FR3117327A1 - Device for hemostasis or tissue closure. - Google Patents

Device for hemostasis or tissue closure. Download PDF

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Publication number
FR3117327A1
FR3117327A1 FR2013120A FR2013120A FR3117327A1 FR 3117327 A1 FR3117327 A1 FR 3117327A1 FR 2013120 A FR2013120 A FR 2013120A FR 2013120 A FR2013120 A FR 2013120A FR 3117327 A1 FR3117327 A1 FR 3117327A1
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allowing
wire
clip
control wire
arms
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FR2013120A
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French (fr)
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FR3117327B1 (en
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Abdelkrim Kada
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    • 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
    • A61B17/1285—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 for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
    • 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
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

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  • 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

Titre : Dispositif pour l’hémostase ou la fermeture de tissu. L’invention concerne un dispositif pour l’hémostase ou la fermeture d’une ouverture spontanée ou secondaire à une intervention au niveau de la paroi interne ou externe du tube digestif ou d'autres lumières corporelles et organes creux, de façon efficace et durable. Le dispositif comprend un premier (6) et un second (8) bras, un fil de serrage (7) reliant les deux extrémités distales des premier et second bras, un fil souple de commande (1) passant à travers une fente(14), ledit fil souple de commande (1) présentant à son extrémité une boucle (5) entourant ledit fil de serrage (7), une saillie (3) permettant de retenir la boucle (5) et permettant la fixation du fil de serrage (7) en position de traction et un fil rigide de commande (11) positionné dans une encoche(2). Figure pour l’abrégé: fig.1Title: Device for hemostasis or tissue closure. The invention relates to a device for the hemostasis or the closure of a spontaneous opening or secondary to an intervention at the level of the internal or external wall of the digestive tract or other body lumens and hollow organs, in an effective and durable manner. The device comprises a first (6) and a second (8) arm, a tightening wire (7) connecting the two distal ends of the first and second arms, a flexible control wire (1) passing through a slot (14) , said flexible control wire (1) having at its end a loop (5) surrounding said tightening wire (7), a projection (3) allowing the loop (5) to be retained and allowing the fixing of the tightening wire (7 ) in the traction position and a rigid control wire (11) positioned in a notch (2). Figure for the abstract: fig.1

Description

Dispositif pour l’hémostase ou la fermeture de tissu.Device for hemostasis or tissue closure.

Selon les modes de réalisation, la présente invention concerne un dispositif pour l’hémostase ou la fermeture d’une ouverture spontanée ou secondaire à une intervention au niveau de la paroi interne ou externe du tube digestif qui est relativement simple à fabriquer et à utiliser. Des exemples de clips disponibles disposent d’outils de type: clips métalliques pour hémostase de fabrication complexe, avec une force de serrage faible des bras du clip et un système de séparation complexe. Un autre système de clip métallique a l’inconvénient de devoir retirer l’endoscope avec une procédure complexe et lente pour l’installation d’une partie de l’outillage sur l’extrémité distale de l’endoscope avec un capuchon limitant la visibilité et une deuxième partie de l’outil s’utilise dans le canal opérateur de l’endoscope, ce qui conduit à une perte de temps. La présente invention vise donc à remédier à ces inconvénients : avoir un outil simple, qui s’utilise dans le canal de travail d’un endoscope sans la nécessite du retrait de l’endoscope, l’homme de métier peut l’utiliser comme une pince ou un clip standard. Il a une force de serrage prédéfinie permettant l’hémostase ou la fermeture du tissu de façon efficace et durable, s’utilise rapidement en cas d’urgence par l’introduction du dispositif dans le canal de travail de l’endoscope.According to the embodiments, the present invention relates to a device for the hemostasis or the closure of a spontaneous opening or secondary to an intervention at the level of the internal or external wall of the digestive tract which is relatively simple to manufacture and to use. Examples of clips available have tools of the type: metal clips for hemostasis of complex manufacture, with a weak clamping force of the arms of the clip and a complex separation system. Another metal clip system has the disadvantage of having to remove the endoscope with a complex and slow procedure for the installation of part of the tooling on the distal end of the endoscope with a cap limiting visibility and a second part of the tool is used in the working channel of the endoscope, which leads to a loss of time. The present invention therefore aims to remedy these drawbacks: having a simple tool, which is used in the working channel of an endoscope without the need to remove the endoscope, the person skilled in the art can use it as a pliers or a standard clip. It has a predefined tightening force allowing hemostasis or tissue closure in an effective and durable way, can be used quickly in case of emergency by introducing the device into the working channel of the endoscope.

Ce dispositif comprend un élément tubulaire (12) allongé, flexible, utilisé à travers un canal de travail d’un endoscope dont une extrémité proximale reste externe au corps, accessible à un utilisateur avec manette (poignée de contrôle) tandis qu'une extrémité distale de l'élément flexible est insérée dans le corps après son introduction dans le canal de travail d’un endoscope jusqu’à un emplacement adjacent au tissu cible à clipper. Il comprend aussi deux fils de commande s'étendant à travers l'élément flexible (12) couplés de manière amovible à un clip comprenant un premier (6) et second (8) bras de clip dont les deux extrémités distales sont reliées par un fil (7) de serrage avec une longueur prédéfinie. Le fil (7) entouré par une boucle (5) d’une longueur prédéfinie de l’extrémité distale du fil (1) souple de commande. L’extrémité de la boucle (4) est retenue sur une saillie (3) à l’extrémité proximale du clip. La partie proximale du clip est fixée par l’extrémité distale d’un fil (11) rigide de commande positionnée dans une encoche (2) permettant une liaison fragile qui échoue lorsqu’elle est soumise à une force prédéterminée pour séparer le clip de l’attache du fil (11) rigide de commande. Un actionneur à l’extrémité proximale de l’élément flexible (12) couplé au fil (11) rigide de commande et configuré pour déplacer le clip dans l’extrémité de l’élément flexible jusqu’à la sortie du premier (6) et second (8) bras du clip permettant une position ouverte et son retrait dans l’extrémité distale de l’élément flexible (12) pour une configuration fermée. Le premier (6) et le second (8) bras du clip présentent une angulation (10) proximale prédéfinie permettant l’écartement des deux extrémités du premier (6) et du second (8) bras du clip une fois sortie de l’extrémité distale de l’élément flexible (12). Dans la configuration ouverte, les extrémités distales des premier (6) et second (8) bras du clip sont séparées, permettant de positionner le clip sur la zone de tissu à saisir.This device comprises an elongated, flexible tubular element (12), used through a working channel of an endoscope, a proximal end of which remains external to the body, accessible to a user with a joystick (control handle) while a distal end of the flexible element is inserted into the body after its introduction into the working channel of an endoscope to a location adjacent to the target tissue to be clipped. It also comprises two control wires extending through the flexible element (12) removably coupled to a clip comprising a first (6) and second (8) clip arm whose two distal ends are connected by a wire (7) clamping with a predefined length. The wire (7) surrounded by a loop (5) of a predefined length from the distal end of the flexible control wire (1). The end of the loop (4) is retained on a projection (3) at the proximal end of the clip. The proximal part of the clip is fixed by the distal end of a rigid control wire (11) positioned in a notch (2) allowing a fragile connection which fails when subjected to a predetermined force to separate the clip from the clip. attachment of the rigid control wire (11). An actuator at the proximal end of the flexible element (12) coupled to the rigid control wire (11) and configured to move the clip in the end of the flexible element until the exit of the first (6) and second (8) arm of the clip allowing an open position and its withdrawal into the distal end of the flexible element (12) for a closed configuration. The first (6) and the second (8) arm of the clip have a predefined proximal angulation (10) allowing the separation of the two ends of the first (6) and of the second (8) arm of the clip once released from the end distal of the flexible element (12). In the open configuration, the distal ends of the first (6) and second (8) arms of the clip are separated, allowing the clip to be positioned over the area of tissue to be grasped.

Fonctionnement du dispositifDevice Operation

Dans la configuration ouverte , les extrémités distales des premier (6) et second (8) bras du clip sont positionnées sur la zone de tissu à saisir. L'application d'une force prédéfinie sur l'actionneur permet le retrait du fil (1) souple de commande, entraînant avec lui la boucle (5) à l’extrémité du fil (1) à travers une fente (14) dans l’extrémité proximale du clip. Le déplacement de la boucle (5) entraîne le déplacement du fil (7) souple fixé entre l’extrémité du premier (6) et du second (8) bras de clip jusqu’à sa fixation sur une saillie (3) au niveau de la partie proximale du clip, permettant la fixation du fil (7) en position de traction. Cette traction provoque le rapprochement des extrémités distales des premier (6) et second (8) bras du clip permettant ainsi la fermeture du tissu à saisir. La poursuite de l’application de la force prédéfinie de la traction sur le fil (1) permet la fixation de l’extrémité distale de la boucle (5) du fil souple de commande sur une saillie (13) de l’extrémité distale du fil (11) rigide de commande, ce qui provoque la séparation de la liaison fragile (2) de l’extrémité distale de fil (11) et par conséquence la séparation du clip de l’élément flexible .In the open configuration , the distal ends of the first (6) and second (8) arms of the clip are positioned over the area of tissue to be grasped. The application of a predefined force on the actuator allows the removal of the flexible control wire (1), carrying with it the loop (5) at the end of the wire (1) through a slot (14) in the proximal end of the clip. The displacement of the loop (5) causes the displacement of the flexible wire (7) fixed between the end of the first (6) and of the second (8) clip arm until it is fixed on a projection (3) at the level of the proximal part of the clip, allowing the fixing of the wire (7) in the traction position. This traction causes the distal ends of the first (6) and second (8) arms of the clip to come together, thus allowing the closure of the tissue to be grasped. The continuation of the application of the predefined force of traction on the wire (1) allows the fixing of the distal end of the loop (5) of the flexible control wire on a projection (13) of the distal end of the rigid control wire (11), which causes the separation of the fragile link (2) from the distal end of the wire (11) and consequently the separation of the clip from the flexible element .

DESCRIPTION BRÈVE DES DESSINSBRIEF DESCRIPTION OF DRAWINGS

est une vue d’un clip hémostatique monobloc selon un mode de réalisation de la présente invention; is a view of a one-piece hemostatic clip according to one embodiment of the present invention;

:est une vue en perspective d'un clip hémostatique monobloc après séparation du clip selon un mode de réalisation de la présente invention; :is a perspective view of a one-piece hemostatic clip after clip separation according to one embodiment of the present invention;

Légende :Legend :

Fil souple de commande(1) ;Flexible control wire(1);

Liaison fragile(2) ;Fragile link(2);

saillie au niveau de la partie proximale du clip(3) ;protrusion at the level of the proximal part of the clip (3);

L’extrémité de la boucle (5) du fil souple de commande(4) ;The end of the loop (5) of the flexible control wire (4);

Boucle d’une longueur prédéfinie de l’extrémité distale du fil souple de commande (5) ;Loop of a predefined length of the distal end of the flexible control wire (5);

Premier second bras du clip(6) ;First second arm of the clip(6);

Fil souple fixé entre l’extrémité du premier et du second bras de clip(7) ;Flexible wire fixed between the end of the first and the second clip arm (7);

Second bras du clip(8) ; Point de fixation du fil sur l’extrémité du bras du clip(9) ;Second clip arm(8); Wire attachment point on the end of the clip arm (9);

Angulation proximale prédéfinie du bras du clip(10) ;Predefined proximal angulation of the clip arm(10);

Fil rigide de commande(11) ;Rigid control wire (11);

saillie de l’extrémité distale du fil rigide de commande(13) ;protrusion of the distal end of the rigid control wire (13);

Fente(14) dans l’extrémité proximale du clip,Slot(14) in the proximal end of the clip,

Claims (3)

Dispositif pour l’hémostase ou la fermeture d’une ouverture suite à une intervention au niveau d’un organe creux caractérisé en ce qu’il comprend un premier (6) et un second (8) bras, un fil de serrage (7) reliant les deux extrémités distales des premier (6) et second (8) bras, un fil souple de commande (1) passant à travers une fente (14), ledit fil souple de commande (1) présentant à son extrémité une boucle (5) entourant ledit fil de serrage (7), une saillie (3) permettant de retenir la boucle (5) et permettant la fixation du fil de serrage (7) en position de traction et un fil rigide de commande (11) positionné dans une encoche (2).Device for haemostasis or closing an opening following an intervention at the level of a hollow organ, characterized in that it comprises a first (6) and a second (8) arm, a tightening wire (7) connecting the two distal ends of the first (6) and second (8) arms, a flexible control wire (1) passing through a slot (14), said flexible control wire (1) having at its end a loop (5 ) surrounding said tightening wire (7), a projection (3) allowing the loop (5) to be retained and allowing the fixing of the tightening wire (7) in the traction position and a rigid control wire (11) positioned in a notch (2). Dispositif selon la revendication (1), caractérisé en ce que le fil (11) rigide de commande est configuré pour déplacer le dispositif dans une extrémité d’un élément flexible (12) de tel sorte que les premier (6) et second (8) bras dudit dispositif puissent sortir de l’élément flexible (12) permettant une position ouverte dudit dispositif et/ou que les premier (6) et second (8) bras dudit dispositif puissent être retirés dans l’extrémité distale de l’élément flexible (12) permettant une position fermée dudit dispositif.Device according to Claim (1), characterized in that the rigid control wire (11) is configured to move the device in one end of a flexible element (12) in such a way that the first (6) and second (8 ) arms of said device can come out of the flexible element (12) allowing an open position of said device and/or that the first (6) and second (8) arms of said device can be withdrawn in the distal end of the flexible element (12) allowing a closed position of said device. Dispositif selon la revendication (2), caractérisé en ce que les premier (6) et second (8) bras du dispositif sont configurés pour présenter une angulation (10) proximale prédéfinie permettant l’écartement des extrémités distales desdits premier (6) et second (8) bras, une fois sortie de l’extrémité distale de l’élément flexible (12) de tel sorte que dans la position ouverte dudit dispositif, les extrémités distales des premier (6) et second (8) bras sont séparées, permettant de positionner ledit dispositif sur la zone de tissu à saisir.Device according to Claim (2), characterized in that the first (6) and second (8) arms of the device are configured to present a predefined proximal angulation (10) allowing the separation of the distal ends of the said first (6) and second (8) arm, once released from the distal end of the flexible element (12) such that in the open position of said device, the distal ends of the first (6) and second (8) arms are separated, allowing to position said device on the area of tissue to be grasped.
FR2013120A 2020-12-13 2020-12-13 Device for hemostasis or tissue closure. Active FR3117327B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR2013120A FR3117327B1 (en) 2020-12-13 2020-12-13 Device for hemostasis or tissue closure.

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FR2013120 2020-12-13
FR2013120A FR3117327B1 (en) 2020-12-13 2020-12-13 Device for hemostasis or tissue closure.

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FR3117327A1 true FR3117327A1 (en) 2022-06-17
FR3117327B1 FR3117327B1 (en) 2022-10-28

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4331506A1 (en) * 2022-09-03 2024-03-06 Abdelkrim Kada Device for ligating tissue

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10116168A1 (en) * 2001-03-31 2001-11-29 Joachim Heinzl Clip has gripper arms operated by articulated lever mechanism and joined by spacer piece, tie rod, pulley cable, locking mechanism with cogging and pawl
WO2003030746A1 (en) * 2001-10-05 2003-04-17 Boston Scientific Limited Through the scope endoscopic hemostatic clipping device
US20120116419A1 (en) * 2010-11-09 2012-05-10 Cook Medical Technologies Llc Clip system having tether segments for closure
US20190105046A1 (en) * 2017-10-11 2019-04-11 Boston Scientific Scimed, Inc. Reinforced mechanical hemostasis clip

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10116168A1 (en) * 2001-03-31 2001-11-29 Joachim Heinzl Clip has gripper arms operated by articulated lever mechanism and joined by spacer piece, tie rod, pulley cable, locking mechanism with cogging and pawl
WO2003030746A1 (en) * 2001-10-05 2003-04-17 Boston Scientific Limited Through the scope endoscopic hemostatic clipping device
US20120116419A1 (en) * 2010-11-09 2012-05-10 Cook Medical Technologies Llc Clip system having tether segments for closure
US20190105046A1 (en) * 2017-10-11 2019-04-11 Boston Scientific Scimed, Inc. Reinforced mechanical hemostasis clip

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP4331506A1 (en) * 2022-09-03 2024-03-06 Abdelkrim Kada Device for ligating tissue
FR3139271A1 (en) * 2022-09-03 2024-03-08 Abdelkrim Kada Device for tissue ligation.

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