巴西专利BR112012018338B1 medical devices with rotatable and detachable claws

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专利摘要:
MEDICAL DEVICES WITH ROTARY AND REMOVABLE CLAWS. The present invention relates to medical systems, devices and methods for fitting tissue, for example, for fixing tissue, closing a perforation or forming hemostasis. Generally, the medical system (20) includes a housing (42), first and second jaws (44.46) rotatable with respect to the housing, a driver (48), and an elongated guiding wire (22). The elongated guide wire can be disconnected from the actuator, the first and second claws and the housing, which are left attached with the tissue in vivo.
公开号:BR112012018338B1
申请号:R112012018338-9
申请日:2010-12-17
公开日:2021-03-02
发明作者:Vihar C. Surti；Michelle D. Martinez
申请人:Cook Medical Technologies Llc；
IPC主号:

专利说明:

BACKGROUND
[0001] In a conventional manner, a staple can be inserted into a body cavity through an endoscope to grab living tissue from a body cavity for hemostasis, marking, and / or ligation. Such clamps are often known as surgical clamps, endoscopic clamps, clamps for hemostasis and vascular clamps. In addition, staples are currently being used in a variety of applications related to gastrointestinal bleeding, such as peptide ulcers, Mallory-Weiss syndrome, Dieulafoy lesion, angiomas, post-papillary bleeding and small varicose veins with active bleeding. Attempts were made to use staples to close stomach perforations.
[0002] Gastrointestinal bleeding is a serious and certainly common condition that is often fatal if left untreated. This problem motivated the development of a variety of therapeutic endoscopic approaches for obtaining hemostasis such as the injection of sclerosing agents and contact thermocoagulation techniques. Although such approaches are often effective, bleeding continues in several patients and corrective surgery is therefore necessary. Because surgery is an invasive technique that is associated with a high mortality rate and several other unwanted side effects, there is a need for highly effective and less invasive procedures.
[0003] Hemostatic mechanical devices, such as clamps, have been used in various parts of the body, which includes gastrointestinal applications. However, one of the problems associated with conventional hemostatic devices and clamps is that several devices are not resistant enough to cause permanent hemostasis. In addition, attempts are made to use staples to close perforations in the stomach or gastrointestinal structures, however, unfortunately traditional staples suffer from a difficult disposition and have a limited ability to grab tissues, potentially resulting in incomplete closure. SUMMARY
[0004] The invention can include any of the following aspects in various combinations and can also include any other aspect described below in the written description or in the accompanying drawings.
[0005] In a first aspect, a medical device is provided to fit the tissue, the medical device including a housing, first and second claws pivotally connected to the housing, and a trigger. The housing defines an internal passage and a longitudinal geometric axis that extends between the proximal and distal ends of the housing. The housing defines the first and second guide surfaces along the internal passage. The first and second claws are connected in a sliding and swiveling manner to the housing, and each has proximal and distal ends. The first gripper is slidably received inside the internal passage for longitudinal movement along the first guide surface between an extended position and a retracted position. The second gripper is slidably received inside the internal passage for longitudinal movement along the second guide surface between an extended position and a retracted position. The housing is structured to block the rotation of the first and second jaws when they are in their retracted positions, and structured to allow the rotation of the first and second jaws when they are in their extended positions. The driver is engaged with the proximal ends of the first and second jaws, where the longitudinal movement of the driver moves the first and second jaws longitudinally along the first and second guides between their retracted and extended positions. The longitudinal movement of the actuator rotates the first and second jaws in relation to the housing when the first and second jaws are in their extended positions.
[0006] According to more detailed aspects, the approximate ends of the first and second jaws are located adjacent to the distal end of the housing when the first and second jaws are in their extended positions. The proximal ends of the first and second claws are sliding and swiveling and are fixed to the housing. The housing defines a joint within the internal passage, and the driver includes a locking tab positioned to fit the joint and limit the longitudinal movement of the driver and the first and second jaws. The hinge changes the locking tab to the position out of the socket with the hinge when a distally directed longitudinal force on the driver reaches a predetermined force to allow the longitudinal movement of the driver and the first and second grips in a distal direction. Preferably, the housing defines a third guide surface that directs the longitudinal movement of the driver within the housing. The third guide surface can define the joint.
[0007] Still according to other detailed aspects, the device can also include an elongated targeting thread. The elongated guiding wire is selectively connected to the actuator for longitudinal movement with it, and the locking tab fits tightly on the guiding wire when the locking tab is positioned distally from the joint, and the tab locking tab does not fit tightly on the steering wire when the locking tab is positioned proximal to the hinge to allow the steering wire to be disconnected from the driver. The guiding wire may have an enlarged distal head, and the driver includes a socket sized to selectively receive the enlarged distal head of the guiding wire. The socket faces proximally and is preferably constructed with a resilient material that flexes to adjust the size of the socket. The proximal ends of the first and second jaws include gear teeth, and the driver includes matching teeth that interlock with the gear teeth of the jaws. Preferably the proximal ends of the first and second jaws are formed as pinions, and the driver is formed as a rack, in which the longitudinal movement of the driver and the rack rotates the pinions and the first and second claws in their extended positions. The driver includes a central column that extends longitudinally and the teeth that extend laterally from the central column. Preferably, the actuator includes pairs of teeth that extend in laterally opposite directions from the column to form two sets of teeth, one of the two sets of teeth is engaged with the pinion of the first claw, the other of the two sets of teeth fitted with the pinion of the second claw.
[0008] In a second aspect, a medical system is provided for the tissue fitting, the medical system including a housing, first and second claws pivotally connected to the housing, a driver and an elongated guiding wire. The housing defines an internal passage and a longitudinal geometric axis that extends between the proximal and distal ends of the housing. The housing further defines a guide surface of the driver along the internal passage, the guide surface of the driver including a proximal portion that has a proximal width and a distal portion that has a distal width. The proximal width is greater than a distal width. The actuator is engaged with the proximal ends of the first and second jaws. The longitudinal movement of the actuator rotates the first and second jaws in relation to the housing. The driver also includes a movable locking tab. The elongated guiding wire selectively connects to the actuator for longitudinal movement with it. The locking tab fits tightly on the guide wire when it is positioned along the distal portion of the driver's guide surface, and the locking tab allows the guide wire to be disconnected from the driver when the locking tab is positioned at along the proximal portion of the driver's guide surface.
[0009] According to more detailed aspects, the elongated directing wire has a distal head and the actuator includes a socket dimensioned to receive the distal head. The locking tab is positioned on an outlet inlet and moves to vary the size of the inlet. The driver includes two locking tabs on opposite sides of the socket, and the guide surface of the driver includes two surfaces on opposite sides of the housing corresponding to the two locking tabs. The medical system can also include a tubular connector that defines a lumen dimensioned to receive a connection block slidably. The connection block is structured to fit frictionally to the proximal end of the housing and to define, in a sliding way, a hole that receives the guiding wire. A distal end of the guidewire defines a distal head that has a size that is wider than the hole, in which the distal head fits into the connection block during the proximal retraction of the guidewire and slides proximally in relation to to the tubular connector to detach the connection block from the housing.
[00010] Still according to other aspects, the housing preferentially defines a joint in the transition between the proximal portion and the distal portion of the actuator's guide surface, and the locking tab is positioned to fit the joint and limit the longitudinal movement of the actuator. The pivot deflects the flap to the position out of joint with the pivot when a longitudinal force distally directed on the actuator reaches a predetermined force to allow the longitudinal movement of the actuator and the first and second grips in a distal direction.
[00011] In a third aspect, a method is provided for fixing tissue. The method includes providing a medical device or system such as those described above and hereinafter. The guiding wire is distally advanced to transfer the first and second jaws distally in relation to the housing. The guide wire is distally advanced to rotate the first and second jaws away from each other. The fabric is positioned between the first and second jaws, and the targeting wire is retracted proximally to rotate the first and second jaws towards each other to fix the fabric between them. The guiding wire is retracted proximally to translate the first and second claws proximally to the housing. The guiding wire is removed from the actuator to leave the first and second claws attached to the fabric and connected to the housing. According to other detailed aspects, the step for retracting the guiding wire to proximally transfer the first and second jaws, preferably proximally, includes restricting the distal movement of the actuator to maintain tissue fixation. BRIEF DESCRIPTION OF THE DRAWINGS
[00012] The attached drawings incorporated here and which form a part of the specification, illustrate various aspects of the present invention and together with the description, they serve to explain the principles of the invention. In the drawings: figure 1 is a top view of a medical system that has a medical device for fitting tissue, constructed in accordance with the teachings of the present invention; figure 2 is a top view similar to figure 1, but showing the external structures in dotted lines and the internal sections in continuous lines and a partial cross section; figure 3 is a side view of the medical system and the device described in figure 1; figure 4 is a side view similar to figure 3, but showing the outer structures in dotted lines and the inner structures in continuous lines and a partial cross section; figure 5 is a side view of a medical device that is part of the medical system described in figures 1-4; figure 6 is a front view of a housing that forms a portion of the medical system and the device described in figures 15; figure 7 is a perspective view of the housing described in figure 6; figures 8-12 are side views showing the operation of the medical system and the device described in figures 1-5; figures 13 and 14 are top and partially cross-sectional views that describe the operation of the medical system and the device described in figures 1-4; figures 15 and 16 are cross-sectional views showing the operation of the medical system described in figures 1-4; and figure 17 is a side view of a cable that forms a portion of the medical system of figure 1. DETAILED DESCRIPTION
[00013] The terms "proximal" and "distal" as used here are intended to have a point of reference in relation to the user. Specifically, throughout the specification, the terms "distal" and "distal" should denote the position, direction or orientation that is generally far from the user, and the terms "proximal" and "in a manner proximal "should denote the position, direction or orientation that is generally towards the user.
[00014] An exemplary medical system 20 that has a medical device 40 to fit the T tissue (figure 11) is shown in figures 1 through 4. The medical system 20 and device 40 are generally dimensioned and structured for operation through the operating channel of an endoscope (not shown) or another scope, although system 20 and device 40 can also be used in conjunction with other elongated devices such as catheters, fiber optic display systems, needles and the like. Generally, the medical system 20 includes a guiding wire 22 slidably housed by a cover 23 and which has a tubular connector 24 at the distal end for a connection and selective operation of the medical device 40. The form will be described in further detail here , the medical device 40 generally includes a housing 42 which has a first jaw 44 and a second jaw 46 pivotally connected thereto to fit the tissue T. Generally, jaws 44, 46 are shown forming grasping clamps, although jaws have been designed to be used in tissue fixation, for example, to close an opening or for hemostasis. Consequently, it will be recognized that the shape and structure of the claws can take various forms and serve various purposes and functions, all in accordance with the teachings of the present invention.
[00015] In the medical system 20, the guide wire 22 slidably extends through the tubular connector 24. Although the term "wire" is used to refer to the guide wire 22, it will be recognized that any elongated control member capable of transmitting longitudinal force over a distance (as required in typical endoscopic, laparoscopic and similar procedures) can be used and this includes plastic rods or tubes, single filament or multifilament wires and the like. A connection block 26 is slidably inserted into the tubular connector 24 and it defines a hole 28 therethrough and which receives the guide wire 22 slidably. The outer part of the connection block 26 includes a portion with recess 27, and a pin 30 is connected to the tubular connector 24 and fits within the recessed portion 27 to limit the longitudinal movement of the connection block 26.
[00016] A distal end of the guidewire 22 defines a distal head 32 which is sized larger than the guidewire 22, and likewise wider than the bore 28 and the connection block 26. According to will be described hereinafter, the distal head 32 is used to slide the connection block 26 into the tubular connector 24 and disconnect the medical device 40 from the medical system 20. As also seen in figures 1-4, the housing 42 of the medical device 40 is a tubular member defining an interior space 43. The proximal end of the housing 42 frictionally receives a distal end of the connection block 26 within the interior space 43 for selective connection therewith.
[00017] The internal passage 43 of the housing 42 also receives the first and second jaws 44, 46 and an actuator 48 which is used to interconnect the guiding wire 22 in jaws 44, 46. As best seen in figures 1, 2 and 5, the driver 48 has a proximal portion which defines a socket 50 dimensioned to receive the extended distal head 32 of the guiding wire 22. At the proximal entrance of the socket 50, two deviable locking tabs 52 are formed, which rotate in relation to to the rest of the driver 48. The locking tabs 52 can be formed separately and swiveled to the driver 48, or they can be formed integrally with the driver 48 and made of a resilient material which flexes to allow the rotation of the tabs locking element 52 radially inward and radially outward. A distal portion of the driver 48 defines a rack 54 for engaging and operating the claws 44, 46. In the embodiment described, the rack 54 includes a central column 56 that has teeth 58 that protrude out of the central column 56 and on opposite sides column 56. One set of teeth 58 on one side of column 56 generally operates the first jaw 44 while the other set of teeth 58 on the other side of column 56 operates the second jaw 46. It will be recognized that rack 54 may include a set single tooth or other geared structures that interface with grips 44, 46.
[00018] As best seen in figure 5, the first and second jaws 44, 46 include distal ends 60, 62 which are structured to grip and fit the fabric, and preferably they are shaped like a claw as described in 61 / 141,934 filed on December 31, 2008, the description of which is incorporated herein in its entirety for reference. The proximal ends 64, 66 of the first and second jaws 44, 46 each include a pinion gear 68, 70 having a series of teeth. The teeth of the pinion 68, 70 intertwine with the teeth of the rack 54 of the driver 48 in such a way that the longitudinal translation of the driver 48 induces rotation in the first and second jaws 44, 46 relative to each other. Generally, the distal translation of the driver 48 causes the first and second jaws 44, 46 to rotate out and away from each other, while the proximal retraction of the driver 48 causes the first and second jaws 44, 46 to rotate inward. towards each other. The pins 80 are fitted through each of the proximal ends of the claws 44,46, to swivelly connect the claws in the housing 42. Other structures for forming a swivel connection can be used and preferably the swivel connection is centrally arranged in relation to pinions 68, 70.
[00019] In addition to the claws 44, 46 being swiveled to the housing 42, the first and second claws 44, 46 are also slidably attached to the housing 42. As best seen in figures 6 and 7 (and in conjunction with figures 1-4) the housing 42 defines a first guide surface 82 for the first jaw 44, and a second guide surface 84 for the second jaw 46. As seen in figure 3, the first and second guide surfaces 82, 84 are formed by elongated slits 82a, 82b, 84a, 84b formed on the opposite sides of the housing 42 which leaves the thickness of the housing 42 exposed to serve as the guide surface. The slots 82a, 82b are aligned to receive the connecting pin 80 of the first jaw 44, and likewise the slots 84a, 84b are aligned to receive the connecting pin 80 of the second jaw 46. The ends of the slits, for example, the distal ends 92, 94 shown in figure 7, serve to restrict the longitudinal movement of the claws 44, 46 in relation to the housing 42. The proximal ends 64, 66 of the claws 44, 46 include openings 72, 74 which receive pins 80 ( figures 1, 2 and 3) which are used to slide and rotate the first and second claws 44, 46 in the housing 42.
[00020] It can also be seen in figures 6 and 7 that the housing 42 defines a third guide surface 86 that guides the longitudinal movement of the driver 48 within the housing 42. The guide surface 86 in the described embodiment includes a guide surface to the left 86a and a guide surface on the right 86b formed as C-shaped channels. As shown in figure 7, the transitions from the third guide surface 86 from a smaller proximal width to a larger distal width to define a joint 88 in transition, which will still be described below with reference to figures 13 and 14. Various combinations of slots, guide surfaces, pins and other structures with sliding fit can be used to connect the claws to the housing.
[00021] As also shown in figure 6, the internal passage 43 of the housing 42 extends through the distal end of the housing, and through which the first and second jaws 44, 46 can extend. In addition, as shown in figures 1 and 2, the housing 42 defines opposite slots 45 which are dimensioned to allow the first and second jaws 44, 46 to pass through it when they rotate radially outward. Consequently, it is also clear from figures 1 and 2 that the housing 42 serves to block the rotation of the first and second jaws 44, 46 when they are totally or partially contained within the internal passage 43 of the housing 42.
[00022] The operation of the medical device 40 will now be described with reference to figures 812. As shown in figure 8, the first and second jaws 44, 46 are shown in a retracted position where they are substantially contained within the housing 42. Depending on the application, the distal ends 60, 62 of the claws 44, 46 can project subtly from the distal end of the housing 42 in their retracted positions, or they can be fully positioned within the housing 42. When the guiding wire 22 is transferred from distal way (to the right on the page in figure 8) the distal head 32 fits into the driver 48, and since the rack 54 of the driver 48 is interlaced with the pinions 68, 70 at the proximal ends 64, 60 of the claws 44, 46 , the driver 48 and the claws 44, 46 slide distally through the housing 42 in function of the housing 42 blocking their rotation. As previously mentioned, this longitudinal movement is guided by the first and second guide surfaces 82, 84 which receive the pins 80 which in a sliding and rotating manner connect the claws 44, 46 to the housing 42.
[00023] As shown in figure 9, the first and second jaws 44, 46 have an extended position where the jaws substantially project from a distal end of housing 42, and their proximal ends 64, 66 are positioned adjacent to the end distal from housing 42. As a result, it will be seen that still an additional distal advance of the guiding wire 22 and, therefore, the driver 48, causes the pinion 68 to rotate on the teeth 58 of the rack 54. As best seen in figure 10, the first and second jaws 44, 46 rotate radially outward from one another within a fabric receiving the position. In particular, due to the presence of cracks 45 at the distal end of the housing 42, the claws 44, 46 are allowed to rotate a full 90 °, thereby forming at least an angle of 180 ° between them. It will be recognized that by dimensioning the slots 45 and the construction of the rack 54 and pinions 68, 70, the first and second jaws 44, 46 can rotate further away from each other.
[00024] In the fabric receiving the configuration shown in figure 10, the medical device 40 and its claws 44, 46 can be positioned adjacent to a T fabric. As shown in figure 11, the T fabric can be arranged between the first and second jaws 44, 46 and jaws 44, 46 rotated back to their position shown in figure 9. T-fabric was shown as a single layer, although multiple layers can be attached between jaws 44, 46. Generally, proximal retraction the guiding wire 22 and the driver 48 causes the rotation of the first and second jaws 44, 46 again to grip the fabric T between them. As shown in figure 12, further proximal retraction of the guiding wire 22 and the driver 48 will cause the claws 44, 46 to move longitudinally in a proximal direction (to the left on the page in figure 12).
[00025] In order for the medical device 40 to be able to serve as a clamp and maintain its tightness in the T fabric, or to maintain the attachment of two layers of tissue against each other, the claws 44, 46 can be locked in position and the guiding wire 22 of the medical system 20 disconnected from the medical device 40. As shown in figure 13, the third guide surface 86 (which guides the actuator 48) includes a proximal portion 86p and a distal portion 86d. The proximal portion 86p of the third guide surface 86 has a width (measured upstream and downstream on the page in figure 13) that is greater than the width of the distal portion 86d of the third guide 86. As previously discussed, the third surface- guide 86 is formed by opposing the C-shaped surfaces or channels 86a, 86b of the housing 42. The transition between the proximal portion 86p and the distal portion 86d defines a joint 88, namely two joints 88a, 88b on sides housing opposites 42. Joints 88a, 88b are dimensioned and positioned to fit opposite locking tabs 52, located on driver 48.
[00026] As shown in figure 13, when the driver 48 is located within the distal portion 86d of the third guide surface 86, the locking tabs 52 are forced radially inward in a firm frictional fit with the guiding wire 22. In in other words, the socket 50 formed by the actuator 48 to receive the distal head 32 has an entrance which is narrowed by the internal deviation of the locking tabs 52. In this state described in figure 13, the guiding wire 22 is firmly engaged with the actuator 48 and consequently with the first and second jaws 44, 46. When the guide wire 22 and the driver 48 are retracted proximally, for example, during the tightening of the fabric as shown in figure 12, the proximal end of the driver 48 is received within the proximal portion 86p of the third guide surface 86 which has a greater width that allows outward movement of the locking tabs 52. Consequently, in the described in figure 14, the locking tabs 52 can be loosely and detachable connected to the distal head 32 of the guiding wire 22. That is, the proximal retraction of the claws 44, 46 will be limited either by the T fabric that fits on the end distal from housing 42, or by the pins 80 that will touch the proximal ends of the slits 82a, 82b, 84a, 84b defining the first and second guide surfaces 82, 84. Therefore, when the proximal movement of the claws 44, 46 and the driver 48 is therefore limited and another proximal movement of the guiding wire 22 and its distal head 32 can be used to remove the distal head 32 from the socket 50 of the driver 48. This operation can also be used to further bypass plus the locking tabs 52 radially outward. If the natural elasticity of the fabric T tends to pull the claws 44, 46 out of the housing towards its extended position, the locking tabs 52, 54 will abut the joints 88a, 88b of the third guide surface of the housing 42 to avoid another distal movement of the claws 44, 46.
[00027] In a preferred embodiment, the locking tabs 52 are plastically deformable and can be folded around the distal head 32 of the guiding wire 22 during manufacture. In this way, the driver 48 and its tabs 52 can have an initial size to slide into the distal portion 86d of the third guide surface 86, and the proximal retraction of the guiding wire 22 and the distal head 32 of a predetermined force will plastically deform the locking tabs 52 outwardly in position to engage the joints 88a, 88b and lock the clamp by preventing the distal movement of the claws 44, 46 beyond.
[00028] Now changing to figures 15 and 16, during yet another proximal retraction of the guiding wire 22 and the distal head 32, the enlarged distal head 32 will lean against the connection block 26 which is slidably inserted inside the tubular connector 24. Sufficient proximal force on the guiding wire 22 will overcome the frictional fit between the connection block 26 and the proximal end of the housing 42, thereby moving the connection block 26 proximally (to the right on the page of figures 15 and 16) to retract the connection block 26 inside the tubular connector 24. An elongated cover 23 slidably fits the guiding wire 22, and extends proximally along it to the proximal end of the device. The cover 23 can be used to provide a counter-force on the connector 24 and the housing 42 and at the same time a proximal retraction of the guiding wire 22 and the connecting block 26. Consequently, the guiding wire 22, the tubular connector 24 and the connection block 26 can be completely disconnected from the medical device 40, thus leaving the first and second jaws 44, 46 and the housing 42 in a state that has the T tissue fixed between the jaws 44, 46 and retained in vivo.
[00029] It will be recognized by those skilled in the art that the guiding wire 22 and its distal head 32 could be reconnected to the driver 48 and its socket 50, thereby allowing additional manipulation of the medical device to adjust the fixed tissue T. Likewise, additional medical devices can be attached to the guiding wire 22 and the tubular connector 24 of the medical system 20 for the distribution of additional medical devices, for example, multiple devices 40 for fixing the T tissue can be used to close perforation or obtain hemostasis. Generally, the support ring 34 (figures 1-4) fixed on the guiding wire 22 can be used to limit the distal movement of the guiding wire 22, and it can be distally advanced to the contact position with the connection block 26. Therefore, the guiding wire 22 and the support ring 34 can be used to push the connection block 26 distally out of the tubular connector 24 in such a way that it can be fixed to the housing (for example, example 42) of a new medical device (eg 40), or to the previously arranged medical device 40. Alternatively, the user can manually press the connection block 26 distal way out of the tubular connector 24 for connection to another medical device.
[00030] The medical system 20 also includes a device with a proximal end for the operation of the medical device 40, and preferably a cable 90 as shown. The cable 90 includes an outer member 92 which slidably receives an inner member 94. The outer member 92 is a tubular member defining a passage which receives the inner member 94, and includes a coil 96 formed on the outer surface which it is shaped to be grasped by the health professional's fingers. The inner member 94 may have a tubular or rod shape, and includes a thumb ring 98 at its proximal end for the health professional to handle. The outer member 92 is attached to the cover 23, which is preferably a catheter with a wound and coated wire as is known in the art. The inner member 94 is connected to the guide wire 22. Thus, the translation of the inner member 94 and the thumb loop 98 in relation to the outer member 92 and the coil 96 causes a relative translation of the guide wire 22 in relation to the cover. 23. This in turn operates the medical device 40, that is, the clamp defined by the housing 42 and the claws 44, 46 which rotate in relation to each other, as previously described. A side orifice 100 can also be provided in communication with the internal passage of the outer member 92 and the cover 23 for the injection of fluids or other agents to facilitate hemostasis, closure, cleaning or other aspects related to the methods described above.
[00031] It will be recognized by persons skilled in the art that, although the methods described above generally include the provision of devices for tissue in the tissue through an internal body lumen, it will be recognized that the systems, devices and methods can be used in any layer of material (for example, fabrics, clothing, polymers, elastomers, plastics and rubber) which may or may not be associated with the body of a human or animal and a body lumen. For example, systems, devices and methods may find use in a laboratory and industrial environment for fixing (or cutting, bonding or tightening) one or more layers of material that may or may not find application in the body of a human or a person. an animal, and in the same way that it can close holes or perforations in the layers of material that are a body tissue Some examples include sewing or suturing and related manufacturing, working with synthetic fabrics, polymeric sheets for connection or repair, animal studies, veterinary applications, and postmortem activities.
[00032] The foregoing description of various embodiments of the invention has been presented for the purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise modalities described here. Numerous modifications or variations are possible in view of the above teachings. The modalities discussed were chosen and described to provide the best illustration of the principles of the invention and its practical application, thus allowing a person skilled in the art to use the invention in various modalities and with several modifications when it is suitable for the particular contemplated use. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted according to the scope for which they are fairly, legally and equivalently entitled.

权利要求:
Claims (13)
[0001]
1. Medical device (40) for fitting tissue (T), the medical device (40) comprising: a housing (42) that defines an internal passage (43) and a longitudinal geometric axis that extends between the proximal ends and distal from the housing, the housing (42) defining first and second guide surfaces (82, 84) along the inner passage (43); a first claw (44) slidably connected to the housing (42), the first claw (44) having proximal and distal ends (64, 60), the first claw (44) slidably received within the internal passage (43) for longitudinal movement along the first guide surface (82) between an extended position and a retracted position; a second claw (46) slidably connected to the housing (42), the second claw (46) having proximal and distal ends (66, 62), the second claw (46) slidably received inside the internal passage (43) for longitudinal movement along the second guide surface (84) between an extended position and a retracted position; the housing (42) structured to block the rotation of the first and second claws (44, 46) when it is in its retracted positions, the housing (42) structured to allow the rotation of the first and second claws (44, 46) when it is in the their extended positions; a driver (48) fitted with the proximal ends of the first and second jaws (44, 46), configured so that the longitudinal movement of the driver moves the first and second jaws (44, 46) longitudinally along the first and second guide surfaces (82, 84) between their retracted and extended positions, where the first claw (44) is also pivotally connected to the housing (42) and the first guide surface (82) has a distal end (92 ) in which, in the extended position of the first claw (44), the distal end (92) of the first guide surface (82) limits the longitudinal movement of the first claw (44) beyond the extended position; and where the second claw (46) is also pivotally connected to the housing (42) and the second guide surface (84) has a distal end (94), where in the extended position of the second claw (46), the distal end (94) of the second guide surface (84) restricts longitudinal movement of the second claw (46) beyond the extended position, characterized by the fact that the first guide surface (82) is formed by a pair of elongated first slits (82a , 82b) formed on opposite sides of the housing (42) and the second guide surface (84) is formed by a pair of second elongated slits (84a, 84b) formed on opposite sides of the housing (42), in which the first slits elongated (82a, 82b) are aligned to receive a connecting pin (80) from the first jaw (44) and the second elongated slots (84a, 84b) are aligned to receive a connecting pin (80) from the second jaw (46) and where the distal ends (92, 94) serve to restrict the longitudinal movement of the first and second the claws (44, 46) in relation to the housing (42); and when the first and second jaws (44, 46) are in their extended positions, additional longitudinal distal movement of the actuator (48) rotates the first and second jaws (44, 46) in relation to the housing (42) and radially outward between into a tissue receiving position.
[0002]
2. Medical device (40) according to claim 1, characterized in that the proximal ends of the first and second jaws (44, 46) are slidably and swiveled to the housing (42).
[0003]
Medical device (40) according to claim 1, characterized in that the housing (42) defines an articulation (88) within the internal passage (43), and in which the driver (48) includes a flap locking mechanism (52) positioned to fit the hinge (88) to limit the longitudinal movement of the driver (48) and the first and second jaws (44, 46).
[0004]
4. Medical device (40) according to claim 3, characterized by the fact that the hinge (88) is configured to move the locking tab (52) to a position out of joint with the hinge (88) when a longitudinal force distally directed on the actuator (48) reaches a predetermined force to allow the longitudinal movement of the actuator (48) and the first and second grips (44, 46) in a distal direction.
[0005]
5. Medical device (40), according to claim 4, characterized by the fact that it still comprises an elongated directing wire (22) selectively connected to the actuator (48) for longitudinal movement with it, and in which the locking tab (52) is configured to fit tightly on the guide wire (22) when the locking tab (52) is positioned distally from the hinge (88), and where the locking tab does not fits tightly on the guiding wire (22) when the locking tab (52) is positioned proximally to the hinge (88) to allow the guiding wire (22) to be disconnected from the driver (48).
[0006]
Medical device (40) according to claim 4, characterized in that the housing (42) defines a third guide surface (86), the third guide surface (86) guiding the longitudinal movement of the driver ( 48) inside the housing (42), the third guide surface (86) defining the articulation (88).
[0007]
7. Medical device (40), according to claim 1, characterized by the fact that it still comprises an elongated directing wire (22) that has an enlarged distal head (32), and in which the driver (48) includes a socket (50) closely opposite, the actuator (48) constructed with a resilient material that flexes to adjust the socket size (50), the socket (50) dimensioned to selectively receive the extended distal head (32) of the wire targeting (22).
[0008]
8. Medical device (40) according to claim 1, characterized in that the proximal ends (64, 66) of the first and second jaws (44, 46) include teeth with gear (68, 70), and in that the driver (48) includes corresponding teeth (58) which intertwine with the gear teeth (68, 70) of the claws (44, 46).
[0009]
9. Medical device (40) according to claim 8, characterized by the fact that the proximal ends (64, 66) of the first and second claws (44, 46) are formed as pinions (68, 70), and in that the driver (48) is formed as a rack (54), in which the longitudinal movement of the driver (48) and the rack (54) rotates the pinions (68, 70) and the first and second claws (44, 46) in their extended positions.
[0010]
10. Medical device (40) according to claim 9, characterized by the fact that the driver (48) includes a central column (56) that extends longitudinally and teeth (58) that extend laterally from the central column (56).
[0011]
Medical device (40) according to claim 10, characterized in that the driver (48) includes pairs of teeth (58) that extend in laterally opposite directions from the column (56) to form two sets of teeth (58), one of the two sets of teeth (58) fitted with the pinion (68) of the first claw (44), the other of the two sets of teeth (58) fitted with the pinion (70) of the second claw ( 46).
[0012]
Medical device (40) according to claim 7, characterized by the fact that the locking tab (52) is positioned on an outlet inlet (50) and moves to vary the size of the inlet.
[0013]
13. Medical device (40) according to claim 12, characterized by the fact that the actuator (48) includes two locking tabs (52) on opposite sides of the socket (50), and in which the guide surface of the The driver (86) includes two surfaces (86a, 86b) on opposite sides of the housing (42) corresponding to the two locking tabs (52).

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同族专利:

公开号 | 公开日

EP3441015A1|2019-02-13|

EP2515770B1|2018-10-31|

DK2515770T3|2019-02-25|

AU2010341612A1|2012-07-26|

US20180256169A1|2018-09-13|

JP2015163222A|2015-09-10|

CN102762157A|2012-10-31|

US9987018B2|2018-06-05|

JP5739907B2|2015-06-24|

CA2785246A1|2011-07-21|

WO2011087723A1|2011-07-21|

US20140257343A1|2014-09-11|

BR112012018338B8|2021-06-22|

US10813650B2|2020-10-27|

EP2515770A1|2012-10-31|

EP3441015B1|2020-09-16|

EP3437571A3|2019-04-03|

EP3437571B1|2020-06-17|

CA2785246C|2014-10-21|

US20110152887A1|2011-06-23|

US8771293B2|2014-07-08|

US9375219B2|2016-06-28|

US20150297239A1|2015-10-22|

BR112012018338A2|2018-06-05|

EP3437571A2|2019-02-06|

JP6062994B2|2017-01-18|

CN102762157B|2015-04-01|

AU2010341612B2|2013-02-28|

JP2013514865A|2013-05-02|

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法律状态:
2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

2020-09-08| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

2020-12-29| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

2021-03-02| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 10 (DEZ) ANOS CONTADOS A PARTIR DE 02/03/2021, OBSERVADAS AS CONDICOES LEGAIS. |

2021-06-22| B16C| Correction of notification of the grant|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 17/12/2010, OBSERVADAS AS CONDICOES LEGAIS. PATENTE CONCEDIDA CONFORME ADI 5.529/DF, QUE DETERMINA A ALTERACAO DO PRAZO DE CONCESSAO |

优先权:

申请号 | 申请日 | 专利标题

US28929709P| true| 2009-12-22|2009-12-22|

US61/289,297|2009-12-22|

PCT/US2010/061077|WO2011087723A1|2009-12-22|2010-12-17|Medical devices with detachable pivotable jaws|

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