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