CN107753082A - A kind of tissue folder of expanded letter jig arm - Google Patents

Abstract

A tissue clip with wide-body clip arms, each of the tissue clips includes a V-shaped clip body integrally formed by a first arc-shaped clip arm and a second arc-shaped clip arm, and the first arc-shaped clip arm and the second The free ends of the arc-shaped clamping arms are hooks and corresponding slots respectively. A "hinge" structure is formed between the first arc-shaped clamping arm and the second arc-shaped clamping arm. The clamping surfaces of the clamping arms are provided with several The anti-slip tooth-shaped area, the first arc-shaped clamp arm and the second arc-shaped clamp arm form a V-shaped clamp body in a free state; the anti-skid tooth-shaped area of the first arc-shaped clamp arm and the second arc-shaped clamp arm has a width greater than that of the arc The head-to-tail width of the shaped clip arm; the card slot can also be called a card protrusion, which locks the neck of the hook.

Description

Tissue clip with wide body clip arm

technical field

The present invention relates to an auxiliary medical instrument for surgical operation, especially a clip used for closing blood vessels or tissues during surgical operations, also known as blood vessel clip or ligation clip.

Background technique

Minimally invasive (endoscopic) surgery has been popularized and applied in a large number. This kind of surgery has less trauma to the human body and is more and more favored by both doctors and patients; closed to stop bleeding. Clamping the ruptured vessel with a hemostat and then ligating it with sutures is not suitable for the quick and easy requirements of laparoscopic surgery. Hemostatic tissue clips using polymer materials have been widely used. The tissue clip includes a V-shaped clamp body integrally formed by a first arc-shaped clamp arm and a second arc-shaped clamp arm. The free ends of the first arc-shaped clamp arm and the second arc-shaped clamp arm are hooks and grooves respectively. There is a "hinge" structure between the arc-shaped clamp arm and the second arc-shaped clamp arm. The hinge structure is as follows: the connection between the first arc-shaped clamp arm and the second arc-shaped clamp arm is composed of two connecting bodies The bifurcation is formed, and there is a hole between the inner and outer two connecting bodies. When the first arc-shaped clamping arm and the second arc-shaped clamping arm form a V-shaped clamping body, the hole is U-shaped. When the hooks and slots at the free ends of the first arc-shaped clamp arm and the second arc-shaped clamp arm are closed, the tissue clamp is closed in a straight line to stop bleeding, and the arc shape of the first arc-shaped clamp arm and the second arc-shaped clamp arm The stress makes the hook and the slot fit closely. Considering that the pressure on the biological tissue cannot cause necrosis or operation, there is generally a slit between the two clamp arms, and several tooth-shaped areas are provided on the clamping surface of the clamp arms. Make the biological tissue and the clamp arm form greater friction.

In order to adapt to the specifications of laparoscopic surgery and the diameter of human vascular tissue, the tissue clamps have three to five specifications of different sizes, and a series of special clip appliers and clip removers are provided for different specifications and sizes. organization to use. Both the clip applier and the clip remover have long handles and can be used in laparoscopic surgery. Of course, the tissue clip can also be made of metal material or absorbable material. The prior art has disclosed and perfected the above-mentioned scheme, and it is also a surgical accessory used by a large number of equipment in hospitals. Typical Chinese patents and patent applications include: CN201110023843, 201310334138 and 201410777554; however, there are still deficiencies in the prior art: although the reliability of the clip (there are slits on the clip) is already very good, in actual operation, it usually requires a doctor to apply The second clip, sometimes it is difficult to apply the second clip at the position of the stump of the tissue incision. For example, when complete clamping is required or higher reliability is required, the second clip is often used by doctors; endoscopic surgery The front end of the clip applier of the existing clip used (with a metal jaw to clamp the prominence and apply force, because the tissue clip width is only 1mm or even narrower) is fully wrapped around the tissue clip, although there is a guide mirror ( Or special image acquisition device) as the observation window. However, it still has an impact on the surgical field of view, and sometimes it all depends on the feel when the clip applier blocks the blood vessel. US2005/0171560A1 discloses a schematic structural view of a clip applier.

Many clips stay in the patient's body for a long time. When the arteries or important blood vessels are clamped, the doctor will choose the safe double clip if the conditions permit, but for those who keep the vascular stump too short The existing products and technologies cannot clamp two independent tissue clips at the same time. For example, if the tissue clip applied at the rear end is at the stump of the blood vessel, it is extremely difficult to clip.

The tissue clips in the prior art are all designed with a single clip or a single root. The side of the tissue clip is provided with a protuberance as the supporting end of the clip applier or clip applier. Friction and damage, especially after lung lobe surgery, patients will have symptoms of coughing and bleeding; the clamping arm head is clamped by a hook and a card slot, and the card slot is provided on both sides of the clamp arm (the second arc clamp arm). The protrusion is formed, and the section at the center of the bottom of the slot is a wedge that matches the hook. The slot is a double guarantee that the clamp arm is only locked/occluded without "lock" and "buckle". Larger blood vessels are easy to "break open", and there is concern that the clamp will not be tight. The tissue (such as a blood vessel) is thick or cannot be clamped or clamped tightly. The cross-sectional shape of the two clamp arms of the tissue clip is rectangular (the edges are slightly polished), and cannot be changed to an oval shape, because after the single clip is changed to an oval shape, the external force (vertical clamping force or resistance when the blood vessel is stripped horizontally) ) is prone to torque and deformation;

The protrusions on both sides of the card slot are designed in a drop shape, which has a navigation function during clipping, but in the case of incorrect nail removal (nail is a common name for tissue clips), or when the blood vessel is not free or clean, or the blood vessel is too thick , Single nail clipping is easy to deform, the design of water droplets, the tip is not hard enough, can not be effectively navigated, so the phenomenon of nail clipping occurs; when the unilateral clipping of blood vessels requires high reliability, 2 clips will be used, and the small tissue clip is wide (Clamp arm + carina) 2mm, medium and large tissue clip width 3mm. It is impossible for the two tissue clips to stick together tightly when they are clamped, because they will squeeze each other and cause side slips. At the same time, due to the limitations of surgical instruments, doctor's technique and the protrusion of the single clip, the two clips cannot be well connected. Paste together, so in theory, to clip two single clips, at least 2mm+2mm+1mm (2-clip distance) = 5mm distance or medium and large size need 3mm+3mm+1mm (2-clip distance) = 7mm distance .

In the past, two clips, the so-called double insurance, are actually not safe, because once the dynamic pulse opens one clip, the other clip has no difference in clamping force and non-slip properties compared to the previously opened clip, so It is not safe; in the case of usually using one clip to clamp the blood vessel, it is mostly because the stump of the blood vessel (cuff length) is too short, or the area available for clamping is too narrow, or the free blood vessel exposed by the doctor’s quick operation is not fine, so it cannot be used more , not because using one is enough.

In addition, the existing clip applicator wraps the clip for clipping, and the clip is about to be clamped. The field of view is not clear, and it is impossible to intuitively see whether the clipping of the blood vessel is completed. When the clip itself is closed, there needs to be a gap; especially for free Unclean or overly thick blood vessels often have "false clipping", and fatal bleeding phenomena such as collapse during and after surgery, slippage, etc., especially postoperative collapse, can easily lead to patient death or infection. The second operation is a medical malpractice. In addition, the tissue clip clamping in the prior art is composed of a hook and a slot, but there is still room for improvement. The slot is formed by the upward protrusions on both sides of the clamp arm (the second arc clamp arm). The section at the center of the bottom of the slot is a sharp wedge that matches the hook. For loose tissue or large blood vessels, " Before it collapsed, there was concern that the clip would not be tight, and it was difficult to find. Simultaneous application of double clamps helps to overcome the above situation, but the diameter tends to exceed the working diameter of the endoscope.

Contents of the invention

The object of the present invention is to provide a tissue clip with wide body clip arms to overcome or avoid the problems in the prior art. It surpasses and has the function of two parallel clips or even multiple clips, and the width of the clip does not affect the clip applier, and it is easier to meet the use requirements of the endoscope (mainly the diameter meets the requirements, and the maximum width is not greater than 2.8mm) , can be completely clamped, and has higher reliability, applying once is equivalent to applying two tissue clips.

In order to solve the problems of the prior art, the technical solution of the present invention is a tissue clip with a wide-body clip arm, and each tissue clip includes a V-shaped clip integrally formed by a first arc-shaped clip arm and a second arc-shaped clip arm body, the free ends of the first arc-shaped clamping arm and the second arc-shaped clamping arm are hooks and corresponding slots respectively, and there is a hinge structure between the first arc-shaped clamping arm and the second arc-shaped clamping arm Composition, the clamping surface of the clamp arm is provided with a number of anti-slip tooth-shaped areas, the first arc clamp arm and the second arc clamp arm form a V-shaped clamp body in a free state; the first arc clamp arm and the second arc clamp The width of the central area of the arm is greater than the width of the head and tail of the arc-shaped clamping arm;

Further, the central areas of the first arc-shaped clamp arm and the second arc-shaped clamp arm are prepared with more than two sub-arms perpendicular to the clamp arm and parallel to each other.

Further, the central area (clamping area or anti-slip tooth-shaped area) of the first arc-shaped clamping arm and the second arc-shaped clamping arm is provided with a section of rounded polygon or ellipse.

Further, the rounded polygon or ellipse has a hole in the center.

Further, the anti-slip tooth-shaped areas of the first arc-shaped clamp arm and the second arc-shaped clamp arm are prepared with more than two sub-arms perpendicular to and parallel to the clamp arms.

Further, the anti-slip tooth-shaped areas of the first arc-shaped clamp arm and the second arc-shaped clamp arm are rounded polygons or ovals; rectangles or rounded rectangles are also good choices.

The anti-slip tooth-shaped area is prepared with more than two sub-arms perpendicular to the clamp arm and parallel; rounded polygon or ellipse; rectangle or rounded rectangle with a total width of 2.8mm can be used for the use of the cavity mirror, if used for open Or semi-open surgical applications, the width can be made to be more than 3mm; and the clip applier of the tissue clip is exactly the same as the clip applier used by the existing medical side, that is, there are supporting grooves and ridges for clip applier clip applier .

Further, the improvement of the present invention also includes that an inlay is provided on the tissue clamp clamp arm of the wide-body clamp arm; especially the oval (round tortoise clamp) can surpass the previous tissue clamp by using a simple material. Partially embedded inert metal rings, or overall embedded inert metal, can achieve smaller volume and the same toughness/hardness than non-inlaid round tortoise clips.

The clamping surface of the clamp arm is provided with several "eight" anti-slip tooth-shaped areas 8, and the teeth of the anti-slip tooth-shaped areas 8 of each tissue clamp are in the shape of oblique lines. The tooth-shaped area after the clamping of the two tissue clips is a number of "eight" shapes; each oblique tooth is divided into upper and lower parts, and the upper and lower oblique teeth are straight teeth or interlaced teeth.

Beneficial effects of the present invention: the existing clip applier used in endoscopic surgery fully wraps the tissue clips, although there is a guide mirror (or a special image acquisition device) as an observation window when in use. However, it still has an impact on the surgical field of view, and sometimes it all depends on the feel when the clip applier blocks the blood vessel. The present invention provides a tissue clip to overcome or avoid the above problems.

It has the function of preventing sideslip in multiple dimensions: 1) The previous single-piece tissue clip is only one-dimensionally placed and slipped. Once the lateral slip of the blood vessel occurs, the tissue clip will slip off and vascular bleeding will easily cause the risk of death. The round leg clip of the wide body clip (especially the optimized round tortoise clip with wide clip body) can form double protection and squeeze the tissue into the circular inner ring, which not only has the effect of double clipping, but also The vascular protrusions in the ring form an effective fixed resistance to prevent side slipping; 2) Although the previous double-joint tissue clips can effectively squeeze blood vessels to prevent lateral slippage of blood vessels, when "large clips clamp small blood vessels" it is easy to appear longitudinal The sideslip of the tortoise clip can cut the blood vessels, while the circular inner ring of the round tortoise clip is evenly stressed, and the raised blood vessels in the ring can effectively prevent the vertical side slip from occurring, and can effectively avoid the clip body from cutting the blood vessels; so the previous single Both body and double tissue clips are one-dimensional clipping, while the round tortoise clip is two-dimensional clipping, which is safer and more stable;

The present invention has smaller volume and smaller use space: 1) The single clip needs 3mm (including the width of the single clip containing the carina)+3mm (the width of the single clip including the carina)+1mm (gap)=7mm to complete the double clipping of the single clip For the above use space, the double clamp overall needs 2mm (excluding the width of the single leg of the carina) + 2mm (excluding the width of the single leg of the carina) + 1mm (the distance between the legs) about 5mm of use space, while the part of the round tortoise clip only needs 3mm The following use space is basically the same as the existing single clip body, because the width of the corresponding draw-in groove on the existing tissue clip is originally wider than the clip arm. Compared with any tissue clip, it achieves the smallest self-volume and use space, which reduces the difficulty of surgical operation. For example, the length of the free part of the blood vessel is shortened, and the operating space in the body required for clipping becomes smaller, especially in the part where it is difficult to expose the blood vessel. Applicators compatible with existing tissue clips. The width does not affect the use of the existing clip applier, it meets the requirements of the endoscope (mainly the diameter meets the requirements), it can be completely clamped, and has higher reliability. Applying a tissue clip by the doctor is equivalent to applying two Tissue clips only. To overcome the deficiency of existing tissue clips. Possess and exceed the functions of two parallel tissue clips.

The gap between the arms of the tissue clip of the present invention leaves sufficient space for the blood vessels to ensure the activity of the blood vessels. At the same time, because the blood vessels are squeezed during clamping, the blood vessels in the middle gap of the arms protrude from the gap between the arms, which plays a very good role. The effect of anti-slip, so the clamping force of the tissue clip is large, and the anti-slip force is greater "1+1">2, and the resistance of the blood vessel in the gap is added at the same time>3.

Description of drawings

Fig. 1 is a three-dimensional schematic diagram of a tissue clip of the present invention;

Fig. 2 is a top view schematic diagram when the clip of the present invention is opened;

Fig. 3 is a schematic side view of the present invention;

Fig. 4 is a schematic diagram of the head of a clip applier in the prior art.

Fig. 5 is a schematic diagram of the shape of the curved clamp arm of the tissue clip of the present invention as a hexagonal clamp arm;

Fig. 6 is a schematic diagram showing the shape of the curved clamp arm of the tissue clip of the present invention as a rectangular clamp arm;

Fig. 7 is a schematic diagram of the shape of the arc-shaped clamp arms (pairs) of the tissue clip of the present invention prepared with three sub-arms perpendicular to the clamp arms and parallel to the clamp arms.

Detailed ways

As shown in the figure, Fig. 1 is a three-dimensional schematic diagram of a tissue clip with a bulge structure; a V-shaped clamp body formed integrally of the first arc-shaped clamp arm and the second arc-shaped clamp arm, and the first arc-shaped clamp arm and the second arc-shaped clamp body The free ends of the clamp arms are hooks and slots respectively. There is a "hinge" structure between the first arc-shaped clamp arm and the second arc-shaped clamp arm. The hinge structure is as follows: the first arc-shaped clamp arm and the second arc-shaped clamp arm. The connection of the two arc-shaped clamp arms is formed by the bifurcation of the inner and outer two connectors, and there is a hole between the inner and outer two connectors. When the first arc-shaped clamp arm and the second arc-shaped clamp arm form a V-shaped clamp body , the hole is U-shaped. When the hooks and slots at the free ends of the first arc-shaped clamp arm and the second arc-shaped clamp arm are closed, the tissue clamp is closed in a straight line to stop bleeding, and the arc shape of the first arc-shaped clamp arm and the second arc-shaped clamp arm The stress makes the hook and the slot fit closely. Considering that the pressure on the biological tissue cannot cause necrosis or operation, there is generally a slit between the two clamp arms, and several tooth-shaped areas are provided on the clamping surface of the clamp arms. Make the biological tissue and the clamp arm form greater friction.

In order to adapt to the specifications of laparoscopic surgery and the diameter of human vascular tissue, the tissue clamps have three to five specifications of different sizes, and a series of special clip appliers and clip removers are provided for different specifications and sizes. organization to use. Both applier and extractor have long handles

The hinge structure in the middle of the first arc-shaped clamping arm 5 and the second arc-shaped clamping arm 6 is as follows: the connection between the first arc-shaped clamping arm and the second arc-shaped clamping arm is formed by bifurcations of two connecting bodies inside and outside, inside and outside A hole 10 is formed between the two connecting bodies. When the first arc-shaped clamping arm and the second arc-shaped clamping arm form a V-shaped clamping body, the hole 10 is U-shaped. When the hooks and slots at the free ends of the first arc-shaped clamp arm and the second arc-shaped clamp arm are closed, the tissue clamp is closed in a straight line to stop bleeding, and the arc shape of the first arc-shaped clamp arm and the second arc-shaped clamp arm The stress makes the hook and the groove closely match. Considering that the pressure on the biological tissue cannot cause necrosis or operation, there is usually a slit between the two clamp arms, so that blood vessels and other tissues will not be cut when clamping. The surface is provided with several tooth-shaped areas 8, so that the biological tissue and the clamping arm form greater friction. Two clips connected in parallel, that is double clip design, the ridges can be inside without protruding, the connecting rod is between the two clips, and the first ridge is connected on the adjacent side to form a connecting rod for connecting two tissue clips 2 , can protrude, and the connecting rod rod is the bulge 9 on the outside of the clamp arm. The keel can also be the supporting force point of the clip applier. The first arc-shaped clamp arm 5, the second arc-shaped clamp arm 6, and the integrated V shaped folder body, the free ends of the first arc-shaped clamp arm and the second arc-shaped clamp arm are hooks 4 and slots 7 respectively.

In the figure, except the first arc-shaped clamp arm 5 and the second arc-shaped clamp arm 6, the tissue clip is the basic structure of HEM-O-LOCK; each tissue clip includes the first arc-shaped clamp arm and the second arc-shaped clamp arm The V-shaped clip body formed by one piece of clip arm, the free ends of the first arc-shaped clip arm and the second arc-shaped clip arm are hooks and corresponding slots respectively, the first arc-shaped clip arm and the second arc-shaped clip There is a "hinge" structure between the arms. The clamping surface of the clamping arm is provided with a number of anti-slip tooth-shaped areas. The first arc-shaped clamping arm and the second arc-shaped clamping arm form a V-shaped clamping body in a free state; the first The anti-slip tooth-shaped areas of the arc-shaped clamp arm and the second arc-shaped clamp arm have a width greater than the width of the head and tail of the arc-shaped clamp arm; the locking groove can also be called a locking protrusion, and locks the neck of the locking hook.

The overall width of the tissue clip of the present invention is within 2.8 mm; tissue clips with a width greater than 3 mm can also be prepared.

Schematic diagram of the distribution of the tooth-shaped areas of the double clamp arms of the tissue folder; that is, a schematic diagram of the distribution of two kinds of teeth on the clamp arms; there are several tooth-shaped areas on the clamping surface of the clamp arms, the first arc-shaped clamp arm and the second arc-shaped clamp When the arm is in a free state, it forms a V-shaped clamp body; the clamping surface of the clamp arm is provided with a number of tooth 8-shaped areas; each oblique tooth is divided into upper and lower parts, and the upper and lower oblique teeth are straight teeth or staggered tooth.

For a tissue clip with a wide-body clip arm, more than two sub-arms perpendicular to and parallel to the clip arm are prepared in the anti-slip tooth-shaped areas of the first arc-shaped clip arm and the second arc-shaped clip arm;

The anti-slip tooth-shaped areas of the first arc-shaped clamp arm and the second arc-shaped clamp arm are rounded polygons or ovals; rectangles or rounded rectangles are also good choices. A rounded polygon or ellipse has a hole in the center of the shape.

The anti-slip tooth-shaped area is prepared with more than two sub-arms perpendicular to the clamp arm and parallel; rounded polygon or ellipse; rectangle or rounded rectangle with a total width of 2.8mm can be used for the use of the cavity mirror, if used for open Or semi-open surgical applications, the width can be made to be more than 3mm; and the clip applier of the tissue clip is exactly the same as the clip applier used by the existing medical side, that is, there are supporting grooves and ridges for clip applier clip applier .

The present invention mainly uses biomedical polymer materials, including ABS resin, polyetheretherketone, reinforced polytetrafluoroethylene, including ultra-high molecular weight polyethylene (UHMWPE), polypropylene, polyoxymethylene or nylon. Biocompatible materials can also be used, such as chitin materials, etc., and metal materials can also be used, but the preparation process is different. The structure is still the same. The tissue clamp arm of the wide-body clamp arm is provided with an inlay, which is inlaid with biocompatible alloys such as titanium alloy; a titanium alloy metal ring is partially embedded in the oval ring, or a titanium alloy metal ring and strip metal are embedded as a whole, then It can achieve smaller volume and the same toughness/hardness than non-mosaic round turtle clips.

The metal pliers head 32 on the clip applier head 30 of the clip applier in FIG. 4 is aligned with the connecting rod and the clip groove as the force application end. The 31st, metal pliers handle.

Embodiment: all prepare hollow hexagon on the first arc clip arm of Fig. 5 and the second arc clip arm 5,6 (central part), there is the tooth-shaped area 8 on the hexagon, and the hexagon is clamping is coincident (coincidence).

Embodiment: Figure 6 The first arc-shaped clamp arm and the second arc-shaped clamp arm 5, 6 (central part) are all prepared with a hollow rectangle, and there is a toothed area 8 on the rectangle. Rectangles are coincident (coincident) when clamped.

Embodiment: Figure 7 The first arc-shaped clamp arm and the second arc-shaped clamp arm 5, 6 (mainly the anti-slip toothed area part) are prepared with three sub-arms 5-2 perpendicular to the clamp arm and parallel; three The sub-arms that are perpendicular to the clamp arm and parallel are alive (synthetic) when clamping. Two or four sub-arms perpendicular to the arc clamp arm and parallel, wave-shaped or sub-arms with broken lines are also possible.

Those of ordinary skill in the art should understand that: the above descriptions are only specific embodiments of the present invention, and are not intended to limit the present invention. Any modifications, equivalent replacements, and improvements made within the spirit and principles of the present invention etc., should be included within the protection scope of the present invention.

Claims (8)

1. A tissue clip with a wide-body clip arm, characterized in that each of the tissue clips includes a V-shaped clip body integrally formed by a first arc-shaped clip arm and a second arc-shaped clip arm, and the first arc-shaped clip arm The free ends of the clamp arm and the second arc-shaped clamp arm are hooks and corresponding slots respectively. A hinge structure is formed between the first arc-shaped clamp arm and the second arc-shaped clamp arm. The clamping surface of the clamp arm is There are several anti-slip tooth-shaped areas, and the first arc-shaped clamp arm and the second arc-shaped clamp arm form a V-shaped clamp body in a free state; the central area of the first arc-shaped clamp arm and the second arc-shaped clamp arm has a width greater than The width of the head and tail of the arc-shaped clamp arm; the card slot clamps the neck of the hook. 2. The tissue clip with wide body clip arm according to claim 1, characterized in that the central area of the first arc clip arm and the second arc clip arm is prepared with more than two clip arms perpendicular to the clip arm and parallel to each other. child arm. 3. The tissue clip with wide body clip arm according to claim 1, characterized in that the central area of the first arc-shaped clip arm and the second arc-shaped clip arm is provided with a section of rounded polygon or ellipse. 4. The tissue clip with wide body clip arm according to claim 3, characterized in that the rounded polygon or oval shape has a hole in the center. 5. The tissue clip with wide-body clip arm according to claim 3, characterized in that the central areas of the first arc-shaped clip arm and the second arc-shaped clip arm are provided with a section of rectangle or rounded rectangle. 6. The tissue clip with wide-body clamp arm according to any one of claims 1-5, characterized in that the first arc-shaped clamp arm and the second arc-shaped clamp arm of the tissue clamp with wide-body clamp arm are provided with inlays . 7. The tissue clip with wide-body clip arm according to claim 1-5, characterized in that the clamping surface of the clip arm is provided with several "character-eight" anti-slip tooth-shaped areas, and the anti-slip tooth-shaped area of each tissue clip Teeth are oblique. 8. The tissue clip with wide-body clip arm according to claim 7, characterized in that the tooth-shaped area after the clamping of the first arc-shaped clip arm and the second arc-shaped clip arm is several "eight" shapes.