Threaded holder, endoscopic clip and method of operating the same

Abstract

The application provides a threading holder, an endoscope clamp and an operating method thereof, and relates to the technical field of interventional medical devices. The threading holder comprises a clamp body and a clamp seat. The clamp body is arranged in the clamp seat. The clamp body comprises at least two clamp arms and a connecting part for connecting the proximal ends of the at least two clamp arms. A threading hole for threading a suture is arranged on the clamp body. The clamp body moves relative to the clamp seat. The at least two clamp arms overcome the elastic tension to approach each other and are clamped by the abutting constraint of the clamp seat. After the at least two clamp arms are clamped, the clamp seat covers the threading hole to fix the suture. The suture of a wound can be completed by using multiple threading holders. The wound healing is facilitated. The threading holder is especially suitable for the suture of a large-area wound. The difficulty of suture is effectively reduced, and the suture effect is improved.

Description

Technical Field

[0001] This application relates to the field of interventional medical device technology, specifically to a suture clamp, an endoscope clamp, and their operating methods. Background Technology

[0002] With the development of endoscopic minimally invasive technology, some digestive tract diseases that previously required open surgery or laparoscopy, such as early-stage digestive tract tumors, can now be treated with minimally invasive surgery under digestive endoscopy.

[0003] In minimally invasive surgery, taking early-stage gastrointestinal tumors as an example, gastrointestinal bleeding and perforation, as well as suturing gastrointestinal mucosal defects, are among the most common problems requiring rapid and effective management during tumor resection. Currently, the instruments used for suturing in endoscopic minimally invasive surgery mainly include endoscopic clips, nylon cords combined with metal clips, endoscopic suturing devices (such as OTSC), and surgical suture instruments (such as Overstitch). Among them, endoscopic suture clips are simple to operate and inexpensive, and are widely used in clinical surgery. However, they are not effective for large defects or defects in difficult locations with tricky angles. Nylon ropes combined with metal clips can suture large wounds in one go, but due to poor closing force, they may not be able to completely close the wound. In addition, the metal clips are not easy to control during suturing and may fall into the wound, causing inconvenience to the operation. Endoscopic suturing devices (such as OTSC) can provide strong closing force for full-thickness suturing of perforated wounds, but their wound range is limited. They are difficult to operate on wounds larger than 10 mm. This endoscopic suturing device can only perform one suture per insertion, and multiple assembly operations are required during the operation. Surgical suture instruments are difficult to operate and require a high level of operator proficiency. Operators need professional training and long-term practical operation to master them well. Summary of the Invention

[0004] The purpose of this application is to provide a suture holder, an endoscope clamp, and a method for operating the same, which facilitates wound suturing during minimally invasive endoscopic surgery. The structure is ingenious, the operation is simple and easy to learn, and it is applicable to wounds of various shapes and sizes, with good suturing results.

[0005] In one aspect of the embodiments of the present application, a suture clamping device is provided, which comprises a clamping body and a clamping seat, the clamping body is arranged in the clamping seat, the clamping body comprises at least two clamping arms and a connecting portion for connecting proximal ends of the at least two clamping arms, a suture hole for threading a suture is arranged on the clamping body, the clamping body moves relative to the clamping seat, the at least two clamping arms are clamped to each other by the resistance of the clamping seat to the clamping arms to overcome the elastic tension, and the at least two clamping arms continue to move to a locking position after being clamped to each other, the clamping seat covers the suture hole to fix the suture.

[0006] Optionally, a positioning member and a clamping adjusting structure are arranged on the clamping body and the clamping seat respectively, the positioning member and the clamping adjusting structure can cooperate with each other, the clamping adjusting structure is used to adjust the positioning member, and the clamping body moves or is positioned on the clamping seat through the adjustment of the clamping adjusting structure to the positioning member.

[0007] Optionally, the positioning member is arranged on the connecting portion, and the clamping adjusting structure is arranged on the clamping seat, the positioning member can move in position in the clamping adjusting structure.

[0008] Optionally, the positioning member is a protruding portion extending outward, and the clamping adjusting structure comprises a guide groove for accommodating the protruding portion, wherein the guide groove is a strip-shaped groove extending along the relative movement direction.

[0009] Optionally, the clamping adjusting structure further comprises a locking portion, the locking portion and the guide groove are arranged in a linear interval along the movement direction, and the locking portion is located at the proximal end of the guide groove.

[0010] Optionally, the guide groove is a strip-shaped through groove, or the guide groove is a strip-shaped recessed groove protruding outward toward the clamping seat; and the protruding portion is a protruding block or a stepped platform.

[0011] Optionally, the locking portion is a locking groove, a locking hole or a stepped surface expanding outward from the inner wall of the clamping seat to expand the inner diameter of the clamping seat.

[0012] Optionally, the positioning member comprises at least two positioning members, and the at least two positioning members are arranged in a distribution along the circumference of the connecting portion or the clamping seat.

[0013] Optionally, the clamping body moves to the locking position by being clamped to each other, the distance between the center of the suture hole and the edge of the clamping seat and the path length of the movement of the clamping body relative to the clamping seat are in a ratio of 0.1-1.3.

[0014] Optionally, the distal end surface of the clamping arm is a stepped surface, and the distal end surfaces of the at least two clamping arms are matched with each other when the at least two clamping arms are clamped to each other.

[0015] In another aspect of the embodiments of the present application, an endoscope clamp is provided, which comprises a handle, a sheath tube and a pushing member which can be pushed in the channel of the sheath tube by the handle between the distal end and the proximal end, and further comprises the suture clamping device of any one of the above, the distal end of the pushing member is releasably connected with the clamping body of the suture clamping device, and the suture clamping device is detachably connected with the sheath tube.

[0016] Optionally, the pushing member comprises an operating wire and a releasing part connected to the distal end of the operating wire, the ridge of the connecting part of the threading holder is provided with a cooperating releasing structure, and the cooperating releasing structure is detachably connected with the releasing part of the pushing member.

[0017] Optionally, the cooperating releasing structure comprises a clamping part provided on the connecting part, and the releasing part is provided with a cooperating part matched with the clamping part, the cooperating part is clamped on the clamping part in a deformable manner, and the cooperating part is separated from the clamping part when the clamping body is in the locking position under the pulling action of the operating wire.

[0018] Optionally, the releasing part comprises at least two releasing arms, and the at least two releasing arms are shaped into a resiliently outwardly extending structure, and the clamping part is correspondingly provided with at least two clamping parts at the edge of the ridge of the connecting part, so that the releasing arms are clamped between the corresponding clamping parts and the clamping seat in a deformed manner.

[0019] Optionally, the cooperating releasing structure is a resilient releasing hole, and the distal end of the releasing part is clamped in the resilient releasing hole; after the releasing part is retracted to the proximal end to the threading holder in the locking position, the distal end of the releasing part is separated from the resilient releasing hole under the pulling force.

[0020] Optionally, a sheath tube is arranged at the distal end of the sheath, the inner diameter of the sheath tube is greater than the inner diameter of the channel, the sheath tube is sleeved on the proximal end of the clamping seat, an insurance ring is sleeved on the releasing part, the outer edge of the insurance ring abuts against the variable-diameter platform between the sheath tube and the channel, and the inner diameter of the insurance ring is smaller than the diameter of the distal end of the releasing part; the distal end of the releasing part is separated from the resilient releasing hole of the threading holder, and the sheath tube is separated from the clamping seat.

[0021] In still another aspect of the embodiments of the present application, an operating method of the endoscope clip is provided, comprising:

[0022] The suture is threaded on the threading hole of the threading holder of the endoscope clip, and the endoscope clip is sent to the preset area at the distal end through the channel; at least two clamping arms of the clamping body of the threading holder are operated by the handle to approach each other to clamp or move away to open, until the clamping arms stably clamp the target object at the target position; the clamping state of the threading holder is maintained, the length of the suture threaded through the threading hole is adjusted, until the threading holder and the previous threading holder clamped on the target object reach the preset distance; the clamping arms of the threading holder are continuously moved to the locking position by operating the handle, and in the locking position, the suture is locked by the surrounding side of the threading hole and the clamping seat; the pushing member is released from the threading holder by operating the handle, and the threading holder is separated from the endoscope clip after being released; and the endoscope clip is withdrawn after the separated threading holder.

[0023] The beneficial effects of the present application include:

[0024] The application provides a wire clamping device, an endoscope clamp and an operation method thereof, which comprises a clamp body and a clamp seat, the clamp body is arranged in the clamp seat, the clamp body comprises at least two clamp arms and a connecting part for connecting proximal ends of the at least two clamp arms, a wire hole for arranging a suture is arranged on the clamp body, the clamp body moves relative to the clamp seat, the at least two clamp arms are clamped to each other by overcoming the elastic tension through the abutting constraint of the clamp seat, and the clamp seat covers the wire hole to fix the suture after the at least two clamp arms are clamped to each other and continue to move to a locking position, so that the suture of a wound can be completed through a plurality of wire clamping devices, the wound healing is facilitated, and the wire clamping device is especially suitable for the suture of a large-area wound, effectively reduces the difficulty of suture and improves the suture effect. BRIEF DESCRIPTION OF DRAWINGS

[0025] In order to more clearly illustrate the technical solutions of the embodiments of the application, the following will briefly introduce the drawings needed to be used in the embodiments of the application. It should be understood that the following drawings only show some of the embodiments of the application, and therefore should not be regarded as a limitation on the scope. For those skilled in the art, other related drawings can also be obtained without creative labor on the basis of these drawings.

[0026] Figure 1 is one of the structural schematic diagrams of the clamp body of the wire clamping device provided by the embodiments of the application;

[0027] Figure 2 is a structural schematic diagram of the clamp seat of the wire clamping device provided by the embodiments of the application;

[0028] Figure 3 is one of the schematic diagrams of the holding clamped state of the wire clamping device provided by the embodiments of the application;

[0029] Figure 4 is one of the schematic diagrams of the wire clamping device in the locking position provided by the embodiments of the application;

[0030] Figure 5 is the second schematic diagram of the holding clamped state of the wire clamping device provided by the embodiments of the application;

[0031] Figure 6 is the second schematic diagram of the wire clamping device in the locking position provided by the embodiments of the application;

[0032] Figure 7 is a schematic diagram of the wire clamping device suturing a wound provided by the embodiments of the application;

[0033] Figure 8 is the second structural schematic diagram of the clamp body of the wire clamping device provided by the embodiments of the application;

[0034] Figure 9is a structure diagram of a release part of a threading holder provided by an embodiment of the present application;

[0035] Figure 10 is a structure diagram of an endoscope clamp provided by an embodiment of the present application;

[0036] Figure 11 is Figure 10 is a local enlarged view of region A in FIG. 8;

[0037] Figure 12 is a diagram of suturing a wound by an endoscope clamp provided by an embodiment of the present application.

[0038] Icon: 10-threading holder; 20-suture; 30-wound; 31-first threading holder; 32-second threading holder; 33-third threading holder; 34-fourth threading holder; 100-clamp body; 110-clamp arm; 111-threading hole; 112-step surface; 120-connection part; 121-elastic release hole; 122-protrusion; 123-convex part; 124-clamping groove; 200-clamp seat; 210-guiding groove; 220-locking part; 230-shaped elastic outwardly extending part; 300-release part; 310-release arm; 400-sheath tube; 510-operating wire; 600-handle; 700-sheath tube. DETAILED DESCRIPTION

[0039] The technical solutions in the embodiments of the present application will be clearly and completely described in combination with the drawings in the embodiments of the present application.

[0040] In the description of the present application, it should be noted that the directions or position relationships indicated by the terms “inner”, “outer” and the like are based on the directions or position relationships shown in the drawings, or the directions or position relationships in which the products of the present application are usually placed, and are only for the convenience of describing the present application and simplifying the description, and thus cannot be understood as indicating or implying that the devices or elements must have a particular direction, be constructed and operated in a particular direction, and thus cannot be understood as limiting the present application. In addition, the terms “first”, “second” and the like are only used for differentiation and description, and cannot be understood as indicating or implying relative importance.

[0041] It should also be noted that, unless otherwise explicitly specified and limited, the terms “set”, “connected” should be understood broadly, for example, can be fixedly connected, can be detachably connected, or integrally connected; can be directly connected, or indirectly connected through an intermediate medium; can be connected inside two elements. For those skilled in the art, the specific meanings of the above terms in the present application can be understood according to the specific circumstances.

[0042] In the technical solutions provided in the present application, one end of the entire device placed in the human body is referred to as a distal end, which is mainly used for performing surgical actions on tissues; and the other end located outside the body is referred to as a proximal end, which is mainly used for operation by a surgeon. Unless otherwise specified, the distal end of each component refers to the end close to the side in the body, and the proximal end of each component refers to the end close to the side outside the body.

[0043] The embodiment of the present application provides a threading holder, which comprises a holder body 100 and a holder seat 200, the holder body 100 comprises at least two holder arms 110, and the proximal ends of the at least two holder arms 110 are connected to a connecting part 120. Figure 1 Figure 2 As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120. Figure 1

[0044] As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120. Figure 1 Figure 3 As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120. Figure 1 As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120.

[0045] Figure 3 As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120.

[0046] As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120. Figure 3 Figure 4 As shown in FIG. 1, the holder body 100 comprises two oppositely arranged holder arms 110, and the proximal ends of the two oppositely arranged holder arms 110 are connected to the connecting part 120.​​​​​Figure 5 and Figure 6 As shown, for ease of description, it can be divided into at least two consecutive motion phases. For example... Figure 3 or Figure 5 As shown, in the first movement phase, the clamping seat 200 can apply a restraining effect to the clamping arms 110 in a resisting manner, so that at least two clamping arms 110 can overcome elastic tension and move closer to each other to complete the clamping of the tissue; as Figure 4 or Figure 6 As shown, in the second movement phase, at least two clamping arms 110 maintain a clamping state under the action of the clamping seat 200. The clamping body 100 continues to move in the same direction as in the first movement phase until it reaches the locking position, so that the clamping body 100 in the locking position stops moving relative to the clamping seat 200 and is locked. At this time, the suture hole 111 on the clamping body 100 is covered by the clamping seat 200, and the suture 20 is fixed by the cooperation between the clamping body 100 and the clamping seat 200. In some embodiments, the suture hole 111 is not covered by the clamping seat 200 after the first movement phase, that is, the suture holder 10 does not fix the suture 20. In other words, at this time, the clamping body 100 of the suture holder 10 can move relative to the suture 20. In this way, based on the fact that the tissue has been clamped and fixed by the suture holder 10, the suture 20 can be smoothly wound and unwound relative to the suture holder 10, realizing flexible adjustment of tissue suturing.

[0047] In practical applications, the clamping arms 110 of the first suture holder 31 can be initially in an open state. At this time, one end of the suture 20 can be threaded through the suture hole 111 on the clamp body 100. Then, the endoscopic clamp equipped with the first suture holder 31 is inserted from proximal to distal through the channel, bringing the first suture holder 31 to the vicinity of the wound 30, and aligning the clamping arms 110 with the first target position of the wound 30. The clamp body 100 is driven to move relative to the clamp seat 200, causing at least two clamping arms 110 to approach each other and clamp the tissue at the first target position. While the clamping arms 110 maintain their clamping effect on the tissue, the clamp body 100 continues to move relative to the clamp seat 200 and enters a locked position. Simultaneously, the clamp seat 200 covers the suture hole 111, thereby fixing the suture 20. Figure 7 As shown in Figure a, to prevent the first suture holder 31 from sliding freely along the suture 20, after the operation is completed, release it to leave the first suture holder 31 in the clamping position before withdrawing the endoscope clip. Then, remove the endoscope clip equipped with the second suture holder 32, pass the other end of the suture 20 through the suture hole 111 on the clip body 100 of the second suture holder 32, and insert the endoscope clip equipped with the second suture holder 32 into the vicinity of the wound 30 in the same manner as the first suture holder 31, aligning the clamp arm 110 with the second target position of the wound 30. (See Figure a for details.) Figure 7As shown in Fig. b, the second threading holder 32 is driven to clamp the tissue at the second target position. As shown in Fig. Figure 7 As shown in Fig. c, while the clamping body 100 of the second threading holder 32 is kept in the clamping state, the suture 20 is pulled so that the first threading holder 31 and the second threading holder 32 are moved closer to each other, i.e. the tissue at the first target position and the tissue at the second target position are moved closer to each other. As shown in Fig. Figure 7 As shown in Fig. d, the clamping body 100 of the second threading holder 32 is then driven to move so that the clamping body 100 is moved to the locking position while the fixation of the suture 20 by the second threading holder 32 is simultaneously completed. As shown in Fig. Figure 7 As shown in Fig. e, an endoscope clamp provided with a third threading holder 33 is taken out, sent to the vicinity of the wound 30, clamped to the tissue at the third target position, and then withdrawn after the third threading holder 33 and the suture 20 are fixed. As shown in Fig. Figure 7 As shown in Fig. f, an endoscope clamp provided with a fourth threading holder 34 is taken out, sent to the vicinity of the wound 30, clamped to the tissue at the fourth target position, and then withdrawn after the fourth threading holder 34 and the suture 20 are fixed. In this way, the wound can be continuously sutured by the multiple threading holders 10 cooperating with the suture 20, which facilitates the healing of the wound, especially for suturing a large area wound, effectively reduces the difficulty of suturing, and improves the effect of suturing. At the same time, since the threading holder 10 can lock the suture 20, additional locking instruments are not required during the suturing process.

[0048] In some embodiments, as shown in Figs. Figure 1 and Figure 2 A positioning member is arranged on the clamping body 100, and the clamping adjusting structure is arranged on the clamping base 200. Figure 3 and Figure 4 The positioning member can move within the clamping adjusting structure to complete the movement and / or positioning of the clamping body 100 relative to the clamping base 200. The movement corresponds to the aforementioned movement of the clamping body 100 relative to the clamping base 200, i.e. the movement includes the first movement stage and the second movement stage. The positioning corresponds to the aforementioned locking of the clamping body 100 to the locking position and the clamping base 200. In some embodiments, the positioning member can also be arranged on the clamping arm 110.

[0049] Before the clamping body 100 is moved to the locking position, the clamping body 100 can reciprocate relative to the clamping base 200, i.e. the clamping body 100 can be switched back and forth between the close and open states, so as to facilitate the flexible adjustment of the tissue position clamped by the threading holder 10 by the operator.

[0050] In some embodiments, the clamping adjusting structure is arranged on the clamping body 100, the positioning member is arranged on the connecting portion 120, and the positioning member is arranged on the clamping seat 200. Since the positioning member and the clamping adjusting structure are in relative motion, the positioning member can also move in the clamping adjusting structure to complete the motion and / or positioning of the clamping body 100 relative to the clamping seat 200. In some embodiments, the clamping adjusting structure can also be arranged on the clamping arm 110.

[0051] Optionally, the positioning member is an outwardly extending protrusion 123, and the clamping adjusting structure includes a guide groove 210. During the motion of the clamping body 100 relative to the clamping seat 200, the protrusion 123 can move in the guide groove 210. In this way, the limit and guiding effect of the guide groove 210 are utilized to improve the stability of the clamping body 100 during sliding and avoid phenomena such as rotation deviation. Of course, the clamping body 100 can also be locked so that the clamping body 100 is in a locked position.

[0052] Optionally, the positioning member is an outwardly extending protrusion 123, and the clamping adjusting structure includes a guide groove 210 for accommodating the protrusion 123 and a locking portion 220. In this way, the protrusion 123 moves in the guide groove 210 to achieve the motion of the clamping body 100 relative to the clamping seat 200, and the protrusion 123 is located in the locking portion 220 to achieve the locking of the clamping body 100 and the clamping seat 200. The guide groove 210 is a strip-shaped groove extending in the relative motion direction, so that when the protrusion 123 of the clamping body 100 slides in the guide groove 210, the clamping body 100 is prevented from rotating and deviating during sliding in the clamping seat 200, improving the stability of the motion of the clamping body 100 relative to the clamping seat 200, and also facilitating the accuracy of the clamping body 100 during repeated clamping / non-clamping of the tissue.

[0053] For example, the clamping adjusting structure is arranged on the clamping seat 200, and the positioning member is arranged on the clamping body 100. As shown in Figure 2 , the clamping seat 200 is a sleeve, a strip-shaped groove extending along the axial direction of the sleeve is formed on the sleeve, the locking portion 220 and the guide groove 210 are arranged in a straight line and spaced apart along the axial direction of the sleeve, and the locking portion 220 is located on the proximal side of the guide groove 210. As shown in Figure 1 , the clamping body 100, the proximal end of the connecting portion 120 of the clamping body 100 is arranged in the guide groove 210 of the clamping seat 200, and the protrusion 123 of the clamping body 100 is arranged in the locking portion 220 of the clamping seat 200. Figure 2The lower opening (distal end) of the sleeve extends into the sleeve and the protrusion 123 on the clip body 100 is located in the guide groove 210. During the suturing process, the clip arms 110 of the clip body 100 are spread apart from each other, and the suture 20 is threaded into the threading hole 111 on the clip arm 110. The clip body 100 is driven to move axially along the sleeve from the distal end to the proximal end, and the clip arms 110 are brought together to clamp the tissue under the constraint of the sleeve distal end opening, and in this movement process, the guide groove 210 can guide the protrusion 123 on the clip body 100 to enable the clip body 100 to slide axially along the sleeve without rotating offset. As shown in Figure 3 and Figure 5 When the clip arms 110 are brought together to clamp the tissue, the threading hole 111 is still not in the sleeve, and at this time, the wound 30 can be brought together relative to the two sides by pulling the suture 20, and after the wound 30 is brought together, the clip body 100 is continuously driven to move axially along the sleeve from the distal end to the proximal end, and the threading hole 111 gradually enters the sleeve, as shown in Figure 4 and Figure 6 When the protrusion 123 on the clip body 100 enters the locking portion 220 from the guide groove 210, the clip body 100 is in the locked position, at this time, the threading hole 111 is completely covered by the inner wall of the sleeve, and under the action of the clip body 100 recovering the deformation, the clip body 100 is resisted by the inner wall of the sleeve, and the relative fixation of the threading and clamping device 10 and the suture 20 is completed.

[0054] In some embodiments, the protrusion 123 can be brought into abutment with the groove wall at the distal end of the guide groove 210, so that the clip body 100 is in the clamping state, and at this time, the threading hole 111 is not covered by the clip seat 200, so that the timing of pulling the suture 20 is clear to the operator, the accuracy and convenience of the operation are improved, and the fatigue of the operator is reduced.

[0055] In some embodiments, as shown in Figure 2 The guide groove 210 is a strip-shaped through groove, that is, the guide groove 210 penetrates through in the radial direction of the sleeve. In some embodiments, the guide groove 210 is a strip-shaped recess that protrudes outwardly toward the clip seat 200.

[0056] In some embodiments, as shown in Figure 2 The locking portion 220 is a locking hole. In some embodiments, the locking portion 220 is a locking groove. The locking of the clip body 100 and the clip seat 200 is achieved by the cooperation of the protrusion 123 and the locking hole or the locking groove. In some embodiments, the locking portion 220 can also be that the inner wall of the clip seat 200 expands outwardly to expand the inner diameter of the clip seat 200, so as to form a stepped surface on the inner wall of the clip seat 200, and thus the locking can be completed by the cooperation of the protrusion 123 and the stepped surface. The stepped surface can also be a multi-stage stepped surface.

[0057] In some embodiments, as shown in Figure 2 In some embodiments, the convex part 123 is a convex block. In some embodiments, the convex part 123 is a stepped platform. In some embodiments, the convex part 123 can be made of elastic material, so that the convex part 123 can deform and enter the locking part 220 from the guide groove 210 under a certain driving force. In some embodiments, a guide wall can be arranged on the side of the convex part 123 close to the proximal end, and a blocking wall can be arranged on the side of the convex part 123 close to the distal end. In this way, the guide wall can make the convex part 123 deform and slide into the locking part 220 with less force, improving the smoothness of operation. The blocking wall can abut against the locking part 220 after the convex part 123 slides into the locking part 220, avoiding reverse movement (from the proximal end to the distal end) of the clamp body 100, causing the fixation of the suture 20 to fail, and affecting the suturing of the wound 30.

[0058] In some embodiments, the guide groove 210 and the locking part 220 can be arranged in groups. The guide groove 210 and the locking part 220 can be one group, two groups, or multiple groups. Correspondingly, the number of convex parts 123 corresponds to the number of groups. In some embodiments, the guide groove 210 can be multiple. The multiple guide grooves 210 can be arranged in a circumferential distribution along the sleeve. The distribution can be uniform or non-uniform. Similarly, in some embodiments, the positioning member can also be arranged in a circumferential distribution along the connecting part 120 or the clamping seat 200. The distribution can be uniform or non-uniform.

[0059] Optionally, as shown in Figure 4 When the clamping arms 110 of the clamp body 100 are close to each other in the clamping state and continue to move to the locking position, the ratio of the distance between the center of the threading hole 111 and the edge of the clamping seat 200 to the path length of the movement of the clamp body 100 relative to the clamping seat 200 is between 0.1 and 1.3. In this way, the clamping seat 200 can sufficiently cover the threading hole 111, so that the fixed part of the suture 20 is longer, effectively improving the reliability of the fixation of the suture 20.

[0060] Optionally, as shown in Figure 5 The distal end surface of the clamping arm 110 is a stepped surface 112. When the at least two clamping arms 110 are close to each other in the clamping state, the distal end surfaces of the clamping arms 110 are opposite to each other. In this way, the clamping arms 110 can have good clamping stability when clamping the tissue, avoiding the tissue from loosening from the clamp body 100 in the clamping state.

[0061] In another aspect of the embodiments of the present application, an endoscopic clamp is provided, as shown in Figure 10As shown, the system includes the handle 600, the sheath 400, and a pusher that can be pushed by the handle 600 in the channel of the sheath 400 between the distal end and the proximal end, and further includes the wire threading holder 10 of any of the above, the distal end of the pusher is releasably connected with the clamping body 100 of the wire threading holder 10, and the wire threading holder 10 is detachably connected with the sheath 400.

[0062] In actual application, in order to promote wound healing, the wire threading holder 10 should be left in the patient's body after the wire threading holder 10 cooperates with the suture 20 to suture the wound, therefore, in the operation, the clamping seat 200 of the wire threading holder 10 needs to be detached from the sheath 400, and the clamping body 100 of the wire threading holder 10 needs to be detached from the pusher, so that the endoscopic clip can be withdrawn after the wire threading holder 10 is left in the patient's body. The proximal end of the clamping seat 200 of the wire threading holder 10 is detachably assembled to the distal end of the sheath 400, and the proximal end of the clamping body 100 of the wire threading holder 10 is detachably connected to the distal end of the pusher. When the clamping arms 110 of the clamping body 100 are in the open state, corresponding to the tissue position of the wound, the pusher is pulled by the handle 600, the clamping body 100 of the wire threading holder 10 is pulled by the pusher to move from the distal end to the proximal end, and in the movement process, the clamping arms 110 are constrained by the clamping seat 200 to fold to clamp the tissue. If the suture 20 needs to be pulled, the suture 20 can be pulled to make the wound fold. Then the pusher is continuously pulled by the handle 600, the clamping body 100 of the wire threading holder 10 is continuously pulled by the pusher to move from the distal end to the proximal end to the locking position, at this time, the clamping body 100 cooperates with the clamping seat 200 to also synchronously complete the fixation of the suture 20. The pusher is continuously pulled, the clamping seat 200 of the wire threading holder 10 is detached from the sheath 400, the clamping body 100 of the wire threading holder 10 is detached from the pusher, and the endoscopic clip can be operated to be withdrawn after the wire threading holder 10 is left in the patient's body.

[0063] Optionally, the pusher includes an operating wire 510 and a release part 300 connected to the distal end of the operating wire 510, and the ridge of the connecting part 120 of the wire threading holder 10 is provided with a matching release structure, the release part 300 is detachably connected with the matching release structure, and the detachable connection of the pusher and the clamping body 100 is realized. When the pusher and the clamping body 100 need to be detached, the release part 300 and the matching release structure can be detached to achieve the detachment.

[0064] In some embodiments, as shown, Figure 8 The matching release structure includes a clamping part provided on the connecting part 120, and the release part 300 is provided with a matching part matched with the clamping part. The matching part is clamped on the clamping part, and under the pulling of the operating wire 510, the clamping body 100 moves with the operating wire 510 from the distal end to the proximal end until the clamping body 100 moves to the locking position, and then the matching part is detached from the clamping part, and the detachment of the clamping body 100 and the pusher is completed.

[0065] In some embodiments, as shown in Figure 9 The release part 300 includes at least two release arms 310 shaped as elastic outwardly extending structures, and the clamping part is provided with at least two corresponding clamping portions at the edge of the ridge of the connecting part 120. When the release arms 310 are located in the clamping seat 200, they are deformed and clamped between the corresponding clamping portions and the clamping seat 200.

[0066] In actual application, in combination with Figure 8 and Figure 9 The clamping portion is a clamping groove 124, the clamping seat 200 is a sleeve, the sheath 400 is sleeved on the outer periphery of the sleeve, and the inner diameter of the sheath 400 is greater than that of the sleeve. In this way, the release arms 310 of the release part 300 are compressed by the inner wall of the sleeve, and are elastically deformed to enter the clamping groove 124. When the release arms 310 are in the sleeve, the pushing member can drive the clamping body 100 to slide in the sleeve through the release arms 310. When the clamping body 100 moves to the locking position, the release arms 310 are separated from the sleeve and enter the sheath 400, and the release arms 310 are elastically outwardly extended to be separated from the clamping groove 124, so as to separate the pushing member from the clamping body 100.

[0067] In some embodiments, in combination with Figure 1 and Figure 11 The matching release structure is an elastic release hole 121, and the distal end of the release part 300 is clamped in the elastic release hole 121. After the release part 300 is retracted to the threading holder 10 in the locking position, the distal end of the release part 300 is separated from the elastic release hole 121 under the tension.

[0068] In actual application, the connecting part 120 is a U-shaped plate structure, the clamping arms 110 are connected to the two curved arms of the U-shaped plate structure, the elastic release hole 121 is arranged on the U-shaped plate structure, and the elastic release hole 121 has an extension part extending along the direction of the bending of the U-shaped plate structure, and a protrusion 122 is arranged outward on the side of the U-shaped plate structure. The release part 300 extends into the connecting part 120 through the elastic release hole 121. When the connecting part 120 is located in the sleeve, the protrusion 122 of the connecting part 120 abuts against the inner wall of the sleeve, so that the elastic release hole 121 is compressed, and the clamping between the release part 300 and the connecting part 120 is completed. In this state, the pushing member can push the clamping body 100 to slide in the sleeve. When the clamping body 100 moves to the locking position, the protrusion 122 is separated from the sleeve and enters the sheath 400, the elastic release hole 121 expands, the release part 300 is separated from the elastic release hole 121, and the pushing member is separated from the clamping body 100.

[0069] Optionally, as shown in Figure 11As shown, a sheath tube 700 is arranged at the distal end of the sheath 400, the inner diameter of the sheath tube 700 is larger than the inner diameter of the channel, and the sheath tube 700 is sleeved on the proximal end of the holder 200. At this time, the sheath tube 700 can be used to restore the release arm 310 or the elastic release hole 121 to the state before being compressed in the foregoing embodiment.

[0070] An insurance ring can be sleeved on the release part 300, the outer edge of the insurance ring abuts against the variable-diameter platform between the sheath tube 700 and the channel, the inner diameter of the insurance ring is smaller than the diameter of the distal end of the release part 300, and thus the movement of the release part 300 from the distal end to the proximal end can be limited.

[0071] In some embodiments, as shown, Figure 2 As shown, when the sheath 400 is separated from the holder 200, a shaped elastic expansion member 230 can be arranged at the proximal end of the holder 200, one end of the shaped elastic expansion member 230 protrudes outward, and the other end is retracted inward. When the proximal end of the holder 200 is assembled at the distal end of the sheath 400, a abutting groove is arranged at the distal end inner wall of the sheath 400 (when the sheath tube 700 is included, the abutting groove can be arranged at the distal end inner wall of the sheath tube 700). When the distal end of the sheath 400 is sleeved on the proximal end of the holder 200, the shaped elastic expansion member 230 abuts against the abutting groove, and the holder 200 is limited to be separated from the sheath 400. When the pusher drives the clamp body 100 to move to the locking position, the connecting part 120 of the clamp body 100 pushes the outward protruding end of the shaped elastic expansion member 230 to retract the inward retracted end, thereby releasing the abutment between the shaped elastic expansion member 230 and the abutting groove, and the sheath 400 is separated from the holder 200.

[0072] In still another aspect of the embodiments of the present application, an operating method of an endoscopic clamp is provided, which is combined with Figure 10 , Figure 11 and Figure 12 As shown, the method comprises the following steps.

[0073] As shown, Figure 11 First, a first threading holder 31 is connected to the first endoscopic clamp, a suture 20 is arranged on the threading hole 111 of the first threading holder 31, and the first threading holder 31 is sent to the preset area at the distal end of the sheath 400 through the channel of the sheath 400, such as the wound 30 area or the area to be sutured.

[0074] As shown, Figure 12As shown in Figure a, by operating the handle 600, at least two clamping arms 110 of the clamping body 100 of the first suture holder 31 are brought closer together to clamp or opened apart until the clamping arms 110 stably clamp the target object, such as tissue, at the first target position. Maintaining the clamping state of the first suture holder 31, the length of the suture 20 passing through the suture hole 111 is adjusted by the handle 600, causing the clamping arms 110 to continue moving to the locking position. In the locking position, the suture 20 is locked by the clamping body 100 and clamping seat 200 on the sides surrounding the suture hole 111, completing the fixation of the first suture holder 31 and the suture 20. Operating the handle 600 causes the pusher to release the first suture holder 31, separating the released first suture holder 31 from the sheath 400. The first suture holder 31 remains inside the body, and the endoscopic clamp is withdrawn after the first suture holder 31 is released.

[0075] A second suture holder 32 is connected to the proximal end of the pusher of the second endoscope clip. The same suture 20 is threaded through the suture hole 111 of the second suture holder 32. Figure 12 As shown in b, the endoscope clamp equipped with the second threading clamp 32 is inserted into the preset area at the distal end. For example... Figure 12 As shown in Figure c, the second threading clamp 32 is operated via the handle 600 to stably clamp the target object at the second target position. There is a gap between the first target position and the second target position, meaning the second target position is located at another position on the wound 30. Figure 12 As shown in diagram d, while maintaining the clamping state of the second thread-holding clamp 32, the length of the suture 20 passing through the thread-holding hole 111 is adjusted using the handle 600 until the interval is shortened to the target distance. This causes the second thread-holding clamp 32 to move closer to the first thread-holding clamp 31, thereby reducing the size of the wound 30. Figure 12 As shown in e, the clamping arm 110 continues to move to the locking position to lock the clamping state and target distance; the second suture clamp 32 is released by operating the handle 600, leaving the second suture clamp 32 in the body, and the endoscope clamp after releasing the second suture clamp 32 is withdrawn, completing the suturing of the wound 30 from the first target position to the second target position.

[0076] A third suture holder 33 is connected to the proximal end of the pusher of the third endoscope clip. The same suture 20 is threaded through the suture hole 111 of the third suture holder 33. Figure 12 As shown in Figure f, the endoscope clamp equipped with the third suture holder 33 is inserted into the preset area at the distal end. The third suture holder 33 is operated via the handle 600 until it stably clamps the target object at the third target position. There is a gap between the third target position and the second target position; that is, the third target position is located at another position on the wound 30. After adjusting the length of the suture 20 passing through the suture hole 111 via the handle 600, the third suture holder 33 is released via the handle 600, and the endoscope clamp is withdrawn after the third suture holder 33 is released.

[0077] As ​ As shown in FIG. 6G, a fourth threading holder 34 is connected to the proximal end of the pushing member of the fourth endoscopic clamp, and the same suture 20 is threaded through the threading hole 111 of the fourth threading holder 34. The endoscopic clamp provided with the fourth threading holder 34 is sent to the preset area at the distal end. The fourth threading holder 34 is operated by the handle 600 to stably hold the target object at the fourth target position, which is spaced apart from the third target position, i.e., the fourth target position is located at another position of the wound 30. The length of the suture 20 threaded through the threading hole 111 is adjusted by the handle 600 until the interval distance is shortened to the target distance, so that the fourth threading holder 34 is moved closer to the third threading holder 33, so as to reduce the size of the wound 30. The clamping state and the target distance are locked by the continued movement of the clamping arm 110 to the locking position. The fourth threading holder 34 is released by the handle 600, and the endoscopic clamp is withdrawn after the release of the fourth threading holder 34, thereby completing the suturing of the wound 30 from the third target position to the fourth target position.

[0078] The above operations are repeated, and the suturing of the wound 30 is completed by the endoscopic clamp provided with the plurality of threading holders 10, thereby facilitating the healing of the wound 30, especially for the suturing of a larger area wound 30, effectively reducing the difficulty of suturing and improving the effect of suturing.

[0079] The above only describes the embodiments of the present application and is not used to limit the protection scope of the present application. For those skilled in the art, the present application can have various modifications and changes. Any modification, equivalent replacement, improvement, etc. made within the spirit and principles of the present application shall be included in the protection scope of the present application.

Claims

1. A threading clamp, characterized in that, The device includes a clamp body and a clamp base. The clamp body is disposed within the clamp base. The clamp body includes at least two clamping arms and a connecting portion for connecting the proximal ends of the at least two clamping arms. A threading hole for threading a suture is provided on the clamp body. The clamp body and the clamp base move relative to each other. The clamp base restrains the clamping arms, causing the at least two clamping arms to overcome elastic tension and move closer to each other to clamp. At this time, the threading hole is not covered by the clamp base. The clamp body of the threading clamp can move relative to the suture. After the at least two clamping arms move closer to clamp, they continue to move to the locking position. The clamp base covers the threading hole and the suture is fixed by the cooperation of the clamp body and the clamp base. The clamping bodies move from a position of mutual clamping to a locked position, and the ratio of the distance between the center of the threading hole and the edge of the clamping seat to the path length of the clamping body relative to the clamping seat is between 0.1 and 1.

3. The clamp body and the clamping seat are respectively provided with positioning elements and clamping adjustment structures that can cooperate with each other, so that the clamp body can move or be positioned on the clamping seat by adjusting the positioning elements through the clamping adjustment structure.

2. The threading clamp according to claim 1, characterized in that, The positioning element is disposed on the connecting part, the clamping adjustment structure is disposed on the clamping seat, and the positioning element can move within the clamping adjustment structure.

3. The threading clamp according to claim 2, characterized in that, The positioning element is an outwardly extending protrusion, and the clamping adjustment structure includes a guide groove for accommodating the protrusion, wherein the guide groove is a strip-shaped groove extending along the relative movement direction.

4. The threading clamp according to claim 3, characterized in that, The clamping adjustment structure further includes a locking part, which is arranged at intervals with the guide groove along the direction of movement, and the locking part is located at the proximal end of the guide groove.

5. The threading clamp according to claim 3 or 4, characterized in that, The guide groove is a strip-shaped through groove, or the guide groove is a strip-shaped groove protruding towards the outside of the clamp; the protrusion is a protrusion or a stepped platform.

6. The threading clamp according to claim 4, characterized in that, The locking part is a locking groove, a locking hole, or a stepped surface that expands outward from the inner wall of the clamp to increase the inner diameter of the clamp.

7. The threading clamp according to claim 1, characterized in that, The positioning element includes at least two, and the at least two positioning elements are distributed along the circumference of the connecting portion or the circumference of the clamp.

8. The threading clamp according to claim 1, characterized in that, The distal surface of the clamping arm is a stepped surface, and when the at least two clamping arms are close to each other, the distal surfaces of the clamping arms are aligned with each other.

9. An endoscope clip, characterized in that, The device includes a handle, a sheath, and a pusher that can be pushed between a distal and proximal end via the handle within a channel of the sheath. It also includes a threading clamp as described in any one of claims 1 to 8, wherein the distal end of the pusher is releasably connected to the clamp body of the threading clamp, and the threading clamp is detachably connected to the sheath.

10. The endoscope clip according to claim 9, characterized in that, The pusher includes an operating wire and a release part connected to the distal end of the operating wire. The ridge of the connecting part of the threading clamp is provided with a cooperating release structure, which is detachably connected to the release part of the pusher.

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