Endoscopic snare combined with a clip applier

Abstract

An elongated endoscopic apparatus has an elongated catheter provided with a snare provision for performing a snaring procedure, a surgery clip, and a clip applier for clipping the wound left by the snaring procedure with the surgery clip. Preferably the elongated catheter is formed with an elongated inner tubular conduit that can accommodate a plurality of surgery clips, each having a C-shape characterized by a pair of elongated jaws mated together at a hinge end, wherein the jaws have tip ends forming the head end for the clip and hinge end forms the tail end for the clip when said plurality of clips are loaded into core of the inner tubular conduit in head to tail procession. The clip applier dispenses the clips a single at a time.

1 . An elongated endoscopic apparatus, comprising:
 a snare provision for performing a snaring procedure;   a surgery clip; and   a clip applier for clipping the wound left by the snaring procedure with the clip.   
     
     
         2 . The elongate endoscopic apparatus of  claim 1 , wherein:
 the snare provision is arranged and configured for performing a polypectomy procedure.   
     
     
         3 . The elongate endoscopic apparatus of  claim 1 , further comprising:
 an elongated catheter having defined therein an elongated inner tubular conduit;   a plurality of surgery clips, each having a C-shape characterized by a pair of elongated jaws mated together at a hinge end, wherein the jaws have tip ends forming the head end for the clip and hinge end forms the tail end for the clip when said plurality of clips are loaded into core of the inner tubular conduit in head to tail procession; and   a plunger rod for pushing the line of clips through the core of the inner tubular conduit at an incrementally indexed or metered rate of one clip at a time.   
     
     
         4 . An elongated endoscopic apparatus, comprising:
 an elongated catheter terminating in a dispensing end;   a snare provision; and   a surgery clip; and   a clip applier for dispensing the clip from the dispensing end of the elongated catheter;   wherein said elongated catheter is formed with one elongated inner tubular conduit having an opening through the dispensing end and for use by the snare provision, as well as, another elongated inner tubular conduit having a respective opening through the dispensing end and for use by the clip applier.   
     
     
         5 . The elongated endoscopic apparatus of  claim 4 , wherein:
 said surgery clip has a C-shape characterized by a pair of elongated jaws mated together at a tail end, wherein the jaws have tip ends forming the head end for the clip;   said clip applier comprises said surgery clip loaded into said other inner tubular conduit for the tip ends of the jaws to dispense out the opening of said other tubular conduit with the tail end trailing, and, a plunger rod for pushing the clip out of said other inner tubular conduit.   
     
     
         6 . The elongated endoscopic apparatus of  claim 5 , wherein:
 said snare provision comprises a wire snare loop having an extension and a retraction stroke out of the opening through the dispensing end for said one inner tubular conduit.   
     
     
         7 . The elongated endoscopic apparatus of  claim 6 , wherein:
 said wire snare loop is generally contained in one plane;   said clip is can be partitioned in two by another plane that partitions each jaw in two and the tail end in two (eg.,  FIG. 5 ); and   said wire snare loop is oriented in the one inner tubular conduit and said clip is cooperatively oriented in the other tubular conduit such that said one and said other plane are generally co-planar (eg.,  FIG. 4  or  8 );   whereby the snare provision and clip applier can be worked cooperatively to remove the bulb end of a peduncular-style polyp with the clip left behind pinching the stem proximate the anatomical wall to which the polyp is attached.   
     
     
         8 . The elongated endoscopic apparatus of  claim 7 , further comprising:
 a plurality of said surgery clips, loaded into the core of said other inner tubular conduit in head to tail procession;   whereby said plunger rod is controllable for pushing the line of clips through the core of said other inner tubular conduit at an incrementally indexed or metered rate of one clip at a time.   
     
     
         9 . An elongated endoscopic apparatus, comprising:
 an elongated catheter terminating in a dispensing end;   a snare provision; and   a surgery clip; and   a clip applier for dispensing the clip from the dispensing end;   wherein said elongated catheter is formed with a common lumen having an opening through the dispensing end and for use by both the snare provision and the clip applier.   
     
     
         10 . The elongated endoscopic apparatus of  claim 9 , wherein:
 said surgery clip has a C-shape characterized by a pair of elongated jaws mated together at a tail end, wherein the jaws have tip ends forming the head end for the clip;   said clip applier comprises said surgery clip loaded into said common lumen for the tip ends of the jaws to dispense out the opening therefor, and, a plunger rod for pushing the clip out the opening.   
     
     
         11 . The elongated endoscopic apparatus of  claim 10 , wherein:
 said snare provision comprises a wire snare loop having an extension and a retraction stroke out of the opening of the common lumen.   
     
     
         12 . The elongated endoscopic apparatus of  claim 11 , wherein:
 said wire snare loop is generally contained in one plane;   said clip is can be partitioned in two by another plane that partitions each jaw in two and the tail end in two (eg.,  FIG. 28 ); and   said wire snare loop is oriented in the one inner tubular conduit and said clip is cooperatively oriented in the other tubular conduit such that said one and said other plane are generally co-planar (eg.,  FIG. 23 );   whereby the snare provision and clip applier can be worked cooperatively to remove the bulb end of a peduncular-style polyp with the clip left behind pinching the stem proximate the anatomical wall to which the polyp is attached.   
     
     
         13 . The elongated endoscopic apparatus of  claim 12 , wherein:
 said clip further comprises an axially extending recessed groove ( 290 ) formed through the tail end for the snare provision to operate therein.   
     
     
         14 . The elongated endoscopic apparatus of  claim 12 , further comprising:
 a plurality of said surgery clips, loaded into the core of said other inner tubular conduit in head to tail procession;   whereby said plunger rod is controllable for pushing the line of clips through the core of said other inner tubular conduit at an incrementally indexed or metered rate of one clip at a time.   
     
     
         15 . The elongated endoscopic apparatus of  claim 11 , wherein:
 said clip further comprises an axially extending recessed groove ( 290 ) formed through the tail end for the snare provision to operate therein.   
     
     
         16 . The elongated endoscopic apparatus of  claim 9 , further comprising:
 a plurality of said surgery clips, loaded into the core of said other inner tubular conduit in head to tail procession; and   a plunger rod for pushing the line of clips through the core of said common lumen at an incrementally indexed or metered rate of one clip at a time.   
     
     
         17 . The elongated endoscopic apparatus of  claim 16 , wherein:
 each said surgery clip has a C-shape characterized by a pair of elongated jaws mated together at a tail end, wherein the jaws have tip ends forming the head end for the clip; and   each clip further has an axially extending recessed groove ( 290 ) formed through the tail end for the snare provision to operate therein.   
     
     
         18 . The elongated endoscopic apparatus of  claim 17 , wherein:
 said snare provision comprises a wire snare loop having an extension and a retraction stroke out of the opening of the common lumen, and said wire snare loop is generally contained in one plane;   said clips can be partitioned in two by another plane that partitions each jaw in two and the tail end in two (eg.,  FIG. 28 ); and   said wire snare loop and said procession of clips are cooperatively oriented in the common lumen therefor such that said one and said other plane are generally co-planar (eg.,  FIG. 23 );   whereby the snare provision and clip applier can be worked cooperatively to remove the bulb end of a peduncular-style polyp with at least one clip left behind pinching the stem proximate the anatomical wall to which the polyp is attached.   
     
     
         19 . The elongated endoscopic apparatus of  claim 18 , wherein:
 the head end of the clips and the tail end of the clips are formed with interfitting provisions such that when formed up in a line in the core of the common lumen, the plurality of clips maintain a relative angular orientation with respect to one another whereby the axially extending recessed grooves ( 290 ) of the procession of chips align on a common axially extending longitudinal axis (eg.,  FIG. 28  or  23 ).   
     
     
         20 . The elongated endoscopic apparatus of  claim 9 , further comprising:
 a source of illumination and a camera, both disposed at the dispensing end of said catheter.