Drawings
Fig. 1 is a schematic structural view of a clip applier provided in an embodiment of the disclosure.
Fig. 2A-2B are schematic structural views of a cartridge provided by an embodiment of the present disclosure.
Fig. 3 is a schematic structural view of a clip provided in an embodiment of the present disclosure.
Fig. 4 is a partial cross-sectional view of a clip applier provided by an embodiment of the disclosure, with a jaw assembly in an open state.
Fig. 4A is a schematic structural diagram of the switching mechanism in fig. 4.
Fig. 4B is a schematic structural view of the coupling mechanism in fig. 4.
Fig. 5A is a schematic cross-sectional view of a portion of a clip applier provided in an embodiment of the disclosure, at the perspective of M-M of fig. 5B, wherein the clip feeding assembly is not in abutment with the clip.
Fig. 5B is a schematic cross-sectional view of a portion of the clip applier provided in an embodiment of the disclosure, at the view L-L of fig. 5A, wherein the clip feeding assembly is not in abutment with the clip.
Fig. 6A is a schematic cross-sectional view of a portion of the clip applier provided in an embodiment of the disclosure, at the perspective M-M of fig. 6B, with the clip feeding assembly abutting the clip and pushing the clip into the jaw assembly.
Fig. 6B is a schematic cross-sectional view of a portion of the clip applier provided in an embodiment of the disclosure, taken at the perspective L-L of fig. 6A, wherein the clip feeding assembly abuts the clip and pushes the clip into the jaw assembly.
Fig. 6C is a schematic cross-sectional view of a partial area of the clip applier provided by an embodiment of the disclosure, at the perspective M-M of fig. 6D, with the jaw assembly closed.
Fig. 6D is a schematic cross-sectional view of a portion of a clip applier provided by an embodiment of the disclosure, at the view L-L of fig. 6C, with the jaw assembly closed.
Fig. 6E is a schematic view of a clamp feed block and resilient bar engaged with a clamp provided by an embodiment of the present disclosure.
Fig. 7 is a schematic structural view of a first head housing provided in an embodiment of the present disclosure.
Fig. 8 is a schematic structural view of a second head housing provided by an embodiment of the present disclosure.
Fig. 9 is a schematic structural view of a counting mechanism provided in an embodiment of the present disclosure.
Fig. 10 is another angular structural schematic diagram of a counting mechanism provided by an embodiment of the present disclosure.
Fig. 11 is a schematic structural view of a clutch mechanism provided in an embodiment of the present disclosure.
Fig. 12 is a schematic structural view of a guide pivot provided by an embodiment of the present disclosure.
Fig. 13 is another angular structural schematic view of a guide pivot provided by an embodiment of the present disclosure.
Fig. 14 is a schematic structural view of a wrench provided in an embodiment of the present disclosure.
Fig. 15 is a schematic structural view of a guide channel provided in an embodiment of the present disclosure.
Fig. 16 is a schematic view of the structure of the clip applier provided by the disclosed embodiments, wherein the wrench is in an open position and a portion of the housing of the clip applier is removed.
Fig. 17 is a front view of the counter mechanism mated with the clutch mechanism when the wrench is in the open position provided by the embodiments of the present disclosure.
Fig. 18 is a schematic view of the counter mechanism mated with the clutch mechanism when the wrench is in the open position provided by embodiments of the present disclosure.
Fig. 19 is a schematic view of the first head housing mated with the base and counter drive mechanism when the wrench is in the open position provided by embodiments of the present disclosure.
Fig. 20 is a partial cross-sectional view of a clip applier provided by an embodiment of the disclosure, with a wrench in an intermediate position.
Fig. 21 is a schematic view of the structure of the clip applier provided by the disclosed embodiments, wherein the wrench is in an intermediate position and a portion of the housing of the clip applier is removed.
Fig. 22 is a front view of the counter mechanism mated with the clutch mechanism when the wrench is in the neutral position, provided by embodiments of the present disclosure.
Fig. 23 is a schematic view of the counter mechanism mated with the clutch mechanism when the wrench is in the neutral position provided by the embodiments of the present disclosure.
Fig. 24 is a partial cross-sectional view of a clip applier provided by an embodiment of the disclosure, with a wrench in a closed position.
Fig. 25 is a schematic view of the structure of the clip applier provided by the disclosed embodiments, wherein the wrench is in a closed position and a portion of the housing of the clip applier is removed.
Fig. 26 is a front view of the counter mechanism engaged with the clutch mechanism during the movement of the wrench from the neutral position to the counting position provided by the embodiments of the present disclosure.
Fig. 27 is a schematic view of the counter mechanism engaged with the clutch mechanism during the process of the wrench from the intermediate position to the counting position provided by the embodiment of the present disclosure.
FIG. 28 is a schematic view of the first head housing mated with the base and counter drive mechanism during the movement of the wrench from the neutral position to the counter position provided by embodiments of the present disclosure.
Fig. 29 is a schematic view of the engagement of the first head housing with the base after the wrench reaches the counting position, provided by an embodiment of the present disclosure.
Fig. 30 is a schematic view of the engagement of the first head housing with the base after the wrench reaches the count position, provided by embodiments of the present disclosure.
Reference numerals:
1-operation assembly, 2-head housing, 3-handle housing, 4-wrench, 5-shaft assembly, 6-clamping bin, 7-bottom, 8-first side, 9-second side, 10-inlet, 11-first transverse barb, 12-second transverse barb, 13-inclined end, 14-jaw assembly, 15-first jaw arm, 16-second jaw arm;
201-first head housing, 202-second head housing, 203-first mount, 204-clutch drive, 205-second mount, 206-stop mechanism, 207-mounting slot, 208-stop tooth, 209-guide surface, 210-stop surface;
22-clip, 23-first clip arm, 25-first ear, 26-connection, 27-second clip arm, 29-second ear;
30-clamping parts, 31-pushing clamping blocks, 32-jaw driving pipes, 33-ribs, 34-baffle plates, 35-sleeves, 36-first reset pieces, 37-bases, 38-guide grooves and 39-guide surfaces;
40-clamping rod, 41-elastic rod, 42-clamping block, 43-clamping driving tube, 44-groove, 45-third reset piece and 46-clamping seat;
50-counting driving mechanism, 51-fixing part, 52-first driving part, 53-second driving part, 54-elastic connecting part and 55-bending part;
62-seat body, 621-first connection part, 622-second connection part, 623-extension part, 624-mating hole mechanism, 63-first clutch member, 64-second clutch member, 65-guide post, 66-first guide surface, 67-second guide surface, 68-fourth reset member, 69-upper rack;
70-lower rack, 71-intermediate piece, 72-spring, 73-guide pivot piece, 74-bias spring, 75-guide piece, 76-pivot portion, 77-force-bearing portion, 78-guide portion, 79-stop portion;
80-first swivel arm, 81-second swivel arm, 82-third swivel arm, 83-guide wall, 84-blocking wall, 85-pivot end, 86-guide channel, 87-main channel, 88-opening, 89-slave channel;
90-counting mechanism, 91-indicating part, 92-ratchet, 93-mounting hole, 94-stop part, 95-rod part, 96-matching part and 97-blocking wall.
Detailed Description
In order to make the objects, technical solutions and advantages of the present disclosure more apparent, the present disclosure will be further described in detail with reference to the accompanying drawings and examples. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the present disclosure. Based on the embodiments in this disclosure, all other embodiments that a person of ordinary skill in the art would obtain without making any inventive effort are within the scope of protection of this disclosure.
It is to be understood that the terms "proximal", "posterior" and "distal" and "anterior" are used herein with respect to a clinician manipulating the handles of the clip applier. The terms "proximal", "posterior" and "anterior" refer to the portion proximal to the clinician, and the terms "distal" and "anterior" refer to the portion distal to the clinician. I.e., the handle assembly is proximal and the jaw assembly is distal, e.g., the proximal end of a component represents an end relatively close to the handle assembly and the distal end represents an end relatively close to the jaw assembly.
In this disclosure, unless explicitly stated or limited otherwise, terms such as "connected," "coupled," and the like, are to be construed broadly, and may be, for example, fixedly connected, detachably connected, movably connected, or integrally formed, directly connected, indirectly connected via an intermediate medium, or in communication with each other between two elements or in an interaction relationship such as abutment. The specific meaning of the terms in this disclosure will be understood by those of ordinary skill in the art as the case may be. It should be noted that, when the terms "connected" and "connected" are used in the meanings defined by the corresponding terms, they are used in the excluding of the obvious cases, and not excluding other possible cases.
In order to observe the number of the remaining clips during the use of the clip applier, a counting mechanism can be arranged in the clip applier shell, and the counting mechanism is driven by the counting driving mechanism to change the counting value when the wrench moves forward. However, during one movement stroke of the wrench, the counter drive mechanism may continue to overdrive the counter mechanism, causing the counter mechanism to repeat counting such that the indicated count value of the counter mechanism does not accurately indicate the number of clips.
In order to solve the technical problem in the prior art, the present disclosure aims to provide a clip applier with simple and stable structure, which effectively avoids repeated counting of a counting mechanism in a wrench movement stroke and effectively improves the accuracy of counting of the counting mechanism to the clip. In the present disclosure, a counting mechanism is used to count the number of clips remaining in the clip magazine or to count the number of clips that have been applied.
The technical idea of the present disclosure in the specific embodiments will be described in detail with reference to the accompanying drawings.
The term "axial" as used herein refers to the length of the cannula. As used herein, a "wrench movement stroke" refers to the process of pushing a clip from a cartridge to a jaw assembly and onto tissue during a single clip feed and application, from an open position through an intermediate position to a closed position. Herein, "first direction" refers to a direction from the proximal end toward the distal end of the clip applier, and "second direction" refers to a direction from the distal end toward the proximal end of the clip applier.
Referring to fig. 1 to 4, fig. 1 is a schematic structural diagram of a clip applier according to an embodiment of the disclosure. Fig. 2A-2B are schematic structural views of a cartridge provided by an embodiment of the present disclosure. The cartridge 6 houses a plurality of clips 22. Fig. 3 is a schematic structural view of a clip provided in an embodiment of the present disclosure. Fig. 4 is a partial cross-sectional view of a clip applier provided by an embodiment of the disclosure, with a jaw assembly in an open state.
Referring to fig. 1, the present embodiment provides a clip applier, such as a continuous clip applier, for applying clip 22 to tissue or blood vessels. In general positional relationship, the clip applier includes an operating assembly 1, a shaft assembly 5 extending from the operating assembly 1, a transmission mechanism, a clip cartridge 6, and a jaw assembly 14 disposed at a distal end of the shaft assembly 5.
The operating assembly 1 comprises a body and a wrench 4. The body comprises a housing to which the wrench 4 is movably connected. The housing is divided into a head housing 2 and a handle housing 3 extending from the underside of the head housing 2 in a positional relationship, and the handle housing 3 and the wrench 4 constitute a handle assembly. The user can grasp the handle housing 3 with one hand and pull or press the wrench 4 with a finger so that the wrench 4 moves relative to the body to drive the transmission mechanism in a first direction.
In this embodiment, the wrench 4 has a forward movement and a reverse movement, and the direction of the forward movement and the direction of the reverse movement are opposite. The wrench 4 has an open position (the position of the wrench 4 shown in fig. 1), an intermediate position (the position of the wrench 4 shown in fig. 21), and a closed position (the position of the wrench 4 shown in fig. 25), and a movement path of the wrench from the open position to the closed position via the intermediate position is a closed path. After the wrench 4 moves forward from the open position under the action of external force, the free end of the wrench 4 can stay at the intermediate position close to the handle shell 3, and the wrench 4 is continuously pressed, so that the wrench 4 moves forward from the intermediate position to the closed position. When the wrench 4 is released in a state in which the wrench 4 is in the closed position, the wrench 4 is reversely moved from the closed position to the open position.
Referring to fig. 1 and 2A-2B, a cartridge 6 is provided to the shaft assembly 5. The proximal end of the cartridge 6 is connected to the body of the operating assembly 1 and the distal end of the cartridge 6 is connected to the jaw assembly 14. Before clamping, the clips 22 are placed in the clip magazine 6. Referring to fig. 2A, the cartridge 6 houses a plurality of clips 22, the plurality of clips 22 being sequentially arranged from the distal end to the proximal end of the cartridge 6, respectively a first clip, a second clip to an nth clip. The first clip is closest to the distal end of the cartridge 6 and is first fed into the jaw assembly 14. The clips 22 other than the first clip in the clip magazine 6 are defined as other clips. The clamp bin 6 comprises M stations, wherein the M stations are arranged from the far end to the near end of the clamp bin 6 and are respectively a first station, a second station and an M station, the first clamp is located at the first station of the forefront end, and the second clamp is arranged at the second station to the N station in sequence corresponding to the N clamp. M is more than or equal to 2, and M is more than or equal to N.
Referring to fig. 3, the clip 22 includes a first clip arm 23, a second clip arm 27, and a connecting portion 26 between the first clip arm 23 and the second clip arm 27. The connection 26 is flexible so that the first clamp arm 23 and the second clamp arm 27 can pivot relative to each other. One end of the first clamping arm 23 is connected with the connecting part 26, and the other end is provided with two first lugs 25, one first lug 25 is arranged on one side of the first clamping arm 23, and the other first lug 25 is arranged on the opposite side of the first clamping arm 23. One end of the second clip arm 27 is connected to the connecting portion 26, and the other end is provided with an engaging portion 30, for example, the engaging portion 30 is a curved C-shaped hook portion. The second clamping arm 27 is provided with two second lugs 29 near the clamping part 30, one second lug 29 is arranged on one side of the second clamping arm 27, and the other second lug 29 is arranged on the other opposite side of the second clamping arm 27.
The size of the engaging portion 30 is larger than the distance between the two first ear portions 25, and the two first ear portions 25 have a certain elasticity and can be deformed. Thus, the first clamping arm 23 and the second clamping arm 27 are close to each other under the driving of the external force, the clamping portion 30 moves between the two first ear portions 25, the two first ear portions 25 deform under the action of the clamping portion 30 to clamp the clamping portion 30 between the two first ear portions 25, so that the first clamping arm 23 and the second clamping arm 27 are sufficiently clamped, and the blood vessel or tissue placed between the first clamping arm 23 and the second clamping arm 27 can be effectively clamped and stopped.
Referring to fig. 2A-2B, the cartridge 6 includes an axially extending bottom portion 7 and opposed first and second side portions 8, 9. When the clip 22 is installed in the clip cartridge 6, the clip 22 is compressed, limited by the size and interior space of the clip cartridge 6. Specifically, the first arm 23 of the clip 22 abuts the first side 8 and the second arm 27 abuts the second side 9, such that the two arms 23,27 are compressed but not compressed to a closed state, i.e. the two arms 23,27 of the clip 22 are close to each other but not engaged.
The bottom 7 of the cartridge 6 is formed with a plurality of abutment assemblies along its length, one at each station. Referring to fig. 2A, each abutment assembly comprises a first transverse barb 11 and a second transverse barb 12. The first transverse barbs 11 are arranged in a row and the second transverse barbs 12 are arranged in a row, the first transverse barbs 11 and the second transverse barbs 12 are arranged in two rows on the bottom 7, the first transverse barbs 11 are arranged near the first side 8, the second transverse barbs 12 are arranged near the second side 9, and the transverse barbs on each row are arranged at equal intervals, for example along the axial direction. Each transverse barb is inclined from the bottom 7 of the cartridge 6 towards the distal end of the cartridge 6 and into the cartridge 6, i.e. the proximal end of each transverse barb is connected to the bottom 7, the distal end being movable, in this embodiment the transverse barb is for example an elastic tab with a distal end turned up. The distal end of each transverse barb is a beveled tip 13.
Referring to fig. 2A, 2B and 3, the first transverse barb 11 of each abutment assembly abuts a first ear 25 of a clip 22 from behind the second ear 29 of the same clip 22 when the second transverse barb 12 abuts the first ear 25 from behind the second ear 29. Specifically, when the angled end 13 of the first transverse barb 11 engages a first ear 25, the angled end 13 of the second transverse barb 12 engages a second ear 29 on the same side of the first ear 25. Thus, each abutment assembly is capable of preventing the clip 22 from entering an adjacent proximal station from the current station in the cartridge 6.
As the clip 22 moves axially forward, the clip 22 slidably contacts the forward transverse barb to press the transverse barb against the base 7 so that the clip 22 can pass smoothly over the transverse barb to allow the clip 22 to enter an adjacent distal station from the current station. Specifically, as the clip 22 moves axially forward, the first arm 23 of the clip 22 slides past the first transverse barb 11 in front of it, while the second arm 27 of the clip 22 slides past the second transverse barb 12 in front of it, causing both the first transverse barb 11 and the second transverse barb 12 to flex toward the base 7, so that the clip 22 passes smoothly over the first transverse barb 11 and the second transverse barb 12 to enter the adjacent distal station.
To apply the plurality of clips 22 in succession, the clip applier needs to perform three actions, a clip feeding action by the clip feeding driving mechanism, a jaw closing action (clip applying action) by the jaw driving mechanism, and a clip pushing action by the clip pushing driving mechanism.
Referring to fig. 1 and 4 in combination, the transmission mechanism includes a clip feed drive mechanism, a jaw drive mechanism, and a push clip drive mechanism. In response to movement of the wrench 4 from the open position to the intermediate position, the clip feed drive mechanism drives the first clip from the clip magazine 6 into the jaw assembly 14. In response to movement of the wrench from the intermediate position to the closed position, the jaw drive mechanism drives the jaw assembly closed to close the clip 22 in the jaw assembly, applying the clip 22 to tissue or a blood vessel. As shown in fig. 5B, when the wrench 4 is in the closed position, the push clamp blocks 31 of the respective push clamp driving mechanisms are located at the rear sides of the second clip to the nth clip, respectively. In response to movement of the wrench 4 from the closed position to the open position, the plurality of push blocks 31 are advanced to drive the second clip to the nth clip, respectively, to advance one station.
The clip applier can apply clips continuously, i.e., by pressing the wrench 4 multiple times, a plurality of clips 22 in the clip magazine 6 can be sequentially applied to tissue or blood vessels. As shown in FIG. 4, to indicate the number of clips 22, the clip applier also includes a counter mechanism 90 and a counter drive mechanism 50. The counting mechanism 90 is used to indicate the number of clips 22 remaining in the clip magazine or to indicate the number of clips 22 that have been applied. The counting mechanism 90 includes an actuation portion and an indication portion. The count driving mechanism 50 is provided with a first driving section. When the wrench 4 is moved forward from the open position, the counter drive mechanism 50 is moved in a first direction until the first drive portion engages the actuating portion, and the first drive portion drives the actuating portion to move in a first counter direction to change the counter value of the indicating portion. The head housing 2 is provided with an observation window which faces the indication portion, and the display content of one indication area of the indication portion facing thereto can be observed through the observation window. The indication part is provided with a plurality of indication marks for indicating the number of the remaining clips, and when the indication part is driven to move along the first counting direction, the indication part switches different indication marks into the indication area. The indication identifier may be, for example, a number, a specified letter, a specified symbol, a specified color, a specified graphic, or other type of identifier.
Here, changing the count value of the indication portion is embodied as changing the indication mark in the indication area of the indication portion observed from the observation window of the head casing 2. The indication mark observed from the observation window represents the current count value for the doctor. The movement of the actuating part along the first counting direction drives the indicating part to move along the first counting direction, so that different indication marks of the indicating part move to the positions of the mark areas opposite to the observation window. For example, when the indication mark includes a plurality of consecutive numbers, the indication portion moves in the first counting direction so that the number which is incremented or decremented from the number in the current indication area moves to the indication area position opposite to the observation window each time the clip is applied. The doctor can see the count value after the increment or decrement.
When the count value of the indication portion has changed and the movement stroke of the current wrench 4 has not ended (the wrench 4 has not reached the closed position), the wrench 4 is continuously pressed, and the wrench 4 continues to move in the forward direction. In order to avoid the excessive movement of the actuating part to repeatedly count the indicating part during the continuous forward movement of the wrench 4, the clip applier is further provided with a clutch driving part, and the counting driving mechanism 50 is further provided with a second driving part connected with the first driving part. After the count value of the indicating part is changed and the wrench continues to move forward, the clutch driving part is matched with the second driving part, the second driving part drives the first driving part to move to be separated from the actuating part, the first driving part does not continuously act on the actuating part, and the first driving part is prevented from continuously driving the actuating part to move along the first counting direction, so that only one counting in one wrench movement stroke is ensured, and the accuracy of the counting mechanism for the number of clamps is improved.
It should be noted that the descriptions of the specific structures of the clip feeding driving mechanism, the jaw driving mechanism, the push clip driving mechanism, the counting driving mechanism, and the clutch driving portion in the following embodiments are only exemplary, and are intended to be used for explaining the present disclosure, and are not to be construed as limiting the present disclosure.
The clip feed drive mechanism is used to drive clips 22 into the jaw assembly 14 (clip feed action), the jaw drive mechanism is used to drive the jaw assembly 14 into motion, and the push clip drive mechanism is used to drive other clips in the clip magazine 6 forward one station (clip push action). The counting driving mechanism 50 is used for driving the counting mechanism 90 to change the counting value of the indicating part, and the clutch driving part is used for driving the counting driving mechanism 50 to be separated from the counting mechanism 90 to avoid the repeated counting of the counting mechanism 90 when the counting mechanism 90 changes the counting value and the current wrench continues to move forward. The wrench 4 drives the transmission mechanism to move, thereby driving the clip feeding driving mechanism, the jaw driving mechanism to move, and the clip pushing driving mechanism to cause the clip feeding driving mechanism to perform the clip feeding action, the jaw driving mechanism to perform the jaw closing action (clip applying action), and the clip pushing driving mechanism to perform the clip pushing action. And the wrench 4 drives the transmission mechanism to move in the first direction, the counter drive mechanism 50 moves synchronously in the first direction.
Referring to fig. 4, the jaw drive mechanism includes a jaw drive tube 32 and a sleeve 35. The jaw drive tube 32 is housed in the head housing 2. The sleeve 35 is disposed over the cartridge 6, and the sleeve 35 also forms a portion of the shaft assembly 5 (shown in fig. 1). The proximal end of the sleeve 35 is coupled to the jaw drive tube 32, and the distal end of the sleeve 35 mates with the jaw assembly 14, and in response to forward movement of the wrench 4 from the intermediate position to the closed position, the jaw drive tube 32 moves distally to drive the sleeve 35 distally to thereby drive the jaw assembly 14 (shown in FIG. 1) closed.
The jaw drive mechanism also includes a first reset member 36. The first reset member 36 is disposed within the head housing 2 of the clip applier and is disposed over the jaw drive tube 32. The proximal end of the first return member 36 abuts the stop 34 on the outer surface of the jaw drive tube 32 and the distal end abuts the inner wall of the head housing 2. The first return member 36 is configured to store energy as the jaw drive mechanism advances, and the first return member 36 returns to deformation to release the energy and thereby power the return of the jaw drive mechanism. For example, the first return member 36 is a spring.
As shown in fig. 5A, the jaw assembly includes a first jaw arm 15 and a second jaw arm 16, each pivotally connected to a distal end of the cartridge 6. A second return member, for example a spring, is provided between the first 15 and second 16 jawarms for opening the jaws. As shown in fig. 4 and 5B, as the jaw drive tube 32 drives the sleeve 35 distally, the jaw assembly can be at least partially received within the sleeve 35 from the distal end of the sleeve 35 such that the jaw assembly is closed, with the second return member between the two jawarms 15,16 being compressed, while the first return member 36 is also compressed. When crimping is completed, the cannula 35 is moved proximally by the first restoring member 36, and the jaw assembly can be extended from the distal end of the cannula 35, and the second restoring member can release energy to open the jaw assembly.
Referring to fig. 5A-5B, the shaft assembly 5 further includes a base 37, the base 37 having a relatively high rigidity, the base 37 being disposed partially within the sleeve 35 and partially within the head housing 2. The base 37 is mounted on the outside of the bottom 7 of the cartridge 6. Referring to fig. 2A and 2B, the clip 22, the first side 8 of the cartridge 6 and the second side 9 of the cartridge 6 are all located on the inside of the base 7, the inside and outside referring to both sides of the plane in which the base 7 lies.
Referring to fig. 4, 5A-5B, and 6A-6B, the pinch drive mechanism includes a pinch assembly and a pinch drive tube 43. The feed clip drive tube 43 is partially located within the jaw drive tube 32 and is axially movable within the jaw drive tube 32. The proximal end of the clip feed assembly is connected to a clip feed drive tube 43, which tube 43 moves distally to drive the clip feed assembly distally in response to forward movement of the wrench 4 from the open position such that the clip feed assembly drives the clip 22 from the clip magazine 6 into the jaw assembly. The guiding groove 38 is arranged on the base 37, the guiding groove 38 accommodates the clip feeding assembly and moves axially, the guiding surface 39 is arranged at the far end of the guiding groove 38, the guiding surface 39 is an inclined surface, and the guiding surface 39 is arranged at an angle with the axial direction. The guide surface 39 is inclined from its proximal end to its distal end in a direction towards the cartridge 6. The bottom 7 of the cartridge 6 is provided with an inlet 10 corresponding to the guide surface 39.
The pinch drive mechanism further comprises a third return member 45, for example, the third return member 45 is a spring. Referring to fig. 4, the inner wall of the jaw drive tube 32 is provided with ribs 33. The distal end of the third restoring member 45 abuts against the rib 33 of the jaw drive tube 32, and the proximal end abuts against the distal end surface of the clip feeding drive tube 43. The third reset piece 45 is used for storing energy when the clip feeding driving mechanism advances, and the third reset piece 45 recovers deformation to release the energy so as to provide power for the reset and back of the clip feeding driving mechanism.
Referring to fig. 5A-5B, 6A-6B and 6E, the clip feed assembly includes a clip feed bar 40, an elastic bar 41 and a clip feed block 42. The proximal end of the pinch rod 40 is connected to a pinch drive tube 43, the distal end of the pinch rod 40 is connected to the proximal end of the elastic rod 41, and the distal end of the elastic rod 41 is connected to a pinch block 42. The clip feed lever 40 is rigid and does not deform easily, avoiding blocking of the clip feed assembly due to bending during axial movement in the guide slot 38.
Referring to fig. 5A-5B and fig. 6A-6B, when the clip feed driving tube 43 is driven to move in the first direction, the clip feed driving tube 43 drives the clip feed lever 40 to move distally, so that the elastic lever 41 and the clip feed block 42 also move distally, and at this time, the third restoring member 45 is deformed. When the resilient bar 41 moves distally to the point where the feed block 42 abuts the guide surface 39, the resilient bar 41 begins to flex and the feed block 42 is advanced obliquely along the guide surface 39 from the entrance 10 of the cartridge 6 between the first clip and the second clip within the cartridge 6 and abuts the first clip at the rear end of the first clip to advance into the jaw assembly.
After the clip 22 is clamped in the jaw assembly, the feed block 42 at the distal end of the resilient bar 41 continues to abut the clip 22 from the rear end of the clip 22 to prevent proximal (i.e., rearward) movement of the clip 22 during application. Closing the jaw assembly closes the clip 22 and then opens the jaw assembly to disengage the clip 22 from the jaw assembly, i.e., complete clip application. After the jaw assembly is closed, the clip feed assembly is reset by the third reset member 45, and in particular, the clip feed lever 40 moves axially proximally (in the second direction) in the guide slot 38, driving the resilient lever 41 and the clip feed block 42 back from the inlet 10 into the guide slot 38 along the guide surface 39.
Referring to fig. 4, 5B and 6B, the push clip drive mechanism includes a push clip seat 46. The proximal end of the push holder 46 is located within the clip feed drive tube 43, and the other portion of the push holder 46 extends distally and is disposed within the sleeve 35, with the base 37 mounted on one side of the cartridge 6 and the push holder 46 disposed on the opposite side of the cartridge 6. The push holder 46 is axially movable in the feed gripper driving tube 43.
Referring to fig. 5A-5B and fig. 6A-6B, corresponding to M stations of the clamping magazine 6, M side cavities are provided on the push clamping seat 46 at intervals, and a push clamping block 31 is provided in each side cavity. Each push clamp block 31 is connected with the push clamp seat 46 through a spring 72. The spring 72 provides a force to the push clamp block 31 that rotates toward the outside of the side cavity, specifically tilting the distal end of the push clamp block 31 out of the side cavity toward the clip 22. In response to the push clips 46 being advanced axially distally, the distal end of each push clip block 31 abuts and pushes one clip 22 forward, respectively, such that the clip 22 moves axially distally, and the clip 22 passes smoothly over the first transverse barb 11 and the second transverse barb 12 (see fig. 2A), thereby bringing the clip 22 from the current station into an adjacent distal station. Thereby, the pushing holder 46 pushes the other clips (clips 22 other than the first clip) in the clip magazine 6 forward by one station. When the push clip seat 46 is retracted proximally in the axial direction, the clip 22 cannot be retracted under the action of the first transverse barb 11 and the second transverse barb 12, so that the push clip block 31 abuts against the clip and is extruded by the clip 22 to rotate in the side cavity, the push clip block 31 is retracted proximally along the side surface of the clip 22, the clip 22 is avoided, and the push clip block 31 is prevented from being retracted proximally with the clip 22 during retraction.
As described above, the clip applier includes the transmission mechanism, the wrench 4 drives the transmission mechanism to move, so that the clip feeding driving mechanism performs the clip feeding action, the jaw driving mechanism performs the clip applying action, and the clip pushing driving mechanism performs the clip pushing action, and the transmission mechanism realizes the transmission action between the wrench and the clip feeding driving mechanism, the jaw driving mechanism, and the clip pushing driving mechanism. In this embodiment, the counter drive mechanism 50 is provided in a transmission mechanism, for example, the counter drive mechanism 50 is fixedly connected to or integrally formed with the rotation mechanism. The counting mechanism 90 is mounted inside the head housing 2. In response to the wrench moving forward along the closed path, the transmission mechanism is driven by the wrench to synchronously drive the counting driving mechanism 50 to move along the first direction, and the counting driving mechanism 50 can drive the counting mechanism 90 to change the counting value when moving along the first direction.
Referring to fig. 4, 7-10, the head housing 2 includes a first head housing 201 (fig. 7) and a second head housing 202 (fig. 8) disposed along a radial direction of the sleeve 35, and lower sides of the first head housing 201 and the second head housing 202 extend out of a first handle housing and a second handle housing (not shown) respectively, and the first head housing 201 and the second head housing 202 may be buckled to form an internal cavity. The first head housing 201 is provided with a first mounting portion 203 and a clutch driving portion 204 on the inner side, and the second head housing 202 is provided with a second mounting portion 205 on the inner side. The first and second mounting portions 203 and 205 are respectively raised fixing posts. The counting mechanism 90 is a counting wheel capable of rotating around an axis, the center of the counting wheel is provided with a mounting hole 93, and the mounting hole 93 is rotatably sleeved on the radial outer sides of the first mounting part 203 and the second mounting part 205, so that the counting mechanism 90 is rotatably mounted on the handle housing 3. When the counter driving mechanism 50 drives the counter mechanism 90 to move to change the count value, the counter mechanism 90 rotates around the first counting direction, that is, the first counting direction is the first rotation direction (counterclockwise direction in fig. 4).
The transmission mechanism also comprises a switching mechanism and a matching mechanism. The structure and principle of the switching mechanism will be described in more detail below with reference to the placement direction and angle of the clip applier in fig. 4:
Referring to fig. 4, 4A and 4B, 11, 16, the switching mechanism includes a housing 62 and a clutch mechanism including a first clutch 63, a clutch switching mechanism, and a second clutch 64. The seat body 62 includes a first connecting portion 621, a second connecting portion 622, and an extending portion 623, the first connecting portion 621 has a fitting hole mechanism 624, the fitting hole mechanism 624 includes a first kidney-shaped hole and a second kidney-shaped hole, and the first kidney-shaped hole and the second kidney-shaped hole are oppositely disposed in a direction perpendicular to the paper surface (with reference to a placement angle of the clip applier in fig. 16). The first clutch member 63 is accommodated in the housing 62, the second clutch member 64 is connected to a second connecting portion of the housing 62, that is, a distal end surface of the housing 62, and the extension portion 623 extends in a proximal direction with respect to the first connecting portion 621 and the second connecting portion 622. The one side surface of the extension portion 623 facing the counting mechanism 90 (the upper surface of the extension portion 623) is provided with a counting driving mechanism 50. Accordingly, as shown in fig. 4 and 16, when the wrench 4 is in the open position, the counter drive mechanism 50 is located on the proximal side of the counter mechanism 90 with a certain interval in the axial direction from the counter mechanism 90, and the counter drive mechanism 50 does not act on the counter mechanism 90. When the wrench 4 moves forward to drive the base 62 to move in the first direction, the counter drive mechanism 50 moves synchronously with the base 62 in the first direction until the counter drive mechanism 50 cooperates with the counter mechanism 90 to change the counter value of the counter mechanism 90.
The clip feeding driving tube 43 is sleeved outside the clip pushing seat 46. The feed clip drive tube 43 is partially located within the jaw drive tube 32 and is axially movable within the jaw drive tube 32. The proximal end of the clip feed drive tube 43 is provided with circumferentially extending grooves 44. In the initial state, the seat 62 is sleeved outside the clamp driving tube 43, the bottom end of the first clutch member 63 is inserted into the groove 44, and the upper end of the first clutch member 63 is connected with the clutch switching mechanism.
The clutch switching mechanism includes a guide post 65 and a guide rail. The upper end of the first clutch 63 is connected to a guide post 65. The guide rail is provided in the head housing 2, and the guide post 65 is movable on the guide rail. The guide rail is symmetrically arranged on the inner walls of the first head shell and the second head shell. That is, the inner wall of the first head housing is provided with a guide rail, and the inner wall of the second head housing is also provided with a guide rail.
The guide post 65 is accommodated in the seat 62, and the guide post 65 has a first guide end and a second guide end. The first guide end of the guide post 65 is located on and movable on the guide rail of the inner wall of the first head housing after protruding from the first kidney-shaped hole, and the second guide end of the guide post 65 is located on and movable on the guide rail of the inner wall of the second head housing after protruding from the second kidney-shaped hole. Each kidney-shaped hole extends in the up-down direction, and the guide post 65 is movable in the up-down direction. The guide rail includes a first guide surface 66 and a second guide surface 67, the second guide surface 67 being higher than the first guide surface 66.
When the guide post 65 moves on the first guide surface 66, the first clutch 63 and the clip feed driving tube 43 are kept in a coupled state, that is, the clutch mechanism is coupled with the clip feed driving mechanism. The wrench 4 pushes the base 62 to move the base 62 distally along the first direction, and the first clutch 63 advances forward and drives the clip feeding driving mechanism to move distally to perform the clip feeding operation. The guide post 65 is capable of following the movement of the first clutch 63 to move on the guide rail. Since the second guide surface 67 is higher than the first guide surface 66, when the guide post 65 moves onto the second guide surface 67 of the guide rail, the first clutch member 63 is driven to move upward, so that the first clutch member 63 is separated from the clip feeding driving tube 43 by being separated from the groove 44 of the clip feeding driving tube 43, and the clutch mechanism is separated from the clip feeding driving mechanism.
The second clutch member 64 (distal end face of the housing 62) gradually approaches the proximal end face of the jaw drive tube 32 during distal movement of the clip feed drive mechanism by the wrench 4 driven by the switching mechanism. In response to the first clutch member 63 being disengaged from the clip feeding driving tube 43, the second clutch member 64 abuts against the proximal end face of the jaw driving tube 32, the clutch mechanism is engaged with the jaw driving mechanism, and the seat 62 pushes the jaw driving tube 32 to move through the second clutch member 64, thereby driving the jaw driving mechanism to move to perform the jaw closing action.
One of the mating mechanisms is connected to the housing 62 and the other is connected to the proximal end of the push holder 46, with a distance between one of the mating mechanisms and the other. When the clip feeding driving mechanism advances, the clip pushing driving mechanism retreats to store energy, and the clip feeding action executed by the clip feeding driving mechanism is asynchronous with the clip pushing action executed by the clip pushing driving mechanism.
Referring to fig. 4, 4A, 16, the mating mechanism includes an upper rack 69, an intermediate member 71, and a lower rack 70, the intermediate member 71 including a gear. The upper rack 69 is meshed with the gear and the lower rack 70 is meshed with the gear. The clip feed drive tube 43 is drivingly connected to the upper rack 69, and the clip feed drive tube 43 and the upper rack 69 move in the same direction, e.g., as previously described, the housing 62 is drivingly connected to the clip feed drive tube 43, the upper rack 69 is connected to the extension 623 of the housing 62, and the push holder 46 is connected to the lower rack 70. The upper rack 69 and the lower rack 70 move in opposite directions, and when the upper rack 69 moves distally, the lower rack 70 moves proximally. The upper rack 69 and the lower rack 70 are both disposed in the axial direction, and the pinion is disposed between the upper rack 69 and the lower rack 70. The push-grip driving mechanism further includes a fourth restoring member 68, one end of the fourth restoring member 68 being connected to the head housing 2, and the other end being connected to the proximal end of the lower rack 70. For example, the fourth restoring member 68 is a spring.
As shown in fig. 7-10, the counter mechanism 90 is a counter wheel mounted between two head housings 201,202, the center of which is provided with a mounting hole 93, and the first mounting portion 203 and the second mounting portion 205 pass through the mounting hole 93. For example, the first mounting portion 203 penetrates the second mounting portion 205, improving the accuracy of alignment between the first head housing 201, the second head housing 202, and the counter mechanism 90. The counting mechanism 90 includes an annular indicating portion 91, an actuating portion located on a first side of the indicating portion 91, and an arc-shaped blocking wall 97 located on a second side of the indicating portion 91, wherein the arc-shaped blocking wall 97 is sleeved on the outer side of the second mounting portion 205. The outer peripheral surface of the indication portion 91 is provided with a plurality of indication marks for indicating the count value, and the indication marks are described here as numerals. The actuating part includes a cylindrical structure and a plurality of ratchet teeth 92 distributed on an outer circumferential surface of the cylindrical structure, and the ratchet teeth 92 are arranged along a circumferential direction of the cylindrical structure. The ratchet 92 corresponds to the number on the indication portion 91, i.e. when the ratchet 92 rotates one tooth position in the first counting direction, the number of the indication area on the indication portion 91 opposite to the observation window is converted into an adjacent number.
As shown in fig. 4B, 10 and 11, the counter drive mechanism 50 includes a spring arm integrally formed with or fixedly connected to the transmission mechanism that deforms in response to an external force applied to the spring arm. The spring arm is provided with a fixed part 51, a first driving part 52 and a second driving part 53 connected to the transmission mechanism. The spring arm can be integrally formed with or fixedly connected with the transmission mechanism through the fixing part 51. Thus, the spring arms can move in the same direction in synchronism with the axial movement of the housing 62. For example, the first end of the spring arm is provided with a fixing portion 51, the second end of the spring arm is provided with a first driving portion 52 and a second driving portion 53, and the second end of the spring arm extends in the second direction relative to the first end of the spring arm. Therefore, the first end of the spring arm is a fixed end, and the second end is a free end. The first driving portion 52 is a tooth-like protrusion. When the first drive portion 52 moves into engagement with the actuator portion, the first drive portion 52 engages the ratchet 92. Since the first driving part 52 and the second driving part 53 are provided at the same end, i.e., the second end, the first driving part 52 and the second driving part 53 can be driven to move synchronously. In response to the clutch driving part 204 driving the second driving part 53, the spring arm is stressed to deform, so that the first driving part 52 moves to be separated from the actuating part, namely, when the clutch driving part 204 acts on the second driving part 53 to enable the second driving part 53 to move towards the direction close to the base 62, the second driving part 53 synchronously drives the first driving part 52 to move towards the direction far away from the ratchet 92 to be separated from the ratchet 92, so that each time the first driving part 52 is matched with one ratchet 92, the rotation of one tooth position is completed, the number change of an indication area opposite to the observation window on the indication part 91 is realized, and the repeated counting of the counting mechanism 90 is effectively avoided.
As shown in fig. 4B, a deformation yielding space is formed by a certain interval between the spring arm and the surface of the base 62 in the up-down direction, when the second driving portion 53 is driven by the clutch driving portion 204, the second end of the spring arm can rotate relative to the fixing portion 51 to move in a direction approaching the base 62, and the spring arm deforms, so that the first driving portion 52 moves downward to be able to disengage from the counting mechanism 90. An elastic connection 54 is provided between the first and second ends of the spring arm.
In this embodiment, the second end of the spring arm is provided with a bend 55. The top of the bending part 55 is bent and protruded towards the counting mechanism 90, and the first driving part 52 is arranged at the top of the bending part 55, so that the first driving part 52 can drive the counting mechanism 90 to change the counting value more easily. The first driving portion 52 may be a flange provided on top of the bending portion 55. The height of the first driving portion 52 is higher than the height of the elastic connection portion 54 so that the elastic connection portion 54 does not interact with the actuating portion when the elastic connection portion 54 moves below the counting mechanism 90. And the height of the first driving part 52 is higher than the highest point height of the second driving part 53 so that the second driving part 53 does not interfere with the ratchet 92. The second driving portion 53 is disposed on a side of the bending portion 55 facing the first end of the spring arm, i.e., a side facing the elastic connection portion 54. The second driving portion 53 is disposed, for example, directly adjacent to the bending portion 55. When the elastic arm is not elastically deformed, the elastic connecting portion 54 of the elastic arm is substantially parallel to the surface of the base 62, and when the second driving portion 53 is driven by the clutch driving portion 204 to move the bending portion 55 downward, the bending portion 55 and the elastic connecting portion 54 are at least partially elastically deformed. After the second driving portion 53 is separated from the clutch driving portion 204, the bending portion 55 and the elastic connecting portion 54 can move upward again to return to the original state under the elastic deformation restoring force of the spring arm.
The existing counting driving mechanism and counting mechanism have the problem of complex structure, the overall structure complexity and cost of the clip applier are increased, and the existing counting driving mechanism and counting mechanism possibly have the condition of structural failure in the process of recycling, so that the clip applier is not stable enough.
The embodiment provides the spring arm of locating pedestal 62 surface and regard as count actuating mechanism 50, on the one hand count actuating mechanism 50 can with pedestal 62 synchronous axial motion, and need not to additionally set up other structures of drive count mechanism 90 count, the structure of whole clamp that applys has been simplified, guarantee the synchronous motion of count actuating mechanism 50 and drive mechanism, and carry out spacing to count actuating mechanism 50 through drive mechanism, prevent that the unnecessary drunkenness from taking place for count actuating mechanism 50, guarantee the reliability of count function realization structure, on the other hand can realize the combination separation switching between spring arm and count mechanism 90, the separation and reunion drive portion 204 through spring arm self elasticity, simple structure, and rely on spring arm self elasticity, be difficult for because the condition of elasticity inefficacy takes place for a plurality of repeated uses, reduce count function inefficacy risk, improve the structural reliability of count actuating mechanism and count mechanism.
As shown in fig. 7 and 19, the clutch driving portion 204 is disposed on the first head housing 201, for example, is a protruding portion disposed below the first mounting portion 203, and the axial width of the lower portion of the clutch driving portion 204 is greater than the width of the upper portion of the clutch driving portion 204, so that the clutch driving portion 204 has a larger contact area with the second driving portion 53, and the stability of the engagement between the clutch driving portion 204 and the second driving portion 53 is improved. In another alternative embodiment, the clutch driving portion 204 may also be provided on the second head housing 202, for example, below the second mounting portion 205.
9-11 And 21, when the base 62 drives the counting driving mechanism 50 to move from the proximal end along the first direction to be matched with the counting mechanism 90, the first driving part 52 of the counting driving mechanism 50 is meshed with the ratchet 92 of the actuating part, the counting mechanism 90 is driven to rotate along the first counting direction by the actuating part, the number of the indication part 91 aligned with the observation window is changed, and a doctor can observe the change of the count value of the counting mechanism 90 outside the head shell, so that the number of the left clips or the number of the applied clips in the current clip bin can be known. After the count value of the counting mechanism 90 is changed, when the base 62 continues to drive the counting driving mechanism 50 to move along the first direction, the second driving portion 53 moves below the clutch driving portion, the clutch driving portion abuts against the second driving portion 53 and acts on the second driving portion 53, the second driving portion 53 is driven to move, so that the first driving portion 52 is driven to move along a direction away from the counting mechanism, the spring arm is elastically deformed, and the first driving portion 52 is separated from the ratchet 92 and does not act on the ratchet 92. The second driving part 53 includes a guide slope, the height of which gradually decreases in the first direction, that is, the height of which gradually increases in the second direction, and a space exists between the guide slope and the counting mechanism. As the counter drive mechanism 50 continues to move in the first direction, the clutch drive portion 204 moves along the guiding slope of the second drive portion 53, and the clutch drive portion 204 is first opposite to the lower position of the guiding slope and gradually acts on the upper position of the guiding slope, and the guiding slope smoothly guides the movement of the counter drive mechanism 50 relative to the clutch drive portion 204, so that the counter drive mechanism 50 can smoothly pass under the counter mechanism 90 without affecting the smoothness of the movement of the base 62 in the distal direction.
In this embodiment, when the wrench 4 is in the open position, the counter drive mechanism 50 is located on the proximal side of the counter mechanism 90 and there is an axial spacing between the first drive portion 52 and the lowermost ratchet teeth 92 of the counter mechanism 90, the length of which determines the timing of the counter drive mechanism 50 to engage the counter mechanism 90. In an embodiment, in the process that the wrench 4 moves from the open position to the intermediate position, the counting driving mechanism 50 moves below the counting mechanism 90, and the first driving part 52 engages the ratchet 92 and drives the counting mechanism 90 to rotate along the first counting direction, when the wrench 4 reaches the intermediate position, the counting value in the designated area is synchronously changed by the indicating part 91 of the counting mechanism 90, and this embodiment can ensure that the feeding operation is synchronous with the change of the counting value, and the doctor can also know that the feeding operation is finished currently through the change of the counting value. Each time the clip feeding operation is completed, the number of clips in the clip magazine is synchronously reduced by one, and the count value of the indication part 91 observed from the outside of the head housing is synchronously changed by one. When the wrench 4 continues to move forward from the intermediate position to the closed position, the clutch driving portion 204 acts on the second driving portion 53 to disengage the first driving portion 52 from the ratchet 92, so that the counter mechanism 90 is maintained at the current position. In another embodiment, a counting position is defined between the intermediate position and the closed position. In the process of moving the wrench 4 from the intermediate position to the counting position, the first driving part 52 moves below the counting mechanism 90, the first driving part 52 is meshed with the ratchet 92 and drives the counting mechanism 90 to rotate along the first counting direction to change the counting value of the indicating part 91, and when the wrench 4 moves to the counting position, the indicating part 91 completes the change of the counting value. This is advantageous in that the count value of the counting mechanism 90 is not changed until each time the pinch is ensured to be successful. When the wrench 4 continues to move forward from the counting position to the closing position, the clutch driving portion 204 acts on the second driving portion 53 to disengage the first driving portion 52 from the ratchet 92, so that the counting mechanism 90 is maintained at the current position. The position of the wrench 4 corresponding to the change of the count value of the indication portion 91 of the counting mechanism 90 may be other positions.
The counting mechanism 90 can only rotate in one direction, i.e. can only rotate anticlockwise but not rotate clockwise in the view of fig. 4, the number of the indication part 91 corresponding to the observation window can only change in one direction, for example, when the counting mechanism 90 is used for indicating the number of clips remaining in the clip magazine, the number of the indication part 91 can only gradually decrease, and when the counting mechanism 90 is used for indicating the number of clips already applied, the number of the indication part 91 can only gradually increase. To achieve unidirectional rotation of the counting mechanism 90, the housing further comprises a stop mechanism 206, the counting mechanism 90 further being provided with a stop 94. After the wrench 4 reaches the closed position, the wrench 4 is loosened, the wrench 4 can be reset to the open position, the transmission mechanism is reset along the second direction under the action of the reset piece, the counting driving mechanism 50 is driven to move along the second direction, the stop mechanism 206 is combined with the stop portion 94, and the blocking actuating portion is driven by the first driving portion 52 to move along the second counting direction. In this embodiment, the second counting direction is opposite to the first counting direction, i.e. clockwise in the view of fig. 4.
As shown in fig. 8 and 10, the stopper mechanism includes a mounting groove 207, and the inner wall of the mounting groove 207 is provided with a plurality of stopper teeth 208 arranged in a circumferential direction. The stopper 94 includes a lever 95 and an engaging portion 96 located at the distal end of the lever 95, and the engaging portion 96 protrudes outward relative to the lever 95. Both the retaining wall 97 and the stop 94 are located inside the mounting groove 207, and the mating portion 96 remains engaged with the stop tooth 208. The stop tooth 208 includes a guide surface 209 and a stop surface 210, with the guide surface 209 having a smaller angle of inclination relative to the stop surface 210. When the actuating portion is driven by the first driving portion 52 to move along the first counting direction, the engaging portion 96 is engaged with the guide surface 209 of the stop tooth 208, and the engaging portion 96 can move along the guide surface 209 and move along the adjacent guide surface 209 after jumping to rotate relative to the stop tooth 208, so that the stop mechanism 206 does not block the rotating movement of the actuating portion along the first counting direction, and thus normal counting of the counting mechanism 90 is not affected. When the counter driving mechanism 50 moves in the second direction, the first driving portion 52 acts on the actuating portion to enable the counter mechanism 90 to have a tendency to rotate in the second counting direction, and the engaging portion 96 engages with the stop surface 210 of the stop tooth 208 to block the counter mechanism 90 from moving in the second counting direction, so that the counter mechanism 90 can only rotate unidirectionally in the first counting direction. In the above embodiment, the counting mechanism 90 is provided with the stopper, and the case is provided with the stopper inside. In another alternative embodiment, the counting mechanism 90 may be provided with a stop mechanism, where the stop mechanism includes a mounting groove and a plurality of stop teeth disposed on the inner side of the mounting groove, and the inner side of the housing is provided with a stop portion, and the stop portion has a rod portion and a mating portion protruding outwards, and the mating portion is engaged with the stop teeth, so that unidirectional rotation of the counting mechanism 90 may be ensured. In yet another alternative embodiment, the stop mechanism disposed on the inner side of the housing or the counting mechanism 90 may include a cylindrical structure and a plurality of stop teeth disposed on the outer peripheral surface of the cylindrical structure, and the stop portion disposed on the inner side of the counting mechanism 90 or the housing includes a rod portion and a mating portion protruding inward, wherein the rod portion is disposed on the outer side of the cylindrical structure, and the mating portion is engaged with the stop teeth, so that unidirectional rotation of the counting mechanism 90 may be ensured. The positional relationship between the stopper wall 97 and the stopper 94 is not limited to that shown in the drawings, or the stopper wall 97 may not be provided. Such variations are within the scope of the present disclosure.
The clip applier further includes a retaining mechanism that can abut against the clip feeding driving mechanism to prevent the clip feeding driving mechanism from backing when the first clutch 63 of the switching mechanism is separated from the clip feeding driving mechanism. When the wrench 4 is in the intermediate position, the user releases the wrench 4, and the stop mechanism still abuts against the clip feeding driving mechanism to prevent the clip feeding driving mechanism from retreating, as will be described later.
Referring to fig. 4 and 12 to 15, the backstop mechanism includes a guide pivot 73 and a biasing spring 74. The guide pivot member 73 has a pivot portion 76. The pivot 76 is pivotally connected to the handle housing 3 via a first pivot axis such that the guide pivot 73 rotates about the first pivot axis relative to the handle housing 3. The biasing spring 74 gives a pushing force to the guide pivot member 73 so that the guide pivot member 73 tends to rotate clockwise. The guide pivot member 73 is provided with a stopper 79. The wrench 4 is relatively movably connected with the guide pivot 73. During movement of the wrench 4 from the open position to the intermediate position, the biasing spring 74 urges the guide pivot member 73 to rotate such that the stopper 79 approaches and abuts against the clip feed drive tube 43 to prevent rearward movement.
The guide pivot member 73 further has a force receiving portion 77, a guide portion 78, a first rotating arm 80 extending proximally from the pivot portion 76, and a second rotating arm 81 extending distally from the pivot portion 76. The guide pivot member 73 further includes a third arm 82 extending obliquely upward from the pivot 76, the third arm 82 making an obtuse angle with the first arm 80. The first arm 80 has a force receiving portion 77 at its distal end, the second arm 81 has a guide portion 78 at its distal end, and the third arm 82 has a retreating portion 79 at its distal end.
One end of the biasing spring 74 abuts the force receiving portion 77, and the other end abuts the handle housing 3. The first rotating arm 80 and the second rotating arm 81 form a lever with the first rotation axis of the pivoting portion 76 as a fulcrum, the biasing spring 74 and the guide portion 78 are located at two ends of the lever, and when the biasing spring 74 is in a compressed state, the biasing spring 74 applies a pushing force to the force receiving portion 77, so that the guide pivoting member 73 has a tendency to rotate counterclockwise, that is, the retaining portion 79 and the guide portion 78 also have a tendency to rotate counterclockwise (referring to the placement angle of the clip applier in fig. 4).
Referring to fig. 16, the wrench 4 is provided with a pivoting end 85 pivotally connected to the handle housing, and the wrench 4 rotates about the pivoting end 85. The wrench 4 also has a guide channel 86. Referring to fig. 12 and 13, the retaining mechanism of the present embodiment further includes a guide 75, and the guide 75 is disposed at a guide portion 78 of the guide pivot member 73. At least a portion of the guide 75 is received in the guide channel 86. When the wrench 4 is rotated about its pivoting end 85, the guide channel 86 rotates therewith, and the guide 75 rotates about the first rotation axis 76 of the pivot 76 under the influence of the biasing spring 74. Guide channel 86 is a circumferentially enclosed channel, and guide 75 is restrained from moving circumferentially within guide channel 86 and cannot leave guide channel 86, so that guide 75 cannot be disengaged from wrench 4 in this embodiment.
Referring to fig. 14 and 15, the guide channel 86 includes a start point a, a stop point b, and an end point c. The distance from the start point a to the pivoting end 85 of the wrench 4 and the distance from the end point c to the pivoting end 85 of the wrench 4 are smaller than the distance from the stop point b to the pivoting end 85 of the wrench 4. That is, the position of the stop point b is higher than the start point a and the end point c.
The guide passage 86 includes a main passage 87 and only one sub-passage 89 extending from an opening portion 88 of the main passage 87, the opening portion 88 being located between both ends of the main passage 87. The secondary channel 89 extends from the opening 88 of the primary channel 87 in a direction away from the pivoting end 85 of the wrench 4, i.e. the distance between the secondary channel 89 and the pivoting end 85 is greater than the distance between the primary channel 87 and the pivoting end 85. The main channel 87 has a start point a and an end point c at both ends, respectively. The stop point b is located in the secondary channel 89. The biasing spring 74 applies a force to the guide pivot member 73 such that the guide member 75 can disengage from the primary channel 87 into the secondary channel 89.
When the wrench 4 is in the open position, the guide 75 is located at the starting point a. The movement of the wrench 4 from the open position to the intermediate position causes the wrench 4 to drive the guide 75 to rotate clockwise from the start point a under the action of the biasing spring 74 to lift up into the passage 89 and move from the passage 89 to the stop point b. From the intermediate position, the wrench 4 moves to the closed position, and the wrench 4 moves the guide 75 from the stop point b in the channel 89 down to the end point c of the main channel 87. When the guide member 75 enters the slave passage 89, the guide pivot member 73 is rotated upward, so that the stopper 79 of the guide pivot member 73 moves upward.
Referring to fig. 15, the secondary channel 89 includes a blocking wall 84. The main channel 87 comprises a first wall extending from the starting point a to the connection with the blocking wall 84, the first wall and the blocking wall 84 being at right or acute angles. Thus, by a simple angular design of the guide channel 86, it is ensured that the blocking wall 84 effectively prevents the guide 75 from retracting from the stop point b to the starting point a, so that the wrench 4 can stay in the intermediate position.
To enable the guide 75 to move from the stop point b to the end point c, the secondary channel 89 further includes a guide wall 83. The main channel 87 further comprises a second wall extending from the end point c to be connected to the guide wall 83, the second wall making an obtuse angle with the guide wall 83. The simple angular design of the guide channel thus ensures that the guide 75 can move from the stop point b to the end point c.
Referring to fig. 12-15, when the user presses the wrench 4 to move the wrench 4 from the open position to the intermediate position, the guide 75 moves from the start point a to the stop point b, the guide 75 enters the slave passage 89 from the master passage 87, the guide pivot member 73 is lifted up by rotating upward, at this time, the first clutch member 63 is separated from the clip feeding drive tube 43, the second clutch member 64 abuts the jaw drive tube 32, at this time, the clip applier is in the clip feeding completed state, the clip 22 is in the ready position, and the stop 79 moves up to abut the clip feeding drive tube 43 to prevent the clip from backing.
The user continues to press the wrench 4, and the wrench 4 moves from the intermediate position to move the guide member 75 from the stop point b to the end point c, the guide member 75 continues to move in the channel 89, the guide pivot member 73 does not move downward, and the stop portion 79 keeps abutting against the clip feeding driving tube 43 to avoid the clip feeding driving tube 43 from retreating, so that the clip feeding block 42 abuts against the clip 22 at the proximal end of the clip 22, and the clip 22 does not retreat during clip application, thereby ensuring clip application stability. In this process, the second clutch member 64 abuts the jaw drive tube 32 and the switching mechanism drives the jaw drive mechanism to move distally to perform a jaw closing action (pinching action).
When the user continues to press the wrench 4 and the wrench 4 reaches the closed position and moves the guide 75 from the stop point b to the end point c in the main passage 87 along the secondary passage 89, the stop 79 moves below the clip feed drive tube 43, the stop 79 is separated from the clip feed drive tube 43, and the clip feed drive tube 43 is retracted by the third restoring member 45. When guide 75 reaches terminus c, the clip applier is in the clip applier-completed state and clip 22 held in jaw assembly 14 is compressed to the closed state. The wrench 4 is loosened, the jaw driving mechanism is reset under the action of the first reset piece 36, the switching mechanism is reset under the action of the fourth reset piece 68, and the wrench 4 is reset under the drive of the switching mechanism.
The operation of the clamp applier's drive mechanism to perform the clamp feeding action, clamp applying action, clamp pushing action, and counter drive mechanism to move in the first direction to change the counter value of the counter mechanism is described in detail below. The following takes the example of the count value of the counting mechanism being changed when the wrench moves to the counting position, but the disclosure is not limited thereto. By adjusting the axial distance between the first drive portion 52 and the lowermost ratchet tooth of the actuator portion when the wrench is in the open position, the timing of the counting mechanism can be adjusted during forward movement of the wrench, e.g., the smaller the axial distance, the earlier the first drive portion engages the ratchet tooth during forward movement of the wrench and the greater the axial distance, the later the first drive portion engages the ratchet tooth during forward movement of the wrench.
As shown in fig. 4 and 16-19, when the wrench 4 is in the open position, the counter drive mechanism 50 is located on the proximal side of the counter mechanism 90, with an axial distance between the first drive portion 52 and the lowermost ratchet teeth 92 of the actuating portion of the counter mechanism 90, and no interaction between the counter drive mechanism 50 and the counter mechanism 90. There is an axial distance between the second drive portion 53 and the clutch drive portion 204, and there is no interaction between the second drive portion 53 and the clutch drive portion 204. The plurality of push clamp blocks 31 are located at the front sides of the second clip to the nth clip, respectively. The user presses the wrench 4 to move the wrench 4 from the open position toward the intermediate position, the wrench 4 pushes against the base 62 of the switching mechanism to move the switching mechanism distally, the guide post 65 moves on the first guide surface 66, the first clutch 63 advances with the switching mechanism and drives the clip feeding driving mechanism to move distally to perform the clip feeding action, and the upper rack 69 moves distally. In the process of moving the upper rack 69 distally, the upper rack 69 drives the lower rack 70 to retreat through the intermediate piece 71, and the lower rack 70 is connected with the pushing clamp seat 46 to further drive the pushing clamp seat 46 to retreat, so that the fourth reset piece 68 stores energy, and the pushing clamp blocks 31 respectively move proximally.
As shown in fig. 20 and 21, when the wrench 4 reaches the intermediate position, the guide post 65 of the switching mechanism moves onto the second guide surface 67 of the guide rail, the first clutch piece 63 is separated from the clip feeding drive tube 43, the clip feeding drive mechanism is finished (the clip feeding action is completed), the clip 22 enters the jaw assembly 14, and the second clutch piece 64 abuts against the proximal end surface of the jaw drive tube 32 to push the jaw drive tube 32 to move. The guide 75 of the retaining mechanism enters the secondary channel 89 from the main channel 87 of the guide channel 86, and the guide pivot 73 is lifted up in a rotating manner, which gives a click to the user, the wrench 4 is released when the wrench has reached the intermediate position, and the wrench 4 can stay in the intermediate position due to the blocking wall 84 of the guide channel 86. The clip feed block 42 of the clip feed drive mechanism continues to abut the clip 22 from the rear end of the clip 22 by the stop mechanism, retaining the clip 22 in the jaw assembly 14. As shown in fig. 6A and 6B, each push block 31 moves to one side of the second clip to the nth clip in the radial direction of the clip magazine 6, respectively. For example, taking the push block 31 located on the front side of the second clip when the wrench 4 is located at the open position as the distal-most push block 31 in fig. 5A and 5B, the push block 31 moves proximally to one side of the second clip in the radial direction of the clip magazine 6, and the two overlap in the radial direction of the clip magazine 6, as shown in fig. 6A and 6B, the push block 31 has not moved to the rear side of the second clip. The radial direction of the cartridge 6 is perpendicular to the axial direction of the cartridge 6, which is along the width direction of the cartridge. Taking fig. 6A as an example, the radial direction of the cartridge 6 is a direction perpendicular to the drawing plane. As shown in fig. 20 to 23, when the wrench 4 moves from the open position to the intermediate position, the counter driving mechanism 50 moves along the first direction along with the base 62 to approach the counter mechanism 90, and the elastic connection portion 54 of the counter driving mechanism 50 is at least partially located below the counter mechanism 90. The first drive portion 52 is still located on the proximal side of the counting mechanism 90 and does not contact and interact with the ratchet teeth 92.
As shown in fig. 24 and 25, when the wrench 4 is in the intermediate position, pressing the wrench 4 causes the wrench 4 to move from the intermediate position toward the closed position, the retaining mechanism gradually disengages from the clip feed drive tube 43, the switching mechanism continues to push the jaw drive mechanism and the upper rack 69 forward under the action of the wrench 4, while the upper rack 69 continues to drive the lower rack 70 to retract through the intermediate member 71, and since the lower rack 70 is connected to the push holder 46, the push holder 46 continues to retract, and when the push holder 46 retracts, the fourth reset member 68 continues to store energy, and the jaw drive tube 32 drives the sleeve 35 forward to close the jaw assembly 14. When the wrench 4 reaches the closed position, the jaw assembly 14 is closed (the clamping action is completed), the energy storage of the fourth reset member 68 is completed, the backstop mechanism is completely separated from the clamp feeding driving tube 43, and the clamp feeding driving tube 43 is reset under the action of the third reset member 45. As shown in fig. 6C and 6D, each push block 31 is moved proximally to the rear side of the second clip to the N-th clip, respectively, taking the push block 31 located on the front side of the second clip when the wrench 4 is located at the open position as an example, the push block 31 moves to the rear side of the second clip. Releasing the wrench 4, the jaw drive mechanism is reset by the first reset member 36 and the push grip block 46 is advanced by the fourth reset member 68 to advance the other clips in the cartridge 6 one station (push grip action completed).
The state of the counter drive mechanism and the counter mechanism between the intermediate position and the closed position of the wrench is described in detail below with reference to fig. 26-30. A counting position is defined between the middle position and the closing position, when the wrench is in the middle position and continuously pressed, the wrench moves to the counting position at first, the counting value of the counting mechanism is changed, the wrench continues to move to the closing position, and a movement stroke of the wrench is completed. As shown in fig. 26 and 27, when the wrench is pressed to move from the intermediate position toward the counting position, the wrench drives the base 62 to move in the first direction, the base 62 drives the counting driving mechanism 50 to continue to move in the first direction until the first driving portion 52 is located below the counting mechanism 90, the first driving portion 52 is engaged with one of the ratchet teeth 92 at the lowest position of the actuating portion of the counting mechanism 90, and when the counting driving mechanism 50 continues to move in the first direction, the first driving portion 52 applies a force to the ratchet teeth 92 to rotate in the first counting direction (counterclockwise in fig. 26), the counting mechanism 90 rotates in the first counting direction to change the number of the indicating portion 91 opposite to the viewing window, so as to change the count value of the counting mechanism 90. As shown in fig. 28, in the process of the first driving portion 52 driving the counting mechanism 90 to change the count value, the clutch driving portion 204 is opposed to the lower position of the guide slope of the second driving portion 53, and does not act on the second driving portion 53, and does not affect the driving action of the first driving portion 52 on the counting mechanism 90. When the wrench reaches the counting position, the counting mechanism 90 completes the change of the count value.
As shown in fig. 29 and 30, when the wrench reaches the counting position and is pressed to move the wrench further to the closing position, the guiding inclined surface of the second driving portion 53 moves in the first direction, the clutch driving portion 204 abuts against the second driving portion 53 and applies a downward force to the second driving portion 53, so that the second driving portion 53 drives the first driving portion 52 to move downward together, the spring arm is at least partially elastically deformed, the first driving portion 52 is separated from the ratchet teeth of the counting mechanism, the counting driving mechanism 50 can pass under the clutch driving portion 204, and the first driving portion 52 no longer acts on the counting mechanism. After the second driving part 53 moves to the distal end of the clutch driving part 204, the clutch driving part 204 does not act on the second driving part 53 any more, and the initial state can be partially or completely restored under the action of the elastic restoring force of the spring arm. Through the cooperation of the second driving part 53 and the clutch driving part 204, the first driving part 52 is effectively prevented from overdriving the counting mechanism to rotate, and repeated counting is avoided.
After the wrench reaches the closed position, the wrench is released and the wrench returns from the closed position to the open position. The transmission mechanism moves and resets along the second direction under the action of the resetting piece, and drives the counting driving mechanism 50 to move along the second direction. The second driving portion 53 of the counter driving mechanism 50 is first abutted against the clutch driving portion 204, and as the counter driving mechanism 50 moves in the second direction, the second driving portion 53 gradually disengages from the clutch driving portion 204, and when the counter driving mechanism 50 continues to move to the position of the counter mechanism 90 in the second direction, the first driving portion 52 applies a force to the actuating portion of the counter mechanism 90 to rotate in the second counter direction, so that the actuating portion has a tendency to rotate in the second counter direction. Under the action of the stop mechanism 206 (shown in fig. 8) and the stop portion 94 (shown in fig. 10) of the counting mechanism 90, the counting mechanism 90 cannot rotate in the second counting direction, the first driving portion 52 is subjected to the reaction force of the ratchet to move away from the counting mechanism 90 (move downwards) so that the spring arm is at least partially elastically deformed, and after the deformed counting driving mechanism passes through the lower portion of the counting mechanism 90 and returns to the proximal end of the counting mechanism 90, the counting driving mechanism 50 can return to the initial state under the action of the elastic restoring force of the spring arm itself.
In summary, by adopting the clip applier of this embodiment, the first driving portion 52 of the counting driving mechanism 50 is matched with the actuating portion of the counting mechanism 90, the count value of the indication portion 91 of the counting mechanism 90 is changed to realize the counting of the clips, and after the count value of the indication portion 91 is changed, the clutch driving portion 204 is matched with the second driving portion 53 of the counting driving mechanism 50 to drive the first driving portion 52 to be separated from the actuating portion of the counting mechanism 90, so that the actuating portion is not driven continuously, thereby effectively avoiding repeated counting of the counting mechanism 90 and improving the accuracy of the counting of the clips of the counting mechanism 90.
In an alternative embodiment, the counting driving mechanism 50 includes the elastic arm disposed on the base 62, so that synchronous movement of the elastic arm and the transmission mechanism is ensured, stability of the counting driving mechanism and the transmission mechanism is improved, an independent counting driving mechanism and a fixing structure of the counting driving mechanism are not required to be additionally arranged, the overall structure of the clip applier is simpler, cooperation between the first driving part 52 and the counting mechanism 90 and between the second driving part 53 and the clutch driving part 204 is realized through self elasticity of the elastic arm, a functional failure problem possibly caused by repeated use is avoided, reliability is higher, and an additional elastic component is not required to be arranged to separate the counting driving mechanism 50 from the clutch driving part 204 and then reset, and the structure is simpler.
In addition, in an alternative embodiment, by providing the stop portion 94 on one side of the counting mechanism 90 and providing the stop mechanism 206 on the inner side of the housing, when the transmission mechanism drives the counting driving mechanism 50 to move along the second direction after the clamping action is completed, the first driving portion 52 cannot drive the counting mechanism 90 to rotate along the second counting direction, so that it is ensured that the counting mechanism 90 can only rotate unidirectionally, and the indication mark of the indication portion 91 can only change unidirectionally.
In other embodiments of the present disclosure, the clip feeding action and the clip pushing action may be accomplished simultaneously, i.e., the clip pushing drive mechanism is provided to the clip feeding drive mechanism. For example, the clip feeding assembly is provided with a plurality of pushing barbs axially, each pushing barb corresponding to one clip in the clip magazine, and each pushing barb is secured at its proximal end to the clip feeding assembly and at its distal end to an inclined end extending toward the clip, the clip feeding assembly pushing the plurality of clips 22 in the clip magazine 6 distally one station distance by the pushing barb while pushing the clips 22 in the most distal station in the clip magazine 6 into the jaw assembly in response to movement of the wrench 4 from the open position to the intermediate position.
In other embodiments of the present disclosure, the clutch mechanism may be configured to provide for a powered switching between the clip feed drive mechanism and the jaw drive mechanism in a resiliently deformable manner. For example, the clutch mechanism includes a spring provided between the clip feed driving mechanism and the housing 62, wherein the housing 62 is in direct contact with the wrench 4 for transmitting power of the wrench 4. In response to movement of the wrench 4 from the open position to the intermediate position, the spring is of original length, the clip feed drive mechanism moves in synchronization with the housing 62 to push the distal-most clip in the clip cartridge into the jaw assembly, and in response to movement of the wrench 4 from the intermediate position to the closed position, the clip feed drive mechanism is restrained, the spring is compressed to allow the housing 62 to continue to move distally, the housing 62 moves distally against the sleeve 35 to close the jaw assembly 14.
It should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is for clarity only, and that the skilled artisan should recognize that the embodiments may be combined as appropriate to form other embodiments that will be understood by those skilled in the art.
The above list of detailed descriptions is only specific to practical embodiments of the present disclosure, they are not intended to limit the scope of the present disclosure, and all equivalent embodiments or modifications that do not depart from the spirit of the present disclosure should be included in the scope of the present disclosure.