannot be disconnected from the driver when the tab is positioned along a distal portion of the driver guide surface, the driver guide surface allowing movement of the locking tab to permit the drive wire to be disconnected from the driver when the locking tab is positioned along a proximal portion of the driver guide surface.
13. The medical device of claim 12 , wherein the elongated drive wire has a distal head and the driver includes a socket sized to receive the distal head, and wherein the locking tab is positioned at an entrance to the socket and moves to vary the size of the entrance.
14. The medical device of claim 13 , wherein the driver includes two locking tabs on opposing sides of the socket, and wherein the driver guide surface includes two surfaces on opposing sides of the housing corresponding to the two locking tabs.
15. The medical device of claim 12 , further comprising a tubular connector defining a lumen sized to slidably receive a connection block, the connection block structured to frictionally engage a proximal end of the housing, the connection block defining a bore slidably receiving the drive wire, a distal end of the drive wire defining a distal head having a size that is larger than the bore, wherein the distal head engages the connection block upon proximal retraction of the drive wire and slides the connection block proximally relative to the tubular connector to disengage the connection block from the housing.
16. The medical device of claim 12 , wherein the shoulder is defined at the transition between the proximal portion and distal portion of the driver guide surface, and wherein the locking tab is positioned to engage the shoulder to limit longitudinal movement of the driver.
17. The medical device of claim 16 , wherein the shoulder deflects the tab to a position out of engagement with the shoulder when a distally directed longitudinal force on the driver reaches a predetermined level to permit longitudinal movement of the driver and the first and second jaws in a distal direction.
18. The medical device of claim 16 , wherein the extended position is defined by the first and second guide surfaces each including a distal end structured to limit the longitudinal movement of the first and second jaws in a distal direction.
19. The medical device of claim 1 , wherein the first and second jaws are entirely contained within the housing in the retracted position.
20. The medical device of claim 1 , wherein the first guide surface includes a first pair of opposing slots, and wherein the second guide surface includes a second pair of opposing slots.
21. The medical device of claim 20 , further comprising a first pin slidably connected to the first pair of opposing slots, the first pin pivotally connected to the first jaw, and further comprising a second pin slidably connected to the second pair of opposing slots, the second pin pivotally connected to the second jaw.