Clip applier and cartridge

PRIORITY This application claims priority to U.S. Provisional Patent Application No. 62/700,031, filed July 18, 2018, the entire disclosure of which is incorporated herein by reference.

TECHNICAL FIELD The present disclosure relates generally to medical devices and, more particularly, to clip appliers and cartridges for applying surgical clips to tissue.

Ligation of tissue (e.g., blood vessels, lymph nodes, nerves, cystic ducts, or cardiac tissue) is a common practice in many surgical procedures. Current ligation systems often include a surgical clip, a clip applier, and/or a cartridge. The clip applier allows a user to grasp a surgical clip from the cartridge and apply the surgical clip to tissue, for example, to ligate a blood vessel (such as a vein or artery).

<p><patcit num="1"><text>U.S. Pat. No. 5,100,416</text></patcit><patcit num="2"><text>U.S. Patent No. 9,445,820</text></patcit><patcit num="3"><text>U.S. Patent Application Serial No. 15/927,763</text></patcit><patcit num="4"><text>U.S. Patent No. 6,880,699</text></patcit></p>

<p>The inventors have recognized a need for improving one or more features of a clip applier system. Current clip applier systems lack a completely reliable interface between the cartridge, the surgical clip, and/or the jaw members of the clip applier. For example, users often find it difficult to load a surgical clip from the cartridge into the clip applier. Due to the small size of the surgical clip and the lack of alignment features on the cartridge, alignment of the clip applier with the boss of the surgical clip can be difficult. Poor engagement between the two components can result in the surgical clip being misaligned or dislodged during application. When the surgical clip contacts tissue while being placed within the body, the proximal portion of the clip can move laterally or "fishtail" relative to the clip applier due to lack of stability of the proximal portion of the surgical clip. The disclosed clip applier, cartridge, and/or clip applier system are directed to alleviate and/or overcome one or more of these problems, and/or other problems of the prior art.</p>

<p>A first aspect of the present invention relates to a clip applier configured to releasably secure a surgical clip contained in a cavity of a cartridge , the surgical clip may include first and second leg members, the clip applier comprising: a first jaw member including a first clip engaging portion configured to engage the first leg member and a first cartridge engaging portion having at least one first flange extending laterally of the first clip engaging portion, the at least one first flange configured to abut a first side of the cartridge to align the first jaw member with the first leg member; and a second jaw member including a second clip engaging portion configured to engage a second leg member and a first cartridge engaging portion having at least one second flange extending laterally of the second engaging portion, the at least one second flange configured to abut a second side of the cartridge to align the second jaw member with the second leg member.</p><p>In some embodiments of the clip applier, the first cartridge engaging portion can have a width greater than a width of the first clip engaging portion, and the second cartridge engaging portion can have a width greater than a width of the second clip engaging portion. In some embodiments of the clip applier, the first clip engaging portion and the second clip engaging portion can be configured to be inserted into the cavity to engage a surgical clip while the at least one first flange and the at least one second flange remain outside the cavity. In some embodiments of the clip applier, the first clip engaging portion can include at least one recess configured to receive a boss on the first leg member, and the second clip engaging portion can include at least one recess configured to receive a boss on the second leg member. In some embodiments of the clip applier, the at least one recess of the first clip engaging portion can include first and second spaced apart recesses configured to receive first and second bosses on the first leg member, and the at least one recess of the second clip engaging portion can include first and second spaced apart recesses configured to engage first and second bosses on the second leg member. In some embodiments of the clip applier, the at least one first flange can include a pair of first flanges extending in opposed transverse directions of the first clip engaging portion, and the at least one second flange can include a pair of second flanges extending in opposed transverse directions of the second clip engaging portion. In some embodiments of the clip applier, the at least one first flange can be at least partially tapered, and the at least one second flange can be at least partially tapered. In some embodiments of the clip applier, the clip applier may further include a stabilizing portion of at least one of the first and second jaw members, the stabilizing portion configured to laterally stabilize a proximal portion of the surgical clip. In some embodiments of the clip applier, the stabilizing portion may include first and second projections, the clip applier configured to receive a proximal portion of the surgical clip between the first and second projections. In some embodiments of the clip applier, the stabilizing portion may extend from an attachment portion of at least one of the first and second jaw members, the stabilizing portion may have a width less than a width of the attachment portion. In some embodiments of the clip applier, the at least one first flange and the at least one second flange may form a V-shape when the clip applier is in the open configuration.</p><p>A second aspect of the invention relates to a method of loading a surgical clip from a cartridge into a clip applier, the surgical clip including first and second leg members and the clip applier including first and second jaw members, the method including aligning the first jaw member with the first leg member by abutting at least one first flange of the first jaw member against a first side of the cartridge, aligning the second jaw member with the second leg member by abutting at least one second flange of the second jaw member against a second side of the cartridge, engaging the first leg member with a first engagement portion of the first jaw member, and engaging the second leg member with a second engagement portion of the second jaw member.</p><p>In some embodiments of the method, the method can include receiving a first boss in at least one recess of the first jaw member to engage the first leg member, and receiving a second boss in at least one recess of the second jaw member to engage the second leg member. In some embodiments of the method, abutting the at least one first flange of the first jaw member can include abutting a pair of laterally extending first flanges of the first engagement portion against a first side surface, and abutting the at least one second flange of the second jaw member can include abutting a pair of laterally extending second flanges of the second engagement portion against a second side surface. In some embodiments of the method, the method can further include inserting a stabilizing portion of the clip applier into the recess of the cartridge to laterally stabilize a proximal portion of the surgical clip with the stabilizing portion.</p><p>A third aspect of the invention relates to a cartridge of surgical clips. The cartridge can include a base and a plurality of walls extending from the base, the plurality of walls spaced apart by at least one cavity configured to receive a surgical clip, the plurality of walls including first and second sides that define an angle between about 15 and 30 degrees, the first and second sides configured to engage a clip applier in an open configuration during loading of the surgical clip.</p><p>In some embodiments of the cartridge of the third aspect, the angle can be between about 18 degrees and 25 degrees. In some embodiments of the cartridge of the third aspect, the side can be outside of the at least one cavity. In some embodiments of the cartridge of the third aspect, the cartridge can further include a support member configured to support a surgical clip, the support member extending between the plurality of walls. In some embodiments of the cartridge of the third aspect, the cartridge can further include at least one recess configured to receive a stabilizing portion of a clip applier during loading of the surgical clip, the at least one recess extending along at least one of the plurality of walls. In some embodiments of the cartridge of the third aspect, the side can extend from the base. In some embodiments of the cartridge of the third aspect, the cartridge can further include a flexible insert configured to engage the surgical clip when received in the at least one cavity.</p><p>A fourth aspect of the invention relates to a cartridge of surgical clips that may include a base, first and second walls extending from the base, a cavity configured to receive a surgical clip between the first and second walls, a support member extending between the first and second walls and configured to support the surgical clip, and at least one recess extending along at least one of the first and second walls configured to receive a jaw member of a clip applier during loading of the surgical clip.</p><p>In some embodiments of the cartridge of the fourth aspect, the at least one recess can include a first recess between the support member and the first wall and a second recess between the support member and the second wall. In some embodiments of the cartridge of the fourth aspect, the cartridge can further include at least one recessed portion defining the at least one recess. In some embodiments of the cartridge of the fourth aspect, the at least one recess can include a first recess between the support member and the first wall and a second recess between the support member and the second wall. In some embodiments of the cartridge of the fourth aspect, the at least one recess can have a length that is greater than a length of the support member. In some embodiments of the cartridge of the fourth aspect, the plurality of walls can include first and second sides that define an angle between about 15 and 30 degrees, the first and second sides being configured to engage a clip applier in an open configuration during loading of a surgical clip.</p><p>In order that the invention may be readily understood, embodiments thereof are illustrated by way of example in the accompanying drawings, in which: FIG.</p>

<figref num="1">FIG. 1 is a side view of an exemplary embodiment of a clip applier according to the present invention.</figref><figref num="2">2 is a side view of the exemplary embodiment of the clip applier of FIG. 1 loaded with a surgical clip according to the present invention.</figref><figref num="3">FIG. 3 is a perspective view of the exemplary clip applier of FIGS. 1 and 2.</figref><figref num="4A">1 illustrates a perspective view of a first exemplary embodiment of a cartridge including a surgical clip according to the present invention;</figref><figref num="4B">FIG. 4B is a side view of the first exemplary cartridge of FIG. 4A.</figref><figref num="4C">FIG. 4C is a top view of the first exemplary cartridge of FIGS. 4A-B.</figref><figref num="5A">FIG. 4D is a perspective view of the exemplary clip applier of FIGS. 1-3 loaded with a surgical clip from a first exemplary cartridge of FIGS. 4A-4C.</figref><figref num="5B">FIG. 4C is a side view of the exemplary clip applier of FIGS. 1-2 loaded with a surgical clip (not visible) from the first exemplary cartridge of FIGS. 4A-4C.</figref><figref num="6A">FIG. 2 is a perspective view of a second exemplary embodiment of a cartridge according to the present invention.</figref><figref num="6B">FIG. 6B is a top view of the second exemplary cartridge of FIG. 6A.</figref>

The same reference numbers are used in the drawings and the following detailed description to refer to the same or similar elements.

The present invention generally relates to a cartridge, clip applier, and/or clip applier assembly configured to facilitate loading and/or stabilization of a surgical clip. In some embodiments, the clip applier can include a cartridge engaging portion and a clip engaging portion on each of the first and second jaw members. The cartridge engaging portion can include one or more flanges extending laterally from a distal portion of the jaw members of the clip applier. The one or more flanges can interact with the cartridge during loading and/or picking up of the clip. The one or more flanges can form an acute angled "V" shape when in the open configuration. Further, in some embodiments, the acute angle can be formed between angled inner surfaces that create a taper of at least a portion of the one or more flanges. The acute angle of the one or more flanges can match an angle between sides of a wall of the cartridge that includes the surgical clip. Thus, the clip applier can engage and/or mate with a mating shape of the cartridge, which can guide the clip applier in an ideal direction to consistently and successfully engage the bosses of the clip. The clip engaging portion can also be configured to be inserted into a cavity of the cartridge to securely engage a surgical clip during loading and/or pick-up.

In some embodiments, the clip applier can include a third contact point between the clip applier and the surgical clip. The third contact point can be formed between one or more protrusions of the clip applier and a proximal portion of the surgical clip to substantially increase lateral stability of the surgical clip. The one or more protrusions can provide a lateral force to a hinge portion of the surgical clip to eliminate or reduce fishtailing of the surgical clip during loading and/or application. The cartridge can include one or more recesses configured to receive the protrusions when loading the surgical clip from the cartridge cavity. Thus, the cartridge engaging portion can have a lateral width that exceeds the clip engaging portion and the stabilizing portion to provide a secure mating engagement with the cartridge. The cartridge engaging portion can also have a height in a pivotal direction of the clip applier that is less than the clip engaging portion and the stabilizing portion such that the clip applier engages the surgical clip in the cartridge cavity while the flange remains outside the cavity.

Figure 1 illustrates a side view of clip applier 100, Figure 2 illustrates a side view of clip applier 100 loaded with a surgical clip 200, and Figure 3 illustrates a perspective view of clip applier 100 without a surgical clip 200. As shown, clip applier 100 can include a handle mechanism 12 connected to a proximal end of shaft 14 and a jaw mechanism 16 pivotally connected to a distal end of shaft 14. Handle mechanism 12 can include an actuator trigger 18 configured to actuate jaw mechanism 16 between an open configuration and a closed configuration.

The surgical clip 200 may include a first leg member 202 and a second leg member 204 pivotally coupled at a hinge portion 206. The surgical clip 200 may include one or more latch or locking mechanisms. For example, the first leg member 202 may include a distal end portion having a hook member 208 and the second leg member 204 may include a distal end portion having a tip member 210. The first leg member 202 and/or the second leg member 204 may be configured at the hinge portion 206 to pivot relative to one another between an open configuration and a closed configuration. The hook member 208 may be configured to deflect about the tip member 210 to lock and/or latch the surgical clip 200 in the closed configuration. The surgical clip 200 may further include one or more engagement portions. For example, first leg member 202 can include one or more bosses 212 at a distal end portion near hook member 208, and second leg member 204 can include one or more bosses 210 at a distal end portion at tip member 210. The one or more bosses 212, 214 can be secured to clip applier 100 during loading and/or application of surgical clip 200 to tissue. Exemplary embodiments of surgical clip 200 are further disclosed in U.S. Patent Nos. 5,100,416 and 9,445,820, the entire disclosures of which are incorporated herein by reference.

Jaw mechanism 16 of clip applier 100 can load surgical clips 200 from cartridges 300, 400 (e.g., FIGS. 4A-5B and 6A-B) and apply surgical clips 200 to tissue. Jaw mechanism 16 can include a first jaw member 102 configured to engage a first leg member 202 and a second jaw member 104 configured to engage a second leg member 204. First jaw member 102 and/or second jaw member 104 can be configured to pivot relative to one another, for example, by a hinge pin 228 (e.g., FIG. 5A), to move surgical clip 200 between an open configuration and a closed configuration.

The first jaw member 102 may include a first clip engaging portion 112 configured to engage a distal end portion of a first leg member 202 and a second clip engaging portion 114 configured to engage a distal end portion of a second leg member 204. As further shown in FIG. 3, the first clip engaging portion 112 may include first and second walls or protrusions 116 spaced apart by a channel 118. The first leg member 202 may be received in the channel 118. Each of the first and second protrusions 116 may have a recess 124 configured to receive one or more bosses 212 of the first leg member 202. Similarly, the second clip engaging portion 112 may include first and second walls or protrusions 120 spaced apart by a channel 122. The second leg member 204 may be received in the channel 122. Each of the first and second projections 120 may have a recess 126 configured to receive one or more bosses 210 of the second leg member 204 .

The first jaw member 102 may include a first cartridge engaging portion including at least one first flange 140 extending laterally of the first clip engaging portion 112. For example, the first jaw member 102 may include a pair of first flanges 140 extending laterally of the first clip engaging portion 112. The second jaw member 104 may include a second cartridge engaging portion including at least one second flange 142 extending laterally of the second clip engaging portion 114. For example, the second jaw member 104 may include a pair of second flanges 142 extending laterally of the second clip engaging portion 112. In other words, the clip engaging portions 112, 114 extend in a pivotal direction toward the opposing jaw members 102, 104, and the at least one flange 140, 142 extends circumferentially of the clip engaging portions 112, 114 across the pivotal direction. For ease of discussion of the width of the flanges 140, 142, the cartridge engaging portion of each of the jaw members 102, 104 can be considered to be an outer portion that includes one or more opposing flanges 140, 142 and a portion of the clip applier 100 that attaches to and bridges the clip engaging portions 112, 114.

The clip engaging portion 112, 114 and/or the flanges 140, 142 can be configured to align the clip applier 100 with the surgical clip 200 when included in the cartridge 300, 400. For example, the clip engaging portion 112 can be inserted into the cavity 304, 404 of the cartridge 300, 400 (e.g., FIGS. 4A-5B) to engage an inner surface to prevent and/or reduce lateral and/or rotational movement relative to the cartridge 300, 400. As discussed further herein, the flanges 140, 142 can engage an outer side 310 of the cavity 304, 404 of the cartridge 300, 400 (e.g., FIGS. 4A-5B) to guide the clip applier 100 longitudinally relative to the cartridge 300, 400. The flanges 140, 142 can have a pivotal height that is substantially less than the projections 116, 120. The flanges 140, 142 can have an angled inner surface 143 extending along at least a portion of the flanges 140, 142, and can be at least partially tapered such that the flanges 140, 142 gradually decrease in height in the distal direction. The angled inner surface 143 of the flanges 140, 142 can create a flush engagement with the side 310 of the cartridge 300, 400, as shown in FIG. 5B. In some embodiments, the angled inner surface 143 can extend substantially the entire length of the flanges 140, 142.

Jaw mechanism 16 may include a stabilizing portion 130 of one or both of first and second jaw members 102, 104. Stabilizing portion 130 may be configured to engage and/or receive a proximal portion (e.g., hinge portion 206) of surgical clip 200. For example, stabilizing portion 130 may include first and second protrusions 132 spaced apart by a channel 136. The proximal portion of surgical clip 200 may be received within channel 136, and first and second protrusions 132 may be configured to apply a lateral force to the proximal portion (e.g., hinge portion 206) of surgical clip 200 to stabilize surgical clip 200 and/or prevent or reduce fishtailing. Stabilizing portion 130 may be prevented from abutting proximally against surgical clip 200 to allow leg members 202, 204 to extend as hook member 208 deflects about tip member 210 during closure. When on the first jaw member 102, the stabilizing portion 130 can be spaced apart from the second jaw member 104 in an open configuration (FIGS. 1-3) and received in the wide portion 123 of the channel 122 of the second jaw member 104 in a closed configuration (not shown). However, the stabilizing portion 130 can have other configurations. For example, the first and second protrusions 134 can extend from the opposing jaw members 102, 104. In this exemplary embodiment, the first and second protrusions 134 can be laterally offset to apply a lateral force to the surgical clip 200 while still preventing interference when opening and closing the clip applier 100. The channel 136 between the protrusions 132 can be in communication with the channel 118 and/or the channel 122. The stabilizing portion 130 can be releasably secured and/or integral to at least one of the first jaw member 102 and the second jaw member 104. Exemplary features and embodiments of the stabilizing portion 130 are further disclosed in US patent application Ser. No. 15/927,763, the disclosure of which is incorporated herein by reference in its entirety.

The stabilizing portion 130 can extend from at least one attachment portion 134 of the first jaw member 102. The stabilizing portion 130 can have a width narrower than that of the attachment portion 134 to facilitate insertion of the stabilizing portion 130 into the cavity 304, 404 of the cartridge 300, 400 for engagement with the surgical clip 200. The stabilizing portion 130 can also be configured to align the clip applier 100 with the surgical clip 200 when included within the cartridge 300, 400. For example, the stabilizing portion 130 can be inserted into the cartridge 300, 400 to receive the surgical clip 200 within the channel 136, while the protrusion 132 engages an inner surface of the cavity 304, 404 to prevent or reduce lateral and/or rotational movement of the clip applier 100 relative to the cartridge 300, 400 and maintain the attachment portion 134 outside the cavity 304, 404. A distal surface of the mounting portion 134 may engage a portion of the wall 302 .

Thus, to facilitate mating with the cartridge 300, 400, the first cartridge-engaging portion can have a width (e.g., width between opposing sides of the opposing flanges 140, 142) that is greater than the width of the first clip-engaging portion (e.g., width between opposing sides of the opposing protrusions 116, 120) and the width of the stabilizing portion (e.g., width between opposing sides of the opposing protrusions 132). The cartridge-engaging portion also has a height in a pivotal direction of the clip applier (e.g., distance between the inner surface 143 and the outer surface of the flanges 140, 142) that is substantially less than the height of the clip-engaging portion (e.g., distance between the inner and outer ends of the protrusions 116, 120) and the height of the stabilizing portion (e.g., distance between the inner and outer ends of the stabilizing portion 130), such that the clip-engaging portion 112, 114 and the stabilizing portion 130 extend further inwardly into the cavity 304, 404 while the flanges remain outside the cavity 304, 404. The cartridge engaging portion, the clip engaging portion 112, 114, and/or the stabilizing portion 130 may be integrally formed with each of the first and second jaw members 102, 104.

4A-C show a first embodiment of a cartridge 300 loaded with surgical clips 200. The cartridge 300 can include a plurality of walls 302 defining one or more cavities 304 therebetween. The one or more cavities 304 can receive one or more surgical clips 200 in a stored configuration. The surgical clips 200 can be supported by one or more support members 306 disposed within the cavities 304. For example, the hinge portion 206 can engage the support member 306, and the first and second leg members 202, 204 can straddle opposing sides of the support member 306. The support member 306 can extend between adjacent walls 302 and/or recesses 308.

The walls 302 may include multiple surfaces. For example, the walls 302 may include one or more side surfaces 310, one or more intermediate surfaces 312, and one or more upper convex surfaces 314. The side surfaces 310 may extend from a base 316 to the intermediate surface 312, which may be joined at the top by the upper convex surface 314. Each wall 302 may have first and second side surfaces 310 on opposing sides. The first and second side surfaces 310 may be substantially planar and define an acute angle therebetween. The acute angle of the side surfaces 310 may coincide with the acute angle defined by the flanges 140, 142 of the first and second jaw members 102, 104 in the open configuration. Thus, the first and second sides 310 can engage and/or guide the first and second jaw members 102, 104 in an open configuration when the clip applier 100 is inserted into the cartridge 300 to load the surgical clip 200. The angle between the first and second sides 310 can be optimized for the size of the surgical clip 200 and to abut the open configuration of the first and second jaw members 102, 104. In some embodiments, the angle between the first and second sides 310 can be between about 15 degrees and 30 degrees. In some embodiments, the angle between the first and second sides 310 can be between about 18 degrees and 25 degrees. The intermediate surface 312 can define a larger angle therebetween than the sides 310, allowing the walls 302 to be wider and receive the surgical clip 100 between adjacent walls 302. The sides 310 are outside or exterior to the cavity 304 and can abut against the flanges 140 , 142 of the clip applier 100 .

One or more notches or recesses 308 can extend along the wall 302 and can define a notch or recess 309 configured to receive the stabilizing portion 130 of the clip applier 100. The recesses 308 can be disposed at opposing ends of the support member 306 between the support member 306 and the wall 302. The recesses 308 can have a length extending along the wall 302 that exceeds the length of the support member 306, and the recesses 308 can support sides of the leg members 202, 204 of the surgical clip 200. As shown, the recesses 308 can embody a protrusion extending from the wall 302, and the recesses 308 can define a substantially flat, vertically facing shoulder extending along the wall 302. However, it is contemplated that the recesses 308 can embody a number of other shapes and configurations. Thus, the recesses 309 can extend vertically between the respective concave portions 308 and the upper convex portions 314 and laterally between the respective support members 306 and the walls 302. Although the cavities 314 and the recesses 309 can be described herein as separate regions, it should be readily apparent that the cavities 314 and the recesses 309 can communicate with one another as a continuous open region of the cartridge 300. Thus, the recesses 309 can be upper portions of the lateral cavities 314 of the surgical clip 200 and configured to receive or accommodate the stabilizing portion 130. The recesses 309 can create a width of the cavity 314 that extends between the walls 302 at least twice as wide as the surgical clip 200 to receive the stabilizing portion 130 and facilitate mating of the clip applier 200, as discussed herein.

4A-C, the base 316 can include a bottom 326 and an outer wall 328. The wall 302 can extend from the bottom 326 of the base 316 between the outer wall 328 of the base 316. The wall 302, the support member 306, the recessed portion 308, and the base 316 can be integrally formed. For example, the components can be unitary plastic bodies and formed by injection molding. However, it is contemplated that one or more of the components can be formed separately and attached, for example, by welding or adhesive.

Cartridge 300 may further include a flexible insert having tabs that extend into cavity 304 to secure surgical clip 200, as illustratively shown with respect to cartridge 400 in Figures 6A-B. The tabs may engage leg members 202, 204 and/or bosses 212, 214 to prevent surgical clip 200 from falling out of cartridge 300. The tabs may be deflected downward when jaw members 102, 104 are inserted into cartridge 300 to release surgical clip 200. The flexible insert may be secured to base 316 with apertures in the flexible insert that receive pins 318 extending from base 316.

5A-B show the clip applier 100 loaded with a surgical clip 200 (not visible) from a cartridge 300. The cartridge 300 can receive the surgical clip 200 in the cavity 304 in a stored configuration. The cartridge 300 can receive the clip applier 100 in an open configuration when the surgical clip 200 is loaded into the clip applier. For example, the clip engaging portions 112, 114 of the clip applier 100 can be inserted into the cavity 304 to engage the leg members 202, 204 of the surgical clip 200. The stabilizing portion 130 can be inserted into the recess 309 to receive the proximal end of the surgical clip 200, but the mounting portion 134 can be sized such that it is not received in the cavity 304. The flanges 140, 142 can be inserted into the cartridge 300 to abut the side 310 while remaining outside the cavity 304. In that sense, the first jaw member 102 and the second jaw member 104 can include a first portion sized to be received in the cavity 304 of the cartridge 300 and a second portion sized not to be received in the cavity 304 of the cartridge 300. Similarly, the stabilizing portion 130 can include a first portion (protrusion 132) sized to be received in the recess 309 of the cartridge 300 and a second portion 134 sized not to be received in the recess 309 of the cartridge 300.

As shown in FIG. 5B, the angle α between the flanges 140, 142 when the clip applier 100 is in the open configuration can match the angle α between the sides 310. In some embodiments, the angle α can be between about 15 degrees and 30 degrees. In some embodiments, the angle α can be between about 18 degrees and 25 degrees. The sides 310 can guide the jaw members 102, 104 to align the clip applier 100 and ensure proper engagement of the leg members 202, 204. For example, the sides 310 can ensure that the bosses 212, 214 are properly received in the recesses 124, 126 as shown in FIG. 2. The angle α of the flanges 140, 142 can be defined by the angled inner surface 143.

6A-B show a second embodiment of a cartridge 400. The cartridge 400 can include features similar to those of the cartridge 300 and similarly illustrated in the figures, which are not discussed herein for the sake of brevity. The cartridge 400 can include a plurality of walls 402 defining one or more cavities 404 therebetween. The one or more cavities 404 can receive one or more surgical clips 200 in a stored configuration. The surgical clips 200 can be supported by one or more support members 406 disposed within the cavities 404. For example, the hinge portion 206 can engage the support member 406, and the first and second leg members 202, 204 can straddle opposing sides of the support member 406. The support member 346 can extend between adjacent walls 402 and/or recesses 408.

The walls 402 may include multiple surfaces. For example, the walls 302 may include one or more side surfaces 410 and one or more upper convex surfaces 414. The side surfaces 410 may extend from a base 416 and be joined at the top by the convex surface 414. Each wall 402 may have first and second side surfaces 410 on opposite sides. The first and second side surfaces 410 may be substantially flat and define an acute angle therebetween. The acute angle of the side surfaces 410 may coincide with the acute angle defined by the flanges 140, 142 of the first and second jaw members 102, 104 in the open configuration. Thus, the first and second surfaces 410 may engage and/or guide the first and second jaw members 102, 104 in the open configuration when the clip applier 100 is inserted into the cartridge 400 to load the surgical clip 200. In some embodiments, the angle between the first and second sides 410 can be between about 15 degrees and 30 degrees. In some embodiments, the angle between the first and second sides 410 can be between about 18 degrees and 25 degrees. The wall 402 can include an intermediate surface (corresponding to intermediate surface 312 in FIGS. 4A-5B) having a shortened length to allow the cartridge 400 to be sized to include smaller surgical clips 200. The side 410 can be on the outside or exterior of the cavity 404 to abut the flanges 140, 142 of the clip applier 100.

One or more recesses 408 can extend along the wall 402 and can define recesses 409 configured to receive the stabilizing portion 130 of the clip applier 100. The recesses 408 can be disposed at opposing ends of the support member 406 between the support member 406 and the wall 402. The recesses 408 can have a length extending along the wall 402 that exceeds the length of the support member 406, and the recesses 408 can support sides of the leg members 202, 204 of the surgical clip 200. As shown, the recesses 408 can embody a protrusion extending from the wall 402, and the recesses 408 can define a substantially flat, vertically facing shoulder extending along the wall 402. However, it is contemplated that the recesses 408 can embody a plurality of shapes and configurations. Thus, the recesses 409 can extend vertically between the respective concave portions 408 and the upper convex portions 414 and laterally between the respective support members 406 and the walls 402. Although the cavities 414 and the recesses 409 can be described herein as separate regions, it should be readily apparent that the cavities 414 and the recesses 309 can communicate with one another as a continuous open region of the cartridge 400. Thus, the recesses 409 can be upper portions of the lateral cavities 414 of the surgical clip 200 and configured to receive or accommodate the stabilizing portion 130. The recesses 409 can create a width of the cavity 414 that extends between the walls 402 at least twice as wide as the surgical clip 200 to receive the stabilizing portion 130 and facilitate mating of the clip applier 200 as discussed herein.

6A-6B, the base 416 can include a bottom (not shown) and an outer wall 428. The wall 402 can extend from the bottom of the base 416 between the outer wall 428 of the base 416. The wall 402, the support member 406, the recessed portion 408, and the base 416 can be integrally formed. For example, the components can be unitary plastic bodies and formed by injection molding. However, it is contemplated that one or more of the components can be formed separately and attached, for example, by welding or adhesive.

The cartridge 400 may include a flexible insert 420 having a tab 422 that extends into the cavity 404 to secure the surgical clip 200 (not shown), as shown in Figures 6A-6B. The tab 422 may engage the leg members 202, 204 and/or bosses 212, 214 to prevent the surgical clip 200 from falling out of the cartridge 400. The tab 422 may be deflected downward when the jaw members 102, 104 are inserted into the cartridge 400 to release the surgical clip 200. The flexible insert 420 may be secured to the base 416 with an aperture 424 in the flexible insert 420 that receives a pin 418 extending from the base 416. Further discussion regarding retention of the surgical clip 200 and/or manufacture of the cartridges 300, 400 may be found in U.S. Patent No. 6,880,699, the entire disclosure of which is incorporated herein by reference.

The many features and advantages of the present invention are apparent from the detailed specification, and thus, it is intended by the appended claims to cover all such features and advantages of the present invention that fall within the true spirit and scope of the invention. Moreover, because numerous modifications and variations will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation as illustrated and described, and therefore, all suitable modifications and equivalents may be resorted to, which are within the scope of the present invention.

Other embodiments of the invention are described below.

[Embodiment 1] A method of loading a surgical clip from a cartridge into a clip applier, the surgical clip comprising a first leg member and a second leg member, the clip applier comprising a first jaw member and a second jaw member, the method comprising the steps of abutting at least one first flange of the first jaw member against a first side of the cartridge to align the first jaw member with the first leg member, abutting at least one second flange of the second jaw member against a second side of the cartridge to align the second jaw member with the second leg member, engaging the first leg member with a first engagement portion of the first jaw member, and engaging the second leg member with a second engagement portion of the second jaw member.

[Embodiment 2] A method as described in embodiment 1, comprising the steps of receiving a first boss in at least one recess of the first jaw member to engage the first leg member, and receiving a second boss in at least one recess of the second jaw member to engage the second leg member.

[Embodiment 3] A method according to embodiment 1 or 2, wherein the step of abutting at least one first flange of the first jaw member includes abutting a pair of laterally extending first flanges of the first engagement portion against the first side surface, and the step of abutting at least one second flange of the second jaw member includes abutting a pair of laterally extending second flanges of the second engagement portion against the second side surface.

[Embodiment 4] A method according to any one of embodiments 1 to 3, further comprising the step of inserting a stabilizing portion of the clip applier into a recess of the cartridge to laterally stabilize a proximal portion of the surgical clip with the stabilizing portion.

[Embodiment 5] A surgical clip cartridge comprising a base and a plurality of walls extending from the base, the plurality of walls spaced apart by at least one cavity configured to receive the surgical clip, the plurality of walls including first and second sides defining an angle between approximately 15 and 30 degrees, the first and second sides configured to engage a clip applier in an open configuration during loading of the surgical clip.

[Embodiment 6] The cartridge described in embodiment 5, wherein the angle is between approximately 18 and 25 degrees.

[Embodiment 7] A cartridge described in embodiment 5 or 6, wherein the first side and the second side are outside the at least one cavity.

[Embodiment 8] A cartridge described in any one of embodiments 5 to 7, further comprising a support member configured to support the surgical clip, the support member extending between the plurality of walls.

[Embodiment 9] A cartridge described in any one of embodiments 5 to 8, further comprising at least one recess configured to receive a stabilizing portion of the clip applier during loading of the surgical clip, the at least one recess extending along at least one of the plurality of walls.

[Embodiment 10] A cartridge described in any one of embodiments 5 to 9, wherein the side extends from the base.

[Embodiment 11] A cartridge described in any one of embodiments 5 to 10, further comprising a flexible insert configured to engage the surgical clip when received in the at least one cavity.

[Embodiment 12] A surgical clip cartridge comprising: a base; a first wall and a second wall extending from the base; a cavity configured to receive the surgical clip between the first wall and the second wall; a support member extending between the first wall and the second wall and configured to support the surgical clip; and at least one recess configured to receive a jaw member of a clip applier during loading of the surgical clip and extending along at least one of the first wall and the second wall.

[Embodiment 13] A cartridge as described in embodiment 12, wherein the at least one recess includes a first recess between the support member and the first wall and a second recess between the support member and the second wall.

[Embodiment 14] A cartridge described in embodiment 12 or 13, further comprising at least one recessed portion defining the at least one recess.

[Embodiment 15] A cartridge as described in embodiment 14, wherein the at least one recess includes a first recess between the support member and the first wall and a second recess between the support member and the second wall.

[Embodiment 16] A cartridge described in embodiment 14 or 15, wherein at least one recess has a length greater than the length of the support member.

[Embodiment 17] A cartridge described in any one of embodiments 13 to 16, wherein the plurality of walls first include a first side and a second side that define an angle between approximately 15 and 30 degrees, and the first side and second side are configured to engage a clip applier in an open configuration during loading of the surgical clip.

18. A clip applier configured to releasably secure a surgical clip contained in a cavity of a cartridge, the surgical clip comprising a first leg member and a second leg member, a first jaw member including a first clip-engaging inner portion and a first cartridge-engaging outer portion, the first clip-engaging inner portion including at least one recess configured to receive a portion of the first leg member, the first cartridge-engaging outer portion including at least one first flange extending transversely of the first clip-engaging inner portion, the at least one first flange abutting a first side of the cartridge to secure the first leg member to the first jaw member. a clip applier comprising: a first jaw member configured to align the jaw member with the first leg member; and a second jaw member including a second clip-engaging inner portion and a second cartridge-engaging outer portion, the second clip-engaging inner portion including at least one recess configured to receive a portion of the second leg member, the second cartridge-engaging outer portion including at least one second flange extending laterally of the second clip-engaging inner portion, the at least one second flange configured to abut a second side of the cartridge to align the second jaw member with the second leg member.

[Embodiment 19] A clip applier as described in embodiment 18, wherein the first cartridge engaging outer portion has a width wider than the width of the first clip engaging inner portion, and the second cartridge engaging outer portion has a width wider than the width of the second clip engaging inner portion.

[Embodiment 20] A clip applier as described in embodiment 18 or 19, wherein the at least one recess of the first clip engaging inner portion and the at least one recess of the second clip engaging inner portion are configured to be inserted into the cavity to engage the surgical clip while the at least one first flange and the at least one second flange remain outside the cavity.

[Embodiment 21] A clip applier described in any one of embodiments 18 to 20, wherein the at least one recess of the first clip engaging inner portion includes a first recess and a second recess configured to receive a first boss and a second boss on the first leg member and spaced apart, and the at least one recess of the second clip engaging inner portion includes a first recess and a second recess configured to receive a first boss and a second boss on the second leg member and spaced apart.

[Embodiment 22] A clip applier described in any one of embodiments 18 to 21, wherein the at least one first flange includes a pair of first flanges extending in opposing laterally opposite directions of the first clip engaging inner portion, and the at least one second flange includes a pair of second flanges extending in opposing laterally opposite directions of the second clip engaging inner portion.

[Embodiment 23] A clip applier described in any one of embodiments 18 to 22, wherein the at least one first flange is at least partially tapered and the at least one second flange is at least partially tapered.

[Embodiment 24] A clip applier described in any one of embodiments 18 to 23, wherein the clip applier includes a first protrusion and a second protrusion on at least one of the first jaw member and the second jaw member, and is configured to receive a proximal portion of the surgical clip between the first protrusion and the second protrusion to laterally stabilize the proximal portion of the surgical clip.

[Embodiment 25] A clip applier as described in embodiment 24, wherein the first protrusion is on the first jaw member and the second protrusion is on the second jaw member.

[Embodiment 26] A clip applier as described in embodiment 24 or 25, wherein the first protrusion and the second protrusion extend from an attachment portion of at least one of the first jaw member and the second jaw member, and the first protrusion and the second protrusion have a width that is smaller than a width of the attachment portion.

[Embodiment 27] A clip applier described in any one of embodiments 18 to 26, wherein when the clip applier is in an open configuration, the at least one first flange and the at least one second flange form a V-shape.

28. A clip applier configured to releasably secure a surgical clip contained in a cavity of a cartridge, the surgical clip including a first leg member and a second leg member, the first jaw member including a first clip engaging portion configured to engage the first leg member and a first cartridge engaging portion including at least one first flange extending transversely of the first clip engaging portion, the at least one first flange being configured to abut a first side of a cartridge to align the first jaw member with the first leg member, and a second clip applier configured to engage the second leg member. a second jaw member including a mating portion and a second cartridge engaging portion including at least one second flange extending laterally of the second clip engaging portion, the at least one second flange configured to abut a second side of the cartridge to align the second jaw member with the second leg member, the clip applier including a first protrusion and a second protrusion on at least one of the first and second jaw members and configured to receive a proximal portion of the surgical clip between the first protrusion and the second protrusion to laterally stabilize the proximal portion of the surgical clip.

[Embodiment 29] A clip applier as described in embodiment 28, wherein the first clip engaging portion includes at least one recess configured to receive a portion of the first leg member and the second clip engaging portion includes at least one recess configured to receive a portion of the second leg member.

[Embodiment 30] A clip applier as described in embodiment 28 or 29, wherein the first protrusion is on the first jaw member and the second protrusion is on the second jaw member.

12 Handle mechanism

14 shaft

16 Jaw mechanism

18 Actuator Trigger

100 Clip Applier