CN113017929A

CN113017929A - Clamping apparatus

Info

Publication number: CN113017929A
Application number: CN202110376339.1A
Authority: CN
Inventors: 阙诗昊; 徐军; 程增兵; 林林
Original assignee: Shanghai Huihe Healthcare Technology Co Ltd
Current assignee: Shanghai Huihe Healthcare Technology Co Ltd
Priority date: 2021-04-02
Filing date: 2021-04-02
Publication date: 2021-06-25
Also published as: WO2022205561A1

Abstract

The application provides a clamping apparatus, which mainly comprises a base capable of being positioned at a target center position, and at least two clamping structures arranged on the base in a surrounding mode, wherein each clamping structure can be switched between a clamping state and a releasing state, so that different target tissues adjacent to the target center position are clamped, and the spacing distance between the target tissues is adjusted. Therefore, the clamping instrument can capture different target tissues separately or simultaneously, so that the capturing probability is improved, and the capturing difficulty is reduced.

Description

Clamping apparatus

Technical Field

The embodiment of the application relates to the technical field of medical instruments, in particular to a clamping instrument.

Background

The regurgitation of heart valves (mitral valve and tricuspid valve) is a common heart disease, and is exemplified by the tricuspid valve, which is located at the orifice of the right atrioventricular, and the common onset is tricuspid valve insufficiency, i.e. the systolic blood flow flows back from the right ventricle to the right atrium, causing the right atrium to be highly enlarged, the pressure to be increased, and the venous blood backflow disorder. Right heart failure is likely to occur due to the compensatory hypertrophy of the load in the right ventricle.

Tricuspid valve regurgitation is generally caused by pulmonary hypertension, right ventricular enlargement and tricuspid valve annulus dilation, and is clinically commonly represented by the causes of the tricuspid valve regurgitation (left heart failure, pulmonary hypertension and the like), and the symptoms of right heart failure such as weakness, ascites, edema, liver pain, dyspepsia, anorexia and the like are aggravated after the tricuspid valve regurgitation occurs. Mild regurgitation of the tricuspid valve has no obvious clinical symptoms, but surgical treatment is required when there is severe regurgitation.

Traditional treatment methods include drug therapy, and surgical procedures with corresponding surgical indications. Wherein the surgical method further comprises a valve replacement procedure and a valve repair procedure.

In recent years, with the development of science and technology, equipment manufacturers at home and abroad develop a batch of interventional clamping equipment for treating mitral valve or tricuspid valve regurgitation. Taking mitral regurgitation treatment as an example, the clamping device can be punctured through the interatrial septum by the catheter femoral vein, and is conveyed downwards from the left atrium to the vicinity of the mitral valve so as to clamp and fix the free edges of the anterior and posterior valve leaflets of the mitral valve, and the mitral valve is clamped into double holes by the clamping device, so that the anterior and posterior valve leaflets can be well involuted in the end of systole, and the regurgitation phenomenon is reduced.

The problem that the difficulty of capturing valve leaflets is large exists in most of the existing mitral valve edge-to-edge repair technologies, a clamping component of a clamping instrument can only capture the valve leaflets on two sides at the same time, and for patients with severe mitral valve regurgitation, the incomplete valve closure can lead to long operation time and large difficulty of capturing the valve leaflets at the same time.

How to solve the problems of high difficulty in capturing the valve leaflet and high failure rate of capturing is the technical problem to be solved by the application.

Disclosure of Invention

In view of the above, the present application provides a clamping device to overcome or at least partially address the above-mentioned problems.

The embodiment of the application provides a clamping apparatus, it includes: a base positionable at a target center location; and at least two clamping structures, wherein each clamping structure can be arranged on the base, extends towards different directions, and can be switched between a clamping state and a releasing state relative to the base so as to adjust the spacing distance between the target tissues by clamping different target tissues adjacent to the target center position.

Optionally, the clamping apparatus includes two clamping structures respectively disposed on opposite sides of the base for respectively clamping an anterior mitral valve and a posterior mitral valve.

Optionally, the clamping device comprises two clamping structures arranged on the base in a surrounding manner, and the two clamping structures are used for respectively clamping any two valves of the tricuspid valve; or the clamping device comprises three clamping structures which are arranged on the base in a surrounding way and are used for clamping each valve of the tricuspid valve respectively.

Optionally, each said gripping structure is synchronously switchable between said gripping state and said release state; or each said sandwich structure may be independently switchable between said sandwiched state and said released state.

Optionally, the positioning angle of each clamping structure in the clamping state relative to the base can be the same or different.

Optionally, the clamping structure comprises an inner clamp arm and an outer clamp arm; the inner clamping arm and the outer clamping arm respectively comprise fixed ends pivoted with the base, and the inner clamping arm and the outer clamping arm can respectively pivot relative to the base through the fixed ends so as to switch the clamping structure between a clamping state and a releasing state.

Optionally, the inner clamp arm comprises an inner arm clamp portion and the outer clamp arm comprises an outer arm clamp portion, the outer arm clamp portion cooperating with the inner arm clamp portion to clamp or release the target tissue.

Optionally, the inner clamping arm further comprises an inner arm anti-falling part arranged on the inner arm clamping part; and/or the outer clamping arm also comprises an outer arm anti-falling part arranged on the outer arm clamping part; when the clamping structure is in a clamping state, the inner arm anti-falling part and/or the outer arm anti-falling part are/is used for preventing the target tissue from falling off between the outer arm clamping part and the inner arm clamping part.

Optionally, inner arm anticreep portion is including locating on the inner arm clamping part and towards a plurality of barbs that the direction of outer arm clamping part extends, outer arm anticreep portion including form in a plurality of anticreep grooves on the outer arm clamping part.

Optionally, the inner arm clamp comprises an elastic band and the outer arm clamp comprises an arcuate blade.

Optionally, the inner clamp arm further includes a free end opposite to the fixed end, and the free end can be forced to drive the fixed end of the inner clamp arm to pivot relative to the base so as to adjust the pivot angle of the inner clamp arm relative to the base.

Optionally, the gripping structure further comprises an actuating lever and a linkage lever; the actuating rod can movably penetrate through the base, and two opposite sides of the linkage rod are respectively pivoted with the outer clamping arm and the actuating rod; and wherein the actuating rod is movable relative to the base in an axial direction thereof to drive the outer clamp arm to pivot relative to the base via the linkage rod, thereby adjusting a pivot angle of the outer clamp arm relative to the base.

Optionally, the clamping instrument comprises two actuating rods corresponding to the two clamping structures; the two actuating rods comprise an outer rod and an inner rod which are arranged in the base in a penetrating mode and sleeved with each other; the two linkage rods are respectively pivoted with the bottom of the outer rod and the bottom of the inner rod, the bottom of the inner rod is located between the bottom of the outer rod and the base, and the spacing distance between the bottom of the outer rod and the base can limit the maximum moving interval of the bottom of the inner rod relative to the base.

Optionally, the clamping apparatus includes two actuating rods corresponding to the two clamping structures, and the two actuating rods are respectively inserted into the base and can independently slide relative to the base.

Optionally, the clamping structure further comprises a locking structure disposed on the base; wherein the locking structure is switchable between a locked position and an unlocked position relative to the base to limit or allow movement of the actuating lever relative to the base.

To sum up, the clamping apparatus provided by the embodiment of the present application can improve the capturing probability of the target tissue and reduce the capturing difficulty by enabling each clamping structure enclosed on the base to independently perform the clamping capturing operation of the target tissue.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present application, and other drawings can be obtained by those skilled in the art according to the drawings.

Fig. 1-2 are side views of different configurations of a clamping instrument of the present application.

Fig. 3-4 are schematic structural views of an embodiment of an actuating rod of the clamping instrument of the present application.

Fig. 5 is a schematic structural view of another embodiment of an actuating rod of the clamping instrument of the present application.

Fig. 6 is a schematic structural view of a locking structure of a clamping instrument of the present application.

Element number

1: a clamping device;

2: a base;

3: a clamping structure;

4: an inner clamping arm;

402: a fixed end;

404: an inner arm clamping portion;

406: an inner arm drop-preventing part;

408: a barb;

410: an elastic band;

412: a free end;

5: an outer clamping arm;

502: a fixed end;

504: an outer arm clamping portion;

506: an outer arm drop-preventing part;

508: a drop-proof groove;

510: an arc-shaped blade;

512: an actuating lever;

514: a linkage rod;

516: an outer rod;

518: an inner rod;

520: the bottom of the outer rod;

522: the bottom of the inner rod;

6: and a locking structure.

Detailed Description

In order to make those skilled in the art better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be described clearly and completely below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, but not all embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application shall fall within the scope of the protection of the embodiments in the present application.

The existing clamping apparatus for treating mitral insufficiency can only capture two side valve leaflets, so that the problems of high difficulty in capturing the valve leaflets and long operation time are caused. In view of the above, the present disclosure provides a clamping device, which can independently perform the clamping operation of each leaflet to improve the above technical problems.

The following further describes specific implementations of the embodiments of the present application with reference to the drawings of the embodiments of the present application.

The clamping apparatus 1 of the embodiment can be used as an edge-to-edge repair implant in the field of interventional therapy of structural heart diseases, and can reach a designated anatomical position through a vascular minimally invasive approach or through the atrial appendage to realize repair therapy of heart lobes.

As shown in fig. 1 and 2, the clamping apparatus 1 of the present application mainly comprises a base 2 and at least two clamping structures 3.

In the present embodiment, the base 2 can be positioned at the target center position, and each clamping structure 3 can be enclosed on the base 2 and can be switched between a clamping state and a releasing state relative to the base 2, so as to adjust the spacing distance between each target tissue by clamping or releasing each target tissue adjacent to the target center position.

Alternatively, the clamping device 1 may comprise two clamping structures 3 respectively disposed at two opposite sides of the base 2, the target tissue may comprise an anterior mitral valve and a posterior mitral valve, and the anterior mitral valve and the posterior mitral valve may be clamped by the two clamping structures 3 of the clamping device 1, respectively, to treat the mitral insufficiency.

Alternatively, the clamping device 1 may also be used for treatment of tricuspid regurgitation.

In one embodiment, the clamping device 1 may comprise two clamping structures 3 surrounding the base 2, which may be used to clamp any two pieces of the tricuspid valve, respectively.

In another embodiment, the clamping device 1 may also comprise three clamping structures 3 arranged around the base 2 for clamping respective valves of the tricuspid valve.

Alternatively, each gripping structure 3 may be switched between the gripping state and the release state synchronously, or each gripping structure 3 may be switched between the gripping state and the release state independently.

In the present embodiment, the positioning angles of the clamping structures 3 in the clamping state relative to the base 2 may be the same or different.

In this embodiment, the clamping structure 3 may include an inner clamping arm 4 and an outer clamping arm 5.

Specifically, the inner and

outer clamp arms

4, 5 each include a fixed end 402,502 pivotally connected to the base 2, and the inner and

outer clamp arms

4, 5 are pivotable relative to the base 2 via the fixed ends 402,502, respectively, to provide for switching the clamping structure 3 between a clamped state and a released state.

In this embodiment, inner arm 4 may include an inner arm grip 404, and correspondingly, outer arm 5 may include an outer arm grip 504, wherein outer arm grip 504 and inner arm grip 404 may cooperate to grip or release the target tissue.

Optionally, the inner arm grip 404 may include an elastic band 410. The outer arm clamp 504 may include an arcuate blade 510.

Optionally, the inner arm 4 may further include an inner arm retaining portion 406 provided on the inner arm holding portion 404.

Optionally, the outer arm 5 may further include an outer arm retaining portion 506 provided on the outer arm gripping portion 504.

When the clamping structure 3 is in the clamped state, the inner arm retaining portion 406 and/or the outer arm retaining portion 506 may be used to prevent the target tissue from falling out from between the outer arm clamping portion 504 and the inner arm clamping portion 404, so as to ensure that the target tissue is firmly clamped between the outer arm clamping portion 504 and the inner arm clamping portion 404.

Alternatively, the inner arm retaining portion 406 may include a plurality of barbs 408 disposed on the inner arm gripping portion 404 and extending in the direction of the outer arm gripping portion 504.

Optionally, outer arm retaining portion 506 includes a plurality of retaining grooves 508 formed on outer arm gripping portion 504.

In this embodiment, the inner clip arm 4 further includes a free end 412 opposite the fixed end 402.

Wherein, the free end 412 of the inner clip arm 4 can be forced to drive the fixed end 402 of the inner clip arm 4 to pivot relative to the base 2, so as to adjust the pivoting angle of the inner clip arm 4 relative to the base 2.

For example, the purpose of independently controlling the opening and closing angle of the inner clamping arm 4 relative to the base 2 is achieved by connecting the free end 414 of the inner clamping arm 4 with a control wire (not shown) to drive the inner clamping arm 4 to pivot relative to the base 2 by applying a force to the free end 412 of the inner clamping arm 4 via the control wire.

In this embodiment, the clamping structure 3 further includes an actuating rod 512 and a linkage rod 514.

Wherein, the actuating rod 512 is movably disposed on the base 2, and two opposite sides of the linkage rod 514 are respectively pivoted to the outer clamping arm 5 and the actuating rod 512.

In the embodiment, the actuating rod 512 can move along its axial direction relative to the base 2 to drive the outer clamping arm 5 to pivot relative to the base 2 through the linkage rod 514, so as to adjust the pivoting angle of the outer clamping arm 5 relative to the base 2, thereby achieving the purpose of independently controlling the opening and closing angle of the outer clamping arm 5 relative to the base 2.

Referring to fig. 3 and 4, in an embodiment, in the case that the clamping apparatus 1 includes two clamping structures 3, the two actuating rods 512 corresponding to the two clamping structures 3 may include an outer rod 516 and an inner rod 518 disposed through the base 2 and sleeved with each other.

Specifically, the two linkage rods 514 are respectively pivoted to the outer rod bottom 520 of the outer rod 516 and the inner rod bottom 522 of the inner rod 518, and the inner rod bottom 522 is located between the outer rod bottom 520 and the base 2 (i.e., the inner rod bottom 522 is closer to the base 2 than the outer rod bottom 520), so as to define the maximum moving interval of the inner rod bottom 522 relative to the base 2 by means of the spacing distance between the outer rod bottom 520 and the base 2.

Referring to fig. 5, in another embodiment, in a case that the clamping apparatus 1 includes two clamping structures 3, two actuating rods corresponding to the two clamping structures 3 may be respectively inserted into the base 2, for example, the two actuating rods may be inserted into the base 2 side by side, so as to independently slide relative to the base 2.

Optionally, the sandwich structure 3 may further comprise a locking structure 6 (refer to fig. 6) provided on the base 2, wherein the locking structure 6 is switchable between a locking position (e.g., the locking structure 6 in the dashed line position in fig. 6) and an unlocking position (e.g., the locking structure 6 in the solid line position in fig. 6) with respect to the base 2 to limit or allow the actuation rod 512 to move with respect to the base 2.

To sum up, the clamping apparatus of the present application can independently control each clamping structure to perform the clamping operation of the target tissue, and can effectively improve the capture probability of the target tissue and reduce the capture difficulty of the target tissue.

Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the embodiments of the present application, and are not limited thereto; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions in the embodiments of the present application.

Claims

1. A clamping instrument, comprising:

a base positionable at a target center location; and

at least two clamping structures, each clamping structure can be arranged on the base in a surrounding mode and can be switched between a clamping state and a releasing state relative to the base, and therefore the separation distance between the target tissues can be adjusted by clamping different target tissues adjacent to the target center position.

2. The clamping instrument of claim 1, wherein the clamping instrument comprises two clamping structures disposed on opposite sides of the base for clamping an anterior mitral valve and a posterior mitral valve, respectively.

3. The clamping instrument of claim 1,

the clamping device comprises two clamping structures which are arranged on the base in a surrounding way and are used for respectively clamping any two valves of the tricuspid valve; or

The clamping device comprises three clamping structures which are arranged on the base in a surrounding mode and are used for clamping each valve of the tricuspid valve respectively.

4. The clamping instrument of claim 1,

each of the clamping structures is synchronously switchable between the clamping state and the releasing state; or

Each of the clamping structures is independently switchable between the clamped state and the released state.

5. A clamping apparatus according to claim 1 wherein the angle of orientation of each clamping structure in the clamped condition relative to the base may be the same or different.

6. The clamping instrument of claim 5, wherein the clamping structure comprises an inner clamp arm and an outer clamp arm;

the inner clamping arm and the outer clamping arm respectively comprise fixed ends pivoted with the base, and the inner clamping arm and the outer clamping arm can respectively pivot relative to the base through the fixed ends so as to switch the clamping structure between a clamping state and a releasing state.

7. A clamping instrument according to claim 6,

the inner clamping arm comprises an inner arm clamping portion, the outer clamping arm comprises an outer arm clamping portion, and the outer arm clamping portion and the inner arm clamping portion are cooperatively matched to clamp or release the target tissue.

8. A clamping instrument according to claim 7,

the inner clamping arm also comprises an inner arm anti-falling part arranged on the inner arm clamping part; and/or the outer clamping arm also comprises an outer arm anti-falling part arranged on the outer arm clamping part;

when the clamping structure is in a clamping state, the inner arm anti-falling part and/or the outer arm anti-falling part are/is used for preventing the target tissue from falling off between the outer arm clamping part and the inner arm clamping part.

9. The clamping instrument of claim 8, wherein the inner arm retaining portion comprises a plurality of barbs disposed on the inner arm gripping portion and extending in a direction toward the outer arm gripping portion, and the outer arm retaining portion comprises a plurality of anti-slip grooves formed on the outer arm gripping portion.

10. The clamping instrument of claim 7, wherein the inner arm clamp comprises a resilient band and the outer arm clamp comprises an arcuate blade.

11. The clamping instrument of claim 6, wherein the inner clamp arm further includes a free end opposite the fixed end, the free end being configured to be forced to pivot the fixed end of the inner clamp arm relative to the base to adjust the pivot angle of the inner clamp arm relative to the base.

12. The clamping instrument of claim 6, wherein the clamping structure further comprises an actuation rod and a linkage rod; wherein the content of the first and second substances,

the actuating rod is movably arranged on the base in a penetrating mode, and two opposite sides of the linkage rod are respectively pivoted with the outer clamping arm and the actuating rod;

and wherein the actuating rod is movable relative to the base in an axial direction thereof to drive the outer clamp arm to pivot relative to the base via the linkage rod, thereby adjusting a pivot angle of the outer clamp arm relative to the base.

13. A clamping instrument according to claim 12, wherein the clamping instrument comprises two actuating levers corresponding to the two clamping formations; the two actuating rods comprise an outer rod and an inner rod which are arranged in the base in a penetrating mode and sleeved with each other; wherein the content of the first and second substances,

the two linkage rods are respectively pivoted with the bottom of the outer rod and the bottom of the inner rod, the bottom of the inner rod is positioned between the bottom of the outer rod and the base, and the spacing distance between the bottom of the outer rod and the base can limit the maximum moving interval of the bottom of the inner rod relative to the base.

14. The clamping instrument of claim 12, wherein the clamping instrument comprises two actuating rods corresponding to the two clamping structures, the two actuating rods are respectively arranged in the base in a penetrating way and can independently slide relative to the base.

15. The clamping instrument of claim 12, wherein the clamping structure further comprises a locking structure disposed on the base;

wherein the locking structure is switchable between a locked position and an unlocked position relative to the base to limit or allow movement of the actuating lever relative to the base.