JP2501759B2 - Surgical clip - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical clip, and more particularly to a surgical clip suitable for applying to damaged cerebral blood vessels and cerebral aneurysms.

[0002]

2. Description of the Related Art In order to prevent the rupture of a cerebral aneurysm generated in a hump in a cerebral blood vessel, the root of the aneurysm is clipped and blocked to prevent the rupture by a normal surgical operation. . Such surgical clips are described, for example, in US Pat. No. 4,360,023.

By the way, when a blood vessel is expanded in a spindle shape or when an aneurysm is small, a clip having a normal shape cannot be caught.

For the surgical treatment in such a case, conventionally, the outer periphery of the inflated blood vessel is fixed with a living body bond, the blood vessel is covered with a special clip capable of sandwiching the blood vessel in a tubular shape, and a sheet piece is attached to the blood vessel. The method of covering with the shape is taken.

[0005]

However, there is a problem in that none of the above methods can be carried out easily. For example, the above-mentioned special clip that holds a blood vessel in a tubular shape has a special shape that has a blade part that is inserted in a specific direction behind the blood vessel. However, various shapes must be prepared according to the state of the blood vessel. In addition, in the method of covering the blood vessel with the sheet piece in a tubular shape, it is difficult to wrap the sheet piece into the blood vessel so as to wrap the sheet piece, and the work of closing both ends of the sheet piece must be performed. Also,
There is a problem that it is necessary to prepare sheet pieces of various sizes depending on the diameter of the blood vessel.

Therefore, according to the present invention, by applying a simple sheet piece to an existing clip having a normal shape, it is possible to cover the sheet piece with various sizes of blood vessels without slack, and further, to attach the sheet piece to the blood vessel. It is an object of the present invention to obtain a surgical clip that can be easily performed and that can embrace a small aneurysm together with a parent blood vessel.

[0007]

SUMMARY OF THE INVENTION A surgical clip according to the present invention is substantially semi-circular in shape and is opposed in the same virtual plane.
A pair of arm portions that form a space through which blood vessels pass, a pair of parallel blades that integrally project from the tip ends of both arm portions in a direction intersecting the virtual plane, and base ends of both arm portions. A clip that is connected to the side and has elastic portions that exert elasticity on both arm portions so as to bring the pair of blades into close contact with each other, and is configured by connecting the connecting portions at both end edges with a continuous sheet material. A blood vessel embracing sheet, wherein the connecting portions of the blood vessel embracing sheet are connected to each of the pair of blades, and the sheet material is provided in a relaxed band shape extending from one blade to the other blade. It is characterized by being.

[0008]

With the above-described structure of the present invention, when a pair of arm portions of a clip are grasped by the tips of known forceps, the arm portions are elastically deformed against the force of the elastic portion and the pair of blades are separated from each other. To be displaced. Therefore, the space between the two connecting portions of the blood vessel holding sheet in a relaxed band shape between the blades is opened. In this state, the inner surface of the blood vessel holding sheet of the clip held by the tip of the forceps is applied to the outer peripheral wall of the desired portion of the blood vessel, both arms are positioned on both sides of the blood vessel, and the arm is moved forward. When the force of gripping the arm is released, the elastic force of the elastic parts causes the two blades to move closer to each other, and the two connecting parts of the blood vessel holding sheet also come closer, so that the blood vessel holding sheet between the two connecting parts wraps the outer peripheral wall of the blood vessel without loosening. Will be

[0009]

Embodiments of the present invention will be described below with reference to the drawings.

In FIG. 1, 2 is a clip and 3 is a blood vessel holding sheet. The clip 2 is a known surgical clip, and includes a pair of arm portions 4 and 4 having a substantially semicircular arc shape. These arm portions 4 and 4 have a substantially semi-arcuate shape, and their concave curved surfaces are provided so as to face each other, and are included in the same virtual plane P. Both arms 4 and 4 have a substantially circular shape as a whole, and a space between them constitutes a blood vessel.

A pair of parallel blades 5 and 5 are integrally connected to the tip ends (upper end side in FIG. 1) of both arm portions 4 and 4. These blades 5 and 5 are bent in a direction intersecting the virtual plane, for example, in a direction orthogonal to each other. In the illustrated state, both blades 5 and 5 are in contact with each other.

The base end sides (lower end sides in FIG. 1) of both arm portions 4 and 4 intersect each other, and are integrally connected by an elastic portion 6 on the front side of the intersection portion. The elastic portion 6 is a coil portion, and the elastic force of the coil portion acts on the arm portions 4 and 4 and exerts a force to bring the pair of blades 5 and 5 into close contact with each other. A thin wire 7 that connects one arm 4 to the other arm 4 is connected so that the arms 4 and 4 do not twist when separated from each other at the intersection. The above arm portions 4, 4, the blades 5, 5 and the elastic portion 6 are basically formed by one wire.

The blood vessel holding sheet 3 is a substantially rectangular sheet, and has connecting portions 9 and 9 at both ends thereof, and both connecting portions are connected by a continuous strip-shaped sheet material 10. The connecting parts 9, 9 are formed as loop parts in this embodiment. The blood vessel holding sheet 3 is formed by stacking one sheet as shown in FIGS. 2 and 3 and folding back on both sides to form loop portions 9 and 9. I try to fuse them together. Blood vessel holding sheet 3
Is preferably made of a silicon resin or a polyfluoroethylene resin having a thickness of about 0.15 mm and has a rough surface and is semitransparent or transparent. When the blood vessel holding sheet 3 is made of such a material, the blood vessel holding sheet has some elasticity. The blood vessel holding sheet 3 is preferably made by cutting a long strip-like sheet with scissors so as to obtain a required dimension L as shown by an arrow S in FIG.

The blood vessel embracing sheet 3 having the above construction is used by fitting the loop-shaped connecting portions 9, 9 at both ends thereof around the respective blades 5, 5 in the arrow direction of FIG. As a result, the blood vessel holding sheet 3 is provided in a relaxed band shape as shown by the phantom line in FIG.

FIG. 9 shows a known forceps C for handling surgical clips. This forceps C has a pair of crossed arms 14, 14 pivotally supported to each other.
At the tips of 4 and 14, a holding portion 14 having an inwardly concave portion is formed.
a and 14a are provided. The base ends of the arms 14 and 14 are connected to the grip portions 16 and 16, respectively.
6 and 16 are integrally provided with leaf springs 17 and 17, and the leaf springs 17 and 17 are provided in a direction in which the grip portions 16 and 16 are separated from each other.
17 is exerting power. Elastic latching pieces 18, 19 project inside the grip portions 16, 16, respectively. When the gripping portions 16, 16 are gripped and displaced inward against the force of the leaf spring 17, the latching pieces 18, 19 project. 18, 19 are hooked to each other, and the holding portions 14a, 14a are brought close to each other and held in that state. When the engaging pieces 18 and 19 are disengaged by utilizing their elasticity, the grip portions 16 and 16 are separated from each other, and the holding portions 14a and 14a are separated to the state of FIG.

Next, the operation of the surgical clip of the present invention described above will be described.

By the action of the elastic portion 6, the clip normally takes the state of FIG. 1 in which the blades 5 and 5 and the connecting portions 9 and 9 are pressed against each other, that is, the closed state.

This clip is attached to a blood vessel which is desired to prevent damage by an instrument during brain surgery, a blood vessel B which is expanded in a spindle shape as shown in FIG. 6, and a blood vessel B which is partially bulged as shown in FIG. When used, the gripping portions 14a, 14a of the forceps C are applied to the portion including the elastic portion 6 of the clip. At this time, the forceps C is in the state shown in FIG. 9, and the holding portions 14a, 14a are open.

Next, when the grips 16 and 16 are gripped,
The holding parts 14a, 14a are close to each other in the directions indicated by arrows F, F in FIG.
Press against the force of. When the grip portions 16 and 16 are compressed until the hooking pieces 18 and 19 are engaged with each other, the gripping portions 14a and 14a are closest to each other, and this state is maintained by the engagement of the hooking pieces 18 and 19. Narrow holding part 14
While the a and 14a are displaced to the closest position, the arm portions 4 and 4 are separated via the wire portions on both sides of the elastic portion 6, and finally the blades 5 and 5 are separated as shown in FIG. . As a result, the strip-shaped sheet material 10 passed between the blades 5 and 5 is opened so as to form a gutter-like shape. In this state, as long as the hooking pieces 18 and 19 are engaged, the grip 1
It is maintained even if the grip force on 6, 16 is released.

Next, the operator applies the blood vessel grasping sheet 3 of the grip held at the tip thereof to the front side of the target blood vessel with the forceps C. Then, when the grip is pushed so that the blades 5 and 5 are on both sides of the blood vessel, the strip-shaped sheet material 10 of the blood vessel embracing sheet 3 is applied to the blood vessel so as to at least partially surround the blood vessel B, and the blades 5 and 5 are formed.
When the locking pieces 18, 19 of the forceps are disengaged when the blades 5 and 5 have moved sufficiently, the blades 5 and 5 are brought closer to each other by the force of the elastic portion 6 and become as shown in FIG. As shown, the blood vessel holding sheet 3 is held around the blood vessel B with an appropriate tension. Since the blood vessel holding sheet 3 has an appropriate elasticity, it exerts an action of pressing the blood vessel B. In addition, by making the blood vessel holding sheet 3 translucent, the inside can be seen,
Be beneficial.

On the other hand, when the hooking pieces 18, 19 of the forceps C are removed, the holding portions 14a, 14a thereof are opened, and the grip in the state of FIG. 8 is left on the blood vessel B as it is. It is desirable that the length dimension of the blood vessel holding sheet 3 be different according to the diameter of the blood vessel B. However, even if the length dimension of the blood vessel holding sheet 3 is slightly short, the blades 5 and 5 will be closed. The tension of the blood vessel holding sheet 3 is maintained by the force. Also, the blade 5,
Since 5 always receives the force to close, it wraps the blood vessel B from the outside in the area where the small aneurysm exists.

[0022]

According to the surgical grip according to the present invention, the grip body itself is publicly known, but by simply attaching a blood vessel holding sheet having a special structure between the blades of the grip body, the blood vessel can be very easily and surely. The damage preventing part and the bulging part can be wrapped with a sheet material without slack. Moreover, since the blood vessel holding sheet is constantly under tension from the blade of the grip body, the attached state is surely maintained.

[Brief description of drawings]

FIG. 1 is an exploded perspective view of a surgical grip according to the present invention in a normal state.

FIG. 2 is a perspective view of a blood vessel holding sheet used in the present invention.

FIG. 3 is a sectional view of the same.

FIG. 4 is a diagram showing the surgical grip of the present invention gripped by forceps.

FIG. 5 is a perspective view of the surgical grip of the present invention in an open state.

FIG. 6 is a diagram showing an example of a state of blood vessels.

FIG. 7 is a diagram showing another example of the state of blood vessels.

FIG. 8 is a perspective view showing a state in which the surgical grip of the present invention is attached to a blood vessel.

FIG. 9 is a perspective view of forceps.

[Explanation of symbols]

 2 Grip 3 Blood vessel holding sheet 4 Arm part P Virtual plane 5 Blade 6 Elastic part 9 Connecting part (loop part) 10 Band-like sheet material C Forceps 14 Arm 14a Holding part 16 Grip part 17 Leaf springs 18, 19 Hooking piece B Blood vessel

Claims (3)

(57) [Claims] 1. A substantially semi-circular arc-shaped member facing each other in the same virtual plane,
A pair of arm portions that form a space through which blood vessels pass, a pair of parallel blades that integrally project from the tip ends of both arm portions in a direction intersecting the virtual plane, and base ends of both arm portions. A clip that is connected to the side and has elastic portions that exert elasticity on both arm portions so as to bring the pair of blades into close contact with each other, and is configured by connecting the connecting portions at both end edges with a continuous sheet material. A blood vessel embracing sheet, wherein the connecting portions of the blood vessel embracing sheet are connected to each of the pair of blades, and the sheet material is provided in a relaxed band shape extending from one blade to the other blade. A surgical clip characterized by being provided. 2. The surgical clip according to claim 1, wherein the connecting portion is formed as a loop portion fitted to each of the blades. 3. The surgical clip according to claim 1, wherein the blood vessel holding sheet is made of an elastic material.