SUTURE CLIP AND SUTURE CLIP APPLIER

Abstract

A suture clip includes a disc body having at least two adjacent portions joined by a hinge at one end and a latch at another end. Suture engagement surfaces are formed on a first and second portion of the disc body so that the first and second suture engagement surfaces can close sufficiently tightly to immobilize a pair of suture lengths therebetween when the two portions are closed and held together by the latch. A suture clip applier holds a plurality of such suture clips typically in a magazine, an open configuration where the suture engagement surfaces are held apart. Single suture clips are advanced by an advancement mechanism over a pair of suture ends having a midsection in tissue. A closing mechanism closes and latches the first and second portions of the disc body together to capture the pair of suture ends therebetween.

Claims

1. A suture clip applier comprising: a shaft having a proximal end and a distal end; a magazine housing secured to the distal end of the shaft, said magazine housing having a dispensing slot; a stack of suture clips disposed in the magazine housing, wherein the suture clips are held in an open configuration with spaced-apart suture engagement surfaces; a mechanism for advancing a distal-most of the open suture clips to a position within the housing adjacent to the dispensing slot; a mechanism for compressing the distal-most clip in the housing to secure sutures between the suture engagement surfaces; wherein the compressed clip is released and passes through the slot after compressed over suture.

2. A suture clip applier as in claim 1, wherein the suture clips each comprise: a disc body having two adjacent portions joined by a hinge at a first location on a perimeter of the disc body and having a latch at a second location on the perimeter of the disc body diametrically opposite to the first location; wherein a first suture engagement surface is disposed on a first portion of the disc body; and a second suture engagement surface on a second portion of the disc body; wherein then first and second suture engagement surfaces close sufficiently tightly to immobilize a pair of suture lengths therebetween when the two portions are closed and held together by the latch.

3. A suture clip applier as in claim 2, wherein each portion of the disc body has a guide hole formed therein and where the guide holes are received over guide rails in the housing of the suture clip applier.

4. A suture clip applier as in claim 3, wherein the guide rails terminate at locations in the magazine housing such that the distal-most suture clip is released from the guide rails so that it can be released through the dispensing slot after closure.

5. A suture clip applier as in claim 1, wherein the mechanism for advancing a distal-most of the open suture clips to a position within the housing adjacent to the dispensing slot a spring to advance the stack of suture clips each time the distal-most suture clip is released through the dispensing slot comprises a spring.

6. A suture clip applier as in claim 1, wherein the mechanism for compressing the distal-most clip in the housing to secure sutures between the suture engagement surfaces comprises a pair of opposed closing arms disposed in the housing adjacent to the dispensing slot.

7. A method for delivering suture clips from a suture clip applier to a pair of suture lengths, said method comprising: loading a magazine onto the clip applier, wherein the magazine carries a stack of suture clips, which suture clips are held in an open configuration with two adjacent portions joined by a hinge at a first location, a first suture engagement surface disposed on a first portion of the clip, and a second suture engagement surface disposed on a second portion of the clip; advancing a distal-most of the open suture clips to a position within the magazine adjacent to a dispensing slot; positioning the spaced-apart suture engagement surfaces of the distal-most of the open suture clips over suture lengths; closing the two adjacent portions of the distal-most clip to secure sutures between the suture engagement surfaces; releasing the closed distal-most clip through the dispensing slot in the magazine after said clip has been secured over the suture lengths.

8. The method of claim 7, wherein the suture clips are malleable and closing comprises applying an external clamping force.

9. The method of claim 8, applying the external clamping force comprises actuating a trigger on a handle to close a pair of crimping arms located on opposite sides of the dispensing slot.

10. The method of claim 7, wherein the suture clips are elastic and held open by constraint in the magazine and wherein closing comprises releasing the suture clips from constraint to self-close over the suture length.

11. The method of claim 7, wherein each portion of the disc body has a guide hole formed therein and where the guide holes are received over guide rails in the housing of the suture clip applier.

12. The method of claim 11, wherein the guide rails terminate at locations in the magazine housing such that the distal-most suture clip is released from the guide rails so that it can be released through the dispensing slot after closure.

13. The method of claim 7, wherein the distal-most of the open suture clips to a position within the housing adjacent to the dispensing slot is advanced by a spring each time the distal-most suture clip is released through the dispensing slot.

14. The method of claim 7, wherein the suture clips further comprise a latch at a second location on the perimeter of the disc body diametrically opposite to the first location.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0016] FIG. 1 is a perspective view of a suture clip constructed in accordance with the principles of the present invention.

[0017] FIG. 2A is a top view of the suture clip of FIG. 1 shown in an open position with a pair of suture lengths held between engagement surfaces of the clip.

[0018] FIG. 2B is a view of the suture clip of FIG. 2A after the opposed portions of the suture clip have been closed to secure the suture lengths therebetween.

[0019] FIG. 3A is a side view of the suture clip of FIG. 1, showing the suture clip having an arcuate profile.

[0020] FIG. 3B is a side view of the clip of FIG. 1, showing an embodiment having a planar profile.

[0021] FIG. 4 is a side view of a clip delivery tool constructed in accordance with the principles of the present invention showing deflected distal end configurations in phantom view.

[0022] FIGS. 5A and 5B are detailed views of a clip magazine of the type used in the clip delivery tool of FIG. 4.

[0023] FIG. 6A through 6D illustrate use of the clip delivery tool of FIG. 4 for sequentially delivering a plurality of suture clips to a plurality of suture length.

[0024] FIGS. 7A and 7B are side and top views, respectively, of the multiple suture clips after delivery as illustrated in FIG. 6A through 6D.

DETAILED DESCRIPTION OF THE INVENTION

[0025] Referring to FIG. 1, a suture clip 10 includes a first potion or half 12 joined to a second portion or half 14 by a hinge 16. The suture clip 10 is shown in a closed configuration in FIG. 1 but can assume an opened configuration, as shown in FIG. 2A, as well as a closed configuration with suture lengths SL, as shown in FIG. 2B. The hinge 16 is typically a living hinge, i.e., one that is formed by the material of the disk body of the suture clip and which elastically or inelastically deforms between the opened and closed configurations of the suture clip.

[0026] The suture lengths SL are held in a locking zone 18 formed by opposed surfaces on each of the first and second portions 12 and 14, respectively, of the disk body of the suture clip 10. A latch mechanism 20 is provided in order to assure a tight closure of the two portions of the disk body and typically includes a barb 22 formed on one of the portions and a locking arm 24 formed on the other of the portions. In this way, the two portions can be closed from the configuration shown in FIG. 2A so that the barb 22 engages the locking arm 24 with the engagement surfaces in the locking zone 18 tightly closed against one another in order to secure the suture lengths SL therebetween.

[0027] The suture clip 10 typically also includes a resting arm 26 which projects outwardly from the first portion 12 of the suture clip at a location just above the hinge 16. The resting arm 26 is received in a slot 28 formed in the second portion 14 of the suture clip so that the two portions can be closed. The resting arm 26 acts as a “back stop” to maintain the suture lengths SL within the locking zone 18 and prevent the suture lengths from accidently entering an open gap which forms part of the hinge structure 16. In addition to the features described thus far, the suture clips will typically also include first and second guide holes 30 and 32 which are used to stack multiple suture clips 10 in a clip delivery tool 40 (FIG. 4), as will be described hereinafter.

[0028] The disk body of the suture clip 10 may have either an arcuate profile, as shown at 10a in FIG. 3A, or a planar profile 10b, as shown in FIG. 3B. The planar profile will be suitable for most purposes. An arcuate profile will be useful when the clip is used on a curved tissue surfaces, implant surfaces, or other situations where a curved clip profile will conform to an adjacent surface.

[0029] Referring now to FIG. 4, a clip delivery tool 40 constructed in accordance with principles of the present invention comprises a shaft 42 having a magazine 44 at a distal end thereof and a handle 46 at a proximal end thereof. The handle includes a trigger 48 which is used to delivery individual suture clips 10 from the magazine 44, as will be described below. Optionally, the shaft may have a flexible or deformable distal end (shown in phantom view) so the magazine can be repositioned for better access to remote tissue sites.

[0030] Referring to FIGS. 5A and 5B, the suture clip magazine 44 comprises a housing 52 having a dispensing slot 54 formed at a distal-most end thereof. A suture-receiving channel or groove 56 is formed along one surface of the housing so that suture may be received therein and passed through a V-shaped notch 57 at the bottom of the housing. A pair of closure or crimping arms 58 is disposed on opposed lateral sides of the housing 52 and have distal clip-engaging ends which are aligned with the dispensing slot 54 in the housing. A plurality of suture clips 10 are stacked on guideposts 62 within the housing 52 and are urged in a distal direction by a pair of advancement springs 60. In this way, a distal-most of the suture clips 10 (at the bottom in FIGS. 5A and 5B) will be maintained adjacent the dispensing slot 54 and between the distal ends of the crimping arms 58.

[0031] As shown in FIG. 5A, the distal-most suture clip 10 remains in its open configuration (FIG. 2A) with suture length SL present in the suture channel 56 and passing through the open suture clip and the V-shaped notch 57. Once the suture lengths are thus positioned in the opening of the suture clip 10 between the engagement surfaces of the locking zone 18, the handle 48 on the clip delivery tool 40 can be actuated to advance a slider 50, as shown in FIG. 5B, in order to compress and close the crimping arms 58 in order to fully close the distal-most suture clip 10, as shown in FIG. 5B. At that point, the trigger can be released, allowing the slider 50 to move proximally and release the crimping arm 58 from the distal-most suture clip 10. At that point, the closed suture clip (FIG. 2B) can be pulled away, leaving the suture clip in place over the tissue, as shown in FIGS. 7A and 7B below.

[0032] Use of the clip delivery tool 40 for sequentially delivering multiple suture clips 10 is described with reference to FIG. 6A through 6D. As shown in FIG. 6A, the magazine 44 is initially engaged to capture adjacent strands of a first suture length SL.sub.1 to c in the suture channel 56 of the magazine. As the magazine 44 is pressed down against the tissue surface TS, the user will also pull upwardly on the first suture SL.sub.1 to tension the suture prior to suture clip closure, as shown in FIG. 6B. The trigger 48 on handle 46 is then actuated in order to close the suture clip, and the clip applier 40 pulled away. The excess suture can then be trimmed, and the magazine moved to a second suture length SL.sub.2, as shown in FIG. 6C. The clip delivery tool 40 is then actuated to then deliver a second clip 10 over the second suture length SL.sub.2, and the second suture length then trimmed. The clip delivery tool 40 can then be moved to a third suture length SL.sub.3, and the procedure repeated in order to place a third suture clip 10 on the third suture length.

[0033] After the procedure is complete, three suture clips 10 will be placed on the first through third suture length as shown in FIGS. 7A and 7B. FIG. 7A shows a side view of the suture clips while FIG. 7B shows a top view of the suture clips.

[0034] The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. The term “connected” is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.

[0035] All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.

[0036] Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.