CN102727276A - Tissue hemostasis clamping device - Google Patents
Tissue hemostasis clamping device Download PDFInfo
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- CN102727276A CN102727276A CN2012102328030A CN201210232803A CN102727276A CN 102727276 A CN102727276 A CN 102727276A CN 2012102328030 A CN2012102328030 A CN 2012102328030A CN 201210232803 A CN201210232803 A CN 201210232803A CN 102727276 A CN102727276 A CN 102727276A
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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 a kind of tissue hemostasis clamping device, specifically, is a kind of clamping device that is used under the scope reaching through the clamping biological tissue hemostasis purpose.
Background technology
Gastronintestinal system, digestive system, biliary system, vascular system and other body cavitys and hollow organ's pathologic is hemorrhage to be the common emergency case of internal medicine; Merely through Drug therapy; The course of treatment is long; Side effect is big, have in addition be in peril of one's life, must cure through endoscopic surgery in case of necessity and just can reach the hemostatic purpose.And along with the technological development of scope lower hemostasia, the hemostasis of application hemostatic clamp has become first-selection under the scope.In the most simply using; The hemostatic clamping device is extend into the tissue of depths in the body through the working clamp road of endoscope; At the desired position place, with above-mentioned folder promptly, after this clip is separated with the control assembly of near-end the edge around the bleeding tissue; And remain in the body said, make wound closure to allow the normal healing process.
In the prior art, use following hemostasis clamping device, so that biological tissue is carried out clamping:
The patent No. at U.S.'s bulletin is among the patent of invention ENDOSCOPIC HEMOSTATIC CLIPPING APPRATUS of US8062311B2; Clip is separately two; Be connected with a stress part jointly; Be accommodated in the cinch tube, intermediate plate moves in the gap of cinch tube, and under the compressing on cinch tube both sides, makes the intermediate plate closure with grasping tissue.
The patent No. at U.S.'s bulletin is among the patent of invention CLIP APPARATUS FOR LIGATURING LIVING TISSUE of US 7854739 B2; Clip is the one bending; Have a pair of elasticity intermediate plate to be opened/closed, be stuck in one that can rupture and with grab that the rear end functional unit links to each other on, through applying pulling force backward; The semicircle that the intermediate plate bending forms is out of shape under the compressing of cinch tube, thereby forces the closed clamping of accomplishing tissue of intermediate plate.
Clamping device in the 2004-121285 patent of japanese publication; Clip has a pair of intermediate plate that receives the pulling force expansion; To push in addition to manage to wrap to be embedded in makes a pair of folder closure get up to grasp tissue on the clip; And utilize cinch tube that a pair of intermediate plate is kept closed, thus biological tissue is carried out clamping.
The clamping device of the disclosed 03/030746A1 patent of WIPO is connected with clip at the bourdon tube front end, and this clip has a pair of clip to be opened/closed foot.In addition, the foot of intermediate plate is drawn in make in the cinch tube that clip foot is closed to grasp 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 the pressing component (cinch tube), and it is taken in through sheath.Through the advance and retreat of an advance and retreat limiting mechanism restriction pressing component,, clip is advanced and retreat and opening and closing with respect to pressing component, thereby biological tissue is carried out ligation again by operating line push-and-pull clip at the sheath leading section.
In the patent No. that China announces is in the application for a patent for invention hemostasis clamping 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 linkage are contained in the utricule, the opening and closing of the promotion control clip through the control cable, simultaneously; When connector bears predetermined power, break off, clip and control cable are separated.
When actual clinical was used, because the normal creepage of gastrointestinal functions of body cavities, clip was closed into a half, and with the slippage of organizing of treating clamping, need open clip this moment again, carries out the secondary clamping easily; 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 hemostatic purpose; Therefore, if biological tissue is carried out unsuitable clamping, then do not have the hemostatic purpose.During clinical use, the operation doctor is down auxiliary the endoscope visual field, can judge at first that whether clip has carried out clamping to the correct position of tissue, just can discharge clip then.But; Hemostasis clamping device in the above-mentioned patent documentation; Perhaps under the compressing of cinch tube, be out of shape and can't open again because of the meeting in the process of closure of two intermediate plates; Perhaps, perhaps can't open again because lack stationary positioned between cinch tube and the sheath flexible pipe because the cinch tube bag is embedded on two intermediate plates stuckly and can not open once more.When the object tissue of finding ligation clinically is improper, can only clip be broken like this, withdraw from remaining clamping device then, send into new clip more in addition, so just cause waste or incured loss through delay the time of the valuable processing of doctor.And, the hemostasis clamping device in the above-mentioned patent documentation, owing to receive the restriction of receiving clamping structure, isolating construction: the certain structures complicacy can only adopt the Sheet Metal Forming Technology manufacturing, inevitably has sharp corner, causes the damage of pincers road and body cavities easily; The length of some cinch tube and push-and-pull pipe is longer, causes clip length overall overlength (surpass 20mm), in endoscope is in human body, under the situation of head-bent, is difficult to through its bending section; Some clip is kept somewhere intravital part overlength (16mm nearly); At small space or in than the thin-walled tract; When the body cavities normal creepage of gastrointestinal functions, very easily scratch causes its scuffing or perforation to the normal structure of opposite tract wall; And keep somewhere the sharp corner of intravital cinch tube, also rapid wear hurts tissue; In addition; Some also can't be accommodated in clip in the sheath flexible pipe, and the claw of intermediate plate exposes outside sheath, in the time of in the pincers road such as the insertion endoscope of like this clamping device being run through; Just have claw damage pincers road inwall, or claw hangs on the pincers road inwall and the probability that required insertion strength is increased.
Summary of the invention
In order to solve above-mentioned technical problem, the purpose of this invention is to provide a kind of tissue hemostasis clamping device, have simple and reasonable, characteristics such as clamping is reliable and stable, repeatedly clamping in advance again, clip indwelling volume is little, profile is bright and clean.
In order to reach above-mentioned purpose, the technical scheme below the present invention has adopted:
A kind of tissue hemostasis clamping device comprises clip, relieving mechanism, traction component, Handleset and epitheca pipe; Said traction component comprises traction steel wire and sheath flexible pipe; Said epitheca pipe is taken in said clip and relieving mechanism wherein; Said clip comprises: can have bare terminal end and push-and-pull end in external force control switching and to the stop blooding intermediate plate of clamping of biological tissue down; Be fixedly connected the connector that is integral with the push-and-pull end of said intermediate plate; Be used to take in the push-and-pull end of said intermediate plate and the cinch tube of connector, the slip of can in this cinch tube pipeline, advancing and retreat of the push-and-pull end of said intermediate plate and connector; When rear portion that the push-and-pull end and the connector of said intermediate plate moves to cinch tube, connector is fixed through anti-loose structure and cinch tube snapping, and the bare terminal end of said intermediate plate is closed up by the front portion effect of cinch tube; The front portion of said cinch tube is set with the intermediate plate spacing block that moves forward, and the jig arm of said intermediate plate is provided with retreats spacing closed stop to intermediate plate; Said relieving mechanism comprises: be positioned at the push-and-pull pipe of cinch tube pipeline, the front portion of push-and-pull pipe is connected with connector with the connected mode that can when bearing above predetermined pull, lose efficacy, and the rear portion of push-and-pull pipe is fixedly connected traction steel wire; Connection tube, the front portion of connection tube is connected through 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 the sheath flexible pipe; When the push-and-pull pipe moved to the rear portion of cinch tube, the push-and-pull pipe made connection tube and cinch tube releasing knot that can be undone by a pull be connected through removing structure.
In the technique scheme, intermediate plate and connector fuse, and connector and push-and-pull pipe constitute isolating construction for the first time; Thereby the push-and-pull pipe drives advance and retreat by traction steel wire and makes the motion that intermediate plate can be level and smooth in cinch tube; Realize opening through intermediate plate self elasticity, realize the closure of intermediate plate through the front portion effect of cinch tube, because cinch tube is connected with the connection tube knot that can be undone by a pull; Connection tube is fixed on the sheath flexible pipe; Can cinch tube be carried out relative fixed like this, traction steel wire can be controlled the folding of intermediate plate through slide handle moving forward and backward on handle, repeatedly repeats to open and close preparatory clamping.Intermediate plate receives to move past in the journey after the traction steel wire pulling, after move on to ad-hoc location after, connector is fixed through anti-loose structure and cinch tube snapping, this rear jaw can't be opened; When moving after the continuation, intermediate plate by after move spacing can't moving, and the pulling force of traction steel wire continue to increase, and when the pulling force on the handle during greater than the predetermined release force that requires, is connected inefficacys between push-and-pull pipe and the connector, the push-and-pull pipe breaks away from connector, the realization separation first time; Push-and-pull pipe and connector break away from continued and move backward; The push-and-pull pipe ejects the knot that can be undone by a pull that is connected with cinch tube on the connection tube through removing structure; Cinch tube and connection tube break away from, and the push-and-pull pipe is pulled out from cinch tube, realize separating for the second time; Clip separates with single unit system like this, and is stranded in the living body biological tract.Like this, the cinch tube structure is simple relatively, can adopt injection mo(u)lding, any surface finish; The cinch tube relative fixed can be carried out repeatedly clamping in advance, and is easy to operate, accurate positioning; After the clamping, clip is locked through anti-loose structure fully, and clamping is reliable and stable, keeps somewhere intravital clip and only comprises intermediate plate, connector and cinch tube; Advantages of small volume, profile is bright and clean, can not cause tissue injury.
As preferably, said push-and-pull pipe is connected with connector through brace, and said intermediate plate, brace and connector link into an integrated entity through embedded injection moulding.Simple in structure like this, easily manufactured, be connected firmly, profile is bright and clean.
As preferably, said intermediate plate is processed via rubber-like sheet metal bending forming, and said brace is the sheet metal of flat, which is provided with dog hole.The front portion of said 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 said brace, connector and intermediate plate, when said push-and-pull pipe bears above predetermined pull; Crotch is straightened, and is connected inefficacy between push-and-pull pipe and the brace.Adopt the crotch structure as the isolating construction first time, simple in structure small and exquisite, easily manufactured, connect reliable.
As preferably, said connector and said cinch tube cooperate guiding to slide through groove, tongue.Through the guiding slide construction, make that the slip of connector is more level and smooth, respective outer side edges is more accurate.
As preferably, said anti-loose structure is meant that said connector is provided with barb, and the skewback on this barb and the cinch tube is detained mutually.Simple in structure like this, connect reliable.
As preferably, said connection tube front portion is provided with at least two can elasticity expand the cantilever of opening and withdrawing, and cantilever is provided with convex closure, and said convex closure can buckle into and form knot that can be undone by a pull in the button hole on the cinch tube and connect.Simple in structure like this, connection cooperates reliable.
As preferably, said releasing structure is meant, the rear portion of push-and-pull pipe is provided with the inclined-plane that can the convex closure on the connection tube be ejected button hole on the cinch tube or protruding.Simple in structure like this, connection cooperates reliable.
Compared with prior art, advantage of the present invention and good effect are: intermediate plate and connector are linked to be an integral body, can be in the cinch tube pipeline level and smooth advance and retreat; And two jig arm of intermediate plate are opened and closed repeatedly, and cinch tube is carried out relative fixed, this just makes the hemostasis clamping device that the repeatedly clamping of biological tissue is become possibility; General, intermediate plate can open and close more than five times at least repeatedly, is beneficial to the hemostasis clamping device is placed on optimal position; Reach best haemostatic effect; Avoided sending into new clip again, both alleviated doctor's workload, for the patient gets valuable treatment time owing to unsuitable clamping; Reduce the operation cost again, reduced waste.Simultaneously, the present invention has shortened clamping device greatly and has been detained the length that inside of human body divides, and has avoided causing owing to long indwelling part the scuffing or the perforation of human intracavity road normal structure, has reduced postoperative risk.
Description of drawings
Fig. 1 is the structural representation of the hemostasis clamping device of embodiment 1;
Fig. 2 is accommodated in the viewgraph of cross-section in the epitheca pipe for embodiment 1 with clip;
Fig. 3 stretches out the open viewgraph of cross-section of epitheca pipe for embodiment 1 clip;
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 soft handle pipe of embodiment 1 and the sketch map that is connected of epitheca pipe;
Figure 14 is the connection sketch map that is used for illustrative embodiment 1 intermediate plate clip when fully closed;
Figure 15 is used for the sketch map that illustrative embodiment 1 brace and push-and-pull pipe pull;
Figure 16 is used for the sketch map that illustrative embodiment 1 push-and-pull pipe ejects connection tube;
Figure 17 is used for illustrative embodiment 1 cinch tube and the isolating sketch map of connection tube;
Figure 18 is used for illustrative embodiment 1 clip to be released the sketch map that flexible member is recalled;
Figure 19 is the cutaway view of second embodiment of chuck of the present invention;
Figure 20 is the axonometric chart of 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 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 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
Do a detailed explanation below in conjunction with the accompanying drawing specific embodiments of the invention.
Embodiment 1:
A kind of tissue hemostasis clamping device as shown in Figure 1 comprises clip 100, relieving mechanism 200, traction component 300, Handleset 400 and epitheca pipe 500; Said traction component 300 comprises traction steel wire 310 and sheath flexible pipe 320; Said epitheca pipe 500 is taken in said clip 100, relieving mechanism 200 and traction component 300 wherein; Said clip 100 comprises: can have bare terminal end and push-and-pull end in external force control switching and to the stop blooding intermediate plate 110 of clamping of biological tissue down; Be fixedly connected the connector 130 that is integral with the push-and-pull end of said intermediate plate 110; Be used to take in the cinch tube 120 of the push-and-pull end and the connector 130 of said intermediate plate 110, the slip of can in these cinch tube 120 pipelines, advancing and retreat of the push-and-pull end of said intermediate plate 110 and connector 130; When the push-and-pull end of said intermediate plate 110 and connector 130 moved to the rear portion of cinch tube 120, connector 130 was fixed through anti-loose structure and cinch tube 120 snappings, and the bare terminal end of said intermediate plate 110 is closed up by the front portion effect of cinch tube 120; The front portion of said cinch tube 120 is set with the intermediate plate 110 spacing block 150 that moves forward, and the jig arm of said intermediate plate 110 is provided with retreats spacing closed stop 113 to intermediate plate 110.Said 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 connected with connector 130 with the connected mode that can when bearing above predetermined pull, lose efficacy, and the rear portion of push-and-pull pipe 220 is fixedly connected traction steel wire 310; Connection tube 210, the front portion of connection tube 210 is connected through 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 moved to the rear portion of cinch tube 120, push-and-pull pipe 220 made connection tube 210 be connected with cinch tube 120 releasing knots that can be undone by a pull through removing structure.
In the present embodiment, said push-and-pull pipe 220 is connected with connector 130 through brace 140, and said intermediate plate 110, brace 140 and connector 130 link into an integrated entity through embedded injection moulding.Said intermediate plate 110 is processed via rubber-like sheet metal bending forming; Said brace 140 is the sheet metal of flat; Which is provided with dog hole 141, the front portion of said push-and-pull pipe 220 is provided with crotch 221, and 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 said brace 140, connector 130 and intermediate plate 110; When said push-and-pull pipe 220 bore above predetermined pull, crotch 221 was straightened, and was connected inefficacy between push-and-pull pipe 220 and the brace 140.Said connector 130 cooperates guiding to slide with said cinch tube 120 through groove 131, tongue 125.Said anti-loose structure is meant that said connector 130 is provided with barb 132, and this barb 132 is detained with the skewback 122 on the cinch tube 120 mutually.Said connection tube 210 front portions are provided with two can elasticity expand the cantilever 217 of opening and withdrawing, and cantilever 217 is provided with convex closure 211, and said convex closure 211 can buckle into and form the knot that can be undone by a pull connection in the button hole 124 on the cinch tube 120.Said releasing structure is meant that the rear portion of push-and-pull pipe 220 is provided with the inclined-plane 224 that can the convex closure on the connection tube 210 211 be ejected button hole 124 on the cinch tube 120.
The building block and the structure of each assembly are detailed respectively below.
Said clip 100, with other parts of tissue hemostasis clamping device be detachable structure, it is by intermediate plate 110, cinch tube 120, the connector 130 of embedded injection moulding, brace 140 is formed with block 150, that can advance and retreat is accommodated in epitheca pipe 500 tube chambers; Intermediate plate 110 is linked to be an integral body with brace 140 through embedded moulding 130, in cinch tube 120 pipelines 127, slides jointly; Cinch tube 120 is the tubular of hollow, and its rear end and connection tube 210 are connected through knot that can be undone by a pull, and after knot that can be undone by a pull was ejected, cinch tube 120 was released together with clip 100; Block 150 is connected in cinch tube 120 front aperture 121 through welding or mode such as hinged, and two jig arm 112 up and down of intermediate plate 110 are separated in its both sides; Clip described in the present embodiment 100 is processed by the material that satisfies biocompatibility such as rustless steel, medical high polymer, NiTi etc.
Said relieving mechanism 200 is made up of connection tube 210 and push-and-pull pipe 220, and connection tube 210 is a hollow housing, and its front end is connected with cinch tube 120 knots that can be undone by a pull through convex closure 211, and the rear end is provided with the shoulder hole 213 that is connected with flexible hose 320; Push-and-pull pipe 220 is the substantial cylindrical shape, and its front end is established crotch 221 and linked to each other with long lumbar hole 141 on the brace 140, and rear end deep hole 226 links together through modes such as welding or crimping with traction steel wire 310, to transmit push-pull effort; Connection tube 210 described in the present embodiment can be processed by the stainless steel metal material that satisfies biocompatibility with push-and-pull pipe 220.
Said traction component 300 is by traction steel wire 310, and flexible hose 320 is formed with conduit 330, is elongated flexible member, so that the working clamp road of this device through endoscope extend into depths in the body, clip 110 delivered to the destination organization place; In the present embodiment; Said traction steel wire 310 is single stainless steel metal filament; Also can be entwined, or, be any other elongated, flexible metal steel cable that is fit to as alternative by the multiply filament; Its front end links to each other with push-and-pull pipe 220; The rear end links to each other with slide handle 420 through the conduit 330 that it go up to connect, and through sliding and in flexible hose 320, do relative advance and retreat motion in the front and back of slide handle 420 in the groove 412 of handle 410, and push-pull effort is passed to clip 110 so that it does switching moves; Said flexible hose 320 is formed by stainless flat wire compact winding for having elasticity and certain inflexible spring hose being arranged, or as alternative, is any other suitable hollow, flexible structure.
Said Handleset 400 is by handle 410, and slide handle 420 is formed with soft handle pipe 430, as doctor's handheld component, and the opening and closing of control far-end intermediate plate 110; Handle 410 is provided with thumb rings 411, cooperates with slide handle 420 both sides forefinger chutes 421, can make the doctor operate slide handle 420 front and back on the groove 412 of handle 410 easily and move; It is outer near handle side that soft handle pipe 430 is enclosed within epitheca pipe 500, can spur epitheca pipe 500 and make it to relatively move with flexible hose 320; In the present embodiment, handle 410 and slide handle 420 be by macromolecular material such as ABS, PC, and injection mo(u)ldings such as PE, soft handle pipe (430) adopts materials such as silica gel or rubber to process.
Said epitheca pipe 500 is elongated flexible, hollow tubulose structure, and smooth and its size of its surfaces externally and internally receives the size restrictions in endoscope working clamp road, is used for said clip 100, and relieving mechanism 200 and traction component 300 are taken in wherein; In the present embodiment, epitheca pipe 500 is processed by single tract PE plastic tube.
With reference to Fig. 2 and Fig. 3 clip 100 opening and closing processes are described below.Act on the pulling force on the Handleset 400; Pass to clip 100 through traction component 300 and relieving mechanism 200; Brace 140 is moved in the pipeline 127 of cinch tube 120 with injection moulding all-in-one-piece intermediate plate 110 backward; Two jig arm 112 of intermediate plate 110 are limited in motion in the space " D " of block 150 and cinch tube 120, and close up each other under the compressing of inwall 128 up and down in cinch tube.When protruding folder end of intermediate plate 110 111 and recessed folder end 116 are drawn close and during butt, clip is closed fully each other.Same, after clip 100 exposes epitheca pipe 500, act on the thrust on the Handleset 400; Pass to clip 100 through traction component 300 and relieving mechanism 200, make brace 140 with the motion forward in the pipeline 127 of cinch tube 120 of injection moulding all-in-one-piece intermediate plate 110, and under the separation of block 150; Separate gradually; Two jig arm 112 of intermediate plate 110 are opened, and when advancing during the face of placing restrictions on 152 butts of embedded moulding 130 front end faces 134 and block, clip 100 can not continue to move forward again; This moment, intermediate plate 110 was flared to maximum, and aimed at clamping object tissue A down assisting of endoscope.
With reference to Fig. 4 to Figure 10 the structure of clip 100 is described below, the clip described in the present embodiment is by intermediate plate 110, cinch tube 120, and embedded moulding 130, brace 140 is formed with block 150.
With reference to Fig. 4, Fig. 5 and Fig. 6, said intermediate plate 110 is used for biological tissue pressed from both sides and closes, and it can be an one; Also can be two-piece type, in the present embodiment, intermediate plate 110 be to adopt the integrated punching molding; It has two symmetric jig arm 112, recessed folder end 111, protruding folder end 116; Closed stop 113, the big bent angle 118 of chuck small bend angle 117 and jig arm.The main effect of said jig arm 112 is to form certain space in clip 100 closed backs, and biological tissue is clamped in the said 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) make-up each other gets up; Symmetric jig arm (112) both sides that are located at of closed stop (113) realize that through the alar part of bending on jig arm angle together it mainly acts on is after clip 100 complete closures, and restriction clip 100 continues to get in cinch tube 120 pipelines; The bending of chuck small bend angle 117 through recessed folder end 111 and protruding folder are held 116 certain angles invaded the certain depth organized with grasping tissue to form big relatively size when clip 100 opens; The big bent angle 118 of jig arm is through the bending of certain angle, so that intermediate plate 110 forms the span of opening of " L ", helps grasping the tissue of bulk.
With reference to Fig. 8 a, Fig. 8 b and Fig. 9, cinch tube 120 is the general cylindrical shape shape, and its front end is provided with the hole 121 that is connected with block 150, and block 150 can be through welding, riveted joint, and hinged or any other inflexible affixed mode is connected in its hole; The rear end is provided with the irregularly-shaped hole 124 that is connected with connection tube 210 knots that can be undone by a pull; Barb 132 on the skewback 122, 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 cooperates with groove 131 on the embedded moulding 130, and clip 100 is moved along guiding is level and smooth in cinch tube pipeline 127.
With reference to Fig. 5, embedded moulding (connector) 130 is the substantial cylindrical shape, and it is linked to be an integral body with intermediate plate 110 and brace 140, common slip of in cinch tube pipeline 127, advancing and retreat.In the present embodiment, said embedded moulding 130 is by medical macromolecular materials that satisfy biocompatibility such 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.Said connection tube 210 is a hollow housing, and front end is provided with symmetric convex closure 211, this convex closure 211 place can elastic expansion open and the cantilever 217 of withdrawing on, when installing, expand slightly and open cantilever 217, convex closure 211 is put into the irregularly-shaped hole 124 of said cinch tube 120; Front end shoulder hole 216, thin stepped end 129 matched in clearance of itself and cinch tube 120 afterbodys; After rear end shoulder hole 213, an end face of itself and flexible hose 320 insert and butt lives the bottom surface, connect through welding, crimping, hinged or any other inflexible affixed mode; Afterbody chamfering 214, its any sharp-pointed corner angle, edge are all removed with the form of said 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.Said push-and-pull pipe 220 is the 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 the push-and-pull pipe axial vane surface is designed to make brace 140 thickness directions to pass through, but long lumbar hole 141 is laterally deviate from; Symmetric inclined-plane 224 and plane 223 with certain angle processed in the centre; When said push-and-pull pipe 220 is retreated with respect to said cinch tube 120; Inclined-plane 224 contacts the convex closure 211 on the connection tube 210 earlier, and convex closure 211 is moved upward with respect to inclined-plane 224, finally arrives the plane 223 of push-and-pull pipe 220; Cantilever 217 is expanded open, convex closure 211 is ejected in the irregularly-shaped hole 124 of cinch tube 120; Rear end deep hole 226 and traction steel wire 310 link together through welding, crimping, hinged or any other inflexible affixed mode, to transmit push-pull effort.
With reference to Figure 14 to Figure 18 operation principle and the use of tissue hemostasis clamping device are elaborated below, in this embodiment, will organize the use that combines of stop blooding clamping device and endoscope.
With reference to Fig. 1 and Figure 14, at first, staff inserts thumb in the thumb annular distance 411 of handle 410; And forefinger and middle finger held the both sides chute 421 of slide handle 420 respectively, the pulled backwards slide handle 420 then, make it in the groove 421 of handle, to move backward; And pulling force is passed to the push-and-pull pipe 220 that connects on it through traction steel wire 310; Make it drive brace 140 and move backward with injection moulding all-in-one-piece intermediate plate 110, close up each other under the compressing of two jig arm 112 of intermediate plate 110 inwall 128 about cinch tube, the span " L " of opening of intermediate plate 110 is also dwindled gradually; When protruding folder end of intermediate plate 110 111 and recessed folder end 116 draw close each other and butt after; Clip is closed fully, promotes soft handle pipe 430 this moment to away from handle 410 side shiftings, and the clip 100 that the epitheca pipe 500 that connects on it can will be closed up is taken in wherein fully; Like this better protection clip, also avoid the sharp intermediate plate of clip 110 corner angle to scratch the pincers road.Then, be inserted in the endoscope working clamp road, slowly insert and send, under the visual field, can observe clip 100, and, make it near focus A by the approximate location that endoscope adjusts clip 100 in endoscope with drawing good tissue hemostasis clamping device in.Next, pulling soft handle pipe 430 drives the epitheca pipe 500 relative flexibility flexible pipes 320 that connect on it and moves near handle 410 side shiftings, and clip 100 is exposed outside the epitheca pipe 500 fully.
Next; Promote slide handle 420 forward; Make it in the groove 421 of handle, to move forward, and, two jig arm 112 of intermediate plate 110 are slowly separated through transmitting similar mode with above-mentioned pulling force of having illustrated; Connect until the front end face 134 of embedded moulding and the face of placing restrictions on 152 that advances of block 150, this moment, the span " L " of opening of clip 100 reached maximum; At this moment, can under the cooperation of endoscope, carry out clamping accurately, that kind as shown in Figure 3 to destination organization; The root of the recessed folder end 111 of intermediate plate 110 and protruding folder end 116 intrusion clamping tissues, after endoscope's visual field affirmation clamping correctly, slow pulled backwards slide handle 420; 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 the clamping with the hemostasis purpose,, but under the situation of unsuitable clamping, just can not solve bleeding problems, here, so need carry out clamping again if, then can solve bleeding problems to the suitable clamping of clamping object position A.Under the situation of carrying out clamping again, promote slide handle 420 like aforesaid step constantly, intermediate plate 110 is opened once more, like this, the A that organizes of clamping just is released.Carry out above-mentioned operation repeatedly, until suitable clamping object tissue A is carried out clamping till.
With reference to Figure 15, after confirming that suitable object tissue A is held, can produce tactile feedback, prompting can discharge clip 100.At this moment, the working tension that continues is on slide handle 420, and when making the pulling force that is delivered on the push-and-pull pipe 220 surpass predetermined clip release force, the crotch 221 of push-and-pull pipe is straightened, and from the long lumbar hole 141 of brace, breaks away from, and accomplishes 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 that is applied on the push-and-pull pipe 220 is no more than predetermined clip release force, push-and-pull pipe 220 can slide in cinch tube pipeline 127 normally and be unlikely to throw off.Herein; Preset clip release force is designed to make the stretching power of the crotch 221 of push-and-pull pipe; Intelligible like those skilled in the art; Described clip release force should be roughly and changes between the 30N to 80N, and thus, the sectional area size of push-and-pull pipe crotch 221 is dimensioned to guarantee that crotch will be pulled out of shape under the effect of said clip release force.
With reference to Figure 16, when push-and-pull pipe 220 and brace 140 accomplish separates for the first time after, push-and-pull pipe 220 continues to move under the effect of traction steel wire 310 pulling force backward; Its inclined-plane 224 contacts the convex closure 211 on the connection tube 210 earlier, makes convex closure 211 passive moving upward with respect to inclined-plane 224, finally arrives the plane 223 of push-and-pull pipe 220; In this process; The cantilever 217 of connection tube 210 is expanded under the effect of radial thrust to be opened, and convex closure 211 is deviate from irregularly-shaped hole 124, separates thereby accomplish for the second time; So far, whole clip dispose procedure finishes.
With reference to Figure 17 and Figure 18, after clip 100 is released, permanently separate with push-and-pull pipe 220 with connection tube 210, the clip 100 of closed-lock is stayed organizing on the A of being held.And slide handle 420 continues to apply pulling force, so relieving mechanism 300 can be recalled in body with traction component 400.
Second embodiment of clip of the present invention is described with reference to Figure 19.To having the structural member with the first embodiment said function, be marked with identical label, and omit explanation it.As indicated above; Intermediate plate can be an integral type; Also can be two-piece type, Figure 19 illustrates upper and lower intermediate plate 110b and embedded moulding 130 ways of connecting, and described upper and lower intermediate plate 110b can be identical; Also can be symmetric different two, the characteristic that intermediate plate 110b has be identical with first embodiment.
With reference to Figure 20 and Figure 21 second, third embodiment of the embedded moulding of the present invention (being connector) is described.The main effect of embedded moulding is that intermediate plate and brace are linked to be an integral body, and in the pipeline of cinch tube, slides; Therefore, as long as the size of embedded moulding is enough to be installed in the pipeline of cinch tube, its shape is unessential, can be various geometries, and cuboid shown in figure 21 also can be ellipsoid, and square etc. omit at this; In addition; The main effect of the characteristic groove on it is to match with the tongue 125 of cinch tube, makes the moving of clip 100 can be more level and smooth, therefore; As long as the geometry of groove matches square groove 131b shown in figure 20 or oval-shaped groove 131c shown in Figure 21 with tongue.
Second, third embodiment of connection tube of the present invention is described with reference to Figure 22 and Figure 23.As indicated 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, ejects the secondary separation of accomplishing clip through the inclined-plane 224 of push-and-pull pipe 220; Therefore, its shape is unessential, can be various geometries; Like cuboid, ellipsoid or cylinder etc.In the 3rd embodiment, the indoor design of connection tube 210 is straight hole 216c, has cancelled preceding shoulder hole 216 and back shoulder hole 213, and when the rear end was connected with flexible hose 320, it was dark or shallow excessively to need frock to assist to avoid flexible hose to insert, and influences 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 among the cinch tube 120 front aperture 121b, and through welding, hinged or any other inflexible affixed mode 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, and is 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 on the cinch tube 120 preceding transverse plane 121d, and connects through modes such as welding.
Compared with prior art, advantage of the present invention and good effect are: intermediate plate and brace are linked to be an integral body by embedded moulding, can be in the cinch tube pipeline level and smooth advance and retreat; And two jig arm of intermediate plate are opened and closed repeatedly, this just makes the hemostasis clamping device that the repeatedly clamping of biological tissue is become possibility, and is general; The hemostasis clamping device can open and close more than five times at least repeatedly; The clamping device that is beneficial to stop blooding is placed on optimal position, reaches best haemostatic effect, has avoided sending into new clip again owing to unsuitable clamping; Both alleviated doctor's workload; For the patient gets valuable treatment time, reduced the operation cost again, reduced waste.Simultaneously, the present invention has shortened clamping device greatly and has been detained the length that inside of human body divides, and has avoided causing owing to long indwelling part the scuffing or the perforation of human intracavity road normal structure, has reduced postoperative risk.And; Because intermediate plate of the present invention adopts the integrated punching molding; Its symmetrical configuration, it is evenly moderate that folder closes power, and after the hemostasis clamping device discharges; The barb on the embedded moulding and the skewback of cinch tube are fixed owing to detaining two jig arm up and down that make intermediate plate mutually firmly, have avoided because the lax risk that hemostatic clamp is come off of jig arm.
It is emphasized that: above only is preferred embodiment of the present invention; Be not that the present invention is done any pro forma restriction; Every foundation technical spirit of the present invention all still belongs in the protection domain of technical scheme of the present invention any simple modification, equivalent variations and modification that above embodiment did.
Claims (7)
1. a tissue hemostasis clamping device comprises clip (100), relieving mechanism (200), traction component (300), Handleset (400) and epitheca pipe (500); Said traction component (300) comprises traction steel wire (310) and sheath flexible pipe (320); Said epitheca pipe (500) is taken in said clip (100) and relieving mechanism (200) wherein; It is characterized in that,
Said clip (100) comprising:
Can have bare terminal end and push-and-pull end in external force control switching and to the stop blooding intermediate plate (110) of clamping of biological tissue down;
Be fixedly connected the connector (130) that is integral with the push-and-pull end of said intermediate plate (110);
Be used to take in the cinch tube (120) of the push-and-pull end and the connector (130) of said intermediate plate (110), the slip of can in this cinch tube (120) pipeline, advancing and retreat of the push-and-pull end of said intermediate plate (110) and connector (130); When the push-and-pull end of said intermediate plate (110) and connector (130) move to the rear portion of cinch tube (120); Connector (130) is fixed through anti-loose structure and cinch tube (120) snapping, and the bare terminal end of said intermediate plate (110) is closed up by the front portion effect of cinch tube (120);
The front portion of said cinch tube (120) is set with intermediate plate (110) the spacing block (150) that moves forward, and the jig arm of said intermediate plate (110) is provided with retreats spacing closed stop (113) to intermediate plate (110); Said 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 connected with connector (130) with the connected mode that can when bearing above predetermined pull, lose efficacy, and the rear portion of push-and-pull pipe (220) is fixedly connected traction steel wire (310);
Connection tube (210), the front portion of connection tube (210) is connected through 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) moved to the rear portion of cinch tube (120), push-and-pull pipe (220) made connection tube (210) and cinch tube (120) releasing knot that can be undone by a pull be connected through removing structure.
2. a kind of tissue hemostasis clamping device according to claim 1; It is characterized in that; Said push-and-pull pipe (220) is connected with connector (130) through brace (140), and said intermediate plate (110), brace (140) and connector (130) link into an integrated entity through embedded injection moulding.
3. a kind of tissue hemostasis clamping device according to claim 2; It is characterized in that; Said intermediate plate (110) is processed via rubber-like sheet metal bending forming, and said brace (140) is the sheet metal of flat, which is provided with dog hole (141); The front portion of said push-and-pull pipe (220) is provided with crotch (221); This crotch (221) is hooked in the dog hole (141) of brace (140), and the intensity of this crotch (221) is less than the bonding strength of said brace (140), connector (130) and intermediate plate (110), when said push-and-pull pipe (220) bears above predetermined pull; Crotch (221) is straightened, and is connected inefficacy between push-and-pull pipe (220) and the brace (140).
4. a kind of tissue hemostasis clamping device according to claim 1 is characterized in that said connector (130) and said cinch tube (120) cooperate guiding to slide through groove (131), tongue (125).
5. a kind of tissue hemostasis clamping device according to claim 1 is characterized in that said anti-loose structure is meant that said connector (130) is provided with barb (132), and this barb (132) is detained with the skewback (122) on the cinch tube (120) mutually.
6. a kind of tissue hemostasis clamping device according to claim 1; It is characterized in that; Said connection tube (210) front portion is provided with at least two can elasticity expand the cantilever (217) of opening and withdrawing; Cantilever (217) is provided with convex closure (211), and said convex closure (211) can buckle into and form the knot that can be undone by a pull connection in the button hole (124) on the cinch tube (120).
7. a kind of tissue hemostasis clamping device according to claim 6; It is characterized in that; Said releasing structure is meant that the rear portion of push-and-pull pipe (220) is provided with and can the convex closure (211) on the connection tube (210) be ejected inclined-plane (224) or the convexity that cinch tube (120) goes up button hole (124).
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Also Published As
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CN102727276B (en) | 2014-04-23 |
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