A laparoscopic clip applier for applying surgical clips to tissue structures

Abstract

Laparoscopic clip applier for applying surgical clips to a tissue structure, comprising a handle, a shaft integrated into the handle, a jaw mounted at the end of the shaft, a trigger lever pivotably mounted relative to the handle, a tendon assembly providing a movable connection between the trigger lever and the jaw, wherein the tendon assembly extends along the longitudinal axis of the shaft, wherein for an initial position of the trigger lever the jaw is in an initial open position, characterized in that the clip applier is provided with a mechanism (7) for changing the initial position of the trigger lever (2), which mechanism comprises an adjustable first stop element (26A) and a second stop element (26B), wherein the trigger lever (2) is provided with a third stop element (2B) which comes into contact with the first stop element (26A) or the second stop element (26B) when the jaw (5) is in the initial position.

Description

Technical Field

[0001] The subject of this invention is a laparoscopic clamping device suitable for applying clamps—surgical clamps—of different sizes to tissue structures. Background Technology

[0002] In surgical practice, endoscopic surgical clamping machines are used, where the end effector for clamp application is a movable jaw that can be opened and closed. Existing clamping machines for applying clamps to tissue structures comprise two main components:

[0003] The handle, equipped with a movable trigger lever and an endoscope section—the lever body, which is typically tubular and ends with a pair of movable jaws—is a manipulator. The movable jaws are mounted at the end of the lever body, and the jaw movement triggering mechanism includes at least one actuator or tendon, typically axially positioned within the lever body and moved by the triggering mechanism. The triggering mechanism usually includes a trigger lever, through which the actuator moves and the jaws close. A spring located in the handle returns the trigger lever to its initial position and the jaws open. The mechanism that moves the jaws between two positions (initial open position and closed position) does not allow the clamp size to increase or decrease as the jaws move within a fixed opening range, meaning that a particular clamping machine is only suitable for one type of clamp. Therefore, in surgical cases requiring clamps of different sizes, several clamping machines are needed instead of a single clamping machine.

[0004] According to the description of invention EP3560442A1, a laparoscopic clamping machine is known, comprising a rod body, a handle, a trigger rod, and a mechanism that transmits the movement of the trigger rod to the jaws via a pusher located in the clamping machine rod body, wherein the jaws are connected to the trigger rod so that the pusher is actuated when the jaws are clamped. The clamping machine's jaws are provided with clamps, and the clamps are inserted between the clamps. The clamps are clamped by pressing the trigger rod against the handle, wherein the clamping machine includes a lever mechanism for moving the tendon.

[0005] Because different sizes of clamps are frequently used during a single surgical procedure, clamping machines capable of applying clamps of various sizes are needed. Since many different specialized laparoscopic instruments may be used during surgery, there is an expectation that new laparoscopic instruments should be simple, intuitive to use, and ergonomic.

[0006] Because the procedure requires a variety of actions, including clamps of different sizes, it is necessary to be able to change the initial jaw opening without changing the instrument, and the performance of the clamping machine should be repeatable regardless of the size of the clamps. Summary of the Invention

[0007] The purpose of this invention is to provide a laparoscopic clamping device with a simple design that allows for quick changes in the initial spacing of the clamps. This enables the clamping device to accommodate clamps of different sizes, thereby shortening the duration of the surgical procedure.

[0008] The subject of this invention is a laparoscopic clamping machine for applying surgical clamps to tissue structures, comprising a handle, a rod integrated into the handle, jaws mounted at the end of the rod, a trigger rod pivotally mounted relative to the handle, and a tendon assembly providing a movable connection between the trigger rod and the jaws, wherein the tendon assembly extends along the longitudinal axis of the rod, and wherein the jaws are in an initially open position for an initial position of the trigger rod. A clamping machine is characterized by having a mechanism for changing the initial position of the trigger rod, the mechanism comprising an adjustable first stop element and a second stop element, wherein the trigger rod has a third stop element that contacts either the first stop element or the second stop element when the jaws are in the initial position.

[0009] The clamping machine is characterized in that the mechanism for changing the initial position of the trigger rod includes a trigger rod initial position changing knob, the trigger rod initial position changing knob having a first stop surface including a first stop element and a second stop surface including a second stop element.

[0010] The first stop surface and the second stop surface can be positioned perpendicular to the longitudinal axis of the rod.

[0011] The clamping machine is characterized in that the trigger rod initial position change knob is a ring, and its inner cylindrical surface is located on the body integrated with the handle.

[0012] The trigger lever initial position changing mechanism can be equipped with a latch to lock the position of the trigger lever initial position changing knob.

[0013] The latch can be in the form of a ball latch, wherein the trigger lever initial position changing knob can have a groove for forming the latch on the inner cylindrical surface.

[0014] The trigger lever initial position change knob can be set with an indicator to show the selected initial jaw spacing.

[0015] The clamping machine is characterized in that the third stop element is a cylindrical stop surface.

[0016] The third stop element may be a stop pin or a threaded element located on the trigger rod.

[0017] The clamping machine is characterized in that the rotary joint of the trigger rod and the third stop element are located on opposite sides of the longitudinal axis of the rod body.

[0018] The clamping machine is characterized in that the trigger rod is provided with a pull joint pin located between the trigger rod rotary joint and the third stop element, and the pull joint is connected to the tendon assembly.

[0019] One advantage of the laparoscopic clamping device according to the present invention is that the knob provided for changing the initial clamp spacing, in addition to its main function, also serves as an indicator for clamp spacing selection. Furthermore, it allows for auditory and tactile recognition of the clamp spacing selection action. Therefore, the operator can control the change of clamp spacing visually, audibly, and tactilely.

[0020] A simple knob for changing the jaw spacing is a highly ergonomic solution. The operator has one knob to change the jaw angle, and adjacent to it, another knob, connected to the jaws, changes the initial position of the trigger lever, thus altering the initial jaw spacing. The simplicity of the mechanism ensures intuitive knob adjustment, with the expected knob position readily apparent. This simplicity guarantees the tool's consistent accuracy and durability. Attached Figure Description

[0021] The object of the invention will be described in more detail with reference to the embodiments shown in the accompanying drawings, wherein:

[0022] Figure 1 A three-dimensional view of the laparoscopic clamping machine is shown.

[0023] Figure 2a 3a shows a clamping mechanism with a mechanism in the initial position of the smaller clamp.

[0024] Figure 2b 3b shows a clamping mechanism with a mechanism in the initial position of a larger clamp, and

[0025] Figure 4 The image shows the clamping machine in place after the trigger lever has been tightened. Detailed Implementation

[0026] The laparoscopic clamping device includes a handle 1, a trigger rod 2, a rod body 3, a jaw angle position changing mechanism 4, jaws 5, and a tendon assembly 6. The clamping device is equipped with a mechanism 7 for changing the initial position of the trigger rod 2. The trigger rod 2 is rotatably mounted on a rotary joint 8 arranged in the handle 1. Figure 2a Jaw 5 is pivotally mounted on connector 9 at the distal end of rod 3, wherein jaw 5 is movable via tendon assembly 6. Figure 2a , 2b ).

[0027] The tendon assembly 6 includes a distal end 10 and a tendon 11 on one side of the jaw 5, and a proximal end 12 on one side of the handle 1. The tendon assembly 6 is designed to move along the longitudinal axis k of the rod 3, which can be the geometric axis of both the rod 3 and the tendon 11.

[0028] The distal end 10 is threaded to the tendon 11. The proximal end 12 is also threaded to the tendon 11. The tendon assembly 6 movably connects the jaws 5 to the trigger rod 2, wherein the triggering mechanism 15 includes the trigger rod 2, a slider 16, a spring 23, and the tendon assembly 6. The proximal end 12 of the tendon assembly 6 is provided with a head 13, which moves via the trigger rod 2 through the slider 16. Rotation of the trigger rod 2 toward the handle 1 causes the jaws 5 to clamp. The jaws 5 are provided with clamps 5A and 5B, into which the jaws are inserted. The jaws 5 are provided with openings 5C and 5D, in which a bolt 14 attached to the other end 10 moves. Movement of the bolt 14 causes the jaws 5 to rotate.

[0029] The slider 16 of the trigger mechanism 15 moves within the opening 17 of the main body 18, which is securely connected to the handle 1 and forms an integral part of the handle 1. The slider 16 has a first opening 19 with an axis perpendicular to the longitudinal axis k of the rod 3. A head 13 is placed within the opening 19, which opens on one side of the tendon assembly 6. The head 13, together with the opening 19, forms a connector 20 for the proximal end 12 of the tendon 11. Furthermore, a second opening 21 is provided inside the slider 16, in which the pin 2A of the trigger rod 2 is located. The pin 2A may be cylindrical, with its axis m perpendicular to the longitudinal axis k of the rod. The second opening 21 may have a rectangular cross-section. The second opening 21, together with the pin 2A, forms a pull connector 22. Any other shape of the pull connector 22 is possible. The pivotally mounted trigger rod 2 forces the slider 16 and the tendon assembly 6 to move linearly along the longitudinal axis k through the movement of the pull connector 22. The trigger mechanism 15 is equipped with a spring 23, which is a compression spring and is installed in the body 18, thereby forcing the slider 16 to move toward the jaws 5. Manual pressure on the trigger rod 2 causes the slider 16 to move and the spring 23 to compress. The release of pressure causes the trigger rod 2 to return to its initial position under the action of the spring 23.

[0030] The initial position changing mechanism 7 of the trigger lever 2, together with the tendon assembly 6, constitutes the initial spacing changing mechanism 25 of the jaws 5. The initial spacing of the jaws 5, i.e., the distance between clamps 5A and 5B, is directly related to the change in the initial position of the trigger lever 2. The initial position changing mechanism 7 of the trigger lever 2 is provided with an initial position changing knob 26 of the trigger lever 2, which is also the initial spacing changing knob of the jaws 5. The initial position changing knob 26 of the trigger lever 2 is annular and has an inner cylindrical surface 26K rotatably mounted on the cylindrical surface 18A of the body 18 of the handle 1. The initial position changing knob 26 of the trigger lever 2 may be provided with a first stop element and a second stop element, which are adjustable to support the trigger lever, i.e., determine the initial position of the trigger lever 2. The stop elements of the initial position changing knob 26 of the trigger lever 2 can be of any form, for example, they can be stop bolts. The third stop element located on the trigger lever 2 can be of any form. In the embodiment of the initial position changing knob 26 of the trigger lever 2 shown, the first stop element 26A has the form of a stop surface 26A and the second stop element 26B has the form of a second stop surface 26B (as shown in Figures 3a and 3b), while the third stop surface 2B has the form of a convex surface, wherein the convex surface faces the jaws 5. The third stop surface 2B can be in the form of a cylindrical surface, or it can be in the form of any protrusion on the trigger lever 2 on the side of the lever body 3. For example, a stop bolt pressed into the trigger lever 2 or an element screwed into the trigger lever 2 can be used. In the initial position of the trigger lever 2, the third stop surface 2B on the trigger lever 2 can be pressed against the first stop surface 26A or the second stop surface 26B on the initial position changing knob 26 of the trigger lever 2 under the action of the spring 23. In the embodiment shown, the support of the trigger lever 2 against the first stop surface 26A is adapted to open the jaws 5 to set an opening suitable for a L-sized clamp ( Figure 2a And 3a). The support of the trigger lever 2 on the second stop surface 26B ensures maximum pivoting of the trigger lever 2 and is adapted to open the jaws 5 to set the opening to fit the size XL clamp. Figure 2b(and 3b). The distance between the first stop surface 26A and the second stop surface 26B along a direction parallel to the longitudinal axis k, as shown in d in Figure 3a, allows for two different initial positions of the trigger lever 2, wherein the stop surfaces 26A and 26B are repositioned by rotating the knob 26. Furthermore, the initial position changing knob 26 of the trigger lever 2 has an intermediate surface 26C connecting the first stop surface 26A and the second stop surface 26B, providing a smooth transition between these surfaces. The knob 26 is provided with an indicator 26L, which indicates one of the possible pitches of the jaws 5, namely pitch L or XL, as shown in Figures 3a and 3b. When the knob 26 is locked, the indicator 26L can be positioned in front of one of the L or XL descriptions on the handle 1. The indicator 26L is in the shape of a circular finger, close to the cylindrical surface 18A of the body 18. The axial position of the initial position changing knob 26 of the trigger lever 2 is fixed by a flange 26G, which rests against the groove 1A of the handle 1 and is arranged along the longitudinal axis k of the lever body 3 by a nut 27. The initial position changing mechanism 7 of the trigger lever 2 is provided with a latch 28, which has a latching element 29, which is spherical and arranged to lock the knob 26. For the pitch L, the latching element 29 slides into the recess 26E, and for the pitch XL, the latching element 29 slides into the recess 26F.

[0031] The trigger mechanism 15 is designed such that the fastening assembly 6 of the lever 2, which is pressed against the handle 1, moves in the direction toward the handle 1. The rotary joint 8 of the trigger lever 2 and the third stop surface 2B of the trigger lever 2 are located on opposite sides of the longitudinal axis k of the lever body 3 and opposite sides of the pull joint 22. Similarly, the grip portion 2G of the trigger lever 2 and the rotary joint 8 of the trigger lever 2 are located on opposite sides of the longitudinal axis k of the lever body 3 and the pull joint 22.

[0032] The clamping machine is equipped with an angle position changing mechanism 4 for the jaws 5, which includes a sleeve 31 for the jaws 5 and an angle position changing knob 32. The rod body 3 is fixedly connected to the sleeve 31, and the sleeve 31 maintains contact with the inner track of the bearing 33 and rotates with the inner track of the bearing 33. Rotation of the angle position changing knob 32 of the jaws 5 causes rotation of the rod body 3 and the jaws 5 fixed to the rod body 3.

[0033] like Figure 2a and 2b As shown in Figures 3a and 3b, the trigger lever 2 and jaws 5 are in their initial positions, where... Figure 2a In the middle, the third stop surface 2B on the trigger lever 2 rests against the first stop surface 26A on the knob 26, and the distance between the jaws 5 and the jaws is suitable for clamps of size L. The indicator 26L of the knob 26 indicates the selected size L (Fig. 3a), while... Figure 2bIn the middle, the knob 26 is rotated so that the indicator 26L displays the selected size XL (Fig. 3b), the third stop surface 2B of the trigger lever 2 rests against the second stop surface 26B on the knob 26, and the spacing of the jaws 5 is suitable for the XL size clamp.

[0034] Figure 4 This shows that when the clamp is gripped, the clamping machine is in such a position that the trigger lever 2 is tightened to the maximum extent relative to the handle 1.

[0035] The jaw spacing 5 is changed by gripping the handle 1 and the trigger lever 2, wherein the trigger lever 2 and the handle 1 must be slightly tightened so that the trigger lever 2 rotates toward the handle 1, which causes the jaws 5 to close. Then, it is necessary to use the other hand or thumb to turn the knob 26 to change the initial position of the trigger lever 2, changing the initial jaw spacing 5 to a position consistent with the size of the L or XL clamp used, i.e., the 26L indicator is positioned in front of one of the L or XL descriptions on the body 18. The knob 26 is positioned in one of the possible positions by a latch 28 audibly locking in one of the recesses 26E or 26F, wherein the locking of the latch can be felt by hand because the locking causes a small vibration in the handle and the knob. Therefore, the operator of the clamp according to the invention has triple confirmation that the initial opening setting of the clamp jaws has been changed.

[0036] The jaw 5 angle position changing mechanism 4 is independent of the jaw 5 initial spacing changing mechanism 25. The jaw 5 angle position changing mechanism 4 may be equipped with a latching element.

Claims

1. A laparoscopic clamping machine for applying surgical clamps to tissue structures, comprising: -handle, - The lever body, integrated into the handle. - Jaws, installed at the end of the rod. - A trigger lever, pivotally mounted relative to the handle. A tendon assembly provides a movable connection between the trigger rod and the jaws, wherein the tendon assembly extends along the longitudinal axis of the rod body. With respect to the initial position of the trigger lever, the jaws are in the initial open position. Its features are, It is equipped with an initial position changing mechanism (7) for the trigger rod (2), including an adjustable first stop element (26A) and a second stop element (26B), wherein the trigger rod (2) is provided with a third stop element (2B), and when the jaws (5) are in the initial position, the third stop element (2B) contacts the first stop element (26A) or the second stop element (26B). in, The initial position changing mechanism (7) of the trigger rod (2) includes an initial position changing knob (26) of the trigger rod (2). The initial position changing knob (26) is provided with a first stop surface including a first stop element (26A) and a second stop surface including a second stop element (26B). The initial position changing knob (26) of the trigger rod (2) is annular, and its inner cylindrical surface (26K) is located on a main body (18). The main body (18) and the handle (1) are integrated. in, The initial position changing mechanism (7) of the trigger rod (2) is provided with a latch (28) for locking the position of the initial position changing knob (26) of the trigger rod (2), and the initial position changing knob (26) of the trigger rod (2) has a recess (26E, 26F) for the latch (28) formed on the inner cylindrical surface (26K).

2. The clamping machine according to claim 1, characterized in that, The first stop surface (26A) and the second stop surface (26B) are positioned perpendicular to the longitudinal axis (k) of the rod (3).

3. The clamping machine according to claim 1 or 2, characterized in that, The latch (28) is a spherical latch.

4. The clamping machine according to claim 1, characterized in that, The initial position changing knob (26) of the trigger lever (2) is equipped with an indicator (26L) for indicating which initial jaw spacing has been selected.

5. The clamping machine according to claim 1, characterized in that, The third stop element (2B) is a cylindrical stop surface.

6. The clamping machine according to claim 1, characterized in that, The third stop element (2B) is a stop bolt or screw element located on the trigger rod (2).

7. The clamping machine according to claim 1, characterized in that, The rotary joint (8) of the trigger rod (2) and the third stop element (2B) are located on opposite sides of the longitudinal axis (k) of the rod body (3).

8. The clamping machine according to claim 1, characterized in that, The trigger rod (2) is provided with a pull joint (22) pin (2A) located between the trigger rod (2) rotary joint (8) and the third stop element (2B), wherein the pull joint (22) is connected to the tendon assembly (6).

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