WO2008050048A9 - Surgical clip for ligaturing vessels and/or joining tissues - Google Patents

Abstract

The strands (1a), (1b), (1c), (1d) are of flat cross section and result from cuts (2) formed in a plate constituting the filiform element and are positioned relative to one another so as to serve as a clip by elastic deformation.

Description

 Surgical clip for vessel ligation and / or tissue assembly

The invention relates to the technical sector of surgical clips for vessel ligation and / or tissue assembly.

In many surgical procedures, it is necessary to ligate blood vessels or other, before cutting or assembling organic or synthetic fabrics. Generally, these ligatures or assemblies are made either by suturing with a suitable wire, or by means of metal clips or staples. These solutions do not give complete satisfaction.

Sutures, by means of a wire, are generally difficult to achieve if one uses an operative technique under colonoscopy. The suture operation as such is slow to perform.

The metal clips, generally U-shaped, acting as staples are easier and quick to put in place. However, for the ligature and / or assembly sought to be reliable, it is often necessary to ask several to obtain a security and a sufficient seal.

The object of the invention is to remedy these disadvantages in a simple, safe, effective and rational manner.

The problem that the invention proposes to solve is to be able to ligate the finest vessels of the anatomy and / or to assemble tissues organic and / or synthetic, also very thin, with the aim of obtaining a gripping effect in a plane parallel to the vessels or tissues, to obtain an effective ligature or assembly while aiming to facilitate the ligation or assembly as such.

To solve such a problem, it was designed and developed a clip made from a filamentary element having several rectilinear strands properly positioned relative to each other to act as clamp by elastic deformation of the strands.

From this basic design, the strands are of round section and result from a shaped wire constituting the filiform element, or the strands are of flat section and result from cuts formed in a plate constituting the filiform element .

Given the manufacturing technologies available to the skilled person such as laser cutting, it is possible to obtain, continuously, clips of very small dimensions, of the order of a few millimeters.

Advantageously, to solve the problem of obtaining the desired clamp effect, the filiform element has at least three parallel strands.

When the filiform element is made from a shaped wire, various embodiments may be provided. According to a first embodiment, the clip has four strands disposed in the same plane and one of which is joined by a half-loop to a second strand itself joined by another half-loop to a third strand disposed of a way contiguous to the first strand, said third strand being joined by another half-loop to a fourth strand disposed in a manner contiguous to the second strand.

According to one embodiment, the clip has four parallel strands arranged in the same plane and one of which is joined by a half-loop to a second strand joined by another half-loop of larger diameter to a third strand itself. even joined by another half loop to a fourth strand disposed in a contiguous manner or substantially contiguous to the first strand.

When the filiform element results from a properly cut plate, several embodiments can also be envisaged.

In a first embodiment, the clip has four parallel strands arranged in the same plane and resulting from a first substantially rectilinear cut connected, in parallel manner, to a second cutout, said second cutout being connected, in a manner parallel to a third cut by another cut.

In a second embodiment, the clip has three parallel strands disposed in the same plane and resulting from a first substantially straight cut connected in a manner parallel to a second cut by a rounded cut or the like.

Advantageously, the cuts constitute a toothing for the rectilinear strands resulting therefrom. These provisions make it possible to avoid lateral and radial sliding, thus conferring a total safety vis-à-vis the ligature achieved.

To solve the problem posed to promote good anchoring in tissues, especially in the context of use for anastomosis, the ends of the strands are bent.

Advantageously, the clip is made of a super elastic alloy or shape memory, or a bio-resorbable material.

The invention is described below in more detail with reference to the figures of the accompanying drawings, in which:

- Figures 1 and 2 are plan views showing two embodiments of a clip according to the invention, made from a shaped wire;

- Figures 3 and 4 are plan views showing two embodiments of a clip according to the invention, made from a properly cut plate;

- Figure 5 is a side view corresponding to any one of Figures 1 and 2;

FIG. 6 is a profile view corresponding to any one of FIGS. 3 and 4;

FIG. 7 is a perspective view showing the use of the clip according to the embodiment illustrated in FIG. 3, for ligation of a vessel;

FIG. 8 is a perspective view showing the use of a clip corresponding to the embodiment illustrated in FIG. 3 for the assembly of organic or synthetic fabrics; Fig. 9 is a plan view of an embodiment of Fig. 3;

- Figure 10 is a side view corresponding to Figure 9;

FIG. 11 is a perspective view corresponding to FIG. 9;

- Figure 12 is a variant of Figure 11;

FIG. 13 is a schematic view of an exemplary embodiment of an apparatus for setting up the clips according to the invention; FIG. 14 is a partial perspective view showing the principle of placing the clips by means of an apparatus illustrated in FIG. 12.

The surgical clip, according to the invention, is made from a filiform element (1) having a plurality of rectilinear strands (1a), (Ib), (Ic), (Id) suitably positioned relative to one another, for acting as forceps by elastic deformation of said strands at the time of ligation of the vessels and / or assembly of tissues. In a preferred manner, the filiform element (1) is made from a shape memory alloy of the "NITINOL" type or another superelastic alloy.

Note that the element (1) can also be made of absorbable material.

To obtain the clamping effect, the different strands close in parallel.

In the embodiments illustrated in FIGS. 1, 2 and 5, the strands (Ia), (Ib), (Ic), (Id) are of round section and result from a shaped wire. in order to constitute the whole of the filiform element (1). More particularly, in the embodiment illustrated in Figure 1, the element (1) has four parallel strands (la), (Ib), (Ic), (Id) arranged in the same plane. The first strand (la) is joined by a half loop (le) to the second strand (Ib), itself joined by another half-loop (If) third strand (Ic). This third strand (Ic) is disposed in a contiguous manner to the first strand (la) which is joined by another half-loop (Ig) to the fourth strand (1) disposed in a manner contiguous to the second strand (Ib).

In the embodiment illustrated in FIG. 2, the first strand (la) is joined by a loop (Ih) at the second strand (Ib) joined by a loop (Ii) of larger diameter at the third strand (Ic). This third strand (Ic) is itself joined by a loop (Ij), preferably identical to the loop (Ih), the fourth strand (Id). The fourth strand (Id) is disposed in a contiguous, or substantially contiguous manner, to the first strand (1a).

In the embodiment illustrated in Figures 3 and 4, the strands (la), (Ib), (Ic), (Id) which are of flat section, result from cuts formed in a plate constituting the filiform element (1). . In FIG. 3, the element (1) has four parallel strands (la), (Ib),

(Ic), (Id) arranged in the same plane. These strands result from a first cut (2a) substantially rectilinear to form the strands (la) and (Ic). This cutout (2a) is connected, in parallel manner, to a second cutout (2b) delimiting the strands (Ib) and (Id), in combination with a third cutout (2c) parallel to the cuts (2a) and (2b). ). The connection between the cuts (2a), (2b) and (2c) can be achieved by other cuts of rounded shape or other. In Figure 4, the filiform element has only three parallel strands (la), (Ib) and (Ic) arranged in the same plane. The strands (Ia), (Ib) and (Ic) therefore have two substantially rectilinear cuts (2d) and (2e) connected in parallel manner by a cutout (2f).

Referring to FIGS. 7 and 8 which show a ligature of the vessels (FIG. 7) and an assembly of the tissues (FIG. 8) made by means of a clip according to the characteristics of the invention and according to any one of the embodiments illustrated figures of the drawings. The pincer effect results from the elastic deformation of the strands in two parallel planes making it possible to obtain the ligatures and tight joints.

Advantageously, to prevent lateral and radial sliding, the different cuts (2a), (2b), (2d), (2e), for example, may constitute a plurality of asperities (3). Similarly, the ends of the strands may be curved in (4) to improve the anchoring of tissues, especially in the context of use for astomose.

FIGS. 13 and 14 show an exemplary embodiment of a device for fitting clips as defined according to the characteristics of the invention.

This apparatus comprises a body (5) extended by a tube (6) of reduced diameter corresponding substantially to the section of the clips. A determined number of clips is arranged in the tube one behind the other. For example, the clips are arranged in a rail (7) secured to the inside of the tube (6). The length of the tube (6) is suitable for use in laparoscopic surgery or for use in open surgery. A rotary system (8) makes it possible to act on the tube (6) in order to orient it to ideally present the clip according to the type of ligature or assembly to be made. A device, not shown, advances the clips to present the first clip in the open position outside the tube (Figure 14). This advance is effected, for example, by means of a control trigger (9) articulated on a portion of the body (5) and manually operable. At the end of the trigger stroke (9), a stronger pressure on the latter releases the clip.

The advantages are apparent from the description.

Claims

R E V E N D I C A T IO N S -1- Surgical clip for ligation of vessels and / or assembly of tissues, made from a filiform element (1) having a plurality of straight strands (1a), (Ib), (Ic), (Id), characterized in that the strands (la), (Ib), (Ic), (Id) are of flat section and result from cuts (2) formed in a plate constituting the filiform element and are positioned relative to each other to act as a clamp by elastic deformation. -2- clip according to claim 1, characterized in that the filiform element (1) has at least three parallel strands. -3- Clip according to claims 1 and 2, characterized in that it has four strands (la), (Ib), (Ic), (Id) arranged in the same plane and one of which (la) is joined by a half-loop (1c) to a second strand (Ib) itself joined by another half-loop (If) to a third strand (Ic) arranged contiguously with the first strand ( la), said third strand (Ic) being joined by another half-loop (Ig) to a fourth strand (Id) disposed contiguously with the second strand (Ib). -4- clip according to claims 1 and 2, characterized in that it has four parallel strands (la), (Ib), (Ic), (Id) arranged in the same plane and one (la) is joined by a half-loop (Ih) to a second strand (Ib) joined by another half-loop (Ii) to a third strand (Ic) itself joined by another half-loop to a fourth strand (Id) disposed in a contiguous or substantially contiguous manner to the first strand (la). -5- Clip according to claims 1 and 2, characterized in that it has four parallel strands (la), (Ib), (Ic), (Id) arranged in the same plane and resulting from a first cut (2a ) substantially rectilinear connected in parallel manner to a second cutout (2b), said second cutout (2d) being connected in parallel manner to a third cutout (2c). -6- clip according to claims 1 and 2, characterized in that it has three parallel strands (la), (Ib), (Ic) arranged in the same plane and resulting from a first cut (2d) substantially rectilinear connected in a manner parallel to a second cut (2e). -7- Clip according to claims 5 and 6, characterized in that the cuts constitute a toothing (3) for the rectilinear strands resulting. -8- Clip according to claim 1, characterized in that the ends (4) of the strands are bent. -9- Clip according to one of claims 1 to 8, characterized in that it is made of a super elastic alloy or shape memory. Clip according to one of claims 1 to 8, characterized in that it is made of a bio-resorbable material.