Clip applying apparatuses and methods for vascular ligation

Abstract

An apparatus and method for applying ligating clips to perform minimally invasive vascular ligation. An actuating assembly contacts a clip applier to actuate the clip applier among at least a first position, a second position and a third position. The clip applier is capable of receiving a first ligating clip when the clip applier is in the first position and a second ligating clip when the clip applier is in the second position. The actuating assembly actuates the clip applier to the third position to close the ligating clip being held by the clip applier.

What is claimed is:  
     
         1 . A surgical apparatus comprising: 
 a clip applier; and    an actuating assembly contacting said clip applier for actuating said clip applier among at least a first position, a second position and a third position.    
     
     
         2 . An apparatus as in  claim 1  wherein said clip applier comprises a jaw having a first portion adjacent to a second portion.  
     
     
         3 . An apparatus as in  claim 2  wherein said first portion is rotatably coupled to said second portion of said jaw.  
     
     
         4 . An apparatus as in  claim 3  wherein said actuating assembly is coupled to said second portion of said jaw such that said second portion is translatable.  
     
     
         5 . An apparatus as in  claim 2  wherein said first and second portions are resilient.  
     
     
         6 . An apparatus as in  claim 5  wherein said actuating assembly concurrently urges said first and second portions of said jaw toward each other.  
     
     
         7 . An apparatus as in  claim 1  wherein said clip applier is capable of receiving a first ligating clip when said clip applier is in said first position, and wherein said clip applier is capable of receiving a second ligating clip when said clip applier is in said second position, said first and second ligating clips having different sizes.  
     
     
         8 . An apparatus as in  claim 1  wherein said first and second positions are open positions and said third position is a closed position.  
     
     
         9 . An apparatus as in  claim 1  further comprising a housing disposed around said actuating assembly.  
     
     
         10 . A surgical apparatus comprising: 
 a housing;    a jaw having first and second movable sections, said jaw mateable with a plurality of ligating clips having different sizes; and    an actuating mechanism disposed substantially within said housing and contacting said jaw.    
     
     
         11 . An apparatus as in  claim 10  wherein said housing is tubular.  
     
     
         12 . An apparatus as in  claim 10  wherein said actuating mechanism comprises a translatable tube disposed within said housing and surrounding said jaw, said translatable tube concurrently urging said first and second sections of said jaw when said translatable tube is translated toward a distal end of said jaw.  
     
     
         13 . An apparatus as in  claim 10  wherein said actuating mechanism comprises a rod coupled to said second movable section of said jaw, said first moveable section of said jaw rotatably coupled to both said second movable section and a support member fixed to said housing.  
     
     
         14 . An apparatus as in  claim 10  wherein said actuating mechanism comprises a handle coupled to said housing, said handle and said jaw located at opposite ends of said housing.  
     
     
         15 . A surgical apparatus comprising: 
 an elongated housing having a first end and a second end;    an actuating assembly having a translatable member extending through said housing and a handle coupled to said translatable member adjacent to said first end of said housing;    a fixed member coupled to said housing at said second end; and    a jaw having first and second sections, said first section rotatably coupled to said fixed member and said second section, said second section coupled to said translatable member and extending away from said second end of said housing, said first section having a first range of movement and said second section having a second range of movement, said first range of movement dictated by said second range of movement.    
     
     
         16 . An apparatus as in  claim 15  wherein said first section of said jaw rotates through said first range of movement as said second section of said jaw translates through said second range of movement.  
     
     
         17 . A surgical apparatus comprising: 
 an elongated outer housing having a first end and a second end;    an actuating assembly having a translatable elongated inner housing disposed within said outer housing and a handle coupled to said inner housing adjacent to said first end of said outer housing; and    a jaw having a first resilient portion and a second resilient portion, said first and second resilient portions disposed within said inner housing and extending away from said second end of said outer housing;    said inner housing concurrently urging said first and second resilient portions of said jaw toward each other when said inner housing translates through said outer housing.    
     
     
         18 . A method comprising: 
 actuating a clip applier to a first position;    mating said clip applier with a first ligating clip such that said first ligating clip is held by said clip applier;    moving said clip applier adjacent to a first vessel; and    applying said first ligating clip to said first vessel by actuating said clip applier to a second position.    
     
     
         19 . A method as in  claim 18  further comprising: 
 unmating said clip applier from said first ligating clip after said applying;  
 actuating said clip applier to a third position;  
 mating said clip applier with a second ligating clip such that said second ligating clip is held by said clip applier;  
 moving said clip applier adjacent to a second vessel;  
 applying said second ligating clip to said second vessel by actuating said clip applier to said second position.  
 
     
     
         20 . A method as in  claim 19  wherein said first and third positions are open positions and said second position is a closed position.  
     
     
         21 . A method as in  claim 18  wherein actuating said clip applier to said first position comprises translating an actuating member toward said clip applier and wherein actuating said clip applier to said second position comprises translating said actuating member away from said clip applier.  
     
     
         22 . A method as in  claim 18  wherein actuating said clip applier to said first position comprises translating an actuating member away from said clip applier and wherein actuating said clip applier to said second position comprises translating said actuating member toward said clip applier.