WO2024109588A1 - Poignée de poussée et système de transport - Google Patents

Poignée de poussée et système de transport Download PDF

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Publication number
WO2024109588A1
WO2024109588A1 PCT/CN2023/131506 CN2023131506W WO2024109588A1 WO 2024109588 A1 WO2024109588 A1 WO 2024109588A1 CN 2023131506 W CN2023131506 W CN 2023131506W WO 2024109588 A1 WO2024109588 A1 WO 2024109588A1
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WO
WIPO (PCT)
Prior art keywords
ring
control
groove
pushing
rod
Prior art date
Application number
PCT/CN2023/131506
Other languages
English (en)
Chinese (zh)
Inventor
黄广念
王刚
陈翰文
余文超
Original Assignee
深圳市健心医疗科技有限公司
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
Priority claimed from CN202223198959.XU external-priority patent/CN219353996U/zh
Priority claimed from CN202211676682.9A external-priority patent/CN118252656A/xx
Application filed by 深圳市健心医疗科技有限公司 filed Critical 深圳市健心医疗科技有限公司
Publication of WO2024109588A1 publication Critical patent/WO2024109588A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body

Definitions

  • the invention belongs to the technical field of medical devices, and in particular relates to a pushing handle and a conveying system.
  • Mitral valve disease is a common disease among the elderly, including two common types: mitral regurgitation and mitral stenosis, of which mitral regurgitation is the most common. According to statistics, the incidence of mitral regurgitation in people over 75 years old is as high as 10%. Mild mitral regurgitation generally has no effect on normal life, while moderate to severe or severe mitral regurgitation requires interventional treatment. Traditional surgical treatment is open-chest treatment, which opens the heart with the support of an extracorporeal circulation machine to repair or replace the valve, but high-risk patients cannot tolerate it. The rise of interventional treatment in recent years has brought hope to high-risk patients with mitral regurgitation. Interventional treatment generally involves delivering the device to the lesion site through a catheter to repair or replace the valve.
  • a clamping device to clamp the anterior and posterior leaflets of the mitral valve to reduce the valve opening area, thereby achieving the purpose of treating reflux.
  • a control line is used to connect the clamping device, and the control line is operated by a push handle to control the clamping device to capture the mitral valve leaflets.
  • the end of the control line is not easy to fix, and it is easy to cause the head of the control line to loosen during long-term storage of the product.
  • the outer sheath and inner sheath will increase the pulling force of the control line when they are bent, and there is also a risk that the head of the control line will loosen from the operating end of the push handle.
  • the loosening of the control line will increase the effective length of the control line, affecting the normal operation of the clamping device, and in severe cases may lead to surgical failure.
  • the purpose of the present invention is to at least solve the problem that the control line of the existing mitral valve repair device is loosened and affects the normal operation of the clamping device.
  • the present invention proposes a pushing handle, which includes a handle body and a step locking device arranged on the handle body, and the step locking device includes a control mechanism and a compensation mechanism; the control mechanism controls a clamping device through a control line, and the control mechanism includes a sleeve and a control rod slidably connected to the sleeve, and the control line can be connected between the clamping device and the control rod; the compensation mechanism is used to adjust the moving stroke of the control rod.
  • the push handle of the present invention can adjust the moving stroke of the control rod through the compensation mechanism when the connecting piece is loose, thereby compensating for the loose length of the connecting piece and restoring the normal operation of the clamping instrument, thereby improving the surgical efficiency and success rate.
  • the push handle according to the present invention may also have the following additional technical features:
  • the compensation mechanism includes a stepping assembly and a limiting assembly
  • the stepping assembly includes a stepping positioning block connected to the sleeve and a stepping clamping strip axially arranged on the stepping positioning block, and the stepping clamping strip is used to clamp the control rod.
  • the stepping card strip includes a plurality of edges.
  • Axially spaced latch teeth are arranged on the step positioning block, and a plurality of the latch teeth are used to selectively latch the control rod; the proximal end of the control rod is connected to the control line, and the distal end of the control rod is provided with an elastic buckle, and the elastic buckle is used to selectively latch and adapt with one of the plurality of the latch teeth.
  • the limit assembly includes a limit ring rotatably connected to the sleeve, a push handle for controlling the rotation of the limit ring is provided on the outer side of the limit ring, and a stop block is provided on the inner side of the limit ring, and the stop block is used to limit the moving range of the control rod.
  • a support ring is provided at the proximal end of the limiting ring, the support ring is fixedly connected to the handle body, the limiting ring is rotatably connected to the support ring, and a clamping portion is provided between the support ring and the limiting ring.
  • a hanging platform is provided on the outer wall of the control rod, and the axial height of the stop block is greater than the axial height of the hanging platform; a guide groove is axially provided on the inner wall of the sleeve, and the hanging platform is slidably connected to the guide groove, and a avoidance groove is circumferentially provided on the side of the guide groove, and the avoidance groove is used to adapt to the stop block.
  • the locking teeth include a positioning tooth and a plurality of compensating teeth, the positioning tooth is arranged on the distal side of the stepping clamping bar, and the plurality of compensating teeth are arranged at intervals on the proximal side of the stepping clamping bar; when the stop block is located in the guide groove, the elastic clip can be engaged with the positioning tooth, and when the stop block is located in the avoidance groove, the elastic clip can be engaged with one of the compensating teeth.
  • the inner wall of the sleeve is axially
  • a return slide groove is provided, and the return slide groove and the guide slide groove are spaced apart in the circumferential direction of the sleeve.
  • a rotating platform is provided between the return slide groove and the guide slide groove, and the axial height of the rotating platform is smaller than the axial height of the hanging platform. The rotating platform is connected to the return slide groove and the guide slide groove.
  • control mechanism also includes a sleeve guide rod inserted into the sleeve, the sleeve guide rod is coaxially arranged with the sleeve, the control rod is axially provided with a through control cavity, the control rod is sleeved with the sleeve guide rod through the control cavity, so that the control rod can slide along the sleeve guide rod.
  • the sleeve guide rod is axially provided with a through connecting cavity, and the connecting cavity is connected to the control cavity and the interior of the handle body; the control line passes through the connecting cavity and the control cavity in sequence.
  • an end cap is provided at the proximal end of the joystick, the end cap is detachably connected to the joystick, a sealing structure is provided between the joystick and the end cap, and the control line is connected to the sealing structure.
  • the pushing handle also includes a pushing guide rod and a tensioning device arranged at the distal end of the handle body, the tensioning device includes a tightening block and an elastic ring, the proximal end of the pushing guide rod passes through the distal end of the handle body and enters the interior of the handle body, and the pushing guide rod can move axially relative to the handle body, the elastic ring and the tightening block are both movably mounted on the pushing guide rod, the tightening block and the elastic ring are both accommodated in the handle body, and the elastic ring is closer to the distal end of the handle body than the tightening block, and when the tightening block is pressed against the elastic ring, the pushing guide rod is stationary relative to the handle body.
  • the tensioning device includes a tightening block and an elastic ring
  • the tensioning device also includes a distal cover, the proximal end of the pushing guide rod passes through the distal cover and enters the handle body, and the distal cover rotates relative to the handle body around the longitudinal center axis of the handle body, and the distal cover is threadedly engaged with the clamping block.
  • the distal cover rotates relative to the handle body, the distal cover drives the clamping block to move toward or away from the elastic ring.
  • a plurality of claw structures are provided at one end of the clamping block close to the elastic ring, and the ends of the plurality of claw structures close to the elastic ring are inclined toward the pushing guide rod to form a contraction structure.
  • the present invention also proposes a delivery system, which includes a push handle as described in any of the above items and a delivery sheath connected to the push handle, the clamping device is arranged at the distal end of the delivery sheath, the clamping device includes a hook, and the control line is detachably connected to the hook.
  • FIG1 is a schematic diagram of the overall structure of a push handle according to an embodiment of the present invention.
  • FIG2 is an enlarged view of point A in FIG1 according to an embodiment of the present invention.
  • FIG3 is a schematic diagram of the internal structure of a push handle according to an embodiment of the present invention.
  • FIG4 is a schematic diagram of the internal structure of a step-by-step locking device according to an embodiment of the present invention.
  • FIG5 is a schematic diagram of the overall structure of a step-by-step locking device according to an embodiment of the present invention.
  • FIG6 is a schematic diagram of the structure of a control lever in an embodiment of the present invention.
  • FIG7 is a schematic diagram of the structure of the control lever when it is engaged in an embodiment of the present invention.
  • FIG8 is a cross-sectional view of a compensation mechanism in an embodiment of the present invention.
  • FIG9 is an enlarged view of point C in FIG7 according to an embodiment of the present invention.
  • FIG. 10 is a schematic diagram of the structure of a limit ring in an embodiment of the present invention.
  • FIG11 is an assembly diagram of a sleeve and a limiting ring in an embodiment of the present invention.
  • FIG. 12 is a schematic diagram of a limiting ring located in a avoiding groove according to an embodiment of the present invention.
  • FIG13 is a schematic diagram of the assembly of the push handle and the handle body in an embodiment of the present invention.
  • FIG. 14 is a schematic diagram of a stop block abutting against a hanging platform in an embodiment of the present invention.
  • FIG15 is an enlarged view of point D in FIG14 according to an embodiment of the present invention.
  • Fig. 16 is a cross-sectional view of the A-A section in Fig. 14 according to an embodiment of the present invention.
  • FIG17 is an enlarged view of point E in FIG15 according to an embodiment of the present invention.
  • FIG. 18 is a schematic diagram of the structure of the filter basket in an embodiment of the present invention.
  • FIG. 19 is a schematic diagram of the structure of the filter element in an embodiment of the present invention.
  • 20 is a schematic diagram of the overall structure of the assembly substrate in an embodiment of the present invention.
  • FIG. 21 is a schematic diagram of the assembly structure of the assembly substrate in an embodiment of the present invention.
  • FIG. 22 is a schematic diagram of the exploded structure of the push handle in the embodiment of the present invention.
  • FIG. 23 is an enlarged view of point G in FIG. 22 .
  • FIG. 24 is an enlarged view of point H in FIG. 23 .
  • FIG. 25 is a schematic diagram of the three-dimensional structure of the distal cover and the locking member in an embodiment of the present invention.
  • 26 is a schematic diagram of the cross-sectional structure of the distal end of the push handle in an embodiment of the present invention.
  • Push handle 20. Handle body; 21. Operation hole; 30. Step locking device; 40. Clamping device; 41. Hook; 50. Delivery sheath; 100. Control mechanism; 110. Sleeve; 111. Guide slide; 112. Avoidance groove; 113. Return slide; 114. Rotating platform; 120. Control rod; 121. Control cavity; 122. Grip; 123. End cover; 124. Scale structure; 130. Elastic buckle; 140. Hanging table; 150. Sleeve guide rod; 151. Connecting cavity; 152. Sealing gasket; 160. Push guide rod; 200. Compensation mechanism; 210. Step assembly; 211. Step positioning block; 212. Step clamping strip; 213. Clamping tooth; 214. Positioning tooth; 215. Compensation tooth; 220.
  • Limit assembly 221.
  • spatially relative terms may be used herein to describe the relationship of one element or feature relative to another element or feature as shown in the figures, such as “inside”, “outside”, “inner side”, “outer side”, “below”, “below”, “above”, “above”, etc.
  • Such spatially relative terms are intended to include different orientations of the device in use or operation in addition to the orientation depicted in the figures.
  • proximal and distal refers to the end close to the operator and “distal” refers to the end away from the operator.
  • axial direction should be understood in this patent to mean the direction in which the interventional element is pushed in and out, and the direction perpendicular to the "axial direction” is defined as the "radial direction”.
  • Embodiment 1 the embodiment of the present invention proposes a push handle 10, wherein, as shown in FIGS. 1 to 4, it comprises a handle body 20 and a step locking device 30 disposed on the handle body 20, the step locking device 30 comprises a control mechanism 100 and a compensation mechanism 200, the control mechanism 100 comprises a step locking device 30 disposed on the handle body 20, and the step locking device 30 comprises a control mechanism 100 and a compensation mechanism 200, The control mechanism 100 and the compensation mechanism 200 are respectively arranged on the handle body 20, and the control mechanism 100 controls the clamping device 40 through the control line 300.
  • the control mechanism 100 includes a sleeve 110 and a control rod 120, the control rod 120 is slidably connected in the sleeve 110, and the sleeve 110 is fixedly arranged in the handle body 20.
  • control line 300 One end of the control line 300 is connected to the clamping device 40, and the other end of the control line 300 is connected to the control rod 120.
  • the control line 300 is driven to move by pushing and pulling the control rod 120, thereby controlling the clamping device 40.
  • the material of the control line 300 is polyethylene, PET, e-PTFE or PTFE line.
  • the control line 300 needs to be detachably connected to the control rod 120 and the clamping device 40.
  • the operator separates the proximal end of the control line 300 from the control rod 120, and then pulls the control line 300 out of the handle body 20.
  • the pulling force on the control line 300 will be increased when the delivery sheath 50 is bent during the operation.
  • the delivery sheath 50 is always in a bent state, and the long-term bending of the delivery sheath 50 will also increase the pulling force on the control line 300.
  • the increase in the pulling force of the control line 300 will cause the part where the control line 300 and the joystick 120 are detachably connected to slide, thereby increasing the actual effective length of the control line 300. If the part where the control line 300 is connected to the joystick 120 is loose, it will affect the normal operation.
  • control line is usually removed from the joystick, the control line is tightened and then reconnected to the joystick, and then the operation is restarted. This method will greatly increase the operation time and difficulty.
  • the clamping device 40 when the clamping device 40 does not extract the control line 300 and release the action, if it is found that the clamping device 40 is hooked or entangled with the tendon during the surgical operation, the clamping device 40 can be straightened to get rid of the tendon and the operation can be restarted. Or when the clamping device 40 needs to be replaced, the clamping device 40 can be straightened and recovered, and removed from the body for replacement. As shown in FIG2, when the clamping device 40 is recovered, if its opening size is larger than the inner diameter of the delivery sheath 50, the clamping device 40 will be stuck at the tube opening of the delivery sheath 50, resulting in failure of recovery.
  • a compensation mechanism 200 is provided on the handle body 20 of the push handle 10, and the compensation mechanism 200 is used to adjust the movement stroke of the control rod 120. If the clamping device 40 cannot be smoothly recovered due to the loosening of the control line 300, the movement stroke of the control rod 120 can be adjusted by the compensation mechanism 200, thereby compensating for the length of the loosened control line 300, and then the normal operation of the clamping device 40 can be quickly restored, thereby improving the efficiency and success rate of the operation.
  • the compensation mechanism 200 includes a stepping assembly 210 and a limiting assembly 220.
  • the stepping assembly 210 includes a stepping positioning block 211 and a stepping clamping strip 212.
  • the stepping positioning block 211 is connected to the sleeve 110.
  • the stepping clamping strip 212 is axially arranged on the stepping positioning block 211.
  • the stepping clamping strip 212 is arranged toward the inner direction of the sleeve 110.
  • the stepping clamping strip 212 is used to control the movement stroke of the control rod 120.
  • the stepping clamping strip 212 includes a plurality of latching teeth 213 arranged axially on the stepping positioning block 211 at intervals.
  • the plurality of latching teeth 213 are used to respectively clamp the stepping positioning block 211 and the stepping clamping strip 212.
  • the control rod 120 is connected to be fixed at different strokes.
  • the proximal end of the control rod 120 is connected to the control line 300 , and the distal end of the control rod 120 is provided with an elastic buckle 130 , which is engaged with the latching teeth 213 .
  • the latching teeth 213 on the stepping clamping strip 212 include positioning teeth 214 and compensating teeth 215.
  • the positioning teeth 214 are arranged on the distal side of the stepping clamping strip 212, and the compensating teeth 215 are arranged on the proximal side of the positioning teeth 214.
  • a plurality of compensating teeth 215 are arranged, and the plurality of compensating teeth 215 are arranged at intervals.
  • the positioning teeth 214 are used to clamp the control rod 120 when the control line 300 is not loose.
  • the plurality of compensating teeth 215 are used to perform graded compensation for the moving stroke of the control rod 120 after the control line 300 is loose.
  • step positioning blocks 211 and step clamping strips 212 are provided on both sides of the sleeve 110, and the control rod 120 is provided with two elastic buckles 130 corresponding to the step clamping strips 212 on both sides, so as to balance the clamping relay forces on both sides.
  • the control line 300 When manipulating the clamping device 40, the control line 300 needs to be pulled toward the proximal end. For example, when the clamping device 40 is a mitral valve clip, the control line 300 causes the clamping device 40 to open and clamp tissue structures such as the mitral valve through the hook 41. After the clamping device 40 is opened, the clamping device 40 needs to be kept in the open state, and then the doctor fine-tunes the position and state of the clamping device 40 through the conveying device so that the clamping device 40 accurately captures tissue structures such as the mitral valve.
  • the operating rod 120 As described above, after the operating rod 120 is moved to pull the control line 300 to open the clamping device 40, the operating rod 120 needs to be axially fixed so that the doctor can free his hands and further operate other components of the push handle 10.
  • the present application uses the positioning teeth 214 to clamp and fix the operating rod 120. When the control line 300 is not loose, the positioning teeth 214 can be used to fix the operating rod 120. 214
  • the control rod 120 can be fixed by snapping.
  • control rod 120 When the control line 300 and the control rod 120 are loose, the actual control length of the control line 300 increases, and the control rod 120 needs to be moved a longer distance to compensate for the loose length of the control line 300.
  • the control rod 120 After the elastic buckle 130 of the control rod 120 is engaged with the positioning tooth 214, the control rod 120 is further moved toward the proximal end, so that the elastic buckle 130 is engaged with the compensation tooth 215.
  • the multiple compensation teeth 215 are spaced apart in the axial direction. When the elastic buckle 130 is engaged with different compensation teeth 215, the control rod 120 achieves compensation of different distances.
  • four compensation teeth 215 are provided on the stepping clamping bar 212.
  • the compensation stroke of the control lever 120 can be adjusted in stages, thereby adapting to different loosening lengths of the control line 300, thereby preventing the control lever 120 from pulling the control line 300 too tight after the compensation mechanism 200 is turned on, thereby preventing the control line 300 from breaking or further loosening due to excessive pulling force.
  • the limiting assembly 220 is used to control the engagement of the latching teeth 213 of the operating rod 120 with the positioning teeth 214 , or to enable the latching teeth 213 of the operating rod 120 to engage with the compensation teeth 215 .
  • the limiting assembly 220 includes a limiting ring 221 rotatably connected to the sleeve 110, a push handle 222 for controlling the rotation of the limiting ring 221 is disposed on the outer side of the limiting ring 221, and a stop block 223 is disposed on the inner side of the limiting ring 221, and the stop block 223 is used to limit the movement stroke of the control rod 120.
  • An operation hole 21 is disposed on the handle body 20, and after the step locking device 30 is assembled with the handle body 20, the push handle 222 is located in the operation hole 21, and the push handle 222 protrudes from the handle body 20, so as to facilitate the doctor's operation.
  • a hanging platform 140 is provided on the outer wall of the control rod 120, and the axial height of the stop block 223 is large.
  • the axial height of the hanging platform 140 is such that the stop block 223 can block the movement of the hanging platform 140 in the axial direction.
  • a guide groove 111 is axially arranged on the inner wall of the sleeve 110, and the hanging platform 140 is slidably connected to the guide groove 111.
  • the side of the guide groove 111 is circumferentially arranged with a avoidance groove 112, and the avoidance groove 112 is adapted to the stop block 223.
  • the stop block 223 When the stop block 223 is located in the guide groove 111, the stop block 223 can block the movement path of the hanging platform 140; when the stop block 223 is located in the avoidance groove 112, there is no obstruction in the guide groove 111, and the hanging platform 140 can continue to slide along the guide groove 111.
  • the limit ring 221 can rotate along the circumference of the sleeve 110, and the operator drives the limit ring 221 to rotate by operating the push handle 222.
  • the stop block 223 is located in the guide groove 111 under the drive of the limit ring 221, since the axial height of the stop block 223 is greater than the axial height of the hanging platform 140, the stop block 223 blocks the hanging platform 140 in the axial direction.
  • the hanging platform 140 moves axially toward the proximal end along the guide groove 111, it eventually abuts against the stop block 223 and cannot continue to slide toward the proximal end.
  • the control rod 120 moves synchronously with the hanging platform 140.
  • the hanging platform 140 is blocked by the stop block 223 and cannot continue to slide toward the proximal end, the movement of the control rod 120 toward the proximal end is restricted.
  • the elastic buckle 130 at the distal end of the control rod 120 is engaged with the positioning tooth 214, so that the movement of the proximal end and the distal end of the control rod 120 is restricted, thereby achieving the axial fixation of the control rod 120 and the sleeve 110.
  • the control line 300 arranged on the control rod 120 moves axially toward the proximal end under the drive of the control rod 120, and drives the clamping device 40 to deform, thereby completing the control of the clamping device 40.
  • a return slot 113 is also provided on the inner wall of the sleeve 110.
  • the return slot 113 is provided along the axial direction of the sleeve 110.
  • the return slot 113 and the guide slot 111 are spaced apart in the circumferential direction of the sleeve 110.
  • the return slot 113 and the guide slot 111 are spaced apart in the circumferential direction by 90 degrees.
  • a rotating platform 114 is provided between the return slot 113 and the guide slot 111.
  • the axial height of the rotating platform 114 is less than the axial height of the hanging platform 140, so that the rotating platform 114 is connected to the return slot 113 and the guide slot 111, so that the hanging platform 140 can move between the return slot 113 and the guide slot 111 along the rotating platform 114.
  • the hanging platform 140 can rotate along the rotating platform 114 in the circumferential direction.
  • the control rod 120 is rotated to disengage the elastic buckle 130 from the positioning clamping tooth 213. Since the axial height of the rotating platform 114 is less than the axial height of the hanging platform 140, the movement of the hanging platform 140 is not hindered.
  • the control rod 120 is rotated, the hanging platform 140 moves from the guide chute 111 to the return chute 113 through the rotating platform 114.
  • the hanging platform 140 moves into the return chute 113, the hanging platform 140 is slidably connected with the return chute 113, and the control rod 120 can move axially. At this time, the control rod 120 can be moved toward the far end, so that the control line 300 moves toward the far end with the movement of the control rod 120.
  • a support ring 230 is provided at the proximal end of the limiting ring 221 .
  • the support ring 230 is fixedly connected to the handle body 20 .
  • the limiting ring 221 is rotatably connected to the support ring 230 .
  • a clamping portion 240 is provided between the support ring 230 and the limiting ring 221 .
  • the engaging portion 240 includes a stopper 241 and an unlocking member 242, and the stopper 241 and the unlocking member 242 are respectively arranged on the inner wall of the support ring 230.
  • the engaging portion 240 also includes a stopper 224 arranged on the outer wall of the stopper ring 221, and the stopper 241 and the unlocking member 242 are used to respectively engage the stopper 224.
  • the stopper block 223 is located in the guide slot 111, so that the stopper block 223 can abut against the hanging platform 140 to limit the movement of the control rod 120 toward the proximal end.
  • the stopper block 223 When the limiter 224 is engaged with the unlocking clamp 242, the stopper block 223 is located in the avoidance groove 112 to make the guide slot 111 unobstructed, so that the hanging platform 140 can continue to move toward the proximal end, so that the movement stroke of the control rod 120 is increased, thereby compensating for the length of the loosened control line 300.
  • the control mechanism 100 further includes a sleeve guide rod 150 inserted into the sleeve 110, the sleeve guide rod 150 is coaxially arranged with the sleeve 110, and the control rod 120 is axially provided with a through control cavity 121, and the control rod 120 is sleeved with the sleeve guide rod 150 through the control cavity 121, so that the control rod 120 can slide along the sleeve guide rod 150.
  • the sleeve guide rod 150 is fixedly connected to the handle body 20 and sleeved with the control rod 120. When the control rod 120 moves along the axial direction of the sleeve 110, the sleeve guide rod 150 guides the control rod 120.
  • a sealing gasket 152 is arranged between the sleeve guide rod 150 and the control rod 120.
  • the sleeve guide rod 150 is provided with a through connection cavity 151 along the axial direction, and the connection cavity 151 is connected to the control cavity 121 and the inside of the handle body 20.
  • the control line 300 passes through the connection cavity 151 and the control cavity 121 in the handle body 20 in sequence, the proximal end of the control line 300 is connected to the control rod 120, and the distal end of the control line 300 is connected to the clamping device 40.
  • an end cap 123 is provided at the proximal end of the control rod 120 , and the end cap 123 is detachably connected to the control rod 120 , a sealing structure 400 is provided between the control rod 120 and the end cap 123 , and the control line 300 is connected to the sealing structure 400 .
  • a gripping portion 122 is disposed on the control rod 120 , and the operator operates the control rod 120 through the gripping portion 122 .
  • the sealing structure 400 is disposed at the proximal end of the gripping portion 122 .
  • the scale structure 124 When the control rod 120 is moved, the scale structure 124 is located outside the handle body 20, so that the doctor can observe the moving stroke of the control rod 120.
  • the scale structure 124 is printed on the control rod 120 by ink.
  • the scale structure 124 includes multiple axially arranged scale lines. When there is no need to adjust the moving stroke of the joystick 120, if one scale line is observed, it means that the joystick 120 has moved into place; if the moving stroke of the joystick 120 needs to be compensated, the moving stroke of the joystick 120 can be determined by observing the multiple scale lines of the scale structure 124.
  • the sealing structure 400 includes a sealing groove 410, a sealing ring 420 and a fixing ring 430.
  • the sealing groove 410 is arranged at the proximal end of the control rod 120.
  • the sealing groove 410 is arranged in a ring shape.
  • the sealing ring 420 and the fixing ring 430 are arranged in the sealing groove 410 in sequence.
  • the fixing ring 430 is arranged on the proximal side of the sealing ring 420.
  • the proximal end of the control line 300 is wound and fixed with the fixing ring 430.
  • the end cap 123 is threadedly connected to the proximal end of the control rod 120, and a notch 411 is provided at the proximal end of the sealing groove 410, and the control line 300 is connected to the fixing ring 430 through the notch 411.
  • a first groove 440 is formed between the fixing ring 430 and the side wall of the sealing groove 410, and a second groove 450 is formed between the fixing ring 430 and the sealing ring 420.
  • the control line 300 is wound and fixed in the first groove 440 and the second groove 450, respectively.
  • the sealing structure 400 of the present application squeezes the control line 300 through the sealing ring 420, the fixing ring 430 and the end cover 123.
  • the inner wall of the end cover 123 squeezes the fixing ring 430 and the sealing ring 420, so that the fixing ring 430 and the sealing ring 420 produce elastic deformation and squeeze the control line 300 together to form a continuous and stable pressing force, so that the control line 300 is pressed and fixed.
  • the control line 300 wound inside the end cover 123 is kept fixed by the clamping force and the squeezing of the threaded assembly at the same time, thereby ensuring that the control line 300 can be stored for a long time without being easily loosened.
  • control line 300 is alternately wound and fixed in the first groove 440 and the second groove 450.
  • the control line 300 is first tightened, then crosses the notch 411 to enter the first groove 440, and is wound and fixed in the first groove 440. Then, the control line 300 crosses the outer surface of the fixing ring 430 to enter the second groove 450, and is wound and fixed in the second groove 450.
  • control line 300 when the control line 300 is wound and fixed in the first groove 440 and the second groove 450, it can be wound for several turns, for example, 3-5 turns, so that there is a certain clamping force between the control line 300 and the sealing structure 400, and when the end cover 123 is tightened, the fixing ring 430 and the sealing ring 420 press the control line 300 more tightly under compression to fix the control line 300.
  • control line 300 is wound and fixed in the second groove 450
  • the control line 300 is turned back to the first groove 440 across the outer surface of the fixing ring 430, and is wound and fixed in the first groove 440 again, so that the control line 300 is alternately wound and fixed in the first groove 440 and the second groove 450, so that the control line 300 is fixed more firmly, avoiding The control line 300 is loose.
  • the end cover 123 is screwed and fixed on the control rod 120, so that the fixing ring 430 and the sealing ring 420 squeeze the position where the control line 300 is wound, and the control line 300 is pressed and fixed by the squeezing force.
  • control line 300 is not wound around the outer side of the sealing ring 420 of the sealing structure 400 of the present application, the outer edge structure of the sealing ring 420 is complete, and when the end cap 123 is screwed and fixed outside the sealing structure 400, the inner wall of the end cap 123 can fit closely with the outer edge of the sealing ring 420, thereby ensuring good sealing.
  • a fixing ring 430 is provided on the proximal side of the sealing ring 420, and the control line 300 is alternately wound around the two ends of the fixing ring 430, and a pressing force is applied to the sealing ring 420 and the fixing ring 430 through the end cap 123, so that the control line 300 is squeezed and fixed, thereby preventing the control line 300 from loosening.
  • control line 300 can be prevented from loosening while ensuring the sealing performance of the control rod 120.
  • the pushing handle 10 also includes a pushing guide rod 160 and a tensioning device 250 disposed at the distal end of the handle body 20, the tensioning device 250 includes a tightening block 251 and an elastic ring 252, the proximal end of the pushing guide rod 160 passes through the distal end of the handle body 20 and enters the interior of the handle body 20, and the pushing guide rod 160 can move axially relative to the handle body 20.
  • the elastic ring 252 and the tightening block 251 are both movably mounted on the pushing guide rod 160, the tightening block 251 and the elastic ring 252 are both accommodated in the handle body 20, and the elastic ring 252 is closer to the distal end of the handle body 20 relative to the tightening block 251.
  • the tensioning device 250 further includes a distal cover 253, through which the proximal end of the push guide rod 160 passes and enters the handle body 20, and the distal cover 253 rotates relative to the handle body 20 around the longitudinal center axis of the handle body 20.
  • the distal cover 253 is threadedly matched with the abutting block 251, and when the distal cover 253 rotates relative to the handle body 20, the distal cover 253 drives the abutting block 251 to move toward or away from the elastic ring 252.
  • the end of the abutting block 251 close to the elastic ring 252 is provided with a plurality of gripping structures 2511, and the ends of the plurality of gripping structures 2511 close to the elastic ring 252 are inclined toward the push guide rod 160 to form a contraction structure 2512.
  • the distal cover 253 rotates to drive the abutting block 251 to move in the direction close to the elastic ring 252
  • the contraction structure 2512 abuts against the elastic ring 252
  • the contraction structure 2512 enters the gap between the elastic ring 252 and the push guide rod 160
  • the gripping structure 2511 is squeezed and radially fits the push guide rod 160, so that the push guide rod 160 is fixed relative to the handle body 20.
  • the contraction structure 2512 is a slope-type structure toward the distal end.
  • a groove 2513 is provided on one side of the gripping structure 2511 close to the push guide rod 160, and the deformability of the gripping structure 2511 is improved by providing the groove 2513.
  • a through slot 2514 is disposed between two adjacent gripping claw structures 2511 .
  • the through slot 2514 includes a short through slot 2515 and a long through slot 2516 .
  • the two adjacent through slots 2514 are a short through slot 2515 and a long through slot 2516 .
  • the distal cover 253 rotates to drive the abutting block 251 to move toward the direction close to the elastic ring 252.
  • the distal cover 253 is continuously rotated, and the contraction structure 2512 enters the gap between the elastic ring 252 and the pushing guide rod 160.
  • the elastic ring 252 will gradually be mounted on the contraction structure 2512 due to the slope structure toward the far end.
  • the elastic ring 252 will squeeze the multiple gripping structures 2511, and the multiple gripping structures 2511 will contract toward the direction of the pushing guide rod 160.
  • the multiple gripping structures 2511 will radially fit the pushing guide rod 160 to fix the pushing guide rod 160 relative to the handle body 20.
  • the number of the gripping structures 2511 is set to 8.
  • the 8 gripping structures 2511 are arranged at intervals circumferentially at one end of the abutting block 251 close to the elastic ring 252. It can be understood that if the number of the gripping structures 2511 is greater than 8, the circumferential length of a single gripping structure 2511 is too small, which will result in the gripping structure 2511 being too weak and prone to breaking. If the number of the gripping structures 2511 is less than 8, the strength of a single gripping structure 2511 is too great, making it difficult for the gripping structure 2511 to deform and shrink, and thus unable to fit the push guide rod 160.
  • the gripping claw structure 2511 can be formed integrally with the abutting block 251, or can be formed by cutting and grinding the abutting block 251.
  • the gripping claw structure 2511 can also be made separately from the abutting block 251, and then connected to the abutting block 251 by gluing, snap connection, threaded connection, etc.
  • the pushing guide rods 160 of different sizes can be provided according to the different objects to be transported, and the pressing rods 160 of different sizes can be provided accordingly.
  • two grooves 2513 are arranged at intervals on a surface of each of the gripping claw structures 2511 close to the push guide rod 160.
  • the arrangement of the grooves 2513 improves the deformability of the gripping claw structure 2511, thereby preventing the gripping claw structure 2511 from being too deformable and being broken after being squeezed by the elastic ring 252.
  • the gripping claw structure 2511 can also better fit the push guide rod 160.
  • a through groove 2514 is arranged between two adjacent gripping claw structures 2511, that is, the two adjacent gripping claw structures 2511 are arranged at intervals by the through groove 2514. At the same time, the arrangement of the through groove 2514 ensures that the gripping claw structure 2511 can be retracted.
  • the two adjacent through grooves 2514 are a short through groove 2515 and a long through groove 2516. That is, the short through slots 2515 and the long through slots 2516 are alternately arranged on the circumference of the pressing block 251 near one end of the elastic ring 252.
  • the overall deformability of the plurality of the gripping structures 2511 is not too large or too small. If all the through slots 2514 are the short through slots 2515, the overall deformability of the plurality of the gripping structures 2511 is too small, and the gripping structures 2511 cannot shrink and fit the push guide rod 160.
  • the alternating arrangement of the short through slots 2515 and the long through slots 2516 can ensure the uniformity of the overall deformation of the plurality of gripping structures 2511, thereby preventing the gripping structures 2511 on one side from having a relatively strong deformation ability and the gripping structures 2511 on the other side from having a relatively weak deformation ability, thereby preventing the gripping structures 2511 from having no deformation ability.
  • the method of pressing the pushing guide rod 160 is to prevent the pushing guide rod 160 from being pressed against the pushing guide rod
  • the number of the grooves 2513 disposed on one side of each of the gripping claw structures 2511 close to the push guide rod 160 may be 1 or 3, etc.
  • two short through grooves 2515 and two long through grooves 2516 may be alternately disposed on the circumference of one end of the abutting block 251 close to the elastic ring 252.
  • the handle body 20 includes a locking member 2011, and the locking member 2011 includes a main body 2013 of a circular ring structure and two locking rods 2012 mounted on the inner side of the main body 2013.
  • the main body 2013 can be fixed in the distal end of the handle body 20 by means of snap fit, threaded connection, etc.
  • Two receiving holes 2014 penetrating the side wall of the main body 2013 are provided on the side wall of the main body 2013, which are used to respectively accommodate one of the locking rods 2012.
  • the distal cover 253 is provided with a knob portion 2531 and a matching portion 2532, and a matching groove 2533 is provided on the outer surface of the matching portion 2532 of the distal cover 253.
  • the locking rod 2012 is inserted into the locking member 2011, and the portion of the locking rod 2012 located inside the main body 2013 is accommodated in the matching groove 2533.
  • the locking rod 2012 cooperates with the matching groove 2533 to achieve position limiting, thereby achieving the matching of the distal cover 253 and the distal end of the handle body 20, and fixing the distal cover 253 on the distal end of the handle body 20.
  • the locking rod 2012 can be omitted, and a protrusion (not shown) is provided on the inner surface of the locking member 2011.
  • the protrusion can be integrally formed with the locking member 2011, or can be made separately and provided on the inner surface of the locking member 2011 by gluing, snap-fitting, inlaying, etc.
  • a silicone strip is provided on the inner surface of the locking member 2011 by gluing or inlaying.
  • the distal cover 253 is connected to the distal end of the handle body 20 by the cooperation between the protrusion and the cooperation groove 2533.
  • the number of the receiving holes 2014 may also be four, and the four receiving holes 2014 are arranged opposite to each other in pairs, that is, one locking rod 2012 may also be received in two opposite receiving holes 2014. In this case, both ends of the locking rod 2012 are respectively received in the two opposite receiving holes 2014, and the middle portion of the locking rod 2012 is mounted on the inner wall of the main body 2013.
  • the present invention also proposes a delivery system, which, as shown in Figures 1 and 2, includes the pushing handle 10 as described above and a delivery sheath 50 connected to the handle, and a clamping device 40 is arranged at the distal end of the delivery sheath 50.
  • the clamping device 40 includes a hook 41, and the control line 300 is detachably connected to the hook 41.
  • the clamping device 40 may be a mitral valve clip, and the hook 41 is used to clamp the mitral valve tissue.
  • the hook 41 can be pulled open to capture the mitral valve tissue.
  • the control line 300 is also moved toward the proximal end, and the hook 41 is straightened under the pulling action of the control line 300, and the opening of the hook 41 is smaller than the opening of the delivery sheath 50, so that the clamping device 40 can be recovered from the delivery sheath 50.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une poignée de poussée (10), qui comprend un corps de poignée (20) et un dispositif de verrouillage pas à pas (30) disposé sur le corps de poignée (20). Le dispositif de verrouillage pas à pas (30) comprend un mécanisme de commande (100) et un mécanisme de compensation (200). Le mécanisme de commande (100) commande un instrument de clampage (40) au moyen d'une ligne de commande (300) et le mécanisme de commande (100) comprend un manchon (110) et une tige de commande (120) reliée en coulissement au manchon (110). La ligne de commande (300) peut être reliée entre l'instrument de clampage (40) et la tige de commande (120). Le mécanisme de compensation (200) est conçu pour ajuster le mouvement de décalage de la tige de commande (120). Lorsque la ligne de commande (300) se relâche, le mouvement de décalage de la tige de commande (120) peut être ajusté au moyen du mécanisme de compensation (200) pour compenser la longueur de relâchement de la ligne de commande (300), ce qui restaure le fonctionnement normal de l'instrument de clampage (40) et améliore l'efficacité et le taux de réussite d'interventions chirurgicales.
PCT/CN2023/131506 2022-11-25 2023-11-14 Poignée de poussée et système de transport WO2024109588A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN202223198959.X 2022-11-25
CN202223198959.XU CN219353996U (zh) 2022-11-25 2022-11-25 控制手柄及输送系统
CN202211676682.9 2022-12-26
CN202211676682.9A CN118252656A (en) 2022-12-26 Pushing handle and conveying system

Publications (1)

Publication Number Publication Date
WO2024109588A1 true WO2024109588A1 (fr) 2024-05-30

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ID=91195168

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2023/131506 WO2024109588A1 (fr) 2022-11-25 2023-11-14 Poignée de poussée et système de transport

Country Status (1)

Country Link
WO (1) WO2024109588A1 (fr)

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB190921713A (en) * 1909-09-23 1910-01-13 John Parker Improvements in and relating to Automatic Regulators or Compensators for use in connection with Signal or other Wires, Ropes, Chains or Rigid Connections.
US4688555A (en) * 1986-04-25 1987-08-25 Circon Corporation Endoscope with cable compensating mechanism
US20190365550A1 (en) * 2016-12-15 2019-12-05 Venus Medtech (Hangzhou), Inc. Guidewire Adjuster and Delivery-System Control Handle
CN210408511U (zh) * 2019-04-12 2020-04-28 杭州诺茂医疗科技有限公司 介入医疗器械推送器及介入医疗器械输送系统
WO2022222855A1 (fr) * 2021-04-21 2022-10-27 上海申淇医疗科技有限公司 Système d'agrafage de valve manipulable
CN116327269A (zh) * 2022-11-25 2023-06-27 深圳市健心医疗科技有限公司 控制手柄及输送系统
CN219353996U (zh) * 2022-11-25 2023-07-18 深圳市健心医疗科技有限公司 控制手柄及输送系统
CN219940900U (zh) * 2022-12-26 2023-11-03 深圳市健心医疗科技有限公司 一种推送手柄以及输送系统

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB190921713A (en) * 1909-09-23 1910-01-13 John Parker Improvements in and relating to Automatic Regulators or Compensators for use in connection with Signal or other Wires, Ropes, Chains or Rigid Connections.
US4688555A (en) * 1986-04-25 1987-08-25 Circon Corporation Endoscope with cable compensating mechanism
US20190365550A1 (en) * 2016-12-15 2019-12-05 Venus Medtech (Hangzhou), Inc. Guidewire Adjuster and Delivery-System Control Handle
CN210408511U (zh) * 2019-04-12 2020-04-28 杭州诺茂医疗科技有限公司 介入医疗器械推送器及介入医疗器械输送系统
WO2022222855A1 (fr) * 2021-04-21 2022-10-27 上海申淇医疗科技有限公司 Système d'agrafage de valve manipulable
CN116327269A (zh) * 2022-11-25 2023-06-27 深圳市健心医疗科技有限公司 控制手柄及输送系统
CN219353996U (zh) * 2022-11-25 2023-07-18 深圳市健心医疗科技有限公司 控制手柄及输送系统
CN219940900U (zh) * 2022-12-26 2023-11-03 深圳市健心医疗科技有限公司 一种推送手柄以及输送系统

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