Surgical clip applier

Abstract

The present invention relates to a surgical clip applier including: an operation member; a guide member which has one end mounted on the operation member and extends in hollow tubular form from the operation member: a case disposed inside the guide member and accommodating a clip therein; a movement member for moving the clip disposed inside the case to the other end of the guide member according to manipulation of the operation member; and a jaw member which includes a first sub-jaw and a second sub-jaw, facing each other, and which is configured so that the clip moved to the other end of the guide member by the movement member is separated or fixed between the first sub-jaw and the second sub-jaw as the first sub-jaw and the second sub-jaw approach or move away from each other, wherein the surgical clip applier further comprises: an opening and closing mechanism for applying a force to the jaw member so that the first sub-jaw and the second sub-jaw approach or move away from each other according to the manipulation of the operation member; and, in addition to and separately from the opening and closing mechanism, a forced opening mechanism for applying a physical force to the jaw member so that the first sub-jaw and the second sub-jaw move away from each other according to the manipulation of the operation member.

Description

Surgical clip applicator

[0001] The present invention relates to a surgical clip applier, and more particularly, to a surgical clip applier that is a device for sequentially supplying a plurality of medical clips to a surgical site for ligation of blood vessels or tissues in open surgery or laparoscopic surgery, and that allows the clip applier to be opened by an external operation of a user even when the ligation-used tool does not open while engaged after ligation is performed.

[0002] Medical clips can be used to grasp or ligate longitudinally extending organs, such as blood vessels or the appendix, during surgical procedures within the human body. For example, clips are used to grasp, ligate, or control bleeding in the appendix or blood vessels during an appendectomy.

[0003] Recently, automatic appliers have been developed to replace the conventional manual type applier, which uses polymer clips for vascular ligation, one by one, and then supplies them to the surgical site. Unlike conventional manual appliers, automatic appliers have cartridges equipped with multiple clips, and polymer clips are automatically supplied during surgery, minimizing trocar entry and shortening surgical time.

[0004] An example of such an automatic type clip applier is disclosed in Patent Document 1. As illustrated in FIG. 22, the clip applier disclosed in Patent Document 1 includes an operating member (10), a guide member (20) extending from the operating member (10), an operating coupler (21) formed at an end of the guide member (20), and a jaw member (30) provided at an end side of the operating coupler (21). In addition, the operating member (10) includes a handle portion (11) gripped by a user, a trigger (15) operated by a user's finger, and a knob (14) that rotates by the operation of the trigger (15).

[0005] When the user pulls the trigger (15) to a certain extent, one of the plurality of clips (100) provided inside the guide member (20) is moved to the tip of the guide member (30) by a non-illustrated moving member inside the guide member (20), and the moved clip (100) is fixed at both ends by the fixed parts of a pair of sub-joints (31, 32) as shown in (a) of FIG. 23.

[0006] And, in this state, when the user further pulls the trigger (15), as shown in (b) of Fig. 23, the operating coupler (21) moves forward, applying force to the joint member (30) in the direction in which the pair of sub-joints (31, 32) close. This strongly presses the clip (100) held by the pair of sub-joints (31, 32) in the up-and-down direction, thereby causing the clip (100) to be coupled, thereby ligating the blood vessel and tissue.

[0007] After the blood vessel and tissue are ligated by the clip (100), the trigger (15) returns, the operating coupler (21) also returns to its original position, and accordingly, the pair of sub-joints (31, 32) are moved away from each other again by a joint spring or the like as shown in (a) of Fig. 23. Through this, the joint member (30) is separated from the clip (100) on which ligation has been performed, allowing the guide member (20) to be removed from the previous operation location, and the clip (100) can be supplied again at the next operation location to prepare for ligation.

[0008] (Patent Document 1) Republic of Korea Patent No. 10-2292116 (August 20, 2021)

[0009]

[0010] As illustrated in Fig. 23, in order to position the clip (100) at the surgical position, the surgical clip applicator must have a pair of sub-jaws (31, 32) in an open state, and in order to ligate a blood vessel or the like using the clip (100) at the surgical position, the pair of sub-jaws (31, 32) in an open state must be switched to an interlocked state. In addition, after the ligamentation is performed, in order to separate the jaw member (30) from the clip (100) and to allow the guide member (20) to be removed from the previous surgical position, the pair of sub-jaws (31, 32) must be switched from an interlocked state to an open state again.

[0011] However, if, after the operating coupler (21) moves forward to switch to a state where a pair of sub-joints (31, 32) are engaged with each other, some of the mechanisms for operating the operating coupler (21) are damaged or components are detached, making it impossible to retract the operating coupler (21), there may be cases where it is impossible to switch from a state where a pair of sub-joints (31, 32) are engaged to an open state.

[0012] In particular, if the above-mentioned problem occurs during an endoscopic procedure, the endoscopic procedure must be converted to an open surgery in order to separate the clip (100) and the clip applier in a ligated state, which may pose a great risk to the patient's safety.

[0013] In addition, as illustrated in the above-described Fig. 22, in the case of a conventional clip applier, the loading step of the clip (100) between a pair of sub-joints (31, 32) and the step of attaching the clip (100) to a blood vessel, etc. are sequentially performed by a single action of pulling the trigger (15). Therefore, if the transition between the loading step and the ligation step is not accurately recognized by the user, and the user carelessly pulls the trigger (15) hard, the loading and ligation are performed in an instant, and the clip (100) becomes engaged before reaching the surgical site. In this case, the distal end of the clip applier needs to be pulled out of the patient's body again in order to discard the engaged clip (100) and load a new clip, which unnecessarily increases the surgical time. Therefore, a means is required to accurately recognize the transition between the loading step and the ligation step by sight, hearing, touch, etc., for the user.

[0014] In particular, the jaw holder (41) that is fastened to a pair of sub-jaws (31, 32) and a movable member inside the guide member (20) to apply elastic force, and the U-shaped clip (42) that is fastened to a pair of sub-jaws (31, 32) and a case (40) inside the guide member (20) are designed in a structure in which the fastening part is likely to come off, so that when the product is moved, dropped, or impacted, it may come off from its original position, causing a problem in which the applicator malfunctions or the dislodged part falls on the surgical site of the patient.

[0015] Additionally, if the user is not aware of the exact number of clips stored inside the clip applier, the user may not be able to clearly recognize the time to replace the medical device during surgery, which may result in wasted time for replacement.

[0016] The present invention has been devised to solve the problems of the above-mentioned prior art, and aims to provide a clip applier that can separate a clip and a clip applier in a ligated state even when a pair of sub-joints cannot be switched from an interlocked state to an open state after ligation by a clip.

[0017] In order to solve the above-described problem, the clip applier according to the present invention comprises: an operating member; a guide member having one end mounted on the operating member and extending from the operating member in a hollow tubular shape; a case disposed inside the guide member and housing a clip therein; a moving member for moving the clip disposed inside the case to the other end of the guide member according to the operation of the operating member; The invention relates to a surgical clip applicator, comprising a first sub-task and a second sub-task facing each other, and a jaw member configured such that a clip moved to the other end of a guide member by a moving member is separated or fixed between the first sub-task and the second sub-task by approaching or moving away from each other, characterized in that, in addition to having an opening / closing mechanism for applying a force to the jaw member so that the first sub-task and the second sub-task approach or move away from each other according to the operation of an operating member, the invention further comprises a forced opening mechanism, separate from the opening / closing mechanism, for applying a physical force to the jaw member so that the first sub-task and the second sub-task move away from each other according to the operation of the operating member.

[0018] Preferably, the opening / closing mechanism may include an elastic member that applies an elastic force in a direction in which the first sub-joule and the second sub-joule move away from each other, and when the guide member moves forward according to the operation of the operating member, the first sub-joule and the second sub-joule may approach each other against the elastic force by the guide member, and when the guide member moves backward according to the operation of the operating member, the first sub-joule and the second sub-joule may move away from each other by the elastic force.

[0019] As an example of a desirable forced opening mechanism, it includes a protrusion provided on the inner surface of the guide member, and when the guide member moves rearward according to the operation of the operating member, the protrusion passes through the gap between the first sub-joint and the second sub-joint, thereby applying force to the first sub-joint and the second sub-joint so that the first sub-joint and the second sub-joint move away from each other.

[0020] As another example of a preferred forced opening mechanism, a first plate member is provided inside a plate rail and a guide member formed in at least one of the first sub-jaw and the second sub-jaw, and has a plate pin inserted into the plate rail at one end and the other end extending to the operating member, and when the other end of the first plate member is manipulated to move the first plate member rearward, the plate pin moves along the plate rail, thereby applying a force to the jaw member so that the first sub-jaw and the second sub-jaw move away from each other.

[0021] As another example of a desirable forced opening mechanism, a first gear portion formed in at least one of the first sub-jaw and the second sub-jaw and provided inside the guide member, the second gear portion meshing with the first gear portion at one end, and the second plate having the other end extending to the operating member are provided, and when the other end of the second plate is manipulated so that the second plate moves rearward, the first gear portion meshing with the second gear portion rotates, thereby applying a rotational force to the jaw member so that the first sub-jaw and the second sub-jaw move away from each other.

[0022] Preferably, the forced opening mechanism further comprises a wire portion having one end connected to the guide member and the other end extending to the operating member, and by manipulating the other end of the wire portion, the guide member can be forcibly withdrawn rearward. Alternatively, preferably, the mechanism further comprises a knob that is provided to be relatively movable to the operating member, and the knob is fixed to the guide member, and by manipulating the knob, the guide member can be forcibly withdrawn rearward.

[0023] Preferably, the operating member has a handle portion that can be held by a user and a trigger that is provided on the handle portion and operates the guide member and the movable member by being pulled by the user, and the trigger can be configured to perform, in stages, a first step of moving the movable member forward to move the clip to the jaw member and seat it, and a second step of moving the guide member forward to engage the first sub-joint and the second sub-joint of the jaw member with the clip to fasten the clip, depending on the degree of manipulation of the trigger.

[0024] Preferably, the device may include a first trigger that is slidably operated in the forward and backward direction so that the first step is performed, and a second trigger that is positioned below the first trigger and is operated to rotate around a predetermined rotation axis so that the second step is performed.

[0025] Preferably, the trigger is configured to rotate around a predetermined rotation axis according to a user's operation, and the trigger is provided on a rotation path during rotation and has an indicator member that rotates integrally with the trigger, and the indicator member is configured such that at least a portion of the indicator member is exposed to the outside of the handle portion before the trigger is operated, and the indicator member is inserted into the inside of the handle portion when the trigger is rotated so that the first step is performed.

[0026] Preferably, the trigger is configured to rotate around a predetermined rotation axis according to a user's operation, and the trigger has a sub-trigger and a main trigger that rotates coaxially with the sub-trigger and is positioned rotationally rearward of the sub-trigger, and the sub-trigger is configured to rotate first by the user's operation so that a first step is performed, and the sub-trigger and the main trigger are configured to rotate simultaneously by the user's operation so that a second step is performed, and the main trigger is configured to have a thickness dimension larger than that of the sub-trigger so that at least a part of the sub-trigger is accommodated inside the main trigger when the trigger is operated to perform the second step.

[0027] Preferably, the clip applier further includes a pair of jaw holders having one end fixed to one side of the movable member and the other end connected to the ends of the first sub-jaw and the second sub-jaw, respectively, and the jaw holder-side ends of the jaw holders are bent so that a cross-section perpendicular to the longitudinal direction of the jaws has a T-shape, so that the ends of the first sub-jaw and the second sub-jaw pass through the T-shaped internal space and engage with the jaw holders.

[0028] Preferably, the clip applier according to the present invention further includes a U-shaped clip having a pair of corners, one end of which is fixed to the other side of the case and the other end of which is connected to the ends of the first sub-joule and the second sub-joule, respectively, and the case may have a ring portion protruding from the other side, and the U-shaped clip may have a hole portion that is fitted into the ring portion.

[0029] Preferably, the operating member may further be provided with a clip counter that displays the number of clips remaining in the case externally by rotating clockwise by rearward movement of the moving member linked to the operation of the operating member.

[0030]

[0031] According to the surgical clip applier according to the present invention, in addition to an opening / closing mechanism for applying force to a jaw member for loading and ligation, a forced opening mechanism is provided so that a pair of sub-jaws can be forced to open each other by an external operation, thereby enabling the clip and clip applier in a ligated state to be easily separated even when the pair of sub-jaws cannot be switched from an engaged state to an open state after ligation by the clip is performed.

[0032] According to the surgical clip applicator of the present invention, by providing a means for allowing the user to accurately recognize the transition between the loading step and the ligation step through sight, hearing, touch, etc., there is an effect of helping the user clearly recognize the timing of each step and perform it appropriately.

[0033] According to the surgical clip applier according to the present invention, in order to prevent the detachment of the jaw holder (41) that is connected to a pair of sub-jaws (31, 32) and a moving member (50) inside a guide member (20) to apply elastic force, and the U-shaped clip (42) that is connected to a pair of sub-jaws (31, 32) and a case (40) inside the guide member (20), a T-shaped structure is applied to the part connected to the sub-jaw in the case of the jaw holder, and a ring is applied to the part connected to the case in the case of the U-shaped clip, so that the product does not detach from its original position when movement, dropping, impact, etc. of the product occurs.

[0034] According to the surgical clip applier according to the present invention, a counter is provided that can easily check the number of clips remaining inside the clip case of the clip applier, thereby enabling the user to clearly recognize the time of replacement of the medical device during surgery.

[0035]

[0036] FIG. 1 is a drawing illustrating a clip applier according to a preferred embodiment of the present invention.

[0037] FIG. 2 is a drawing showing an exposed part of the internal part of the operating member of the clip applier illustrated in FIG. 1.

[0038] Fig. 3 is a drawing showing a part of the clip applier's jaw member and guide member shown in Fig. 1.

[0039] FIG. 4 is a drawing showing the opening and closing state of a joint member according to the operation of an opening and closing mechanism and a forced opening mechanism according to one embodiment of the present invention.

[0040] FIG. 5 is a drawing showing a portion of an operating member and a knob exposed to explain a forced withdrawal mechanism of an inductive member according to one embodiment of the present invention.

[0041] FIG. 6 is a drawing showing an exposed portion of the interior of an operating member to explain a forced withdrawal mechanism of an inductive member according to another embodiment of the present invention.

[0042] FIGS. 7A and 7B are drawings showing an exposed portion of an internal portion of an inductive member to explain a forced opening mechanism according to another embodiment of the present invention.

[0043] Fig. 8 is a drawing showing the opening and closing state of the joint member according to the operation of the forced opening mechanism shown in Fig. 7a.

[0044] FIG. 9 is a drawing showing an internal portion of the guide member and knob exposed to explain the forced opening mechanism according to the embodiment shown in FIG. 7.

[0045] FIG. 10 is a drawing showing an exposed portion of the interior of an induction member to explain a forced opening mechanism according to another embodiment of the present invention.

[0046] FIG. 11 is a drawing showing an internal portion of an operating member exposed to explain a forced opening mechanism according to the embodiment shown in FIG. 10.

[0047] FIG. 12 is a drawing showing a preferred embodiment of a clip applier according to the present invention and an embodiment in which a clip is fixed to a joint member of the clip applier.

[0048] Figure 13 is a drawing showing the operating state of the trigger according to the pre-trigger operation stage, loading stage, and ligation stage.

[0049] FIG. 14 is a drawing showing an exposed portion of an internal portion of an operating member of a clip applier having a dual trigger according to one embodiment of the present invention.

[0050] FIG. 15 is a drawing showing an operating member of a clip applier having a dual trigger according to another embodiment of the present invention.

[0051] FIG. 16 is a drawing showing a jaw holder provided in a clip applier according to a preferred embodiment of the present invention.

[0052] Fig. 17 is a drawing showing an internal portion of an inductive member exposed to explain a state in which the holder shown in Fig. 16 is equipped on a clip applier.

[0053] FIG. 18 is a drawing illustrating a U-shaped clip provided in a clip applier according to a preferred embodiment of the present invention.

[0054] Fig. 19 is a drawing showing an exposed portion of the inner part of the guide member to explain the state in which the U-shaped clip shown in Fig. 18 is equipped on the clip applier.

[0055] FIG. 20 is a drawing showing an internal part of an operating member of a clip applier according to a preferred embodiment of the present invention and an exploded view showing the main part of a clip counter provided in the operating member.

[0056] Fig. 21 is a drawing for explaining the operation of the clip counter shown in Fig. 20.

[0057] Fig. 22 is a drawing showing a clip applier according to the prior art.

[0058] Figure 23 is a drawing showing a part of the joint member and the guide member to explain the loading step and the ligation step of the clip.

[0059]

[0060] What each symbol represents is as follows:

[0061] 10: Operating member 11: Main body

[0062] 12: Handle 13: Head

[0063] 14: Knob 15: Trigger

[0064] 16: Display section 17: Drive section

[0065] 20: Inductive member 21: Actuating coupler

[0066] 22: Protrusion 23: Fixing hole

[0067] 30: Absence of Joe 31: 1st Sub Joe

[0068] 32: Second sub-section 33: Plate rail

[0069] 40: Case 41: Joe Holder

[0070] 42: U-shaped clip 43: Hook

[0071] 50: Moving member 51: Guide home

[0072] 60: First plate 61, 62: Plate pin

[0073] 63: Support section 70: Second plate

[0074] 71: Second gear section (first rack gear) 72: Second rack gear

[0075] 73: 2nd pinion gear 74: 3rd rack gear

[0076] 80: Wire section

[0077]

[0078] Hereinafter, embodiments of surgical clip applicators according to the present invention will be described in detail with reference to the attached drawings. If it is determined that a description of a known technology related to the present invention may obscure the gist of the present invention, a detailed description of the known technology will be omitted.

[0079] The surgical clip applier according to the present invention comprises, as illustrated in FIGS. 1 to 7, an operating member (10) that is held by a user and receives the user's manipulation, a guide member (20) having one end mounted on the operating member (10) and extending from the operating member in a hollow tube shape, a case (40) disposed inside the guide member (20) and having a clip (100) accommodated therein, a moving member (50) for moving the clip (100) disposed inside the case (40) to the other end of the guide member (20) according to the manipulation of the operating member (10), and a first sub-joint (31) and a second sub-joint (32) facing each other, and the clip (100) moved to the other end of the guide member (20) by the moving member (50) is separated between the first sub-joint (31) and the second sub-joint (32) by approaching or moving away from each other. It includes a joint member (30) configured to be fixed.

[0080] As illustrated in FIGS. 1 and 5, the guide member (20) has a hollow tubular shape with a circular or square cross-section, and one end facing the operating member (10) extends through the knob (14) to the inside of the operating member (10). As described below, one end of the guide member (20) extending to the inside of the operating member (10) is connected to the tip of the hollow guide tube (5). In addition, a pin member (14a) protruding from the inner surface of the knob (14) in a direction perpendicular to the longitudinal direction of the guide member (20) is preferably configured to be inserted into a hole (23) penetrating a part of the guide member (20) in the vertical direction. Through this, one end of the guide member (20) is fixed to the knob (14). In addition, as illustrated in FIG. 3, an operating coupler (21) is formed at the other end of the guide member (20). Preferably, the operating coupler (21) may have a hollow cylindrical shape and may be formed integrally with the other end of the guide member (20). As described below, when the guide member (20) moves forward along its length, it applies force to the guide member (30) in a direction in which the first sub-joint (31) and the second sub-joint (32) constituting the guide member (30) are engaged with each other by covering the guide member (30).

[0081] A case (40) is provided inside the guide member (20). The case (40), like the guide member (20), may have a tubular shape extending in the longitudinal direction of the guide member (20). Alternatively, preferably, the case (40) may have a shape in which one side is open in a ㄷ-shaped cross-section perpendicular to the longitudinal direction as a whole, and only a portion of the tip connected to the guide member (30) may have a closed ㅁ-shaped cross-section. In this case, the moving member (50) may be fastened through the open side of the portion of the case (40) having the ㄷ-shaped cross-section, so that the entire case may have a closed ㅁ-shaped cross-section like the tip. And, in this case, as described later, the jaw holder (41) that is arranged longitudinally rearward of the jaw member (30) and fixes the jaw member (30) is fastened to one side of the movable member (50) provided in a part of the case (40) as described above, and the U-shaped clip (42) is fastened to the case (40) facing one side of the movable member (50) to which the jaw holder (41) is fastened. The case (40) can be configured so that a plurality of clips (100) arranged in the clip applier can be accommodated, and the plurality of clips (100) can be sequentially supplied one by one from the clip (100) arranged in the front. To this end, the case (40) may be provided with a plurality of ring portions on which a plurality of clips (100) can be respectively mounted, and a plurality of clips (100) arranged in parallel along the length direction of the case (40) through the ring portions are separated from the case (40) by a moving member (50) and transferred to a clamping member (30) provided on the other end side of the case (40).

[0082] The moving member (50) is provided inside the guide member (20) and preferably has a plate or bar shape extending in the longitudinal direction of the guide member (20). The moving member (50) is configured such that one end on the operating member (10) side extends to the inside of the operating member (10) and is connected to the front end of the push bar (4) inside the operating member (10), which will be described later. The front end on the jaw member (30) side of the case (40) is preferably provided with a push elastic piece that comes into contact with the clip (100), so as to separate the clip (100) from the case (40) and press the separated clip (100) forward so that the clip (100) is transferred to the jaw member (30). In addition, as illustrated in FIG. 5, the moving member (50) is formed with a guide groove (51) extending in the longitudinal direction of the moving member (50) and penetrating the case (40), the moving member (50), and the guide tube (5) so that the forward and backward movement of the moving member (50) is not interfered with by the pin member (14a) penetrating a part of the guide member (20). The pin member (14a) is configured to be inserted into the guide groove (51), so that the moving member (50) can move forward and backward independently of the guide member (20) within the longitudinal dimension range of the guide groove (51) without being interfered with by the pin member (14a).

[0083] The clip member (30) is configured to fix the clip (100) guided along the longitudinal direction of the guide member (20) through the moving member (50) of the clip applier to the loading position, and to press the clip (100) in the up-and-down direction so that a human body part, such as a blood vessel, is ligated by the clip (100). As illustrated in FIG. 3, the clip member (30) may be composed of a first sub-joint (31) and a second sub-joint (32). As illustrated in FIG. 12, the first sub-joint (31) and the second sub-joint (32) load the clip (100) into the clip member (30) while the first fixing portion (31a) and the second fixing portion (32a) are open to each other, and when the first fixing portion (31a) and the second fixing portion (32a) are closed, the blood vessel, etc., can be ligated by the clip (100).

[0084] The first sub-joint (31), as illustrated in FIGS. 3, 4, and 19, has a first fixing portion (31a) having a catch formed at one end thereof to catch one of the upper and lower ends of the clip (100) to load the clip (100), main bodies (31b, 31c) extending from the first fixing portion (31a) in a longitudinal direction of the guide member (20) with a gap therebetween, and a fastening portion (31d) extending rearward from each of the main bodies (31b, 31c) and fastening to a joint holder (41) and a U-shaped clip (42) described later, respectively. In addition, preferably, the first sub-joint (31) can be connected to the case (40) via a predetermined axis (S2) so as to be rotatable about a predetermined axis (S2).

[0085] The second sub-joint (32) is similar to the first sub-joint (31), and is provided with a second fixed portion (32a), a main body portion (32b, 32c), and a fastening portion (32d), and is provided with a structure that is opposed to the first sub-joint (31) in the vertical direction and can be opened or closed with respect to the first sub-joint (31).

[0086] As illustrated in FIGS. 16 and 17, the jaw holder (41) is preferably a plate-shaped member made of an elastic material, and includes a main body (41) fixed to one side of a movable member (50) via a fixing clip (41e) or the like, and a pair of angled portions (41a, 41b) extending from the main body (41) toward the jaw member (30) and spaced apart from each other in the vertical direction. At this time, as illustrated in FIG. 16, one end of the pair of angled portions (41a, 41b) facing the jaw member (30) further includes a ring portion (41c, 41d) configured such that a cross-section perpendicular to the longitudinal direction is bent into a ㄷ shape, so that the fastening portions (31d, 32d) of the first sub-jaw (31) and the second sub-jaw (32) pass through the ㄷ-shaped internal space and engage with the angled portions (41a, 41b). As illustrated in Fig. 17, the fastening portions (31d, 32d) of the first sub-joint (31) and the second sub-joint (32) are configured so that the bent ends are interlocked with the ring portions (41c, 41d) while a portion thereof is accommodated within the internal space of the letter ㄷ shape of the ring portion (41c, 41d), so that even when the clip applier is subjected to shock due to vibration or dropping during transportation, the joint member (30) is not easily separated from the case (40).

[0087] As illustrated in FIGS. 18 and 19, the U-shaped clip (42) is preferably a plate-shaped member made of an elastic material, and includes a main body portion (42a) fixed to the other side of the case (40) opposite to one side of the movable member (50) to which the jaw holder (41) is fastened, and a pair of angled portions (42b, 42c) extending vertically apart from each other from the main body portion (42a) toward the jaw member (30). As illustrated in FIG. 18, one end of each of the angled portions (42b, 42c) facing the jaw member (30) is bent in the direction toward the other side of the case (40) so as to engage with the bent portions formed at the ends of the fastening portions (31d, 32d) of the first sub-jaw (31) and the second sub-jaw (32). Meanwhile, as illustrated in FIG. 19, the other side of the case (40) is provided with a ring portion (43) that protrudes toward the main body (42a) of the U-shaped clip (42) and has its end bent. In addition, the main body (42a) of the U-shaped clip (42) is provided with a hole portion (42f) into which the ring portion (43) is fitted and engaged. Through the above-described coupling structure, the U-shaped clip (42) is firmly fixed to the other side of the case (40), so that even when the clip applier is subjected to shock due to vibration or dropping during transportation, the U-shaped clip (42) that holds the joint member (30) is not easily separated from the case (40).

[0088] Meanwhile, the operating member (10) is a module for operating the inductive member (20) and the moving member (50), and as shown in FIGS. 1, 2, and 6, may include a handle part (12) held by a user, a main body part (11) formed on the upper part of the handle part (12), a head part (13) provided on the front of the main body part (11), and a knob (14) provided to enable the inductive member (20) to be separated and installed on the head part (13).

[0089] And, as shown in FIGS. 2 and 6, the main body (11) is provided with a push bar (4) connected to the end of the operating member (10) side of the moving member (50) and a first spring (4a) for applying elastic force to the push bar (4) so ​​that the push bar (4) and the moving member (50) return to their original positions when the operating force applied to the moving member (50) through the push bar (4) is released. And, a hollow guide tube (5) is provided on the front end side of the main body (11) rather than the push bar (4) so ​​that the push bar (4) is inserted and passed through the inside thereof, and is connected to one end of the operating member (10) side of the guide member (20). In addition, the guide tube (5) is provided with a second spring (5a) for applying elastic force to the guide tube (5) so that the guide member (20) and the guide tube (5) return to their original positions when the operating force applied to the guide member (20) through the guide tube (5) is released.

[0090] And, a trigger (15) is provided in front of the handle portion (12) so as to be rotatable about a predetermined rotation axis (S) with respect to the operating member (10). Preferably, the trigger (15) may have a through hole formed so that a finger of a user holding the handle portion (12) with the palm can be inserted and passed through. An interference wing (1) is provided on a part of the trigger (15) provided inside the operating member (10), and this interference wing (1) is configured to interfere with a ratchet stem gear (2) formed inside the handle portion (12) when the trigger (15) is rotated. And, a pressure piece (3) is formed above the interference wing (1) of the trigger (15) to apply an operating force to the push bar (4) according to the rotation operation of the trigger (15).

[0091] Accordingly, when the user first holds the handle portion (12) and pulls the trigger (15) with his or her fingers, the first loading step is performed in which the trigger (15) rotates around the rotation axis (S) until the interference wing (1) formed on the trigger (15) catches the middle groove of the ratchet stem gear (2) formed inside the handle portion (12). When the first step is performed, an operating force is applied to the rear end of the push bar (4) by the pressure piece (3) formed on the trigger (15), and the push bar (4) overcomes the elastic force of the first spring (4a) and moves the moving member (50) connected to the front end of the push bar (4) forward within the guide member (20).

[0092] In this state, when the user further pulls the trigger (15), the operating force is applied to the rear end of the guide tube (5) together with the push bar (4) by the pressure piece (3) formed in the trigger (15), and the guide tube (5) overcomes the elastic force of the second spring (5a) and advances the guide member (20) connected to the front end of the guide tube (5), which is the second step, the ligation step.

[0093] And, after the second step is performed, when the user stops operating the trigger (15), the guide tube (5) and the push bar (4) are retracted by the elastic force of the second spring (5a) and the first spring (4a), so that the guide tube (5), the push bar (4), and the trigger (15) return to their original positions.

[0094]

[0095] <Opening and closing mechanism without a lid>

[0096] Hereinafter, the opening and closing mechanism for opening and closing the clip member (30) for loading the clip and ligating blood vessels, etc. using the clip applier in a preferred embodiment of the present invention will be described in detail with reference to the attached drawings.

[0097] First, a preferred embodiment of an opening / closing mechanism for opening a clip using a clip applier and ligation of blood vessels, etc. (30) is described with reference to the attached drawings.

[0098] Figure 1 is a drawing showing the state of the clip applier before the user's operation by the trigger (15) is performed.

[0099] As illustrated in FIG. 1, in this state, the guide member (20) and the operating coupler (21) formed at the tip of the guide member (20) and the moving member (50) are retracted rearward. Meanwhile, as previously described with reference to FIG. 17, the fastening portions (31d, 32d) of the first sub-joint (31) and the second sub-joint (32) are configured to engage with the ring portions (41c, 41d) of the joint holder (41) made of an elastic material. Therefore, in a state where the operating coupler (21) is retracted rearward of the joint member (30) as illustrated in FIG. 1 and no force is applied to the joint member (30), only the elastic force of the joint holder (41) acts, so that a force is applied to the first sub-joint (31) and the second sub-joint (32) in a direction away from each other. Therefore, in this state, the first sub-section (31) and the second sub-section (32) are spaced apart from each other, as shown in Fig. 1.

[0100] Meanwhile, when the user operates the trigger (15) and pulls the trigger (15) to a predetermined range, as shown in FIG. 12 and FIG. 4 (a) (the clip shape is omitted in this drawing for visual convenience), the movable member (50) moves forward to transport one of the clips (100) accommodated in the case (40) to the clamp member (30), thereby loading the upper and lower portions of the clip (100) into the first fixing portion (31a) and the second fixing portion (32a) of the first sub-joint (31) and the second sub-joint (32), respectively. In this state, the user moves the clip applier so that the ligation location of the blood vessel and tissue is located between the gaps of the clips (100).

[0101] Thereafter, when the user further pulls the trigger (15), the guide member (20) advances. Accordingly, as illustrated in (b) of FIG. 4, the operating coupler (21) formed at the tip of the guide member (20) advances to tighten and wrap around the opened jaw member (30). As a result, the elastic force of the jaw holder (41) is overcome, and the first sub-jaw (31) and the second sub-jaw (32) are engaged with each other, so that the clip (100) is strongly pressed by the first sub-jaw (31) and the second sub-jaw (32), and the clip (100) is coupled, as illustrated in (b) of FIG. 23. As a result, ligation of a blood vessel or tissue is performed by the coupled clip (100).

[0102] Thereafter, when the user stops operating the trigger (15), the moving member (50) and the guiding member (20) retract, and accordingly, the force applied to the jaw member (30) through the operating coupler (21) is also removed. Accordingly, the elastic force of the jaw holder (41) causes the gap between the first sub-joint (31) and the second sub-joint (32) to open, thereby separating the clip (100) and the jaw member (30).

[0103] <Forced Opening Mechanism in the Absence of Joe>

[0104] Hereinafter, when a situation occurs where the clip (100) cannot be opened using the opening / closing mechanism after the clip (100) has been fastened using the opening / closing mechanism of the clip applier, a forced opening mechanism for separating the clip (30) and the clip (100) will be described with reference to the attached drawings.

[0105] Figure 4 illustrates the opening and closing state of the joint member according to the operation of the forced opening mechanism according to the first embodiment of the present invention.

[0106] Referring to FIG. 4, the forced opening mechanism according to the first embodiment of the present invention may include a protrusion (22) protruding toward the gap between the first sub-joint (31) and the second sub-joint (32) from the inner surface of the operating coupler (21) formed at the tip of the inductive member (20).

[0107] As shown in (b) of FIG. 4, after the first sub-joint (31) and the second sub-joint (32) are interlocked with each other and the ligation by the clip (100) is completed, if the joint between the joint holder (41) and the joint member (30) is released due to damage to the joint holder (41) or the like, even if the guide member (20) is retracted thereafter, an elastic force is not applied to the joint member (30), and thus a problem may occur in which the joint member (30) does not open. However, in the case where the protrusion (22) is provided as illustrated in FIG. 4, when the guide member (20) is retracted by the operation of the trigger (15), as illustrated in (c) of FIG. 4, the protrusion (22) passes through the gap between the first sub-joint (31) and the second sub-joint (32), thereby applying a forcible force to the first sub-joint (31) and the second sub-joint (32) so that the first sub-joint (31) and the second sub-joint (32) move away from each other. Therefore, a gap sufficient to separate the joint member (30) from the clip (100) can be formed through manipulation from outside the patient.

[0108] Meanwhile, it is preferable that the gap between the first sub-joint (31) and the second sub-joint (32) be set to a size such that the sub-joint (30) does not interfere with the protrusion (22) during the opening and closing process when the sub-joint (30) is normally opened and closed by the aforementioned opening and closing mechanism. In other words, it is preferable that the forced opening mechanism be able to operate when the opening and closing mechanism is not normally operated, so that the sub-joint (30) and the protrusion (22) do not interfere with each other during normal operation.

[0109] However, when the jaw holder (41) is normally mounted, even if the protrusion (22) is not provided, when the guide member (20) is retracted, the jaw member (30) is opened largely in the direction in which the first sub-jaw (31) and the second sub-jaw (32) move away from each other due to the elasticity of the jaw holder (41). In addition, even if the jaw holder (41) is not provided or, as described above, the jaw holder (41) is detached from the jaw member (30), when the knob (14) described below is retracted toward the user as one unit with the guide member (20) near the jaw member (30), a certain amount of movement may be imparted to the jaw member (30) through this, so that the jaw member (30) may be opened to a predetermined gap. Therefore, the protrusion (22) described above is a means for assisting in more reliably opening the jaw member (30), but is not an essential component for opening the jaw member (30).

[0110]

[0111] FIG. 5 is a drawing showing a part of an operating member and a knob exposed to explain a forced withdrawal mechanism of an inductive member according to one embodiment of the present invention.

[0112] After the second step of ligating blood vessels or tissues is performed, there may be cases where the guide member (20) cannot be retracted by operating the trigger (15) due to internal damage such as damage to the operating member (10) or guide tube (5). Fig. 5 illustrates a forced withdrawal mechanism of the guide member (20) to solve this problem.

[0113] As described above, in the clip applier according to a preferred embodiment of the present invention, the pin member (14a) protruding from the inner surface of the knob (14) in a direction perpendicular to the longitudinal direction of the guide member (20) is configured to be inserted into a hole portion (23) penetrating a portion of the guide member (20) in the vertical direction. That is, one end of the guide member (20) is fixed to the knob (14). In this case, when the second step of further pulling the trigger (15) to advance the guide member (20) for ligation of a blood vessel or the like is performed, the knob (14) is also separated from the head portion (13) and advanced integrally with the guide member (20), as illustrated in (a) of FIG. 5. Then, when the ligation is completed and the operation of the trigger (15) is stopped, the knob (14) is also retracted integrally with the guide member (20) and reconnected with the head portion (13), as illustrated in (b) of FIG.

[0114] Therefore, in the case where the guide member (20) cannot be retracted by operating the trigger (15) due to damage or the like inside the operating member (10), the user can force the guide member (20) to advance and retreat by holding the handle (12) of the clip applier with one hand, holding the knob (14) with the other hand, and forcibly pulling the knob (14) in the forward and backward directions. Therefore, even when the guide member (20) cannot be withdrawn using the trigger (15), it becomes possible to forcibly withdraw the guide member by external operation. In particular, when this forced withdrawal mechanism is combined with the protrusion (22), which is a forced opening mechanism illustrated in FIG. 4, the clip (100) and the jaw member (30) can be reliably separated by forcibly retracting the guide member (20) while forcibly opening the jaw member (30).

[0115] FIG. 6 is a drawing showing a portion of an operating member exposed to explain a forced withdrawal mechanism of an inductive member according to another embodiment of the present invention.

[0116] In the forced withdrawal mechanism according to the embodiment illustrated in FIG. 6, a wire portion (80) is further provided, one end of which is connected to the guide member (20) and the other end of which extends to the operating member (10). In the above embodiment, the tip of the wire portion (80) is fixed to the hollow inner or outer surface of the guide member (20), and extends along the guide member (20), passes through the inside of the knob (14), and extends to the inside of the operating member (10). Preferably, the other end of the wire portion (80) extends to the outside by penetrating the main body (11) of the operating member (10), as illustrated in FIG. 6. For this purpose, if necessary, it is preferable that a hole through which the wire portion (80) can penetrate is formed in a structural component such as a push bar (4).

[0117] In the forced withdrawal mechanism according to the embodiment illustrated in FIG. 6, the user can forcibly withdraw the guide member (20) backward by holding the handle portion (12) of the clip applicator with one hand and pulling the end of the exposed wire portion (80) with the other hand. Therefore, even when withdrawal of the guide member (20) using the trigger (15) is not possible, it is possible to forcibly withdraw the guide member by external operation. In particular, when combined with the protrusion (22) which is the forced opening mechanism illustrated in FIG. 4, the clip (100) and the guide member (30) can be forcibly opened while forcibly retracting the guide member (20), thereby reliably separating the clip (100) and the guide member (30).

[0118] FIG. 7a is a drawing showing an internal part of an induction member exposed to explain a forced opening mechanism according to a second embodiment of the present invention, and FIG. 8 is a drawing showing an opening / closing state of a guide member according to the operation of the forced opening mechanism shown in FIG. 7a.

[0119] Referring to FIG. 7a, a forced opening mechanism according to a second embodiment of the present invention includes a plate rail (33) formed in at least one of a first sub-joint (31) and a second sub-joint (32) and a first plate (60) provided inside an induction member (20), having a plate pin (61) inserted into the plate rail (33) at one end and extending to the operating member at the other end.

[0120] Here, the plate rail (33) may have a groove shape formed by cutting out a part of the main body (31b, 32b) of the first sub-section (31) or the second sub-section (32), as illustrated in FIG. 7A. In the case of the example illustrated in FIG. 7A, the plate pin (61) formed at one end of the first plate (60) has a shape of a plate-shaped member bent so that the portion inserted into the plate rail (33) follows the surface of the main body (31b, 32b), but the present invention is not limited thereto, and there is no limitation on the shape of the protruding plate pin (61) as long as it can move according to the shape of the plate rail (33). For example, in FIG. 7b, a plate pin (61) protrudes from a plate (60) provided on an induction member (20), and when the induction member (20) moves rearward by the operation of the operating member, the plate pin (61) passes through a gap (e.g., plate rail (33)) between the first sub-joint (31) and the second sub-joint (32), thereby applying force to the first sub-joint (31) and the second sub-joint (32) so that the first sub-joint (31) and the second sub-joint (32) move away from each other. Preferably, the first plate (60) may have a plate shape that extends long along the inside of the induction member (20), and as illustrated in FIG. 9, the other end thereof may extend to the inner space of the knob (14). A support portion (63) may be provided at the other end of the first plate (60) extending into the knob (14), and a pressure switch (14b) linked to the support portion (63) may be provided on the knob (14). Accordingly, when a user holds the handle portion (12) of the clip applicator with one hand and presses the pressure switch (14b) of the exposed knob (14) with the finger of the other hand, the pressure switch (14b) is pressed, thereby pressurizing the linked support portion (63) to retract the first plate (60).And, when the finger is removed from the pressure switch (14b), the pressure switch (14b) is pressed by the spring provided on the surface facing the support part (63), thereby moving the first plate (60) forward again.

[0121] Meanwhile, as illustrated in FIGS. 7 and 8, the plate rail (33) is shaped such that its height gradually decreases in the direction from the clamp member (30) toward the operating member (10). Therefore, when the user presses the pressure switch (14b) to retract the first plate (60) in a state where ligation of a blood vessel, etc. is completed as illustrated in FIG. 8 (a), the plate pin (61) retracts together with the first plate (60), and as the plate pin (61) retracts, as illustrated in FIGS. 8 (b) and (c), force is applied to the clamp member (30) so that the first sub-claw (31) and the second sub-claw (32) move away from each other by the plate pin (61) moving along the plate rail (33). Therefore, a gap sufficient to separate the clamp member (30) from the clip (100) through manipulation from outside the patient can be formed.

[0122] Meanwhile, it is preferable that the position of the plate pin (61) be positioned so as not to interfere with the plate rail (33) when the joint member (30) is normally opened and closed by the aforementioned opening and closing mechanism. In other words, it is preferable that the forced opening mechanism be able to operate when the opening and closing mechanism is not normally operated, so that the plate pin (61) and the plate rail (33) do not interfere with each other during normal operation.

[0123] FIG. 10 is a drawing showing an exposed part of the inside of an induction member to explain a forced opening mechanism according to a third embodiment of the present invention, and FIG. 11 is a drawing showing an exposed part of the inside of an operating member to explain a forced opening mechanism according to the embodiment shown in FIG. 10.

[0124] Referring to FIGS. 10 and 11, a forced opening mechanism according to a third embodiment of the present invention includes a first gear portion (S2a) formed in at least one of the first sub-joint (31) and the second sub-joint (32) and a second plate (70) provided inside the guide member (20), having a second gear portion (71) engaged with the first gear portion (S2a) at one end and extending to the operating member (10) at the other end.

[0125] Here, the first gear portion (S2a) may be a first pinion gear that is formed by protruding from the side surface of the first sub-joint (31) or the second sub-joint (32), as illustrated in FIG. 10, and is coaxial with the rotational axis (S2) of the first sub-joint (31) or the second sub-joint (32). In addition, the second plate (70) may be a plate-shaped member that extends long along the inside of the guide member (20), and the second gear portion (71) may be a first rack gear that extends long in the longitudinal direction near one end of the second plate (70) on the jaw member (30) side and meshes with the first gear portion (S2a), which is a first pinion gear formed on the jaw member (30).

[0126] Meanwhile, as illustrated in Fig. 11, the other end of the second plate (70) on the side of the operating member (10) can extend to the inner space of the operating member (10). A second rack gear (72) extending long along the longitudinal direction can be formed at the other end of the second plate (70) extending to the inside of the operating member (10), and the second rack gear (72) meshes with the second pinion gear (73) provided inside the operating member (10). Therefore, when the second pinion gear (73) is rotated by external operation of an external switch linked with the second pinion gear (73), the second plate (70) can be driven forward and backward. Alternatively, as illustrated in Fig. 11, a third rack gear (74) that meshes with the second pinion gear (73) may be further provided, and the second plate (70) may be driven forward and backward by driving the third rack gear (74) forward and backward by external manipulation of the operating member (10).

[0127] Accordingly, when the ligation of the blood vessel, etc. is completed, when the user operates the operating member (10) to advance the second plate (70), the first pinion gear (S2a) that engages with the first rack gear (71) formed on the second plate (70) rotates according to the advancement of the second plate (70), and the first jaw member (31) or the second jaw member (32) that is integrally formed with the first pinion gear (S2a) also rotates integrally, causing the first sub-jaw (31) and the second sub-jaw (32) to rotate in a direction away from each other, as illustrated in FIG. 10. Therefore, a gap that allows the jaw member (30) to be separated from the clip (100) through manipulation from outside the patient can be formed.

[0128] Meanwhile, it is preferable that the position of the first rack gear (71) of the second plate (70) be arranged at a position that does not interfere with the first pinion gear (S2a) when the joint member (30) is normally opened and closed by the aforementioned opening and closing mechanism. In other words, it is preferable that the forced opening mechanism be able to operate when the opening and closing mechanism is not normally operated, so that the first rack gear (71) and the first pinion gear (S2a) are not in a state of meshing with each other during normal operation.

[0129]

[0130] Trigger Structure

[0131] Hereinafter, the structure of a trigger according to a preferred embodiment of the present invention, which allows the user to accurately perceive the transition between the loading stage and the ligation stage visually, audibly, or tactilely, will be described with reference to the attached drawings.

[0132] FIG. 13 is a drawing showing the operational states of a trigger according to a pre-trigger operation step, a loading step, and a ligation step in a clip applier having a trigger structure according to a preferred embodiment of the present invention.

[0133] In the example shown in Fig. 13, the trigger (15) is configured to rotate around a predetermined rotation axis, and an indicator member (16) is provided between the trigger (15) and the handle portion (12) on a rotation path when the trigger (15) rotates and rotates integrally with the trigger (15).

[0134] As shown in (a) of Fig. 13, before the user operates the trigger (15), the indicator member (16) is positioned so that at least a portion of it is exposed to the outside of the handle portion (12).

[0135] And, when the user holds the handle part (12) with the palm and pulls the trigger (15) with the finger, the indicator member (16) rotates integrally with the trigger (15) and is gradually inserted into the handle part (12) through the opening provided in the handle part (16a). And, preferably, as shown in (b) of Fig. 13, when the loading step is completed, the indicator member (16) is configured to be entirely inserted into the handle part (12). In this case, by visually confirming the degree to which the indicator member (16) is inserted into the handle part (12), it becomes possible to visually recognize the completion time of the loading step.

[0136] Meanwhile, as shown in (c) of Fig. 13 after the loading step is completed, the user can proceed from the loading step to the ligation step by pulling the trigger (15) all the way.

[0137] In addition, more preferably, as illustrated in FIG. 13, the handle portion (12) may be provided with an indication window (12a) penetrating the handle portion (12), and the indication member (16) may be provided with an indication box (16a) having a shape corresponding to the indication window (12a). In this case, the indication box (16a) displayed on the indication member (16) is formed on the indication member (16) so that, when the trigger (15) is pulled and the loading step is completed, the indication box (16a) is at a position corresponding to the indication window (12a) of the handle portion (12). According to the above configuration, the completion time of the loading step can be clearly recognized by visually confirming whether the indication box (16a) is displayed on the indication window (12a) displayed on the handle portion (12). Therefore, the user can clearly recognize the completion time of the loading step, thereby allowing the loading step and the tying step to be performed at an appropriate time.

[0138] FIG. 14 is a drawing showing an exposed internal portion of an operating member of a clip applier having a dual trigger according to another preferred embodiment of the present invention.

[0139] In the example shown in Fig. 14, the trigger has a first trigger (15a) that is slidably operated in the forward and backward direction so that a loading step is performed, and a second trigger (15b) that is positioned below the first trigger (15a) and is operated to rotate around a predetermined rotation axis so that a ligation step is performed.

[0140] The first trigger (15a) has a bar shape extending along the front-back direction of the operating member (10), and is formed in a shape such that the thumb of a user holding the handle portion (12) can be rested on the tip thereof. In addition, the first trigger (15a) is configured such that a rack gear is formed on at least a portion of the upper surface thereof and is engaged with a pinion gear (18a) provided inside the main body portion (11) of the operating member (10). In addition, a push member (18c) is provided above the pinion gear (18a), one end of which is engaged with the rear end of the push bar (4), and a rack gear is formed on a portion of the lower surface of the push member (18c) and is configured such that it is engaged with the pinion gear (18a). Accordingly, when the user pulls the first trigger (15a) using the thumb while holding the handle portion (12) with the palm, the push bar (4) can be pushed forward through the pinion gear (18a) and the push member (18c). Meanwhile, preferably, a click claw (18b) is provided inside the operating member (10), so that when the pinion gear (18a) rotates, the click claw (18b) can generate a sound by striking the gear portion of the pinion gear (18a), and also prevent the rotated pinion gear (18a) from moving backward even when the finger is released from the first trigger (15a). Accordingly, the user can determine whether the loading step is completed by whether a sound is generated from the click claw (18b), and the first trigger (15a) can be fixed when the finger is moved for ligation after loading. In addition, it is preferable to have a support member (18d) supporting the lower portion of the guide tube (5), and the lower portion of this support member (18d) may be configured to mesh with the rack gear of the first trigger (15a). In this case, when the first trigger (15a) is pulled rearward, the support member (18d) rotates forward, thereby assisting the guide tube (5) to be pulled forward in addition to the push member (18c).

[0141] After the loading step is completed, the user initiates the ligation step by pulling the second trigger (15b) with the fingers other than the thumb. When the second trigger (15b) rotates, the push bar (4) that was advanced forward in the loading step is further advanced together with the guide tube (5) by the pressure piece formed integrally with the second trigger (15b), thereby executing the ligation step.

[0142] According to the clip applier having the trigger structure according to the present invention as illustrated in FIG. 14, the trigger for executing the loading step and the trigger for executing the ligation step are configured separately and then operated in different ways, thereby preventing a mistake in which loading and ligation are performed sequentially with a single operation. In addition, by configuring the trigger for executing the loading step and the trigger for executing the ligation step separately and allowing these multiple triggers to be executed step by step with one hand of the user, the user's convenience in operation can be improved. In addition, by generating a sound using the click claw (18b) during the execution of the loading step, the user can recognize audibly whether the loading step is in progress.

[0143] FIG. 15 is a drawing showing an operating member of a clip applier having a dual trigger according to another embodiment of the present invention.

[0144] In the example shown in Fig. 15, the trigger has a sub-trigger (15c) that rotates around a predetermined rotation axis (S) according to the user's operation, and a main trigger (15d) that is positioned on the rear side of the sub-trigger (15c) in the rotational direction and rotates coaxially with the sub-trigger (15c).

[0145] Accordingly, when the user first pulls the sub-trigger (15c) using his fingers while holding the handle (12) with his palm, the push bar (4) is pressed by the pressurizing piece integrally provided above the sub-trigger (15c), thereby initiating the loading step.

[0146] Meanwhile, the main trigger (15d) is configured to have a thickness dimension larger than that of the sub-trigger (15c), and a space is formed inside the main trigger (15d) to accommodate the sub-trigger (15c). In addition, the relative positions of the sub-trigger (15c) and the main trigger (15d) are predetermined so that the sub-trigger (15c) is accommodated inside the main trigger (15d) at the time when the loading step is completed by pulling the sub-trigger (15c). Therefore, after the loading step is completed, the user pulls the main trigger (15d) with the sub-trigger (15c) accommodated inside, thereby rotating the sub-trigger (15c) and the main trigger (15d) simultaneously. At this time, the guide tube (5) is pressed forward together with the push bar (4) by a pressure piece integrally provided above the sub-trigger (15c), thereby performing the ligation step.

[0147] As described above, according to the trigger structure according to the preferred embodiment of the present invention illustrated in FIG. 15, a sub-trigger (15c) and a main trigger (15d) having different thicknesses are provided, and a loading step is performed by pulling the sub-trigger (15c) alone, and a ligation step is performed by pulling the main trigger (15d) together with the sub-trigger (15c). According to the above structure, the point in time when the loading step is completed and the transition to the ligation step is made can be clearly recognized by the touch and sight of the finger. Therefore, a mistake in which loading and ligation are performed sequentially with a single operation can be prevented in advance. In addition, by separately configuring the trigger for executing the loading step and the trigger for executing the ligation step, while allowing these multiple triggers to be executed step by step with one hand of the user, the convenience of operation for the user can be improved.

[0148]

[0149] <Clip Counter Structure>

[0150] Hereinafter, with reference to FIGS. 20 and 21, a clip counter structure is described in which the number of clips remaining in the case (40) is displayed to the outside of the operating member (10) by the backward operation of the push bar (4) linked to the operation of the trigger (15).

[0151] FIG. 20 is a drawing showing an internal part of an operating member of a clip applier according to a preferred embodiment of the present invention and an exploded drawing showing a main part of a clip counter provided in the operating member, and FIG. 21 is a drawing for explaining the operation of the clip counter shown in FIG. 20.

[0152] As illustrated in Fig. 20, the main body (11) of the operating member (10) includes a clip counter structure that displays the number of remaining clips (100) inside the case (40).

[0153] The clip counter structure includes a counter shaft (6) extending integrally rearward from the push bar (4), a number display wheel (7) that rotates around a predetermined rotation axis and displays numbers in descending order in a clockwise direction to indicate the number of clips (100), and a ratchet gear (7a) that rotates coaxially with the number display wheel (7).

[0154] While the user loads and ties the clip (100) using the clip applier, the push bar (5) linked by the operation of the trigger (15) performs one forward and backward movement. Therefore, in the clip counter structure according to the preferred embodiment of the present invention, when the loading and ties of one clip (100) are completed and the push bar (5) moves backward by releasing the trigger (15), the rear end (6a) of the counter shaft (6) that moves backward integrally with the push bar (5) pushes one gear of the ratchet gear (7a) so that the ratchet gear (7a) rotates by one gear. In addition, the number arrangement of the number display wheel (7) that rotates integrally with the ratchet gear (7a) is arranged so that the numbers can be switched by one for each rotation of one gear of the ratchet gear (7a). In the example illustrated in Fig. 21, a display portion that is fixed and does not rotate is provided in the center of the number display wheel (7), and the number display wheel (7) rotates around the display portion. In this case, the number indicated on the display portion changes so that the arrow indicated on the display portion indicates the number of clips (100) provided in the case (40) according to the rotation of one gear stage of the ratchet gear (7a). However, the present invention is not limited to the example illustrated in Fig. 21, and a display window that allows the number of the number display wheel (7) to be displayed may be provided on the main body of the operating member (10), and a number indicating the number of clips (100) provided in the case (40) may be displayed through the display window according to the rotation of one gear stage of the ratchet gear (7a).

[0155] According to the clip counter structure according to the present invention described above, the number of clips (100) remaining inside the case (40) can be displayed externally in a simple manner without resorting to a complex additional power transmission structure. Therefore, there is an effect of reducing the possibility of failures such as breakage or separation of components used in the clip counter structure and increasing maintenance efficiency.

[0156]

[0157] <Verification experiment results of a clip applier according to a preferred embodiment of the present invention>

[0158] Table 1 shows the results of a drop test using a clip applier that connects a jaw member (30) with a jaw holder (41) and a U-shaped clip (42) according to the present invention as described above, and a clip applier according to a comparative example. In the case of the clip applier according to the comparative example, unlike the jaw holder (41) according to the present invention, the ends of each part are bent in an L-shape instead of a T-shape, and the U-shaped clip (42) is configured to have a structure that is simply hung over the case (40) without a fastening structure using a ring portion with respect to the case (40).

[0159] In this experiment, after dropping from a height of 80 cm six times, the occurrence of defects was determined. In Table 1, loading defects refer to clip loading defects and binding defects that occur due to separation of the U-shaped clip or jaw holder, jaw locking defects refer to defects in which the jaw member does not open, and jamming defects refer to defects in which multiple clips are ejected at once.

[0160] Classification General Conditions Worst Conditions (6 drops from 80cm height) Comparative Example Implementation Example Comparative Example Implementation Example Clip Defect Loading Defect 9.3% (7 pieces / 75 pieces, total 5 sets evaluated) 0.0% (0 pieces / 270 pieces, total 18 sets evaluated) 14.7% (11 pieces / 75 pieces, total 5 sets evaluated) 0.0% (0 pieces / 270 pieces, total 18 sets evaluated) Binding Defect 1.3% (1 piece / 75 pieces, total 5 sets evaluated) 0.0% (0 pieces / 270 pieces, total 18 sets evaluated) 18.7% (14 pieces / 75 pieces, total 5 sets evaluated) 0.0% (0 pieces / 270 pieces, total 18 sets evaluated) Applicator Defect Locking Defect 0.0% (0 sets / 5 sets, total 5 sets evaluated) 0.0% (0 pieces / 18 sets, total 18 sets evaluated) Evaluation) 20% (1 Set / 5 Set, Total 5 Set Evaluation) 0.0% (0 Set / 18 Set, Total 18 Set Evaluation) Jamming Failure 0.0% (0 Set / 5 Set, Total 5 Set Evaluation) 0.0% (0 / 18 Set, Total 18 Set Evaluation) 20% (1 Set / 5 Set, Total 5 Set Evaluation) 0.0% (0 Set / 18 Set, Total 18 Set Evaluation)

[0161]

[0162] As shown in Table 1 above, when the joint member (30) is fixed to the case (40) through the joint holder (41) and U-shaped clip (42) according to the present invention, the assembly stability is improved, and no defects occur even when dropped six times from a height of 80 cm, whereas in the case of the comparative example, a large number of defects occur.

[0163] Table 2 below shows the results of evaluating whether the opening function of the jaw member operates normally using the forced opening mechanism according to the first embodiment in a state where some of the components constituting the clip applier according to the present invention were intentionally removed or damaged.

[0164] Component condition evaluation results #1 U-shaped clip removal operation confirmed #2 Group holder removal operation confirmed #3 U-shaped clip, group holder removal operation confirmed #4 Case fastening part 1 wear operation confirmed #5 Case fastening part 2 wear operation confirmed

[0165]

[0166] As shown in Table 2 above, even if some of the parts constituting the clip applier are damaged or removed and the jaw member cannot be opened by a conventional opening / closing mechanism, it can be seen that when the forced opening mechanism according to the first embodiment of the present invention is driven, the jaw member can be opened normally, and the clip can be successfully separated from the jaw member.

[0167]

[0168] According to the surgical clip applier according to the present invention, in addition to an opening / closing mechanism for applying force to a jaw member for loading and ligation, a forced opening mechanism is provided so that a pair of sub-jaws can be forced to open each other by an external operation, thereby enabling the clip and clip applier in a ligated state to be easily separated even when the pair of sub-jaws cannot be switched from an engaged state to an open state after ligation by the clip is performed.

[0169] According to the surgical clip applicator of the present invention, by providing a means for allowing the user to accurately recognize the transition between the loading step and the ligation step through sight, hearing, touch, etc., there is an effect of helping the user clearly recognize the timing of each step and perform it appropriately.

[0170] According to the surgical clip applier according to the present invention, in order to prevent the detachment of the jaw holder (41) that is connected to a pair of sub-jaws (31, 32) and a moving member (50) inside a guide member (20) to apply elastic force, and the U-shaped clip (42) that is connected to a pair of sub-jaws (31, 32) and a case (40) inside the guide member (20), a T-shaped structure is applied to the part connected to the sub-jaw in the case of the jaw holder, and a ring is applied to the part connected to the case in the case of the U-shaped clip, so that the product does not detach from its original position when movement, dropping, impact, etc. of the product occurs.

[0171] According to the surgical clip applier according to the present invention, a counter is provided that can easily check the number of clips remaining inside the clip case of the clip applier, thereby enabling the user to clearly recognize the time of replacement of the medical device during surgery.

Claims

1. Absence of operation; A guide member having a hollow tubular shape and being mounted on the operating member; A case disposed inside the inductive member and having a clip accommodated therein; A moving member for moving a clip arranged inside the case to the other end of the inductive member according to the operation of the operating member; A surgical clip applicator comprising a first sub-section and a second sub-section facing each other, and a jaw member configured such that the clip moved to the other end of the guide member by the moving member is separated or fixed between the first sub-section and the second sub-section when the first sub-section and the second sub-section approach or move away from each other, An opening / closing mechanism for applying force to the joint member so that the first sub-joint and the second sub-joint approach or move away from each other according to the operation of the above-mentioned operating member, and A surgical clip applicator characterized in that, separately from the above opening and closing mechanism, it further comprises a forced opening mechanism for applying a physical force to the jaw member so that the first sub-jaw and the second sub-jaw move away from each other according to the operation of the operating member.

2. In claim 1, The above opening and closing mechanism is, The first sub-section and the second sub-section include an elastic member that applies an elastic force in a direction away from each other, A surgical clip applicator, wherein when the guide member moves forward by the operation of the operating member, the first sub-joint and the second sub-joint approach each other against the elastic force by the guide member, and when the guide member moves backward by the operation of the operating member, the first sub-joint and the second sub-joint move away from each other by the elastic force.

3. In claim 1, The above forced opening mechanism is, Including a protrusion provided on the inner surface of the above-mentioned inductive member, A surgical clip applicator, wherein when the guide member moves rearward in accordance with the operation of the operating member, the protrusion passes through the gap between the first sub-joint and the second sub-joint and applies force to the first sub-joint and the second sub-joint so that the first sub-joint and the second sub-joint move away from each other.

4. In claim 1, The above forced opening mechanism is, A plate rail formed in at least one of the first sub-section and the second sub-section; and A first plate member is provided inside the inductive member, has a plate pin inserted into the plate rail at one end, and has the other end extending to the operating member, A surgical clip applicator, wherein when the first plate member is moved rearward by manipulating the other end of the first plate member, a force is applied to the plate member so that the first sub-joint and the second sub-joint move away from each other while the plate pin moves along the plate rail.

5. In claim 1, The above forced opening mechanism is, A first gear part formed in at least one of the first sub-section and the second sub-section, and A second plate is provided inside the inductive member, has a second gear part that engages with the first gear part at one end, and has the other end extending to the operating member, A surgical clip applicator, wherein when the second plate is moved rearward by manipulating the other end of the second plate, a rotational force is applied to the jaw member so that the first gear portion, which meshes with the second gear portion, rotates and the first sub-jaw and the second sub-jaw move away from each other.

6. In claim 1, The above forced opening mechanism is, It further comprises a wire part, one end of which is connected to the inductive member and the other end of which extends to the operating member. A surgical clip applicator configured to forcibly withdraw the inductive member backward by manipulating the other end of the wire portion.

7. In claim 1, Further comprising a knob provided to be movable relative to the above-mentioned operating member, A surgical clip applicator, wherein the knob is fixed to the guide member and configured to forcibly withdraw the guide member rearward by operating the knob.

8. In claim 1, The above operating absence is, A handle part that can be gripped by the user A trigger is provided on the handle part and is configured to operate the inductive member and the moving member by being pulled by the user. The above trigger has a first step of moving the movable member forward and moving the clip to the clamp member and settling it, depending on the degree of operation of the above trigger; A surgical clip applicator, wherein a second step of advancing the guide member to engage the first sub-joint and the second sub-joint of the guide member with the clip and thereby ligating the clip is performed stepwise.

9. In claim 8, The above trigger is, A first trigger that slides forward and backward so that the above first step is performed, A surgical clip applicator having a second trigger positioned below the first trigger and operable to rotate around a predetermined rotation axis so that the second step is performed.

10. In claim 8, The above trigger is configured to rotate around a predetermined rotation axis according to the user's operation, The above trigger is provided on the rotation path during the rotation, and has an indicator member that rotates integrally with the trigger, The above-mentioned absence of the indication is at least partially exposed to the outside of the handle portion before the above-mentioned trigger is operated, A surgical clip applicator, wherein the indicator member is configured to be inserted into the interior of the handle portion when the trigger is rotated so that the first step is performed.

11. In claim 8, The above trigger is configured to rotate around a predetermined rotation axis according to the user's operation, The above trigger has a sub-trigger and a main trigger that rotates coaxially with the sub-trigger and is positioned at the rear in the rotational direction relative to the sub-trigger, The sub-trigger is first rotated by the user's operation so that the above first step is performed, In order for the above second step to be performed, the sub-trigger and the main trigger are configured to rotate simultaneously by the user's operation, A surgical clip applicator, wherein the main trigger is configured to have a thickness dimension larger than that of the sub-trigger, such that at least a portion of the sub-trigger is accommodated inside the main trigger when the trigger is operated to perform the second step.

12. In claim 1, First, the above moving member is fixed to one side, The other end further includes a jaw holder having a pair of corners each connected to the ends of the first sub-joule and the second sub-joule, A surgical clip applicator, wherein the end portion of each of the above-mentioned parts on the holder side is bent so that a cross-section perpendicular to the longitudinal direction of each part has a T-shape, and the end portions of the first sub-joint and the second sub-joint pass through the internal space of the T-shape and are interlocked with each of the above-mentioned parts.

13. In claim 1, First, it is fixed to the other side of the above case, The other end further comprises a U-shaped clip having a pair of corners each connected to the ends of the first sub-section and the second sub-section, The above case has a ring portion protruding from the other side, A surgical clip applicator, wherein the U-shaped clip has a hole portion that fits into the ring portion.

14. In claim 1, A surgical clip applicator, wherein the operating member further comprises a clip counter that displays the number of clips remaining in the case externally by rotating clockwise by rearward movement of the moving member in conjunction with operation of the operating member.

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