JP2003033361A - Surgical clip feeding device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical clip feeding device which can reduce the number of part items, simplify its constitution, and lower the cost of production. SOLUTION: This surgical clip feeding device has a clip feeding mechanism which is set inside a guide pipe 144 and pushes clips one by one in order to a space between a pair of jaw elements of a jaw. The clip feeding mechanism comprises a clip carry 242 which extends within the guide pipe 144 and feeds the clip between the jaw elements, a reset spring 244 which energizes the clip carry 242 in an axial backward direction, an elastic deformable locking part 246 which is fixed on a pushrod rear 202 and has a protruding part 246b that is formed by pushing with the elastic force of the locking part 246 in the direction to lock on the clip carry 242, and a reset member 248 which is fixed inside the guide pipe 144 ahead of the locking part 246 and moves the protruding part 246b of the locking part 246 to a non-locking position with the clip carry 242.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical clip applying apparatus for applying clips to body tissues in surgical treatment.

[0002]

2. Description of the Related Art For example, in endoscopic surgery, a small incision is made in the abdomen, and a medical instrument such as an elongated tube or a cannula for guiding the inside and outside the body is inserted into the incision, and a surgical clip is attached through them. The device is inserted, and the surgical clip applying device applies clips to the trachea, blood vessels, ducts, and other body tissues in the body to stop bleeding.

As this kind of surgical clip applying device,
For example, the one described in JP-A-10-118083 is known.

[0004]

However, the surgical clip applier described in the above publication requires a large number of parts, has a complicated structure, and is difficult to assemble, resulting in a high manufacturing cost. Has the problem of becoming.

SUMMARY OF THE INVENTION The present invention has been made in view of the above conventional problems, and it is an object of the present invention to provide a surgical clip applicator capable of reducing the number of parts, simplifying the structure, and reducing the manufacturing cost. To aim.

[0006]

In order to achieve the above-mentioned object, the invention according to claim 1 has a handle portion, a shaft portion extending from the handle portion to the tip side, and a shaft fixed to the shaft portion. A guide mechanism that axially guides a plurality of clips that are arranged in series within the shaft portion; and a pair of jaw elements that are arranged near the tip of the shaft portion and are movable between a separated position and a close position. With Joe
A push rod that extends in the shaft portion and is axially movable in response to an operation of the handle portion, and a jaw closure for moving the jaw element of the jaw to a close position in response to the axial movement of the push rod. A surgical clip applier that includes a member and a clip supply mechanism that is disposed in a shaft portion and that sequentially presses the clips one by one between a pair of jaw elements of the jaw. So, the clip supply mechanism,
A clip carrier that extends in the shaft portion and supplies a clip between the jaw elements, a biasing device that biases the clip carrier axially rearward, and a clip carrier that is attached to the push rod and locks in the clip carrier. An elastically deformable locking member having a locking portion elastically repulsed, and a locking portion of the locking member that is fixed in the shaft portion in front of the locking member and is not locked by a clip carrier. And a reset member for moving to a position.

When the push rod is moved forward within the shaft portion by operating the handle portion, the locking member of the clip supply mechanism attached to the push rod moves forward integrally. Since the locking portion of the locking member is locked to the clip carrier, the clip carrier also moves forward against the biasing means. Then, the clip carrier pushes the clip guided by the guiding mechanism between the jaw elements. Then, the locking member that has been advanced in the shaft portion together with the push rod reaches the reset member fixed in the shaft portion in the front. Then, the clip carrier is released from the locking member in order to deform the locking member that is elastically deformable by the reset member and move the locking portion to the non-locking position with the clip carrier. , Back by the biasing means. Further, when the handle portion is operated continuously, the jaw closing member moves the jaw elements of the jaws to the close position in response to the movement of the push rod, so that the clip pushed between the jaw elements by the clip carrier is moved to the jaw element. Crushed between
It is given to body tissues.

Since the locking member itself is made of an elastically deformable member, it is possible to omit a component such as a spring as a separate component, simplify the configuration with a small number of components, and reduce the manufacturing cost. Can be reduced.

According to a second aspect of the present invention, the locking member according to the first aspect has a "V" shape, and a locking portion for locking the clip carrier is provided at the top of the locking member. A pivot portion pivotally attached to the push rod is provided on one side portion, and a leaf spring portion is provided on the other side portion, and the reset member acts on the locking member to lock the locking portion. It is characterized by having a cam surface that presses downward.

The locking portion formed on the top of the locking member is
Although it is normally locked to the clip carrier, the reset member acts by the locking member to push the locking portion downward, and the locking portion to the non-locking position from the clip carrier. Can be moved.

According to a third aspect of the present invention, the locking member according to the first aspect is formed of a leaf spring and is attached to the push rod so as to be swingable in the left and right directions, and the clip carrier is attached to the top of the push rod. The reset member is provided with a locking portion, and the reset member has a cam surface that acts on the locking member to press the locking portion to the left or right.

The locking portion formed on the top of the locking member is
It is always locked to the clip carrier, but when the reset member acts by the leaf spring, the locking part is pushed to the left or right direction, and the locking part is unlocked from the clip carrier. Can be moved to.

The invention according to claim 4 is the invention according to claims 1 to 3.
In the guide mechanism according to any one of claims 1 to 5, there is provided blocking means for blocking the backward movement of the clip carry when the last clip is pushed between the jaw elements by the clip carry, and the rear end of the clip carry is provided. Is characterized in that a stopper piece for preventing the push rod from retracting is formed.

When the last clip is pushed between the jaw elements by the clip carrier, the blocking means prevents the clip carrier from retracting, so that the stopper piece formed at the rear end of the clip carrier prevents the push rod from retracting. Can be made. Such movement can inform the operator that all clips have been used. Since the clip carrier directly prevents the push rod from retracting, the configuration can be simplified with a small number of parts, and the manufacturing cost can be reduced.

The invention according to a fifth aspect is the first to the fourth aspects.
The jaw closing member according to any one of items 1 to 6 is integrally connected to the push rod.
Alternatively, the jaw closure member can be integrally formed with the push rod.

The invention according to claim 6 is the invention according to claims 1 to 5.
The guide mechanism according to any one of 1 to 3 above is configured by a clip case and a clip case cover that covers the upper side of the clip case, and the clip case and the clip case cover are combined to define an internal space of the clip case. A clip spring for urging the clip forward is disposed in the internal space of the clip case, and the spring force from the rear end of the clip spring is applied to either the clip case or the clip case cover. On the other hand, while receiving the clip case and the clip case cover,
One of the clip case and the clip case cover is slid backward relative to the other to be coupled, and one of the clip case and the clip case cover is connected to the other. It is characterized in that the connection is released by sliding it forward. When connecting the clip case and the clip case cover, one of the clip case and the clip case cover is slid rearward with respect to the other. After connecting, either the clip case or clip case cover that receives the spring force from the clip spring to the rear,
Even if it tries to slide backward due to the spring force, the connection is not broken. Thus, the spring force of the clip spring can prevent the clip case and the clip case cover from being unintentionally disengaged.

[0017]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. The following embodiments do not limit the present invention.

FIG. 1 is an overall perspective view of a surgical clip applier according to the present invention. This surgical clip applying device 1
0 indicates the handle portion 12 and the handle portion 12 as a whole.
Shaft portion 14 extending from the end to the tip side, and the shaft portion 14
The guide mechanism 16 disposed inside, the jaw 18 arranged near the tip of the shaft portion 14, and the inside of the shaft portion 14 which extend in the shaft portion 14 and are movable in the axial direction according to the operation of the handle portion 12. Push rod 20 and push rod 2
A jaw closure member 22 for moving the jaw elements of said jaw 18 to a proximate position in response to an axial movement of zero.
A clip supply mechanism 24, which is disposed in the shaft portion 14 and sequentially sets one clip between the pair of jaw elements of the jaw 18, is provided. Hereinafter, detailed description of each unit will be given.

[1] Handle part 12 As shown in FIG. 1, the handle part 12 has a grip right case 121 and a grip left case 122.
These grip right case 121 and grip left case 1
22 and 22 constitute a grip case 124, and a case internal space is defined therein. Grip case 12
4 is formed with a grip portion 124a suitable for being gripped by an operator. As shown in FIG. 2, the trigger 123 is axially mounted in the case inner space, and the pin 124 b of the trigger 123 penetrates the pin 124 b projecting from the case inner space of the grip case 124. . Trigger 123
The lower end portion of the is protruded from the grip case 124 and swingably moves toward and away from the grip portion 124a. The operator holding the grip 124a sets the clip C on the jaw 18 and tightens the clip C by pulling the trigger 123 to perform a series of operations to apply the clip C to a desired portion of the body tissue, as described later. be able to.

As shown in FIG. 2, the upper end portion of the trigger 123 is engaged with a protrusion 126a formed on a push bar 126 arranged on the same line as the shaft portion 14. In the space inside the case, the push bar 126 is
It is arranged so as to be movable in the axial direction of the shaft portion 14,
The swinging movement of the trigger 123 is converted into movement of the push bar 126 in the axial direction of the shaft portion 14. As shown in FIG. 3, a downward bulging portion is formed at the rear end portion of the push bar 126, and ratchet teeth 126b are formed on the lower surface of the bulging portion. This ratchet tooth 1
Each tooth of 26b has an isosceles right triangle shape.
The front side and the rear side of the bulging portion where the ratchet teeth 126b are formed are relief portions 126c and 126d. A shaft portion 126e extends at the tip of the push bar 126, and a receiving portion 126f that rotatably accommodates a received portion 202a at the rear end of the push rod rear 202 of the push rod 20 described later is formed at the tip thereof. Has been done. Receiving part 126f
Has a tubular shape in which a part of the peripheral surface is cut out.

Further, a ratchet member 128 is axially mounted in the case internal space, and a pin 124c protruding from the rat case member 128 penetrates a pin through hole 128a of the ratchet member 128. As shown in FIG. 4, the ratchet member 128 has its tip end portion formed into a mountain shape, and ratchet teeth 128b and 128c are formed on both slopes of the mountain shape, respectively. These ratchet teeth 128b, 128c are in the shape of an isosceles right triangle so that they can mesh with the ratchet teeth 126b of the push bar 126. A lower portion of the ratchet member 128 is a flexible thin plate spring portion 128d. The leaf spring portion 128d of the ratchet member 128 passes through the inside of the gate 124d formed in the case internal space of the grip case 124, and the ratchet member 128 is in the range where the leaf spring portion 128d exists in the gate 124d. It is rotatable about the pin 124c.

A rotating piece 130 is rotatably disposed at the tip opening of the grip case 124. Rotating piece 130
As shown in FIG. 5, has a base portion 130a arranged in the case internal space. A plurality of ribs 130b extending in the outer diameter direction are formed on the base portion 130a, and elastic portions formed by cutting and raising the grip right case 121 and the grip left case 122 between the ribs 130b, respectively. Pieces 121a and 122a (12
Only 2a is shown in FIG. 1). Further, a screw portion 130c is formed on the tip end side of the base portion 130a of the rotating piece 130.

A return spring 132 is wound around the outer periphery of the shaft portion 126e of the push bar 126, and the tip end of the return spring 132 is a step portion 130d (see FIG. b))
Is in contact with. The rear end of the return spring 132 is in contact with the step portion 126g of the push bar 126, and the push bar 126 is
Is always urged in the direction to move backward. Also,
The receiving portion 126f and the shaft portion 126 of the push bar 126.
When the push bar 126 is moved forward against the urging force of the return spring 132, the tip of e moves to the rotating top 1
The handle portion 12 can be inserted and penetrated from the handle portion 12.

The operation of only the handle portion 12 constructed as above will be described first. The operator holds the grip portion 124a.
When the operator pushes the trigger 123 and pulls the trigger 123 to approach the grip portion 124a, the upper end of the trigger 123 is engaged with the protrusion 126a of the push bar 126.
6 moves forward, ie moves towards the shaft portion 14. As a result, the tip end head portion of the ratchet member 128 hits the ratchet teeth 126b of the push bar 126, and as shown in FIG.
Pushed down to the side. The ratchet teeth 128b mesh with the ratchet teeth 126b of the push bar 126.
At the same time, the leaf spring portion 128d is bent so as to be convex to the right in FIG. 6 while hitting the pillar at the right end of the gate 124d in FIG. By the spring force of the leaf spring portion 128d,
The tip portion of the ratchet member 128 has a push bar 12
6, ratchet teeth 126b, and in particular upper right in FIG. As the push bar 126 continues to move forward, the tip end of the ratchet member 128
By swinging between the upper right side and the lower left side in FIG. 6, the ratchet tooth 128b moves relative to the ratchet tooth 126b while appropriately escaping from the ratchet tooth 126b. When the swinging motion of the trigger 123 is stopped and the forward motion of the push bar 126 is stopped, the tip end head portion of the ratchet member 128 is pressed upward rightward toward the ratchet teeth 126b, and the ratchet teeth 128b and the ratchet teeth 128b. Tooth 126b
The engagement between the push bar 126 and the push bar 126 is maintained. At this time, the push bar 126
The biasing force of the return spring 132 acts to move the push bar 126 backward, but the ratchet teeth 128b and the ratchet tooth 126b are meshed with each other, and the ratchet tooth 128b is the push bar 126.
Because you can not escape in the direction that allows the retreat of
Retraction of the push bar 126 is prohibited.

When the push bar 126 is further advanced by pulling the trigger 123 further, as shown in FIG. The tip of the head is the escape portion 126.
Enter d. In this way, the push bar 126 is released from the ratchet member 128.

When the force applied to the trigger 123 is released, the push bar 1 is urged by the urging force of the return spring 132.
26 moves back. At this time, the tip head portion of the ratchet member 128 has the ratchet teeth 126 b of the push bar 126.
In response to this, as shown in FIG. 8, the tip head portion is pushed down to the rear side, that is, the side opposite to the shaft 14. The ratchet tooth 128c is the ratchet tooth 1 of the push bar 126.
Engages with 26b. At the same time, the leaf spring portion 128d is connected to the gate 12
4d is bent so as to be convex to the left in FIG. 8 while hitting the column at the left end in FIG. Due to the spring force of the plate spring portion 128d, the tip end head portion of the ratchet member 128 is pressed toward the ratchet teeth 126b of the push bar 126, and particularly toward the upper left of FIG. When the push bar 126 continues to retract, the ratchet member 128
8 swings between the upper left side and the lower right side in FIG. 8, and the ratchet tooth 128c of the ratchet tooth 126b moves.
While relatively escaping from, it moves relative to the ratchet teeth 126b. If the trigger 123 is pulled again to move the push bar 126 forward in the midway state as shown in FIG. 8, the ratchet teeth 128c and the ratchet teeth 126
Since the ratchet teeth 128c are in mesh with each other and the ratchet teeth 128c cannot escape in the direction in which the forward movement of the push bar 126 is allowed, the forward movement of the push bar 126 is prohibited.

When the push bar 126 is further retracted, the state shown in FIG. 2 is restored, and the ratchet teeth 128c of the ratchet member 128 and the ratchet teeth 126b of the push bar 126 are disengaged from each other, and the ratchet member 12 is released.
The tip end head of 8 enters the escape portion 126c. In this way, the push bar 126 is released from the ratchet member 128.

By the action of the push bar 126 and the ratchet member 128 described above, the operation of one cycle consisting of the complete pulling operation and the complete releasing operation of the trigger 123 is surely performed, and the halfway operation is prevented. This is prevented so that the application of the clip C and the preparation of the next clip C are surely performed as will be described later.

In the handle portion 12, since the ratchet member 128 itself has the plate spring portion 128d, a separate spring member can be omitted, and the number of parts can be reduced.

The handle portion 12 of this embodiment is made of plastic except for the return spring 132, and after use, the return spring 132 can be removed for separate disposal.

[2] Shaft 14 Next, the shaft 14 is composed of a rotary knob 142 and a guide pipe 144, as shown in FIG.

As shown in FIG. 9, the rotary knob 142 has a screw portion 142b formed on the inner peripheral surface thereof to be screwed into the screw portion 130c of the rotating piece 130 of the handle portion 12. Further, the flange portion 144 a formed at the rear end of the guide pipe 144 is provided on the front end surface of the rotating piece 130 and the rotating knob 14.
It is sandwiched between the stepped portion 142a formed on the inner peripheral surface of the second member. As a result, the rotary knob 142, the guide pipe 144, and the rotary piece 130 are integrally connected. Therefore, when the operator rotates the rotary knob 142, the guide pipe 144 and the rotary piece 130 rotate integrally, and the parts described below arranged in the guide pipe 144 also rotate integrally. Therefore, when the operator wants to rotate the direction in which the clip C is applied, the operator can make an appropriate adjustment by rotating the rotation knob 142.

[3] Guide Mechanism 16 Next, the guide mechanism 16 occupies the front portion of the guide pipe 144 of the shaft portion 14 and occupies substantially the upper half of the guide pipe 144 in the circular cross section. It is composed of a clip case 162 and a clip case cover 164.

As shown in FIGS. 10 and 11, the clip case 162 has a bottom surface 162a on which a plurality of clips C are placed in series, and side portions 162b formed on both sides of the bottom surface 162a. The upper end of the side portion 162b is bent so as to be substantially parallel to the bottom surface 162a, and
62b encloses the side portion of the clip C. The clip case cover 164 covers the upper side of the clip case 162, and together with the clip case 162, defines a clip case internal space.

In the interior space of the clip case, a plurality of clips C and a clip push-out bar 166, which is behind the rearmost clip C and presses the clip C, are provided.
A clip spring 168 that biases the clip push-out bar 166 in the forward direction is housed. The clip C has a substantially U-shape, and is arranged on the bottom surface 162a of the clip case 162 with its base end facing rearward.

The side surface 162 of the clip case 162
A plurality of substantially L-shaped locking piece portions 162c are formed in b, separated from each other in the axial direction. The substantially inverted L-shaped locking piece portion 162c includes a vertical portion 162c1 extending upward and a parallel portion 162c2 bent at a right angle from the vertical portion 162c1 and extending rearward in the axial direction.

At the side edge of the clip case cover 164, a plurality of cutouts 164a are provided axially separated from each other in correspondence with the locking piece 162c, and adjacent to the cutouts 164a, other cutouts are formed. The lower supporting surface 164b is formed.

To connect the clip case 162 and the clip case cover 164, as shown in FIG.
The position of the locking piece 162c of the clip case 162 is aligned with the position of the cutout 164a of the clip case cover 164, and the locking piece 162c is inserted into the cutout 164a (FIG. 12A). Next, the clip case cover 164
12 is slid forward with respect to the clip case 162 (arrow direction in FIG. 12A) so that the parallel portion 162c2 of the locking piece 162c of the clip case 162 comes on the support surface 164b of the clip case cover 164. To
As a result, the locking piece 162c is supported by the support surface 164b, and the clip case 162 and the clip case cover 164 are integrated.

The rear end of the clip spring 168 abuts on the reset bar 248 connected to the rear end of the clip case 162, which will be described later.
The spring force acts as a force to push the clip case 162 rearward relative to the clip case cover 164, and acts on the clip case 162. Even if such a force is received by the clip case 162, the connection between the clip case 162 and the clip case cover 164 cannot be broken unless the clip case 162 moves forward relative to the clip case cover 164. Therefore, the clip case 162 and the clip case cover 164 are not accidentally disconnected from each other.

Returning to FIG. 10, the clip case cover 16
4 has a long hole 164c into which a tip of a clip carrier 242 of a clip supply mechanism 24 described later enters.
Are formed. In addition, the clip case 162,
A claw portion 162e that holds the base end portion of the leading clip C in a portion corresponding to the elongated hole 164c of the clip case cover 164 to prevent the clip C from accidentally popping out.
Are formed.

Further, the claw portion 16 of the clip case 162
An elastic piece 162f cut and raised from the bottom surface 162a is formed at a position slightly rearward of 2e. Elastic piece 16
2f is engageable with a recess formed on the bottom surface of the clip pushing bar 166. This elastic piece 162f
The clip push-out bar 166 functions as a blocking unit that blocks the backward movement of the clip carrier 242 of the clip supply mechanism 24, which will be described later, when the last clip C is pushed out to the jaw 18, as described later.

Further, at the rear end of the clip case 162, a reset bar 248 of a clip supply mechanism 24, which will be described later, is provided.
An engaging hole 162d for engaging with is formed.

[4] Jaw 18 Next, the jaw 18 is integrally joined to the lower surface of the clip case 162 by laser welding or the like. As shown in FIGS. 13 and 14, the tip portion of the jaw 18 is split into a forked shape, and each becomes a pair of jaw elements 18a, 18a for sandwiching the clip C. These jaw elements 18a, 18a can be moved between the separated position and the approached positions which are close to each other by utilizing the elasticity thereof.
A guide inclined surface 18b for receiving the clip C is formed on the upper surface side of the jaw elements 18a, 18a. On the other hand, cam surfaces 18c and 18c are formed on the lower surfaces of the jaw elements 18a and 18a, respectively (FIG. 14 (c)).
The cam surfaces 18c, 18c are inclined surfaces that are separated from each other toward the tip end side. The cam surfaces 18c, 18c are for engaging with a cam surface 22c of a jaw closing member 22 described later.

A plurality of projections 1 are provided on the rear side surface of the jaw 18.
8d, 18d are formed, and these protrusions 18d,
18d is fitted into an opening 144b (see FIGS. 1 and 9) formed in the guide pipe 144 of the shaft portion 14. In this way, the jaw 18 and the guide mechanism 16 are fixed to the guide pipe 144 of the shaft portion 14.

Positioning protrusions 18e, 18e are formed on the lower surface of the center of the jaw 18, and a jaw closing member 22 to be described later is provided.
It is fitted in the guide groove 22b.

[5] Push Rod 20 Next, the push rod 20 is arranged in substantially the lower half of the circular cross section of the guide pipe 144 of the shaft portion 14, and as shown in FIG. Rod rear 202 and push rod front 204
It consists of and. These push rod rear 2
02 and the push rod front 204 may be formed as an integral part to reduce the number of parts, or may be formed as separate parts by giving priority to formability as in this embodiment.

At the rear end of the push rod rear 202,
A cylindrical receiving portion 202a is rotatably fitted to the receiving portion 126f of the push bar 126. In addition, at the front end of the push rod rear 202,
A long hole 202b extending in the axial direction is formed, and a locking member 246 described later is pivotally attached to the long hole 202b. Therefore, a bearing recess 202d into which the shaft portion 246a of the locking member 246 is fitted is formed on the side surface of the long hole 202b (see FIG. 16B). Further, a concave portion 202g for receiving the second shaft portion 246c of the locking member 246 is formed on the side surface of the long hole 202b.

A shaft portion 202e extending in the axial direction at the rear portion of the push rod rear 202 has a cross-shaped cross section, and a front end of the shaft portion 202e is defined between the shaft portion 202e and the elongated hole 202b. A stepped portion 202f is formed.

The front end portion of the push rod rear 202 is formed with a concave and convex hook portion 202c for connecting with the push rod front 204, while the push rod front 204 has a push rod rear portion. Uneven shaped hook portion 20 that fits with the hook portion 202c of 202
4a is formed. Further, a hook portion 204b that engages with the next jaw closing member 22 is formed at the tip of the push rod front 204.

[6] Jaw Closing Member 22 The jaw closing member 22 is connected to the push rod 20 and is disposed below the jaw 18. Although the jaw closing member 22 can be formed integrally with the push rod 20 described above, in this embodiment, the jaw closing member 22 is provided.
In order to securely close the jaw elements 18a, 18a of No. 8, the push rod 20 is a separate part and is a metal plate material.

As shown in FIGS. 17 and 18, an engaging hole 22a is formed in the central portion of the jaw closing member 22, and the engaging hole 22a is formed at the tip of the push rod front 204. The hooked portion 204b is engaged. In addition, two guide grooves 22b are provided on the upper surface of the central portion.
The positioning protrusion 18e of the jaw 18 is inserted into the guide groove 22b. The positioning protrusion 18e of the jaw 18 relatively slides along the guide groove 22b, whereby the jaw closing member 22
Moves linearly with respect to the jaws 18. The jaw element 18 is provided at the tip of the jaw closing member 22.
A cam surface 22c is formed in sliding contact with the cam surface 18c of the jaw element 18a for moving the a and 18a in the closing direction.

FIG. 19 shows the jaw 18 and the jaw closing member 2.
It is a figure showing the relationship with 2. 19 (a) shows a state in which the cam surface 22c of the jaw closing member 22 is rearward of the cam surface 18c of the jaw element 18a of the jaw 18, and FIG. 19 (b) shows the push rod 20 (push rod 20).・ Jaw closing member 2 as front 204) advances
2 shows a state in which the cam surface 22c of the jaw closing member 22 and the cam surface 18c of the jaw element 18a are engaged with each other to move the jaw elements 18a, 18a to the close position by moving forward.

[7] Clip Supply Mechanism 24 The clip supply mechanism 24 is mainly shown in FIGS.
As shown in FIG. 7, a clip carrier 242 extending in the axial direction of the shaft portion 14, a reset spring 244 (biasing means) for urging the clip carrier 242 axially rearward, and a reset spring 244 wound around the peripheral surface thereof. Spring shaft 245 and push rod rear 20
The shaft recess 246a is fitted in the bearing recess 202d formed in the second long hole 202b, and is formed at the rear end of the clip case 162 and the locking member 246 that can swing about the shaft recess 246a. And a reset bar 248 which engages with the engaged hole 162d.

The clip carrier 242 has the shaft portion 1.
The guide pipe 144 of No. 4 extends in the axial direction of the shaft portion 14 above the guide mechanism 16 occupying substantially the upper half of the guide pipe 144 (see FIG. 13). As shown in FIG. 22, the tip of the guide mechanism 16 is inserted into the long hole 164c formed in the clip case cover 164 of the guide mechanism 16, and the clip of the guide mechanism 16 is provided on both sides of the tip. A guide piece 242a for pushing the leading clip C in the case internal space to the jaw 18 is formed. Further, as shown in FIG. 20, a cut-and-raised portion 242b which is cut and raised vertically downward is formed in the central rear portion of the clip carrier 242, and the cut-and-raised portion 242b is provided with the reset bar 24.
8 through the opening 248a extending in the axial direction and through a slit formed at the rear end of the spring shaft 245, and is locked at the rear end of the spring shaft 245. Further, a locking hole 242c for locking the locking member 246 is formed in the rear portion of the clip carrier 242. further,
At both ends of the rear end of the clip carrier 242, stopper pieces 242d that slide on the shaft portion 202e of the push rod rear 202 having the cross-shaped cross section are formed (see FIG. 23).

As described above, the spring shaft 245 has a cut-and-raised portion 242b of the clip carrier 242 at its rear end.
Is locked and the tip of the lock bar is reset bar 248.
It is inserted into the inside of a cylindrical portion 248b formed at the tip of the. Then, the reset spring 244 wound around the spring shaft 245 has the reset bar 248.
It is inserted between the cylindrical portion 248b and the cut-and-raised portion 242b of the clip carrier 242, and always urges them in a direction of separating from each other. The cut-and-raised part 242b of the clip carrier 242 is capable of axially advancing within the opening 248a of the reset bar 248 while compressing the reset spring 244.

Further, the cylindrical portion 248b of the reset bar 248.
Is inserted into the rear end of the clip case internal space formed by the clip case 162 and the clip case cover 164, and the tip of the tubular portion 248b receives the clip spring 168. Furthermore, the tubular portion 2
The engaging hole 16 of the clip case 162 is provided in the vicinity of 48b.
An engagement protrusion 248c that engages with 2d is formed. Therefore, the reset bar 248 is fixed to the guide mechanism 16.

Next, the locking member 246 is made of plastic or the like, and as shown in FIG.
As described above, the shaft portion 246a protruding in the lateral direction is fitted into the bearing recess 202d formed in the long hole 202b of the push rod rear 202 at the end of one side portion thereof as described above. Has been. The locking member 246 is formed with a protruding portion (locking portion) 246b protruding upward from the push rod rear 202 on the top of the locking member 246, and on the other side thereof, below the protruding portion 246b. Thus, a second shaft portion 246c protruding laterally, a leaf spring portion 246d extending downward from the second shaft portion 246c, and a lower end portion 246e at the lower end of the leaf spring portion 246d are formed. The lower end portion 246e is in contact with the inner peripheral surface of the guide pipe 144. Due to the leaf spring portion 246d, the locking member 246 has elasticity by itself, and as shown in FIG. 21 or 23, the projecting portion 246b always projects upward, that is, the clip carry 242.
Is being urged toward. Then, in the normal state, the projecting portion 246b of the locking member 246 is positioned so as to enter the locking hole 242c of the clip carrier 242.

At the rear end of the reset bar 248, there is formed a cam surface 248d which descends downward as it goes forward. This cam surface 248d is the locking member 2
46, and the protruding portion 24 of the locking member 246.
Clip carry 242 by pulling 6b downward.
Play a role of retreating.

[8] Overall Operation Next, the overall operation of the clip applying device 10 will be described. First, the jaw 18 is attached to the part of the body tissue to which the clip is to be attached.
The jaw elements 18a, 18a of the. Then
An operation of pulling the trigger 123 of the handle portion 12 is performed. As already described in the section [1] Handle 12, the push bar 126 causes the return spring 1 to move.
It moves forward against the urging force of 32. As a result, the push rod 20 connected to the push bar 126, that is, the push rod rear 202 and the push rod front 204 both advance in the shaft portion 14.

As the push rod / rear 202 moves forward, the locking member 246 having the shaft portion 246a attached to the push rod / rear 202 moves forward. Locking member 2
The projecting portion 246b of the clip 46 is a clip carrier 242.
The clip carrier 242 also moves forward together with the fact that the clip carry 242 has entered and locked (see FIG. 21).
When the clip carrier 242 moves forward, as shown in FIG. 25, the tip of the clip carrier 242 that has entered the clip case internal space of the guide mechanism 16 advances in the clip case internal space. This allows the clip carrier 24
The guide piece 242a at the tip of 2 pushes out the leading clip C in the internal space of the clip case, and the front jaw 18
Of the jaw elements 18a, 18a.

When the operation of pulling the trigger 123 is further continued, the push rod 20 and the locking member 246 connected to the push bar 126 are further advanced, and the locking member 24
As shown in FIGS. 26 and 27, the sixth second shaft portion 246c interferes with the cam surface 248d at the rear end of the reset bar 248 connected to the rear end of the guide mechanism 16. The locking member 246 is pushed downward by the cam surface 248d, and the projecting portion 246b of the locking member 246 retracts from the locking hole 242c of the clip carrier 242.
As a result, the clip carrier 242 is locked by the locking member 24.
In order to be released from 6, the reset spring 244 is retracted by the biasing force of the reset spring 244.

Further, when the operation of pulling the trigger 123 is continued, the cam surface 22c of the jaw closing member 22 connected to the push rod 20 is moved to the jaw element 1 of the jaw 18.
Refer to FIG. 19 (b) to move the jaw elements 18a, 18a into close proximity with each other by engaging with the cam surface 18c of 8a, 18a. This allows the jaw element 1
8a and 18a sandwich the clip C previously guided by the clip carrier 242, and the work of applying the clip C is completed.

Next, when the force applied to the trigger 123 is weakened, the push bar 126 is moved to the return spring 13
The push rod rear 202 connected to the push bar 126, the push rod front 204, and the jaw closing member 22 connected to the push rod front 204 are moved backward by the urging force of 2. In addition, the locking member 246 axially attached to the push rod rear 202 is also retracted, and the overhanging portion 246b of the locking member 246 is again locked in the locking hole 242c of the clip carrier 242 that has already moved back. To do.

In the internal space of the clip case, the clip spring 168 pushes the next leading clip C to the tip of the internal space of the clip case. The clip C at the beginning is the clip case 16
It is held by a claw portion 162e formed at the tip of the second. The guide piece 242a of the clip carrier 242 is positioned behind the base end of the leading clip C and stands by for pushing the leading clip C out.

The clip carrier 242 inserts the last clip C in the clip case inner space into the jaw element 18
When pushed out between a and 18a, the clip push-out bar 166, which is pressing the clip C, becomes
Elastic piece 162f formed at the tip of bottom surface 162a of 62
, The clip pusher bar 166 cannot move forward or backward and stops there. As a result, the clip push-out bar 166 occupies the tip of the clip case internal space. It is sandwiched between the tip of the case cover 164 and cannot return to the rear. Then, when the force of the trigger 123 is weakened after the last clip C is applied to the body tissue, the push rod rear 202 tries to retract as described above, but the clip carrier 242 does not return to the rear. For the clip carrier 242
Push rod rear 20 to stopper piece 242d of
The second step portion 202f comes into contact with the push rod / rear so that the push rod / rear cannot be further retracted. by this,
The trigger 123 remains in the pulled state and can no longer be operated.

In the clip applying device according to the present invention, the number of parts is reduced at various places, and the most characteristic part thereof is the locking member 246 of the clip supply mechanism 24. By using the locking member 246 having the plate spring portion 246d, it is possible to configure with a small number of parts without using a lot of springs unlike the conventional product.

Further, in the present invention, since the number of parts is reduced and the structure is simplified, the assembling property thereof, particularly the guide mechanism 1 into the extremely thin shaft portion 14, is provided.
6, the jaw 18, the push rod 20, the jaw closing member 22, and the clip supply mechanism 24 have an advantage in accommodating each component. Next, the assembling procedure will be described.

[9] Assembling Procedure First, before inserting the component into the guide pipe 144 in the shaft portion 14, a plurality of clips C and a clip push-out bar 166 are previously provided inside the clip case 162 to which the jaws 18 are welded. , Clip spring 168 is set, clip case 162 and clip case cover 16
4 and 4 are coupled by the procedure of FIG. 12 as already described, and the guide mechanism 16 is assembled. Further, the cut-and-raised part 242b of the clip carrier 242 is connected to the reset bar 2
The spring shaft 245 is inserted through the opening 248a of the spring shaft 245 into the slit at the rear end of the spring shaft 245, and the reset spring 244 is arranged on the outer periphery of the spring shaft 245.
5 is inserted into the cylindrical portion 248b of the reset bar 248, and the clip carrier 242, the reset spring 244, the spring shaft 245, and the reset bar 248 are integrally assembled. Then, the tubular portion 248b of the reset bar 248 is further inserted into the rear end of the guide mechanism 16.

The shaft portion 246a of the locking member 246 is fitted in the bearing recess 202d of the elongated hole 202b of the push rod rear 202.

Next, the push rod rear 202 is inserted into the guide pipe 144 from the rear end. To some extent
When the push rod rear 202 is inserted into the guide pipe 144, the rear end of the clip carrier 242 integrally assembled with the clip carrier 242, the guide mechanism 16 and the like is put on the tip of the push rod rear 202 from above. At this time, be careful that the projecting portion 246b of the locking member 246 is locked in the locking hole 242c of the clip carrier 242. Then, the push rod rear 202 is inserted into the guide pipe 144 together with the clip carrier 242, and when the push rod rear 202 is almost inserted into the guide pipe 144, the push rod rear 202 and the push rod front 204 are inserted. Push rod front 204
Also insert together. Further, together with the clip carrier 242, the spring shaft 245, which is previously assembled integrally,
The reset spring 244, the reset bar 248, the guide mechanism 16 and the jaw 18 are also inserted into the guide pipe 144 together. And the push rod front 20
4 is almost inserted into the guide pipe 144, the jaw closing member 22 is connected to the push rod front 204 and inserted into the guide pipe 144. Then, the protrusions 18d and 18d of the jaw 18 are pushed into the opening 144b of the guide pipe 144 and fixed. From the rear end of the guide pipe 144, the receiving portion 202a of the push rod rear 202 that is inserted first projects.

As described above, the insertion into the guide pipe 144 is easily completed. Next, the trigger 123 of the handle portion 12 that has been assembled in advance is pulled, the push bar 126 is moved forward, and the receiving portion 126f thereof is projected from the tip opening of the handle portion 12. When the receiving portion 202a of the push rod rear 202 protruding from the rear end of the guide pipe 144 is connected to the receiving portion 126f of the push bar 126 and the trigger 123 is released, the push bar 126 and the push rod 126 are released. Rear 202
The rear end is pulled into the handle portion 12. Finally, the rotation knob 142 is passed through the front end of the guide pipe 144 and screwed into the rotation piece 130 of the handle portion 12,
The flange 144a at the rear end of the guide pipe 144 is attached to the rotating top 1.
The handle portion 12 and the shaft portion 14 are completely connected by being sandwiched by the 30 and the rotary knob 142. With the above work, the assembly is completed.

As described above, the number of parts is reduced as compared with the conventional product, and the small spring parts and the like are reduced to simplify the structure, so that the assembly is very simple. .

[10] Modification of Clip Supply Mechanism FIG. 27 is a view showing another configuration of the clip supply mechanism 34. The clip supply mechanism 34 in this modified example has a clip carrier 342 extending in the axial direction of the shaft portion 14.
A reset spring 244 (biasing means) that biases the clip carrier 342 axially rearward, and the spring shaft 2 around which the reset spring 244 is wound.
45, and a locking member 346 fitted in the push rod rear 202 and capable of swinging laterally, that is, in the left-right direction.
And a reset bar 348 that engages with an engagement hole 162d formed at the rear end of the clip case 162. The same members as those in the above-mentioned configuration are designated by the same reference numerals.

The clip carrier 342 differs from the clip carrier 242 in that not the locking hole 242c but a notched hole 342c whose side portion is notched is formed. The cutout hole 342c is located in the rear portion and is cut out larger than the center line of the clip carrier 342 in the left-right direction, and the cutout hole 342c is not as large as the first cutout hole 342c1.
The second notch hole 342c2 is located at the front and is cut out to be smaller than the center line in the left-right direction. In other respects, it is almost the same as the clip carry 242.

The locking member 346 is a leaf spring made of metal, is fitted in the elongated hole 202b of the push rod rear 202, and has one end attached to the elongated hole 202b of the push rod rear 202. In addition, a locking portion 346b protruding from the long hole 202b is formed on the top portion, and the locking portion 346b can swing in the left-right direction around the attachment point within the long hole 202b. There is.
The locking member 346 is normally biased by the elasticity of its leaf spring so as to be parallel to the axial direction in the elongated hole 202b, and the locking portion 346b is provided with the cutout hole 342c of the clip carrier 342. Is locked in the first cutout hole 342c1.

At the rear end of the reset bar 348, a cam surface 348d that spreads in the left and right direction as it goes forward.
Are formed. The cam surface 348d engages with the locking member 346, and locks the locking portion 34 of the locking member 346.
6b is moved in the lateral direction, that is, in the left-right direction, to retract the clip carrier 342.

The clip supply mechanism 34 configured as described above also operates similarly to the clip supply mechanism 24. That is, when the push rod rear 202 moves forward,
The locking member 346 moves forward together, and the locking portion 346b of the locking member 346 causes the first cutout hole 342 of the clip carrier 342 to move.
Since it is locked to c1, the clip carrier 342
Move forward together. Clip carry 342 moves forward,
It is shown in FIG. 2 that the tip pushes the leading clip C and guides it between the jaw elements 18a, 18a of the jaw 18.
As shown in FIG. Next, the locking portion 346b of the locking member 346 is moved to the cam surface 3 at the rear end of the reset bar 348.
Interferes with 48d. As shown in FIG. 29, this cam surface 3
The locking member 346 is swung in the left-right direction by 48d, and the locking portion 346b of the locking member 346 is retracted from the first cutout hole 342c1 of the clip carrier 342. As a result, the clip carrier 342 is locked by the locking member 346.
In order to be released from the vehicle, it is retracted by the biasing force of the reset spring 244.

When the work of applying the clip C is completed,
When the push rod rear 202 retracts, the locking member 3
46 is also retracted, the locking portion 346b passes through the second cutout hole 342c2 of the clip carrier 342, and the first cutout hole 3 of the clip carrier 342 already retracted forward.
Re-engage with 42c1.

In this way, similarly to the clip supply mechanism 24, the clip supply mechanism 34 can be constructed using the locking member 346 made of a leaf spring.

[0080]

As described above, according to the present invention, the number of parts is small, the structure is simple, and the assembling is easy.

[Brief description of drawings]

FIG. 1 is an overall perspective view of a clip applying device of the present invention.

FIG. 2 is a diagram showing an internal configuration of the handle portion when the grip left case is removed.

FIG. 3 is a side view of a push bar of a handle portion.

FIG. 4 is a side view of a ratchet member of a handle portion.

FIG. 5A is a perspective view of a rotating top of the handle portion;
(B) is a semi-longitudinal sectional view.

FIG. 6A is a diagram showing an internal configuration in the middle of pulling the trigger as seen when the grip left case of the handle portion is removed, and FIG. 6B is a diagram showing the ratchet teeth of the push bar and the ratchet member of the ratchet member. FIG.

FIG. 7 is a diagram showing an internal configuration showing a state in which the grip left case of the handle portion is removed and the trigger is completely pulled.

FIG. 8A is a view showing an internal configuration in the middle of returning the trigger as seen after removing the grip left case of the handle portion, and FIG. 8B is an enlarged view of the ratchet teeth of the push bar and the ratchet teeth of the ratchet member. Is.

FIG. 9 is a vertical cross-sectional view of a rotating top and a shaft portion.

FIG. 10 is an exploded perspective view of the guide mechanism.

FIG. 11 is a cross-sectional view of the guide mechanism.

FIG. 12A is a perspective view showing a state in which the clip case cover and the clip case are joined together, and FIG. 12B is a perspective view showing a state in which the clip case cover and the clip case are joined together.

FIG. 13 is a perspective view of a guide mechanism, a jaw and a clip carrier.

14 (a) is a plan view, FIG. 14 (b) is a side view, FIG.
(C) is a bottom view.

FIG. 15 is an exploded perspective view of a push rod.

FIG. 16 (a) of the push rod rear is a plan view,
(B) is a longitudinal sectional view.

FIG. 17 is a perspective view of a jaw closure member.

18 (a) is a plan view and FIG. 18 (b) is a longitudinal sectional view of the jaw closing member.

FIG. 19 is a view showing a relationship between a jaw and a jaw closing member, (a) showing a state in which a cam surface of the jaw closing member is behind a cam surface of a jaw element of the jaw, and (b).
Shows the cam surface of the jaw closure member engaged with the cam surface of the jaw element of the jaw.

FIG. 20 is a vertical cross-sectional view of a part of the clip supply mechanism.

FIG. 21 is an enlarged vertical sectional view of a part of the clip supply mechanism.

FIG. 22 is a perspective view showing the vicinity of the clip carry, the guide mechanism, and the tip of the jaw.

FIG. 23 is a perspective view showing the vicinity of the rear end of the clip carrier.

24 (a) is a plan view and FIG. 24 (b) is a side view.

FIG. 25 is a perspective view showing the vicinity of the tip of the clip carry, the guide mechanism, and the jaw, showing a state in which the clip carry has advanced.

FIG. 26 is an enlarged vertical cross-sectional view of a part of the clip supply mechanism, showing a state where the locking member interferes with the cam surface of the reset bar.

FIG. 27 is a perspective view showing the vicinity of the rear end of the clip carry, showing a state where the locking member interferes with the cam surface of the reset bar.

FIG. 28 is a perspective view of a main part showing a modified example of the clip supply mechanism.

FIG. 29 is a perspective view showing the vicinity of the rear end of a clip carrier of a modified example of the clip supply mechanism, showing a state in which the locking member interferes with the cam surface of the reset bar.

[Explanation of symbols]

12 Handle 14 Shaft 16 induction mechanism 162 clip case 164 clip case cover 162f Elastic piece (blocking means) 166 clip push-out bar (blocking means) 168 clip spring 18 Joe 20 push rod 22 Jaw closure 24 clip supply mechanism 242 clip carry 242d Stopper piece 244 Reset spring (biasing means) 246 locking member 246a Shaft part (pivot part) 246b Overhanging part (locking part) 246d leaf spring part 248 reset member 248d cam surface 34 Clip supply mechanism 342 clip carry 346 locking member 346b Locking part 348 reset member 348d cam surface

Claims (6)

[Claims] 1. A handle portion, a shaft portion extending from the handle portion to a tip side, and fixed in the shaft portion,
A guide mechanism for guiding a plurality of clips arranged in series in the shaft portion in the axial direction, and a pair of jaw elements arranged near the distal end portion of the shaft portion and movable between a separated position and a close position. A jaw provided with the push rod, which extends in the shaft portion and is movable in the axial direction in response to an operation of the handle portion; and a jaw element of the jaw is moved to a close position in response to the axial movement of the push rod. A jaw closure member for causing the jaws to move, and a clip supply mechanism disposed in the shaft portion for sequentially pushing the clips one by one between the pair of jaw elements of the jaws,
A surgical clip applying device for applying a clip to body tissue, wherein the clip supply mechanism extends inside a shaft part and supplies a clip between the jaw elements,
An elastically deformable lock having an urging means for urging the clip carrier axially rearward, and a lock part attached to the push rod and elastically repulsed by its own elastic force in the direction of locking the clip carrier. And a reset member that is fixed in the shaft portion in front of the locking member and moves the locking portion of the locking member to a non-locking position with the clip carrier. Clip attachment device. 2. The locking member has a "V" shape, a locking portion for locking the clip carrier is provided on the top of the locking member, and one side of the locking member is pivotally attached to the push rod. And a leaf spring portion on the other side, and the reset member has a cam surface that acts on the locking member to press the locking portion downward. The surgical clip applying apparatus according to claim 1, wherein: 3. The locking member is formed of a leaf spring and is attached to the push rod so as to be swingable in the left-right direction, and a locking portion for locking the clip carrier is provided at the top of the locking member. The surgical clip applying apparatus according to claim 1, wherein the reset member has a cam surface that acts on the locking member to press the locking portion leftward or rightward. 4. A guide means is provided in the guide mechanism to prevent the clip carry from retracting when the last clip is pushed between the jaw elements by the clip carry, the rear end of the clip carry comprising: The surgical clip applying apparatus according to claim 1, further comprising a stopper piece portion that prevents the push rod from retracting. 5. The surgical clip applier according to claim 1, wherein the jaw closing member is integrally connected to the push rod. 6. The guide mechanism includes a clip case and a clip case cover that covers the upper side of the clip case, and the clip case and the clip case cover are coupled to each other to define a clip case internal space. A clip spring for urging the clip forward is disposed in the clip case inner space, and the spring force from the rear end of the clip spring is received by either the clip case or the clip case cover. With
The clip case and the clip case cover are joined by sliding one of the clip case and the clip case cover relatively rearward with respect to the other, and the clip case and the clip case cover are combined. The surgical clip applier according to any one of claims 1 to 5, wherein the connection is released by sliding one of the slides forward relative to the other.