CN110537946A - tissue clamping device and using method thereof - Google Patents
tissue clamping device and using method thereof Download PDFInfo
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- CN110537946A CN110537946A CN201910915950.XA CN201910915950A CN110537946A CN 110537946 A CN110537946 A CN 110537946A CN 201910915950 A CN201910915950 A CN 201910915950A CN 110537946 A CN110537946 A CN 110537946A
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- 238000000034 method Methods 0.000 title claims description 15
- 230000007246 mechanism Effects 0.000 claims description 33
- 230000005540 biological transmission Effects 0.000 claims description 22
- 230000001154 acute effect Effects 0.000 claims description 2
- 210000004115 mitral valve Anatomy 0.000 description 18
- 230000008901 benefit Effects 0.000 description 5
- 210000005246 left atrium Anatomy 0.000 description 5
- 230000033001 locomotion Effects 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 229910000831 Steel Inorganic materials 0.000 description 4
- 210000005240 left ventricle Anatomy 0.000 description 4
- 239000010959 steel Substances 0.000 description 4
- 206010027727 Mitral valve incompetence Diseases 0.000 description 3
- 238000010586 diagram Methods 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 230000000712 assembly Effects 0.000 description 2
- 238000000429 assembly Methods 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 239000011521 glass Substances 0.000 description 2
- 239000002070 nanowire Substances 0.000 description 2
- 208000020446 Cardiac disease Diseases 0.000 description 1
- 230000001746 atrial effect Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 208000019622 heart disease Diseases 0.000 description 1
- 210000003709 heart valve Anatomy 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 208000005907 mitral valve insufficiency Diseases 0.000 description 1
- 208000006887 mitral valve stenosis Diseases 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 210000003492 pulmonary vein Anatomy 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
Abstract
The application discloses a tissue clamping device. The tissue gripping device comprises: a fixing member; the inner clamping arm assembly comprises a first inner arm and a second inner arm, the inner clamping arm assembly is arranged on the fixing piece, and the first inner arm and the second inner arm can be relatively closed or opened; an outer clamp arm assembly comprising first and second outer arms disposed on the fixture, the first and second outer arms being capable of closing or opening relative to one another and enabling tissue to be clamped between the first inner arm and the first outer arm and between the second inner arm and the second outer arm; the first and second outer arms are lockable at different opening angles.
Description
Technical Field
the application relates to the field of medical supplies, in particular to a tissue clamping device and a using method thereof.
Background
In surgery, surgical repair of body tissue often requires the clamping fixation of the tissue by a tissue clamping device. Taking the treatment of mitral regurgitation, a more common cardiac disorder, as an example, the mitral valve is located between the left atrium and the left ventricle, and when the left ventricle contracts, the mitral valve acts as a check valve to tightly close the atrioventricular orifice and prevent blood from flowing back from the left ventricle into the left atrium; however, when the mitral valve is diseased it may be difficult to close the left ventricle completely when it contracts, causing the left atrium to receive a large amount of regurgitated blood, which may cause the left atrium and pulmonary vein pressure to rise dramatically. Therefore, in the operation of treating mitral regurgitation, the opposite sides of the mitral valve can be clamped by a tissue clamping device, so that the valve of the mitral valve is changed from a big hole into two small holes, thereby effectively preventing the mitral valve regurgitation.
Disclosure of Invention
One of the embodiments of the present application provides a tissue clamping device, which includes: a fixing member; the inner clamping arm assembly comprises a first inner arm and a second inner arm, the inner clamping arm assembly is arranged on the fixing piece, and the first inner arm and the second inner arm can be relatively closed or opened; an outer clamp arm assembly comprising first and second outer arms disposed on the fixture, the first and second outer arms being capable of closing or opening relative to one another and enabling tissue to be clamped between the first inner arm and the first outer arm and between the second inner arm and the second outer arm; the first and second outer arms are lockable at different opening angles.
One of the embodiments of the present application provides a method for using a tissue clamping device, which includes the following steps: delivering the tissue gripping device to a predetermined location; controlling the first outer arm and the second outer arm of the outer clamp arm assembly to be opened, and controlling the first outer arm and the second outer arm to be locked at the opened angle when the first outer arm and the second outer arm are opened to a preset angle; controlling the first and second inner arms of the inner clamp arm assembly to open such that tissue is clamped between the first inner arm and the first outer arm and between the second inner arm and the second outer arm; controlling the first and second outer arms of the outer clamp arm assembly to close; and controlling the first outer arm and the second outer arm to be locked after being folded.
drawings
The present application will be further explained by way of exemplary embodiments, which will be described in detail by way of the accompanying drawings. These embodiments are not intended to be limiting, and in these embodiments like numerals are used to indicate like structures, wherein:
FIG. 1 is a schematic structural view of a tissue gripping device according to some embodiments of the present application;
FIG. 2 is a schematic view of a tissue gripping device shown in a closed position according to some embodiments of the present application;
FIG. 3 is a schematic view of a tissue gripping device according to some embodiments of the present application in an open state;
FIG. 4 is a schematic view of another expanded state of the tissue gripping device according to some embodiments of the present application;
FIG. 5 is a schematic perspective view of a tissue gripping device according to some embodiments of the present application;
FIG. 6 is a schematic perspective view of a resilient latch of the tissue gripping device according to some embodiments of the present application;
FIG. 7 is a schematic structural view of a control rod and a guide rod of the tissue gripping device according to some embodiments of the present application;
FIG. 8 is a schematic structural view of a guide rod of a tissue gripping device according to some embodiments of the present application;
FIG. 9 is a schematic view of the connection of a first guide rod body and a second guide rod body of a tissue gripping device according to some embodiments of the present application;
FIG. 10 is a schematic view of a fastener of a tissue gripping device according to some embodiments of the present application.
In the drawing, 110 is a fixing member, 120 is an inner clamping arm assembly, 130 is an outer clamping arm assembly, 140 is a first control mechanism, 150 is a locking assembly, 160 is a guide rod, 111 is a housing, 112 is a first accommodating chamber, 113 is a second accommodating chamber, 114 is a third accommodating chamber, 151 is an elastic locking member, 121 is a first inner arm, 122 is a second inner arm, 123 is a bottom plate, 124 is a barb, 131 is a first outer arm, 132 is a second outer arm, 141 is a control rod, 142 is a first transmission assembly, 143 is a second transmission assembly, 161 is a first guide rod body, 162 is a second guide rod body, 1410 is a locking groove, 1411 is a first control rod body, 1412 is a second control rod body, 1421 is a first connecting rod, 1422 is a second connecting rod, 1511 is a first plate body, and 1512 is a second plate body.
Detailed Description
In order to make the objects, technical solutions and advantages of the present application more apparent, the present application is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the present application and are not intended to limit the present application.
On the contrary, this application is intended to cover any alternatives, modifications, equivalents, and alternatives that may be included within the spirit and scope of the application as defined by the appended claims. Furthermore, in the following detailed description of the present application, certain specific details are set forth in order to provide a better understanding of the present application. It will be apparent to one skilled in the art that the present application may be practiced without these specific details.
The embodiment of the application relates to a tissue clamping device and a using method thereof, the tissue clamping device can clamp tissue between an inner clamping arm assembly and an outer clamping arm assembly, in addition, a first outer arm and a second outer arm of the outer clamping arm assembly can be locked under different opening angles, and the tissue clamping device can be conveniently operated by an operator in the process of tissue clamping by using the tissue clamping device. The tissue clamping device can be applied to various occasions, for example, the tissue clamping device can be used for clamping tissues such as heart valves or blood vessel valves, and can reach a preset position through various paths in the process of clamping the tissues, and the application is not limited to the method.
FIG. 1 is a schematic view of a tissue holding device according to some embodiments of the present application, FIG. 2 is a schematic view of a closed state of a tissue holding device according to some embodiments of the present application, FIG. 3 is a schematic view of an open state of a tissue holding device according to some embodiments of the present application, FIG. 4 is a schematic view of another open state of a tissue holding device according to some embodiments of the present application, and FIG. 5 is a schematic view of a perspective view of a tissue holding device according to some embodiments of the present application. The tissue gripping device according to the embodiments of the present application will be described in detail below with reference to fig. 1 to 5. It should be noted that the following examples are only for explaining the present application and do not constitute a limitation to the present application.
in an embodiment of the present application, as shown in FIGS. 1-5, the tissue gripping device may include a fastener 110, an inner clamp arm assembly 120, and an outer clamp arm assembly 130. The inner clamp arm assembly 120 may include a first inner arm 121 and a second inner arm 122, the inner clamp arm assembly 120 is disposed on the fixing member 110, and the first inner arm 121 and the second inner arm 122 can be folded or unfolded with respect to each other. The outer clamp arm assembly 130 can include a first outer arm 131 and a second outer arm 132, the first outer arm 131 and the second outer arm 132 each disposed on the fastener 110, the first outer arm 131 and the second outer arm 132 being capable of closing or opening relative to each other and enabling tissue to be clamped between the first inner arm 121 and the first outer arm 131 and between the second inner arm 122 and the second outer arm 132. The first outer arm 131 and the second outer arm 132 can be locked at different opening angles. In some embodiments, the number of inner and outer arms may also be increased for the inner and outer clamp arm assemblies 120, 130. For example, inner clamp arm assembly 120 may further include a third inner arm and a fourth inner arm, while outer clamp arm assembly 130 may include a third outer arm and a fourth outer arm, respectively, such that tissue may also be clamped between the third inner arm and the third outer arm, and between the fourth inner arm and the fourth outer arm.
in some embodiments, there may be various solutions for making the first inner arm 121 and the second inner arm 122 relatively close or open. For example, the first inner arm 121 and the second inner arm 122 may be elastically connected or the first inner arm 121 and the second inner arm 122 may be elastically connected to the fixing member 110, respectively, so that the first inner arm 121 and the second inner arm 122 can be closed or opened by the elastic force; alternatively, the first inner arm 121 and the second inner arm 122 may be rotatably connected or the first inner arm 121 and the second inner arm 122 may be respectively rotatably connected to the fixing member 110, and the relative rotation of the first inner arm 121 and the second inner arm 122 may be controlled by another control device. In some embodiments, there may be various solutions for making the first outer arm 131 and the second outer arm 132 relatively close or open. For example, the first and second outer arms 131 and 132 may be rotatably connected to the fixing member, and the first and second outer arms 131 and 132 may be controlled to be relatively closed or opened by a rack and pinion combination, or the first and second outer arms 131 and 132 may be controlled to be relatively closed or opened by a link mechanism. In some embodiments, enabling the first outer arm 131 and the second outer arm 132 to be locked at different opening angles can also be achieved by various technical solutions. For example, the relative distance between first outer arm 131 and second outer arm 132 may be defined by a defining mechanism, or the relative angle of first outer arm 131 and second outer arm 132 may be defined by a defining mechanism. The opening angle at which the first and second outer arms 131 and 132 are locked may be any reasonable angle (e.g., 0 °, 60 °, 90 °, 120 °, 150 °, 180 °, 220 °, 360 °, etc.), wherein fig. 3 is a schematic diagram of the opening angle of the first and second outer arms 131 and 132 being 90 °, and fig. 4 is a schematic diagram of the opening angle of the first and second outer arms 131 and 132 being 180 °. The angle at which first outer arm 131 and second outer arm 132 are locked open can be set by one skilled in the art depending on the requirements of the tissue gripping device when gripping tissue.
in some embodiments, the tissue gripping device can include a first control mechanism 140 and a locking assembly 150. The first control mechanism 140 is used for controlling the first outer arm 131 and the second outer arm 132 to rotate relative to the fixing member 110 to close or open each other. Locking assembly 150 is adapted to cooperate with first control mechanism 140 to lock first outer arm 131 and second outer arm 132 at different opening angles. For example, the first control mechanism 140 may include a control handle and a control link connected between the control handle and the outer clamp arm assembly, the control handle controlling the first and second outer arms 131 and 132 to be closed or opened with respect to each other by controlling the control link to be extended or retracted; and the locking assembly 150 may be provided on the control handle to lock the first and second outer arms 131 and 132 at different opening angles by locking the control link to the control handle after the control link is extended or retracted to different lengths.
In some embodiments, the first control mechanism 140 may include a control rod 141 connected to the outer clamp arm assembly 130, and the control rod 141 moves along the axial direction thereof to control the first outer arm 131 and the second outer arm 132 to rotate relative to the fixing member 110 to close or open each other. At least two locking grooves 1410 are formed on the outer wall of the control rod 141, and the at least two locking grooves 1410 are arranged at intervals along the axial direction of the control rod 141. The locking assembly 150 is disposed on the fixture 110 and prevents the lever 141 from moving when the locking assembly 150 is snapped into the catch 1410. Locking assembly 150 can be snapped into different snap slots 1410 to lock first outer arm 131 and second outer arm 132 at different opening angles. It should be noted that the number of the locking slots 1410 may be two, three, six, eight, etc., and those skilled in the art can set the opening angle of the first outer arm 131 and the second outer arm 132 according to actual needs, which is not limited in this application. In addition, a person skilled in the art may also determine the spacing distance between two adjacent card slots 1410 according to the opening angle required to be locked, and the spacing distance between two adjacent card slots 1410 may be the same or different for all the card slots 1410. By providing at least two detents 1410, the operator can adjust the degree of tightness with which the tissue holding device holds tissue (e.g., a mitral valve) by snapping the locking assembly 150 into the different detents 1410 when the outer clamp arm assembly 130 is closed to hold the tissue. For example, if an over-tight grip condition occurs, the operator can change the channel 1410 into which the locking assembly 150 snaps to cause the outer clamp arm assembly 130 to open slightly, thereby reducing the tightness of the tissue gripping device. Conversely, if the grip is too loose, the operator may also change the detent 1410 into which the locking assembly 150 is snapped to allow the outer clamp arm assembly 130 to further close, thereby increasing the tightness of the tissue value device. Since the tissue clamping device of the prior art cannot adjust the clamping tightness, when the tissue clamping device of the prior art is used for clamping the mitral valve, it may cause the mitral valve stenosis problem due to over-tight clamping of the mitral valve. Therefore, compared with the tissue clamping device in the prior art, the tissue clamping device can realize the optimal clamping state of the tissue (such as a mitral valve), thereby further ensuring the treatment effect on a patient.
in some embodiments, the locking assembly 150 includes an elastic locking member 151 and a second control mechanism (not shown) connected to the elastic locking member 151, the second control mechanism can control the elastic locking member 151 to be locked in or unlocked from the locking slot 1410, and the elastic locking member 151 can be locked with the control rod 141 under its own elastic force. The elastic locking member 151 may be a member including an elastic element such as a spring, a leaf spring, or an elastic body, or may be a member having elasticity in structure or material.
FIG. 6 is a perspective view of a resilient latch of the tissue gripping device according to some embodiments of the present application. In some embodiments, as shown in fig. 6, the elastic locking member 151 includes a first plate 1511 and a second plate 1512 connected to one end of the first plate 1511, an included angle between the first plate 1511 and the second plate 1512 is an acute angle, the control rod 141 passes through the first plate 1511 and the second plate 1512, the second plate 1512 can be clamped into the clamping groove 1410, and the second plate 1512 can be locked with the control rod 141 under its own elastic force. The second control mechanism can control the second plate body 1512 to rotate towards the first plate body 1511, so that the second plate body 1512 can be taken out of the slot 1410. Through such an arrangement, under the condition that the control rod 141 and the elastic locking piece 151 are locked, after the tissue clamping device is used for a long time, the elastic locking piece 151 can be effectively prevented from failing due to elastic force by the structure, so that the locking between the elastic locking piece 151 and the control rod 141 is more stable, and the service life of the tissue clamping device is prolonged. In alternative embodiments, the resilient locking member 151 may have other configurations. For example, the elastic locking member 151 may include a locking tongue rotatably connected to the fixed member 110, and an elastic member disposed between the locking tongue and the fixed member 110, wherein the locking tongue can be locked with the control lever 141 by an elastic force of the elastic member; the second control mechanism can control the bolt to rotate relative to the fixed part 110 to be separated from the clamping groove 1410, and at the moment, the elastic part is compressed; when the second control mechanism does not apply an acting force to the latch, the latch may be locked into the locking groove 1410 again by an elastic restoring force of the elastic member.
In some embodiments, the second control mechanism may include a first pull cable attached to the second plate 1512. As shown in fig. 6, the second plate body 1512 may be located at a lower end of the first plate body 1511, and the first pulling cable may pull the second plate body 1512 toward an upper end, so that when an operator pulls the first pulling cable toward the upper end, the second plate body 1512 may be rotated toward the first plate body 1511, so that the second plate body 1512 can be released from the slot 1410. In the description of the present specification, upper and lower ends refer to upper and lower in the drawings, and are for convenience of description only and do not represent upper and lower in an actual product. In some embodiments, the lower end may be understood as the end near the tissue being clamped and the upper end may be understood as the end away from the tissue being clamped or near the operator of the tissue clamping device. The first traction cable may include a steel wire, a nano-wire, a glass rope, or the like, which is not limited in this application.
In some embodiments, first control mechanism 140 may further include a first transmission assembly 142 connected between lever 141 and first outer arm 131, and a second transmission assembly 143 connected between lever 141 and second outer arm 132. The first transmission assembly 142 and the second transmission assembly 143 may have the same structure. The first transmission assembly 142 and the second transmission assembly 143 may each include a first connection rod 1421 and a second connection rod 1422, one end of the first connection rod 1421 is rotatably connected to the control rod 141, and the other end thereof is rotatably connected to one end of the second connection rod 1422, and the other end of the second connection rod 1422 is rotatably connected to the fixing member 110; wherein the other end of the first link 1421 of the first transmission assembly 142 is connected to the first outer arm 131, and the other end of the first link of the second transmission assembly 143 is connected to the second outer arm 132. In alternative embodiments, first drive assembly 142 and second drive assembly 143 may have other configurations. For example, the first transmission assembly 142 and the second transmission assembly 143 may include a rack gear disposed on the control lever 141 in the axial direction of the control lever 141 and a gear rotatably coupled to the fixing member 110, the gear of the first transmission assembly 142 being coupled to the first outer arm 131, and the gear of the second transmission assembly 143 being coupled to the second outer arm 132. When the control rod 141 moves in its axial direction, the rack gear can rotate the gear, so that the first and second outer arms 131 and 132 connected to the gear rotate to be closed or opened with each other.
In some embodiments, the first control mechanism 140 may include a second traction cable coupled to an end of the control rod 141, the second traction cable being capable of reciprocating the control rod 141 along an axial direction thereof. A second traction cable may be attached to the upper end of the control lever 141 to facilitate an operator's manipulation of the second traction cable to control the movement of the control lever 141. The second traction cable may reciprocate the control rod 141 in its axial direction when the operator pulls the second traction cable upward or pushes the second traction cable downward. In some embodiments, the second traction cable may have a hardness. For example, the second traction cable may be a steel wire or a hard plastic rope, or the like.
in some embodiments, the control lever 141 may include a first control lever 1411 and a second control lever 1412, one end of the first control lever 1411 is detachably connected to one end of the second control lever 1412, and the locking groove 1410 is disposed on the first control lever 1411. In this embodiment, the upper end of the first control stick 1411 is connected to the lower end of the second control stick 1412, and the second control stick 1412 and the first control stick 1411 may be connected together by clamping or screwing. After the tissue gripping device is in place and tissue is gripped, second control rod 1412 can be detached from first control rod 1411 and second control rod 1412 can be withdrawn from the body to reduce the volume of the tissue gripping device remaining in the body and to minimize the effect of the tissue gripping device on the surrounding tissue.
Fig. 7 is a schematic diagram of the control rod and guide rod of the tissue gripping device according to some embodiments of the present disclosure, and in some embodiments, as shown in fig. 7, the first control rod 1411 and the second control rod 1412 are both tubular structures. The tissue gripping device may also include a guide rod 160 disposed within the tubular structure. The guide bar 160 may include a first guide bar body 161 and a second guide bar body 162. One end of the first guiding rod 161 is connected to one end of the second guiding rod 162, and the other end of the first guiding rod 161 is connected to the fixing member 110. In this embodiment, the upper end of the first guide rod 161 is connected to the lower end of the second guide rod 162, and the lower end of the first guide rod 161 is connected to the fixing member 110. The guide rod 160 guides the movement of the control rod 141, so that the control rod 141 can always perform an axial reciprocating motion along the guide rod 160. In addition, the guide bar 160 is provided as two parts, and the first guide bar 161 and the second guide bar 162 are clamped together, so that after the tissue is clamped by the tissue clamping device, the second guide bar 162 can be separated from the first guide bar 161 and the second guide bar 162 can be removed. Second control rod 1412 and second guide rod 162 are withdrawn from the body while the remaining components of the tissue gripping device remain in the body. In some embodiments, the length of the guide lever 160 may be set to be longer than the length of the control lever 141. The length of the second guide bar 162 can be set longer to enable the operator to better manipulate the tissue gripping device of the present application. In some embodiments, the first guide rod 161 is provided with a groove extending along an axial direction thereof, and the groove penetrates the first guide rod 161 along a radial direction of the first guide rod 161. By providing such a slot, the rotation shaft of the first connecting rod 1421 connected to the control rod 141 can be accommodated in the slot, and at the same time, by designing the length of the slot, the range of movement of the control rod 141 relative to the guide bar 160 in the axial direction can be further limited, so as to limit the opening and closing angle (e.g., the maximum opening angle) between the first outer clamping arm 131 and the second outer clamping arm 132.
In some embodiments, as shown in fig. 7, the first control rod 1411 and the second control rod 1412 are connected by threads. In some embodiments, the connection between the first guide rod 161 and the second guide rod 162 is located outside the first control rod 1411 when the tissue gripping device is in the closed position, and inside the second control rod 1412 when the first control rod 1411 is threaded into the second control rod 1412. With such an arrangement, when the first control rod 1411 and the second control rod 1412 are connected together, the control rod 141 can limit the joint between the first guide rod 161 and the second guide rod 162, so as to prevent the first guide rod 161 and the second guide rod 162 from being separated during the process of placing the tissue clamping device into a predetermined position or clamping the tissue. When the tissue clamping device is completely placed (i.e., the tissue clamping device is in a closed state) and the first control rod 1411 is separated from the second control rod 1412, the movement of the joint between the first guide rod 161 and the second guide rod 162 is no longer limited by the second control rod 1412, which is convenient for the operator to remove the second guide rod 162 from the first guide rod 161, thereby removing the second guide rod 162.
fig. 8 is a schematic view of a guide rod of a tissue gripping device according to some embodiments of the present disclosure, and fig. 9 is an enlarged view of a junction between a first guide rod body and a second guide rod body of the tissue gripping device according to some embodiments of the present disclosure. In some embodiments, as shown in fig. 9, one end of the first guiding rod 161 has a first concave portion and a first convex portion along the axial direction, and the corresponding end of the second guiding rod 162 has a second convex portion and a second concave portion along the axial direction, the second convex portion can be clamped into the first concave portion, and the first convex portion can be clamped into the second concave portion, so that the first guiding rod 161 and the second guiding rod 162 are clamped. Through such an arrangement, the first guide rod body 161 and the second guide rod body 162 can be stably connected when being connected, and when the second guide rod body 162 needs to be separated from the first guide rod body 161, the first guide rod body 161 and the second guide rod body 162 can be quickly separated. In some alternative embodiments, the first guide rod 161 and the second guide rod 162 may be clamped by other structures. For example, a locking hole is formed at one end of the first guiding rod 161, and a hook capable of being hooked into the locking hole is formed at the corresponding end of the second guiding rod 162.
in some embodiments, the inner clamp arm assembly 120 includes a base plate 123 connected to the fixing member 110, the first inner arm 121 and the second inner arm 122 are respectively connected to opposite ends of the base plate 123, the inner clamp arm assembly 120 is in a U shape when the first inner arm 121 and the second inner arm 122 are folded, the first inner arm 121, the second inner arm 122 and the base plate 123 are in an integrated structure, and the first inner arm 121 and the second inner arm 122 can automatically rotate and spring away relative to the base plate 123 under the self-elastic force of the inner clamp arm assembly 120 to open each other. In alternative embodiments, the inner clamp arm assembly 120 may have other configurations. For example, the first inner arm 121, the second inner arm 122 and the base plate 123 may be three independent components, the first inner arm 121 and the second inner arm 122 may be rotatably connected to opposite ends of the base plate 123, respectively, and the first inner arm 121 and the second inner arm 122 may be capable of rotating relative to the base plate 123 to be closed or opened.
In some embodiments, the tissue gripping device of the present application may further comprise a third control mechanism (not shown) coupled to the inner arm assembly 120, the third control mechanism being capable of controlling the relative rotation of the first inner arm 121 and the second inner arm 122 to close or open each other. In the present embodiment, the third control mechanism is connected to the upper ends of the first and second inner arms 121 and 122, and the first and second inner arms 121 and 122 can be rotated about the lower ends thereof, respectively.
In some embodiments, the third control mechanism comprises a third pull cable connected to one end of the first inner arm 121 and the second inner arm 122, and when the third pull cable is released, the first inner arm 121 and the second inner arm 122 can automatically rotate around the connection position of the first inner arm and the second inner arm with the base plate 123 to spring apart and open each other. When the third traction cable is pulled, the first inner arm 121 and the second inner arm 122 can rotate around the connection position of the first inner arm and the second inner arm with the bottom plate 123 respectively to be folded. The third traction rope may be a steel wire, a nano wire, a glass rope, a plastic rope, or the like, which is not limited in this application. In alternative embodiments, when the first and second inner arms 121 and 122 are pivotally connected to the base plate 123, the third pull cable may be configured to control both the pivoting of the first and second inner arms 121 and 122 relative to the base plate 123 to close and the pivoting of the first and second inner arms 121 and 122 relative to the base plate 123 to open. For example, the third traction cable may be a steel wire with a certain hardness or a hard plastic rope.
FIG. 10 is a schematic view of a fastener of a tissue gripping device according to some embodiments of the present application. In some embodiments, as shown in fig. 5 and 10, the fixing member 110 includes a housing 111, and the housing 111 has a first receiving chamber 112, a second receiving chamber 113, and a third receiving chamber 114. The first accommodating cavity 112 is used for accommodating the control rod 141, and the second accommodating cavity 113 is used for being clamped with the bottom plate 123; the third receiving cavity 114 is used for receiving the locking assembly 150. In some embodiments, housing 111 may further include a fourth receiving cavity for receiving first drive assembly 142 and second drive assembly 143. In other embodiments, the housing 111 may be provided with two openings, and the first transmission assembly 142 and the second transmission assembly 143 can respectively extend out of the housing 111 from the two openings. In some alternative embodiments, the housing 111 includes left and right halves that are identical in structure, and the left and right halves can be spliced together, which facilitates assembly of the various components of the tissue gripping device together. In some alternative embodiments, the housing 111 is provided with a receiving hole, and the first guide rod 161 can be inserted and fixed in the receiving hole, so that the first guide rod 161 can be stably connected with the housing 111. In some embodiments, a through hole for passing the first traction cable may be further provided on the housing 111, and the through hole extends from the upper end of the housing to the third receiving cavity 114.
in some embodiments, barbs 124 for hooking tissue are provided on the outer side of each of the first inner arm 121 and the second inner arm 122. With this arrangement, first inner arm 121 and second inner arm 122 can be secured to tissue after first inner arm 121 and second inner arm 122 are opened, so that tissue can be stably clamped between inner and outer clamp arm assemblies 120 and 130, and particularly tissue can be prevented from being released from the tissue clamping device during the process of bringing together first and second outer arms 131 and 132. In alternative embodiments, barbs 124 may also be provided on the inner side of first and second outer arms 131, 132 for hooking tissue.
The benefits that may be provided by the tissue gripping devices disclosed herein include, but are not limited to: (1) the first outer arm and the second outer arm of the outer clamping arm assembly are locked at different opening angles, so that an operator can clamp tissues between the inner clamping arm assembly and the outer clamping arm assembly accurately and quickly; (2) the locking assembly can be clamped into different clamping grooves on the control rod, so that the first outer arm and the second outer arm are locked at different opening angles, the locking is stable and reliable, and an operator can conveniently clamp tissues; (3) the tightness degree of the tissue clamped by the tissue clamping device can be adjusted to ensure the treatment effect on the patient; (4) the guide rod is utilized to guide the control rod to move along the axial direction, so that the control rod is effectively prevented from deviating in the moving process, and the tissue clamping device can be ensured to work stably; (5) after the tissue clamping device is used for clamping and fixing the tissue, the second control rod body and the second guide rod body can be withdrawn out of the body, so that the volume of the tissue clamping device remained in the body is reduced; (6) through set up the barb on first inner arm and second inner arm, organize and can be by the centre gripping between interior arm lock subassembly and the outer arm lock subassembly steadily. It is to be noted that different embodiments may produce different advantages, and in different embodiments, any one or combination of the above advantages may be produced, or any other advantages may be obtained.
Some embodiments of the present application also relate to a method of using a tissue gripping device, i.e. any of the embodiments of the tissue gripping device described above. The method of using the tissue gripping device may comprise the steps of:
(1) The tissue gripping device is delivered to a predetermined location.
(2) The first and second outer arms 131 and 132 of the outer clamp arm assembly 130 are controlled to be opened, and when the first and second outer arms 131 and 132 are opened to a predetermined angle, the first and second outer arms 131 and 132 are controlled to be locked at the opened angle. Specifically, the first outer arm 131 and the second outer arm 132 of the outer clamp arm assembly 130 can be controlled to be opened by the control rod 141, and when the first outer arm 131 and the second outer arm 132 are opened to a predetermined angle, the control locking assembly 150 is clamped into the clamping groove 1410 of the control rod 141.
(3) The first and second inner arms 121, 122 of the inner clamp arm assembly 120 are controlled to open such that tissue is clamped between the first inner arm 121 and the first outer arm 131 and between the second inner arm 122 and the second outer arm 132.
(4) The first and second outer arms 131, 132 of the outer clamp arm assembly 130 are controlled to close. Specifically, the control rod 141 may be unlocked by the locking assembly 150, and then the first outer arm 131 and the second outer arm 132 of the outer clamp arm assembly 130 may be controlled to be closed by the control rod 141.
(5) The first outer arm 131 and the second outer arm 132 are controlled to be locked after being closed. Specifically, locking assembly 150 may be controlled to snap into a catch 1410 of lever 141 to lock first outer arm 131 and second outer arm 132.
for example, in treating mitral regurgitation by grasping a mitral valve with a tissue grasping device, the tissue grasping device can be delivered to the mitral valve via the left atrium, and then the first and second outer arms 131, 132 of the outer arm assembly 130 can be controlled by the control rod 141 to expand such that the first and second outer arms 131, 132 are positioned on the left ventricular side of the mitral valve, and when the first and second outer arms 131, 132 expand to a predetermined angle (e.g., an angle that facilitates capturing the mitral valve), the control lock assembly 150 snaps into the snap-in slot 1410 of the control rod 141 such that the outer arm assembly 130 can capture the mitral valve. The first and second inner arms 121, 122 of the inner clamp arm assembly 120 are then controlled to open, the first and second inner arms 121, 122 being located on the left atrial side of the mitral valve, so that the mitral valve can be clamped between the first inner arm 121 and the first outer arm 131 and between the second inner arm 122 and the second outer arm 132. Finally, the first outer arm 131 and the second outer arm 132 of the outer clamping arm assembly 130 are controlled to be closed through the control rod 141, and the locking assembly 150 is controlled to be clamped into the clamping groove 1410 of the control rod 141, so that the first outer arm 131 and the second outer arm 132 are locked, and the tissue clamping device clamps the mitral valve, wherein the mitral valve is changed from a large hole into two small holes.
In some embodiments, the tissue gripping device can be first delivered to a predetermined position and then the first and second outer arms 131, 132 of the outer arm assembly 130 can be controlled to expand by the control rod 141. In other embodiments, the first outer arm 131 and the second outer arm 132 of the outer arm assembly 130 may be controlled to be opened by the control rod 141, and when the first outer arm 131 and the second outer arm 132 are opened to a predetermined angle, the control locking assembly 150 is snapped into the snapping slot 1410 of the control rod 141; the tissue gripping device is then advanced to the predetermined position. The operator can select a specific operation sequence according to the actual situation of the lesion part during the operation.
In some embodiments, when the control rod 141 comprises a first control rod 1411 and a second control rod 1412 and the guide rod 160 comprises a first guide rod 161 and a second guide rod 162, the method of using the tissue gripping device comprises: after the control locking assembly 150 is snapped into the snap-in groove 1410 of the lever 141 to lock the first and second outer arms 131, 132, the second control rod 1412 can be removed from the first control rod 1411 (e.g., moved a distance outward or removed from the body), and then the second guide rod 162 can be disengaged from the first guide rod 161 and the second guide rod 162 can be removed (removed from the body).
In the description of the present application, it should be noted that the terms "first", "second", etc. are used for descriptive purposes only and are not to be construed as indicating or implying any number of indicated technical features. The terms "upper end," "lower end," and the like, are used in an orientation or positional relationship indicated in the drawings for convenience in describing the present application and for simplicity in description, and do not indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be construed as limiting the present application.
The present invention is not intended to be limited to the particular embodiments shown and described, but is to be accorded the widest scope consistent with the principles and novel features herein disclosed.
Claims (18)
1. A tissue gripping device, comprising:
A fixing member (110);
the inner clamping arm assembly (120) comprises a first inner arm (121) and a second inner arm (122), the inner clamping arm assembly (120) is arranged on the fixing piece (110), and the first inner arm (121) and the second inner arm (122) can be relatively closed or opened;
an outer clamp arm assembly (130) comprising a first outer arm (131) and a second outer arm (132), the first outer arm (131) and the second outer arm (132) being provided on the fixture (110), the first outer arm (131) and the second outer arm (132) being capable of relative closing or opening and enabling tissue to be clamped between the first inner arm (121) and the first outer arm (131) and between the second inner arm (122) and the second outer arm (132);
The first outer arm (131) and the second outer arm (132) can be locked at different opening angles.
2. The tissue gripping device of claim 1, further comprising:
a first control mechanism (140) for controlling the first outer arm (131) and the second outer arm (132) to rotate relative to the fixing member (110) to close or open each other;
A locking assembly (150) for cooperating with the first control mechanism (140) to lock the first and second outer arms (131, 132) at different opening angles.
3. The tissue gripping apparatus of claim 2,
the first control mechanism (140) comprises a control rod (141) connected with the outer clamp arm component (130), and the control rod (141) moves along the axial direction thereof to control the first outer arm (131) and the second outer arm (132) to rotate relative to the fixing component (110) to be mutually closed or opened; the outer wall of the control rod (141) is provided with at least two clamping grooves (1410), and the at least two clamping grooves (1410) are arranged at intervals along the axial direction of the control rod (141);
the locking assembly (150) is arranged on the fixing piece (110), and when the locking assembly (150) is clamped into the clamping groove (1410), the control rod (141) can be prevented from moving; the locking assembly (150) can be snapped into different snap slots (1410) to lock the first outer arm (131) and the second outer arm (132) at different opening angles.
4. The tissue holding device according to claim 3, characterized in that the locking assembly (150) comprises an elastic locking member (151) and a second control mechanism connected with the elastic locking member (151), the second control mechanism can control the elastic locking member (151) to be clamped into or separated from the clamping groove (1410), and the elastic locking member (151) can be locked with the control rod (141) under the action of the elastic force of the elastic locking member.
5. the tissue holding device according to claim 4, wherein the elastic locking member (151) comprises a first plate body (1511) and a second plate body (1512) connected to one end of the first plate body (1511), the included angle between the first plate body (1511) and the second plate body (1512) is an acute angle, the control rod (141) passes through the first plate body (1511) and the second plate body (1512), the second plate body (1512) can be clamped into the clamping groove (1410), and the second plate body (1512) is locked with the control rod (141) under the action of its own elastic force; the second control mechanism can control the second plate body (1512) to rotate towards the first plate body (1511) so that the second plate body (1512) can be pulled out of the clamping groove (1410).
6. The tissue holding device of claim 5, wherein said second control mechanism comprises a first pull cable attached to said second plate (1512).
7. The tissue gripping device of claim 3, wherein the first control mechanism (140) further comprises a first transmission assembly (142) connected between the control lever (141) and the first outer arm (131), and a second transmission assembly (143) connected between the control lever (141) and the second outer arm (132), the first transmission assembly (142) and the second transmission assembly (143) each comprising a first link (1421) and a second link (1422), one end of the first link (1421) being rotationally connected to the control lever (141) and the other end thereof being rotationally connected to one end of the second link (1422), the other end of the second link (1422) being rotationally connected to the fixture (110); wherein said other end of the first link (1421) of said first transmission assembly (142) is connected to said first outer arm (131), and said other end of the first link of said second transmission assembly (143) is connected to said second outer arm (132).
8. The tissue gripping apparatus according to claim 3, wherein the first control mechanism (140) includes a second pull cable connected to an end of the control rod (141), the second pull cable being capable of controlling the control rod (141) to reciprocate axially therealong.
9. The tissue gripping device of claim 3, wherein the control lever (141) comprises a first control lever (1411) and a second control lever (1412), wherein an end of the first control lever (1411) is detachably connected to an end of the second control lever (1412), and the catch (1410) is disposed on the first control lever (1411).
10. the tissue gripping device of claim 9, wherein the first control rod (1411) and the second control rod (1412) are each tubular structures, the tissue gripping device further comprises a guide rod (160) disposed within the tubular structures, the guide rod (160) comprises a first guide rod (161) and a second guide rod (162), one end of the first guide rod (161) is engaged with one end of the second guide rod (162), and the other end of the first guide rod (161) is connected to the fixing member (110).
11. The tissue gripping device of claim 10, wherein the first control rod (1411) and the second control rod (1412) are threadably connected;
When the tissue clamping device is in a closed state, the connection position of the first guide rod body (161) and the second guide rod body (162) is positioned outside the first control rod body (1411), and when the first control rod body (1411) is in threaded connection with the second control rod body (1412), the connection position is positioned inside the second control rod body (1412).
12. The tissue clamping device of claim 10, wherein the one end of the first guide rod body (161) has a first recess and a first protrusion in sequence along the axial direction, and the corresponding end of the second guide rod body (162) has a second protrusion and a second recess in sequence along the axial direction, the second protrusion being capable of being snapped into the first recess and the first protrusion being capable of being snapped into the second recess, such that the first guide rod body (161) and the second guide rod body (162) are snapped in.
13. The tissue gripping device according to claim 3, wherein the inner arm assembly (120) comprises a base plate (123) connected to the fixing member (110), the first inner arm (121) and the second inner arm (122) are respectively connected to two opposite ends of the base plate (123), the inner arm assembly (120) is in a U shape when the first inner arm (121) and the second inner arm (122) are folded, the first inner arm (121), the second inner arm (122) and the base plate (123) are in an integral structure, and the first inner arm (121) and the second inner arm (122) can automatically rotate and spring away relative to the base plate (123) under the self-elastic force of the inner arm assembly (120) to mutually open.
14. the tissue gripping device of claim 13, further comprising a third control mechanism coupled to the inner arm assembly (120), the third control mechanism being configured to control the relative rotation of the first inner arm (121) and the second inner arm (122) to either close or open each other.
15. the tissue holding device according to claim 14, wherein said third control mechanism comprises a third pull cable connected to one end of said first inner arm (121) and said second inner arm (122), said first inner arm (121) and said second inner arm (122) being capable of automatically pivoting open and closing apart from each other about their connection to said base (123) when said third pull cable is released, and said first inner arm (121) and said second inner arm (122) being capable of automatically pivoting open and closing together about their connection to said base (123) when said third pull cable is tensioned.
16. The tissue holding device of claim 13, wherein the fastener (110) comprises a housing (111), the housing (111) has a first receiving cavity (112), a second receiving cavity (113) and a third receiving cavity (114), the first receiving cavity (112) is used for receiving the control rod (141), the second receiving cavity (113) is used for clamping with the bottom plate (123); the third accommodating cavity (114) is used for accommodating the locking assembly (150).
17. The tissue gripping device according to claim 1, wherein the first inner arm (121) and the second inner arm (122) are provided with barbs (124) on their outer side for hooking tissue.
18. A method of using the tissue gripping device of any of claims 1-17, comprising the steps of:
Delivering the tissue gripping device to a predetermined location;
Controlling a first outer arm (131) and a second outer arm (132) of an outer clamp arm assembly (130) to be opened, and controlling the first outer arm (131) and the second outer arm (132) to be locked at a predetermined opening angle when the first outer arm (131) and the second outer arm (132) are opened to the opening angle;
controlling a first inner arm (121) and a second inner arm (122) of an inner clamp arm assembly (120) to open such that tissue is clamped between the first inner arm (121) and the first outer arm (131) and between the second inner arm (122) and a second outer arm (132);
Controlling the first outer arm (131) and the second outer arm (132) of the outer clamp arm assembly (130) to close;
Controlling the first outer arm (131) and the second outer arm (132) to lock after being closed.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910915950.XA CN110537946A (en) | 2019-09-26 | 2019-09-26 | tissue clamping device and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910915950.XA CN110537946A (en) | 2019-09-26 | 2019-09-26 | tissue clamping device and using method thereof |
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| CN110537946A true CN110537946A (en) | 2019-12-06 |
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| CN201910915950.XA Pending CN110537946A (en) | 2019-09-26 | 2019-09-26 | tissue clamping device and using method thereof |
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| CN113940791A (en) * | 2021-12-22 | 2022-01-18 | 科瑞迈吉(北京)医疗科技有限公司 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
| US11517718B2 (en) | 2016-11-07 | 2022-12-06 | Edwards Lifesciences Corporation | Apparatus for the introduction and manipulation of multiple telescoping catheters |
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| US11602431B2 (en) | 2017-04-18 | 2023-03-14 | Edwards Lifesciences Corporation | Heart valve sealing devices and delivery devices therefor |
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| US11730598B2 (en) | 2017-09-07 | 2023-08-22 | Edwards Lifesciences Corporation | Prosthetic device for heart valve |
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| CN113940792B (en) * | 2021-12-22 | 2023-02-28 | 科瑞迈吉(北京)医疗科技有限公司 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
| CN113940791B (en) * | 2021-12-22 | 2023-02-28 | 科瑞迈吉(北京)医疗科技有限公司 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
| CN113940791A (en) * | 2021-12-22 | 2022-01-18 | 科瑞迈吉(北京)医疗科技有限公司 | Mitral valve forceps holder and mitral valve forceps holder conveying device |
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