CN102727276B - Tissue hemostasis clamping device - Google Patents
Tissue hemostasis clamping device Download PDFInfo
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- CN102727276B CN102727276B CN201210232803.0A CN201210232803A CN102727276B CN 102727276 B CN102727276 B CN 102727276B CN 201210232803 A CN201210232803 A CN 201210232803A CN 102727276 B CN102727276 B CN 102727276B
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Abstract
The invention discloses a tissue hemostasis clamping device, comprising a clamp, a releasing mechanism, a drawing assembly, a handle assembly and an external sheathing canal, wherein the clamp comprises a clamping plate and a connector integrally fixed with a pull-push end of the clamping plate; the pull-push end of the clamping plate and the connector can slide back and forth in a tightening pipe, the connector is buckled with the tightening pipe by a loose-preventing mechanism; the front part of the tightening pipe is provided with a stopper; a clamping arm of the clamping plate is provided with a closing stop; the releasing mechanism comprises a pull-push pipe, wherein the front part of the pull-push pipe is connected with the connector in a manner of connection failure when the front part of the pull-push pipe bears the stress exceeding a predetermined tensile force, while the rear part of the pull-push pipe is fixedly connected with a drawing steel wire; the front part of the connection pipe is connected with the rear part of the tightening pipe by a slipknot, and the rear part of the connecting pipe is fixedly connected with a sheathing tube; and the slipknot connection of the connection pipe and the tightening pipe is relieved by a pull-push pipe through the releasing mechanism. With the adoption of the technical scheme, the device has advantages of simple and reasonable structure, stable and reliable clamping, possible repeated pre-clamping, small volume of the clamp and smooth appearance.
Description
Technical field
The present invention relates to one and organize hemostatic clipping device, specifically, is a kind of for reach the clamping device of hemostasis object under scope by clamping biological tissue.
Background technology
Gastronintestinal system, digestive system, biliary system, vascular system and other body cavitys and hollow organ's Pathology bleeding is the common emergency case of internal medicine, merely through Drug therapy, the course for the treatment of is long, side effect is large, what have is even in peril of one's life, and must cure the object that just can reach hemostasis by endoscopic surgery if desired.And along with the development of scope lower hemostasia technology, applying hemostatic clamp hemostasis under scope has become first-selection.In the most simply applying, the clamping device of hemostasis is extend into the tissue of depths in body by the working clamp road of endoscope, in desired position, with above-mentioned folder by bleeding tissue edge around promptly, after this clip is separation with the control assembly of near-end, and remain in body described in inciting somebody to action, to allow normal healing process to make wound closure.
In prior art, use following hemostatic clipping device, so that biological tissue is clamped:
In the patent of invention ENDOSCOPIC HEMOSTATIC CLIPPING APPRATUS that is US8062311B2 in the patent No. of U.S.'s bulletin, clip is separately two, jointly be connected with a stress part, be accommodated in cinch tube, intermediate plate moves in the gap of cinch tube, and under the compressing on cinch tube both sides, makes intermediate plate closure with grasping tissue.
The patent No. at U.S.'s bulletin is in the patent of invention CLIP APPARATUS FOR LIGATURING LIVING TISSUE of US 7854739 B2, clip is integrated bending, there is a pair of elasticity intermediate plate to be opened/closed, be stuck on a grab that can rupture and that be connected with rear end functional unit, by applying pulling force backward, the semicircle that intermediate plate bending forms is out of shape under the compressing of cinch tube, thereby forces the closed clamping completing tissue of intermediate plate.
At the clamping device of the 2004-121285 patent of Japanese publication, clip has a pair of intermediate plate of under tension expansion, in addition pressing tube bag is embedded on clip and makes a pair of folder closure get up to clamp tissue, and utilize cinch tube that a pair of intermediate plate is kept closed, thus biological tissue is clamped.
The clamping device of the disclosed 03/030746A1 patent of WIPO, is connected with clip at bourdon tube front end, and this clip has a pair of clip to be opened/closed foot.In addition, the foot of intermediate plate being drawn in to cinch tube Zhong Shi clip foot closure clamps biological tissue.
The patent No. at China bulletin is in the patent of invention apparatus for ligating of CN 101087564 B, clip can advance and retreat in be contained in pressing component (cinch tube), and received by sheath.Advance and retreat by an advance and retreat limiting mechanism restriction pressing component at sheath leading section, then by operating line push-and-pull clip, make clip with respect to pressing component advance and retreat and opening and closing, thereby biological tissue is carried out to ligation.
The patent No. of announcing in China is in the application for a patent for invention hemostatic clipping apparatus and method of CN 102065780 A, the front end of flexible member is connected with utricule, the portions of proximal of clip and frangible connector are contained in utricule, by controlling the opening and closing of promotion control clip of cable, simultaneously, when connector bears predetermined power, disconnect, clip and control cable are separated.
When actual clinical is used, due to the normal creepage of gastrointestinal functions of body cavities, clip is closed into a half, easy and to be held organizes slippage, now needs again to open clip, carries out secondary clamping; In addition, from haemostatic effect, for arteriolar hemorrhage, the root that folder closes tremulous pulse can effectively stop blooding; For the blood outlet of strip, the organization edge that needs folder to close both sides just can reach the object of hemostasis; Therefore,, if biological tissue is carried out to unsuitable clamping, do not have the object of hemostasis.During clinical use, first operation doctor, under the endoscope visual field auxiliary, can judge that whether clip clamps the correct position of tissue, then just can discharge clip.But, hemostatic clipping device in above-mentioned patent documentation, or because two intermediate plates can be out of shape and cannot reopen in closed process under the compressing of cinch tube, or because cinch tube bag is embedded in stuck on two intermediate plates, can not again open, or cannot reopen because lack stationary positioned between cinch tube and sheath flexible pipe.When finding that clinically the object tissue of ligation is improper, clip can only be broken like this, then exit remaining clamping device, then send in addition new clip, so just caused waste or incured loss through delay the time of the processing of doctor's preciousness.And the hemostatic clipping device in above-mentioned patent documentation, owing to being subject to receiving the restriction of clamping structure, isolating construction: certain structures complexity can only adopt Sheet Metal Forming Technology manufacture, inevitably has sharp corner, easily cause pincers road and body cavities damage; The length of some cinch tube and push-and-pull pipe is longer, causes clip overall length overlength (exceeding 20mm), in endoscope in human body, head-bent in the situation that, be difficult to by its bending section; Part overlength (16mm nearly) in some clip indwelling body, at small space or in compared with thin-walled tract, when body cavities normal creepage of gastrointestinal functions, very easily scratch is to the normal structure of opposite tract wall, cause its scuffing or perforation, and the sharp corner of the cinch tube in indwelling body, also rapid wear hurts tissue; In addition, some also cannot be accommodated in clip in sheath flexible pipe, and the claw of intermediate plate is exposed outside sheath, in the time of in the Deng Qian of the insertion endoscope road like this clamping device being run through, just have claw damage pincers road inwall, or claw hangs on pincers road inwall and the probability that required insertion force is increased.
Summary of the invention
In order to solve above-mentioned technical problem, the object of this invention is to provide one and organize hemostatic clipping device, have simple and reasonable, clamp reliable and stable, can be repeatedly clamping in advance again, the feature such as clip indwelling volume is little, profile is bright and clean.
To achieve the above object, the present invention has adopted following technical scheme:
One is organized hemostatic clipping device, comprises clip, relieving mechanism, traction component, Handleset and epitheca pipe; Described traction component comprises traction steel wire and sheath flexible pipe; Described epitheca pipe is received described clip and relieving mechanism wherein; Described clip comprises: can under external force control, open and close and biological tissue is carried out the intermediate plate of hemostatic clipping, have bare terminal end and push-and-pull end; Be fixedly connected with integral connector with the push-and-pull end of described intermediate plate; For receiving the push-and-pull end of described intermediate plate and the cinch tube of connector, the slip of can advancing and retreat in this cinch tube pipeline of the push-and-pull end of described intermediate plate and connector; When the push-and-pull end of described intermediate plate and connector move to the rear portion of cinch tube, connector is fixed by anti-loose structure and cinch tube snapping, and the bare terminal end of described intermediate plate is closed up by the front portion effect of cinch tube; The front portion of described cinch tube is fixedly installed the intermediate plate spacing block that moves forward, and is provided with intermediate plate is retreated to spacing closed stop in the jig arm of described intermediate plate; Described relieving mechanism comprises: be positioned at the push-and-pull pipe of cinch tube pipeline, the front portion of push-and-pull pipe is being connected with connector bearing the connected mode losing efficacy while exceeding predetermined pull, and the rear portion of push-and-pull pipe is fixedly connected with traction steel wire; Connection tube, the front portion of connection tube is connected by knot that can be undone by a pull with the rear portion of cinch tube, and the rear portion of connection tube is fixedly connected with sheath flexible pipe; When push-and-pull pipe moves to the rear portion of cinch tube, push-and-pull pipe is connected connection tube and cinch tube releasing knot that can be undone by a pull by relief structure.
In technique scheme, intermediate plate and connector are connected, connector and push-and-pull pipe form isolating construction for the first time, thereby push-and-pull pipe drives advance and retreat to make the motion that intermediate plate can be level and smooth in cinch tube by traction steel wire, by intermediate plate self elasticity, realize and opening, by the front portion effect of cinch tube, realize the closure of intermediate plate, because cinch tube is connected with connection tube knot that can be undone by a pull, connection tube is fixed on sheath flexible pipe, cinch tube can be fixed relatively like this, traction steel wire can be by slide handle moving forward and backward on handle control the folding of intermediate plate, repeatedly repeat to open and close pre-clamping.Intermediate plate moves past in journey after pulled by traction steel wire, after move on to after ad-hoc location, connector is fixed by anti-loose structure and cinch tube snapping, this rear jaw cannot be opened; While moving after continuation, after intermediate plate quilt, move spacing cannot movement, and the pulling force of traction steel wire continues to increase, when the pulling force on handle is greater than the release force of pre-provisioning request, Joint failure between push-and-pull pipe and connector, push-and-pull pipe and connector depart from, and realize separation for the first time; After departing from, push-and-pull pipe and connector continue motion backward, push-and-pull pipe ejects by relief structure the knot that can be undone by a pull being connected with cinch tube on connection tube, cinch tube and connection tube depart from, push-and-pull pipe pulls out from cinch tube, realize for the second time and separating, clip is separation with single unit system like this, and is stranded in living body biological tract.Like this, cinch tube structure is relatively simple, can adopt injection mo(u)lding, any surface finish, cinch tube is relatively fixing, can repeatedly clamp in advance, easy to operate, accurate positioning, completely after clamping, clip is locked by anti-loose structure, clamp reliable and stablely, the clip in indwelling body only comprises intermediate plate, connector and cinch tube, and volume is small and exquisite, profile is bright and clean, can not cause tissue injury.
As preferably, described push-and-pull pipe is connected with connector by brace, and described intermediate plate, brace and connector link into an integrated entity by embedded injection moulding.Simple in structure like this, easily manufactured, be connected firmly, profile is bright and clean.
As preferably, described intermediate plate is made via having elastic sheet metal bending forming, and the sheet metal that described brace is flat, which is provided with dog hole.The front portion of described push-and-pull pipe is provided with crotch, this crotch is hooked in the dog hole of brace, and the intensity of this crotch is less than the bonding strength of described brace, connector and intermediate plate, when described push-and-pull pipe bears while exceeding predetermined pull, crotch is straightened, the Joint failure between push-and-pull pipe and brace.Adopt crotch structure as isolating construction for the first time, simple in structure small and exquisite, easily manufactured, connect reliable.
As preferably, described connector and described cinch tube coordinate guiding to slide by groove, tongue.By guiding slide construction, make the slip of connector more level and smooth, respective outer side edges is more accurate.
As preferably, described anti-loose structure refers to, described connector is provided with barb, and the skewback in this barb and cinch tube is detained mutually.Simple in structure like this, connect reliable.
As preferably, described connection tube front portion is provided with at least two cantilevers that can elasticity expand and retract, and cantilever is provided with convex closure, and described convex closure can buckle into and in the button hole in cinch tube, form knot that can be undone by a pull and connect.Simple in structure like this, connection coordinates reliable.
As preferably, described relief structure refers to, the rear portion of push-and-pull pipe is provided with inclined-plane or the projection that the convex closure on connection tube can be ejected to button hole in cinch tube.Simple in structure like this, connection coordinates reliable.
Compared with prior art, advantage of the present invention and good effect are: intermediate plate and connector connect in aggregates, advance and retreat that can be level and smooth in cinch tube pipeline, and under the effect of lower wall, two jig arm of intermediate plate are opened and closed repeatedly in cinch tube, and cinch tube is fixed relatively, this just makes hemostatic clipping device become possibility to the repeatedly clamping of biological tissue, general, intermediate plate can open and close more than five times at least repeatedly, be beneficial to hemostatic clipping device to be placed on optimal position, reach best haemostatic effect, avoided again sending into new clip due to unsuitable clamping, both alleviated doctor's workload, for patient gets valuable treatment time, reduced again operation cost, reduced waste.Meanwhile, the present invention has greatly shortened clamping device and has been detained the length that inside of human body divides, and has avoided causing due to long indwelling part scuffing or the perforation of human intracavity road normal structure, has reduced postoperative risk.
Accompanying drawing explanation
Fig. 1 is the structural representation of the hemostatic clipping device of embodiment 1;
Fig. 2 is that embodiment 1 is accommodated in the viewgraph of cross-section in epitheca pipe by clip;
Fig. 3 is that embodiment 1 clip stretches out the viewgraph of cross-section that epitheca pipe opens;
Fig. 4 is the axonometric chart of the clip of embodiment 1;
Fig. 5 is the axonometric chart of the chuck of embodiment 1;
Fig. 6 is the cutaway view of the chuck of embodiment 1;
Fig. 7 is the axonometric chart of the brace of embodiment 1;
Fig. 8 a is the structural representation of the cinch tube of embodiment 1;
Fig. 8 b is the A-A cutaway view of Fig. 8 a;
Fig. 9 is the axonometric chart of the cinch tube of embodiment 1;
Figure 10 is the axonometric chart of the block of embodiment 1;
Figure 11 is the cutaway view of the connection tube of embodiment 1;
Figure 12 is the cutaway view of the push-and-pull pipe of embodiment 1;
Figure 13 is the connection diagram of soft handle pipe and the epitheca pipe of embodiment 1;
Figure 14 is the connection diagram of clip when illustrating that embodiment 1 intermediate plate is completely closed;
Figure 15 is the schematic diagram for illustrating that embodiment 1 brace and push-and-pull pipe pull;
Figure 16 is the schematic diagram for illustrating that embodiment 1 push-and-pull pipe ejects connection tube;
Figure 17 is for the embodiment 1 cinch tube schematic diagram separation with connection tube is described;
Figure 18 is for illustrating that embodiment 1 clip is released, the schematic diagram that flexible member is withdrawn;
Figure 19 is the cutaway view of the second embodiment of chuck of the present invention;
Figure 20 is the axonometric chart of the second embodiment of connector of the present invention;
Figure 21 is the axonometric chart of the 3rd embodiment of connector of the present invention;
Figure 22 is the cutaway view of the second embodiment of connection tube of the present invention;
Figure 23 is the cutaway view of the 3rd embodiment of connection tube of the present invention;
Figure 24 is the second embodiment of block of the present invention and the installation diagram of cinch tube;
Figure 25 is the 3rd embodiment of block of the present invention and the installation diagram of cinch tube;
Figure 26 is the 4th embodiment of block of the present invention and the installation diagram of cinch tube.
The specific embodiment
Below in conjunction with accompanying drawing, the specific embodiment of the present invention is made a detailed explanation.
Embodiment 1:
One is as shown in Figure 1 organized hemostatic clipping device, comprises clip 100, relieving mechanism 200, traction component 300, Handleset 400 and epitheca pipe 500; Described traction component 300 comprises traction steel wire 310 and sheath flexible pipe 320; Described epitheca pipe 500 is received described clip 100, relieving mechanism 200 and traction component 300 wherein; Described clip 100 comprises: can under external force control, open and close and biological tissue is carried out the intermediate plate 110 of hemostatic clipping, have bare terminal end and push-and-pull end; Be fixedly connected with integral connector 130 with the push-and-pull end of described intermediate plate 110; For receiving the cinch tube 120 of push-and-pull end and connector 130 of described intermediate plate 110, the slip of can advancing and retreat in these cinch tube 120 pipelines of the push-and-pull end of described intermediate plate 110 and connector 130; When the push-and-pull end of described intermediate plate 110 and connector 130 move to the rear portion of cinch tube 120, connector 130 is fixed by anti-loose structure and cinch tube 120 snappings, and the bare terminal end of described intermediate plate 110 is closed up by the front portion effect of cinch tube 120; The front portion of described cinch tube 120 is fixedly installed the intermediate plate 110 spacing block 150 that moves forward, and is provided with intermediate plate 110 is retreated to spacing closed stop 113 in the jig arm of described intermediate plate 110.Described relieving mechanism 200 comprises: be positioned at the push-and-pull pipe 220 of cinch tube 120 pipelines, the front portion of push-and-pull pipe 220 is being connected with connector 130 bearing the connected mode losing efficacy while exceeding predetermined pull, and the rear portion of push-and-pull pipe 220 is fixedly connected with traction steel wire 310; Connection tube 210, the front portion of connection tube 210 is connected by knot that can be undone by a pull with the rear portion of cinch tube 120, and the rear portion of connection tube 210 is fixedly connected with sheath flexible pipe 320; When push-and-pull pipe 220 moves to the rear portion of cinch tube 120, push-and-pull pipe 220 makes connection tube 210 remove knot that can be undone by a pull with cinch tube 120 by relief structure to be connected.
In the present embodiment, described push-and-pull pipe 220 is connected with connector 130 by brace 140, and described intermediate plate 110, brace 140 and connector 130 link into an integrated entity by embedded injection moulding.Described intermediate plate 110 is made via having elastic sheet metal bending forming, the sheet metal that described brace 140 is flat, which is provided with dog hole 141, the front portion of described push-and-pull pipe 220 is provided with crotch 221, this crotch 221 is hooked in the dog hole 141 of brace 140, the intensity of this crotch 221 is less than the bonding strength of described brace 140, connector 130 and intermediate plate 110, when described push-and-pull pipe 220 bears while exceeding predetermined pull, crotch 221 is straightened, the Joint failure between push-and-pull pipe 220 and brace 140.Described connector 130 and described cinch tube 120 coordinate guiding to slide by groove 131, tongue 125.Described anti-loose structure refers to, described connector 130 is provided with barb 132, and this barb 132 is detained mutually with the skewback 122 in cinch tube 120.Described connection tube 210 front portions are provided with two cantilevers 217 that can elasticity expand and retract, and cantilever 217 is provided with convex closure 211, and the interior formation knot that can be undone by a pull of button hole 124 that described convex closure 211 can buckle in cinch tube 120 connects.Described relief structure refers to, the rear portion of push-and-pull pipe 220 is provided with the inclined-plane 224 that the convex closure on connection tube 210 211 can be ejected to button hole 124 in cinch tube 120.
Building block and the structure of each assembly are described in detail in detail respectively below.
Described clip 100, with other parts of organizing hemostatic clipping device be detachable structure, it is by intermediate plate 110, cinch tube 120, the connector 130 of embedded injection moulding, brace 140 and block 150 form, that can advance and retreat is accommodated in epitheca pipe 500 tube chambers; Intermediate plate 110 and brace 140 connect in aggregates by embedded moulding 130, jointly in the interior slip of cinch tube 120 pipeline 127; The tubular that cinch tube 120 is hollow, its rear end is connected by knot that can be undone by a pull with connection tube 210, and after knot that can be undone by a pull is ejected, cinch tube 120 is released together with clip 100; Block 150 is connected in cinch tube 120 front aperture 121 by welding or the mode such as hinged, and two jig arm 112 up and down of intermediate plate 110 are separated in its both sides; Clip 100 described in the present embodiment is made as rustless steel, medical high polymer, NiTi etc. by the material that meets biocompatibility.
Described relieving mechanism 200 is comprised of connection tube 210 and push-and-pull pipe 220, the housing that connection tube 210 is hollow, and its front end is connected with cinch tube 120 knots that can be undone by a pull by convex closure 211, and rear end is provided with the shoulder hole 213 being connected with flexible hose 320; Push-and-pull pipe 220 is substantial cylindrical shape, and its front end is established crotch 221 and is connected with the long lumbar hole 141 on brace 140, and rear end deep hole 226 links together by modes such as welding or crimping with traction steel wire 310, to transmit push-pull effort; Connection tube 210 described in the present embodiment and push-and-pull pipe 220 can be made by the stainless steel metal material that meets biocompatibility.
Described traction component 300 is by traction steel wire 310, and flexible hose 320 and conduit 330 form, and is elongated flexible member, so that this device is extend into depths in body by the working clamp road of endoscope, clip 110 is delivered to destination organization place; In the present embodiment, described traction steel wire 310 is single stainless steel metal filament, also can be entwined by multiply filament, or as alternative, for any other elongated, flexible metal steel cable being applicable to, its front end is connected with push-and-pull pipe 220, rear end is connected with slide handle 420 by the conduit 330 connecting on it, sliding and in flexible hose 320, do relative advance and retreat motion in front and back by slide handle 420 in the groove 412 of handle 410, and push-pull effort is passed to clip 110 so that it does switching motion; Described flexible hose 320 is the spring hose that has elasticity and have certain rigidity, is formed, or as alternative, be any other suitable hollow, flexible structure by stainless flat wire compact winding.
Described Handleset 400 is by handle 410, and slide handle 420 and soft handle pipe 430 form, and as doctor's handheld component, controls the opening and closing of far-end intermediate plate 110; Handle 410 is provided with thumb rings 411, coordinates with slide handle 420 both sides forefinger chutes 421, can make doctor operate easily slide handle 420 and move forward and backward on the groove 412 of handle 410; It is outer near handle side that soft handle pipe 430 is enclosed within epitheca pipe 500, can pull epitheca pipe 500 to make it to relatively move with flexible hose 320; In the present embodiment, handle 410 and slide handle 420 by macromolecular material as ABS, PC, the injection mo(u)ldings such as PE, soft handle pipe (430) adopts the materials such as silica gel or rubber to make.
Described epitheca pipe 500 is elongated flexible hollow tubulose structure, and smooth and its size of its surfaces externally and internally is subject to the size restrictions in endoscope's working clamp road, and for by described clip 100, relieving mechanism 200 and traction component 300 are received wherein; In the present embodiment, epitheca pipe 500 is made by single tract PE plastic tube.
Below with reference to Fig. 2 and Fig. 3, clip 100 opening and closing processes are described.Act on the pulling force on Handleset 400, by traction component 300 and relieving mechanism 200, pass to clip 100, brace 140 is moved backward together with injection moulding all-in-one-piece intermediate plate 110 in the pipeline 127 of cinch tube 120, two jig arm 112 of intermediate plate 110 are limited in the interior motion in space " D " of block 150 and cinch tube 120, and mutually close up under the compressing of the upper and lower inwall 128 of cinch tube.When the protruding folder end 111 of intermediate plate 110 with recessed folder end 116 is drawn close mutually and during butt, clip is completely closed.Same, when clip 100 exposes after epitheca pipe 500, act on the thrust on Handleset 400, by traction component 300 and relieving mechanism 200, pass to clip 100, brace 140 is travelled forward together with injection moulding all-in-one-piece intermediate plate 110 in the pipeline 127 of cinch tube 120, and under the separation of block 150, separate gradually, two jig arm 112 of intermediate plate 110 are opened, when advancing during the face of placing restrictions on 152 butt of embedded moulding 130 front end faces 134 and block, clip 100 can not continue to move forward again, now intermediate plate 110 is flared to maximum, and clamp object tissue A auxiliary lower aligning of endoscope.
Below with reference to Fig. 4 to Figure 10, the structure of clip 100 is described, the clip described in the present embodiment is by intermediate plate 110, cinch tube 120, and embedded moulding 130, brace 140 and block 150 form.
With reference to Fig. 4, Fig. 5 and Fig. 6, described intermediate plate 110 is for biological tissue is pressed from both sides and closed, and it can be one, can be also two-piece type, in the present embodiment, intermediate plate 110 is to adopt integrated punching molding, and it has the jig arm 112 of two symmetries, recessed folder end 111, protruding folder end 116, closed stop 113, chuck small bend angle 117, and the large bent angle 118 of jig arm.The Main Function of described jig arm 112 is to form certain space after clip 100 is closed, and biological tissue is clamped in described space; The triangle that recessed folder end 111 is provided with depression is levied, and protruding folder end (116) is provided with the triangle character of protrusion, and the triangle character of recessed folder end (111) and protruding folder end (116) mutually make-up gets up; Closed stop (113) is symmetrical is located at jig arm (112) both sides, by the alar part of bending in jig arm together angle, realizes, and its Main Function is when after the complete closure of clip 100, limits clip 100 and continues to enter in cinch tube 120 pipelines; Chuck small bend angle 117 is by the bending that recessed folder end 111 and protruding folder are held to 116 certain angles, to form certain depth that relatively large size invades tissue when clip 100 opens with grasping tissue; The large bent angle 118 of jig arm is by the bending of certain angle, so that intermediate plate 110 forms the span of opening of " L ", is conducive to capture the tissue of bulk.
With reference to Fig. 8 a, Fig. 8 b and Fig. 9, cinch tube 120 is general cylindrical shape shape, and its front end is provided with the hole 121 being connected with block 150, and block 150 can be by welding, riveted joint, and affixed mode hinged or any other rigidity is connected in its hole; Rear end is provided with the irregularly-shaped hole 124 being connected with connection tube 210 knots that can be undone by a pull; Skewback 122, the barb 132 on itself and embedded moulding 130 is detained mutually, after clip 100 is released, prevents that intermediate plate 110 from getting loose to front slide; Tongue 125, it coordinates with the groove 131 on embedded moulding 130, makes clip 100 interior moving along guide flat slippage at cinch tube pipeline 127.
With reference to Fig. 5, embedded moulding (connector) 130 is substantial cylindrical shape, and it connects intermediate plate 110 and brace 140 in aggregates, the common slip in cinch tube pipeline 127 interior advance and retreat.In the present embodiment, described embedded moulding 130 is by the medical macromolecular materials that meet biocompatibility as ABS, and PC etc. are via embedded injection mo(u)lding.
With reference to Figure 11, the structure of connection tube 210 is described.The housing that described connection tube 210 is hollow, front end is provided with symmetrical convex closure 211, and this convex closure 211 is placed on the cantilever 217 that can elasticly expand and retract, and when installing, expands slightly cantilever 217, convex closure 211 is put into the irregularly-shaped hole 124 of described cinch tube 120; Front end shoulder hole 216, thin stepped end 129 matched in clearance of itself and cinch tube 120 afterbodys; Rear end shoulder hole 213, an end face of itself and flexible hose 320 inserts and butt is lived behind bottom surface, by welding, crimping, affixed mode hinged or any other rigidity, connects; Afterbody chamfering 214, its any sharp-pointed corner angle, edge are all removed with the form of described chamfering, in order to avoid the working clamp road of damage endoscope.
With reference to Figure 12, the structure of push-and-pull pipe 220 is described.Described push-and-pull pipe 220 is substantial cylindrical shape, and its front end is provided with crotch 221, and it is hooked in the long lumbar hole 141 of brace 140; Gap 222 between crotch and push-and-pull pipe axial vane surface is designed to make brace 140 thickness directions to pass through, but can not make long lumbar hole 141 laterally deviate from; The symmetrical inclined-plane with certain angle 224 and plane 223 are made in centre, when described push-and-pull pipe 220 retreats with respect to described cinch tube 120, inclined-plane 224 first contacts the convex closure 211 on connection tube 210, convex closure 211 is moved upward with respect to inclined-plane 224, the final plane 223 that arrives push-and-pull pipe 220, cantilever 217 is expanded, convex closure 211 is ejected in the irregularly-shaped hole 124 of cinch tube 120; Rear end deep hole 226 links together by welding, crimping, affixed mode hinged or any other rigidity with traction steel wire 310, to transmit push-pull effort.
Below with reference to Figure 14 to Figure 18, operation principle and the use procedure of organizing hemostatic clipping device are elaborated, in the present embodiment, will organize the use that combines of hemostatic clipping device and endoscope.
With reference to Fig. 1 and Figure 14, first, staff inserts thumb in the thumb annular distance 411 of handle 410, and forefinger and middle finger are held respectively to the both sides chute 421 of slide handle 420, then pull back slide handle 420, make it to move backward in the groove 421 of handle, and by traction steel wire 310, pulling force is passed to the push-and-pull pipe 220 connecting on it, make it drive brace 140 to move backward together with injection moulding all-in-one-piece intermediate plate 110, two jig arm 112 of intermediate plate 110 are mutually closed up under the compressing of the upper and lower inwall 128 of cinch tube, the span " L " of opening of intermediate plate 110 is also dwindled gradually, when the protruding folder end 111 of intermediate plate 110 and recessed folder end 116 is drawn close mutually and butt after, clip is completely closed, now promote soft handle pipe 430 to away from handle 410 side shiftings, the epitheca pipe 500 that makes to connect on it can be received the clip closing up 100 wherein completely, the better like this clip of having protected, also avoid intermediate plate 110 corner angle that clip is sharp to scratch pincers road.Then, the hemostatic clipping device of organizing having drawn in is inserted in endoscope's working clamp road, slowly inserts and send, until can observe clip 100 under the visual field of endoscope, and by endoscope, adjust the approximate location of clip 100, make it near focus A.Next, pull soft handle pipe 430 near handle 410 side shiftings, be with the epitheca pipe 500 relative flexibility flexible pipes 320 that are dynamically connected on it to move, clip 100 is exposed outside epitheca pipe 500 completely.
Next, promote forward slide handle 420, make it to move forward in the groove 421 of handle, and by transmitting similar mode to above-mentioned pulling force of having illustrated, two jig arm 112 of intermediate plate 110 are slowly separated, until the front end face 134 of embedded moulding connects with the face of placing restrictions on 152 that advances of block 150, now the span " L " of opening of clip 100 reaches maximum; Now, can under the cooperation of endoscope, to destination organization, clamp accurately, as shown in Figure 3, the recessed folder end 111 of intermediate plate 110 and protruding folder end 116 are invaded the root of clamping tissue, after confirming that clamping is correct, slowly pull back slide handle 420 by the endoscope visual field, as previously mentioned, intermediate plate 110 is drawn in the pipeline of cinch tube 120 fully, thereby clip 100 is closed fully, and this is interim clamping (clamping in advance).In clamping with the object of stopping blooding, if to the suitable clamping of clamping object position A, can solve bleeding problems, but the in the situation that of unsuitable clamping, just can not solve bleeding problems, so need to again clamp here.In the situation that again clamping, step promotes slide handle 420 as the aforementioned constantly, and intermediate plate 110 is opened again, and like this, the A that organizes of clamping is just released.Repeatedly carry out above-mentioned operation, until suitable clamping object tissue A is clamped.
With reference to Figure 15, after confirming that suitable object tissue A is held, can produce tactile feedback, prompting can discharge clip 100.Now, lasting working tension is in slide handle 420, and when making to be delivered to pulling force on push-and-pull pipe 220 and exceeding predetermined clip release force, the crotch 221 of push-and-pull pipe is straightened, and departs from from the long lumbar hole 141 of brace, completes for the first time and separates.As mentioned above, clip in use needs opening and closing repeatedly, as long as but the push-pull effort being applied on push-and-pull pipe 220 is no more than predetermined clip release force, push-and-pull pipe 220 can be unlikely in the interior slip of cinch tube pipeline 127 to throw off normally.Herein, default clip release force is designed to make the stretching power of crotch 221 of push-and-pull pipe, as understood by the skilled person, described clip release force should be roughly and changes between 30N to 80N, thus, the sectional area size of push-and-pull pipe crotch 221 is designed to guarantee that crotch will be pulled out of shape under the effect of described clip release force.
With reference to Figure 16, when push-and-pull pipe 220 and brace 140 complete Fen Li for the first time after, push-and-pull pipe 220 continues motion backward under the effect of traction steel wire 310 pulling force, its inclined-plane 224 first contacts the convex closure 211 on connection tube 210, make passive the moving upward with respect to inclined-plane 224 of convex closure 211, the final plane 223 that arrives push-and-pull pipe 220, in this process, the cantilever 217 of connection tube 210 is expanded under the effect of radial thrust, convex closure 211 is deviate from irregularly-shaped hole 124, thereby complete for the second time, separate, so far, whole clip dispose procedure finishes.
With reference to Figure 17 and Figure 18, after clip 100 is released, permanent separation with push-and-pull pipe 220 with connection tube 210, the clip of closed-lock 100 is stayed to organizing on A of being held.And slide handle 420 continues to apply pulling force, so relieving mechanism 300 and traction component 400 can be recalled in body.
The second embodiment of clip of the present invention is described with reference to Figure 19.To having and the structural member of the first embodiment said function, be marked with identical label, and omit its description.As described above, intermediate plate can be integral type, also can be two-piece type, Figure 19 illustrates the mode that upper and lower intermediate plate 110b is connected with embedded moulding 130, described upper and lower intermediate plate 110b can be identical, also can be symmetrical different two, the feature that intermediate plate 110b has be identical with the first embodiment.
Second, third embodiment of the embedded moulding of the present invention (being connector) is described with reference to Figure 20 and Figure 21.The Main Function of embedded moulding is intermediate plate and brace to be connected in aggregates, and slides in the pipeline of cinch tube; Therefore, as long as the size of embedded moulding is enough to be arranged in the pipeline of cinch tube, its shape is unessential, can be various geometries, and cuboid as shown in figure 21, also can be ellipsoid, and square etc., omit at this; In addition, the Main Function of the feature groove on it is to match with the tongue 125 of cinch tube, makes the movement of clip 100 can be more level and smooth, therefore, as long as the geometry of groove matches with tongue, the oval-shaped groove 131c shown in square groove 131b or Figure 21 as shown in figure 20.
Second, third embodiment of connection tube of the present invention is described with reference to Figure 22 and Figure 23.As described above, the convex closure 211 of connection tube 210 is connected with irregularly-shaped hole 124 knots that can be undone by a pull of cinch tube 120 rear ends, has ejected the secondary separation of clip through the inclined-plane 224 of push-and-pull pipe 220, therefore, its shape is unessential, can be various geometries, as cuboid, ellipsoid or cylinder etc.In the 3rd embodiment, the indoor design of connection tube 210 is straight hole 216c, has cancelled front shoulder hole 216 and rear shoulder hole 213, when rear end is connected with flexible hose 320, needs frock to assist to avoid flexible hose to insert dark or excessively shallow, affects bonding strength.
With reference to Figure 24 to Figure 26, second, third and the 4th embodiment that block of the present invention is connected with cinch tube is described.In Figure 24, block 150b is designed to pin feature, penetrate in cinch tube 120 front aperture 121b, and by welding, affixed mode hinged or any other rigidity links together, thereby two jig arm 112 of intermediate plate 110 are separated in its both sides; In Figure 25, block 150c is designed to helicitic texture, same, and cinch tube 120 front aperture 121c also change to female thread accordingly, and to match with it, such advantage is detachable and easy for installation; In Figure 26, block 150d is designed to " U " shape structure, is nested in the front transverse plane 121d of cinch tube 120 upper, and connects by modes such as welding.
Compared with prior art, advantage of the present invention and good effect are: intermediate plate and brace connect in aggregates by embedded moulding, advance and retreat that can be level and smooth in cinch tube pipeline, and under the effect of lower wall, two jig arm of intermediate plate are opened and closed repeatedly in cinch tube, this just makes hemostatic clipping device become possibility to the repeatedly clamping of biological tissue, general, hemostatic clipping device can open and close more than five times at least repeatedly, be beneficial to hemostatic clipping device to be placed on optimal position, reach best haemostatic effect, avoided again sending into new clip due to unsuitable clamping, both alleviated doctor's workload, for patient gets valuable treatment time, reduced again operation cost, reduced waste.Meanwhile, the present invention has greatly shortened clamping device and has been detained the length that inside of human body divides, and has avoided causing due to long indwelling part scuffing or the perforation of human intracavity road normal structure, has reduced postoperative risk.And, because intermediate plate of the present invention adopts integrated punching molding, its symmetrical configuration, press from both sides the power of closing evenly moderate, and after hemostatic clipping device discharges, barb on embedded moulding and the skewback of cinch tube make two jig arm up and down of intermediate plate fixing firmly owing to detaining mutually, have avoided the lax risk that hemostatic clamp is come off due to jig arm.
It is emphasized that: be only preferred embodiment of the present invention above; not the present invention is done to any pro forma restriction; any simple modification, equivalent variations and modification that every foundation technical spirit of the present invention is done above embodiment, all still belong in the protection domain of technical solution of the present invention.
Claims (8)
1. organize a hemostatic clipping device, comprise clip (100), relieving mechanism (200), traction component (300), Handleset (400) and epitheca pipe (500); Described traction component (300) comprises traction steel wire (310) and sheath flexible pipe (320); Described epitheca pipe (500) is received described clip (100) and relieving mechanism (200) wherein; It is characterized in that,
Described clip (100) comprising:
The intermediate plate (110) that can open and close and biological tissue be carried out hemostatic clipping under external force control, has bare terminal end and push-and-pull end;
Be fixedly connected with integral connector (130) with the push-and-pull end of described intermediate plate (110);
Be used for the cinch tube (120) of push-and-pull end and the connector (130) of receiving described intermediate plate (110), the slip of can advancing and retreat of the push-and-pull end of described intermediate plate (110) and connector (130) in this cinch tube (120) pipeline; When the push-and-pull end of described intermediate plate (110) and connector (130) move to the rear portion of cinch tube (120), connector (130) is fixed by anti-loose structure and cinch tube (120) snapping, and the bare terminal end of described intermediate plate (110) is closed up by the front portion effect of cinch tube (120);
The front portion of described cinch tube (120) is fixedly installed intermediate plate (110) the spacing block (150) that moves forward, and is provided with intermediate plate (110) is retreated to spacing closed stop (113) in the jig arm of described intermediate plate (110); Described relieving mechanism (200) comprising:
Be positioned at the push-and-pull pipe (220) of cinch tube (120) pipeline, the front portion of push-and-pull pipe (220) is being connected with connector (130) bearing the connected mode losing efficacy while exceeding predetermined pull, and the rear portion of push-and-pull pipe (220) is fixedly connected with traction steel wire (310);
Connection tube (210), the front portion of connection tube (210) is connected by knot that can be undone by a pull with the rear portion of cinch tube (120), and the rear portion of connection tube (210) is fixedly connected with sheath flexible pipe (320); When push-and-pull pipe (220) moves to the rear portion of cinch tube (120), push-and-pull pipe (220) is connected connection tube (210) and cinch tube (120) releasing knot that can be undone by a pull by relief structure.
2. one according to claim 1 is organized hemostatic clipping device, it is characterized in that, described push-and-pull pipe (220) is connected with connector (130) by brace (140), and described intermediate plate (110), brace (140) and connector (130) link into an integrated entity by embedded injection moulding.
3. one according to claim 2 is organized hemostatic clipping device, it is characterized in that, described intermediate plate (110) is made via having elastic sheet metal bending forming, the sheet metal that described brace (140) is flat, which is provided with dog hole (141), the front portion of described push-and-pull pipe (220) is provided with crotch (221), this crotch (221) is hooked in the dog hole (141) of brace (140), the intensity of this crotch (221) is less than described brace (140), the bonding strength of connector (130) and intermediate plate (110), when described push-and-pull pipe (220) bears while exceeding predetermined pull, crotch (221) is straightened, Joint failure between push-and-pull pipe (220) and brace (140).
4. one according to claim 1 is organized hemostatic clipping device, it is characterized in that, described connector (130) and described cinch tube (120) coordinate guiding to slide by groove (131), tongue (125).
5. one according to claim 1 is organized hemostatic clipping device, it is characterized in that, described anti-loose structure refers to, described connector (130) is provided with barb (132), and this barb (132) is detained mutually with the skewback (122) in cinch tube (120).
6. one according to claim 1 is organized hemostatic clipping device, it is characterized in that, described connection tube (210) front portion is provided with at least two cantilevers (217) that can elasticity expand and retract, cantilever (217) is provided with convex closure (211), and described convex closure (211) can buckle into formation knot that can be undone by a pull in the button hole (124) in cinch tube (120) and connect.
7. one according to claim 6 is organized hemostatic clipping device, it is characterized in that, described relief structure refers to, the rear portion of push-and-pull pipe (220) is provided with the inclined-plane (224) that the convex closure (211) on connection tube (210) can be ejected to the upper button hole (124) of cinch tube (120).
8. one according to claim 6 is organized hemostatic clipping device, it is characterized in that, described relief structure refers to, the rear portion of push-and-pull pipe (220) is provided with the projection that the convex closure (211) on connection tube (210) can be ejected to the upper button hole (124) of cinch tube (120).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210232803.0A CN102727276B (en) | 2012-07-05 | 2012-07-05 | Tissue hemostasis clamping device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210232803.0A CN102727276B (en) | 2012-07-05 | 2012-07-05 | Tissue hemostasis clamping device |
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| Publication Number | Publication Date |
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| CN102727276A CN102727276A (en) | 2012-10-17 |
| CN102727276B true CN102727276B (en) | 2014-04-23 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201210232803.0A Active CN102727276B (en) | 2012-07-05 | 2012-07-05 | Tissue hemostasis clamping device |
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| WO2013067662A1 (en) * | 2011-11-11 | 2013-05-16 | Zhu Jian | Clamping or ligating device |
| DE102013003315B3 (en) * | 2013-02-28 | 2014-06-18 | Olympus Winter & Ibe Gmbh | endoscope |
| CN103536327A (en) * | 2013-10-31 | 2014-01-29 | 王东 | Combined tissue perforation suturing instrument |
| CN103536328B (en) * | 2013-10-31 | 2016-04-06 | 王东 | Rapid tissue perforation suture instrument |
| CN103989500B (en) * | 2014-05-23 | 2015-11-18 | 南京微创医学科技有限公司 | A kind of hemostatic clamp |
| CN104586444B (en) * | 2014-12-17 | 2017-03-22 | 中国人民解放军第一七五医院 | Endoscopic grasper for closing digestive tract perforation |
| CN204671214U (en) * | 2015-05-15 | 2015-09-30 | 江苏唯德康医疗科技有限公司 | Clip type repeats folding hemostatic clamp |
| WO2017028037A1 (en) * | 2015-08-14 | 2017-02-23 | 杭州安杰思医学科技有限公司 | Soft tissue clamp |
| EP3366236B1 (en) * | 2015-10-23 | 2021-10-13 | Hangzhou Ags Medtech Co., Ltd. | Ligation device |
| JP6274233B2 (en) * | 2016-02-23 | 2018-02-07 | 住友ベークライト株式会社 | Clip cartridge system |
| CN105615938A (en) * | 2016-03-15 | 2016-06-01 | 沈阳尚贤微创医疗器械股份有限公司 | Disposable digestive tract soft tissue clamp |
| CN105877803B (en) * | 2016-05-27 | 2020-04-07 | 苏州法兰克曼医疗器械有限公司 | Hemostatic clamp |
| CN106236195B (en) * | 2016-08-31 | 2019-02-05 | 施爱德（厦门）医疗器材有限公司 | A kind of grasping tissue pincers |
| CN106491176A (en) * | 2016-11-15 | 2017-03-15 | 浙江创想医学科技有限公司 | One kind is rotatable to be repeated to be opened and closed hemostatic clamp |
| CN106473805B (en) * | 2016-11-15 | 2023-12-01 | 浙江创想医学科技有限公司 | Digestive tract hemostatic clamp with electrification and repeated opening and closing and rotating functions |
| CN109788955B (en) * | 2016-12-28 | 2021-08-17 | 株式会社钟化 | Medical clamp box |
| CN106725699A (en) * | 2017-02-24 | 2017-05-31 | 上海埃尔顿医疗器械有限公司 | One kind hemostasis clamp apparatus |
| CN107280723B (en) * | 2017-06-12 | 2020-06-23 | 南微医学科技股份有限公司 | Medical tissue clamp releasing device |
| CN110393564B (en) * | 2018-04-25 | 2021-11-12 | 杭州安杰思医学科技股份有限公司 | Clamping device |
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| CN109480950A (en) * | 2018-12-27 | 2019-03-19 | 扬州发特利医疗器械科技有限公司 | Endoscope-use clamp apparatus |
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| CN111839649A (en) * | 2020-08-20 | 2020-10-30 | 苏州朗特斯医疗科技有限公司 | Structure for preventing tissue from slipping in tissue clamp |
| CN114587446B (en) * | 2020-12-04 | 2023-09-29 | 杭州安杰思医学科技股份有限公司 | End effector and method of operation |
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