WO2021083143A1

WO2021083143A1 - Clip cartridge apparatus and surgical instrument

Info

Publication number: WO2021083143A1
Application number: PCT/CN2020/124029
Authority: WO
Inventors: 张翚; 刘殿臣; 杜运峰
Original assignee: 苏州英途康医疗科技有限公司
Priority date: 2019-10-28
Filing date: 2020-10-27
Publication date: 2021-05-06
Also published as: CN112716558B; CN112716558A

Abstract

A clip cartridge apparatus (100) and a surgical instrument. The clip cartridge apparatus (100) comprises a mounting housing having a mounting cavity (54) formed inside, a rotating housing (7) provided in the mounting cavity (54) and capable of moving relative to the mounting housing, several clip cartridge components (10) provided in the rotating housing (7), a clip discharge component pushing the clip cartridge components (10) in the rotating housing (7) to move out of the clip cartridge apparatus (100), a driving component driving the rotating housing (7) to rotate relative to the mounting housing, and a braking member (3) that is abutted against and matched with the rotating housing (7) to limit the rotation of the rotating housing (7) relative to the mounting housing; the braking member (3) and the mounting housing are fixed with each other in a circumferential direction. If the several clip cartridge components (10) are accommodated in the rotating housing (7) in the mode of being arranged along a circumferential direction, the entire structure of the clip cartridge apparatus (100) become small and light, thereby facilitating reducing the pressure of storing a medical instrument.

Description

Clamping device and surgical instruments

This application claims the priority of the Chinese patent application No. 201911031154.6 filed on October 28, 2019, and the content of the above-mentioned Chinese patent application is quoted here in full as a part of this application.

Technical field

The embodiment of the present disclosure relates to a clamping device and a surgical instrument.

Background technique

In order to fully expose the surgical field of vision during the surgical operation, it is necessary to ligate the blood vessels around the target tissue to prevent bleeding. Hemostasis technology has become one of the core of basic surgical techniques. Surgical operations on any part of the human body almost without exception involve bleeding and hemostasis. Generally, surgical instruments are used to apply a ligation clip, and the ligation clip ligates blood vessels around the target tissue.

Summary of the invention

According to an embodiment of the present disclosure, there is provided a clamping device including a mounting housing with a mounting cavity formed therein, a rotating housing arranged in the mounting cavity and movable relative to the mounting housing, and a rotating housing arranged in the rotating housing. A number of clamping bin assemblies in the housing, a clamping assembly that pushes the clamping bin assembly in the rotating housing to move out of the clamping bin device, a drive assembly that drives the rotating housing to rotate relative to the mounting housing, and the The rotating shell is a stopper that is fitted to restrict the rotation of the rotating shell relative to the mounting shell, and the stopper and the mounting shell are fixed to each other in the circumferential direction. A plurality of storage cavities for accommodating the plurality of clamping bin assemblies are formed in the rotating housing, and each of the receiving cavities extends along the axial direction of the rotating housing and passes through the rotating housing, and the plurality of receiving cavities The cavities are evenly arranged in the circumferential direction around the axis of the rotating housing; the mounting housing includes a first end surface and a second end surface disposed opposite to each other, and the first end surface of the mounting housing is provided with the plurality of receiving cavities A discharging hole communicated with one of the storage chambers; the clamping assembly pushes the clamping bin assembly contained in the one containing chamber communicating with the discharging hole to move out of the clamping bin device; pushing the clamping assembly During the process of moving the clamping bin assembly contained in the one storage cavity out of the clamping bin device, the brake restricts the rotation of the rotating housing relative to the mounting housing; After the clamping bin assembly contained in the one storage cavity is moved out of the clamping bin device, the drive assembly drives the rotating housing to rotate relative to the mounting housing to make the other storage cavity of the plurality of storage cavities Communicate with the discharge hole.

For example, the clip-out assembly includes a rod body extending from the outside of the mounting housing into the mounting cavity and a push block provided on the rod body; the push block is driven by the rod body to enter and exit the mounting cavity. The one receiving cavity communicated with the material hole pushes the clamping bin assembly in the receiving cavity to move in the direction of the discharge hole to remove the clamping bin device.

For example, the rotating housing includes a cylinder extending along the axial direction of the rotating housing, the plurality of receiving cavities formed in the cylinder, and a central cavity formed in the cylinder, the center The cavity extends along the axis of the rotating housing and passes through the rotating housing, and a pushing groove is formed between the central cavity and each of the receiving cavities to communicate the central cavity with each of the receiving cavities The pushing groove is arranged along the axis of the rotating housing and penetrates at least one side of the receiving cavity close to the second end surface, the rod body extends into the central cavity, and the pushing block passes through The pushing groove enters the one receiving cavity communicating with the discharge hole.

For example, the rod body is a screw threaded with the push block; the push block includes a connecting portion that is threadedly connected to the screw, a connecting rod extending from the connecting portion to a side away from the screw, and A pushing portion formed on the end of the connecting rod; when the pushing block enters the one receiving cavity communicating with the discharge hole via the pushing groove, the connecting portion is located in the central cavity, so The pushing part is located in the one receiving cavity communicating with the discharge hole, and the connecting rod passes through the pushing groove.

For example, the clip-out assembly further includes a gear set mounted on the mounting housing and used to drive the screw to rotate. The gear set includes a driving wheel and a driven wheel meshing with the driving wheel. The moving wheel is sleeved on the screw.

For example, the screw passes through the central cavity of the rotating housing and is inserted into the first end surface of the mounting housing.

For example, the drive assembly includes a number of oblique wedges arranged on the rotating shell and arranged in the circumferential direction of the rotating shell, formed in the mounting shell and arranged on the second part of the mounting shell. The catch sleeve between the two end faces and the rotating housing, and a first elastic member arranged between the first end face of the mounting housing and the rotating housing; each of the oblique wedge faces The end of the second end surface has an inclined surface; the catch sleeve is formed with a number of inclined grooves arranged along the circumference of the rotating housing and corresponding to the number of the inclined wedges and matched with the inclined wedges In the process that the clip out assembly pushes the clip bin assembly contained in the one receiving cavity to move out of the clip bin device, the first elastic member is deformed; in the clip out assembly pushes the one contained bin After the clamping bin assembly contained in the cavity is moved out of the clamping bin device, the first elastic member pushes the rotating housing to move away from the discharge hole under the action of its elastic restoring force so as to make the first elastic member move away from the discharge hole. The oblique wedge moves to the oblique groove, and the oblique wedge cooperates with the oblique groove to rotate the rotating housing at an angle relative to the mounting housing, and the rotating housing is relative to the mounting housing. After the housing rotates by an angle, the other one of the plurality of receiving cavities communicates with the discharge hole.

For example, the number of the plurality of oblique wedges is equal to the number of the plurality of receiving cavities and is arranged in a one-to-one correspondence.

For example, each of the oblique wedge extends toward the second end surface of the mounting housing, so that the end of the oblique wedge having the inclined surface protrudes from the rotating housing.

For example, an annular groove is concavely formed on the outer peripheral wall of the rotating shell, and the first elastic member is sleeved on the annular groove.

For example, the stopper is arranged between the second end surface of the mounting housing and the rotating housing, and the stopper includes a plurality of oblique wedges arranged toward the A number of V-shaped grooves matched to the wedges, and the number of the number of V-shaped grooves is equal to the number of the plurality of oblique wedges and arranged in a one-to-one correspondence; the brake also includes an axis along the mounting housing A plurality of card slots extending in the direction, each of the card slots is located between adjacent V-shaped grooves, the mounting housing is formed with a number of clamping blocks respectively matched with the plurality of card slots, passing through the plurality of card slots The clamping and matching with the plurality of clamping blocks to make the braking member and the mounting housing be fixed to each other in the circumferential direction; the clamping assembly pushes the one storage communicating with the discharge hole During the process of moving the clamping bin assembly contained in the cavity out of the clamping bin device, the plurality of V-shaped grooves respectively resist the plurality of oblique wedges to restrict the rotation of the rotating housing relative to the mounting housing; In the vertical direction perpendicular to the axial direction of the clamping device, each of the oblique wedges protrudes from the corresponding V-shaped groove, so that the rotating housing moves in a direction away from the discharge hole to When the oblique wedge moves to the oblique groove, the oblique wedge is blocked by the oblique groove so that the oblique wedge is separated from the V-shaped groove, and the V-shaped groove is no longer restricted The rotating housing rotates in the circumferential direction of the mounting housing, and the oblique wedge cooperates with the oblique groove to rotate the rotating housing by an angle relative to the mounting housing.

For example, the plurality of clamping blocks are arranged on the grasping sleeve, and each of the clamping blocks does not protrude from the grasping sleeve in the axial direction of the mounting housing.

For example, the braking member further includes a sheet body and a plurality of clamping sheets arranged on the sheet body along the circumferential direction, each of the clamping sheets is formed with the V-shaped groove, and two adjacent clamping sheets are formed. The clamping groove is formed between the holding pieces, the rod body penetrates the piece body and enters the rotating housing, and the pushing block is located between the piece body and the rotating housing.

For example, the sheet body is provided with a restriction cavity with an opening facing the pushing block and used for accommodating the pushing block.

For example, the push block is located between the brake and the rotating housing, and after the clamping out assembly pushes the clamping bin assembly contained in the one accommodating cavity to move out of the clamping bin device, The push rod drives the push block to move in a direction away from the discharge hole, and then the push block pushes the brake to move in a direction away from the discharge hole.

For example, the clamping device further includes a second elastic member clamped between the second end surface of the mounting housing and the braking member, and the second elastic member is sleeved on the rod body; After the clamping assembly pushes the clamping bin assembly contained in the one storage cavity to move out of the clamping bin device, the push block pushes the brake member to move away from the discharge hole and causes the first The two elastic members are deformed; and in the process of pushing the clamping bin assembly contained in the one receiving cavity to move out of the clamping bin device by the clamping out assembly, under the action of the elastic restoring force of the second elastic member The stopper moves toward the direction of the discharging hole and engages with the rotating housing to restrict the rotation of the rotating housing relative to the mounting housing.

For example, a clamping assembly is formed on each of the clamping bin components, and the plurality of clamping bin assemblies are sequentially moved out of the clamping bin device and arranged in a row along the axial direction of the clamping bin device. The bin components are connected to each other through the clamping component.

For example, the mounting housing includes a first housing and a second housing sleeved outside the first housing, the first housing and the second housing are surrounded to form the mounting cavity, so The installation cavity extends along the axial direction of the clamping device, the first end surface is arranged on the first housing, and the second end surface is arranged on the second housing.

According to an embodiment of the present disclosure, there is provided a surgical instrument, including: a grip, a working head detachably connected to the grip, a shaft assembly detachably mounted on the working head, and a detachable The clamping device as described above installed on the working head, wherein the holding part and/or the working head includes a driving device, and the side of the shaft assembly close to the clamping device is arranged There is an opening, and the opening is in communication with the discharge hole.

For example, the shaft assembly includes a push-clamping rod, an inner sleeve, a clamp, and a firing sleeve. The clamp is arranged at an end of the inner sleeve away from the working head; the function of the driving device The several clamping components in the clamping device are sequentially moved out of the clamping device and arranged in a row in the inner sleeve; under the action of the driving device, the pushing and clamping rod will hold the clamping components The ligation clip in the clevis is fed into the pliers; and the firing sleeve closes the pliers under the action of the driving device, and the ligation clip located in the pliers is applied to the target tissue.

Description of the drawings

In order to more clearly describe the technical solutions of the embodiments of the present disclosure, the following will briefly introduce the drawings of the embodiments of the present disclosure. Obviously, the drawings described below only refer to some embodiments of the present disclosure, and do not limit the present disclosure. .

Fig. 1 is an exploded view of a bin clamping device according to an embodiment of the disclosure;

Figure 2 is an exploded view of the clamping device shown in Figure 1 in another direction;

Figure 3 is an exploded view of the clamping device shown in Figure 1 in another direction;

Figure 4 is a cross-sectional view of the clamping device shown in Figure 1;

Fig. 5 is a schematic diagram of the structure of the clamping bin assembly in Fig. 1;

Figure 6 is an exploded view of the folder assembly shown in Figure 5;

7 is a schematic diagram of the movement principle between the oblique wedge and the oblique groove in the bin clamping device of the embodiment of the disclosure;

Fig. 8 is a schematic diagram of a surgical instrument according to an embodiment of the disclosure;

Fig. 9 is an exploded view of the surgical instrument shown in Fig. 8.

Detailed ways

In order to make the objectives, technical solutions, and advantages of the embodiments of the present disclosure clearer, the technical solutions of the embodiments of the present disclosure will be described clearly and completely in conjunction with the accompanying drawings. Obviously, the described embodiments are part of the embodiments of the present disclosure, rather than all of the embodiments. Based on the described embodiments of the present disclosure, all other embodiments obtained by those of ordinary skill in the art without creative labor are within the protection scope of the present disclosure.

Unless otherwise defined, the technical terms or scientific terms used herein shall be the ordinary meanings understood by those with ordinary skills in the field to which this disclosure belongs. The "first", "second" and similar words used in the specification and claims of the present disclosure do not indicate any order, quantity or importance, but are only used to distinguish different components. "Including" or "including" and other similar words mean that the elements or items before "including" or "including" now cover the elements or items listed after "including" or "including" and their equivalents, and do not exclude other Components or objects. The terms "upper", "lower", "left", "right", etc. are only used to indicate the relative positional relationship. When the absolute position of the described object changes, the relative positional relationship may also change accordingly.

For example, during surgery, due to the requirement for the number of ligation clips, the operator needs to perform multiple clip application operations, which reduces work efficiency, increases operation time, increases patient bleeding, and prolongs patient recovery time. Under this circumstance, clamps capable of continuously feeding clamps came into being, but most of the clamps capable of continuously feeding clamps are disposable and integrated with the working head, which increases medical costs and increases the economic pressure on patients. .

The surgical instrument shown in an embodiment of the present disclosure includes a holding part 200, a working head 300 detachably connected to the holding part, a shaft assembly 400 detachably mounted on the working head 300, and a detachable The clamping device 100 is installed on the working head 300. For example, the holding part 200 and/or the working head 300 include the driving device 500; in this case, the holding part 200 may include the driving device 500 and the working head 300 does not include the driving device 500, or the working head 300 may include the driving device 500. The device 500 and the holding part 200 do not include the driving device 500, or it may be that the holding part 200 includes a part of the driving device 500 and the working head 300 includes another part of the driving device 500. For example, the shaft assembly 400 includes a push rod 401, an inner sleeve 402, a clamp 403, and a firing sleeve 404; the clamp 403 is provided at an end of the inner sleeve 402 away from the working head 300; the inner sleeve 402 is inserted in the firing Inside the sleeve 404, and the clamp 403 is exposed from the end of the firing sleeve 404 away from the working head 300; the push clamp rod 401 is inserted into the inner sleeve 402. The shaft assembly 400 has an opening on one side close to the clamping device 100, and the opening is in communication with the discharge hole 11 of the clamping device 100. The clamping assembly 10 in the clamping device 100 is pushed out of the clamping device 100 through the aforementioned The opening enters into the shaft assembly 400, more precisely, into the inner sleeve 402 of the shaft assembly 400. Under the action of the driving device 500, the several clamping assemblies 10 in the clamping device 100 are moved out of the clamping device 100 one by one and arranged in the shaft assembly 400 along the axial direction; then, pushed under the action of the driving device 500 The clamping rod 401 pushes the clamping piece 103 to send a ligature clip 104 in the clamping bin assembly 10 into the clamp 403; then, under the action of the driving device 500, the sleeve 404 is fired to close the clamp 403, and the firing is completed. 104 is applied to the target tissue. The clip feeding and firing are repeated until all the ligature clips 104 in the several clamping bin assemblies 10 are fired. After that, the new clamping device 100 is replaced.

1 to 4, the clamping device 100 includes a mounting housing mounted on a working head and a mounting cavity 54 formed therein, and a rotating housing disposed in the mounting cavity 54 and movable relative to the mounting housing. Body 7, several clamping bin assemblies 10 arranged in the rotating shell 7, pushing the clamping bin assembly 10 in the rotating shell 7 to move out of the clamping assembly of the clamping bin device, and driving the rotating shell 7 relative to The drive assembly for the rotation of the mounting housing, the brake 3 that is in a resisting fit with the rotating housing 7 to limit the rotation of the rotating housing 7 relative to the mounting housing, and the brake 3 that is arranged on the rotating housing 7 The first elastic member 2 and the second elastic member 4 on opposite sides of the Here, it should be noted that the axial direction of the clamping device 100 (ie, the longitudinal direction of the clamping device 100), the axial direction of the mounting housing, and the axial direction of the rotating housing 7 are all the same.

For example, the mounting housing includes a first housing 1 and a second housing 5 sleeved outside the first housing 1, and the first housing 1 and the second housing 5 surround a mounting cavity 54 , The installation cavity 54 extends along the axial direction of the clamping device 100. For example, both the first housing 1 and the second housing 5 have a barrel-shaped structure; however, the embodiment of the present disclosure is not limited to this, and one of the first housing 1 and the second housing 5 may be a barrel-shaped structure. The other is a cover, and the cover is arranged on the barrel-shaped structure to define the installation cavity 54. For example, the mounting housing has a first end surface 12 and a second end surface 51 opposite to each other. The first end surface 12 is formed on the first housing 1, the second end surface 51 is formed on the second housing 5. The end surface 12 and the second end surface 51 are two end surfaces defining the mounting cavity 54 respectively. The first end surface 12 is provided with a discharging hole 11 communicating with the mounting cavity 54. After the clamping device 100 is installed on the working head, the discharging hole 11 is butted with the opening of the shaft assembly. In the embodiment of the present disclosure, the purpose of setting the mounting housing as the first housing 1 and the second housing 5 is to facilitate the overall assembly of the clamping device. The first housing 1 and the second housing 5 are clamped between the first housing 1 and the second housing 5. The solid structure (not numbered) realizes the connection. Of course, they can also be connected by other means, such as connection by fasteners.

The rotating housing 7 includes a cylinder 71 extending along the axis of the clamping device 100, a plurality of storage cavities 73 formed in the cylinder 71 for accommodating the clamping bin assembly 10, and a cylinder 71 formed in the cylinder 71 Central cavity 74. The accommodating cavity 73 and the central cavity 74 extend along the axial direction of the bin clamping device 100 and penetrate the cylinder 71 of the rotating housing 7 along the axial direction of the bin clamping device 100. The central axis of the central cavity 74 overlaps the central axis of the rotating housing 7, and a number of said receiving cavities 73 are evenly arranged around the axis of the rotating housing 7 in the circumferential direction of the rotating housing 7. There is always a receiving cavity 73 in the plurality of receiving cavities 73 that is connected to the discharge hole 11 (including when the clamping assembly does not move any one of the clamping bin assemblies 10 out of the initial state of the clamping bin device 100). A pushing groove 75 is formed between the central cavity 74 and each accommodating cavity 73 to connect the central cavity 74 and each accommodating cavity 73. The pushing groove 75 is arranged along the axial direction of the clamping device 100 and penetrates at least The side of the receiving cavity 73 close to the second end surface 51.

The clip-out assembly includes a rod body 8 extending from the outside of the mounting housing into the mounting cavity 54 and a push block 6 provided on the rod body 8. The push block 6 is driven by the rod body 8 into one of the receiving cavities 73 and pushes the clamping bin assembly 10 in the receiving cavity 73 to move in the direction of the discharge hole 11. In the embodiment of the present disclosure, the rod body 8 is a screw threaded with the push block 6, and the screw 8 cooperates with the thread of the push block 6, so that the rotation movement of the screw 8 becomes the linear movement of the push block 6. In order to make the push block 6 move in the receiving cavity 73. The rod body 8 extends into the central cavity 74. The pushing block 6 includes a connecting portion 61 threadedly connected to the screw 8, a connecting rod 62 extending from the connecting portion 61 to a side away from the screw 8, and a pushing portion 63 formed on the end of the connecting rod 62, When the pushing block 6 enters one of the receiving cavities 73, the connecting portion 61 is located in the central cavity 74, the pushing portion 63 is located in the corresponding receiving cavity 73, the connecting rod 62 passes through the corresponding pushing groove 75, and the screw 8 rotates to drive The pushing part 63 moves linearly, and the pushing part 63 pushes the clamping bin assembly 10 in the receiving cavity 73 to move toward the discharge hole 11. For example, in order to stabilize the screw 8, one end of the screw 8 passes through the rotating housing 7 and is inserted into the first end surface 12. Of course, the embodiment of the present disclosure does not limit the structure of the clamping assembly. For example, the following arrangement can also be adopted. For example, the push block 6 is directly fixed on the rod body 8, and the rod body 8 can rotate relative to the rotating housing 7 along the rotating housing 7. Move in the direction of the axis, so that the push block 6 is moved in the receiving cavity 73 by pushing the rod body 8. In this structure, the central cavity 74 may not be provided.

The brake 3 and the mounting housing are fixed to each other in the circumferential direction. The brake 3 includes a plurality of V-shaped grooves 34 and a plurality of clamping grooves 35 extending along the axial direction of the rotating housing 7. For example, the number of the V-shaped grooves 34 is equal to the number of the oblique wedges 72 and is arranged in a one-to-one correspondence. For example, the braking member 3 includes a circular plate body 36 and a plurality of clamping plates 37 arranged on the circular plate body 36 in a circumferential direction, each of the clamping plates 37 is formed with a V-shaped groove 34 A card slot 35 is formed between two adjacent holding pieces 37. The brake 3 is arranged between the second end surface 51 and the rotating housing 7. The rod body 8 passes through the circular plate body 36, and the central axis of the rod body 8 overlaps with the central axis of the circular plate body 36. The push block 6 is located between the circular plate body 36 and the rotating housing 7, and the circular plate body 36 of the brake 3 protrudes toward the direction of the push block 6 to form a useful for accommodating the push block 6 The restricting block 33 has a restricting cavity 38 concavely formed on the restricting block 33, and the opening of the restricting cavity faces the pushing block 6. When the push block 6 is moved out of the receiving cavity 73, the push block 6 enters the restriction cavity 38, and the restriction cavity 38 can prevent the push block 6 from rotating under the drive of the rod body 8, so that the push block 6 is kept on a circle In the angular position, when the push block 6 enters the next storage cavity 73, the corresponding positions of the push block 6 and the storage cavity 73 are misaligned. For example, in the embodiment of the present disclosure, the clip-out assembly further includes a gear set 9 installed on the second housing 5 and used to drive the screw to rotate. The gear set 9 includes a driving wheel 91 and a gear set. The driven wheel 92 meshed with the driving wheel 91. After the clamping device 100 is installed on the working head, the driving wheel 91 is connected with the driving device 500 to transmit the force of the driving device 500 to the driven wheel 92. The driven wheel 92 sets It is arranged on the rod body 8, and the rod body 8 and the driven wheel 92 are connected by plugs and other components. For example, the rod body 8 passes through the second end surface 51 to extend from the outside of the mounting housing into the installation cavity 54. There is a clearance fit between the rod body 8 and the second end surface 51, so that when the rod body 8 is driven to rotate by the driven wheel 92 , The second housing 5 will not rotate with it.

The drive assembly includes a number of oblique wedges 72 arranged on the rotating housing 7 and arranged in the circumferential direction of the rotating housing 7, formed in the mounting housing (for example, the first housing 5) and A catching sleeve 52 arranged in the circumferential direction of the mounting housing (for example, the first housing 5) and a first elastic member 2 provided between the first end surface 12 of the mounting housing and the rotating housing 7. For example, the first elastic member 2 and the second elastic member 4 are springs; however, the embodiment of the present disclosure is not limited to this, and the first elastic member 2 and the second elastic member 4 may also be other elastic members. With reference to FIGS. 1-3 and 7, the end of the oblique wedge 72 facing the second end surface 51 has an oblique surface configured to resist an oblique surface of the V-shaped groove 34; further, for example, an oblique surface The wedge 72 extends toward the second end surface 51 to protrude from the cylinder 71 so that the end of the oblique wedge 72 having the above-mentioned inclined surface protrudes from the cylinder 71, and the inclined surface is configured to be inclined with one of the V-shaped grooves 34 Face resistance. For example, by providing a rectangular parallelepiped raw material piece, the rectangular raw material piece is cut by cutting off one corner of a rectangular surface of the rectangular parallelepiped raw material piece to obtain an oblique wedge 72. A plurality of oblique grooves 521 arranged along the circumference of the installation housing (for example, the first housing 5) and corresponding to the number of the oblique wedges 72 and matched with the oblique wedges 72 are formed on the grasping sleeve 52 . In the embodiment of the present disclosure, a plurality of oblique wedges 72 are formed extending from the outer circumferential surface of the cylinder 71 toward the second end surface 51, and a plurality of oblique wedges 72 protrude from the end surface of the cylinder 71. In the embodiment of the present disclosure, for example, a plurality of oblique wedges 72 and the cylinder 71 are integrally formed. For example, the grasping sleeve 52 is integrally formed on the inner wall of the second housing 5. The holding piece 37 is located between the oblique wedge 72 and the second end surface 51, the V-shaped groove 34 on the holding piece 37 faces the oblique wedge 72, and the V-shaped groove 34 resists the oblique wedge 72 to restrict rotation The housing 7 rotates along the axial direction in which the housing is installed. The mounting housing (for example, the first housing 5) is formed with a clamping block 522 that cooperates with the clamping groove 35. The clamping block 522 is formed on the catch sleeve 52 and is in the axial direction of the clamping device 100. The clamping block 522 does not protrude from the grasping sleeve 52, an insertion groove 523 is formed between two adjacent clamping blocks 522, and the clamping piece 37 can be inserted into the insertion groove 523. In the embodiment of the present disclosure, the stopper 3 and the mounting housing are fixed to each other in the circumferential direction through the cooperation of the clamping block 522 and the clamping groove 35. The brake 3 may also have other structures, for example, it may be a movable block arranged on the second housing 5. For example, in the vertical direction perpendicular to the axial direction of the clamping device 100, the oblique wedge 72 protrudes from the V-shaped groove 34; in this way, when the oblique wedge 72 and the V-shaped groove 34 move toward the second end surface 51 together When reaching the oblique groove 521, the oblique wedge 72 is blocked by the oblique groove 521 because it protrudes from the V-shaped groove 34 in the vertical direction, and the oblique wedge 72 is separated from the V-shaped groove 34 so that the V-shaped groove 34 can no longer be restricted. The rotating housing 7 rotates in the circumferential direction of the mounting housing, and the oblique wedge 72 rotates along the circumferential direction of the mounting housing under the guidance of the oblique groove 521, thereby driving the entire rotating housing 7 to rotate in the circumferential direction of the mounting housing. . For example, the first elastic element 2 is clamped between the first end surface 12 and the rotating housing 7, and the second elastic element 4 is clamped between the second end surface 51 and the braking element 3. For example, the outer circular side wall of the rotating housing 7 is concavely formed with an annular groove for sheathing the first elastic member 2. The second elastic member 4 is sleeved on the rod body 8. The second elastic member 4 pushes the braking member 3 to move in the direction of the discharge hole 11 to make the braking member 3 resist the rotating housing 7. At this time, the first elastic member 2 is deformed, for example, by Compression; After the push block 6 moves away from the discharge hole 11 and moves out of the receiving cavity 73, the clamping assembly pushes the brake 3 to move away from the discharge hole 11 and makes the The second elastic member 4 is deformed, for example, compressed; the previously deformed first elastic member 4 pushes the rotating housing 7 to move away from the discharge hole 11 under the action of its elastic restoring force; When the wedge 72 and the V-shaped groove 34 are moved to the oblique groove 521 of the catching sleeve 52 in a direction away from the discharge hole 11, the oblique wedge 72 is obliquely grooved because it protrudes from the V-shaped groove 34 in the vertical direction. Blocked by 521, the oblique wedge 72 is separated from the V-shaped groove 34, and the oblique wedge 72 cooperates with the oblique groove 521 to rotate the rotating housing 7 by an angle relative to the mounting housing. The number of cavities 73 is equal to the number of receiving cavities 73 and arranged in a one-to-one correspondence. After the rotating housing 7 rotates an angle relative to the mounting housing, one of the receiving cavities 73 is butted with the discharge hole 11. It should be noted here that when the push block 6 is still located in the receiving cavity 73, the braking member 3 is held against the diagonal wedge 72 due to the elastic restoring force of the second elastic member 4, and this At this time, the restricting cavity 38 abuts against the end surface of the rotating housing 7, and the restricting cavity 38 is connected to the receiving cavity 73 provided with the push block 6. Therefore, when the pushing block 6 is moved out of the receiving cavity 73 (the pushing block 6 faces the second After the end face 51 moves in the direction), it will directly enter the restriction cavity 38. Then, when the push block 6 moves in the direction of the second end surface 51 again, the push block 6 pushes the stopper 3, and the stopper 3 compresses the second elastic element 4 to deform the second elastic element 4. In other embodiments, instead of using the push block 6 to move the braking member 3 backward to compress the second elastic member 4, for example, a pressure block is provided on the rod body 8, and the pressure block is located on the second elastic member 4. Between the push block 6 and the push block 6, when the rod 8 drives the push block 6 to move away from the discharge port 11, the pressing block moves synchronously, and the second elastic member 4 is compressed and deformed by the pressing block.

Referring to FIGS. 5 and 6 in combination with FIG. 1, in the embodiment of the present disclosure, in order to facilitate the subsequent extraction of the clamping cartridge assembly 10 from the shaft assembly to install a new clamping cartridge assembly 10, the surgical device can be reused The total length of the plurality of clamping bin assemblies 10 after unfolding is substantially equal to the length of the shaft assembly. For example, the plurality of clamping bin assemblies 10 are arranged in the shaft assembly along the axis direction after being unfolded, and the clamping bin assembly 10 located in the shaft assembly and farthest from the clamp 403 is called the end clamping bin assembly and the end clamping bin The assembly 10 and the discharge hole 11 are fixed to each other. For example, each of the clamping bin assemblies 10 is formed with a clamping assembly 101 for clamping and cooperating with the clamping bin assemblies 10 adjacent in the axial direction. For example, each silo assembly 10 includes a silo body 102, a push clip 103 arranged on the silo body 102 to surround the silo body 102 to form a silo cavity 105, and a ligature clip 104 that is accommodated in the silo cavity 105 And the clamping components 101 formed on the front and rear ends of the bin body 102. The bin cavity 105 penetrates the front and rear ends of the bin body 102, and the bin body 102 is formed with elastic ratchet teeth 106 useful to prevent the ligation clip 104 in the bin cavity 105 from retreating. Insert the elastic ratchet teeth 107 of the clamp 403. The clamping assembly 101 includes a first assembly 1011 and a second assembly 1012. The first assembly 1011 includes two elastic arms (not numbered) respectively fixed at the rear end of the bin body 102 and the rear end of the pushing clip 103, Each elastic arm is formed with a locking groove (not numbered), the second assembly 1012 includes a locking block (not numbered) respectively formed at the front end of the bin body 102 and the front end of the push clip 103, adjacently arranged The clamping grooves and the buckling blocks of the two clamping bin assemblies 10 cooperate to connect the two clamping bin assemblies 10. In the embodiment of the present disclosure, each storage cavity 73 is provided with a clamping bin assembly 10. The way in which the end clamping bin assembly 10 and the discharge hole 11 are fixed to each other is that a claw (not shown) is formed on the end clamping bin assembly 10.

For example, the working principle of the clamping device of the embodiment of the present disclosure for switching the storage cavity 73 to dock with the discharge hole 11 is as follows: Please refer to FIGS. 1 to 3, for ease of description, the switching of the two storage cavities 73 will be explained. In FIG. 2, one of the receiving cavities 73 is called the first receiving cavity 731, and the other receiving cavity 73 is called the second receiving cavity 732. Initially, the first receiving cavity 731 is butted with the discharge hole 11. At this time, The second elastic member 4 is in a normal state. The second elastic member 4 resists the braking member 3 so that the V-shaped groove 34 of the braking member 3 resists the oblique wedge 72 (that is, the oblique wedge 72 is inserted into the V-shaped groove 34). Inside), the oblique wedge 72 is restricted from moving and rotating. Since the elasticity of the second elastic member 4 is greater than the elastic force of the first elastic member 2, when the braking member 3 is pushed by the second elastic member 4 to keep it in the same position as shown in Fig. 4 When the rotating housing 7 is at the position held by the first elastic member 2 in a compressed state, at this time, the force of the driving device can be transmitted to the rod body 8 through the gear set 9, so that the rod body 8 rotates clockwise, and the rod body 8 is clockwise. After the clock hand rotates, the push block 6 moves in the direction of the first end surface 12, the push block 6 enters the first storage cavity 731, and moves the clamping bin assembly 10 in the first storage cavity 731 toward the discharge hole 11 to make the clamping The bin assembly 10 moves from the storage cavity 731 to the shaft assembly. After the push block 6 pushes the clamping bin assembly 10 into the shaft assembly, the gear set 9 drives the rod 8 to rotate counterclockwise, and the push block 6 faces the second end 51 Move in the direction until it moves out of the first receiving cavity 731 and directly enters the restriction cavity 38, and because the stopper 3 is restricted from rotating in the circumferential direction by the cooperation of the block 522 and the slot 35, when the push block 6 enters After reaching the restriction cavity 38, the restriction cavity 38 restricts the push block 6 to rotate with the rod body 8 after leaving the first receiving cavity 731. When the push block 6 moves out of the first receiving cavity 731 into the restriction cavity 38, the rod body 8 still rotates counterclockwise, so that the push block 6 continues to move toward the second end surface 51, and the push block 6 pushes the brake 3 toward the second The end surface 51 moves, and the second elastic member 4 between the second end surface 51 and the braking member 3 is compressed. At this time, the rotating housing 7 also faces the second end surface 51 under the action of the elastic restoring force of the first elastic member 2. When the oblique wedge 72 of the rotating housing 7 and the V-shaped groove 34 of the brake 3 move to the oblique groove 521 toward the second end surface 51, the oblique wedge 72 protrudes from the V groove in the vertical direction. The oblique groove 34 is blocked by the oblique groove 521. The oblique wedge 72 is separated from the V groove 34 so that the V groove 34 can no longer restrict the rotation of the rotating housing 7 in the circumferential direction of the mounting housing. The brake 3 is applied to The force on the rotating housing 7 is cancelled. At this time, the brake 3 is separated from the oblique wedge 72 on the rotating housing 7, and the cooperation of the oblique wedge 72 and the oblique groove 521 causes the rotating housing 7 to rotate. Angle, after rotation, the first storage cavity 731 and the discharge hole 11 are not on the same axis, and the second storage cavity 732 and the discharge hole 11 are on the same axis; when the rotating housing 7 rotates by an angle, the oblique wedge 72 is located at the corresponding At the position of another V-shaped groove 34; then, the gear set 9 drives the rod body 8 to rotate clockwise, and the rod body 8 drives the push block 6 to move toward the first end surface 12. The push block 6 exerts the force on the brake 3 slowly Cancelled, the braking member 3 moves toward the first end surface 12 under the action of the elastic restoring force of the second elastic member 4 so that the other V-shaped groove 34 described above is against the diagonal wedge 72, thereby braking The member 3 pushes the rotating housing 7 to move toward the first end surface 12 together until the second receiving cavity 732 butts with the discharge hole 11, and the brake member 3 returns to the position of FIG. 4, at this time, the first elastic member 2 is compressed again Then, the rod body 8 then drives the push block 6 to move toward the first end surface 12 from the restriction cavity 38 into the second storage cavity 732 to push the cartridge assembly 10 in the second storage cavity 732.

Please refer to Figure 1, Figure 2 and Figure 7, in order to more clearly illustrate the way of cooperation between the oblique wedge 72 and the oblique groove 521, please refer to FIG. 7, the following is one of the oblique wedges 72 and two oblique grooves 521 The way of cooperation is explained. The two oblique grooves 521 are respectively named the first oblique groove 5211 and the second oblique groove 5212. The first oblique groove 5211 has an end point A, an end point B, and an end point C, and the end point B is an oblique groove. The trough point of 521, the end point A and the end point C are the crest points of the oblique groove 521 (that is, the end point B is closer to the second end surface 51 than the end point A and the end point C). The second oblique groove 5212 has an end point A', an end point B', and an end point C'. The end point B'is the trough point of the oblique groove 521, and the end point A'and the end point C'are the crest points of the oblique groove 521 (that is, the end point B'is closer to the second end surface 51) than the end point A'and the end point C'. The end point A of the first oblique groove 5211 is the end point C'of the second oblique groove 5212. When the oblique wedge 72 of the rotating housing 7 and the V-shaped groove 34 of the braking member 3 move toward the second end surface 51 to the oblique groove 521, the front end point 721 of the oblique wedge 72 and the first oblique groove 5211 The end point C is in contact, and the state at this time is called the critical state. At this time, the oblique wedge 72 is still inserted in the V-shaped groove 34; when the oblique wedge 72 of the housing 7 and the V-shaped groove 34 of the brake 3 are rotated Continue to move toward the second end surface 51, the oblique wedge 72 is blocked by the oblique groove 521 because it protrudes from the V-shaped groove 34 in the vertical direction, and the oblique wedge 72 is separated from the V-shaped groove 34 so that the V-shaped groove 34 can no longer be used. To restrict the rotation of the rotating housing 7 in the circumferential direction of the mounting housing, the oblique wedge 72 moves along the first oblique groove 5211 (in the direction indicated by the arrow a in FIG. 7) through the guiding action of the inclined surface 5213 of the first oblique groove 5211 ), the front end point 721 of the oblique wedge 72 moves to the end point B, and the front end point 721 of the oblique wedge 72 moves from the end point C to the end point B (the direction of movement from the end point C to the end point B is indicated by the arrow a in Figure 7 In the process of ), the rotating housing 7 rotates from the end point C to the end point B. When the front end of the oblique wedge 72 reaches the end point B, the oblique wedge 72 corresponds to the other V-shaped groove 34; when the first When the elastic member 2 is compressed again, that is, under the elastic restoring force of the second elastic member 4, the brake member 3 is inserted into another V-shaped groove 34 as described above to push the rotating housing 7 to move toward the first end surface 12 ( When the moving direction is indicated by the arrow b in Figure 7), the oblique wedge 72 moves along the right-angled surface 5214 of the first oblique groove 5211, and the front end point of the oblique wedge 72 moves from the end point B to the end point A (that is, the end point C). '), at this time it is in a critical state again.

According to an embodiment of the present disclosure, the clamping device utilizes the cooperation of the rotating housing 7, the mounting housing, and the first elastic member 2 to realize the rotation of the rotating housing 7 relative to the mounting housing, so that one of the rotating housings 7 is accommodated The cavity 73 is docked with the discharge port on the mounting housing, and then the clamping bin assembly 10 in the storage cavity 73 is driven by the clamping drive assembly to enter the shaft assembly from the discharge hole 11 in turn; and in the storage cavity 73 and the output After the material openings are docked, the brake 3 and the second elastic member 4 are matched to prevent the rotating housing 7 from moving relative to the mounting housing, so that the clamping bin assembly 10 is deployed smoothly; this clamping device is used in all clamping bin assemblies. 10 Before entering the shaft assembly, all the bin assemblies 10 can be arranged in the circumferential direction and stored in the rotating housing 7, so that the overall structure of the bin assembly becomes compact and light, which helps reduce storage. The pressure of medical equipment.

The above-mentioned technical features can be combined arbitrarily. In order to make the description concise, all possible combinations of the above-mentioned technical features are not described. However, as long as there is no contradiction in the combination of these technical features, they should be considered as falling into this category. Open scope of protection.

The above are only exemplary implementations of the present disclosure, and are not used to limit the protection scope of the present disclosure, which is determined by the appended claims.

Claims

A clamping device includes a mounting housing in which a mounting cavity is formed, a rotating housing arranged in the mounting cavity and movable relative to the mounting housing, and a plurality of clamping components arranged in the rotating housing , Pushing the clamping bin assembly in the rotating housing out of the clamping assembly of the clamping bin device, driving the rotating housing to rotate relative to the mounting housing, and abutting and fitting with the rotating housing to A braking member that restricts the rotation of the rotating housing relative to the mounting housing, and the braking member and the mounting housing are fixed to each other in the circumferential direction, wherein,

A plurality of storage cavities for accommodating the plurality of clamping bin assemblies are formed in the rotating housing, and each of the receiving cavities extends along the axial direction of the rotating housing and passes through the rotating housing, and the plurality of receiving cavities The cavities are evenly arranged in the circumferential direction around the axis of the rotating shell;

The mounting housing includes a first end surface and a second end surface that are opposed to each other, and the first end surface of the mounting housing is provided with a discharge hole communicating with one of the plurality of receiving cavities;

The clamping assembly pushes the clamping bin assembly contained in the one containing cavity communicating with the discharging hole to move out of the clamping bin device;

During the process of pushing the clamping bin assembly contained in the one receiving cavity to move out of the clamping bin device by the clamping out assembly, the brake restricts the rotation of the rotating housing relative to the mounting housing;

After the clamping out assembly pushes the clamping bin assembly contained in the one accommodating cavity to move out of the clamping bin device, the driving assembly drives the rotating housing to rotate relative to the mounting housing so that the plurality of The other storage cavity in the storage cavity is in communication with the discharge hole.
The bin clamping device according to claim 1, wherein:

The clip-out assembly includes a rod body extending from the outside of the mounting housing into the mounting cavity and a push block provided on the rod body;

The pushing block is driven by the rod body into the one receiving cavity connected with the discharge hole and pushes the clamping bin assembly in the receiving cavity to move toward the discharge hole to remove the clamping bin device.
The bin clamping device according to claim 2, wherein:

The rotating housing includes a cylinder extending along the axial direction of the rotating housing, the plurality of receiving cavities formed in the cylinder, and a central cavity formed in the cylinder. The axis of the rotating housing extends and passes through the rotating housing, and a pushing groove is formed between the central cavity and each of the receiving cavities to connect the central cavity with each of the receiving cavities, so The pushing groove is provided along the axial direction of the rotating housing and penetrates at least one side of the receiving cavity close to the second end surface, the rod body extends into the central cavity, and the pushing block passes through the The pushing groove enters the one receiving cavity communicating with the discharge hole.
The bin clamping device according to claim 3, wherein:

The rod body is a screw threaded with the push block;

The pushing block includes a connecting part threadedly connected with the screw rod, a connecting rod extending from the connecting part to a side away from the screw rod, and a pushing part formed on the end of the connecting rod;

When the pushing block enters the one receiving cavity communicating with the discharge hole through the pushing groove, the connecting portion is located in the central cavity, and the pushing portion is located in the communication with the discharge hole. In the one receiving cavity, the connecting rod passes through the pushing groove.
The clamping bin device according to claim 4, wherein the clamping out assembly further comprises a gear set mounted on the mounting housing and used to drive the screw to rotate, and the gear set includes a driving wheel and a gear set. The driven wheel engages with the driving wheel, and the driven wheel is sleeved on the screw.
The clamping device according to claim 4 or 5, wherein the screw passes through the central cavity of the rotating housing and is inserted into the first end surface of the mounting housing.
The clamping device according to any one of claims 2-6, wherein:

The drive assembly includes a number of oblique wedges arranged on the rotating housing and arranged in the circumferential direction of the rotating housing, formed in the mounting housing and arranged on the second end surface of the mounting housing A grasping sleeve between and the rotating housing, and a first elastic member arranged between the first end surface of the mounting housing and the rotating housing;

The end of each oblique wedge facing the second end surface has an inclined surface;

A number of oblique grooves arranged along the circumference of the rotating housing and corresponding to the number of the oblique wedges and matched with the oblique wedges are formed on the catch sleeve;

In the process that the clip ejecting component pushes the clip bin assembly contained in the one storage cavity to move out of the clip bin device, the first elastic member is deformed;

After the clip out assembly pushes the clip bin assembly contained in the one receiving cavity to move out of the clip bin device, the first elastic member pushes the rotating housing away from the clamping bin under the action of its elastic restoring force The direction of the discharge hole moves so that the oblique wedge moves to the oblique groove, and the oblique wedge cooperates with the oblique groove to rotate the rotating housing relative to the mounting housing. Angle, after the rotating housing rotates by an angle relative to the mounting housing, the other one of the plurality of housing cavities communicates with the discharge hole.
7. The bin clamping device of claim 7, wherein the number of the plurality of oblique wedges is equal to the number of the plurality of receiving cavities and is arranged in a one-to-one correspondence.
The clamping device according to claim 7 or 8, wherein each of the oblique wedge extends toward the second end surface of the mounting housing, so that the end of the oblique wedge having the inclined surface Protruding from the rotating housing.
The clamping device according to any one of claims 7-9, wherein the outer peripheral wall of the rotating housing is concavely formed with an annular groove, and the first elastic member is sleeved on the annular groove .
The clamping device according to any one of claims 7-10, wherein:

The braking member is provided between the second end surface of the mounting housing and the rotating housing, and the braking member includes a plurality of oblique wedges arranged toward the plurality of oblique wedges to respectively communicate with the plurality of oblique wedges. A number of matching V-shaped grooves, and the number of the plurality of V-shaped grooves is equal to the number of the plurality of oblique wedges and arranged in a one-to-one correspondence;

The brake also includes a plurality of clamping grooves extending along the axial direction of the mounting housing, each of the clamping grooves is located between adjacent V-shaped grooves, and the mounting housing is respectively formed with the A plurality of clamping blocks matched with a plurality of clamping grooves, through the clamping and cooperation between the plurality of clamping grooves and the plurality of clamping blocks, so that the braking member and the mounting housing are fixed to each other in the circumferential direction;

In the process of pushing the clamping bin assembly contained in the one containing cavity communicating with the discharging hole to move out of the clamping bin device by the clamping outlet assembly, the plurality of V-shaped grooves respectively resist the plurality of clamping bins. Oblique wedges to restrict the rotation of the rotating housing relative to the mounting housing;

In the vertical direction perpendicular to the axial direction of the clamping device, each of the oblique wedges protrudes from the corresponding V-shaped groove, so that the rotating housing moves in a direction away from the discharge hole to When the oblique wedge moves to the oblique groove, the oblique wedge is blocked by the oblique groove so that the oblique wedge is separated from the V-shaped groove, and the V-shaped groove is no longer restricted The rotating housing rotates in the circumferential direction of the mounting housing, and the oblique wedge cooperates with the oblique groove to rotate the rotating housing by an angle relative to the mounting housing.
The clamping device according to claim 11, wherein the plurality of clamping blocks are provided on the grasping sleeve, and each of the clamping blocks does not protrude from the grasping sleeve in the axial direction of the mounting housing. set.
The clamping device according to claim 11 or 12, wherein the braking member further comprises a sheet body and a plurality of clamping sheets arranged on the sheet body in a circumferential direction, and each of the clamping sheets is formed with In the V-shaped groove, the clamping groove is formed between two adjacent clamping plates, the rod body penetrates the plate body and enters the rotating housing, and the push block is located in the plate body And the rotating shell.
15. The bin clamping device according to claim 13, wherein the sheet body is provided with a restriction cavity with an opening facing the pushing block and used for accommodating the pushing block.
The clamping bin device according to claims 11-14, wherein the pushing block is located between the braking part and the rotating housing, and the clamping out assembly pushes the all contained in the one receiving cavity After the clamping bin assembly moves out of the clamping bin device, the push rod drives the push block to move away from the discharge hole, and then the push block pushes the brake part away from the discharge hole In the direction of the move.
The clamping device according to any one of claims 2-15, further comprising a second elastic member clamped between the second end surface of the mounting housing and the braking member, the second elastic member Sleeved on the rod body;

After the clamping assembly pushes the clamping bin assembly contained in the one storage cavity to move out of the clamping bin device, the push block pushes the brake member to move away from the discharge hole and causes The second elastic member is deformed; and

In the process that the clip ejection component pushes the clip bin assembly contained in the one receiving cavity to move out of the clip bin device, the braking element faces toward under the action of the elastic restoring force of the second elastic element The direction of the discharging hole moves and engages with the rotating housing to limit the rotation of the rotating housing relative to the mounting housing.
The clamping device according to any one of claims 1-16, wherein:

A clamping component is formed on each of the clamping bin components,

The plurality of clamping bin assemblies are sequentially moved out of the clamping bin device and then arranged in a row along the axial direction of the clamping bin device, and two adjacent bin clamping assemblies are connected to each other through the clamping assembly.
The clamping device according to any one of claims 1-17, wherein the mounting housing comprises a first housing and a second housing sleeved outside the first housing, and the first housing Surrounding the second housing to form the mounting cavity, the mounting cavity extends along the axis of the clamping device, the first end surface is disposed on the first housing, and the second The end surface is arranged on the second casing.
A surgical instrument, comprising: a holding part, a working head detachably connected to the holding part, a shaft assembly detachably installed on the working head, and a detachable working head installed on the working head The clamping device according to any one of claims 1 to 18, wherein:

The holding part and/or the working head include a driving device,

An opening is provided on one side of the shaft assembly close to the clamping bin device, and the opening is communicated with the discharge hole.
The surgical instrument according to claim 19, wherein:

The shaft assembly includes a push-clamp rod, an inner sleeve, a clamp, and a firing sleeve, and the clamp is arranged at an end of the inner sleeve away from the working head;

Under the action of the driving device, the several clamping components in the clamping device are sequentially moved out of the clamping device and arranged in a row in the inner sleeve;

Under the action of the driving device, the push clamp rod sends the ligation clamp in the clamp bin assembly into the clamp; and

The firing sleeve closes the clamp under the action of the driving device, and the ligation clip located in the clamp is applied to the target tissue.