Background technology
Clip Applier is a kind of common medical instrument, is commonly available to needle and holds in the operation of suture, for clamping blood vessel, is risen
To anastalsis, so occasionally referred to as haemostatic clamp.In medical operating, especially minimal invasive techniques, patient is the bleeding the case where
Under, after taking hemostatic, blood vessel main artery is clamped with Clip Applier, does not allow blood flow to go out.The principle of Clip Applier as clip, but
It sterilized.Clip Applier is divided into large and small, with teeth, anodontia, straight, bending.Different type is selected according to different operation position
Clip Applier.
Clip Applier is being used in operative process due to being, for example, to may bleeding position or the bleeding seen
Point carries out clamp first.It is accurate to be required when clamp blutpunkte as a result, and preferably primary success not bring health tissues into excessively.
Since this kind of Minimally Invasive Surgery operating space is narrow and complicated, instrument is smaller using stroke, and required precision is high.Therefore, traditional skill
Art is partial to improve the operation ease of Clip Applier, precision raising and structure improvement etc..
For example, Chinese patent application the 201711310132.4th discloses a kind of minimally invasive haemostatic clamp convenient for disassembly and assembly comprising
Determine handle, fixed handle, fixed pincers and dynamic pincers, fixed handle is driven by drive connection piece with the one end for determining the steel wire rope in handle is extend into
Dynamic connection, the other end of the steel wire rope are drivingly connected with the dynamic pincers determined on pincers are rotatably connected on.Steel wire rope with positioned at determining handle
The steel wire rope connecting rod that is inside slidably connected is connected, and the stay rod pin positioned at drive connection piece one end is connected in steel wire rope connecting rod, passes
The dynamic connection sheet other end is rotatablely connected with fixed handle, and is provided between drive connection piece and fixed handle and is made stay rod pin clamping steel wire
The torque spring for connecting rod of restricting.In the disclosure in this patent, it is indicated that the haemostatic clamp disassembly, cleaning are convenient, easy to operate, not cumbersome, should
Haemostatic clamp can fill different types of jaw to meet the use of medical staff on a kind of handle, reach multi-edged
Function, disassembling can also so that instrument cleaning is more thorough, at the same can also allow medical staff use more easily, folder
It is reliable accurate that holding force is adjusted, and control is flexible, to improve the efficiency of Minimally Invasive Surgery.
However, the improved structure in either above-mentioned patent application or traditional hemostasis wrench structure, all inevitable to meet with
Meet a realistic problem.That is, in operative process, generally not only a blood vessel needs clamp hemostasis, but have two or three
Root very, clamp by even more blood vessel needs.And existing haemostatic clamp can only all carry a plastic grip, clip is all disposable
It uses.In structure as disclosed in aforementioned patent applications, Clip Applier has longer connecting rod.Therefore, operation stops every time
When blood, it is required for being inserted into patient's body by so long Clip Applier, it is clear that totally unfavorable.
It, can not due to being single operation although the Clip Applier of traditional single operation has many improvement in structure
It avoids having the following disadvantages:When on the one hand, for needing simultaneously to more Vascular haemostasis, needs operation multiple, necessarily extend hand
The art time, it is understood that operating time is to seize every minute and second, and current medical instrument is wanted for first with saving the surgical time
Business.Because the time is longer, the easier fatigue of doctor, and also it is bigger to the physical effects of patient.On the other hand, Clip Applier is continually
Disengaging will greatly increase operation risk, increase Infection probability.In addition, in surgical procedure, doctor typically encounters in hemostasis
The problem of be that many places blood vessel is being bled, usually when putting Clip Applier into for the second time, cause original blood vessel fuzzy not due to bleeding
Clearly, it is not easy to find, it is sometimes desirable to clean the blood vessel that can just find and need to stop blooding again, more spend the time in this way, patient can also need
It bleeds excessive, constitution is excessively overdrawed, unhealthful recovery progress.
Invention content
In view of this, more Vascular haemostasis, easy to operate, running fire clamp with high accuracy can be given simultaneously it is necessary to provide a kind of
Pincers.
A kind of running fire Clip Applier, including driving handle, tube rod, the binding clip loaded on tube rod front end, by driving handle drive
Push-pull rod, feed device and storing cabin, the storing cabin have the front end being flexibly connected with binding clip and the rear end opposite with front end,
One end of the push-pull rod is connected to driving handle, and the other end connect and acted on the rear end in storing cabin storing cabin, makes binding clip
It opens or clamps, the feed device includes driving member and the actuator for driving driving member to move, built in the storing cabin
There are multiple clips for clamping blood vessel, the driving member to be inserted into storing cabin to push clip to enter in binding clip.
Preferably, the storing cabin includes front deck and rear deck, and the rear deck has close to the front end of binding clip and far from binding clip
Rear end, the front deck is set to the front inner wall of rear deck and extends to the opening of binding clip by the front end of rear deck, the driving member
Stretch into front deck.
Preferably, the front end of the rear deck be extended with forward it is parallel to each other and between the upper and lower every upper labial plate and labial plate, institute
It states upper labial plate and labial plate is facing is extended with protruding shaft, the binding clip has oblique slot, the protruding shaft close to the end in storing cabin
It is inserted in oblique slot, the end of the binding clip is sandwiched between front deck outer wall and rear deck inner wall, is transported in oblique slot by protruding shaft
It moves to drive binding clip to open or clamp.
Preferably, the tube rod front end is equipped with upper installation sheet and lower installation sheet, and two installation sheets are respectively equipped with shaft, the pincers
Head includes a pair of of tong arm, this connect tong arm rear end with tube rod and in the rear end equipped with the axis hole for filling shaft, make the binding clip around
Shaft rotation, this is acted to making clamping and release under the tong arm in the rear pulling in cabin.
Preferably, the front deck has opens respectively close to the forehatch of binding clip and after hatch, the rear end both sides of the rear deck
Equipped with side slot, the hatch of each side slot from rear deck rear end extends at the after hatch of front deck, and the driving member has accommodating
The hollow cavity of the push-pull rod, the hollow cavity front end both sides of the driving member are axially extending respectively side strip, two side strips
Corresponding two side slots for being inserted in the rear deck, the push-pull rod further extend between side strip and with the rear end of rear deck
Connection.
Preferably, the driving member also has there are one mandril, and the mandril is connected to side strip front end and axially extending stretches
Enter front deck, the front deck acts on the clip in front deck, and clip is sent to binding clip for storing blood vessel clip by mandril
Opening.
Preferably, the actuator includes gear assembly, and the rear end of the driving member has rack line, the gear assembly
With with rack line meshed gears, rotated by gear, driving member driven to move.
Preferably, the tube rod is connected close to the end of driving handle there are one installing pipe, and the installing pipe is sheathed on
The position of one end of driving member striped with teeth, the installing pipe corresponding teeth striped offers rach slot, and the groove of the gear is stretched
Enter rach slot to engage with rack line.
Preferably, the installing pipe is installed on driving handle, and the installing pipe is equipped with fixing piece in the both sides of rach slot,
Between the gear is clipped on two fixing pieces by a shaft, the one end of the gear far from groove extends that there are one take turns handle
Hand makes gear driving driving member movement, rear end of the push-pull rod far from storing cabin has diameter by pulling the wheel handle
More than the holding section of push-pull rod main part, card slot is equipped at the top of the driving handle, the holding section is caught in card slot.
Preferably, the binding clip includes a pair of of tong arm, and two opposite medial surfaces of tong arm are respectively equipped with axially extending lead
Slot, the guide groove are communicated with storing cabin, and clip is made to enter guide groove under driving member promotion.
Above-mentioned running fire Clip Applier includes feed device and storing cabin, and several prevention blood vessels can be stored in advance in storing cabin
Then clip coordinates feed device, feeding and clamp substep are carried out.First, it is pushed by driving member and to be stored in storing cabin
Clip enters in binding clip, and clip conveys in place.Then, push-pull rod acts on storing cabin front end, passes through the activity of front end and binding clip
Connection, makes binding clip clamp, makes the clamp blood vessel for being sent to binding clip.It needs to unclamp binding clip after clamping blood vessel, then passes through push-pull rod
Push-and-pull action, by storing cabin front end drive binding clip open, then turn to next blood vessel clamp action.Therefore,
Above-mentioned running fire Clip Applier can be carried out at the same time the feeding and clamping of multiple or running fire hemostasis clip, need not replace, need not take
Go out Clip Applier in refitting clip in vitro, precisely can quickly give more Vascular haemostasis in time, whole process is easy to operate, significantly
Operating time is saved, procedure efficiency is improved, improves surgical quality, reduces operation risk, mitigates patient's pain significantly, it is postoperative extensive
It is multiple fast, and higher precision can be kept.
Specific implementation mode
Below with reference to specific embodiments and the drawings, the present invention is described in detail.
It please refers to Fig.1 and Fig. 2, a kind of running fire Clip Applier 100 provided in an embodiment of the present invention, including driving handle is shown
10, tube rod 20, the binding clip 30 loaded on 20 front end of tube rod, push-pull rod 12, feed device 40 and the storing driven by driving handle 10
Cabin 50, the storing cabin 50 have the front end being flexibly connected with binding clip 30 and the rear end opposite with front end, the push-pull rod 12
One end is connected to driving handle 10, and the other end connect with the rear end in storing cabin 50 and act on storing cabin 50, and binding clip 30 is made to open
Or clamp, the feed device 40 includes driving member 41 and the actuator 42 for driving driving member 41 to move, the storing cabin
50 are built-in with multiple clips for clamping blood vessel, and the driving member 41 is inserted into storing cabin 50 to push clip to enter binding clip 30
It is interior.
Preferably, the storing cabin 50 includes front deck 51 and rear deck 55, and the rear deck 55 has close to the front end of binding clip 30
With the rear end far from binding clip 30, the front deck 51 is set to the front inner wall of rear deck 55 and extends to binding clip 30 by the front end of rear deck 55
Opening, the driving member 41 stretches into front deck 51.
As shown in Fig. 2, the front end of the rear deck 55 be extended with forward it is parallel to each other and between the upper and lower every upper labial plate 56 and under
Lips 57, the upper labial plate 56 and labial plate 57 is facing is extended with protruding shaft 561 and 562.As shown in Figures 2 and 3, the binding clip 30
Close to the end in storing cabin 50 there is oblique slot 35, the protruding shaft 561 and 562 to be inserted in oblique slot 35, the binding clip 30 is somebody's turn to do
End is sandwiched between 55 inner wall of 51 outer wall of front deck and rear deck, is moved in oblique slot 35 to drive binding clip by protruding shaft 561 and 562
30 open or clamp.Therefore, protruding shaft 561,562 is interspersed in oblique slot 35, and two tong arms 31,32 are pivot with protruding shaft 561,562
Axis.In this way, shaft 23 is used as pivot point, the protruding shaft 561,571 in storing cabin 50, two tong arms 31,32 is pulled to make clamp action,
Storing cabin 50 is post-tensioning action simultaneously, and therefore, front deck 51 is retraction at this time, is the equal of avoiding clip 60.In this way, can make
It obtaining before clamp, 60 end of clip can also stop a part in the front end of front deck 51, when post-tensioning, 51 retraction of front deck, completely
Clip 60 is discharged, makees clamp action convenient for two tong arms 31,32.
As shown in Figures 2 and 3,20 front end of the tube rod is equipped with upper installation sheet 21 and lower installation sheet 22, two installation sheets 21,22
Shaft 23 is respectively housed, the binding clip 30 includes a pair of of tong arm, as shown is the first tong arm 31 and the second tong arm 32, this is to tong arm
31 and 32 rear end connect with tube rod 20 and is equipped with the axis hole 36 of dress shaft 23 in the rear end, makes the binding clip 30 around shaft 23
Rotation, this is acted to making clamping and release under tong arm 31, the 32 in the rear pulling in cabin 55.
Preferably, the front deck 51 has after the forehatch 510 of binding clip 30 and after hatch 519, the rear deck 55
End both sides offer side slot 58 respectively, and the hatch of each side slot 58 from 55 rear end of rear deck extends to the after hatch of front deck 51
At 519, the driving member 41 has the hollow cavity for housing the push-pull rod 12, the hollow cavity front end both sides point of the driving member 41
It is not axially extending to there is side strip 48, two side strips 48 to correspond to two side slots 58 for being inserted in the rear deck 55, the push-and-pull
Bar 12 is further extended between side strip 48 and is connect with the rear end of rear deck 55.
As shown in Figures 2 and 3, further, the rear end inner wall digging of the rear deck 55 has mounting groove 59, the running fire Clip Applier
Including a push-pull rod 12, one end of the push-pull rod 12 is combined closely in the mounting groove 59, and a push-pull rod 12 is passed through
Push-and-pull action in driving the action that is clamped and unclamps of binding clip 30.The front end of push-pull rod 12 can pass through interference fit
It is installed on mounting groove 59, so that push-pull rod 12 is combined closely in the rear end of rear deck 55, the two moves synchronously.
Storing cabin 50 and driving member 41 are preferably tubulose, and side slot 58 is preferably cut by the side of rear deck 55 and formed, and two
A 58 axial symmetry of side slot is simultaneously communicated with space in cabin, side strip 48 can be by by tubulose excision top and the bottom formed, and
Side strip 48 is the equal of the complementary portion of the tubular structure of side slot 58, that is to say, that storing cabin 50 and driving member 41 two
All it is tubulose and diameter is equal, side strip 48 merges into a pipe after being inserted into side slot 58, so that structure is compacter,
Improve instrument precision.In addition, in 41 pushing course of drive link, side strip 48 moves forward along side slot 58, therefore, side strip 48
Full entire side slot 58 is not filled at the very start.Side strip 48 and side slot 58 are fitted close, when side strip 48 moves forward with
Side slot 58 is guide groove, the same length of side strip 48 and both side slots 58.
As shown in Fig. 2,3 and 4, driving member 41 also has there are one mandril 43, and positioned at the front end of driving member 41.The mandril
43 be connected to 48 front end of side strip and it is axially extending be inserted into front deck 51, the front deck 51 passes through for storing blood vessel clip 60
Mandril 43 acts on the clip 60 in front deck 51, and clip 60 is sent to 30 opening of binding clip.As shown in figure 4,51 content of front deck
There are 4 clips 60, clip 60 is to flatten shape when in front deck 51, when leaving front deck 51 between a pair of of tong arm 31 and 32,
Clip 60 is in nature expanded shape, the clip 60 ' of natural opening shape as shown in Figure 4.
As shown in figure 3, the side strip 48 of driving member 41 has the first fastener, the mandril 43 close to the end of rear deck 55
Rear end is equipped with the second fastener, and second fastener is mutually fastened with the first fastener, makes mandril 43 as the axis of drive link
To extension, the clip 60 in front deck 51 is acted on by mandril 43, clip 60 is sent to clamp opening.Specifically, such as
In embodiment shown in figure, second fastener and the first fastener are recess portion and protrusion, and the second fastener is after mandril 43
End is in I-shaped, and the first fastener is in concave shape.Certainly, in other embodiments, second fastener and the first fastener
It is engaged for the fastening structure or groove of axial grafting, can also be threaded connection.These connection structures are mainly by mandril
43 are connected with driving member 41, can disjunctor action, while easy disassembly.For example, in schematic structure, second fastener with
It is non-disconnectable on first fastener axial direction, and can easily be dismantled in axial direction.Mandril 43 is preferably sheet,
Length is substantially suitable with the length of front deck 51.
As shown in Fig. 2,3 and 4, it is preferable that actuator 42 includes gear assembly, and the rear end of the driving member 41 has rack
Line 45, the gear assembly have with 45 meshed gears 46 of rack line, rotated by gear 46, drive driving member 41 move.
Specifically, as shown in figure 3, gear 46 is loaded on a shaft 47, there are one wheels for one end extension of the gear 46 far from groove
Handle 48 makes gear 46 be moved with carry-over bar by pulling the wheel handle 48.
As shown in Figures 3 and 4, specifically, there are one installing pipes in the end connection of close driving handle 10 for the tube rod 20
26, the installing pipe 25 is sheathed on one end of 41 striped 45 with teeth of driving member, the position of 25 corresponding teeth striped 45 of the installing pipe
Rach slot 26 is offered, the groove of the gear 46 is inserted into rach slot 26 and is engaged with rack line 45.
As shown in Figures 3 and 4, it is preferable that the installing pipe 25 is installed on driving handle 10, and the installing pipe 25 is in rack
The both sides of slot 26 are equipped with fixing piece 49, and the gear 46 is clipped on by a shaft 47 between two fixing pieces 49.The push-and-pull
There is the holding section 13 that diameter is more than 12 main part of push-pull rod, the driving handle 10 to push up for rear end of the bar 12 far from storing cabin 50
Portion is equipped with card slot 14, and the holding section 13 is caught in card slot 13.Card slot 13 digs downwards one by the top surface at 10 top of driving handle
Cylindrical groove, card slot 13 have the line of rabbet joint towards installing pipe 25, and slot width is identical as the diameter of 12 main part of push-pull rod, and small
The cylindrical shape diameter of diameter in holding section 13, card slot 13 is identical as the diameter of holding section 13.The holding section of push-pull rod 12 as a result,
13 pack into card slot 13 by the top surface of driving handle 10, and limit it and axially deviate from, and are only taken out from top surface.
As Figure 4-Figure 6, there are one locking nuts 27 for the tool of installing pipe 25, and the locking nut 27 is perpendicular to installing pipe 25
Axially direction tightens spiral shell through setting there are one screw 28 when the driving member 41 send clip 60 to clamp 31,32 opening
Nail 28, makes screw 28 press in the driving member outer surface, with fixed conveyor bar 41, prevents drive link 41 from returning pine.Screw 28 passes through
Poling bar 20.The socket of screw 28 is there are one pull rod 281 is locked, for locking screw 28.
As shown in fig. 6, installing pipe 25 is being equipped with external screw thread close to the front end of locking nut 27, there are one outer spiral shells for external thread sleeve
Mother 24.Installing pipe 25 is dug at the corresponding inner wall of outer screw position step 251, rear end pipe of the tube rod 20 close to locking nut 27
Diameter is shunk, and with the smaller connection pipeline section of one section of caliber, connects the end of pipeline section with step 251 against connection pipeline section housing has
One casing 29,29 outer wall of casing have flange collar, push down flange collar by outer nut 24 and block outer nut 24.It is first loose when dismounting
Screw 28 is opened, locking nut 27 is taken off, tube rod 20 can extract out, you can clean, tear open to feed device 40 and storing cabin 50
Dress is convenient, easy to clean quick.Then, outer nut 24 is unclamped again, you can dismounting installing pipe 25, it can be by feed device 40 and storing
Cabin 50 detaches, and takes out push-pull rod 12, replaceable or cleaning, same convenient, simple and efficient to handle.
As shown in fig. 7, the front deck 51 has upper inner wall and lower inner wall, the upper inner wall and lower inner wall are respectively equipped with axial direction
What is extended helps sliding rib 512, and 43 upper and lower surface of the mandril, which reclines, helps sliding rib 512 to slide described in two, the front deck 51 exists
The hatch lateral edges being open close to clamp 31,32 offer export notch 513, translateral when for the abjection front deck 51 of clip 60
Export notch 513 skids off.As shown in figure 3, the front end of the mandril 43 is equipped with corrugated slot 431, withstood by corrugated slot 431
Clip 60.The rear end of clip 60 has ripple struction, and corrugated slot 431 coordinates with ripple struction, so that mandril 43 is in front deck 51
It is tightly engaged into clip 60 when Forward, active force conduction is more smooth, laborsaving.
Two 31,32 opposite medial surfaces of tong arm are respectively equipped with axially extending guide groove 311 and 321, the guide groove 311,
321 communicate with storing cabin 50, and clip 60 is made to enter guide groove 311,321 under the promotion of driving member 41.Specifically, guide groove 311,321
It is communicated axially with front deck 50, that is to say, that extension of the guide groove 311,321 as space in front deck 50 so that clip 60 is deviate from
After front deck 51, two clamp arm of clip 60 can smoothly enter into guide groove 311,321, when to Vascular haemostasis, pass through the work of push-pull rod 12
With driving two tong arms 31,32 to clamp, clip 60 is made to clamp Vascular haemostasis.
It follows that above-mentioned running fire Clip Applier 100 includes feed device 40 and storing cabin 50, it can be advance in storing cabin 50
Several clips 60 for preventing blood vessel are stored, then coordinates feed device 40, feeding and binding clip 30 is carried out step by step.First, pass through
Driving member 41 pushes the clip 60 stored in storing cabin 50 to enter in binding clip 30, and clip 60 conveys in place.Then, push-pull rod 12 is made
For 50 front end of storing cabin, by being flexibly connected for front end and binding clip 30, so that binding clip 30 is clamped, make the clip 60 for being sent to binding clip 30
Clamp blood vessel.It needs to unclamp binding clip 30 after clamping blood vessel, then by the push-and-pull action of push-pull rod 12, passes through 50 front end band of storing cabin
Dynamic binding clip 30 opens, and then turns to 60 pinching action of clip of next blood vessel.Therefore, above-mentioned running fire Clip Applier can be carried out at the same time
The feeding and clamping of multiple or running fire hemostasis clip 60, need not replace, and need not take out Clip Applier 100 in external refitting folder
Son 60 precisely can quickly give more Vascular haemostasis in time, and whole process is easy to operate, greatlys save operating time, improves
Procedure efficiency improves surgical quality, reduces operation risk, mitigates patient's pain significantly, post-operative recovery is fast, and can keep higher
Precision.
It should be noted that the invention is not limited in the above embodiment, creative spirit according to the present invention, this field
Technical staff can also make other variations, and the variation that these creative spirit according to the present invention are done should all be included in this hair
It is bright it is claimed within the scope of.