Articulating clip applier cartridge

1. An end effector for operative connection to a surgical handle assembly including an axially reciprocatable drive assembly having a flexible drive cable operatively connected to the end effector, the end effector comprising:

a distal housing portion defining a proximal end, a distal end, and a longitudinal axis;

a knuckle portion extending proximally from the proximal end of the distal housing portion, the knuckle portion being bifurcated into a first geared portion and a second geared portion, the distal housing portion being rotatably mounted to the knuckle portion to allow the distal housing portion to rotate about the longitudinal axis with respect to the knuckle portion;

a proximal housing pivotably connected to the knuckle portion;

a gear train supported in the proximal housing, wherein a distal-most gear of the gear train is operatively engaged with the first geared portion and the second geared portion of the knuckle portion;

a jaw assembly supported on the distal housing portion, the jaw assembly including a first jaw and a second jaw extending distally from the distal housing portion and being movable between a spaced apart position and an approximated position;

a plurality of surgical clips loaded in the housing in a partially stacked fashion; and

a jaw closure mechanism disposed in the distal housing portion and operatively associated with the jaw assembly and the plurality of surgical clips,

wherein a distal end of the flexible drive cable is connected to the jaw closure mechanism so as to transmit an operative force to the jaw closure mechanism when the longitudinal axis of the distal housing portion is either axially aligned or angled with respect to a longitudinal axis of the surgical handle; and

wherein the jaw closure mechanism feeds a clip into the jaw assembly and forms the fed clip upon a single complete stroke of the flexible drive cable.

2. The end effector according to claim 1 , further comprising a rack slidably supported in the proximal housing, wherein the rack defines at least one axial row of gear teeth, and wherein the axial row of gear teeth is engaged with a proximal-most gear of the gear train.

3. The end effector according to claim 2 , wherein axial displacement of the rack relative to the proximal housing portion results in articulation of the distal housing portion relative to the proximal housing portion.

4. An end effector for application of surgical clips to body tissue, the end effector comprising:

a base portion defining a proximal end, a distal end, and a longitudinal axis;

a knuckle portion extending proximally from the proximal end of the base portion, the knuckle portion being bifurcated into a first geared portion and a second geared portion, the base portion being rotatably mounted to the knuckle portion to allow the base portion to rotate about the longitudinal axis with respect to the knuckle portion;

a proximal housing portion connected to the knuckle portion such that the base portion is pivotable off-axis with respect to the proximal housing portion, wherein the proximal housing portion supports a gear train in a distal region thereof, and wherein a distal-most gear of the gear train is operatively engaged with the first geared portion and the second geared portion of the knuckle portion;

a jaw assembly extending distally from the base portion, the jaw assembly including a first jaw and a second jaw movable between a spaced apart position and an approximated position; and

a plurality of fasteners located within the base portion, each of the plurality of fasteners having a pair of legs extending from a backspan, each of the plurality of fasteners defining a fastener axis extending in a direction substantially parallel to the pair of legs, each of the plurality of fasteners being arranged within the base portion to form an angle between the fastener axis and the longitudinal axis, each of the plurality of fasteners being located adjacent to another of the plurality of fasteners to form a stack.

5. The end effector according to claim 4 , wherein the knuckle includes a pivot structure that defines a pivot axis.

6. The end effector according to claim 4 , further comprising a jaw closure mechanism operatively connected to the jaw assembly, the jaw closure mechanism providing an approximating force to the first jaw and the second jaw.

7. The end effector according to claim 4 , wherein the knuckle portion includes a plurality of teeth.

8. The end effector according to claim 4 , wherein the plurality of fasteners are stacked in a non-colinear position with respect to the second longitudinal axis.

9. The end effector according to claim 4 , wherein the first jaw and the second jaw are angled with respect to the longitudinal axis.

10. The end effector according to claim 9 , wherein the legs of the plurality of fasteners are disposed in a substantially parallel orientation to the first jaw and the second jaw.

11. The end effector according to claim 4 , wherein the stack extends parallel to the longitudinal axis.

12. The end effector according to claim 4 , further comprising a rack slidably supported in a proximal region of the proximal housing portion, wherein the rack defines at least one axial row of gear teeth, and wherein the axial row of gear teeth is engaged with a proximal-most gear of the gear train.

13. The end effector according to claim 12 , wherein axial displacement of the rack relative to the proximal housing portion results in articulation of the base portion relative to the proximal housing portion.

14. An end effector for operative connection to a surgical handle assembly including an axially reciprocatable drive assembly having a flexible drive cable operatively connected to the end effector, the end effector comprising:

a distal housing portion defining a proximal end, a distal end and a longitudinal axis;

a knuckle portion interconnecting the proximal end of the distal housing portion and the distal end of the proximal housing portion, wherein the knuckle portion permits rotation of the distal housing portion relative thereto and articulation of the distal housing portion relative to the proximal housing portion, the knuckle portion being bifurcated into a first geared portion and a second geared portion;

a proximal housing portion defining a proximal end, a distal end and a longitudinal axis;

a gear train supported in the proximal housing portion, wherein a distal-most gear of the gear train is operatively engaged with the first geared portion and the second geared portion of the knuckle portion;

a jaw assembly supported in the distal end of the distal housing portion, the jaw assembly including a first jaw and a second jaw movable between a spaced apart position and an approximated position; and

a plurality of fasteners loaded within the distal housing portion, each of the plurality of fasteners having a pair of legs extending from a backspan, each of the plurality of fasteners defining a fastener axis extending in a direction substantially parallel to the pair of legs, each of the plurality of fasteners being arranged within the distal housing portion such that the fastener axis is disposed at an angle with respect to the longitudinal axis of the distal housing portion, and wherein the plurality of fasteners are arranged in a stack.

15. The end effector according to claim 14 , further comprising a jaw closure mechanism operatively connected to the jaw assembly, the jaw closure mechanism providing an approximating force to the first jaw and the second jaw upon a proximal movement thereof relative to the first jaw and the second jaw.

16. The end effector according to claim 15 , wherein the jaw closure mechanism includes a cam plate axially slidably supported in the distal housing portion, wherein the cam plate includes a camming aperture formed therein, wherein the camming aperture has a substantially “V” shaped profile, and wherein each of first jaw and second jaw includes a post extending therefrom and into the camming aperture of the cam plate;

wherein movement of the cam plate proximally relative to the first jaw and second jaw engages an edge of the camming aperture against the nubs of the first jaw and the second jaw to approximate the first jaw and the second jaw.

17. The end effector according to claim 16 , wherein the cam plate includes a protrusion extending distally into the camming aperture; wherein movement of the cam plate distally relative to the first jaw and second jaw engages the protrusion of the camming aperture between the nubs of the first jaw and the second jaw to separate the first jaw and the second jaw.