JP5748239B2 - 外科手術用クリップアプライアおよび組み立て方法 - Google Patents
外科手術用クリップアプライアおよび組み立て方法 Download PDFInfo
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- 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
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Description
本願は、2008年8月25日に出願された米国仮出願番号61/091,467に対する優先権の利益を主張する。この米国仮出願の全内容は、本明細書中に参考として援用される。
本願は、外科手術用器具およびそれらの組み立て方法に関し、そしてより特定すると、複数のクリップを有し、これらのクリップを外科手術手順中に身体組織および脈管に適用するための外科手術用クリップアプライア、ならびにそれらの組み立て方法に関する。
(項目1)
外科手術用クリップアプライアであって、
ハウジング;
該ハウジングに旋回可能に接続された少なくとも1つのハンドル;
該ハウジングから遠位に延びるチャネルアセンブリ;
該チャネルアセンブリ内に配置されたクリップキャリアであって、該クリップキャリア内にチャネルおよび複数の窓を規定する、クリップキャリア;
該クリップキャリアの該チャネル内にスライド可能に配置された複数のクリップ;
該チャネルアセンブリ内に往復可能に配置された楔プレートであって、該楔プレートは、該ハンドルに作動可能に接続されており、そして該楔プレートの長さに沿って形成された複数の開口部分を備える、楔プレート;ならびに
該クリップキャリアの該チャネル内にスライド可能に配置され、そして該複数のクリップの近位に配置された、クリップ従動子であって、該クリップ従動子は、該クリップキャリアの該窓および該楔プレートの該開口部分との選択的な係合のために構成および適合されており、該クリップ従動子は、該楔プレートの往復移動の際に、該複数のクリップを、該クリップキャリアに対して遠位の方向に推進するように構成および適合されている、クリップ従動子、
を備える、外科手術用クリップアプライア。
上記クリップ従動子が、上記楔プレートの遠位への並進の際に上記楔プレートと係合して遠位に移動するように構成されており、そして上記楔プレートの近位への並進の際に上記クリップキャリアと係合して該クリップキャリアの近位への移動を止めるように構成されている、上記項目に記載のクリップアプライア。
上記チャネルアセンブリの端部から上記ハウジングの反対側に延びる1対の顎を備える顎アセンブリをさらに備え、該顎アセンブリは、内部にクリップを収容するように適合されており、そして上記ハンドルの移動に応答して、クリップの形成を行うように作動可能である、上記項目のうちのいずれかに記載のクリップアプライア。
上記ハウジングおよび上記チャネルアセンブリのうちの少なくとも一方の内部に往復可能に配置されたクリップ押し棒をさらに備え、該押し棒は、該ハンドルのうちの少なくとも一方に作動可能に接続された第一の端部、およびプッシャーを規定する第二の端部を有し、該押し棒は、該ハンドルが第一の方向に近接される際に、該顎の方へ、該顎の間に最も遠位のクリップを移動させるための初期量だけ移動可能であり、そして該押し棒は、該ハンドルが該第一の方向にさらなる量だけ近接される際に、該ハウジングの方へ、該プッシャーを上記複数のクリップのうちの最も遠位のクリップの後ろへと移動させるために移動するように構成および適合されている、上記項目のうちのいずれかに記載のクリップアプライア。
運動増倍システムをさらに備え、該運動増倍システムは、上記ハンドルの初期起動の際に、上記押し棒をある増分だけ遠位に移動させるように構成されており、そして該ハンドルの初期起動に続いて、該押し棒および上記楔プレートを近位に移動させるように構成されている、上記項目のうちのいずれかに記載のクリップアプライア。
上記ハウジングおよび上記チャネルアセンブリのうちの少なくとも一方の内部に並進可能にスライド可能に配置された駆動チャネルをさらに備え、該駆動チャネルは、該少なくとも1つのハンドルに作動可能に接続された第一の端部、ならびに上記1対の顎に選択的に係合して該1対の顎の閉鎖を行うような構成および寸法にされた第二の端部を有し、該駆動チャネルは、該少なくとも1つのハンドルが移動されて第一の方向に起動される際に、上記顎アセンブリの方へと移動して、該駆動チャネルの該第二の端部を該顎に押し付けて移動させ、該顎を閉じ、該駆動チャネルは、該少なくとも1つのハンドルが第二の量だけ移動される際に、該顎から離れるように移動して、該駆動チャネルの該第二の端部を該顎から離すように移動させ、該顎を開かせる、上記項目のうちのいずれかに記載のクリップアプライア。
上記楔プレートおよび上記駆動チャネルに作動可能に接続された運動反転機構をさらに備え、該駆動チャネルの遠位への移動中の該運動反転機構の回転は、該楔プレートの近位への移動を生じる、上記項目のうちのいずれかに記載のクリップアプライア。
上記運動増倍システムが、
上記ハウジング内に旋回可能に支持され、そして上記押し棒に旋回可能に接続された、ベルクランク歯車;
該ハウジング内にスライド可能に支持され、そして該ベルクランク歯車に作動可能に接合された、加速器ラック;および
上記駆動チャネルと該加速器ラックとを相互接続する付勢部材、
を備え、該駆動チャネルの遠位への並進が、該付勢部材を介して、該加速器ラックの遠位への並進を引き起こし、そして該加速器ラックの遠位への並進が、該ベルクランク歯車の第一の回転および該押し棒の遠位への並進を引き起こす、上記項目のうちのいずれかに記載のクリップアプライア。
上記ベルクランク歯車が、該ベルクランク歯車から半径方向に延びるアーム、および該アームに形成された細長スロットを備え、該細長スロットは、上記押し棒と作動可能に関連するボスをスライド可能に受容する、上記項目のうちのいずれかに記載のクリップアプライア。
運動反転機構をさらに備え、該運動反転機構は、上記駆動チャネルおよび上記楔プレートに作動可能に接続されており、そして上記押し棒と選択的に係合可能であり、該駆動チャネルの遠位への並進中の該運動反転機構の回転は、該楔プレートおよび該押し棒の近位への移動を生じる、上記項目のうちのいずれかに記載のクリップアプライア。
上記チャネルアセンブリの遠位端に配置されたロックアウトをさらに備える、上記項目のうちのいずれかに記載のクリップアプライア。
最後のクリップが上記クリップアプライアから排出される際に、上記ロックアウトが上記クリップ従動子により起動される、上記項目のうちのいずれかに記載のクリップアプライア。
上記ロックアウトが上記クリップ従動子によって推進されて上記駆動チャネルの経路を横切って延び、これによって、該駆動チャネルが遠位に移動することを防止する、上記項目のうちのいずれかに記載のクリップアプライア。
上記ハウジングおよび上記チャネルアセンブリのうちの少なくとも一方に支持された計数表示機構をさらに備え、該計数表示機構は、上記少なくとも1つのハンドルの各起動の際に、上記クリップアプライアの状態の変化を表示するように構成および適合されている、上記項目のうちのいずれかに記載のクリップアプライア。
外科手術用クリップアプライアであって、
ハウジング;
該ハウジングの反対側に旋回可能に接続された少なくとも1つのハンドル;
該ハウジングに固定されて該ハウジングから延びるチャネルアセンブリ;
該チャネルアセンブリの遠位端に支持されて該遠位端から延びる1対の顎;
該チャネルアセンブリ内に配置されてチャネルを規定するクリップキャリア;
該クリップキャリアの該チャネル内にスライド可能に配置された複数のクリップ;
該クリップキャリアの該チャネル内で該複数のクリップの近位の位置にスライド可能に配置されたクリップ従動子;
該ハウジングおよび該チャネルアセンブリのうちの少なくとも一方の内部に並進可能に配置された駆動チャネルであって、該駆動チャネルは、該ハンドルのうちの少なくとも1つに作動可能に接続された第一の端部、ならびに該1対の顎と選択的に係合して該顎の閉鎖を行うための構成および寸法にされた第二の端部を有する、駆動チャネル;
該ハウジングおよび該チャネルアセンブリのうちの少なくとも一方の内部に並進可能に配置された押し棒であって、該押し棒は、運動増倍システムを介して該駆動チャネルに接続されており、該押し棒の遠位端は、該複数のクリップのうちの最も遠位のクリップと係合するように構成されている、押し棒;
該ハウジングおよび該チャネルアセンブリのうちの少なくとも一方の内部に往復可能に配置された楔プレートであって、該楔プレートの遠位端は、該1対の顎の間に選択的に挿入可能である、楔プレート;ならびに
運動反転機構であって、該駆動チャネルに接続された第一の端部、および該楔プレートに接続可能であり、該押し棒により係合可能な第二の端部を備える、運動反転機構、
を備え、
該駆動チャネルの遠位への並進は、該運動増倍システムを介して該押し棒を遠位に並進させ;そして
該駆動チャネルの遠位への並進は、停留期間の後に、該運動反転機構を介して、該押し棒および該楔プレートを近位に並進させる、
外科手術用クリップアプライア。
上記チャネルアセンブリの遠位端内に配置されたロックアウトをさらに備え、該ロックアウトは、最後のクリップが上記クリップアプライアから排出される際に、上記クリップ従動子により起動され、該ロックアウトは、該クリップ従動子によって、上記駆動チャネルの経路を横切って延び、これによって、該駆動チャネルが遠位に移動することを防止する、上記項目のうちのいずれかに記載のクリップアプライア。
上記楔プレートが、該楔プレートの長さに沿って形成された複数の開口部分を規定し、上記クリップアプライアが、該クリップアプライアの長さに沿って形成された複数の窓を規定し、上記クリップ従動子が、該クリップキャリアの該窓および該楔プレートの該開口部分と選択的に係合するために構成および適合されており、該クリップ従動子が、該楔プレートの遠位への前進の際に、上記複数のクリップを該クリップキャリアに対して一定量ずつ遠位に推進するように構成および適合されている、上記項目のうちのいずれかに記載のクリップアプライア。
上記1対の顎が、内部にクリップを収容するように適合されており、そして上記駆動チャネルの遠位への並進に応答して、クリップの形成を行うように作動可能である、上記項目のうちのいずれかに記載のクリップアプライア。
インジケータをさらに備え、該インジケータは、上記1対の顎内へのクリップの装填、および該1対の顎によるクリップの形成のうちの少なくとも一方の際に、可聴指標および触知可能指標のうちの少なくとも1つを生じるように構成されている、上記項目のうちのいずれかに記載のクリップアプライア。
上記運動増倍システムが、ベルクランク歯車を備え、該ベルクランク歯車が、該ベルクランク歯車から半径方向に延びるアーム、および該アームに形成された細長スロットを有し、該細長スロットは、上記押し棒に作動可能に関連するボスをスライド可能に受容する、上記項目のうちのいずれかに記載のクリップアプライア。
上記運動増倍システムが、一連の歯を有する加速器ラックを備え、そして上記ベルクランク歯車が、該加速器ラックの該歯と係合する一連の歯を備え、該加速器ラックの軸方向の並進が、該ベルクランク歯車の回転および上記押し棒の軸方向並進を生じる、上記項目のうちのいずれかに記載のクリップアプライア。
上記加速器ラックが、付勢部材を介して上記駆動チャネルに接続されている、上記項目のうちのいずれかに記載のクリップアプライア。
ラチェット機構をさらに備え、該ラチェット機構は、
複数のラチェット歯を有し、上記駆動チャネルに関連するラック;および
少なくとも1つの歯を有し、該ラックと選択的に係合する位置に配置されるつめ、
を備え、
該つめは、該ラックと係合するように付勢されており、上記駆動チャネルが長手軸方向に往復運動するにつれて、該複数の歯が該つめを越えて通過し、そして該つめは、上記少なくとも1つのハンドルの全部の作動前に、該駆動チャネルが不慮に戻ることを防止する、上記項目のうちのいずれかに記載のクリップアプライア。
上記駆動チャネルが、上記顎および上記楔プレートを少なくとも部分的に囲むような構成および寸法にされており、該駆動チャネルは、該顎および該楔プレートを該駆動チャネル内に維持するために、該駆動チャネルの遠位端を横切って延びるストラップを備える、上記項目のうちのいずれかに記載のクリップアプライア。
計数機構をさらに備え、該計数機構は、上記クリップアプライアの1回の発射シーケンスの際に起動可能であり、そして該計数機構は、該クリップアプライア中に1つ少ないクリップが存在することの指標を提供する、上記項目のうちのいずれかに記載のクリップアプライア。
少なくとも比較的小さい外科手術用クリップ、中程度の外科手術用クリップ、および比較的大きい外科手術用クリップを送達するために作動可能な外科手術用クリップアプライア機構であって、該外科手術用クリップアプライア機構は、
並進移動が可能な駆動チャネル;
該駆動チャネルの遠位端により係合可能な1対の顎であって、該1対の顎は、該駆動チャネルの遠位への並進の際に近接される、1対の顎;
該駆動チャネルに対して往復並進が可能な楔プレートであって、該楔プレートの遠位端は、該1対の顎の間に選択的に配置可能であり、該楔プレートは、該楔プレートの長さに沿って形成された複数の開口部分を規定する、楔プレート;
該駆動チャネルに対して固定されて配置されたクリップキャリアであって、該クリップキャリアは、該クリップキャリアの長さに沿って形成されたチャネルおよび複数の窓を規定する、クリップキャリア;
該クリップキャリアの該チャネル内にスライド可能に配置された複数のクリップ;
該クリップキャリアの該チャネル内に、該複数のクリップの近位の位置でスライド可能に配置されたクリップ従動子;
該駆動チャネルに対して往復並進が可能な押し棒であって、該押し棒の遠位端は、該複数のクリップのうちの最も遠位のクリップとの係合のために構成されている、押し棒;
ベルクランク歯車および加速器ラックを備える運動増倍システムであって、該加速器ラックは、付勢部材を介して該駆動チャネルに結合されており、該ベルクランク歯車は、相補的な歯車歯を介して該加速器ラックに結合されており、そして該ベルクランク歯車は、該押し棒に結合されている、運動増倍システム;ならびに
運動反転機構であって、該駆動機構に接続された第一の端部、および該楔プレートに接続され、そして該押し棒によって係合可能な第二の端部を備える、運動反転機構、
を備え、
該駆動チャネルの遠位への並進は、該加速器ラックを遠位に並進させ、該ベルクランク歯車を回転させ、該押し棒を遠位に並進させ;
該駆動チャネルの遠位への並進は、該運動反転機構の該第一の端部を遠位に並進させ、該運動反転機構の該第二の端部を近位方向に並進させ、これによって、該楔プレートを近位方向に並進させ;そして
該押し棒の遠位への並進は、該押し棒が該運動反転機構の該第二の端部に接触すると止められる、
外科手術用クリップアプライア機構。
上記運動反転機構の上記第二の端部の近位方向へのさらなる並進は、上記押し棒を近位方向に並進させる、上記項目に記載の外科手術用クリップアプライア機構。
上記駆動チャネルによる上記運動反転機構の起動は、停留期間の後に行われる、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
インジケータをさらに備え、該インジケータは、上記押し棒による上記1対の顎内へのクリップの装填、および該1対の顎によるクリップの形成のうちの少なくとも一方の際に、可聴指標および触知可能指標のうちの少なくとも1つを生じるように構成されている、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
ラチェット機構をさらに備え、該ラチェット機構は、
複数のラチェット歯を有し、上記駆動チャネルに関連するラック;および
少なくとも1つの歯を有し、該ラックと選択的に係合可能な位置に配置されるつめ、
を備え、該つめは、該ラックと係合するように付勢されており、該駆動チャネルが往復並進する際に、該ラックの該複数の歯は、該つめを越えて通過し、そして該つめは、該駆動チャネルの完全な遠位への並進の前に、該駆動チャネルが戻ることを防止する、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
上記駆動チャネルが、上記1対の顎および上記楔プレートを少なくとも部分的に囲むような構成および寸法にされており、該1対の顎および該楔プレートを該駆動チャネル内に維持するために、ストラップが、該駆動チャネルの遠位端を横切って延びる、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
計数機構をさらに備え、該計数機構は、上記クリップアプライア機構の1回の発射シーケンスの際に起動可能であり、そして該計数機構は、1つ少ないクリップが存在することの指標を提供する、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
上記駆動チャネルの遠位端の近位に配置されたロックアウトをさらに備え、該ロックアウトは、最後のクリップが排出されるときに上記クリップ従動子により起動され、そして該ロックアウトは、該クリップ従動子により推進されて、該駆動チャネルの経路を横切って延び、これによって、該駆動チャネルが遠位に移動することを防止する、上記項目のうちのいずれかに記載の外科手術用クリップアプライア機構。
本願は、複数のクリップを有し、これらのクリップを外科手術手順中に身体組織および脈管に適用するための、外科手術用クリップアプライア、ならびにこれらの組み立て方法に関する。
system)をさらに備え得、この運動増倍システムは、これらのハンドルの初期起動の際に、次第に増加する量で押し棒を遠位に移動させるように構成され、そしてこれらのハンドルの初期起動に引き続いて、この押し棒およびこの楔プレートを近位に移動させるように構成される。
本開示による外科手術用クリップアプライアの実施形態が、ここで図面を参照しながら詳細に記載される。図面において、同じ参照番号は、類似かまたは同一の構造要素を識別する。図面に示され、そして以下の説明全体に記載される場合、伝統的であるように、外科手術用器具の相対位置に言及する場合、用語「近位」とは、その装置の使用者に近い方の端部をいい、そして用語「遠位」とは、その装置の使用者から遠い方の端部をいう。
比較的小さい規模のクリップアプライアについて、比較的小さい規模のベルクランク歯車154についての約45°の所定の回転は、比較的小さいサイズのクリップを顎120に装填する目的で、比較的小さい規模の押し棒160の、約0.345インチ(約8.76mm)の軸方向移動を生じることが企図される。同様に、比較的中程度の規模のクリップアプライアについて、比較的中程度の規模のベルクランク歯車154についての約70°の所定の回転は、比較的中程度のサイズのクリップを顎120に装填する目的で、比較的中程度の規模の押し棒160の、約0.485インチ(約12.3mm)の軸方向移動を生じることが企図される。同様に、比較的大きい規模のクリップアプライアについて、比較的大きい規模のベルクランク歯車154についての約90°の所定の回転は、比較的大きいサイズのクリップを顎120に装填する目的で、比較的大きい規模の押し棒160の、約0.710インチ(約18.0mm)の軸方向移動を生じることが企図される。
102 ハンドルアセンブリ
104 ハウジング
104a 上ハウジング半体
104b 下ハウジング半体
104c 窓
104d ハンドル旋回ポスト
104e 細長チャネル
106 ハンドル
106a 開口部分
106b 旋回点
108 チャネルアセンブリ
110 顎アセンブリ
122 リンク部材
122a 遠位端
124 駆動ピン
140 駆動チャネル
140a 旋回点
Claims (11)
- 外科手術用クリップアプライアであって、
ハウジング;
該ハウジングに旋回可能に接続された少なくとも1つのハンドル;
該ハウジングから遠位に延びるチャネルアセンブリ;
該チャネルアセンブリ内に配置されたクリップキャリアであって、該クリップキャリア内にチャネルおよび複数の窓を規定する、クリップキャリア;
該クリップキャリアの該チャネル内にスライド可能に配置された複数のクリップ;
該チャネルアセンブリ内に往復可能に配置された楔プレートであって、該楔プレートは、該ハンドルに作動可能に接続されており、そして該楔プレートの長さに沿って形成された複数の開口部分を備える、楔プレート;
該クリップキャリアの該チャネル内にスライド可能に配置され、そして該複数のクリップの近位に配置された、クリップ従動子であって、該クリップ従動子は、該クリップキャリアの該窓および該楔プレートの該開口部分との選択的な係合のために構成および適合されており、該クリップ従動子は、該楔プレートの往復移動の際に、該複数のクリップを、該クリップキャリアに対して遠位の方向に推進するように構成および適合されている、クリップ従動子;
該チャネルアセンブリの端部から該ハウジングの反対側に延びる1対の顎を備える顎アセンブリであって、該顎アセンブリは、内部にクリップを収容するように適合されており、そして該ハンドルの移動に応答して、クリップの形成を行うように作動可能である、顎アセンブリ;
該ハウジングおよび該チャネルアセンブリのうちの少なくとも一方の内部に往復可能に配置されたクリップ押し棒であって、該押し棒は、該ハンドルのうちの少なくとも一方に作動可能に接続された第一の端部、およびプッシャーを規定する第二の端部を有し、該押し棒は、該ハンドルが第一の方向に近接される際に、該顎の方へ、該顎の間に最も遠位のクリップを移動させるための初期量だけ移動可能であり、そして該押し棒は、該ハンドルが該第一の方向にさらなる量だけ近接される際に、該ハウジングの方へ、該プッシャーを該複数のクリップのうちの最も遠位のクリップの後ろへと移動させるために移動するように構成および適合されている、クリップ押し棒;
運動増倍システムであって、該運動増倍システムは、該ハンドルの初期起動の際に、該押し棒をある増分だけ遠位に移動させるように構成されており、そして該ハンドルの初期起動に続いて、該押し棒および該楔プレートを近位に移動させるように構成されている、運動増倍システム;
を備え、
該運動増倍システムは、
該ハウジング内に旋回可能に支持され、そして該押し棒に旋回可能に接続された、ベルクランク歯車;
該ハウジング内にスライド可能に支持され、そして該ベルクランク歯車に作動可能に接合された、加速器ラック;および
該駆動チャネルと該加速器ラックとを相互接続する付勢部材、
を備え、該駆動チャネルの遠位への並進が、該付勢部材を介して、該加速器ラックの遠位への並進を引き起こし、そして該加速器ラックの遠位への並進が、該ベルクランク歯車の第一の回転および該押し棒の遠位への並進を引き起こす、外科手術用クリップアプライア。 - 前記クリップ従動子が、前記楔プレートの遠位への並進の際に該楔プレートと係合して遠位に移動するように構成されており、そして該楔プレートの近位への並進の際に前記クリップキャリアと係合して該クリップキャリアの近位への移動を止めるように構成されている、請求項1に記載のクリップアプライア。
- 前記ハウジングおよび前記チャネルアセンブリのうちの少なくとも一方の内部に並進可能にスライド可能に配置された駆動チャネルをさらに備え、該駆動チャネルは、該少なくとも1つのハンドルに作動可能に接続された第一の端部、ならびに前記1対の顎に選択的に係合して該1対の顎の閉鎖を行うような構成および寸法にされた第二の端部を有し、該駆動チャネルは、該少なくとも1つのハンドルが移動されて第一の方向に起動される際に、前記顎アセンブリの方へと移動して、該駆動チャネルの該第二の端部を該顎に押し付けて移動させ、該顎を閉じ、該駆動チャネルは、該少なくとも1つのハンドルが第二の量だけ移動される際に、該顎から離れるように移動して、該駆動チャネルの該第二の端部を該顎から離すように移動させ、該顎を開かせる、請求項1に記載のクリップアプライア。
- 前記楔プレートおよび前記駆動チャネルに作動可能に接続された運動反転機構をさらに備え、該駆動チャネルの遠位への移動中の該運動反転機構の回転は、該楔プレートの近位への移動を生じる、請求項3に記載のクリップアプライア。
- 前記ベルクランク歯車が、該ベルクランク歯車から半径方向に延びるアーム、および該アームに形成された細長スロットを備え、該細長スロットは、前記押し棒と作動可能に関連するボスをスライド可能に受容する、請求項1に記載のクリップアプライア。
- 運動反転機構をさらに備え、該運動反転機構は、前記駆動チャネルおよび前記楔プレートに作動可能に接続されており、そして前記押し棒と選択的に係合可能であり、該駆動チャネルの遠位への並進中の該運動反転機構の回転は、該楔プレートおよび該押し棒の近位への移動を生じる、請求項1に記載のクリップアプライア。
- 前記チャネルアセンブリの遠位端に配置されたロックアウトをさらに備える、請求項1に記載のクリップアプライア。
- 最後のクリップが前記クリップアプライアから排出される際に、前記ロックアウトが前記クリップ従動子により起動される、請求項7に記載のクリップアプライア。
- 前記ロックアウトが前記クリップ従動子によって推進されて前記駆動チャネルの経路を横切って延び、これによって、該駆動チャネルが遠位に移動することを防止する、請求項8に記載のクリップアプライア。
- 前記ハウジングおよび前記チャネルアセンブリのうちの少なくとも一方に支持された計数表示機構をさらに備え、該計数表示機構は、前記少なくとも1つのハンドルの各起動の際に、前記クリップアプライアの状態の変化を表示するように構成および適合されている、請求項1に記載のクリップアプライア。
- 前記駆動チャネルが、前記顎および前記楔プレートを少なくとも部分的に囲むような構成および寸法にされており、該駆動チャネルは、該顎および該楔プレートを該駆動チャネル内に維持するために、該駆動チャネルの遠位端を横切って延びるストラップを備える、請求項1に記載のクリップアプライア。
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US20200113569A1 (en) | 2020-04-16 |
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JP2015062689A (ja) | 2015-04-09 |
JP2010046489A (ja) | 2010-03-04 |
US20170086850A1 (en) | 2017-03-30 |
EP2158850B1 (en) | 2015-10-21 |
JP5478150B2 (ja) | 2014-04-23 |
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