Surgical clip applicator and apparatus including the same
Apparatus and methods for delivering a surgical clip to a patient during a minimally invasive surgical procedure are disclosed herein. An exemplary apparatus for isolating an atrial appendage of a patient includes a surgical clip that locks onto the atrial appendage of the patient, and a surgical clip applicator that releasably engages the surgical clip. The surgical clip can include a top portion and a bottom portion. The surgical clip applicator can include a first flexible flap and a second flexible flap. The first and second flexible flaps can be sufficiently rigid to prevent the surgical clip from falling off of the surgical clip applicator when the surgical clip is engaged to the surgical applicator and the surgical clip applicator is in a relaxed state, and sufficiently flexible to facilitate separation of the surgical clip from the surgical clip applicator when the surgical clip is locked onto the atrial appendage.
1. A method of deploying a surgical clip about a region of tissue with a surgical clip applicator, the method comprising: releasably securing the surgical clip to the surgical clip applicator where the surgical clip comprises a first leg and a second leg terminating in a hinge region and a portion of the second leg extends to form at least one tissue engagement device, where the surgical clip applicator comprises a bottom surface extending between a first flexible flap and a second flexible flap, where the surgical clip applicator comprises a slot portion formed by the first and second flexible flaps and extending longitudinally along the surgical clip applicator to releasably engage the surgical clip, the first and second flexible flaps extending only partially along a length of the bottom surface and forming at least one open region along the bottom surface, wherein the at least one tissue engagement device is aligned with the open region; releasably securing the surgical clip applicator to a clamp, where the clamp comprises a longitudinal slot that releasably engages the surgical clip applicator; inserting the surgical clip into a patient and positioning the surgical clip about a target tissue structure; securing the surgical clip to the target issue structure; and separating the surgical clip applicator from the surgical clip such that the surgical clip separates from the slot portion and the at least one tissue engagement device presses into the region of tissue and facilitates formation of scar tissue about the at least one tissue engagement device to further prevent movement of the surgical clip.
2. The method of claim 1 , wherein releasably securing the surgical clip to the surgical clip applicator comprises sliding the surgical clip onto the surgical clip applicator such that the surgical clip applicator releasably engages the surgical clip.
3. The method of claim 1 , wherein inserting the surgical clip into the patient comprises inserting the surgical clip into a chest of the patient through an access port.
4. The method of claim 1 , wherein securing the surgical clip to the target issue structure comprises securing the surgical clip to the region of tissue on an epicardial surface of an atrial appendage.
5. A method of delivering a surgical clip to an atrial appendage of a patient, the method comprising:
inserting the surgical clip into the patient while the surgical clip is releasably engaged with a surgical clip applicator, wherein the surgical clip has a top portion and a bottom portion, wherein a portion of a leg of the surgical clip extends to form at least one tissue engagement device, the surgical clip applicator has a bottom surface extending between a first flexible flap and a second flexible flap, the first flexible flap has a fixed end connected to the bottom surface and a free end, and the second flexible flap has a fixed end connected to the bottom surface and a free end such that the first flexible flap and second flexible flap form a slot portion that extends longitudinally along the surgical clip actuator, the first and second flexible flaps extending only partially along a length of the bottom surface and forming at least one open region along the bottom surface, the at least one open region configured to receive the at least one tissue engagement device, wherein the surgical clip is releasably engaged within the slot portion which prevents the surgical clip from falling off;
locking the surgical clip onto the atrial appendage of the patient; and
releasing the surgical clip from the surgical clip applicator by causing the surgical clip to disengage from the slot portion, wherein the surgical clip presses into the atrial appendage and facilitates formation of scar tissue about the at least one tissue engagement device to further prevent movement of the surgical clip.
6. The method of claim 5 , wherein the first and second flexible flaps of the surgical clip applicator are configured to deflect during release of the surgical clip from the surgical clip applicator.
7. The method of claim 5 , wherein locking the surgical clip onto the atrial appendage of the patient comprises compressing the surgical clip with the surgical clip applicator.
8. The method of claim 5 , wherein the surgical clip comprises a first locking member and a second locking member, and locking the surgical clip onto the atrial appendage of the patient comprises engaging the first and second locking members together.
9. The method of claim 5 , wherein the surgical clip comprises first and second inwardly extending cam surfaces and first and second deflectable latches, and locking the surgical clip onto the atrial appendage of the patient comprises engaging the first and second deflectable latches with the first and second cam surfaces, respectively.
10. The method of claim 1 , wherein the surgical clip applicator comprises a connector configured to be received by the longitudinal slot of the clamp.
11. The method of claim 5 , wherein a central section of the clip bottom portion contacts the bottom surface of the applicator when the surgical clip is releasably engaged to the surgical clip applicator.
12. The method of claim 5 , wherein the first and second flexible flaps comprise a flexible biocompatible material.
13. The method of claim 5 , wherein the first and second flexible flaps comprise a polyurethane silicone material.
14. The method of claim 5 , wherein the first and second flexible flaps comprise a polyurethane/silicone blend material.
15. The method of claim 5 , wherein the first and second flexible flaps comprise a polyether block amide blend material.
16. The method of claim 5 , wherein each of the top and bottom portions of the surgical clip have a curved configuration that is at least partially retained after the surgical clip is locked onto the atrial appendage of the patient.