WO2022135119A1 - 一种组织牵引装置及组织牵引装置的使用方法 - Google Patents

一种组织牵引装置及组织牵引装置的使用方法 Download PDF

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Publication number
WO2022135119A1
WO2022135119A1 PCT/CN2021/135502 CN2021135502W WO2022135119A1 WO 2022135119 A1 WO2022135119 A1 WO 2022135119A1 CN 2021135502 W CN2021135502 W CN 2021135502W WO 2022135119 A1 WO2022135119 A1 WO 2022135119A1
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WO
WIPO (PCT)
Prior art keywords
clamping
clip
arm
distal end
cable assembly
Prior art date
Application number
PCT/CN2021/135502
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English (en)
French (fr)
Chinese (zh)
Inventor
孙思予
王晟
韦建宇
金鸿雁
沈正华
冷德嵘
李常青
张凯
孙贝贝
李宁
Original Assignee
南微医学科技股份有限公司
中国医科大学附属盛京医院
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Filing date
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Application filed by 南微医学科技股份有限公司, 中国医科大学附属盛京医院 filed Critical 南微医学科技股份有限公司
Priority to JP2023600005U priority Critical patent/JP3243428U/ja
Priority to DE212021000379.6U priority patent/DE212021000379U1/de
Publication of WO2022135119A1 publication Critical patent/WO2022135119A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
    • A61B90/17—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins for soft tissue, e.g. breast-holding devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2939—Details of linkages or pivot points
    • A61B2017/294—Connection of actuating rod to jaw, e.g. releasable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2945—Curved jaws

Definitions

  • the present disclosure relates to the technical field of medical devices, and in particular, to a tissue traction device and a method for using the tissue traction device.
  • Endoscopic submucosal dissection refers to the direct dissection of mucosa from the submucosa using a modified needle knife under the endoscope, which is evolved from endoscopic mucosal resection (EMR).
  • EMR endoscopic mucosal resection
  • Both ESD and EMR achieve the resection of lesions with a common single-channel endoscope.
  • EMR cannot remove large lesions en bloc.
  • ESD compared with EMR, ESD has the problems of longer operation time, higher risk, and difficulty in operation. At the same time, there is little bleeding during EMR. However, during the ESD operation, if you are not careful, the visual field will be covered with blood, so you need to stop bleeding and flush the visual field continuously. . Therefore, in order to obtain a good surgical field, various endoscopic-assisted traction techniques have emerged, such as dental floss traction. However, dental floss traction may damage tissue, and it is difficult to accurately grasp tissue with dental floss traction, which can only be pulled but not pushed. , the ability to improve the surgical field of vision is limited.
  • the objectives of the present disclosure include, for example, to provide a tissue distraction device, which can improve the technical problems in the prior art that it is difficult to grasp tissue accurately and the ability to improve the surgical field of view is limited.
  • the purpose of the present disclosure also includes providing a method for using a tissue distraction device, which can improve the technical problems in the prior art that it is difficult to grasp tissue accurately and the ability to improve the surgical field of vision is limited.
  • Embodiments of the present disclosure provide a tissue distraction device, which includes an outer tube assembly; a clamp base connected to the distal end of the outer tube assembly; a clamp body for clamping tissue, and the clip body is movably matched with the clip base; the clip body is provided with a first connection structure, and the clip base is provided with a second connection structure, and the first connection structure is used for connecting with the clip base.
  • the second connecting structure is connected to make the clip body in a clamping and locked state; and a cable assembly, the cable assembly passes through the outer tube assembly, and the distal end of the cable assembly is connected to the clip body , so as to manipulate the clip body through the cable assembly; wherein, the outer tube assembly is used for maintaining the connection with the clip seat when the clip body is in the clamping and locking state, so as to manipulate the clip body traction on the tissue.
  • the tissue traction device further includes a first handle and a second handle that are slidably connected to each other, the proximal end of the outer tube assembly is detachably connected to the first handle, and the proximal end of the cable assembly is detachably connected. It is connected with the second handle, so that when the first handle and the second handle slide relative to each other, the cable assembly moves relative to the outer tube assembly.
  • the proximal end of the outer tube assembly is provided with a snap-on protrusion
  • the first handle is provided with a snap-on groove
  • the snap-on groove is snapped with the snap-on protrusion
  • the proximal end of the outer tube assembly is screwed with the first handle
  • the proximal end of the outer tube assembly is provided with a frangible portion, and the frangible portion is used for breaking to disengage the outer tube assembly from the first handle.
  • the outer tube assembly includes a spring tube, a connecting tube and a fixing tube which are connected in sequence, the fixing tube is connected at the proximal end of the connecting tube, and the outer diameter of the fixing tube is larger than the diameter of the connecting tube.
  • the first handle is provided with a channel communicating with the snap groove, the connecting pipe is accommodated in the channel, and the distal end of the connecting pipe is It extends out of the channel to be connected with the proximal end of the spring tube; the distal end of the spring tube is connected with the clip seat.
  • a support cap is provided at the distal end of the outer tube assembly, and the clamp base is rotatably connected to the support cap, so as to drive the clamp through the rotation of the cable assembly relative to the outer tube assembly body rotation.
  • the inner peripheral wall of the support cap is provided with a first annular groove;
  • the clip base includes a base body and a support arm arranged on the base body, and one end of the support arm extends out of the base body.
  • the outer peripheral wall is clamped in the first ring groove, so that when the support arm rotates along the first ring groove, the clamp seat rotates relative to the support cap, and when the clamp body is in the In the clamping and locking state, one end of the support arm is clamped in the first ring groove, so as to keep the clamp seat and the support cap connected.
  • the support arm is inclined relative to the axis of the base body, the proximal end of the support arm is located inside the base body, and the distal end of the support arm is located outside the base body, so that the The distal end of the support arm protrudes from the outer peripheral wall of the base body and is clamped into the first annular groove.
  • the support arm includes a first arm portion and a second arm portion that are connected to each other, the first arm portion and the second arm portion are respectively arranged obliquely with respect to the axis of the base body, and the first arm portion and the second arm portion are respectively inclined relative to the axis of the base body,
  • the included angle between an arm portion and the axis is greater than the included angle between the second arm portion and the axis;
  • the second arm portion is connected to the base, and the first arm portion is located at the the distal end of the second arm portion, and the distal end of the first arm portion is clamped in the first annular groove.
  • the support arm further includes a third arm portion disposed at the proximal end of the second arm portion, and the second connection structure includes a limiting notch disposed at the proximal end of the third arm portion, so
  • the first connection structure includes a limiting protrusion arranged on the clip body. When the clip body is in the clamping and locking state, the limiting protrusion is snapped into the limiting notch to limit the The clip body slides distally relative to the clip base.
  • the seat body is further provided with a chute
  • the second connection structure includes a proximal end wall of the chute
  • the first connection structure includes a first sliding protrusion disposed on the clip body From then on, the first sliding protrusion is slidably matched with the sliding groove, and when the clamping body is in the clamping and locking state, the first sliding protrusion collides with the proximal end wall of the sliding groove, In order to limit the sliding of the clip body to the proximal end relative to the clip base.
  • the angle formed between the first arm portion and the axis of the seat body is ⁇
  • the axis of the second arm portion and the seat body is ⁇ .
  • the angle formed between them is ⁇ ; 20° ⁇ 80°, 0° ⁇ 60°.
  • the inner peripheral wall of the support cap is provided with a second sliding protrusion
  • the outer peripheral wall of the clamping seat is provided with a second ring groove
  • the second sliding protrusion is matched with the second ring groove to The support cap is rotatably connected with the clip base.
  • the clip base includes a base body and an insert, the distal end of the insert is embedded inside the proximal end of the base body, and the proximal end of the outer peripheral wall of the insert is provided with a stepped portion, so The step portion and the proximal end face of the seat body form the second annular groove.
  • the clip body includes a first clip arm and a second clip arm, the proximal end of the first clip arm and the proximal end of the second clip arm are rotatably connected, and the first clip arm The proximal end of the clamp arm and/or the proximal end of the second clamp arm is connected to the cable assembly; the first clamp arm is provided with a first chute, and the second clamp arm is provided with a second chute , the clamp seat is provided with a fixed shaft, the fixed shaft passes through the first chute and the second chute, the first clamp arm and the second clamp arm are respectively opposite to the fixed shaft Slide along the first sliding groove and the second sliding groove to switch the clamping body between an open state and a closed state.
  • a hook structure is provided on the first clamping arm and the second clamping arm, and the first connecting structure includes a hook provided on the clamping base, when the clamping body is in the clamping In the tightly locked state, the hook structure is engaged with the hook.
  • the clip body further includes a connecting shaft, and the proximal end of the first clip arm and the proximal end of the second clip arm are rotatably connected through the connecting shaft; the distal end of the cable assembly is sleeved
  • the connecting shaft and the distal end of the cable assembly are provided with a notch, so that when the tensile force exerted on the distal end of the cable assembly reaches a preset value, the connecting shaft is disengaged from the notch, so that the The distal end of the cable assembly is disengaged from the clip body.
  • the distal end of the cable assembly is a wire buckle
  • the wire buckle is sleeved with the connecting shaft, and when the tensile force exerted on the wire buckle reaches a preset value, the wire buckle is deformed to make the wire buckle deform.
  • the notch is enlarged, and the connecting shaft is disengaged from the wire buckle from the notch.
  • the distal end of the cable assembly includes a first clamping arm and a second clamping arm that are oppositely arranged, and the first clamping arm and the second clamping arm form a clamping mechanism between the first clamping arm and the second clamping arm.
  • both ends of the connecting shaft protrude from the first clamping arm and the second clamping arm respectively;
  • the distal end of the cable assembly includes a first release part and a second release part, the first A release part and the second release part are respectively sleeved on both ends of the connecting shaft, and the first clamp arm and the second clamp arm are clamped by the first release part and the second release part between.
  • the clip body includes at least two clip arms, the at least two clip arms are arranged around the axis of the clip base; the proximal ends of the at least two clip arms are connected to each other, and when the clip arms When sliding relative to the clamp base in the distal-to-proximal direction, the clamp arm abuts against the clamp base, so that the clamp arm has a tendency to close.
  • the clip arm includes a connecting portion, an intermediate portion and a clipping portion that are connected in sequence, the clipping portion is used to clip the tissue, and the connecting portions of the at least two clip arms are connected to each other;
  • the intermediate portion is configured to interfere with the clip base, so that when the clip arm slides relative to the clip base in a distal-to-proximal direction, the clip arm has a tendency to close.
  • the intermediate portion has elasticity, and when the clamping arm slides relative to the clamping base in the direction from the proximal end to the distal end, the intermediate portion causes the clamping arm to have a tendency to open.
  • the clip body further includes a connecting piece, and the connecting parts of the at least two clip arms are respectively connected with the connecting piece; the connecting piece is connected with the distal end of the cable assembly.
  • the connecting piece has at least two connecting bumps, the connecting portion is provided with a locking hole, and the locking holes of the at least two clamping arms are in a one-to-one correspondence with the at least two connecting bumps.
  • the distal end of the cable assembly has a clamping gap and a connecting groove, the proximal end of the connecting portion is clamped in the clamping gap, and the proximal end of the connecting piece is clamped in the connecting groove; when When the tensile force exerted on the distal end of the cable assembly reaches a preset value, the connecting piece is disengaged from the connecting groove, and the connecting portion is disengaged from the clamping gap, and the distal end of the connecting portion is disengaged from the clamping gap. It is expanded outward to be clamped with the clip base.
  • the connecting portions of the at least two clamping arms are integrally formed.
  • the distal end of the cable assembly is detachably connected to the clip body, and when the tensile force exerted on the distal end of the cable assembly reaches a preset value, the distal end of the cable assembly disengage from the clip.
  • the clip body is provided with a connection hole, the axis of the connection hole extends along the connecting line between the proximal end and the distal end of the clip body, and the distal end of the cable assembly has a line along the pull cable assembly.
  • a clamping groove arranged in the circumferential direction of the cable assembly, the distal end of the cable assembly passes through the connecting hole, and the clip body is clamped in the clamping groove; when on the distal end of the cable assembly When the applied tension reaches a preset value, the distal end of the cable assembly is disengaged from the connection hole.
  • the proximal end of the clip body is provided with a hooking hole, the distal end of the cable assembly is hooked with the hooking hole, and when the pulling force applied on the distal end of the cable assembly reaches In a preset value, the distal end of the cable assembly is disengaged from the hooking hole.
  • Embodiments of the present disclosure also provide a method of using a tissue distraction device.
  • the method of using the tissue traction device includes:
  • the endoscope is withdrawn, the clip body is kept connected with the outer tube assembly, and the proximal end of the outer tube assembly is located outside the body, so as to drive the clip body to pull the tissue through the outer tube assembly .
  • the step of disengaging the handle from the outer tube assembly of the tissue distraction device comprises:
  • the distal end of the outer tube assembly is sheared off to disengage the outer tube assembly from the handle.
  • the proximal end of the outer tube assembly is provided with a frangible portion
  • the step of disengaging the handle from the outer tube assembly of the tissue traction device includes:
  • the outer tube assembly is disconnected from the frangible portion to disengage the outer tube assembly from the handle.
  • tissue distraction device and the method for using the tissue distraction device according to the embodiments of the present disclosure include, for example:
  • Embodiments of the present disclosure provide a tissue distraction device that includes an outer tube assembly, a clip base, a clip body, and a cable assembly.
  • the clip base is connected to the distal end of the outer tube assembly, the clip body is used for holding the tissue, and the clip body is movably matched with the clip base.
  • the clamp body is provided with a first connection structure, the clamp base is provided with a second connection structure, and the first connection structure is used for connecting with the second connection structure, so that the clamp body is in a clamped and locked state.
  • the cable assembly passes through the outer tube assembly, and the distal end of the cable assembly is connected with the clip body, so that the clip body can be manipulated through the cable assembly.
  • the seat moves, so that the clip body is opened or closed, and the precise grasp of the tissue can be realized through the repeated opening and closing adjustment of the clip body.
  • the outer tube assembly is kept connected with the clip base. In this way, the clip body in the body can be pushed and pulled by operating the proximal end of the outer tube assembly extending outside the body, so as to achieve tissue traction. , and can better achieve the improvement of the surgical field, thereby helping to shorten the operation time and reduce the operation risk.
  • Embodiments of the present disclosure also provide a method for using a tissue traction device, which can clamp tissue by operating a handle and under direct vision of an endoscope, ensuring the accuracy of tissue clamping and switching the clamp body.
  • a tissue traction device which can clamp tissue by operating a handle and under direct vision of an endoscope, ensuring the accuracy of tissue clamping and switching the clamp body.
  • the endoscope is withdrawn, so that the outer tube assembly leaves the forceps channel of the endoscope, so that it can pass through the inner tube.
  • the forceps channel of the speculum sends other surgical instruments into the body for surgical operations.
  • the outer tube assembly can be used to drive the clip body to pull the tissue during the operation, so as to obtain a good surgical field. , which can help to shorten the operation time and reduce the operation risk.
  • FIG. 1 is a schematic diagram of the overall structure of a tissue distraction device provided by an embodiment of the present disclosure
  • FIG. 2 is a schematic cross-sectional view of the partial structure of the first tissue traction device provided by the embodiment of the present disclosure when the clip body is in an open state;
  • FIG. 3 is a schematic cross-sectional view of a partial structure of the first tissue distraction device provided by an embodiment of the present disclosure when the clip body is in a clamped and locked state;
  • FIG. 4 is a schematic structural diagram of a handle in a tissue traction device provided by an embodiment of the present disclosure
  • FIG. 5 is a schematic cross-sectional view of the partial structure of the first tissue distraction device provided by an embodiment of the present disclosure when the clip body is in a closed state;
  • FIG. 6 is a schematic diagram of another proximal structure of the outer tube assembly provided by the embodiment of the present disclosure.
  • Fig. 7 is the partial structure enlarged schematic diagram at VII in Fig. 2;
  • FIG. 8 is a schematic cross-sectional view of a partial structure of the first tissue distraction device provided by the embodiment of the present disclosure when the clip body is in a clamping and locked state;
  • FIG. 9 is a schematic structural diagram of a first clip body provided in an embodiment of the present disclosure.
  • FIG. 10 is a schematic structural diagram of a second type of clip body provided in an embodiment of the present disclosure.
  • FIG. 11 is a schematic structural diagram of a third clamp body provided by an embodiment of the present disclosure.
  • FIG. 12 is a schematic structural diagram of a fourth clip body provided by an embodiment of the present disclosure.
  • FIG. 13 is a schematic structural diagram of the pull cable assembly and the clip body in the first tissue traction device provided by the embodiments of the present disclosure
  • FIG. 14 is a schematic cross-sectional view of a partial structure of a second tissue distraction device provided in an embodiment of the present disclosure
  • FIG. 15 is a schematic partial structure diagram of still another cable assembly provided by an embodiment of the present disclosure.
  • FIG. 16 is an enlarged fragmentary cross-sectional view of one embodiment of the tissue distraction device provided in FIG. 1 showing the proximal end of the outer tube assembly screwed to the first handle.
  • Icon 10-tissue traction device; 100-outer tube assembly; 110-spring tube; 120-connecting tube; 130-fixing tube; 140-support cap; 151-first ring groove; 152-second sliding protrusion; 160 -Cut; 200-Cable assembly; 210-Cable; 220-Release; 221-Catching slot; 222-Mating part; Two clamping arms; 300-clamp base; 310-seat body; 312-chute; 320-support arm; 321-first arm; 322-second arm; 323-third arm; 324-limit 330-insert; 331-step; 340-fixed shaft; 350-second ring groove; 360-hook; 400-clamp body; 410-first clamp arm; 411-first chute; 412- Hook structure; 420-second clamp arm; 421-second chute; 430-limiting protrusion; 440-first sliding protrusion; 450-connecting piece; 451-connecting bump; 452-card hole; 460 - connecting shaft;
  • FIG. 1 is a schematic diagram of the overall structure of the tissue traction device 10 provided in the present embodiment
  • FIG. 2 is a schematic cross-sectional view of the partial structure of the first tissue traction device 10 provided by the present embodiment when the clip body 400 is in an open state
  • FIG. 3 is A schematic cross-sectional view of the partial structure of the first tissue traction device 10 provided in this embodiment when the clip body 400 is in the clamping and locking state at a first viewing angle.
  • this embodiment provides a tissue traction device 10 , which includes an outer tube assembly 100 , a clip base 300 , a clip body 400 and a cable assembly 200 .
  • the clamp base 300 is connected to the distal end of the outer tube assembly 100 , the clamp body 400 is used for clamping tissue, and the clamp body 400 is movably matched with the clamp base 300 .
  • the clip body 400 is provided with a first connection structure
  • the clip base 300 is provided with a second connection structure
  • the first connection structure is used for connecting with the second connection structure, so that the clip body 400 is in a clamped and locked state.
  • the cable assembly 200 passes through the outer tube assembly 100, and the distal end of the cable assembly 200 is connected with the clip body 400, so that the clip body 400 can be manipulated by the cable assembly 200. When in use, the cable assembly 200 is opposite to the outer tube assembly 100 by pulling the cable assembly 200.
  • the clip body 400 moves relative to the clip base 300, so that the clip body 400 is opened or closed, and the precise grasping of the tissue can be achieved through the repeated opening and closing adjustment of the clip body 400.
  • the outer tube assembly 100 is kept connected with the clip base 300. In this way, the clip body 400 in the body can be pushed and pulled by operating the proximal end of the outer tube assembly 100 extending to the outside of the body. The traction of the tissue can be achieved, and the improvement of the surgical field can be better achieved.
  • proximal end of a certain component refers to the end of the component that is close to the outside of the human body during use
  • distal end of a certain component refers to the end of the component that is close to the human body during use
  • the proximal end of the cable assembly 200 is the end of the cable assembly 200 close to the handle 500
  • the distal end of the cable assembly 200 is the end of the cable assembly 200 close to the handle 500
  • the proximal end of the outer tube assembly 100 is the end of the outer tube assembly 100 close to the handle 500
  • the distal end of the outer tube assembly 100 is the end of the outer tube assembly 100 close to the clip body 400.
  • tissue traction device 10 provided in this embodiment will be further described below:
  • FIG. 4 is a schematic structural diagram of the handle 500 in the tissue traction device 10 provided in this embodiment.
  • the tissue traction device 10 further includes a first handle 510 and a second handle 520 that are slidably connected to each other.
  • the proximal end of the outer tube assembly 100 is detachably connected to the first handle 510, and the proximal end of the cable assembly 200 is connected to the second handle 520, so that when the first handle 510 and the second handle 520 slide relative to each other, the cable assembly 200 Movement relative to the outer tube assembly 100 .
  • the clip body 400 is opposite to the clip base 300 Activate to switch the clip body 400 between an open state (as shown in FIG. 2 ) and a closed state (as shown in FIG. 5 ).
  • the cable assembly 200 moves in the first direction relative to the outer tube assembly 100, thereby pushing the clamp body 400 to move in the first direction relative to the clamp base 300, In order to switch the clip body 400 to the open state.
  • the cable assembly 200 moves relative to the outer tube assembly 100 in the second direction, thereby pushing the clip body 400 to move relative to the clip base 300 in the second direction, so that the clip The body 400 switches to the closed state.
  • the first direction is the direction from the proximal end to the distal end, in other words, the first direction is the direction from the handle 500 to the clip body 400 ;
  • the second direction is the opposite direction of the first direction , that is, the direction from the distal end to the proximal end, in other words, the second direction is the direction from the clip body 400 to the handle 500 .
  • the proximal end of the outer tube assembly 100 is detachably connected to the first handle 510, when the distal end of the cable assembly 200 is disengaged from the clip body 400 and the clip body 400 is in the clamping and locking state, the proximal end of the outer tube assembly 100 is detached.
  • the outer tube assembly 100 and the first handle 510 can be detached by disassembling the end of the outer tube assembly 100 from the first handle 510.
  • the distal end of the outer tube assembly 100 remains connected to the clamping seat.
  • the outer tube assembly 100, the clip base 300 and the clip body 400 are connected to form a pulling structure for pulling the tissue.
  • the tissue traction device 10 only has the traction structure formed by the outer tube assembly 100 , the clip base 300 and the clip body 400 for pulling the tissue to connect with the tissue in the body.
  • the endoscope is withdrawn, so that the outer tube assembly 100 leaves the forceps channel of the endoscope, so that the endoscope can be re-inserted into the human body during subsequent operations, and the surgical instruments can be inserted into the body along the forceps channel of the endoscope, so as to Surgical operations are performed under the direct vision of the endoscope, and at the same time, the tissue is pulled through the traction structure during the operation to obtain a good surgical field of view, which plays the role of the second hand under the endoscope.
  • the proximal end of the outer tube assembly 100 is snapped with the first handle 510 .
  • the detachable connection between the outer tube assembly 100 and the first handle 510 is realized by snap connection, so that the disassembly process of the outer tube assembly 100 and the first handle 510 is simpler, thereby reducing the burden of surgical operations. It can be understood that, in other embodiments, other structures can also be used to realize the detachable connection between the outer tube assembly 100 and the first handle 510, such as screw connection.
  • the proximal end of the outer tube assembly 100 is provided with a snap-fit protrusion
  • the first handle 510 is provided with a snap-fit groove 511 for snap-fit with the snap-fit protrusion.
  • the connecting protrusion is clamped in the locking groove 511, and the outer tube assembly 100 and the first handle 510 are in a connected state, so the relative movement of the cable assembly 200 and the outer tube assembly 100 can be realized through the first handle 510 and the second handle 520 , and then realize the manipulation of the clamping body 400; when the clamping body 400 is switched to the clamping and locking state, the clamping protrusion is taken out from the clamping groove 511, and the detachment of the outer tube assembly 100 and the first handle 510 can be realized, Then, the pulling structure is disengaged from the first handle 510 , the second handle 520 and the cable assembly 200 .
  • the outer tube assembly 100 includes a spring tube 110 , a connecting tube 120 and a fixing tube 130 which are connected in sequence.
  • the fixing tube 130 is connected to the proximal end of the connecting tube 120, and the outer diameter of the fixing tube 130 is larger than the outer diameter of the connecting tube 120 to form a snap-fit protrusion.
  • the first handle 510 is provided with a channel 512 communicating with the snap groove 511 , the connecting tube 120 is accommodated in the channel 512 , and the distal end of the connecting tube 120 extends out of the channel 512 to connect with the proximal end of the spring tube 110 .
  • the distal end of the spring tube 110 is connected to the clip base 300 . Specifically, the proximal end of the spring tube 110 is welded and fixed to the distal end of the connecting tube 120 , and the proximal end of the connecting tube 120 is welded and fixed to the distal end of the fixing tube 130 .
  • connection should be understood in a broad sense, which may be a direct connection or an indirect connection through the intermediate connecting piece 450, which may be a fixed connection or an active connection .
  • the spring tube 110 , the connecting tube 120 and the fixing tube 130 are all circular tubular parts, and the outer diameter of the connecting tube 120 is smaller than the outer diameter of the fixing tube 130 , so the outer circumference of the fixing tube 130 can be regarded as the outer circumference of the connecting tube 120
  • the proximal end of the surface is formed to protrude in the radial direction, and then the model layer snaps to the protrusion.
  • the first handle 510 is provided with a channel 512 that communicates with the clamping groove 511 .
  • the channel 512 is opened on the side wall of the first handle 510 , and its proximal end communicates with the clamping groove 511 , and the distal end penetrates through the first handle 510 . distal end face.
  • the width of the channel 512 matches the radial dimension of the connecting pipe 120, and the width of the snap groove 511 matches the radial dimension of the fixing pipe 130. Since the radial dimension of the connecting pipe 120 is smaller than that of the fixing pipe 130, Therefore, the width of the channel 512 is smaller than the width of the clip slot 511 , so that the fixing tube 130 can be clipped in the clip slot 511 , and the fixing tube 130 will not come out of the clip slot 511 when the outer tube assembly 100 receives a push-pull force. Both the snap groove 511 and the channel 512 pass through the side wall of the first handle 510, that is, the side wall has an opening communicating with the snap groove 511 and the channel 512. When the outer tube assembly 100 needs to be disassembled from the first handle 510 When opening, the fixing tube 130 and the connecting tube 120 can be taken out from the opening.
  • the purpose of disengaging the outer tube assembly 100 from the first handle 510 is achieved by setting the proximal end of the outer tube assembly 100 to be detachably connected to the first handle 510 .
  • the outer tube assembly 100 can also be separated from the first handle 510 by cutting or other means, or a frangible part is provided at the proximal end of the outer tube assembly 100, and the outer tube assembly 100 can be separated by breaking the frangible part.
  • set the frangible part as the cutout 160 as shown in FIG.
  • the outer tube assembly 100 it is convenient for the outer tube assembly 100 to be disconnected from there, or the proximal end of the outer tube assembly 100 is made of a fragile material to form a frangible portion, so that the proximal end of the outer tube assembly 100 can be easily disconnected from the frangible portion. Can be disconnected.
  • the distal end of the outer tube assembly 100 is provided with a support cap 140 , and the clip base 300 is rotatably connected to the support cap 140 so as to be relative to the outer tube assembly through the cable assembly 200
  • the rotation of 100 drives the clamping body 400 to rotate.
  • the support cap 140 is fixedly connected to the distal end of the spring tube 110 .
  • the clip body 400 can be rotated by rotating the handle 500 and then through the cable assembly 200 to adjust the clamping angle.
  • the support cap 140 is fixed to the distal end of the spring tube 110 by welding.
  • the support cap 140 is provided with a first annular groove 151
  • the clamp base 300 includes a base body 310 and a support arm 320 disposed on the base body 310 .
  • One end of the support arm 320 protrudes from the outer peripheral wall of the base body 310 and is clamped in the first ring groove 151 , so that when the support arm 320 rotates along the first ring groove 151 , the clamp base 300 rotates relative to the support cap 140 .
  • the clamp body 400 is in the clamping and locking state, one end of the support arm 320 is still clamped in the first ring groove 151, so that the clamp base 300 and the support cap 140 remain connected.
  • the support arm 320 is inclined relative to the axis of the base body 310 , the proximal end of the support arm 320 is located inside the base body 310 , and the distal end of the support arm 320 is located outside the base body 310 , that is, the distal end of the support arm 320
  • the outer peripheral wall of the base body 310 is protruded, and the distal end of the support arm 320 is clamped into the first ring groove 151 , so that the movement of the support arm 320 relative to the support cap 140 in the first direction or the second direction is restricted by the first ring groove 151
  • the support arm 320 can rotate around the axis relative to the first ring groove 151 , thereby realizing the rotational connection between the clamp base 300 and the support cap 140 .
  • the rotation connection between the clamp seat 300 and the support cap 140 is realized by setting the support arm 320 to be clamped in the first ring groove 151 . It is understood that in other embodiments, it is also possible to use Other structural parts realize the rotational connection between the clip base 300 and the support cap 140 .
  • the support arm 320 includes a first arm portion 321 and a second arm portion 322 connected to each other, the first arm portion 321 and the second arm portion 322, the first arm portion 321 and the second arm portion 322.
  • An arm portion 321 and a second arm portion 322 are respectively disposed inclined relative to the axis of the base body 310 , and the included angle between the first arm portion 321 and the axis is greater than the included angle between the second arm portion 322 and the axis.
  • the second arm portion 322 is connected to the base body 310 , the first arm portion 321 is located at the distal end of the second arm portion 322 , and the distal end of the first arm portion 321 is clamped in the first annular groove 151 .
  • the proximal end of the seat body 310 is provided with a gap, the gap is a first gap, and the support arm 320 is disposed at the first gap.
  • Two sides of the second arm portion 322 are respectively connected with two sides of the first notch along the circumference of the base body 310 , and under the action of external force, the angle between the second arm portion 322 and the axis of the base body 310 is adjustable.
  • the first arm portion 321 is disposed at the distal end of the second arm portion 322 , and the distal end of the first arm portion 321 protrudes from the outer peripheral wall of the seat body 310 , that is, the distance from the distal end of the first arm portion 321 to the axis of the seat body 310 .
  • the distance is greater than the radial dimension of the outer peripheral wall of the base body 310 , so that the distal end of the first arm portion 321 is clamped in the first annular groove 151 and can rotate along the sliding groove 312 .
  • FIG. 7 is an enlarged schematic view of a part of the structure at VII in FIG. 2 .
  • the angle formed between the first arm portion 321 and the axis of the base body 310 is ⁇ , 20° ⁇ 80° ;
  • the angle formed between the second arm portion 322 and the axis of the seat body 310 is ⁇ , 0° ⁇ 60°.
  • the angle formed between the first arm portion 321 and the axis of the base body 310 and the angle formed between the second arm portion 322 and the axis of the base body 310 change, At this time, the included angle between the first arm portion 321 and the axis of the seat body 310 is 20°, and the included angle between the second arm portion 322 and the axis of the seat body 310 is 0° (as shown in FIG.
  • the distal end of the first arm portion 321 can still be snapped into the first ring groove 151 , so that the clamping base 300 and the support cap 140 are in a connected state. Meanwhile, when the clip body 400 is in the closed state, the included angle between the first arm portion 321 and the seat body 310 is 30°, and the included angle between the second arm portion 322 and the seat body 310 is 0°.
  • FIG. 8 is a schematic cross-sectional view of a partial structure of the first tissue distraction device 10 provided in the present embodiment when the clip body 400 is in a clamping and locking state from a second viewing angle. 2 , 3 , 5 and 6 , in this embodiment, the support arm 320 further includes a third arm portion 323 disposed at the proximal end of the second arm portion 322 , and the second connecting structure includes a third arm portion 323 disposed at the proximal end of the second arm portion 322
  • the limiting notch 324 is used to limit the sliding of the clip body 400 to the distal end relative to the clip base 300 .
  • the base body 310 is further provided with a sliding groove 312
  • the clip body 400 is provided with a first sliding protrusion 440 slidably matched with the sliding groove 312 .
  • the second connecting structure further includes the proximal end of the sliding groove 312, and the first connecting structure further includes a first sliding protrusion 440.
  • the first sliding protrusion 440 is connected to the sliding groove.
  • the proximal wall surface of 312 collides to limit the sliding of the clip body 400 relative to the clip base 300 towards the proximal end.
  • the first sliding protrusion 440 and the limiting protrusion 430 are respectively restrained with the clip base 300, so that the clip Body 400 remains in a clamp-locked state, ensuring that when pulled through outer tube assembly 100, clamp body 400 always clamps tissue.
  • the number of the support arms 320 is two, and the two support arms 320 are disposed opposite to each other along the radial direction of the base body 310 .
  • the number of the limit notches 324 is two, and the limit protrusions provided on the clip body 400
  • the number of 430 is two.
  • the number of the sliding grooves 312 provided on the base body 310 is two, and the two sliding grooves 312 are disposed opposite to each other along the radial direction of the base body 310 .
  • the number of the first sliding protrusions 440 is two.
  • the sliding groove 312 extends along the axial direction of the base body 310 , so that when the first sliding protrusion 440 slides in the sliding groove 312 , the clamping body 400 is switched between the open state, the closed state and the locked state.
  • the support arms 320 and the sliding grooves 312 are alternately arranged, and correspondingly, the first sliding protrusions 440 and the limiting protrusions 430 are alternately arranged along the circumferential direction of the seat body 310 . It can be understood that, in other embodiments, the number of the support arms 320 and the chute 312 can also be set as required.
  • FIG. 9 is a schematic structural diagram of the first clip body 400 provided in this embodiment. 1-9, in this embodiment, the clip body 400 includes at least two clip arms, the at least two clip arms are arranged around the axis of the clip base 300, and when the clip arms are in the direction from the distal end to the proximal end When sliding relative to the clamp base 300, the clamp arm collides with the clamp base 300, so that the clamp arm has a relatively closed tendency.
  • the number of clamping arms is two, and the two clamping arms are the first clamping arm 410 and the second clamping arm 420 respectively.
  • the proximal end of the first clamping arm 410 is connected with the proximal end of the second clamping arm 420, the distal end of the first clamping arm 410 and the distal end of the second clamping arm 420 are separated, and when the distal end of the first clamping arm 410 is far away from the second clamping arm
  • the clip body 400 is in an open state, and when the distal end of the first clip arm 410 and the distal end of the second clip arm 420 approach or collide, the clip body 400 is in a closed state, and the tissue can be Clamped between the distal end of the first clamping arm 410 and the distal end of the second clamping arm 420 .
  • the number of clamping arms is two. It is understood that in other embodiments, the number of clamping arms can also be set as required, for example, the number of clamping arms is set to three or Four and so on.
  • the clip arm includes a connecting portion 481 , an intermediate portion 482 and a holding portion 483 connected in sequence, the holding portion 483 is used for holding tissue, and the connecting portions 481 of at least two clip arms are connected to each other.
  • the middle portion 482 is used to interfere with the clip base 300 so that when the clip arm slides relative to the clip base 300 in the distal-to-proximal direction, the clip arm has a tendency to close.
  • the connecting portion 481 of the first clip arm 410 and the connecting portion 481 of the second clip arm 420 are connected to each other, so that the two clip arms are connected to form the clip body 400 as a whole.
  • the middle portion 482 has elasticity, and when the clip arm slides relative to the clip base 300 in the direction from the proximal end to the distal end, the middle portion 482 has a tendency for the clip arm to open. Specifically, when the clip arm slides relative to the clip base 300 in the direction from the distal end to the proximal end, the middle portion 482 is collided by the clip base 300 and moves in the radially inward direction, so that the gap between the two clip parts 483 is moved in the radially inward direction.
  • the distance decreases; when the clamping arm slides relative to the clamping base 300 in the direction from the proximal end to the distal end, the position where the middle part 482 collides with the clamping base 300 gradually approaches the connecting part 481 , and the elastic restoring force of the clamping part 483 in the middle part 482 Under the action of opening, the distance between the two clamping parts 483 increases.
  • a pull rope around the clamp arm can also be provided, so as to pull the pull rope through the pull cable assembly 200 to manipulate the open or close of the clamp arm (as shown in FIG. 10 ).
  • the first clamping arm 410 and the second clamping arm 420 are made in one piece, in other words, the connecting portion 481 of the first clamping arm 410 and the connecting portion 481 of the second clamping arm 420 are integrally formed by bending, so that the A clamping arm 410 is connected with the second clamping arm 420 .
  • the two first sliding protrusions 440 are respectively disposed on the first clamping arm 410 and the second clamping arm 420 , and the first sliding protrusions 440 are formed by folding a part of the clamping arm outwards.
  • the two limiting protrusions 430 are respectively disposed on both sides of the connection between the first clamping arm 410 and the second clamping arm 420 , so that the limiting protrusions 430 and the clamping arms are alternately distributed in the circumferential direction of the clamping base 300 .
  • first clamping arm 410 and the second clamping arm 420 are made in one piece. It can be understood that in other embodiments, the first clamping arm 410 and the second clamping arm 410 can also be provided as required.
  • the connection method of the arms 420 for example, prefabricates two separate clamping arms, and then realizes the connection between the connection part 481 of the first clamping arm 410 and the connection part 481 of the second clamping arm 420 by welding (as shown in FIG. 11 ) Show).
  • first clamping arm 410 and the second clamping arm 420 are directly connected to form the clamping body 400.
  • the clamping body 400 may also be configured to include connecting pieces 450, the connecting parts 481 of the at least two clip arms are respectively connected with the connecting piece 450, so as to realize the connection of the proximal ends of the at least two clip arms.
  • FIG. 12 shows a schematic structural diagram of the fourth clamp body 400 provided in this embodiment.
  • the connecting member 450 of the fourth type of clip body 400 has at least two connecting protrusions 451
  • the connecting portion 481 is provided with a clamping hole 452
  • the clamping holes 452 of the at least two clamping arms correspond to at least two The connection bumps 451 are snapped together, so as to realize the connection of at least two clamping arms.
  • FIG. 13 is a schematic structural diagram of the pulling cable assembly 200 and the clip body 400 after being separated from the tissue traction device provided in this embodiment.
  • the distal end of the cable assembly 200 is detachably connected to the clip body 400 , and when the pulling force applied to the distal end of the cable assembly 200 reaches At the preset value, the distal end of the cable assembly 200 is disengaged from the clip body 400 . That is, during use, the clip body 400 is driven to slide relative to the clip base 300 by pushing and pulling the cable assembly 200, so that the clip body 400 is switched between the open state and the closed state.
  • the open state is switched to the closed state, continue to pull the cable assembly 200 to move the clip body 400 toward the proximal end, the first connection structure cooperates with the second connection structure, and the clip body 400 is in a clamped and locked state, and the clip body 400 is opposite to each other.
  • the clip base 300 is fixed, and when the tensile force exerted on the distal end of the cable assembly 200 reaches a preset value, the distal end of the cable assembly 200 is disengaged from the clip body 400 .
  • the distal end of the cable assembly 200 is detachably connected to the clip body 400. It can be understood that in other embodiments, the distal end of the cable assembly 200 can also be set to be connected to the clip body 400.
  • the clip body 400 is fixedly connected.
  • the clip body 400 is provided with a connection hole 470 , and the axis of the connection hole 470 extends along the line connecting the proximal end and the distal end of the clip body 400 , that is, the first direction or the second direction.
  • the distal end of the cable assembly 200 has a clamping slot 221 disposed along the circumferential direction of the cable assembly 200 .
  • the cable assembly 200 includes a cable 210 and a release member 220 connected to the distal end of the cable 210 , and the release member 220 is located at the distal end of the cable assembly 200 .
  • the release member 220 is connected with the clip body 400 , and when the tension applied on the release member 220 reaches a preset value, the release member 220 is disengaged from the clip body 400 .
  • the connecting hole 470 is opened at the connection between the first clamping arm 410 and the second clamping arm 420 .
  • the outer peripheral wall of the distal end of the release member 220 is recessed inward to form the clamping slot 221 , that is, the outer diameter of the portion of the release member 220 located at the proximal end of the clamping slot 221 and the outer diameter of the portion of the release member 220 at the distal end of the clamping slot 221 are both It is larger than the radial dimension at the slot 221 .
  • the part of the release member 220 located at the proximal end of the clamping slot 221 is located at the proximal end side of the connection hole 470
  • the part of the release member 220 at the distal end of the clamping slot 221 is located at the far side of the connection hole 470 the end side, so as to realize the connection between the release member 220 and the frame body.
  • the part of the release member 220 located at the distal end of the clamping slot 221 and/or the connecting hole 470 of the clip body 400 is deformed, so that the release member 220 is located far from the clamping slot 221 .
  • the end portion is disengaged from the connecting hole 470 , thereby disengaging the cable assembly 200 from the clip body 400 .
  • connection method between the distal end of the cable assembly 200 and the clip body 400 is not limited here. It can be understood that in other embodiments, the structure of the release member 220 can also be set according to requirements, such as FIG. 11 .
  • the proximal end of the clip body 400 is provided with a hooking hole 490, the distal end of the cable assembly 200 is hooked with the hooking hole 490, and when the tension applied on the distal end of the cable assembly 200 reaches a predetermined When set, the distal end of the cable assembly 200 is disengaged from the hooking hole 490 .
  • the axis of the hooking hole 490 extends along the radial direction of the clip base 300
  • the release member 220 is a hook shape formed by bending multiple sections
  • the release member 220 is hooked to the hooking hole 490 , and when the pulling force exerted on the release member 220 When the preset value is reached, the release member 220 is deformed to straighten the part hooked with the hooking hole 490 , and then disengages from the hooking hole 490 , so as to realize the disengagement of the cable assembly 200 from the clip body 400 .
  • the distal end of the cable assembly 200 has a clamping gap and a connecting groove 223 , and when the tension applied on the distal end of the cable assembly 200 reaches a preset value, the connecting member 450 is connected to The groove 223 is disengaged, the connecting portion 481 is disengaged from the clamping gap, and the distal end of the connecting portion 481 expands outward to be clamped with the clamp base 300 .
  • a through hole is formed on the clamping base 300
  • a clamping gap and a connecting groove 223 are formed on the releasing member 220
  • the connecting groove 223 is a spherical groove with a smaller opening.
  • the connecting member 450 When the connecting member 450 is connected with the connecting groove 223, the connecting portion 481 of the clip arm is clamped in the clamping gap, and when the tension applied on the release member 220 is greater than the preset value, the connecting member 450 is disengaged from the connecting groove 223, and the clip arm The connecting portion 481 is released from the clamping gap, and expands outward under the action of its own elastic restoring force to be clamped into the through hole on the clamping base 300 , so that the clamping body 400 is kept in the clamping and locking state.
  • the tissue distraction device 10 further includes a fitting member 600 disposed in the support cap 140 , and the fitting member 600 has a channel for the release member 220 to pass through.
  • the release member 220 has a matching portion 222 , and the matching portion 222 is located on the proximal side of the locking groove 221 .
  • the concave surface of the outer peripheral surface of the fitting portion 222 that is, along the direction from the proximal end to the distal end, the outer diameter of the fitting portion 222 first decreases and then increases.
  • the part of the release member 220 on the proximal side of the fitting portion 222 penetrates through the channel of the fitting member 600 .
  • the fitting portion 222 penetrates through the fitting member 600 . 600 channels.
  • tissue distraction device 10 According to a tissue distraction device 10 provided in this embodiment, the working principle of the tissue distraction device 10 is as follows:
  • the distal end of the tissue distraction device 10 penetrates into the endoscope channel from the proximal end of the endoscope and extends into the human body along the endoscope channel.
  • the clip body 400 of the tissue distraction device 10 extends from the distal end of the endoscope channel.
  • the end opening extends out of the endoscope to grip tissue.
  • the second handle 520 slides proximally relative to the first handle 510 to pull the cable assembly 200, thereby manipulating the clip body 400 to switch to a closed state to clamp the tissue.
  • the cable assembly 200 so that the clamp body 400 is switched to the clamping lock state and the cable assembly 200 is disengaged from the clamp body 400; if the clamping accuracy is poor, push the second handle 520 to slide to the distal end relative to the first handle 510 , so as to push the cable assembly 200 to manipulate the clamping body 400 to switch to the open state, so that the clamping operation can be repeated until the clamping is accurate.
  • the clamping body 400 is switched to the clamping and locking state and the cable assembly 200 is disengaged from the clamping body 400, the distal end of the outer tube assembly 100 remains connected to the clamping base 300, and the proximal end of the outer tube assembly 100 is detached from the first handle 510 , the first handle 510, the second handle 520 and the cable assembly 200 can be separated from the pulling structure, so that the endoscope can be withdrawn smoothly.
  • the clamp body 400 is located in the human body and stably clamps the tissue.
  • the proximal end of the outer tube assembly 100 is located outside the human body, so during surgical operations, the clip body 400 can be manipulated by pushing and pulling the proximal end of the outer tube assembly 100 outside the body, thereby realizing tissue pulling to improve the surgical field.
  • FIG. 14 shows a schematic cross-sectional view of the partial structure of the second tissue distraction device 10 provided in this embodiment.
  • the second tissue distraction device 10 is substantially the same as the first tissue distraction device 10 provided in this embodiment, except for the structure of the clip body 400 , the clip base 300 and the structure of the release member 220 .
  • the outer peripheral wall of the clip base 300 is provided with a second annular groove 350
  • the inner peripheral wall of the support cap 140 is provided with a sliding protrusion
  • the sliding protrusion is the second sliding protrusion
  • the clip base 300 includes a base body 310 and an insert 330, the distal end of the insert 330 is embedded inside the proximal end of the base body 310, and the proximal end of the outer peripheral wall of the insert 330 is provided with a step portion 331.
  • a second annular groove 350 is formed between 331 and the proximal end surface of the base body 310 .
  • the insert 330 is a circular tubular member, the inner peripheral wall of which is a smooth cylindrical surface, the outer peripheral wall includes a first outer wall and a second outer wall arranged in the axial direction, the first outer wall is located at the proximal end of the insert 330, and The radial dimension of the first outer wall is greater than the radial dimension of the second outer wall, so that a step portion 331 is formed at the proximal end of the insert 330 through the first outer wall and the second outer wall, and the step portion 331, the second outer wall and the proximal portion of the seat body 310 are formed.
  • the end face forms a second annular groove 350 .
  • the second sliding protrusions 152 are disposed at the inner peripheral wall of the distal end of the support cap 140 , in other words, the second sliding protrusions 152 are formed by radially inwardly protruding from the distal end of the inner peripheral wall of the supporting cap 140 .
  • the number of clamping arms is two, and the two clamping arms are the first clamping arm 410 and the second clamping arm 420 respectively, and the proximal end of the first clamping arm 410 and the The proximal end of the second clip arm 420 is rotatably connected, and the proximal end of the first clip arm 410 and/or the proximal end of the second clip arm 420 is connected with the cable assembly 200 .
  • the first clamp arm 410 is provided with a first chute 411
  • the second clamp arm 420 is provided with a second chute 421
  • the clamp base 300 is provided with a fixed shaft 340
  • the fixed shaft 340 passes through the first chute 411 and The second chute 421, so when the cable assembly 200 pushes and pulls the clamp body 400, the first clamp arm 410 and the second clamp arm 420 slide along the first chute 411 and the second chute 421 respectively relative to the fixed shaft 340, that is, the first A clamping arm 410 slides along the first sliding slot 411 relative to the fixed shaft 340 , and the second clamping arm 420 slides along the second sliding slot 421 relative to the fixing shaft 340 .
  • the first sliding groove 411 and the second sliding groove 421 are arc-shaped grooves arranged in opposite directions, so that the first clamping arm 410 and the second clamping arm 420 can be opened or closed.
  • the distal ends of the first sliding slot 411 and the second sliding slot 421 are provided with a bending structure, and when the clip body 400 is in the clamping and locking state, the fixing pin is located in the bending structure.
  • the first connection structure includes a hook structure 412 disposed on the first clip arm 410 and the second clip arm 420
  • the second connection structure includes a hook 360 disposed on the clip base 300 .
  • the hook structure 412 is engaged with the hooks 360 to keep the clamping body 400 in the clamping and locking state to ensure clamping stability.
  • both the first clamping arm 410 and the second clamping arm 420 are provided with hook structures 412, and when the clamping body 400 is in the closed state, the two hooking structures 412 overlap, so that when the clamping body 400 is clamped and locked In the state, the two hook structures 412 are engaged with the same hook 360 at the same time.
  • two hooks 360 may also be provided on the clip base 300 , and the hook structures 412 of the two clip arms are respectively engaged with the two hooks 360 .
  • the clip body 400 further includes a connecting shaft 460 , and the proximal end of the first clip arm 410 and the proximal end of the second clip arm 420 are rotatably connected through the connecting shaft 460 .
  • the distal end of the cable assembly 200 is sleeved with the connecting shaft 460, and the distal end of the cable assembly 200 has a gap, and the gap is a second gap, so that when the tensile force exerted on the distal end of the cable assembly 200 reaches a preset value , the connecting shaft 460 is disengaged from the second notch, so that the distal end of the cable assembly 200 is disengaged from the clip body 400 .
  • the distal end of the cable assembly 200 is set as a wire buckle 224
  • the wire buckle 224 is sleeved with the connecting shaft 460
  • the wire buckle 224 is deformed to increase the second gap.
  • the connecting shaft 460 is separated from the wire buckle 224 from the second notch, so that the cable assembly 200 is separated from the clamping body 400 .
  • the wire buckle 224 is a fan-shaped ring structure with a gap formed by winding a wire.
  • FIG. 15 shows a schematic partial structure diagram of still another cable assembly 200 provided by the embodiment.
  • the distal end of the cable assembly 200 includes a first clamping arm 225 and a second clamping arm 226 which are disposed with each other.
  • a through hole for clamping the connecting shaft 460 is formed between the first clamping arm 225 and the second clamping arm 226 , and a gap communicated with the through hole, and the gap is a third gap.
  • the proximal ends of the first clamping arm 225 and the second clamping arm 226 are both connected to the cable 210, and the distal end of the first clamping arm 225 and the distal end of the second clamping arm 226 are spaced apart to form The third notch, the middle part of the first clamping arm 225 and the middle part of the second clamping arm 226 are spaced apart to form a through hole for clamping the connecting shaft 460 .
  • both ends of the connecting shaft 460 protrude from the first clamping arm 410 and the second clamping arm 420 respectively, that is, the two axial ends of the connecting shaft 460 are located on the side of the first clamping arm 410 away from the second clamping arm 420 and A side of the second clamping arm 420 away from the first clamping arm 410 .
  • the distal end of the cable assembly 200 includes two release parts, the two release parts are a first release part and a second release part respectively, the first release part and the second release part are respectively sleeved on both ends of the connecting shaft 460, the first release part and the second release part
  • the clip arm 410 and the second clip arm 420 are located between the first release portion and the second release portion.
  • the release portion is a wire buckle 224, that is, in this embodiment, the number of the wire buckle 224 is two.
  • the release portion may also be configured as a structure including the first clamping arm 225 and the second clamping arm 226 , in other words, in other embodiments, the first clamping arm 225 and the second clamping arm 226 The number of the two clamping arms 226 is two respectively.
  • the tissue distraction device 10 provided in this embodiment has at least the following advantages:
  • the outer tube assembly 100 and the clip base 300 are arranged in a structure that remains connected when the clip body 400 is in the clamping and locking state, so that during the operation, the external tube assembly 100 can be pushed and pulled
  • the tube assembly 100 realizes the manipulation of the clip body 400 to pull the tissue, thereby obtaining a good surgical field, which is helpful for shortening the operation time and reducing the operation risk.
  • the clamping body 400 can be repeatedly opened and closed for many times, and the clamping body 400 can also be manipulated to rotate through the cable assembly 200 to ensure accurate clamping.
  • This embodiment also provides a method of using the tissue distraction device 10 , which can be implemented by the above-mentioned tissue distraction device 10 .
  • the method of using the tissue traction device 10 includes:
  • S01 The distal end of the tissue distraction device 10 is sent into the body along the forceps channel of the endoscope.
  • the distal end of the tissue distraction device 10 is introduced into the body along the forceps channel of the endoscope, and the clip body 400 of the tissue distraction device 10 is protruded from the distal opening of the forceps channel for tissue clamping.
  • SO2 Operate the handle 500 of the tissue distraction device 10, so that the clip body 400 of the tissue distraction device 10 clamps the tissue, and the clip body 400 is switched to the clamping and locking state.
  • the handle 500 of the tissue pulling device 10 is operated to drive the cable assembly 200 to move, so as to manipulate the clip body 400 to clamp the tissue through the cable assembly 200.
  • the handle 500 can be used to drive the cable assembly 200.
  • the clamping body 400 is rotated to adjust the clamping angle. After the angle adjustment is completed, the pull cable assembly 200 is pulled through the handle 500 to operate the clamp body 400 to switch to the closed state, thereby clamping the tissue. After the clamping is accurate, continue to pull the cable assembly 200 to switch the clamp body 400 to the clamping lock state, and continue to apply sufficient pulling force to the cable assembly 200 to disengage the distal end of the cable assembly 200 from the clamp body 400 .
  • the distal end of the outer tube assembly 100 is detachably connected to the handle 500 , so that the handle 500 can be disengaged from the outer tube assembly 100 by removing the distal end of the outer tube assembly 100 from the handle 500 . It can be understood that, in other embodiments, the distal end of the outer tube assembly 100 can also be cut off to realize the separation of the outer tube assembly 100 from the handle 500 .
  • the distal end of the cable assembly 200 is detachable from the clip body 400, so even if the proximal end of the cable assembly 200 is connected to the handle 500, the clip body 400 and the outer tube assembly can be smoothly connected 100 is completely disengaged from the handle 500. It can be understood that in other embodiments, for example, when the outer tube assembly 100 is separated from the handle 500 by cutting off the distal end of the outer tube assembly 100, the Proximal synchronous snip.

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  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Surgical Instruments (AREA)
PCT/CN2021/135502 2020-12-22 2021-12-03 一种组织牵引装置及组织牵引装置的使用方法 WO2022135119A1 (zh)

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CN117942134A (zh) * 2024-03-26 2024-04-30 杭州索德医疗设备有限公司 一种薄膜粘连装置及使用方法

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WO2023159518A1 (en) * 2022-02-25 2023-08-31 Micro-Tech (Nanjing) Co., Ltd. Medical device for causing hemostasis of blood vessel
WO2023159521A1 (en) * 2022-02-25 2023-08-31 Micro-Tech (Nanjing) Co., Ltd. Medical device for causing hemostasis of blood vessel
CN115444492A (zh) * 2022-10-24 2022-12-09 苏州法兰克曼医疗器械有限公司 一种内窥镜下止血夹闭装置

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