The present invention relates to medical devices and, in particular, to a hemostatic clip.
With the continuous development of endoscopic minimally invasive surgery, various endoscopic surgical procedures, including endoscopic submucosal dissection (ESD), endoscopic retrograde cholangiopancreatography (ERCP) and natural orifice transluminal endoscopic surgery (NOTES), are widely used. For these endoscopic minimally invasive procedures, safe and effective intraoperative closure of defects or perforations in digestive tissue is a critical issue that must be addressed.
Hemostatic clips are instruments for closing defects or perforations in luminal tissue. Existing hemostatic clips have openable-and-closable and rotatably clip heads. After being delivered to a target site, such a clip head is activated by a traction mechanism to open, close and/or rotate, as desired, to clamp tissue at the target site to close a defect or perforation there. After that, the clip head is separated from the traction mechanism and remains in the patient's body until it falls off and is passed out of the body through the gastrointestinal tract after the defect or perforation is closed as a result of tissue growth at the target site.
In the existing hemostatic clips, the clip head can be coupled to the traction mechanism by a hook, and the coupling can be destroyed by breaking the hook. However, if the broken hook falls onto a wound, it may cause inflammation and other issues. Alternatively, the clip head may be coupled to the traction mechanism by a ball head and a mating connecting yoke and decoupled therefrom by causing deformation of the connecting yoke. However, the fabrication of the connecting yoke involves a complicated process.
It is an objective of the present invention to provide a hemostatic clip, which has a simpler structure and does not have the risk of a broken portion remaining in a patient' body during its use.
To this end, the present invention provides a hemostatic clip including:
a traction mechanism defining an inner bore at a distal end thereof; and
a clamping mechanism including a constricting sleeve and a clip head assembly, the constricting sleeve provided thereon with a first locking member, the clip head assembly partially disposed within the constricting sleeve, the clip head assembly including an engagement member and a clip head body, the engagement member having a proximal end portion inserted in the inner bore so as to form an interference fit with the inner bore, the clip head body connected at a proximal end thereof to a distal end of the engagement member, the clip head body distally protruding out of a distal end of the constricting sleeve, the clip head assembly provided with a second locking member, wherein:
the hemostatic clip is configured so that, when the second locking member is separate from the first locking member, the traction mechanism is allowed to drive, under the action of an external force, the clip head assembly to move forth and back along an axis of the constricting sleeve, thereby switching the clip head body between an opened configuration and a closed configuration; and
the hemostatic clip is also configured so that in the closed configuration of the clip head body, movement of the clip head assembly along the axis of the constricting sleeve is prevented when the second locking member is connected to the first locking member, and the proximal end portion of the engagement member will disengage from the inner bore when a pulling force greater than a first predetermined value is applied to the traction mechanism.
Optionally, the hemostatic clip may further include an adaptor bush assembly, which is detachably connected at a distal end thereof to a proximal end of the constricting sleeve, communicates with the constricting sleeve and is configured to rotatable relative to the constricting sleeve, wherein the traction mechanism is partially disposed in the adaptor bush assembly so as to be movable along an axis thereof; and
the hemostatic clip is configured so that the traction mechanism drives, under the action of an external force, both rotation of the clip head assembly about an axis of the traction mechanism and rotation of the constricting sleeve about its own axis.
Optionally, the adaptor bush assembly may be provided with a first limiting member, wherein the traction mechanism is provided with a second limiting member, which cooperates with the first limiting member to prevent the second locking member from being connected to the first locking member.
Optionally, the adaptor bush assembly may include a sleeve, the sleeve having a distal end portion inserted in the constricting sleeve from the proximal end thereof, the sleeve also having a distal end face that makes up the first limiting member, wherein:
the traction mechanism defines at a distal end thereof first bent fins, the first bent fins bent outwardly with respect to the traction mechanism, the first bent fins configured to be elastic, the first bent fins making up the second limiting member; and
the hemostatic clip is configured so that, when the first bent fins abut against the distal end face of the sleeve, the clip head assembly is prevented from moving toward the proximal end of the constricting sleeve, and the second locking member is located distally with respect to the first locking member, and that, wherein a pulling force greater than a second predetermined value is applied to the traction mechanism, the first bent fins deforms so as to allow the traction mechanism to drive the clip head assembly to move toward the proximal end of the constricting sleeve until the second locking member is connected to the first locking member; and the second predetermined value is smaller than the first predetermined value.
Optionally, the clamping mechanism may further include a third limiting member disposed on the constricting sleeve and located distally with respect to the engagement member, the third limiting member configured to define a maximum distance that the clip head assembly is able to move toward a distal end of the constricting sleeve, thereby preventing the clip head assembly from distal dislodgement from the constricting sleeve.
Optionally, the first locking member may include a locking slot defined in a wall of the constricting sleeve, wherein the second locking member includes a stop block provided on a surface of the clip head body on a side thereof closer to an inner wall surface of the constricting sleeve; and
the third limiting member is further configured to limit circumferential relative positions of the clip head assembly and the constricting sleeve, thereby enabling the stop block to enter and engage with the locking slot.
Optionally, the third limiting member may extend radially with respect to the constricting sleeve and delimit two channels together a tubular wall of the constricting sleeve,
wherein the clip head body includes two opposing clip arms, which distally pass through the respective two channels and extend out of the constricting sleeve from the distal end thereof.
Optionally, the third limiting member may include a pin or two first stop walls provided in circumferential symmetry at the distal end of the constricting sleeve.
Optionally, the adaptor bush assembly may include a sleeve and an elastic connecting member, the sleeve including a distal section and a proximal section, the distal section having an outer diameter smaller than an outer diameter of the proximal section so that a step surface is defined on an outer wall surface of the sleeve, the distal section provided therein with a first through hole, the elastic connecting member including a base portion and a shaft portion, the base portion disposed within the sleeve and provided therein with a second through hole for passage of the traction mechanism therethrough, the shaft portion disposed on a side of the base portion closer to a distal end of the sleeve so as to extend along the axis of the sleeve, the shaft portion defining a second bent fin at a distal end thereof, the second bent fin passing through the first through hole and protruding out of the sleeve so as to define an accommodating groove together with the step surface, wherein
the constricting sleeve, at the proximal end thereof, defines an inwardly-projecting fourth limiting member, and is disposed over the distal section of the sleeve so that the fourth limiting member is disposed in the accommodating groove.
Optionally, the traction mechanism may include a core wire and a coupling tube, the coupling tube disposed at a distal end of the core wire, the coupling tube defining the inner bore, the core wire passed through the second through hole, the coupling tube located distally with respect to the base portion, the coupling tube having an outer diameter greater than a diameter of the second through hole, wherein
the hemostatic clip is configured so that, after the proximal end portion of the engagement member has disengaged from the inner bore, when the coupling tube proximally abuts against the base portion and when a pulling force greater than a third predetermined value is applied to the traction mechanism, the second bent fin will deform, thereby separating the adaptor bush assembly from the constricting sleeve.
Optionally, the hemostatic clip may further include a handle assembly, the handle assembly including a grip member, a slidable member and a rotatable member, the grip member defining an axially-extending slide slot, the slidable member disposed in the slide slot so as to be slidable therein, the rotatable member rotatably disposed at a distal end of the grip member, wherein the traction mechanism proximally extends out of the adaptor bush assembly from a proximal end thereof into the handle assembly and is connected to both the slidable member and the rotatable member in the handle assembly; and
the hemostatic clip is configured so that the slidable member drives, when sliding in the slide slot, the traction mechanism to move along the axis of the adaptor bush assembly to cause the clip head assembly to move along the axis of the constricting sleeve and that the rotatable member drives, when rotating relative to the grip member, the traction mechanism to rotate about its own axis to cause rotation of the clip head assembly and the constricting sleeve.
Optionally, the traction mechanism may include a core wire, a coupling tube, a first connecting block and a second connecting block, the coupling tube disposed at a distal end of the core wire and defining the inner bore, the first connecting block and the second connecting block both disposed over the core wire around a proximal end thereof, the second connecting block located proximally with respect to the first connecting block, the first connecting block coupled to the rotatable member and configured to be rotatable in synchronization with the rotatable member and axially movable relative to the rotatable member, the second connecting block coupled to the slidable member and configured to be axially stationary relative to the slidable member and circumferentially rotatable relative to the slidable member.
Alternatively or additionally, the adaptor bush assembly may include a spring tube distally coupled to the proximal section of the sleeve, the spring tube provided at a proximal end thereof with a locating tube, the locating tube coupled to the rotatable member in the handle assembly, the locating tube configured to be axially stationary relative to the rotatable member and circumferentially rotatable relative to the rotatable member.
The hemostatic clip of the present invention has the following advantages over the prior art:
It includes a traction mechanism and a clamping mechanism. The traction mechanism defines an inner bore at a distal end thereof. The clamping mechanism includes a constricting sleeve and a clip head assembly. The constricting sleeve is provided thereon with a first locking member, and the clip head assembly is partially disposed within the constricting sleeve. The clip head assembly includes an engagement member and a clip head body. A proximal end portion of the engagement member is inserted in the inner bore so as to form an interference fit therewith. The clip head body is connected at a proximal end thereof to a distal end of the engagement member and distally protrudes out of a distal end of the constricting sleeve. The clip head assembly is provided with a second locking member. In an initial configuration, the second locking member is separate from the first locking member. The operator may apply an external force to the traction mechanism to drive the clip head assembly to move forth and back along an axis of the constricting sleeve, thereby switching the clip head body between and opened configuration and a closed configuration. After the clip head body has clamped tissue at a target site and been switched to the closed configuration, the operator may apply a pulling force to the traction mechanism to connect the second locking member to the first locking member. As a result, the clip head body is locked in the closed configuration. Subsequently, the operator may apply a pulling force greater than a first predetermined value to the traction mechanism to disengage the proximal end portion of the engagement member from the inner bore, thus separating the clip head assembly from the traction mechanism. The interference fit between the engagement member and the inner bore enables connection of the clip head assembly and the traction mechanism to be achieved with a simple structure. Moreover, the two can be separated simply by applying a suitable pulling force, without involving the breakage of any structural component. Thus, the risk of a broken portion remaining in a patient's body and possibly accessing a wound can be avoided, resulting in higher safety and enhanced reliability.
The accompanying drawings are provided to facilitate a better understanding of the present invention and do not unduly limit the scope thereof in any sense, in which:
Particular embodiments of the present invention will be described below by way of specific examples. Based on the disclosure and teachings provided herein, a person of ordinary skill in the art will readily realize other advantages and benefits provided by the present invention. The present invention may also be otherwise embodied or applied through different embodiments, and various modifications or changes may be made to the details disclosed herein from different points of view or for different applications, without departing from the spirit of the present invention. It should be noted that the accompanying drawings are provided herein merely to schematically illustrate the basic concept of the present invention. Accordingly, they only show components relating to the present invention but not necessarily depict all the components as well as their real shapes and dimensions in practical implementations. In practice, the configurations, counts and relative scales of the components may vary arbitrarily and their arrangements may be more complicated.
In the following, each of the embodiments is described as having one or more technical features. However, this does not mean that the present invention must be practiced necessarily with all such technical features, or separately with some or all the technical features in any of the embodiments. In other words, as long as the present invention can be put into practice, a person skilled in the art may choose some or all of the technical features in any of the embodiments or combine some or all of the technical features in different embodiments based on the teachings herein and depending on relevant design specifications or the requirements of practical applications. In this way, the present invention can be carried out more flexibly.
As used herein, the singular forms “a”, “an” and “the” include plural referents, and the plural form “a plurality of” means “two or more”, unless the context clearly dictates otherwise. As used herein, the term “or” is generally employed in the sense including “and/or” unless the context clearly dictates otherwise. The terms “mounting”, “coupling” and “connection” should be interpreted in a broad sense. For example, a connection may be a permanent, detachable or integral connection, or a mechanical or electrical connection, or a direct or indirect connection with one or more intervening media, or an internal communication or interaction between two elements. Those of ordinary skill in the art can understand the specific meanings of the above-mentioned terms herein, depending on their context.
Objectives, features and advantages of the present invention will become more apparent upon reading the following more detailed description of the present invention, which is set forth by way of particular embodiments with reference to the accompanying drawings. Note that the figures are provided in a very simplified form not necessarily drawn to exact scale and for the only purpose of facilitating easy and clear description of the embodiments. In the drawings, like reference numbers indicate identical or similar elements. Like numerals indicate like elements throughout the several views.
As used herein, the terms “proximal” and “distal” are intended to refer to relative orientations, relative positions and directions between components of a medical device or actions thereof, as viewed by a physician operating the device. Without wishing to be limiting, a “proximal end” usually refers to an end closer to the operator, and a “distal end” to an end first enters the body of a patient, during normal operation of the medical device.
Referring to
The hemostatic clip is configured to allow, when the second locking member is separate from the first locking member, the traction mechanism to drive, under the action of an external force, the clip head assembly 2200 to move an axis of the constricting sleeve 2100 to switch the clip head body between an opened configuration and a closed configuration. In this way, the clip head body can be adjusted in position and orientation to clamp an object.
The hemostatic clip is also configured to prevent, when the clip head body is in the closed configuration and when the second locking member is connected to the first locking member, the clip head assembly 2200 from moving along the axis of the constricting sleeve 2100. In this way, when the clip head body achieves clamping of the object, the connected second and first locking members can lock the clip head body in the closed configuration, thus maintaining the clamping of the object. In this configuration, an operator may apply a pulling force greater than a first predetermined value to the traction mechanism 1000 to disengage the proximal end portion of the engagement member 2210 from the inner bore 1001, separating the clip head assembly 2200 from the traction mechanism 1000. It would be appreciated that the first predetermined value may be determined as any value depending on the strength of the interference fit established between the engagement member 2210 and the inner bore 1001, as long as the interference fit can be overcome by a pulling force exceeding the first predetermined value. In the hemostatic clip of this embodiment of the present invention, the clip head assembly 2200 is connected to the traction mechanism 1000 in a simple and reliable manner. This enables ease of use, and the two can be separated from each other without involving the breakage of any structural component, thereby avoiding the risk of a broken portion accessing a wound to cause inflammation and resulting in increased safety of use.
With particular reference to
The adaptor bush assembly 3000 is provided thereon with a first limiting member, and the traction mechanism 1000 is provided thereon with a second limiting member. The second limiting member can cooperate with the first limiting member to prevent the second locking member from being connected to the first locking member. When the second locking member is not connected to the first locking member, the clip head assembly is movable forth and back along the axis of the constricting sleeve 2100 to adjust a position and orientation of the clip head assembly.
Optionally, the clamping mechanism may further include a third limiting member, the third limiting member is provided on the constricting sleeve 2100 on a distal side of the engagement member 2210 and configured to define a maximum distance that the clip head assembly 2200 is movable toward the distal end of the constricting sleeve 2100, thereby preventing the clip head assembly 2200 from distal dislodgement from the constricting sleeve 2100. Apart from this, the third limiting member is also configured to limit circumferential relative positions of the clip head assembly 2200 and the constricting sleeve 2100 to ensure circumferential alignment and hence successful connection of the second locking member with the first locking member. In this embodiment, the constricting sleeve 2100 is also configured to be rotatable relative to the adaptor bush assembly 3000. In this way, when the traction mechanism 1000 is rotated about its own axis under the action of an external force to drive the clip head assembly 2200 to rotate, the constricting sleeve 2100 will not interfere with the rotation of the clip head assembly 2200. In other words, while driving the clip head assembly 2200 to rotate about an axis of the traction mechanism 1000, the traction mechanism 1000 can simultaneously drive the constricting sleeve 2100 to rotate.
The hemostatic clip further includes a handle assembly 4000 configured to be connected to a proximal end of the traction mechanism 1000. The operator can manipulate the handle assembly 4000 to apply forces to the traction mechanism 1000, thereby activating the clamping mechanism 2000 to perform various motions.
The structures of the various components in the hemostatic clip of the present embodiment and how they are assembled together will be described in detail below with reference to the accompanying drawings. Those skilled in the art would appreciate that the structures of the components as described below are merely those suitable for use in the hemostatic clip of this embodiment rather than mandatory ones and, therefore, should not be construed as limiting the present invention in any sense.
Referring to
Referring to
The traction mechanism 1000 further includes a reinforcing sleeve 1500 disposed over a portion of the core wire 1100 between the first connecting block 1300 and the second connecting block 1400, the opposing axial ends of the reinforcing sleeve 1500 are connected to both the first connecting block 1300 and the second connecting block 1400. The reinforcing sleeve 1500 can strengthen the traction mechanism 1000 and reduce its likelihood of bending.
Referring to
In some embodiments, the constricting sleeve 2100 has an inner diameter that is constant across its entire axial length. The fourth limiting member may be defined at the proximal end of the constricting sleeve 2100 in the form of a second stop wall (not shown). In some other embodiments, as shown in
Referring
As shown in
When the traction mechanism 1000 and the clamping mechanism 2000 are assembled together, the distal end of the two clip arms 2221 protrude through the respective two channels 2104 out of the constricting sleeve 2100. When the operator applies a pushing force to the proximal end of the traction mechanism 1000, the traction mechanism 1000 can drive the clip head assembly 2200 to move away from the proximal end of the constricting sleeve 2100, until the tubular wall of the constricting sleeve 2100 does not compress the clip arms 2221 any longer. As a result, the two clip arms 2221 moves away from each other, switching the clip head body to the opened configuration. When the operator applies a pulling force to the proximal end of the traction mechanism 1000, the traction mechanism 1000 can drive the clip head assembly 2200 to move toward the proximal end of the constricting sleeve 2100. In this process, the tubular wall of the constricting sleeve 2100 will compress the clip arms 2221 to cause them to move toward each other, thereby switching the clip head body to the closed configuration. It would be appreciated that, constrained by the third limiting member (e.g., the pin 2300, or the first stop walls 2105), the clip head assembly 2200 can move substantially only along the axis of the constricting sleeve 2100 without circumferential rotation (such circumferential rotation is made impossible, for example, because the portions of the clip arms 2221 located distally with respect to the constricting sleeve 2100 abut against the tubular wall of the constricting sleeve 2100 and the third limiting member).
Upon the stop blocks 2222 reaching the locking slots 2101 as a result of the movement of the clip head assembly 2200, the stop blocks 2222 will enter and engage with the locking slots 2101 (see
Referring back to
With particular reference to
Further, referring back to
Further, referring to
With additional reference to
In this embodiment, the grip member 4100, the slidable member 4200 and the rotatable member 4300 are all preferred to be modular structures, which can facilitate assembly of the handle assembly 4000 with the traction mechanism 1000 and the adaptor bush assembly 3000.
A method of using the hemostatic clip will be described below.
After the hemostatic clip is delivered to a target site in a patient's body, an operator may manipulate the handle assembly 4000 to cause the slidable member 4200 to slide (distally) within the slide slot 4110 to drive the traction mechanism 1000 to move along the axis of the adaptor bush assembly 3000. As a result, the clip head assembly is driven to move (distally) along the axis of the constricting sleeve 2100, thereby switching the clip head body to the opened configuration. Moreover, the operator may manipulate the rotatable member 4300 to cause the traction mechanism 1000 and hence the clip head assembly to rotate to adjust a position and orientation of the clip head assembly until tissue at the target site is located between the two clip arms 2221. In this way, a pulling force applied by the operator to the slidable member 4200 results in a pulling force smaller than the second predetermined value being exerted on the traction mechanism 1000. Thus, the distal end face of the adaptor bush assembly 3000 stops the first bent fins 1210, preventing the stop blocks 2222 from coming into engagement with the locking slots 2101. As a result, the operator is allowed to make repeated positional and orientational adjustments to the clip head assembly.
After that, the operator may proximally pull the slidable member 4200 to cause the traction mechanism 1000 to drive the clip head assembly to move toward the proximal end of the constricting sleeve 2100 until the first bent fins 1210 comes into abutment against the distal end face of the adaptor bush assembly 3000 (i.e., the first limiting member).
Subsequently, the operator may increase the pulling force to a value greater than the second predetermined value to cause deformation of the first bent fins 1210.
Afterward, the operator may further proximally retract the slidable member 4200 until the stop blocks 2222 enter the locking slots 2101.
Next, the operator may increase the pulling force to a value greater than the first predetermined value to overcome the interference fit between the engagement member 2210 and the inner bore 1001, separating the engagement member 2210 from the traction mechanism 1000.
Following that, the operator may further proximally pull the slidable member 4200 until the coupling tube 1200 comes into abutment against the base portion 3210 of the elastic connecting member 3200. The operator may then increase the pulling force to a value greater than a third predetermined value. When transmitted by the coupling tube 1200 to the elastic connecting member 3200, the pulling force will cause the second bent fins 3221 deform and disengage from the first through holes 3111, separating the adaptor bush assembly 3000 from the constricting sleeve 2100. The third predetermined value may be determined as needed.
Finally, the operator may additionally pull the slidable member 4200 proximally to withdraw the adaptor bush assembly 3000 and the traction mechanism 1000 from the patient's body.
Although the present invention has been disclosed hereinabove, it is not limited to the above disclosure. Those skilled in the art can make various changes and modifications to the invention without departing from the spirit and scope thereof. Accordingly, it is intended that any and all such changes and modifications also fall within the scope of the present invention as defined by the appended claims and equivalents thereof
Number | Date | Country | Kind |
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202011232973.X | Nov 2020 | CN | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2021/125599 | 10/22/2021 | WO |