CN113413245B

CN113413245B - Tissue clamping device and tissue repair equipment

Info

Publication number: CN113413245B
Application number: CN202110876049.3A
Authority: CN
Inventors: 孙圣洁; 肖振昕; 虞奇峰; 秦涛
Original assignee: Shanghai Newpulse Medical Technology Co ltd
Current assignee: Shanghai Newpulse Medical Technology Co ltd
Priority date: 2021-07-30
Filing date: 2021-07-30
Publication date: 2024-01-16
Anticipated expiration: 2041-07-30
Also published as: WO2023005062A1; CN113413245A

Abstract

The application discloses a tissue clamping device and tissue repair equipment. The tissue clamping device comprises a clamping assembly and an elastic support; the clamping assembly comprises a first clamping assembly and a second clamping assembly, and the first clamping assembly and the second clamping assembly are used for clamping tissues; the first clamping assembly comprises a first clamping arm, the second clamping assembly comprises a second clamping arm, and an included angle between the first clamping arm and the second clamping arm is variable; the elastic support piece comprises a first elastic supporting rod and a second elastic supporting rod; the middle part of first elastic support rod with first arm lock is connected or contacts, the middle part of second elastic support rod with second arm lock is connected or contacts, first elastic support rod's middle part can with first arm lock motion, second elastic support rod's middle part can with second arm lock motion.

Description

Tissue clamping device and tissue repair equipment

Technical Field

The present application relates to the field of medical devices, and in particular to a tissue clamping device and a tissue repair device.

Background

In surgical repair of body tissue, it is often necessary to clamp and secure the tissue by means of a tissue clamping device. For example, the treatment of a heart condition, such as mitral regurgitation, is performed by positioning the mitral valve between the left atrium and the left ventricle, and by acting as a check valve when the left ventricle contracts, the mitral valve tightly closes the atrioventricular orifice, preventing blood from flowing back from the left ventricle into the left atrium. However, when the mitral valve is diseased, it may occur that the mitral valve is difficult to completely close when the left ventricle contracts, which results in that the left atrium receives a great amount of regurgitated blood, which may lead to a sharp rise in left atrial and pulmonary venous pressures, an increase in left ventricular diastolic volume load, and further a series of pathological changes such as left ventricular enlargement, pulmonary arterial hypertension, etc., and finally, clinical manifestations such as heart failure, arrhythmia, etc., which may endanger life in severe cases. In the operation of treating mitral regurgitation, the opposite sides of the mitral valve can be clamped by a tissue clamping device, so that the gap between the mitral valves is changed from a big hole to two small holes, the regurgitation area is reduced, and the occurrence of mitral regurgitation is effectively prevented.

Also, the tissue gripping device may be adapted to the tricuspid valve of the heart, with reduced regurgitation area achieved by gripping both side leaflets. Tricuspid valve lesions are one of the most common heart valve diseases, with overall morbidity higher than arterial valve lesions, most of which are tricuspid valve insufficiency. The tricuspid valve has some similarities in structure to the mitral valve. The normal tricuspid valve structure consists of the annulus, leaflets, chordae tendineae and papillary muscles, with the relationship of the leaflets and chordae tendineae and papillary muscles playing an important role in systolic tricuspid valve closure. Changes in the geometry and characteristics of the right ventricle can directly lead to tricuspid valve insufficiency, causing blood to flow from the right ventricle into the right atrium during systole. Treatment of tricuspid regurgitation can be divided into surgical and interventional procedures in addition to drug improvement. While edge-to-edge repair is considered an effective means of interventional treatment of tricuspid regurgitation, edge-to-edge clamps are delivered via the femoral vein to the right atrium, securing the anterior leaflet to the edges of the septal and posterior leaflets, thereby reducing leaflet opening area to reduce tricuspid regurgitation.

Disclosure of Invention

One embodiment of the present application provides a tissue clamping device comprising a clamping assembly and an elastic support; the clamping assembly comprises a first clamping assembly and a second clamping assembly, and the first clamping assembly and the second clamping assembly are used for clamping tissues; the first clamping assembly comprises a first clamping arm, the second clamping assembly comprises a second clamping arm, and an included angle between the first clamping arm and the second clamping arm is variable; the elastic support piece comprises a first elastic supporting rod and a second elastic supporting rod; the middle part of first elastic support rod with first arm lock is connected or contacts, the middle part of second elastic support rod with second arm lock is connected or contacts, first elastic support rod's middle part can with first arm lock motion, second elastic support rod's middle part can with second arm lock motion.

In some embodiments, the widths of the first and second resilient struts correspondingly vary during movement of the middle portion of the first resilient strut relative to the first clip arm and movement of the middle portion of the second resilient strut relative to the second clip arm.

In some embodiments, the middle portion of the first resilient strut is connected to or in contact with the outside of the first clip arm; the middle part of the second elastic supporting rod is connected with or contacted with the outer side of the second clamping arm.

In some embodiments, the middle portion of the first resilient strut is connected to or in contact with the inner side of the first clip arm; the middle part of the second elastic supporting rod is connected with or contacted with the inner side of the second clamping arm.

In some embodiments, the central portion of the first resilient strut includes a first receiving aperture through which the first clip arm passes; the middle portion of the second elastic strut includes a second receiving hole through which the second clip arm passes.

In some embodiments, the first clamp arm includes a first inner clamp arm, a first outer clamp arm, and a first bend, and the second clamp arm includes a second inner clamp arm, a second outer clamp arm, and a second bend; the first inner clamping arm is connected with the first outer clamping arm through the first bending part, and the second inner clamping arm is connected with the second outer clamping arm through the second bending part; the middle part of the first elastic supporting rod can move between the first bending part and one end, far away from the first bending part, of the first inner clamping arm, and the middle part of the second elastic supporting rod can move between the second bending part and one end, far away from the second bending part, of the second inner clamping arm.

In some embodiments, the tissue clamping device comprises a first control line for controlling movement of the middle portion of the first resilient strut relative to the first clamp arm, and a second control line for controlling movement of the middle portion of the second resilient strut relative to the second clamp arm; one end of the first control wire is connected with the middle part of the first elastic supporting rod, and one end of the second control wire is connected with the middle part of the second elastic supporting rod; the other ends of the first control line and the second control line are connected with an external control handle.

In some embodiments, the first control wire and the second control wire drive the first elastic supporting rod and the second elastic supporting rod to synchronously move under the control of the control handle.

In some embodiments, the tissue gripping device further comprises a first elastic member and a second elastic member; one end of the first elastic piece is connected with the first bending part, and the other end of the first elastic piece is connected with the middle part of the first elastic supporting rod; one end of the second elastic piece is connected with the second bending part, and the other end of the second elastic piece is connected with the middle part of the second elastic supporting rod.

In some embodiments, the tissue clamping device comprises a first screw for controlling movement of the middle portion of the first resilient strut relative to the first clamp arm, and a second screw for controlling movement of the middle portion of the second resilient strut relative to the second clamp arm; the middle part of the first elastic supporting rod is in threaded connection with the first screw rod, and the rotation of the first screw rod can drive the middle part of the first elastic supporting rod to move; the middle part of the second elastic supporting rod is in threaded connection with the second screw rod, and the rotation of the second screw rod can drive the middle part of the second elastic supporting rod to move.

In some embodiments, the tissue clamping device further comprises a first screw control line and a second screw control line; the first screw control line is in transmission connection with the first screw so as to drive the first screw to rotate; two free ends of the first screw control wire are connected with an external control handle; the second screw control line is in transmission connection with the second screw so as to drive the second screw to rotate, and two free ends of the second screw control line are connected with an external control handle.

In some embodiments, the tissue clamping device further comprises a first screw control rod and a second screw control rod; the first screw rod control rod is in transmission connection with the first screw rod through a universal joint, and the rotation of the first screw rod control rod can drive the first screw rod to rotate; the second screw rod control rod is in transmission connection with the second screw rod through a universal joint, and the second screw rod control rod can be driven to rotate by rotating.

In some embodiments, the tissue clamping device further comprises a support, a first connector, and a second connector; one end of the supporting part is connected with the first connecting piece; one end of the first inner clamping arm, which is far away from the first bending part, and one end of the second inner clamping arm, which is far away from the second bending part, are connected with the other end of the supporting part; one end of the first outer clamping arm, which is far away from the first bending part, one end of the second outer clamping arm, which is far away from the second bending part, and two ends of the first elastic supporting rod and the second elastic supporting rod are connected with the second connecting piece; the first connecting piece and the second connecting piece can relatively move so as to drive the first inner clamping arm and the second inner clamping arm to relatively open or close.

In some embodiments, the first clamping assembly further comprises a first clip disposed on the first inner clamping arm, and the second clamping assembly further comprises a second clip disposed on the second inner clamping arm; the first and second jaws are openable and closable relative to the first and second inner arms, respectively, and enable tissue to be clamped between the first and first inner arms and between the second and second inner arms.

In some embodiments, a side of the first clip facing the first inner clip arm and a side of the second clip facing the second inner clip arm are provided with a plurality of barbs; the barbs are arranged in a plurality of rows or columns.

In some embodiments, the first inner clip arm and the second inner clip arm are provided with through holes that mate with the plurality of barbs.

In some embodiments, the first clamping assembly or the second clamping assembly is provided with a developing ring, and the control handle of the first clamping assembly or the second clamping assembly is provided with a mark corresponding to the position of the developing ring.

In some embodiments, the elastic support is an integrally formed structure of a shape memory alloy tube that is cut and heat-set.

One of the embodiments of the present application provides a tissue repair device comprising a control handle and a tissue clamping device as described in any of the embodiments of the present application; the control handle is used for conveying the tissue clamping device to a tissue and respectively controlling the clamping of the first clamping component and the second clamping component of the tissue clamping device to the tissue.

In some embodiments, a control mechanism is provided on the control handle, the control mechanism being configured to: and controlling the middle part of the first elastic supporting rod connected or contacted with the first clamping arm to move relative to the first clamping arm, and controlling the middle part of the second elastic supporting rod connected or contacted with the second clamping arm to move relative to the second clamping arm.

Drawings

The present application will be further illustrated by way of example embodiments, which will be described in detail with reference to the accompanying drawings. The embodiments are not limiting, in which like numerals represent like structures, wherein:

FIG. 1 is a schematic perspective view of a tissue clamping device according to some embodiments of the present application;

FIG. 2 is a schematic diagram of a front view of a tissue clamping device according to some embodiments of the present application;

FIG. 3 is a schematic side elevational view of an operative configuration of a tissue clamping device according to some embodiments of the present application;

FIG. 4 is a schematic front view of an operational state of a tissue clamping device according to some embodiments of the present application;

FIG. 5 is a schematic structural view of a resilient support of a tissue clamping device according to some embodiments of the present application;

FIG. 6 is a schematic structural view of a resilient support of a tissue clamping device according to another embodiment of the present application;

FIG. 7 is a schematic view of the structure of a resilient support of a tissue clamping device according to yet another embodiment of the present application;

FIG. 8 is a control schematic of a resilient support of a tissue clamping device according to some embodiments of the present application;

FIG. 9 is a control schematic of a resilient support of a tissue clamping device according to another embodiment of the present application;

FIG. 10 is an enlarged view of a portion of the control schematic of the resilient support of FIG. 9;

FIG. 11 is a control schematic of a resilient support of a tissue clamping device according to yet another embodiment of the present application;

FIG. 12 is an enlarged view of a portion of the control schematic of the resilient support of FIG. 11;

FIG. 13 is a schematic structural view of a tissue gripping device with visualization rings according to some embodiments of the present application;

FIG. 14 is a schematic view of a clip having a developer ring according to some embodiments of the present application;

fig. 15 is a schematic structural view of a tissue repair device according to some embodiments of the present application.

Reference numerals illustrate: 100-tissue clamping device, 110-clamping assembly, 110-1-first clamping assembly, 110-2-second clamping assembly, 111-first clamping arm, 112-second clamping arm, 1111-first inner clamping arm, 1112-first outer clamping arm, 1113-first bend, 1121-second inner clamping arm, 1122-second outer clamping arm, 1123-second bend, 113-first clip, 114-second clip, 1131-securing portion, 1132-clamping portion, 115-barb, 116-through hole, 117-developing ring, 120-resilient support, 120-1-first resilient strut, 120-2-second elastic supporting rod, 121-1-first accommodation hole, 121-2-second accommodation hole, 122-first installation part, 123-second installation part, 124-first connection part, 125-second connection part, 126-first bending part, 127-second bending part, 128-third bending part, 131-first control wire, 132-first screw, 133-first screw control wire, 134-first elastic member, 140-supporting part, 150-first connection member, 160-second connection member, 200-control handle, 300-conveying pipe, 1000-tissue repair device.

Detailed Description

In order to more clearly illustrate the technical solutions of the embodiments of the present specification, the drawings used in the description of the embodiments will be briefly described below. It is apparent that the drawings in the following description are only some examples or embodiments of the present specification, and it is possible for those of ordinary skill in the art to apply the present specification to other similar situations according to the drawings without inventive effort. It should be understood that these exemplary embodiments are presented merely to enable one skilled in the relevant art to better understand and practice the present description, and are not intended to limit the scope of the present description in any way. Unless otherwise apparent from the context of the language or otherwise specified, like reference numerals in the figures refer to like structures or operations.

As used in this specification and the claims, the terms "a," "an," "the," and/or "the" are not specific to a singular, but may include a plurality, unless the context clearly dictates otherwise. In general, the terms "comprises" and "comprising" merely indicate that the steps and elements are explicitly identified, and they do not constitute an exclusive list, as other steps or elements may be included in a method or apparatus. The term "one embodiment" means "at least one embodiment"; the term "another embodiment" means "at least one additional embodiment".

In the description of the present specification, it should be understood that the terms "upper", "lower", "inner", "outer", "away", "near", "symmetrical", "one end", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are merely for convenience in describing the present specification and simplifying the description, and do not indicate or imply that the device or element being referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present specification.

Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include at least one such feature. In the description of the present specification, the meaning of "plurality" means at least two, for example, two, three, etc., unless explicitly defined otherwise.

In this specification, unless clearly specified and limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally formed; either directly or indirectly, through intermediaries, or both, may be in communication with each other or in interaction with each other, unless expressly defined otherwise. The specific meaning of the above terms in this specification will be understood by those of ordinary skill in the art in view of the specific circumstances.

The embodiment of the application relates to a tissue clamping device and tissue repair equipment. The tissue clamping device and the tissue repair equipment can clamp and repair tissues. The tissue clamping device can be suitable for various occasions, for example, the tissue clamping device can be used for clamping tissues such as heart valves (such as mitral valve and tricuspid valve) or vascular valves. In some embodiments, the tissue gripping device may grip and repair tissue through a variety of paths to a predetermined location. For example, the tissue gripping device may be delivered to the mitral valve via the femoral vein, inferior vena cava, right atrium, and left atrium under the control of the control handle to repair the mitral valve. For another example, the tissue gripping device may be delivered to the mitral valve via the left atrial appendage and the left atrium under control of a control handle to repair the mitral valve. For another example, the tissue gripping device may be delivered to the tricuspid valve via the femoral vein, inferior vena cava, and right atrium under the control of the control handle to repair the tricuspid valve.

In mitral and tricuspid regurgitation repair procedures, the difficulty in advancing and retracting the tissue gripping device (also known as the clip) is not low, but once it occurs, it clinically causes adverse events, which may have serious consequences. The tissue clamping device provided by the embodiment of the application is variable in form, and the elastic support piece is movably connected with the clamping arm, so that the tissue clamping device can change the form according to different use conditions of sheath feeding, capturing, sheath discharging and the like, and the problems that the sheath feeding and withdrawing of the clamp are difficult, the valve leaflet capturing is difficult and the like can be solved.

The following describes in detail the tissue clamping device and the tissue repair device provided in the embodiments of the present application with reference to the accompanying drawings.

FIG. 1 is a schematic perspective view of a tissue clamping device according to some embodiments of the present application; FIG. 2 is a schematic diagram of a front view of a tissue clamping device according to some embodiments of the present application; FIG. 3 is a schematic side elevational view of an operative configuration of a tissue clamping device according to some embodiments of the present application; fig. 4 is a schematic front view of an operational state of a tissue clamping device according to some embodiments of the present application.

In some embodiments, as shown in fig. 1-4, tissue clamping device 100 may include a clamping assembly 110 and a resilient support 120. The clamping assembly 110 may represent an element or assembly having a clamping function and the elastic support 120 may represent an element or assembly having a certain elastic property. In some embodiments, the clamp assembly 110 and the resilient support 120 may have a deformability. In some embodiments, the clamping assembly 110 and/or the resilient support 120 may also have the ability to recover deformation. The clamping assembly 110 may include a first clamping assembly 110-1 and a second clamping assembly 110-2, and the elastic support 120 may include a first elastic strut 120-1 and a second elastic strut 120-2. In some embodiments, the first clamping assembly 110-1 and the second clamping assembly 110-2 may be disposed substantially symmetrically (e.g., opposite the y-z plane of symmetry), and the first resilient strut 120-1 and the second resilient strut 120-2 may be disposed substantially symmetrically (e.g., opposite the y-z plane of symmetry). In this specification, "substantially symmetrical" may refer to a plane (i.e., a plane of symmetry, such as a y-z plane) such that a line between any one set of two points corresponding to each other on two objects (e.g., the first clamping assembly 110-1 and the second clamping assembly 110-2, the first elastic strut 120-1 and the second elastic strut 120-2) is perpendicular to the plane or an angle between the two points and the plane is 80 ° (i.e., approximately perpendicular) or more. In this specification, the z-axis may refer to a direction from bottom to top along a central axis of the tissue clamping device, and the x-axis may refer to a connecting line direction of two points corresponding to each other in the first clamping assembly 110-1 and the second clamping assembly 110-2, and the y-axis is perpendicular to both the x-axis and the z-axis. In some embodiments, the first clamping assembly 110-1 and the second clamping assembly 110-2 may be asymmetrically disposed; the first elastic strut 120-1 and the second elastic strut 120-2 may be asymmetrically disposed. For example, the clamp arms (e.g., first inner clamp arm, first outer clamp arm) of the first clamp assembly 110-1 may be longer than the clamp arms (e.g., second inner clamp arm) of the second clamp assembly 110-1, and the first resilient strut 120-1 may be longer than the second resilient strut 120-2.

In some embodiments, the first clamping assembly 110-1 and the second clamping assembly 110-2 may each be used to clamp tissue, e.g., the first clamping assembly 110-1 and the second clamping assembly 110-2 may each be used to clamp two valves of a mitral valve. In some embodiments, the first clamping assembly 110-1 may include a first clamping arm 111, the second clamping assembly 110-2 may include a second clamping arm 112, the first clamping arm 111 and the second clamping arm 112 may be configured to change (e.g., open or close) under the control of an external control handle (e.g., control handle 200) coupled thereto, and an angle (or relative position) between the first clamping arm 111 and the second clamping arm 112 may be configured to change with the configuration of the first clamping assembly 110-1 and the second clamping assembly 110-2. In some embodiments, the angle between the first clamp arm 111 and the second clamp arm 112 may be the angle between the first inner clamp arm 1111 and the second inner clamp arm 1121, or the angle between the first outer clamp arm 1112 and the second outer clamp arm 1122. In some embodiments, the configuration of the first clamping assembly 110-1 and the second clamping assembly 110-2 may be controlled by an external control handle coupled thereto.

In some embodiments, a middle portion of the first resilient strut 120-1 may be connected to or in contact with the first clamp arm 111, and a middle portion of the second resilient strut 120-2 may be connected to or in contact with the second clamp arm 112. Wherein the middle portion of the first elastic strut 120-1 connected to or contacting the first clamping arm 111 may move along the first clamping arm 111 relative to the first clamping arm 111, and the middle portion of the second elastic strut 120-2 connected to or contacting the second clamping arm 112 may move along the second clamping arm 112 relative to the second clamping arm 112. In some embodiments, during opening or closing of the first clamping assembly 110-1 and the second clamping assembly 110-2, a middle portion of the first resilient strut 120-1 that is connected or in contact with the first clamping arm 111 and a middle portion of the second resilient strut 120-2 that is connected or in contact with the second clamping arm 112 may move in the x-z plane along the first clamping arm 111 and the second clamping arm 112, respectively. In some embodiments, the first and second spring struts 120-1 and 120-2 may move relative to the first and second clamp arms 111 and 112 under the control of an external control handle coupled thereto.

Referring to fig. 3-4, wherein fig. 3A, 3B are left side views (y-z plan) of the tissue clamping device, fig. 4A, 4B are front views (x-z plan) of the tissue clamping device. Fig. 3A, 4A are views of a tissue clamping device in a semi-open state (between open and extended states), and fig. 3B, 4B are views of the tissue clamping device in an extended state (or semi-extended state, near extended state, but not fully extended). When the tissue clamping device is in an extended state, the included angle between the connected inner and outer clamp arms (e.g., the first inner clamp arm 1111 and the first outer clamp arm 1112, or the second inner clamp arm 1121 and the second outer clamp arm 1122) is greater than a preset threshold (e.g., 130 °, 150 °, etc.). As can be seen by comparing fig. 3A, 4A with fig. 3B, 4B, the widths (i.e., the dimensions along the y-axis) of the first elastic strut 120-1 and the second elastic strut 120-2 can be correspondingly changed during the movement of the middle portion of the first elastic strut 120-1 connected to or contacting the first clamping arm 111 and the middle portion of the second elastic strut 120-2 connected to or contacting the second clamping arm 112 relative to the first clamping arm 111 and the second clamping arm 112, respectively (or during the change of the tissue clamping device in the open state and the extended state shown in fig. 3-4), and the overall dimension of the tissue clamping device along the x-axis can be correspondingly changed. The tissue clamping device provided by the embodiment of the specification can adjust the overall size of the tissue clamping device in the directions of the x axis and the y axis under the control of the external control handle, so that the clinical requirements of the tissue clamping device in different use stages can be met.

In some embodiments, during the process of capturing tissue (such as a leaflet), the control handle can control the first clamping assembly 110-1 and the second clamping assembly 110-2 in the tissue clamping device to be in an open state (as shown in fig. 1-2), and make the first elastic strut 120-1 and the second elastic strut 120-2 in a natural unfolding state, so that the first elastic strut 120-1 and the second elastic strut 120-2 have a certain width in the y-axis and the x-axis directions, which can increase the capturing area of the tissue clamping device and is beneficial for capturing tissue. During the sheath feeding (i.e., the process of delivering the tissue clamping device to the target site) and the retraction (i.e., the tissue clamping device is required to be withdrawn when malfunctioning), the first clamping assembly 110-1 and the second clamping assembly 110-2 in the tissue clamping device can be controlled to be in an extended state (as shown in fig. 3B or 4B), and at this time, the first elastic strut 120-1 and the second elastic strut 120-2 can be further controlled to be in a closed state (as shown in fig. 3B or 4B), and the width of the tissue clamping device in the x-axis and y-axis directions can be simultaneously reduced (i.e., the cross-sectional area of the tissue clamping device can be reduced), so that the obstruction during the sheath feeding and the retraction can be reduced, thereby facilitating smooth sheath feeding and retraction.

In some embodiments, the external control handle may provide synchronized control of the first clamping assembly 110-1, the second clamping assembly 110-2, and the first resilient strut 120-1, the second resilient strut 120-2. In some embodiments, the external control handles may control the first clamping assembly 110-1, the second clamping assembly 110-2, and the first resilient strut 120-1, the second resilient strut 120-2, respectively.

In some embodiments, the elastic support member may be an integrally formed structure of a shape memory alloy tube that is cut and heat-set. The shape memory alloy may be nickel titanium alloy or cobalt chromium alloy, etc. Preferably, the material of the elastic support member may be a super elastic metal (such as nickel-titanium alloy). In some embodiments, the natural state (which may also be referred to as a memory shape) of the resilient support may be an expanded state, a closed state, or a semi-expanded state (between the expanded state and the closed state). The unfolded state may refer to a state in which the middle portion of the first elastic strut 120-1 is at the maximum distance with respect to the middle portion of the second elastic strut 120-2 in the elastic support, and the folded state may refer to a state in which the middle portion of the first elastic strut 120-1 is at the minimum distance with respect to the middle portion of the second elastic strut 120-2 in the elastic support. In some embodiments, the amount of spring force provided by the first and second spring struts 120-1, 120-2 to the tissue clamping device may be adjusted (e.g., adjusting the width or natural state of the first and/or second spring struts 120-1, 120-2) according to the clamping requirements of different tissues or different patients such that the tissue clamping device employing the first and second spring struts 120-1, 120-2 may be adapted to different tissues or different patients.

Fig. 5 is a schematic structural view of a resilient support of a tissue clamping device according to some embodiments of the present application. In some embodiments, as shown in FIG. 5, the resilient support may include a first resilient strut 120-1, a second resilient strut 120-2, a first mounting portion 122, and a second mounting portion 123. Wherein the first mounting portion 122 and the second mounting portion 123 may be fixed relative to one end of the tissue clamping device (e.g., the second connector). The two ends of the first elastic supporting rod 120-1 are respectively connected with the first installation part 122 and the second installation part 123, and the middle part of the first elastic supporting rod is in a curved arc shape; similarly, the second elastic strut 120-2 has both ends connected to the first and second mounting parts 122 and 123, respectively, and has a middle portion formed in a curved arc shape. In some embodiments, as shown in FIG. 5, one end of the first and second elastic struts 120-1 and 120-2 may be connected to the first mounting part 122 by a first connection part 124; the other ends of the first and second elastic struts 120-1 and 120-2 may be connected to the second mounting part 123 through the second connection part 125. By providing the first and second connection parts 124 and 125, stability of the first and second elastic struts 120-1 and 120-2 can be improved. In some embodiments, the first and second connection parts 124 and 125 may be provided with through holes. The number of through holes may include one or more. The shape of the through hole may include, but is not limited to, an elongated shape, a square shape, a round shape, a rectangular shape, etc. By providing the through holes in the first and second connection parts 124 and 125, the elastic support member (e.g., the end of the elastic support member) can be easily changed in shape at the time of heat treatment.

In some embodiments, a middle portion of the first resilient strut 120-1 may be connected to or in contact with an outer side of the first clip arm 111 (as shown in fig. 2). The middle portion of the second resilient supporting rod 120-2 may be connected to or in contact with the outer side of the second clamping arm 112. In some embodiments, the natural state of the resilient support may be a deployed state. By connecting or contacting the middle portion of the first elastic strut 120-1 with the outer side of the first clamping arm 111 and connecting or contacting the middle portion of the second elastic strut 120-2 with the outer side of the second clamping arm 112, the stability of the tissue clamping device during the capture of the valve leaflet can be enhanced by the elastic force of the elastic support members of the first clamping arm 111 and the second clamping arm 112.

In some embodiments, a middle portion of the first resilient strut 120-1 may be connected to or in contact with an inner side of the first clip arm 111 (as shown in fig. 1). The middle portion of the second resilient supporting rod 120-2 may be connected to or in contact with the inner side of the second clamping arm 112. By connecting or contacting the middle portion of the first elastic strut 120-1 with the inner side of the first clamping arm 111 and connecting or contacting the middle portion of the second elastic strut 120-2 with the inner side of the second clamping arm 112, the clamping force of the tissue clamping device when clamping tissue can be enhanced by the first clamping arm 111 and the second clamping arm 112 under the elastic force of the elastic support member.

Fig. 6 is a schematic structural view of a resilient support of a tissue clamping device according to another embodiment of the present application. In some embodiments, as shown in FIG. 6, the resilient support may include a first resilient strut 120-1, a second resilient strut 120-2, a first mounting portion 122, and a second mounting portion 123. Wherein the first mounting portion 122 and the second mounting portion 123 may be fixed relative to one end of the tissue clamping device (e.g., the second connector). The first elastic supporting rod 120-1 is connected to the first mounting portion 122 and the second mounting portion 123 at both ends thereof. In some embodiments, as shown in fig. 6, the first resilient strut 120-1 may include a first bend 126, a second bend 127, and a third bend 128. The second bending portion 127 may be located between the first bending portion 126 and the third bending portion 128, and the bending direction of the second bending portion 127 is opposite to that of the first bending portion 126 and the third bending portion 128. Specifically, the second curved portion 127 is an inward curved arc, and the first and third curved portions 126 and 128 are outward curved arcs. In the embodiment shown in fig. 6, the middle portion of the first elastic strut 120-1 may be the second curved portion 127. The second elastic supporting rod 120-2 may have the same or similar structure as the first elastic supporting rod 120-1, and will not be described again here. It should be noted that, herein, "bending outwards" may refer to a bending direction opposite to the direction of the two ends of the first elastic supporting rod 120-1 or the second elastic supporting rod 120-2 (downward as shown in fig. 6), and "bending inwards" may refer to a bending direction identical to the direction of the two ends of the first elastic supporting rod 120-1 or the second elastic supporting rod 120-2.

In some embodiments, a middle portion (e.g., second curved portion 127) of the first resilient strut 120-1 may be connected to or in contact with the inner side of the first clip arm 111. Similarly, a middle portion of second resilient strut 120-2 may be connected to or in contact with an inner side of second clip arm 112. In some embodiments, the default state of the elastic support may be a closed or semi-closed state, and by connecting or contacting the middle portion of the first elastic strut 120-1 with the inner side of the first clamping arm 111 and connecting or contacting the middle portion of the second elastic strut 120-2 with the inner side of the second clamping arm 112, the clamping force of the tissue clamping device when clamping the tissue can be enhanced by the elastic force of the elastic support by the first clamping arm 111 and the second clamping arm 112.

Fig. 7 is a schematic view of the structure of a resilient support of a tissue clamping device according to yet another embodiment of the present application. In some embodiments, as shown in FIG. 7, the resilient support may include a first resilient strut 120-1, a second resilient strut 120-2, a first mounting portion 122, and a second mounting portion 123. Wherein the first mounting portion 122 and the second mounting portion 123 may be fixed relative to one end of the tissue clamping device (e.g., the second connector). Both ends of the first elastic strut 120-1 and the second elastic strut 120-2 are connected to the first mounting part 122 and the second mounting part 123, respectively. In some embodiments, as shown in FIG. 7, a middle portion of the first elastic strut 120-1 may include a first receiving hole 121-1, and a middle portion of the second elastic strut 120-2 may include a second receiving hole 121-2. Wherein the first and second receiving holes 121-1 and 121-2 may be formed of a first curved section that is curved outwardly and a second curved section that is curved inwardly. In some embodiments, the first and second receiving holes 121-1 and 121-2 may be oval, oblong, circular, or other shapes. In some embodiments, the shape of the first receiving hole 121-1 may be the same as or different from the shape of the second receiving hole 121-2. It should be noted that, herein, "bending outwards" may refer to a bending direction opposite to the direction of the two ends of the first elastic supporting rod 120-1 or the second elastic supporting rod 120-2 (downward as shown in fig. 7), and "bending inwards" may refer to a bending direction identical to the direction of the two ends of the first elastic supporting rod 120-1 or the second elastic supporting rod 120-2.

In some embodiments, the first clamp arm 111 may pass through the first receiving hole 121-1. The second clamp arm 112 may pass through the second receiving hole 121-2. In some embodiments, the shapes of the first and second receiving holes 121-1 and 121-2 may be designed according to the shapes of the first clip arms 111 and 111. In some embodiments, by passing the first and second clamp arms 111, 112 through the first and second receiving holes 121-1, 121-2, respectively, the first and second elastic struts 120-1, 120-2 may be coupled to or in contact with both the inner sides of the first and second clamp arms 111, 112 and the outer sides of the first and second clamp arms 111, 112, thereby effectively constraining the relative movement between the elastic struts and the clamp arms, preventing the elastic struts from moving laterally, and improving the stability and reliability of the tissue clamping device.

In some embodiments, as shown in fig. 1-2, the first clamp arm 111 may include a first inner clamp arm 1111, a first outer clamp arm 1112, and a first bend 1113, and the second clamp arm 112 may include a second inner clamp arm 1121, a second outer clamp arm 1122, and a second bend 1123. Wherein, the first inner clamping arm 1111 and the first outer clamping arm 1112 are connected by a first bending portion 1113, and the second inner clamping arm 1121 and the second outer clamping arm 1122 are connected by a second bending portion 1123. In some embodiments, the bend angles of first bend 1113 and second bend 1123 may be between 0-180 °. In some embodiments, the bending angles of first bend 1113 and second bend 1123 may be controlled by an external control handle. In the present specification, the connection of the first inner clip arm 1111 and the first outer clip arm 1112 through the first bending portion 1113 and the connection of the second inner clip arm 1121 and the second outer clip arm 1122 through the second bending portion 1123 may be understood as follows: the connection between the first inner clamp arm 1111 and the first outer clamp arm 1112 (i.e., the first bending portion 1113) and the connection between the second inner clamp arm 1121 and the second outer clamp arm 1122 (i.e., the second bending portion 1123) may be bent, the angle between the first inner clamp arm 1111 and the first outer clamp arm 1112 may vary, and the angle between the second inner clamp arm 1121 and the second outer clamp arm 1122 may vary. By the above-described structural designs of the first inner clamp arm 1111, the first outer clamp arm 1112, the second inner clamp arm 1121, and the second outer clamp arm 1122, the first clamping assembly 110-1 and the second clamping assembly 110-2 can achieve stable clamping of tissue.

In some embodiments, a middle portion of the first resilient strut 120-1 may be connected between the first bend 1113 and an end of the first inner clip arm 1111 remote from the first bend 1113, and a middle portion of the second resilient strut 120-2 may be connected between the second bend 1123 and an end of the second inner clip arm 1121 remote from the second bend 1123. The middle portion of the first elastic strut 120-1 connected or contacted with the first clamping arm 111 can move between the first bending portion 1113 and the end of the first inner clamping arm 1111 far from the first bending portion 1113, and the middle portion of the second elastic strut 120-2 connected or contacted with the second clamping arm 112 can move between the second bending portion 1123 and the end of the second inner clamping arm 1121 far from the second bending portion 1123. In some embodiments, the first and second spring struts 120-1 and 120-2 may move relative to the first and second clamp arms 111 and 112 under the control of an external control handle coupled thereto.

In some embodiments, the tissue gripping device may further comprise a support 140, a first connector 150, and a second connector 160. One end (an upper end as shown in fig. 1) of the support part 140 is connected to the first connection member 150. One end of the first inner clamping arm 1111 away from the first bending portion 1113 and one end of the second inner clamping arm 1121 away from the second bending portion 1123 are flexibly connected to the other end (lower end as shown in fig. 1) of the supporting portion 140. The end of the first outer clamping arm 1112 remote from the first bending portion 1113, the end of the second outer clamping arm 1122 remote from the second bending portion 1123, and both ends of the first elastic strut 120-1 and the second elastic strut 120-2 are connected to the second connecting member 160 (the connection manner may include, but is not limited to, bonding, clamping, welding, etc.). Wherein, both ends of the first and second elastic struts 120-1 and 120-2 may be mounted on the second link 160 through the first and second mounting parts 122 and 123, respectively. In some embodiments, the first and second connectors 150, 160 are capable of relative movement to bring the first and second inner clamp arms 1111, 1121 open or close relative to each other. In some embodiments, the first inner clamp arm 1111, the first bend 1113, the first outer clamp arm 1112, the second inner clamp arm 1121, the second bend 1123, and the second outer clamp arm 1122 may be integrally formed with the support portion. In this specification, the bendable connection between the support portion 140 and the first inner clip arm 1111 and the second inner clip arm 1121 may be understood as follows: the connection between the first inner clamping arm 1111 and the support 140 and the connection between the second inner clamping arm 1121 and the support 140 may be bent, so that the first inner clamping arm 1111 and the second inner clamping arm 1121 may be bent toward the support to be relatively closed, or the first inner clamping arm 1111 and the second inner clamping arm 1121 may be bent away from the support to be relatively opened.

In some embodiments, the first connector 150 and the second connector 160 may be connected by a driving rod (not shown). The driving rod may be detachably coupled to the second coupling member 160 after passing through the first coupling member 150 and the supporting portion 140. The driving lever may drive the second link 160 to move relative to the first link 150 (or the supporting part). When the second connecting piece 160 is far away from the supporting portion 140, the first outer clamping arm 1112 and the second outer clamping arm 1122 can pull the first inner clamping arm 1111 and the second inner clamping arm 1121 to open relatively under the driving of the second connecting piece 160; when the second connecting member 160 approaches the supporting portion 140, the first outer clamping arm 1112 and the second outer clamping arm 1122 can pull the first inner clamping arm 1111 and the second inner clamping arm 1121 to close relatively under the driving of the second connecting member 160.

In some embodiments, the cross-sectional shape of the support 140 may be circular or elliptical, and the cross-sectional area of the middle of the support 140 may be greater than the cross-sectional area of both ends thereof. With such a design, possible benefits include, but are not limited to: so that the supporting portion 140 is not vulnerable to damage to tissue; can form effective support for clamped tissues. In some embodiments, the support 140 may also be cylindrical or the like with a relatively rounded shape. Those skilled in the art can determine that the supporting portion 140 has different shapes according to the specific situation of the tissue to be clamped (such as the shape of the mitral valve leaflet to the coaptation edge), so that the shape of the supporting portion 140 is more consistent with the shape of the tissue (such as the mitral valve leaflet to the coaptation edge), and the clamping effect is better. In some embodiments, the support 140 may be a grid structure. The supporting portion 140 of the lattice structure can effectively fill the space between the first inner clamping arm 1111 and the second inner clamping arm 1121 and can prevent thrombus formation after the tissue clamping device clamps tissue (e.g., mitral valve, tricuspid valve).

In some embodiments, the first clamping assembly 110-1 may further include a first jaw 113 disposed on the first inner clamping arm 1111 and the second clamping assembly 110-2 may further include a second jaw 114 disposed on the second inner clamping arm 1121, the first jaw 113 and the second jaw 114 being openable and closable relative to the first inner clamping arm 1111 and the second inner clamping arm 1121, respectively, and enabling tissue to be clamped between the first jaw 113 and the first inner clamping arm 1111 and between the second jaw 114 and the second inner clamping arm 1121.

In some embodiments, the first and second jaws 113, 114 may be coupled to an external control handle (e.g., via a control line connection) that may control the opening and closing of the first jaw 113 relative to the first inner clamp arm 1111 and the opening and closing of the second jaw 114 relative to the second inner clamp arm 1121. In some embodiments, the external control handle may control the first clip 113 and the second clip 114, respectively. In some embodiments, each of the first clip 113 and the second clip 114 may include a fixing portion 1131 and a clamping portion 1132, where the fixing portion 1131 and the clamping portion 1132 are flexibly connected. The fixing portion 1131 may be used to fix the clips (e.g., the first clip 113 and the second clip 114) to the inner clip arms (e.g., the first inner clip arm 1111 and the second inner clip arm 1121), and the clamping portion 1132 may be bent relative to the fixing portion 1131, so that the clips can open and close relative to the inner clip arms (e.g., the first inner clip arm 1111 and the second inner clip arm 1121). When the clamping portion 1132 is bent with respect to the fixing portion 1131, the tissue can be clamped. It should be noted that, in the embodiment of the present application, the connection manner between the fixing portion 1131 and the inner clip arms (e.g., the first inner clip arm 1111 and the second inner clip arm 1121) may include, but is not limited to, adhesion, clamping, welding, and the like.

In some embodiments, as shown in fig. 1, the side of the first clip 113 facing the first inner clip arm 1111 and the side of the second clip 114 facing the second inner clip arm 1121 may further include a plurality of barbs 115. Specifically, one end of the clamping portion 1132 may be connected to the fixing portion 1131 through a bent portion, and the plurality of barbs 115 may be provided at the other end of the clamping portion 1132 not connected to the fixing portion 1131. In some embodiments, the plurality of barbs 115 may be arranged in a plurality of rows or columns to effectively prevent tissue from escaping between the clip and the inner clip arms, making the tissue gripping device more stable in gripping tissue.

In some embodiments, as shown in fig. 1, through holes 116 may be provided in the first inner clamping arm 1111 and the second inner clamping arm 1121 to cooperate with the plurality of barbs 115, thereby further preventing tissue from coming out from between the clamping piece and the inner clamping arm, and making the clamping of the tissue by the tissue clamping device more stable. In some embodiments, the shape and size of the through hole 116 matching the plurality of barbs 115 may be designed according to the shape and size of the barb 115, and the positions of the through holes and the barbs 115 are in one-to-one correspondence.

It should be noted that the above description of the number and arrangement of the barbs 115 and the through holes is merely an example, and in the embodiments of the present application, the designs of the barbs 115 on the first clip 113 and the second clip 114 and the through holes on the second inner clip arms 1121 and 1121 may include, but are not limited to, the foregoing, and those skilled in the art may make corresponding modifications, adaptations or improvements to the foregoing exemplary cases according to actual situations or requirements, and such modifications, adaptations or improvements still fall within the spirit and scope of the exemplary embodiments of the present application.

FIG. 8 is a control schematic of a resilient support of a tissue clamping device according to some embodiments of the present application; FIG. 9 is a control schematic of a resilient support of a tissue clamping device according to another embodiment of the present application; FIG. 10 is an enlarged view of a portion of the control schematic of the resilient support of FIG. 9; FIG. 11 is a control schematic of a resilient support of a tissue clamping device according to yet another embodiment of the present application; FIG. 12 is an enlarged view of a portion of the control schematic of the resilient support of FIG. 11; fig. 13 is a schematic structural view of a tissue gripping device with visualization rings, in accordance with some embodiments of the present application. The manner in which the first resilient strut 120-1 and the second resilient strut 120-2 are controlled in the tissue clamping device provided in some embodiments of the present application is described below in connection with fig. 8-13.

In some embodiments, as shown in fig. 8, the tissue clamping device may include a first control line 131 for controlling movement of the middle portion of the first elastic strut 120-1 connected or contacted with the first clamp arm 111 relative to the first clamp arm 111, and a second control line (corresponding to the first control line 131, not shown) for controlling movement of the middle portion of the second elastic strut 120-2 connected or contacted with the second clamp arm 112 relative to the second clamp arm 112. Wherein one end of the first control wire 131 is connected to the middle of the first elastic strut 120-1, one end of the second control wire is connected to the middle of the second elastic strut 120-2, and the other ends of the first control wire 131 and the second control wire may be connected to an external control handle through the supporting part 140.

In some embodiments, a central portion of the first elastic strut 120-1 may be provided with a control hole through which the first control wire 131 may be connected with the central portion of the first elastic strut 120-1. In some embodiments, the middle portion of the first elastic strut 120-1 may be provided with a groove, and the first control wire 131 may be engaged in the groove to thereby achieve connection with the middle portion of the first elastic strut 120-1. By providing the control hole or the groove, the connection of the first control line 131 with the middle portion of the first elastic supporting rod 120-1 can be conveniently achieved. In some embodiments, the first control wire 131 may include two strands, one end of which may be connected to two locations on the first resilient strut 120-1, respectively, that are symmetrical with respect to the first clamp arm 111, and the other ends of which may be connected together to an external control handle. By this design, the first elastic supporting rod 120-1 can be uniformly stressed under the action of the first control wire 131. The second elastic strut 120-2 may have the same or similar control manner, and will not be described herein.

In some embodiments, the first and second control wires 131, 120-2 may be flexible wires and the natural state of the first and second elastic struts 120-1, 120-2 may be relatively expanded. In some embodiments, the first elastic strut 120-1 and the second elastic strut 120-2 may be folded together under the action of the first control wire 131 and the second control wire, and then be deformed back to the relatively unfolded state by elastic action thereof after the acting force of the first control wire 131 and the second control wire is removed.

In some embodiments, to facilitate handling and to force balance the first and second elastic struts 120-1 and 120-2, the other ends of the first and second control wires 131 and 120-2 may be connected together such that the first and second elastic struts 120-1 and 120-2 may move synchronously under the control of the first and second control wires 131 and 2. In some embodiments, the movement of the first and second resilient struts 120-1, 120-2 relative to the first and second inner clamp arms 1111, 1121, respectively, may be synchronized during control of the deployment of the tissue clamping device via the control handle.

In some embodiments, as shown in fig. 9-10, the tissue clamping device may further include a first elastic member 134 and a second elastic member (corresponding to the first elastic member 134, not shown). One end of the first elastic member 134 may be connected to the first bent portion 1113, and the other end of the first elastic member 134 may be connected to the middle portion of the first elastic strut 120-1. One end of the second elastic member may be connected to the second bending part 1123, and the other end of the second elastic member may be connected to the middle of the second elastic strut 120-2. In some embodiments, the first elastic member and the second elastic member may be elastic elements, such as springs, rubber bands, or the like. In some embodiments, the connection between the first elastic member 134 and the first bending portion 1113 and the first elastic strut 120-1 (or between the second elastic member and the second bending portion 1123 and the second elastic strut 120-2) may include, but is not limited to, bonding, clamping, welding, etc. In some embodiments, considering that the ability of the first and second elastic struts 120-1 and 120-2 to recover deformation may be limited, by providing the first and second elastic members, the first and second elastic struts 120-1 and 120-2 may be assisted to recover, thereby ensuring that the first and second elastic struts 120-1 and 120-2 maintain/recover the expanded state with the first and second clamping assemblies 110-1 and 110-2 when not acted upon by the first and second control wires 131 and 2.

In some embodiments, as shown in fig. 11-12, the tissue clamping device may include a first screw 132 for controlling movement of the middle portion of the first resilient strut 120-1 relative to the first clamp arm 111, and a second screw (corresponding to the first screw 132, not shown) for controlling movement of the middle portion of the second resilient strut 120-2 relative to the second clamp arm 112. In some embodiments, the first screw 132 and the second screw may be connected inside or outside the first inner clamp arm 1111 and the second inner clamp arm 1121, respectively. The middle part of the first elastic supporting rod 120-1 may be in threaded connection with the first screw 132, and the rotation of the first screw 132 can drive the middle part of the first elastic supporting rod 120-1 to move relative to the first clamping arm 111. Similarly, the middle portion of the second elastic supporting rod 120-2 may be in threaded connection with a second screw, and the rotation of the second screw can drive the middle portion of the second elastic supporting rod 120-2 to move relative to the second clamping arm 112. In some embodiments, the first screw and the second screw may be connected to the first inner clamp arm 1111 and the second inner clamp arm 1121 by, but not limited to, bonding, clamping, adhesive, etc. The movement control of the middle part of the first elastic supporting rod 120-1 and the middle part of the second elastic supporting rod 120-2 is realized through the screw, so that the control can be more accurate. In some embodiments, the inner side and the outer side of the first inner clamp arm 1111 may each be provided with a first screw; the second inner clip arm 1121 may be provided with a second screw on both the inside and outside thereof.

In some embodiments, as shown in fig. 11-12, the tissue clamping device may further comprise a first screw control line 133 and a second screw control line (not shown). The first screw control line 133 may be in driving connection with the first screw 132 to drive the first screw 132 to rotate, and both free ends of the first screw control line 133 may be connected with an external control handle. The first screw 132 can rotate under the control of the control handle, so as to drive the middle part of the first elastic supporting rod 120-1 to move relative to the first clamping arm 111. Similarly, the second screw control line may be in driving connection with the second screw to drive the second screw to rotate, and both free ends of the second screw control line may be connected with an external control handle. The second screw rod can rotate under the control of the control handle, so that one end of the second elastic supporting rod 120-2 connected or contacted with the second clamping arm 112 is driven to move relative to the second clamping arm 112.

In some embodiments, the tissue gripping device may include a first screw control rod and a second screw control rod (not shown). The first screw control rod and the first screw rod may be connected through a universal joint, and the rotation of the first screw rod control rod may drive the first screw rod to rotate, so as to drive the middle part of the first elastic supporting rod 120-1 to move relative to the first clamping arm 111. Similarly, the second screw control rod and the second screw rod can be connected through a universal joint in a transmission manner, and the rotation of the second screw rod control rod can drive the second screw rod to rotate, so that the middle part of the second elastic supporting rod 120-2 is driven to move relative to the second clamping arm 112. In some embodiments, the first screw control lever and the second screw control lever may be connected to an external control handle and rotate under the control of the control handle.

FIG. 13 is a schematic structural view of a tissue gripping device with visualization rings according to some embodiments of the present application; fig. 14 is a schematic view of a structure of a clip having a developer ring according to some embodiments of the present application.

In some embodiments, a developing ring 117 may be disposed on the first clamping assembly 110-1 or the second clamping assembly 110-2. A visualization ring may be understood as a component that can be used to display images of blood vessels under ultrasound and digital subtraction angiography (Digital Subtraction Angiography, DSA) techniques. During surgery, ultrasound and Digital Subtraction Angiography (DSA) techniques may be relied upon to display images of the body's blood vessels to indicate the location of the tissue gripping device within the body. However, in the image, it is generally difficult for the operator to distinguish between the first clamping assembly 110-1 and the second clamping assembly 110-2 of the tissue clamping device, and when the control handles control the first clamping assembly 110-1 and the second clamping assembly 110-2, respectively, it is difficult to quickly and accurately operate the control handles to control the corresponding clamping assemblies to perform the clamping operation. The provision of a developer ring on either the first clamping assembly 110-1 or the second clamping assembly 110-2 may be effective to facilitate the operator in distinguishing between the first clamping assembly 110-1 and the second clamping assembly 110-2.

In some embodiments, the developing ring 117 may be disposed on the first inner clamp arm 1111 or the second inner clamp arm 1121. For example, as shown in fig. 13, a developing ring 117 may be provided on the first inner clamp arm 1111. By providing the developing ring, the operator can clearly and definitely distinguish the first inner clamp arm 1111 and the second inner clamp arm 1121 on the image. In some embodiments, a developing ring may be provided on both the first inner clamp arm 1111 and the second inner clamp arm 1121. When developing rings are provided on both the first inner clamp arm 1111 and the second inner clamp arm 1121, the developing rings provided on the first inner clamp arm 1111 and the developing rings provided on the second inner clamp arm 1121 may be different in shape and/or position with respect to the supporting portion 140, thereby distinguishing the first inner clamp arm 1111 and the second inner clamp arm 1121. For example, the developing ring provided on the first inner clamp arm 1111 may have a circular shape, and the developing ring provided on the second inner clamp arm 1121 may have a triangular or rectangular shape. For another example, the developing ring provided on the first inner clamp arm 1111 is relatively close to the junction of the first inner clamp arm 1111 and the supporting portion 140, and the developing ring provided on the second inner clamp arm 1121 is relatively far from the junction of the second inner clamp arm 1121 and the supporting portion 140.

In some embodiments, a developing ring 117 may be provided on the first clip 113 or the second clip 114. For example, as shown in fig. 13, a developing ring 117 may be provided on the first clip 113. By providing a developing ring on the jaws, an operator can clearly and unequivocally distinguish between the first jaw 113 and the second jaw 114 in an image, and thus between the first clamping assembly 110-1 and the second clamping assembly 110-2. In some other embodiments, a developing ring may be provided on both the first and second clips 113 and 114. When the developing rings are disposed on the first and second clamping pieces 113 and 114, the developing rings disposed on the first clamping piece 113 and the developing rings disposed on the second clamping piece 114 may be different in shape and/or position with respect to the supporting portion 140, thereby distinguishing the first and second clamping pieces 113 and 114. For example, the developing ring provided on the first clamping piece 113 may have a circular shape, and the developing ring provided on the second clamping piece 114 may have a triangular or rectangular shape. For another example, the developing ring disposed on the first clamping piece 113 is relatively close to the connection between the first clamping assembly 110-1 and the supporting portion 140, and the developing ring disposed on the second clamping piece 114 is relatively far from the connection between the second clamping assembly 110-2 and the supporting portion 140.

In some embodiments, a developing ring 117 may be provided on both the inner clamp arm and the clamping plate to further enhance the differentiation of the first clamping assembly 110-1 and the second clamping assembly 110-2. For example, the first inner clamping arm 1111 and the first clamping piece 113 may each be provided with a developing ring thereon. In some embodiments, the developer ring may include developer filaments wrapped around the inner clamp arm and/or the clip. The both ends of the developing wire may be fixed to the inner clip arms and/or the clips by welding or bonding or the like so that the developing wire is stably disposed on the inner clip arms and/or the clips. In other embodiments, the developer ring includes a developer sheet secured to the inner clamping arm and/or the clamping plate. The video may be attached to the inner clip arms and/or clips by welding, bonding, clamping, or the like. In some embodiments, the developer wire and developer sheet may be made of platinum iridium alloy, platinum tungsten alloy, tantalum, etc. In some embodiments, the developer ring may also be disposed on other portions (e.g., outer clamp arms) of the first clamp assembly 110-1 and the second clamp assembly 110-2.

In some embodiments, to facilitate operator differentiation, marks corresponding to the positions of the developing rings may be provided on the control handles of the first and second clamping assemblies 110-1 and 110-2. For example, when the developing ring is provided on the first clamping assembly 110-1, marks may be provided on the control handle at positions corresponding to the control mechanism (e.g., first control mechanism) of the first clamping piece 113. For another example, when a developer ring is disposed on the second clamping assembly 110-2, indicia may be disposed on the control handle at a location corresponding to a control mechanism (e.g., a second control mechanism) of the second clamping jaw 114.

The present embodiments also provide a tissue repair device 1000 comprising a control handle 200 and a tissue clamping device according to any of the above-described aspects; the control handle 200 may be used to deliver a tissue clamping device to tissue and control the clamping of tissue by the first clamping assembly 110-1 and the second clamping assembly 110-2, respectively, of the tissue clamping device. In some embodiments, the tissue repair device 1000 may include a delivery tube 300, with the first connector 150 of the tissue gripping device being connected to the control handle 200 via the delivery tube 300.

In some embodiments, control handle 200 may include a first control mechanism that may be used to control first clamping assembly 110-1 (e.g., first jaw 113) to clamp tissue and a second control mechanism that may be used to control second clamping assembly 110-2 (e.g., second jaw 114) to clamp tissue; the first control mechanism and/or the second control mechanism are/is provided with distinguishing marks. Distinguishing the indicia may be understood as enabling an operator to quickly distinguish the indicia of the first control mechanism from the indicia of the second control mechanism. For example, the first control mechanism may be provided with a protrusion structure, a groove structure, or other structures that enable an operator to distinguish between the first control mechanism and the second control mechanism as distinguishing marks. For another example, the first control mechanism may be provided with the identification letter "left", and the second control mechanism may be provided with the identification letter "right".

In some embodiments, the tissue repair device may include a drive rod (not shown) that may be removably coupled to the second connector 160 after passing through the first connector 150 and the support 140. The first connector 150 may be connected to one end of the support 140, and one end of the first outer clip arm 1112 and one end of the second outer clip arm 1122 are connected to the second connector 160, respectively. The driving rod may drive the second link 160 to move relative to the first link 150 (or the supporting part 140). When the second connecting piece 160 is far away from the supporting portion 140, the first outer clamping arm 1112 and the second outer clamping arm 1122 can pull the first inner clamping arm 1111 and the second inner clamping arm 1121 to open relatively under the driving of the second connecting piece 160; when the second connecting member 160 approaches the supporting portion 140, the first outer clamping arm 1112 and the second outer clamping arm 1122 can pull the first inner clamping arm 1111 and the second inner clamping arm 1121 to close relatively under the driving of the second connecting member 160.

In some embodiments, the first control mechanism and the second control mechanism may each include a traction cable, one end of the traction cable of the first control mechanism may be coupled to the movable end of the first clip 113, and one end of the traction cable of the second control mechanism may be coupled to the movable end of the second clip 114. By releasing and tightening the traction cable, the opening and closing of the first clamping piece 113 relative to the first inner clamping arm 1111 and the opening and closing of the second clamping piece 114 relative to the second inner clamping arm 1121 can be controlled.

In some embodiments, control handle 200 may include a housing that may be removably coupled to delivery tube 300. The first control mechanism and the second control mechanism may each include a sliding portion slidably disposed on the housing. The other end of the traction rope of the first control mechanism is connected with the sliding part of the traction rope, and the other end of the traction rope of the second control mechanism is connected with the sliding part of the traction rope. By moving the slide relative to the housing, the traction cable can be loosened and tightened to effect opening and closing of the jaws (e.g., first jaw 113 and second jaw 114) relative to the inner clamp arms (e.g., first inner clamp arm 1111 and second inner clamp arm 1121). It will be appreciated that the first control mechanism and the second control mechanism may be of various other configurations, which are not further limited in this application.

In some embodiments, control handle 200 may also include a control mechanism (also referred to as a third control mechanism) for controlling movement of first and second resilient struts 120-1 and 120-2 relative to first and second clamp arms 111 and 112, respectively. In some embodiments, the control mechanism may be connected to the first elastic strut 120-1 and the second elastic strut 120-2 by a first control line 131 and a second control line, respectively. In some embodiments, the control mechanism may control movement of the middle portion of the first resilient strut 120-1 relative to the first clamp arm 111 and movement of the middle portion of the second resilient strut 120-2 relative to the second clamp arm 112 via the first control line 131 and the second control line. In some embodiments, the control mechanism may control the movement of the middle portion of the first resilient strut 120-1 relative to the first clamp arm 111 and the movement of the middle portion of the second resilient strut 120-2 relative to the second clamp arm 112 by controlling the rotation of the first and second screws.

While the basic concepts have been described above, it will be apparent to those skilled in the art that the foregoing detailed disclosure is by way of example only and is not intended to be limiting. Although not explicitly described herein, various modifications, improvements, and adaptations of the present application may occur to one skilled in the art. Such modifications, improvements, and modifications are intended to be suggested within this application, and are therefore within the spirit and scope of the exemplary embodiments of this application.

Meanwhile, the present application uses specific words to describe embodiments of the present application. Reference to "one embodiment," "an embodiment," and/or "some embodiments" means that a particular feature, structure, or characteristic is associated with at least one embodiment of the present application. Thus, it should be emphasized and should be appreciated that two or more references to "an embodiment" or "one embodiment" or "an alternative embodiment" in various positions in this specification are not necessarily referring to the same embodiment. Furthermore, certain features, structures, or characteristics of one or more embodiments of the present application may be combined as suitable.

Likewise, it should be noted that in order to simplify the presentation disclosed herein and thereby aid in understanding one or more inventive embodiments, various features are sometimes grouped together in a single embodiment, figure, or description thereof. This method of disclosure, however, is not intended to imply that more features than are presented in the claims are required for the subject application. Indeed, less than all of the features of a single embodiment disclosed above.

In some embodiments, numbers describing the components, number of attributes are used, it being understood that such numbers being used in the description of embodiments are modified in some examples by the modifier "approximately", "approximately" or "substantially". Unless otherwise indicated, "substantially", "approximately" or "substantially" indicate that the number allows for a variation of + -10%. Accordingly, in some embodiments, numerical parameters set forth in the specification and claims are approximations that may vary depending upon the desired properties sought to be obtained by the individual embodiments. In some embodiments, the numerical parameters should take into account the specified significant digits and employ a method for preserving the general number of digits. Although the numerical ranges and parameters set forth herein are approximations that may be employed in some embodiments to confirm the breadth of the range, in particular embodiments, the setting of such numerical values is as precise as possible.

Finally, it should be understood that the embodiments described herein are merely illustrative of the principles of the embodiments of the present application. Other variations are also possible within the scope of this application. Thus, by way of example, and not limitation, alternative configurations of embodiments of the present application may be considered in keeping with the teachings of the present application. Accordingly, embodiments of the present application are not limited to only the embodiments explicitly described and depicted herein.

Claims

1. A tissue clamping device comprising a clamping assembly and an elastic support; wherein,

the clamping assembly comprises a first clamping assembly and a second clamping assembly, and the first clamping assembly and the second clamping assembly are respectively used for clamping tissues; the first clamping assembly comprises a first clamping arm, the second clamping assembly comprises a second clamping arm, and an included angle between the first clamping arm and the second clamping arm is variable;

the first clamping arm comprises a first inner clamping arm, a first outer clamping arm and a first bending part, and the second clamping arm comprises a second inner clamping arm, a second outer clamping arm and a second bending part;

the first inner clamping arm is connected with the first outer clamping arm through the first bending part, and the second inner clamping arm is connected with the second outer clamping arm through the second bending part;

the elastic support piece comprises a first elastic supporting rod and a second elastic supporting rod; the middle part of the first elastic supporting rod is connected or contacted with the first clamping arm, and the middle part of the second elastic supporting rod is connected or contacted with the second clamping arm;

the middle part of the first elastic supporting rod can be controlled to move between the first bending part and one end of the first inner clamping arm far away from the first bending part, and the middle part of the second elastic supporting rod can be controlled to move between the second bending part and one end of the second inner clamping arm far away from the second bending part;

During the movement of the middle portion of the first elastic strut relative to the first clamping arm and the movement of the middle portion of the second elastic strut relative to the second clamping arm, the widths of the first elastic strut and the second elastic strut correspondingly change, thereby enabling the widths of the tissue clamping device to correspondingly change.

2. The tissue clamping device of claim 1 wherein the middle portion of the first resilient strut is connected to or in contact with the outside of the first clamping arm; the middle part of the second elastic supporting rod is connected with or contacted with the outer side of the second clamping arm.

3. The tissue clamping device of claim 1 wherein the middle portion of the first resilient strut is connected to or in contact with the inner side of the first clamping arm; the middle part of the second elastic supporting rod is connected with or contacted with the inner side of the second clamping arm.

4. The tissue clamping device of claim 1 wherein the central portion of the first resilient strut includes a first receiving aperture through which the first clamping arm passes; the middle portion of the second elastic strut includes a second receiving hole through which the second clip arm passes.

5. The tissue clamping device of claim 1, wherein the tissue clamping device comprises a first control line for controlling movement of the middle portion of the first resilient strut relative to the first clamp arm and a second control line for controlling movement of the middle portion of the second resilient strut relative to the second clamp arm;

one end of the first control wire is connected with the middle part of the first elastic supporting rod, and one end of the second control wire is connected with the middle part of the second elastic supporting rod; the other end of the first control wire and the other end of the second control wire are connected with an external control handle.

6. The tissue clamping device of claim 5, wherein the first control wire and the second control wire move the first resilient strut and the second resilient strut in synchrony under the control of the control handle.

7. The tissue clamping device of claim 5 further comprising a first resilient member and a second resilient member;

one end of the first elastic piece is connected with the first bending part, and the other end of the first elastic piece is connected with the middle part of the first elastic supporting rod; one end of the second elastic piece is connected with the second bending part, and the other end of the second elastic piece is connected with the middle part of the second elastic supporting rod.

8. The tissue clamping device of claim 1, wherein the tissue clamping device comprises a first screw for controlling movement of the middle portion of the first resilient strut relative to the first clamp arm, and a second screw for controlling movement of the middle portion of the second resilient strut relative to the second clamp arm;

the middle part of the first elastic supporting rod is in threaded connection with the first screw rod, and the rotation of the first screw rod can drive the middle part of the first elastic supporting rod to move;

the middle part of the second elastic supporting rod is in threaded connection with the second screw rod, and the rotation of the second screw rod can drive the middle part of the second elastic supporting rod to move.

9. The tissue clamping device of claim 8 further comprising a first screw control line and a second screw control line;

the first screw control line is in transmission connection with the first screw so as to drive the first screw to rotate; two free ends of the first screw control wire are connected with an external control handle;

the second screw control line is in transmission connection with the second screw so as to drive the second screw to rotate, and two free ends of the second screw control line are connected with an external control handle.

10. The tissue clamping device of claim 8 further comprising a first screw control rod and a second screw control rod;

the first screw rod control rod is in transmission connection with the first screw rod through a universal joint, and the rotation of the first screw rod control rod can drive the first screw rod to rotate;

the second screw rod control rod is in transmission connection with the second screw rod through a universal joint, and the second screw rod control rod can be driven to rotate by rotating.

11. The tissue clamping device of claim 1 further comprising a support, a first connector and a second connector;

one end of the supporting part is connected with the first connecting piece;

one end of the first inner clamping arm, which is far away from the first bending part, and one end of the second inner clamping arm, which is far away from the second bending part, are connected with the other end of the supporting part;

one end of the first outer clamping arm, which is far away from the first bending part, one end of the second outer clamping arm, which is far away from the second bending part, and two ends of the first elastic supporting rod and the second elastic supporting rod are connected with the second connecting piece;

The first connecting piece and the second connecting piece can relatively move so as to drive the first inner clamping arm and the second inner clamping arm to relatively open or close.

12. The tissue clamping device of claim 1 wherein the first clamping assembly further comprises a first clip disposed on the first inner clamping arm and the second clamping assembly further comprises a second clip disposed on the second inner clamping arm; the first and second jaws are openable and closable relative to the first and second inner arms, respectively, and enable tissue to be clamped between the first and first inner arms and between the second and second inner arms.

13. The tissue clamping device of claim 12, wherein a side of the first jaw facing the first inner clamping arm and a side of the second jaw facing the second inner clamping arm are provided with a plurality of barbs; the barbs are arranged in a plurality of rows or columns.

14. The tissue clamping device of claim 13 wherein the first inner clamping arm and the second inner clamping arm are provided with through holes that mate with the plurality of barbs.

15. The tissue clamping device according to claim 1, wherein a developing ring is arranged on the first clamping component or the second clamping component, and a mark corresponding to the position of the developing ring is arranged on a control handle of the first clamping component or a control handle of the second clamping component.

16. The tissue clamping device of claim 1 wherein the resilient support is an integrally formed structure of a shape memory alloy tubing that has been cut and heat set.

17. A tissue repair device comprising a control handle and a tissue gripping apparatus according to any one of claims 1 to 16; the control handle is used for conveying the tissue clamping device to a tissue and respectively controlling the clamping of the first clamping component and the second clamping component of the tissue clamping device to the tissue.

18. The tissue repair device of claim 17, wherein the control handle is provided with a control mechanism for: and controlling the middle part of the first elastic supporting rod connected or contacted with the first clamping arm to move relative to the first clamping arm, and controlling the middle part of the second elastic supporting rod connected or contacted with the second clamping arm to move relative to the second clamping arm.