Medical clips

Abstract

The present invention relates to a medical clip, particularly in the form of an aneurysm clip. The clip comprises a first clamp arm, a second clamp arm, and a biasing element having a first end and a second end. The first clamp arm has a first clamp arm end connected to the first end of the biasing element via a first connector. The second clamp arm has a second clamp arm end connected to the second end of the biasing element via a second connector. The clip comprises a box lock having a first connector and a second connector that engage with each other. The box lock has at least one first box lock opening located or formed in the first connector. The first box lock opening is defined by two first box lock webs. The box lock also has at least one second box lock web, which is formed by a second connector. The second box lock web penetrates the first box lock opening. The first box lock opening has two female sliding surfaces facing each other. At least one second box lock web has two male sliding surfaces facing away from each other and facing the female sliding surfaces.

Description

Technical Field

[0001] The present invention relates to a medical clip, particularly in the form of an aneurysm clip. The medical clip includes a first clamp arm, a second clamp arm, and a biasing element having a first end and a second end. The first clamp arm has a first clamp arm end connected to the first end of the biasing element via a first connection portion. The second clamp arm has a second clamp arm end connected to the second end of the biasing element via a second connection portion. The medical clip includes a so-called box lock (pinch-type hinge joint) having a first connection portion and a second connection portion that engage with each other. The box lock is disposed or formed on the first connection portion and has at least one first box lock opening defined by two first box lock webs. The box lock is constituted by the second connection portion and has at least one second box lock web that penetrates the first box lock opening. The first box lock opening has two female sliding surfaces facing each other. At least one second box lock web faces away from each other and has two male sliding surfaces facing the female sliding surfaces. At least two pairs of sliding surfaces each having a female sliding surface and a male sliding surface are formed. In each pair of sliding surfaces, the female sliding surface and the male sliding surface that engage with each other extend parallel to each other and define a sliding plane.

Background Art

[0002] The type of medical clip described at the beginning is known, for example, from Patent Document 1 (International Publication No. 2022 / 096357). Another medical clip having a box lock is described in Patent Document 2 (DE 20 2004 015 274 U1). In this medical clip, the biasing element serves as a support pin for two joint rings that engage with each other. The two joint rings are rotatable around the axis of the biasing element, and clamp arms are arranged or formed on each. One joint ring, together with a guide plate, forms a box lock opening. The other joint ring forms a second connection that penetrates the box lock opening. Furthermore, Patent Document 2 (German Utility Model No. 202004015274) discloses a similar medical clip having a box lock in Figures 1 and 2, and the box lock is described in detail in Patent Document 3 (German Patent Application Publication No. 19935418). [Prior art documents] [Patent Documents]

[0003] [Patent Document 1] International Publication No. 2022 / 096357 [Patent Document 2] German Utility Model No. 202004015274 Specification [Patent Document 3] German Patent Application Publication No. 19935418

[0004] In particular, in the connection region of an aneurysm clip configured in the form of a boxlock, the connection components (i.e., the first boxlock web of the first connection and at least one second boxlock web of the second connection) move past each other when the clip is opened and closed. Specifically, the first and second boxlock webs slide against each other. This movement causes friction. In other words, when the clip is opened and closed, these boxlock webs slide against each other on the male and female sliding surfaces that engage with each other. This not only causes friction, but can also lead to wear and cold welding (so-called seizing). These effects lead to an increase in repeatability uncertainty (decreased measurement reproducibility) in measuring the closing force of the clip. In other words, it leads to a decrease in repeatability (reproducibility) in measuring the closing force.

[0005] For such clips, it is important that the biasing force (particularly the spring force) applied by the biasing element has a predetermined value. To determine the spring force of an aneurysm clip, the clip is opened to a certain value according to existing standards and placed in a test apparatus. The force determined in this process (i.e., the closing force described above) must be within a certain tolerance range specified by the standard. Otherwise, the clip must be refurbished or discarded as unusable.

[0006] As stated above, the closing force of the clip must be maintained within the specified limits. The maximum deviation must be no more than plus or minus 7.5% of the rated value. In addition, the closing force must not decrease even by a small amount after repeated opening and closing. The specified closing force loss must be less than 5%. The measurement principle for determining the closing force and the specified limits or deviations are described in the ISO 9713:2022 standard.

[0007] The inherently unavoidable friction in the manufacture of clips, and the associated repeatability uncertainty, lead to the loss of a significant portion of the available tolerances in manufacturing. However, this tolerance is urgently needed as a process window in manufacturing. Friction, which is fundamentally unavoidable in clip manufacturing, and the resulting repeatability uncertainty, cause a significant portion of the available tolerance to be lost. Nevertheless, this tolerance is urgently needed as a process window in manufacturing.

[0008] It is known that the stronger the male and female sliding surfaces of a pair of sliding surfaces are pressed against each other, the more friction is generated. However, this pressure cannot be arbitrarily reduced because it would create an undefined amount of play (looseness) between the clamping arms (also called jaws) that engage with each other.

[0009] Therefore, the object of the present invention is to improve the type of medical clip described at the beginning so as to reduce the repeatability uncertainty in the measurement of closing force. [Overview of the project]

[0010] This objective is achieved, according to the present invention, in a medical clip of the type described at the beginning, by the following features: The projected area of ​​a first boxlock web defined by the perpendicular projection of a first boxlock web onto the sliding plane and the projected area of ​​a second boxlock web defined by the perpendicular projection of at least one second boxlock web onto the sliding plane overlap with each other, defining a projected overlap area. At least one of at least two pairs of sliding surfaces, in particular in each, has at least one of the two sliding surfaces that engage with each other having at least one recess. This results in an effective area (actually functional area) of a sliding surface parallel to the sliding plane, defined by a boxlock web having at least one recess, being smaller than the projected area of ​​a boxlock web projected onto the sliding plane from a boxlock web having at least one recess. At least one, in particular in each pair of sliding surfaces, two sliding surfaces that can abut each other or are in surface contact with each other define a contact overlap area. The ratio of the contact overlap area to the projected overlap area is in the range of approximately 1 / 25 to approximately 1 / 3.

[0011] The present invention makes it possible to reduce friction between engaging sliding surfaces in at least two pairs of sliding surfaces. By reducing the dimensions of the sliding surfaces that slide against each other in a planar manner relative to the dimensions of the corresponding box-lock web, static friction is reduced, and the transition to dynamic friction is facilitated. To measure the closing force, the clip can be slightly opened, for example, so that a clamp arm can be positioned on two retaining pins. To measure the closing force, the clip is closed again. At this time, the sliding process in the connection region changes to a static measurement state with static friction. The lower the coefficient of friction during the transition from dynamic to static friction, the lower the friction torque during closing force measurement, which has an impact on closing force measurement and, consequently, reduces the variability of the measurement results. By reducing the contact overlap area relative to the projected overlap area in a specified region, friction is minimized and the repeatability uncertainty is reduced to a desirable degree. To achieve the reduction of the contact overlap area relative to the projected overlap area, it is necessary to reduce one of the two engaging sliding surfaces to a value in the range of approximately 1 / 25 to 1 / 3 relative to the corresponding box-lock web projected area. Alternatively, the size of the two sliding surfaces that engage with each other may be reduced to a size of about 1 / 5 to about 0.58 each. This reduction is achieved by at least one recess provided on one or both of the two sliding surfaces. Preferably, the ratio of the contact overlap area to the projected overlap area is in the range of about 10% to about 20%. Within this range, friction is reduced as desired while still achieving sufficiently good guidance by bringing the sliding surfaces into contact with each other. In particular, the ratio of the contact overlap area to the projected overlap area may be in the range of about 1 / 25 to about 1 / 4, which can further reduce undesirable frictional effects.

[0012] Friction can be reduced in a simple manner if at least one recess is in the form of a groove on the sliding surface or a chamfer on the sliding surface. In particular, the sliding surface may be formed along two side edges that are parallel or substantially parallel to each other. The two side edges are in particular parallel to the direction of extension (longitudinal direction) of the corresponding connection from the biasing element to the corresponding clamp arm. One or two chamfers may be provided on the corresponding box lock web, thereby reducing the effective area of ​​the sliding surface that engages with the mating sliding surface forming the pair of sliding surfaces. The chamfer may in particular define (form) a flat surface or define (form) a curved surface that is convex or concave in the direction away from the corresponding connection.

[0013] Preferably, the groove or chamfer extends parallel to or substantially parallel to the longitudinal direction defined by the corresponding boxlock web. For example, if the groove extends in an S-shape from the biasing element to the clamp arm, the groove may pass through the edge extending longitudinally along the sliding surface.

[0014] It is preferable that the chamfered portion cooperates with the sliding plane to define (form) an inclined surface that surrounds an obtuse chamfer angle. In particular, the inclined surface may extend in a planar or curved shape. The chamfer angle may have a value in the range of approximately 140° to approximately 175°. This results in, for example, a nearly flat angle (an obtuse angle close to 180°) at the transition from the sliding surface to the chamfered portion, thus avoiding the generation of burrs. It is advantageous for the chamfer angle to be in the range of approximately 165° to approximately 172°.

[0015] Furthermore, it is advantageous for the grooves to extend laterally (transversely), particularly perpendicularly, to the longitudinal direction defined by the corresponding box-lock web. This allows for the provision of multiple grooves, which may extend parallel to one another. Moreover, the grooves may have an arc-shaped cross-section, which creates an obtuse angle, preferably a flat angle, particularly at the transition to the remaining sliding surface. This prevents the formation of burrs during the manufacture of the clip.

[0016] It is also preferable that at least one recess is formed in the form of a hollow spherical portion (spherical recess). In particular, the hollow spherical portion is part of a hollow sphere and may have the form of a hollow hemisphere (hemispherical recess) or a part of a hollow hemisphere. This forms a recess without undercuts (with a draft angle ensured). Such a recess can be easily formed, for example, using a ball cutter. Preferably, the depth of the hollow spherical portion is significantly smaller than its radius. In particular, the depth of the hollow spherical portion is less than 1 / 5 of the radius.

[0017] Preferably, at least one recess is formed by a boxlock web perforation that penetrates the boxlock web. For example, such a boxlock web perforation may be formed by a hole (through hole) that penetrates the boxlock web.

[0018] Boxlock web perforations can be easily formed if the cross-section is circular. In particular, boxlock web perforations can be formed by holes (through holes).

[0019] To reduce the effectively effective sliding surface in a desirable manner compared to the corresponding box-lock web projection area, it is advantageous that at least one of the two engaging sliding surfaces in at least one of the two pairs of sliding surfaces (in particular, each) has multiple recesses. For example, the size of the sliding surface that actually contributes to friction in the corresponding pair of sliding surfaces is reduced as desired, and the risk of galling (sticking due to friction) of the engaging sliding surfaces is minimized.

[0020] If multiple recesses have the same configuration, a medical clip can be easily formed.

[0021] In order to optimize the reduction of the sliding surface, it is preferable that at least some of the plurality of recesses are different. In particular, the shapes and / or sizes of the recesses may be different from each other. In particular, both a hollow spherical portion and a groove may be provided as the recesses on the same sliding surface. For example, three or more grooves having different shapes and sizes may be provided. Also, three or more recesses configured in the form of a hollow spherical portion may be provided.

[0022] To achieve a minimum contact overlap area, it is advantageous that both sliding surfaces engaging with each other in each pair of sliding surfaces have at least one recess.

[0023] According to a further preferred embodiment of the present invention, the width of the box lock web in the case where at least one recess is not taken into account is configured to be within a range of about 0.9 mm or more and about 2.1 mm or less with respect to the lateral direction (vertical direction) with respect to the longitudinal direction defined by the corresponding box lock web.

[0024] Furthermore, in the basic position (fully closed position) of the clip, the first clamp arm and the second clamp arm are as close to each other as possible (in particular, in contact with each other), and are movable away from each other from the basic position to the open position (fully open position) against the action of the biasing element. When the clamp arms are released again by the user after the clip is opened, the biasing element applies a force to the two clamp arms to automatically return from the open position to the basic position. The force is a predetermined closing force for the clip, and the closing force is measured with as high a repetition accuracy (reproducibility) as possible, or in other words, with as low a repetition uncertainty as possible.

[0025] When the sliding plane is planar or substantially planar, in particular, the optimal function of the medical clip is achieved. In this case, the sliding surfaces engaging with each other are also planar or substantially planar.

[0026] According to a preferred embodiment of the present invention, the box lock may be configured in the form of a single box lock (single box lock), and the second connecting portion may be configured to include only one second box lock web. In this case, the only one second box lock web may penetrate the first box lock opening. The first box lock opening is defined laterally by two first box lock webs having female sliding surfaces facing each other.

[0027] Furthermore, the box lock may be configured in the form of a double box lock (double box lock), the second connecting portion includes two second box lock webs, the two second box lock webs define the second box lock opening laterally, and one of the two first box lock webs penetrates the second box lock opening, and it is convenient that one of the two second box lock webs penetrates the first box lock opening. The double box lock has the advantage of significantly or completely avoiding the so-called "scissoring" (that is, the phenomenon that the side edges of the clamp arms slide against each other when closing the clip), especially in the case of a medical clip having a particularly long clamp arm (jaw portion). "Scissoring" involves the risk that soft tissue is damaged and, in the worst case, is cut in an undesirable way. This should be avoided as much as possible.

[0028] Preferably, the first clamp arm is configured to be linear, curved, or bent in a direction from the first clamp arm end to the free end, and the second clamp arm is configured to be linear, curved, or bent in a direction from the second clamp arm end to the free end. Thereby, a medical clip having a substantially arbitrary shape of the jaw portion can be formed to optimally treat aneurysms of various shapes and sizes in human or animal patients.

[0029] The clip is preferably made from a metallic material. This ensures, in particular, the stability of the clip as needed. The metallic material is preferably titanium or a titanium-containing alloy (e.g., Ti6Al4V). To avoid rejection reactions, it is advantageous if the clip is made from a biocompatible material.

[0030] In particular, when the sliding surfaces are made of titanium or a titanium-containing alloy, a large overlapping contact area between two sliding surfaces that engage with each other leads to undesirably high friction. Therefore, as described above, it is advantageous that at least one sliding surface in one of at least two pairs of sliding surfaces is reduced relative to the boxlock web projection area.

[0031] Preferably, both sliding surfaces that engage with each other are made of a metallic material. In particular, the metallic material may be titanium or a titanium-containing alloy. It is advantageous if both sliding surfaces that engage with each other are made of a biocompatible material.

[0032] According to a further preferred embodiment of the present invention, the biasing element may be configured in the form of a coil spring having at least one turn. In particular, the coil spring may be configured to have at least about 1.5 turns. For example, the biasing element may be manufactured by winding from a blank (initial material) formed by press molding.

[0033] If the first box lock web and / or the second box lock web have a rectangular cross-sectional shape when at least one recess is not taken into consideration, the manufacture of medical clips, in particular the formation of planar sliding surfaces, can be further simplified.

[0034] Furthermore, it is advantageous to provide a coating layer on at least one of the two interlocking sliding surfaces of the pair of sliding surfaces (particularly on one or both sliding surfaces). In particular, the coating layer may be in the form of a corrosion-reducing coating layer or a passivation coating layer.

[0035] In particular, it is advantageous if the coating layer is configured to reduce friction. This allows the friction-reducing coating layer to reduce undesirable friction between the mutually engaging sliding surfaces in a pair of sliding surfaces, in addition to the effect of reducing the size of the sliding surface by providing at least one recess.

[0036] The coating layer is preferably composed in the form of an oxide layer (oxide film). For example, if the medical clip is made from a titanium-containing material, the coating layer may be titanium oxide. Such an oxide layer is much harder than the base material of the clip (especially in the case of titanium) and is therefore much more resistant to seizing when the sliding surfaces that engage with each other slide against each other.

[0037] The oxide layer can be easily formed by electrochemical treatment (anodic oxidation).

[0038] The medical clip is preferably configured in the form of an aneurysm clip. This allows the medical clip to be used, in particular, for the treatment of aneurysms (especially saccular protrusions in hollow organs). [Brief explanation of the drawing]

[0039] Preferred embodiments of the present invention will be further described below with reference to the attached drawings.

[0040] [Figure 1] This is a schematic perspective view showing the entirety of a medical clip of a first embodiment having a single box lock. [Figure 2] This is a schematic perspective view showing the entirety of a medical clip of a second embodiment having a double box lock. [Figure 3] Figure 1 is a schematic diagram showing the first connection part of the medical clip. [Figure 4] This diagram schematically shows the second connection part of the medical clip shown in Figure 1. [Figure 5] Figure 1 shows a schematic cross-sectional view of the medical clip in the boxlock region. [Figure 6] Figure 2 shows a schematic cross-sectional view of the medical clip in the boxlock region. [Figure 7] A schematic cross-sectional view similar to Figure 5, which shows a medical clip of another embodiment, is shown. [Figure 8] A schematic cross-sectional view similar to Figure 6, which shows a medical clip of another embodiment, is shown. [Figure 9] This figure is similar to Figure 3, which schematically shows the first connection portion of a medical clip in another embodiment. [Figure 10] Figure 9 shows a cross-sectional view along the line 10-10. [Figure 11] This figure is similar to Figure 4, which schematically shows the second connection portion of a medical clip in another embodiment. [Figure 12] This is a schematic plan view showing a partially cut section of the box-lock region of a medical clip, formed by the first connecting portion shown in Figure 9 and the second connecting portion shown in Figure 11. [Figure 12A] This schematic diagram shows an enlarged view of region A in Figure 12 to illustrate the projected overlapping area formed by the overlapping projected areas of the box-lock webs and the contact overlapping area of ​​the two sliding surfaces that engage with each other. [Figure 13] This figure is similar to Figure 9, which schematically shows the first connection portion of a medical clip in another embodiment. [Figure 14] Figure 13 shows a cross-sectional view along line 14-14. [Figure 15] This figure is similar to Figure 11, which schematically shows the second connection portion of a medical clip in another embodiment. [Figure 16] This figure is similar to Figure 9, which schematically shows the first connection portion of a medical clip in another embodiment. [Figure 17] Figure 16 shows a cross-sectional view along line 17-17. [Figure 18] This figure is similar to Figure 11, which schematically shows the second connection portion of a medical clip in another embodiment. [Figure 19] This is a schematic cross-sectional view similar to Figure 5, showing a medical clip of another embodiment. [Modes for carrying out the invention]

[0041] Figure 1 schematically shows a medical clip according to the first embodiment, which is denoted as reference numeral 10 as a whole.

[0042] The medical clip 10 comprises a biasing element 12 and two clamping arms (i.e., a first clamping arm 14 and a second clamping arm 16).

[0043] The biasing element 12 has a first end 18 and a second end 20. The first clamp arm 14 has a first clamp arm end 22. The second clamp arm 16 has a second clamp arm end 24.

[0044] The first end 18 of the biasing element 12 is connected to the first clamp arm end 22 via the first connecting portion 26. The second end 20 of the biasing element 12 is connected to the second clamp arm end 24 via the second connecting portion 28.

[0045] The connection area of ​​the clip 10 is configured in the form of a box lock 30 having two connection parts (a first connection part 26 and a second connection part 28).

[0046] The first connection portion 26 defines the box lock opening 32 (box lock opening portion, box lock penetration portion). The box lock opening 32 is defined laterally by two first box lock webs 34, 36. The second connection portion 28 includes a single second box lock web 38 that penetrates the first box lock opening 32.

[0047] The first box lock opening 32 has two female sliding surfaces 42, 44 facing each other. The second box lock web 38 has two male sliding surfaces 46, 48 facing away from each other. Each male sliding surface 46, 48 faces (opposes) the corresponding female sliding surface 42, 44.

[0048] The box lock 30 comprises two pairs of sliding surfaces 50 and 52. Sliding surface pair 50 comprises a female sliding surface 42 and a male sliding surface 46. Sliding surface pair 52 comprises a female sliding surface 44 and a male sliding surface 48.

[0049] The female sliding surface 42 and the male sliding surface 46, which engage with each other, extend parallel to each other and cooperate to define a single sliding plane 56. The female sliding surface 44 and the male sliding surface 48, which engage with each other, extend parallel to each other and cooperate to define a single sliding plane 58. In this embodiment, the sliding planes 56 and 58 extend parallel to each other.

[0050] The box lock 30 is configured in the form of a single box lock 62. The second connection portion 28 comprises a single box lock web, i.e., only one second box lock web 38.

[0051] Figure 2 schematically shows a medical clip 10 of a second embodiment. Since this clip 10 substantially corresponds in its structure to the clip 10 of the embodiment in Figure 1, the same reference numerals are used in the embodiment of Figure 2 to indicate identical or functionally comparable components and elements.

[0052] The medical clip 10 in Figure 2 differs from the medical clip 10 of the first embodiment in Figure 1 in the structure of the box lock 30. In the embodiment of Figure 2, the box lock 30 is configured as a double box lock 64. In this case, the second connector 28 comprises two second box lock webs 38, 40. The second connector 28 further comprises a second box lock opening 66 (second box lock opening, second box lock penetration). The second box lock opening 66 is defined laterally by the two second box lock webs 38, 40. In the case of the double box lock 64, one of the second box lock webs 38 penetrates the first box lock opening 32, as in the case of the clip 10 in Figure 1. However, in the case of the double box lock 64, one of the first box lock webs 34 penetrates the second box lock opening 66.

[0053] As schematically shown in Figure 6, the other second box lock web 40 has an additional female sliding surface 68 formed thereon, which engages (cooperates) with the male sliding surface 70 of the first box lock web 34. In the case of a double box lock 64, the male sliding surface 48 essentially forms the female sliding surface of the second box lock opening 66. In this case, similarly, the female sliding surface 44 functions as the male sliding surface of the first box lock web 34 and engages (cooperates) with the (female) sliding surface 48.

[0054] The double box lock 64 comprises three pairs of sliding surfaces 50, 52, and 54. Sliding surface pair 50 is formed by sliding surfaces 42 and 46 that engage (cooperate) with each other. Sliding surface pair 52 is formed by sliding surfaces 44 and 48 that engage (cooperate) with each other. Sliding surface pair 54 is formed by sliding surfaces 68 and 70 that engage (cooperate) with each other.

[0055] The known medical clip problem described at the beginning of this specification (i.e., the problem of insufficient repeatability in measuring closing force) is solved in the medical clip 10 of the embodiment described below in conjunction with the drawings by the following feature: at least one of the engaging (cooperating) sliding surfaces 42, 46 (44, 48) (68, 70) has at least one recess 72, thereby reducing the effective size (effective area) of the sliding surface having at least one recess 72 in engagement (cooperation) with the corresponding mating sliding surface. This also reduces the size of the contact overlap area 74. In the case of the clip 10 having a double box lock 64, the minimum requirement is that at least one of the sliding surface pairs 50, 52, 54 has at least one recess 72. The contact overlap area 74 is defined by the surface areas of two sliding surfaces 42, 46 (44, 48) (68, 70) in the pair of sliding surfaces 50, 52, 54 that are able to abut each other or engage (cooperate) to abut each other in surface contact, and that are in contact with each other or slide against each other when the clip 10 is opened and closed.

[0056] As will be described below in relation to the drawings, at least one recess 72 may be configured in various forms.

[0057] As defined, the contact overlap area 74 exists on each of the sliding planes 56, 58, and 60. The sliding plane 60 is defined by the sliding surfaces 68 and 70 that engage (cooperate) with each other.

[0058] It should be noted that in the case of a single box lock 62, the second box lock web 38, and in the case of a double box lock 64, the first box lock web 34 and the second box lock web 38, have a rectangular cross-section, if at least one recess 72 is not taken into consideration. In the clip 10 with a single box lock 62, the cross-section of the first box lock webs 34,36 is substantially elongated ellipse. In the case of a double box lock 64, the cross-sections of the first box lock web 36 and the second box lock web 40 are each roughly rectangular.

[0059] The clip 10 in the embodiment shown in Figures 1, 3, 4, and 5 has a plurality of recesses 72. The plurality of recesses 72 are configured in the form of grooves 76 in the sliding surfaces 42 and 46. The sliding surfaces 42 and 46 engage (cooperate) with each other to define the pair of sliding surfaces 50. In the embodiment shown in Figures 1, 3, 4, and 5, the plurality of grooves 76 extend parallel to each other and extend laterally (perpendicular) with respect to the longitudinal directions 78 and 80, respectively. The longitudinal direction 78 is defined by the first box-lock webs 34 and 36, and the longitudinal direction 80 is defined by the second box-lock web 38.

[0060] In the illustrated embodiment, the groove 76 is milled to achieve a smaller surface area and, consequently, a smaller effective size (effective area) of the sliding surfaces 42 and 46. This can reduce friction between the sliding surfaces 42 and 46.

[0061] The boundary line (contour) of the cross-section of groove 76 forms an arc. This creates a nearly straight, obtuse angle at the transition to the sliding surfaces 42 and 46. This prevents the formation of burrs.

[0062] In the medical clip 10 of the embodiment partially schematicly shown in Figures 13 to 15, only a single groove 76 is formed on each of the sliding surfaces 42 and 46. Each groove 76 extends parallel to or substantially parallel to the longitudinal direction 78 of the corresponding first box-lock web 34 or the longitudinal direction 80 of the second box-lock web 38. The cross-section of the groove 76 in this embodiment is also defined by a line defining the arc portion. This creates an obtuse angle close to a flat angle at the transition to the remaining sliding surfaces 42 and 46, where the size (effective area) is reduced. The portion where the sliding surfaces 42 and 46 contact each other on the common sliding plane 56 is reduced to the area of ​​the overlapping contact area 74. This reduces the friction between the sliding surfaces 42 and 46 compared to the case where there are no grooves 76.

[0063] In another embodiment schematically shown in Figures 9 to 11, two recesses 72 are formed in the first box-lock web 34 and the second box-lock web 38, respectively, in the form of chamfered portions 82 and 84. These chamfered portions 82 and 84 are formed on the sliding surfaces 42 and 46, respectively, and reduce the effective size (effective area) for sliding (contacting) each other. The area of ​​effective size (effective area) extends parallel to the sliding plane 56. As a result, only the narrow strip portion of the sliding surface 42 parallel to the sliding plane 56 and the narrow strip portion of the sliding surface 46 parallel to the sliding plane 56 remain on the closed second box-lock web 38. The chamfered portions 82 and 84 define inclined surfaces 86 and 88. The inclined surfaces 86 and 88 cooperate with the sliding plane 56 to surround an obtuse chamfer angle 90. The chamfer angle 90 has a value in the range of approximately 140° to approximately 175°. In the illustrated embodiment, the chamfer angle 90 is in the range of approximately 165° to approximately 172°.

[0064] As a result of forming the chamfered portions 82 and 84 as described above, only the narrow strip-shaped portions of the sliding surfaces 42 and 46 remain. The width of the narrow strip-shaped portions of the sliding surfaces 42 and 46 corresponds to approximately 1 / 3 of the width 92 of the first box lock web 34 and the second box lock web 38. In this way, the two sliding surfaces 42 and 46 can contact each other by surface contact only in the region defined by the contact overlap area 74. In Figures 12 and 12A, the contact overlap area 74 is schematically shown as the overlapping region of the remaining sliding surfaces 42 and 46. In Figure 12A, the contact overlap area 74 is represented by double hatching with dashed lines.

[0065] The projection area 94 of the first box-lock web 34 onto the sliding plane 56 defines the projection area 94 of the first box-lock web. The projection area 96 of the second box-lock web 38 onto the sliding plane 56 defines the projection area 96 of the second box-lock web. The projection areas 94 and 96 of the first and second box-lock webs overlap on the sliding plane 56, defining a projection overlap area 98. The projection overlap area 98 is schematically shown in Figures 12 and 12A, and is shown by double hatching in Figure 12A. On the other hand, the contact overlap area 74, which forms part of the projection overlap area 98, is shown by quadruple hatching by superimposing the double hatching of the projection overlap area 98 with the dashed double hatching described above.

[0066] In this embodiment, the two sliding surfaces 42, 46 of the sliding surface pair 50 each have at least one recess 72, specifically, recesses 72 in the form of two chamfered portions 82, 84, respectively. As a result, the effective area of ​​the sliding surfaces 42, 46 parallel to the sliding plane 56 is smaller than the projected area 94 of the first box lock web and the projected area 96 of the second box lock web projected onto the sliding plane 56 from the first box lock web 34 and the second box lock web 38. The ratio of the contact overlap area 74 to the projected overlap area 98 is in the range of about 1 / 25 to about 1 / 3. In the embodiment schematically shown in Figures 9 to 12, assuming that about one-third of the corresponding sliding surfaces 42, 46 parallel to the sliding plane 56 are removed by the two chamfered portions 82, 84, respectively, the ratio of the contact overlap area 74 to the projected overlap area 98 is about 1 / 9. The two remaining sliding surfaces 42, 46 are reduced from the original width 92 of the sliding surfaces 42, 46 (i.e., without considering the chamfered portions 82, 84) (without considering the two recesses 72) to one-third of the width of the first box-lock web projection area 94 and the width of the second box-lock web projection area 96, respectively. When the sliding surfaces 42, 46 come into contact with each other, the product of the remaining sliding surfaces 42, 46 (each reduced to about one-third of its original size) results in a contact overlap area 74 that is only about one-ninth of the size of the projected overlap area 98.

[0067] When considering the formation of at least one recess 72 in one of the two engaging (cooperative) sliding surfaces in at least one pair of sliding surfaces 50, 52, 54, the above-described idea for reducing the size of the overlapping contact area 74 is also applicable to other forms of recesses 72. Thus, even when the groove 76 is formed in the lateral (perpendicular) direction to the longitudinal directions 78, 80, the sliding surfaces 42, 46 can be reduced in a similar manner. In this case, instead of only a single overlapping contact area 74 being formed, multiple smaller overlapping contact areas 74 are formed. In this case, the total area of ​​these overlapping contact areas 74 will be a value that has a ratio of about 1 / 25 to about 1 / 3 of the projected overlapping area 98 determined as described above. A similar idea can be obtained for grooves 76 extending parallel to the longitudinal directions 78, 80. In this case, four overlapping contact areas 74 are generated as the two strip-shaped portions remaining on each of the sliding surfaces 42, 46, separated from each other by the groove 76, come into contact with each other. In this case, the ratio of the total area of ​​the four contact overlapping areas (74) to the projected overlapping area (98) is between approximately 1 / 25 and approximately 1 / 3.

[0068] Figures 16 to 18 schematically show the connecting portions 26 and 28 of the clip 10. In this embodiment, a plurality of recesses 72 are formed on the sliding surfaces 42 and 46, specifically in the form of hollow spherical portions 100. In the illustrated embodiment, the depth of the recesses 72 is substantially smaller than the radius of the hollow spherical portion 100. In particular, the hollow spherical portion 100 may have the shape of a hollow hemisphere. In this embodiment as well, the recesses 72 are milled so that a nearly flat (approximately flat angle) obtuse angle is obtained at the transition portion to the remaining sliding surfaces 42 and 46.

[0069] In this embodiment as well, the remaining sliding surfaces 42, 46 that take the recess 72 into account (excluding the recess 72) are significantly reduced compared to the sliding surfaces 42, 46 that do not take the recess 72 into account (when the recess 72 is not present). As described above, the first box-lock web projected area 94 and the second box-lock web projected area 96 on the sliding plane 56 are generated without considering the recess 72. When the recess 72 in the form of the hollow spherical portion 100 is considered, only the contact overlap area 74 remains on the sliding surfaces 42, 46 that abut each other. The contact overlap area 74 has a size such that the ratio of the contact overlap area 74 to the projected overlap area 98 is in the range of approximately 1 / 25 to approximately 1 / 3.

[0070] Alternatively, at least one recess 72 may be formed by a boxlock web perforation (boxlock web through-hole) that penetrates the first boxlock web 34 or the second boxlock web 38. If such a boxlock web perforation has a circular cross-section, it will have a shape similar to that in Figures 16 and 18 on the sliding surfaces 42, 46.

[0071] In the embodiments shown in Figures 3-4, 9-11, and 16-18, at least one of the two mutually engaging (cooperative) sliding surfaces 42, 46 in the pair of sliding surfaces 50 has a plurality of recesses 72.

[0072] In the embodiments shown in Figures 3-4 and 16-18, the multiple recesses 72 have the same configuration.

[0073] In embodiments not shown, at least some of the plurality of recesses 72 may be configured differently, for example, in shape and / or size.

[0074] In the embodiments described above, it is provided that each of the two sliding surfaces 42 and 46 that engage (cooperate) with each other in the pair of sliding surfaces 50 is provided with at least one recess 72.

[0075] When at least one recess 72 is not taken into account (assuming no recess 72 is provided), the widths 92 of the first box lock web 34 and the second box lock web 38 are in the range of about 0.9 mm to about 2.1 mm with respect to the lateral (vertical) direction relative to the corresponding longitudinal directions 78, 80. For example, the clip 10 may have different sizes overall. As a result, the widths 92 of the first box lock web 34 and the second box lock web 38 are ultimately determined by the diameter of the wire forming the initial material for manufacturing the clip 10, and may be, for example, about 1 mm, about 1.2 mm, or about 1.7 mm.

[0076] As schematically shown in Figures 1 and 2, the first clamp arm 14 and the second clamp arm 16 are as close to each other as possible in the basic position of the clip 10. Figures 1 and 2 show an example of a clip 10 in which the first clamp arm 14 and the second clamp arm 16 are in contact with each other in the basic position.

[0077] The first clamp arm 14 and the second clamp arm 16 can be moved away from each other from their basic position to an open position against the action (biasing force) of the biasing element 12. This allows the sac-like projection of the hollow organ to be introduced between the clamping surface 102 of the first clamp arm 14 and the clamping surface 104 of the second clamp arm 16 and clamped. This is done, for example, by releasing the clip 10. This allows the biasing element 12 to apply a biasing force that presses the clamping surface 102 of the first clamp arm 14 and the clamping surface 104 of the second clamp arm 16 against each other.

[0078] The first clamp arm 14 extends in the direction from the end 22 of the first clamp arm toward the free end 106. The second clamp arm 16 extends in the direction from the end 24 of the second clamp arm toward the free end 108.

[0079] In the clip 10 of the embodiments shown in Figures 1 and 2, the first clamp arm 14 and the second clamp arm 16 extend in a straight line. In alternative embodiments not shown, the first clamp arm 14 and the second clamp arm 16 may have a curved or bent shape. In this case, it is necessary to ensure that the clamp surfaces 102, 104 in the basic position abut each other in surface contact over substantially the entire length from the end 22 of the first clamp arm or the end 24 of the second clamp arm to the free ends 106, 108.

[0080] In the embodiments shown in Figures 1 and 2, the biasing element 12 is configured in the form of a coil spring 110 having at least one winding. In the embodiments of Figures 1 and 2, the coil spring 110 has about 1.5 windings.

[0081] In all embodiments, the medical clip 10 is configured in the form of an aneurysm clip 112.

[0082] The clip 10 is made of a metallic material. In the illustrated embodiment, the clip 10 is made of titanium or a titanium-containing alloy (e.g., Ti6Al4V).

[0083] The clip 10 made from the above metal material has sliding surfaces 42, 44, 46, 48 (and 68, 70) made from the metal material (e.g., titanium or titanium-containing alloy).

[0084] At least one of the sliding surfaces 42, 44, 46, 48 (and 68, 70) forming the sliding surface pairs 50, 52 (and 54) is provided with a coating layer in a manner not described in detail. In particular, at least one of the sliding surfaces in each sliding surface pair 50, 52 (and 54) is provided with a coating layer. Such a coating layer is an arbitrary configuration of the clip 10. For example, only one of the sliding surfaces 42, 46, or both of the sliding surfaces 42, 46, may be provided with a coating layer. This configuration can also be applied accordingly to another sliding surface pair 52 (and 54).

[0085] The coating layer is preferably configured to reduce friction.

[0086] When metal materials are used in the manufacture of the clip 10, the coating layer is preferably composed of an oxide layer (oxide film). In the case of the clip 10 made from titanium or a titanium-containing alloy, the oxide layer is preferably a titanium oxide layer.

[0087] The oxide layer for coating the sliding surfaces 42, 44, 46, 48 (and 68, 70) is preferably formed by electrochemical treatment (anodic oxidation).

[0088] Figures 7 and 19 schematically show clips 10 of another embodiment having a single box lock 62. In the embodiment of Figure 7, similar to the embodiment of Figure 5, recesses 72 are provided on both sliding surfaces 42 and 46 that cooperate to form the pair of sliding surfaces 50. In the embodiment of Figure 7, recesses 72 are also provided on both sliding surfaces 44 and 48 that cooperate to form the pair of sliding surfaces 52. In contrast, in the embodiment of Figure 5, the sliding surfaces 44 and 48 that engage (cooperate) with each other are configured not to have recesses 72. In the embodiment of Figure 19, recesses 72 are formed only on the sliding surfaces 42 and 48, and the sliding surfaces 44 and 46 are configured not to have recesses 72. Therefore, in the embodiment of Figure 19, each pair of sliding surfaces 50 and 52 has only one sliding surface 42 and 48, each having at least one recess 72.

[0089] A common feature of the embodiments in Figures 5, 7, and 19 is that at least one pair of sliding surfaces 50, 52 has at least one sliding surface (sliding surfaces 42, 46, sliding surfaces 42, 46, 44, 48, or sliding surfaces 42, 48) with at least one recess 72.

[0090] In the embodiments shown in Figures 5, 7, and 19, the first boxlock web 36 of the first connection portion 26 is formed by a so-called boxlock plate 114. The boxlock plate 114 is inserted into and welded to two setback portions (stepped recessed portions) 116 in the first connection portion 26. The boxlock plate 114 is inserted and welded after the clip 10 is formed by reforming a wire-like blank (initial material).

[0091] Figures 6 and 8 schematically show modified clips 10 having a double box lock 64. In the embodiment of Figure 6, the sliding surfaces 46, 44, and 68 are configured without recesses 72. In contrast, the sliding surfaces 42, 48, and 70 have recesses 72. Thus, at least one of the two sliding surfaces in each pair of sliding surfaces 50, 52, and 54 is provided with at least one recess 72.

[0092] In the embodiment schematically shown in Figure 8, at least one recess 72 is provided on all six sliding surfaces 42, 44, 46, 48, 68, and 70. Therefore, in this embodiment as well, at least one recess 72 is provided on each of the sliding surfaces 42, 44, 46, 48, 68, and 70 that form the sliding surface pairs 50, 52, and 54.

[0093] In the embodiments shown in Figures 2, 6, and 8, the first box lock web 36 and the second box lock web 40 are configured in the form of a box lock plate 114. Similar to the above description relating to the single box lock 62 (Figures 5, 7, and 19), the box lock plate 114 is inserted into and welded to dedicated setback portions (stepped recesses) provided on the two connecting portions 26 and 28, in a manner not shown in detail.

[0094] The medical clip 10 of the embodiments described above is for illustrative purposes only and is not exhaustive. In particular, the number, shape, and size of the recesses 72 shown and described are interchangeable and can be changed to any desired configuration. For example, a groove 76 may be formed on one sliding surface, and one or two chamfered portions 82, 84 or one or more hollow spherical portions 100 may be formed on the other sliding surface. Alternatively, a pair of sliding surfaces 50, 52, 54 may be formed by combining one sliding surface having a groove 76 parallel to the longitudinal directions 78, 80 and the other sliding surface having a groove 76 extending laterally (perpendicularly) to the longitudinal directions 78, 80.

[0095] In particular, in the schematic cross-sectional views shown in Figures 5 to 8 and Figure 19, the schematicly depicted recesses 72 serve only as placeholders. In these embodiments, grooves, chamfers, and / or hollow spherical portions, as well as other forms, can be provided to create the recesses 72.

[0096] In the medical clip 10 of the above-described embodiment, desirable friction reduction is achieved, in particular, when the ratio of the contact overlap area 74 to the projected overlap area 98 is in the range of about 1 / 25 to about 1 / 3, preferably in the range of about 1 / 25 to about 1 / 4. The shape and size of the medical clip 10 are selected according to the selection and configuration of the recess 72 so that the sliding surfaces that engage (cooperate) with each other are sufficiently large to satisfy this specified range of ratios.

[0097] By providing at least one recess 72 on at least one of the sliding surfaces 42, 44, 46, 48, 68, 70 of the sliding surface pairs 50, 52, 54 of the clip 10, the contact overlap area 74 is reduced relative to the projected overlap area 98, thereby reducing the transition from static friction to dynamic friction in at least one of the sliding surface pairs 50, 52, 54. As a result, as described at the beginning, the repeatability accuracy in measuring the closing force of the clip 10 is improved, or the repeatability uncertainty is reduced in a desirable manner. [Explanation of symbols]

[0098] 10 clips 12 biasing factors 14. First clamp arm 16. Second clamp arm 18 First end 20 Second end 22 First clamp arm end 24. Second clamp arm end 26. First connection section 28 Second connection section 30 Box Locks 32 First box lock opening 34 First Box Lock Web 36. First Box Lock Web 38. Second Box Lock Web 40 Second Box Lock Web 42 Female sliding surface 44 Female sliding surface 46 Male side sliding surface 48 Male side sliding surface 50 Sliding surface 52 Sliding surface 54 Sliding surface 56 Sliding plane 58 Sliding plane 60 Sliding plane 62 Single Box Lock 64 Double Box Lock 66 Second box lock opening 68 Female sliding surface 70 Male side sliding surface 72 recesses 74 Contact overlap area 76 Groove 78 Longitudinal direction 80 Longitudinal direction 82 Chamfered section 84 Chamfered section 86 Slope 88 Slope 90-degree chamfer angle 92 width 94 First Boxlock Web Projection Area 96 Second Boxlock Web Projection Area 98 Projected overlap area 100 Hollow sphere 102 Clamping surface 104 Clamping surface 106 Free end 108 Free end 110 Coil spring 112 Aneurysm Clip 114 Box Lock Plate

Claims

1. A medical clip (10) in the form of an aneurysm clip, comprising a first clamp arm (14), a second clamp arm (16), and a biasing element (12) having a first end (18) and a second end (20), The first clamp arm (14) has a first clamp arm end (22) connected to the first end (18) of the biasing element (12) via a first connecting portion (26), The second clamp arm (16) has a second clamp arm end (24) connected to the second end (20) of the biasing element (12) via a second connecting portion (28), The medical clip (10) is equipped with a box lock (30) having a first connecting portion (26) and a second connecting portion (28) that engage with each other. The aforementioned box lock (30) is At least one first box lock opening (32) is located on or formed on the first connection portion (26) and is defined by two first box lock webs (34, 36), It comprises the second connecting portion (28) and at least one second box lock web (38) that penetrates the first box lock opening (32), The first box lock opening (32) comprises two female sliding surfaces (42, 44; 48, 68) facing each other, The at least one second box lock web (38) comprises two male sliding surfaces (46, 48; 44, 70) facing away from each other and each facing the female sliding surface (42, 44), At least two pairs of sliding surfaces (50, 52, 54) are formed, each having a female sliding surface (42, 44; 48, 68) and a male sliding surface (46, 48; 44, 70), In each of the aforementioned pairs of sliding surfaces (50, 52, 54), the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) that engage with each other are arranged to extend parallel to each other, defining a single sliding plane (56, 58, 60). The first box-lock web projection area (94) defined by the vertical projection of the first box-lock web (34, 36) onto the sliding plane (56, 58, 60) and the second box-lock web projection area (96) defined by the vertical projection of at least one second box-lock web (38, 40) onto the sliding plane (56, 58, 60) overlap each other to define a projection overlap area (98). At least one of the at least two pairs of sliding surfaces (50, 52, 54), in particular, in each, at least one of the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) that engage with each other, has at least one recess (72), defined by the first box lock web (34, 36) or the second box lock web (38, 40) having the at least one recess (72), The effective area of ​​the female sliding surface (42, 44; 48, 68) or the male sliding surface (46, 48; 44, 70) parallel to the sliding plane (56, 58, 60) is smaller than the projected area of ​​the first boxlock web (94) or the second boxlock web (96) projected onto the sliding plane (56, 58, 60) from the first boxlock web (34, 36) or the second boxlock web (38, 40) having at least one recess (72), At least one, in particular, in each of the aforementioned pair of sliding surfaces (50, 52, 54), the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) that are able to abut each other or are in surface contact with each other define a contact overlap area (74), The ratio of the contact overlap area (74) to the projected overlap area (98) is in the range of approximately 1 / 25 to approximately 1 / 3. A medical clip characterized by the following features.

2. The medical clip according to claim 1, characterized in that the at least one recess (72) is configured in the form of a groove (76) or chamfered portion (82, 84) in the female sliding surface (42, 44; 48, 68) or the male sliding surface (46, 48; 44, 70).

3. The medical clip according to claim 2, characterized in that the groove (76) or the chamfered portion (82, 84) extends parallel to or substantially parallel to the longitudinal direction (78, 80) defined by the corresponding first boxlock web (34, 36) or the second boxlock web (38, 40).

4. The chamfered portions (82, 84) define the inclined surfaces (86, 88), The inclined surfaces (86, 88) work together with the sliding planes (56, 58, 60) to define an obtuse chamfer angle (90). In particular, the medical clip according to claim 2 or claim 3, characterized in that the chamfer angle (90) is a value within the range of approximately 140° or more and approximately 175° or less, and especially within the range of approximately 165° or more and approximately 172° or less.

5. The medical clip according to any one of claims 2 to 4, characterized in that the groove (76) extends laterally, particularly perpendicularly, with respect to the longitudinal direction (78, 80) defined by the corresponding first boxlock web (34, 36) or the second boxlock web (38, 40).

6. The medical clip according to any one of claims 1 to 5, characterized in that the at least one recess (72) is configured in the form of a hollow spherical portion (100), particularly in the form of a hollow hemispherical portion.

7. The at least one recess (72) is formed by a boxlock web perforation that penetrates the first boxlock web (34, 36) or the second boxlock web (38, 40), In particular, the medical clip according to any one of claims 1 to 6, characterized in that the box lock web perforation has a circular cross-section.

8. At least one of the two pairs of sliding surfaces (50, 52, 54), in particular, in each of them, at least one of the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) that engage with each other has a plurality of recesses (72), especially, (a) The plurality of recesses (72) have the same configuration, or (b) The medical clip according to any one of claims 1 to 7, characterized in that at least a portion of the plurality of recesses (72) are different in particular in shape and / or size.

9. A medical clip according to any one of claims 1 to 8, characterized in that both the female sliding surface (42, 44; 48, 68) and the male sliding surface (46, 48; 44, 70) of each of the sliding surface pairs (50, 52, 54) are provided with at least one recess (72).

10. A medical clip according to any one of claims 1 to 9, characterized in that the width (92) of the first boxlock web (34, 36) and the second boxlock web (38, 40) when the at least one recess (72) is not taken into consideration is in the range of about 0.9 mm to about 2.1 mm in the transverse direction with respect to the longitudinal direction (78, 80) defined by the corresponding first boxlock web (34, 36) or the second boxlock web (38, 40).

11. (a) The box lock (30) is configured as a single box lock (62), and the second connecting portion (28) comprises only one second box lock web (38), or (b) The box lock (30) is configured as a double box lock (64), and the second connecting portion (28) comprises two second box lock webs (38, 40), the two second box lock webs (38, 40) define a second box lock opening (66) from the side, one of the two first box lock webs (34, 36) penetrates the second box lock opening (66), and one of the two second box lock webs (38, 40) penetrates the first box lock opening (32), A medical clip according to any one of claims 1 to 10, characterized in that it is a medical clip.

12. The first clamp arm (14) is configured to be straight, curved, or bent from the end (22) of the first clamp arm to the free end (106). The medical clip according to any one of claims 1 to 11, characterized in that the second clamp arm (16) is configured to be straight, curved, or bent from the end (24) of the second clamp arm to the free end (108).

13. (a) The medical clip (10) is made of a metallic material, in particular titanium or a titanium-containing alloy, in particular Ti6Al4V, and / or (b) The medical clip according to any one of claims 1 to 12, characterized in that the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) are made of a metallic material, particularly titanium or a titanium-containing alloy.

14. The medical clip according to any one of claims 1 to 13, characterized in that the first boxlock web (34, 36) and / or the second boxlock web (38, 40) have a rectangular cross-sectional shape when the at least one recess (72) is not taken into consideration.

15. A coating layer is provided on at least one of the female sliding surfaces (42, 44; 48, 68) and the male sliding surfaces (46, 48; 44, 70) of one pair of sliding surfaces (50, 52, 54), particularly on one or both of the sliding surfaces. especially, (a) The coating layer is configured to reduce friction and / or (b) The medical clip according to any one of claims 1 to 14, wherein the coating layer is composed in the form of an oxide layer, and in particular the oxide layer is an electrochemically treated film.

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