CN111248969B - Closure clip delivery system - Google Patents

Closure clip delivery system Download PDF

Info

Publication number
CN111248969B
CN111248969B CN202010078170.7A CN202010078170A CN111248969B CN 111248969 B CN111248969 B CN 111248969B CN 202010078170 A CN202010078170 A CN 202010078170A CN 111248969 B CN111248969 B CN 111248969B
Authority
CN
China
Prior art keywords
direction control
joint
control
control line
piece
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN202010078170.7A
Other languages
Chinese (zh)
Other versions
CN111248969A (en
Inventor
谢晨光
董士勇
谢北平
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Beijing Lingjian Medical Technology Co ltd
Original Assignee
Beijing Lingjian Medical Technology Co ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Beijing Lingjian Medical Technology Co ltd filed Critical Beijing Lingjian Medical Technology Co ltd
Priority to CN202010078170.7A priority Critical patent/CN111248969B/en
Publication of CN111248969A publication Critical patent/CN111248969A/en
Application granted granted Critical
Publication of CN111248969B publication Critical patent/CN111248969B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1222—Packages or dispensers therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Vascular Medicine (AREA)
  • Reproductive Health (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a closed clamp conveying system which comprises a control handle, a connecting rod and a head end, wherein the control handle is connected with the head end through the connecting rod, two clamping arms are hinged to the head end, a closed clamp is loaded between the two clamping arms, a direction control end, an opening angle control end and a load releasing control end are arranged on the control handle, a direction control line is connected between the direction control end and the head end, an opening device is hinged between the two clamping arms, an opening angle control line is arranged between the opening angle control end and the opening device, the opening angle control end controls the opening device to be opened or closed through the opening angle control line, when the opening device is opened or closed, an included angle between the two clamping arms is increased or decreased, a load releasing control line is connected between the load releasing control end and the closed clamp, and when the load releasing control line is separated from the closed clamp through the load releasing control end, the closed. Its purpose is in order to provide a closed transport system that presss from both sides, and its delivery path is littleer, controls more accurately, and the operation is more convenient.

Description

Closure clip delivery system
Technical Field
The present invention relates to medical devices, and more particularly to a closure clip delivery system.
Background
Atrial fibrillation is short for atrial fibrillation and is one of the common cardiac arrhythmias. Of stroke patients, 20% are associated with atrial fibrillation, and 35% of patients with atrial fibrillation develop one or more thromboembolisms during their lifetime. Atrial fibrillation is an independent risk factor for mortality, with stroke rates rising 5-fold in patients with atrial fibrillation, the primary therapeutic goal of which is to prevent stroke and to ameliorate symptoms. 90-100% of patients with non-rheumatic heart disease atrial fibrillation have thrombus from left atrial appendage.
Evidence-based medicine proves that the left atrial appendage can be sealed to prevent the occurrence of embolism complications of patients with atrial fibrillation. Clinically, cardiac surgery adopts special closed clamp to seal the left atrial appendage, reduces the emergence of the patient's cerebral apoplexy of atrial fibrillation. When the closure clip is closing the left atrial appendage, a delivery system is required to deliver the closure clip from outside the body to the root of the left atrial appendage inside the body. The direction of the head end of the existing conveying system cannot be conveniently adjusted, when the closing clamp is separated from the conveying system, the closing clamp still needs to be subjected to thread cutting operation through the surgical scissors, so that the closing clamp can be separated from the conveying system, the conveying path of the existing conveying system is large, and the operation is not convenient enough.
Disclosure of Invention
The invention aims to provide a closed clamp conveying system which is smaller in conveying path, more accurate in control and more convenient and fast to operate.
The invention discloses a closed clamp conveying system, which comprises a control handle, a connecting rod and a head end, wherein the control handle is connected with the head end through the connecting rod, two clamping arms are hinged on the head end, a closed clamp is loaded between the two clamping arms, a direction control end, an opening angle control end and a load releasing control end are arranged on the control handle, a direction control line is connected between the direction control end and the head end, the direction control end controls the direction of the head end through the direction control line, an opening device is hinged between the two clamping arms, an opening angle control line is arranged between the opening angle control end and the opening device, the opening angle control end controls the opening or closing of the opening device through the opening angle control line, when the opening device is opened or closed, an included angle between the two clamping arms is increased or decreased, a load releasing control line is connected between the load releasing control end and the closed clamp, when the load releasing control line is separated from the closed clamp, the closure clip is unloaded from the clip arm.
The closed clamp conveying system is characterized in that the number of the direction control ends is two, the two direction control ends are respectively a first direction control end and a second direction control end, a first direction control line is connected between the first direction control end and the head end, a second direction control line is connected between the second direction control end and the head end, the first direction control end controls the head end to rotate in a first plane through the first direction control line, and the second direction control end controls the head end to rotate in a second plane through the second direction control line.
The closed clamp conveying system comprises a head end, a first joint, a second joint and a third joint, wherein the two clamp arms are hinged to the first joint, the first joint is hinged to the second joint, the second joint is hinged to the third joint, the third joint is connected with a connecting rod, a first direction control line is connected between the second joint and a first direction control end, a second direction control line is connected between the first joint and a second direction control end, the first direction control end controls the second joint to rotate in a first plane through the first direction control line, and the second direction control end controls the first joint to rotate in a second plane through the second direction control line.
The closed clamp conveying system is characterized in that the number of the unloading control lines is two, one ends of the two unloading control lines, which are connected with the closed clamp, are respectively laid on the outer sides of the two clamping arms, a through groove is formed between the two opposite inner sides of the two clamping arms and used for loading the closed clamp, each clamping arm is provided with a through groove, the through groove penetrates through the outer sides and the inner sides of the clamping arms, clamping arm wire loops penetrate through the through grooves, and the unloading control lines on the outer sides of the clamping arms and the closed clamp on the inner sides of the clamping arms are simultaneously bound by the clamping arm wire loops on.
The closure clip delivery system of the present invention, wherein the control handle comprises a first housing and a second housing connected to each other, the connecting rod is of a cylindrical structure, the first direction control end comprises a first rotating disc and a first direction control key, the first direction control key is arranged on a first rotating disc which is rotatably arranged in the control handle, the first direction control ends extend out of the control handle, the number of the first direction control lines is two, one ends of the two first direction control lines are connected to the first rotary disc, the other ends of the two first direction control lines penetrate through the inner cavity of the connecting rod and then are connected to the second joint, the two first direction control lines connected to the first rotary disc are respectively located on two opposite sides of the rotation center of the first rotary disc, and the two first direction control lines connected to the second joint are respectively located on two opposite sides of the second joint.
The closed clamp conveying system comprises a first direction control end, a first rotating disc, a first joint, a second joint, a connecting rod, a first direction control end, a second direction control end and a second direction control key, wherein the first direction control end comprises a first rotating disc and a first direction control key, the first direction control key is arranged on the first rotating disc, the second rotating disc is rotatably arranged in the control handle, the first direction control end extends out of the control handle, the number of the first direction control line is two, one end of the first direction control line is connected to the first rotating disc, the other end of the first direction control line penetrates through an inner cavity of the connecting rod and then is connected to the first joint, the two first direction control lines connected to the first rotating disc are respectively located on two opposite sides of a rotating center of the first rotating disc, and the two first direction control.
The invention discloses a closed clamp conveying system, wherein a first blind hole is arranged on a first rotary disc, one end of a first direction control key is positioned in the first blind hole, a first compression spring is arranged between the first direction control key and the bottom wall of the first blind hole, a first positioning sheet is fixedly arranged on the first direction control key, a second blind hole is arranged on a second rotary disc, one end of a second direction control key is positioned in the second blind hole, a second compression spring is arranged between the second direction control key and the bottom wall of the second blind hole, a second positioning sheet is fixedly arranged on the second direction control key, a first positioning gear and/or a second positioning gear are arranged on a control handle, the first positioning gear is arranged between the first direction control key and the second direction control key, the second positioning gear is arranged at the position of the inner surface of a first shell, which is close to the first direction control key, and at the position of the inner surface of a second shell, which is close to the second direction control key, under the action of the first compression spring, the first positioning sheet on the first direction control key is clamped on the gear of the first positioning gear and/or the gear of the second positioning gear, and under the action of the second compression spring, the second positioning sheet on the second direction control key is also clamped on the gear of the first positioning gear and/or the gear of the second positioning gear.
The closed clamp conveying system comprises two clamp arms which are arranged in an X shape, a first rivet column is inserted at the intersection part of the two clamp arms, the two clamp arms can rotate relative to the first rivet column, the first rivet column is fixedly arranged on a first joint, the opening device comprises a winding pulley, a first supporting sheet and a second supporting sheet, one end of the first supporting sheet is hinged with the near end of one clamp arm, the other end of the first supporting sheet is hinged with one end of the second supporting sheet through a second rivet column, the other end of the second supporting sheet is hinged with the near end of the other clamp arm, the winding pulley is arranged on the second rivet column, a strip through hole is formed in the first joint, the second rivet column is positioned in the strip through hole, when the second rivet column moves along the strip through hole, the included angle between the two clamp arms is increased or decreased, and the opening angle control end comprises a wrench and a connecting sheet, the one end of spanner is rotationally installed in brake valve lever, the other end of spanner extends to outside the brake valve lever, connection piece slidable mounting is in brake valve lever, the connection piece can make a round trip to slide along brake valve lever's distal end and near-end direction, the distal end of connection piece articulates on the spanner, the one end of opening angle control line is walked around on wire winding pulley is fixed in first joint, the other end of opening angle control line is connected on the connection piece.
The closed clamp conveying system is characterized in that sliding grooves are formed in the inner surface of the control handle and are arranged along the far end direction and the near end direction of the control handle, a sliding block is arranged on one side surface of the connecting piece and is positioned in the sliding grooves, a sliding shaft is arranged on the other side surface of the connecting piece, a sliding shaft wire ring is formed at the other end of the opening angle control wire, and the sliding shaft wire ring is sleeved on the sliding shaft.
According to the closed clamp conveying system, a damping piece for preventing the included angle between the two clamping arms from being reduced is arranged between the opening angle control end and the control handle.
The closed clamp conveying system is characterized in that the damping piece is a damping spring, one end of the damping spring is connected to the near end of the connecting piece, and the other end of the damping spring is connected into the control handle.
According to the closed clamp conveying system, the damping piece is a damping block and a wrench bulge, the damping block is arranged on the control handle, the wrench bulge is arranged on the wrench, and the wrench bulge can be inserted into the damping block.
According to the closed clamp conveying system, the damping piece is a binding ring arranged on the wrench, and the binding ring can be sleeved on the control handle.
The closed clamp conveying system comprises a control handle, a connecting piece and a closed clamp, wherein the control handle is connected with the closed clamp conveying system through a connecting piece, the closed clamp conveying system comprises a damping piece, a concave piece and a convex piece, the damping piece is a concave piece and a convex piece which are matched with each other to rotate, the concave piece and the convex piece are in interference fit, friction materials are arranged between the concave piece and the convex piece, or the convex piece is a damping shaft, one end of the wrench is rotatably arranged in the control handle through the concave piece and the convex piece, and/or the far.
The closed clamp conveying system is characterized in that the damping piece is made of friction materials arranged at the sliding position of the connecting piece and the control handle.
The closed clamp conveying system is characterized in that a rotating shaft is fixedly arranged between the first shell and the second shell, a first rotating disc and a second rotating disc are rotatably mounted on the rotating shaft, a supporting pulley is arranged between the first rotating disc and the second rotating disc, the supporting pulley is rotatably mounted on the rotating shaft, the number of the first supporting sheet and the number of the second supporting sheet are both two, the number of the second riveting columns is one, the two ends of each second riveting column are respectively hinged with the first supporting sheet and the second supporting sheet, the winding pulley is mounted in the middle of each second riveting column, the number of the long through holes is two, the two long through holes are oppositely arranged, and the two ends of each second riveting column are respectively located in the two long through holes.
The closed clamp conveying system comprises a control handle, a control line fixing hole is formed in the unloading plug block positioned in the control handle, and the unloading control line is connected to the control line fixing hole.
The closed clamp conveying system comprises a control handle, a connecting rod and a head end, when the closed clamp conveying system is used, the direction of the head end is adjusted by adjusting the direction control end, the opening angle control end controls the opening or closing of the opening device through the opening angle control line, and the opening device is hinged between the two clamping arms, so that when the opening device is opened or closed, the included angle between the two clamping arms is increased or decreased. Through the direction of adjustment head end (the direction of adjusting the arm lock promptly) and the contained angle size between two arm locks, can make the closed clamp of installing at the head end catch target tissue conveniently, improved the efficiency and the degree of accuracy of implanting, can conveniently adjust the gesture of closed clamp many times according to clinical demand in order to reach best curative effect, improved the accuracy of implantation position to can release closed clamp with the left atrial appendage of clamp accurately. Through adjusting the off-load control end, the off-load control line can be separated from the closed clamp, the closed clamp is off-loaded from the clamping arm, the line shearing of surgical scissors is not needed, the efficiency of releasing the closed clamp is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient in the surgical process is reduced.
The invention will be further explained with reference to the drawings.
Drawings
FIG. 1 is a schematic diagram of the construction of a closure clip delivery system of the present invention;
FIG. 2 is a schematic diagram of a head end structure according to the present invention;
FIG. 3 is an exploded view of the head end of the present invention;
FIG. 4 is a distal end view of the connecting rod of the present invention;
FIG. 5 is a schematic proximal view of a third joint in the headend of the present invention;
fig. 6 is a schematic distal end view of a third joint in the headend of the present invention;
FIG. 7 is a cross-sectional view taken along line A-A of FIG. 5;
FIG. 8 is a cross-sectional view taken along line B-B of FIG. 6;
FIG. 9 is a schematic view of the proximal direction of a second joint in the head end of the present invention;
FIG. 10 is a schematic distal view of a second joint in the tip of the present invention;
FIG. 11 is a cross-sectional view taken along line C-C of FIG. 9;
FIG. 12 is a cross-sectional view taken along line D-D of FIG. 10;
FIG. 13 is a schematic view of the proximal direction of the first joint in the head end of the present invention;
FIG. 14 is a schematic distal view of a first joint in the tip of the present invention;
FIG. 15 is a cross-sectional view taken along line E-E of FIG. 13;
FIG. 16 is a cross-sectional view taken along line F-F of FIG. 14;
FIG. 17 is a schematic view of the proximal end of the clamp arm in the head end of the present invention;
FIG. 18 is a schematic view of the distal end of the clamp arm in the head end of the present invention;
FIG. 19 is a schematic view of the inner side surfaces of the clamp arms in the head end of the present invention;
figure 20 is a schematic view of a support sheet of the present invention;
FIG. 21 is a schematic view of a control line connection in the headend of the present invention (with the second joint hidden);
FIG. 22 is a schematic view of a control line connection in the head end of the present invention (with the first joint, the second joint and the third joint hidden);
FIG. 23 is a schematic view of a connection of control wires in the head end of the present invention (with the first joint, the second joint, the third joint, the upper clamp arm, the lower clamp arm, and the support plate hidden);
FIG. 24 is a schematic view of the distal tip of the present invention shown expanded;
FIG. 25 is a schematic view of the construction of the first housing of the control handle of the present invention;
FIG. 26 is a schematic view of the construction of the second housing in the control handle of the present invention;
FIG. 27 is a schematic view of the control handle of the present invention (with the first housing hidden);
FIG. 28 is a schematic view of a structure of a load shedding plug of the present invention;
FIG. 29 is a schematic view of the proximal end of the connector rod of the present invention;
FIG. 30 is a schematic view of the configuration of the directional control end of the control handle of the present invention;
FIG. 31 is a schematic view of a first positioning gear in the direction control end of the present invention;
FIG. 32 is a schematic view of another direction structure of the first positioning gear in the direction control end of the present invention;
FIG. 33 is a schematic structural diagram of a first direction control end according to the present invention;
FIG. 34 is a schematic view of a second direction control end according to the present invention;
FIG. 35 is an exploded view of the first/second direction control terminals of the present invention;
FIG. 36 is a schematic structural view of a first/second turntable according to the present invention;
FIG. 37 is a schematic view of another orientation of the first/second turntable of the present invention;
FIG. 38 is a schematic view of the flare angle control end of the present invention;
FIG. 39 is a schematic structural view of the flare angle control end of the present invention (closed clip closed state);
FIG. 40 is a schematic view of the flare angle control end of the present invention (the closure clip is open and in a hold state);
FIG. 41 is a schematic view of the structure of the wrench in the flare angle control end of the present invention;
FIG. 42 is a structural view of a connecting piece in the flare angle control end of the present invention;
FIG. 43 is a schematic view showing the construction of a sliding shaft in the opening angle control end of the present invention;
FIG. 44 is a schematic structural diagram of a flare angle control end according to another embodiment of the present invention;
fig. 45 is a schematic structural diagram of an opening angle control end according to yet another embodiment of the present invention.
Detailed Description
In the description of the present invention, for the convenience of understanding the present technical solution, the proximal and distal ends mentioned in the present invention are explained as follows: the proximal and distal ends are relative to the operator's distance, specifically, distal is defined as the distance to the operator and proximal is defined as the distance to the operator.
It should be noted that the terms "center", "upper", "lower", "front", "rear", "left", "right", "middle" head end, etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of describing the present invention and simplifying the description, but do not indicate or imply that the device or element referred to must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention.
In the description of the present invention, it is to be noted that, unless otherwise explicitly specified or limited, the terms "connected" and "connected" are to be interpreted broadly, e.g., as being fixed or detachable or integrally connected; can be mechanically or electrically connected; may be directly connected or indirectly connected through an intermediate. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
The gears and pulleys listed in the embodiment are only one specific transmission mode listed in the invention, so as to facilitate understanding of the embodiment of the invention, and should not be construed as limiting the invention.
The numbers mentioned in the present embodiment are also for the convenience of understanding of the present embodiment and are not to be construed as limiting the present invention.
Without loss of generality, the embodiment is described by taking the minimally invasive field as an example. It should be noted that the surgical device of the present embodiment can be applied to any field requiring implantation, except the minimally invasive field.
As shown in fig. 1 and in conjunction with fig. 2-45, the closure clip conveying system of the present invention includes a control handle 40, a connecting rod 30 and a head end 20, wherein the control handle 40 is connected to the head end 20 through the connecting rod 30, the head end 20 is hinged with two clip arms, two clip arms are hinged between the two clip arms for loading the closure clip, and the closure clip is a V-shaped closure clip 101. Be equipped with direction control end, opening angle control end 70 and off-load control end 80 on brake valve lever 40, be connected with the direction control line between direction control end and the head end 20, the direction control end passes through the direction of direction control line control head end 20, it has strutting device to articulate between two arm locks, be equipped with the opening angle control line between opening angle control end 70 and the strutting device, opening angle control end 70 struts the device through opening angle control line control and opens or closed, and when strutting the device and opening or closed, contained angle grow or diminish between two arm locks, be connected with the off-load control line between off-load control end 80 and the closed clamp, when the off-load control end makes the off-load control line break away from the closed clamp, the closed clamp is off-load from the arm lock.
The closed clamp conveying system comprises two direction control ends, wherein the two direction control ends are respectively a first direction control end 50 and a second direction control end 60, a first direction control line is connected between the first direction control end 50 and the head end 20, a second direction control line is connected between the second direction control end 60 and the head end 20, the first direction control end 50 controls the head end 20 to rotate in a first plane through the first direction control line, and the second direction control end 60 controls the head end 20 to rotate in a second plane through the second direction control line.
As shown in fig. 2, in conjunction with fig. 3, the closed clip transporting system of the present invention, wherein the head end 20 includes a first joint 104, a second joint 105 and a third joint 106, both of the clip arms are hinged to the first joint 104, the first joint 104 is hinged to the second joint 105, the second joint 105 is hinged to the third joint 106, the third joint 106 is connected with the connecting rod 30, the first direction control line is connected between the second joint 105 and the first direction control end 50, the second direction control line is connected between the first joint 104 and the second direction control end 60, the first direction control terminal 50 controls the second joint 105 to rotate in the first plane by the first direction control line, the second direction control end 60 controls the first joint 104 to rotate in a second plane by a second direction control line, the first plane being perpendicular to the second plane.
As shown in fig. 22 and fig. 23, in the closed clamp conveying system according to the present invention, two unloading control lines are provided, one ends of the two unloading control lines 306 and 307 connected to the closed clamp are respectively laid on the outer side surfaces of the two clamping arms, the two opposite inner side surfaces of the two clamping arms are used for loading the closed clamp, each clamping arm is provided with a through groove 447, the through groove 447 penetrates through the outer side surface and the inner side surface of the clamping arm, clamping arm wire loops 308 and 309 penetrate through the through groove 447, and the unloading control line on the outer side of the clamping arm and the closed clamp on the inner side of the clamping arm are simultaneously bound by the clamping arm wire loop on each clamping arm.
As shown in fig. 1 and combined with fig. 25-27 and 30-37, the closure clip delivery system of the present invention comprises a control handle 40 including a first housing 201 and a second housing 202 connected to each other, the connecting rod 30 is a cylindrical structure, the first direction control end 50 includes a first rotating disk 206 and a first direction control key 204, the first direction control key 204 is disposed on the first rotating disk 206, the first rotating disk 206 is rotatably mounted in the control handle 40, the first direction control end 50 extends out of the control handle 40, the first direction control lines are two, one end of each of the two first direction control lines 301 and 302 is connected to the first rotating disk 206, the other end of each of the two first direction control lines 301 and 302 passes through an inner cavity of the connecting rod 30 and then is connected to the second joint 105, and the two first direction control lines 301 and 301 connected to the first rotating disk 206, the second direction control line 204 and the first direction control line 204 are connected to the second rotating disk, 302 are located on opposite sides of the center of rotation of the first turntable 206, and two first direction control wires 301, 302 connected to the second joint 105 are located on opposite sides of the second joint 105.
As shown in fig. 25-27, 30-37, the closure clip delivery system of the present invention, wherein said second direction control end 60 comprises a second dial 207 and a second direction control key 205, the second direction control key 205 is provided on a second dial 207, the second dial 207 is rotatably installed in the control handle 40, the second direction control end 60 extends to the outside of the control handle 40, the number of the second direction control lines is two, one end of each of the two second direction control lines 303 and 304 is connected to the second rotating disc 207, the other end of each of the two second direction control lines 303 and 304 passes through the inner cavity of the connecting rod 30 and then is connected to the first joint 104, the two second direction control lines 303 and 304 connected to the second rotating disc 207 are respectively located at two opposite sides of the rotation center of the second rotating disc 207, and the two second direction control lines 303 and 304 connected to the first joint 104 are respectively located at two opposite sides of the first joint 104.
As shown in fig. 25-27 and 30-37, in the closed clamp conveying system of the present invention, a first blind hole 551 is formed on the first rotary disk 206, one end of the first direction control key 204 is located in the first blind hole 551, a first compression spring 221 is disposed between the first direction control key 204 and the bottom wall of the first blind hole 551, a first positioning plate 217 is fixedly disposed on the first direction control key 204, a second blind hole 559 is formed on the second rotary disk 207, one end of the second direction control key 205 is located in the second blind hole 559, a second compression spring 222 is disposed between the second direction control key 205 and the bottom wall of the second blind hole 559, and a second positioning plate 220 is fixedly disposed on the second direction control key 205. The control handle 40 is provided with a first positioning gear 203 and/or a second positioning gear, the first positioning gear 203 is arranged between the first direction control key 204 and the second direction control key 205, the second positioning gear is arranged at the position of the inner surface of the first shell 201 close to the first direction control key 204 and the position of the inner surface of the second shell 202 close to the second direction control key 205, under the action of a first compression spring 221, a first positioning sheet 217 on the first direction control key 204 is clamped on the gears of the first positioning gear 203 and/or the second positioning gear, and under the action of a second compression spring 222, a second positioning sheet 220 on the second direction control key 205 is also clamped on the gears of the first positioning gear 203 and/or the second positioning gear.
As shown in fig. 17, with reference to fig. 18 to 24, the closed clip conveying system of the present invention, wherein two of the clamping arms are arranged in an X shape, a first rivet column 118 is inserted through an intersection portion of the two clamping arms, both of the two clamping arms can rotate relative to the first rivet column 118, the first rivet column 118 is fixedly disposed on a first joint 104, the spreader device includes a wire winding pulley 119, a first supporting plate and a second supporting plate, one end of the first supporting plate is hinged to a proximal end of one of the clamping arms, the other end of the first supporting plate is hinged to one end of the second supporting plate through a second rivet column 117, the other end of the second supporting plate is hinged to a proximal end of the other clamping arm, the wire winding pulley 119 is mounted on the second rivet column 117 (either fixedly mounted or rotatably mounted), a strip through hole 438 is formed on the first joint 104, the second rivet column 117 is located in the strip through hole 438, when the second rivet stud 117 moves along the elongated through hole 438, the included angle between the two clamping arms becomes larger or smaller. As shown in fig. 27-29 and 38-43, the flare angle control end 70 includes a wrench 208 and a connecting piece 225, one end of the wrench 208 is rotatably installed in the control handle 40, the other end of the wrench 208 extends out of the control handle 40, the connecting piece 225 is slidably installed in the control handle 40, the connecting piece 225 can slide back and forth along the distal and proximal directions of the control handle 40, the distal end of the connecting piece 225 is hinged to the wrench 208, one end of the flare angle control wire 305 is fixed on the first joint 104 after passing around the winding pulley 119, and the other end of the flare angle control wire 305 is connected to the connecting piece 225.
The inner surface of the control handle 40 is provided with sliding grooves 611 arranged along the distal end and the proximal end of the control handle, one side surface of the connecting piece 225 is provided with a sliding block 616, the sliding block 616 is positioned in the sliding groove 611, the other side surface of the connecting piece 225 is provided with a sliding shaft 213, the sliding shaft 213 and the sliding block 616 are coaxially arranged, the other end of the opening angle control wire 305 forms a sliding shaft wire loop, and the sliding shaft wire loop is sleeved on the sliding shaft 213.
A damping piece for preventing the included angle between the two clamping arms from becoming smaller is arranged between the opening angle control end 70 and the control handle 40. The types of the damping member are as follows:
the damping piece is a damping spring 209, one end of the damping spring 209 is connected to the proximal end of the connecting piece 225, and the other end of the damping spring 209 is connected to the inside of the control handle 40.
Damping piece is damping piece 622 and spanner arch 621, damping piece 622 is located on brake handle 40, spanner arch 621 is located on spanner 208, spanner arch 621 can insert in the damping piece 622.
The damping piece is a binding ring 623 arranged on the wrench 208, and the binding ring 623 can be sleeved on the control handle 40.
The damping piece is a concave piece and a convex piece which are matched with each other to rotate, the concave piece and the convex piece are in interference fit, friction materials are arranged between the concave piece and the convex piece, or the convex piece is a damping shaft, one end of the wrench 208 is rotatably arranged in the control handle 40 through the concave piece and the convex piece, and/or the far end of the connecting piece 225 is hinged on the wrench 208 through the concave piece and the convex piece.
The damping member is a friction material disposed at the sliding position of the connecting piece 225 and the control handle 40 (i.e., the sliding block 616 and the sliding groove 611).
As shown in fig. 30, in the closed clamp conveying system according to the present invention, a rotating shaft 212 is fixedly disposed between the first casing 201 and the second casing 202, a first rotating disc 206 and a second rotating disc 207 are rotatably mounted on the rotating shaft 212, a supporting pulley 210 is disposed between the first rotating disc 206 and the second rotating disc 207, the supporting pulley 210 is rotatably mounted on the rotating shaft 212, as shown in fig. 22, two first supporting sheets and two second supporting sheets are provided, one second rivet column 117 is provided, two ends of the second rivet column 117 are respectively hinged to the first supporting sheet and the second supporting sheet, the winding pulley 119 is mounted in the middle of the second rivet column 117, two elongated through holes 438 are provided, two elongated through holes 438 are disposed oppositely, and two ends of the second rivet column 117 are respectively located in the two elongated through holes 438.
As shown in fig. 28, the unloading control end 80 includes an unloading plug 211, the unloading plug 211 is connected to the control handle 40, a control line fixing hole 518 is formed in the unloading plug 211 located in the control handle 40, and the unloading control line is connected to the control line fixing hole 518.
The closed clamp conveying system comprises a control handle 40, a connecting rod 30 and a head end 20, when the closed clamp conveying system is used, the direction of the head end 20 is adjusted by adjusting a direction control end, an opening angle control end 70 controls an opening or closing of a spreading device through an opening angle control line 305, and the spreading device is hinged between two clamping arms, so that when the spreading device is opened or closed, an included angle between the two clamping arms is increased or decreased. Through the direction of adjustment head end 20 (the direction of adjusting the arm lock promptly) and the contained angle size between two arm lock, can make the closed clamp of installing at head end 20 catch target tissue conveniently, improved the efficiency and the degree of accuracy of implanting, can conveniently adjust the gesture of closed clamp many times according to clinical demand in order to reach best curative effect, improved the accuracy of implantation position to can release closed clamp with the left atrial appendage of pressing from both sides closed accurately. Through adjusting the off-load control end 80, the off-load control line can be separated from the closed clamp, the closed clamp is off-loaded from the clamping arm, the line shearing of surgical scissors is not needed, the efficiency of releasing the closed clamp is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient in the surgical process is reduced.
The construction of the closure clip delivery system of the present invention is described in detail below.
As shown in FIG. 1, the distal end of the control handle 40 is connected to the proximal end of the connecting rod 30, the distal end of the connecting rod 30 is connected to the head end 20, and a closing clip is loaded between the two clip arms of the head end 20. The control handle 40 includes a first directional control end 50 for adjusting the orientation of the head end 20 in a plane. The control handle 40 also includes a second directional control end 60 for adjusting the direction of the head end 20 in another plane. The operator can press the button-rotate the button-release the button to adjust the orientation of the head 20 and lock the head. The control handle 40 also includes a release control end 80 to effect separation of the closure clip and the head end 20. Control handle 40 also includes a flare angle control end 70 for adjusting the angle between the two clamping arms in head end 20. The first direction control end 50, the second direction control end 60, the unloading control end 80, and the opening angle control end 70 are assembled in a control handle housing 90. The two clamping arms are respectively an upper clamping arm 102 and a lower clamping arm 103.
As shown in fig. 1-3, the head end 20 includes a third joint 106, the proximal end of the third joint 106 is connected to the distal end of the connecting rod 30, and the distal end of the third joint 106 is connected to the proximal end of the second joint 105. The second joint 105 and the third joint 106 are relatively rotatable in the X-Y plane (i.e., the first plane described above). The distal end of the second joint 105 is connected to the proximal end of the first joint 104 and is relatively rotatable in the Y-Z plane (i.e., the second plane described above). The distal end of first joint 104 is connected to the proximal ends of upper clamp arm 102 and lower clamp arm 103 by a first rivet 118. The upper and lower clamp arms 102, 103 are rotatable about a first rivet post 118. As will be discussed next, the control of the relative rotational movement between the upper and lower clamp arms 102, 103 is accomplished via an opening angle control line 305 to achieve single ended opening and closing operation of the closure clip 101.
As shown in fig. 4-8, the third joint 106 is formed by a proximal circular ring-shaped through-surface 402 that gradually transitions into a distal rectangular depending wall 401. The proximal end of the third joint 106 is provided with a cylindrical groove 403, the interior of which is used for loading the distal end of the connecting rod 30, and the proximal end and the distal end can be fastened by welding, interference fit and the like. The distal end of the connecting rod 30 meets the bottom surface wall 410 of the cylindrical recess 403. The cylindrical slot bottom wall 410 includes a locating hole 411, the locating hole 411 cooperating with a locating boss 456 at the distal end of the connecting rod 30 to effect a locating assembly of the connecting rod 30 with the third joint 106. The cylindrical trough bottom wall 410 includes one rectangular through hole 404 and four circular through holes 405, 406, 407, 408. Two first direction control lines 301 and 302 pass through two circular through holes 405 and 406, respectively, and second direction control lines 303 and 304 pass through the other two circular through holes 407 and 408, respectively. One opening control line 305 and two unloading control lines 306, 307 pass through the rectangular through hole 404.
Short cantilevers 409 are symmetrically arranged on the far end face of the bottom surface 410 of the cylindrical groove along the directions of the two circular through holes 405 and 406 at two sides, so as to limit the rotation range of the second joint 105. The long cantilevers 401 are symmetrically arranged on both sides along the other two circular through holes 407 and 408. The distal ends of the two long cantilevers 401 respectively comprise circular through holes 412 and 413, and the two circular through holes 412 and 413 are coaxially arranged. The distal end of the third joint 106 mates with the proximal end of the second joint 105 through the circular through holes 412, 413 and the rotational axes 107, 108 (as shown in fig. 3).
As shown in fig. 9-12, the second joint 105 is contoured to consist of a proximal radiused surface 414 and a distal two cantilevered structures 415. The second proximal articular surface 414 is provided with two circular through holes 416, 417 and a rectangular through hole 418. Two second direction control wires 303, 304 pass through two circular vias 416, 417, respectively, and one flare control wire 305 and two off- load control wires 306, 307 pass through a rectangular via 418. Two through holes 420 and 421 are symmetrically arranged on the top surface 419 and the bottom surface of the proximal end of the second joint 105, the top surface 419 and the bottom surface of the proximal end of the second joint 105 are embedded between the two long cantilevers 401 at the distal end of the third joint 106, the through hole 420 of the top surface of the second joint and the circular through hole 412 of the long cantilever of the third joint are riveted together through the rotating shaft 107, and the through hole 421 of the bottom surface of the second joint and the circular through hole 413 of the lower cantilever of the third joint are riveted together through the rotating shaft 108. The second joint 105 and the third joint 106 can now rotate about the rotation axes 107, 108, so that the second joint 105 and the third joint 106 are articulated to each other. The maximum range of rotation of the second joint 105 is defined by the short cantilever 409 of the third joint 106.
Wire grooves 422 are formed in the cambered surfaces 414 and the cantilevers 415 at the two sides of the proximal end of the second joint 105, and through holes 423 are formed at the distal ends of the wire grooves 422. The through hole 423 is located at a proximal portion of the cantilever 415. The two first direction control wires 301 and 302 are respectively arranged in the two wire grooves 422 and extend to the through hole 423 along the wire grooves 422, and the far ends of the first direction control wires 301 and 302 are provided with a bulge, wherein the size of the bulge is larger than the diameter of the through hole 423. As shown in fig. 21, the distal ends of the first direction control wires 301 and 302 are fitted so that the projecting portions are located on the inner surface 424 side of the cantilever 415, and the distal ends of the first direction control wires 301 and 302 are caught at the through holes 423. Therefore, when the distal ends of the first direction control wires 301 and 302 move, the second joint 105 is driven to move correspondingly relative to the third joint 106, and the rotation of the second joint 105 is controlled.
Short cantilevers 426 are symmetrically arranged on both sides of the second joint middle surface 425 along the two circular through holes 417 and 418 to limit the rotation range of the first joint 104. Each of the two elongate cantilevers 415 comprises a circular through hole 427, 428 at its distal end, the two circular through holes 427, 428 being arranged coaxially. The distal end of the second joint 105 mates with the proximal end of the first joint 104 through circular through holes 427, 428 and rotational axes 109, 110 (shown in fig. 3).
As shown in fig. 13-16, the first joint 104 is contoured to include a proximal radiused surface 429 and a distal two cantilevered structures 430. The first proximal joint surface 429 is provided with two circular through holes 431 and one rectangular through hole 432. The specific way in which one end (i.e., the distal end) of the flare angle control wire 305 is fixed to the first joint 104 after passing around the winding pulley 119 is as follows: the distal end of the flare angle control wire 305 has a protrusion with a size larger than that of the circular through holes 431, and when the flare angle control wire 305 is assembled, the distal protrusion of the flare angle control wire 305 is placed at the proximal end side of any one of the circular through holes 431, then the proximal end of the flare angle control wire 305 passes through the through holes 431 to extend to the distal end, then the proximal end of the flare angle control wire passes through the rectangular through hole 432 to extend to the proximal end after encircling the winding pulley 119, and the flare angle control wire is connected to the flare. The offload control lines 306, 307 pass through a rectangular via 432.
Two through holes 434 are symmetrically arranged on the top surface 433 and the bottom surface of the proximal end of the first joint 104, the top surface 433 and the bottom surface of the proximal end of the first joint 104 are embedded between the two cantilevers 415 at the distal end of the second joint 105, the first joint top surface through hole 434 and the second joint cantilever upper circular through hole 427 are riveted together through the rotating shaft 109, and the first joint bottom surface through hole 434 and the second joint cantilever lower circular through hole 428 are connected together through the rotating shaft 110. The first joint 104 and the second joint 105 are now rotatable about the axes of rotation 109, 110, such that the first joint 104 and the second joint 105 are articulated relative to each other (as shown in fig. 3). The maximum range of rotation of the first joint 104 is defined by the short cantilever 426 of the second joint 105.
The two side cambered surfaces 429 at the proximal end of the first joint 104 and the two side cantilevers 430 are respectively provided with a wire groove 435, and the distal end of the wire groove 435 is provided with a through hole 436. Through hole 436 is located at the proximal portion of cantilever 430. The two second direction control wires 303, 304 are respectively arranged in the two wire grooves 435 and extend to the through hole 436 along the wire grooves 435, and the distal ends of the second direction control wires 303, 304 are provided with a protrusion, the size of which is larger than the diameter of the through hole 436. The installation is made such that the convex portion of the distal end of the second direction control wire 303, 304 is located on the side of the inner surface 437 of the cantilever 436, so that the distal end of the second direction control wire 303, 304 is caught at the through hole 436. Therefore, when the distal ends of the second direction control wires 303 and 304 move, the first joint 104 is driven to move correspondingly, and the rotation of the first joint 104 is controlled.
The middle parts of the cantilevers 430 at the two sides of the first joint 104 are symmetrically provided with a long through hole 438, the far ends of the cantilevers 430 at the two sides are symmetrically provided with a circular through hole 439, and the far ends of the first joint 104 are connected with the upper clamping arm 102 and the lower clamping arm 103 through the long through hole 438 and the circular through hole 439. The specific connection is described later.
As shown in fig. 17-19, upper clamp arm 102 and lower clamp arm 103 are identical in construction. The proximal ends of upper arm 102 and lower arm 103 include a cantilever 440, and the proximal end of cantilever 440 includes a cylinder 441. A circular through hole 442 is present in the cylindrical body 441. The middle portion of cantilever 440 includes a through-hole 443. The distal end of the cantilever 440 is connected to a long cantilever 445, which is located to the left of the proximal end of the long cantilever 445. The upper clamping arm 102 and the lower clamping arm 103 are connected with the first joint 104 through the through hole 443 and the through hole 442. Referring to FIG. 2, when connected, inner side 444 of upper arm 102 and lower arm 103 contact each other and outer side 448 contacts inner side 437 of cantilever arm 430 of first knuckle 104. As shown in fig. 2, a first rivet 118 is provided through a through hole 439 formed at the distal end of the first joint 104 and through holes 443 formed at the proximal ends of the upper clamp arm 102 and the lower clamp arm 103, the first rivet 118 connects the upper clamp arm 102 and the lower clamp arm 103 with the first joint 104, and the upper clamp arm 102 and the lower clamp arm 103 are allowed to rotate around the first rivet 118, so that the upper clamp arm 102 and the lower clamp arm 103 are hinged to the first joint 104.
As shown in fig. 20, 21 and 22, the through-holes 454 at one ends of the two first support pieces 113 and 114 are respectively caulked to both side surfaces 452 and 453 of the proximal cylinder 441 of the lower arm 103 by the caulking pin 111, and the through-holes 454 at one ends of the two second support pieces 115 and 116 are respectively caulked to both side surfaces 452 and 453 of the proximal cylinder 441 of the upper arm 102 by the caulking pin 112. The wire winding pulley 119, the through hole 455 at the other end of the two first supporting plates 113 and 114, the through hole 455 at the other end of the two second supporting plates 115 and 116, and the elongated through hole 438 on the cantilever 430 of the first joint 104 are riveted together by the second riveting column 117, and the wire winding pulley 119 is located between the two first supporting plates 113 and 114 and also between the two second supporting plates 115 and 116. The aperture control wire 305 is connected to the aperture control terminal 70 by passing around the winding pulley 119. When the opening angle control end 70 is operated to move the opening angle control line 305 to the proximal end, the opening angle control line 305 drives the winding pulley 119 to move to the proximal end along the elongated through hole 438 of the first joint 104, and the winding pulley 119 further causes the first supporting pieces 113, 114 and the second supporting pieces 115, 116 hinged to each other to expand the proximal cantilevers 440 of the upper arm 102 and the lower arm 103 outward, as shown in fig. 22, since the upper arm 102 and the lower arm 103 are hinged together in an X shape, the distal cantilevers 445 of the upper arm 102 and the lower arm 103 rotate around the first rivet column 118 correspondingly, that is, the opening angle between the upper arm 102 and the lower arm 103 increases. Conversely, the wire winding pulley 119 moves distally, and the angle between the upper arm 102 and the lower arm 103 decreases. Therefore, the control of the included angle between the upper clamping arm 102 and the lower clamping arm 103 is realized through the opening angle control line 305. It should be noted that, the first support sheet and the second support sheet in the opening device are used in cooperation, and a group of first support sheet and a group of second support sheet (the number of the first support sheet and the second support sheet in each group is one) may be provided, or two or more groups of first support sheet and second support sheet may be provided.
As shown in fig. 22 to 24, the proximal end face of the long cantilever 445 is provided with a through hole 449, and the distal side of the through hole 449 communicates with the long wire groove 446 formed in the outer surface of the long cantilever 445. The inner side of the long cantilever 445 is provided with a groove consisting of two opposing side walls 450, 451. At the distal and middle ends of the long cantilever 445, a plurality of through slots 447 are arranged. Two unloading control wires 306 and 307 respectively pass through the through holes 449 of the upper clamping arm 102 and the lower clamping arm 103 and extend along the long wire slot 446 to the far end of the long cantilever 445. When installed, the two arms of the V-shaped closure clip 101 are disposed within the grooves formed by the two side walls 450, 451 of the upper and lower clip arms 102, 103, respectively. In the upper clamp arm 102, an appropriate one of the through slots 447 is selected so that a clamp arm wire loop 308 passes through the through slot 447 while binding one side arm of the V-shaped closure clip 101 and the unload control wire 306. In the lower clamp arm 103, the appropriate one of the through slots 447 is selected and a clamp arm wire loop 309 is passed through the through slot 447 while tying down the other side arm of the V-shaped closure clip 101 and the off-load control wire 307. Thereby realizing the connection and fixation of the closing clip 101 with the upper clip arm 102 and the lower clip arm 103. So that the upper clamping arm 102 and the lower clamping arm 103 can drive the V-shaped closing clamp to synchronously move correspondingly. When the unloading control lines 306 and 307 are displaced from the distal end to the proximal end, so that they are disengaged from the clip arm wire loops 308 and 309, the closure clip 101 is disengaged from the upper clip arm 102 and the lower clip arm 103, thereby achieving unloading of the closure clip 101.
As shown in fig. 25 to 29, the control handle 40 includes a first housing 201 and a second housing 202, the first housing 201 includes an inner surface 502, an outer surface 501, and an end surface 503 connecting the two surfaces, and the second housing 202 includes an inner surface 522, an outer surface 521, and an end surface 523 connecting the two surfaces. The inner surface 502 of the first housing 201 is provided with a plurality of positioning posts 532, the end surface 503 comprises a groove 608, the inner surface 522 of the second housing 202 is provided with a plurality of positioning holes 520, and the end surface 523 is provided with a boss 510. The first housing 201 and the second housing 202 are assembled as shown in fig. 1, the positioning hole 520 is matched with the positioning post 532, and the groove 608 on the end surface 503 is matched with the boss 510 on the end surface 523. When assembled, the control handle 40 defines four openings 504, 505, 506, 507 for placement of portions of the components.
The first opening 504 of the control handle 40 is located at the distal end of the handle and is shaped to mate with the connecting rod 30 to allow for connection of the handle to the connecting rod 30. Bosses 508 are arranged at the openings 504 of the first shell 201 and the second shell 202, a semi-cylindrical through hole coaxial with the opening 504 is arranged on each boss 508, and four bosses 510 are arranged on the inner surface of the semi-cylindrical through hole. As shown in fig. 29, the proximal end of the connecting rod 30 includes an inner surface 534, a proximal end surface 533, an outer surface 536, and four grooves 535. In installation, the outer surface 536 of the connector strut 30 is mated with the inner surface of the semi-cylindrical bore of the opening 504, and the boss 510 and recess 535 are mated such that the proximal surface 533 of the connector strut 30 is coincident with the proximal surface 609 of the boss 508, thereby securing the connector strut 30 within the control handle 40. All control wires enter the interior of the control handle 40 via the lumen of the connecting rod 30.
As shown in fig. 25-27 and 30, the second opening 505 of the control handle 40 is located at the upper proximal end of the first housing 201 and the second housing 202, where the first direction control end 50 and the second direction control end 60 are located. A rotating shaft 212 is fixedly arranged between the blind hole 513 of the first housing 201 and the blind hole 524 of the second housing 202, and the first rotating disk 206 and the second rotating disk 207 are rotatably mounted on the rotating shaft 212. The adjustment and locking of the head end 20 in the two in-plane directions are realized through the first direction control key 204, the second direction control key 205 and at least one of the first positioning gear 203 and the second positioning gear. A detailed description of the first direction control terminal 50 and the second direction control terminal 60 is listed later.
As shown in fig. 25-27, the third opening 506 of the control handle 40 is located at the lower proximal end of the first housing 201 and the second housing 202, where the flare angle control end 70 is located. The third opening 506 is sized to mate with the wrench 208. The wrench 208 fits into the control handle 40 through the hole 515 in the first housing 201 and the hole 528 in the second housing 202. When the first casing 201 and the second casing 202 are fastened to each other, the post 527 on the second casing 202 is inserted into the blind hole 514 of the first casing 201. Flare control line 305 is associated with connection tab 225, bypassing sliding shaft 213, and wrench 208 is in turn associated with connection tab 225. By turning the wrench 208, the opening angle of the head end 20 can be adjusted. A detailed description of the flare angle control end 70 is listed later.
As shown in fig. 25-28, the fourth opening 507 of the control handle 40 is located at the proximal end of the first housing 201 and the second housing 202 where the unloading control end 80 is located. The unloading control end 80 includes an unloading stopper 211. The proximal ends of the shedding control lines 306, 307 are tied, glued, crimped, etc. to the control line securing holes 518 of the shedding plugs 211. The unloading stopper 211 is fixed at the fourth opening 507 by interference fit, screw fit, etc. The unloading stopper 211 is removed from the fourth opening 507 and pulled outward, which drives the unloading control lines 306, 307 to move proximally, so that the distal ends of the unloading control lines 306, 307 are disengaged from the clip arm wire loops 308, 309, thereby unloading the V-shaped closure clip 101.
As shown in fig. 30-37, the first direction control end 50 includes a first direction control key 204 and a first dial 206, and the second direction control end 60 includes a second direction control key 205 and a second dial 207. The first positioning gear 203 is located between the first direction control key 204 and the second direction control key 205. Two bosses 538 are arranged on one side surface 540 of the first positioning gear 203, and are arranged in two blind holes 526 at corresponding positions of the opening 505 of the second shell 202 during assembly, so that the bottom surfaces 541 of the bosses 538 are connected with the end surface 525 at the opening 505 of the second shell 202, and a certain distance exists between the side surface 540 of the first positioning gear 203 and the end surface 525 at the opening 505 of the second shell 202, and the second direction control key 205 can be accommodated to pass through the distance. The other side surface 544 of the first positioning gear 203 is provided with two bosses 542, and when the assembly is carried out, the bosses are installed in the two blind holes 512 at the corresponding positions of the first casing 201, so that the bottom surface 543 of the boss 542 is connected with the end surface 511 at the opening 505 of the first casing 201, and at this time, a certain distance exists between the side surface 544 of the first positioning gear 203 and the end surface 511 at the opening 505 of the first casing 201, and the first direction control key 204 can be accommodated to pass through the distance. A gear 539 is arranged inside the middle of the first positioning gear 203. A second positioning gear is provided on the inner surface of the first housing 201 near the end surface 511 (i.e., near the first direction control key of the inner surface of the first housing), and the second positioning gear matches with the gear 539 in the first positioning gear 203. A second positioning gear is also provided on the inner surface of the second housing 202 adjacent to the end surface 525 (i.e., the inner surface of the second housing adjacent to the second direction control key), and is mated with the gear 539 of the first positioning gear 203. The first turntable 206, the second turntable 207, and the support pulley 210 are connected to the first housing 201 and the second housing 202 via a rotation shaft 212. The first turntable 206 and the second turntable 207 are both rotatable about a rotation axis 212. The supporting pulley 210 is located between the first turntable 206 and the second turntable 207.
The first direction control end 50 includes a first direction control key 204, a first positioning piece 217, a first dial 206, a first compression spring 221, a screw 216, a nut 214, and a rotation shaft 212. The first turntable 206 has a circular boss 548 in the center of the top surface 547 for winding the first direction control wires 301 and 302, and a circular through hole 552 in the center of the first turntable 206 for receiving the rotary shaft 212. One side of the top surface 547 of the first turntable 206 includes a circular through-hole 549 and a hexagonal counterbore 550 is present in a corresponding position to the bottom surface 553. The first direction control wires 301, 302 enter the top surface 547 distally and extend along the outer side of the boss 548 to the circular through hole 549. At this point, the first direction control wires 301, 302 are tightened, the nut 214 is placed in the hexagonal counterbore 550, and the screw 218 is then threaded into the nut 214 from the top surface 547 while the first direction control wires 301, 302 are secured between the screw 218 and the first rotor plate 206. Thereby allowing the first direction control wires 301 and 302 to move with the rotation of the first turntable 206, and further causing the second joints 105 connected to the distal ends of the first direction control wires 301 and 302 to rotate in the X-Y plane (i.e., the first plane), thereby rotating the head end 20 in the plane. As can be seen from the above description, the two first direction control wires 301 and 302 connected to the first rotating disk 206 should be located on opposite sides of the rotation center of the first rotating disk 206, so that when the first rotating disk 206 rotates around its rotation center, the two first direction control wires 301 and 302 can pull the second joint 105 to rotate in the X-Y plane (i.e. the first plane), which is a symmetric swing type rotation.
The proximal side of the first dial 206 is provided with a first blind hole 551 into which the first compression spring 221 is inserted. A through groove 545 is formed in the middle of the first direction control key 204, the first positioning piece 217 is installed and fixed in the through groove 545 in a screw, riveting or bonding mode, and meanwhile, two ends of the first positioning piece 217 protrude out of one part of the side face of the first direction control key 204. The bottom surface 546 of the first direction control key 204 is received in the first blind hole 551 of the first dial 206 and contacts the first compression spring 221, so that the first compression spring 221 and the bottom surface 546 of the first direction control key 204 have an interaction force. The top end of the first direction control key 204 extends out of the housing through the gap between the side surface 544 of the first positioning gear 203 and the end surface 511 at the opening 505 of the first housing 201. At this time, due to the outward pushing force of the first compression spring 221, the first direction control key 204 moves outward, so that the first positioning piece 217 moves outward, and the portion of the first positioning piece 217 protruding out of the side surface of the first direction control key 204 is clamped in the gear 539 of the first positioning gear 203, so that the first direction control key 204 is fixed. In order to balance the stress of the first direction control key 204 when the first direction control key 204 is in the fixed state, as mentioned above, the second positioning gear is provided on the inner surface of the first housing 201 near the end surface 511, and the first positioning piece 217 protrudes from two opposite side surfaces of the first direction control key 204, and when the first direction control key 204 moves outwards, the portion of the first positioning piece 217 protruding from the side surface of the first direction control key 204 is also clamped into the second positioning gear on the inner surface of the first housing 201. The first turntable 206 cannot rotate at this time. The first direction control key 204 is pressed towards the bottom surface direction of the first blind hole 551, and is moved along the direction until the first positioning piece 217 is completely separated from the first positioning gear 203 and the second positioning gear on the first housing 201, at this time, the first direction control key 204 can be rotated up and down, so as to drive the first rotary disk 206 to rotate, further to cause the first direction control lines 301 and 302 to drive the second joint 105 to rotate, and further to realize the rotation of the head end 20 in the X-Y plane. The hole wall of the first blind hole 551 is provided with a gap for accommodating the first positioning sheet 217. When the rotation angle of the head end 20 in the X-Y plane is selected, and the pressure on the first direction control key 204 is stopped, the first direction control key 204 moves to the outside of the control handle 40 under the action of the elastic force of the first compression spring 221 until the first positioning piece 217 is clamped into the first positioning gear 203 and the second positioning gear on the first housing 201 again, and at this time, the first direction control key 204 is locked again. In summary, the angular adjustment and locking of the head end 20 in the X-Y plane can be accomplished by the first direction control key 204. It should be noted that the locking of the first direction control key 204 can be completed by only providing one of the first positioning gear 203 and the second positioning gear.
The second direction control end 60 includes a second direction control key 205, a second positioning piece 220, a second rotary disk 207, a second compression spring 222, a screw 219, a nut 215, and a rotary shaft 212. A circular boss 548 is provided at the center of a bottom surface 547 of the second turntable 207 (the bottom surface of the second turntable and the bottom surface of the first turntable share a common reference numeral, since in the drawings of the specification, the first turntable and the second turntable share a common reference numeral, and for the sake of simplicity, the first turntable and the second turntable are not distinguished from each other in the drawings, and the circular boss, the circular through hole, the bottom surface, the hexagonal counter bore, the second blind hole, and the through groove and the bottom surface of the second direction control key, which will be described later, are all the same) for winding the second direction control lines 303, 304. The second turntable 207 has a circular through hole 552 at the center thereof for receiving the rotary shaft 212. One side of the top surface 547 of the second turntable 207 comprises a circular through hole 549 in which a hexagonal counter bore 550 is present in a corresponding position to the bottom surface 553. The second direction control wires 303, 304 extend distally onto the top surface 547 along the outer side of the boss 548 to the circular through hole 549. At this point, second direction control wires 303, 304 are tightened, nut 215 is placed in hexagonal counterbore 550, and screw 219 is threaded into nut 215 from top surface 549 while second direction control wires 303, 304 are secured between screw 219 and second dial 207. Thereby allowing the second direction control wires 303, 304 to move as the second dial 207 is rotated, which in turn causes the first joints 104, distally connected to the second direction control wires 303, 304, to rotate in the Y-Z plane (i.e., the second plane), thereby rotating the head end 20 in that plane. As can be seen from the above description, the two second direction control wires 303 and 304 connected to the second rotary disk 207 should be respectively located at two opposite sides of the rotation center of the second rotary disk 207, so that when the second rotary disk 207 rotates around its rotation center, the two second direction control wires 303 and 304 can pull the first joint 104 to rotate in the Y-Z plane (i.e. the second plane), which is a symmetric swing type rotation.
The second rotary disk 207 has a second blind hole 551 formed in the side surface of the proximal end thereof, into which the second compression spring 222 is inserted. A through groove 545 is formed in the middle of the second direction control key 205, the second positioning piece 220 is installed and fixed in the through groove 545 by means of screws, riveting or bonding, and the like, and two ends of the second positioning piece 220 protrude from the side surface of the second direction control key 205. The bottom surface 546 of the second direction control key 205 is received in the second blind hole 551 of the second rotary disk 207 and contacts the second compression spring 222, so that the second compression spring 222 and the bottom surface 546 of the second direction control key 205 have an interaction force. The top end of the second direction control key 205 extends out of the housing through the gap between the side surface 544 of the first positioning gear 203 and the end surface 525 at the opening 505 of the second housing 202. At this time, due to the outward pushing force of the second compression spring 222, the second direction control key 205 moves outward, which causes the second positioning piece 220 to move outward, and further causes the portion of the second positioning piece 220 protruding out of the side surface of the second direction control key 205 to be clamped into the gear 539 of the first positioning gear 203, so that the second direction control key 205 is fixed. In order to balance the force applied to the second direction control key 205 when the second direction control key 205 is in the fixed state, as mentioned above, the second positioning gear is disposed on the inner surface of the second housing 202 near the end surface 525, and the second positioning plate 220 protrudes from two opposite side surfaces of the second direction control key 205, and when the second direction control key 205 moves outward, the portion of the second positioning plate 220 protruding from the side surface of the second direction control key 205 is also locked in the second positioning gear on the inner surface of the second housing 202. The second turntable 207 cannot rotate at this time. The second direction control key 205 is pressed towards the bottom direction of the second blind hole 551, and is moved along the direction until the second positioning piece 220 is completely separated from the first positioning gear 203 and the second positioning gear on the second housing 202, at this time, the second direction control key 205 can be rotated up and down, so as to drive the second rotary disk 207 to rotate, and further cause the second direction control lines 303 and 304 to drive the first joint 104 to rotate, thereby realizing the rotation of the head end 20 in the Y-Z plane. When the rotation angle of the head 20 in the Y-Z plane is selected, and the pressure on the second direction control key 205 is stopped, the second direction control key 205 moves to the outside of the control handle 40 under the elastic force of the second compression spring 222 until the second positioning piece 220 is locked again in the first positioning gear 203 and the second positioning gear on the second housing 202, and at this time, the second direction control key 205 is locked again. In summary, the angular adjustment and locking of the head end 20 in the Y-Z plane can be accomplished by the second direction control button 205. It should be noted that the second direction control key 205 can be locked by only one of the first positioning gear 203 and the second positioning gear.
As shown in fig. 25-27, 38-43, flare angle control end 70 includes a wrench 208 and a connecting tab 225. The wrench 208 is provided with a boss 564 and a boss 575 on each of the left and right sides thereof, and when the wrench is assembled, one boss 564 and the bottom surface 565 thereof are engaged with the groove 515 of the first housing 201, and the other boss 575 and the bottom surface 576 thereof are engaged with the groove 528 of the second housing 202. So that the wrench 208 can rotate around the rotation axis formed by the bosses 575-564. Wrench 208 has a recess 573 at its distal end and a through hole 570 therein. The coupling piece 225 has a through hole 613 at a distal end thereof, and the coupling piece 225 is inserted into the groove 573 at a distal end side thereof when assembled, and the coupling piece 225 and the wrench 208 are coupled together by the coupling shaft 223 and are relatively rotatable about the coupling shaft 223. The connecting piece 225 has a sliding block 616 in the middle, and a fixing hole 614 is formed in the sliding block 616, so that the sliding block 616 is placed in the sliding groove 611 in the boss 610 of the second housing 202 during assembly. The bottom surface 620 of the tab 225 contacts the top surface 619 of the boss 610. At this time, the slider 616 may move back and forth within the sliding slot 611. The bottom shaft 618 of the slide shaft 213 is fixed to the fixing hole 614 of the coupling piece 225 by welding, bonding, screwing, or the like. The opening angle control wire 305 passes around the bottom shaft 618 between the upper surface 612 of the connecting sheet 225 and the top cover bottom surface 617 of the sliding shaft 213, the proximal end of the opening angle control wire 305 is fixed on the side close to the distal end of the sliding shaft 213 by means of bonding, welding, dimpling, etc., so that the opening angle control wire 305 forms a sliding axis loop which is sleeved on the sliding shaft 213, and the installation is carried out while ensuring that a sufficient gap is left between the bottom surface 617 and the upper surface 612, and ensuring that the sliding axis loop formed by the opening angle control wire 305 can rotate freely between the two surfaces. The damping spring 209 is sleeved on the boss 527 of the second housing 205 and the proximal groove 615 of the connecting piece 225 at two sides.
The normal state of the closure clip 101 is the closed state, and when the closure clip 101 transitions from the open state to the closed state, the opening angle control line 305 is pulled in a distal direction, thereby causing the sliding shaft 213 to abut against the distal side of the sliding groove 611. At this time, the proximal end edge 567 of the grip ring on the wrench 208 is pulled to the proximal end, so that the wrench 208 rotates counterclockwise around the bosses 564 and 575, and the connecting shaft 223 is driven to rotate counterclockwise around the bosses 564 and 575, and thus the included angle a formed by the connecting line between the bosses 564 and 575 and the connecting shaft 223 and the connecting line between the connecting shaft 223 and the sliding shaft 213 is increased continuously. Thereby causing the sliding shaft 213 to move proximally along the sliding slot 611, and further pulling the opening angle control line 305 to move proximally, so as to drive the opening angle between the upper clamping arm 102 and the lower clamping arm 103 of the head end 20 to become gradually larger, and further causing the distal end of the closure clip 101 to open. If the distal edge 568 of the grip ring on the wrench 208 is pushed to the distal end, the wrench 208 rotates clockwise around the bosses 564 and 575, so as to drive the connecting shaft 223 to rotate clockwise, so that the angle a is continuously reduced, the sliding shaft 213 moves distally along the sliding groove 611, the opening angle control line 305 retracts distally, and the closure clip 101 is closed again. Thereby, the flare angle control terminal 70 realizes the control of the flare angle of the head terminal 20.
When wrenching spanner 208 and opening angle control, if angle A's degree is 180 degrees, boss 564, 575, connecting axle 223, sliding shaft 213 triaxial collineation promptly, loosen spanner 208 this moment, because the screens effect that the triaxial collineation leads to for sliding shaft 213 can not kick-back to the distal end this moment, keep in near-end one side, loosen spanner 208 this moment promptly, closure clip 101 still is in the state of opening, that is to say the state of opening of closure clip can lock when triaxial collineation, the art person need not to keep holding the spanner and keep the state of opening of closure clip alright carry the closure clip 101 to left atrial appendage root. That is, the wrench 208 serves three functions: firstly, opening the closing clamp to open the closing clamp for a certain angle; secondly, the opening angle is locked, the opening angle is kept, thirdly, the wrench 208 is pushed clockwise to unlock, and the closing clamp 101 is in a closing state. The advantage of design like this lies in integrating the key-press of spanner with the function of opening, locking, unblock of closure clamp and realizes, has avoided unnecessary key-press design, and this has made things convenient for operation of operative employee on the one hand, and on the other hand has simplified the design and the preparation of apparatus to the reliability of apparatus has been improved.
In a specific embodiment, the degree of the selectable angle a is slightly greater than 180 degrees, for example, 181 degrees or 182 degrees, and at this time, if the wrench is loosened, the sliding shaft 213 is pulled by the opening angle control line 305 to slide distally, and at this time, the connecting shaft 223 and the wrench 208 are driven to rotate counterclockwise around the bosses 564 and 575 continuously, and when the sliding shaft 213 rotates to a certain angle, the rotation cannot be continued due to the limiting function, which can be generated by the contact between the proximal edge 567 of the grip ring of the wrench 208 and the outer surfaces of the first housing 201 and the second housing 202, and at this time, the sliding shaft 213 stops moving, so as to lock the open state of the closure clip 101.
In a specific embodiment, a damping spring 209 may be installed on the connecting piece 225 to increase the reliability and operational feel of the locking, and the damping spring is characterized by generating a counterclockwise moment to the wrench 208 in the locked state.
When the angle A is larger than or equal to 180 degrees, the damping spring is of an optional structure.
In addition, in a specific embodiment, the angle a may be slightly less than 180 degrees, for example 179 degrees, 178 degrees, 177 degrees, etc., when the wrench 208 is loosened, the pulling force of the opening angle control line 305 towards the distal end generates a clockwise moment on the wrench 208 to make the closing clip 101 tend to close, that is, when the opening angle a is less than 180 degrees, it is necessary to provide additional damping for the wrench 208 to maintain the locking state of the closing clip 101, that is, a damping member for preventing the included angle between the two clip arms from decreasing (i.e., generating a counterclockwise moment on the wrench) may be disposed between the opening angle control end and the control handle. The present invention can realize the one-key integration of the opening and locking-unlocking functions of the wrench 208 by using the following damping members, for example, 1) providing the damping spring 209, providing a counterclockwise moment to the wrench 208 in the locking state to balance the clockwise moment generated by the pulling force of the opening angle control line 305 to the wrench 208, and when the two moments are balanced, the sliding shaft 213 stops moving, that is, the closing clamp is opened and locked, and the wrench 208 is pushed clockwise to unlock. 2) As another embodiment shown in fig. 44, a wrench protrusion 621 is disposed on a proximal end edge 567 of the grip ring of the wrench 208, a damping block 622 is disposed at a corresponding position of the first housing 201 and the second housing 202, when the wrench 208 is wrenched to open the closure clip 101 until the wrench protrusion 621 extends into the damping block 622, the wrench 208 is loosened, and at this time, due to the damping action of the damping block, the wrench protrusion 621 cannot be separated from the damping block 622 without applying other external force, so that the closure clip 101 is kept in an open state, and the wrench 208 is rotated clockwise to unlock the closure clip by overcoming the resistance. 3) In another embodiment, shown in fig. 45, a ring 623 is used to prevent rotation of the wrench 208 clockwise, for example, the wrench 208 is provided with the ring 623, preferably, the ring is made of an elastic material, and when the wrench 208 is actuated to open the closure clip 101 to a certain angle, the ring 623 is sleeved on the proximal side of the first and second housings 201 and 202, so that the ring 208 is prevented from rotating clockwise, and when the wrench 208 is released, the closure clip 101 remains open, and the ring 623 can be unlocked by sliding the ring 623 proximally. 4) Increasing damping to prevent wrench 208 from rotating clockwise, such as increasing damping between boss 564 and groove 515, and/or increasing damping between boss 575 and groove 528, such as by an interference fit, or friction material or otherwise modifying boss 564 and/or boss 575 to dampen shaft fit in respective grooves 515 and 528 to increase the dampening force of wrench 208 rotation; the damping method is also applicable to the fitting between the coupling shaft 223 and the through-hole 570 and the through-hole 613. In implementations, the friction between the runner 611 and the slider 616 may also be increased to prevent unintended rotation of the wrench 208.
The following description of the implementation of the closure clip delivery system 10 of the present invention is provided by way of example for left atrial appendage closure:
the first step is as follows: extending the head end 20 and a portion of the connecting rod 30 into the thoracic cavity such that the head end 20 is at the left atrial appendage;
the second step is that: the direction control ends 50 and 60 are adjusted to enable the head end 20 to rotate until the head end 20 is adjusted to a proper angle, and the direction control keys 204 and 205 are loosened to complete the direction locking of the head end 20;
the third step: operating the flare angle control end 70 to move the wrench 208 proximally to increase the flare angle of the distal end of the head end 20, thereby opening the distal end of the closure clip 101, moving the wrench 208 further proximally to contact the proximal end edge 567 of the grip ring of the wrench 208 with the outer surface of the first housing 201 to maintain the head end 20 in the open state, and then releasing the wrench 208 while the head end 20 remains open;
the fourth step: adjusting the position of the head end 20 such that the base of the left atrial appendage is positioned between the arms of the closure clip 101, and then slowly pushing the wrench 208 distally (clockwise rotation) such that the proximal end 569 of the wrench 208 distally rotates until the closure clip 101 is closed;
the fifth step: observing and evaluating the clamping effect of the left atrial appendage, and repeating the operations from the second step to the fourth step if the clamping effect needs to be adjusted;
and a sixth step: through the fifth step, after the positions and directions of the head ends are adjusted for many times until the clamping effect of the left atrial appendage meets the requirement, the unloading chock 211 is unloaded from the opening 507 and pulled outwards to drive the unloading control lines 306 and 307 to move towards the near ends, so that the far ends of the unloading control lines 306 and 307 are separated from the clamping arm wire loops 308 and 309, and the unloading of the V-shaped closing clamp 101 can be realized;
the seventh step: the tip 20 is slowly withdrawn from the body, at which time the closure clip 101 remains in the body and is clipped to the base of the left atrial appendage, completing the closure of the left atrial appendage.
It should be noted that the descriptions of proximal, distal, clockwise, counterclockwise, etc. related to orientation and relative relationship in the present invention are only exemplary and should not be construed as limiting the present invention.
The invention is exemplified by the left atrial appendage to illustrate the working principle and the working process of the closure clip delivery system, and in fact, the invention can also be applied to other tissue sites needing to be closed.
The invention has the following beneficial effects:
according to the invention, the closing clamp arranged at the head end is convenient to capture target tissues by adjusting the direction control key, so that the implantation efficiency and accuracy are improved, the closing clamp can be conveniently adjusted in posture for multiple times according to clinical requirements to achieve the optimal curative effect, the implantation position accuracy is improved, the direction adjustment and locking can be completed by one key, the opening angle maintenance and the closing of the closing clamp can be realized only by pulling the wrench, and the operation convenience is improved. The off-loading plug block is pulled to separate the closing clamp from the upper clamping arm and the lower clamping arm, the cutting of the surgical scissors is not needed, the releasing efficiency is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient is reduced. Thereby allowing the procedure to be performed under minimally invasive conditions.
The above-mentioned embodiments are merely illustrative of the preferred embodiments of the present invention, and do not limit the scope of the present invention, and various modifications and improvements of the technical solution of the present invention by those skilled in the art should fall within the protection scope defined by the claims of the present invention without departing from the spirit of the present invention.

Claims (14)

1. A closure clip delivery system, comprising: the device comprises a control handle, a connecting rod and a head end, wherein the control handle is connected with the head end through the connecting rod, two clamping arms are hinged to the head end, a closed clamp is loaded between the two clamping arms, a direction control end, an opening angle control end and a load shedding control end are arranged on the control handle, a direction control line is connected between the direction control end and the head end, the direction control end controls the direction of the head end through the direction control line, an opening device is hinged between the two clamping arms, an opening angle control line is arranged between the opening angle control end and the opening device, the opening angle control end controls the opening device to be opened or closed through the opening angle control line, when the opening device is opened or closed, the included angle between the two clamping arms is increased or decreased, a load shedding control line is connected between the load shedding control end and the closed clamp, when the load shedding control line is separated from the closed clamp through, the closing clamp is unloaded from the clamping arm,
the number of the direction control ends is two, the two direction control ends are respectively a first direction control end and a second direction control end, a first direction control line is connected between the first direction control end and the head end, a second direction control line is connected between the second direction control end and the head end, the first direction control end controls the head end to rotate in a first plane through the first direction control line, the second direction control end controls the head end to rotate in a second plane through the second direction control line,
the head end comprises a first joint, a second joint and a third joint, the two clamping arms are hinged on the first joint, the first joint is hinged on the second joint, the second joint is hinged on the third joint, the third joint is connected with a connecting rod, a first direction control line is connected between the second joint and a first direction control end, a second direction control line is connected between the first joint and a second direction control end, the first direction control end controls the second joint to rotate in a first plane through the first direction control line, the second direction control end controls the first joint to rotate in a second plane through the second direction control line,
the two clamping arms are arranged in an X shape, a first riveting column is inserted at the intersection part of the two clamping arms, the two clamping arms can rotate relative to the first riveting column, the first riveting column is fixedly arranged on a first joint, the strutting device comprises a winding pulley, a first supporting sheet and a second supporting sheet, one end of the first supporting sheet is hinged with the near end of one clamping arm, the other end of the first supporting sheet is hinged with one end of the second supporting sheet through a second riveting column, the other end of the second supporting sheet is hinged with the near end of the other clamping arm, the winding pulley is arranged on the second riveting column, a strip-shaped through hole is formed in the first joint, the second riveting column is positioned in the strip-shaped through hole, when the second riveting column moves along the strip-shaped through hole, the included angle between the two clamping arms is increased or decreased, and the opening angle control end comprises a wrench and a connecting sheet, the one end of spanner is rotationally installed in brake valve lever, the other end of spanner extends to outside the brake valve lever, connection piece slidable mounting is in brake valve lever, the connection piece can make a round trip to slide along brake valve lever's distal end and near-end direction, be equipped with the spout that arranges along brake valve lever distal end and near-end direction on brake valve lever's the internal surface, be equipped with the slider on the side of connection piece, the slider is located the spout, the distal end of connection piece articulates on the spanner, the one end of opening angle control line is walked around the wire winding pulley and is fixed in on first joint, the other end of opening angle control line is connected on the connection piece.
2. The closure clip delivery system of claim 1, wherein: the off-load control line is established to two, two on off-load control line and closed clamp connection one end lay respectively in the lateral surface of two arm lock, be used for loading between two relative medial surfaces of two arm lock the closed clamp, every all be equipped with logical groove in the arm lock, lead to the lateral surface and the medial surface that the groove runs through the arm lock, wear to be equipped with the arm lock wire loop in leading to the inslot, the off-load control line in the arm lock outside and the inboard closed clamp of arm lock are tied up simultaneously to the arm lock wire loop in every arm lock.
3. The closure clip delivery system of claim 2, wherein: the control handle comprises a first shell and a second shell which are connected with each other, the connecting rod is of a cylindrical structure, the first direction control end comprises a first rotary disc and first direction control keys, the first direction control keys are arranged on the first rotary disc, the first rotary disc is rotatably installed in the control handle, the first direction control ends extend out of the control handle, the first direction control lines are arranged into two pieces, one ends of the two first direction control lines are connected to the first rotary disc, the other ends of the two first direction control lines penetrate through an inner cavity of the connecting rod and then are connected to the second joint, the two first direction control lines connected to the first rotary disc are respectively located on two opposite sides of the rotation center of the first rotary disc, and the two first direction control lines connected to the second joint are respectively located on two opposite sides of the second joint.
4. The closure clip delivery system of claim 3, wherein: the second direction control end includes second carousel and second direction control key, the second direction control key sets up on the second carousel, the second carousel rotationally installs in brake valve lever, the second direction control end extends outside brake valve lever, the second direction control line is established to two, and the one end of two second direction control lines connect in on the second carousel, and the other end of two second direction control lines passes to connect on first joint after the inner chamber of connecting rod, and two second direction control lines of connecting on the second carousel are located the relative both sides of second carousel center of rotation respectively, and two second direction control lines of connecting on first joint are located the relative both sides of first joint respectively.
5. The closure clip delivery system of claim 4, wherein: the first rotary disc is provided with a first blind hole, one end of the first direction control key is positioned in the first blind hole, a first compression spring is arranged between the first direction control key and the bottom wall of the first blind hole, the first direction control key is fixedly provided with a first positioning sheet, the second rotary disc is provided with a second blind hole, one end of the second direction control key is positioned in the second blind hole, a second compression spring is arranged between the second direction control key and the bottom wall of the second blind hole, the second direction control key is fixedly provided with a second positioning sheet, the control handle is provided with a first positioning gear and/or a second positioning gear, the first positioning gear is arranged between the first direction control key and the second direction control key, the second positioning gear is arranged at the position of the inner surface of the first shell, which is close to the first direction control key, and at the position of the inner surface of the second shell, which is close to the second direction control key, under the action of the first compression spring, the first positioning sheet on the first direction control key is clamped on the gear of the first positioning gear and/or the gear of the second positioning gear, and under the action of the second compression spring, the second positioning sheet on the second direction control key is also clamped on the gear of the first positioning gear and/or the gear of the second positioning gear.
6. The closure clip delivery system of claim 5, wherein: and a sliding shaft is arranged on the other side surface of the connecting sheet, a sliding shaft wire ring is formed at the other end of the opening angle control wire, and the sliding shaft wire ring is sleeved on the sliding shaft.
7. The closure clip delivery system of claim 6, wherein: and a damping piece for preventing the included angle between the two clamping arms from becoming smaller is arranged between the opening angle control end and the control handle.
8. The closure clip delivery system of claim 7, wherein: the damping piece is a damping spring, one end of the damping spring is connected to the near end of the connecting piece, and the other end of the damping spring is connected into the control handle.
9. The closure clip delivery system of claim 7, wherein: the damping piece is damping piece and spanner arch, the damping piece is located on brake valve lever, the spanner arch is located on the spanner, the spanner arch can insert in the damping piece.
10. The closure clip delivery system of claim 7, wherein: the damping piece is a binding ring arranged on the wrench, and the binding ring can be sleeved on the control handle.
11. The closure clip delivery system of claim 7, wherein: the damping piece is mutually supported pivoted concave part and protruding piece, be equipped with friction material or protruding piece for the damping axle between concave part and the protruding piece for interference fit or concave part and the protruding piece between, the one end of spanner is rotationally installed in brake valve lever through concave part, protruding piece and/or the distal end of connection piece articulates on the spanner through concave part, protruding piece.
12. The closure clip delivery system of claim 7, wherein: the damping piece is a friction material arranged at the sliding position of the connecting piece and the control handle.
13. The closure clip delivery system of any of claims 8-12, wherein: the fixed rotation axis that is equipped with between first casing and the second casing, rotationally install first carousel and second carousel on the rotation axis, be equipped with supporting pulley between first carousel and the second carousel, supporting pulley rotationally installs on the rotation axis, first supporting sheet and second backing sheet are all established to two, the second is riveted the post and is established to one, the both ends department that the post was riveted to the second is the articulated position of first supporting sheet and second backing sheet respectively, the intermediate position that the post was riveted to the second is installed wire winding pulley, rectangular through-hole is established to two, and two rectangular through-holes set up relatively, two ends that the post was riveted to the second are located two rectangular through-holes respectively.
14. The closure clip delivery system of claim 13, wherein: the unloading control end comprises an unloading plug block, the unloading plug block is connected to the control handle, a control line fixing hole is formed in the unloading plug block located in the control handle, and the unloading control line is connected to the control line fixing hole.
CN202010078170.7A 2020-01-23 2020-01-23 Closure clip delivery system Active CN111248969B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202010078170.7A CN111248969B (en) 2020-01-23 2020-01-23 Closure clip delivery system

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202010078170.7A CN111248969B (en) 2020-01-23 2020-01-23 Closure clip delivery system

Publications (2)

Publication Number Publication Date
CN111248969A CN111248969A (en) 2020-06-09
CN111248969B true CN111248969B (en) 2021-05-18

Family

ID=70942814

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202010078170.7A Active CN111248969B (en) 2020-01-23 2020-01-23 Closure clip delivery system

Country Status (1)

Country Link
CN (1) CN111248969B (en)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113662615B (en) * 2021-10-21 2022-02-08 北京迈迪顶峰医疗科技股份有限公司 Follow-up conveying actuator and auricle clamp conveying device
CN113662614B (en) * 2021-10-21 2022-03-22 北京迈迪顶峰医疗科技股份有限公司 Transport actuator and transport device

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101053537A (en) * 2006-04-11 2007-10-17 叶中权 Opening device for vertebrae thorn
CN202537744U (en) * 2012-04-28 2012-11-21 张兰 Tong for taking out foreign matter from uterine cavity
CN105193471A (en) * 2015-08-11 2015-12-30 北京迈迪顶峰医疗科技有限公司 Auricle clamp and conveying device thereof
WO2016161613A1 (en) * 2015-04-10 2016-10-13 Leo Medical Co., Ltd. Novel Ligation Device
CN206612825U (en) * 2016-11-23 2017-11-07 张大宏 Cartridge-type running fire clip appliers
CN209884246U (en) * 2019-04-11 2020-01-03 北京领健医疗科技有限公司 Left atrial appendage closure delivery system
CN211066825U (en) * 2019-08-06 2020-07-24 北京领健医疗科技有限公司 Closer conveying system

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101053537A (en) * 2006-04-11 2007-10-17 叶中权 Opening device for vertebrae thorn
CN202537744U (en) * 2012-04-28 2012-11-21 张兰 Tong for taking out foreign matter from uterine cavity
WO2016161613A1 (en) * 2015-04-10 2016-10-13 Leo Medical Co., Ltd. Novel Ligation Device
CN105193471A (en) * 2015-08-11 2015-12-30 北京迈迪顶峰医疗科技有限公司 Auricle clamp and conveying device thereof
CN206612825U (en) * 2016-11-23 2017-11-07 张大宏 Cartridge-type running fire clip appliers
CN209884246U (en) * 2019-04-11 2020-01-03 北京领健医疗科技有限公司 Left atrial appendage closure delivery system
CN211066825U (en) * 2019-08-06 2020-07-24 北京领健医疗科技有限公司 Closer conveying system

Also Published As

Publication number Publication date
CN111248969A (en) 2020-06-09

Similar Documents

Publication Publication Date Title
CN112336403A (en) Closer conveying system
CN111248969B (en) Closure clip delivery system
US11337697B2 (en) Adapter with centering mechanism for articulation joint
CN111803165A (en) Left atrial appendage closure delivery system
US5690652A (en) Surgical suturing device
US10765465B2 (en) Tensioning instrument
EP1988814B1 (en) Surgical retractor frame system
AU2007286425B2 (en) Surgical retractor fixing device
US8336754B2 (en) Locking articulation mechanism for surgical stapler
CN211066825U (en) Closer conveying system
US7172605B2 (en) Applicator for a prosthesis assembly comprising such an applicator and fixture system for loading such an applicator
US20150245834A1 (en) Locking articulation mechanism
US9861371B2 (en) Surgical tool
CN209884246U (en) Left atrial appendage closure delivery system
US11653930B2 (en) Robotic assisted clip applier
CA2199741A1 (en) Low profile tool for applying spring action ligation clips
US8986330B2 (en) Aortic cross clamp
EP3256063B1 (en) Combined tunneling tools
WO2021036262A1 (en) End actuator driving device for surgical instrument, and surgical instrument
JP4364807B2 (en) Device for temporarily engaging body tissue
CN114376629A (en) Plugging device and plugging device locking system
CN115429488A (en) Valve clamping system
CN219963181U (en) Delivery device and medical system
CN114176704A (en) A hemostasis rescue device for hospital intracardiac branch of academic or vocational study
CN116115389A (en) Adjustable artificial tendon locking device

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
SE01 Entry into force of request for substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant