CN216876469U

CN216876469U - Metal clip for anastomosing gastrointestinal mucosa under endoscope

Info

Publication number: CN216876469U
Application number: CN202123070334.0U
Authority: CN
Inventors: 连婷婷; 庄则豪
Original assignee: Individual
Current assignee: Individual
Priority date: 2021-12-08
Filing date: 2021-12-08
Publication date: 2022-07-05
Anticipated expiration: 2031-12-08

Abstract

The utility model relates to a metal clip for anastomosing gastrointestinal mucosa under an endoscope, which comprises an operating part, a flexible sleeve and a clip assembly, wherein the clip assembly comprises outer forceps arms distributed on the left and right sides; a spiral middle clamp arm is arranged in the middle of the outer clamp arms; rotate on the operation portion and connect rotatory ring, rotatory epaxial transmission line that is connected with of ring, the transmission line is connected with middle tong arm after passing flexible sleeve, and through rotating rotatory ring, rotatory ring drives spiral helicine middle tong arm through the transmission line and rotates. When the multifunctional forceps are used, the rotating ring drives the middle forceps arm to rotate through the transmission line to enter the lower layer of a tissue mucous membrane, the sliding block drives the outer forceps arm to grab tissues on two sides of a wound surface through the pull rope to fold and fix, and the sliding block is pulled backwards to release the outer forceps arm; the metal clip has reasonable design and can be suitable for the treatment of complex wound surfaces which are difficult to be completely closed by common metal clips.

Description

Metal clip for anastomosing gastrointestinal mucosa under endoscope

The technical field is as follows:

the utility model belongs to the technical field of clinical gastrointestinal endoscopic surgical instruments, and particularly relates to a metal clip for anastomosing gastrointestinal mucosa under an endoscope.

The background art comprises the following steps:

with the continuous development of digestive endoscopy, endoscopic local gastrointestinal resection techniques such as endoscopic mucosal resection (ESD), endoscopic full-thickness resection (EFTR), natural orifice surgery (NOTES) and the like are increasingly mature and widely applied. The closing of the wound surface after the artificial alimentary canal incision is the key step of endoscopic surgery. Digestive tract perforation and digestive tract fistula caused by ulcer, tumor, foreign body injury and other reasons are also indications for endoscopic closure treatment.

The development of endoscope closing technology depends on the continuous updating and perfection of endoscope closing instruments and methods. The existing endoscope closing technology comprises metal clip closing, suture technology, an occluder and the like. Although the endoscope suturing and blocking system realizes full-layer suturing, the endoscope suturing and blocking system is limited by the defects of high operation difficulty, difficulty in controlling suturing strength, high instrument cost and the like, and cannot be widely popularized at present. The metal clip clamps focus and surrounding tissues through mechanical acting force, is the most common endoscope closing technology at present, and is mainly divided into a metal clip (TTSC) passing through an endoscope channel and a rake clip (OTSC) arranged outside an endoscope according to different working ways. TTSC is generally used for closing wounds with smaller diameter and tension, and for wounds with diameter exceeding 1cm or with larger tension, a combined technology of TTSC combined with nylon ropes or rubber rings is often adopted. OTSC have a greater grip and compression force, are stable, can achieve full-thickness closure, are suitable for incisions of larger diameter, but are more difficult to operate, and are difficult to adjust and remove once released. In the acute phase of the inflammatory reaction of the wound surface, the tissue edema is obvious, and the metal clip can fall off early when TTSC and OTSC are closed, so that the closure can not be realized effectively.

Although the existing closing apparatus can be used for closing most of digestive tract defects with different conditions, the complete and rapid closing of complex wounds such as large diameter, irregular shape, inward turning of cutting edges, poor angle, full-layer defects and the like is still difficult in clinic. The conjoined double-endoscope clamp disclosed in patent publication No. CN108523945A can be repeatedly opened and closed in a rotating manner, and can clamp a mucous membrane at one side of a perforation or a mucous membrane defect of a digestive tract and then clamp the other side of the perforation or the mucous membrane defect of the digestive tract, so that the perforation or the mucous membrane defect of the large digestive tract can be effectively repaired. Accordingly, the present disclosure has been made.

The utility model has the following contents:

the utility model aims to solve the problems in the prior art, namely the utility model aims to provide a metal clip for anastomosing gastrointestinal mucosa under an endoscope, which is reasonable in design and easy to operate.

In order to achieve the purpose, the utility model adopts the technical scheme that: a metal clip for anastomosing gastrointestinal mucosa under an endoscope comprises an operation part, a flexible sleeve and a clip assembly which are sequentially connected, wherein the clip assembly comprises a pair of outer forceps arms which are distributed left and right, a slide block is connected to the operation part in a sliding manner, the slide block is connected with a pull wire, the pull wire is connected with the pair of outer forceps arms after penetrating through the flexible sleeve, and a spiral middle forceps arm is arranged in the middle of the pair of outer forceps arms; the operating portion is provided with a rotating ring, the rotating ring is connected with a transmission line, and the transmission line penetrates through the flexible sleeve and then is connected with the middle tong arm.

Further, the operating part comprises an operating handle and a connecting pipe, the operating handle is connected with the sliding block in a sliding mode, and external threads are arranged on the outer side wall of one end, adjacent to the connecting pipe, of the operating handle; the inner wall of the rotating ring is provided with an internal thread matched with the external thread, and the inner wall of the rotating ring is connected with the transmission line through a connecting rod arranged along the radial direction.

Furthermore, a radial screw hole is formed in the side wall of one end, connected with the operating handle, of the rotating ring, and a locking screw is screwed in the radial screw hole.

Furthermore, the clamp assembly further comprises a clamp arm base, a pair of outer clamp arms are connected to the left end and the right end of the clamp arm base, and the middle clamp arm is connected to the middle of the clamp arm base.

Furthermore, one end of the flexible sleeve, which is far away from the operation part, is rotatably connected with a rotating column, and the rotating column is connected with the clamp arm base; the pull wire and the transmission wire both penetrate through the rotary column.

Further, the length of the middle clamp arm is smaller than that of the outer clamp arm.

Furthermore, an upper finger retaining ring and a lower finger retaining ring are respectively arranged at two ends of the sliding block.

Furthermore, the outer forceps arm is in an obtuse arc shape, and the surface of the clamping surface at the front end of the outer forceps arm is in a straight tooth shape.

Furthermore, the stay wire and the transmission wire are distributed in a vertically staggered manner.

Further, the maximum opening angle of a pair of outer jawarms is 135 °.

Compared with the prior art, the utility model has the following effects: the utility model has reasonable design, can enter the submucosal layer of mucous membrane through the spiral middle tong arm, has simple principle, can be applied to the treatment of complicated wound surfaces of larger, deeper, irregular shape, tissue edema and the like, can realize the quick and complete sealing of the wound surface, and has simple and easy operation.

Description of the drawings:

FIG. 1 is a schematic front view configuration of an embodiment of the present invention;

FIG. 2 is a schematic view of the construction of a clip assembly in an embodiment of the present invention;

fig. 3 is a schematic view of the fitting structure of the rotating ring and the operating portion in the embodiment of the present invention.

The specific implementation mode is as follows:

the present invention will be described in further detail with reference to the accompanying drawings and specific embodiments.

In the description of the present invention, it is to be understood that the terms "longitudinal", "lateral", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like, indicate orientations or positional relationships based on those shown in the drawings, are merely for convenience of description of the present invention, and do not indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and thus, are not to be construed as limiting the present invention.

As shown in fig. 1 to 3, the metal clip for anastomosing gastrointestinal mucosa under an endoscope of the utility model comprises an operation part 1, a flexible sleeve 2 and a clip component 3 which are connected in sequence, wherein the clip component 3 comprises a pair of external forceps arms 4 which are symmetrically distributed left and right, a slide block 5 is connected on the operation part 1 in a sliding manner, the slide block 5 is connected with a pull wire 6, the pull wire 6 penetrates through the flexible sleeve 2 and then is connected with the pair of external forceps arms 4, and the slide block 5 drives the pair of external forceps arms 4 to open or clamp through the pull wire 6; a spiral middle clamp arm 7 is arranged in the middle of the pair of clamp arms 4; the operation part 1 is rotatably connected with a rotating ring 8, the rotating ring 8 is connected with a transmission line 9, the transmission line 9 penetrates through the flexible sleeve 2 and then is connected with the middle tong arm 7, and the rotating ring 8 drives the spiral middle tong arm 7 to rotate through the transmission line 9 by rotating the rotating ring 8. When the wound dressing device is used, the rotating ring 8 drives the spiral middle forceps arm 7 to rotate to enter the lower layer of a tissue mucosa through the transmission line 9 when rotating, the flexible sleeve 2 is rotated, the sliding block 5 is controlled to move back and forth, the sliding block 5 drives the pair of outer forceps arms 4 to grab tissues on two sides of a wound surface to fold and fix, and the sliding block 5 is pulled backwards to release the pair of outer forceps arms 4; the method can be suitable for the treatment of complex wound surfaces which are difficult to completely close by common metal clips.

In this embodiment, the operating portion 1 includes an operating handle 10 and a connecting pipe 11, which are sequentially arranged, the operating handle 10 is provided with a sliding track 12, the slider 5 can slide back and forth along the sliding track 12, and the outer side wall of one end of the operating handle 10 adjacent to the connecting pipe 11 is provided with external threads; the inner wall of the rotating ring 8 is provided with an internal thread matched with the external thread, and the inner wall of the rotating ring 8 is connected with the transmission line 9 through a connecting rod 13 arranged along the radial direction. Rotatory ring and connecting pipe, operating handle adopt threaded connection, not only make things convenient for rotatory ring's rotation, connection structure is stable moreover.

In this embodiment, a radial screw hole is formed in a side wall of one end of the rotating ring 8, which is connected with the operating handle 10, and a locking screw 14 is screwed in the radial screw hole, so that the rotating ring and the operating handle can be locked by the locking screw, and the locking of the rotating ring is realized.

In this embodiment, the clip assembly 3 further includes a clamp arm base 15, the pair of outer clamp arms 4 are respectively hinged to the left and right ends of the clamp arm base 15, and the middle clamp arm 7 is rotatably connected to the middle portion of the clamp arm base 15.

In this embodiment, one end of the flexible sleeve 2 away from the operation portion 1 is rotatably connected with a rotary column 16, and the rotary column 16 is connected with the clamp arm base 15; the pull wire and the transmission wire both penetrate through the rotary column.

In this embodiment, the length of the flexible cannula 2 is a suitable length longer than the length of the gastrointestinal tract.

In this embodiment, the length of the middle jawarm 7 is less than the length of the outer jawarm. It should be noted that the number of spiral threads of the middle forceps arm is designed and adjusted according to clinical requirements.

In this embodiment, for convenience of operation, the two ends of the slider 5 are respectively provided with an upper finger-fastening ring 17 and a lower finger-fastening ring 18, which are used for facilitating the finger to pass through.

In this embodiment, the pair of outer arms 4 have the same length, and are in the shape of an obtuse arc, and the surface of the front end clamping surface of each outer arm is in the shape of a straight tooth. It should be noted that the number and length of the insections on the surface of the clamping surface at the front end of the outer forceps arm are designed and adjusted according to clinical requirements, and the insections on the two sides are embedded when the forceps are closed.

In this embodiment, the pull wires and the transmission wires are distributed in a staggered manner.

In this embodiment, the maximum opening angle of a pair of outer jawarms is 135 °.

In this embodiment, the structure that the slider drives the pair of outer forceps arms to open or clamp through the pull wire is the same as the structure of the existing OTSC anastomosis clamp, and the specific structure thereof is not described here again.

In this embodiment, when in use: the medical staff holds the operation handle 10 with one hand and uses the endoscope treatment channel to clamp and convey the metal to the focus. The medical staff controls the finger retaining ring 17 and the lower finger retaining ring 18 to push the slide block 5 to move forwards on the sliding track 12, the slide block 5 drives the pair of outer forceps arms 4 to open through the pair of pull wires 6, and the maximum opening angle of the outer forceps arms 4 at two sides is 135 degrees; when the outer forceps arm 4 is close to one side of the wound surface, the locking screw 14 is rotated, the locking of the rotating ring 8 is released, the rotating ring 8 is rotated towards the direction of the connecting pipe 11, the rotating ring 8 is driven by the transmission line 9 to enable the spiral middle forceps arm 7 to rotate to enter the lower layer of the tissue mucosa when rotating, the flexible sleeve is rotated, tissues on two sides of the wound surface are grabbed to be folded and fixed by controlling the back and forth movement of the sliding block 5, the sliding block 5 is pulled backwards to release the metal clamp, and the method can be suitable for complex wound surface treatment of which the common metal clamp is difficult to completely close.

Through adopting this metal clip, tong arm can be fixed in mucous membrane lower floor in the middle of this metal clip's heliciform, can be in the great diameter, irregular shape, the defective wound surface one side of full layer effectively fixed tissue of full, be favorable to outer tong arm to grab more tissues in wound surface both sides forcefully, create the condition for realizing the quick complete closure of postoperative wound surface, alimentary canal perforation, alimentary canal fistula smoothly. The utility model has simple principle, can be applied to the treatment of large, deep, irregular shape, tissue edema and other complex wound surfaces, is particularly suitable for the wound surfaces which are difficult to grasp and fix by a common metal clamp, can realize the quick and complete sealing of the wound surfaces, and has simple and easy operation.

If the utility model discloses or relates to parts or structures which are fixedly connected to each other, the fixedly connected parts can be understood as follows, unless otherwise stated: a detachable fixed connection (for example using bolts or screws) is also understood as: non-detachable fixed connections (e.g. riveting, welding), but of course, fixed connections to each other may also be replaced by one-piece structures (e.g. manufactured integrally using a casting process) (unless it is obviously impossible to use an integral forming process).

In addition, terms used in any technical solutions disclosed in the present invention to indicate positional relationships or shapes include approximate, similar or approximate states or shapes unless otherwise stated.

Any part provided by the utility model can be assembled by a plurality of independent components or can be manufactured by an integral forming process.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention and not to limit it; although the present invention has been described in detail with reference to preferred embodiments, those skilled in the art will understand that: modifications to the specific embodiments of the utility model or equivalent substitutions for parts of the technical features may be made; without departing from the spirit of the present invention, it is intended to cover all aspects of the utility model as defined by the appended claims.

Claims

1. The utility model provides a metal clip of stomach intestine mucous membrane coincide under endoscope, includes the operating portion, flexible sleeve and the clip subassembly that connect gradually, the clip subassembly contains a pair of outer tong arms that control the distribution, sliding connection has the slider on the operating portion, the slider is connected with the acting as go-between, act as go-between and be connected its characterized in that with a pair of outer tong arms after passing flexible sleeve: a spiral middle clamp arm is arranged in the middle of the pair of outer clamp arms; the operating portion is provided with a rotating ring, the rotating ring is connected with a transmission line, and the transmission line penetrates through the flexible sleeve and then is connected with the middle tong arm.

2. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the operating part comprises an operating handle and a connecting pipe, the operating handle is connected with the sliding block in a sliding mode, and external threads are arranged on the outer side wall of one end, adjacent to the connecting pipe, of the operating handle; the inner wall of the rotating ring is provided with an internal thread matched with the external thread, and the inner wall of the rotating ring is connected with the transmission line through a connecting rod arranged along the radial direction.

3. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 2, wherein: the side wall of one end of the rotating ring, which is connected with the operating handle, is provided with a radial screw hole, and a locking screw is screwed in the radial screw hole.

4. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the clamp assembly further comprises a clamp arm base, a pair of outer clamp arms are connected to the left end and the right end of the clamp arm base, and the middle clamp arm is connected to the middle of the clamp arm base.

5. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 4, wherein: one end of the flexible sleeve, which is far away from the operation part, is rotatably connected with a rotating column, and the rotating column is connected with the clamp arm base; the pull wire and the transmission wire both penetrate through the rotary column.

6. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the length of the middle clamp arm is smaller than that of the outer clamp arm.

7. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: and an upper finger retaining ring and a lower finger retaining ring are respectively arranged at two ends of the sliding block.

8. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the outer forceps arms are in an obtuse arc shape, and the surfaces of the clamping surfaces at the front ends of the outer forceps arms are in a straight tooth shape.

9. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the stay wire and the transmission wire are distributed in a vertically staggered manner.

10. The endoscopic gastrointestinal mucosa-anastomosing metal clip according to claim 1, wherein: the maximum opening angle of a pair of outer jawarms is 135 deg..