CN211066825U - Closer conveying system - Google Patents
Closer conveying system Download PDFInfo
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- CN211066825U CN211066825U CN201921260750.7U CN201921260750U CN211066825U CN 211066825 U CN211066825 U CN 211066825U CN 201921260750 U CN201921260750 U CN 201921260750U CN 211066825 U CN211066825 U CN 211066825U
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- closer
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Abstract
The utility model discloses a 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, it has two arm lock to articulate on the head end, brake valve lever is last to be equipped with the direction control end, open angle control end and off-load control end, the direction of direction control end is passed through to the direction control end, it has strutting arrangement to articulate between two arm lock, open angle control end opens or is closed through opening angle control line control strutting arrangement, when strutting arrangement opens or is closed, contained angle grow between two arm lock or diminish, be connected with the off-load control line between off-load control end and the closer, when the off-load control end makes the off-load control line break away from the closer, the closer is off-load from the arm lock. The purpose is to provide a closer conveying system which can reduce the trauma to a patient in the operation process and can accurately release a closer to clamp a left atrial appendage.
Description
Technical Field
The utility model relates to a surgical instrument, in particular to a 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 closer conveying system, it can reduce the wound that causes the patient among the operation process to can release the closer with the left atrial appendage of pincette accurately.
The utility model discloses 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, articulated on the head end have two arm lock, 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, articulated between two arm lock have strutting arrangement, be equipped with opening angle control line between opening angle control end and the strutting arrangement, opening angle control end opens or closes through opening angle control line control strutting arrangement, when strutting arrangement opens or closes, the contained angle between two arm lock becomes big or diminishes, 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 is unloaded from the clamp arm.
The utility model discloses 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 the 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 closer conveying system, wherein the head end includes first joint, second joint and third joint, two the arm lock all 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 through the first joint of second direction control line control in the second plane rotation.
The utility model discloses closer conveying system, wherein off-load control line is established to two, two off-load control line and closer be connected one end and lay respectively on 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, 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 to the arm lock wire loop in every arm lock simultaneously.
The utility model relates to a 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 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 center of rotation respectively, connects two second direction control lines on first joint and is located the relative both sides of first joint respectively.
The utility model discloses closer conveying system, wherein be equipped with first blind hole on the first carousel, one end of first direction control key is located first blind hole, be equipped with first compression spring between the bottom wall of first blind hole and the first direction control key, fixed being equipped with first spacer on the first direction control key, be equipped with the second blind hole on the second carousel, one end of second direction control key is located the second blind hole, be equipped with second compression spring between the bottom wall of second direction control key and second blind hole, fixed being equipped with the second spacer on the second direction control key, be equipped with first positioning gear and/or second positioning gear on the control handle, first positioning gear locates between first direction control key and second direction control key, second positioning gear locates being close to first direction control key department of first casing internal surface and being close to second direction control key department of second casing internal surface, under the action of the first compression spring, the first positioning sheet on the first direction control key is clamped on the gear of the first positioning gear and/or the gear of the second positioning gear, and under the action of the second compression spring, the second positioning sheet on the second direction control key is also clamped on the gear of the first positioning gear and/or the gear of the second positioning gear.
The utility model discloses closer conveying system, wherein two of the arm locks are arranged in X-shaped, the first riveting column is interpenetrated at the intersection position of the two arm locks, both of the two arm locks can rotate relative to the first riveting column, the first riveting column is fixedly arranged on a first joint, the strutting device comprises a winding pulley, a first supporting sheet and a second supporting sheet, one end of the first supporting sheet is hinged with the near end of one arm lock, the other end of the first supporting sheet is hinged with one end of the second supporting sheet through a second riveting column, the other end of the second supporting sheet is hinged with the near end of the other arm lock, the winding pulley is rotatably arranged on the second riveting column, a strip-shaped through hole is arranged on the first joint, the second riveting column is arranged in the strip-shaped through hole, when the second riveting column moves along the strip-shaped through hole, the included angle between the two arm locks becomes bigger or smaller, the opening 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, one end of the opening angle control line is fixed on the first joint after being wound on the winding pulley, the other end of the opening angle control line is connected with one end of the wrench, which is positioned in the control handle, the opening angle control line 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, under the action of the extension spring, the wrench rotates to enable the opening angle control line to be loosened, a limit button is arranged on the control handle, the limit button comprises a limit block, a third compression spring and a rectangular boss, the rectangular boss is arranged on the inner surface of the second shell, a groove is arranged on the top surface of the rectangular boss, a cylindrical boss is arranged at the top of the limit block, and, the stopper bottom is equipped with a boss, the stopper bottom surface is equipped with a rectangle recess, rectangle recess suit is on the rectangle boss, third compression spring arranges the recess of rectangle boss in, when rotating the taut opening angle control line of spanner, the screens face pastes tightly with the internal surface of first casing under third compression spring's effect mutually, at this moment the boss and the spanner block of stopper bottom, when pressing limit button, the boss and the spanner of stopper bottom are thrown away.
The utility model discloses closer conveying system, wherein the fixed rotation axis that is equipped with between first casing and the second casing, rotationally install first carousel and second carousel on the rotation axis, first backing sheet and second backing sheet are all established to two, the second is riveted the post and is established to one, the both ends department that the post is riveted to the second is the articulated position of first backing sheet and second backing sheet respectively, the intermediate position that the post is riveted to the second rotationally installs the wire winding pulley, rectangular through-hole is established to two, and two rectangular through-holes set up relatively, two ends that the post is riveted to the second are located two rectangular through-holes respectively.
The utility model discloses closer conveying system, wherein the off-load control end carries the knob including the off-load, the off-load knob is connected on brake valve lever, and the off-load that is located brake valve lever is equipped with the control line fixed orifices on carrying the knob, the off-load control line is connected on the control line fixed orifices.
The utility model discloses closer conveying system includes brake valve lever, connecting rod and head end, and when using, through the direction that adjustment direction control end adjusted the head end, opening angle control end opens or is closed through opening angle control line control distraction device, because distraction device articulates between two arm lock, consequently when distraction device opens or is closed, contained angle grow between two arm lock or diminish. Through the direction of adjustment head end (the direction of adjusting the arm lock promptly) and the contained angle size between two arm locks, can make the closer of installing at the head end can conveniently catch target tissue, 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, improved the accuracy of implantation position to can release the closer with the left atrial appendage of clamp accurately. 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 a closer conveying 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 distal end view of the connecting rod of the present invention;
fig. 5 is a schematic view of the proximal end of the third joint in the head end of the present invention;
fig. 6 is a schematic view of a distal end direction of a third joint in the head end of the present invention;
FIG. 7 is a cross-sectional view taken along line A-A of FIG. 5;
FIG. 8 is a cross-sectional view taken along line B-B of FIG. 6;
fig. 9 is a schematic view of the proximal direction of the second joint in the head end of the present invention;
fig. 10 is a schematic view of the direction of the distal end of the second joint in the head end of the present invention;
FIG. 11 is a cross-sectional view taken along line C-C of FIG. 9;
FIG. 12 is a cross-sectional view taken along line D-D of FIG. 10;
fig. 13 is a schematic view of the proximal direction of the first joint in the head end of the present invention;
fig. 14 is a schematic view of the distal direction of the first joint in the head end of the present invention;
FIG. 15 is a cross-sectional view taken along line E-E of FIG. 13;
FIG. 16 is a cross-sectional view taken along line F-F of FIG. 14;
fig. 17 is a schematic view of the proximal end of the clamp arm in the head end of the present invention;
fig. 18 is a schematic view of the distal 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 schematic view of a support sheet of the present invention;
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, the upper clamp arm, the lower clamp arm and the support piece are hidden in the figure);
fig. 24 is a schematic view of the head end of the present invention with two arms 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 first housing is hidden in the drawing);
fig. 28 is a schematic structural view of the unloading control end of the present invention;
fig. 29 is a schematic view of the structure of the proximal end of the connecting rod of the present invention;
fig. 30 is a schematic structural view of a direction control end in the control handle of the present invention;
fig. 31 is a schematic structural view of a first positioning gear in the direction control end of the present invention;
fig. 32 is a schematic view of another structure of the first positioning gear of the direction control end of the present invention;
fig. 33 is a schematic structural diagram of a first direction control end according to the present invention;
fig. 34 is an exploded view of a first directional control end of the present invention;
fig. 35 is a schematic structural diagram of a first turntable in the first direction control end of the present invention;
fig. 36 is a schematic view of another structure of the first rotating disk in the first direction control end of the present invention;
fig. 37 is a schematic structural view of a second direction control end of the present invention;
fig. 38 is an exploded view of a second directional control end of the present invention;
fig. 39 is a schematic structural diagram of a second turntable in a second direction control end according to the present invention;
fig. 40 is a schematic view of another structure of a second turntable in a second direction control end according to the present invention;
fig. 41 is a schematic structural diagram of the flare angle control end of the present invention;
fig. 42 is an exploded view of the flare angle control end of the present invention;
fig. 43 is a schematic structural view of a pulley in the flare angle control end of the present invention;
fig. 44 is a schematic structural view of the wrench in the flare angle control end of the present invention;
fig. 45 is another schematic structural diagram of the wrench in the flare angle control end of the present invention;
fig. 46 is a schematic structural view of a limit button according to the present invention;
fig. 47 is another schematic structural view 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. 2-47, the closer conveying system of the present invention includes a control handle 40, a connecting rod 30 and a head end 20, the control handle 40 is connected to the head end 20 through the connecting rod 30, two clamping arms are hinged to the head end 20, and two clamping arms are used for loading a closer, and the closer is a V-shaped closing clip 101. Be equipped with direction control end, opening angle control end 70 and off-load control end 80 on 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, it has strutting device to articulate between two arm locks, be equipped with the opening angle control line between opening angle control end 70 and the strutting device, opening angle control end 70 struts the device through opening angle control line control and opens or close, and when strutting the device and opening or close, the contained angle grow or diminish between two arm locks, be connected with the off-load control line between off-load control end 80 and the closer, when the off-load control end makes the off-load control line break away from the closer, the closer off-load from the arm lock.
The utility model discloses closer conveying system, 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 the first direction control line between first directional control end 50 and the head end 20, be connected with second directional control line 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 control head end 20, second directional control end 60 is rotatory in the second plane through second directional control line control head end 20.
As shown in fig. 2 in conjunction with fig. 3, the closer delivery system of the present invention, wherein the head end 20 comprises a first joint 104, a second joint 105 and a third joint 106, both of the clamping arms are hinged to the first joint 104, the first joint 104 is hinged to the second joint 105, the second joint 105 is hinged to the third joint 106, the third joint 106 is connected with the connecting rod 30, the first direction control line is connected between the second joint 105 and the first direction control end 50, the second direction control line is connected between the first joint 104 and the second direction control end 60, the first direction control terminal 50 controls the second joint 105 to rotate in the first plane by the first direction control line, the second direction control end 60 controls the first joint 104 to rotate in a second plane by a second direction control line, the first plane being perpendicular to the second plane.
As shown in fig. 22, and it is shown in combination with fig. 23 that the utility model discloses closer conveying system, wherein it establishes to two to unload the control line, two it lays respectively on the lateral surface of two arm lock with the closer one end of being connected of unloading control line 306, 307, is used for loading between two relative medial surfaces of two arm lock the closer, every all be equipped with logical groove 447 on the arm lock, logical groove 447 runs through the lateral surface and the medial surface of arm lock, wear to be equipped with arm lock wire loop 308, 309 in the logical groove 447, the unloading control line in the arm lock outside and the closer of arm lock inboard are tied up to the arm lock wire loop in every arm lock simultaneously.
As shown in fig. 1 and shown in fig. 25-27, 30, 33-36, the closure delivery system of the present invention, wherein the control handle 40 includes a first housing 201 and a second housing 202 connected to each other, the connecting rod 30 is a tubular structure, the first direction control end 50 includes a first rotating disk 206 and a first direction control key 204, the first direction control key 204 is disposed on the first rotating disk 206, the first rotating disk 206 is rotatably installed in the control handle 40, the first direction control end 50 extends out of the control handle 40, the first direction control lines are two, one end of each of the two first direction control lines 301, 302 is connected to the first rotating disk 206, the other end of each of the two first direction control lines 301, 302 passes through the inner cavity of the connecting rod 30 and then is connected to the second joint 105, and the two first direction control lines 301, 302 connected to the first rotating disk 206, 302 are located on opposite sides of the center of rotation of the first turntable 206, and two first direction control wires 301, 302 connected to the second joint 105 are located on opposite sides of the second joint 105.
As shown in fig. 30 and shown in fig. 37-40, the present invention provides a closer conveying system, wherein the second direction control end 60 includes a second rotating disc 207 and a second direction control key 205, the second direction control key 205 is disposed on the second rotating disc 207, the second rotating disc 207 is rotatably disposed in the control handle 40, the second direction control end 60 extends to the outside of the control handle 40, the number of the second direction control lines is two, one end of each of the two second direction control lines 303, 304 is connected to the second rotating disc 207, the other end of each of the two second direction control lines 303, 304 passes through the inner cavity of the connecting rod 30 and is connected to the first joint 104, the two second direction control lines 303, 304 connected to the second rotating disc 207 are respectively located at two opposite sides of the rotation center of the second rotating disc 207, and the two second direction control lines 303, 304 connected to the first joint 104 are respectively located at two opposite sides of the rotation center of, 304 are located on opposite sides of first joint 104.
As shown in fig. 30, and as shown in fig. 31-40, the utility model discloses closer conveying system, wherein be equipped with first blind hole 551 on first carousel 206, the one end of first direction control key 204 is located first blind hole 551, be equipped with first compression spring 221 between the diapire of first direction control key 204 and first blind hole 551, fixed first spacer 217 that is equipped with on the first direction control key 204, be equipped with second blind hole 559 on the second carousel 207, the one end of second direction control key 205 is located second blind hole 559, be equipped with second compression spring 222 between the diapire of second direction control key 205 and second blind hole 559, fixed second spacer 220 that is equipped with on the second direction control key 205. The control handle 40 is provided with a first positioning gear 203 and/or a second positioning gear, the first positioning gear 203 is arranged between the first direction control key 204 and the second direction control key 205, the second positioning gear is arranged at the position of the inner surface of the first shell 201 close to the first direction control key 204 and the position of the inner surface of the second shell 202 close to the second direction control key 205, under the action of a first compression spring 221, a first positioning sheet 217 on the first direction control key 204 is clamped on the gears of the first positioning gear 203 and/or the second positioning gear, and under the action of a second compression spring 222, a second positioning sheet 220 on the second direction control key 205 is also clamped on the gears of the first positioning gear 203 and/or the second positioning gear.
As shown in fig. 17, and as shown in fig. 18-24 and fig. 41-47, the closer conveying system of the present invention includes two of the clamping arms arranged in an X-shape, a first rivet column 118 is inserted into the intersection of the two clamping arms, both of the two clamping arms can rotate relative to the first rivet column 118, the first rivet column 118 is fixed on a first joint 104, the spreader includes a wire winding pulley 119, a first supporting plate and a second supporting plate, one end of the first supporting plate is hinged to the proximal end of one of the clamping arms, the other end of the first supporting plate is hinged to one end of the second supporting plate through a second rivet column 117, the other end of the second supporting plate is hinged to the proximal end of the other clamping arm, the wire winding pulley 119 is rotatably mounted on the second rivet column 117, a strip-shaped through hole 438 is formed on the first joint 104, the second rivet column 117 is located in the strip-shaped through hole 438, when the second rivet stud 117 moves along the strip through hole 438, the included angle between the two clamping arms becomes larger or smaller, the flare angle control end 70 includes a wrench 208, one end of the wrench 208 is rotatably installed in the control handle 40, the other end of the wrench 208 extends out of the control handle 40, one end of the flare angle control line 305 is fixed on the first joint 104 after passing around the winding pulley 119, the other end of the flare angle control line 305 is connected to one end of the wrench 208 located in the control handle 40, the wrench 208 can tighten or loosen the flare angle control line 305 by rotating, an extension spring 209 is connected between the wrench 208 and the inner surface of the control handle 40, under the action of the extension spring 209, the wrench 208 rotates to loosen the flare angle control line 305, the control handle 40 is provided with a limit button, the limit button includes a limit block 225, a third compression spring 226 and a rectangular boss 610, the rectangular boss 610 is arranged on the inner surface of the second shell 202, a groove 611 is arranged on the top surface of the rectangular boss 610, a cylindrical boss 612 is arranged at the top of the limiting block 225, the bottom surface of the cylindrical boss 612 is connected with a clamping surface 615, a boss is arranged at the bottom of the limiting block 225, a rectangular groove 616 is arranged at the bottom surface of the limiting block 225, the rectangular groove 616 is sleeved on the rectangular boss 610, the third compression spring 226 is arranged in the groove 611 of the rectangular boss 610, when the spanner 208 is rotated to tighten the opening angle control line 305, the clamping surface 615 is tightly attached to the inner surface of the first shell 201 under the action of the third compression spring 226, at the moment, the boss at the bottom of the limiting block 225 is clamped with the spanner 208, and when the limiting button is pressed, the boss at the bottom of the limiting block 225 is disengaged from.
As shown in fig. 22, the utility model discloses closer conveying system, wherein the fixed rotation axis 212 that is equipped with between first casing 201 and the second casing 202, rotationally install first carousel 206 and second carousel 207 on the rotation axis 212, first support sheet and second support sheet are all established to two, second riveting column 117 establishes to one, the both ends punishment of second riveting column 117 do not is the articulated position of first support sheet and second support sheet, the intermediate position of second riveting column 117 rotationally installs wire winding pulley 119, rectangular through-hole 438 establishes to two, and two rectangular through-holes 438 set up relatively, two ends of second riveting column 117 are located two rectangular through-holes 438 respectively.
As shown in fig. 28, the unloading control end 80 includes an unloading knob 211, the unloading knob 211 is screwed on the control handle 40, a control line fixing hole 518 is provided on the unloading knob 211 located in the control handle 40, and the unloading control line is connected to the control line fixing hole 518. The unloading knob 211 is not limited to be provided on the control handle 40 by means of screw connection, and may be provided on the control handle 40 by means of other connection means.
The utility model discloses closer conveying system includes brake valve lever 40, connecting rod 30 and head end 20, when using, adjusts the direction of head end 20 through adjustment direction control end, and flare angle control end 70 controls the distraction device through flare angle control line 305 and opens or be closed, owing to the distraction device articulates between two arm lock, consequently when the distraction device opens or is closed, contained angle grow between two arm lock or diminish. Through the direction of adjustment head end 20 (the direction of adjusting the arm lock promptly) and the contained angle size between two arm locks, can make the closer of installing at head end 20 catch target tissue conveniently, improved the efficiency and the degree of accuracy of implanting, can conveniently adjust the gesture of closer many times according to clinical demand in order to reach best curative effect, improved the accuracy of implantation position to can release the closer accurately with the left atrial appendage of pinches. 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 closer delivery system of the present invention will be 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 by a first rivet 118. The upper and lower clamp arms 102, 103 are rotatable about a first rivet post 118. As will be discussed next, the control of the relative rotational movement between the upper and lower clamp arms 102, 103 is accomplished via an opening angle control line 305 to achieve single ended opening and closing operation of the closure clip 101.
As shown in fig. 4-8, the third joint 106 is formed by a proximal circular ring-shaped through-surface 402 that gradually transitions into a distal rectangular depending wall 401. The proximal end of the third joint 106 is provided with a cylindrical groove 403, the interior of which is used for loading the distal end of the connecting rod 30, and the proximal end and the distal end can be fastened by welding, interference fit and the like. The distal end of the connecting rod 30 meets the bottom surface wall 410 of the cylindrical recess 403. The cylindrical slot bottom wall 410 includes a locating hole 411, the locating hole 411 cooperating with a locating boss 456 at the distal end of the connecting rod 30 to effect a locating assembly of the connecting rod 30 with the third joint 106. The cylindrical trough bottom wall 410 includes one rectangular through hole 404 and four circular through holes 405, 406, 407, 408. Two first direction control lines 301 and 302 pass through two circular through holes 405 and 406, respectively, and second direction control lines 303 and 304 pass through the other two circular through holes 407 and 408, respectively. One opening control line 305 and two unloading control lines 306, 307 pass through the rectangular through hole 404.
As shown in fig. 9-12, the second joint 105 is contoured to consist of a proximal radiused surface 414 and a distal two cantilevered structures 415. The second proximal articular surface 414 is provided with two circular through holes 416, 417 and a rectangular through hole 418. Two second direction control wires 303, 304 pass through two circular vias 416, 417, respectively, and one flare control wire 305 and two off- load control wires 306, 307 pass through a rectangular via 418. Two through holes 420 and 421 are symmetrically arranged on the top surface 419 and the bottom surface of the proximal end of the second joint 105, the top surface 419 and the bottom surface of the proximal end of the second joint 105 are embedded between the two long cantilevers 401 at the distal end of the third joint 106, the through hole 420 of the top surface of the second joint and the circular through hole 412 of the long cantilever of the third joint are riveted together through the rotating shaft 107, and the through hole 421 of the bottom surface of the second joint and the circular through hole 413 of the lower cantilever of the third joint are riveted together through the rotating shaft 108. The second joint 105 and the third joint 106 can now rotate about the rotation axes 107, 108, so that the second joint 105 and the third joint 106 are articulated to each other. The maximum range of rotation of the second joint 105 is defined by the short cantilever 409 of the third joint 106.
As shown in fig. 13-16, the first joint 104 is contoured to include a proximal radiused surface 429 and a distal two cantilevered structures 430. The first proximal joint surface 429 is provided with two circular through holes 431 and one rectangular through hole 432. The specific way in which one end (i.e., the distal end) of the flare angle control wire 305 is fixed to the first joint 104 after passing around the winding pulley 119 is as follows: the distal end of the flare angle control wire 305 has a protrusion with a size larger than that of the circular through holes 431, and when the flare angle control wire 305 is assembled, the distal protrusion of the flare angle control wire 305 is placed at the proximal end side of any one of the circular through holes 431, then the proximal end of the flare angle control wire 305 passes through the through holes 431 to extend to the distal end, then the proximal end of the flare angle control wire passes through the rectangular through hole 432 to extend to the proximal end after encircling the winding pulley 119, and the flare angle control wire is connected to the flare. The offload control lines 306, 307 pass through a rectangular via 432.
Two through holes 434 are symmetrically arranged on the top surface 433 and the bottom surface of the proximal end of the first joint 104, the top surface 433 and the bottom surface of the proximal end of the first joint 104 are embedded between the two cantilevers 415 at the distal end of the second joint 105, the first joint top surface through hole 434 and the second joint cantilever upper circular through hole 427 are riveted together through the rotating shaft 109, and the first joint bottom surface through hole 434 and the second joint cantilever lower circular through hole 428 are connected together through the rotating shaft 110. The first joint 104 and the second joint 105 are now rotatable about the axes of rotation 109, 110, such that the first joint 104 and the second joint 105 are articulated relative to each other (as shown in fig. 3). The maximum range of rotation of the first joint 104 is defined by the short cantilever 426 of the second joint 105.
The two side cambered surfaces 429 at the proximal end of the first joint 104 and the two side cantilevers 430 are respectively provided with a wire groove 435, and the distal end of the wire groove 435 is provided with a through hole 436. Through hole 436 is located at the proximal portion of cantilever 430. The two second direction control wires 303, 304 are respectively arranged in the two wire grooves 435 and extend to the through hole 436 along the wire grooves 435, and the distal ends of the second direction control wires 303, 304 are provided with a protrusion, the size of which is larger than the diameter of the through hole 436. The installation is made such that the convex portion of the distal end of the second direction control wire 303, 304 is located on the side of the inner surface 437 of the cantilever 436, so that the distal end of the second direction control wire 303, 304 is caught at the through hole 436. Therefore, when the distal ends of the second direction control wires 303 and 304 move, the first joint 104 is driven to move correspondingly, and the rotation of the first joint 104 is controlled.
The middle parts of the cantilevers 430 at the two sides of the first joint 104 are symmetrically provided with a long through hole 438, the far ends of the cantilevers 430 at the two sides are symmetrically provided with a circular through hole 439, and the far ends of the first joint 104 are connected with the upper clamping arm 102 and the lower clamping arm 103 through the long through hole 438 and the circular through hole 439. The specific connection is described later.
As shown in fig. 17-19, upper clamp arm 102 and lower clamp arm 103 are identical in construction. The proximal ends of upper arm 102 and lower arm 103 include a cantilever 440, and the proximal end of cantilever 440 includes a cylinder 441. A circular through hole 442 is present in the cylindrical body 441. The middle portion of cantilever 440 includes a through-hole 443. The distal end of the cantilever 440 is connected to a long cantilever 445, which is located to the left of the proximal end of the long cantilever 445. The upper clamping arm 102 and the lower clamping arm 103 are connected with the first joint 104 through the through hole 443 and the through hole 442. Referring to FIG. 2, when connected, inner side 444 of upper arm 102 and lower arm 103 contact each other and outer side 448 contacts inner side 437 of cantilever arm 430 of first knuckle 104. As shown in fig. 2, a first rivet 118 is provided through a through hole 439 formed at the distal end of the first joint 104 and through holes 443 formed at the proximal ends of the upper clamp arm 102 and the lower clamp arm 103, the first rivet 118 connects the upper clamp arm 102 and the lower clamp arm 103 with the first joint 104, and the upper clamp arm 102 and the lower clamp arm 103 are allowed to rotate around the first rivet 118, so that the upper clamp arm 102 and the lower clamp arm 103 are hinged to the first joint 104.
As shown in fig. 20, the through holes 454 at one ends of the first support pieces 113 and 114 are respectively caulked to the side surfaces 452 and 453 of the proximal cylinder 441 of the lower arm 103 by the caulking pin 111, and the through holes 454 at one ends of the second support pieces 115 and 116 are respectively caulked to the side surfaces 452 and 453 of the proximal cylinder 441 of the upper arm 102 by the caulking pin 112. The wire winding pulley 119, the through hole 455 at the other end of the two first supporting plates 113 and 114, the through hole 455 at the other end of the two second supporting plates 115 and 116, and the elongated through hole 438 on the cantilever 430 of the first joint 104 are riveted together by the second riveting column 117, and the wire winding pulley 119 is located between the two first supporting plates 113 and 114 and also between the two second supporting plates 115 and 116. The aperture control wire 305 is connected to the aperture control terminal 70 by passing around the winding pulley 119. When the opening angle control end 70 is operated to move the opening angle control line 305 to the proximal end, the opening angle control line 305 drives the winding pulley 119 to move to the proximal end along the elongated through hole 438 of the first joint 104, and the winding pulley 119 further causes the first supporting pieces 113, 114 and the second supporting pieces 115, 116 hinged to each other to expand the proximal cantilevers 440 of the upper arm 102 and the lower arm 103 outward, as shown in fig. 22, since the upper arm 102 and the lower arm 103 are hinged together in an X shape, the distal cantilevers 445 of the upper arm 102 and the lower arm 103 rotate around the first rivet column 118 correspondingly, that is, the opening angle between the upper arm 102 and the lower arm 103 increases. Conversely, the wire winding pulley 119 moves distally, and the angle between the upper arm 102 and the lower arm 103 decreases. Therefore, the control of the included angle between the upper clamping arm 102 and the lower clamping arm 103 is realized through the opening angle control line 305. It should be noted that, the first support sheet and the second support sheet in the opening device are used in cooperation, and a group of first support sheet and a group of second support sheet (the number of the first support sheet and the second support sheet in each group is one) may be provided, or two or more groups of first support sheet and second support sheet may be provided.
As shown in fig. 22 to 24, the proximal end face of the long cantilever 445 is provided with a through hole 449, and the distal side of the through hole 449 communicates with the long wire groove 446 formed in the outer surface of the long cantilever 445. The inner side of the long cantilever 445 is provided with a groove consisting of two opposing side walls 450, 451. At the distal and middle ends of the long cantilever 445, a plurality of through slots 447 are arranged. Two unloading control wires 306 and 307 respectively pass through the through holes 449 of the upper clamping arm 102 and the lower clamping arm 103 and extend along the long wire slot 446 to the far end of the long cantilever 445. When installed, the two arms of the V-shaped closure clip 101 are disposed within the grooves formed by the two side walls 450, 451 of the upper and lower clip arms 102, 103, respectively. In the upper clamp arm 102, an appropriate one of the through slots 447 is selected so that a clamp arm wire loop 308 passes through the through slot 447 while binding one side arm of the V-shaped closure clip 101 and the unload control wire 306. In the lower clamp arm 103, the appropriate one of the through slots 447 is selected and a clamp arm wire loop 309 is passed through the through slot 447 while tying down the other side arm of the V-shaped closure clip 101 and the off-load control wire 307. Thereby realizing the connection and fixation of the closing clip 101 with the upper clip arm 102 and the lower clip arm 103. So that the upper clamping arm 102 and the lower clamping arm 103 can drive the V-shaped closing clamp to synchronously move correspondingly. When the unloading control lines 306 and 307 are displaced from the distal end to the proximal end, so that they are disengaged from the clip arm wire loops 308 and 309, the closure clip 101 is disengaged from the upper clip arm 102 and the lower clip arm 103, thereby achieving unloading of the closure clip 101.
As shown in fig. 25 to 27, 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 and positioning posts 532 are disposed on the inner surface 502 of the first housing 201, the end surface 503 includes a boss, a plurality of mounting and positioning holes 520 are disposed on the inner surface 522 of the second housing 202, and a groove is disposed 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 boss on the end surface 503 is matched with the groove on the end surface 523. When assembled, the control handle 40 defines four openings 504, 505, 506, 507 for placement of portions of the components.
The first opening 504 of the control handle 40 is located at the distal end of the handle and is shaped to mate with the connecting rod 30 to allow for connection of the handle to the connecting rod 30. Bosses 508 are arranged at the openings 504 of the first shell 201 and the second shell 202, a semi-cylindrical through hole coaxial with the opening 504 is arranged on each boss 508, and three bosses 510 are arranged on the inner surface of the semi-cylindrical through hole. As shown in fig. 29, the proximal end of the connecting rod 30 includes an inner surface 534, a proximal 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 opening 504, the inner surface of the semi-cylindrical through bore, and the boss 510 and the recess 535 are mated such that the proximal surface 533 of the connector strut 30 is coincident with the proximal surface 609 of the boss 508, thereby securing the connector strut 30 within the control handle 40. All control wires enter the interior of the control handle 40 via the lumen of the connecting rod 30.
As shown in fig. 25-27 and 30, the second opening 505 of the control handle 40 is located at the upper proximal end of the first housing 201 and the second housing 202, where the first direction control end 50 and the second direction control end 60 are located. A rotating shaft 212 is fixedly arranged between the blind hole 513 of the first housing 201 and the blind hole 524 of the second housing 202, and the first rotating disk 206 and the second rotating disk 207 are rotatably mounted on the rotating shaft 212. The adjustment and locking of the head end 20 in the two in-plane directions are realized through the first direction control key 204, the second direction control key 205 and at least one of the first positioning gear 203 and the second positioning gear. A detailed description of the first direction control terminal 50 and the second direction control terminal 60 is listed later.
As shown in fig. 25-27, the third opening 506 of the control handle 40 is located at the lower proximal end of the first housing 201 and the second housing 202, where the flare angle control end 70 is located. The third opening 506 is sized to mate with the wrench 208. The wrench 208 fits into the control handle 40 through the hole 515 in the first housing 201 and the hole 528 in the second housing 202. The tension spring 209 is connected at both ends to the post 527 of the second housing 202 and the wrench 208, respectively. When the first casing 201 and the second casing 202 are fastened to each other, the post 527 on the second casing 202 is inserted into the blind hole 514 of the first casing 201. The flare control line 305 is connected to the wrench 208 around a pulley 210 located on the rotational axis 213 of the second housing 202. By turning the wrench 208, the opening angle of the head end 20 can be adjusted. A detailed description of the flare angle control end 70 is listed later.
As shown in fig. 25-28, the fourth opening 507 of the control handle 40 is located at the upper middle portion of the first and second housings 201 and 202 where the unloading control end 80 is located. A fixing plate is arranged at the fourth opening 507, and the shape of the fixing plate is matched with that of the fourth opening 507. The fixing plate is provided with a threaded hole 530, and the unloading knob 211 is installed on the threaded hole 530 in a threaded manner. A control line fixing hole 518 is provided on the unloading knob 211 provided in the control handle 40. The proximal ends of the release control wires 306, 307 are attached to the control wire securement hole 518 by knotting, gluing, crimping, or the like. Rotation of the unload knob 211 unloads it from the threaded bore 530 and pulls it outward, causing proximal movement of the unload control wires 306, 307, thereby disengaging the distal ends of the unload control wires 306, 307 from the clip arm wire loops 308, 309, thereby allowing unloading of the V-shaped closure clip 101.
As shown in fig. 30-40, the first direction control end 50 includes a first direction control key 204 and a first dial 206, and the second direction control end 60 includes a second direction control key 205 and a second dial 207. The first positioning gear 203 is located between the first direction control key 204 and the second direction control key 205. Two bosses 538 are arranged on one side surface 540 of the first positioning gear 203, and are arranged in two blind holes 526 at corresponding positions of the opening 505 of the second shell 202 during assembly, so that the bottom surfaces 541 of the bosses 538 are connected with the end surface 525 at the opening 505 of the second shell 202, and a certain distance exists between the side surface 540 of the first positioning gear 203 and the end surface 525 at the opening 505 of the second shell 202, and the second direction control key 205 can be accommodated to pass through the distance. The other side surface 544 of the first positioning gear 203 is provided with two bosses 542, and when the assembly is carried out, the bosses are installed in the two blind holes 512 at the corresponding positions of the first casing 201, so that the bottom surface 543 of the boss 542 is connected with the end surface 511 at the opening 505 of the first casing 201, and at this time, a certain distance exists between the side surface 544 of the first positioning gear 203 and the end surface 511 at the opening 505 of the first casing 201, and the first direction control key 204 can be accommodated to pass through the distance. A gear 539 is arranged inside the middle of the first positioning gear 203. A second positioning gear is provided on the inner surface of the first housing 201 near the end surface 511 (i.e., near the first direction control key of the inner surface of the first housing), and the second positioning gear matches with the gear 539 in the first positioning gear 203. A second positioning gear is also provided on the inner surface of the second housing 202 adjacent to the end surface 525 (i.e., the inner surface of the second housing adjacent to the second direction control key), and is mated with the gear 539 of the first positioning gear 203. The first and second rotating disks 206 and 207 are connected to the first and second housings 201 and 202 via a rotating shaft 212. The first turntable 206 and the second turntable 207 are both rotatable about a rotation axis 212.
The first direction control end 50 includes a first direction control key 204, a first positioning piece 217, a first dial 206, a first compression spring 221, a screw 216, a nut 214, and a rotation shaft 212. The center of the top surface 547 of the first turntable 206 is provided with an annular boss 548 which is sleeved on the corresponding blind hole 513 of the first housing opening 505 during assembly. The first turntable 206 has a circular through hole 552 at the center thereof for receiving the rotary shaft 212. One side of the top surface 547 of the first turntable 206 includes a circular through-hole 549 and a hexagonal counterbore 550 is present in a corresponding position to the bottom surface 553. The first direction control wires 301, 302 enter the top surface 547 distally and extend along the outer side of the boss 548 to the circular through hole 549. The first direction control wires 301, 302 are now tightened, the nut 214 is placed in the hexagonal counterbore 550, and the screw 216 is then threaded into the nut 214 from the top surface 547 while the first direction control wires 301, 302 are secured between the screw 216 and the first rotor plate 206. Thereby allowing the first direction control wires 301 and 302 to move with the rotation of the first turntable 206, and further causing the second joints 105 connected to the distal ends of the first direction control wires 301 and 302 to rotate in the X-Y plane (i.e., the first plane), thereby rotating the head end 20 in the plane.
The proximal side of the first dial 206 is provided with a first blind hole 551 into which the first compression spring 221 is inserted. A through groove 545 is formed in the middle of the first direction control key 204, the first positioning piece 217 is installed and fixed in the through groove 545 in a screw, riveting or bonding mode, and meanwhile, two ends of the first positioning piece 217 protrude out of one part of the side face of the first direction control key 204. The bottom surface 546 of the first direction control key 204 is received in the first blind hole 551 of the first dial 206 and contacts the first compression spring 221, so that the first compression spring 221 and the bottom surface 546 of the first direction control key 204 have an interaction force. The proximal end of the first direction control key 204 extends out of the housing through a gap between a side surface 544 of the first positioning gear 203 and an end surface 511 of the first housing 201 at the opening 505. At this time, due to the outward pushing force of the first compression spring 221, the first direction control key 204 moves outward, so that the first positioning piece 217 moves outward, and the portion of the first positioning piece 217 protruding out of the side surface of the first direction control key 204 is clamped in the gear 539 of the first positioning gear 203, so that the first direction control key 204 is fixed. In order to balance the stress of the first direction control key 204 when the first direction control key 204 is in the fixed state, as mentioned above, the second positioning gear is provided on the inner surface of the first housing 201 near the end surface 511, and the first positioning piece 217 protrudes from two opposite side surfaces of the first direction control key 204, and when the first direction control key 204 moves outwards, the portion of the first positioning piece 217 protruding from the side surface of the first direction control key 204 is also clamped into the second positioning gear on the inner surface of the first housing 201. The first turntable 206 cannot rotate at this time. The first direction control key 204 is pressed towards the bottom surface direction of the first blind hole 551, and is moved along the direction until the first positioning piece 217 is completely separated from the first positioning gear 203 and the second positioning gear on the first housing 201, at this time, the first direction control key 204 can be rotated up and down, so as to drive the first rotary disk 206 to rotate, further to cause the first direction control lines 301 and 302 to drive the second joint 105 to rotate, and further to realize the rotation of the head end 20 in the X-Y plane. When the rotation angle of the head 20 in the X-Y plane is selected, and the pressure on the first direction control key 204 is stopped, the first direction control key 204 moves proximally under the elastic force of the first compression spring 221 until the first positioning piece 217 is clamped into the first positioning gear 203 and the second positioning gear on the first housing 201 again, and at this time, the first direction control key 204 is locked again. In summary, the angular adjustment and locking of the head end 20 in the X-Y plane can be accomplished by the first direction control key 204. It should be noted that the locking of the first direction control key 204 can be completed by only providing one of the first positioning gear 203 and the second positioning gear.
The second direction control end 60 includes a second direction control key 205, a second positioning piece 220, a second rotary disk 207, a second compression spring 222, a screw 219, a nut 215, and a rotary shaft 212. The center of the bottom 562 of the second turntable 207 is provided with a circular boss 561, which is sleeved on the corresponding blind hole 524 at the opening 505 of the second housing 202 during assembly. The second turntable 207 has a circular through hole 558 in the center thereof for receiving the rotary shaft 212. One side of the top surface 555 of the second turntable 207 includes a circular through hole 557, and a hexagonal counterbore 560 is formed at a corresponding position of the bottom surface 562. The second direction control wires 303, 304 extend distally onto the top surface 555, along the outer side of the boss 556, and to the circular through hole 557. At this point, the second direction control wires 303, 304 are tightened, the nut 215 is placed in the hexagonal counterbore 560, and the screw 219 is then threaded into the nut 215 from the top surface 555 while the second direction control wires 303, 304 are secured between the screw 219 and the second dial 207. Thereby allowing the second direction control wires 303, 304 to move with the rotation of the second dial 207, which in turn causes the first joints 105 connected to the distal ends of the second direction control wires 303, 304 to rotate in the Y-Z plane (i.e., the second plane), thereby rotating the head end 20 in that plane.
The second dial 207 has a second blind hole 559 formed in the proximal side thereof for receiving the second compression spring 222 therein. A through groove 562 is formed in the middle of the second direction control key 205, the second positioning plate 220 is assembled and fixed in the through groove 562 by means of screws, riveting or bonding, and a part of the two ends of the second positioning plate 220 protrudes from 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 second blind hole 559 of the second rotary disk 207 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 key 205 extends out of the housing through a gap between a side surface 544 of the first positioning gear 203 and an end surface 525 at the opening 505 of the second housing 202. At this time, due to the outward pushing force of the second compression spring 222, the second direction control key 205 moves outward, which causes the second positioning piece 220 to move outward, and further causes the portion of the second positioning piece 220 protruding out of the side surface of the second direction control key 205 to be clamped into the gear 539 of the first positioning gear 203, so that the second direction control key 205 is fixed. In order to balance the force applied to the second direction control key 205 when the second direction control key 205 is in the fixed state, as mentioned above, the second positioning gear is disposed on the inner surface of the second housing 202 near the end surface 525, and the second positioning plate 220 protrudes from two opposite side surfaces of the second direction control key 205, and when the second direction control key 205 moves outward, the portion of the second positioning plate 220 protruding from the side surface of the second direction control key 205 is also locked in the second positioning gear on the inner surface of the second housing 202. The second turntable 207 cannot rotate at this time. The second direction control key 205 is pressed towards the bottom of the second blind hole 559, and is moved along the direction until the second positioning piece 220 is completely separated from the first positioning gear 203 and the second positioning gear on the second housing 202, at this time, the second direction control key 205 can be rotated up and down, so as to drive the second rotary disk 207 to rotate, 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 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 proximally under the elastic force of the second compression spring 222 until the second positioning piece 220 is locked again in the first positioning gear 203 and the second positioning gear on the second housing 202, and at this time, the second direction control key 205 is locked again. In summary, the angular adjustment and locking of the head end 20 in the Y-Z plane can be accomplished by the second direction control button 205. It should be noted that the second direction control key 205 can be locked by only one of the first positioning gear 203 and the second positioning gear.
As shown in fig. 41 to 47, the flare angle control end 70 includes a wrench 208, an extension spring 209, a pulley 210, a screw 223, a nut 224, a rotation shaft 213, a stopper 225, and a third compression spring 226. The rotary shaft 213 is fixed in the blind hole 516 of the first housing 201 and the blind hole 529 of the second housing 202. An inner surface 577 of the pulley 210 is fitted over the rotation shaft 213. Flare control line 305 is coupled to wrench 208 about outer surface 578 of 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 wrench 208 has a concave left side surface, the concave surface includes a bottom surface 569 and a side surface 574, and the bottom surface 569 has a circular through hole 570. The right side of the wrench 208 includes a hexagonal counterbore 621 corresponding to the circular through 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 line 305 passes around slide shaft 210 and enters through hole 573 along line groove 572. Flare control line 305 passes through hole 573 and into the wrench recess, and flare control line 305 extends along the bottom surface 569 of the recess to the circular through hole 570. At this point, tension control line 305 is tightened, nut 224 is placed in hexagonal counterbore 621, and screw 223 is then threaded into nut 224 from bottom surface 569, while tension control line 305 is secured between screw 223 and wrench 208.
A cantilever 568 is provided at a proximal end of an outer surface 567 of the wrench 208, and a post 527 is provided on the second housing 202, and the tension spring 209 is placed in tension by fitting both ends thereof over the cantilever 568 and the post 527, respectively. At this time, the wrench 208 is wrenched to move the end 571 towards the proximal end, the wrench rotates counterclockwise around the rotating shaft formed by the bosses 575-564, the opening angle control line 305 also moves along with the wrench, and after passing through the pulley 210, the distal end of the opening angle control line 305 moves towards the proximal end, so as to drive the winding pulley 119 to move from the distal end to the proximal end along the long through hole 438, the opening device is gradually opened, the opening angle between the upper clamping arm 102 and the lower clamping arm 103 of the head end 20 is driven to gradually increase, and further the distal end of the closing clamp 101 is opened. 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 is rotated clockwise to the initial position, and the closing clip 101 is re-closed. Thereby, the flare angle control terminal 70 realizes the control of the flare angle of the head terminal 20.
As shown in fig. 41, 42, 46 and 47, the control handle 40 is provided with a limit button, which is engaged with the wrench when the opening angle control line is tightened by rotating the wrench, and disengaged from the wrench when pressed. The limiting button comprises a limiting block 225, a third compression spring 226 and a rectangular boss 610, as shown in fig. 26, the rectangular boss 610 is arranged on the inner surface of the second housing 202, a groove 611 is arranged on the top surface of the rectangular boss 610, a cylindrical boss 612 is arranged at the top of the limiting block 225, and the bottom surface of the cylindrical boss 612 is connected with a clamping surface 615. The bottom of the stop block 225 is provided with a boss, the top surface of the boss is 614, and the side surface of the boss is 613. 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 groove 616 of the stopper 225 is sleeved on the rectangular boss 610 of the second housing 202, and the third compression spring 226 is disposed in the circular blind hole 617 of the groove 616 and the groove 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, and at this time, under the action of the third compression spring 226, the bottom boss 614 of the stopper 225 is closely attached to the bottom surface 619 of the top boss 618 of the wrench 208, and a part of the top cylindrical boss 612 of the stopper 225 passes through the through hole 608 on 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 clipping arms on the head end 20, at this time, the boss 618 and the stopper 225 move relatively, and when the boss surface 614 of the stopper 225 is separated from the bottom surface 619 of the boss 618, under the action of the third compression spring 226, the stopper 225 springs upwards until the clipping surface 615 of the stopper 225 contacts the inner surface 502 of the first housing 201 (the diameter of the clipping surface 615 is larger than the diameter of the through hole 608 on the first housing 201, so that the clipping surface 615 can clip on the inner surface of the first housing 201). When the wrench 208 is released, the side 620 of the boss 618 is blocked by the side 613 of the stopper 225, i.e. the stopper button is engaged with the wrench 208, so that the wrench 208 cannot move further to the initial position, and at this time, the wrench 208 is released, and the two clamping arms on the head end 20 are still kept open. At this time, the cylindrical boss 612 of the stopper 225 is pressed down toward the inside of the first housing 201, so that the side 620 of the boss 618 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, the wrench 208 is restored to the initial position due to the resilient force of the tension spring 209 and the closing force of the closing clip 101, and the two clip arms on the head end 20 are closed.
The following description of the embodiment of the present invention will be made by taking left atrial appendage closure as an example:
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 proximally to increase the opening angle of the distal end of the head end 20, so that the distal end of the closure clip 101 opens, moving the wrench 208 proximally to maintain the head end 20 in the open state by the stopper 225, and then loosening the wrench 208, wherein the head end 20 still remains open;
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 operating 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, after the positions and directions of the head ends are adjusted for many times until the clamping effect of the left atrial appendage meets the requirement, the unloading control end 80 is detached from the threaded hole 530 by rotating the unloading knob 211 and is pulled outwards to drive the unloading control ends 306 and 307 to move towards the near ends, so that the far ends of the unloading control ends 306 and 307 are separated from the clamping arm wire loops 308 and 309, and the unloading of the V-shaped closing clamp 101 can be realized;
the seventh step: the tip 20 is slowly withdrawn 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.
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 off-loading knob is pulled to separate the closer from the upper clamping arm and the lower clamping arm, the thread cutting of the surgical scissors is not needed, the releasing efficiency is improved, the requirement on the size of a surgical path is reduced, and the wound to a patient is reduced. Thereby allowing the procedure to be performed under minimally invasive conditions.
The above-mentioned embodiments are 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 closure delivery system, comprising: the device comprises a control handle, a connecting rod and a head end, wherein the control handle is connected with the head end through the connecting rod, two clamping arms are hinged to the head end, a closer is loaded between the two clamping arms, a direction control end, an opening angle control end and a load shedding control end are arranged on the control handle, a direction control line is connected between the direction control end and the head end, the direction of the head end is controlled by the direction control end through the direction control line, an opening device is hinged between the two clamping arms, an opening angle control line is arranged between the opening angle control end and the opening device, the opening angle control end controls the opening device to be opened or closed through the opening angle control line, when the opening device is opened or closed, an included angle between the two clamping arms is increased or decreased, a load shedding control line is connected between the load shedding control end and the closer, when the load shedding control line is separated from the closer through the, the closer is unloaded from the clamp arm.
2. The closure delivery system of 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. The closure delivery system of claim 2, wherein: the head end comprises a first joint, a second joint and a third joint, the two clamping arms are hinged to the first joint, the first joint is hinged to the second joint, the second joint is hinged to the third joint, the third joint is connected with a connecting rod, a first direction control line is connected between the second joint and the first direction control end, a second direction control line is connected between the first joint and the second direction control end, the first direction control end controls the second joint to rotate in a first plane through the first direction control line, and the second direction control end controls the first joint to rotate in a second plane through the second direction control line.
4. The closure delivery system of 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. The closure delivery system of 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. The closure delivery system of 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. The closure delivery system of claim 6, wherein: the first rotary disc is provided with a first blind hole, one end of the first direction control key is positioned in the first blind hole, a first compression spring is arranged between the first direction control key and the bottom wall of the first blind hole, the first direction control key is fixedly provided with a first positioning sheet, the second rotary disc is provided with a second blind hole, one end of the second direction control key is positioned in the second blind hole, a second compression spring is arranged between the second direction control key and the bottom wall of the second blind hole, the second direction control key is fixedly provided with a second positioning sheet, the control handle is provided with a first positioning gear and/or a second positioning gear, the first positioning gear is arranged between the first direction control key and the second direction control key, the second positioning gear is arranged at the position of the inner surface of the first shell, which is close to the first direction control key, and at the position of the inner surface of the second shell, which is close to the second direction control key, under the action of the first compression spring, the first positioning sheet on the first direction control key is clamped on the gear of the first positioning gear and/or the gear of the second positioning gear, and under the action of the second compression spring, the second positioning sheet on the second direction control key is also clamped on the gear of the first positioning gear and/or the gear of the second positioning gear.
8. The closure delivery system of claim 7, wherein: the two clamping arms are arranged in an X shape, a first riveting column is inserted at the intersection part of the two clamping arms, the two clamping arms can rotate relative to the first riveting column, the first riveting column is fixedly arranged on a first joint, the strutting device comprises a winding pulley, a first supporting sheet and a second supporting sheet, one end of the first supporting sheet is hinged with the near end of one clamping arm, the other end of the first supporting sheet is hinged with one end of the second supporting sheet through a second riveting column, the other end of the second supporting sheet is hinged with the near end of the other clamping arm, the winding pulley is rotatably arranged on the second riveting column, a strip-shaped through hole is formed in the first joint, the second riveting column is positioned in the strip-shaped through hole, when the second riveting column moves along the strip-shaped through hole, the included angle between the two clamping arms is increased or decreased, and the opening angle control end comprises a wrench, one end of the wrench is rotatably installed in the control handle, the other end of the wrench extends out of the control handle, one end of the open angle control line is fixed on the first joint after bypassing the winding pulley, the other end of the open angle control line is connected with one end of the wrench positioned in the control handle, the open angle control line can be tensioned or loosened by rotating the wrench, a tension spring is connected between the wrench and the inner surface of the control handle, under the action of the tension spring, the wrench rotates to loosen the open angle control line, the control handle is provided with a limit button, the limit button comprises a limit block, a third compression spring and a rectangular boss, the rectangular boss is arranged on the inner surface of the second shell, a groove is arranged on the top surface of the rectangular boss, a cylindrical boss is arranged at the top of the limit block, the bottom surface of the cylindrical boss is connected with a clamping surface, and a boss, the stopper bottom surface is equipped with a rectangle recess, rectangle recess suit is on the rectangle boss, the third compression spring is arranged in the recess of rectangle boss, when rotating the taut opening angle control line of spanner, the screens face pastes tightly with the internal surface of first casing under third compression spring's effect mutually, at this moment the boss and the spanner block of stopper bottom, when pressing limit button, the boss and the spanner of stopper bottom are thrown away.
9. The closure delivery system of claim 8, wherein: the fixed rotation axis that is equipped with between first casing and the second casing, rotationally install first carousel and second carousel on the rotation axis, first support sheet and second backing sheet are all established to two, the second rivets the post and establishes to one, the both ends department that the post was riveted to the second is the articulated position of first support sheet and second backing sheet respectively, the intermediate position that the post was riveted to the second rotationally installs wire winding pulley, rectangular through-hole establishes to two, and two rectangular through-holes set up relatively, two ends that the post was riveted to the second are located two rectangular through-holes respectively.
10. The closure delivery system of claim 9, wherein: the unloading control end comprises an unloading knob, the unloading knob is connected to the control handle, a control line fixing hole is formed in the unloading knob located in the control handle, and the unloading control line is connected to the control line fixing hole.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201921260750.7U CN211066825U (en) | 2019-08-06 | 2019-08-06 | Closer conveying system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201921260750.7U CN211066825U (en) | 2019-08-06 | 2019-08-06 | Closer conveying system |
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| Publication Number | Publication Date |
|---|---|
| CN211066825U true CN211066825U (en) | 2020-07-24 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201921260750.7U Active CN211066825U (en) | 2019-08-06 | 2019-08-06 | Closer conveying system |
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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 |
| CN114949541A (en) * | 2022-06-30 | 2022-08-30 | 科睿驰（深圳）医疗科技发展有限公司 | Catheter control handle and adjustable catheter |
-
2019
- 2019-08-06 CN CN201921260750.7U patent/CN211066825U/en active Active
Cited By (3)
| 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 |
| CN114949541A (en) * | 2022-06-30 | 2022-08-30 | 科睿驰（深圳）医疗科技发展有限公司 | Catheter control handle and adjustable catheter |
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