CN113017929A - Clamping apparatus - Google Patents

Abstract

Translated fromChinese

本申请提供一种夹合器械，主要包括可定位于目标中心位置的基座，以及围设于基座上的至少两个夹合结构，各夹合结构可在夹合状态以及释放状态之间切换，以通过夹合邻接目标中心位置的不同目标组织，而调节各目标组织之间的间隔距离。借此，本申请的夹合器械可分开捕获或同时捕获不同的目标组织，以提高捕获概率并降低捕获难度。

The application provides a clamping device, which mainly includes a base that can be positioned at a target center position, and at least two clamping structures enclosed on the base, each clamping structure can be in a clamped state and a released state. Toggle to adjust the separation distance between each target tissue by clamping different target tissue adjacent to the target center location. Thereby, the clipping instrument of the present application 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

The regurgitation of heart valves (mitral valve and tricuspid valve) is a common heart disease, and is exemplified by the tricuspid valve, which is located at the orifice of the right atrioventricular, and the common onset is tricuspid valve insufficiency, i.e. the systolic blood flow flows back from the right ventricle to the right atrium, causing the right atrium to be highly enlarged, the pressure to be increased, and the venous blood backflow disorder. Right heart failure is likely to occur due to the compensatory hypertrophy of the load in the right ventricle.

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

Traditional treatment methods include drug therapy, and surgical procedures with corresponding surgical indications. Wherein the surgical method further comprises a valve replacement procedure and a valve repair procedure.

In recent years, with the development of science and technology, equipment manufacturers at home and abroad develop a batch of interventional clamping equipment for treating mitral valve or tricuspid valve regurgitation. Taking mitral regurgitation treatment as an example, the clamping device can be punctured through the interatrial septum by the catheter femoral vein, and is conveyed downwards from the left atrium to the vicinity of the mitral valve so as to clamp and fix the free edges of the anterior and posterior valve leaflets of the mitral valve, and the mitral valve is clamped into double holes by the clamping device, so that the anterior and posterior valve leaflets can be well involuted in the end of systole, and the regurgitation phenomenon is reduced.

The problem that the difficulty of capturing valve leaflets is large exists in most of the existing mitral valve edge-to-edge repair technologies, a clamping component of a clamping instrument can only capture the valve leaflets on two sides at the same time, and for patients with severe mitral valve regurgitation, the incomplete valve closure can lead to long operation time and large difficulty of capturing the valve leaflets at the same time.

How to solve the problems of high difficulty in capturing the valve leaflet and high failure rate of capturing is 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 address the above-mentioned problems.

The embodiment of the application provides a clamping apparatus, it includes: a base positionable at a target center location; and at least two clamping structures, wherein each clamping structure can be arranged on the base, extends towards different directions, and can be switched between a clamping state and a releasing state relative to the base so as to adjust the spacing distance between the target tissues by clamping different target tissues adjacent to the target center position.

Optionally, the clamping apparatus includes two clamping structures respectively disposed on opposite sides of the base for respectively clamping an anterior mitral valve and a posterior mitral valve.

Optionally, the clamping device comprises two clamping structures arranged on the base in a surrounding manner, and the two clamping structures are used for respectively clamping any two valves of the tricuspid valve; or the clamping device comprises three clamping structures which are arranged on the base in a surrounding way and are used for clamping each valve of the tricuspid valve respectively.

Optionally, each said gripping structure is synchronously switchable between said gripping state and said release state; or each said sandwich structure may be independently switchable between said sandwiched state and said released state.

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

Optionally, the clamping structure comprises an inner clamp arm and an outer clamp arm; the inner clamping arm and the outer clamping arm respectively comprise fixed ends 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 comprises an inner arm clamp portion and the outer clamp arm comprises an outer arm clamp portion, the outer arm clamp portion cooperating with the inner arm clamp portion to clamp or release the target tissue.

Optionally, 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 also 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 between the outer arm clamping part and the inner arm clamping part.

Optionally, inner arm anticreep portion is including locating on the inner arm clamping part and towards a plurality of barbs that the direction of outer arm clamping part extends, outer arm anticreep portion including form in a plurality of anticreep grooves on the outer arm clamping part.

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

Optionally, the inner clamp arm further includes a free end opposite to the fixed end, and the free end can be forced to drive the fixed end of the inner clamp arm to pivot relative to the base so as to adjust the pivot angle of the inner clamp arm relative to the base.

Optionally, the gripping structure further comprises an actuating lever and a linkage lever; the actuating rod can movably penetrate 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 actuating rod is movable relative to the base in an axial direction thereof to drive the outer clamp arm to pivot relative to the base via the linkage rod, thereby adjusting a pivot angle of the outer clamp arm relative to the base.

Optionally, the clamping instrument 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 bottom of the outer rod and the bottom of the inner rod, the bottom of the inner rod is located between the bottom of the outer rod and the base, and the spacing distance between the bottom of the outer rod and the base can limit the maximum moving interval of the bottom of the inner rod 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 inserted into the base and can independently slide relative to the base.

Optionally, the clamping structure further comprises a locking structure disposed on the base; wherein the locking structure is switchable between a locked position and an unlocked position relative to the base to limit or allow movement of the actuating lever relative to the base.

To sum up, the clamping apparatus provided by the embodiment of the present application can improve the capturing probability of the target tissue and reduce the capturing difficulty by enabling each clamping structure enclosed on the base to independently perform the clamping capturing operation of the target tissue.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, 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 can be obtained by those skilled in the art according to the drawings.

Fig. 1-2 are side views of different configurations of a clamping instrument of the present application.

Fig. 3-4 are schematic structural views of an embodiment of an actuating rod of the clamping instrument of the present application.

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

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

Element number

1: a clamping device;

2: a base;

3: a clamping structure;

4: an inner clamping arm;

402: a fixed end;

404: an inner arm clamping portion;

406: an inner arm drop-preventing part;

408: a barb;

410: an elastic band;

412: a free end;

5: an outer clamping arm;

502: a fixed end;

504: an outer arm clamping portion;

506: an outer arm drop-preventing part;

508: a drop-proof groove;

510: an arc-shaped blade;

512: an actuating lever;

514: a linkage rod;

516: an outer rod;

518: an inner rod;

520: the bottom of the outer rod;

522: the bottom of the inner rod;

6: and a locking structure.

Detailed Description

In order to make those skilled in the art better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be described clearly and completely below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, but not all embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application shall fall within the scope of the protection of the embodiments in the present application.

The existing clamping apparatus for treating mitral insufficiency can only capture two side valve leaflets, so that the problems of high difficulty in capturing the valve leaflets and long operation time are caused. In view of the above, the present disclosure provides a clamping device, which can independently perform the clamping operation of each leaflet to improve the above technical problems.

The following further describes specific implementations of the embodiments of the present application with reference to the drawings of the embodiments of the present application.

Theclamping apparatus 1 of the embodiment can be used as an edge-to-edge repair implant in the field of interventional therapy of structural heart diseases, and can reach a designated anatomical position through a vascular minimally invasive approach or through the atrial appendage to realize repair therapy of heart lobes.

As shown in fig. 1 and 2, theclamping apparatus 1 of the present application mainly comprises abase 2 and at least two clampingstructures 3.

In the present embodiment, thebase 2 can be positioned at the target center position, and each clampingstructure 3 can be enclosed on thebase 2 and can be switched between a clamping state and a releasing state relative to thebase 2, so as to adjust the spacing distance between each target tissue by clamping or releasing each target tissue adjacent to the target center position.

Alternatively, theclamping device 1 may comprise two clampingstructures 3 respectively disposed at two opposite sides of thebase 2, the target tissue may comprise an anterior mitral valve and a posterior mitral valve, and the anterior mitral valve and the posterior mitral valve may be clamped by the two clampingstructures 3 of theclamping device 1, respectively, to treat the mitral insufficiency.

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

In one embodiment, theclamping device 1 may comprise two clampingstructures 3 surrounding thebase 2, which may be used to clamp any two pieces of the tricuspid valve, respectively.

In another embodiment, theclamping device 1 may also comprise three clampingstructures 3 arranged around thebase 2 for clamping respective valves of the tricuspid valve.

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

In the present embodiment, the positioning angles of the clampingstructures 3 in the clamping state relative to thebase 2 may be the same or different.

In this embodiment, the clampingstructure 3 may include aninner clamping arm 4 and anouter clamping arm 5.

Specifically, the inner andouter clamp arms 4, 5 each include a fixed end 402,502 pivotally connected to thebase 2, and the inner andouter clamp arms 4, 5 are pivotable relative to thebase 2 via the fixed ends 402,502, respectively, to provide for switching the clampingstructure 3 between a clamped state and a released state.

In this embodiment,inner arm 4 may include aninner arm grip 404, and correspondingly,outer arm 5 may include anouter arm grip 504, whereinouter arm grip 504 andinner arm grip 404 may cooperate to grip or release the target tissue.

Optionally, theinner arm grip 404 may include anelastic band 410. Theouter arm clamp 504 may include anarcuate blade 510.

Optionally, theinner arm 4 may further include an innerarm retaining portion 406 provided on the innerarm holding portion 404.

Optionally, theouter arm 5 may further include an outerarm retaining portion 506 provided on the outerarm gripping portion 504.

When the clampingstructure 3 is in the clamped state, the innerarm retaining portion 406 and/or the outerarm retaining portion 506 may be used to prevent the target tissue from falling out from between the outerarm clamping portion 504 and the innerarm clamping portion 404, so as to ensure that the target tissue is firmly clamped between the outerarm clamping portion 504 and the innerarm clamping portion 404.

Alternatively, the innerarm retaining portion 406 may include a plurality ofbarbs 408 disposed on the innerarm gripping portion 404 and extending in the direction of the outerarm gripping portion 504.

Optionally, outerarm retaining portion 506 includes a plurality of retaininggrooves 508 formed on outerarm gripping portion 504.

In this embodiment, theinner clip arm 4 further includes afree end 412 opposite thefixed end 402.

Wherein, thefree end 412 of theinner clip arm 4 can be forced to drive thefixed end 402 of theinner clip arm 4 to pivot relative to thebase 2, so as to adjust the pivoting angle of theinner clip arm 4 relative to thebase 2.

For example, the purpose of independently controlling the opening and closing angle of theinner clamping arm 4 relative to thebase 2 is achieved by connecting the free end 414 of theinner clamping arm 4 with a control wire (not shown) to drive theinner clamping arm 4 to pivot relative to thebase 2 by applying a force to thefree end 412 of theinner clamping arm 4 via the control wire.

In this embodiment, the clampingstructure 3 further includes anactuating rod 512 and alinkage rod 514.

Wherein, theactuating rod 512 is movably disposed on thebase 2, and two opposite sides of thelinkage rod 514 are respectively pivoted to theouter clamping arm 5 and theactuating rod 512.

In the embodiment, theactuating rod 512 can move along its axial direction relative to thebase 2 to drive theouter clamping arm 5 to pivot relative to thebase 2 through thelinkage rod 514, so as to adjust the pivoting angle of theouter clamping arm 5 relative to thebase 2, thereby achieving the purpose of independently controlling the opening and closing angle of theouter clamping arm 5 relative to thebase 2.

Referring to fig. 3 and 4, in an embodiment, in the case that theclamping apparatus 1 includes two clampingstructures 3, the two actuatingrods 512 corresponding to the two clampingstructures 3 may include anouter rod 516 and aninner rod 518 disposed through thebase 2 and sleeved with each other.

Specifically, the twolinkage rods 514 are respectively pivoted to theouter rod bottom 520 of theouter rod 516 and theinner rod bottom 522 of theinner rod 518, and theinner rod bottom 522 is located between theouter rod bottom 520 and the base 2 (i.e., theinner rod bottom 522 is closer to thebase 2 than the outer rod bottom 520), so as to define the maximum moving interval of theinner rod bottom 522 relative to thebase 2 by means of the spacing distance between theouter rod bottom 520 and thebase 2.

Referring to fig. 5, in another embodiment, in a case that theclamping apparatus 1 includes two clampingstructures 3, two actuating rods corresponding to the two clampingstructures 3 may be respectively inserted into thebase 2, for example, the two actuating rods may be inserted into thebase 2 side by side, so as to independently slide relative to thebase 2.

Optionally, thesandwich structure 3 may further comprise a locking structure 6 (refer to fig. 6) provided on thebase 2, wherein the lockingstructure 6 is switchable between a locking position (e.g., the lockingstructure 6 in the dashed line position in fig. 6) and an unlocking position (e.g., the lockingstructure 6 in the solid line position in fig. 6) with respect to thebase 2 to limit or allow theactuation rod 512 to move with respect to thebase 2.

To sum up, the clamping apparatus of the present application can independently control each clamping structure to perform the clamping operation of the target tissue, and can effectively improve the capture probability of the target tissue and reduce the capture difficulty of the target tissue.

Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the embodiments of the present application, and are not limited thereto; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions in the embodiments of the present application.

Claims (15)

Translated fromChinese

1.一种夹合器械，其特征在于，包括：1. A clamping device, characterized in that, comprising:基座，其可定位于目标中心位置；以及a pedestal that can be positioned at the center of the target; and至少两个夹合结构，各所述夹合结构可围设于所述基座上，并可相对于所述基座在夹合状态和释放状态之间切换，以通过夹合邻接所述目标中心位置的不同目标组织，而调节各所述目标组织之间的间隔距离。at least two clamping structures, each of which can be enclosed on the base and can be switched between a clamped state and a released state relative to the base to abut the target by clamping Different target tissues at the central position, and adjust the separation distance between the target tissues.2.根据权利要求1所述的夹合器械，其特征在于，所述夹合器械包括分设于所述基座的相对两侧的两个夹合结构，用于分别夹合二尖瓣前瓣和二尖瓣后瓣。2 . The clamping apparatus according to claim 1 , wherein the clamping apparatus comprises two clamping structures respectively disposed on opposite sides of the base for clamping the anterior mitral valve respectively. 3 . and the posterior mitral valve.3.根据权利要求1所述的夹合器械，其特征在于，3. The clamping device of claim 1, wherein所述夹合器械包括围设于所述基座上的两个所述夹合结构，用于分别夹合三尖瓣的任意两片瓣膜；或者The clipping device comprises two clipping structures surrounding the base, for clipping any two flaps of the tricuspid valve respectively; or所述夹合器械包括围设于所述基座上的三个所述夹合结构，用于分别夹合三尖瓣的各个瓣膜。The clipping instrument includes three clipping structures surrounding the base and used for clipping each valve of the tricuspid valve respectively.4.根据权利要求1所述的夹合器械，其特征在于，4. The clamping instrument of claim 1, wherein各所述夹合结构可同步地在所述夹合状态和所述释放状态之间切换；或者each of the clamping structures is synchronously switchable between the clamping state and the releasing state; or各所述夹合结构可独立地在所述夹合状态和所述释放状态之间切换。Each of the clamping structures is independently switchable between the clamping state and the releasing state.5.根据权利要求1所述的夹合器械，其特征在于，呈所述夹合状态的各所述夹合结构相对于所述基座的定位角度可为相同或者不同。5 . The clamping apparatus according to claim 1 , wherein the positioning angles of the clamping structures in the clamping state relative to the base can be the same or different. 6 .6.根据权利要求5所述的夹合器械，其特征在于，所述夹合结构包括内夹臂和外夹臂；6. The clamping apparatus according to claim 5, wherein the clamping structure comprises an inner clamping arm and an outer clamping arm;其中，所述内夹臂和所述外夹臂各自包括枢接所述基座的固定端，所述内夹臂和所述外夹臂可分别借由所述固定端相对于所述基座枢转，以供所述夹合结构在夹合状态以及释放状态之间切换。Wherein, the inner clamp arm and the outer clamp arm each include a fixed end pivotally connected to the base, and the inner clamp arm and the outer clamp arm can be relative to the base through the fixed end, respectively pivoting for the clamping structure to switch between a clamped state and a released state.7.根据权利要求6所述的夹合器械，其特征在于，7. The clamping device of claim 6, wherein所述内夹臂包括内臂夹持部，所述外夹臂包括外臂夹持部，所述外臂夹持部与所述内臂夹持部协同配合以夹持或释放所述目标组织。The inner clamping arm includes an inner arm clamping portion, the outer clamping arm includes an outer arm clamping portion, and the outer arm clamping portion cooperates with the inner arm clamping portion to clamp or release the target tissue .8.根据权利要求7所述的夹合器械，其特征在于，8. The clamping device of claim 7, wherein所述内夹臂还包括设于所述内臂夹持部上的内臂防脱部；和/或所述外夹臂还包括设于所述外臂夹持部上的外臂防脱部；The inner clip arm further includes an inner arm detachment prevention part provided on the inner arm clamping part; and/or the outer clip arm further comprises an outer arm detachment prevention part arranged on the outer arm clamping part ;其中，当所述夹合结构处于夹合状态时，所述内臂防脱部和/或所述外臂防脱部用于防止所述目标组织从所述外臂夹持部与所述内臂夹持部之间脱落。Wherein, when the clamping structure is in the clamping state, the inner arm detachment prevention part and/or the outer arm detachment prevention part is used to prevent the target tissue from being separated from the outer arm clamping part and the inner arm It comes off between the arm grips.9.根据权利要求8所述的夹合器械，其特征在于，所述内臂防脱部包括设于所述内臂夹持部上并朝所述外臂夹持部的方向延伸的多个倒刺，所述外臂防脱部包括形成于所述外臂夹持部上的多个防脱槽。9 . The clipping device according to claim 8 , wherein the inner arm disengagement preventing portion comprises a plurality of Barb, the outer arm detachment prevention part includes a plurality of detachment prevention grooves formed on the outer arm clamping part.10.根据权利要求7所述的夹合器械，其特征在于，所述内臂夹持部包括弹性带，所述外臂夹持部包括弧形叶片。10. The clipping instrument of claim 7, wherein the inner arm gripping portion comprises an elastic band and the outer arm gripping portion comprises an arcuate blade.11.根据权利要求6所述的夹合器械，其特征在于，所述内夹臂还包括相对于所述固定端的自由端，所述自由端可受力而驱动所述内夹臂的固定端相对于所述基座枢转，以调节所述内夹臂相对于所述基座的枢转角度。11. The clamping apparatus according to claim 6, wherein the inner clamping arm further comprises a free end opposite to the fixed end, the free end being capable of being forced to drive the fixed end of the inner clamping arm Pivoting relative to the base to adjust the pivot angle of the inner clip arm relative to the base.12.根据权利要求6所述的夹合器械，其特征在于，所述夹合结构还包括致动杆和联动杆；其中，12. The clamping instrument of claim 6, wherein the clamping structure further comprises an actuation rod and a linkage rod; wherein,所述致动杆可活动地穿设于所述基座上，所述联动杆的相对两侧分别枢接所述外夹臂和所述致动杆；The actuating rod is movably passed through the base, and opposite sides of the linkage rod are pivotally connected to the outer clamp arm and the actuating rod respectively;且其中，所述致动杆可沿其轴向相对于所述基座移动，以经由所述联动杆驱动所述外夹臂相对于所述基座枢转，进而调节所述外夹臂相对于所述基座的枢转角度。And wherein, the actuating rod can move relative to the base along its axial direction, so as to drive the outer clamp arm to pivot relative to the base via the linkage rod, so as to adjust the relative position of the outer clamp arm the pivoting angle of the base.13.根据权利要求12所述的夹合器械，其特征在于，所述夹合器械包括两个所述夹合结构对应的两个所述致动杆；其中，两个所述致动杆包括穿设于所述基座中且相互套设的外杆和内杆；其中，13. The clamping instrument according to claim 12, wherein the clamping instrument comprises two actuating rods corresponding to the two clamping structures; wherein the two actuating rods comprise The outer rod and the inner rod are inserted into the base and are sleeved with each other; wherein,所述两个联动杆分别枢接所述外杆的外杆底部和所述内杆的内杆底部，且所述内杆底部位于所述外杆底部与所述基座之间，所述外杆底部与所述基座之间的间隔距离可限定所述内杆底部相对于所述基座的最大移动区间。The two linkage rods are pivotally connected to the bottom of the outer rod of the outer rod and the bottom of the inner rod of the inner rod, and the bottom of the inner rod is located between the bottom of the outer rod and the base, and the bottom of the outer rod is located between the bottom of the outer rod and the base. The separation distance between the bottom of the rod and the base may define a maximum movement range of the bottom of the inner rod relative to the base.14.根据权利要求12所述的夹合器械，其特征在于，所述夹合器械包括两个所述夹合结构对应的两个所述致动杆，所述两个致动杆分别穿设于所述基座中，并可独立地相对于基座滑移。The clamping apparatus according to claim 12, wherein the clamping apparatus comprises two actuating rods corresponding to the two clamping structures, and the two actuating rods are respectively penetrated in the base, and can independently slide relative to the base.15.根据权利要求12所述的夹合器械，其特征在于，所述夹合结构还包括设于所述基座上的锁定结构；15. The clamping apparatus according to claim 12, wherein the clamping structure further comprises a locking structure provided on the base;其中，所述锁定结构可相对于所述基座在锁定位置和非锁定位置之间切换，以限制或允许所述致动杆相对于所述基座移动。Wherein, the locking structure is switchable relative to the base between a locked position and an unlocked position to limit or allow movement of the actuating rod relative to the base.

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