Side-opening type conveying actuator

Abstract

The invention relates to a conveying actuator. The conveying actuator comprises a connecting pedestal; the fixed clamp arm is connected with the connecting pedestal and cannot swing relative to the connecting pedestal; the movable clamp arm is mounted in a swinging manner relative to the fixed clamp arm; the movable clamp arm is arranged on the fixed clamp arm, the actuating element is actuated to promote the movable clamp arm to swing away from the fixed clamp arm, and the object to be implanted is kept by the fixed clamp arm and the movable clamp arm in a releasable mode. By providing the fixed clamp arm which does not swing, the overall dimension of the whole conveying actuator is reduced, and conveying of the conveying actuator in the body is facilitated.

Description

Technical Field

[0001] The present disclosure relates to a surgical device and, thereby, to a delivery actuator for delivering and controlling the implantation of an atrial appendage clip. Background Art

[0002] Atrial fibrillation is one of the most common arrhythmias in clinical practice. The consequences of stroke caused by atrial fibrillation are very serious, with a mortality rate and disability rate of 70%. For patients with valvular atrial fibrillation, 57% of atrial thrombi originate from the left atrial appendage, and for patients with non-valvular atrial fibrillation, 90% of left atrial thrombi originate from the left atrial appendage. Even after sinus rhythm is restored, the left atrial appendage contraction is suppressed, and thrombi may still form again.

[0003] At present, there are three main methods for preventing atrial fibrillation ischemic stroke in clinical practice. One method is to take anticoagulants, such as warfarin, but the use of warfarin has a certain risk of bleeding and requires frequent monitoring. It has many contraindications and is difficult to use clinically. In addition, warfarin may cause osteoporosis and soft tissue necrosis. The second method is to directly remove or ligate the left atrial appendage during cardiac surgery. The main disadvantage of this method is that the complete closure rate of the left atrial appendage is low. Previous studies have shown that the success rate of complete removal of the left atrial appendage is as high as about 80%. The third method is to close the left atrial appendage through a device, using percutaneous intracardiac left atrial appendage occlusion products, but the existing device structure is complex, the risk is high, and the safety and effectiveness need to be verified.

[0004] The existing atrial appendage closure device delivery system is used to place the atrial appendage closure device from outside the heart to the root of the left atrial appendage during open-chest surgery to close the left atrial appendage. When in use, the front end of the atrial appendage closure device is inserted into the patient's body through the wound to perform the closure operation, which causes relatively large surgical trauma, heavy bleeding, and slow recovery.

[0005] The existing atrial appendage clamp delivery device is generally provided with a rectangular atrial appendage clamp fixing outer frame at the front end to facilitate binding the atrial appendage clamp in the atrial appendage clamp fixing outer frame. When in use, a drawstring is provided on the fixing outer frame, which is connected to the clamping arm of the atrial appendage clamp through the drawstring. The drawstring is pulled to drive the two clamping arms of the atrial appendage clamp connected to the drawstring to separate in opposite directions, so that the two clamping arms of the atrial appendage clamp are in an open state and then sleeved on the left atrial appendage. Then, the button at the control end of the handle of the atrial appendage clamp delivery device is pressed to close the two clamping arms of the atrial appendage clamp. Finally, the drawstring is cut to separate the atrial appendage clamp delivery device from the atrial appendage clamp, and the atrial appendage clamp clamps the left atrial appendage. The atrial appendage clamp delivery device is withdrawn from the human body to complete the left atrial appendage clamp closing operation.

[0006] However, during the above-mentioned left atrial appendage closure operation, the rectangular atrial appendage clamp fixing frame is inserted into the patient's body through a thoracotomy or incisional approach to perform the left atrial appendage closure operation. Due to the large size of the rectangular atrial appendage clamp fixing frame, it is difficult to insert, resulting in relatively large surgical trauma, heavy bleeding, slow recovery, and a larger operating space is required at the lesion site, which also makes the closure operation difficult and risky.

[0007] For example, in the prior patent CN218247293U of the present applicant, a delivery actuator is disclosed, which includes a first clamp arm and a second clamp arm. The atrial appendage clamp can be fixed between the two clamp arms, for example, by a binding wire, and the clamp arms are opened and closed by a control mechanism in the control end, thereby controlling the delivery and placement of the atrial appendage clamp. Compared with a fixed outer frame delivery actuator, by using two clamp arms that can be opened and closed, the two clamp arms can be closed during delivery, reducing the overall size of the atrial appendage clamp delivery actuator, which is beneficial to reducing the incision of the operation and thus facilitating postoperative healing. However, there is still room for improvement in this design of relatively open and close clamp arms. Summary of the invention

[0008] According to the present disclosure, a delivery actuator is provided, which is used to be connected to a surgical device to implant an object to be implanted, such as an atrial appendage clip, into a body. The delivery actuator according to the present disclosure has a smaller external profile to facilitate implantation, especially minimally invasive implantation, and the delivery actuator according to the present disclosure has a simple structure and is easy to operate, thereby overcoming the defects of existing delivery actuators.

[0009] According to one aspect of the present disclosure, a delivery actuator is provided, which includes: a connecting base; a fixed clamp arm connected to the connecting base and cannot swing relative to the connecting base; a movable clamp arm swingably mounted relative to the fixed clamp arm; and an actuating element, which is actuated to cause the movable clamp arm to swing away from the fixed clamp arm, wherein the implant is releasably held by the fixed clamp arm and the movable clamp arm.

[0010] In a preferred embodiment, the movable clamp arm swings parallel to and relative to the fixed clamp arm. Therefore, since only one clamp arm of the movable clamp arm swings during the entire process, the structure of the actuator is simplified, and the outline size of the actuator, especially the size when the clamp arm is closed, is reduced, so that the delivery actuator according to the present disclosure can enter the body through a card in a minimally invasive surgery, avoiding a major traumatic surgery. In addition, since only one clamp arm needs to be manipulated, the manipulation of the entire actuator becomes simpler.

[0011] In one embodiment, the movable pliers arm includes a movable seat and a movable pliers head connected to the movable seat, and the fixed pliers arm includes a fixed seat and a fixed pliers head connected to the fixed seat, and the movable pliers head and the movable seat can be connected via a follower mechanism; and / or the fixed pliers head and the fixed seat are connected via a follower mechanism, whereby during the swinging process of the movable pliers arm relative to the fixed pliers arm, the follower mechanism allows relative displacement between the connected fixed seat and the fixed pliers head and / or the movable seat and the movable pliers head, so that the fixed pliers head and the movable pliers head remain parallel and relative.

[0012] The follow-up mechanism overcomes the misalignment between the movable clamp head and the fixed clamp head during the swinging process of the movable clamp arm, thereby allowing the movable clamp head and the fixed clamp head to be always in a relative and parallel state, making it easier to hold and close the movable clamp head and the fixed clamp head when the implant is to be implanted.

[0013] Therefore, only the movable clamp arm of the conveying actuator needs to be operated, and during the operation of the movable clamp arm, the clamp head of the movable clamp arm and the clamp head of the fixed clamp arm are kept parallel and opposite to each other by means of the follow-up mechanism, which simplifies the structure of the entire actuator and simplifies the operation.

[0014] In addition, accommodation spaces can be provided in the fixed seat and the movable seat respectively to accommodate the connecting rod or the swing arm of the opening and closing mechanism, thereby keeping the entire actuator with a small profile, especially when closed, to facilitate the transportation of the actuator.

[0015] According to another aspect of the present disclosure, a surgical device including the above-mentioned delivery actuator is provided, which is suitable for minimally invasive surgery and is easy to manipulate, so as to facilitate the minimally invasive delivery of an implant into a designated position in the body. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the following briefly introduces the drawings of the embodiments of the present invention, wherein the drawings are only used to illustrate some embodiments of the present invention, but not to limit all embodiments of the present invention thereto.

[0017] Figure 1 The present invention is a surgical device of the prior art, which includes a delivery actuator having a pair of relatively openable and closable clamp arms;

[0018] Figures 2 to 10 Perspective views showing different angles of the delivery actuator according to the first embodiment of the present disclosure;

[0019] Figures 11 to 14 A perspective view showing a delivery actuator according to a second embodiment of the present disclosure; and

[0020] Fig.15 and Fig.16 A schematic diagram showing a modified example of the second embodiment. DETAILED DESCRIPTION

[0021] Exemplary embodiments of the present disclosure are described and illustrated below as including surgical devices, and more specifically surgical devices that can be used in minimally invasive procedures. The present disclosure also contemplates surgical devices that facilitate the positioning and deployment of atrial appendage occlusion devices, such as atrial appendage clips. Of course, it will be apparent to those skilled in the art that the embodiments discussed below are exemplary and can be reconfigured without departing from the scope and spirit of the present disclosure.

[0022] In the following description of the present disclosure and the description of the claims, directional terms are used, such as "proximal end" or "proximal side", which refers to a side or position close to the operator, such as a doctor, medical staff, etc., during the operation, while "distal end" or "distal side" is opposite to "proximal end" or "proximal side", and refers to a side away from the operator, such as a doctor, etc., or in other words, a side or position close to the surgical target, such as a patient's tissue. The term "longitudinal direction" or "longitudinal axis" or "longitudinal" refers to a direction or axis extending from the proximal end to the distal end, which is also the direction of the length extension of the surgical device described herein.

[0023] like Figure 1 As shown, Figure 1 A surgical device including two relatively openable and closable clamp arms in the prior art is shown, such as a delivery device 100, which includes a handle 110, a delivery actuator 120, and a connecting rod 130 connected between the handle 110 and the delivery actuator 120. The connecting rod 130 can be rigid or semi-rigid, and has a hollow channel, thereby facilitating the operation of the distal delivery actuator during surgery. The handle 110 includes a control mechanism (not shown), which can manipulate the orientation and opening and closing action of the actuator 120 by means of a pull wire extending to the distal actuator through the hollow channel of the connecting rod 130. The delivery actuator includes a pair of clamp arms 121, and a closure device, such as an atrial appendage clamp 200, is installed between the pair of clamp arms 121 by a binding wire. The atrial appendage clamp is usually kept closed under its own elastic force. After the atrial appendage clamp is delivered to a position, the pair of clamp arms are controlled to open by the control mechanism, so that the atrial appendage clamp is opened and implanted in the target position, and then the atrial appendage clamp is deployed in place by pulling out the binding wire. The delivery actuator with the atrial appendage clamp released can be removed from the body.

[0024] The actuator is connected to the connecting rod 130 via a universal joint, for example, so that the orientation of the actuator can be adjusted by the control of the controller.

[0025] However, this actuator includes relatively openable and closable clamp arms, which leads to problems such as complex structure, high manufacturing cost, and difficulty in operation, and thus there is still room for improvement.

[0026] According to the present disclosure, a biased actuator is proposed, which overcomes the problems existing in the prior art, simplifies the structure, facilitates operation, and further reduces the profile of the entire actuator, thereby making it easier to use in minimally invasive surgery.

[0027] According to the conveying actuator disclosed in the present invention, it includes a fixed clamp arm, which does not swing relative to a connecting base, for example, and a movable clamp arm is the only clamp arm that needs to be manipulated to swing. The movable clamp arm swings relative to the fixed clamp arm, preferably parallel to the fixed clamp arm, thereby opening the auricle clamp installed between the fixed clamp arm and the movable clamp arm.

[0028] It should be pointed out that the present disclosure only relates to the structure of the actuator, which can be used in conjunction with the control mechanism of the prior art. Therefore, in the following description, only the specific structure of the actuator will be described, and the structure of other parts of the surgical device can refer to the corresponding parts in the prior art.

[0029] First embodiment

[0030] Please refer to the attached Figure 2-10 A first embodiment according to the present disclosure is described, wherein: Figures 2 to 6 are perspective views of the actuator from different angles; Figure 7 is a perspective view showing a movable clamp arm of the actuator; Figure 8 is a perspective view showing a fixed clamp arm; Fig. 9 and Fig.10 are perspective views showing two other angles of the actuator.

[0031] like Figure 2-Figure 10 As shown, the offset conveying actuator includes a connecting base 27 on which a fixed clamp arm 1 and a movable clamp arm 2 are arranged. The movable clamp arm 2 is connected to the fixed clamp arm 1 through an opening and closing mechanism 3, so that the movable clamp arm 2 swings parallel to the fixed clamp arm 1.

[0032] The connection base 27 is used to connect the actuator to the connecting rod (not shown) of the surgical device, and then to the handle (control mechanism) of the surgical device, so that during the operation, the doctor can manipulate the control mechanism in the handle to control the action of the actuator. The connection base 27 can be connected to the connecting rod by a universal connection mechanism, for example, which is a connection mechanism used in the prior art and will not be described in detail here. However, the present disclosure is not limited to any connection mechanism.

[0033] A fixed pliers arm is provided on the connecting base 27, and the fixed pliers arm 1 includes a fixed base 12, which extends from the connecting base 27 in the distal direction and can be, for example, formed integrally with the connecting base 27 or fixedly connected to the connecting base 27, and a fixed pliers head 13 is mounted on the fixed base 12, for example, the fixed pliers head 13 can be formed integrally with the fixed base 12 or fixedly connected or mounted to the fixed base, whereby the movable pliers head 13 is fixed relative to the fixed base or the connecting base 27.

[0034] exist Figure 2 In the illustrated embodiment, the movable clamp arm 22 includes a movable seat 24 and a movable lead 22 , and the movable seat 24 is hinged to the fixed seat 12 via a biased parallel opening and closing mechanism 3 .

[0035] The eccentric parallel opening and closing mechanism 3 may include a first swing arm 31 and a second swing arm 32, and the two ends of the first swing arm 31 and the second swing arm 32 are respectively hinged on the fixed seat 12 and the movable seat 24, whereby the first swing arm 31, the second swing arm 32, the fixed seat 12 and the movable seat 24 constitute a parallelogram-like structure, so that the fixed clamp head 13 connected to the fixed seat 12 and the movable clamp head 22 connected to the movable seat 24 can be relatively displaced in parallel. It should be understood that although the fixed clamp arm 1 is described above as including the fixed seat 12 and the fixed clamp arm 13, the two can be integrated, whereby the fixed clamp head 13 can be used as a part of the fixed seat 12, or the fixed seat can be omitted, and thus collectively referred to as the fixed clamp arm. However, the present disclosure is not limited to this. For example, the fixed clamp head 13 can be displaced in the longitudinal direction relative to the fixed seat 12.

[0036] The fixed seat 12 may be, for example, a hollow structure or include an internal space, and a narrow groove is formed on the side wall of the fixed seat 12 facing the movable seat 24, and the narrow groove constitutes a first accommodating space 11, so that during the swinging process, the first swing arm 31 and the second swing arm 32 can be accommodated in the first accommodating space 11; the movable seat 24 may also be, for example, formed into a hollow structure or include an internal space, and a narrow groove is also formed on the side wall of the movable seat 24 facing the fixed seat 12, and the narrow groove is arranged opposite to the narrow groove in the fixed seat, constituting a second accommodating space 21 to accommodate the first swing arm 31 and the second swing arm 32. Thus, the first and second accommodating spaces 11 and 21 provide a movable space for the first swing arm 31 and the second swing arm 32, and when the movable clamp head is buckled on the fixed clamp arm, the first swing arm 31 and the second swing arm 32 can move into the first and second accommodating spaces 11 and 21, reducing the front end size of the movable clamp arm and the fixed clamp arm in the closed state, so as to facilitate the transportation and removal of the actuator.

[0037] As shown in the figure, a wire wheel 26 is formed near the proximal end of the fixing seat 12 close to the connecting platform 27 to guide the control wire 28 for controlling the movable clamp arm 2.

[0038] The movable clamp arm 2 includes a movable clamp head 22 and a movable seat 24. A follower mechanism can be provided between the movable clamp head 22 and the movable seat 24, so that the movable clamp head 22 can be slidably connected to the movable seat 24 in the longitudinal direction, and the slidability can be achieved by the slide rail 23, for example, as Figure 8 As shown, the slide rail 23 is fixedly arranged on the movable seat 24, or is formed integrally with the movable seat 24, and a slide groove 222 is arranged on the movable clamp head 22, and the slide rail 23 is slidably inserted into the slide groove 222, thereby, during the swinging process of the movable clamp arm 2 relative to the fixed clamp arm 1 driven by the opening and closing mechanism 3, the movable clamp head 22 slides longitudinally relative to the movable seat 24, so that the movable clamp head 22 remains relative to and parallel to the fixed clamp head 12 during the entire swinging process. Although the movable clamp arm 2 is configured to be slidable, the present disclosure is not limited thereto, for example, the fixed clamp head and the fixed seat can be configured to be relatively slidable, thereby, during the opening and closing process of the actuator, the fixed clamp head 12 and the movable clamp head 22 follow.

[0039] Although it is described above that a follower mechanism is provided in the movable clamp arm so that the movable clamp head 22 is kept parallel and opposite to the fixed clamp head 13, the follower mechanism may also be provided in the fixed clamp arm, or in both the movable clamp arm and the fixed clamp arm, and the present application is not limited thereto. In addition, although it is described above that the slide rail 23 is provided in the movable seat 24 and the slide groove 222 is provided in the movable clamp head, the present application is not limited thereto, but may be provided in the opposite manner, that is, the slide rail is provided in the movable clamp head and the slide groove is provided in the movable seat. The same is true for the case where the follower mechanism is provided in the fixed clamp arm.

[0040] The connecting base 27 is provided with a control line through hole 271, and the control line 28 passes through the control line through hole 271 on the connecting base 27 and is connected to the connecting column 29 in the second accommodation space 21 of the movable base 24 through the wire wheel 26. The setting of the wire wheel 26 can play a role of transition and guidance for the control line 28. Therefore, by pulling the control line 28, the actuator can be prompted to open.

[0041] In order to accommodate an implant, such as an atrial appendage clamp, the inner surface of the fixed clamp head 13 facing the movable clamp head 22 is an arc-shaped surface, and a first supporting plate 14 is also provided on the inner surface of the fixed clamp head 13, and the first supporting plate 14 forms an arc transition with the inner surface of the fixed clamp head 13, thereby accommodating the implant, such as a clamp arm of the atrial appendage clamp, in the groove surrounded by the first supporting plate 14 and the arc-shaped inner surface, and a positioning groove 9 is provided between the first supporting plate 14 and the distal end of the fixed seat;

[0042] The inner surface of the movable clamp head 22 facing the fixed clamp head 13 is an arc-shaped surface, and a second supporting plate 25 is arranged on the inner surface, and a circular arc transition is formed between the second supporting plate 25 and the inner surface of the movable clamp head 22, thereby accommodating the other clamp arm of the auricle clamp in the groove surrounded by the second supporting plate and the inner surface of the movable clamp head 22. A baffle plate 8 is arranged at one end of the movable clamp head 22 close to the movable seat 24, and a positioning groove 9 is arranged between the baffle plate 8 and the second supporting plate 25 of the implant.

[0043] The positioning groove 9 of the fixed clamp head 13 and the notch of the positioning groove 9 of the movable clamp head 22 are arranged opposite to each other, forming a receiving groove for receiving one end of the implant 50 .

[0044] The present application arranges a first supporting plate 14 on the fixed clamp head 13 and a second supporting plate 25 on the movable clamp head 22. Through the coordinated use of the first supporting plate 14 and the second supporting plate 25, the corresponding sides of the implant 50 are maintained to prevent the implant 50 from falling off from between the fixed clamp head 13 and the movable clamp head 22. Through the positioning groove 9 of the fixed clamp head 13 and the positioning groove 9 of the movable clamp head 22, the implant 50 can be positioned at the installation position on the fixed clamp head 13 and the movable clamp head 22 and can also be fixed.

[0045] An arc transition is adopted between the first supporting plate 14 of the implant and the surface of the fixed clamp head 13 facing the movable clamp head 22; an arc transition is adopted between the second supporting plate 25 of the implant and the surface of the movable clamp head 22 facing the fixed clamp head 13. Such an arrangement can prevent the implant 50, whose overall structure is relatively precise, from being scratched during the process of installing the implant 50 between the fixed clamp head 13 and the movable clamp head 22. Through the above arrangement, the occurrence of situations where external factors affect the structural strength and integrity of the implant 50 is avoided.

[0046] A first wiring groove 131 is provided on the back of the fixed clamp head 13, a plurality of wire entry holes 15 connected to the first wiring groove 131 are provided on the first supporting plate 14, a first binding wire through hole 272 is provided on the connecting base 27, the first binding wire through hole 272 passes through the fixed seat 12 and is connected to the first wiring groove 131 on the fixed clamp head 13, the first binding wire 16 passes through the first binding wire through hole 272 and the fixed seat 12 in turn, enters the first wiring groove 131 on the back of the fixed clamp head 13, and then the suture is passed through the wire entry hole 15 on the fixed clamp head 13, and one clamp arm of the implant 50 is bound to the first binding wire 16, and fixed on the clamp head 13.

[0047] A second wiring groove 221 is provided on the back of the movable clamp head 22, and a plurality of wire entry holes 15 connected to the second wiring groove 221 are provided on the second supporting plate 25 of the implant. A second binding wire through hole 273 is provided on the connecting base 27. The second binding wire 17 passes through the second binding through hole 273 and the movable seat 24 in sequence and enters the second wiring groove 221 on the back of the movable clamp head 22. Then, the suture thread is passed through the wire entry hole 15 on the movable clamp head 22, and the other clamp arm of the implant 50 is bound to the second binding wire 17 and fixed on the movable clamp head 22.

[0048] The first wiring groove 131 and the second wiring groove 221 make the first binding wire 16 and the second binding wire 17 have a hidden wiring design, which has an aesthetic structure and prevents the binding wire 16 from interfering with other components during extension or other components or other surgical instruments during transportation.

[0049] The working process of the actuator according to the first embodiment of the present disclosure is briefly described below:

[0050] The implant 50 is fixed between the fixed clamp head 13 and the movable clamp head 22 by the first binding wire 16 and the second binding wire 17. Under the closing force of the implant 50 itself, the fixed clamp head 13 and the movable clamp head 22 are in a closed state. Since the offset delivery actuator of the present application removes the existing rectangular atrial appendage clamp fixing frame, the offset delivery actuator of the present application can be inserted into the patient's body in a minimally invasive manner with the help of a poking card, without the need for open-chest surgery. During use, a delivery stamp is first implanted in the patient's body to establish a channel, and then the eccentric delivery actuator enters the patient's body through the delivery stamp, pulling the control pull wire 28, and the control pull wire 28 acts on the movable seat 24 through the connecting column 29. Under the pulling force of the control pull wire 28, the movable seat 24 drives the eccentric parallel opening and closing mechanism 3 to move, and the eccentric parallel opening and closing mechanism 3 becomes an open state, thereby, the movable clamp head 22 moves in a direction away from the fixed clamp head 13. At this time, relative movement occurs between the movable clamp head 22 and the slide rail 23, that is, under the action of the eccentric parallel opening and closing mechanism 3, the movable seat 24 is driven to move in a direction away from the movable clamp head 22. Since the slide rail 23 of the movable seat 24 and the slide groove 222 of the movable clamp head 22 are slidably connected, and since the implant 50 is fixed to the fixed clamp head 13 by the first binding wire 16 and the second binding wire 17 The movable clamp head 22 is between the clamp head 13 and the movable clamp head 22, so the movable clamp head 22 will not move with the movable seat 24, but the length of the slide rail 23 exposed in the slide groove 222 gradually increases, thereby offsetting the longitudinal displacement deviation between the fixed clamp head 13 and the movable clamp head 22 during the deployment of the eccentric parallel opening and closing mechanism 3, ensuring that during the deployment of the eccentric parallel opening and closing mechanism 3, the fixed clamp head 13 and the movable clamp head 22 are always in a parallel opening state and will not be misaligned, thereby realizing the parallel opening of the movable clamp arm 2 and the fixed clamp arm 1, driving the implant 50 to be opened, and after the opened implant 50 is placed at the root of the left atrial appendage, the implant 50 is closed, the first binding line 16 and the second binding line 17 connected to the implant are pulled out, and the implant 50 is separated from the fixed clamp head 22 and the movable clamp head 13, and the implant 50 remains in the body, and the eccentric delivery actuator is withdrawn. .

[0051] After the implant 50 is released, the movable clamp arm 2 and the fixed clamp arm 1 are in a parallel free opening and closing state. During the withdrawal of the eccentric conveying actuator from the patient's body, under the action of the conveying stamp, the conveying stamp will apply a wrapping force to the eccentric conveying actuator. Under the action of this wrapping force, the movable seat 24 drives the eccentric parallel opening and closing mechanism 3 to move, and the eccentric parallel opening and closing mechanism 3 changes from an open state to a closed state. As a result, the movable clamp head 22 moves toward the direction close to the fixed clamp head 13. At this time, relative movement occurs between the movable clamp head 22 and the slide rail 23, that is, under the action of the eccentric parallel opening and closing mechanism 3, the movable seat 24 is driven to move toward the direction close to the movable clamp head 22, thereby realizing the parallel closing of the movable clamp arm 2 and the fixed clamp arm 1, which is convenient for withdrawal from the patient's body through the conveying stamp.

[0052] Although in the above description, after the object to be implanted is released, the movable clamp arm 2 and the fixed clamp arm 1 are restored to the closed state by the wrapping force of the stamp, a reset spring can also be installed on the swing axis of at least one of the first and second swing arms, whereby, after the object to be implanted is released and the control line 28 is released, the movable clamp arm 2 is reset to be closed with the fixed clamp arm 1 by the action of the reset spring, thereby removing the delivery actuator from the body.

[0053] Second embodiment

[0054] Refer to the following Figures 11 to 14 Describing the second embodiment of the present disclosure, the second embodiment shown below is different from the first embodiment only in the opening and closing mechanism, and the structures of the fixed clamp arm and the movable clamp arm are basically the same. Therefore, the following description mainly focuses on the differences between the two. Other identical or similar structures or features can refer to the description of the first embodiment, and the same figure marks are used to identify the identical or similar features.

[0055] The difference from the first embodiment is that the opening and closing mechanism of the second embodiment adopts a hard top operation instead of a control line. Fig.11 , Fig.12 , Fig.13 , Fig.14 As shown, a transverse push rod 30 is provided, which can extend from a handle (not shown) via an inner channel of the connecting rod to the actuator, so that the transverse push rod 30 can be manipulated by an operator, such as a doctor, for example, through a control mechanism.

[0056] like Fig.12 As shown, Fig.12 The fixing base 12 is omitted in the figure to show the structure of the parallel opening and closing mechanism including the first swing arm 31, the second swing arm 32, the transverse push rod 30 and the driving arm 42. Fig.12 As shown, the first swing arm 31 and the second swing arm 32 are rotatably connected at one end of the fixed seat 12 through a connecting plate 41. The connecting plate 41 can be two pieces and clamp the ends of the first and second swing arms 31 and 32 from both sides. The shaft 40 passes through the connecting plate 41 and the swing plates 31 and 32. The other end of the first swing arm 31 and 32, that is, one end of the movable seat is hinged to the movable seat, just like the first embodiment. Thus, the connecting plate 41, the first swing arm 31, the second swing arm 32 and the movable seat form a parallelogram structure. The fixed seat 12 forms sliding grooves 122 on the two side walls, and the two ends of the shaft 40 are respectively fitted in the sliding grooves 122 formed on the side walls, so that the ends of the swing arms 31 and 32 and the connecting plate 41 together with the shaft 40 can slide along the sliding grooves 122. The transverse push rod 30 extends through the connecting base 27 and is pivotally connected to the shaft 40 located on the proximal side, that is, as shown in FIG. Fig.12As shown, it is connected to the shaft 40 at the end of the second swing arm 32.

[0057] A driving arm 42 is also provided for driving the second swing arm 32 to swing, one end of the driving arm 42 is connected to the second swing arm 32, and the other end of the driving arm 42 is disposed in the second accommodation space 21 and is pivotally connected to the fixing seat 12. Other structures are the same as the corresponding structures in the first embodiment, and thus are not described in detail.

[0058] The working process of the second embodiment is briefly described below:

[0059] The implant 50 is bound to the first binding line 16 and the second binding line 17 by sutures, and fixed between the fixed clamp head 13 and the movable clamp head 22. Under the action of the closing force of the implant 50, the fixed clamp head 13 and the movable clamp head 22 are in a closed state, and the implant 50 is delivered to the designated position in the human body. The lateral push rod 30 is pushed, and the lateral push rod 30 drives the connecting plate 41, and the connecting plate 41 slides along the sliding groove 122 on the fixed seat 12 through the sliding shaft 40. At this time, the first swing arm 31 and the second swing arm 32 are driven by the connecting plate 41 and at the same time under the action of the driving arm 42, and the connection point 60 between the driving arm 42 and the second swing arm 32 serves as the swing base point of the second swing arm 32. Under the action of the driving arm 42, the second swing arm 32 and the first swing arm 31 can swing, so that the eccentric parallel opening and closing mechanism 3 becomes the open state, thereby, the movable clamp head 22 moves in the direction away from the fixed clamp head 13, at this time, the movable clamp head 22 and the slide rail 23 move relative to each other, that is, under the action of the eccentric parallel opening and closing mechanism 3, the movable seat 24 is driven to move in the direction away from the movable clamp head 22, because the slide rail 23 of the movable seat 24 and the slide groove 22 of the movable clamp head 22 are slidably connected, and by The implant 50 is fixed between the fixed clamp head 13 and the movable clamp head 22 by the first binding wire 16 and the second binding wire 17. Therefore, the movable clamp head 22 will not move with the movable seat 24, but the length of the slide rail 23 exposed from the slide groove 22 will gradually increase, thereby offsetting the lateral displacement deviation between the fixed clamp head 13 and the movable clamp head 22 during the deployment of the eccentric parallel opening and closing mechanism 3, ensuring that during the deployment of the eccentric parallel opening and closing mechanism 3, the fixed clamp head 13 and the movable clamp head 22 are always in a parallel state and will not be misaligned, thereby achieving the parallel opening of the movable clamp arm 2 and the fixed clamp arm 1, driving the implant 50 to open, and after the opened implant 50 is placed at the root of the left atrial appendage, the implant 50 is closed, the first binding wire 16 and the second binding wire 17 connected to the implant are pulled out, the implant 50 is separated from the fixed clamp head 22 and the movable clamp head 13, the implant 50 remains in the body, and the eccentric delivery actuator is withdrawn.

[0060] After the implant 50 is released, the movable clamp arm 2 and the fixed clamp arm 1 are in a parallel free opening and closing state. During the process of the eccentric conveying actuator being withdrawn from the patient's body, under the action of the conveying stamp, the conveying stamp will apply a wrapping force to the eccentric conveying actuator. Under the action of this wrapping force, the movable seat 24 drives the eccentric parallel opening and closing mechanism 3 to move, and the eccentric parallel opening and closing mechanism 3 changes from an open state to a closed state. As a result, the eccentric parallel opening and closing mechanism 3 drives the connecting plate 41, and the connecting plate 41 slides in the opposite direction along the sliding groove 122 on the fixed seat 12 through the sliding shaft 40. At this time, the first swing arm 31 and the second swing arm 32 are driven by the connecting plate 41 and under the action of the driving arm 42, with the connection point between the driving arm 42 and the second swing arm 32 as the connecting plate. The second swing arm 32 is the swing base point, and the second swing arm 32 and the first swing arm 31 can swing, so that the eccentric parallel opening and closing mechanism 3 changes from an open state to a closed state, thereby the movable clamp head 22 moves toward the direction close to the fixed clamp head 13. At this time, the movable clamp head 22 and the slide rail 23 move relative to each other, that is, under the action of the eccentric parallel opening and closing mechanism 3, the movable seat 24 is driven to move toward the direction close to the movable clamp head 22, so as to realize the parallel closure of the movable clamp arm 2 and the fixed clamp arm 1, so as to facilitate the withdrawal of the card from the patient's body through the transport punch. In this process, the fixed clamp head 13 and the movable clamp head 22 are always in a parallel state, but whether there is a misalignment between the fixed clamp head 13 and the movable clamp head 22 is not very important. It is sufficient to ensure that there is no misalignment between the fixed clamp head 13 and the movable clamp head 22 during the opening of the eccentric transport actuator.

[0061] As an optional solution, the first and second swing arms 31 and 32 can be swung by pulling the lateral push rod 30 in the opposite direction, and the movable clamp arm 2 and the fixed clamp arm 1 can be closed under the action of the driving arm 42, thereby withdrawing the entire conveying actuator from the body. Alternatively, as mentioned in the first embodiment, a return spring installed on the pivot shaft of the first swing arm or the second swing arm can be used to close the movable clamp arm 2 and the fixed clamp arm 1.

[0062] Although the transverse push rod 30 is used in the second embodiment to realize the opening of the movable clamp arm relative to the fixed clamp arm, those skilled in the art can conceive that other forms of actuating mechanisms can be used.

[0063] refer to Fig.15 and Fig.16 ,exist Fig.15 and Fig.16 In the embodiment, a pull wire 28 is used to replace the transverse push rod 30 in the second embodiment, thereby achieving the opening of the clamp arms.

[0064] like Fig.15 and 16As shown, in the fixed seat 12, a reversing pulley 50 is provided at the far side of the sliding groove 122, and the pull wire 28 passes through the connecting seat 27 in the far direction and is reversed by the reversing pulley 50, extending along the near side and connected to the shaft 40 or connected to the far end of the connecting plate 41. Thus, pulling the pull wire 28 can play the same role as the lateral push rod 30, and the clamp arm is opened. The other structures are the same as those of the second embodiment, and the relevant description of the second embodiment is introduced here and will not be repeated.

[0065] Although a parallel opening and closing mechanism in the form of a swing arm is described above, the present disclosure is not limited thereto, but other mechanisms such as a cam mechanism may be used to achieve parallel opening and closing between the fixed clamp arm and the movable clamp arm.

[0066] Although the delivery actuator is described above with reference to the atrial appendage clamp, the present disclosure is not limited to the delivery and implantation of the atrial appendage clamp, but can be applied to other implants that need to be implanted in the body through minimally invasive surgery and need to be operated in the body, such as opening or closing. In the case of other implants, the movable clamp arm does not have to open parallel to the fixed clamp arm, in which case the parallel opening and closing mechanism can be omitted or simplified.

[0067] According to the eccentric delivery actuator disclosed in the present invention, when used for left atrial appendage closing operation, the eccentric parallel opening and closing mechanism 3 is used to ensure that the movable clamp arm 2 and the fixed clamp arm 1 are always in a parallel state when opening or closing, thereby ensuring that the front end size of the eccentric delivery actuator can be reduced as much as possible, so that the eccentric delivery actuator disclosed in the present invention can be inserted into the patient's body through the wound to perform the closing operation. Since the front end size of the eccentric delivery actuator is reduced, the difficulty of delivery is reduced, and it can be inserted into the patient's body in a minimally invasive manner, so that the surgical trauma is relatively small, the bleeding is less, the recovery is fast, and no larger operating space is required at the lesion, thereby reducing the operating difficulty of this type of closing operation, and ultimately reducing the overall risk of this type of closing operation.

[0068] The conveying actuator disclosed herein can be implemented according to the following examples:

[0069] Example 1. A biased conveying actuator, comprising:

[0070] connecting pedestal;

[0071] A fixed clamp arm connected to the connection base and cannot swing relative to the connection base;

[0072] a movable caliper arm pivotably mounted relative to the fixed caliper arm; and

[0073] an actuating element, the actuating element being actuated to cause the movable clamp arm to swing away from the fixed clamp arm,

[0074] The object to be implanted is releasably held by the fixed clamp arm and the movable clamp arm.

[0075] Example 2. The conveying actuator as described in Example 1 also includes a parallel opening and closing mechanism, which is connected between the fixed clamp arm and the movable clamp arm, so that when the movable clamp arm swings relative to the fixed clamp arm, the movable clamp arm and the fixed clamp arm remain parallel and opposite.

[0076] Example 3. A conveying actuator as described in Example 2, wherein the fixed clamp arm includes a fixed seat and a fixed clamp head connected to the fixed seat; the movable clamp arm includes a movable seat and a movable clamp head connected to the movable seat, wherein the fixed clamp arm and / or the movable clamp arm include a follow-up mechanism, and the follow-up mechanism enables the fixed clamp head to be longitudinally displaced relative to the movable seat and / or the movable clamp head to be longitudinally displaced relative to the movable seat during the swinging process, so that the movable clamp head remains parallel and opposite to the fixed clamp head.

[0077] Example 4. The conveying actuator as described in Example 3, wherein the follower mechanism includes a slide rail formed on one of the fixed seat and the fixed clamp head and a slide groove formed on the other of the fixed seat and the fixed clamp head and cooperating with the slide rail; and / or

[0078] The following mechanism comprises a slide rail formed on one of the movable seat and the movable tongs head and a slide groove formed on the other of the movable seat and the movable tongs head and matched with the slide rail.

[0079] Example 5. A delivery actuator as described in Example 3 or 4, wherein each of the fixed clamp head and the movable clamp head includes a curved inner surface and a support plate, and the implant is installed between the curved inner surfaces opposite to each other and is held by the support plate.

[0080] Example 6. The conveying actuator according to Example 5, wherein in each of the fixed clamp head and the movable clamp head, the support plate and the arc-shaped inner surface are in a circular arc transition.

[0081] Example 7. The delivery actuator as described in Example 6, wherein the fixed clamp head and the movable clamp head are respectively provided with a positioning groove to accommodate one end of the implant.

[0082] Example 8. A conveying actuator as described in any one of Examples 3 to 7, wherein the parallel opening and closing mechanism includes a first swing arm and a second swing arm, and both ends of each of the first swing arm and the second swing arm are pivotally connected to the fixed seat and the movable seat, respectively, so that the fixed seat, the first swing arm, the movable seat and the second swing arm constitute a parallelogram mechanism.

[0083] Example 9. The delivery actuator of Example 8, wherein the actuating element comprises a control wire.

[0084] Example 10. The delivery actuator according to Example 9, wherein the control wire is connected to the movable clamp arm, so that pulling the control wire causes the movable clamp arm to swing relative to the fixed clamp arm.

[0085] Example 11. The conveying actuator as described in any one of Examples 8 to 10, wherein the fixed seat and the movable seat are respectively provided with a receiving space to receive the first swing arm and the second swing arm.

[0086] Example 12: The transport actuator according to any one of Examples 1 to 11, further comprising a reset element, wherein the reset element biases the movable clamp arm toward the fixed clamp arm.

[0087] Example 13. A conveying actuator as described in any one of Examples 3 to 7, wherein the parallel opening and closing mechanism includes a first swing arm, a second swing arm and a driving arm, the first end of the first swing arm and the first end of the second swing arm are spaced apart and pivotally connected to the movable clamp arm, the second end of the first swing arm and the second end of the second swing arm are pivotally connected by a connecting plate and are movable relative to the fixed clamp arm together with the connecting plate, the first end of the driving arm is pivotally connected to the fixed clamp arm and the second end of the driving arm is pivotally connected to the second swing arm.

[0088] Example 14. The delivery actuator of Example 13, wherein the actuating element comprises a transverse push rod, which pushes the connecting plate in a distal direction so that the movable clamp arm opens relative to the fixed clamp arm.

[0089] Example 15. The delivery actuator of Example 13, wherein the actuating element comprises a pull wire, and the pull wire pulls the connecting plate distally to open the movable clamp arm relative to the fixed clamp arm.

[0090] Example 16: A delivery actuator as described in any one of Examples 1 to 15 above, wherein wiring grooves are provided in the fixed clamp arm and the movable clamp arm, and the first binding wire and the second binding wire are respectively connected to the implant through the wiring grooves.

[0091] Example 17: The delivery actuator as described in any of the above examples, wherein the object to be implanted is an atrial appendage clip.

[0092] Example 18: A surgical device comprising:

[0093] handle;

[0094] A delivery actuator as described in any one of Examples 1 to 17; and

[0095] A connecting rod connecting the delivery actuator to the handle,

[0096] Wherein, the handle comprises a control mechanism, and the control mechanism is operably connected to the actuating element to manipulate the transport actuator.

[0097] Example 19: The surgical device of Example 18, wherein the connecting rod is connected to the delivery actuator via a universal joint to control the orientation of the delivery actuator.

[0098] From the above description, it is apparent to those of ordinary skill in the art that, although the methods and apparatus described herein constitute exemplary embodiments of the present disclosure, the present invention is not limited to these specific embodiments, and changes may be made to such embodiments without departing from the scope of the present invention as defined by the claims. In addition, it is to be understood that the present invention is defined by the claims, and this does not mean that any limitation or element describing the exemplary embodiments set forth herein will be incorporated into the interpretation of any claim element unless such limitation or element is expressly stated. Similarly, it is to be understood that not all of the mentioned advantages or purposes of the invention disclosed herein need to be met in order to fall within the scope of any claim, because the present invention is defined by the claims and because there may be inherent and / or unforeseen advantages of the claimed invention even though they may not have been explicitly discussed herein.

Claims

1. A deflecting conveying actuator, comprising: connecting pedestal; A fixed clamp arm connected to the connection base and cannot swing relative to the connection base; A movable clamp arm pivotably mounted relative to the fixed clamp arm; as well as an actuating element, wherein the actuating element is actuated to cause the movable clamp arm to swing relative to the fixed clamp arm, The object to be implanted is releasably held by the fixed forceps arm and the movable forceps arm.

2. The conveying actuator as described in claim 1 further includes a parallel opening and closing mechanism, which is connected between the fixed clamp arm and the movable clamp arm, so that when the movable clamp arm swings relative to the fixed clamp arm, the movable clamp arm and the fixed clamp arm remain parallel and opposite.

3. The conveying actuator according to claim 2, wherein: The fixed pliers arm comprises a fixed seat and a fixed pliers head connected to the fixed seat; the movable pliers arm comprises a movable seat and a movable pliers head connected to the movable seat, wherein the fixed pliers arm and / or the movable pliers arm comprise a follow-up mechanism, and the follow-up mechanism enables the fixed pliers head to be longitudinally displaced relative to the movable seat and / or the movable pliers head to be longitudinally displaced relative to the movable seat during the swinging process, so that the movable pliers head remains parallel and opposite to the fixed pliers head.

4. The conveying actuator according to claim 3, wherein: The following mechanism includes a slide rail formed on one of the fixed seat and the fixed pliers head and a slide groove formed on the other of the fixed seat and the fixed pliers head and cooperating with the slide rail; and / or the following mechanism includes a slide rail formed on one of the movable seat and the movable pliers head and a slide groove formed on the other of the movable seat and the movable pliers head and cooperating with the slide rail.

5. The conveying actuator according to claim 3 or 4, wherein: Each of the fixed jaw and the movable jaw comprises an arc-shaped inner surface and a support plate. The object to be implanted is installed between the arc-shaped inner surfaces opposite to the fixed jaw and the movable jaw, and is held by the support plate.

6. The conveying actuator according to claim 5, wherein: In each of the fixed pliers and the movable pliers, there is an arc transition between the supporting plate and the arc-shaped inner surface.

7. The conveying actuator according to claim 6, wherein: The fixed clamp head and the movable clamp head are respectively provided with positioning grooves to position one end of the object to be implanted.

8. The conveying actuator according to any one of claims 3 to 7, wherein: The parallel opening and closing mechanism includes a first swing arm and a second swing arm, and both ends of each of the first swing arm and the second swing arm are pivotally connected to the fixed seat and the movable seat, respectively, so that the fixed seat, the first swing arm, the movable seat and the second swing arm form a parallelogram mechanism.

9. The conveying actuator according to claim 8, wherein: The actuation element comprises a control wire.

10. The conveying actuator according to claim 9, wherein: The control wire is connected to the movable clamp arm so that pulling the control wire causes the movable clamp arm to swing relative to the fixed clamp arm.

11. The conveying actuator according to any one of claims 8 to 10, wherein: The fixed seat and the movable seat are respectively provided with an accommodation space to accommodate the first swing arm and the second swing arm.

12. The conveying actuator according to any one of claims 1 to 11, wherein: Also included is a restoring element that biases the movable clamp arm toward the fixed clamp arm.

13. The conveying actuator according to any one of claims 3 to 7, wherein: The parallel opening and closing mechanism includes a first swing arm, a second swing arm and a driving arm, the first end of the first swing arm and the first end of the second swing arm are spaced apart and pivotally connected to the movable clamp arm, the second end of the first swing arm and the second end of the second swing arm are pivotally connected by a connecting plate and are movable relative to the fixed clamp arm together with the connecting plate, the first end of the driving arm is pivotally connected to the fixed clamp arm and the second end of the driving arm is pivotally connected to the second swing arm.

14. The conveying actuator according to claim 13, wherein: The actuating element comprises a transverse push rod, which pushes the connecting plate in a distal direction so that the movable clamp arm is opened relative to the fixed clamp arm.

15. The conveying actuator according to claim 13, wherein: The actuating element includes a pull wire, and the pull wire pulls the connecting plate distally to open the movable clamp arm relative to the fixed clamp arm.

16. The conveying actuator according to any one of claims 1 to 15, wherein: The fixed clamp arm and the movable clamp arm are provided with wiring grooves, and the first binding wire and the second binding wire are respectively connected to the object to be implanted through the wiring grooves.

17. The delivery actuator according to any one of the preceding claims, wherein the object to be implanted is an atrial appendage clip.

18. A surgical device comprising: handle; The conveying actuator according to any one of claims 1 to 17; as well as A connecting rod connecting the delivery actuator to the handle, Wherein, the handle comprises a control mechanism, and the control mechanism is operably connected to the actuating element to manipulate the transport actuator.

19. The surgical device of claim 18, wherein: The connecting rod is connected to the conveying actuator through a universal joint to control the orientation of the conveying actuator.

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