EP3713503A1 - Clip chirurgical muni d'un système de guidage sans poignée - Google Patents

Clip chirurgical muni d'un système de guidage sans poignée

Info

Publication number
EP3713503A1
EP3713503A1 EP18810949.0A EP18810949A EP3713503A1 EP 3713503 A1 EP3713503 A1 EP 3713503A1 EP 18810949 A EP18810949 A EP 18810949A EP 3713503 A1 EP3713503 A1 EP 3713503A1
Authority
EP
European Patent Office
Prior art keywords
clip
industry
industries
groove
branches
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP18810949.0A
Other languages
German (de)
English (en)
Inventor
Wolfgang Sauter
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of EP3713503A1 publication Critical patent/EP3713503A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227—Spring clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation

Definitions

  • the invention relates to a surgical clip, in particular an aneurysm clip, for clamping or jamming of vessels.
  • Aneurysm clips are used, which are used surgically and remain in the body of the patient. By clipping cerebral vessels, vascular glands can be cut off from the rest of the bloodstream, preventing blood from entering the blood vessel
  • Aneurysm can flow into it.
  • the surgical clip is placed on the neck of an aneurysm during the operation and, in a permanent closed position, clamps the blood supply into the vessel lining. Bursting of the vessel is thus prevented and the aneurysm can heal.
  • a surgical clip on two branches or jaw parts, which at its proximal end by a connector, usually in the form of a
  • the end facing the user or the end facing the user is referred to as distal to the end facing away from the user or the end facing away from the user.
  • the jaws are by the resilient portion or element in the inserted state of the clip
  • spring-elastic connecting element occupies, at their proximal ends
  • the Z-shaped branches do not cross each other and their distal ends point away from the central axis of the clip.
  • the distal portions of the Z-shape gripping surfaces are arranged, which in the
  • the clip By applying force, the clip is transferred from the production position to the mounting position.
  • the branches In the assembly position, the branches cross each other in the area of the middle sections of the Z-shape.
  • the industries are bent or shaped so that the gripping surfaces in the assembled state face each other and against the
  • the branches in the prior art are guided on one side or on both sides.
  • the industries are in the cross-over area of the middle
  • a through-connection is created, which is produced for example in the form of a securing bracket or locking plate.
  • a securing element for example.
  • the fuse element is welded to the clip.
  • Scissor-type surgical instruments in which the branches are pivotally connected between their ends, are known to prevent slipping of the branches in the transverse direction by lap closing or double flap closing.
  • a flap closure offers only up to an opening angle at which the opening distance of the branches to each other does not exceed the height of the lobes, securing against slipping of the branches.
  • the flaps are therefore located near the fulcrum, where the distance between the inner surfaces of the sector is minimal.
  • crossover-style surgical clips (alpha-design)
  • the branches are joined together at their ends, and where the clip is open for insertion
  • the practically required spacing of the branches from each other is also at its lowest point If the usual flap height far exceeds, a lobe closure is unsuitable.
  • a basic idea of the invention is to manufacture a surgical clip including a securing mechanism for securing the closing region of the clip falcons without an additional, separate component.
  • the task is solved by a surgical clip of the industries
  • S-shaped clip industries each having a proximal portion, a Z- or S-shaped middle portion and a distal portion, the further on each a proximal end of the clip industries via a resilient connector or biasing member, for example in the form of a leg spring, (integrally material in one piece) are connected to each other and at each of a distal portion of the clip industries have a jaw part with a (profiled) gripping surface, wherein in a (metastable) mounting position of the clip, the clip industries (at their middle sections,
  • juxtaposed,) are crossed, the gripping surfaces facing each other, preferably substantially flush, and this by a
  • At least one first clip sector in the S- or Z-shaped, middle section
  • Both clip industries preferably each have one
  • the proximal sections and / or the distal sections of the clip branches preferably extend linearly / straight in the longitudinal direction of the clip / clip branches.
  • the clip industries are therefore at the ingestion of (metastable) mounting position from a defined degree of closure, when leaving the (metastable) mounting position up to a defined opening degree, and while remaining in the (metastable)
  • the securing mechanism can be milled into the clip in the form of the open (longitudinal) groove.
  • Transverse slipping / transverse displacement for example, the arrangement of a so-called bullet / push-through box known. Accordingly, in the middle section of an industry of a clip of the cross industry type a box or loop-shaped opening / penetration is formed, through which the other industry is passed. The production or assembly of such a clip is difficult and expensive.
  • At least one clip sector in the Z- or S-shaped central portion is formed on the side facing the other clip industry side with the longitudinal groove, which, because in the Z or. S-shaped middle
  • Section arranged obliquely to the clip longitudinal axis extends. If now the other clip industry is likewise introduced into the groove in the region of its Z- or S-shaped middle section (ie in its region extending obliquely to the clip longitudinal direction), this results in a kind of tongue and groove guide, according to which or S-shaped section of the other clip industry in the groove of a clip sector slanted to the clip (longitudinal) axis is guided.
  • the oblique orientation in this area is such that with a relative movement of the two clip industries away from each other or towards each other the clip industry in the groove of a clip industry
  • the clip if it is not under external force, can basically assume two positions. In the production position of the clip in which it is produced, the clip industries are not yet crossed. By external force on the clip industries they are then placed in a crossed position, in particular the middle, Z- or S-shaped sections of the clip industries are crossed and at least the other clip industry used in the at least one groove of a clip industry.
  • the (metastable) mounting position of the clip is to be understood as meaning the state or the position of the clip after crossover of the clip branches, in which the gripping surfaces (positive and / or non-positive) are held against each other, while the clip is no longer is under external force. It can also be said that the gripping surfaces rest on / against one another in the mounting position of the clip, while the clip clips are characterized by the biasing force of the clip
  • resilient, proximal connector are biased against each other.
  • a proximal end or section is always an end or section facing the user (surgeon) or facing away from the patient, and correspondingly below a distal end or section is always an end or section facing away from the user or facing the patient (patient tissue Engaging section) to understand.
  • the two gripping surfaces on the clip industries are in one
  • the groove of the first clip industry and the second clip industry can move along each other in a raillike manner or the clip branches are guided along one another like a rail.
  • at least the second clip industry may have a section (rail, strip, spring) corresponding to the groove of the first clip sector, which is held and / or guided in the groove or on which the groove is positioned and / or slides along.
  • the second clip industry preferably also has a groove in which a corresponding section on the first clip sector is equally held and / or guided by sliding.
  • the middle section of the (respectively) other clip branch can be guided, at least in sections or completely, and / or is held in the groove.
  • Clip industry Since the middle sections are crossed over in the mounting position, guiding the middle section of a clip industry allows the two clip branches to simultaneously guide each other through respective grooves.
  • the clip industries can thus along a central portion / the middle portions during the opening and / or closing movement of the clip up to a defined opening angle or from a defined
  • a side wall of the groove / groove flank in the form of a projection, in particular a tab, is formed, which faces the other clip industry, in particular its central portion.
  • the projection may be disposed at the distal end of the central portion and oriented to be away from the proximal end of the distal portion (longitudinally of the clip / clip sector or oblique to the longitudinal direction of the clip / clip industry).
  • the protrusion can be arranged at or in the area of the proximal end (s) of the distal section of at least one clip branch, preferably both clip branches, such that the groove faces the (intersecting) middle section of the (respectively) other The clip industry.
  • the projection is in particular integral
  • the formed material integral with the clip industry and more preferably the groove is created by milling is easily accessible due to the Z- or S-shape of the clip industries, so that this position during production, eg. When milling, can be used advantageously.
  • the groove (in each case) is preferably arranged acentrically on the clip branch, in particular the groove lies completely in the transverse direction of the clip industry
  • Clip branches in the mounting position (flush) can lie against each other.
  • the middle section of a clip industry or both clip industries has a recess / material removal in function of a guideway, which is provided and adapted to guide and / or receive the projection arranged on the (respectively) other clip sector. It can the
  • the recess is milled in a side surface of the central portion.
  • Side surfaces are understood to mean the surfaces of a clip industry that run orthogonally to the gripping surface.
  • the proximal sections of the clip industries in the transverse direction and / or longitudinal direction of the clip industries are at least partially, ideally completely, opposite or at least partially, ideally completely, at an altitude to each other.
  • this is a bias of the clip industries and the gripping surfaces in their
  • the middle portion of at least the second clip industry is approximately half the width of the proximal portion and the distal portion.
  • the middle sections of the two clip branches can be placed against one another such that the clip is not wider in the area of the middle sections than in sections of the distal sections and proximal sections.
  • two clip industries / jaws have, which are integrally connected in one piece at their proximal ends on the leg spring.
  • Both clip branches can each have an S- or Z-shaped loop / curve at their middle sections, such that the two clip branches can intersect freely in these middle sections (free).
  • at least one of the two clip branches can or Z-shaped curved central portion having an open longitudinal groove facing the other clip sector or its S- or Z-shaped curved middle portion in a crossed state and in which the other clip sector or its S- or Z-shaped curved middle Section can be guided.
  • the clip can be converted to a simple manner from a non-crossed production position in a crossed mounting position by the clip industry in its S- or Z-shaped curved middle section in the open groove in the S- or Z-shaped curved middle Section of the other clip industry, creating a lateral cross-industry
  • this also a side guide when (partially) opening the clip from the mounting position and when closing or re-taking the
  • Fig. 1 is a side view of a surgical clip in an embodiment of the
  • FIG. 2 is a side view of the surgical clip of Fig. 1 in the mounting position
  • Fig. 3 is a perspective view of the surgical clip of Fig. 1 in the
  • Fig. 4 is a perspective view of the surgical clip of Fig. 1 in the
  • Fig. 5 is a perspective view of the surgical clip of Fig. 1 in a transition position
  • Fig. 6 is a perspective view of the surgical clip of Fig. 1 in the critical opening state
  • Fig. 1 shows a surgical clip 1 in an embodiment of the invention with two Z- or S-shaped clip industries 2a, 2b, which are connected to each other at a proximal end 4a, 4b of the clip industries 2a, 2b via a connecting piece 6.
  • the connecting piece 6 is a leg spring in this embodiment.
  • Clip branches 2a, 2b each have a linearly extending distal section 8a, 8b, on which jaw parts 10a, 10b with profiled gripping surfaces 12a, 12b are arranged, a Z- or S-shaped middle section 14a, 14b and a linearly extending proximal section 16a, 16b.
  • the gripping surfaces 12a, 12b point away from each other or face away from each other.
  • the clip 1 leaves the production position and the Clip branches 2a, 2b are crossed so that the gripping surfaces 12a, 12b now face each other and the middle sections 14a, 14b intersect.
  • the middle portions 14a, 14b have a narrower cross section (not shown in Fig. 1) than the distal and proximal portions 8a, 8b, 16a, 16b.
  • the central portions 14a, 14b slide along each other in the crossed area and the gripping surfaces 12a, 12b move towards each other until they come into abutment with each other due to their (nearly) parallel alignment.
  • the clip 1 has thus assumed its mounting position described below.
  • the central portions 14a, 14b of the clip industries 2a, 2b are crossed and the gripping surfaces 12a, 12b of the distal portion 8a, 8b face each other and against each other.
  • the gripping surfaces 12a, 12b are in their transverse direction
  • Fig. 3 shows a perspective view of the surgical clip of Fig. 1 in the mounting position.
  • the first clip branch 2a is (approximately) half as wide in the area of the middle section 14a as in the distal and proximal sections 8a, 16a.
  • the side surfaces of the proximal, middle and distal portions 16a, 14a, 8a are flush aligned, while on the other side In the clip industry 2a, the side surface of the middle portion 14a to (approximately) half the width (in the sector transverse direction) of the distal and proximal portions 8a, 16a (that is, to the center thereof) is reset.
  • the middle section 14a On the side face facing away from the crossing middle section 14b, the middle section 14a has a recess 18a following the Z- or S-shaped course of the middle section such that at the top of the clip branch 2a in the area of the middle portion, a guide ridge 20a is formed which is narrower than the total width of the middle portion 14a (in the transverse direction of the clip industry 2a).
  • the upper side of a clip branch 2 a, 2 b is understood to mean the side on which the gripping surface 12 a, 12 b is arranged,
  • the second clip branch 2b has a tab-shaped projection 22b at the side facing the intersecting central portion 14a at the proximal end of its distal portion 8b and at the distal end of the central portion 14b, respectively.
  • the projection 22b forms a groove flank / sidewall of a groove 24b, the groove 24b facing the guide ridge 20a of the first clip branch 2a, ie open in the direction of the guide flute 20a.
  • Section 14b (the sector transverse surface at the distal end) forms the groove bottom.
  • the groove 24b surrounds the guide ridge 20a, preferably complementary, wherein the projection 22b is received in the guide track 18a and / or is guided along the guide track 18a or slides along the guide track 18a during the opening and / or closing of the clip 1. This prevents movement of the clip branches 2a, 2b in the transverse direction. More specifically, the crossed portion of the middle portions 14a, 14b limits the transverse movement of the clip branches 2a, 2b toward each other and the projection 22b limits the transverse movement of the clip branches 2a, 2b away from each other.
  • both the distal sections 8a, 8b and the proximal sections 16a, 16b in the transverse direction and longitudinal direction of the
  • Clip branches 2a, 2b but at least in the transverse direction, substantially completely opposite each other.
  • the middle sections 14a, 14b are arranged in the transverse direction next to one another or one behind the other. In this case, the resetting of the mutually facing side surfaces of the middle sections 14a, 14b to half the width of the distal and proximal sections 8a, 8b 16a, 16b is effective.
  • the loop 26 of the leg spring is angled or curved in such a way that the side surfaces of the proximal sections 16a, 16b are respectively arranged substantially flush with one another on both sides.
  • the clip industries 2a, 2b are designed in the same shape and engage in the same way.
  • FIG. 4 shows a perspective view of the surgical clip 1 from FIG. 1 in the production position.
  • the clip industries 2a, 2b are not yet cross.
  • the clip 1 is transferred to the mounting position.
  • Fig. 5 shows a perspective view of the surgical clip 1 of Fig. 1 in a transition position during the transfer from the manufacturing position to the mounting position. Under external force on the clips falcons 2a, 2b,
  • the clip industries 2a, 2b are pushed apart in the transverse direction as described above.
  • the distal sections 8a, 8b lie next to one another before they are guided past one another under (increasing) external force on the clip branches 2a, 2b in the opening / closing direction of the jaw parts 10a, 10b the clip industries 2a, 2b at the central portions 14a, 14b
  • Fig. 6 shows a perspective view of the surgical clip 1 of FIG. 1 in a critical opening state in which the grooves 24 a, 24 b respectively on the
  • the clip 1 can be posted when reaching or exceeding the critical opening state and transferred back to its production position.
  • An unintentional exceeding of the critical opening state in which the clip 1 is unhooked can be prevented by means of a suitable application pliers.
  • a suitable application pliers For example, it is possible, the opening movement of the clip industries 2a, 2b when reaching a critical opening angle or before reaching the critical
  • the clip industries 2a, 2b are secured against displacement in the transverse direction to each other.
  • the guide of the grooves 24a, 24b of the clip industries 2a, 2b are posted or in a position in which the opening angle is greater than the critical opening angle, the guide of the grooves 24a, 24b on and / or be posted.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un clip chirurgical du type à branches croisées muni de deux branches de clip à en forme de Z qui sont raccordées l'une à l'autre respectivement au niveau d'une extrémité proximale des branches du clip au moyen d'une pièce de liaison (6) élastique et qui présentent sur respectivement un segment distal (8a, 8b) des branches du clip une pièce formant mâchoire munie d'une surface de préhension. Dans une position de montage du clip, les branches sont croisées, les surfaces de préhension sont opposées l'une à l'autre et celles-ci sont en contact l'une avec l'autre grâce à la force de fermeture de la pièce de liaison élastique. L'invention est caractérisée en ce qu'au moins une première branche du clip présente une encoche (24b) dans laquelle la seconde branche du clip est maintenue au moins par endroits et/ou guidée de manière à empêcher un déplacement des branches du clip dans une direction transversale des branches du clip.
EP18810949.0A 2017-11-20 2018-11-20 Clip chirurgical muni d'un système de guidage sans poignée Withdrawn EP3713503A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102017127290.9A DE102017127290A1 (de) 2017-11-20 2017-11-20 Chirurgischer clip mit bügellosem führungssystem
PCT/EP2018/081886 WO2019097075A1 (fr) 2017-11-20 2018-11-20 Clip chirurgical muni d'un système de guidage sans poignée

Publications (1)

Publication Number Publication Date
EP3713503A1 true EP3713503A1 (fr) 2020-09-30

Family

ID=64500357

Family Applications (1)

Application Number Title Priority Date Filing Date
EP18810949.0A Withdrawn EP3713503A1 (fr) 2017-11-20 2018-11-20 Clip chirurgical muni d'un système de guidage sans poignée

Country Status (6)

Country Link
US (1) US11311299B2 (fr)
EP (1) EP3713503A1 (fr)
JP (1) JP2021503349A (fr)
CN (1) CN111601558A (fr)
DE (1) DE102017127290A1 (fr)
WO (1) WO2019097075A1 (fr)

Families Citing this family (5)

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Publication number Priority date Publication date Assignee Title
DE102018103904A1 (de) * 2018-02-21 2019-08-22 Aesculap Ag Chirurgischer Clip
CN113194845A (zh) * 2018-08-02 2021-07-30 迈克·西根塔勒 用于控制出血的可侧向或切向施用的外科手术夹
CN110025351A (zh) * 2019-05-27 2019-07-19 南京微创医学科技股份有限公司 一种手术夹
JP6647648B1 (ja) * 2019-08-19 2020-02-14 国立大学法人高知大学 開閉クリップ
DE102020128942A1 (de) 2020-11-03 2022-05-05 Aesculap Ag Medizinischer Clip

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CN111601558A (zh) 2020-08-28
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DE102017127290A1 (de) 2019-05-23
US11311299B2 (en) 2022-04-26

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