The final design of the Multi-Load Clip Applier contains six key components: a clip cartridge, a clip pusher plate, modified clip applier jaws, a jaw closer plate, and a clip cartridge holder, with everything being packed together in the outer shell. Due to part sizing, along with friction between components, the assembly holds itself together in one portable piece, with the assembly attaching to the existing forceps instrument to create a clip applier that can both store multiple clips and reload within the body.
The components of the final design along with its functionalities is described below:
The clip cartridge serves as the storage and loading mechanism for multiple titanium clips. It ensures that clips are aligned for transfer into the applier jaws. The clips are stacked at a 45 degree angle within the cartridge, and as each clip is used, a spring-loaded mechanism pushes the next clip into position for reloading. The cartridge also has an extrusion on its back to secure the applier jaws in position so that they can be aligned with the awaiting clip.
The pusher plate is responsible for transferring clips from the cartridge into the applier jaws. The plate moves in a controlled linear motion, with the extended tab feeding into a slit in the front of the cartridge to push a clip into the correct position.
The applier jaws are the functional ends of the device that hold and compress the titanium clip around the target tissue. The inner surface of the jaws contains a groove to hold a clip in position until ready for firing, with the ends being sloped to properly orient the clip. The two jaws are separate, connected via a torsional spring to allow for the required closing and opening motion needed.
The closer plate is responsible for actuating the clip applier jaws. When the plate moves in a controlled linear motion, it compresses the jaws to fire a clip onto the targeted vessel.
A cable is threaded through the holes present in both plates, enabling controlled movement of the main mechanism in the assembly. When one side is pulled, the pusher plate moves up, loading a clip into place, and when the other side is pulled, the closer plate moves up, compressing the jaws to fire the clip.
The cartridge holder anchors the clip cartridge to the outer shell, providing structural rigidity to the inner assembly. Additionally, the upper extrusions act as supports for the cable system, ensuring proper tension is maintained in the wire. The holder also connect the clip applier to the da Vinci rod with the teeth on the bottom section, providing a secure grip during surgical applications.
The outer shell houses all internal components of the assembly, ensuring that no moving parts come into contact with surrounding tissues. It is removable and reusable, allowing multiple clip appliers to share the component.
Photos of Final Built Assembly
Instrument is set up prior to surgery, with the clip applier assembly attached to the end of the forceps. Instrument will be fed through a port in the patient's chest.
Assembly is navigated to clip site via surgeon control.
Surgeon pulls on first cable, pushing a clip into the applier jaws in preparation.
Surgeon pulls on second cable, compressing jaws and securing clip onto targeted vessel.
If another clip is needed, surgeon navigates to the next clip site and repeats the loading/firing process. Otherwise, instrument is removed from patient's body, completing the procedure.
Proposed Final Design Workflow Process for Multi-load Clip Applier System