CN209884246U - Left atrial appendage closure delivery system - Google Patents
Left atrial appendage closure delivery system Download PDFInfo
- Publication number
- CN209884246U CN209884246U CN201920484851.6U CN201920484851U CN209884246U CN 209884246 U CN209884246 U CN 209884246U CN 201920484851 U CN201920484851 U CN 201920484851U CN 209884246 U CN209884246 U CN 209884246U
- Authority
- CN
- China
- Prior art keywords
- direction control
- joint
- control
- baffle
- wrench
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Images
Landscapes
- Surgical Instruments (AREA)
Abstract
The utility model discloses a left atrial appendage closer conveying system, it includes brake valve lever, connecting rod and head end, brake valve lever passes through the connecting rod and the head end is connected, be equipped with two arm lock on the head end, be used for loading the closer between two arm lock, the last directional control end that is equipped with of brake valve lever, open angle control end and off-load control end, be connected with the direction control line between directional control end and the head end, the direction of direction control end through direction control line control head end, be connected with open angle control line between open angle control end and two arm lock, open angle control end is through the contained angle of two arm lock of open angle control line control, be connected with the off-load control line between off-load control end and the closer, when off-load control end makes the off-load control line break away from the closer, the closer off-. The purpose is to provide a left atrial appendage closure delivery system which can reduce trauma to a patient during surgery and can accurately release a closure to clamp the left atrial appendage.
Description
Technical Field
The utility model relates to a surgical instrument, in particular to a left auricle closer conveying system suitable for minimally invasive surgery.
Background
Atrial fibrillation is short for atrial fibrillation and is one of the common cardiac arrhythmias. Of stroke patients, 20% are associated with atrial fibrillation, and 35% of patients with atrial fibrillation develop one or more thromboembolisms during their lifetime. Atrial fibrillation is an independent risk factor for mortality, with stroke rates rising 5-fold in patients with atrial fibrillation, the primary therapeutic goal of which is to prevent stroke and to ameliorate symptoms. 90-100% of patients with non-rheumatic heart disease atrial fibrillation have thrombus from left atrial appendage.
Evidence-based medicine proves that the left atrial appendage can be sealed to prevent the occurrence of embolism complications of patients with atrial fibrillation. Clinically, cardiac surgery adopts dedicated closer to seal the left auricle, reduces the emergence of the patient's cerebral apoplexy of atrial fibrillation. The closure requires a delivery system to deliver the closure from outside the body to the left atrial appendage within the body while closing the left atrial appendage. Existing delivery systems are unreliable in releasing the closure device, causing the closure device to be unable to accurately close the left atrial appendage. In addition, when the closer is detached from the delivery system, the closer needs to be detached from the delivery system by a cutting operation with surgical scissors, thereby requiring a larger-sized surgical path and causing a larger trauma to the patient.
SUMMERY OF THE UTILITY MODEL
The to-be-solved technical problem of the utility model is to provide a left atrial appendage closer conveying system, it can reduce the wound that causes the patient among the operation process to can release the closer with the clamp left atrial appendage accurately.
The utility model discloses left auricle closer conveying system, including brake valve lever, connecting rod and head end, brake valve lever passes through the connecting rod and the head end is connected, be equipped with two arm lock on the head end, be used for loading the closer between two arm lock, the last directional control end, opening angle control end and the off-load control end of being equipped with of brake valve lever, be connected with the direction control line between directional control end and the head end, the direction of direction control end through direction control line control head end, be connected with opening angle control line between opening angle control end and two arm lock, opening angle control end is through the contained angle of two arm lock of opening angle control line control, be connected with the off-load control line between off-load control end and the closer, when off-load control end makes the off-load control line break away from the closer, the closer off-load from the arm.
The utility model discloses left auricle closer conveying system, wherein the direction control end is established to two, two the direction control end is first direction control end and second direction control end respectively, be connected with first direction control line between first direction control end and the head end, be connected with second direction control line between second direction control end and the head end, first direction control end is rotatory in the first plane through first direction control line control head end, second direction control end is rotatory in the second plane through second direction control line control head end.
The utility model discloses left auricle closer conveying system, wherein the head end includes first joint, second joint and third joint, two at least one in the arm lock articulate in on the first joint, first joint articulates on the second joint, the second joint articulates on the third joint, the third joint links to each other with the connecting rod, be connected with between second joint and the first direction control end first direction control line, be connected with between first joint and the second direction control end second direction control line, first direction control end is rotatory in the first plane through first direction control line control second joint, second direction control end is rotatory in the second plane through second direction control line control first joint, first plane perpendicular to the second plane.
The utility model discloses left atrial appendage closer conveying system, wherein the off-load control line is established to two, two the off-load control line is connected one end with the closer and is laid respectively on the lateral surface of two arm locks, is used for loading between two relative medial surfaces of two arm locks the closer, every all be equipped with logical groove in the arm lock, lead to the lateral surface and the medial surface that the groove runs through the arm lock, lead to the inslot and wear to be equipped with the arm lock wire loop, the off-load control line in the arm lock outside and the inboard closer of arm lock are tied up simultaneously to the arm lock wire loop in every arm lock.
The utility model relates to a left auricle closer conveying system, wherein the control handle comprises a first shell and a second shell which are connected with each other, the connecting rod is of a cylindrical structure, the first direction control end comprises a first rotating disc and a first direction control key, the first direction control key is arranged on a first rotating disc which is rotatably arranged in the control handle, the first direction control ends extend out of the control handle, the number of the first direction control lines is two, one ends of the two first direction control lines are connected to the first rotary disc, the other ends of the two first direction control lines penetrate through the inner cavity of the connecting rod and then are connected to the second joint, the two first direction control lines connected to the first rotary disc are respectively located on two opposite sides of the rotation center of the first rotary disc, and the two first direction control lines connected to the second joint are respectively located on two opposite sides of the second joint.
The utility model discloses left auricle closer conveying system, wherein second direction control end includes second carousel and second direction control key, second direction control key sets up on the second carousel, the second carousel is rotationally installed in brake valve lever, second direction control end extends to outside the brake valve lever, second direction control line establishes to two, the one end of two second direction control lines connect in on the second carousel, the other end of two second direction control lines passes and connects on first joint after the inner chamber of connecting rod, connects two second direction control lines on the second carousel and is located the relative both sides at second carousel rotation center respectively, and two second direction control lines of connecting on first joint are located the relative both sides of first joint respectively.
The utility model discloses left auricle closer conveying system, wherein be equipped with first boss and first blind hole on two relative sides of first carousel respectively, first boss and first blind hole all are located the rotation center department of first carousel, first boss and the coaxial arrangement of first blind hole, be equipped with second boss and third boss on two relative sides of second carousel respectively, second boss and third boss all are located the rotation center department of second carousel, second boss and the coaxial arrangement of third boss, be equipped with the second blind hole on the internal surface of first casing, be equipped with the third blind hole on the internal surface of second casing, the second boss is located first blind hole, first boss is located the second blind hole, the third boss is located the third blind hole.
The utility model discloses a left auricle closer conveying system, wherein be equipped with the fourth blind hole on the first carousel, one end of first direction control key is located the fourth blind hole, be equipped with first compression spring between the bottom wall of first direction control key and fourth blind hole, fixed being equipped with first spacer on the first direction control key, be equipped with the fifth blind hole on the second carousel, one end of second direction control key is located the fifth blind hole, be equipped with the second compression spring between the bottom wall of second direction control key and fifth blind hole, fixed being equipped with the second spacer on the second direction control key, be equipped with the location gear between first direction control key and the second direction control key, the location gear is fixed on the control handle, under the effect of first compression spring, first spacer on the first direction control key block on the gear of locating gear, under the action of the second compression spring, the second positioning piece on the second direction control key is also clamped on the gear of the positioning gear.
The utility model discloses a left auricle closer conveying system, wherein the flare angle control end includes the spanner, the one end of spanner is rotationally installed in brake valve lever, the other end of spanner extends to outside brake valve lever, the flare angle control line is set to at least one, the quantity of flare angle control line is the same with the arm lock quantity that articulates on first joint, flare angle control line and the arm lock one-to-one setting that articulates on first joint, one end of flare angle control line is connected with the corresponding arm lock that articulates on first joint, the other end of flare angle control line is connected to the one end of spanner that is located in brake valve lever, the rotation spanner can strain or loosen the flare angle control line, be connected with extension spring between the internal surface of spanner and brake valve lever, under extension spring's effect, the spanner rotates and makes the flare angle control line relax, brake valve lever is last to be equipped with limit button, when the spanner is rotated to tighten the flare angle control line, the limit button is clamped with the spanner, and when the limit button is pressed, the limit button is separated from the spanner.
The utility model discloses a left atrial appendage closer conveying system, wherein the off-load control end includes off-load spanner and off-load pole, the one end sliding connection of off-load spanner is in brake valve lever, the other end of off-load spanner extends outside brake valve lever, brake valve lever internal fixation is equipped with first baffle and second baffle, off-load pole slidable mounting is on first baffle and second baffle, the cover is equipped with slide sheet and third baffle on the off-load pole, slide sheet and third baffle are located the relative both sides of second baffle respectively, the slide sheet is located between first baffle and the second baffle, be equipped with third compression spring between first baffle and the slide sheet, be equipped with fourth compression spring between second baffle and the third baffle, third compression spring and fourth compression spring all suit are on off-load pole, the off-load spanner is equipped with the notch, one end of the sliding sheet is located in the notch, a stop block is arranged on the inner surface of the second baffle or the control handle, when the third baffle is far away from the second baffle under the action of the fourth compression spring and moves, the stop block prevents one side edge of the third baffle from continuing to move, the far end of the unloading rod is located on one side of the third baffle, the near end of the unloading rod is located on one side of the first baffle, the far end of the unloading rod is connected with the unloading control line, a fourth baffle is arranged in the control handle and located in the sliding direction of the unloading rod, the fourth baffle is located on one side of the near end of the unloading rod, and when the near end of the unloading rod is abutted against the fourth baffle, the unloading control line is separated from the clamping arm wire ring.
The utility model discloses left atrial appendage closer conveying system includes brake valve lever, connecting rod and head end, when using, through adjustment direction control end and opening angle control end, makes the closer of installing at the head end catch the target tissue conveniently, has improved the efficiency and the degree of accuracy of implanting, can conveniently adjust the gesture of closer many times according to clinical demand in order to reach best curative effect, has improved the accuracy of implantation position to can release the closer accurately in order to press from both sides and close left atrial appendage. Through the adjustment of the off-load control end, the off-load control line can be separated from the closer, the closer is off-loaded from the clamping arm, the line shearing of surgical scissors is not needed, the efficiency of releasing the closer is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient in the surgical process is reduced.
The present invention will be further explained with reference to the accompanying drawings.
Drawings
Fig. 1 is a schematic structural view of the left atrial appendage occluder delivery system of the present invention;
fig. 2 is a schematic structural view of the head end of the present invention;
fig. 3 is an exploded view of the head end of the present invention;
fig. 4 is a schematic view of the proximal end of the third joint in the head end of the present invention;
fig. 5 is a schematic view of a distal end direction of a third joint in the head end of the present invention;
FIG. 6 is a cross-sectional view taken along line A-A of FIG. 4;
FIG. 7 is a cross-sectional view taken along line B-B of FIG. 5;
fig. 8 is a schematic view of the direction of the distal end of the second joint in the head end of the present invention;
fig. 9 is a schematic view of the proximal direction of the second joint in the head end of the present invention;
FIG. 10 is a cross-sectional view taken along line C-C of FIG. 8;
FIG. 11 is a cross-sectional view taken along line D-D of FIG. 9;
fig. 12 is a schematic view of the proximal direction of the first joint in the head end of the present invention;
fig. 13 is a schematic view of the distal direction of the first joint in the head end of the present invention;
FIG. 14 is a cross-sectional view taken along line E-E of FIG. 12;
FIG. 15 is a cross-sectional view taken along line F-F of FIG. 13;
fig. 16 is a view of a first joint in the head end of the present invention from the distal end to the proximal end;
fig. 17 is a schematic view of the proximal end of the clamp arm in the head end of the present invention;
fig. 18 is a schematic view of the distal direction of the clamp arm in the head end of the present invention;
FIG. 19 is a schematic view of the inner side surface of the clamp arm at the head end of the present invention;
fig. 20 is a view of the clamp arm of the head end of the present invention from the proximal end to the distal end;
fig. 21 is a schematic view of the connection of the control line in the head end of the present invention (the second joint is hidden);
fig. 22 is a schematic view of the connection of the control line in the head end of the present invention (the first joint, the second joint and the third joint are hidden in the figure);
fig. 23 is a schematic view of the connection of the control line in the head end of the present invention (the first joint, the second joint, the third joint and the clamping arm are hidden in the figure);
fig. 24 is a schematic view of the present invention with the distal end of the head end open;
fig. 25 is a schematic structural view of a first housing in the control handle of the present invention;
fig. 26 is a schematic structural view of a second housing in the control handle of the present invention;
fig. 27 is a schematic structural view of the control handle of the present invention (the second housing is hidden in the drawing);
fig. 28 is a schematic view of the structure of the proximal end of the connecting rod of the present invention;
fig. 29 is a schematic structural view of a direction control end in the control handle of the present invention;
fig. 30 is a schematic structural view of a positioning gear in the direction control end of the present invention;
fig. 31 is a schematic view of another structure of the positioning gear in the direction control end of the present invention;
fig. 32 is a schematic structural diagram of a first direction control end according to the present invention;
fig. 33 is an exploded view of a first directional control end of the present invention;
fig. 34 is a schematic structural diagram of a first turntable in the first direction control end of the present invention;
fig. 35 is a schematic view of another structure of the first rotating disc in the first direction control end of the present invention;
fig. 36 is a schematic structural view of a second direction control end of the present invention;
fig. 37 is an exploded view of a second directional control end of the present invention;
fig. 38 is a schematic structural view of a second rotary plate in a second direction control end according to the present invention;
fig. 39 is a schematic view of another structure of a second turntable in a second direction control end according to the present invention;
fig. 40 is a schematic structural view of a wrench in the flare angle control end of the present invention;
fig. 41 is another schematic structural diagram of the wrench in the flare angle control end of the present invention;
fig. 42 is a schematic side view of the wrench in the flare angle control end of the present invention;
fig. 43 is a schematic view of the structure of the pulley in the flare angle control end of the present invention;
fig. 44 is a schematic structural view of the unloading control end of the present invention;
fig. 45 is a schematic structural view of the unloading control end of the present invention located in the first housing part;
fig. 46 is a schematic structural view of a unloading rod in the unloading control end of the present invention;
fig. 47 is a schematic structural view of a load releasing wrench in the load releasing control end of the present invention;
fig. 48 is another schematic structural view of the unloading wrench in the unloading control end of the present invention;
fig. 49 is a schematic structural view of a third baffle plate in the unloading control end of the present invention;
fig. 50 is a schematic structural view of a slide plate in the unloading control end of the present invention;
fig. 51 is a schematic view of a first modified structure of the clamp arm in the head end of the present invention;
fig. 52 is a schematic view of a second modified structure of the clip arm in the head end of the present invention;
fig. 53 is a schematic structural view of the limit button of the present invention;
fig. 54 is another schematic structural view of the limit button of the present invention;
fig. 55 is a mounting state diagram of the limit button of the present invention.
Detailed Description
In the description of the present invention, for the convenience of understanding the technical solution, the proximal end and the distal end mentioned in the present invention are explained as follows: the proximal and distal ends are relative to the operator's distance, specifically, distal is defined as the distance to the operator and proximal is defined as the distance to the operator.
It should be noted that the terms "center", "upper", "lower", "front", "rear", "left", "right", "middle" and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of describing the present invention and simplifying the description, but do not indicate or imply that the device or element referred to must have a specific orientation, be constructed in a specific orientation, and be operated, and thus should not be construed as limiting the present invention.
In the description of the present invention, it is to be noted that, unless otherwise explicitly specified or limited, the terms "connected" and "connected" are to be interpreted broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; may be directly connected or indirectly connected through an intermediate. The specific meaning of the above terms in the present invention can be understood in specific cases to those skilled in the art.
The gear, the pulley that enumerate in this embodiment have only enumerated the utility model discloses a concrete transmission mode is for the convenience of understanding the utility model discloses the embodiment, should not be understood as right the utility model discloses a restriction. Also, the control wires and the loading wires mentioned in the present embodiment are only one embodiment, and are not to be construed as limiting the scope of the present invention.
The numbers mentioned in the present embodiment are also for the convenience of understanding of the present embodiment, and should not be construed as limiting the present invention.
Without loss of generality, the embodiment is described by taking the minimally invasive field as an example. It should be noted that the surgical device of the present embodiment can be applied to any field requiring implantation, except the minimally invasive field.
As shown in fig. 1, and as shown in fig. 2-52, the present invention provides a conveying system 10 for a left atrial appendage closure device, which includes a control handle 40, a connecting rod 30 and a head end 20, wherein the control handle 40 is connected to the head end 20 via the connecting rod 30, and the head end 20 is provided with two clamping arms, which are an upper clamping arm 102 and a lower clamping arm 103. Be used for loading the closer between two arm lock, be equipped with direction control end, opening angle control end 70 and off-load control end 80 on the control handle 40, be connected with the direction control line between direction control end and the head end 20, the direction control end passes through the direction of direction control line control head end 20, be connected with the opening angle control line between opening angle control end 70 and two arm lock, opening angle control end 70 is through the contained angle of two arm lock of opening angle control line control, be connected with the off-load control line between off-load control end 80 and the closer, when off-load control end 80 made the off-load control line break away from the closer, the closer was off-loaded from the arm lock.
The utility model discloses left atrial appendage closer conveying system 10, wherein the directional control end is established to two, two the directional control end is first directional control end 50 and second directional control end 60 respectively, be connected with first direction control line 301, 302 between first directional control end 50 and the head end 20, be connected with second directional control line 303, 304 between second directional control end 60 and the head end 20, first directional control end 50 is rotatory in the first plane through first directional control line 301, 302 control head end 20, second directional control end 60 is rotatory in the second plane through second directional control line 303, 304 control head end 20.
The utility model discloses left atrial appendage closure delivery system 10, wherein head end 20 includes first joint 104, second joint 105 and third joint 106, two at least one in the arm lock articulate in first joint 104, first joint 104 articulates in second joint 105, second joint 105 articulates in third joint 106, third joint 106 links to each other with connecting rod 30, be connected with first direction control line 301, 302 between second joint 105 and the first direction control end 50, be connected with second direction control line 303, 304 between first joint 104 and the second direction control end 60, first direction control end 50 controls second joint 105 to rotate in the first plane through first direction control line 301, 302, second direction control end 60 controls first joint 104 to rotate in the second plane through second direction control line 303, 304, the first plane is perpendicular to the second plane.
The utility model discloses left atrial appendage closer conveying system 10, wherein the off-load control line is established to two, two off- load control line 307, 308 is connected one end with the closer and is laid respectively on the lateral surface of two arm lock, is used for loading between two relative medial surfaces of two arm lock the closer, every all be equipped with logical groove 457 on the arm lock, it runs through the lateral surface and the medial surface of arm lock to lead to groove 457, wear to be equipped with the arm lock wire loop in leading to groove 457, the off-load control line in the arm lock outside and the inboard closer of arm lock are tied up simultaneously to the arm lock wire loop on every arm lock.
The utility model discloses left atrial appendage closure delivery system 10, wherein control handle 40 includes first casing 201 and second casing 202 of interconnect, connecting rod 30 is the tubular structure, first direction control end 50 includes first carousel 207 and first direction control key, first direction control key 204 sets up on first carousel 207, first carousel 207 rotatably installs in control handle 40, first direction control end 50 extends to outside control handle 40, first direction control line 301, 302 sets up to two, and the one end of two first direction control lines 301, 302 is connected to on first carousel 207, and the other end of two first direction control lines 301, 302 passes behind the inner chamber of connecting rod 30 and connects on second joint 105, and two first direction control lines 301, 302 that connect on first carousel 207 are located the relative both sides of first carousel 207 rotation center respectively, two first direction control wires 301, 302 connected to the second joint 105 are located on opposite sides of the second joint 105.
The present invention relates to a left atrial appendage closure delivery system 10, wherein the second direction control end 60 comprises a second rotary disk 206 and a second direction control key 205, the second direction control button 205 is provided on a second dial 206, the second dial 206 is rotatably mounted within the control handle 40, the second direction control end 60 extends to the outside of the control handle 40, two second direction control lines 303 and 304 are provided, one end of each of the two second direction control lines 303 and 304 is connected to the second rotating disc 206, the other end of each of the two second direction control lines 303 and 304 passes through the inner cavity of the connecting rod 30 and then is connected to the first joint 104, the two second direction control lines 303 and 304 connected to the second rotating disc 206 are respectively located at two opposite sides of the rotation center of the second rotating disc 206, and the two second direction control lines 303 and 304 connected to the first joint 104 are respectively located at two opposite sides of the first joint 104.
The utility model relates to a left auricle closer conveying system 10, wherein a first boss 554 and a first blind hole 548 are respectively arranged on two opposite side surfaces of the first turntable 207, the first boss 554 and the first blind hole 548 are both located at the center of rotation of the first rotary disk 207, the first boss 554 and the first blind hole 548 are coaxially arranged, a second boss 556 and a third boss 561 are respectively arranged on two opposite side surfaces of the second rotary plate 206, the second boss 556 and the third boss 561 are both located at the rotation center of the second turntable 206, the second boss 556 and the third boss 561 are coaxially arranged, a second blind hole 513 is provided on the inner surface of the first housing 201, the inner surface of the second housing 202 is provided with a third blind hole 524, the second boss 556 is located in the first blind hole 548, the first boss 554 is located in the second blind hole 513, and the third boss 561 is located in the third blind hole 524.
The utility model discloses a left atrial appendage closer conveying system 10, wherein be equipped with fourth blind hole 551 on the first carousel 207, one end of first direction control key 204 is located fourth blind hole 551, be equipped with first compression spring 221 between the bottom wall of first direction control key 204 and fourth blind hole 551, fixed being equipped with first spacer 220 on first direction control key 204, be equipped with fifth blind hole 559 on second carousel 206, one end of second direction control key 205 is located fifth blind hole 559, be equipped with second compression spring 222 between the bottom wall of second direction control key 205 and fifth blind hole 559, fixed being equipped with second spacer 217 on second direction control key 205, be equipped with location gear 203 between first direction control key 204 and the second direction control key 205, location gear 203 is fixed to be located on control handle 40, under the effect of first compression spring 221, the first positioning piece 220 of the first direction control key 204 is engaged with the gear 539 of the positioning gear 203, and the second positioning piece 217 of the second direction control key 205 is also engaged with the gear 539 of the positioning gear 203 by the second compression spring 222.
The utility model discloses left atrial appendage closer conveying system 10, wherein flare angle control end 70 includes spanner 208, one end of spanner 208 is rotationally installed in brake valve lever 40, the other end of spanner 208 extends to outside brake valve lever 40, flare angle control line sets up to at least one, the quantity of flare angle control line is the same with articulate the arm lock quantity on first joint 104, flare angle control line and articulate the arm lock one-to-one setting on first joint 104, flare angle control line's one end and the corresponding arm lock that articulates on first joint 104 are connected, flare angle control line's the other end is connected to spanner 208's the one end that is located in brake valve lever 40, and rotation spanner 208 can strain or loosen flare angle control line, be connected with extension spring 209 between spanner 208 and the internal surface of brake valve lever 40, under extension spring 209's effect, rotation of the wrench 208 causes the flare control line to loosen.
The utility model discloses left atrial appendage closure delivery system 10, wherein it includes off-loading spanner 211 and off-loading pole 224 to off-load control end 80, the one end sliding connection of off-loading spanner 211 is in brake valve lever 40, the other end of off-loading spanner 211 extends to outside brake valve lever 40, brake valve lever 40 internal fixation is equipped with first baffle 518 and second baffle 519, off-loading pole 224 sliding mounting is on first baffle 518 and second baffle 519, the cover is equipped with slide 213 and third baffle 215 on off-loading pole 224, slide 213 and third baffle 215 are located the relative both sides of second baffle 519 respectively, slide 213 is located between first baffle 518 and second baffle 519, be equipped with third compression spring 212 between first baffle 518 and slide 213, be equipped with fourth compression spring 214 between second baffle 519 and the third baffle 215, third compression spring 212 and fourth compression spring 214 all suit are on off-loading pole 224, the unloading wrench 211 is provided with a notch, one end of the sliding plate 213 is located in the notch, the inner surface of the second baffle 519 or the control handle 40 is provided with a stopper 583, when the third baffle 215 moves away from the second baffle 519 under the action of the fourth compression spring 214, the stopper 583 prevents one side edge of the third baffle 215 from moving continuously, the distal end of the unloading rod 224 is located on one side of the third baffle 215, the proximal end of the unloading rod 224 is located on one side of the first baffle 518, the distal end of the unloading rod 224 is connected with the unloading control line, the control handle 40 is provided with a fourth baffle 531, the fourth baffle 531 is located in the sliding direction of the unloading rod 224, the fourth baffle 531 is located on one side of the proximal end of the unloading rod 224, and when the proximal end of the unloading rod 224 abuts against the fourth baffle 531, the unloading control line disengages from the wire loop.
The utility model discloses left atrial appendage closer conveying system 10 includes brake valve lever 40, connecting rod 30 and head end 20, when using, through adjustment direction control end and opening angle control end 70, makes the closer of installing at head end 20 catch the target tissue conveniently, has improved the efficiency and the degree of accuracy of implantation, can conveniently adjust the gesture of closer many times according to clinical demand in order to reach best curative effect, has improved the accuracy of implanting the position to can release the closer accurately with the left atrial appendage of clamp closure. Through adjustment off-load control end 80, the off-load control line can be separated from the closer, the closer is off-loaded from the clamping arm, the line shearing of surgical scissors is not needed, the efficiency of releasing the closer is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient in the surgical process is reduced.
The structure of the left atrial appendage closure delivery system 10 of the present invention is described in detail below.
As shown in FIG. 1, the distal end of the control handle 40 is connected to the proximal end of the connecting rod 30, the distal end of the connecting rod 30 is connected to the head end 20, and the closer is loaded between the two clamping arms of the head end 20. The control handle 40 includes a first directional control end 50 for adjusting the orientation of the head end 20 in a plane. The control handle 40 also includes a second directional control end 60 for adjusting the direction of the head end 20 in another plane. The operator can press the button-rotate the button-release the button to adjust the orientation of the head 20 and lock the head. The control handle 40 also includes a dump control end 80 to effect separation of the obturator and the head end 20. Control handle 40 also includes a flare angle control end 70 for adjusting the angle between the two clamping arms in head end 20. The first direction control end 50, the second direction control end 60, the unloading control end 80, and the opening angle control end 70 are assembled in a control handle housing 90. The two clamping arms are respectively an upper clamping arm 102 and a lower clamping arm 103.
As shown in fig. 1-3, the head end 20 includes a third joint 106, the proximal end of the third joint 106 is connected to the distal end of the connecting rod 30, and the distal end of the third joint 106 is connected to the proximal end of the second joint 105. The second joint 105 and the third joint 106 are relatively rotatable in the X-Y plane (i.e., the first plane described above). The distal end of the second joint 105 is connected to the proximal end of the first joint 104 and is relatively rotatable in the Y-Z plane (i.e., the second plane described above). The distal end of first joint 104 is connected to the proximal ends of upper clamp arm 102 and lower clamp arm 103 via a rotating shaft 107. Upper and lower clamp arms 102 and 103 are rotatable about rotation axis 107. As will be discussed next, control of the relative rotational movement between upper and lower clamp arms 102, 103 is achieved by opening angle control lines 305, 306 (see fig. 22) to achieve single ended opening and closing operation of closure clip 101.
As shown in fig. 4-7, the third joint 106 is formed by a proximal circular ring-shaped transition surface 402 that gradually transitions into a distal rectangular depending wall 401. The proximal end of the third joint 106 is provided with a cylindrical groove 403, the interior of which is used for loading the distal end of the connecting rod 30, and the proximal end and the distal end can be fastened by welding, interference fit and the like. The distal end of the connecting rod 30 meets the bottom surface wall 410 of the cylindrical recess 403. The cylindrical trough bottom wall 410 includes one first rectangular through hole 404 and four first circular through holes 405, 406, 407, 408. As shown in fig. 21, two first direction control lines 301 and 302 pass through two first circular through holes 405 and 406, respectively, and second direction control lines 303 and 304 pass through the other two first circular through holes 407 and 408, respectively. Two aperture control lines 305, 306 and two off- load control lines 307, 308 pass through a first rectangular via 404. The specific arrangement of the control lines is discussed subsequently.
As shown in fig. 8-11, the second joint 105 is contoured to transition from a proximal rectangular surface 429 to a distal two cantilevered structures 418 via a radiused surface 428. Two second circular through holes 415, 416 and a second rectangular through hole 414 are provided between the second proximal joint surface 429 and the central end surface 430. Two second direction control wires 303, 304 pass through two second circular through holes 415, 416, respectively, and two flare control wires 305, 306 and two unloading control wires 307, 308 pass through a second rectangular through hole 414. Two first grooves 422 are symmetrically arranged on the top surface 417 and the bottom surface of the proximal end of the second joint 105, and a first boss 424 is arranged in the center of the first grooves 422. First elastic gaskets 110 and 111 (see fig. 3) are respectively sleeved between the first bosses 424 and the first groove side walls 423 on the two sides, then the proximal end of the second joint 105 is matched with the distal end of the third joint 106 (see fig. 2 and 4-7), so that the proximal end surface 417 of the second joint 105 is positioned between the inner side surfaces of the two long cantilevers 401 of the third joint 106, the side surfaces of the first elastic gaskets 110 and 111 are attached to the arc end surface of the inner surface 412 of the C-shaped groove at the distal end of the third joint 106, at this time, the first elastic gaskets 110 and 111 are clamped between the bottom surface 411 of the C-shaped groove of the third joint 106 and the bottom surface of the first groove 422 of the second joint 105, and due to the elasticity of the first elastic gaskets 110 and 111, pressure is generated on the bottom surfaces 411 of the C-shaped groove of the third joint 106 and the bottom surface of the first groove 422. Through the structure, the far end of the third joint 106 and the near end of the second joint 105 form a damping rotating shaft structure, the third joint and the near end of the second joint can rotate around the first boss 424, and meanwhile, the first elastic gaskets 110 and 111 generate pressure on the bottom surface 411 of the C-shaped groove of the third joint 106 and the bottom surface of the first groove 422, so that certain friction resistance exists during rotation, and the stability of the structure is improved. The maximum range of rotation of the second joint 105 is defined by the short cantilever 409 of the third joint 106.
A wire groove 420 is arranged on the two side cambered surfaces 428 at the proximal end of the second joint 105 and the two side cantilevers 418, and a through hole 421 is arranged at the distal end of the wire groove 420. The through hole 421 is located at the proximal portion of the cantilever 418. The two first direction control wires 301 and 302 are respectively arranged in the two wire grooves 420 and extend to the through hole 421 along the wire grooves 420, and the distal ends of the first direction control wires 301 and 302 are provided with a bulge (see fig. 22) which is larger than the diameter of the through hole 421. The installation is made such that the convex portion of the distal end of the first direction control wire 301,302 is located on the side of the inner surface 427 of the cantilever 418, so that the distal end of the first direction control wire 301,302 is caught at the through hole 421. Therefore, when the distal ends of the first direction control wires 301 and 302 move, the second joint 105 is driven to move correspondingly, and the rotation of the second joint 105 is controlled.
As shown in fig. 12 to 16, the proximal end of the first joint 104 is composed of a first cantilever 432 and two second cantilevers 431, and the two second cantilevers 431 are symmetrically disposed on opposite sides of the first cantilever 432. The near ends of the three parallel cantilevers are all arc-shaped. The medial portion of the first knuckle 104 has a thin wall 448 with 436 on the proximal side and 449 on the distal side. The distal end of the first joint 104 is composed of one third cantilever 445 and two fourth cantilevers 433, and the two fourth cantilevers 433 are symmetrically arranged on opposite sides of the third cantilever 445. The distal ends of the three parallel cantilevers are semicircular. The third cantilever 445 is perpendicular to the first and second cantilevers 432 and 431, and the fourth cantilever 433 is also perpendicular to the first and second cantilevers 432 and 431. Two grooves 443 are symmetrically arranged on the top and bottom surfaces of the proximal end of the first joint 104, and a boss 441 is arranged at the center of each groove 443. Second elastic gaskets 108 and 109 (see fig. 3) are respectively sleeved between the bosses 441 and the groove side walls 444 on the two sides, then the far end of the second joint 105 is matched with the near end of the first joint 104 (see fig. 2 and 4-7), so that the near end surface 431 of the first joint 104 is positioned between the far end surfaces 427 of the second joints, the side surfaces of the second elastic gaskets 108 and 109 are attached to the arc end surface of the inner surface 426 of the C-shaped groove at the far end of the second joint 105, at the moment, the second elastic gaskets 108 and 109 are clamped between the groove bottom surface 425 of the second joint 105 and the groove bottom surface 443 of the first joint 104, and due to the elasticity of the second elastic gaskets 108 and 109, pressure is generated on the bottom surface 425 and the bottom surface 443. With the above structure, the distal end of the second joint 105 and the proximal end of the first joint 104 form a damping rotation shaft structure, which can rotate around the boss 441, and due to the pressure generated by the second elastic gaskets 108, 109 on the bottom surface 425 and the bottom surface 443, a certain friction resistance exists during rotation, thereby improving the stability of the structure. The maximum range of rotation of first joint 104 is defined by short cantilever arm 419 of second joint 105.
A wire slot 434 is included on the arcuate end surface of the first arm 432 proximal to the first joint 104, and the distal end of the wire slot 434 includes a through hole 435. The through hole 435 is located at a proximal portion of the fourth cantilever 433. The second direction control wires 303, 304 are disposed in the wire groove 434, and both extend to the through hole 435 along the wire groove 434, respectively, and the distal ends of the second direction control wires 303, 304 are provided with a protrusion (see fig. 22) having a size larger than the diameter of the through hole 435. The installation is made such that the convex portion of the distal end of the second direction control wire 303, 304 is located on the inner surface 450 side of the fourth cantilever 433, so that the distal end of the second direction control wire 303, 304 is caught at the through hole 435. Therefore, when the distal ends of the second direction control wires 303 and 304 move, the first joint 104 is driven to move correspondingly, and the rotation of the first joint 104 is controlled.
The distal ends of the first and second cantilevered arms 432, 431 are each connected to the proximal face 436 of the thin wall 448. The second cantilever 431 is provided with an inclined through hole 447, the upper side of the thin wall 448 is provided with a through hole 437, the lower side of the thin wall 448 is provided with a through hole 440, one unloading control wire 307 passes through the inclined through hole 447 and the through hole 437 which are positioned on one side of the first joint 104, and the other unloading control wire 308 passes through the inclined through hole 447 and the through hole 440 which are positioned on the other side of the first joint 104. Thin wall 448 is provided with two through holes 438, 439 having a proximal end located on face 436 and sandwiched between second arm 431 and first arm 432 and a distal end located on face 449 and sandwiched between fourth arm 433 and third arm 445. Two flare control lines 305, 306 pass through two vias 438, 439, respectively.
The proximal ends of the third and fourth cantilevers 445, 433 are connected to the face 449, and the distal ends are semicircular. A through hole 442 is formed at the center of the semicircular circle at the distal end of the fourth cantilever 433. A through hole 446 is arranged at the center of the semicircular circle at the far end of the third cantilever 445. The through-hole 442 and the through-hole 446 are coaxially arranged. The far end of the first joint 104 is connected with the upper clamping arm 102 and the lower clamping arm 103 through the structure. The specific connection is discussed later.
As shown in fig. 17-20, upper clamp arm 102 and lower clamp arm 103 are identical in construction. The proximal ends of the upper and lower clamp arms 102, 103 include a cylindrical body 451, the distal end of the cylindrical body 451 being connected to a cantilever 454, the connection being located on a portion of the cantilever 454 that is offset to the left of the proximal end. The cylinder body 451 is axially provided with a through hole 453, and the upper clamping arm 102 and the lower clamping arm 103 are connected with the first joint 104 through the cylinder body 451 and the through hole 453. Referring to fig. 2, 12-16, when connected, the cylinder 451 is disposed between the fourth cantilever 433 and the third cantilever 445 of the first joint 104, wherein the right side 452 of the cylinder 451 is connected to the third cantilever 445, and the left side 460 of the cylinder 451 is connected to the fourth cantilever 433. Through holes 442, 446 formed through the distal end of first knuckle 104 and through holes 453 formed through the proximal ends of upper arm 102 and lower arm 103 are provided with a rivet 107, where rivet 107 connects upper arm 102 and lower arm 103 to first knuckle 104 and allows upper arm 102 and lower arm 103 to pivot about rivet 107.
On the proximal, leftward side of the arms 454 in the upper and lower clamp arms 102, 103, there is a through hole 455 between the upper and lower surfaces 458, 464, through which two opening angle control wires 305, 306 pass respectively in the through holes 455 in the upper and lower clamp arms 102, 103. The distal end of the opening angle control lines 305, 306 are provided with a protrusion (see fig. 22) having a size larger than the diameter of the through hole 455. Installation is such that the distal raised portion of the flare control lines 305, 306 is located on the side of the inner surface 464 of the cantilever 454, thereby allowing the distal ends of the flare control lines 305, 306 to snap into the aperture 455. Therefore, when the distal ends of the opening angle control lines 305 and 306 move, the upper clamping arm 102 and the lower clamping arm 103 are driven to rotate around the rotating shaft 107 (as shown in fig. 24), so that the included angle between the upper clamping arm 102 and the lower clamping arm 103 changes, and the opening angle between the upper clamping arm 102 and the lower clamping arm 103 at the head end is controlled.
The proximal surface 459 of arm 454 has a through hole 461, and the distal side of through hole 461 communicates with the elongated slot 456 on the upper surface 458 of arm 454. The underside of the arm 454 is provided with a recess formed by a bottom surface 462 and a side wall 463. At the distal end of the cantilever 454, between the upper surface 458 and the lower surface 462, a plurality of through slots 457 are arranged. Two unloading control wires 307, 308 respectively pass through the through holes 461 of the upper clamping arm 102 and the lower clamping arm 103 and extend along the long wire slot 456 to the far end of the cantilever 454. When installed, the two arms of V-shaped closure clip 101 are positioned within the recesses formed by bottom surface 462 and side walls 463 of upper clip arm 102 and lower clip arm 103, respectively (see fig. 2 and 24). In upper clamp arm 102, an appropriate one of the slots 457 is selected so that a clamp arm wire loop 309 passes through the slot 457 while binding one side arm of the V-shaped closure clamp 101 and the unload control wire 307. In lower clamp arm 103, the appropriate one of the channels 457 is selected so that one clamp arm wire loop 310 passes through the channel 457 while binding the other side arm of the V-shaped closure clip 101 and the unload control wire 308. Thereby realizing the connection and fixation of the closing clip 101 with the upper clip arm 102 and the lower clip arm 103. So that the upper clamping arm 102 and the lower clamping arm 103 can drive the V-shaped closing clamp to synchronously move correspondingly. When the unloading control lines 307, 308 are displaced from the distal end to the proximal end, so that they are disengaged from the clip arm wire loops 309, 310, the closure clip 101 is disengaged from the upper clip arm 102 and the lower clip arm 103, thereby achieving unloading of the closure clip 101.
Referring to fig. 1-24, the overall structural layout and routing structure of the headend 20 of the present invention is illustrated. The first direction control lines 301, 302, the second direction control lines 303, 304, the opening angle control lines 305, 306 and the unloading control lines 307, 308 pass through the lumen of the connector rod 30 into the third joint 106. The third knuckle 106 is connected to the connecting rod 30 through the cylindrical groove 403 and guides the control wire to extend distally. Wherein the first direction control line 301 passes through the first circular via 405, the first direction control line 302 passes through the first circular via 406, the second direction control line 303 passes through the first circular via 407, the second direction control line 304 passes through the first circular via 408, and the remaining opening angle control lines 305, 306 and the unloading control lines 307, 308 pass through the first rectangular via 404. After all the control wires have passed through the third knuckle 106, the proximal end of the second knuckle 105 is connected to the distal end of the third knuckle 106 such that the proximal first boss 424 and the first resilient shim 110, 111 of the second knuckle are between the distal C-shaped groove floor 411 of the third knuckle 106. To control the position of the second joint 105, the first direction control wires 301, 302 are extended along the wire slot 420 to both sides and have their distal ends pass through the through hole 421. The distal end of the first direction control wire 301, 302 is protruded by welding, knotting or the like to a size larger than the diameter of the through hole 421, so that the distal end of the first direction control wire is restricted to the end surface 427 side of the through hole 421 when the first direction control wire 301, 302 is moved proximally. The first direction control wires 301, 302 are now tensioned and secured at their proximal ends at the first direction control end 50 such that rotation of the first direction control end 50 causes relative rotation between the second joint 105 and the third joint 106 in the X-Y plane. Two second direction control wires 303, 304 pass through two second circular through holes 415, 416 of the second joint 105, respectively, and the opening angle control wires 305, 306 and the unloading control wires 307, 308 pass through a second rectangular through hole 414 of the second joint 105.
After the control wire passes through the second knuckle 105, the proximal end of the first knuckle 104 is connected to the distal end of the second knuckle 105 such that the proximal boss 441 and the second resilient pads 108, 109 of the first knuckle 104 are between the two distal C-shaped grooves of the second knuckle. To control the position of the first joint 104, the second direction control wires 303, 304 are extended laterally along the wire slot 434 with their distal ends passing through the through holes 435. The distal ends of the second direction control wires 303, 304 are protruded by welding, knotting, or the like to have a size larger than the diameter of the through hole 435, so that the distal ends of the second direction control wires 303, 304 are restrained at the side of the end surface 450 of the through hole 435 when they are moved proximally. Second direction control wires 303, 304 are now tensioned and secured at their proximal ends at second direction control end 60 such that rotation of second direction control end 60 causes relative rotation between second joint 105 and first joint 104 in the Y-Z plane. Two second direction control wires 303, 304 pass through two second circular through holes 415, 416 of the second joint 105, one flare control wire 305 passes through a through hole 439 of the first joint 104, the other flare control wire 306 passes through a through hole 438 of the first joint 104, one unloading control wire 307 passes through an inclined through hole 447 and a through hole 437 on one side of the first joint 104, and the other unloading control wire 308 passes through an inclined through hole 447 and a through hole 440 on the other side of the first joint 104.
The proximal ends of upper and lower clamp arms 102, 103 are then connected to the distal end of first joint 104. The proximal cylinders 451 of the upper and lower clamp arms 102, 103 extend between the two distal cantilever arms 433, 445 of the first joint 104, respectively, wherein the inner surface 452 of the cylinder 451 is connected to the cantilever arms 445, and the outer surface 460 of the cylinder 451 is connected to the cantilever arms 433. The upper and lower clamp arms 102 and 103 are connected to the first knuckle 104 by the rivet 107 passing through the through holes 442 and 446 at the distal end of the first knuckle 104 and the through hole 453 of the proximal cylinders 451 of the upper and lower clamp arms 102 and 103, and the upper and lower clamp arms 102 and 103 are rotatable about the rivet 107. Two opening angle control lines 305, 306 pass through the through holes 455 at the proximal ends of the upper and lower clamp arms 102, 103, respectively. The distal ends of the opening angle control wires 305, 306 are protruded by welding, knotting or the like to have a size larger than the diameter of the through hole 455, so that the distal ends of the opening angle control wires are restrained on the side of the end surface 464 of the through hole 455 when the opening angle control wires 305, 306 are moved proximally. At this point, flare control lines 305, 306 are pulled tight and secured at their proximal ends at flare control end 70 such that rotation of flare control end 70 causes a change in the flare angle between upper clamp arm 102 and lower clamp arm 103.
Two off- load control lines 307, 308 extend through holes 461 in proximal faces 459 of upper and lower clamp arms 102, 103, respectively, into slot 456 and extend distally. At this point the closure clip 101 is loaded. In this embodiment, the closure clip 101 is a single ended open V-clip. The V-shaped closure clip 101 is open-faced distally when loaded. The upper clamp arm of closure clip 101 is tied with off-load control line 307 in slot 456 of upper clamp arm 102 by threading clamp arm wire loop 309 through channel 457. The lower clamp arm of closure clamp 101 is tied to unload control line 308 in slot 456 of lower clamp arm 103 by threading clamp arm loop 310 through channel 457. Thereby allowing the closure clip 101 to be loaded onto the head end 20. Rotation of the upper and lower clamp arms 102, 103 at this time may cause a change in the opening angle of the closure clamp 101. The proximal ends of the unloading control wires 307 and 308 are connected to the unloading control end 80, and when the unloading control end 80 is operated to move the distal ends of the unloading control wires 307 and 308 proximally until the unloading control wires 307 and 308 are disengaged from the clamping arm wire loops 309 and 310, the closing clamp 101 is disengaged from the upper clamping arm 102 and the lower clamping arm 103, so that the unloading of the closing clamp 101 is realized. Control of the state of the first direction control lines 301, 302, second direction control lines 303, 304, opening angle control lines 305, 306 and unload control lines 307, 308 is achieved by the control handle 40.
Referring to fig. 25-28, the control handle 40, the first direction control end 50, the second direction control end 60, the opening angle control end 70, and the unloading control end 80 will be described in detail.
The control handle 40 includes a first housing 201 and a second housing 202, the first housing 201 includes an inner surface 502, an outer surface 501, and an end surface 503 connecting the two surfaces, and the second housing 202 includes an inner surface 522, an outer surface 521, and an end surface 523 connecting the two surfaces. A plurality of mounting positioning holes 520 are formed in the inner surface 502 of the first housing 201, a groove is formed in the end surface 503, a plurality of mounting positioning posts 532 are arranged on the inner surface 522 of the second housing 202, and a boss is arranged on the end surface 523. The first housing 201 and the second housing 202 are assembled as shown in fig. 1, the positioning hole 520 is matched with the positioning post 532, and the groove on the end surface 503 is matched with the boss on the end surface 523. When assembled, the control handle 40 defines four openings 504, 505, 506, 507 for placement of portions of the components.
The first opening 504 of the control handle 40 is located at the distal end of the handle and is shaped to mate with the connecting rod 30 to allow for connection of the handle to the connecting rod 30. Bosses 508 are arranged at positions of the first shell 201 and the second shell 202 close to the opening 504, a semi-cylindrical through hole 509 coaxial with the opening 504 is arranged on each boss 508, and three bosses 510 are arranged on the inner surface of the through hole 509. The proximal end of the connecting rod 30 includes an inner surface 534, a proximal surface 533, an outer surface 536, and three grooves 535. In installation, the outer surface 536 of the connector strut 30 is mated with the inner surfaces of the opening 504 and bore 509, and the boss 510 and recess 535 are mated such that the proximal surface 533 of the connector strut 30 is coincident with the proximal surface 609 of the boss 508, thereby securing the connector strut 30 within the control handle 40. All control wires enter the interior of the control handle 40 via the lumen of the connecting rod 30.
The second opening 505 of the control handle 40 is located at the upper portion of the proximal ends of the first housing 201 and the second housing 202, where the first direction control end 50 and the second direction control end 60 are located. The second dial 206 and the first dial 207 are coupled to the control handle 40 through a second blind hole 513 and a third blind hole 524, respectively. The adjustment and locking of the head end 20 in two in-plane directions are realized through the first direction control key 204, the second direction control key 205 and the positioning gear 203. A detailed description of the first direction control terminal 50 and the second direction control terminal 60 is listed later.
The third opening 506 of the control handle 40 is located at the lower proximal end of the first housing 201 and the second housing 202, where the flare angle control end 70 is located. The opening is sized to match the wrench 208. The wrench 208 fits through the holes 515, 528 in the control handle 40. The two ends of the extension spring 209 are connected to the positioning post 514 and the wrench 208 respectively. The opening angle control lines 305, 306 are connected to the wrench 208 by bypassing the rotating shaft 210 on the positioning post 516. By turning the wrench 208, the opening angle of the head end 20 can be adjusted. A detailed description of the flare angle control end 70 is listed later.
The fourth opening 507 of the control handle 40 is located at the lower middle portion of the first and second housings 201 and 202, where the unloading control end 80 is located. The size of the opening is matched with the unloading wrench 211 and the movable range thereof. The unloading wrench 211 is fitted in the control handle 40 through long grooves 517, 530 provided on the first and second housings 201, 202, respectively, and a slide lever 216. The unloading control end 80 further comprises a first stop 518, a second stop 519, a fourth stop 531, a slide 213, a third stop 215, a third compression spring 212, a fourth compression spring 214, and an unloading lever 224. The unloading of the V-shaped closure clip 101 can be achieved by pulling the unloading wrench 211 back and forth several times. This section is described in detail later.
As shown in fig. 29-39, the first direction control end 50 includes a first direction control key 204 and a first dial 207, and the second direction control end 60 includes a second direction control key 205 and a second dial 206. The positioning gear 203 is located between the first direction control key 204 and the second direction control key 205. Two bosses 538 are provided on one side 540 of the positioning gear 203, and are assembled into the blind holes 526 at the corresponding positions of the opening 505 of the second housing 202 (see fig. 26), so that the bottom surfaces 541 of the bosses 538 are connected with the end surface 525 at the opening 505 of the second housing 202, and at this time, a certain distance exists between the side 540 of the positioning gear 203 and the end surface 525 at the opening 505 of the second housing 202, and the second direction control key 205 can be accommodated to pass through the distance. The other side surface 544 of the positioning gear 203 is provided with two bosses 542, and when assembling, the bosses are installed in the blind holes 512 (refer to fig. 25) at the corresponding positions of the first casing 201, so that the bottom surfaces 543 of the bosses 542 are connected with the end surfaces 511 at the opening 505 of the first casing 201, and at this time, a certain distance exists between the side surface 544 of the positioning gear 203 and the end surface 511 at the opening 505 of the first casing 201, and the first direction control key 204 can be accommodated to pass through. And a gear 539 is arranged on the inner side of the middle part of the positioning gear. The inner surface of the first housing 201 adjacent the end surface 511 is provided with a gear which mates with a gear 539 in the positioning gear 203. The inner surface of the second housing 202 adjacent the end face 525 is provided with a gear which mates with a gear 539 in the positioning gear 203.
The first direction control end 50 includes a first direction control key 204, a first positioning tab 220, a first rotary disk 207, a first compression spring 221, and a screw 218. A first boss 554 is centrally provided on one side 553 of the first turntable 207 and is fitted into a corresponding blind hole 513 at the first housing opening 505 when assembled. The center of the other side 547 of the first rotary disk 207 is provided with a first blind hole 548, the first blind hole 548 is coaxial with the first boss 554, when assembled, the first blind hole 548 is matched with the boss 556 at the center of one side 555 of the second rotary disk 206, when assembled, the boss 561 at the center of the other side 562 of the second rotary disk 206 is inserted into the corresponding blind hole 524 at the opening 505 of the second housing 202, so that the first rotary disk 207 can rotate around the rotating shaft formed by the first blind hole 548 and the first boss 554. Two through holes 549, 550 are also provided between the opposite sides 553, 547 of the first turntable 207. The first direction control wires 301, 302 enter the through holes 549, 550, respectively, from the side 553, then extend out onto the side 547, and continue into the threaded hole 552. The first direction control wires 301, 302 are now tightened and then the first direction control wires 301, 302 are secured in the threaded bore 552 by the screw 218. So that the first direction control wires 301 and 302 can move along with the rotation of the first rotating disk 207, and further the second joints 105 connected with the distal ends of the first direction control wires 301 and 302 can be caused to rotate in the X-Y plane, so that the head end 20 can rotate in the plane.
The proximal side of the first rotating disk 207 is provided with a fourth blind hole 551 into which the first compression spring 221 is inserted. A through groove 545 is formed in the middle of the first direction control key 204, the first positioning piece 220 is installed and fixed in the through groove 545 in a screw, riveting or bonding mode, and a part of each of two ends of the first positioning piece 220 protrudes from the side surface of the first direction control key 204. The bottom surface 546 of the first direction control key 204 is received in the fourth blind hole 551 of the first dial 207 and contacts the first compression spring 221, so that the first compression spring 221 and the bottom surface 546 of the first direction control key 204 have an interaction force. The proximal end of the first direction control key 204 extends out of the housing through a gap between a side surface 544 of the positioning gear 203 and the end surface 511 at the opening 505 of the first housing 201. At this time, due to the outward pushing force of the first compression spring 221, the first direction control key 204 moves outward, which causes the first positioning piece 220 to move outward, and further causes the portion of the first positioning piece 220 protruding out of the side surface of the first direction control key 204 to be locked in the gear 539 (refer to fig. 32) of the positioning gear 203, so that the first direction control key 204 is fixed. In order to balance the stress of the first direction control key 204 when the first direction control key 204 is in the fixed state, as mentioned above, the gear is disposed on the inner surface of the first housing 201 near the end surface 511, and the first positioning piece 220 protrudes from two opposite side surfaces of the first direction control key 204, when the first direction control key 204 moves outward, the portion of the first positioning piece 220 protruding from the side surface of the first direction control key 204 is also clamped into the gear on the inner surface of the first housing 201. The first rotary disk 207 cannot rotate at this time. The first direction control key 204 is pressed towards the bottom direction of the fourth blind hole 551, and is moved along the direction until the first positioning piece 220 is completely separated from the positioning gear 203 and the gear on the first housing 201, at this time, the first direction control key 204 can be rotated up and down, so as to drive the first rotary disk 207 to rotate, and further cause the first direction control lines 301 and 302 to drive the second joint 105 to rotate, thereby realizing the rotation of the head end 20 in the X-Y plane. When the pressure on the first direction control key 204 is stopped after the rotation angle of the head end 20 in the X-Y plane is selected, the first direction control key 204 moves proximally under the elastic force of the first compression spring 221 until the first positioning piece 220 is again caught in the positioning gear 203 and the gear on the first housing 201, and at this time, the first direction control key 204 is locked again. In summary, the angular adjustment and locking of the head end 20 in the X-Y plane can be accomplished by the first direction control key 204.
The second direction control end 60 includes a second direction control key 205, a second positioning piece 217, a second dial 206, a second compression spring 222, and a screw 219. The center of the side 562 of the second rotary disk 206 is provided with a third boss 561, which is inserted into a corresponding third blind hole 524 at the opening 505 of the second housing 202 during assembly. The second boss 556 is provided at the center of the other side 555 of the second rotary plate 206, the second boss 556 and the third boss 561 are coaxial, and when the assembly is performed, the second boss 556 is installed in the first blind hole 548 at the center of the side 547 of the first rotary plate 207, so that the second rotary plate 206 can rotate around the rotating shaft formed by the first blind hole 548 and the second boss 556. Two through holes 557, 558 are also provided between the side 555 and the other side 562 of the second turntable 206. The two second direction control wires 303, 304 enter the through holes 557, 558 from the side 555 at the distal end, and then extend out onto the side 562 to continue into the threaded hole 560. At this point the second direction control wires 303, 304 are tightened and then the second direction control wires 303, 304 are secured in the threaded holes 560 by the screws 219. The second direction control wires 303, 304 are thus movable in response to rotation of the second dial 206, which in turn causes the first joints 104, distally connected to the second direction control wires 303, 304, to rotate in the Y-Z plane, thereby rotating the head end 20 in that plane.
The proximal side of the second dial 206 is provided with a fifth blind hole 559 into which the second compression spring 222 is inserted. The middle of the second direction control key 205 includes a through groove 562, the second positioning piece 217 is installed and fixed in the through groove 562 by means of screws, riveting or bonding, and both ends of the second positioning piece 217 protrude a portion of the side surface of the second direction control key 205. The bottom surface 563 of the second direction control key 205 is inserted into the fifth blind hole 559 of the second rotation plate 206 and contacts the second compression spring 222, so that the second compression spring 222 and the bottom surface 563 of the second direction control key 205 have an interaction force. The proximal end of the second direction control button 205 extends out of the housing through a gap between a side 540 of the positioning gear 203 and an end 525 at the opening 505 of the second housing 202. At this time, due to the outward pushing force of the second compression spring 222, the second direction control key 205 moves outward, which causes the second positioning piece 217 to move outward, and the portion of the second positioning piece 217 protruding out of the side surface of the second direction control key 205 is caught by the gear 539 (refer to fig. 36) of the positioning gear 203, so that the second direction control key 205 is fixed. In order to balance the force applied to the second direction control key 205 when the second direction control key 205 is in the fixed state, as described above, the gear is disposed on the inner surface of the second housing 202 near the end surface 525, and the second positioning piece 217 protrudes from two opposite sides of the second direction control key 205, and when the second direction control key 205 moves outward, the portion of the second positioning piece 217 protruding from the side of the second direction control key 205 is also locked in the gear on the inner surface of the second housing 202. The second dial 206 is now unable to rotate. The second direction control key 205 is pressed towards the bottom of the fifth blind hole 559, and is moved along the direction until the second positioning piece 217 is completely separated from the positioning gear 203 and the gear of the second housing 202, at this time, the second direction control key 205 can be rotated up and down, so as to drive the second turntable 206 to rotate, further to cause the second direction control lines 303 and 304 to drive the first joint 104 to rotate, and further to realize the rotation of the head end 20 in the Y-Z plane. When the rotation angle of the head end 20 in the Y-Z plane is selected, and the pressure on the second direction control key 205 is stopped, the second direction control key 205 moves to the proximal end under the elastic force of the second compression spring 222 until the second positioning piece 217 is clamped into the positioning gear 203 and the gear of the second housing 202 again, and at this time, the second direction control key 205 is locked again. In summary, the angular adjustment and locking of the head end 20 in the Y-Z plane can be accomplished by the second direction control button 205.
As shown in fig. 1, 25-27, and 40-43, flare angle control end 70 includes a wrench 208, a tension spring 209, a pulley 210, and a screw 223. The inner surface 577 of the pulley 210 fits over the post 516 of the first housing 201 and the opening angle control lines 305, 306 are attached to the wrench 208 around the outer surface 578 of the pulley 210. The wrench 208 is provided with a boss 564 and a boss 575 on each of the left and right sides thereof, and when the wrench is assembled, one boss 564 and the bottom surface 565 thereof are engaged with the groove 528 of the second housing 202, and the other boss 575 and the bottom surface 576 thereof are engaged with the groove 515 of the first housing 201. So that the wrench 208 can rotate around the rotation axis formed by the bosses 575-564. The right surface of the wrench 208 has a concave surface comprising a bottom surface 569 and a side surface 574, and the bottom surface 569 has a threaded hole 570. A slot 572 is provided in the top of wrench 208 on the outside thereof, and a bore 573 is provided in the end of slot 572, the bore 573 communicating between wrench outer surface 567 and concave side surface 574. Flare control lines 305, 306 pass around slide shaft 210 and enter through hole 573 along line groove 572. Flare control lines 305, 306 pass through holes 573 and into the wrench recess, and flare control lines 305, 306 pass along recess bottom surface 569 into threaded hole 570. At this time, the opening angle control wires 305, 306 are tightened, and the opening angle control wires 305, 306 are fixed in the threaded holes 570 by the screws 223.
A cantilever 568 is provided at a proximal end of the outer surface 567 of the wrench 208, a post 514 is provided on the first housing 201, and the tension spring 209 is placed in tension by fitting the two ends of the spring over the cantilever 568 and the post 514, respectively. At this time, the wrench 208 is pulled to move the end 571 towards the proximal end, and the wrench rotates clockwise around the rotating shaft formed by the boss 575-the boss 564 (refer to fig. 27), and at this time, the opening angle control lines 305 and 306 also move, and after passing through the pulley 210, the distal ends of the opening angle control lines 305 and 306 move towards the proximal end, so as to drive the opening angle between the upper clamping arm 102 and the lower clamping arm 103 of the head end 20 to gradually increase, and further open the distal end of the closing clamp 101. After the wrench 208 is rotated to a certain angle, the wrench is loosened, and at this time, due to the resilience of the tension spring 209 and the closing force of the closing clip 101, the wrench 208 rotates counterclockwise to the initial position, and the closing clip 101 is closed again. Thereby, the flare angle control terminal 70 realizes the control of the flare angle of the head terminal 20.
As shown in fig. 53, and in conjunction with fig. 54-55, 25-27, and 40, the control handle is provided with a limit button that engages the wrench when the wrench is turned to tighten the flare angle control line and disengages the wrench when the limit button is pressed.
As shown in fig. 53, and with reference to fig. 54 and 26, the stop button includes a stop block 225, a fifth compression spring 226, and a rectangular boss 610, the rectangular boss 610 is disposed on the inner surface of the second housing 202, a groove 611 is disposed on a top surface of the rectangular boss 610, a cylindrical boss 612 is disposed on a top surface 615 of the stop block 225, and a side surface 613 of the stop block 225 is connected to the top surface 615. The bottom of the stop block 225 is provided with a boss, the top surface of which is 614. The bottom surface of the stopper 225 is provided with a rectangular recess 616 having a size slightly larger than the rectangular boss 610 of the second housing 202, and the bottom surface of the recess 616 is provided with a circular blind hole 617. During assembly, the recess 616 of the stopper 225 is engaged with the rectangular boss 610 of the second housing 202, and the fifth compression spring 226 is disposed in the circular blind hole 617 of the recess 616 and the recess 611 in the rectangular boss 610. When the wrench 208 is standing still under the action of the extension spring 209, the two clamping arms on the head end 20 are in a closed state, at this time, under the action of the fifth compression spring 226, the bottom boss 614 of the stopper 225 is tightly attached to the outer surface 617 of the slot 572 of the wrench 208, and a part of the top cylindrical boss 612 of the stopper 225 passes through the through hole 608 of the first housing 201. When the limit button is pressed, the cylindrical boss 612 extending to the outside of the first housing 201 is pressed. When the wrench 208 is pulled to gradually open the two clamping arms on the head end 20, the slot 572 and the stopper 225 move relatively, and when the boss 614 of the stopper 225 is separated from the outer surface 617 of the slot 572, the stopper 225 springs upward under the action of the fifth compression spring 226 until the top surface 615 of the stopper 225 contacts the inner surface 502 of the first housing 201. When wrench 208 is released, wrench 208 cannot move further to the initial position because side 618 of slot 572 is blocked by side 613 of stopper 225, i.e., the stopper button engages wrench 208, and the two arms of head 20 remain open when wrench 208 is released. At this time, the cylindrical boss 612 of the stopper 225 is pressed down toward the inside of the housing, so that the side 618 of the slot 572 is no longer in contact with the side 613 of the stopper 225, i.e., the stopper button is disengaged from the wrench 208, and at this time, due to the resilience of the tension spring 209 and the closing force of the closing clip 101, the wrench 208 is restored to the initial position, and the two clip arms on the head end 20 are closed.
As shown in fig. 25-27, 44-50, the unloading control end 80 comprises an unloading wrench 211, an unloading rod 224, a sliding plate 213, a third baffle 215, a sliding rod 216, a third compression spring 212, a fourth compression spring 214, and a sliding slot 517 on an inner surface 502 of the first housing 201, a first baffle 518, a second baffle 519, and a sliding slot 530 and a fourth baffle 531 on an inner surface 522 of the second housing 202. The proximal ends of the two unloading control wires 307, 308 respectively pass through two through holes 605, 606 at the distal end of the unloading rod 224, and the proximal ends of the unloading control wires 307, 308 are fixed on the unloading rod 224 by knotting, welding, gluing, etc., so that the unloading control wires 307, 308 can move correspondingly with the movement of the unloading rod 224.
The first casing 201 is provided with a sliding groove 517 at the opening 507, a first baffle 518 and a second baffle 519 are arranged beside the sliding groove 517, a circular through hole 580 is arranged at the center of the first baffle, and a circular through hole 582 is also arranged at the center of the second baffle. The two circular through holes 580, 582 are in a coaxial relationship and both have a diameter slightly larger than the outer diameter of the load bar 224. A stop 583 is provided on the inner surface of the second stop 519 or control handle 40. in this embodiment, the upper surface 584 of the second stop 519 is distally presented by the stop 583. The third baffle 215 has a through hole 599 at the center, and the diameter of the through hole is slightly larger than the outer diameter of the unloading rod 224. The top end of the third baffle 215 is provided with a boss 600. When assembled, the third baffle 215 is positioned on the proximal side of the stop 583. The unloading rod 224 passes through a through hole 599 on the third baffle 215 and a through hole 582 on the second baffle 519. The inner diameter of the fourth compression spring 214 is slightly larger than the outer diameter of the unloading lever 224, and the outer diameter of the fourth compression spring 214 is larger than the diameters of the through hole 599 and the circular through hole 582. The fourth compression spring 214 is placed over the outer surface 607 of the unloading lever 224 and between the end surface 581 of the second plate 519 and the end surface 598 of the third plate 215. At this time, due to the elastic force of the fourth compression spring 214, the third blocking plate 215 moves distally, so that the boss 600 on the third blocking plate 215 contacts the stopper 583 on the second blocking plate 519 to stop the distal movement, and the rest of the third blocking plate 215 continues to move distally due to the force of the fourth compression spring 214, so that the third blocking plate 215 tilts until both end surface edges of the through hole 599 on the third blocking plate 215 contact the outer surface 607 of the unloading rod 224 and stop the movement due to the frictional resistance. At this time, the outer surface 607 of the unloading rod 224 and the edges of the two end surfaces of the through hole 599 of the third baffle 215 have friction, and if the unloading rod 224 is moved distally, a sufficiently large force must be applied to the unloading rod 224 in the distal direction.
The unloading wrench 211 comprises a long arm 587, two symmetrical cantilevers 590 and 591 are arranged at the tail end of the long arm 587, and through holes 594 and 595 are respectively arranged at the far ends of the two cantilevers 590 and 591. The two through holes 594, 595 are in coaxial relationship and have a diameter slightly larger than the outer diameter of the slide rod 216. A boss 596 is arranged on one end face 588 of the unloading wrench 211, a boss 597 is arranged on the other end face 589 of the unloading wrench 211, the two bosses 596 and 597 are in coaxial relation, the diameter of the bosses 596 and 597 is not larger than the width of the sliding groove 517 on the first shell 201 and the width of the sliding groove 530 on the second shell 202, and the height of the bosses is not larger than the depth of the sliding groove 517 and the depth of the sliding groove 530. The slide plate 213 has a through hole 602 at the center, and the diameter of the through hole is slightly larger than the outer diameter of the unloading rod 224. The distance between its opposite end faces 603, 604, i.e. the width of the slide 213, is not greater than the distance between the two cantilevered inner surfaces 592, 593 of the load release wrench 211. When assembled, the wiper 213 is positioned between the first and second stops 518, 519. The unloading lever 224 is passed through the through hole 602 in the slide plate 213 and the through hole 580 in the first flap 518. The inner diameter of the third compression spring 212 is slightly larger than the outer diameter of the unloading rod 224, and the outer diameter of the third compression spring 212 is larger than the diameters of the through hole 602 and the through hole 580. The third compression spring pocket 212 is placed over the outer surface 607 of the load bar 224 between the end face 579 of the first stop 518 and the end face 601 of the slide 213. The boss 597 of the unloading wrench 211 is placed in the sliding groove 517, and the boss 596 is placed in the sliding groove 530. The slide rod 216 is inserted through the through holes 594 and 595 of the cantilever of the off-loading wrench 211, and the two ends thereof are respectively located in the two slide grooves 517 and 530. So that the unloading wrench 211 can move along the sliding groove 517. One end of the slide plate 213 is placed between the cantilevered inner surfaces 592, 593 of the unload wrench 211 such that the slide bar 216 is positioned between the slide plate 213 and the second stop 519. The two cantilevered arms of the unload wrench 211 and the slide bar 216 form the previously described slot in which one end of the slide plate 213 is located. The slider 213 is moved in the distal direction by the urging force of the third compression spring 212 until it contacts the boss 586 of the second stopper 519 and the slide rod 216. At this point, a proximal force is applied to the long arm 587 of the unload wrench 211, causing the unload wrench 211, along with the slide bar 216, to move proximally along the slide slot 517. At this time, one end of the slide plate 213 is biased by the slide rod 216 toward the proximal end, so that the edges of both end surfaces of the central through hole 602 contact the outer surface 607 of the release lever 224. At this point, as the release wrench 211 continues to move proximally, the slide plate 213 continues to move proximally. At the same time, the unloading rod 224 moves along with the sliding plate 213 in the proximal direction due to the friction between the two edges of the through hole 602 of the sliding plate 213 and the outer surface 607 of the unloading rod 224. The unloading control wires 307, 308 attached to the distal end of the unloading bar 224 are also moved proximally. When the unloading wrench 211 is moved a predetermined distance proximally and the external force is stopped, the slide plate 213 is rebounded back to the original position where it is connected to the second stopper 519 due to the resilient force of the third compression spring 212, so that the slide bar 216 and the unloading wrench 211 are returned to the original position. During the rebound process, the unload lever 224 does not rebound distally with it due to the frictional resistance between the unload lever 224 and the through hole 599 of the third baffle 215, but remains in the proximally displaced position. Further, by repeating the above steps, the unloading rod 224 will gradually move towards the proximal end, so as to drive the unloading control wires 307 and 308 to move towards the proximal end, until the proximal end of the unloading rod 224 contacts with the fourth baffle 531 on the second housing 202, at this time, the unloading rod 224 cannot move towards the proximal end continuously due to the blocking of the fourth baffle 531. During this process, the distal ends of the unloading control wires 307, 308 move proximally and disengage the clip arm wire loops 309, 310, and the closure clip 101 separates from the head end 20, completing the unloading of the closure clip 101. By selecting the length of the unloading control lines 307, 308 properly, the distal ends of the unloading control lines 307, 308 are not disengaged from the clamping arm wire loops 309, 310 when the unloading wrench 211 is pulled for the first few times, and the unloading control lines 307, 308 are completely disengaged from the clamping arm wire loops 309, 310 during the process when the unloading wrench 211 is pulled to be connected with the fourth baffle 531 and the pulling cannot be continued. Through the arrangement, the shedding of the closing clamp 101 can be completed, the accidental shedding caused by misoperation can be prevented, meanwhile, the shedding of the closing clamp 101 is completed when the shedding wrench 211 cannot be pulled, and the structure can also provide a shedding confirmation sensing function for an operator.
By properly setting the length of the unloading control line, the distal end of the unloading control line is not separated from the clamping arm wire loop when the sliding plate 213 is moved for the first few times, and the distal end of the unloading control line is gradually separated from the clamping arm wire loop when the sliding plate 213 is moved for the second few times, and finally, the unloading control line is ensured to be separated from the clamping arm wire loop when the unloading rod 224 cannot be moved due to the blocking of the fourth baffle 531.
The following description of the implementation of the left atrial appendage occluder delivery system 10 of the present invention is provided by way of example for the left atrial appendage occlusion:
the first step is as follows: extending the head end 20 and a portion of the connecting rod 30 into the thoracic cavity along the catheter such that the head end 20 is at the left atrial appendage;
the second step is that: the direction control ends 50 and 60 are adjusted to enable the head end 20 to rotate until the head end 20 is adjusted to a proper angle, and the direction control keys 204 and 205 are loosened to complete the direction locking of the head end 20;
the third step: operating the opening angle control end 70 to move the wrench 208 to the near end, so that the opening angle of the far end of the head end 20 is increased, the far end of the closing clip 101 is opened, the wrench 208 is moved to the near end continuously, the head end 20 is maintained in an opened state through the limiting block 225 of the limiting button, and then the wrench 208 is loosened, so that the head end 20 still keeps opened;
the fourth step: adjusting the position of the head end 20 to make the root of the left atrial appendage located between the two arms of the closure clip 101, and pressing the limit button at this time to make the wrench 208 rotate to the far end under the action of the closure clip 101 and the extension spring 209, so as to close the closure clip 101;
the fifth step: observing and evaluating the clamping effect of the left atrial appendage, if the clamping effect needs to be adjusted, moving the wrench 208 to the near end again to open the closing clamp 101, loosening the wrench 208 after the limiting button keeps the closing clamp 101 in an open state, then performing the operation of the second step, adjusting the posture and the position of the head end 20, and then pressing the limiting button to enable the wrench 208 to rotate to the far end under the action of the closing clamp 101 and the extension spring 209 so as to close the closing clamp 101;
and a sixth step: through the fifth step, the position and the direction of the head end are adjusted for multiple times until the clamping effect of the left auricle meets the requirement, the unloading wrench 211 is pulled to the near end to the maximum distance and then loosened, the operation is repeated repeatedly until the unloading wrench 211 cannot be pulled continuously, and at this time, the closing clamp 101 finishes unloading from the head end 20;
the seventh step: the tip 20 is slowly withdrawn through the catheter and out of the chest while the closure clip 101 remains in the body and clamps onto the base of the left atrial appendage, completing the closure of the left atrial appendage.
Fig. 51 and 52 show two alternative designs of the arms of the head 20. In fig. 51, the lower clamping arm 103 is fixed to the first joint 104, and at this time, the upper clamping arm 102 is operated only by one opening angle control line, so that the upper clamping arm 102 rotates around the rotating shaft 107, the lower clamping arm 103 does not rotate, and the opening angle change between the upper clamping arm 102 and the lower clamping arm 103 is realized only by the rotation of the upper clamping arm 102. In fig. 52, the upper arm 102 is fixed to the first joint 104, and the lower arm 103 is operated by only one opening angle control line so as to rotate about the rotation axis 107, the upper arm 102 does not rotate, and the opening angle change between the upper arm 102 and the lower arm 103 is realized only by the rotation of the lower arm 103.
It can be seen that there is at least one opening angle control line, the number of the opening angle control lines is the same as that of the clamping arms hinged to the first joint 104, the opening angle control lines and the clamping arms hinged to the first joint 104 are arranged in a one-to-one correspondence manner, one end of each opening angle control line is connected with the corresponding clamping arm hinged to the first joint 104, and the other end of each opening angle control line is connected to one end of the wrench 208 located in the control handle 40.
The utility model has the advantages as follows:
the utility model discloses an adjustment direction control key makes and installs the convenient target tissue of catching of closer at the head end, has improved the efficiency and the degree of accuracy of implanting, and the closer can conveniently adjust the gesture in order to reach best curative effect many times according to clinical demand, has improved the accuracy of implanting the position, and adjusts and lock and die can accomplish by a key, has improved the convenient degree of operation. The slider is adjusted to separate the closer from the upper clamping arm and the lower clamping arm, the cutting of surgical scissors is not needed, the releasing efficiency is improved, the requirement on the size of a surgical path is reduced, the wound to a patient is reduced, meanwhile, the accidental unloading of the closing clamp caused by accidental misoperation can be prevented, the function of successfully confirming the unloading of the closing clamp is achieved, and the safety and the reliability of the surgery are improved.
The above-mentioned embodiments are only for describing the preferred embodiments of the present invention, and are not intended to limit the scope of the present invention, and various modifications and improvements made by those skilled in the art without departing from the design spirit of the present invention should fall into the protection scope defined by the claims of the present invention.
Claims (10)
1. A left atrial appendage closure delivery system, comprising: including brake valve lever, connecting rod and head end, brake valve lever passes through the connecting rod and the head end is connected, be equipped with two arm lock on the head end, be used for loading the closer between two arm lock, brake valve lever is last to be equipped with direction control end, opening angle control end and off-load control end, be connected with the direction control line between direction control end and the head end, the direction of direction control end through direction control line control head end, be connected with opening angle control line between opening angle control end and two arm lock, opening angle control end is through the contained angle of opening angle control line two arm lock, be connected with the off-load control line between off-load control end and the closer, when off-load control end made the off-load control line break away from the closer, the closer was off-loaded from the arm lock.
2. A left atrial appendage closure delivery system as in claim 1, wherein: the two direction control ends are respectively a first direction control end and a second direction control end, a first direction control line is connected between the first direction control end and the head end, a second direction control line is connected between the second direction control end and the head end, the first direction control end controls the head end to rotate in a first plane through the first direction control line, and the second direction control end controls the head end to rotate in a second plane through the second direction control line.
3. A left atrial appendage closure delivery system as in claim 2, wherein: the head end comprises a first joint, a second joint and a third joint, at least one of the two clamping arms is hinged to the first joint, the first joint is hinged to the second joint, the second joint is hinged to the third joint, the third joint is connected with a connecting rod, a first direction control line is connected between the second joint and a first direction control end, a second direction control line is connected between the first joint and a second direction control end, the first direction control end controls the second joint to rotate in a first plane through the first direction control line, the second direction control end controls the first joint to rotate in a second plane through the second direction control line, and the first plane is perpendicular to the second plane.
4. A left atrial appendage closure delivery system as in claim 3, wherein: the off-load control line is established to two, two on off-load control line and closer connection one end lay respectively in the lateral surface of two arm lock, be used for loading between two relative medial surfaces of two arm lock the closer, every all be equipped with logical groove in the arm lock, lead to the lateral surface and the medial surface that the groove runs through the arm lock, wear to be equipped with the arm lock wire loop in leading to the inslot, the off-load control line in the arm lock outside and the closer of arm lock inboard are tied up simultaneously to the arm lock wire loop in every arm lock.
5. A left atrial appendage closure delivery system as in claim 4, wherein: the control handle comprises a first shell and a second shell which are connected with each other, the connecting rod is of a cylindrical structure, the first direction control end comprises a first rotary disc and first direction control keys, the first direction control keys are arranged on the first rotary disc, the first rotary disc is rotatably installed in the control handle, the first direction control ends extend out of the control handle, the first direction control lines are arranged into two pieces, one ends of the two first direction control lines are connected to the first rotary disc, the other ends of the two first direction control lines penetrate through an inner cavity of the connecting rod and then are connected to the second joint, the two first direction control lines connected to the first rotary disc are respectively located on two opposite sides of the rotation center of the first rotary disc, and the two first direction control lines connected to the second joint are respectively located on two opposite sides of the second joint.
6. A left atrial appendage closure delivery system as in claim 5, wherein: the second direction control end includes second carousel and second direction control key, the second direction control key sets up on the second carousel, the second carousel rotationally installs in brake valve lever, the second direction control end extends outside brake valve lever, the second direction control line is established to two, and the one end of two second direction control lines connect in on the second carousel, and the other end of two second direction control lines passes to connect on first joint after the inner chamber of connecting rod, and two second direction control lines of connecting on the second carousel are located the relative both sides of second carousel center of rotation respectively, and two second direction control lines of connecting on first joint are located the relative both sides of first joint respectively.
7. A left atrial appendage closure delivery system as in claim 6, wherein: be equipped with first boss and first blind hole on two relative sides of first carousel respectively, first boss and first blind hole all are located the rotation center department of first carousel, first boss and first blind hole coaxial arrangement, be equipped with second boss and third boss on two relative sides of second carousel respectively, second boss and third boss all are located the rotation center department of second carousel, second boss and third boss coaxial arrangement, be equipped with the second blind hole on the internal surface of first casing, be equipped with the third blind hole on the internal surface of second casing, the second boss is located first blind hole, first boss is located the second blind hole, the third boss is located the third blind hole.
8. A left atrial appendage closure delivery system as in claim 7, wherein: a fourth blind hole is arranged on the first rotary disc, one end of the first direction control key is positioned in the fourth blind hole, a first compression spring is arranged between the first direction control key and the bottom wall of the fourth blind hole, a first positioning sheet is fixedly arranged on the first direction control key, a fifth blind hole is arranged on the second turntable, one end of the second direction control key is positioned in the fifth blind hole, a second compression spring is arranged between the second direction control key and the bottom wall of the fifth blind hole, a second positioning sheet is fixedly arranged on the second direction control key, a positioning gear is arranged between the first direction control key and the second direction control key, the positioning gear is fixedly arranged on the control handle, under the action of the first compression spring, the first positioning sheet on the first direction control key is clamped on the gear of the positioning gear, under the action of the second compression spring, the second positioning piece on the second direction control key is also clamped on the gear of the positioning gear.
9. A left atrial appendage closure delivery system as in claim 8, wherein: the field angle control end comprises a wrench, one end of the wrench is rotatably installed in the control handle, the other end of the wrench extends out of the control handle, at least one field angle control line is provided, the number of the field angle control lines is the same as that of the clamping arms hinged on the first joint, the field angle control lines and the clamping arms hinged on the first joint are arranged in a one-to-one correspondence manner, one end of each field angle control line is connected with the corresponding clamping arm hinged on the first joint, the other end of each field angle control line is connected with one end of the wrench positioned in the control handle, the field angle control lines can be tensioned or loosened by rotating the wrench, an extension spring is connected between the wrench and the inner surface of the control handle, the wrench rotates to loosen the field angle control lines under the action of the extension spring, a limit button is arranged on the control handle, when the field angle control lines, the limit button is clamped with the wrench, and when the limit button is pressed, the limit button is separated from the wrench.
10. A left atrial appendage closure delivery system as in claim 9, wherein: the off-load control end comprises an off-load wrench and an off-load rod, one end of the off-load wrench is connected in the control handle in a sliding manner, the other end of the off-load wrench extends out of the control handle, a first baffle and a second baffle are fixedly arranged in the control handle, the off-load rod is installed on the first baffle and the second baffle in a sliding manner, a sliding sheet and a third baffle are sleeved on the off-load rod and are respectively positioned on two opposite sides of the second baffle, the sliding sheet is positioned between the first baffle and the second baffle, a third compression spring is arranged between the first baffle and the sliding sheet, a fourth compression spring is arranged between the second baffle and the third baffle, the third compression spring and the fourth compression spring are sleeved on the off-load rod, a notch is formed in the off-load wrench, one end of the sliding sheet is positioned in the notch, and a stop block is arranged on the inner surface of the second baffle or the control handle, when the third baffle is far away from the second baffle and moves under the effect of the fourth compression spring, the stop block prevents one side edge of the third baffle from continuously moving, the far end of the unloading rod is positioned on one side of the third baffle, the near end of the unloading rod is positioned on one side of the first baffle, the far end of the unloading rod is connected with the unloading control line, a fourth baffle is arranged in the control handle, the fourth baffle is positioned in the sliding direction of the unloading rod, the fourth baffle is positioned on one side of the near end of the unloading rod, and when the near end of the unloading rod is abutted against the fourth baffle, the unloading control line is separated from the clamping arm wire ring.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201920484851.6U CN209884246U (en) | 2019-04-11 | 2019-04-11 | Left atrial appendage closure delivery system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201920484851.6U CN209884246U (en) | 2019-04-11 | 2019-04-11 | Left atrial appendage closure delivery system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN209884246U true CN209884246U (en) | 2020-01-03 |
Family
ID=69018931
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201920484851.6U Active CN209884246U (en) | 2019-04-11 | 2019-04-11 | Left atrial appendage closure delivery system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN209884246U (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111248969A (en) * | 2020-01-23 | 2020-06-09 | 北京领健医疗科技有限公司 | Closure clip delivery system |
| CN113662615A (en) * | 2021-10-21 | 2021-11-19 | 北京迈迪顶峰医疗科技股份有限公司 | Follow-up conveying actuator and auricle clamp conveying device |
-
2019
- 2019-04-11 CN CN201920484851.6U patent/CN209884246U/en active Active
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111248969A (en) * | 2020-01-23 | 2020-06-09 | 北京领健医疗科技有限公司 | Closure clip delivery system |
| CN111248969B (en) * | 2020-01-23 | 2021-05-18 | 北京领健医疗科技有限公司 | Closure clip delivery system |
| CN113662615A (en) * | 2021-10-21 | 2021-11-19 | 北京迈迪顶峰医疗科技股份有限公司 | Follow-up conveying actuator and auricle clamp conveying device |
| CN113662615B (en) * | 2021-10-21 | 2022-02-08 | 北京迈迪顶峰医疗科技股份有限公司 | Follow-up conveying actuator and auricle clamp conveying device |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN112336403A (en) | Closer conveying system | |
| CN111803165A (en) | Left atrial appendage closure delivery system | |
| US9844371B2 (en) | Locking articulation mechanism | |
| US8336754B2 (en) | Locking articulation mechanism for surgical stapler | |
| US11883049B2 (en) | Forceps drive shaft control | |
| CN209884246U (en) | Left atrial appendage closure delivery system | |
| JP5297016B2 (en) | Device for applying surgical clips | |
| CA2080616C (en) | Endoscopic multiple ligating clip applier with rotating shaft | |
| US7207997B2 (en) | Ligation clip and clip applier | |
| US5858018A (en) | Low profile tool for applying spring action ligation clips | |
| US8986330B2 (en) | Aortic cross clamp | |
| CN211066825U (en) | Closer conveying system | |
| CN111248969B (en) | Closure clip delivery system | |
| US20220133324A1 (en) | Powered surgical tack applier | |
| WO2024114466A1 (en) | Swivel head mechanism and surgical stapler | |
| CN217987619U (en) | Articulation assembly for surgical device | |
| US20240252169A1 (en) | Articulation assembly for a surgical device | |
| CN215129359U (en) | Nail box turning control mechanism and anastomat | |
| CN219963181U (en) | Delivery device and medical system | |
| US11723669B2 (en) | Clip applier with clip cartridge interface | |
| CN219814421U (en) | Delivery device and medical system | |
| US20230380843A1 (en) | Devices and methods for applying a hemostatic clip assembly | |
| CN115414154A (en) | Artificial prosthesis delivery system | |
| CN115153699A (en) | Minimally invasive needle holder | |
| JP2023500713A (en) | Medical slide shaft instrument |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| GR01 | Patent grant | ||
| GR01 | Patent grant |