CN113017929B

CN113017929B - Clamping equipment

Info

Publication number: CN113017929B
Application number: CN202110376339.1A
Authority: CN
Inventors: 阙诗昊; 徐军; 程增兵; 林林
Original assignee: Shanghai Huihe Healthcare Technology Co Ltd
Current assignee: Shanghai Huihe Healthcare Technology Co Ltd
Priority date: 2021-04-02
Filing date: 2021-04-02
Publication date: 2025-02-25
Anticipated expiration: 2041-04-02
Also published as: CN113017929A; WO2022205561A1

Abstract

The application provides a clamping device, which mainly comprises a base capable of being positioned at a target center position and at least two clamping structures which are arranged on the base in a surrounding mode, wherein each clamping structure can be switched between a clamping state and a releasing state so as to adjust the interval distance between each target tissue by clamping different target tissues adjacent to the target center position. Therefore, the clamping device can capture different target tissues separately or simultaneously so as to improve the capture probability and reduce the capture difficulty.

Description

Clamping apparatus

Technical Field

The embodiment of the application relates to the technical field of medical instruments, in particular to a clamping instrument.

Background

Heart valve (mitral valve, tricuspid valve) regurgitation belongs to a common heart disease, and in the case of tricuspid valve, the tricuspid valve is positioned at the right atrioventricular orifice, and the common occurrence is tricuspid valve insufficiency, namely, systolic blood flow returns from the right ventricle to the right atrium, which causes the right atrium to be highly enlarged, pressure to rise and venous blood backflow to be blocked. Right heart failure is likely to occur due to the increased right ventricular load, compensatory and hypertrophic.

Tricuspid regurgitation is generally caused by pulmonary hypertension, right ventricular enlargement and tricuspid valve annulus expansion, and clinically, the symptoms of right heart failure such as weakness, ascites, edema, liver pain, dyspepsia, anorexia and the like are aggravated after tricuspid valve regurgitation occurs, which are usually manifested by the cause of tricuspid valve regurgitation (left heart failure, pulmonary hypertension and the like). Mild regurgitation of the tricuspid valve has no obvious clinical symptoms, but requires surgical treatment when there is severe regurgitation.

Traditional treatments include medication, and surgical methods with corresponding surgical indications. Among other surgical methods, valve replacement and valve repair are also included.

In recent years, with the development of technology, domestic and foreign instrument manufacturers develop a batch of interventional clamping instruments for treating mitral valve or tricuspid valve regurgitation. For example, the mitral valve regurgitation treatment, the clamping device can puncture through the atrial septum by catheter femoral vein puncture, and is downwards conveyed to the vicinity of the mitral valve from the left atrium, so as to clamp and fix the free edges of the front and rear valve leaflets of the mitral valve, and the mitral valve is clamped into double holes by the clamping device, so that the front and rear valve leaflets can be well combined at the end systole stage, and the regurgitation phenomenon is reduced.

The prior art of edge-to-edge repair of the mitral valve mostly has the problem of great difficulty in capturing the valve leaflets, the clamping component of the clamping device can only capture the valve leaflets at two sides simultaneously, and for patients with serious mitral regurgitation, the incomplete valve closure can cause longer operation time and great difficulty in capturing the valve leaflets.

How to solve the problems of high difficulty and high failure rate of capturing of the prior valve leaflet, namely the technical problem to be solved by the application.

Disclosure of Invention

In view of the above, the present application provides a clamping device to overcome or at least partially solve the above problems.

The embodiment of the application provides a clamping device, which comprises a base and at least two clamping structures, wherein the base can be positioned at a target center position, the clamping structures can be arranged on the base and extend towards different directions, and can be switched between a clamping state and a releasing state relative to the base so as to adjust the interval distance between different target tissues by clamping the different target tissues adjacent to the target center position.

Optionally, the clamping apparatus comprises two clamping structures separately arranged on two opposite sides of the base for clamping the anterior mitral valve and the posterior mitral valve respectively.

Optionally, the clamping device comprises two clamping structures surrounding the base and used for clamping any two valves of the tricuspid valve respectively, or the clamping device comprises three clamping structures surrounding the base and used for clamping each valve of the tricuspid valve respectively.

Alternatively, each of the clamping structures may be switched between the clamping state and the release state simultaneously, or each of the clamping structures may be switched between the clamping state and the release state independently.

Optionally, the positioning angle of each clamping structure in the clamping state relative to the base may be the same or different.

The clamping structure comprises an inner clamping arm and an outer clamping arm, wherein the inner clamping arm and the outer clamping arm respectively comprise a fixed end pivoted with the base, and the inner clamping arm and the outer clamping arm can respectively pivot relative to the base through the fixed ends so as to switch the clamping structure between a clamping state and a releasing state.

Optionally, the inner clamp arm includes an inner arm clamping portion, and the outer clamp arm includes an outer arm clamping portion that cooperates with the inner arm clamping portion to clamp or release the target tissue.

Optionally, the inner arm further comprises an inner arm anti-drop part arranged on the inner arm clamping part, and/or the outer arm further comprises an outer arm anti-drop part arranged on the outer arm clamping part, wherein when the clamping structure is in a clamping state, the inner arm anti-drop part and/or the outer arm anti-drop part are used for preventing the target tissue from dropping off from between the outer arm clamping part and the inner arm clamping part.

Optionally, the inner arm anti-falling portion includes a plurality of barbs disposed on the inner arm clamping portion and extending toward the outer arm clamping portion, and the outer arm anti-falling portion includes a plurality of anti-falling grooves formed on the outer arm clamping portion.

Optionally, the inner arm clamping portion comprises an elastic band and the outer arm clamping portion comprises an arcuate blade.

Optionally, the inner clamp arm further includes a free end opposite the fixed end, the free end being forced to drive the fixed end of the inner clamp arm to pivot relative to the base to adjust the pivot angle of the inner clamp arm relative to the base.

The clamping structure comprises a base, an outer clamping arm, a base, a clamping structure, a connecting rod, an actuating rod and a connecting rod, wherein the actuating rod and the connecting rod are movably arranged on the base in a penetrating mode, two opposite sides of the connecting rod are respectively pivoted with the outer clamping arm and the actuating rod, the actuating rod can move relative to the base along the axial direction of the actuating rod, the outer clamping arm is driven to pivot relative to the base through the connecting rod, and therefore the pivoting angle of the outer clamping arm relative to the base is adjusted.

The clamping device comprises a base, a clamping structure, an outer rod, an inner rod, a linkage rod, a connecting rod and a connecting rod, wherein the clamping structure comprises two actuating rods corresponding to the two clamping structures, the two actuating rods comprise an outer rod and an inner rod which are arranged in the base in a penetrating mode and sleeved with each other, the two linkage rods are respectively pivoted with the outer rod bottom of the outer rod and the inner rod bottom of the inner rod, the inner rod bottom is located between the outer rod bottom and the base, and the distance between the outer rod bottom and the base can limit the maximum movement interval of the inner rod bottom relative to the base.

Optionally, the clamping apparatus includes two actuating rods corresponding to the two clamping structures, and the two actuating rods are respectively penetrating in the base and can independently slide relative to the base.

Optionally, the clamping structure further comprises a locking structure provided on the base, wherein the locking structure is switchable relative to the base between a locked position and an unlocked position to restrict or allow movement of the actuation rod relative to the base.

In summary, according to the clamping apparatus provided by the embodiment of the application, the clamping and capturing operation of the target tissue is independently performed by each clamping structure enclosed on the base, so that the capturing probability of the target tissue can be improved, and the capturing difficulty can be reduced.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present application, and other drawings may be obtained according to these drawings for a person having ordinary skill in the art.

Fig. 1 to 2 are side views of different configurations of the clamping device of the present application.

Fig. 3 to 4 are schematic structural views of an embodiment of an actuating lever of the clamping device according to the application.

Fig. 5 is a schematic view of another embodiment of an actuation rod of the clamping instrument of the present application.

Fig. 6 is a schematic structural view of a locking structure of the clamping device of the present application.

Element labels

1, Clamping an instrument;

2, a base;

3, a clamping structure;

4, an inner clamping arm;

402, fixing end;

404, an inner arm clamping part;

406, an inner arm anti-drop part;

408 barbs;

410 an elastic band;

412 a free end;

5, an outer clamping arm;

502, fixing end;

504, an outer arm clamping part;

506, an outer arm anti-drop part;

508, an anti-drop groove;

510, arc-shaped blades;

512 actuation rod;

514, a linkage rod;

516, outer rod;

518, inner rod;

520, the bottom of the outer rod;

522, the bottom of the inner rod;

And 6, locking structure.

Detailed Description

In order to better understand the technical solutions in the embodiments of the present application, the following description will clearly and completely describe the technical solutions in the embodiments of the present application with reference to the accompanying drawings in the embodiments of the present application, and it is obvious that the described embodiments are only some embodiments of the present application, not all embodiments. All other embodiments, which are derived by a person skilled in the art based on the embodiments of the present application, shall fall within the scope of protection of the embodiments of the present application.

The existing clamping device for treating mitral insufficiency only can capture valve leaflets at two sides, so that the problems of greater difficulty in capturing the valve leaflets and longer operation time are caused. In view of the above, the embodiments of the present application provide a clamping device capable of independently performing the clamping operation of each leaflet, so as to improve the above-mentioned technical problems.

Embodiments of the present application will be further described with reference to the accompanying drawings.

The clamping device 1 of the embodiment can be used as an edge-to-edge repair implant in the field of interventional treatment of structural heart diseases, and can realize repair treatment of heart valves by reaching a designated anatomical position through a vascular minimally invasive approach or through the auricle.

As shown in fig. 1 and 2, the clamping device 1 of the present application mainly comprises a base 2 and at least two clamping structures 3.

In this embodiment, the base 2 can be positioned at a target center position, each clamping structure 3 can be enclosed on the base 2, and can be switched between a clamping state and a releasing state relative to the base 2, so as to adjust the interval distance between the target tissues by clamping or releasing the target tissues adjacent to the target center position.

Alternatively, the clamping apparatus 1 may comprise two clamping structures 3 arranged on opposite sides of the base 2, the target tissue may comprise a mitral valve anterior valve and a mitral valve posterior valve, and the mitral valve insufficiency problem may be treated by clamping the mitral valve anterior valve and the mitral valve posterior valve respectively by the two clamping structures 3 of the clamping apparatus 1.

Alternatively, the clipping device 1 may also be used for treatment of tricuspid regurgitation.

In one embodiment, the clamping device 1 may comprise two clamping structures 3 surrounding the base 2, which may be used to clamp any two valves of the tricuspid valve, respectively.

In another embodiment, the clamping apparatus 1 may also comprise three clamping structures 3 surrounding the base 2 to clamp the respective tricuspid valve.

Alternatively, each clamping structure 3 may be switched between the clamping state and the release state synchronously, or each clamping structure 3 may be switched between the clamping state and the release state independently.

In this embodiment, the positioning angles of the clamping structures 3 in the clamping state relative to the base 2 may be the same or different.

In this embodiment, the clamping structure 3 may include an inner clamping arm 4 and an outer clamping arm 5.

Specifically, the inner and outer clamp arms 4, 5 each include a fixed end 402,502 pivotally connected to the base 2, and the inner and outer clamp arms 4, 5 are pivotable relative to the base 2 via the fixed ends 402,502, respectively, to provide switching of the clamping structure 3 between the clamped and released states.

In this embodiment, the inner arm 4 may include an inner arm clamping portion 404, and the outer arm 5 may include an outer arm clamping portion 504, wherein the outer arm clamping portion 504 and the inner arm clamping portion 404 may cooperate to clamp or release the target tissue.

Alternatively, the inner arm clamp 404 may include an elastic band 410. The outer arm clamp 504 may include an arcuate blade 510.

Optionally, the inner clip arm 4 may further include an inner arm drop-off prevention portion 406 provided on the inner arm clip portion 404.

Optionally, the outer arm 5 may further include an outer arm drop-off prevention portion 506 provided on the outer arm clamping portion 504.

When the clamping structure 3 is in the clamped state, the inner arm anti-drop portion 406 and/or the outer arm anti-drop portion 506 may be used to prevent the target tissue from falling out from between the outer arm clamping portion 504 and the inner arm clamping portion 404 to ensure that the target tissue is securely clamped between the outer arm clamping portion 504 and the inner arm clamping portion 404.

Alternatively, the inner arm drop off prevention portion 406 may include a plurality of barbs 408 provided on the inner arm clamping portion 404 and extending in the direction of the outer arm clamping portion 504.

Optionally, the outer arm drop-out prevention portion 506 includes a plurality of drop-out prevention grooves 508 formed on the outer arm clamping portion 504.

In this embodiment, the inner clip arm 4 also includes a free end 412 opposite the fixed end 402.

Wherein the free end 412 of the inner arm 4 is forced to pivot the fixed end 402 of the inner arm 4 relative to the base 2 to adjust the pivot angle of the inner arm 4 relative to the base 2.

For example, the free end 414 of the inner arm 4 is connected to a control wire (not shown) to apply a force to the free end 412 of the inner arm 4 by the control wire to drive the inner arm 4 to pivot relative to the base 2, so as to independently control the opening and closing angle of the inner arm 4 relative to the base 2.

In this embodiment, the clamping structure 3 further includes an actuation rod 512 and a linkage rod 514.

The actuation rod 512 is movably disposed on the base 2, and opposite sides of the linkage rod 514 are respectively pivoted to the outer clamping arm 5 and the actuation rod 512.

In the present embodiment, the actuation lever 512 is movable along the axial direction thereof relative to the base 2 to drive the outer clamping arm 5 to pivot relative to the base 2 via the linkage lever 514, so as to adjust the pivot angle of the outer clamping arm 5 relative to the base 2, thereby achieving the purpose of independently controlling the opening and closing angle of the outer clamping arm 5 relative to the base 2.

Referring to fig. 3 and 4, in an embodiment, in the case that the clamping apparatus 1 includes two clamping structures 3, two actuating rods 512 corresponding to the two clamping structures 3 may include an outer rod 516 and an inner rod 518 penetrating through the base 2 and sleeved with each other.

Specifically, the two linkage rods 514 are pivotally connected to the outer rod bottom 520 of the outer rod 516 and the inner rod bottom 522 of the inner rod 518, respectively, and the inner rod bottom 522 is located between the outer rod bottom 520 and the base 2 (i.e., the inner rod bottom 522 is closer to the base 2 than the outer rod bottom 520) to define a maximum movement interval of the inner rod bottom 522 relative to the base 2 by a separation distance between the outer rod bottom 520 and the base 2.

Referring to fig. 5, in another embodiment, in the case that the clamping apparatus 1 includes two clamping structures 3, two actuating rods corresponding to the two clamping structures 3 may be respectively disposed in the base 2, for example, the two actuating rods may be disposed in the base 2 side by side, so as to slide independently relative to the base 2.

Optionally, the clamping structure 3 may further comprise a locking structure 6 (see fig. 6) provided on the base 2, wherein the locking structure 6 is switchable relative to the base 2 between a locked position (e.g. the locking structure 6 in the dashed line position in fig. 6) and an unlocked position (e.g. the locking structure 6 in the solid line position in fig. 6) to restrict or allow the actuation rod 512 to move relative to the base 2.

In summary, the clamping device of the application can independently control each clamping structure to perform the clamping operation of the target tissue, thereby effectively improving the capturing probability of the target tissue and reducing the capturing difficulty of the target tissue.

It should be noted that the above-mentioned embodiments are merely for illustrating the technical solutions of the embodiments of the present application, and not for limiting the same, and although the present application has been described in detail with reference to the above-mentioned embodiments, it should be understood by those skilled in the art that the technical solutions described in the above-mentioned embodiments may be modified or some technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application.

Claims

1. A clamping instrument, comprising:

A base capable of being positioned at a target center position, and

At least two clamping structures, each of which is enclosed on the base and can be switched between a clamping state and a releasing state relative to the base so as to adjust the interval distance between the target tissues by clamping different target tissues adjacent to the target central position;

The clamping structure comprises an inner clamping arm and an outer clamping arm;

The inner clamping arm and the outer clamping arm respectively comprise a fixed end pivoted with the base, and the inner clamping arm and the outer clamping arm can respectively pivot relative to the base by virtue of the fixed ends so as to enable the clamping structure to be switched between a clamping state and a release state;

The clamping structure also comprises an actuating rod and a linkage rod, wherein,

The actuating rod movably penetrates through the base, and two opposite sides of the linkage rod are respectively pivoted with the outer clamping arm and the actuating rod;

And wherein the actuation lever is movable in its axial direction relative to the base to drive the outer clip arm to pivot relative to the base via the linkage lever to thereby adjust the pivot angle of the outer clip arm relative to the base;

the clamping device comprises two actuating rods corresponding to the two clamping structures, wherein the two actuating rods comprise an outer rod and an inner rod which are arranged in the base in a penetrating manner and are mutually sleeved,

The two linkage rods are respectively pivoted with the outer rod bottom of the outer rod and the inner rod bottom of the inner rod, the inner rod bottom is positioned between the outer rod bottom and the base, and the interval distance between the outer rod bottom and the base can limit the maximum movement interval of the inner rod bottom relative to the base;

the clamping structure further comprises a locking structure arranged on the base;

Wherein the locking structure is switchable relative to the base between a locked position and an unlocked position to limit or permit movement of the actuation lever relative to the base.

2. A clamping device as claimed in claim 1, characterised in that the clamping device comprises two clamping structures, separate on opposite sides of the base, for clamping the anterior and posterior mitral valves respectively.

3. The clamping apparatus according to claim 1, wherein,

The clamping device comprises two clamping structures which are arranged on the base in a surrounding way and are used for respectively clamping any two valves of the tricuspid valve, or

The clamping apparatus comprises three clamping structures which are arranged on the base in a surrounding mode and are used for clamping all valves of the tricuspid valve respectively.

4. The clamping apparatus according to claim 1, wherein,

Each of the clamping structures being capable of being switched between the clamping state and the release state simultaneously, or

Each of the clamping structures is independently switchable between the clamped state and the released state.

5. A clamping device as claimed in claim 1, characterised in that the angle of positioning of each of the clamping formations in the clamped condition relative to the base is the same or different.

6. The clamping apparatus according to claim 1, wherein,

The inner clamping arm comprises an inner arm clamping part, the outer clamping arm comprises an outer arm clamping part, and the outer arm clamping part is matched with the inner arm clamping part in a cooperative manner to clamp or release the target tissue.

7. The apparatus of claim 6, wherein the clamping device comprises,

The inner clamping arm further comprises an inner arm anti-falling part arranged on the inner arm clamping part, and/or the outer clamping arm further comprises an outer arm anti-falling part arranged on the outer arm clamping part;

When the clamping structure is in a clamping state, the inner arm anti-falling part and/or the outer arm anti-falling part are/is used for preventing the target tissue from falling off from between the outer arm clamping part and the inner arm clamping part.

8. The clamping instrument of claim 7, wherein the inner arm drop-out prevention portion includes a plurality of barbs disposed on the inner arm clamping portion and extending in a direction of the outer arm clamping portion, the outer arm drop-out prevention portion including a plurality of drop-out prevention grooves formed on the outer arm clamping portion.

9. The clamping instrument of claim 6, wherein the inner arm clamping portion comprises an elastic band and the outer arm clamping portion comprises an arcuate blade.

10. The clamping instrument of claim 5, wherein the inner clamp arm further comprises a free end opposite the fixed end, the free end being capable of being forced to drive the fixed end of the inner clamp arm to pivot relative to the base to adjust the pivot angle of the inner clamp arm relative to the base.