WO2013067662A1 - 一种夹持或结扎装置 - Google Patents

一种夹持或结扎装置 Download PDF

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Publication number
WO2013067662A1
WO2013067662A1 PCT/CN2011/002006 CN2011002006W WO2013067662A1 WO 2013067662 A1 WO2013067662 A1 WO 2013067662A1 CN 2011002006 W CN2011002006 W CN 2011002006W WO 2013067662 A1 WO2013067662 A1 WO 2013067662A1
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WO
WIPO (PCT)
Prior art keywords
ligating
tube
clamping
ligation
piece
Prior art date
Application number
PCT/CN2011/002006
Other languages
English (en)
French (fr)
Inventor
朱俭
Original Assignee
Zhu Jian
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 Zhu Jian filed Critical Zhu Jian
Publication of WO2013067662A1 publication Critical patent/WO2013067662A1/zh

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227Spring clips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128Surgical 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
    • A61B17/1285Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2905Details of shaft flexible

Definitions

  • the present invention pertains to a clamping or ligation device, and more particularly to a clamping device for clamping living tissue by a clip. Background technique
  • the tissue is clamped using a clip that is used in combination with an endoscope to hold a living tissue in a body cavity by a clip.
  • the clip has a pair of clamping arms that are expanded by tension, and the pressing tube is embedded in the clip so that the pair of clamping arms hold the tissue together, and The pair of grip arms are held closed by the pressing tube, thereby clamping the living tissue.
  • the holding device of the patent publication No. 03/030746 A1 which has a clip attached to the front end of the spring tube, the clip having a pair of openable and closable clips. Further, the base of the clip is pulled into the spring tube to close the clip to hold the living tissue, and the clip is held in a closed state, thereby clamping the living tissue.
  • the Chinese Patent No. 200580044431. 7 has a clip that can be accommodated in the spring tube. When in use, the clip needs to be pushed out to expose the clip to the outside of the spring tube, and then the clip arm is opened and closed. Further, the pressing tube having an elastic structure encloses the clip on the clip so that the pair of clips hold the tissue together, and the pair of grip arms are held closed by the pressing tube, thereby clamping the living tissue.
  • the clip device of Japanese Patent Publication No. 2004-121285 may have a possibility of improperly holding the living tissue in a clinical position.
  • the retaining device is retained in the body for a long period of time, and the tail portion after release is sharp, and the surface of the opposite channel wall is easily scratched when released in a narrow space or a thin cavity wall. Or perforation, not suitable for small space cavity release or for the clamping of living body thinner wall tissue.
  • the clip of the Chinese Patent No. 200580044431. 7 can not be stored once it is sent out of the spring hose.
  • the sharp claw angle of the clip is bare exposed, because the claw is easy to damage the inner wall of the passage, or the claw is hung on the inner wall of the passage, which needs to be enlarged.
  • Push force When a temporary condition occurs, the clip can only be pulled off and then the remaining gripping device is withdrawn. The clip was not effectively used.
  • the present invention has been made in view of the above problems, and an object thereof is to provide a ligation device which is most suitable for ligation of a tissue in a living organism.
  • a clamping device includes: a ligating portion (1000) that can be opened and closed a plurality of times and can be ligated from a new position a plurality of times, and can be released for a period of time in the biological cavity; the ligating portion ( 1000)
  • the ligating piece (1100) is provided with a portion of the accommodating and enveloping tube (1200), and the lower portion of the extending and shrinking tube (1200) can be pushed and pulled by an external force, and the tube is embedded in the tube (1200).
  • the separation piece (1210) or (1302) or the separation pin (1303) provided or equipped, it can realize repeated multiple opening and closing and new positioning ligation, which is convenient for the doctor to ligature the tissue that needs to be ligated more quickly and accurately.
  • the release of the ligation portion (1000) can be separated from other parts of the ligation device, and the body cavity of the living organism is retained for a certain period of time to be ligated, and finally the ligation portion (1000) After a period of time, it falls off on its own and is excreted by living organisms;
  • a conveying portion (2000) is substantially a flexible tubular structure, the distal end of which is connected to the ligating portion (1000) through a connecting portion (7000), and the proximal end is connected to the operating portion (4000);
  • the ligation portion (1000) for ligation is transported to the lesion portion of the living organism by the endoscope clamp, and the traction portion (5000) is interposed therebetween, and is used to offset the operation portion (4000) when the operation portion (4000) is operated.
  • a sheath tube (3000) wherein the sheath is a generally tubular flexible structure having a continuous smooth inner and outer wall, and at least one passage thereof allows the ligation portion (1000) and the transport portion (2000) to pass freely therein,
  • the length of the ligature (1000) is exceeded, and the ligature (1000) is protected from the ligature (1100) to prevent damage to the body cavity of the forceps and living organisms.
  • Channels (3133), (3123), (3122) are used to transport liquids or gases or to pass some other instruments;
  • a traction portion (5000) penetrating through the conveying portion (2000) the main body of which is a traction wire (5200) having a substantially flexible filament structure, and a connecting hook (5100) is connected at a distal end thereof, and the proximal end is connected
  • the catheter (5300), the connecting hook (5100) is hinged for the ligating piece (1100) of the ligature (1000), and the sliding handle (4200) of the operating portion (4000) is pulled back through the catheter (5300), traction
  • the conduction of the wire (5200) drives the connecting hook (5100) to pull the ligating piece (1100) backward, and then the hook portion (5120) of the connecting hook (5100) and the ligating piece (1100) abut (1120) Contacting and transmitting tension through the ligating piece (1100) into the submerged tube, forcing the separate ligating pieces (1100) to close together with each other under the action of the inner hole (1260) of the covering tube (1200); (4000)
  • the sliding handle (4200) is
  • the connecting hook (5100) pushes the ligating piece (1100) forward, the connecting hook ( 5100) Abutment portion of the resisting portion and the ligating piece (1100) (1120) And a touch sheet by ligating its thrust transmitting (1100) entrapping projecting tube (1200) acts and the separation plate (1210) (1302) or isolated pin (1303) so that the sheet ligation (1100) each opening.
  • a clamping device is characterized in that the stopper (6000) has an elastic structure and can be caught on the tube body of the conveying portion (2000) and located at the operating portion (4000) and the sheath tube ( Between 3000), the function is to feed the ligation device through the endoscope clamp so that the front end of the sheath tube (3000) always exceeds the ligation portion (1000) - a certain distance to protect the body cavity of the forceps and living organisms from being The sharp edge of the sharp ligature (1100) is damaged and also protects the position of the relatively fragile ligature (1000) in the ligation device from the delivery (2000), which does not damage premature separation when transported through the caliper , causing the device to fail;
  • a clamping device is characterized in that the connecting portion (7000) has a wing portion (7110) and a sleeved tube (1200) and a connecting tube (2100) that are sleeved together. Corresponding side hole (1220),
  • the pin hole is formed so that the tube (1200) and the connecting tube (2100) are connected together through the connecting portion (7000) to form a unitary structure, and can withstand a certain pushing force, when the doctor observes the ligature through the endoscope (1000)
  • the sliding handle (4200) can be pulled by force, and the tail end (5150) of the connecting hook (5100) and the urging part (7130) of the connecting portion (7000) are connected.
  • the force applying portion (7130) continues to move, and when the blocking force reaches a certain level, the wings are inserted into the side holes (1220) and (2120) of the covering portion and the connecting tube (2100).
  • Fig. 1 is a view showing a ligation apparatus of a first embodiment of the present invention.
  • Fig. 2 is a schematic view showing the first embodiment of the present invention in which the ligature portion is retracted into the outer sheath tube.
  • Fig. 3 is a view showing the ligature portion of the first embodiment of the present invention.
  • Fig. 4 is a view showing the package tube of the first embodiment of the present invention.
  • Fig. 5 is a view showing the outer sheath tube of the first embodiment of the present invention.
  • Fig. 6 is a view showing a conveying portion of a first embodiment of the present invention.
  • Fig. 7 is a view showing a connecting pipe of a first embodiment of the present invention.
  • Fig. 8 is a view showing the traction portion of the first embodiment of the present invention.
  • Fig. 9 is a view showing the connection portion of the first embodiment of the present invention.
  • Fig. 10 is a schematic view showing the ligating portion of the first embodiment of the present invention.
  • Fig. 11 is a view showing the pre-ligation of the first embodiment of the present invention.
  • Fig. 12 is a view showing the separation of the connecting hook and the ligating sheet of the first embodiment of the present invention.
  • Fig. 13 is a view showing the separation of the ligation portion and the other portions of the ligation device according to the first embodiment of the present invention.
  • Fig. 14 is a schematic view showing a second embodiment of the ligating portion of the present invention.
  • Fig. 15 is a view showing a third embodiment of the ligating portion of the present invention.
  • Fig. 16 is a schematic view showing a fourth embodiment of the ligating portion of the present invention.
  • Fig. 17 is a view showing the second embodiment of the clad tube and the separator of the present invention.
  • Fig. 18 is a view showing a third embodiment of the clad tube and the separating pin of the present invention.
  • Fig. 19 is a view showing the fourth embodiment of the wrapped tube of the present invention.
  • Fig. 20 is a view showing a second embodiment of the outer sheath tube of the present invention.
  • Figure 21 is a view showing a third embodiment of the outer sheath tube of the present invention.
  • Fig. 22 is a view showing a second embodiment of the connecting pipe of the present invention.
  • Fig. 23 is a view showing a second embodiment of the connecting portion of the present invention.
  • Fig. 24 is a view showing a third embodiment of the joint portion of the present invention.
  • Fig. 25 is a view showing a fourth embodiment of the joint portion of the present invention.
  • Fig. 26 is a view showing a fifth embodiment of the joint portion of the present invention.
  • Fig. 27 is a view showing a sixth embodiment of the joint portion of the present invention.
  • Fig. 28 is a view showing a seventh embodiment of the joint portion of the present invention.
  • Fig. 29 is a view showing the eighth embodiment of the joint portion of the present invention. detailed description
  • the ligation portion (1000) and the other portion of the ligation device are separable, and the ligation portion (1000) is Installed at the front end of the ligation device and penetrated into the sheath tube (3000), the ligation portion (1000) is composed of a ligating piece (1100), a covering tube (1200), and a separating piece whose front end can be bent into 90° (1210) Composition, the ligature portion (1000) in this embodiment
  • the parts are made of stainless steel that can meet the corresponding biocompatibility, and the ligating piece (1100) of the ligature (1000) is combined with the separating tube (1200) and the separating piece (1210) provided thereon.
  • the ligating piece (1100) has reproducible opening and closing; the conveying part (2000) penetrates inside the sheath tube (3000) and, when in use, passes the ligature (1000) through the endoscope to clamp the ligature (1000)
  • the body of the conveying portion (2000) is a tubular body (2200) made of a tightly wound spring, which penetrates into the sheath tube (3000).
  • the flat steel wire is tightly wound;
  • the sheath tube (3000) is a continuous tubular structure with a flexible inner surface for accommodating the ligation portion (1000) and the delivery portion (2000) of the ligation device, and the proximal end of the sheath tube (3100) is connected with an easy-to-grip handle. (3200), in this embodiment, the sheath tube (3000) is a plastic tube of a single-channel PE material;
  • the operation portion (4000) is connected to the rear end of the pipe body (2200), and controls the opening, closing and releasing of the ligature portion (1000) by pushing and pulling the traction portion (5000); the operation portion (4000) has a fine
  • the long handle (4100) is equipped with a sliding handle (4200) that can slide the handle (4100) in the axial direction; in order to push and pull the sliding handle (4200) and the handle (4100), the handle (4100) Keeping it relatively motionless, with a finger ring (4120) at the end of the handle (4100);
  • the traction part (5000) is composed of a pulling wire (5200) connecting hook (5100), a duct (5300), and the like, which is freely penetrated in the tube body (2200) for operating the ligation portion (1000); the traction portion (5000) The end of the catheter through which the end is connected
  • the pulling wire (5200) is a single wire connected to the connecting hook (5100), and the hook portion (5120) at the front end of the connecting hook (5100) is connected with the ligating piece (1100).
  • the stopper (6000) has an elastic structure and can be caught on the tube body of the conveying portion (2000) and located between the operation portion (4000) and the sheath tube (3000), and the function is
  • the ligature device is fed through the endoscope clamp so that the front end of the sheath tube (3000) always exceeds the ligature (1000) at a fixed distance to protect the body cavity of the caliper and the living organism from being sharply ligated (1100).
  • the sharp edge is damaged, and at the same time, the position where the relatively fragile ligation portion (1000) of the ligation device is connected with the transport portion (2000) is protected, and the premature separation is not damaged when transported through the clamp, resulting in device failure;
  • the connecting portion (7000) has a wing portion (7110) and a corresponding side hole (1220) and (2120) of the sleeved tube (1200) and the connecting tube (2100) which are sleeved together to form a pin hole fit.
  • the structure is such that the enveloping tube (1200) and the connecting tube (2100) are connected together through the connecting portion (7000) to form a unitary structure, and the connecting structure can withstand a certain pushing and pulling force without being destroyed, when the doctor passes the endoscope After observing the ligature (1000) team to effectively ligature the living tissue, the sliding handle (4200) can be pulled by force. At this time, the tail end (5150) of the connecting hook (5100) and the connecting portion (7000) are applied.
  • the ligating piece (1100) of the ligating device of the present invention is generally formed in a "U" shape, and the ligating piece (1100) is provided with an abutting portion (1120) for connecting with the connecting hook ( 5100) hinged to transmit push and pull force to the ligating piece (1100);
  • the tube (1200) is a substantially stepped cylindrical structure, the front end of which is large and is provided with a separating piece (1210), and the separating piece (1210) is It needs to be bent inward by about 90° to form a blocking function; a part of the ligating piece (1100) can not be blocked in the tube (1200), and a part of the ligating piece (1100) can be contracted by external action.
  • the two arms (1110) of the ligating piece (1100) can be closed close together; the small step (1230) is used for wearing Into the distal end of the connecting tube (2100) (2130), the side wall of the small step end (1230) is provided with a side hole (1220) for penetrating the connecting portion (700 ⁇ wing portion (7110) forming a pin hole matching structure, the step end surface (1270) and the connecting tube The end face (2170) of (2100) is abutted against pressure;
  • a preferred embodiment of the present invention is a sheath tube (2000) of a ligation device having a single channel of a sheath material (3100) having a hollow interior and allowing a closed ligation portion (1000). And the conveying part (2000) is free to pass, the outer diameter is smaller than the endoscope clamp; the rear end is provided with a handle (3200) for easy grip;
  • the main body of the conveying portion (2000) of the ligation device of the present invention is a tubular body (2200) which is tightly wound by a flat steel wire and penetrates through the sheath tube (3000).
  • a connecting pipe (2100) is connected to the front end, and an operating portion (4000) is connected to the rear end, and a traction portion (5000) is inserted in the inner portion thereof.
  • the connecting pipe (2100) has a substantially cylindrical structure, and a stepped hole is arranged inside the connecting pipe (2100).
  • the side wall of the distal inner hole (2130) is provided with a side hole (2120) for the wing portion (7110) of the connecting portion (7000) to form a pin hole matching structure, and the inner hole (2130) is used for the inner hole (2130)
  • the small step end (1230) of the tube (1200) is inserted therein, and the end surface (2170) is used for the step end surface (1270) of the enveloping tube (1200) to abut against the pressure, and the abutting portions of the tube (1200) are abutted against each other.
  • (1220) and the side hole (2120) of the connecting pipe (2100) is substantially concentric, and the projection space is sufficient for the wing portion (7110) of the lower connecting portion (7000);
  • the traction wire (5200) of the traction portion (5000) of the preferred ligation device of the present invention is a single wire having a distal end welded with a connecting hook (5100) and a proximal end crimped with a catheter (5300).
  • the conduit (5300) is connected to the sliding handle (4200) for transmitting the pushing and pulling force from the operating portion (4000), and the hook portion (5120) of the connecting hook (5100) is hinged with the ligating sheet (1100);
  • the connecting portion of the ligation device of the present invention has a substantially "several" shape of an elastic structure having two wings (7110) and two elongated elastic portions. (7120) and a force applying portion (7130) for abutting the tail portion (5150) of the connecting hook (5100); the wing portion (7110) and the side hole (1220) of the tube (1200) and the connecting tube ( 2100)
  • the side hole (2120) constitutes a pin hole matching structure, and the covering tube (1200) and the connecting tube (2100) are integrally connected, and the pin hole matching structure can be applied to the applying portion (7130) with a certain external force. This pin hole mating structure is broken to separate the wrap tube (1200) from the connecting tube (2100).
  • the specific use method of the preferred embodiment of the present invention firstly closes the ligature portion by pulling the slider (4200 ) with a finger and retracts into the sheath tube (3000), and the stopper (6000) Engaged on the tube body (2200) of the conveying portion (2000) and located between the operating portion (4000) and the sheath tube (3000), at which time the sheath tube (3000) is beyond the ligature (1000) - a fixed distance, After being fed into the endoscope and reaching the lesion, remove the stopper (6000), and then pull the sheath tube (3000) backward to expose the ligature (1000) to the sheath tube (3000), and push it forward.
  • the shank (4200), the abutting portion (5130) of the connecting hook (5100) and the abutting portion (1120) of the ligating piece (1100) are transmitted to the guide wire (5300) of the traction portion (5000) (5200), etc.
  • the abutting transmits the thrust to the ligating piece (1100) to move outward relative to the covering tube (1200) and separate the two arms (1110) from each other under the action of the separating piece (1210), thereby causing the ligature ( 1000) Open, enter the state of preparation for ligature, at this time the connection hook (5100) back end (5150) and connection (7000)
  • the force application part (7130) has a distance of " ⁇ "; in the endoscope, the ligation device is slowly pushed to the living tissue, and then the sliding handle (4200) is slowly pulled.
  • the hook (5100) is connected at this time.
  • the hook portion (5120) is in contact with the abutting portion (1120) of the ligating piece (1100), and then the ligating piece (1100) is driven to move inward relative to the wrapping tube (1200), and the inner hole is chamfered ( 1250)
  • the two arms (1110) of the ligating piece (1100) under compression can be closed close together, so that the living tissue is pre-ligated, and when the ligation position is inappropriate through the endoscope, the slider is pushed forward (4200).
  • the abutting portion (5130) of the connecting hook (5100) and the abutting portion (1120) of the ligating piece (1100) are transmitted to each other in the conduit (5300) of the traction portion (5000), and the abutting portion (1120) of the connecting hook (5100) is abutted against each other.
  • the thrust is transmitted to the ligating piece (1100) to move outward relative to the tube (1200) and the two arms (1110) are separated from each other by the separating piece (1210), thereby causing the ligature (1000) Open, re-enter the state of ligation, until the end of the endoscopic ligation position is appropriate, the ligation is completed, the ligation piece 1100)
  • the movement to a certain extent can no longer be retracted into the tube (1200)
  • the movement of the opposite tube (1200) will be stopped, and then the hook of the connecting rod (5200) will continue to be pulled.
  • the part (5120) will be deformed, and the hook (5120) will gradually straighten until it is separated from the ligature piece (1100).
  • the ligature piece has been firmly ligated on the living tissue.
  • the connecting hook (5100) has a distance "G" from the ligating piece (1100).
  • the sliding handle (4200) will continue to move under the action of inertia, and the connecting hook (5100)
  • the tail end (5150) will abut the urging portion (7130) of the connecting portion (7000) and drive it to continue moving backwards.
  • the connecting portion (7000) wing portion (7110) will also Deformation occurs and escapes from the inserted side hole (1220) (2120), and enters into the tube body (2200) with the hook portion (5120), causing the pin hole mating structure to fail and causing the ligation portion (1000) to be Release; such that the ligature is retained in the cavity of the living organism to continue ligation of the ligated tissue until it detaches itself and excretes the living organism.
  • the ligating piece in another form of the ligating portion of the present invention, may be in the form of two arms intersecting the ligating piece (1102) shown in FIG. 14 or as shown in FIG.
  • the ligating pieces (1103) are connected by a connecting body (1403) in the form of two arms, and may be a three-arm type as shown in Fig. 16.
  • the other forms of the wrapping tube and the separating piece or the separating pin of the present invention are three pieces as shown in Fig. 16, and the three pieces of the separating pin (1212) are evenly distributed, and the ligating piece is to be ligated. (1114) spaced apart; the separator (1302) as shown in Fig. 17 is a one piece and welded, at the front end of the tube (1202); the separation pin (1303) shown in Fig. 18 is worn in the package
  • the front end of the tube (1202) is provided with a structure in the pin hole (1293); the inner tube of the tube (1204) shown in Fig. 19 has a stepped structure, and the large hole (1294) is used for the purpose shown in Fig. 22.
  • the small step end (2152) of the connecting pipe (2102) is inserted therein, and the separating piece or the separating piece or the separating pin provided at the front end thereof is also any one of the structures mentioned in Figs. 16 to 18.
  • the sheath tube main body sheath of the present invention may be a double lumen sheath tube (3102) as shown in FIG. 20, wherein the channel (3112) is used for the ligation portion and the delivery portion.
  • the channel (3122) can be used for liquid or gas exchange during surgery, and a standard gas and liquid interface (3302) is provided at the handle (3202) for connecting a device for transporting gas or liquid, which is beneficial for surgery.
  • the channel (3113) is used for the ligation (1000) and the delivery (2000), the channel (3123) and the channel (3133), there is a corresponding standard gas and liquid interface (3303) at the handle (3203) for connecting the device for transporting gas or liquid, which can be used for the exchange of liquid or gas during the operation, which is conducive to the smooth operation of the operation. get on.
  • the connecting tube (2102) of the present invention is substantially stepped, and the small step end (2152) is inserted into the large hole (1294) of the wrapping tube (1204) shown in Fig. 19;
  • the other structure is substantially the same as the preferred embodiment.
  • connection portion of the present invention may be in the form of a substantially “several" shape of a single wing portion (7112) as shown in Fig. 23;
  • the structure of the "X"-shaped double wing (7113) which is substantially closed at the upper end; may be an "X"-shaped single wing portion (7114) structure which is substantially closed at the upper end as shown in Fig. 25;
  • the two rods shown are connected by a connecting block (7148) into a substantially "eight"-shaped double wing (7118) structure; a rod portion as shown in Fig. 27 may be connected by a connecting block into a single wing portion (7115).
  • Structure; may be a three-bar jointed block (7146) as shown in Fig. 28 connected to a substantially evenly distributed three-wing (7116) structure; may have a wing as shown in Fig. 29 ( 7117) Spring-loaded construction.

Abstract

一种通过夹子对活体组织进行夹持的夹持装置,其包括结扎部(1000)、输送部(2000)、护套管(3000)、操作部(4000)、牵引部(5000)、限位器(6000)以及连接部(7000),其中连接部(7000)利用孔和销配合结构将结扎部(1000)和输送部(2000)连接成为一体,在确认所述结扎部(1000)对活体组织有效结扎后通过破坏所述连接部(7000)将所述结扎部(1000)和所述输送部(2000)进行分离。

Description

一种夹持或结扎装置
技术领域
本发明属于一种夹持或结扎装置, 特别是涉及一种通过夹子对活体组织进行夹持的夹持 装置。 背景技术
以往, 使用如下的夹子对组织进行夹持, 即, 与内窥镜组合使用, 通过夹子对体腔内的 活体组织进行夹持。
1. 在日本公开的第 2004-121285号专利的夹持装置, 夹子具有受到拉力扩张的一对夹 臂, 此外将按压管包嵌在夹子上使一对夹臂和起来夹持住组织, 并利用按压管将一 对夹臂保持闭合状态, 由此对活体组织进行夹持。
2. 環际公开第 03/030746A1号专利的夹持装置, 在弹簧管前端连接有夹子, 该夹子具 有一对可开闭的夹片。 此外, 将夹片的基部拉入弹簧管中使夹片闭合起来把活体组 织夹持住, 将夹片保持在闭合状态, 由此对活体组织进行夹持。
3. 中国公开的第 200580044431. 7号专利具有可收纳与弹簧管内的夹子,在使用时需要 向外推出夹子使夹子露出与弹簧管外, 然后再对夹臂进行张开闭合控制。 此外具有 弹性结构的按压管将夹片包嵌在夹片上使一对夹片和起来夹持住组织, 并利用按压 管将一对夹臂保持闭合状态, 由此对活体组织进行夹持。
在日本公开的 2004-121485号专利的夹持装置中, 如果按压管包嵌在夹片上, 夹片 就不能再次打开, 就不能从新对活体组织进行夹持。 因而日本公开的第 2004-121285号 专利的夹子装置在临床使用时可能存在对活体组织夹持位置不合适的可能。
现在临床使用的夹持装置中, 通常为了可靠的把夹持住活体组织, 在夹片的前端都 设有锋利的爪部。 国际公开的第 03/030746A1号专利中的夹持装置无法将夹持装的的夹 片收纳起来, 夹片的爪角裸露。 因为将夹持装置贯穿的插入内窥镜等通道中就存在爪部 易损伤通道内壁, 或爪部挂在通道内壁上需要增大推送力, 因为国际公开的第 03/030746A1号专利中的夹持装置不适合插入体腔内。 另外因该装的结构较为复杂导致 ■ 该夹持装置释放后滞留体内较长, 并且释放后的尾部较为锋利, 在狭小空间或较薄腔道 壁位置释放时易造成对面腔道壁的划伤或穿孔, 不适于小空间腔道释放也不是适于活体 较薄腔道壁组织的夹持。
现在临床使用的夹持装置中, 有时需根据实际临床情况及时更换器械, 以适应临床上出现的 突发事情, 中国公开的第 200580044431. 7号专利的夹子一旦被送出弹簧软管就不能收纳如弹 簧软管内, 夹片的锋利爪角就裸露裸露在外, 因为将夹持装置贯穿的插入内窥镜等通道中就 存在爪部易损伤通道内壁, 或爪部挂在通道内壁上需要增大推送力。 当出现临时状况时夹子 只能拉断, 然后退出余下的夹持装置。 夹子并没得到有效的使用, 即使医生强行将夹子装置 拉出, 该装置因夹子已经在弹簧管外不能收纳其中了和锋利的爪角裸露在外, 不能顺利的插 入体内, 造成该装置的报废, 造成浪费或延误医生宝贵的处理的时间。 . 发明内容 本发明就是着眼于上述课题完成的,其目的在于提供一种最适合活体生物体腔内组织结 扎的结扎装置。
本发明的一实施方式的夹持装置的特征在于, 具备: 结扎部(1000), 其可多次开闭可多 次从新定位结扎,并可被释放滞留生物腔道内一段时间;该结扎部(1000)设有结扎片(1100) 其部分的收纳与包嵌管 (1200 ) 内, 并可在外力推拉下部分的伸出和缩包嵌管(1200), 并在 所述包嵌管 (1200) 设有或装配有的分离片 (1210) 或 (1302 ) 或分离销 (1303) 的作用下, 实现反复多次张开和闭合从新定位结扎, 方便医生更快速准确的结扎最需要结扎的组织, 当 医生通过内窥镜观察到结扎位置准确后可将结扎部(1000)释放与结扎装置的其他部分分离, 滞留活体生物的体腔内继续对组织进行一定期限的结扎, 最后结扎部 (1000 ) 经过一段时间 后自行脱落并被活体生物排除体外;
输送部 (2000), 所述输送部 (2000) 大体为柔性管状结构, 其远端通过连接部 (7000) 与结扎部(1000)连接,近端与操作部(4000)连接; 用于将主要起结扎作用的结扎部(1000) 通过内窥镜钳道输送到活体生物的病灶部位,其中间贯穿有牵引部(5000), 当操作部(4000) 操作时用来抵消来自在操作部 (4000) 的作用力;
护套管(3000), 所述护套为大体管状的内外壁均连续光滑的柔性结构, 其至少有一个通 道可以允许所述结扎部 (1000) 和输送部 (2000) 自由的通过其中, 在进入内窥镜钳道时超 出结扎部 (1000) —定长度, 将结扎部 (1000) 保护于其中防止锋利的结扎片 (1100) 对钳 道和活体生物的体腔造成损伤, 也可设有其他通道 (3133 )、 (3123 )、 ( 3122) 用于输送液体 或气体或通入其他的一些器械;
牵引部 (5000), 其贯穿于所述输送部(2000) 内, 其主体为大体为柔性丝状结构的牵引 丝(5200), 其远端连接有有连接钩(5100), 近端连接有导管(5300), 所述的连接钩(5100) 用于结扎部 (1000) 的结扎片 (1100 ) 铰接, 当操作部 (4000) 的滑动柄 (4200) 向后拉通 过导管(5300)、牵引丝(5200)的传导带动当连接钩(5100)牵拉结扎片(1100) 向后运动, 这时连接钩 (5100) 的钩状部 (5120) 与结扎片 (1100 ) 的抵接部 (1120) 接触并通过其传 递拉力使结扎片 (1100) 缩入包潜管内, 在包嵌管 (1200) 的内孔 (1260) 的作用下迫使分 开的结扎片 (1100) 相互靠拢闭合; 当操作部 (4000) 的滑动柄 (4200) 向前推时通过导管 (5300)、 牵引丝 (5200) 的传导带动当连接钩 (5100) 向前推动结扎片 (1100) 向前运动, 这时连接钩 (5100) 的抵挡部与结扎片 (1100 ) 的抵接部 (1120) 接触并通过其传递推力使 结扎片 ( 1100)伸出包嵌管 ( 1200) 并在分离片 ( 1210) ( 1302) 或分离销 ( 1303 ) 的作用下 使结扎片 ( 1100) 相互张开。
本发明优选的一实施方式的夹持装置的特征在于, 所述限位器 (6000) 具有弹性结构 可以卡在输送部 (2000) 的管体上并位于操作部 (4000) 与护套管 (3000) 之间, 其作用 是在通过内窥镜钳道送入结扎装置使使护套管 (3000) 的前端始终超出结扎部 (1000) — 定距离以保护钳道和活体生物的体腔不被锋利的结扎片 (1100) 的锐边所损伤, 同时也保 护结扎装置中相对脆弱的结扎部 (1000) 与输送部 (2000) 连接的位置, 在通过钳道输送 时不会损坏过早的分离, 导致器械失效;
本发明优选的一实施方式的夹持装置的特征在于, 所述的连接部(7000)其所具有的翼 部 ( 7110) 与套接在一起的包嵌管 ( 1200) 和连接管 (2100), 的相对应的侧孔 (1220)、
(2120) 形成销孔配合使包嵌管 (1200) 和连接管 (2100) 通过连接部 (7000) 连接在一 起成为一体结构, 能否承受一定推拉力, 当医生通过内窥镜观察到结扎部 (1000) 队对活 体组织进行了有效的结扎后,就可用力拉滑动柄(4200),这时连接钩(5100)的尾端(5150) 与连接部 (7000) 的施力部 (7130) 抵接后会继续带动施力部 (7130) 继续移动, 挡力量 达到一定程度时, 原,来插入到包嵌部和连接管(2100) 的侧孔(1220)、 (2120) 内的翼部 (7110) 就会从其中脱离出来, 该销孔配合就在外力的牵拉下遭到了破坏, 从而使包嵌管 ( 1200) 和连接管 (2100) 处于相对自由状态, 从而实现结扎部 (1000) 与结扎装置的其 他部分的分离。 附图说明
图 1表示本发明的第一实施方式结扎装置示意图。
图 2表示本发明的第一实施方式结扎部缩入外鞘管示意图。
图 3表示本发明的第一实施方式结扎部示意图。
图 4表示本发明的第一实施方式包嵌管示意图。
图 5表示本发明的第一实施方式外鞘管示意图。
图 6表示本发明的第一实施方式输送部示意图。
图 7表示本发明的第一实施方式连接管示意图。
图 8表示本发明的第一实施方式牵引部示意图。
图 9表示本发明的第一实施方式连接部示意图。
图 10表示本发明的第一实施方式结扎部张开准备结扎示意图。
图 11表示本发明的第一实施方式预结扎示意图。
图 12表示本发明的第一实施方式连接钩子与结扎片分离示意图。
图 13表示本发明的第一实施方式结扎部与结扎装置其他部分分离示意图。
图 14表示本发明的结扎部的第二实施方式置示意图。
图 15表示本发明的结扎部的第三实施方式置示意图。
图 16表示本发明的结扎部的第四实施方式置示意图。
图 17表示本发明的包嵌管与分离片的第二实施方式置示意图。
图 18表示本发明的包嵌管与分离销的第三实施方式置示意图。
图 19示本发明的包嵌管第四实施方式置示意图。
'图 20表示本发明的外鞘管第二实施方式示意图。
图 21表示本发明的外鞘管第三实施方式示意图。
图 22表示本发明的连接管第二实施方式示意图。
图 23表示本发明的连接部第二实施方式示意图。
图 24表示本发明的连接部第三实施方式示意图。
图 25表示本发明的连接部第四实施方式示意图。
图 26表示本发明的连接部第五实施方式示意图。
图 27表示本发明的连接部第六实施方式示意图。
图 28表示本发明的连接部第七实施方式示意图。
图 29表示本发明的连接部第八实施方式示意图。 具体实施方式
参照图 1至图 13说明本发明的第一实施方式, 在本实施方式的结扎装置中, 结扎部 (1000), 与结扎装置的其他部分为可分离式结构, 所述结扎部 (1000 ) 被安装 在结扎装置的前端, 并贯穿于护套管 (3000 ) 内, 所述结扎部 (1000) 由结扎片 (1100)、 包 嵌管(1200 )和其前端可弯折成 90° 的分离片(1210 )组成, 本实施例中所述结扎部(1000) 的部件均由可满足相应生物相容性的不锈钢制成, 结扎部 (1000) 的结扎片 (1100) 在包嵌 管 (1200) 和其上设有的分离片 (1210) 的共同作用下是结扎片 (1100) 具有可重复开闭; 输送部 (2000), 贯穿于护套管 (3000)之内并在使用时将结扎部 (1000)通过内窥镜的 钳道将结扎部 (1000) 输送到活体体腔内, 所述输送部 (2000) 主体为紧密缠绕弹簧制成的 管体 (2200) 其贯穿于护套管 (3000 ) 内, 本实施方式中为了获得更大的空间管体 (2200) 采用了扁钢丝经紧密缠绕而成;
护套管(3000), 为柔性内表面连续的管状结构, 用于将结扎装置的结扎部 (1000)和输 送部 (2000) 收纳其中, 鞘管 (3100)近端连接有易于握持的把手 (3200), 本实施例中护套 管 (3000) 为单腔道的 PE材料的塑料管;
操作部 (4000), 连接于管体 (2200) 的后端, 通过推、 拉牵引部 (5000) 从而操控结 扎部 (1000) 的张开、 闭合及释放; 所述操作部 (4000) 具有细长的手柄 (4100), 其上装配 有可延手柄(4100)轴线方向自由滑动的滑动柄(4200);为了使滑动柄(4200)与手柄(4100) 做推、 拉运动时, 手柄 (4100) 保持相对不动, 在手柄 (4100) 末端设有可容纳手指的指环 (4120);
牵引部 (5000), 由牵引丝 (5200) 连接钩 (5100)、 导管 (5300) 等组成, 其自由的贯 穿在管体(2200) 内, 用于操作结扎部(1000); 牵引部 (5000) 的末端通过其上连接的导管
(5300) 与滑动柄 (4200) 相连, 通过使滑动柄 (4200 ) 与手柄 (4100) 相对推、 拉运动, 使牵引部 (5000) 相对与管体 (2200 ) 做推、 拉运动, 本实施例中牵引丝 (5200) 为单根金 属丝, 与连接钩 (5100)连接, 所述连接钩 (5100)前端的钩状部 (5120) 与结扎片 (1100) 连接
限位器(6000), 所述限位器(6000)具有弹性结构可以卡在输送部(2000) 的管体上 并位于操作部 (4000) 与护套管 (3000) 之间, 其作用是在通过内窥镜钳道送入结扎装置 使使护套管 (3000) 的前端始终超出结扎部 (1000) —定距离以保护钳道和活体生物的体 腔不被锋利的结扎片 (1100 ) 的锐边所损伤, 同时也保护结扎装置中相对脆弱的结扎部 ( 1000) 与输送部 (2000) 连接的位置, 在通过钳道输送时不会损坏过早的分离, 导致器 械失效;
连接部(7000)其所具有的翼部(7110)与套接在一起的包嵌管( 1200)和连接管(2100), 的相对应的侧孔 ( 1220)、 (2120)形成销孔配合结构, 使包嵌管 ( 1200)和连接管(2100) 通过连接部 (7000) 连接在一起, 成为一体结构, 所述的连接结构能否承受一定推、 拉力 不被破坏, 当医生通过内窥镜观察到结扎部 (1000) 队对活体组织进行了有效的结扎后, 就可用力拉滑动柄(4200), 这时连接钩(5100) 的尾端(5150) 与连接部 (7000) 的施力 部 (7130) 抵接, 继续拉动就会带动施力部 (7130) 继续一起移动, 当力量达到一定程度 时, 原来插入到包嵌部和连接管 (2100) 的侧孔 (1220)、 (2120) 内的翼部 (7110) 就会 从中脱离出来, 所述的销孔配合结构就在外力的牵拉下遭到了破坏, 从而使包嵌管(1200) 和连接管 (2100) 处于相对自由状态, 从而实现结扎部 (1000) 与结扎装置的其他部分的 分离;
下面参照图 2进行说明, 结扎部 (1000) 闭合后可被自由的缩入和伸出护套管 (3000) 内, 结扎部 (1000) 在伸出鞘管 (3100) 前端后就可对其进行张开、 闭合释放等操作。
下面参照图 3和图 4进行说明, 本发明优选方案结扎装置的结扎片(1100)大体成 "U" 字型,结扎片(1100)上设有抵接部(1120)用于与连接钩(5100)铰接,来向结扎片(1100) 传递推、 拉力; 包嵌管 (1200) 大致成阶梯的筒状结构, 其前端大并设有分离片 (1210), 所述分离片 (1210) 在装配时需要向内弯折大约 90° 形成阻挡功能; 所述结扎片 (1100) 的一部分 其阻挡在包嵌管(1200) 内不能出来, 结扎片(1100) 的一部分可在受到外来作 用下缩入包嵌管 (1200) 的内孔 (1260) 内, 在内孔倒角 (1250) 的压迫下结扎片 (1100) 的两臂 (1110) 可逐渐靠拢闭合; 小阶梯 ( 1230) 用于穿入连接管 (2100) 的远端内孔 (2130), 所述小阶梯端 (1230) 侧壁设有侧孔 (1220), 用于穿入连接部 (700^ 翼部 (7110) 形成销孔配合结构, 阶梯端面 (1270) 与连接管 (2100) 的端面 (2170) 相抵接 承受压力;
下面参照图 5进行说明, 本发明优选方案为结扎装置的护套管(2000)其主体为单通道 的 ΡΕ材料制成的鞘管(3100)其内部中空,并能允许闭合的结扎部(1000)和输送部(2000) 自由通过, 其外径小于内窥钳道; 后端设有把手 (3200 ) 易于握持;
下面参照图 6和图 7进行说明, 本发明优选方案结扎装置的输送部(2000)主体为采用 了扁钢丝经紧密缠绕而成的管体 (2200) 其贯穿于护套管 (3000 ) 内, 其前端连接有连接 管(2100),后端连接有操作部(4000) ,其内部贯穿有牵引部(5000),所述连接管(2100) 大致成筒状结构, 其内部设有阶梯孔, 其远端内孔 (2130) 侧壁上设有侧孔 (2120) 用于 穿入连接部(7000)的翼部(7110)形成销孔配合结构,其内孔(2130)用于供包嵌管(1200) 的小阶梯端 (1230) 插入其中, 端面 (2170) 用于包嵌管 (1200) 的阶梯端面 (1270) 相 抵接承受压力,其相互抵接后包嵌管(1200)侧孔(1220)和连接管(2100)的侧孔(2120 ) 大致同心, 其投影空间足够容的下连接部 (7000) 的翼部 (7110);
下面参照图 8进行说明, 本发明优选方案结扎装置的牵引部 (5000) 的牵引丝 (5200) 为单根钢丝, 其远端焊接有连接钩 (5100)其近端压接有导管 (5300), 导管 (5300 )连接与 滑动柄 (4200), 用于传递来自操作部 (4000) 的推、 拉力, 连接钩 (5100)前端设有钩状部 ( 5120) 与结扎片 (1100) 铰接;
下面参照图 9进行说明, 本发明优选方案结扎装置的连接部, 其大致成"几"字状的弹 性结构, 其具有外翘的两个翼部 (7110) 和两个细长的弹性杆部 (7120) 和用于与连接钩 ( 5100) 的尾部 (5150)相抵接用的施力部 (7130); 所述翼部 ( 7110)与嵌管 ( 1200)侧 孔 ( 1220) 和连接管 (2100) 的侧孔 (2120) 构成销孔配合结构, 将包嵌管 ( 1200) 和连 接管 (2100) 连为一体, 该销孔配合结构可再在一定的外力施加于施力部 (7130) 时将这 种销孔配合结构破坏, 使包嵌管 (1200) 和连接管 (2100 ) 相分离。
下面参照图 10和图 13进行说明, 本发明优选方案的具体使用方法, 首先用手指拉动滑 柄 (4200 ) 将结扎部闭合, 并缩入护套管 (3000) 内, 限位器 (6000 ) 卡于输送部 (2000) 的管体(2200)上, 并且位于操作部 (4000) 和护套管 (3000) 之间, 这时护套管 (3000) 超 出结扎部 (1000)—定距离, 被送入内窥镜钳到并到达病灶部位后取掉限位器(6000), 然后 向后拉动护套管 (3000) 使结扎部 (1000) 露出护套管 (3000), 向前推动滑柄 (4200 ), 在 牵引部 (5000) 的导管 (5300) 牵引丝 (5200) 等传递下连接钩 (5100) 的抵接部 (5130) 与结扎片 (1100) 的抵接部(1120)相互抵接将推力传递给结扎片 (1100 ), 使其相对于包嵌 管 (1200 ) 向外运动并在分离片 (1210 ) 的作用下使两片臂 (1110) 相互分离, 从而使结扎 部(1000)张开, 进入准备结扎状态, 这时连接钩 (5100 ) 的后端 (5150) 与连接部 (7000) 的施力部 (7130) 距离为 "Ε"; 在内窥镜目视先将结扎装置缓慢的推向活体组织, 然后缓慢 的拉动滑动柄 (4200)这时连接钩 ( 5100)的钩状部 ( 5120)与结扎片 ( 1100)的抵接部(1120) 接触,然后带动结扎片(1100)使其作相对于包嵌管(1200)向内的运动,在内孔倒角(1250) 的压迫下结扎片 (1100) 的两臂 (1110) 可逐渐靠拢闭合, 这样就对活体组织进行预结扎, 当通过内窥镜观察结扎位置不合适时,再向前推动滑柄(4200)在牵引部(5000)的导管(5300) 牵引丝 (5200)等传递下连接钩 ( 5100)的抵接部 ( 5130)与结扎片 ( 1100)的抵接部 ( 1120) 再相互抵接将推力传递给结扎片(1100), 使其相对于包嵌管(1200)作向外运动并在分离片 ( 1210) 的作用下使两片臂 (1110) 相互分离, 从而使结扎部(1000)张开, 再次进入准备结 扎状态, 直到在内窥镜观察结扎位置合适为止预结扎完成, 结扎片 (1100) 当运动到一定程 度再也不能缩入包嵌管 (1200) 时, 将停止相对包嵌管 (1200) 的于运动, 这时继续拉动滑 动柄 (4200) 连接钩 (5100) 的钩状部 (5120 ) 会发生变形, 钩状部 (5120) 会逐渐变直, 直到与结扎片 (1100)相互分离, 这时结扎片已经牢牢的结扎在活体组织上了这时的 "Ε" 已 经变小了, 连接钩 (5100) 与结扎片 (1100) 有了距离 "G", 这时由于分离的力量较大滑 柄(4200)会在惯性的作用下继续运动,连接钩(5100)的尾端(5150)会抵接到连接部(7000〕 的施力部(7130),并带动其一起继续向后运动,当力量达到一定时,连接部(7000)翼部(7110〕 也会发生变形并从插入的侧孔 (1220) (2120)内脱出, 并随钩状部 (5120) —起进入到管体 (2200) 内,使销孔配合结构失效从而使结扎部(1000)被释放; 这样结扎部就会滞留于活体 生物的腔体内继续对结扎的组织进行结扎, 直到其自行脱落并排除活体生物体外。
下面参照图 14和图 16进行说明, 本发明的结扎部的其他形式, 其结扎片也可为图 14所 示的结扎片(1102)交叉的两个臂形式,也可为图 15所示两个结扎片(1103)经过连接体(1403〕 连接而成的两臂形式, 也可为如图 16 所示的三臂式结构等。
下面参照图 16和图 19进行说明, 本发明的包嵌管和分离片或分离销的其他形式, 如图 16 所示的为三片形式, 分离销 (1212) 三片均匀分布, 将结扎片 (1114) 间隔开; 如图 17 所示的分离片(1302)为一整块并焊接,于包嵌管(1202)的前端的结构; 如图 18所示的分离销 (1303)穿在包嵌管(1202)的前端设有的销孔 (1293 ) 中的结构; 图 19 所示的包嵌管(1204) 的内孔为阶梯结构, 其大孔 (1294) 用于供图 22所示的连接管 (2102) 的小阶梯端 (2152) 插入其中, 其前端的设有的分离片或连接有的分离片或分离销也为图 16到图 18中提到任意 一种结构。
下面参照图 20和图 21进行说明, 本发明的护套管主体鞘管可为如图 20所示的双腔道 鞘管 (3102), 其中通道 (3112 ) 用于供结扎部和输送部贯穿于其中, 通道 (3122 ) 可在手术 时供进行液体或气体的交换, 在把手 (3202) 处设有标准的气体、 液体接口 (3302 ) 用于连 接输送气体或液体的装置,有利于手术的顺利进行;也可为如图 21所示的三腔道鞘管(3103), 其中通道 (3113) 用于供结扎部 (1000) 和输送部 (2000) 贯穿于其中, 通道 (3123) 和通 道(3133), 在把手(3203) 处设有相应标准的气体、 液体接口 (3303 )用于连接输送气体或 液体的装置, 可在手术时分别供进行液体或气体的交换, 有利于手术的顺利进行。
下面参照图 22进行说明, 本发明的连接管(2102)大致成阶梯状, 其小阶梯端 (2152), 用插入到图 19所示的包嵌管(1204)的大孔 (1294) 中; 其他结构与优选方案大致相同。
下面参照图 23和图 29进行说明, 本发明的连接部的其形式可为如图 23所示的大致成 "几"字状的单翼部 (7112) 结构; 可为如图 24所示的大致成上端封闭的 "X"字状的双翼 部 (7113) 结构; 可为如图 25所示的大致成上端封闭的 "X"字状的单翼部 (7114) 结构; 可为如图 26所示的两个杆部被连接块 (7148 ) 连接成大致 "八"字状的双翼部 (7118) 结 构; 可为如图 27所示的一个杆部被连接块连接成单翼部 (7115 ) 结构; 可为如图 28所示的 三个杆部被连接块 (7146) 连接成大致 均匀分布的的三翼部 (7116) 结构; 可为如图 29所 示的带有一个翼部 (7117 ) 的弹簧式结构。

Claims

WO 2013/067662 权 利 要 求 书 PCT/CN2011/002006
1、 一种夹持或结扎装置, 其特征在于其特征在于具有:
结扎部 (1000): 可被重定位对活体复进行多次结扎, 为了有效的对活体组织进行结扎 至少一部分可被释放滞留于活体生物体消化腔道内一段时间并可自行脱落最终排除活体生 物体外;
输送部(2000): 用于将所述结扎部(1000)通过内窥镜其输送到活体生物的病灶位置; 护套管(3000): 所述结扎部(1000)和输送部(2000)贯穿于其中,其将结扎部(1000) 保护在其中; 并可设其他通道用于通过其输送液体或气体等;
操作部(4000): 用于通过控制其从而控制所述结扎部(1000) 的开、 闭、 释放等状态; 牵引部 (5000): 用于操作部 (4000) 的一部分连接并将操作部 (4000) 的推、 拉力传 递给结扎部 (1000), 并控制其各种状态;
限位器 (6000): 其卡于输送部 (2000) 上并位于操作部 (4000) 前, 其使所述护套管 (3000) 前端超出结扎部 (1000) —段距离起到保护结扎部 (1000) 的作用;
连接部 (7000), 利用孔和销配合结构将结扎部 (1000) 和输送部 (2000) 通过其连接 预成为一体, 在确认结扎装置对活体组织有效结扎后可通过破坏所述连接部 (7000) 将所 述结扎部 (1000) 与输送部 (2000) 进行分离。
2、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部(1000)设有可重复开合 的结扎片 (1100), 其一部可进、 出于包嵌管 (1200) 内; 所述包嵌管 (1200 ) 前端设 有或装配有分离片 (1210) 或分离销 (1303 ), 所述分离销或分离片将结扎片 (1100) 均匀的分隔。
3、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述输送部(2000)主体部分管 体(2200)为柔性管状结构, 其近端与所述操作部 (4000)连接, 其远端连接有连接管
(2100), 连接管 (2100) 与所述结扎部 (1000) 通过所述的连接部.(7000) 连接。
4、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所 ί&护套管(3000)其主体为一 个内外表面连续、 光滑的管状结构的鞘管 (3100 ), 其至少具有一个可容纳下结扎部
( 1000)和输送部(2000) 的通道, 其后端可设有或装配有易于握持的把手(3200)或 不设有或装配有把手 (3200)。
5、 根据权利要求 1所述的夹持或结扎装置,其特征在于,所述操作部(4000)由手柄(4100) 和在其上滑动的滑动柄 (4200) 组成。
6、 根据权利要求 1 所述的夹持或结扎装置, 其特征在于, 所述牵引部 (5000) 由牵引丝
(5200)、 连接钩 (5100)、 导管 (5300) 等组成, 并贯穿于所述输送部 (2000) 内。
7、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述限位器(6000)其至少一部 分为弹性结构可弹性的卡在临近操作部(4000)前端输送部(2000)的管体(2200)上, 其可被易于夹持上并可被易于取下。
8、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 连接部(7000)为可被破坏的弹 性结构, 其通过销与孔的配合结构将结扎部(1000)与输送部(2000)连接在一起, 其 弹性的收纳于结扎部 (1000 )、 输送部 (2000) 和护套管 (3000) 内。
9、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部中结扎片(1100)可为单 片结构经过弯折成 "U"字结构、 交叉的 "8" 字结构和多爪结构等或多片结构, 由多 片组合而成的大致对称多爪结构。
10、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部中的包嵌管 (1200) 其 前端可设有分离片结构或装配有分离片(1210)或分离销(1303 ), 将所述靠拢的或交 叉的结扎片 (1100) 相互分离从而使 扎部 (1000) 张开。 、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部中的包嵌管 (1200) 其 设有用于与所述连接部 (7000) 形成孔和销配合结构的侧孔或侧槽等可穿入销的孔或 槽的结构。 . . .
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部中的包嵌管 (1200) 当 完全包嵌住结扎片(1100)时是通过相互施加摩擦力使结扎片(1100)不与包嵌管(1200)
. 分离, 保证对活体组织了结扎的有效性。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 结扎部中的包嵌管 (1200) 大 致成桶状结构, 或外侧成阶梯状或内孔成阶梯状, 与所述包嵌管 (1200) 的相应的内 阶梯或外阶梯配合形成间隙套接结构。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 输送部中管体 (2200) 为柔性 结构, 可承受一定的推、 拉力从而控制结扎部 (1000) 张开、 闭合、 释放等并能通过 弯曲的内窥镜钳道, 其可为一段或多段弹簧结构或编织网管状结构或编织网加塑材的 复合结构、 弹簧管加塑料的符合结构等。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 输送部中连接管 (2100) 设有 用于与所述连接部 (7000) 形成孔和销配合结构的侧孔或侧槽等可穿入销的孔、 槽的 结构。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 输送部中连接管 (2100) 其大 致成筒状, 其内孔成有阶梯状后外圆成阶梯状, 与所述包嵌管 (1200) 的相应的外阶 梯或内阶梯配合形成间隙套接结构。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 护套管中鞘管 (3100) 设 ^"通 道为一个或多个管腔的柔性结构, 当为单通道时可用于将结扎部 (1000 ) 和输送部
(2000) 贯穿于其中, 也可通过其间隙输送液体或气体也可不做输送液体、 气体用; 当所述的鞘管 (3100) 为多通道时, 可一个通道专门用于容纳结扎部 (1000) 和输送 部 (2000), 其余的通道用于输送液体或气体、 或通入其他的器械只用等。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述连接钩 (5100) 与结扎片
( 1100) 可分离的铰接在一起, 在受到拉力时连接钩 (5100) 带动结扎片 (1100') 的 一部分进入包嵌管 (1200) 内, 受到推力时连接钩 (5100) 带动结扎片 (1100) 的一 部分伸出包嵌管 (1200)。 ^
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, '所述牵引丝 (5200) 可单股或 多股钢丝。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述连接钩 (5100) 至少设有 钩状部 (5120)、 抵接部 (5130) 用于在受到推拉力时向结扎片 (1100) 传递推拉力。 、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述限位器为金属或塑料制成 具有一定宽度可卡在输送部 (2000) 的管体 (2200) 上并位于操作部 (4000) 与护套 管 (3000) 之间, 其道将护套管 (3000) 强迫伸出并长于结扎部 (1000) —段距离的 作用。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述连接部 (7000) 为具有外 伸的一个或多个翼部 (7110) 和用于承受拉力使翼部 (7110) 与所配合孔或槽脱落从 而破坏其形成的销孔配合结构从而使结扎部 (1000 ) 与输送部 (2000) 分离的施力部
( 7130)。
、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 连接部 (7000) 可有一个丝材 或片材经弯折成的成 "几"字状、 "X"上面连接起来的形状等类似的具有至少 1个具 有外翘的翼部(7110)结构或由几个丝材或片材经组合形成的 "几"、字状 "八"字状、
"X"字状等具有至少 1个具有外翘翼 ( 7110) 的结构。 、 根据权利要求 1所述的夹持或结扎装置, 其特征在于, 所述包嵌管 (1200) 与连接管 (2100) 套接后, 其所述翼部 (7110) 可同时插入到包嵌管 (1200) 的侧孔和与之相 对应的连接管 (2100) 的侧孔内形成销孔配合结构, 并将所述包嵌管 (1200) 与连接 管 (2100)通过其连接在一起, 从而使结扎部 (1000)与输送部 (2000)连接在一起。
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