Surgical clip

Abstract

To provide means allowing an operator to perform an operation with an operation support robot, including a process of clipping a biological tissue.SOLUTION: A clip C includes: a first clip member 10 and a second clip member 20 extending in the longitudinal direction; and a spring member (40) provided between the first clip member and the second clip member, and energizing in such a direction that in the front, the first clamping piece 11 of the first clip member and the second clamping piece 12 of the second clip member come into contact with each other to close a clamping part 1 and, in the rear, the first operating piece 12 of the first clip member and the second operating piece 22 of the second clip member are separated from each other. When the clamping part 1 is closed, force acting between the first clamping piece 11 and the second clamping piece 21 is 1 [N] or more, and operating force required to open the clamping part 1 against the energizing force of the spring member is 8.5 [N] or less.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a surgical clip for temporarily clamping and holding biological tissue during a surgical procedure. [Background technology]

[0002] In surgery, various organs, nerve tissues, blood vessels, fat layers, and other biological tissues may be located around the site to be treated in a folded manner. In such a case, if a laparotomy is performed by making a large incision in the abdomen with a scalpel, the surrounding biological tissues can be removed using abdominal wall hooks, fascial hooks, flat hooks, etc. to expose the treatment site, and a tumor can be removed using surgical instruments such as scissors and an electric scalpel. On the other hand, endoscopic surgery, which is rapidly spreading in the medical field because of its minimal invasiveness, generally involves making 4 to 5 holes in the abdomen and inserting a trocar, inflating the abdominal cavity with gas, and inserting surgical instruments such as a laparoscope, forceps, scissors, and an electric scalpel through the trocar to remove the tumor.

[0003] In such endoscopic surgery, surgical instruments are basically inserted into the abdominal cavity through a trocar, so large and bulky instruments such as abdominal wall hooks and fascial hooks used in open surgery cannot be used. Therefore, in endoscopic surgery, a thread is fastened to a small clip like a small clothespin and the thread is led out of the abdominal cavity, and a forceps introduced from another trocar is used to hold the biological tissues such as organs and nerves located around the treatment site with the clip, and the thread fastened to the clip and led out of the abdominal cavity is pulled to move the biological tissues near the treatment site, exposing the treatment site in the abdominal cavity (for details on surgical clips, see Patent Documents 1 and 2, for example). In recent years, surgery using surgical support robots such as "Da Vinci" and "Hinotori" has also been performed in relatively large hospitals throughout Japan in endoscopic surgery. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Utility Model Application Publication No. 57-97510 [Patent Document 2] Patent Publication No. 2022-42626 Summary of the Invention [Problem to be solved by the invention]

[0005] The reported advantages of surgical robots include the ability for the surgeon to perform surgery while viewing a 3D stereoscopic image 10 to 15 times larger than the naked eye, and the ability to safely perform delicate work as it is equipped with a filter function to remove tremors in the hands of the surgeon operating the master controller.However, surgical robots do not have a sense of touch, so even if the surgeon operates the master controller and touches biological tissue with an instrument, the surgeon cannot feel it.

[0006] That is, in normal endoscopic surgery, when the surgeon opens and closes the handle of the forceps, the operating force is transmitted directly to the jaw at the tip via the rod, and when biological tissue is grasped with the jaw, a reaction force according to the grasping force is transmitted to the handle, so the surgeon can intuitively know how much force is being used to grasp the biological tissue. On the other hand, in a surgical support robot, when the surgeon opens and closes the forceps using the master controller, the operation is detected by a sensor and converted into an electrical signal, and after necessary signal processing such as filtering is performed, the signal is converted into a drive signal that drives each instrument and transmitted to the patient cart. In the patient cart, the manipulators (e.g., electric motors, pneumatic cylinders, artificial muscles, etc.) provided on each instrument operate according to the drive signal, and the jaws at the tip of the forceps open and close at a speed and angle according to the surgeon's opening and closing operation.

[0007] In this way, in the surgical support robot, the manipulator is driven and the jaws are opened and closed in response to the surgeon's operation, but the reaction force acting on the jaws from the biological tissue is not transmitted to the master controller, and the surgeon does not know how strongly the biological tissue is being grasped. Under such a configuration, instruments that grasp or process biological tissue (for example, forceps or bipolar forceps for grasping biological tissue) are configured so that they do not generate more than a predetermined force, so that the biological tissue is not accidentally crushed when grasped with forceps.

[0008] Such a function (limiter function) is preferable from the viewpoint of treatment safety, since it protects biological tissue even if the surgeon makes an erroneous operation or if an abnormality occurs in the master controller. However, due to the existence of this limiter function, a situation has arisen in which clips used in conventional endoscopic surgery cannot be used properly. That is, even if an attempt is made to pinch the operating part on the base end side of the clip with a forceps instrument to open the clamping part at the tip of the clip, the limiter function is activated midway and the clamping part cannot be opened sufficiently, resulting in a situation in which the biological tissue cannot be grasped as desired. Therefore, the process of grasping and moving the biological tissue around the treatment site with the clip to expose the treatment site and the process of removing the clip had to be performed on the patient by a doctor other than the surgeon who operates the master controller using endoscopic surgical forceps. This means that in addition to the surgeon (operator), a doctor who can perform endoscopic surgery and an endoscopic system are also needed when performing surgery. Furthermore, if it is necessary to have such a specialized doctor waiting in the operating room, there is a problem that the effectiveness of remote treatment using a surgical support robot is reduced.

[0009] The present invention has been made in consideration of the above-mentioned problems, and aims to provide a means for performing endoscopic surgery using a surgical support robot that allows the surgeon to perform all steps, including clipping and unclipping biological tissue, using a master controller, without requiring an assistant doctor or system just for these steps. [Means for solving the problem]

[0010] In order to solve the above problems, a surgical clip in an exemplary embodiment of the present invention includes a first clip member and a second clip member extending forward and backward, and a spring member provided between the first clip member and the second clip member, which biases the first clamping piece of the first clip member and the second clamping piece of the second clip member in a direction such that the clamping portions are closed at the front when the first clamping piece of the first clip member and the second clamping piece of the second clip member abut against each other at the front, and the first operating piece of the first clip member and the second operating piece of the second clip member are separated at the rear. The clip is configured such that the force acting between the first clamping piece and the second clamping piece when the clamping portions are closed is 1 [N] or more, and the operating force when opening the clamping portions against the biasing force of the spring member is 8.5 [N] or less.

[0011] It is preferable that one of the first clamping piece and the second clamping piece is formed in a U-shape with a groove portion extending forward and backward in the left-right central portion and an open front end, and that the other of the first clamping piece and the second clamping piece is formed so that the left-right width of the front end is equal to or less than the width of the groove portion and overlaps with the groove portion in a planar view and is positioned within the groove when the clamping portion is closed.

[0012] It is also preferable that the inner surfaces of the first and second clamping pieces have a plurality of laterally extending unevennesses arranged front to back. The unevennesses formed on the inner surface of the first clamping piece and the unevennesses formed on the inner surface of the second clamping piece are preferably configured such that when the clamping section is closed, the convex portion of the first clamping piece and the concave portion of the second clamping piece face each other vertically, and the concave portion of the first clamping piece and the convex portion of the second clamping piece face each other vertically. It is also preferable that the unevennesses of the first clamping piece and the unevennesses of the second clamping piece are also formed behind the rear end of the groove, and that when the clamping section is closed, the convex portion of the first clamping piece and the concave portion of the second clamping piece mesh with each other behind the rear end of the groove, and the concave portion of the first clamping piece and the convex portion of the second clamping piece mesh with each other.

[0013] It is also preferable that at least one of the first operating piece and the second operating piece is provided with a locking protrusion protruding upward and downward outward from the surface, and that at least the other of the first clamping piece and the second clamping piece is formed with a locking hole that penetrates upward and downward to allow the thread to pass through. Effect of the Invention

[0014] The surgical clip according to the present invention is configured so that the force acting between the first clamping piece and the second clamping piece when the clamping parts at the tip of the clip are closed is 1 [N] or more, and the force required to open the clamping parts against the biasing force of the spring member is 8.5 [N] or less. A surgical clip configured in this way can provide a means that allows the surgeon to perform a procedure including these steps using a master controller without requiring an assistant surgeon or system just for the steps of clipping and releasing biological tissue in an endoscopic surgery using a surgical support robot.

[0015] In addition, when one of the first clamping piece and the second clamping piece is configured such that a groove extending forward and backward is formed in the left-right center and the other is configured so that the left-right width of the front end is less than or equal to the width of the groove and overlaps with the groove in a planar view when the clamping portion is closed, and is positioned within the groove, when the clamping portion is closed, the biological tissue is held in a clamped manner between the U-shaped groove and the clamping piece positioned within this groove.Therefore, when the clamping portion is closed, the force acting between the first clamping piece and the second clamping piece (minimum clamping force) can be kept to a relatively small value, while the biological tissue clamped in the clamping portion can be clamped and held.

[0016] Furthermore, by forming multiple unevennesses extending left and right in a front-to-back arrangement on the inner surfaces of the first clamping piece and the second clamping piece, the multiple unevennesses extending left and right prevent the clamped biological tissue from slipping in the front-to-back direction, so that the clamped biological tissue can be firmly held with a relatively small clamping force.

[0017] In addition, when the unevenness formed on the first clamping piece and the unevenness formed on the second clamping piece are configured such that the convex portion of the first clamping piece and the concave portion of the second clamping piece face each other vertically when the clamping portion is closed, and the concave portion of the first clamping piece and the convex portion of the second clamping piece face each other vertically, thin biological tissue can be held with a relatively small clamping force. Furthermore, when the unevenness of the first clamping piece and the unevenness of the second clamping piece are formed behind the rear end of the U-shaped groove, and when the clamping portion is closed, the convex portion of the first clamping piece and the concave portion of the second clamping piece engage with each other behind the rear end of the groove, thin biological tissue can be reliably held with a relatively small clamping force.

[0018] Furthermore, by providing a pin protruding vertically outward from the surface on at least one of the first and second operating pieces, and forming a hole that penetrates vertically through at least the other, through which a thread can be inserted, it is possible to provide a surgical clip that is easy to use and will not fly off during surgery when used with fenestrated forceps in which windows are formed that penetrate vertically through the first and second operating pieces. [Brief description of the drawings]

[0019] [Figure 1] 1 is a perspective view of a surgical clip illustrating an aspect of the present invention; [Diagram 2] 2A is a plan view, FIG. 2B is a front view, and FIG. 2C is a bottom view of the surgical clip. [Diagram 3] FIG. 2 is a right side view of the surgical clip. [Figure 4] 4 is a cross-sectional view taken along the line IV-IV in FIG. 2(c). [Diagram 5] FIG. 2 is a perspective view of the surgical clip as viewed obliquely from the front and below. [Figure 6] 5 is a partially enlarged view of the tip portion of the clip in FIG. 4. [Figure 7] 1 is a photograph illustrating a fenestrated forceps for use in surgical procedures. [Figure 8] FIG. 13 is a perspective view showing a modification of the surgical clip. [Figure 9]1A is a plan view, FIG. 1B is a front view, and FIG. 1C is a bottom view of the modified surgical clip. [Figure 10] 1 is a photograph of a surgical clip illustrating another embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0020] Hereinafter, an embodiment of the present invention will be described. Fig. 1 shows a perspective view of a surgical clip (hereinafter, referred to as "clip") C illustrating an embodiment of the present invention, Fig. 2(a), (b), and (c) show a plan view, a front view, and a bottom view of the clip C, Fig. 3 shows a right side view of the clip C, Fig. 4 shows a cross-sectional view taken along the line IV-IV in Fig. 2(c), and Fig. 5 shows a perspective view of the clip C as seen obliquely from below and in front. Note that in Fig. 1, axes of front-rear, left-right, and up-down are added, and the description will be made based on these, with the front, rear, etc. being described, but these are added for convenience to facilitate understanding, and do not specify the direction, etc., of the clip when it is used.

[0021] Clip C is composed of a first clip member 10 and a second clip member 20 extending in the front-to-rear direction, a pin member 30 that connects these clip members 10, 20 at the front-to-rear middle portion so that they can swing freely relative to each other around an axis extending left and right, and a spring member 40 provided between the first clip member 10 and the second clip member 20.

[0022] A clamping portion 1 for clamping biological tissue, etc. is formed at the front of the clip C, an operating portion 2 for opening and closing the clamping portion 1 is formed at the rear, and a hinge portion 3 is formed at the midpoint between the front and rear of the clip C to connect the first clip member 10 and the second clip member 20 so that they can swing relative to each other.

[0023] The first clip member 10 has an I-shape or a rectangular shape in plan view that extends forward and backward with a generally constant width in the left-right direction as a whole, and is manufactured by machining a metal material such as surgical stainless steel such as SUS316L or SUS420J or surgical titanium. A first clamping piece 11 constituting the clamping portion 1 is provided at the front of the first clip member 10, a first operating piece 12 constituting the operating portion 2 is provided at the rear, and semicircular tongue-shaped first hinge pieces 13, 13 constituting the hinge portion 3 are provided at the front-rear intermediate portion so as to protrude downward from the left and right side edges.

[0024] The second clip member 20 is wider in the left-right direction than the first clip member 10, and is further widened forward of the hinge portion 3, forming an overall Y-shape in plan view. The second clip member 20 is manufactured by machining using the same metal material as the first clip member 10. A second clamping piece 21 constituting the clamping portion 1 is provided in the front of the second clip member 20, a second operating piece 22 constituting the operating portion 2 is provided in the rear, and semicircular tongue-shaped second hinge pieces 23, 23 constituting the hinge portion 3 are provided in the front-rear intermediate portion so as to protrude upward from the left and right side edges.

[0025] The second clamping piece 21 is configured to be U-shaped as a whole, with a groove 21g formed by cutting the left and right central part backward from the front end by a predetermined width. The width of the groove 21g is somewhat larger than the width of the first clamping part 11 of the first clip member 10, and is configured so that the front end of the first clamping piece 11 overlaps with the groove 21g of the second clamping piece and is located within the groove width when the clamping part 1 is closed. The second hinge pieces 23, 23 are set so that the inner surface distance between these two opposing hinge pieces is somewhat larger than the outer surface distance between the first hinge pieces 13, 13 that are also opposed to each other. In other words, when the first clip member 10 and the second clip member 20 are opposed to each other vertically, the first hinge pieces 13, 13 are positioned inside the left and right second hinge pieces 23, 23, and the hinge pieces are opposed to each other. The first and second hinge pieces 13, 13, 23, 23 are formed with pin holes through which the pin members 30 are inserted.

[0026] The pin member 30 is made of a wire material such as surgical stainless steel whose outer diameter is slightly smaller than the inner diameter of the pin hole formed in the first and second hinge pieces 13, 13, 23, 23 and whose overall length is somewhat longer than the outer surface distance of the second hinge pieces 23, 23. The pin member 30 is attached by vertically opposing the first clip member 10 and the second clip member 20 to align the pin hole of the first hinge piece 13, 13 with the pin hole of the second hinge piece 23, 23, and then inserting and setting a coil portion 41 of a spring member 40 described later, and then crimping the pin member 30 on the left and right outer sides of the second hinge pieces 23, 23. As a result, the first hinge pieces 13, 13 and the second hinge pieces 23, 23 are connected by the pin member 30 to form the hinge portion 3, and the first clip member 10 and the second clip member 20 are supported so as to be able to swing freely relative to each other around the axis of the pin member 30 extending to the left and right.

[0027] The spring member 40 is provided between the first clip member 10 and the second clip member 20 as described above. This embodiment shows a configuration in which a torsion spring consisting of a cylindrical coil portion 41 and upper and lower arm portions 42, 42 extending rearward from the coil portion is used as the spring member 40. The spring member 40 is attached between the first clip member 10 and the second clip member 20 by supporting the coil portion 41 with the pin member 30, and engaging one of the arm portions 42, 42 extending from the coil portion 41 with a groove that is U-shaped in cross section formed on the lower surface side of the first operating piece 12 and engaging the other with a groove that is U-shaped in cross section formed on the upper surface side of the second operating piece 22 (see FIGS. 3 and 4). When the spring member 40 is attached, the first clip member 10 and the second clip member 20 are biased in the direction in which the first operating piece 12 and the second operating piece 22 move away from each other at the rear operating part 2, with the pin member 30 as an axis, and at the front, the first clamping piece 11 and the second clamping piece 22 abut against each other to hold the clamping part 1 in a closed state.

[0028] In the clamping unit 1, a plurality of rows of laterally extending unevenness are formed in a front-rear direction on the lower surface of the first clamping piece 11 and the upper surface of the second clamping piece 21, i.e., on the opposing surfaces of both clamping pieces. In this embodiment, a configuration is illustrated in which a plurality of rows of laterally extending wavy unevenness are formed in a rear direction from the front end of the clamping unit 1 on the opposing surfaces of the first clamping piece 11 and the second clamping piece 21. As shown in FIG. 6, which is an enlarged view of the tip of the clip in FIG. 4, the unevennesses opposing each other in the upper and lower directions have the same pitch and are synchronized in the phase of the waveform, and when the clamping unit 1 is closed, the convex portion 11a on the first clamping piece side and the concave portion 21b on the second clamping piece side face each other in the upper and lower directions, and the concave portion 11b on the first clamping piece side and the convex portion 21a on the second clamping piece side face each other in the upper and lower directions.

[0029] Furthermore, these irregularities 11b, 11a, 21b, 21a are formed from the front end of the clamping part 1 to the vicinity of the hinge part 3, and behind the groove part 21g, when the clamping part 1 is closed, the convex part 11a of the first clamping piece and the concave part 21b of the second clamping piece mesh with each other, and the concave part 11b of the first clamping piece and the concave part 21b of the second clamping piece mesh with each other. The cross-sectional shape of the upper and lower interlocking irregularities can be a waveform in which semicircular concaves and convexities are smoothly connected and repeated as illustrated in each figure, a sine wave shape, or a sawtooth or rack shape in which triangular, rectangular, or trapezoidal concaves and convexities are repeated. If the cross-sectional shape is a waveform or sine wave shape in which semicircular concaves and convexities are repeated as illustrated, relatively soft biological tissues such as membranes and internal organs can be grasped without damaging them. On the other hand, if the cross section is made to have a sawtooth shape such as a triangle or trapezoid, it can reliably grip relatively hard biological tissue such as cartilage and tendons, surgical instruments, etc.

[0030] In the operating part 3, the upper surface of the first operating piece 12 and the lower surface of the second operating piece 22, i.e., the outer surfaces of both operating pieces, are subjected to a twill knurling process having a slip-resistant function. Furthermore, a small-diameter locking projection 15 is provided at the rear of the first operating piece 12 so as to protrude upward from the surface, and a small-diameter locking hole 25 is formed in the second clamping piece, which passes vertically through the second clip member 20 and through which the thread is inserted. The locking projection 15 is provided by, for example, pressing and fixing a pin made of surgical stainless steel into a small-diameter hole formed vertically through the first clip member 10.

[0031] In this way, the outer surface of the operating pieces 12, 22 of the clip C is knurled, and further, a small-diameter locking protrusion 15 is provided at the rear of the first operating piece 12, protruding upward from the surface. Therefore, by using a fenestrated forceps 80 having windows 85w, 85w penetrating vertically through two jaws 85, 85 at the tip of a shaft part 83 as an instrument in endoscopic surgery, as exemplified in FIG. 7, it is possible to prevent the clip C held by the jaws from falling off. That is, when the first and second operating pieces 12, 22 of the clip C are held by the jaws 85, 85 to open the clamping part 1, the clip C is held in a state in which the locking protrusion 15 is located within the window 85w of one of the jaws, so that it is possible to significantly prevent the clip C from coming off and jumping off during the opening and closing operation of the clip C. A small-diameter locking hole 25 is formed in the operating piece 22 of the second clip member 20, and by passing a thread through this and tying it, and pulling the other end to an appropriate position, the clamped biological tissue can be moved to a position that does not interfere with the surgery.

[0032] The clip C is set so that the force acting between the first clamping piece 11 and the second clamping piece 21 when the clamping portion 1 is closed is 1 [N] or more, and the force acting to open the clamping portion 1 against the biasing force of the spring member 40 is 8.5 [N] or less.

[0033] In order to derive appropriate values ​​for the force Fc acting between the first clamping piece 11 and the second clamping piece 21 when the clamping portion 1 is closed, and the force Fo when opening the clamping portion 1 against the biasing force of the spring member 40, the inventors produced several prototypes by successively changing the shape and dimensions of each part of the clip C and the torque spring constant of the spring member, and repeated testing in situations approximating actual robot-assisted surgery to derive the above numerical values.

[0034] First, when the clamping unit 1 is closed, that is, when the first clamping piece 11 and the second clamping piece 21 are in contact with each other and the opening angle θ of the clamping unit 1 is 0 degrees, the force Fc acting between the first clamping piece 11 and the second clamping piece 21 is the minimum clamping force generated in the clamping unit 1 by the torque based on the torsion angle (initial torsion angle) of the spring member 40 provided between the first operating piece 12 and the second operating piece 22 when the spring member 40 is attached, and defines the force for holding a relatively thin biological tissue. The inventors conducted numerous tests on various biological tissues and derived that the minimum clamping force Fc is preferably 1 [N] or more, and more preferably 1.2 [N] or more. If the clamping force Fc is about 1 [N], a relatively thin biological tissue can be moved while being clamped by the clamping unit 1, and if the clamping force Fc is 1.2 [N] or more, even an extremely thin biological tissue such as a membrane can be moved to an arbitrary position while being securely clamped by the clamping unit 1.

[0035] On the other hand, when attempting to open the clamping portion 1 by pressing the first operating piece 12 and the second operating piece 22 from a closed state of the clamping portion 1, an increase in the opening angle θ of the clamping portion 1 is equivalent to an increase in the torsion angle of the spring member 40, and the spring reaction force increases in proportion to the opening angle θ of the clamping portion 1. In a region where the opening angle θ of the clamping portion 1 is small, the operating force Fo [N] to open increases in proportion to the distance between the opposing first clamping piece 11 and second clamping piece 21 (hereinafter referred to as the "opening degree of the clamping portion 1").

[0036] Meanwhile, in surgical robots, the instruments that grasp and process biological tissue are set so as not to generate more than a certain amount of force, but the companies that manufacture and sell surgical robots have not disclosed a specific value for what this force is [N]. As a result of repeating various experiments using a surgical robot, the inventors have derived that clip C can be effectively used in surgery using instruments that grasp biological tissue by setting the operating force Fo for opening the clamping portion 1 to 8.5 [N] or less.

[0037] Here, "opening" the clamping portion 1 means opening it to an opening size that is useful for clamping biological tissue between the upper and lower first clamping pieces 11 and second clamping pieces 21 in endoscopic surgery, and in this specification means that the distance between the lower surface of the first clamping piece 11 and the upper surface of the second clamping piece 21 is 5 mm or more. According to the clip C having such a configuration, it is possible to provide a means that allows the surgeon to perform a procedure including these steps using the master controller without requiring an assistant surgeon just for the steps of clipping and releasing the biological tissue in endoscopic surgery using a surgical support robot.

[0038] It is preferable that the operating force Fo when opening the clamping portion 1 against the spring force of the spring member 40 is 8 [N] or less, and more preferably, the distance between the lower surface of the first clamping piece 11 and the upper surface of the second clamping piece 21 when the clamping portion 1 is opened is 7 [mm] or more. By setting the operating force Fo when opening the clamping portion 1 to 8 [N] or less, the clip C can be opened and closed reliably regardless of individual differences in surgical support robots and instruments, and further, if the opening degree when the clamping portion 1 is opened with the operating force Fo is 7 [mm] or more, a surgical clip with extremely good operability during surgery can be provided.

[0039] Figures 8 and 9 show clip C' in which the shape of the first clamping piece 11 of clip C has been partially modified. Figure 8 is a perspective view of clip C', and Figures 9(a), (b), and (c) are a plan view, a front view, and a bottom view of clip C'. Note that components similar to those of clip C described above are given the same numbers and duplicated explanations will be omitted.

[0040] In the clamping unit 1, the lower surface of the first clamping piece 11' and the upper surface of the second clamping piece 21, which face each other vertically, are formed with multiple rows of wavy projections and recesses extending left and right, lined up front and back, similar to the clip C described above. The projections and recesses facing each other vertically have the same pitch and are synchronized in phase with each other, so that when the clamping unit 1 is closed, the projections 11a on the first clamping side and the recesses 21b on the second clamping side face each other vertically, and the recesses 11b on the first clamping side and the projections 21a on the second clamping side face each other vertically. In other words, when the clamping unit is closed, the projections and recesses on the first clamping side and the projections and recesses on the second clamping side face each other as if they were meshing with each other (see FIG. 6).

[0041] On the other hand, in the clip C', multiple rows of wavy unevenness extending up and down are formed in a line in the front and back on the left and right side surfaces of the first clamping piece 11'. The unevenness on the left and right side surfaces is formed in alignment with the unevenness on the bottom surface, and the recesses on the left and right side surfaces are formed by connecting with the recesses 11b on the bottom surface of the first clamping piece 11'. The unevenness on the left and right side surfaces is formed so that the tops of the protrusions are approximately flush with the left and right side surfaces of the first clamping piece 10, and the recesses are carved so that they are recessed from the side surfaces. With this configuration, when the clamping part 1 is closed, the unevenness on the first clamping piece side and the unevenness on the second clamping piece side face each other as if they are meshing with each other, and a small gap is formed between them. As a result, even extremely thin biological tissue such as a membrane can be reliably clamped between the upper and lower unevennesses without being cut between the edges of the two.

[0042] In the above, the second clamping piece 21 has been exemplified as having a groove 21g that penetrates the second clip member 20 vertically and extends rearward, but the groove may be cut to a predetermined depth without penetrating the second clip member 20 vertically. Also, the groove 21g may be surrounded by irregularities, but the groove 21g may extend rearward only to the left and right without providing irregularities behind it, and the entire surface of the second clamping piece 21 may be a wide corrugated irregular surface without providing a groove.

[0043] In addition, although the configuration in which the locking projection 15 is provided on the first operating piece 12 and the locking hole 25 is provided on the second operating piece 22 has been exemplified, the positions of the locking projection 15 and the provided locking hole 25 may be reversed. Moreover, the locking projection 15 may be provided on both the first operating piece 12 and the second operating piece 22, and the locking hole 25 may be provided on both the first operating piece 12 and the second operating piece 22 (shifted in position from the locking projection 15).

[0044] In addition, the configuration in which the first clip member 10 and the second clip member 20 are connected by the pin member 30 that supports them so as to be relatively swingable around an axis extending left and right at the front-rear intermediate portion has been exemplified, but it is also possible to configure the clip without using the pin member by vertically crossing the first clip member 10 and the second clip member 20 at the front-rear intermediate portion, as shown in other clip configuration examples Ca and Cb in Figures 10(a) and 10(b). Note that members and parts having the same functions as the clip C already described will be given the same symbols and redundant explanations will be omitted.

[0045] In addition, a torsion spring is used as the spring member 40 for biasing the clamping part 1 in the closing direction, and the coil part 41 is supported by the pin member 30, and the arm parts 42, 42 are engaged with the grooves of the first operating piece 12 and the second operating piece 22. However, the spring member may have other configurations as long as it functions to bias the clamping part 1 in the closing direction. For example, a compression coil spring may be provided between the lower surface of the first operating piece 12 and the upper surface of the second operating piece 22 (not shown), or the arm parts 42, 42 of the spring member 40 may be connected to the rear end of the first operating piece 12 and the rear end of the second operating piece 22 by crimping, as shown in FIG. 10(b). Furthermore, as shown in FIG. 10(a), a part of the rear part of the first clip member from the first operating piece 12 and the rear part of the second operating piece 22 of the second clip member may be thinly cut to form a spring part with a required spring constant, and the rear end part may be connected to form an integrated spring member. [Explanation of symbols]

[0046] C,C′ Surgical Clips 1 Clamping part 2 Control section 3 Hinge part 10 First clip member 11,11′ First clamping piece (11a convex part, 11b concave part) 12 1st operation piece 13 First hinge piece 15 Locking protrusion 20 Second clip member 21 Second clamping piece (21a convex part, 21b concave part) 22 2nd operation piece 23 Second hinge piece 25 Locking hole 30 Pin member 40 Spring member 41 Coil section 42 Arm section

Claims

1. a first clip member and a second clip member extending in the front-rear direction; a spring member that is provided between the first clip member and the second clip member, the spring member biasing the first clamping piece of the first clip member and the second clamping piece of the second clip member in a direction in which the clamping portion is closed by abutting the first clamping piece of the first clip member and the second clamping piece of the second clip member in a front portion and in a direction in which the first operating piece of the first clip member and the second operating piece of the second clip member are separated from each other, When the clamping portion is in a closed state, the force acting between the first clamping piece and the second clamping piece is 1 [N] or more, and when the clamping portion is opened against the biasing force of the spring member, the operating force is 8.5 A surgical clip having a length of [N] or less.

2. Either the first clamping piece or the second clamping piece is formed in a U-shape with a groove extending forward and backward in a left-right central portion and an open front end, 2. The surgical clip according to claim 1, wherein the other of the first clamping piece and the second clamping piece is formed so that the left-right width of the front end is equal to or less than the width of the groove portion and overlaps with the groove portion in a planar view and is positioned within the groove when the clamping portion is in a closed state.

3. 3. The surgical clip according to claim 1, wherein a plurality of projections and recesses extending laterally are formed in a front-to-rear direction on the opposing surfaces of the first clamping piece and the second clamping piece.

4. The unevenness formed on the first clamping piece and the unevenness formed on the second clamping piece are 4. The surgical clip according to claim 3, wherein when the clamping portions are in a closed state, the convex portion of the first clamping piece and the concave portion of the second clamping piece face each other vertically, and the concave portion of the first clamping piece and the convex portion of the second clamping piece face each other vertically.

5. 5. The surgical clip according to claim 4, wherein the unevenness of the first clamping piece and the unevenness of the second clamping piece are also formed rearward of the rear end of the groove portion, and configured such that, rearward of the rear end of the groove portion, when the clamping portion is in a closed state, the convex portion of the first clamping piece and the concave portion of the second clamping piece interlock with each other, and the concave portion of the first clamping piece and the convex portion of the second clamping piece interlock with each other.

6. At least one of the first operating piece and the second operating piece is provided with a locking protrusion protruding outwardly above and below from a surface thereof, 4. The surgical clip according to claim 3, wherein at least the other of said first clamping piece and said second clamping piece has a locking hole formed therethrough in a vertical direction for inserting a suture.

Images