Split-type left atrial appendage closure clamp system

Abstract

A split-type left atrial appendage closure clamp system, comprising a clamp head and a clamp applying apparatus. The clamp applying apparatus comprises a fixing handle (3), a clamping handle (4), a deflection adjusting rotating sleeve (5), a clamping transmission member (6), a deflection transmission member (7), and a connecting pipe (8). The clamping handle (4) is slidably connected to the fixing handle (3). The deflection adjusting rotating sleeve (5) is in threaded connection with the fixing handle (3). The clamping transmission member (6) is connected between the clamping handle (4) and the clamp head. The deflection transmission member (7) is connected between the deflection adjusting rotating sleeve (5) and the clamp head. The connecting pipe (8) is connected between the clamp head and the fixing handle (3). The clamping transmission member (6) and the deflection transmission member (7) are inserted into the connecting pipe (8) and connected. A clamp head deflection mechanism driven by the deflection transmission member (7) is arranged between the clamp head and the clamp applying apparatus. The split-type left atrial appendage closure clamp system can change the closure method for the left atrial appendage from ligation and suture methods into a clamping compression closure method. The system is easy and convenient to operate, thereby facilitating the use of left atrial appendage closure instruments and improving the safety and effectiveness thereof.

Description

A split left atrial appendage closure clip system Technical Field

[0001] The present invention relates to a cardiac surgical instrument, and more particularly to a split left atrial appendage closure clip system. Background Art

[0002] Atrial fibrillation is a major cause of stroke. Current research shows that the majority of thrombi that cause atrial fibrillation-related stroke originate from the left atrial appendage (LAA). Due to its unique anatomical structure and functional characteristics, the LAA has become a research hotspot for atrial fibrillation-related stroke. Cardiac surgeons often perform LAA treatment simultaneously with conventional open-chest surgery, while some patients also undergo minimally invasive thoracoscopic-assisted surgery. For patients with isolated atrial fibrillation requiring surgical radiofrequency ablation for atrial fibrillation, thoracoscopic-assisted ablation is currently the most common method for concurrent LAA treatment. Whether performed open-chest or thoracoscopically, LAA treatment traditionally involves suture ligation, excision and suturing, or the use of a cutting and stapling device. However, these procedures can be challenging and prone to complications. The advantage of suturing after LAA excision is complete removal with a low rate of residual cavity. However, the disadvantage is the cumbersome procedure and a high risk of bleeding. The advantage of the left atrial appendage ligation method is that it is simple and quick, but there is indeed a possibility that it is difficult to completely close the left atrial appendage. If this probability is to be reduced, it is necessary to increase the strength of the suture ligation, which may result in the possibility of cutting the root of the left atrial appendage, increasing the risk of surgery. The root of the left atrial appendage is a flat structure. Clamping the left atrial appendage is more consistent with its anatomical structure, making it easier to close the root of the left atrial appendage and avoiding the potential hidden dangers of leaving a residual cavity and incomplete ligation. For this reason, a clamping method can be considered to avoid the shortcomings of both suturing and ligating methods while having the advantages of both. The invention with publication number CN114869381A discloses an atrial appendage clamp, which includes a tying wire and a guide rod. The tying wire encloses a tying ring that can be used to tie and close the left atrial appendage, and the guide rod can guide the tying ring to the surgical site. This invention can reduce the surgical wound and reduce the obstruction of the surgical field by the atrial appendage clamp. However, this invention is essentially a ligation method, and therefore it is still difficult to overcome the inherent defects of the ligation method.

[0003] Summary of the Invention

[0004] The existing closure methods used in left atrial appendage surgery have problems such as incomplete ligation, easy bleeding, and high surgical risks. To overcome these defects, the present invention provides a split left atrial appendage closure clip system, which can conveniently and safely achieve left atrial appendage closure in a clamping manner.

[0005] The technical solution of the present invention is: a split left atrial appendage closure clamp system, comprising a chuck and a clamping device, wherein the clamping device comprises a fixed handle, a clamping handle, a deflection adjustment sleeve, a clamping transmission member, a deflection transmission member, and a connecting tube. The clamping handle is slidably connected to the fixed handle, the deflection adjustment sleeve and the fixed handle are threadedly connected, the clamping transmission member is connected between the clamping handle and the chuck, the deflection transmission member is connected between the deflection adjustment sleeve and the chuck, the connecting tube is connected between the chuck and the fixed handle, the clamping transmission member and the deflection transmission member are connected within the connecting tube, and a chuck deflection mechanism driven by the deflection transmission member is provided between the chuck and the clamping device. When the present invention is used, a chuck body is loaded onto the chuck, which enters the body through a small incision channel, wraps around the left atrial appendage, and operates under the control of an external clamping device. The clamping handle is operated to clamp the chuck body via the clamping transmission member, thereby achieving left atrial appendage closure. The chuck deflection mechanism, controlled by the deflection adjustment sleeve and the deflection transmission element, drives the chuck to deflect, adjusting the relative angle between the chuck and the connecting tube. This allows the chuck to be inserted into the left atrial appendage at an optimal angle, avoiding obstruction of the operator's line of sight and providing the operator with an optimal field of view and closure angle. The minimally invasive thoracoscopic left atrial appendage clipping method based on this split left atrial appendage closure clip system is an extracardiac intervention on the left atrial appendage, with a high closure rate, simple operation, high safety, minimal trauma, rapid recovery, ease of operation, and fewer complications.

[0006] Preferably, the fixed handle includes a handle bar, and the clamping handle is slidably sleeved onto the handle bar. A pull head groove is provided on the circumference of the handle bar along its axial direction. The end of the clamping transmission member is slidably embedded in the pull head groove and fixedly connected to the clamping handle. When a force is applied to the clamping handle, causing the clamping handle to slide on the handle bar, the clamping handle also causes the end of the clamping transmission member to slide, pulling the clamping transmission member and transmitting the pulling force to the clamping head, thereby controlling the clamping body to complete the clamping action.

[0007] As preferred, the clamping transmission member is connected to the clamping handle via a pin rod connected to the clamping handle. The connection between the clamping handle and the clamping transmission member is achieved through the pin rod, which has a simple structure and is easy to implement.

[0008] Preferably, a step is provided on the inner wall of the center hole of the deflection adjustment sleeve, a pull head is provided at the rear end of the deflection transmission member, and a pair of pull head pins are radially fixed to the pull head. The pull head pins are connected to and extend out of the pull head slot, and the portions of the pull head pins exposed from the pull head slot are engaged by the step on the inner wall of the center hole of the deflection adjustment sleeve. To deflect the chuck, the deflection adjustment sleeve only needs to be rotated. The relative rotation between the deflection adjustment sleeve and the fixed handle is converted into axial motion via a thread. The step on the inner wall of the center hole of the deflection adjustment sleeve pushes the pull head of the deflection transmission member to move, causing the deflection transmission member to generate axial tension, which is transmitted to the chuck, providing power for the deflection of the chuck.

[0009] Preferably, the clamping transmission member is a cable, which is connected to the deflection transmission member, which is in turn connected to the handle. The clamping transmission member and the deflection transmission member pass through the center of the handle and the connecting tube, and the transmission path is concealed, which helps the present invention maintain a compact structure, a simple appearance, and reliable operation.

[0010] Preferably, the chuck comprises a moving clamp arm and a chuck frame, wherein a first clamp body is detachably connected to the moving clamp arm, and a second clamp body is detachably connected to a side frame of the chuck frame opposite the moving clamp arm, a clamping and locking structure is provided between the first clamp body and the second clamp body, the moving clamp arm is slidably connected within the chuck frame and is connected to a clamping transmission member, and a rubber band is provided between the moving clamp arm and the chuck frame to reset the moving clamp arm. A clamp body is respectively installed on the moving clamp arm and the side frame of the chuck frame opposite the moving clamp arm, and a force acting on the clamping handle is transmitted to the moving clamp arm via the clamping transmission member, pulling the moving clamp arm to overcome the reset force of the rubber band and slide, so that the first clamp body gradually approaches the second clamp body. When the first and second clamp bodies are brought together, the two clamp bodies close the clamp system and tighten the left atrial appendage through the clamping and locking structure, and the first and second clamp bodies can be separated from the moving clamp arm and the side frame of the chuck frame through subsequent operations, and the clamp bodies can also be removed from the human body, making it more convenient to use and reducing the time the clamp bodies stay in the human body.

[0011] Preferably, the chuck deflection mechanism includes a connecting lug and a deflection push rod. The connecting lug is mounted on the chuck frame and hingedly connected to the end of the connecting tube. One end of the deflection push rod is hingedly connected to the connecting lug, and the other end of the deflection push rod is hingedly connected to a deflection transmission member. The deflection transmission member, upon receiving a driving force from the deflection adjustment sleeve, drives the connecting lug to rotate about the hinge point between the connecting tube and the connecting lug, thereby achieving deflection of the chuck.

[0012] Preferably, a slider guide groove is provided on the frame of the chuck frame, and the release slider is slidably connected in the slider guide groove. A C-shaped spring piece is sleeved on the frame of the chuck frame, and the second chuck body is attached to the inner side of the frame of the chuck frame by the constraint of the C-shaped spring piece. The back of the release slider is provided with an inclined surface that contacts the C-shaped spring piece. An unlocking cable is connected to the release slider, and the unlocking cable is passed through the connecting tube and connected to a release handle. The release handle is hinged on a release handle ring, and the release handle ring is fixed to the fixed handle. The second clamp is released from the constraint between it and the release slider and detaches from the release slider, so that the first clamp and the second clamp are completely detached from the clamp.

[0013] Preferably, the first and second clamps are made of POM, which is stable and friendly to the human body environment, and will not interfere with imaging examinations or cause human rejection reactions.

[0014] Preferably, the connecting pipe comprises two half-cut pipes, which are spliced ​​together. The connecting pipe is formed by splicing the two half-cut pipes, which facilitates the arrangement of the clamping transmission member and the deflection transmission member in the connecting pipe.

[0015] The beneficial effects of the present invention are:

[0016] Improve the convenience, safety and effectiveness of left atrial appendage closure devices. The present invention can change the closure method of the left atrial appendage from ligation and suturing to clamping and compression closure, which is convenient and quick to operate, can avoid bleeding, and close completely. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] FIG1 is a schematic structural diagram of the present invention;

[0018] FIG2 is a schematic structural diagram of the present invention after the connecting pipe is removed;

[0019] FIG3 is a schematic diagram of the transmission structure between the chuck and the clamping device of the present invention;

[0020] FIG4 is a schematic structural diagram of a fixed handle in the present invention;

[0021] FIG5 is a schematic diagram of the transmission structure between the chuck deflection mechanism and the deflection adjustment rotary sleeve in the present invention;

[0022] FIG6 is a schematic diagram of the disassembled structure of the clip applier device of the present invention;

[0023] FIG7 is a schematic diagram of the matching structure of the pulling head of the deflection transmission member and the deflection adjustment sleeve in the present invention;

[0024] FIG8 is a schematic diagram of the separation state of the half-cut tube and the deflection transmission member in the present invention;

[0025] FIG9 is a schematic diagram of the transmission structure between the chuck and the clamping device of the present invention from another perspective;

[0026] FIG10 is a schematic diagram of the exploded structure of the chuck of the present invention;

[0027] FIG. 11 is a schematic diagram showing the cooperation relationship between the release slider, the C-shaped spring piece and the second clamping body in the present invention.

[0028] In the figure, 1-moving clamping arm, 2-release slider, 201-inclined surface, 202-unlocking cable, 3-fixed handle, 301-handle, 302-handle, 303-pull head groove, 304-through groove, 4-clamping handle, 401-pin rod, 5-deflection adjustment rotary sleeve, 6-clamping transmission member, 7-deflection transmission member, 701-pull head, 702-tube cavity, 703-return spring, 704-pull head pin, 8-connecting tube, 801-half-section tube, 802-front end head limit block, 9-clamp frame, 901-connecting ear seat, 902-deflection push rod, 903-slider guide groove, 904-C-shaped spring, 10-release handle, 11-release handle ring, 12-first clamp body, 13-second clamp body, 1201-elastic buckle tooth, 1301-tooth groove, 14-rubber band. DETAILED DESCRIPTION

[0029] The present invention will be further described below with reference to specific embodiments of the drawings.

[0030] Example 1:

[0031] As shown in Figures 1 to 11, a split left atrial appendage closure clamp system includes a clamp and a clamping device, wherein the clamping device includes a fixed handle 3, a clamping handle 4, a deflection adjustment sleeve 5, a clamping transmission member 6, a deflection transmission member 7 and a connecting tube 8. The clamping handle 4 is slidably connected to the fixed handle 3, the deflection adjustment sleeve 5 is connected to the fixed handle 3 by a thread, the clamping transmission member 6 is connected between the clamping handle 4 and the clamp, the deflection transmission member 7 is connected between the deflection adjustment sleeve 5 and the clamp, the connecting tube 8 is connected between the clamp and the fixed handle 3, the clamping transmission member 6 and the deflection transmission member 7 are passed through the connecting tube 8, and a clamp deflection mechanism driven by the deflection transmission member 7 is provided between the clamp and the clamping device. The fixed handle 3 comprises a hollow stem 301 and a handle 302. The clamping handle 4 is slidably mounted on the stem 301. A pull-head groove 303 is provided on the threaded surface of the stem 301, extending axially along the stem 301. The stem 301 also has a slot 304 extending radially through the stem 301. The end of the clamping transmission member 6 is fixedly connected to the clamping handle 4, and the connecting tube 8 is interference-fitted into the front end of the stem 301. The clamping transmission member 6 is connected to the clamping handle 4 via a pin 401, which is integrally formed with the clamping handle 4 and extends through the slot 304. The end of the clamping transmission member 6 is wrapped around the pin 401. The inner wall of the center hole of the deflection adjustment sleeve 5 is provided with a step. The rear end of the deflection transmission member 7 is provided with a pull head 701. A pair of pull head pins 704 are radially fixed to the pull head 701. The pull head pins 704 are connected to the pull head slot 303 and extend outside the pull head slot 303. The portion of the pull head pins 704 exposed from the pull head slot 303 is stuck on the inner wall step of the center hole of the deflection adjustment sleeve 5. The clamping transmission member 6 is a steel cable. The deflection transmission member 7 is a semi-open tubular member with an arched cross section and a lumen 702. The cable is passed through the lumen 702 of the deflection transmission member 7, and the deflection transmission member 7 is passed through the handle 301. The chuck includes a movable clamp arm 1 and a chuck frame 9. The movable clamp arm 1 has a first clamp body embedded groove on its inner side. The first clamp body 12 is adapted to be embedded in the first clamp body embedded groove, so that the first clamp body 12 is detachably connected to the movable clamp arm 1. A second clamping body 13 is detachably connected to the upper frame of the chuck frame 9. A clamping and locking structure is provided between the first and second clamping bodies 12, 13. The clamping and locking structure includes elastic teeth 1201 located at both ends of the first clamping body 12 and tooth grooves 1301 located at both ends of the second clamping body 13 and capable of forming a mating engagement with the elastic teeth 1201. The moving clamping arm 1 is slidably connected within the chuck frame 9 and is connected to the clamping transmission member 6. A rubber band 14 is provided between the moving clamping arm 1 and the chuck frame 9 to reset the moving clamping arm 1. The rubber band 14 is fixed to the lower frame of the chuck frame 9. Under normal conditions, the moving clamping arm 1 approaches the lower frame under the action of the rubber band 14. T-shaped guide grooves are provided on the inner walls of both sides of the chuck frame 9. The two ends of the moving clamping arm 1 are adapted to slide and engage with the T-shaped guide grooves. The release slider 2 is provided on one frame of the chuck frame 9.The chuck deflection mechanism includes a connecting ear seat 901 and a deflection push rod 902. The connecting ear seat 901 is arranged on the chuck frame 9 and is integrally formed with the chuck frame 9. A U-shaped connecting seat is provided at the end of the connecting tube 8. The connecting ear seat 901 is embedded in the U-shaped connecting seat and is hinged to the end of the connecting tube 8 through a first rotating shaft. One end of the deflection push rod 902 is hinged to the connecting ear seat 901 through a second rotating shaft, and the other end of the deflection push rod 902 is hinged to the deflection transmission member 7. The outer side of the upper frame of the chuck frame 9 is provided with a slider guide groove 903, in which a release slider 2 is slidably connected. The inner side of the upper frame of the chuck frame 9 is provided with a second clamp body embedding groove. The upper frame of the chuck frame 9 is provided with a C-shaped spring clip 904. The second clamp body 13 is embedded in the second clamp body embedding groove of the chuck frame 9 by the constraint of the opening side of the C-shaped spring clip 904. The C-shaped spring clip 904 is stuck in the spring clip groove on the frame. The opening of the C-shaped spring clip 904 is located on the inner side of the frame. Under normal conditions, the C-shaped spring clip 904 contracts under its own elastic force, and the opening gap is reduced to be sufficient to hook the second clamp body 13, realizing a detachable connection of the second clamp body 13 to the upper frame of the chuck frame 9. The moving clamp arm 1, the release slider 2 and the chuck frame 9 are all made of plastic. The back of the release slider 2 is provided with an inclined surface 201 that contacts the C-shaped spring 904. An unlocking cable 202 is connected to the release slider 2. The unlocking cable 202 is threaded through the connecting tube 8 and connected to a release handle 10. The release handle 10 is hingedly connected to a release handle ring 11, which is fixedly sleeved on the handle 301 of the fixed handle 3. The connecting tube 8 comprises two half-section tubes 801, which are joined together. One of the half-section tubes 801 is provided with a front end stop 802, which is embedded in the lumen 702. A return spring 703 is embedded in the front end of the lumen 702. One end of the return spring 703 abuts the front end wall of the lumen 702, and the other end abuts the front end stop 802.

[0032] When using the present invention, the first clamp 12 and the second clamp 13 are loaded on the chuck. The first clamp 12 and the second clamp 13 are made of a polymer implantable material, POM, which has good biocompatibility. The chuck enters the body through a small incision channel and is displayed by a thoracoscope to enclose the left atrial appendage. The relative angle between the chuck and the connecting pipe 8 is then adjusted by the chuck deflection mechanism so that the chuck can be enclosed in the left atrial appendage at an optimal angle, avoiding blocking the operator's sight and allowing the operator to obtain the best visual field. When deflecting the chuck, it is only necessary to rotate the deflection adjustment sleeve 5. The relative rotation between the deflection adjustment sleeve 5 and the fixed handle 3 is converted into axial motion by thread. The step on the inner wall of the center hole of the deflection adjustment sleeve 5 pushes the pull head 701 of the deflection transmission member 7 to move, so that the deflection transmission member 7 generates axial tension, which is transmitted to the chuck, providing power for the deflection of the chuck. Hold the handle 302 and the clamping handle 4 with your hands, squeeze the clamping handle 4, and the clamping handle 4 will move the end of the clamping transmission member 6 closer to the handle 302. The clamping transmission member 6 will pull the moving clamping arm 1 to overcome the reset force of the rubber band 14 and slide, gradually approaching the upper frame of the clamping head frame 9. When the first clamping body 12 and the second clamping body 13 are close to each other, the elastic buckle 1201 is stuck in the tooth groove 1301, and the first clamping body 12 and the second clamping body 13 are clamped together to achieve the closure of the left atrial appendage, and the two clamping bodies are connected together by the clamping locking structure. After the first clamp body 12 and the second clamp body 13 close and clamp the left atrial appendage, the clamping handle 4 is first released, the tension of the clamping transmission member 6 disappears, and the rubber band 14 drives the moving clamp arm 1 to reset. Since the second clamp body 13 is constrained on the clamp head frame 9 by the C-shaped spring piece 904, it cannot move with the first clamp body 12. The binding force between the first clamp body 12 and the second clamp body 13 is greater than the binding force between the first clamp body 12 and the moving clamp arm. Therefore, the first clamp body 12 is taken away from the moving clamp arm 1 by the second clamp body 13; then the release handle 10 is pressed to drive the unlocking cable 20 2. The unlocking cable 202 pulls the release slider 2 to slide in the slider guide groove 903. The contact point between the inclined surface 201 on the back of the release slider 2 and the C-shaped spring piece 904 gradually shifts from the low point of the inclined surface 201 to the high point. The pressure between the inclined surface 201 and the C-shaped spring piece 904 becomes greater and greater until the opening of the C-shaped spring piece 904 is stretched to a point that is not enough to hang the second clamp 13. The second clamp 13 is then released from the constraint between it and the release slider 2 and detaches from the release slider 2. In this way, the first clamp 12 and the second clamp 13 are completely detached from the clamp.

[0033] Example 2:

[0034] The clamping and locking structure includes teeth grooves at both ends of the first clamp body 12 and elastic buckles at both ends of the second clamp body 13 that can cooperate with the teeth grooves.

Claims

1. A split-type left atrial appendage closure clip system, comprising a clip head and a clip applier, the clip head comprising:a clip head frame;a movable clamp arm;a first clamping body being detachably connected to the movable clamp arm;a second clamping body being detachably connected to the clip head frame opposite the movable clamp arm;a clamping and locking structure being provided between the first clamping body and the second clamping body; andthe clip applier comprising:a fixed handle;a clamping handle slidably connected to the fixed handle;a deflection adjustment sleeve threadedly connected to the fixed handle;a clamping transmission member connected between the clamping handle and the clip head;a deflection transmission member connected between the deflection adjustment sleeve and the clip head; anda connecting tube connected between the clip head and the fixed handle, wherein the clamping transmission member and the deflection transmission member are threaded through the connecting tube,wherein the movable clamp arm is slidably connected inside the clip head frame and connected to the clamping transmission member such that movement of the clamping transmission member moves the movable clamp arm relative to the clip head frame to bring the first clamping body and the second clamping body together,wherein provided between the clip head and the clip applier is a clip head deflection mechanism comprising a connecting lug and a deflection push rod, the connecting lug being provided on the clip head frame, and hingedly connected to an end of the connecting tube,wherein one end of the deflection push rod is hingedly connected to the connecting lug, and an opposite end of the deflection push rod is hingedly connected to the deflection transmission member, andwherein rotation of the deflection adjustment sleeve causes axial movement of the deflection transmission member to deflect the clip head relative to the connecting tube.2023415222   10 Sep 20262. The split-type left atrial appendage closure clip system according to Claim 1, wherein the fixed handle comprises a handle rod, the clamping handle being slidably sleeved on the handle rod, a pull-head slot is provided on a circumferential surface of the handle rod along an axial direction thereof , and an end of the clamping transmission member being connected to the clamping handle.

3. The split-type left atrial appendage closure clip system according to Claim 2, wherein the clamping transmission member is connected to the clamping handle through a pin rod connected to the clamping handle.

4. The split-type left atrial appendage closure clip system according to Claim 2, wherein a step is provided on an inner wall of a central hole of the deflection adjustment sleeve, a pull head is provided at a rear end of the deflection transmission member, a pair of pull-head pins are radially fixed to the pull head, the pull-head pins being threaded through the pull-head slot and extending outwardly therefrom, and a part of the pull-head pin projecting outwardly from the pull-head slot being clamped on the step of the inner wall of the central hole of the deflection adjustment sleeve.

5. The split-type left atrial appendage closure clip system according to Claim 2, wherein the clamping transmission member is a cable, which is threaded through the deflection transmission member, and the deflection transmission member is threaded inside the handle rod.

6. The split-type left atrial appendage closure clip system according to Claim 1, wherein the clip head comprises a rubber band for resetting the movable clamp arm being provided between the movable clamp arm and the clip head frame.

7. The split-type left atrial appendage closure clip system according to Claim 6, wherein a slider guide slot is provided on the clip head frame, a release slider is slidably connected inside the slider guide slot, a C-shaped elastic piece is sleeved on the clip head frame, the second clamping body is caused to abut against an inner side of the clip head frame by the C-shaped elastic piece, an inclined surface configured to contact the C-shaped elastic piece is provided on a rear of the release slider, an unlocking cable is connected to the release slider, the unlocking cable being threaded through the connecting tube and connected to a release handle, the release handle being hingedly connected to a release handle ring, and the release handle ring being fixed on the fixed handle.2023415222   10 Sep 20268. The split-type left atrial appendage closure clip system according to Claim 1, wherein the first clamping body and the second clamping body are made of POM.

9. The split-type left atrial appendage closure clip system according to any one of Claims 1 to 8, wherein the connecting tube comprises two half-section tubes, and the two half-section tubes are joined together.

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