WO2022143957A1 - Applicateur d'agrafes - Google Patents

Applicateur d'agrafes Download PDF

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Publication number
WO2022143957A1
WO2022143957A1 PCT/CN2021/143401 CN2021143401W WO2022143957A1 WO 2022143957 A1 WO2022143957 A1 WO 2022143957A1 CN 2021143401 W CN2021143401 W CN 2021143401W WO 2022143957 A1 WO2022143957 A1 WO 2022143957A1
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WO
WIPO (PCT)
Prior art keywords
clip
clamp
feeding
jaw
push
Prior art date
Application number
PCT/CN2021/143401
Other languages
English (en)
Chinese (zh)
Inventor
孙宝峰
戴霞红
Original Assignee
江苏风和医疗器材股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 江苏风和医疗器材股份有限公司 filed Critical 江苏风和医疗器材股份有限公司
Publication of WO2022143957A1 publication Critical patent/WO2022143957A1/fr

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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
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for 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
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding

Definitions

  • the invention relates to the field of medical instruments, in particular to a clamp applicator.
  • Temporary or permanent ligation of blood vessels or other tissues in the human body is commonly required during surgical operations to reduce bleeding.
  • There are two ways to ligate blood vessels the first is to suture the blood vessels with needles and surgical sutures, and the other is to use clips to close the blood vessels.
  • the first suturing method requires doctors to perform complex suturing operations, which is time-consuming and difficult to perform in endoscopic surgery with limited space and low visibility.
  • the method of closing blood vessels with clips is simple and can be performed quickly. Therefore, The use of clips in endoscopic surgery has increased dramatically.
  • Such clips are applied to a blood vessel or other tissue using an instrument, commonly referred to as a clip applier.
  • the traditional clip applier can only be used once. After a clip is installed outside the body, the jaws of the clip applier are sent into the body, the clip is applied, and a single clip is repeatedly installed, which is inconvenient to use. In recent years, there has been a trend for continuous clamp appliers that can apply multiple clamps in succession.
  • a continuous clamp applier which includes a jaw assembly, a clamp box, a handle and a push mechanism.
  • the clamp case is a long box, and the inside accommodates a first clamp located at the farthest end and other clamps arranged one by one behind the first clamp.
  • the clip needs to be fed, pushed and applied in use.
  • the feeding is about to push the first clip into the jaw position, and the pushing is about to push other clips to move to the front in the clip box, so that there is a new first clip at the front end.
  • the clip complements the clip application, which closes the jaws so that the clips located within the jaw assembly are closed, and the handle provides power to drive the clip feed, push and apply the clip.
  • the push mechanism is an integrally formed sheet metal strip, the push piece, which is installed on the side of the clip box.
  • the front end of the push piece is provided with a clip feeding piece, and the middle end is provided with a plurality of push clip pieces corresponding to the distances between the other clips.
  • Both the clip and the push clip are elastically inclined to the main body of the push piece, and the rear end of the push piece is connected to the handle, so that the movement of the handle drives the push piece to move forward or back and forth. Tilt against the first clip, a plurality of push clips tilt against the other clips, and all the clips advance simultaneously.
  • the clip feed piece and the clip push piece must be sheet-like, otherwise the clip feed piece and the push clip piece will collide with the clip and interfere with the clip when moving backward, but the rigidity of the sheet-like structure is not enough and it is easy to bend, resulting in the clip feeding and pushing.
  • the clips are unstable and are integrally formed, which requires high production technology; the size of the jaw assembly is designed to meet the advancing length of the clips, and the distance between two adjacent clips in the clip box is equal to the advancing length of the push clips.
  • the present invention aims to provide a clamp applier: including a jaw assembly, an operation assembly, and a shaft assembly extending from the operation assembly; the shaft assembly includes a clamp box, a clamp feed assembly and a push clamp assembly , the cartridge includes a first end connected to the jaw assembly and a second end opposite to the first end, the cartridge accommodates N clips, N is greater than or equal to 2, and the N clips include a sequence from the first end to the second end Arranged first clip, second clip ⁇ up to the Nth clip; the clip feeding assembly is used to abut and push the first clip to move forward into the jaw assembly; the push clip assembly is used to abut and push the second clip to the Nth clip The clip moves forward.
  • the clip includes a first clip arm, a second clip arm, and a connecting portion between the first clip arm and the second clip arm.
  • the first clip arm and the second clip arm form a clamping surface.
  • the clamping surfaces of multiple clips are located on the same plane;
  • the operating component drives the clip feeding component and the clip pushing component to move forward, and drives the jaw component to perform the jaw closing action;
  • the clip feeding component is located on the first side of the clamping surface of the clip ;
  • the push clip assembly is located on the second side of the clamping surface of the clip, and the first side is different from the second side.
  • the N clamping surfaces of the N clips are located on the same plane.
  • the clip box includes a bottom wall, a first side wall and a second side wall opposite to each other, the clip box body of the clip accommodated in the clip box is parallel to the bottom wall; the push clip assembly is located inside the bottom wall of the clip box.
  • the bottom wall of the cartridge includes an opening through which the clip feed assembly enters the cartridge and is located between the first clip and the second clip.
  • the clip feeding assembly includes an elastic push rod and a clamp feeding block disposed at one end of the elastic push rod;
  • the rod body assembly further includes a base, and the base includes a guide groove extending in the axial direction and a block groove communicated with the guide groove,
  • the block groove includes a guide inclined surface, and the guide inclined surface is arranged at an angle to the axial direction; the guide groove accommodates the elastic push rod and guides the elastic push rod to move along the axial direction, the block groove accommodates the clip feeding block, and the guiding inclined surface guides the clip feeding block into the opening.
  • the bottom wall comprises a first bottom wall located in front of the opening and a second bottom wall located behind the opening; the base is mounted to the cartridge, and the guide slope is in contact with the first bottom wall.
  • the thickness of the clip feeding block is greater than that of the elastic push rod.
  • the clip feeding assembly further includes a connecting rod extending in the axial direction, one end of the connecting rod is connected with the elastic push rod, and the other end of the connecting rod is connected with the operating assembly.
  • the guide groove also accommodates the connecting rod and guides the connecting rod to move in the axial direction.
  • the operating assembly further includes an actuating member and a matching mechanism; the actuating member is used to provide power to the clip-feeding assembly and the clip-pushing assembly; the matching mechanism includes a first matching member, an intermediate member and a second matching member, The first adapter drives the second adapter through the middle piece; the clip feeding component is linked with the first adapter; the push clip component is linked with the second adapter; the movement direction of the first adapter is connected with the second adapter. The movement of the fittings is reversed.
  • the beneficial effect of the present invention is that the clip feeding component and the clip pushing component are independent components, which are located on both sides of at least one clip respectively, and the first clip and other clips are independently pushed from both sides, thereby feeding the clips.
  • the advance length of the jaw assembly and the advance length of the push clamp do not need to be equal, the size design of the jaw assembly and the size design of the clamp box can be independent of each other, which provides a design space for the independent optimization of the jaw assembly structure and the clamp box structure, and also optimizes the push
  • the structure of the clip assembly and the clip feed assembly provides a design space, and the clip applier has a simple structure and a more compact size.
  • Fig. 1 is the three-dimensional schematic diagram of the clamp applier provided by the first embodiment of the present invention
  • Fig. 2 is the front view of the partial casing of the clamp applier shown in Fig. 1 after being hidden;
  • FIG. 3 is a schematic perspective view of a part of the casing of the clamp applier shown in FIG. 1 after being hidden;
  • Fig. 4A is the front structure schematic diagram of the clip of the clip applier shown in Fig. 1;
  • Fig. 4B is the side structure schematic diagram of the clamp of the clamp applier shown in Fig. 1;
  • Figure 5 is an exploded perspective view of the jaw assembly and the shaft assembly of the clamp applier shown in Figure 1;
  • Fig. 6 is the structural representation of the jaw drive mechanism of the clamp applier shown in Fig. 1;
  • Figure 7 is an exploded perspective view of part of the jaw drive mechanism shown in Figure 6;
  • FIG. 8 is a schematic structural diagram of the clip feeding drive mechanism of the clip applier shown in FIG. 1;
  • FIG 9 is an exploded perspective view of the clip feeding drive mechanism of the clip applier shown in Figure 8.
  • FIG. 10 is a front view of the push-clamp rod and the adapter block of the push-clamp drive mechanism of the clamp applier shown in FIG. 1;
  • Fig. 11 is a perspective view of the push-clamp rod of the push-clamp drive mechanism of the clamp applier shown in Fig. 10;
  • FIG. 12 to 14 are schematic diagrams of state changes of the transmission mechanism of the clamp applier shown in FIG. 1;
  • FIG. 15A is a cross-sectional view of the jaw assembly and the shaft assembly from the M-M perspective of FIG. 15B when the wrench of the clamp applier shown in FIG. 1 is in an open position;
  • FIG. 15B is a cross-sectional view of the jaw assembly and the shaft assembly from the L-L perspective of FIG. 15A when the wrench of the clamp applier shown in FIG. 1 is in the open position;
  • 16A is a cross-sectional view of the jaw assembly and the shaft assembly from the M-M perspective of FIG. 16B when the wrench of the clamp applier shown in FIG. 1 is in a neutral position;
  • 16B is a cross-sectional view of the jaw assembly and the shaft assembly from the L-L perspective of FIG. 16A when the wrench of the clamp applier shown in FIG. 1 is in a neutral position;
  • 17A is a cross-sectional view of the jaw assembly and the shaft assembly from the M-M perspective of FIG. 17B when the wrench of the clamp applier shown in FIG. 1 is in a closed position;
  • 17B is a cross-sectional view of the jaw assembly and the shaft assembly from the L-L perspective of FIG. 17A when the wrench of the clamp applier shown in FIG. 1 is in the closed position;
  • Fig. 18 is a perspective exploded view of the partial switching mechanism of the clamp applier shown in Fig. 1;
  • FIG. 19 is an exploded perspective view of the partial switching mechanism of the clamp applier shown in FIG. 1 from another perspective;
  • FIG. 20 is a schematic structural diagram of the transmission mechanism of the knob assembly part of the clamp applier shown in FIG. 1;
  • FIG. 21 is a schematic structural diagram of the mating mechanism of the clamp applier shown in FIG. 1;
  • Figure 22 is an exploded schematic view of the fitting block of the clamp applier shown in Figure 1 assembling the second fitting;
  • Figure 23A is a schematic diagram of the movement process of the clip feeding block of the clip applier shown in Figure 1;
  • Figure 23B is a schematic diagram of the movement trajectory of the clip feeding block of the clip applier shown in Figure 23A;
  • Fig. 24A is a schematic diagram of the movement process of the push block of the clamp applier shown in Fig. 1;
  • Fig. 24B is a schematic diagram of the movement trajectory of the push block of the clamp applier shown in Fig. 24A;
  • Figure 25 is a schematic structural diagram of the wrench for applying the clamp shown in Figure 2;
  • Figure 26 is a schematic exploded view of the structure of the guide channel of the wrench for applying the clamp shown in Figure 25;
  • Figure 27 is a schematic structural diagram of the guide pivot member of the clamp applier shown in Figure 2;
  • Fig. 28 is a schematic view of the assembly of the guide pivot member and the wrench locking spring element of the clamp applier shown in Fig. 2;
  • Fig. 29 is a schematic structural diagram of the path switching member of the clamp applier shown in Fig. 2;
  • FIG. 30 is a schematic view of the internal structure of the housing of the part of the clamp applier shown in FIG. 1;
  • 31A is a state diagram of the wrench locking mechanism when the wrench of the clamp applier shown in FIG. 2 is in the open position;
  • FIG. 31B is a state diagram of the wrench locking mechanism when the wrench of the clamp applier shown in FIG. 2 moves forward to the middle position;
  • 31C is a state diagram of the wrench locking mechanism when the wrench of the clamp applier shown in FIG. 2 is in the closed position;
  • 31D is a state diagram of the wrench locking mechanism when the wrench of the clamp applier shown in FIG. 2 is reset and moved to the middle position;
  • FIG. 32 is a cross-sectional view of the clamp applier shown in FIG. 1 from a perspective of a path switching member;
  • 33A is a state diagram of the path switching member when the wrench of the clamp applier shown in FIG. 1 is in the open position;
  • 33B is a state diagram of the path switching member when the wrench of the clamp applier shown in FIG. 1 moves forward to the first adjacent position;
  • 33C is a state diagram of the path switching member when the wrench of the clamp applier shown in FIG. 1 is in the closed position;
  • 33D is a state diagram of the path switching member when the wrench of the clamp applier shown in FIG. 1 is reset and moved to the second adjacent position;
  • Figure 34 is a schematic structural diagram of the jaw assembly of the clamp applier shown in Figure 1;
  • Figure 35 is a schematic structural diagram of the first clamping arm or the second clamping arm of the jaw assembly shown in Figure 34;
  • Figure 36 is a cross-sectional view of the jaw assembly shown in Figure 34 from a perspective;
  • Fig. 37 is a schematic structural diagram of the stopper of the jaw assembly shown in Fig. 34 being matched with the clip;
  • Figure 38 is a schematic structural diagram of the stopper of the jaw assembly shown in Figure 34;
  • Figure 39 is a cross-sectional view of the jaw assembly shown in Figure 34 from another perspective;
  • Figure 40 is a cross-sectional view of the jaw assembly assembly cartridge shown in Figure 34;
  • Figure 41 is a schematic view of the jaw assembly shown in Figure 34 in a closed state
  • Figure 42 is a schematic view of the jaw assembly shown in Figure 34 in an open state
  • 43 to 45 are schematic diagrams of state changes of part of the transmission mechanism of the clamp applier provided by the second embodiment of the present invention.
  • 46 is an exploded perspective view of a part of the switching mechanism of the clamp applier provided by the third embodiment of the present invention.
  • 47 to 50 are schematic diagrams of state changes of a part of the transmission mechanism of the surgical instrument provided by the third embodiment of the present invention.
  • 51 is an exploded perspective view of the switching mechanism of the clamp applier provided by the fourth embodiment of the present invention.
  • 52 to 54 are schematic diagrams showing state changes of a part of the transmission mechanism of the clamp applier according to the fourth embodiment of the present invention.
  • first clamp arm; 1' the second clamp arm; 10, the clip; 11, the bottom; 12, the first side part; 13, the second side part; 14, the notch; 15, the first guide part; 16, second guide part; 17, first accommodating part; 18, second accommodating part; 19, protrusion; 2, stopper; 21, first stopper; 22, end; 23, base; 25, Middle part; 31, first clamping arm; 32, second clamping arm; 33, connecting part; 35, first engaging part; 36, second engaging part; 41, first protruding part; 42, second protruding part part; 51, guide surface; 52, first part; 53, second part; 60, first elastic element; 71, proximal side; 72, distal side; 73, junction; 80, pit; 100, jaw assembly 200, shaft assembly; 210, sleeve; 220, cartridge; 221, bottom wall; 221a, first bottom wall; 221b, second bottom wall; 222, first side wall; 223, second side wall; 224, opening; 225, transverse barb; 231, clip feeding block; 232
  • the user of the surgical instrument may be a clinician, a doctor who manipulates the surgical instrument during surgery to perform surgery.
  • proximal refers to the part relatively close to the clinician
  • distal refers to the part relatively far from the clinician.
  • Left and “Right” refer to the position of the surgical instrument shown in Figure 1, eg, the jaw assembly is “left” and the cannula 210 is “right.”
  • upper and “lower” refer to the relative positions of the upper jaw and the lower jaw of the jaw assembly.
  • the upper jaw is “upper” and the lower jaw is “lower”. It is to be understood that the orientations “near”, “rear”, “far”, “front”, “left”, “right”, “up” and “down” are defined for ease of description, however, surgical instruments can be in many orientations and positions use, so these terms expressing relative positional relationships are not restrictive and absolute.
  • the clamp applier 1000 includes an operating assembly 300 , a shaft assembly 200 extending from the operating assembly 300 , and a jaw assembly 100 disposed at one end of the shaft assembly 200 .
  • the clip applier 1000 needs to perform three actions: a clip feeding action, a jaw closing action (clamping action) and a pushing action, and the clip feeding action must be followed by a jaw closing action.
  • the above three actions need to be completed. The number of times the clip applier 1000 is used depends on the number of clips contained therein.
  • the operating assembly 300 includes a main body 320 and a wrench (actuator 330 ) movably mounted on the main body 320 , the main body 320 includes a housing 321 , the wrench is movably connected to the housing 321 , and the housing 321 is divided into roughly spindles according to the positional relationship
  • a cylindrical head casing and a handle casing extending from the lower side of the head casing, the handle casing and the wrench form a handle assembly, the user can grasp the handle casing with one hand, and pull the wrench with fingers to make the wrench relative to each other.
  • the main body 320 moves.
  • the clip applier also includes a transmission mechanism, and part of the transmission mechanism is accommodated in the housing 321 of the operating assembly 300, and part of the transmission mechanism is located in the shaft assembly 200.
  • the transmission mechanism includes a clip feeding driving mechanism, a jaw driving mechanism and a pushing clip driving mechanism, and the wrench drives the transmission mechanism to move, thereby driving the clip feeding drive.
  • the mechanism, jaw drive mechanism and push-clamp drive mechanism move.
  • the clamp-feeding mechanism executes the clamp-feeding action
  • the jaw-drive mechanism executes the jaw closing action (clamp-applying action)
  • the push-clamp drive mechanism executes the push-clamp action.
  • the clamp 10 for applying the clamp includes a first clamping arm 31 , a second clamping arm 32 and a connecting portion 33 , and the connecting portion 33 is located between the first clamping arm 31 and the second clamping arm 32 During this time, the two clamping arms can pivot relative to each other around the connecting portion 33 .
  • the first clamp arm 31 includes two first protrusions 41
  • the second clamp arm 32 includes two second protrusions 42
  • the first clamp arm 31 further includes a first engaging portion 35
  • the second clamp arm 32 further includes a first clamping portion 35 .
  • Two engaging parts 36 are two engaging parts.
  • the first clamping arm 31 and the second clamping arm 32 of the clip 10 approach each other under the driving of the external force, and finally the first engaging portion 35 is engaged with the second engaging portion 36 of the second clamping arm 32, so that the A clamping arm 31 and a second clamping arm 32 are fixed to each other to realize the clamping of the tissue located between the first clamping arm 31 and the second clamping arm 32.
  • the first clamping arm 31 and the second clamping arm 32 are combined. It is defined that the clip 10 is in a closed/locked state when the first clip arm 31 and the second clip arm 32 of the clip 10 are combined with each other, and the clip 10 is in an open state when the first clip arm 31 and the second clip arm 32 of the clip 10 are disengaged from each other.
  • the first engaging portion 35 is a tip portion disposed at the distal end of the first clip arm 31
  • the second engaging portion 36 is a curved C-shaped hook portion disposed at the distal end of the second clip arm 32 .
  • the jaw assembly 100 includes a first clamp arm 1 and a second clamp arm 1' pivotably connected to the shaft assembly 200, respectively, and a clamp 10 can be supported between the first clamp arm 1 and the second clamp arm 1',
  • the jaw assembly 100 switches between an open state and a closed state. In the open state, the jaw assembly 100 clamps a clamp 10 in an open state. Due to structural limitations, the jaw assembly 100 cannot be opened unrestrictedly.
  • the open state of the jaw assembly 100 includes an open bottom state. The distance between the distal end of the clamp arm 1 and the distal end of the second clamp arm 1' is the largest in the up-down direction. When the jaw assembly 100 is in the closed state, the distal ends of the first clamp arm 1 and the second clamp arm 1' are in the up-down direction.
  • the closing of the jaw assembly 100 causes the clip 10 to transition from the open state to the closed state.
  • the proximal driving member of the jaw drives the sleeve 210 (the distal driving member of the jaw) to move forward and backward, and the specific manner can be found in the movement mode of the jaw driving mechanism described later.
  • the forward movement of the sleeve 210 causes the closing movement of the jaw assembly 100 to close the jaw assembly 100, the first jaw arm 1 and the second jaw arm 1' compress the clip 10 located therein, and the rearward movement of the sleeve 210 causes the jaw assembly
  • the 100 opening movement opens the jaw assembly 100 .
  • the shaft assembly 200 includes a clip box 220 , a base 240 , a clip feeding assembly, a clip push assembly, and a sleeve 210 sleeved on the clip box 220 , the clip feeding assembly, and the clip push assembly.
  • the clip feeding assembly belongs to the clip feeding drive mechanism
  • the push clip assembly belongs to the push clip drive mechanism
  • the sleeve 210 belongs to the jaw drive mechanism.
  • the first end (distal end) of the clip box 220 is connected to the jaw assembly 100, and the second end (proximal end) opposite to the first end is fixedly connected to the main body 320.
  • the clip box 220 can accommodate at most M clips 10, and M is greater than Equal to 2, which is related to the size of the cartridge 220.
  • the number of clips 10 in the cartridge 220 is reduced by one when the clip applier is used once.
  • N clips 10 are accommodated in the clip box 220, N is less than or equal to M, and the N clips 10 are sequentially arranged from the first end to the second end, namely the first clip, the second clip to the Nth clip.
  • the first clip is closest to the first end and is fed into the jaw assembly 100 first.
  • the clips other than the first clip in the clip box 220 are defined as other clips.
  • the cartridge 220 includes M stations, which are arranged from the distal end of the cartridge 220 to the proximal end, which are the first station, the second station, ... the Mth station, and the first clip is located at the frontmost first station.
  • the corresponding sequence of the second clip to the Nth clip is arranged in the second station to the Nth station.
  • the cartridge 220 has a bottom wall 221, the bottom wall 221 is formed with a plurality of transverse barbs 225 along its length, towards the distal end of the cartridge 220 and inclined into the cartridge 220, the transverse barbs 225 are equally spaced, and the transverse barbs 225 The distal end of the slanted end.
  • the clip 10 moves forward in the axial direction, the clip 10 slides into contact with the front transverse barb 225 and bends it to the bottom wall 221 to smoothly pass through the transverse barb 225, so that the clip 10 enters the adjacent front end tool from the current station.
  • the inclined ends of the transverse barbs 225 abut against the rear side of the clip 10 to prohibit the clip 10 from retreating, thereby prohibiting the clip 10 from entering the adjacent rear end station from the current station. It can be seen from this that the transverse barbs 225 have a one-way locking function to prevent the clip 10 from retreating between adjacent stations.
  • a first transverse barb and a second transverse barb are arranged between two adjacent stations.
  • the transverse barb catches the second protrusion 42 on the same side of the same clip 10 behind the clip 10 to prevent the clip 10 from entering the adjacent rear end station from the current station in the magazine 220 .
  • the clamp box 220 , the clamp feed assembly and the push clamp assembly at the shaft assembly 200 form a special three-layer design, and the specific details are as follows.
  • the clip feeding assembly is used to abut and push the first clip to move forward to enter the jaw assembly 100; the push clip assembly is used to abut and push the second clip to the Nth clip to move forward; the jaw assembly 100 is used to move from
  • the cartridge 220 receives one of the clips 10 (the first clip) and performs a closing action to compress the clips 10 to a closed state.
  • the clip feeding component is located on the first side of the clamping surface of the clip 10
  • the clip pushing component is located on the second side of the clamping surface of the clip 10 , and the first side is different from the second side.
  • the clip-feeding assembly and the push-clamp assembly are independent parts, located on two sides of at least one clip 10, respectively, and independently push the first clip or other clips from both sides, so that the advancing length of the clip feeding and the advancing length of the pushing clip do not need to be equal
  • the size design of the jaw assembly 100 and the size design of the clamp box 220 can be independent of each other, which provides a design space for independently optimizing the structure of the jaw assembly 100 and the structure of the clamp box 220, and also optimizes the structure of the push clamp assembly and the clamp feed assembly itself.
  • the design space is provided, and the clamp applier has a simple structure and a more compact size.
  • the advancing length of the clip feeding and the advancing length of the pushing clip are equal, so that the size design of the jaw assembly 100 and the size design of the clamp box 220 must match each other.
  • the size of the clamp appliers is not compact and the design is complicated. For example, the distance between the adjacent clamps 10 in the clamp box 220 cannot be too small, otherwise the size of the jaw assembly 100 is too small to stably hold the first clamp.
  • the size of the jaw assembly 100 It should not be too large, otherwise the distance between the clamp box 220 adjacent to the clip 10 is large, resulting in a long size of the clamp box 220 and a large overall size of the clamping forceps.
  • the distance between the clips 10 in the clip box 220 can be designed to be small enough, and it is not necessary to consider the advancing length of the clipping assembly, the clips of the jaw assembly 100
  • the movable channel of the 10 can be designed to be long enough to meet the stable guiding, clamping and compression of the clip 10, without being limited by the distance between the clips 10; in addition, the clip feeding component and the clip pushing component can be individually designed to be sufficiently rigid To solve the problem that the clip cannot be pushed stably in the prior art.
  • the first clamping arm 31 and the second clamping arm 32 respectively have a center line
  • the clamp 10 includes a first side surface and a second side surface that are parallel. Since the clamp 10 is substantially C-shaped in the open state, the first side surface in the open state is and the second side surface are C-shaped.
  • the clamping surface is a surface formed by the two centerlines of the first clamping arm 31 and the second clamping arm 32, and the two sides of the surface are the above-mentioned places where the clip feeding component and the clip pushing component are arranged respectively. The first side and the second side of the clamping surface.
  • a first clamping surface is formed on the first side surface of the C-shape
  • a second clamping surface is formed on the second side surface
  • the inner side is between the first clamping surface and the second clamping surface
  • the two outer sides of the first clamping surface and the second clamping surface are the above-mentioned first and second sides of the clamping surfaces where the clip feeding component and the clip pushing component are respectively arranged.
  • the clip 10 when the clip 10 is installed in the clip box 220, the two clip arms of the clip 10 are pressed against the first side wall 222 and the second side wall 223 respectively and are compressed, but are not compressed to the closed state, the clip The plane is parallel to the bottom wall 221, and the clamping surfaces of the clips 10 are on the same plane.
  • a plurality of clips 10 may be arranged obliquely in the clip box 220, the clamping surfaces of the plurality of clips 10 are not on the same plane, but the clamping surfaces of the plurality of clips 10 are parallel to each other, and the clip feeding assembly and the pusher The clip assemblies are still disposed relative to each clamping surface on the first side and the second side of the clamping surface.
  • the cartridge 220 includes a lengthwise extending bottom wall 221 and opposing first and second side walls 222 and 223 to form a generally C-shaped structure.
  • the clamping surface of the clip 10 is parallel to the bottom wall 221; In this way, the clip feeding component and the clip pushing component push the first clip and other clips separately from both sides of the clip box 220, the space in the sleeve 210 and on both sides of the clip box 220 is fully utilized, and the clip pushing component and the clip feeding component are fully utilized.
  • the design freedom of the components is improved, and the clamp applier structure is more stable and compact.
  • the inner and outer sides of the bottom wall 221 refer to two sides of the plane where the bottom wall 221 is located, and the clip 10 , the first side wall 222 and the second side wall 223 are located on the inner side of the bottom wall 221 .
  • the bottom wall 221 of the cartridge 220 has an opening 224, the opening 224 is disposed near the distal end of the bottom wall 221, and the clip feeding assembly enters the cartridge 220 from the opening 224 and is located between the first clip and the second clip.
  • the opening 224 ensures that the clip feeding assembly can smoothly enter and exit the cartridge 220 and enter between the first clip and the second clip, so that the rear end of the first clip abuts the first clip to push it forward.
  • a portion of the opening 224 is located at the first station and another portion is located at the second station.
  • the clip feeding component includes an elastic push rod 232 and a clip feeding block 231 connected to one end of the elastic push rod 232.
  • the clip feeding block 231 is used to abut and push the first clip;
  • the base 240 is provided with a receiving and feeding clip assembly and a shaft for its shaft.
  • the channel for movement includes an axially extending guide groove 241 and a block groove 242 communicating with the guide groove 241.
  • the block groove 242 includes a guide inclined surface 243, and the guide inclined surface 243 is arranged at an angle to the axial direction.
  • the guiding inclined surface 243 faces the distal end and is inclined toward the cartridge 220, and the elastic push rod 232 is formed by stacking a plurality of metal sheets, which is elastic and can be bent.
  • the guide groove 241 accommodates the elastic push rod 232
  • the block groove 242 accommodates the clamp feeding block 231
  • the guide groove 241 guides the elastic push rod 232 to move in the axial direction, and guides the elastic push rod 232 to move in the axial direction.
  • the guiding slope 243 guides the clip feeding block 231 into the opening 224 .
  • the elastic push rod 232 moves axially forward along the guide groove 241
  • the elastic pushing rod 232 begins to bend, and the clip feeding block 231 moves along the guiding inclined surface.
  • 243 enters the opening 224 of the clip box 220 obliquely, so that the rear end of the first clip abuts the first clip to push it forward, and then the elastic push rod 232 moves axially backward along the guide groove 241 to drive the clip feeding block 231 is retracted from the opening 224 into the block groove 242 along the guide slope 243 .
  • the base 240 has strong rigidity, and its channel accommodates the clip feeding assembly, which ensures the stable and reliable arrangement of the clip feeding assembly in the clamping jaw at the initial moment.
  • the guide groove 241 provides a fixed channel for the elastic elastic push rod 232.
  • the movement space is limited to avoid excessive bending or even bending of the elastic push rod 232 when it moves, which is blocked in the sleeve 210 and affects the function of clip feeding.
  • the rigid guiding slope 243 ensures the stability of the movement of the clip feeding block 231 .
  • the bottom wall 221 of the cartridge 220 further includes a first bottom wall 221a located at the front end of the opening 224 and a second bottom wall 221b located at the rear end of the opening 224; when the base 240 is mounted on the cartridge 220, the guiding slope 243 is connected to the first bottom wall 221b.
  • the bottom walls 221a meet.
  • the guiding inclined surface 243 is directly connected with the first bottom wall 221a, and there is basically no gap, which can ensure that the clip feeding block 231 can smoothly enter the opening 224 without being blocked by accident.
  • the thickness of the clip feeding block 231 is greater than that of the elastic push rod 232 .
  • the elastic push rod 232 adopts a thin and elastic structure to ensure that it can be bent along the guiding inclined surface 243 , so that the clip feeding block 231 can move along the guiding inclined surface 243 . If the thickness of the clip feeding block 231 is large, the strength of the clip feeding block 231 is high, and it is not easy to be deformed, and due to the large thickness, the clip feeding block 231 forms a first contact surface at the distal end that contacts the clip 10, and the first contact surface is formed at the distal end of the clip feeding block 231. An abutting surface has a larger area and can stably push the first clip.
  • the clip feeding block 231 and the elastic push rod 232 are independent parts, which can be optionally fixed by welding.
  • the clip feeding assembly further includes an axially extending clip feeding rod 233 .
  • One end of the clip feeding rod 233 is connected to the elastic push rod 232 , and the other end is connected to the operating assembly 300 .
  • the guide groove 241 accommodates the clip feeding rod 233 .
  • the operating assembly 300 drives the clip feeding rod 233 to move axially, so that the clip feeding rod 233 drives the elastic push rod 232 and the clip feeding block 231 to move together.
  • the clip feeding rod 233 is a cylindrical rod or a square rod or similar structure. Different from the elastic elastic push rod 232, the clamping feeding rod 233 has strong rigidity and is not easily deformed, which prevents the elastic push rod 232 from being easily in the guide groove when it moves axially.
  • the inner bending of 241 causes the block of the clip feeding assembly, which improves the stability of the movement of the clip feeding assembly.
  • the guide groove 241 of the base 240 also accommodates the clip feeding rod 233 and guides the clip feeding rod 233 to move along the axial direction.
  • the clip feeding rod 233 moves axially along the path planned by the guide groove 241 of the base 240 , which enhances the stability of the axial movement of the clip feeding rod 233 .
  • the push-clamp assembly is a push-clamp base 250, the push-clamp base 250 includes a push-clamp block 253, an elastic member 254, and a push-clamp rod 251, the push-clamp rod 251 is provided with a side cavity 252, and the side cavity 252 or the push-clamp block 253 is provided with a rotating shaft 255 , the push-clamp block 253 is rotatably installed into the side cavity 252 through the rotating shaft 255 .
  • the push-clamp block 253 includes an abutting end, which can abut and push the clip 10 forward. The abutting end is disposed at the distal end of the push-clamp block 253.
  • the elastic member 254 provides the push-clamp block 253 with a force to rotate toward the outside of the side cavity 252 , specifically, the abutment end of the push-clamp block 253 is inclined toward the clamp 10 .
  • a plurality of side cavities 252 are arranged on the push-clamp rod 251 at intervals, and each side cavity 252 is provided with an elastic member 254 and a push-clamp block 253.
  • the abutting ends of the plurality of push-clamp blocks 253 respectively abut and push one of the clamps 10 forward.
  • the push-clamp assembly retreats in the axial direction, the push-clamp blocks 253 are squeezed by the clamp 10 and move toward the side cavity 252 The inner rotation avoids the clip 10, thereby preventing the push-clamp block 253 from retreating with the clip 10 when retreating.
  • the push-clamp block 253 has a certain thickness, so that the abutting end of the push-clamp block 253 is a second abutting surface with a certain area, which ensures the stability of abutting with the clip 10 .
  • the abutting end can also be set as a concave portion, and the clamping arm of the clip 10 is just snapped into the concave portion, which further enhances the stability of the abutment.
  • the push-clip assembly is the push-clip distal end driving member in the present invention.
  • the first side wall 222 and the second side wall 223 of the clamp box 220 are respectively provided with protruding first and second clamp bars, and the upper and lower sides of the push clamp rod 251 of the push clamp seat 250 are respectively provided with first and second clamp bars.
  • the clamping strip and the second clamping strip are matched with the first clamping groove and the second clamping groove, so that the push-clamp base 250 is slidably installed into the clamp box 220 .
  • the operating assembly 300 further includes a fitting mechanism, the actuating member 330 is used to provide power to the feeding clip assembly and the pushing clip assembly, and the fitting mechanism includes a first fitting member, an intermediate member and a second fitting member, the said The first adapter drives the second adapter through the middle piece, the clip feeding component is linked with the first adapter, the push clip component is linked with the second adapter, and the movement direction of the first adapter is connected with the second adapter. The movement of the fittings is reversed.
  • the structure of the specific matching mechanism, the movement process, and the linking mode of the matching mechanism with the clip feeding assembly and the clip pushing assembly are described in detail below, and the benefits are the same as those shown below, and will not be repeated here.
  • the transmission mechanism includes a clip feeding driving mechanism and a jaw driving mechanism.
  • the clip feeding driving mechanism is used to drive the clip 10 into the jaw assembly 100
  • the jaw driving mechanism is used to drive the jaw assembly 100 to move.
  • the transmission mechanism further includes a switching mechanism for selectively driving the clip feeding driving mechanism or the jaw driving mechanism; the transmission mechanism includes a first state and a second state, in the first state, the switching mechanism is separated from the jaw driving mechanism, and It is combined with the clip feeding driving mechanism to drive the clip feeding driving mechanism to move; in the second state, the switching mechanism is separated from the clip feeding driving mechanism, and is combined with the jaw driving mechanism to drive the jaw driving mechanism to move.
  • the jaw driving mechanism when the switching mechanism drives the clip feeding driving mechanism to move, the jaw driving mechanism is not driven and is in a static state.
  • the mouth driving mechanism is combined to drive the jaw driving mechanism to move, and energy is alternatively transmitted to the clip feeding driving mechanism or the jaw driving mechanism in the process, so the energy consumption is low, and the force required by the doctor to operate the actuating member 330 is correspondingly reduced. , the operation is more comfortable, so that the clamp applier can be better operated and the product experience can be improved.
  • the movement of the feeding drive mechanism and the jaw drive mechanism is independent and time-sharing, which can also prevent other problems caused by the linkage between the two, such as complex structure and complex motion relationship.
  • the switching mechanism includes a first clutch mechanism and a second clutch mechanism, the first clutch mechanism is connected with the second clutch mechanism, and when the switching mechanism moves under the action of the actuating member 330, the first clutch mechanism and the second clutch mechanism move together; In the first state, the first clutch mechanism is combined with the clip feeding driving mechanism to drive the clip feeding driving mechanism to move, and the second clutch mechanism is separated from the jaw driving mechanism; in the second state, the first clutch mechanism and the clip feeding driving mechanism are separated, The second clutch mechanism is combined with the jaw driving mechanism to drive the jaw driving mechanism to move.
  • the first clutch mechanism includes a first clutch member and a clutch switching mechanism; the first clutch member is connected with the clutch switching mechanism; in the first state, the first clutch member is combined with the clip feeding drive mechanism; in the second state, The first clutch is separated from the clip feeding drive mechanism.
  • the second clutch mechanism includes a second clutch member, and the second clutch member is connected to the first clutch mechanism.
  • the second clutch member is the distal end of the first clutch mechanism. Specifically, it is the distal end of the first clutch.
  • the distal end of the first clutch mechanism is its distal end surface; in the first state, the distal end surface of the first clutch mechanism is separated from the proximal end surface of the jaw driving mechanism, and in the second state , the distal end surface of the first clutch mechanism is combined with the proximal end surface of the jaw driving mechanism.
  • the distal end portion of the first clutch mechanism is a hook portion protruding from the distal end thereof, and the proximal end of the jaw driving mechanism is provided with a groove that matches the hook portion. , the hook portion is not inserted into the groove of the jaw driving mechanism, and in the second state, the hook portion is inserted into the groove of the jaw driving mechanism to push the jaw driving mechanism to move.
  • the clutch switching mechanism includes a moving part and a moving guide, and the moving part is connected with the first clutch; when the moving part is guided by the moving guide to move from the first position to the second position, the first clutch and the clip feeding drive mechanism are in a combined state. Switch to detached state.
  • the moving part is a guide post 490 connected with the first clutch part
  • the moving guide part is a guide rail provided in the housing 321, and the guide post 490 can move on the guide rail.
  • the head casing of the clamp applier includes a first head casing and a second head casing, the first head casing and the second head casing are arranged axially symmetrically, and the guide rails are alternatively arranged on the first head casing.
  • the guide rails are symmetrically arranged on the inner walls of the first head housing and the second head housing.
  • the guide rail includes a first guide surface 494 and a second guide surface 496 higher than the first guide surface 494; the guide post 490 is located on the first guide surface 494 in the first position, and is located on the second guide surface 496 in the second position .
  • the first guide surface 494 is smoothly connected with the second guide surface 496 through the inclined surface 498, so that the movement of the moving part is smoother.
  • the guide column 490 can follow the movement of the first clutch member to move on the guide rail.
  • the first clutch member and the clip feeding driving mechanism remain in a combined state.
  • the guide rails have different heights.
  • the moving member moves to the second guide surface 496 of the guide rail, it drives the first clutch member to move upward to separate from the clip feeding drive mechanism, and when the first clutch member is separated from the clip feeding drive mechanism, the first clutch member is separated from the clip feeding drive mechanism.
  • the distal end of a clutch mechanism engages with the proximal end of the jaw drive mechanism to push the jaw drive mechanism in motion.
  • the clutch switching mechanism has a simple structure, no additional devices are required, and the internal space of the housing 321 is fully utilized, resulting in a compact structure; on the other hand, the power consumption is low, and the operation is smooth and labor-saving.
  • the switching mechanism has a switching mechanism body 500.
  • part of the first clutch mechanism is accommodated in the switching mechanism.
  • the switching mechanism body 500 includes a proximal end surface 502 , a distal end surface 508 , a first through hole 510 penetrating the proximal end surface 502 and the distal end surface 508 , and an upper arc through the upper end surface of the switching mechanism and the first through hole 510 .
  • the second clutch member is the distal end portion of the switching mechanism body 500 , and the distal end portion may be the distal end surface 508 as described above. In the first state, the distal end of the switching mechanism is spaced from the proximal end of the jaw driving mechanism; in the second state, the distal end of the switching mechanism is mated with the proximal end of the jaw driving mechanism.
  • the first clutch member includes a blocking block 482, which is accommodated in the second through hole 512.
  • the clip feeding drive mechanism includes a clip slot, and the clip block 482 cooperates with the clip slot to combine the first clutch member with the clip feeding driving mechanism.
  • the clamping block 482 includes a first end and a second end extending perpendicular to the longitudinal direction from the first end; the first end is connected with the guide post 490, and the second end is detachably connected with the clamping slot; the first clutch member also includes an elastic The element, such as a spring, in the first state, the elastic element exerts a downward force on the clamping block 482, so that the clamping block 482 abuts against the clamping groove, so that the first clutch can be well combined with the driving mechanism for feeding the clip, improving the The stability of the feeding action.
  • the clamping groove is a first annular groove 422 disposed on the outer peripheral surface of the proximal end of the clip feeding drive mechanism, and the second end of the clamping block 482 includes a connection with the first annular groove 422.
  • the first clutch member may also include a groove, and the clip feeding driving member includes a protrusion matched with the first clutch member.
  • the switching mechanism is sleeved on the driving mechanism for feeding clips.
  • the switching mechanism and the driving mechanism for jaws are arranged at intervals.
  • the driving mechanism for feeding clips is pushed forward.
  • the surface is gradually approached with the proximal end surface of the jaw driving mechanism;
  • the switching mechanism is separated from the clamping feeding driving mechanism, and is matched with the jaw driving mechanism to drive the jaw driving mechanism forward, and the proximal end of the jaw driving mechanism
  • the face is gradually separated from the proximal face of the clip feed drive mechanism.
  • the jaw driving mechanism is sleeved on the feeding driving mechanism, that is, the feeding driving mechanism
  • the mechanism part is located in the jaw driving mechanism, and can travel in the jaw driving mechanism; the clamping driving mechanism and jaw driving mechanism move in the longitudinal direction under the action of the switching mechanism, and the clamping driving mechanism is on a plane perpendicular to the longitudinal direction.
  • the projection is located inside the projection of the jaw drive mechanism on the plane, and the projection of the jaw drive mechanism on the plane is located inside the projection of the switch mechanism on the plane.
  • the actuating member 330 is used to provide power to the transmission mechanism. Specifically, the actuating member 330 is in contact with the switching mechanism, thereby driving the switching mechanism to move, and the switching mechanism selectively transmits the power to the clip feeding driving mechanism or the jaw driving mechanism mechanism; the proximal end of the switching mechanism has a driving surface 504 and a first stop part 506, wherein the driving surface 504 abuts with the actuating member 330 to receive the power, and the first stop part 506 is used to limit the actuating member 330 .
  • the driving surface 504 is a concave surface formed by the first stop part 506 and the surface of the switching mechanism, and the head of the actuating member 330 abuts against the concave surface.
  • the first stop parts 506 are symmetrically arranged on both sides of the proximal end of the switching mechanism in the traveling direction, and correspondingly the actuating member 330 has a gripping portion , and push claws extending from the grip portion to the inside of the housing and symmetrically arranged, the two push claws are respectively in contact with the driving surfaces 504 on both sides of the switching mechanism.
  • the first stopper 506 is protruded from the outer surface of the switching mechanism and extends in the longitudinal direction.
  • the inner walls of the first head housing and the second head housing of the clamp are symmetrically arranged in the shape of the first stopper 506 .
  • the matching guide groove, the first stopper 506 can move in the longitudinal direction in the guide groove, and the guide groove can limit the height direction of the first stopper 506, which can effectively reduce the movement of the switching mechanism. Shaking, making the transmission more stable and reliable.
  • the clip applier also includes a clip feeding and retracting stop mechanism, which includes a biasing spring and a guide pivot member 350 .
  • the guide pivot member 350 includes a pivot end 352 pivotally connected to the housing 321 , a guide member 351 and a backstop end 354 extending outward from the pivot end 352 ; the guide member 351 is movably connected with the actuating member 330 to actuate The movement of the member 330 drives the guide member 351 and the stop end 354 to move around the pivot end 334 under the action of the biasing spring; in the first state, the stop end 354 gradually approaches the proximal end of the clip feeding drive mechanism; in the second state , the stop end 354 abuts against the proximal end of the clip feeding drive mechanism to prevent the clip feeding drive mechanism from retreating.
  • the retracting stop end 354 of the clip feeding stopping mechanism can move to the proximal end of the clip feeding driving mechanism and abut against the feeding clip driving mechanism to prevent the clip feeding driving mechanism from retreating.
  • the clip feeding and retracting mechanism cannot stand against the clip feeding driving mechanism, and the clip feeding and retracting mechanism can be separated before the switching mechanism and the clip feeding driving mechanism.
  • the stop end 354 has moved to the proximal end of the clip feed drive mechanism.
  • the clip feed drive mechanism retreats a short distance under the action of the first reset member 418 until it reaches the clip feed stop mechanism.
  • the anti-retraction end 354 of the clip 10 abuts to prevent the clip feeding drive mechanism from retreating further to make the clip 10 retreat.
  • the elastic push rod 232 of the clip feeding driving mechanism has elasticity, it is compressed when the clip feeding driving mechanism moves forward, so the elastic push rod 232 gradually recovers when the clip feeding driving mechanism retreats a short distance under the action of the first reset member 418 .
  • the clip feeding block 231 still abuts against the clip 10, so the clip 10 will not retreat when the clip feeding driving mechanism retreats a short distance.
  • the actuating member 330 has a guiding channel 340, the guiding channel 340 includes a start point a, an end point c, and a locking point b between the start point a and the end point c; the distance from the start point a to the pivot center of the actuating member 330 and the end point c
  • the distance to the pivot center of the actuating member 330 is smaller than the distance from the locking point b to the pivot center of the actuating member 330; when the actuating member 330 rotates around its pivot center, the guide channel 340 rotates accordingly, so that the guide There is relative movement between the channel 340 and the guide member 351, and the guide member 351 can pass through the starting point a, the locking point b and the ending point c in sequence with the movement of the actuating member 330; in the first state, the guide member 351 gradually locks toward the locking point 351.
  • Point b moves relatively, and the stop end 354 gradually approaches the proximal end of the clip feeding drive mechanism; in the second state, when the guide member 351 relatively moves to the locking point b, the retreat stop end 354 abuts against the proximal end of the clip feeding drive mechanism. connected to prevent the clip feed drive mechanism from retreating.
  • the existence of the clip feeding and retracting mechanism can avoid the problem that the clip 10 in the jaw assembly 100 cannot be clamped due to the retraction of the clip 10, thereby improving the reliability and safety of the operation. A more detailed introduction to the actuating member 330 will be described later.
  • the jaw driving mechanism includes a jaw proximal driving member and a jaw distal driving member connected with the jaw proximal driving member.
  • the switching mechanism When the switching mechanism is in the second state, it drives the jaw proximal driving member to move, thereby driving the jaws
  • the distal drive moves.
  • the proximal driving member of the jaws is the jaw driving tube 432
  • the distal driving member of the jaws is the sleeve 210 .
  • One end of the sleeve 210 is connected with the jaw drive tube 432, and the other end is matched with the jaw assembly 100; in the second state, the switching mechanism is combined with the jaw drive tube 432 to drive the jaw drive tube 432 to move, thereby driving the sleeve 210 moves to drive jaw assembly 100 closed.
  • the inner wall of the distal end of the jaw driving tube 432 is provided with protruding ribs 436 at intervals, the adjacent protruding ribs 436 and the inner wall of the jaw driving tube 432 form a second annular groove 438, and the outer periphery of the proximal end of the sleeve 210 is provided with an annular sheet 442,
  • the annular sheet 442 is inserted into the second annular groove 438 , and the protruding ribs 436 abut against the annular sheet 442 .
  • the annular plate 442 is provided with a notch 444 symmetrically in the circumferential direction, and the second annular groove 438 is internally provided with a protrusion 440 which is shaped to match with it.
  • the jaw drive mechanism also includes a second reset member 446, such as an elastic element.
  • the elastic element is sleeved on the outside of the jaw driving tube 432, one end is in contact with the baffle 434 on the outer surface of the jaw driving tube 432, and the other end extends forward and is in contact with the inner wall of the shell 321 of the clamp.
  • the driving mechanism for feeding clips includes a proximal driving member for feeding clips and a distal driving member for feeding clips connected with the proximal driving member for feeding clips; when the switching mechanism is in the first state, it drives the proximal driving member for feeding clips to move, and then drives the feeding clips at the proximal end.
  • the distal drive moves.
  • the distal end driving member for feeding the clip includes a base 240 and a feeding assembly, and a channel is arranged in the base 240; in the first state, the switching mechanism is combined with the proximal driving member for feeding the clip to drive the proximal driving member for feeding the clip to move, and then The clip feed assembly is driven to move within the channel to drive the clip 10 into the jaw assembly 100 .
  • the distal end of the channel is provided with a guiding inclined surface 243, and the clip-feeding proximal driving member drives the clip-feeding assembly to move in the channel and move through the guiding inclined surface 243 to abut against the first clip in the clip box 220, In turn, the first clip is driven into the jaw assembly 100 .
  • the clip-feeding proximal driving member is the clip-feeding drive tube 402 , which is fixedly connected to the clip-feeding assembly.
  • the base 240 is located on the outside of the cartridge 220, its first end is fixedly connected with the housing 321, and is located in the clip feeding drive tube 402, the second end extends from the first end to the distal end, and the second end is connected with the pin 316 through the pin 316.
  • the tabs on the outer side of the cartridge 220 are fixedly connected.
  • the clip feeding assembly includes a clip feeding rod 233, an elastic push rod 232 and a clip feeding block 231 which are connected in sequence.
  • the hole 404 is used to accommodate the bent portion 406 of the clip feeding rod 233.
  • the bent portion 406 of the proximal end of the clip feeding rod 233 passes through the proximal end of the channel of the base 240 and is installed on the distal end of the clip feeding drive tube 402.
  • the distal end of the clip feeding rod 233 has an accommodating groove 408
  • the proximal end of the elastic push rod 232 has a clamping portion 410 that is shaped to match the accommodating groove 408 , and the clamping portion 410 is inserted into the accommodating groove 408 to realize elastic pushing
  • the connection between the rod 232 and the clip feeding rod 233; the distal end of the elastic push rod 232 has an arc-shaped depression 412, and the lug 414 at the proximal end of the clamping block 231 cooperates with the arc-shaped depression 412 to realize the elastic push rod 232 Connection with clip feed block 231.
  • the channel of the base 240 provides a space for accommodating the clip feeding assembly, and on the other hand, it also facilitates the movement of the clip feeding assembly in the channel.
  • the clip-feeding driving tube 402 drives the clip-feeding block 231 to move in the channel and moves through the guiding inclined surface 243 to abut with the clip 10 , thereby driving the clip 10 to enter the jaw assembly 100 .
  • two or more elastic push rods 232 are provided, and each elastic push rod 232 is formed by stacking multiple pieces.
  • the elastic push rod 232 itself has elasticity and can be deformed and bent, so that the clip feeding block 231 can send the clip 10 to the position.
  • the clip feeding driving mechanism also includes a first restoring member 418, such as an elastic element.
  • a first restoring member 418 such as an elastic element.
  • One end of the elastic element is in contact with the inner wall of the jaw driving tube 432 close to the rib 436 of the clip feeding driving tube 402, and the other end extends backwards and is in contact with the distal end surface of the clip feeding driving tube 402.
  • the clip applier also includes a knob 310, wherein the proximal end of the knob 310 has a protruding portion 312, and the distal end of the operating assembly 300 is provided with a concave portion that is shaped to match the protruding portion 312, and the concave portion and the protruding portion 312 cooperate with each other so that the The knob 310 is assembled with the operating assembly 300 .
  • a pin 316 is provided in the knob 310 , a first waist-shaped hole 420 is provided on the clip feeding driving tube 402 , and a second waist-shaped hole 448 is provided on the jaw driving tube 432 .
  • the proximal end of the base 240 is accommodated in the clip feeding drive tube 402 , and is provided with a first pin hole 416 .
  • the cooperation of the pin 316 and the first pin hole 416 enables the base 240 to be fixedly installed with the knob 310 .
  • the proximal end of the cartridge 220 is also accommodated in the clip feeding drive tube 402 , and is provided with a second pin hole. The engagement of the pin 316 and the second pin hole enables the cartridge 220 to be fixedly installed with the knob 310 .
  • One end of the pin 316 is installed at the first part of the side wall of the knob 310 , and the other end is installed on the side wall of the knob 310 after passing through the second waist-shaped hole 448 , the first pin hole 416 , the second pin hole and the first waist-shaped hole 420
  • the other place is symmetrical with the first place, so that when the knob 310 is rotated, it can drive the jaw driving tube 432, the clamping driving tube 402, the base 240 and the clamping box 220 to rotate together, and then can drive the sleeve 210, jaws
  • the assembly 100 and the clip feeding assembly rotate together, so that the doctor can adjust the angle to a suitable angle to clamp the blood vessel or tissue.
  • the knob 310 drives the clip feeding drive mechanism and the jaw drive mechanism to rotate 360 degrees. In order to increase the feel of the doctor turning the knob 310, and at the same time, the knob 310 can be stopped at the current position after being rotated at any angle, so as to facilitate the operation of the doctor.
  • a damping member 318 is provided at the connection of the handle assembly. More specifically, a groove 314 is provided on the outer periphery of the protruding portion 312 at the proximal end of the knob 310.
  • the concave portion abuts.
  • the friction force between the damping member 318 and the handle assembly is used to increase the force for rotating the knob 310, and the damping member 318 can stop at the current position after the rotation at any angle is stopped.
  • the damping member 318 is a rubber ring.
  • the proximal end of the drive tube 432 is close; when the actuating member 330 moves to the middle position, the moving member of the switching mechanism runs to the second guide surface 496 in the housing 321, and the clamping block 482 is disengaged from the clamping groove of the clip feeding drive tube 402 , the switching mechanism is separated from the clip feeding drive mechanism, the forward stroke of the clip feeding driving mechanism ends, the clip 10 located at the farthest end of the clip box 220 is sent into the jaw assembly 100 (the clip feeding action is completed), the distal end surface of the switching mechanism and the The proximal end face of the jaw drive mechanism abuts.
  • the retraction stop end 354 of the clip feeding and retracting mechanism can abut against the clip feeding driving tube 402 after the switching mechanism is separated from the clip feeding driving mechanism to prevent the clip 10 in the jaw assembly 100 from retreating due to the retracting of the clip feeding driving mechanism.
  • the actuating member 330 moves from the open position to the middle position, when the guide member 351 of the clip feeding and retracting mechanism relatively moves to the locking point b in the guide channel 340 of the actuating member 330, the actuating member 330 is unidirectional Locked, that is, the actuating member 330 can only move towards the closed position but not towards the open position under the action of external force, so that the doctor can clearly know that the clip feeding action has been completed, and on the other hand, operate the clip applier to complete the clip feeding.
  • the action instead of holding down the actuating member 330 all the time, it is possible to stop to locate the blood vessel or tissue and then continue to operate the actuating member 330 to perform the jaw closing action.
  • the transmission mechanism further includes a push-clamp drive mechanism; the transmission mechanism further includes a third state, and the transmission mechanism alternatively has a first state and a third state; in the first state, the clamp-feeding drive mechanism drives the clamp box 220, the most distal clip 10 moves forward into the jaw assembly 100; in the third state, the push-clamp driving mechanism drives the remaining clips 10 in the clip box 220 to move forward by one station.
  • the most distal clip 10 refers to the aforementioned "first clip”
  • the remaining clips 10 refers to the aforementioned "other clips”.
  • the clip applier can not only apply the clip continuously, but also because the first state and the third state are at different times, the clip feeding action performed by the clip feeding drive mechanism is asynchronous with the clip pushing action performed by the push clip driving mechanism, which can effectively The problem of interference between the clip feeding action and the clip pushing action can be avoided.
  • the clip feeding driving mechanism and the clip pushing driving mechanism are independent driving mechanisms, the design space is increased, and the structures of the clip feeding driving mechanism and the clip pushing driving mechanism are stable and reliable. Therefore, using the technical solution of this embodiment to perform the clip feeding and pushing operations is more stable and reliable, and the safety of the clip applying forceps is improved.
  • the transmission mechanism includes a driving member and a matching mechanism; the driving member is in contact with the actuating member 330 to receive power, and the matching mechanism is connected with the driving member at one point, and is connected with the push-clamp driving mechanism at the other position. There is a distance between one part of the connecting mechanism and the other part.
  • the driving part is used to drive the clip feeding driving mechanism forward to push the most distal clip 10 of the clip box 220 to move forward into the jaw assembly 100, and is also used to drive the matching mechanism to move to drive the push clip driving mechanism to move backward to store energy;
  • the push-clamp drive mechanism includes a third reset member 456 for storing the energy; releasing the energy, the push-clip drive mechanism advances under the action of the third reset member 456 to remove the remaining energy in the cartridge 220 The clamp 10 moves forward by one station.
  • the driving member is the above-mentioned switching mechanism for selectively driving the clip feeding driving mechanism or the jaw driving mechanism.
  • the driving member In the first state, the driving member is separated from the jaw driving mechanism, and is combined with the clip feeding driving mechanism to drive the clip feeding driving mechanism forward, and at the same time drive the matching mechanism to move to drive the pushing clip driving mechanism to retreat to store the first energy; In the second state, the driving member is combined with the jaw driving assembly to drive the jaw driving mechanism forward, and is separated from the clip feeding driving mechanism, and at the same time drives the matching mechanism to move to drive the push clip driving mechanism to retreat to store the second energy; the first An energy and the second energy together constitute the above energy.
  • the push-clamp driving mechanism advances under the action of the energy to move the remaining clamps 10 in the clamp box 220 forward by one station.
  • the push-clamp drive mechanism is connected with the switch mechanism through the matching mechanism, and the push-clamp drive mechanism and the switch mechanism move in opposite directions; under the action of the actuating member 330, the switch mechanism is first separated from the jaw drive mechanism, and is separated from the feeder mechanism.
  • the clip driving mechanism is combined to drive the clip feeding driving mechanism forward to perform the clip feeding action, and then separate from the clip feeding driving mechanism, and is combined with the jaw driving mechanism to drive the jaw driving mechanism forward to perform the jaw closing action.
  • the switching mechanism drives the clip feeding driving mechanism and the jaw driving mechanism to move forward, it drives the matching mechanism to move at the same time to drive the push clip mechanism to retreat and store energy; Move forward to perform a push-clamp action. How the switching mechanism realizes the combination and separation of the clip feeding driving mechanism and the jaw driving mechanism has been introduced in the above description, and will not be repeated here.
  • the driving member does not have a clutch function
  • the driving member is respectively connected with the clip feeding driving mechanism and the clip pushing driving mechanism
  • the actuating member 330 includes a first actuating member and a second actuating member
  • the first actuating member is The second actuating member abuts against the jaw driving mechanism.
  • the driving member drives the clip feeding driving mechanism forward under the action of the first actuating member to move the most distal clip 10 of the clip box 220 forward into the jaw assembly 100, and at the same time drives the matching mechanism to move to move forward.
  • the push-clamp drive mechanism is driven backward to store energy; the push-clamp drive mechanism includes a third reset member 456 for storing the energy.
  • the first actuating member 330 is released, and the push-clamp driving mechanism advances under the action of the third reset member 456 to move the remaining clamps 10 in the cartridge 220 forward by one station.
  • pressing the second actuator drives the jaw drive assembly to close the jaw assembly 100 .
  • the first actuating member makes the push-clamp driving mechanism move forward under the action of the third reset member 456 to move the remaining clamps 10 in the cartridge 220 forward by one station.
  • the jaw driving mechanism is sleeved on the clamping feeding driving mechanism.
  • the proximal end surface of the clamping feeding driving mechanism and the proximal end surface of the jaw driving mechanism are gradually approached, and the distal end surface of the driving member is close to the jaw driving mechanism.
  • the proximal end surface is gradually approached; in the second state, the proximal end surface of the jaw driving mechanism and the proximal end surface of the clip feeding driving mechanism are gradually separated, and the distal end surface of the driving member is abutted with the proximal end surface of the jaw driving mechanism.
  • the matching mechanism includes a first matching piece, an intermediate piece and a second matching piece, the first matching piece is connected with the above-mentioned driving member, and the second matching piece is connected with the push-clamp driving mechanism; the first matching piece passes through the middle
  • the second matching piece drives the second matching piece, and the movement direction of the second matching piece is opposite to that of the second matching piece; the driving piece drives the first matching piece forward; when the first matching piece advances, the second matching piece retreats to drive the push clip driving mechanism back.
  • the push-clamp drive mechanism further includes a push-clip drive.
  • the push clip driving member is connected with the matching mechanism and the third reset member 456. Specifically, one end of the third reset member 456 is connected with the housing 321, and the other end is connected with the proximal end of the second matching member. Of course, it can be understood that the third reset member 456 can also be directly connected with the push clip driving member.
  • the push-clamp driving member is connected with the distal end of the second fitting member.
  • the push-clamp driving member is provided with a plurality of side cavities 252 at intervals along the longitudinal direction. Each side cavity 252 is correspondingly installed with a push-clamp block 253.
  • the push-clamp block 253 is driven to move so as to move the remaining clamps 10 in the clamp box 220 forward by one station.
  • the push-clamp driving member includes a push-clamp proximal-end driving member and a push-clamp distal-end driving member, and the push-clamp distal-end driving member here is the aforementioned push-clamp assembly or push-clamp base 250 .
  • the third reset member 456 can be an elastic element, such as a spring.
  • the proximal driving member of the push clip is an adapter block 452
  • the distal driver of the push clip includes a push rod 251 and a push clip block 253
  • the proximal end of the adapter block 452 is connected to the distal end of the second adapter member.
  • the distal end of the fitting block 452 is connected with the push-clamp rod 251 .
  • a plurality of side cavities 252 are arranged at equal intervals along the shaft direction of the push-clamp rod 251 , and each side cavity 252 is correspondingly installed with a push-clamp block 253 .
  • Each push-clamp block 253 is deflectably disposed in the corresponding side cavity 252 of the push-clamp rod 251 through an elastic member 254 (eg, a spring).
  • an elastic member 254 eg, a spring
  • the proximal end of the push clamp block 253 is installed in the pin holes 404 of the upper and lower walls of the side cavity 252 through the rotating shaft 255, and the elastic member 254 is arranged in the side cavity 252, and its proximal end is connected with the proximal end of the side cavity 252, and the distal end is connected with the pusher 252.
  • the clamp block 253 is attached proximally.
  • the distal end of the push-clamp block 253 is inclined downward along the shaft deviating from the push-clamp rod 251.
  • the push-clamp block 253 retreats with the push-clamp rod 251, the push-clamp block 253 is turned upward by the clamp 10 around the shaft 255 toward the shaft of the push-clamp rod 251 with an upward force, so when the push-clamp rod 251 retreats , the push clamp block 253 will not interfere with the clamp 10 .
  • each push-clamp block 253 moves to abut against the tail of the clip 10 adjacent to its proximal end or moves to a predetermined distance behind the clip 10 adjacent to its proximal end, in the third state , the push-clamp rod 251 drives the push-clamp block 253 forward.
  • the push-clamp block 253 moves forward, it pushes the remaining clamps 10 in the clamp box 220 to advance to one station to prepare for the next clamp feeding.
  • the clip feeding proximal end driver is sleeved on the push clip proximal end drive
  • the distal end driving member for feeding the clip and the distal end driving member for pushing the clip are located on both sides of the clip box 220 .
  • the jaw driving mechanism includes a jaw driving tube 432 and a sleeve 210 connected to the jaw driving tube 432.
  • the jaw driving tube 432 drives the sleeve 210 to move, thereby driving the jaw assembly 100 to move;
  • the clamping drive mechanism It includes a clip feeding driving tube 402 and a clip feeding assembly connected with the clip feeding driving tube 402 .
  • the driving mechanism for feeding the clamping, the driving mechanism for the jaws and the driving mechanism for pushing the clamps are all arranged in the longitudinal direction.
  • the projection of the clamp feed drive tube 402 on a plane perpendicular to the longitudinal direction is located in the projection of the jaw drive tube 432 on this plane, and the clamp feed drive mechanism can move in the longitudinal direction within the jaw drive mechanism, and the jaw drive tube 432 is in the vertical direction.
  • the projection of the plane in the longitudinal direction is located in the projection of the driving member (that is, the switching mechanism) on the plane; the projection of the plane of the push-clamp proximal driving member is located in the projection of the clip-feeding drive tube 402 on the plane, and the push-clamp driving mechanism can Moving along the longitudinal direction in the clip feeding driving mechanism, the distal end driving member for pushing the clip and the clip feeding assembly are located on both sides of the clip box 220 .
  • the proximal driving member for feeding the clip the proximal driving member for pushing the clip and the jaw driving tube 432 are coaxial.
  • the clip feeding drive tube 402 is located in the jaw driving tube 432, and the proximal end of the push clip driving member is located in the clip feeding drive tube 402, and can move in the clip feeding drive tube 402.
  • the fitting block 452 is close to the The end is located in the clip feeding drive tube 402 , and the clip push rod 251 and the clip feeding assembly are located on both sides of the clip box 220 .
  • the structure, location, etc. of the cartridge 220 can be referred to above, and details are not repeated here.
  • the clamping forceps includes a knob 310, and a pin 316 is arranged in the knob 310.
  • One end of the pin 316 is installed at the first part of the side wall of the knob 310, and the other end passes through the proximal driving member of the jaw driving mechanism,
  • the proximal driving member, the base 240 and the clip box 220 of the clip feeding driving mechanism are installed at another position on the side wall of the knob 310 that is symmetrical with the first position; the proximal driving member of the jaw driving mechanism is provided with a second
  • the waist-shaped hole 448, the proximal driving member of the clip feeding drive mechanism are provided with a first waist-shaped hole 420, the base 240 is provided with a first pin hole 416, and the clip box 220 is provided with a second pin hole.
  • the proximal drive member of the push-clip drive mechanism is provided with a third waist-shaped hole 458 for accommodating the pin 316 , and one end of the pin 316 is mounted on the first side wall of the knob 310 .
  • the other end passes through the first waist-shaped hole 420, the second waist-shaped hole 448, the first pin hole 416, the second pin hole and the third waist-shaped hole 458, and is installed on the side wall of the knob 310 and the first place
  • the jaw driving mechanism, the clip feeding driving mechanism, the clip box 220 , and the clip pushing driving mechanism can all rotate together with the knob 310 .
  • the driving member ie, the switching mechanism
  • the proximal end of the clip-feeding drive tube 402 and the distal end of the drive member gradually approach the proximal end of the jaw drive tube 432;
  • the moving member 330 moves to the middle position, the moving member of the driving member runs to the second guide surface 496 in the housing 321, the clamping block 482 is separated from the clamping groove of the driving tube 402 for feeding the clip, and the driving member is separated from the driving mechanism for feeding the clip.
  • the forward stroke of the driving mechanism for feeding the clip ends, and the clip 10 located at the farthest end of the clip box 220 is sent into the jaw assembly 100 (the clip feeding operation is completed), and the distal end surface of the driving member is in contact with the proximal end surface of the jaw driving mechanism.
  • the retraction stop end 354 of the clip feeding and retracting mechanism can abut against the clip feeding driving tube 402 after the driving member is separated from the clip feeding driving mechanism to prevent the clip 10 in the jaw assembly 100 from being retracted due to the retracting of the clip feeding driving mechanism.
  • the 330 moves to the closed position, the forward stroke of the jaw driving mechanism is completed (the jaw closing action is completed), the energy storage of the third reset member 456 is completed, and the clamping feeding and retracting mechanism is completely separated from the clamping feeding driving pipe 402, and the clamping driving pipe 402 is in The first reset member 418 is reset under the action of the first reset member 418 .
  • the actuating member 330 is released, the jaw driving mechanism is reset under the action of the second reset member 446, and the push-clamp driving mechanism is advanced under the action of the third reset member 456 to move the remaining clips 10 in the cartridge 220 forward by one station (Push clip action completed).
  • the matching mechanism includes a first matching piece, a middle piece and a second matching piece, the first matching piece drives the second matching piece through the middle piece; the firing driving mechanism is linked with the first matching piece; the continuous firing driving mechanism It is linked with the second adapter; the movement direction of the first adapter is opposite to the movement direction of the second adapter, wherein the firing drive mechanism includes the above-mentioned clip feeding driving mechanism and jaw driving mechanism, which are used to complete the clip feeding.
  • Action and clamping action jaw closing action
  • the burst driving mechanism is the above-mentioned push-clamp drive mechanism, which is used to complete the push-clamp action.
  • the linkage here refers to the connection of two moving parts, which move in the same direction and move synchronously.
  • the clip feeding drive mechanism and the clip pushing drive mechanism are independent driving mechanisms, which increases the design space and can realize more reliable and stable execution of the clip feeding and pushing action.
  • the asynchronous action can effectively avoid the interference problem of the clip feeding action and the clip pushing action, thereby effectively improving the safety and reliability of the clip applier.
  • the firing driving mechanism is linked with the first fitting through a switching mechanism, and the switching mechanism is used to selectively drive the clip feeding driving mechanism and the jaw driving mechanism; specifically, the proximal end of the switching mechanism is fixedly connected with the first fitting,
  • the switching mechanism is detachably connected to the firing drive mechanism. Press the above-mentioned actuating member 330, and under the action of the actuating member 330, the switching mechanism first drives the clip-feeding driving mechanism forward to perform the clip-feeding action, and then drives the jaw driving mechanism forward to perform the clip-applying action, and simultaneously drives the first adapter.
  • the burst driving mechanism includes a third reset member 456 for storing the energy; release the actuating member 330, the burst driving mechanism is in the third reset member 456 456 moves forward to perform a push-clamp action.
  • the structure, positional relationship, connection relationship, etc. of the switching mechanism, the driving mechanism for feeding the clip, the driving mechanism for the jaw and the driving mechanism for pushing the clip are the same as those described above, and will not be repeated here.
  • the first adapter includes an upper rack 462, the second adapter includes a lower rack 468, and the middle element includes a first gear 464 and a second gear 466; the upper rack 462 meshes with the first gear 464, and the lower rack 468 Meshing with the second gear 466, the first gear 464 and the second gear 466 are coaxially arranged, the diameter of the first gear 464 is larger than the diameter of the second gear 466, that is, the firing drive mechanism is connected with the upper rack 462 through the switching mechanism , the burst driving mechanism is connected with the lower rack 468, and the movement directions of the upper rack 462 and the lower rack 468 are opposite, when the upper rack 462 moves a first distance in the first direction, the lower rack 468 moves in the first direction
  • the opposite direction moves a second distance, that is, when the firing drive mechanism moves a first distance in a first direction, the burst driving mechanism moves a second distance in a second direction opposite to the first direction, and the first distance is greater than the second distance .
  • the first direction is the forward direction of the clip feeding driving mechanism and the jaw driving mechanism.
  • the distance of retreat is equal to the distance of its advance
  • the distance of advance is equal to the distance that the clip 10 in the cartridge 220 is moved forward by one station
  • the second distance of retreat is less than the first distance of the firing drive mechanism, and the clip 10 in the cartridge 220 is moved forward by one station. It can be arranged as closely as possible, that is to say, more clips 10 can be accommodated in the clip box 220 , and the number of times of continuous clip application can be increased, so as to meet the surgical needs of doctors.
  • the first matching member and the second matching member are arranged in the longitudinal direction, and the intermediate member is arranged between the first matching member and the second matching member, and is arranged along the longitudinal direction. Orientation setting perpendicular to the portrait orientation.
  • the continuous-fire driving mechanism and the second fitting are moved in the longitudinal direction in the clip-feeding driving mechanism.
  • the axis of the first fitting is perpendicular to the axis of the intermediate piece and is parallel to the axis of the second fitting; the axis of the second fitting is the same as the axis of the proximal driving member (the fitting block 452 ) of the continuous driving mechanism.
  • the axes of the proximal drives of the firing drive mechanism (clamp drive tube 402 and jaw drive tube 432) are coaxial.
  • the housing 321 is provided with a first guide groove 472 and a second guide groove 474, and the first adapter is in the first guide groove. 472 , the second fitting moves in the second guide groove 474 .
  • the burst driving mechanism includes a push-clamp drive member and a third reset member 456, the push-clip drive member is connected with the distal end of the second fitting member; the push-clip drive member is provided with a plurality of side cavities 252 at intervals along the longitudinal direction , each side cavity 252 is correspondingly installed with a push-clamp block 253 , and the push-clamp driving member moves under the action of the third reset member 456 to make the push-clamp block 253 move to perform the push-clamp action.
  • the third reset member 456 stores energy when the continuous-fire driving mechanism retreats.
  • the third reset member 456 of the continuous-fire driving mechanism is located in the second guide groove 474, one end of which is connected to the second guide groove 474.
  • the proximal end of the fitting is connected, and the other end is connected with the housing 321 located at the proximal end of the second guide groove 474 .
  • the distal end of the second adapter has an accommodating space.
  • the accommodating space has an opening.
  • the proximal end of the clip driver is accommodated in the accommodating space through the opening, and can be rotated in the accommodating space;
  • the proximal end of the push clip driver has a second stop portion 454, which is connected to a limiting surface 470 in the accommodating space. abutting, so that the continuous-fire driving mechanism is axially fixed with the distal end of the second fitting.
  • the proximal end of the clip driving tube 402 and the distal end of the switching mechanism gradually approach the proximal end of the jaw driving tube 432; when the actuating member 330 moves to the middle position, the moving member of the switching mechanism runs to the second position in the housing 321
  • the block 482 of the switching mechanism is disengaged from the slot of the clip feeding drive tube 402
  • the switching mechanism is separated from the clip feeding drive mechanism, and the forward stroke of the clip feeding drive mechanism is completed (the clip feeding operation is completed).
  • the retraction stop end 354 of the clip feeding and retracting mechanism can abut against the clip feeding driving tube 402 after the switching mechanism is separated from the clip feeding driving mechanism to prevent the clip 10 in the jaw assembly 100 from retreating due to the retracting of the clip feeding driving mechanism.
  • the third reset member 456 continues to store energy, the jaw drive tube 432 drives the sleeve 210 forward to close the jaw assembly 100 (the clamping action is completed), the energy storage of the third reset member 456 ends, and the clip feeding and retracting mechanism is completely disengaged from the feeding mechanism.
  • the clip driving tube 402 and the clip feeding driving tube 402 are reset under the action of the first reset member 418 .
  • the actuating member 330 is released, the jaw drive mechanism is reset under the action of the second reset member 446, and the push-clamp drive mechanism is advanced under the action of the third reset member 456 to move the remaining clips 10 in the cartridge 220 forward by one work. position (the push-clamp action is completed).
  • the clip feeding drive mechanism is used to drive the most distal clips 10 of the clip box 220 to move forward into the jaw assembly 100
  • the clip push drive mechanism is used to drive the remaining clips 10 in the clip box 220 to move forward by one process.
  • the driving mechanism for feeding the clip includes a proximal driving member for feeding the clip and a distal driving member for feeding the clip connected with the proximal driving member for the clip
  • the driving mechanism for pushing the clip includes a proximal driving member for pushing the clip and a driving member connecting with the proximal driving member for the pushing clip
  • the movement track of the clip-feeding proximal-end driver is parallel to the movement track of the clip-push proximal-end driver, and the movement track of the clip-sending distal-end driver intersects with the movement track of the push-clip distal-end driver.
  • Different driving mechanisms are used to perform the clip feeding and pushing actions respectively, which increases the design space and can realize more reliable and stable execution of the clip feeding and pushing actions, and the feeding action is performed earlier than the pushing action.
  • the actions of the users are not synchronized and will not interfere with each other, thereby effectively improving the safety and reliability of the clamp.
  • the motion trajectory refers to the motion trajectory formed during the movement of each point on the component.
  • the motion trajectory of component A and the motion trajectory of component B are both straight lines, if the motion trajectory of component A is in the If at least one straight line is collinear with at least one straight line in the motion trajectory of element B, the motion trajectory of element A and the motion trajectory of element B are said to be "coaxial”; if all the straight lines in the motion trajectory of element A are coaxial with the motion trajectory of element B All straight lines are parallel, then the motion trajectory of element A is said to be "parallel" to the motion trajectory of element B.
  • the movement trajectory of the component refers to the movement trajectory formed in one execution cycle.
  • the proximal driving member for pushing the clip is movably located in the proximal driving member for feeding the clip, and the distal driving member for feeding the clip and the distal driving member for pushing the clip are located on both sides of the clip box 220.
  • the distal driver is located on the side of the cartridge 220 that accommodates the clip 10 (inside the cartridge 220 ), and the distal drive for feeding the clip is located on the side of the cartridge 220 that does not accommodate the clip 10 (outside the cartridge 220 ).
  • the proximal driving member for feeding clips advances in the longitudinal direction, and drives the distal driving member for feeding clips to move from the outside of the clip box 220 to the plane where the clip 10 is located and abut against the clip 10 at the farthest end of the clip box 220, and further
  • the clip feeding proximal driving member drives the clip feeding distal driving member to return to the initial position along the original path.
  • the proximal drive member of the push clip retreats in the longitudinal direction, and drives the distal end drive member of the push clip to retreat.
  • the distal end of the push clip 220 moves from the position abutting against the corresponding clip 10 toward the inner side of the clip box 220 . Move away from the bottom wall 221 of the cartridge 220 to the rear of the clip 10 adjacent its proximal end.
  • the proximal drive member of the push clip is advanced in the longitudinal direction, the distal end drive member of the push clip is driven to advance to push the remaining clips 10 in the cartridge 220 forward by one station. Therefore, during the movement of the transmission mechanism, the movement trajectory of the distal drive of the clip feed intersects with the movement trajectory of the distal drive of the push clip, and the intersection of the component movement trajectory includes the intersection of the component movement trajectory itself and the extension of the component movement trajectory.
  • the lines intersect, and the movement track of the proximal drive member for feeding the clip is parallel to the movement track of the proximal driving member for pushing the clip.
  • the clip-feeding proximal-end driving member is sleeved on the clip-pushing proximal-end driving member, so that the structure of the transmission mechanism is more compact and the space is fully utilized.
  • the clip feeding driving mechanism and the clip pushing driving mechanism can move in the jaw driving mechanism.
  • the jaw drive mechanism advances or retreats in the longitudinal direction, and its movement track is parallel to the movement track of the proximal drive member of the clip feeding or the movement track of the proximal drive member of the push clip, and is parallel to the movement track of the distal end drive member of the clip feeding or with the pusher.
  • the motion trajectories of the distal driver of the clip intersect.
  • the jaw driving mechanism includes a jaw driving tube 432 and a sleeve 210 connected thereto.
  • the jaw driving tube 432 drives the sleeve 210 to move to close the jaw assembly 100 , and the movement trajectory of the jaw driving tube 432 is the same as the movement trajectory of the sleeve 210 Together they form the motion trajectory of the jaw drive mechanism.
  • Such a design makes the transmission mechanism reasonable in layout and compact in structure.
  • the proximal driving member for feeding the clip includes a driving tube 402 for feeding the clip, and the distal driving member for feeding the clip comprises a feeding block 231; the feeding block 231 is used to drive the clip 10 into the jaw assembly 100; Connecting block 452, the distal end driving member of the push clip includes a push clamp block 253, and the push clamp block 253 is used to drive the remaining clamps 10 in the clamp box 220 to move forward one station;
  • the movement trajectory of the clamp is parallel to the movement trajectory of the jaw driving mechanism, and the movement trajectory of the clamping block 231 intersects with the movement trajectory of the push clamping block 253 and the movement trajectory of the jaw driving mechanism.
  • the adapter block 452 is partially located in the clip feeding drive tube 402, and can move in the longitudinal direction in the clip feeding drive tube 402.
  • the proximal end of the clip feeding drive tube 402 is located in the jaw drive tube 432, which can Moves in the longitudinal direction within the jaw drive tube 432 .
  • the clip feeding block 231 is connected with the clip feeding driving tube 402 through the clip feeding rod 233;
  • the clip feeding driving mechanism further includes a base 240 fixed with the casing 321, and the base 240 is slidingly matched with the clip feeding rod 233; the distal end of the base 240
  • a guide slope 243 is provided to guide the clip feeding block 231 to push out from the base 240 to drive the most distal clip 10 of the clip box 220; the movement trajectory of the clip feeding rod 233 is parallel to the movement trajectory of the jaw drive mechanism.
  • the push-clamp block 253 is connected to the matching block 452 through the push-clamp rod 251 , a plurality of side cavities 252 are arranged along the shaft direction of the push-clamp rod 251 , and a push-clamp block 253 is correspondingly installed in each side cavity 252 ; the push-clamp rod
  • the movement track of 251 is parallel to the movement track of the jaw drive mechanism. This design makes the layout of the whole machine reasonable and the space fully utilized.
  • FIGS. 23A and 23B are schematic diagrams of the movement process of the clip feeding block 231 and a schematic diagram of its motion trajectory when the clip feeding drive mechanism advances;
  • the clip feeding block 231 moves to the guide slope 243 at the distal end of the base 240 on the first plane where the base 240 is located, and then moves along the guide slope 243 to the second plane and the clip box 220 where the clip 10 is located.
  • the farthest clip 10 abuts, and its movement process is shown in FIG. 23A , from which a schematic diagram of the movement track formed by any point on it can be obtained as shown in FIG.
  • FIG. 24A and FIG. 24B it is a schematic diagram of a movement process and a movement track of the push-clamp block 253 when the push-clamp drive mechanism is retracted.
  • the push-clamp block 253 follows the push-clamp drive mechanism to retreat, and when it retreats to the clip 10 adjacent to its proximal end, the distal end of the push-clamp block 253 is turned upward around the rotating shaft 255 with an upward force by the clip 10,
  • the distal end of the push clamp block 253 flips down to the original position under the action of the spring, and its movement process is shown in FIG.
  • FIG. 24A from which the movement trajectory of the push-clamp block 253 can be obtained.
  • the schematic diagram of the movement trajectory formed by the push-clamp block 253 is shown in FIG. 24B . It should be noted. This is just a schematic indication. According to the actual specific design, its motion trajectory will also be adjusted, such as the radian of the curve. It can be seen from this that during the movement of the transmission mechanism, the movement track of the clip feeding block 231 intersects with the movement track of the push clip block 253 .
  • the transmission mechanism also includes a switching mechanism and a matching mechanism.
  • the switching mechanism is used to selectively drive the clip feeding driving mechanism or the jaw driving mechanism;
  • the matching mechanism is connected with the switching mechanism at one point, and is connected with the push clip driving mechanism at the other. There is a distance between the one and the other; under the action of the actuating member 330, the switching mechanism successively drives the clip feeding driving mechanism and the jaw driving mechanism to move in the first direction, and simultaneously drives the matching mechanism to move to drive the pusher.
  • the clip driving mechanism moves in a second direction to store energy, wherein the first direction is opposite to the second direction;
  • the push clip driving mechanism includes a third reset member 456 for storing the energy.
  • the actuating member 330 is released, and the push-clamp drive mechanism advances under the action of the third reset member 456 to move the remaining clamps 10 in the cartridge 220 forward by one station; the movement trajectory of the switching mechanism is the same as that of the jaw driving mechanism.
  • the shaft makes full use of the space and the structure is more compact.
  • the matching mechanism includes a first matching member and a second matching member driven by the first matching member, the first matching member is connected with the switching mechanism, and the second matching member is connected with the push-clamp driving mechanism;
  • the movement track of the piece is parallel to the movement track of the jaw drive mechanism, and the movement track of the second matching piece is parallel to the movement track of the jaw drive mechanism.
  • the clip applier also has a structural design for realizing the locking of the special position of the wrench, and the specific details are as follows.
  • the wrench is movably connected to the housing 321 of the main body 320, and the wrench movement can be in three special positions: at the initial moment, when the user does not operate the wrench, the wrench is in the open position; The position of the wrench when the clamping is completed is the middle position; when the user operates the wrench, the position of the wrench when the clamping is completed is the closed position, and the user cannot operate the wrench to move further. From the initial moment, the user keeps operating the wrench, and the wrench moves from the open position to the intermediate position and then to the closed position.
  • the movement of the wrench in the direction of the closed position is defined as the forward movement of the wrench, and the movement of the wrench from the open position to the middle position and the movement of the wrench from the middle position to the closed position are both positive movements; correspondingly, define the direction of the wrench to open.
  • the movement in the direction of the position is the reset movement of the wrench.
  • the movement of the wrench from the closed position to the middle position and the movement of the wrench from the middle position to the open position belong to the reset movement.
  • the movement of the wrench from the open position to the middle position is the forward movement of the first stage of the wrench
  • the movement of the wrench from the middle position to the closed position is the forward movement of the second stage of the wrench
  • the movement of the wrench from the closed position to the middle position is the second stage of the wrench.
  • the first stage of reset movement of the wrench is the movement of the wrench from the middle position to the open position. The user operates the wrench to make a positive movement, and in response to the user's operation, the wrench moves from the open position to the intermediate position and then to the closed position.
  • the clip feed drive mechanism and at least part of the jaw drive mechanism are accommodated in the housing 321, such as the clip feed proximal drive member and the jaw proximal drive member above, the clip feed drive mechanism and The jaw drive mechanism is connected to the wrench and is driven by the wrench to move forward.
  • a clip feed drive mechanism drives the clip 10 forward into the jaw assembly 100 in response to the wrench moving from the open position to the neutral position.
  • the clip 10 is in the ready position, that is, the first segment of the wrench moves forward to drive the clip feeding action and realize the clip feeding in place.
  • the ready position is the first clip stably clamped by the jaw assembly 100.
  • the jaw drive mechanism drives the previous movement of the jaw drive mechanism in response to the wrench moving from the neutral position to the closed position, thereby driving the jaw assembly 100 to close movement, and when the wrench is in the closed position, the jaw assembly 100 is closed.
  • the state, that is, the positive movement of the second segment of the wrench drives the closing action and realizes that the jaws are closed to the end and the clamping is in place.
  • the clamp applier of the present embodiment is a clamp applicator that can continuously apply a plurality of clips.
  • the wrench needs to be reset and moved to the open position to prepare for the next application of the clamp 10. If the user also operates the reset, it is troublesome, resulting in poor user experience.
  • the clamping forceps further includes a wrench reset mechanism, which is connected to the wrench. When the user stops operating the wrench, the wrench reset mechanism drives the wrench to perform reset movement, and the direction of the reset movement is opposite to the direction of the forward movement.
  • the wrench reset mechanism includes an elastic element. When the wrench moves forward, the elastic element is compressed and deformed to store energy.
  • the wrench reset mechanism is the third reset member 456 of the push-clamp drive mechanism.
  • the connection between the third reset member 456 and the wrench is as described above.
  • the wrench reset mechanism includes, in addition to the third reset member 456, a second reset member 446 of the jaw driving mechanism.
  • the second restoring element 446 also provides restoring force to the handle. Specifically, during the movement of the wrench from the closed position to the intermediate position, the jaw drive tube 432 is always in contact with the input piece, and the second restoring force is always in contact with the input piece.
  • the component 446 When the component 446 resets itself, it drives the jaw driving tube 432 to retreat, and the jaw driving tube 432 pushes the input component to retreat, so that the driving surface of the input component pushes the wrench to perform the reset movement until the jaw driving tube 432 returns to the position at the initial moment, and the The input piece is disengaged, and from this moment on the wrench will be provided with a restoring force by the third restoring mechanism alone.
  • the doctor operates the wrench to move forward to perform the clip feeding and clip application in sequence. If there is no obvious pause or boundary between the clip feeding action and the clip application action, the doctor will feel bad when using it.
  • the clamp applier in this embodiment further includes a wrench locking mechanism.
  • the wrench locking mechanism includes a guide member 351 and a guide channel 340 disposed on the wrench and moving with the wrench.
  • the guide channel 340 includes a starting point a, a locking point b and an end point , at least part of the guide member 351 is accommodated in the guide channel 340, and the guide member 351 moves relatively with the guide channel 340; the guide member 351 relatively moves from the starting point a to the locking point b in response to the wrench moving from the open position to the intermediate position, The guide 351 relatively moves from the locking point b to the end point in response to the wrench moving from the neutral position to the closed position.
  • the guide member 351 prevents the wrench from performing the reset movement at the locking point b.
  • the user operates the wrench to move the wrench, which drives the guide channel 340 to move, so that the guide channel 340 moves relative to the guide member 351 , also referred to as the guide member 351 moving relative to the guide channel 340 or the guide member 351 moving relatively.
  • the guide channel 340 is a closed channel provided in the wrench, and the guide member 351 cannot be separated from the guide channel 340, and thus cannot be separated from the wrench.
  • the locking point b of the wrench locking mechanism can provide a pause point for the clip feeding and clip application operations. At this pause point, the doctor can observe whether the position of the jaw assembly 100 is suitable for the tissue to be clamped, and can adjust the forceps if necessary.
  • the position of the mouth assembly 100 improves the user experience; the lock point b is provided by the wrench itself, and the structure is simple; the guide channel 340 on the wrench is a closed channel, the moving channel of the guide member 351 is stable, and the locking effect of the wrench is stable .
  • the guide channel 340 only when the guide member 351 is located at the locking point b, the guide member 351 prevents the wrench from returning to movement. That is, the guide channel 340 only provides a locking point b that prevents the wrench from performing the reset movement.
  • the wrench reset mechanism will not work. Drive the wrench to do the reset movement. In this way, in the process of operating the wrench, the wrench is only locked in the middle position to remind the completion of the clip feeding, and is not disturbed by other positions, which improves the user experience.
  • the wrench reset mechanism drives the wrench to reset to the intermediate position, and the guide member 351 responds to the wrench's reset movement to the intermediate position. Move to the locking point b, and the guide member 351 prevents the wrench from continuing the reset movement at the locking point b. In this way, only one locking point provided by the guide channel 340 that prevents the reset movement of the wrench is further fully utilized. If the operation of the wrench is stopped during the clip application process, the wrench will stop to the middle position after the clip feeding is completed, instead of being directly reset to the open position. , to prevent the user from operating the wrench over the middle position and not being able to know the completion of the clip feeding, providing the user with the opportunity to observe the operation and adjust the clamping position of the jaw assembly 100 before the clip feeding is completed, thereby improving the user experience.
  • the wrench reset mechanism drives the wrench to reset and move to the middle position, it also drives the jaw drive mechanism to move backward at the same time, thereby driving the jaw assembly 100 to open and move. Whether before or after the wrench reaches the closed position, if a second return movement occurs, the jaw drive mechanism is driven backward and the jaw assembly 100 is opened.
  • the clip applier has started to apply the clip, but has not completed the clip application, the wrench has not reached the closed position, the jaw assembly 100 has not been closed to the end, and the clip 10 has not been compressed to the closed state, and the wrench can be released at this time.
  • the jaw assembly 100 returns to the fully open state, the clip 10 returns to the open state, and the subsequent adjustment of the position of the jaw assembly 100 on the tissue will not damage the tissue, and this design is safer and more user-friendly .
  • the guide channel 340 is a closed groove.
  • the closed groove is a groove surrounded all around, and the guide member 351 is restricted from moving around in the groove and cannot leave the groove, so that the guide member 351 cannot be separated from the wrench in this embodiment.
  • the closed groove provides a fixed moving channel for the guide member 351 , and the movement stability is strong, and further, the locking stability of the guide member 351 and the guide channel 340 at the locking point b is good.
  • the closed groove is a closed groove passing through the wrench body 320 , and the radial direction is perpendicular to the axial direction.
  • the guide channel 340 may also be a closed groove that does not penetrate through the wrench body, and it is only necessary to provide a closed channel in which the guide member 351 moves.
  • the wrench includes a wrench main body 331 , a user-operated pressing part 332 disposed at one end of the wrench main body 331 , and a pushing part 333 disposed at the other end of the wrench main body 331 .
  • the wrench main body 331 is provided with a pivot end 334 pivotally connected to the housing 321 of the main body 320 of the operating assembly 300 .
  • the guide channel 340 is located on the wrench body 331 and between the pivoting end 334 and the pushing portion 333 . Therefore, the guide channel 340 is in the middle position of the wrench, which further improves the stability of the movement of the guide member 351, and no additional structure is required to set the guide channel 340, and the structure of the wrench locking mechanism is compact.
  • the guide channel 340 includes a main channel 341 and only one secondary channel 343 extending from an opening 342 of the main channel 341 .
  • the opening 342 is located between two ends of the main channel 341 .
  • the two ends of the channel 341 are respectively provided with a starting point a and an end point c, and the end of the channel 343 away from the opening 342 is provided with a locking point b;
  • the wrench body 331 also includes a wrench locking elastic element 355, which applies A force is given to the guide 351 to disengage the main channel 341 and enter the slave channel 343 , so that the wrench locking elastic element 355 drives the guide 351 to disengage from the main channel 341 and enter the slave channel 343 .
  • the guide channel 340 only provides a locking point that prevents the wrench from resetting movement.
  • the wrench When the wrench is not in the first segment of positive movement in the middle position of the wrench, if the wrench is released, the wrench will reset to the open position and stop. , When the wrench leaves the middle position and continues to move forward, if the wrench is released before reaching the closed position, the wrench will reset to the middle position and be locked in the middle position by the locking point b of the above-mentioned wrench locking mechanism, The reset movement cannot be continued.
  • the user can clearly feel the pause of the wrench in the middle position when the wrench is released when the clip feeding action is completed and before the clip application action is completed. After the clip application is completed, the user can also adjust the position of the clip application force, which has a good user experience.
  • the slave channel 343 includes the blocking wall 344.
  • the guide member 351 When the wrench is not operated and the guide member 351 is located at the locking point b, the guide member 351 abuts the blocking wall 344 in the direction of the wrench's reset movement, thereby preventing the wrench from performing the reset movement at the locking point b. That is, the blocking wall 344 prevents the guide member 351 at the locking point b from moving toward the starting point a.
  • the main channel 341 includes a first wall extending from a starting point a to a first wall connected with the blocking wall 344 , the first wall and the blocking wall 344 forming a right or acute angle.
  • the simple angle design of the guide channel in this way can ensure that the blocking wall 344 can effectively prevent the guide piece 351 from breaking away from the locking point b of the slave channel 343, and in the forward motion, when the guide piece 351 enters the slave channel 343 from the main channel 341, it passes through The right-angle point or the acute-angle point will make a collision sound, and the sound clearly reminds the user that the wrench has reached the middle position, and reminds the user that the clip is in place at the moment.
  • the slave channel 343 also includes a guide wall 345 connected to the blocking wall 344, and the guide wall 345 guides the guide member 351 to move bidirectionally between the locking point b and the end point c.
  • the simple channel wall structure design from the channel 343 is adopted, that is, two-way movement is realized between the locking point b and the end point c, the wrench will not be locked in both directions, and can be smoothly operated by the user to the closed position or reset. To the intermediate position, no additional guide elements are required, and the structure is simple and compact.
  • the main channel 341 also includes a second wall extending from the end point c to connect with the guide wall 345 , the second wall forming an obtuse angle with the guide wall 345 .
  • the simple angle design of the guide channel in this way further ensures the bidirectional movement between the locking point b and the end point c, and the wrench will not be locked in both directions.
  • the main channel 341 is an arc channel with the pivot end 334 of the wrench as the center of the circle, and the sub channel 343 extends from the opening 342 of the main channel 341 to the direction away from the pivot end 334 , that is, from The distance between the channel 343 and the pivot end 334 is greater than the distance between the main channel 341 and the pivot end 334, and the distance between the guide 351 located in the main channel 341 and the pivot end 334 is defined as X, since the main channel 341 For the above-mentioned circular arc channel, the distance X of the guide member 351 remains unchanged when the main channel 341 moves (including the start point a and the end point c), and the distance between the guide member 351 and the pivot end 334 when the guide member 351 is located in the slave channel 343 is defined as Y, When the guide member 351 moves from entering the slave channel 343 to the locking point b, Y keeps increasing, and Y is always greater than X, especially the
  • the guide channel 340 is not limited to the above-mentioned shape.
  • the main channel 341 is an arc-shaped channel.
  • X is still smaller than Y, and the above-mentioned wrench locking function is also realized.
  • the wrench locking mechanism further includes a guide pivot member 350, and the guide pivot member 350 is accommodated in the housing In 321, the guide pivot member 350 includes a pivot end 352 pivotally connected to the housing 321, a force end 353 extending from the pivot end 352, and the above-mentioned guide member 351.
  • the wrench locking elastic element 355 abuts against the The force-receiving end 353 abuts the casing 321 at the other end.
  • the guide pivot member 350 When the elastic force of the wrench locking elastic element 355 acts on the force-receiving end 353, it drives the guide pivot member 350 to rotate with the pivot end 352 as the rotation center, and also drives the guide member 351 to take the pivot end 352 as the rotation center.
  • the guide pivot member 350 defines an arc-shaped movement trajectory of the guide member 351, which ensures that it can switch back and forth between the main channel 341 and the slave channel 343 stably, and further ensures the stability of the wrench locking mechanism.
  • the guide pivot member 350 includes a first pivot arm and a second pivot arm respectively extending from the pivot end 352 , and the end of the first pivot arm is the force-receiving end 353
  • the guide member 351 is disposed at the end of the second rotating arm, one end of the spanner locking elastic element 355 is connected to the force end 353 , and the other end of the spanner locking elastic element 355 is connected to the housing 321 .
  • the first rotating arm and the second rotating arm use the pin of the pivot end 352 as a fulcrum to form a lever, and the wrench locking elastic element 355 and the guide member 351 are located at both ends of the lever.
  • the first rotating arm and the second rotating arm may be levers connected horizontally as shown in FIG. 27 , or may be levers connected at an angle.
  • the above is a specific embodiment of the guide pivot member 350 --- a lever, and the structure of the guide pivot member 350 is not limited to this.
  • a rotating arm, the guide member 351 is arranged at the end of the first rotating arm, and the middle point of the first rotating arm is the force end 353 connected to the wrench locking elastic element 355. This method also enables the wrench locking elastic element 355 to pass through. It is within the scope of the present invention to guide the pivot member 350 to apply a force to the guide member 351 to disengage the main channel 341 and enter the secondary channel 343 .
  • the wrench locking elastic element 355 is indirectly connected to the guide member 351 through the guide pivot member 350.
  • the element 355 drives the guide piece 351 away from the main channel 341 and enters the secondary channel 343".
  • a "V"-shaped rod can be used as a wrench to lock the elastic element 355, and one end of the V rod is fixedly connected to the housing 321. The other end is provided with the above-mentioned guide member 351, the "V"-shaped rod is made of rigid material, and the V-shaped bend of the "V"-shaped rod is bent to a small extent, so as to provide the guide member 351 with a "disengagement from the main channel 341 to enter.
  • a wrench locking elastic element 355 is formed of an elastic material capable of large deformation, and the wrench locks the elastic element 355 is, for example, a "V" metal dome 522 or a spring, one end is fixedly connected to the housing 321, and the other end is provided with a guide 351. Due to the greater elasticity of the locking elastic element, the guide 351 connected to it moves in the channel. The stability is poor, and the function of locking the wrench in the middle position cannot be well achieved.
  • the indirect connection between the wrench locking elastic element 355 and the guide member 351 and the application of the force entering the slave channel 343 through the guide pivot member 350 in this embodiment in addition to the above benefits, also has the following advantages Benefit:
  • the problem of parts being damaged or broken is less likely to occur, the stability of the movement of the guide member 351 is ensured, and the stability of the locking mechanism of the wrench is further ensured.
  • the wrench locking elastic element 355 is a spring.
  • the guide pivot member 350 also includes a stop end 354 extending from the pivot end 352. Before the wrench moves from the open position to the intermediate position, the stop end 354 is kept disengaged from the drive mechanism for feeding the clip; the wrench moves from the intermediate position. Before reaching the closed position, the back-stop end 354 is kept in contact with the clip feeding driving mechanism to prevent the clip feeding driving mechanism from retreating.
  • the third pivot arm extending from the pivot end 352 of the guide pivot member 350 is guided, and the end of the third pivot arm stops at the retreat end 354 , so that the guide member 351 , the stopper Both the end 354 and the force-receiving end 353 move around the pivot end 352 .
  • the wrench is in the open position when the clamp is not in use, the guide pivot member 350 is located below the clip feeding drive mechanism, and the stop end 354 is not in contact with the clip feeding drive mechanism; when the wrench moves forward, the guide member 351 is in the When the main channel 341 moves toward the opening 342, the driving mechanism for feeding the clip moves forward, and the stop end 354 is still not in contact with the driving mechanism for feeding the clip; when the guide member 351 enters from the channel 343 and moves to the locking point b, the stop is stopped.
  • the distance between the end 354 and the end of the clip feed drive mechanism gradually decreases until it abuts against its end, preventing it from retreating; when the guide 351 exits the slave channel 343 along the guide wall 345 and returns to the main channel 341, the jaw drive mechanism During the clip application, the back-stop end 354 always keeps abutting with the end of the clip feeding drive mechanism to prevent it from retreating, thereby ensuring that the clip 10 located in the jaw assembly 100 will never retreat during the clip application process, ensuring the clip application. stability. Specifically, as shown in FIGS.
  • the channel 343 extends from the opening 342 of the main channel 341 toward the direction away from the pivot end 334 of the wrench, and the distances from the starting point a and the end point c to the pivot end 334 of the wrench are less than The distance from the locking point b to the pivot end 334 of the wrench.
  • the guide member 351 has a first movement path when the wrench moves forward and a second movement path when the wrench returns to the closed position after the wrench reaches the closed position.
  • the first movement path includes a master channel 341 and a slave channel 343,
  • the second path includes the master channel 341 and does not include the slave channel 343 .
  • the above-mentioned movement path is the path of the relative movement of the guide member 351 .
  • the motion path is the path formed by the passages reached during the motion.
  • the clamp applier further includes a path switching member 360 for switching the first movement path and the second movement path.
  • the path switching member 360 is located in the housing 321, and the path switching member 360 has two states. When the path switching member 360 is in the first state, the path switching member 360 moves away from the slave channel 343 to allow the guide member 351 to enter or exit the slave channel. 343 , when the path switching member 360 is in the second state, the path switching member 360 blocks the guide member 351 from entering the slave channel 343 .
  • the guide member 351 is a cylindrical body extending along the radial direction and passes through the guide channel 340.
  • the guide member 351 includes a first part and a second part connected to each other.
  • the part is outside the guide channel 340 and protrudes from the surface of the wrench body 331.
  • the second part will correspondingly form an active space with the movement of the first part.
  • the path switching member 360 blocks the first part of the guide member 351 from the opening 342 into the space passing through the slave passage 343, the guide member 351 can be prevented from entering the slave passage 343, and the entire slave passage 343 does not need to be blocked.
  • the member 360 blocks the second part of the guide member 351 from entering the above-mentioned movable space or the way to enter the above-mentioned movement, which prevents the first part of the guide member 351 from entering the slave channel 343 , that is, it can also prevent the guide member 351 from entering the slave channel 343 .
  • the guide piece 351 enters and exits the slave channel 343 from the opening 342 of the main channel 341 .
  • the opening 342 includes a starting point 342 a and an ending point 342 b . Between the starting point 342 a and the ending point 342 b is the entrance and exit of the slave channel 343 , the starting point 342 a Close to the start point a of the main channel 341 , the end point 342 b is close to the end point c of the main channel 341 .
  • the path switching member 360 when the wrench moves forward, when the guide member 351 is located at the starting point 342a of the opening 342 of the main channel 341, the path switching member 360 is in the first state, the guide member 351 enters the slave channel 343, and the guide member 360 is in the first state.
  • the path switching member 360 is in the first state, so that the guide member 351 can smoothly enter and exit from the channel 343 when the wrench moves forward; after the wrench reaches the closed position Do the reset movement, at least when the guide member 351 is located at the end point 342b of the opening portion 342 of the main channel 341 , the path switching member 360 is in the second state and maintains the second state at least until the guide member 351 moves to the opening portion 342 of the main channel 341 The starting point 342a, so that the guide 351 can never enter the slave channel 343 during the reset movement.
  • the above state control logic of the path switching member 360 needs to be designed based on the structure of the opening portion 342, in order to ensure the basis for forming the first motion path and the second motion path.
  • the path switching member 360 has the following state logic which is relatively easy to implement. During the period when the wrench moves forward and moves from the open position to the closing position, the path switching member 360 is in the first position. When the wrench moves forward and reaches the closed position, the path switching member 360 switches from the first state to the second state, and after the wrench reaches the closed position During the reset movement and the movement from the closed position to the intermediate position, the path switching member 360 is in the second state, so that the guide member 351 can never enter the secondary channel 343 during the reset movement from the closed position.
  • the state control logic of the path switching member 360 in this embodiment controls the state of the path switching member 360 based on the position of the wrench, which achieves the same function, is more stable, and has a simpler design.
  • the path switching member 360 when the wrench reaches the closed position and starts the reset movement, when the wrench is in the open position, the path switching member 360 is in the first state. That is, during the reset movement of the wrench from the neutral position to the open position, the path switching member 360 is switched from the second state to the first state. In this way, at the end of one use cycle of the continuously applied clamping forceps, the path switching member 360 returns to the initial state, so that the next use cycle can function normally
  • the path switching member 360 is in the first state; during the reset movement of the wrench, at least when the guide member 351 passes through the opening 342 , the path switching member 360 is in the second state.
  • the clamp applier further includes a path driving member 370 , which is located in the housing 321 .
  • the path switching member 360 is disposed on one of the wrench and the main body 320
  • the path driving member 370 is disposed on the other of the wrench and the main body 320 .
  • the path switching member 360 is provided on one of the housings 321 of the wrench and the main body 320
  • the path driving member 370 is provided on the other of the housings 321 of the wrench and the main body 320 .
  • the path switching member 360 When the wrench moves forward or resets, when the path driving member 370 abuts the path switching member 360 , the path switching member 360 is driven to move, so that the path switching member 360 switches between the first state and the second state.
  • the movement of the wrench drives the path driving member 370, and then drives the path switching member 360 to change its state, and finally returns to the switching of the movement path of the guide channel 340 of the wrench itself.
  • the movement of the wrench is the power source for switching the movement path of the wrench. Implementing an inner loop is simple and reliable, and does not require an additional power source to change the motion path.
  • the path driving member 370 can selectively abut or disengage from the path switching member 360.
  • the path switching member 360 does not move and is in a fixed position, and the state remains unchanged.
  • the path switching member 360 moves and the position changes, and the state may change; in another embodiment, the path switching member 360 can continue to abut with the path driving member 370 and continue to move, when it moves to a certain position , a switch between the first state and the second state occurs.
  • the path switching member 360 includes a pivoting portion 361 , a triggering portion and an executing portion 363 , and the path switching member 360 rotates with the pivoting portion 361 as an axis.
  • the triggering part includes a first triggering part 362a and a second triggering part 362b respectively disposed on both sides of the pivoting part 361;
  • the path driving member 370 is a guide rib, and the guide rib includes a first guide rib 371 and a second guide rib 373.
  • a guide rib 371 has a first guide slope 372, a second guide rib 373 has a second guide slope 374, the first guide rib 371 is located on the front side of the first trigger portion 362a, and the second guide rib 373 is located on the second trigger portion
  • the rear side of the 362b when the first trigger part 362a abuts the first guide rib 371 and moves along the first guide slope 372, the path switching member 360 rotates toward the first direction, and the path switching member 360 switches from the first state to the second state
  • the second trigger portion 362b abuts against the second guide rib 373 and moves along the second guide slope 374, the path switching member 360 rotates toward the second direction, and the path switching member 360 switches from the first state to the second state; path switching
  • the execution part 363 moves away from the slave channel 343 to allow the guide member 351 to enter or exit the slave channel 343; when the path switching member 360 is in the second state, the execution part 363 blocks the guide member 351
  • the path switching member 360 and the path driving member 370 move relative to each other.
  • the front side and the rear side respectively refer to the fact that the first guide rib 371 is located on the path switching member 360 relative to the path driving member when the wrench moves forward.
  • the second guide rib 373 is located at the rear side in the relative movement direction of the path switching member 360 relative to the path driving member 370 when the wrench moves forward.
  • the above-mentioned pivoting portion 361 is a rotating shaft, which is fixed in the horizontal pin hole of the wrench body.
  • the plates are the first plate 362a' and the second plate 362b' respectively, and have an obtuse angle.
  • the execution part 363 is the rib 363' connecting the first plate 362a'; the pivot part 361 of the path switching member 360 is connected to a wrench, especially a wrench
  • the main body 33 is close to the passageway 343, the obtuse angles of the first plate 362a' and the second plate 362b' face the inner side of the casing 321, the guide ribs are arranged on the inner side of the casing 321, the first guide slope 372 and the second guide slope
  • the bevel of 374 faces the wrench body 331 .
  • the first plate 362a' and the first plate 362a' may be at an acute or right angle.
  • the above-mentioned front and rear sides of the path switching member 360 and the path driving member 370 are arranged so that the path switching member 360 selectively abuts or disengages from the path switching member 360 when the wrench moves forward or resets.
  • the positions of the wrench also include a first proximal position between the neutral position and the closed position, and a second proximal position between the open position and the open position.
  • the movement process of the path switching member 360 and the path driving member 370 is as follows: at the initial moment, the wrench is in the open position, and the path switching member 360 is in the first position relative to its own pivot portion 361, which is in the first position.
  • the path switching member 360 moves around the pivot end 334 of the wrench with the wrench, and the first trigger
  • the portion 362a gradually approaches the first guide rib 371, the path switching member 360 does not move in the first direction or the second direction relative to its pivot portion 361, and is still in the first position and in the first state; the wrench moves forward and When reaching the first approaching position, the path switching member 360 begins to abut the first guide slope 372 of the first guide rib 371, and the path switching member 360 is still in the first position and in the first state;
  • the first trigger portion 362a of the path switching member 360 moves along the first guide slope 372, and the path switching member 360 rotates rapidly toward the first direction, leaving the first position, but still in the first position.
  • the first state when the wrench reaches the closed position, the path switching member 360 has rotated a total angle of A in the first direction from the first position, the path switching member 360 is located at the second position relative to its pivot portion 361, and the path The switching member 360 is switched from the first state to the second state; during the reset movement of the wrench and from the closed position to the second adjacent position, the path switching member 360 moves around the pivot end 334 of the wrench along with the wrench, and the second trigger portion 362b is gradually approaching the second guide rib 373, and is also in a disengaged state from the first guide rib 371.
  • the path switching member 360 does not move in the first direction or the second direction relative to its pivot portion 361, and remains in the second position.
  • the lengths of the first guide rib 371 and the second guide rib 373 are relatively short, so as to achieve a relatively fast rotation of the A angle, relatively fast switching between the first state and the second state, the structure is simple, the cost is low, and the path switching is performed.
  • the path switching member 360 has a stable position and a stable state, and the state of applying the clamp is more stable.
  • the position of the wrench further includes a third adjacent position and a fourth adjacent position located between the open position and the intermediate position, and the fourth adjacent position is closer to the open position, and the wrench reset movement
  • the second trigger portion 362b and the second guide rib 373 are in a disengaged state, and the specific position, movement and state of the path switching member 360 are the same as above, and the wrench moves from the third proximity position to the fourth proximity position.
  • the second trigger portion 362b abuts the second guide rib 373 and rotates in the second direction along the second guide slope 374.
  • the path switching member 360 When the path switching member 360 is in the fourth adjacent position, the path switching member 360 returns to the first position and The first state is as described above; and during the subsequent movement of the wrench from the fourth adjacent position to the open position, the second guide rib 373 is in a disengaged state from the path switching member 360, and the path switching member 360 remains in the first position and second state. In this way, the path switching member 360 can also be restored to the initial state, so as to function normally in the next use cycle of the continuously applied clamp applier.
  • the clip applier further includes a positioning mechanism.
  • the positioning mechanism includes a first positioning member 381 and a second positioning member 382 .
  • the first positioning member 381 is disposed on the pivot portion 361 of the path switching member 360 .
  • the first positioning member 381 uses the pivot portion 361 as the rotation shaft 255 to move synchronously
  • the second positioning member 382 includes a The first concave 383, the second concave 384 and the convex portion 385 located between the first concave 383 and the second concave 384, one of the first positioning member 381 and the convex portion 385 is an elastic element
  • the first positioning member 381 can only be fixed in the first recess 383 or the second recess 384, and cannot be located at other positions, then the positioning of the path switching member 360 relative to its pivot portion 361 can only be fixed at a fixed position two positions, such as the above-mentioned first position and the above-mentioned second position, and the path switching member 360 is in the first state in the first position, and the path switching member 360 is in the second state in the second position.
  • the first positioning member 381 is located in the first recess 383.
  • the first positioning member 381 also rotates in the first direction, and the first positioning member 381 abuts against the raised portion 385.
  • one of them is an elastic element and can be compressed
  • the first positioning member 381 can smoothly pass over the convex portion 385 and enter the second recess 384;
  • the positioning member 381 can also return to the first recess 383 under the reaction force of the elastic element.
  • the first positioning member 381 passes over the protruding portion 385 from the second recess 384 and smoothly enters the first recess 383 , which is not repeated here.
  • the path switching member 360 and the path driving member 370 can be in a disengaged state. If there is no positioning mechanism, the path switching member 360 can move freely relative to its own pivot portion 361. When the clamp applier is shaken or shaken , the path driving member 370 will freely rotate in the first direction or the second direction, so as to accidentally enter the second state during the period when the first state is required, and accidentally enter the first state during the period when the second state is required. The first motion path of the forward motion and the second motion path of the reset motion of the clamp are damaged and cannot be used normally. Therefore, the above-mentioned positioning mechanism prevents the path switching member 360 from moving unexpectedly, and ensures the normal movement path of the clamp applier.
  • the first positioning member 381 may be a first protruding rib, facing away from the obtuse angle and protruding from the pivoting portion 361 , and the protruding portion 385 is a second protruding rib.
  • the elastic element can also be a C-shaped raised metal rod with elasticity.
  • the jaw assembly 100 has a design capable of stably guiding, clamping and compressing the first clip, the details of which are as follows.
  • the jaw assembly 100 includes a first jaw arm 1 and a second jaw arm 1'.
  • the structure of the first clamp arm 1 is the same as that of the second clamp arm 1', and the present invention focuses on describing the structure of the first clamp arm 1 .
  • the first clamp arm 1 includes a bottom portion 11 , a first side portion 12 and a second side portion 13 .
  • the bottom portion 11 , the first side portion 12 and the second side portion 13 make the cross-section of the first clamp arm 1 Roughly U-shaped.
  • the first side portion 12 includes a first guide portion 15 and a first accommodating portion 17
  • the first guide portion 15 and the first accommodating portion 17 are both disposed on the inner wall of the first side portion 12
  • the second side portion 13 includes a second
  • the guide portion 16 and the second accommodating portion 18 are both disposed on the inner wall of the second side portion 13 .
  • the bottom 11 is located between the first guide portion 15 and the second guide portion 16
  • a gap 14 is formed between the first accommodating portion 17 and the second accommodating portion 18 .
  • the structures of the first guide portion 15 and the second guide portion 16 are the same, and the structures of the first accommodating portion 17 and the second accommodating portion 18 are the same.
  • the present disclosure focuses on describing the structures of the first guide portion 15 and the first accommodating portion 17 .
  • the first guide portion 15 includes a guide surface 51, and at least the second portion 53 of the guide surface 51 is substantially arc-shaped.
  • the guide surface 51 includes a first portion 52 that is flush with the upper surface of the bottom portion 11 , and further includes a second portion 53 that is higher than the upper surface of the bottom portion 11 .
  • the second portion 53 is formed by extending the first portion 52 in a substantially arcuate direction. , the first part 52 and the second part 53 transition smoothly.
  • the first accommodating portion 17 is located far from the first guide portion 15 , and the first accommodating portion 17 is recessed.
  • the first accommodating portion 17 includes a proximal side 71 and a distal side 72 .
  • the proximal side 71 meets the second portion 53 of the guide surface 51 , and the intersection 73 forms a rounded corner.
  • the intersection 73 is the distal end of the second portion 53 .
  • the jaw assembly 100 also includes a stop 2 .
  • the stoppers 2 are arranged on the first clamp arm 1 and the second clamp arm 1 ′, and are respectively connected with the first guide part 15 and the second guide part 16 of the first clamp arm 1 and the second clamp arm 1 ′.
  • the two guides of the arm 1' cooperate.
  • the structures of the four stoppers 2 are the same, and the first stopper 21 matched with the first guide portion 15 is used as an example to illustrate their structures.
  • the first stopper 21 is located above the first guide portion 15 .
  • the first stopper 21 includes a base portion 23 and a movable portion.
  • the movable portion includes an end portion 22 and a middle portion 25 .
  • the middle portion 25 Located between the end portion 22 and the base portion 23 .
  • the size of the base portion 23 is larger than that of the middle portion 25 and the end portion 22 , and the base portion 23 is engaged in the groove provided on the first side portion 12 , so that the base portion 23 is fixed to the first side portion 12 .
  • Both the middle portion 25 and the end portion 22 are located inside the inner wall of the first side portion 12 .
  • the movable part can move in the upward and downward directions.
  • the first guide portion 15 and the first stopper 21 together form a guide space for the clip 10 .
  • the first clamp arm 1 and the second clamp arm 1' also have three guiding spaces.
  • the first clamp arm 1 and the second clamp arm 1' have a total of four guiding spaces, which are matched with the four protrusions of the clip 10 in one-to-one correspondence.
  • the first stopper 21 does not cooperate with the protrusion of the clip 10 , and the distance between the second portion 53 of the guide surface 51 and the first stopper 21 decreases in the direction toward the distal end of the guide surface 51 .
  • the aforementioned distance is at a minimum between the intersection 73 and the first stop 21 .
  • the above-mentioned distance can be determined by, for example, the minimum distance between a certain point along the second portion 53 and the lower surface of the first stopper 21, and the above-mentioned minimum distance decreases in the direction toward the distal end of the guide surface 51.
  • the stopper 2 has elasticity, including the following two methods.
  • the material of the stopper 2 has elasticity, and the material includes but not limited to metal, so that the stopper 2 tends to maintain its original position.
  • at least a part of the stopper 2 is connected to the clamp arm, the clamp arm is further provided with a torsion spring, one end of the torsion spring is connected to the clamp arm, and the other end is connected to the stopper 2, The stopper 2 tends to approach the guide surface 51 .
  • the stopper 2 has elasticity, so that the protruding portion of the clip 10 is constrained by the stopper 2 in the guide space, so that the clip 10 is kept in the guide space during the process of moving far away, so that the clip 10 is gradually opened.
  • the stopper 2 includes a base 23 and a movable part, and the movable part can move up and down, including two ways: in one way shown in this embodiment, the base 23 and the clamp The arm is connected, and the movable part can move up and down due to the elasticity of the material of the stopper 2; in another way shown in other embodiments, the base 23 is pivotally connected to the clamp arm, and the movable part also follows It can be pivoted to move up and down, one end of the torsion spring is connected to the clamp arm, and the other end is connected to the movable part, so that the movable part tends to move toward the guide surface 51 .
  • the movable part can move up and down, which can make room for the protru
  • the maximum size of the first protrusion 41 and the maximum size of the second protrusion 42 are approximately the same, and the shape of the first protrusion 41 and the shape of the second protrusion 42 may be the same or different.
  • the second protrusions 42 are applicable to substantially the same guide space. It should be noted that the size of the first protruding portion 41 can also be set to be different from that of the second protruding portion 42, and even the sizes of the two first protruding portions 41 can be set to be different, and the two second protruding portions The dimensions of the 42 are set to be different. In this case, the guiding space matched with the protruding portion can be appropriately changed, that is, the relative position, shape and/or size of the guiding portion and the stopper 2 are appropriately changed.
  • the clip 10 In the state where the jaw assembly 100 is opened, that is, in the state of being opened to the bottom, the clip 10 is pushed to move far away under the driving of the clip feeding drive mechanism, so as to enter the jaw assembly 100 from the clip box 220, and the first The protruding portion 41 and the second protruding portion 42 respectively enter the corresponding guide spaces, and move distally in the corresponding guide spaces until the clip 10 is located at the distal end of the jaw assembly 100, at least a part of the first protruding portion 41 and the second protruding portion 41 At least a part of the portions 42 respectively enter and are accommodated in the accommodating portions.
  • Both the first protruding portion 41 and the second protruding portion 42 are guided by the guide portion, thereby moving along the guide surface under the restraint of the stopper 2 , so that the clip 10 moves in a desired direction.
  • the clip 10 Before being fed into the jaw assembly 100, the clip 10 is partially compressed and stored in the clip box 220 due to the size and internal space of the cartridge 220. At this time, the clip 10 is not fully opened, and is compressed for a period of time. Therefore, after the clip 10 is separated from the sleeve 210 , an external force is required to restore the original shape of the clip 10 , that is, the opened shape of the clip 10 . Compressed means that the two arms of the clip 10 are close to each other, but are not engaged.
  • the clip 10 Since the clip 10 will continue to be used for a period of time after being assembled to the cartridge 220, the clip 10 tends to maintain its compressed shape due to the compression during this period. Both the first protrusion 41 and the second protrusion 42 are also constrained by the stopper 2, so that in the process of moving them far in the guide space, they overcome the above-mentioned tendency to maintain the compressed shape, so that the first clamp of the clamp 10
  • the arm 31 and the second clamping arm 32 are gradually opened in the process of moving distally, until the original shape is restored, or the opening angle of the jaw assembly 100 remains the same.
  • the clip 10 returns to its original shape, or maintains the same angle as the jaw assembly 100 is opened, maximizing the clamping space between the two arms of the clip 10 and facilitating the holding of the tissue to be clamped therein.
  • the protruding portion of the clip 10 does not enter the guide space and is not constrained by the stopper 2 .
  • the distance between the second portion 53 of the guide surface 51 and the corresponding stopper 2 is directed toward the guide surface 51
  • the direction of the distal end decreases until the distance between the distal end of the second portion 53 (ie the distal end of the guide surface 51 ) and the stopper 2 is minimized.
  • the first protrusion 41 and the second protrusion 42 of the clip 10 gradually approach the outlet of the guide space (ie, the first protrusion 41 and the second protrusion 42 move toward the distal end of the guide surface 51 ).
  • the intersection 73) and the entrance close to the accommodating part, so that the first protruding part 41 and the second protruding part 42 can smoothly enter the accommodating part.
  • the aforementioned distance decreases in the direction towards the distal end of the guide surface 51 , for example by the fact that at least the second portion 53 of the guide surface 51 is substantially arcuate.
  • the restraining force they receive becomes larger and larger, so that the protruding part of the clip 10 is guided by the second part 53 of the guide surface 51 .
  • the moving speed of the protruding portion of the clip 10 is restrained, preventing the protruding portion from passing over the entrance of the accommodating portion due to the excessive speed after leaving the guide space and failing to enter the accommodating portion.
  • first protruding portion 41 and the second protruding portion 42 reach and cross the intersection 73 (ie, the intersection 73 formed by the intersection of the proximal side of the accommodating portion and the second portion 53 of the guide surface 51 ), the stop Under the restraint of the piece 2, they will not continue to move in the original direction so as not to enter the accommodating portion.
  • the first protruding portion 41 and the second protruding portion 42 enter the accommodating portion after crossing the intersection 73 .
  • the clip 10 is moved in place and is in the above-mentioned preparation position, and the clip feeding is completed.
  • the movable part of the stopper 2 can move up and down, under the condition that the distance between the second part 53 of the guide surface 51 and the corresponding stopper 2 decreases in the direction toward the distal end of the guide surface 51 , the While the stopper 2 constrains the protruding part of the clip 10, the movable part of the stopper 2 can make room for the protruding part of the clip 10 through the movement, so that it can leave the guide space and enter the container when it is constrained. set department.
  • the restriction on the protrusion by the stopper 2 can be realized, for example, by the stopper 2 abutting against the protrusion.
  • At least a portion of the first protruding portion 41 and at least a portion of the second protruding portion 42 are respectively accommodated in the accommodating portions, so that the clip 10 maintains a stable position during the closing process of the jaws, that is, during the clip applying process.
  • the accommodating portion is a concave, which helps the first protruding portion 41 and the second protruding portion 42 of the clip 10 to remain in the accommodating portion continuously without being easily disengaged.
  • first protruding portion 41 and the second protruding portion 42 accommodated in the accommodating portion are both subjected to the force exerted by the stopper 2 abutting against them, so that the first protruding portion 41 and the second protruding portion 42 more stable in the receptacle.
  • the above-mentioned force may be, for example, a substantially downward and upward force, or a substantially distant force, which is related to the position where the stopper 2 abuts against the protruding portion.
  • the positions of the first protruding portion 41 and the second protruding portion 42 are stable, so that the clip 10 maintains a stable position during the closing process of the jaws, thereby ensuring the clamping effect.
  • the present invention also includes a clip feeding and retracting mechanism, which is used to prevent the clip feeding drive mechanism from retreating, thereby preventing the clip 10 from retreating. The position of the end remains stable for smooth clip application.
  • the jaw assembly 100 enters the closing process, the first jaw arm 1 and the second jaw arm 1' approach each other until reaching the closing stroke dead point, at which time the jaw assembly 100 completes the closing.
  • the jaw arm cannot exert force on at least one protruding portion through the accommodating portion, resulting in As a result, the clip 10 is twisted or disengaged from the correct position, so that the two clip arms cannot be engaged, resulting in a clamping failure.
  • At least a part of the first protruding part 41 and at least a part of the second protruding part 42 are both accommodated in the accommodating part, thus, during the closing process of the jaw assembly 100, the first jaw arm 1 drives the first clamping arm 31, the The two clamp arms 1' drive the second clamp arm 32 to rotate around the connecting portion so that the first clamp arm 31 and the second clamp arm 32 are close to each other, and finally the first engagement portion of the first clamp arm 31 is engaged with the second clamp arm
  • the second engaging portion 32 makes the first clamping arm 31 and the second clamping arm 32 fixed to each other.
  • the two first protruding portions 41 are both abutted by the stopper 2
  • the two second protruding portions 42 are also abutted by the stopper 2 , which further ensures that The protruding portion is accommodated in the accommodating portion and does not escape from the accommodating portion.
  • the structure of the first clamp arm 1 is different from that of the second clamp arm 1'.
  • the structure of the first clamp arm 1 is the same as that of the previous embodiment.
  • the difference in structure between the second clamp arm 1' and the first clamp arm 1 is that the first part 52 of the guide surface 51 of the first guide portion 15 of the second clamp arm 1' includes a stroke extension structure, and the second clamp arm 1' has a stroke extension structure.
  • the first portion 52 of the guide surface 51 of the second guide portion 16 also includes a stroke extension structure.
  • the stroke extension structure is a dimple 80 .
  • the stroke extension structure makes the stroke of the first gripping arm 31 of the clip 10 longer, and the distance that the second gripping arm 32 moves towards the far side is greater than the distance that the first gripping arm 31 moves towards the far side at the same time, thereby making the clip 10 rotates in the counterclockwise direction in FIG. 39 during the movement, so that the first protruding part 41 and the second protruding part 42 of the clip 10 are on the same vertical line.
  • the state where the two protruding parts 42 are not on the same vertical line thereby avoiding the unbalanced movement of the clip 10 caused by the unbalanced force during the moving process, and also preventing the first protruding part 41 of the first clip arm 31 from entering the container first. shocks received by the Ministry.
  • the first protrusion 41 of the first clip arm 31 is located at the second protrusion of the second clip arm 32 part 42 in the distance.
  • the first guide portion 15 of the second clamp arm 1 ′ and the first portion 52 of the guide surface 51 of the second guide portion 16 may be flush with the upper surface of the bottom portion 11 . .
  • the clamp applier also includes a first elastic element 60 .
  • both the first jaw arm 1 and the second jaw arm 1 ′ include accommodating grooves, and the accommodating grooves are through grooves for accommodating the driving mechanism for feeding the clamp when the jaw assembly 100 is closed, especially the above-mentioned feeding
  • the clip feeding block 231 and part of the elastic push rod 232 of the clip driving mechanism prevent the first jaw arm 1 and the second jaw arm 1 ′ from interfering with the clip feeding driving mechanism when the jaw assembly 100 is closed.
  • the proximal end of the first clamp arm 1 has a protrusion 19 and the cartridge 220 has a hole 404 in which the protrusion 19 is received so that the proximal end of the first clamp arm 1 is pivotally connected to the distal end of the cartridge 220,
  • the proximal end of the second clamp arm 1' is pivotally connected to the distal end of the cartridge 220, one end of the first elastic element 60 is connected to the proximal end of the first clamp arm 1, and the other end is connected to the second clamp arm 1' connected to the proximal end.
  • the elastic force of the first elastic element 60 makes the proximal end of the first clamp arm 1 and the proximal end of the second clamp arm 1' move away from each other, thereby keeping the first clamp arm 1 and the second clamp arm 1' in an open state ( fully open state of the jaw assembly 100).
  • the proximal end of the first forceps arm 1 and the proximal end of the second forceps arm 1' are located in the casing 210. As shown in FIG. 42, the distal end of the casing 210 is connected to the lower surface of the first forceps arm 1 and the second forceps. The upper surface of the arm 1' is fitted.
  • the cannula 210 is moved by the jaw drive mechanism, and the distal end of the cannula 210 moves with it.
  • the distal end of the sleeve 210 moves distally, the distal end of the sleeve 210 cooperates with the lower surface of the first clamp arm 1 and the upper surface of the second clamp arm 1 ′ to drive the first clamp arm 1 and the second clamp arm The 1' pivots so that they approach each other, allowing the jaw assembly 100 to close. After the jaw assembly 100 is closed, the first elastic element is compressed to store energy.
  • the energy accumulated after the first elastic element 60 is compressed is released, and the elastic force of the first elastic element 60 makes the first clamp arm 1
  • the proximal end of the clamp arm 1' and the proximal end of the second clamp arm 1' are far away from each other, so that the first clamp arm 1 and the second clamp arm 1' are opened.
  • the first elastic element 60 is a U-shaped spring. After being compressed, the two arms of the U-shaped spring approach each other to realize energy storage. The U-shaped spring takes up less space and its elastic force is larger than that of the ordinary spring. The meaning of opening above is the same as opening.
  • the distance may be a direction generally facing the distance, including the longitudinal direction, and also the direction forming a certain angle with the longitudinal direction.
  • the difference between the present embodiment and the first embodiment is that the driving member selectively drives the clip feeding driving mechanism or the clip pushing driving mechanism under the action of the actuating member 330; in the first state, the driving member is separated from the clip pushing driving mechanism, It is combined with the clip feeding driving mechanism to drive the clip feeding driving mechanism to move; in the third state, the driving member is separated from the clip feeding driving mechanism, and is combined with the clip pushing driving mechanism to drive the pushing clip driving mechanism to move.
  • the driving member drives the clip-feeding drive mechanism to move
  • the clip-push drive mechanism does not move backwards to store energy, but does not move at the initial position without any movement; in this way, the clip-feeding action and the clip-pushing action can also be effectively ensured. Actions are not synchronized and no interference occurs.
  • the overall structure of the clamp applicator is simpler.
  • the jaw driving mechanism is sleeved on the clip feeding driving mechanism and the clip pushing driving mechanism, and is used to drive the jaw assembly 100 to close; in the above-mentioned third state, the driving member is combined with the jaw driving mechanism and the clip pushing driving mechanism at the same time to drive the jaw assembly 100 to close.
  • the jaw drive mechanism and the push clamp drive mechanism move synchronously.
  • the transmission mechanism has no second state.
  • the clip feeding drive mechanism includes a clip feeding drive tube 402 and a clip feeding assembly connected with the clip feeding drive tube 402.
  • the clip feeding drive tube 402 drives the clip feeding assembly to move to drive the clip 10 into the jaw assembly 100.
  • the specific structure is the same as the above;
  • the mouth driving mechanism includes a jaw driving tube 432 and a sleeve 210 connected with the jaw driving tube 432, and the specific structure is the same as the above;
  • the push-clamp driving member is provided with a plurality of side cavities 252 at intervals along the longitudinal direction, each side cavity 252 is correspondingly installed with a push-clamp block 253, and the push-clamp driving member drives the push-clamp block 253 to move.
  • the push-clamp drive The component is a push-clamp rod 251, and the specific structure of the push-clamp rod 251 is the same as that described above.
  • the structure of the driving member is the same as the structure of the switching mechanism described above or later, and will not be described here.
  • the push-clamp drive pipe 459 is sleeved on the clamp-feed drive pipe 402 , the push-clamp drive pipe 459 is coaxial with the clamp-feed drive pipe 402 , and the clamp-feeding assembly and the push-clamp drive member are located on both sides of the clamp box 220 Specifically, the clip-feeding assembly is located outside the clip box 220 , and the clip-pushing driver is located inside the clip box 220 .
  • the proximal end of the push-clamp driving tube 459 is flush with the proximal end of the jaw driving tube 432, and the distal end surface of the driving member is aligned with the proximal end surfaces of the two.
  • the proximal end of the push-clamp drive tube 459 and the proximal end of the jaw drive tube 432 may not be flush.
  • the distance from the distal end surface of the clamp to the push clip driving tube 459 may be equal to the distance between the distal end surface of the driving member abutting against the jaw driving tube 432 and the jaw driving tube 432 .
  • the driving member first drives the push-clamp drive mechanism to move to be combined with the jaw drive mechanism, and then drives the jaw drive mechanism and the push-clamp drive mechanism to move synchronously.
  • the jaw driving mechanism is sleeved on the clip feeding driving mechanism and the clip pushing driving mechanism.
  • the distance from the proximal end of the pushing clip driving tube 459 to the distal end of the driving member is smaller than the distance between the proximal end of the jaw driving tube 432 and the driving member.
  • the distance from the distal end in this way, during the movement of the driving member, it is first combined with the push-clamp drive tube 459, pushes the push-clamp drive tube 459 to move to be combined with the jaw drive drive tube, and then pushes the jaw drive tube 432 and the push-clamp drive tube 459 sports together.
  • the push-clamp driving tube 459 is sleeved on the clip-feeding driving tube 402 .
  • the jaw drive mechanism also includes a second reset member 446, such as an elastic element.
  • the elastic element is sleeved on the outside of the jaw driving tube 432, one end is in contact with the baffle 434 on the outer surface of the jaw driving tube 432, and the other end extends forward and is in contact with the inner wall of the shell 321 of the clamp.
  • the energy is stored when the jaw driving mechanism moves forward, and the elastic element recovers and deforms to release the energy so as to provide power for the restoration of the jaw driving mechanism.
  • the push clip driving mechanism also includes a third reset member 456, such as an elastic element.
  • the elastic element is used to store energy when the push-clamp drive mechanism advances, and the elastic element The energy is released by restoring the deformation to provide power for the reset of the push-clamp drive mechanism.
  • the clip feeding driving mechanism also includes a first restoring member 418, such as an elastic element.
  • One end of the elastic element is in contact with the protruding rib 436 on the inner wall of the push-clamp driving tube 459, and the other end extends backwards and abuts against the distal end surface of the clip-feeding driving tube 402.
  • the elastic element is used to store energy when the clip-feeding driving mechanism advances, The elastic element recovers the deformation and releases the energy to provide power for the reset of the clip feeding drive mechanism.
  • the driving element is combined with the jaw drive mechanism and the push-clamp drive mechanism at the same time, and the synchronous movement of the jaw drive mechanism and the push-clamp drive mechanism is taken as an example to introduce the realization of the clamp-applier to realize the feeding and clamping of the jaws.
  • the retraction stop end 354 of the clip feeding and retracting mechanism can abut against the clip feeding driving tube 402 after the switching mechanism is separated from the clip feeding driving mechanism to prevent the clip 10 in the jaw assembly 100 from retreating due to the retracting of the clip feeding driving mechanism.
  • the actuating member 330 moves from the middle position to the closed position, and the clip feeding and retracting mechanism is gradually separated from the clip feeding driving tube 402;
  • the mechanism is advanced, the jaw drive tube 432 drives the sleeve 210 forward to close the jaw assembly 100, the clamp drive mechanism is pushed forward to advance the remaining clamps 10 within the cartridge 220 by one station, and the actuator 330 moves to the closed position
  • the jaw assembly 100 is closed (the jaw closing action is completed) and the remaining clips 10 in the clamp box 220 are moved forward by one station (the clamping action is completed)
  • the clip feeding and retracting mechanism is completely separated from the clip feeding drive tube 402
  • the clip feeding driving tube 402 is reset under the action of the first reset member 418 .
  • the actuating member 330 is released, the jaw driving mechanism is reset under the action of the second reset member 446 , and the push-clamp driving mechanism is reset under the action of the third reset member 456 . That is to say, in the working process, the switching mechanism is first separated from the jaw drive mechanism and the push clamp drive mechanism, and combined with the clamp feed drive mechanism to drive the clamp feed drive mechanism to move, and then separated from the clamp feed drive mechanism, and is combined with the clamp feed drive mechanism.
  • the jaw drive mechanism and the push clamp drive mechanism are combined at the same time to drive the jaw drive mechanism and the push clamp drive mechanism to move synchronously.
  • the switching mechanism is respectively connected with the driving mechanism for feeding the clip, the driving mechanism for jaws and the driving mechanism for pushing the clip; the switching mechanism is in contact with the actuating member 330 for receiving power; under the action of the actuating member 330, the switching mechanism follows a preset sequence
  • the clip feeding driving mechanism is driven to perform the clip feeding action
  • the jaw driving mechanism is driven to perform the jaw closing action
  • the clip pushing driving mechanism is driven to perform the clip pushing action
  • the number of the actuating members 330 is one.
  • the advantage of this design is that the doctor operates one actuating member 330, which acts on the switching mechanism through the actuating member 330, and then acts on three different driving mechanisms---the driving mechanism for feeding the clip, the driving mechanism for the jaws, and the driving mechanism for pushing the clip , so that the three different driving mechanisms can complete the corresponding actions according to the preset sequence. That is, the doctor can operate one actuating member 330 to complete the three actions of the clip feeding action, the jaw closing action and the clip pushing action, and these three actions meet the preset sequence, and there will be no problem of mutual interference, which ensures the doctor's operation.
  • the operation is safe and smooth, and the operation is simple and user-friendly.
  • the three actions of the jaw closing action, the clamping action and the pushing action cannot be performed at the same time.
  • Jaws closing action, pushing action That is to say, the clip feeding action is performed first, and the jaw closing action and the clip pushing action are performed later.
  • Execute the action of pushing the clamp it can also be that in the second embodiment, the action of feeding the clamp is performed first, followed by the closing action of the jaws and the action of pushing the clamp.
  • the clamping action resynchronizes the jaw closing action and the pushing action.
  • the push-clamp drive mechanism is connected to the switch mechanism through the matching mechanism, and the push-clip drive mechanism and the switch mechanism move in opposite directions; Under the action, it is first separated from the jaw drive mechanism, and combined with the clip feed drive mechanism to drive the clip feed drive mechanism forward to perform the clip feeding action, and then separated from the jaw drive mechanism and combined with the jaw drive mechanism to drive the jaw drive.
  • the mechanism moves forward to perform the jaw closing action; when the switching mechanism drives the feeding driving mechanism and the jaw driving mechanism to advance, the matching mechanism is simultaneously driven to drive the push-clamp drive mechanism to retreat and store energy; the push-clamp drive mechanism includes a third reset
  • the actuator 456 is used to store the energy; the actuating element 330 is released, and the push-clamp drive mechanism advances under the action of the third reset element 456 to perform the push-clamp action.
  • the structure, positional relationship, connection relationship, motion relationship, etc. of the switching mechanism, the driving mechanism for feeding the clip, the driving mechanism for the jaw and the driving mechanism for pushing the clip are the same as those in the first embodiment, and will not be repeated here.
  • the switching mechanism is first separated from the jaw drive mechanism and the push-clamp drive mechanism, and is combined with the clamp-feeding drive mechanism to drive the clamp-feeding drive mechanism to move, and then is combined with the clamp-feeding drive mechanism.
  • the clip feeding drive mechanism is separated and combined with the jaw drive mechanism and the push clip drive mechanism at the same time to drive the jaw drive mechanism and the push clip drive mechanism to move synchronously; or the switching mechanism is first separated from the jaw drive mechanism and the push clip drive mechanism, and Combined with the clip feeding drive mechanism to drive the clip feeding drive mechanism to move, and then separated from the clip feeding drive mechanism, and combined with the push clip drive mechanism to drive the push clip drive mechanism to move to the jaw drive mechanism to drive the jaw drive mechanism. It moves synchronously with the push-clamp drive mechanism.
  • the structure, positional relationship, connection relationship, motion relationship, etc. of the switching mechanism, the driving mechanism for feeding the clip, the driving mechanism for the jaw and the driving mechanism for pushing the clip are the same as those in the third embodiment, and will not be repeated here.
  • the structure of the actuating member 330 is the same as the above, and will not be repeated here.
  • FIGS. 46 to 50 it is a third embodiment of the present invention, which is the same as the previous embodiment, and this embodiment relates to a clamp applicator.
  • the first clutch member includes a pivoting block 514.
  • the clutch switching mechanism is the same as that described above.
  • a first groove 524 is provided at the proximal end of the clip feeding drive mechanism.
  • the clutch part is combined with the clip feeding drive mechanism.
  • the second clutch member is the distal end surface of the switching mechanism body 500 .
  • the pivoting block 514 is pivotably disposed on the switching mechanism body 500 .
  • the pivoting block 514 includes a block-shaped body 516 , a first engaging notch 518 located at the lower end of the block-shaped body 516 , and a first rotating shaft located at the rear end of the block-shaped body 516 .
  • the pivot block 514 is pivotally connected to the switching mechanism body 500 through the first rotating shaft 520, the upper end of the pivot block 514 is provided with a hole 404 for installing the guide post 490, and the pivot block 514 passes through the guide post 490 and the guide rail in the housing 321 Slip fit.
  • the first clutch member further includes an elastic piece 522 disposed above the first guide surface 494, the elastic piece 522 provides downward force to the guide column 490, so that the first clutch member can be better combined with the clip feeding driving mechanism.
  • the first engaging notch 518 of the pivoting block 514 remains engaged with the first groove 524 of the clip feeding drive mechanism, the actuating member 330 drives the switching mechanism forward, and the pivoting block 514 moves forward and drives the feeding mechanism.
  • the clip driving mechanism moves to the distal end to perform the clip feeding action.
  • the guide post 490 moves to the second guide surface 496 along the inclined surface 498, the pivot block 514 turns upward around the first rotation shaft 520 to lift the first engaging recess.
  • the opening 518 is separated from the first groove 524, that is, it is separated from the clip feeding driving tube 402.
  • the distal end surface of the switching mechanism body 500 is combined with the proximal end of the jaw driving mechanism, thereby driving the jaw driving mechanism.
  • the present embodiment is different in the structure of the switching mechanism.
  • the switching mechanism does not include a moving part and a moving guide, and the switching mechanism includes a rotating arm 526 pivotally arranged on the switching mechanism body 500 , wherein the rotating arm 526 includes a rotating arm body 528 and is located on the rotating arm body 526 .
  • the second engaging notch 530 at the lower end of the 528 and the second rotating shaft 532 at the rear end of the rotating arm body 528.
  • the rotating arm 526 is pivotally connected with the switching mechanism body 500 through the second rotating shaft 532, and the switching mechanism body 500 is sleeved on the clip feeding drive mechanism.
  • the second engaging notch 530 of the rotating arm 526 engages with the second groove 534 of the clip feeding driving mechanism; the actuating member 330 drives the switching mechanism forward to drive the clip feeding driving mechanism to move to the distal end for feeding. Clamping action, when the rotating arm 526 moves to the proximal end of the jaw drive mechanism, the switching mechanism continues to be driven, and the inclined surface of the rotating arm 526 is turned upward under the guidance of the proximal guide surface of the jaw drive mechanism, thereby making the rotating arm
  • the second engaging notch 530 of 526 is disengaged from the second groove 534, and at this time, the distal end surface 508 of the switching mechanism moves to be combined with the jaw driving mechanism, thereby driving the jaw driving mechanism to advance.
  • the advantage of this design is that the structure of the switching mechanism is simplified and the overall structure is more compact.

Abstract

L'invention concerne un applicateur d'agrafes (1000), comprenant un ensemble mâchoire (100), une boîte à agrafes (220), un ensemble d'alimentation en agrafes et un ensemble de poussée d'agrafes, N agrafes (10) étant logées dans la boîte à agrafes, l'ensemble d'alimentation en agrafes est utilisé pour pousser une première agrafe à l'extrémité la plus en avant pour être introduite dans l'ensemble mâchoire, l'ensemble de poussée d'agrafes est utilisé pour pousser d'autres agrafes à l'exception de la première agrafe pour se déplacer vers l'avant par une station de travail, deux bras d'agrafe (31, 32) forment une surface de serrage lorsque la pince (10) est dans un état ouvert, l'ensemble d'alimentation en agrafes est situé sur un premier côté de la surface de serrage, l'ensemble de poussée d'agrafes est situé sur un second côté de la surface de serrage, et le premier côté est différent du second côté ; et l'ensemble d'alimentation en agrafes et l'ensemble de poussée d'agrafes de l'applicateur d'agrafes (1000) sont des composants indépendants, de telle sorte que la longueur avant de l'alimentation en agrafes et la longueur avant de la poussée d'agrafes n'ont pas besoin d'être égales, et la conception de taille de l'ensemble mâchoire (100) et la conception de taille de la boîte à agrafes (220) peuvent être indépendantes l'une de l'autre, de telle sorte que la structure est plus simple et plus compacte.
PCT/CN2021/143401 2020-12-31 2021-12-30 Applicateur d'agrafes WO2022143957A1 (fr)

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