WO2018110784A1

WO2018110784A1 - Clip applier

Info

Publication number: WO2018110784A1
Application number: PCT/KR2017/006545
Authority: WO
Inventors: 전성태; 정오
Original assignee: (주)써지코어
Priority date: 2016-12-12
Filing date: 2017-06-21
Publication date: 2018-06-21
Also published as: KR101966939B1; KR20180067385A; KR101762761B1; KR101930414B1; KR20180067386A

Abstract

A clip applier of the present invention comprises: a handle housing having a lever; a clip ligation unit provided at the handle housing and provided in a tube member having a predetermined length and diameter, so as to ligate a part of the body by using a clip; a clip loading unit provided inside the tube member at the lower side of the clip ligation unit so as to supply the clip to the first and second jaws of the clip ligation unit; and the clip ligation unit provided at the handle housing and moving a slider forward when the lever retracts such that the first and second jaws are moved in a closing direction so as to ligate the clip, and an operating unit for moving a clip loading member forward when the lever move forwards such that the clip is loaded in the clip loading unit.

Description

Clip Applier

The present invention relates to a clip pliers, and more particularly, to a clip applier that can prevent a malfunction in the supply of the clip and the ligation of the ligation clip in the vessel, duct, cent.

BACKGROUND ART Surgical advances have generally been made through the implementation of laparoscopic and endoscopic surgeries such as cholecystectomy, gastrointestinal scavenging, intestinal tail resection and hernia repair.

These procedures are accomplished through a trocar assembly, a surgical instrument used to puncture the body cavity. A trocar assembly typically has a tubing needle with a sharp tip and a tube or cannula. The cannula associated with the trocar is inserted into the skin to access the cavity of the body and the cannula remains on the body as the trocar is removed. Surgical operation is performed by inserting a surgical instrument into the body through the cannula. One of the surgical instruments for surgery through the cannula is a surgical clip applier for ligation of portions of blood vessels, ducts, shunts or body tissues during surgery.

Korean Patent Laid-Open Publication No. 2006-01085363 discloses an advancement and alignment mechanism of a surgical clip. The published clip applier is disposed in the elongated shaft, the elongated shaft having a handle housing to which the trigger is coupled, an opposing jaw extending from the handle housing and formed at its distal end and movable between an open position and a closed position; A clip advancement assembly for advancing at least one clip through the elongated shaft to position a clip between the opposing jaws and a clip advancement assembly disposed within the handle housing to transfer motion from the trigger to the clip advancement assembly A flexible link for advancing at least one clip in response to movement of the trigger.

However, such a clip applier has a problem in that a jam occurs in the clip and a clip supply travel occurs when the jaw is manipulated.

Korean Patent Registration No. 1288789 discloses a surgical clip applicator latch mechanism. In addition, Korean Patent No. 2006-108560 discloses a force limiting device for medical devices, and Korean Patent Publication No. 2006-0108559 discloses a surgical clip application method.

The technical problem to be solved of the present invention is to prevent the trouble caused by the supply of the clip because it can fundamentally prevent the occurrence of the jam that does not open when the jaw is closed when the supply of the clip (ligation clip) for ligating the body part The present invention provides a clip applier that can increase the reliability of clip ligation by preventing the handle from being returned when a complete clip is not ligated.

The technical problem to be solved of the present invention is to provide a clip applier having a relatively simple structure by allowing the supply of the clip and the ligation of one clip using one handle.

Clip applier of the present invention for solving the above technical problem is a handle housing, the tubular member is installed in the handle housing and having a predetermined length and diameter; Installed in the pipe member, from the first and second jaws, which are provided at the end of the rod housing, the rod extending from the handle housing, the first and second jaws opposite to each other so as to be movable between the open position and the closed position, the clip support is provided on the corresponding surface, respectively. A jaw manipulation unit including an jaw member having an elastic portion extending to provide an elastic force in an opening direction of the first jaws, and a slider slidably installed on the rod to open and close the first jaws of the jaw members; ;

A guide body part installed in the lower side pipe member of the jaw manipulation unit and provided with a clip guide part for guiding a clip to the side of the first and second jaws at the end thereof; A clip loading member for moving the clip supplied from the cartridge unit along the clip guide part and loading the clip support part of the first and second jaws, and a cover member coupled to the guide main part to guide the transfer of the clip loading member. A clip loading unit provided;

When the lever installed in the handle housing is retracted, the slider is moved to the whole and the first and second jaws are closed in the direction of closing the clip, and when the lever is displayed, the clip loading member is advanced to supply the clip to the clip support unit. With a unit.

In the present invention, the operation unit is installed in the handle housing and the guide rail member formed with a first guide portion for moving forward and backward in the longitudinal direction of the slider member and the clip loading member, and the guide rail member A first pin forward and backward in the longitudinal direction along the first guide groove formed in the longitudinal direction, and coupled to an end of the slider;

A second pin which is advanced back and forth along the second guide groove formed in the longitudinal direction of the rear end side of the guide rail member, and coupled to an end of the clip loading member;

A first conveying member forward and backward along the guide rail member and having a first pin coupled thereto, a second conveying member installed forward and backward on the rear end side of the guide rail member and having a second pin coupled thereto;

A lever installed in the handle housing rotatably by a hinge shaft and having a first manipulating portion provided with a first hook coupled to first transfer shafts formed on both sides of the first transfer member;

A first guide hole coupled with a first movable pin fixed to a portion spaced apart from the first hinge axis of the lever, and a transfer main part and a transfer main body rotatably installed by the first hinge axis in the handle housing; A second manipulation member provided at an upper portion of the portion and having a second hook coupled to a second transfer shaft at both sides of the second transfer member;

It provides an elastic force for rotating the lever to the tube member side, and has a first elastic spring coupled to both ends of the support pin formed on one side of the lever and the lower side of the handle housing.

And the operation unit is further provided with a clip ligation safety unit for allowing the lever to return when the ligation of the clip is completely made by the operation of the lever.

The clip ligation safety unit is rotatably installed on the first hinge shaft, the safety operation member including a support portion supported on the lever, the rack portion is installed on the other side of the support portion and the first teeth are formed in an arc shape, and the rack portion The installation on the handle housing adjacent to and is formed at a position eccentrically from the ratchet shaft on one side rotatably installed on the ratchet shaft to move in an unjoined state when the lever for the ligation of the clip is retracted, A ratchet member having second racks coupled with the first teeth of the rack part to prevent the lever from moving forward when the retreat is not sufficiently performed, and elastically biasing the second teeth installed on the ratchet member toward the wrap part side. It is provided with an elastic spring for rotating the latch member for the rack side.

The guide rail member is composed of first and second members separated in the longitudinal direction, and the first and second transfer members slidably installed on the guide rail member are installed on the handle housing and the first and second transfer members. The springs are elastically biased in mutual directions.

An end portion of the cover member is provided with a bent portion bent downward to press the end portion of the clip loading member toward the cartridge side when the clip loading member is moved forward or backward, and a pressing portion extending in the horizontal direction from the bent portion.

The jaw member includes a base formed with a coupling hole coupled to a support protrusion formed at an end side of the rod, and an elastic support part connecting the base and the first and second jaws to provide an elastic force in the opening direction of the first and second jaws. ,

At the end of the slider, a jaw manipulation part is formed to wrap the elastic support and closely contact the first and second jaws when advancing so that the clip is ligated and the first and second jaws are spaced apart when retreating.

Clip applier according to the present invention can reduce the trouble caused by the supply of the clip for ligation of the body, and can fundamentally prevent the occurrence of jam that does not open after the first and second jaws of the jaw members are closed, and the reliability of supplying the clip Can increase.

And the clip applier according to the present invention is relatively simple structure of the operation unit by allowing the supply of the clip to the ligation of the clip and the clip support of the first and second jaws due to one lever operation. And by biasing the end of the clip loading member for loading the clip toward the cartridge unit side it is possible to increase the reliability of the supply of the clip.

1 is a perspective view of a clip applier according to the present invention,

2 is an exploded perspective view of the clip applier according to the present invention;

3 is a cross-sectional view of a clip applier in accordance with the present invention.

Figure 4a is a perspective view showing an extract of the clip ligation unit shown in FIG.

Figure 4b is a perspective view showing another embodiment of the clip ligation unit.

5 is a perspective view showing an extract of the clip loading unit shown in FIG.

Figure 6 is a partially cutaway perspective view of the guide body portion of the clip loading unit, the cartridge unit and the clip loading member is coupled,

Figure 7 is an exploded perspective view of the handle housing shown in FIG.

FIG. 8 is a half section view of the handle housing shown in FIG. 2; FIG.

Figure 9 is a side cross-sectional view showing the operating state of the clip carrier,

10 is a perspective view schematically showing a state in which a clip is ligated by a jaw of a clip applier;

11 is a side cross-sectional view of the clip appliance;

12 is an enlarged cross-sectional view illustrating a state in which a clip is loaded by a clip loading unit of a clip appliance;

13 and 14 are views showing the operating state of the clip ligation safety unit of the clip applier.

The clip applier according to the present invention is for ligation of a portion of blood vessels, ducts, shunts or body tissues during surgery without open surgery, one embodiment of which is shown in FIGS.

Referring to the drawings, the clip applier 10 according to the present invention includes a handle housing 20 and a tubular member 21 installed in the handle housing 20 and having a predetermined length and a hollow portion 22. . And it is installed on the tube member 21, one side is fixed to the handle housing 20 and installed in the rod 41 and the end of the rod 41 by the hollow portion 22 of the tube member 21 And extending from the first and

second jaws

42 and 43, which are opposed to each other so as to be movable between the open position and the closed position, and the clip supporting portions are provided on corresponding surfaces, respectively, to provide the elastic force in the opening direction. Slider for sliding the jaw member 46 and the rod 41 and the first and second jaws (42, 43) of the jaw member (46) having elastic support parts (44, 45) to And a clip ligation unit 40 including 48).

The clip guide for supplying the clip 200 to the side of the first and

second jaws

42 and 43 at an end thereof is installed in the hollow portion 22 of the lower tube member 21 of the clip ligation unit 40. Part (51)

The guide body portion 50 is provided, the cartridge unit 60 is installed on the guide body portion 50 to supply the clip, the clip supplied from the cartridge unit 60, the clip guide portion 51 It is coupled to the clip loading member 71 for loading the clip support portion of the first and second jaws (42, 43) to move along the guide body portion 50 to guide the transfer of the clip loading member 71 And a clip loading unit 70 having a cover member 75. And

When the lever 26 installed on the handle housing 20 is retracted, the slider 48 is advanced in the direction in which the first and

second jaws

42 and 43 are closed to ligation the clip, and when the lever 26 is moved forward. The operation unit 100 for advancing the clip loading member 71 to supply the clip to the

clip support portions

42a and 43a.

The clip applier 10 according to the present invention configured as described above will be described in more detail for each component as follows.

The clip applier 10 according to the present invention clips 200 a portion of blood vessels, ducts, shunts or body tissues in the course of performing laparoscopy and endoscopic surgical procedures such as cholecystectomy, gastrointestinal insufficiency, intestinal tail resection and hernia repair. ) To ligation. The handle housing 20 is formed by combining two members as shown in Figures 2 and 3, the handle portion 25 is provided downward, rotatably installed on the front of the handle portion 25 The lever 26 is provided. And the tubular member 21 is supported by a cap 23 installed to communicate with the inside of the front of the handle housing 20, and has a sufficient length and hollow portion 22 for the procedure of laparoscopy (Fig. 1). , See 2) The handle housing 20 is not limited to the above-described embodiment and may be designed in various shapes.

The clip ligation unit 40 uses a clip 200 supported by the

clip support portions

42a and 43a of the first and

second jaws

42 and 43, as shown in FIGS. 2 to 4a and 4b. Guide to the ligation of a portion of the vessel, duct, shunt or body tissue using the clip 200, is located in the hollow portion 22 of the tubular member 21, one side end guide is installed in the handle housing 20 A rod 41 supported at the front end of the rail member 110 and a jaw member 46 provided at the end of the rod are provided. And the front and rear by the operation unit 100 and the jaw member 46 is fitted with a slider 48 for relatively moving the first and second jaws (42) 43 of the jaw member (46).

Guide rods 41a are formed in the rod 41 in the longitudinal direction to guide the sliders 48. A plurality of support protrusions 41b for supporting the jaw member 46 are formed at the end 41 of the rod. The front end of the rod 41 has a length such that the first and

second jaws

42 and 43 of the jaw member 46 may protrude toward the end of the tubular member 21 when coupled with the jaw member 46.

The jaw member 46 has a base 47 having a plurality of coupling holes 47a coupled thereto at a position corresponding to the support protrusion 41b, and a first extending at an angle gradually extending from the base 47. And second

elastic support portions

44 and 45 and first and

second jaws

42 and 43 formed at ends of the first and second

elastic support portions

44 and 45, respectively. The first and

second jaws

42 and 43 are installed so that their ends are inclined upward from the center of the tube member 21 so that ligation of the clip 200 can be performed smoothly. It is desirable to allow the clip 200 to be loaded smoothly by the unit. In addition, the

clip support portions

42a and 43a formed to support the clip 200 on surfaces corresponding to the first and

second jaws

42 and 43 are the clip 200 as illustrated in FIGS. 4A and 4B. The back is open for insertion.

And the end of the slider 48 is moved forward and backward by the operation unit 100 is coupled with the jaw member 46 to move the first and second jaws (42) 43 in the direction of closing the clip to move forward It is provided with a jaw operating portion (48a) to be ligated, and to be opened by the first and second elastic support portions (44, 45) of the jaw member 46 when retracting. The closed cross-sectional area of the jaw manipulation portion 48a is formed to be substantially the same as the cross-sectional area of the first and second

elastic support portions

44 and 45 adjacent to each other when the first and

second jaws

42 and 43 are in close contact with each other. It is preferable to allow the first and

second jaws

42 and 43 to be opened and closed during the forward and backward movement of the 48. In addition, one side of the slider 48 corresponding to the support protrusion 41b of the rod 41 prevents the jaw member 46 from being separated from the rod 41, and the jaw member does not leave the slider 48. In addition, the separation prevention piece 48b for inducing a linear motion is provided, and this separation prevention piece 48b can be formed by lance processing the plate-shaped slider 48. As shown in FIG. 4B, the separation preventing piece may be bent inward from both edges of the slider 48.

The rod 41 is coupled to the guide main body 50 to be described later, is located in the hollow of the tubular member 21, and partitions the guide groove 41a in which the slider 48 moves.

As shown in FIGS. 2 to 6, the clip loading unit 70 attaches a clip to the

clip support portions

42a and 43a of the first and

second jaws

42 and 43 constituting the clip ligation unit 40. For loading, it is provided with a guide body portion 50 which is located in the hollow portion 22 of the tubular member 21, the clip guide portion 51 is provided at the end. The clip guide part 51 is provided with an elastic guide piece 55 for guiding the clip 200 to the

clip support parts

42a and 43a. The guide body 50 is coupled to the rod 41. And the guide body portion 50 is provided with a cartridge mounting portion 52 for supplying the clip in the longitudinal direction, the cartridge mounting portion 52 is provided with a cartridge unit 60 loaded with the clips. Although not shown in detail, the cartridge unit 60 has a cartridge body in which a clip mounting space in which clips are stacked in a length direction is formed, and a clip installed in the cartridge body and stacked in a clip mounting space in the front of an elastic spring. The pusher for elastic biasing is provided. In addition, a clip pressing elastic piece 64 for pressing the clip drawn out by the pusher from the clip mounting space is provided at the upper end of the cartridge body, and guide guide grooves 66 are provided at both sides of the clip pressing elastic piece 64. ) Is formed. The clip pressing elastic piece 64 is provided with a clip pressing auxiliary elastic piece 65 formed by lancing in the longitudinal direction.

And the upper surface of the cartridge unit 60 mounted on the cartridge mounting portion 52 of the guide body portion 50 by the operation unit 100 relative to the slider 48 (reversely reverse, forward and backward) clip The loading member 71 is installed.

The clip loading part 72 is installed at the front end side of the clip loading member 71, and the clip loading part 72 is coupled to the guide guide groove 66 to transfer the clip 200 to move the clip 200. 73 is formed. The transfer protrusion 73 has a rear surface 73a inclined so that interference does not occur in the clip 200 when the clip loading member 71 is retracted, and the front side forms a vertical state. The rear end side of the clip loading member 71 is formed with a second pin coupling hole 71a to be coupled with the second pin to be described later, and the first pin coupled with the slider 48 penetrates to the side adjacent thereto. The long hole 71b is formed to prevent interference with the first pin when the clip loading member 71 moves forward and backward.

And the upper portion of the clip loading member 71 is coupled to both sides of the guide body 50 and both sides is provided with a cover member 75 for securing the guide space when the front and rear of the clip loading member 71 . An end portion of the cover member 75 is bent downwardly in order to press the end portion of the clip loading member 71, ie, the clip loading portion 72, to the cartridge side when the clip loading member 71 is moved forward or backward. 76 is formed, and the press part 77 extended in the horizontal direction from this bend part 76 is formed.

The operation unit 100 relatively moves the slider 48 and the clip loading member 71 to the

clip support portions

42a and 43a of the first and

second jaws

42 and 43 of the jaw member 46. In addition to ligation of the body using the attached clip 200 and to load the clip by the clip loading unit 70 to the empty clip support (42a) (43a) after ligation, Figures 1 and 7, 8 Showed.

Referring to the drawings, the operation unit 100 is installed in the housing corresponding to the tubular member 21 supported by the handle housing 20 and the cap 23, and has a guide rail member 110. The guide rail member 110 is composed of two first and

second members

111 and 112 separated in the longitudinal direction, and the slider 48 and the clip loading member 71 are disposed in the front and rear directions corresponding to the guide rail member 110. The first guide part 101 is drawn in the longitudinal direction to guide it during movement. In addition, the outer circumferential surface of the guide rail member 110 is formed with a plurality of circumferential jaws 113 for fixing and partitioning, the outer circumferential surface of the circumferential jaw 113 is coupled to the rib formed in the inside of the handle housing 20 113a is formed.

The slider 48 of the clip ligation unit 40 installed inside the tubular member 21 when the lever 26 installed in the handle housing 20 is rotated in the counterclockwise direction on the front end side of the guide rail member 110. ) And a first conveying part 120 for retracting the slider when the lever 26 is rotated clockwise. In addition, the rear end of the guide rail member 110 by pulling the lever (26) installed in the handle housing 20 when the rotation in the counterclockwise direction clip loading of the clip loading unit 70 installed inside the pipe member 21 A second conveying part 140 is provided to retract the member 71 and to advance the clip loading member 71 when the lever 26 is rotated clockwise.

The first transfer part 120 is formed in the guide rail member 110, the first guide hole 121 having a predetermined length penetrating in the longitudinal direction, the tube member 21 in the first guide hole 121 The first pin 122 is installed in the inner side and coupled to the first pin coupling hole 48c formed at the end of the slider 48 of the clip ligation unit 40 guided by the first guide member 101. The guide rail member 110 is installed to be capable of moving forward and backward in the longitudinal direction. In addition, the guide rail member 110 is provided with a first transfer member 125 supporting the upper and lower portions of the first pin 122 and sliding forward and backward along the guide rail member 110. The first transfer member 125 is formed by combining two members separated in the up and down direction and on both sides the first transfer shaft for moving the first transfer member 125 along the guide rail member 110 and back. 126 is installed. A first catching jaw 127 is formed at an end of the first feed shaft 126 to prevent the hook, which will be described later, from being detached. In addition, the upper side of the lever 26 is provided with a first hook member 129 coupled with the first transfer shaft 126 is installed on both sides of the first transfer member 125. The first hook member 129 is integrally formed with the lever 26, and an upper portion of the first hinge shaft 25 supporting the lever 26 to be rotated in a direction opposite to the rotation direction of the lever 26. Is located on the side. The first hook member 129 is coupled to the first transfer shaft 126 has a structure in which the upper portion of the first transfer shaft coupling portion 130 is opened so that interference does not occur in the process of moving forward and backward.

The second conveying part 140 passes through the guide rail member 110 on the rear side adjacent to the first guide hole 121 formed in the guide rail member 110 in the longitudinal direction, and has a predetermined length. 141 is formed, the second guide hole 141 is formed in the end of the clip loading member 71 which is installed inside the pipe member 21 and guided by the first guide member 101 The second pin 142 is installed so as to be able to move forward and backward in the longitudinal direction of the guide rail member 110 coupled to the second pin 142. The guide rail member 110 supports the upper and lower portions of the second pin 142 and is provided with a second transfer member 145 sliding along the guide rail member 110 in the front and rear directions. The second conveying member 145 is formed by combining two members separated in the up and down direction, and the second conveying shaft for moving the second conveying member 145 forward and backward along the guide rail member 110 on both sides. 146 is installed. A second catching jaw 147 is formed at the end of the second feed shaft 146 to prevent the hook which will be described later from being detached.

In addition, the second hook member 150 is rotatably rotated by the second hinge shaft 151 on the handle housing 20 to advance the second conveying member 145 forward and backward by the rotational force of the lever 26. It is installed, the second side of the second hook member 151 is coupled to the second transfer shaft 146 is provided with a second transfer shaft coupling portion 153 for forward and backward. The second transfer shaft coupling portion 153 is a U-shaped second transfer shaft coupling groove of which the upper portion is opened so that interference with the second transfer shaft 146 does not occur when the second transfer member 145 moves forward or backward. 153a is formed. In order to transmit the rotational force of the lever 26 to the second hook member 150, the first extension extending from one side of the lever 26 and the second extending from the second hook member 150 A second operation extension portion 156 is formed, the second operation extension portion 156 is formed with a first guide long hole 157 for the rotation of the second hook member 150, the first guide long hole 157 ) Is coupled to the guide shaft 158 provided in the first operating extension 156 so that the hook member 150 rotates clockwise when the lever 26 rotates counterclockwise. To this end, the first guide long hole 157 is preferably formed in the longitudinal direction of the first operating extension 156 and formed in a curved shape extending in the center portion downward. In addition, a second guide long hole 155a is formed in the first operation extension part 155 to guide the rotation of the lever 26, and the second guide long hole 155a is formed in the handle housing 20. It may be combined with the guide pin 155b. This may limit the range of rotation of the lever 26.

First and second

spring engaging protrusions

125a and 145a are formed on the upper surfaces of the first and

second transfer members

125 and 145, respectively, and the spring support shafts 28 and the first and second springs are formed on the handle housing 20, respectively. By being connected by two connecting springs (125b, 145b) it is elastically biased in a direction close to each other.

On the other hand, the operation unit 100 further includes a clip ligation safety unit 170 to allow the lever to be returned when the ligation of the clip is completely made by the operation of the lever 26.

The clip ligation safety unit 170 is rotatably installed on the first hinge shaft, the support part 171 supported by the lever 26, and is installed on the other side of the support part 171 and has a first tooth in an arc shape. And a safety manipulation member 173 including a rack portion 172 on which 172a are formed. The coupling portion of the first hinge shaft and the safety control member 173 is positioned between the support portion 171 and the rack portion 172. And installed in the handle housing 20 adjacent to the rack portion 172 is formed in the second hinge shaft 151 at a position eccentric from the second hinge shaft 151 shaft on one side lever 26 for ligation of the clip When the retreat moves forward in a non-engaged state and the retract of the lever 26 for the ligation of the clip is not fully retracted, it is engaged with the first tooth 172a of the rack part 172 and the lever 26 The latch member 176 is provided with second teeth 175 to prevent the advancement. An elastic spring 177 is provided to rotate the latch member 176 for elastically biasing the second teeth 175 installed in the latch member 176 toward the rack portion 172.

The second tooth 175 formed in the latch member 176 is positioned above the central axis connecting the center of the first hinge shaft 25 and the second hinge shaft 151 supporting the lever 26, The first teeth 172a of the rack part 172 are arranged in an arc shape (circular arc having a radius corresponding to the distance of the rack part spaced apart from the first hinge axis) about the first hinge axis 25.

Referring to the operation of the clip applier according to the present invention configured as described above are as follows.

First, in order to ligate part of the tissue using the clip 200 in the course of performing laparoscopy and endoscopic surgery using the clip applier, the first and

second jaws

42 and 43 of the clip ligation unit 40 are used. The ligation site of the tissue is inserted between the first and second jaws (42a) (43a) installed at the end of the tube member (21) in the abdomen while the clip is loaded on the clip support (42a) (43a). To be located.

In this state, the lever 26 is pulled out. In this way, while the lever 26 of the operation unit 100 is rotated as shown in FIGS. 8 to 11, the first hook member 129 integrally formed with the lever 26 rotates counterclockwise. Advancing the first transfer member 125 along the guide rail member 110 and the second operating extension 156 connected by the first operating extension 155 of the lever 26 and the guide shaft 158. Is rotated so that the second hook member 150 is rotated in the clockwise direction so that the second transfer member 145 is retracted along the guide rail member (110).

In connection with this, the first transfer member 125 is coupled to the first pin 122 supported by the first guide hole 121 of the guide rail member 110, and the first pin 122 is a slider 48. The slider 48 is advanced because it is coupled with the first pin coupling hole (48c).

The advancing slider 48 moves first and second

elastic support portions

44 and 45 while the jaw manipulation portion 48a installed at the end of the slider 48 is moved along the jaw member 46 supported by the rod 41. The first and second jaws (42, 43) supported on the plate are moved in the closing direction. In particular, since the outer side of the first and

second jaws

42 and 43 protrudes obliquely to the outside, the first and

second jaws

42 and 43 are tightened when the jaw manipulation part 48a moves. Accordingly, the tissues such as blood vessels are ligated by tightening the clips 200 supported by the

clip support portions

42a and 43a of the first and

second jaws

42 and 43.

In this process, the second hook member 153 is rotated in the clockwise direction so that the second transfer member 145 is retracted. Accordingly, the second pin 142 and the second pin supported on the second transfer member 145 are made. The clip loading member 71 coupled by the two-pin coupling hole 71a is retracted backward. Therefore, the loading protrusion 73 formed at the clip loading portion 72 provided at the end of the clip loading member 71 moves backward along the guide guide groove 66 and is supplied by the pusher of the cartridge unit 60. By contacting the back of the clip 200 is in the standby state of the clip loading. At this time, since the pressing portion 77 bent downward is formed at the end of the cover member 75 coupled with the guide body 50, the clip loading portion 72 is elastically downward by the pressing portion 77. Is pressurized.

When the ligation of the clip 200 is completed as described above, the lever 26 is returned to the first elastic spring 27 when the feed force to the rear, ie, the gripping force, is removed. When the lever 26 is rotated to the front side due to the return of the lever 26, the first transfer member 125 is retracted by the first hook member 129. Accordingly, the slider 48 coupled by the first transfer member 125 and the first pin 122 is retracted, and the jaw manipulation portion 48a of the slider 48 coupled to the jaw member 46 is separated. The first and

second jaws

42 and 43 are opened by the first and second

elastic support parts

44 and 45 supporting them.

In this process, the second transfer member 145 is advanced by the second hook member 150, and the clip loading member 71 coupled by the second pin 142 and the second pin coupling hole 71a. ) Is advanced, and the clip loading portion 72 provided at the end thereof is advanced to load the clip 200 into the

clip support portions

42a and 43a of the first and

second jaws

42 and 43. .

In this process, the clip pressing piece 64 provided at the end of the cartridge unit 60 presses the clip 200 downward, and the elastic guide piece 52 provided at the elastic guide part 51 is provided with the first, The clips inserted into the clip supports 42a and 43a of the two

jaws

42 and 43 are pressed down to prevent them from being separated therefrom.

On the other hand, since the clip applier of the present invention includes the clip ligation safety unit 170, the ligation of the tissue by the clip 200 is not completely performed as described above, and the clip by the doubler clip loading unit 70 It is possible to prevent the lever 26 from moving forward in a state where the supply standby state of the 200 is not completely achieved.

In more detail, when the lever 26 is pulled to ligation the clip 40, the rack part 172 of the safety control member 173 rotating together with the lever 26 is formed of the latch member 176. In contact with the two teeth 175 are moved. This movement is above the center axis connecting the center of the first hinge shaft 25 and the second hinge shaft 151 supporting the lever 26 by the second tooth 175 formed on the latch member 176. Since the position is positioned, the first and

second teeth

172a and 175 are not coupled to each other when the rack 172 moves.

However, when the conveyance force of the lever 26 is removed in the process of being moved, the safety control member 173 rotates in the clockwise direction together with the lever 26, and the first teeth 172a of the rack portion 172 are latched. In combination with the second tooth 175 of the member 176, the rotation of the safety control member 73 and the lever 26 is fixed.

Therefore, the lever 200 is not returned when the clip 200 is not completely ligated.

When the ligation of the clip is completed by fully pulling the lever 26, as shown in FIG. 13, the rack part 172 is out of the second tooth 175 of the ratchet member 176. When the lever 26 is returned in this state, as shown in FIG. 14, the safety control member 173 rotates in a counterclockwise direction, and the rack part 172 is engaged with the second tooth 175 of the latch member 176. It will not slide but will return the lever 26 to its original state.

As described above, the clip applicator according to the present invention is relatively simple in structure since the ligation of the clip and the supply of the clip can be simultaneously performed by one lever operation. In addition, the jaw is prevented from being opened while the ligation of the clip is not completed, thereby increasing the reliability of the ligation.

Although the present invention has been described with reference to the embodiments shown in the drawings, this is merely exemplary, and it will be understood by those skilled in the art that various modifications and equivalent other embodiments are possible. Therefore, the true technical protection scope of the present invention will be defined by the technical spirit of the appended claims.

Claims

A handle housing and a tubular member installed at the handle housing and having a predetermined length and diameter;

And a rod extending from the handle housing and first and second jaws provided on the end of the rod so as to be movable between an open position and a closed position, each having a clip support on a corresponding surface. A clip ligation unit including a jaw member having an elastic part extending to provide an elastic force in an opening direction of the first jaws, and a slider slidably installed on the rod to open and close the first jaws of the jaw members; ;

A guide body part installed in the lower side pipe member of the clip ligation unit and provided with a clip guide part for guiding the clip to the side of the first and second jaws, and a cartridge unit installed on the guide body part to supply the clip; A clip loading member for moving the clip supplied from the cartridge unit along the clip guide part and loading the clip support part of the first and second jaws, and a cover member coupled to the guide main part to guide the transfer of the clip loading member. A clip loading unit provided;

When the lever installed in the handle housing is retracted, the slider is moved forward to move the first and second jaws in the direction of closing and the clip is ligated, and when the lever is advanced, the clip loading member is advanced to supply the clip to the clip support unit. Clip applier comprising: a unit.
The method of claim 1,

The operation unit

A guide rail member installed inside the handle housing and having a first guide portion for moving the slider and the clip loading member in the longitudinal direction of the pipe member and a first guide groove formed in the guide rail member in the longitudinal direction; A first pin which is forward and backward along the length direction and is coupled to an end of the slider,

A second pin which is advanced back and forth along the second guide groove formed in the longitudinal direction of the rear end side of the guide rail member, and coupled to an end of the clip loading member;

A first conveying member forward and backward along the guide rail member and having a first pin coupled thereto, a second conveying member installed forward and backward on the rear end side of the guide rail member and having a second pin coupled thereto;

A lever having a first hook member rotatably installed on the handle housing by a hinge shaft and having a first transfer shaft engaging portion coupled to first transfer shafts formed on both sides of the first transfer member;

It is rotatably coupled to a second hinge shaft fixed to a portion spaced apart from the first hinge shaft of the lever, and has a second transfer shaft coupling portion coupled to the second transfer shaft installed on both sides of the second transfer member, A second hook member having a second operating extension formed with a first guide hole coupled with a guide shaft of the first operating extension extending from the lever;

It provides an elastic force for rotating the lever to the tube member side, the clip applicator comprising a first elastic spring coupled to both ends of the support pin formed on one side of the lever and the lower side of the handle housing.
The method of claim 2,

And the operation unit further comprises a clip ligation safety unit for returning the lever when the ligation of the clip is completed by the operation of the lever.
The method of claim 3,

The clip ligation safety unit is rotatably installed on the first hinge shaft, the safety operation member including a support portion supported on the lever, the rack portion is installed on the other side of the support portion and the first teeth are formed in an arc shape, and the rack portion It is installed in the handle housing adjacent to the rotatably installed on the ratchet shaft and is coupled with the first teeth of the rack portion when the lever is not fully retracted for the ligation of the clip to prevent the advance of the lever And a latch member having two racks, and an elastic spring for rotating the latch member for elastically biasing the second teeth provided on the latch member toward the wrap portion.
The method of claim 2,

The guide rail member is composed of first and second members separated in the longitudinal direction, and the first and second transfer members slidably installed on the guide rail member are installed on the handle housing and the first and second transfer members. Clip applier characterized in that the elastic biased in the mutual direction by the springs.
The method of claim 2,

The clip loading member is a clip applier, characterized in that the long hole is inserted into which the first pin is inserted so that interference with the first pin does not occur when the clip loading member is moved forward or backward.
The method of claim 2,

At the end of the clip loading member is formed a pair of loading protrusions for loading with a clip supplied from the cartridge unit,

The clip guide part is a clip applier, characterized in that an elastic guide piece for guiding the clip to the clip support part.
The method of claim 1,

An end portion of the cover member is provided with a bent portion bent downward to press the end portion of the clip loading member to the cartridge side when the clip loading member is moved forward and backward, and a pressing portion extending in the horizontal direction from the bent portion Clip applier.
The method of claim 1,

The jaw member includes a base formed with a coupling hole coupled to a support protrusion formed at an end side of the rod, and an elastic support part connecting the base and the first and second jaws to provide an elastic force in the opening direction of the first and second jaws. ,

Clip end portion of the slider is characterized in that the jaw operating portion for wrapping the elastic support portion and the first and second jaw close to the ligation clip to form a clip when moving forward.
The method of claim 9,

The rod to which the jaw member is coupled is a clip applier, characterized in that the jaw member further comprises a support for preventing the jaw from being separated from the rod and the jaw is shifted, the jaw member can move along the slider.