• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    medical devices with detachable rotating claws. these are medical methods, devices and systems for attaching a tissue, for example, for attaching the tissue, closing a perforation or performing hemostasis. in general, the medical system includes a housing, first and second rotating jaws in relation to the housing, first and second connections pivotally attached to the jaws and a driver. the housing, the first and second claws and the first and second connections form an integration mechanism that allows the claws to engage the tissue and are left in vivo.
    公开号:BR112013008755B1
    申请号:R112013008755-2
    申请日:2011-10-11
    公开日:2021-04-27
    发明作者:John Crowder Sigmon Jr.；Michelle D. Martinez；Vihar C. Surti
    申请人:Cook Medical Technologies Llc；
    IPC主号:
    专利说明:

    BACKGROUND
    [001] Conventionally, a fastener can be inserted into a body cavity through an endoscope to apprehend living tissue in a body cavity for hemostasis, marking and / or ligation. Such fasteners are often known as surgical fasteners, endoscope fasteners, hemostasis fasteners and vascular fasteners. In addition, fasteners are now used in a variety of applications related to gastrointestinal bleeding, such as peptic ulcers, Mallory-Weiss tears, Dieulafoy lesions, angiomas, post-papillary bleeding, and small varicose veins with active bleeding. Attempts were also made to use fasteners to close stomach perforations
    [002] Gastrointestinal bleeding is a somewhat common and serious condition that is often fatal if left untreated. This problem led to the development of several endoscopic therapeutic approaches to achieve hemostasis, such as the injection of sclerosing agents and contact thermocoagulation techniques. Although such approaches are often effective, bleeding continues for many patients and, therefore, corrective surgery is necessary. Due to the fact that surgery is an invasive technique that is associated with a high rate of morbidity and many other undesirable side effects, there is a need for less invasive and highly effective procedures.
    [003] Mechanical hemostatic devices, such as fasteners, have been used in various parts of the body, including gastrointestinal applications. However, one of the problems associated with conventional hemostatic fasteners and devices is that many devices are not strong enough to cause permanent hemostasis. In addition, the use of fasteners was also attempted to close perforations in the stomach or gastrointestinal structures, but, unfortunately, traditional fasteners suffer from difficult positioning and the ability to seize a limited amount of tissue, potentially resulting in incomplete closure. SUMMARY
    [004] 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.
    [005] In a first aspect, a medical device is provided to engage the tissue, the medical device including a housing, first and second jaws, the first and second connections, and a driver. The housing defines an internal passage and a longitudinal geometric axis that extends between the proximal and distal ends of the housing. The housing also defines a jaw guiding surface, a first connecting guiding surface and a second connecting guiding surface, each of the guiding surfaces extending longitudinally between the proximal and distal ends of the guiding surfaces. The first jaw is slidably and pivotably connected to the housing, and has proximal and distal ends. The first clamp is slidably received inside the internal passage for longitudinal movement along the clamp guide surface. The second jaw is slidably and pivotably connected to the housing, and has proximal and distal ends. The second clamp is slidably received inside the internal passage for longitudinal movement along the clamp guide surface. The first link has the first and the second ends. The first end is pivotably attached to the first jaw, and the second end is slidably and pivotably attached to the housing for longitudinal movement along the first connecting guide surface. The second connection has the first and the second ends. The first end is pivotably attached to the second jaw, and the second end is slidably and pivotably attached to the housing for longitudinal movement along the second connecting guide surface. The driver is operatively connected to the first and second jaws, whereby the longitudinal movement of the driver moves the first and second jaws longitudinally along the jaw guiding surface and moves the second ends of the first and second connections along the first and second connecting guide surfaces. The longitudinal movement of the driver rotates the first and second jaws with respect to the housing when the second ends of the first and second connections reach the distal ends of the first and second guide surfaces.
    [006] According to more detailed aspects, the proximal ends of the first and second jaws are fixed in a sliding and pivotable manner to the housing. Preferably, the proximal ends are pivotably attached to the housing around a shared jaw pivot geometric axis. A jaw pivot pin can be used to positively connect the proximal ends of both the first and second jaws to the housing. The jaw guide surface is defined by the opposing jaw slits formed in the housing, with the opposing jaw slots receiving the opposite ends of the jaw pivot pin. Preferably, the jaw guide surface extends longitudinally and parallel to the central geometric axis. The jaw guide surface can be located between the first and second connecting guide surfaces. The first ends of the first and second connections are pivotably fixed at an intermediate point of the first and second jaws, respectively, while the second ends of the first and second connections are slidably and pivotably connected to the housing.
    [007] According to additional detailed aspects, the driver is engaged with the proximal ends of the first and second jaws when the driver is moved distally. The actuator is engaged with the second ends of the first and second connections when the actuator is moved proximally. Preferably, the driver includes a distal end to engage the first and second jaws, the distal end of the driver includes a first flange that engages the proximal end of the first jaw and is shaped to allow rotation of the first jaw with respect to the first flange while engaged, the distal end of the driver including a second flange that engages the proximal end of the second jaw and is shaped to allow rotation of the second jaw with respect to the second flange while engaged. The driver extends longitudinally to a position located proximal to the second ends of the first and second connections.
    [008] According to still further detailed aspects, the first and second jaws are longitudinally slidable between an extended position and a retracted position, and the housing is structured to block the rotation of the first and second jaws when in their retracted positions, and the housing is structured to allow rotation of the first and second jaws when in their extended positions. The first and second connections are also longitudinally slidable between an extended position and a retracted position, and at the same time or alternatively, the housing is structured to block the rotation of the first and second connections when in their retracted positions, and the housing is structured to allow the rotation of the first and second connections when in their extended positions. The housing, the first connection, and the first jaw are rotatable with respect to each other, and the housing, the second connection, and the second jaw are rotatable with respect to each other, and, in addition, the second ends of the first and the second connections are longitudinally slidable with respect to the proximal ends of the first and second jaws, whereby the distance between the second and proximal ends determines the rotation of the first and second jaws between a closed configuration and an open configuration . The device can also include an elongated drive wire selectively connected to the actuator for longitudinal movement with it, and an elongated tubular member (e.g., a catheter) selectively connected to the housing. Sufficient proximal translation of the drive wire disconnects the driver from the drive wire and the housing of the elongated tubular member.
    [009] According to more detailed aspects, the device can also include a first link pivot pin that pivotably connects the second end of the first link to the housing, and a second link pivot pin that pivotably connects to second end of the second connection to the housing. The first connecting guide surface is defined by the first opposite connecting slits formed in the housing, and the second connecting guide surface is defined by the second connecting slits formed in the housing, where the first opposite connecting slits receive the opposite ends of the first connecting pivot pin, and where the second connecting slots receive the opposite ends of the second connecting pivot pin.
    [010] In a second aspect, a method is provided for securing the fabric. The method includes providing a medical device comprising a housing, the first and the second jaws, the first and the second connections, and a driver, in which the first and the second jaws are slidably and pivotably connected to the housing, the first and the second connections are slidably and pivotably connected to the housing, the first and second connections are pivotably attached to the first and second jaws, respectively, and the driver is operatively connected to the first and second jaws. The actuator is advanced distally to transfer the first and second jaws and the first and second connections distally with respect to the housing. The distal translation of the first and second connections is limited or blocked while additionally advancing the actuator distally to rotate the first and second jaws with respect to the housing. The actuator is retracted proximally to rotate the first and second jaws with respect to the housing. According to more detailed aspects, the medical device can also comprise an elongated drive wire selectively connected to the driver for longitudinal movement with it, and the drive wire can be detached from the driver. BRIEF DESCRIPTION OF THE DRAWINGS
    [011] The accompanying drawings incorporated and forming a part of the specification illustrate several aspects of the present invention, and together with the description, they serve to explain the principles of the invention. In the drawings:
    [012] Figure 1 is a top view of a medical system that has a medical device for engaging tissue, constructed in accordance with the teachings of the present invention;
    [013] Figure 2 is a top view similar to Figure 1, but showing the outer structures in dotted lines and the inner sections in solid lines and partial cross section;
    [014] Figure 3 is a side view of the medical device and system depicted in Figure 1;
    [015] Figure 4 is a side view similar to Figure 3, but showing the outer structures in dotted lines and the inner structures in solid lines and partial cross section
    [016] Figure 5 is a front perspective view of the interior structures of the medical device and system depicted in Figures 1 to 4;
    [017] Figure 6 is a rear perspective view of the interior structures of the medical device and system depicted in Figures 1 to 4;
    [018] Figures 7 to 11 are side views showing the operation of the medical device and system depicted in Figures 1 to 4;
    [019] Figures 12 and 13 are top views, partially in cross-section, which depict the operation of the medical device and system depicted in Figures 1 to 4; and
    [020] Figures 14 and 15 are seen in cross section showing the operation of the medical system depicted in Figures 1 to 4. DETAILED DESCRIPTION
    [021] The terms "proximal" and "distal" used in this document are intended to have a point of reference with respect to the user. Specifically, throughout the specification, the terms "distal" and "distally" should denote a position, direction or orientation that is generally away from the user, and the terms "proximal" and "proximally" should denote a position, direction or orientation that is usually towards the user.
    [022] An exemplary medical system 20 that has a medical device 40 for engaging the T tissue (Figure 11) is shown in Figures 1 to 4. Device 40 and medical system 20 are generally dimensioned and structured for operation through the channel working scope of an endoscope (not shown) or other scope, although system 20 and device 40 can also be used alone or in conjunction with other elongated devices, such as catheters, fiber optic visualization systems, needles and the like. Generally, the medical system 20 includes a drive wire 22 slidably housed within the distal end 23 of a catheter 24 for selective connection to, and operation of, the medical device 40. As will be described in further detail herein, the medical device 40 generally includes a housing 42 that has a first jaw 44 and a second jaw 46 pivotally connected to it to engage the T tissue. Generally, the jaws 44, 46 have been shown to form the apprehension forceps, although the cheeks are intended to be used to secure tissue, for example, to close an opening or for hemostasis. Consequently, it will be recognized that the shape and structure of the jaws can take many forms and serve many purposes and functions, all in accordance with the teachings of the present invention.
    [023] In medical system 20, the drive wire 22 extends slidably through catheter 24. Although the term "wire" is used to refer to drive 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 tubes or rods, multiple filament or single filament yarns and the like. The drive wire 22 must also be able to properly transmit a torsion / rotation force from the proximal end to the distal end to rotate the medical device 40 and the jaws 44, 46, and thus it is currently preferred that the drive wire 22 is formed of nitinol (e.g., a nitinol wire) or other superelastic alloy.
    [024] A connection block 26 is slidably fixed within the distal end 23 of the catheter 24 and defines a hole 28 through which the drive wire 22 slidably receives. The exterior of the connection block 26 includes a portion recessed 27, and two pins 30 (for example, formed of stainless steel wire) are connected to catheter 24 and positioned within the recessed portion 27 (that is, between the proximal and distal flanges that define the recessed portion 27) to limit the longitudinal movement of the connection block 26.
    [025] A distal end of the drive wire 22 defines a distal head 32 which is dimensioned as larger than the drive wire 22, and likewise larger than the hole 28 in the connection block 26. As will be described later in this document, the distal head 32 is used to slide the connection block 26 into the catheter 24 to disconnect the medical device 40 from the medical system 20. As also seen in Figures 1 to 4, the housing 42 of the medical device 40 is a tubular member defining an interior space 43. A proximal end of the housing 42 receives with friction a distal end of the connection block 26 within the interior space 43 for selective connection therewith.
    [026] The internal passage 43 of the housing 42 also receives the first and second jaws 44, 46 and a driver 48 which is used to interconnect the drive wire 22 to the jaws 44, 46. As best seen in Figure 5, the first and second jaws 44, 46 include distal ends 60, 62 which are structured to seize and engage the tissue, which have a claw shape as revealed in 61 / 141,934 filed on December 31, 2008, the disclosure of which is incorporated in this document by reference in its entirety. Generally, the distal translation of the actuator 48 causes the first and second jaws 44, 46 to rotate out and away from each other, while the proximal retraction of the actuator 48 causes the first and second jaws 44, 46 rotate inwards towards each other.
    [027] As best seen in Figures 1, 2 and 5 to 6, the driver 48 has a proximal portion that defines a socket 50 sized to receive the enlarged distal head 32 of the drive wire 22. At the proximal socket entrance 50, two defectable locking tabs 52 are formed, which rotate with respect to the rest of the driver 48 to increase or decrease the size of socket 50. The locking tabs 52 can be formed separately and pivotably attached to the driver 48, or they can be integrally formed with the driver 48 and formed of a resilient material that flexes to allow rotation of the locking tabs 52 radially inward and radially outward. Preferably, the locking tabs 52 are deformable in a plastic way, such that they can be locked in the drive wire 22 or in the housing 42, as discussed further in the present document.
    [028] As best seen in Figures 5 to 6, a distal portion of the driver 48 defines double L-shaped flanges 56, 58 to engage and operate the jaws 44, 46. The inner surface of the flange 56 engages a proximal end 66 of the jaw 46, while the inner surface of the flange 58 engages a proximal end 64 of the jaw 44. The flanges 56, 58 are shaped to allow the rotation of the proximal ends 64, 66 of the jaws 44, 46 with respect to the flanges 56, 58 while engaged with them. Although the flanges 56, 58 and the proximal ends 64, 66 have been shown as square (so that they engage firmly in the fully open and fully closed positions), the coupling surfaces can be rounded or, otherwise, shaped to promote rotation between flanges 56, 58 and proximal ends 64, 66 of jaws 44, 46.
    [029] The proximal ends 64, 66 of the jaws 44, 46 are pivotably attached to the housing 42 directly by means of a pin 49 that extends through the proximal ends 64, 66 and through the opposite jaw slits 86 formed in the housing , as best seen in Figures 3 to 4. By virtue of the jaw slits 86, the jaws 44, 46 are thus both pivotally and slidably fixed to the housing 42. The opposite jaw slits 86 act and define, thus , a jaw guiding surface of the housing 42 that guides the longitudinal movement of the jaws 44, 46 with respect to the housing. The distal ends of the jaw slits 86 also serve to restrict the longitudinal movement of the jaws 44, 46 with respect to the housing 42. It will be recognized that the jaw guiding surface could also be formed by channels, recesses or other structures formed in the housing 42, instead of, or in conjunction with nipple slits 86. During assembly, slots allow the pins of the device 40 to be inserted after the jaws, the connections and the driver are positioned with the housing, and the slots can later be covered with a sleeve, strip, secondary housing or other material if desired.
    [030] Returning to Figures 5 and 6, the first and the second jaws 44, 46 are also indirectly connected to the housing 42 by means of the first and second connections 68, 70, respectively. The distal ends of the first and second connections 68, 70 are pivotably attached to the first and second jaws 44, 46 by means of pivots 81. The swivel connections (pivots 81) are formed at an intermediate point of the first and second jaws 44, 46, that is, anywhere between the proximal ends 66, 68 and the distal ends 60, 62 of the first and second jaws 44, 46. The proximal ends of the first and second connections 68, 70 are fixed securely sliding and pivotable mode to the housing 42 by means of two pins 80. In particular, and as best seen in Figures 3 to 4, the housing 42 defines the first opposite connecting slots 82 which are dimensioned and positioned to receive the pin 80 of the the first connection 68, as well as the second connection slots 84 which are dimensioned and positioned to receive the pin 80 of the second connection 70. In Figures 1 to 2, the first opposite connection slots 82 are individually identified reference numerals 82a and 82b. Consequently, the opposing first and second connecting slots 82, 84 act and define the first and second connecting guide surfaces of the housing 42 that guide the longitudinal movement of the first and second connections 68, 70 with respect to the housing 42. As with the jaw guide surface, the first and second connecting guide surfaces could also be formed by channels, recesses other structures formed in the housing 42, instead of, or in conjunction with the first and second connecting slits 82, 84 .
    [031] Actuator 48 extends between the proximal plus ends of the first and second connections 68, 70, and engages the proximal ends 64, 66 of the first and second jaws 44, 46 to first expose and then open the jaws 44, 46, as shown in Figures 5 and 6. At the same time, the proximal ends of the connections 68, 70 and their pins 80 are located in such a way that the proximal retraction of the driver 48 (through the wire drive 22) causes the outer surface of the L-shaped flanges 56, 58 to engage pins 80 (or connections 68, 70) for retraction and closure of jaws 44, 46, as will be described in further detail below. Thus, it can be seen that the jaw guide surface of the slot 86 is located between the first and second guide surfaces of the slots 82, 84 (which are above and below the slot 86), as best seen in Figures 3 to 4.
    [032] The internal passage 43 of the housing 42 extends through the distal end of the housing 42, and it is through this passage 43 that the first and second jaws 44, 46 can extend. Additionally, as shown in Figures 1 to 4, the housing 42 defines the opposite slots 45 which are dimensioned to allow the first and second jaws 44, 46 and the first and second connections 68, 70 to pass through them 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 connections 68, 70 when they are entirely or partially contained within the internal passage 43 of the housing 42. Suitable plastics to form the housing include, but are not limited to, polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (EPTFE), polyethylene ketone ether (PEEK), polyvinyl chloride (PVC), polycarbonate (PC), polyamide, polyimide, polyurethane, polyethylene (density high, medium or low), and suitable metals include stainless steel, nitinol and alloys and metals of similar medical grade.
    [033] Turning to the sequence of Figures 7 to 11, the operation of the medical device 40 will now be described. As shown in Figure 7, the first and second jaws 44, 46 are shown in a retracted position where they are substantially contained within housing 42. Depending on the application, the distal ends 60, 62 of the jaws 44, 46 can protrude slightly from the distal end of the housing 42 in its retracted positions, or they can be positioned entirely within the housing 42. When the drive wire 22 is moved distally (to the left on the page in Figure 7), the head distal 32 engages the actuator 48, which in turn engages the proximal ends 64, 66 of the jaws 44, 46 (via the actuator flanges 56, 58 (Figures 5-6)), which causes jaws 44, 46 slide distally through and out of housing 42, as shown in Figure 8. As mentioned earlier, this longitudinal movement is guided by the jaw guiding surface of jaw slot 86 (which receives pin 49), and the super These connection guides of the connection strips 82, 84 (which receive the pins 80) that connect the jaws 44, 46 in a pivotable and slidable way to the housing 42.
    [034] As shown in Figure 8, the first and second jaws 44, 46 have an extended position where the jaws protrude substantially from a distal end of housing 42. In this extended position, pins 80 at the proximal ends of the first and from the second connections 68, 70 reached the end of their slits 82, 84, while pin 49 at the proximal ends 64, 66 of the jaws 44, 46 did not reach the end of the slit 86. Consequently, it will be seen that the additional distal advance drive wire 22, and therefore the driver 48 causes the proximal ends 64, 66 of the jaws 44, 46 to continue to move distally (to the left on the page), while connections 68, 70 induce rotation of the jaws 44, 46 away from each other, as shown in Figure 9. Eventually, the pin 49 reaches the end of the jaw slot 86, at which point the jaws 44, 46 are fully open. It was shown that the jaws 44, 46 rotate by about 75o, thus forming an opening of 150o between them, however, the housing 42 and its slits can be dimensioned to allow rotation through 90o or more, forming, thus, at least 180 ° between them. Slots 45 in housing 42 are dimensioned to allow rotation of jaws 44, 46 and connections 68, 70 out of the housing, and these slots 45 can also be used to limit their rotation, in addition to, or separately from, the sizing of slots 82, 84, 86. Therefore, it will be seen that the distance between pins 80 (at the ends of the first and second connections 68, 70) and the proximal ends 64, 66 of the jaws 44, 46 determines the rotation of the first and the second morbid between a closed and an open configuration.
    [035] In the tissue receiving configuration (open configuration) shown in Figure 9, the medical device 40 and its jaws 44, 46 can be positioned adjacent to the T tissue. As shown in Figure 10, the T tissue can be placed between the first and the second jaws 44, 46 and the jaws 44, 46 rotated backwards in the direction of their positions shown in Figure 8. T-fabric was shown as a single layer, although multiple layers can be trapped between the jaws 44, 46. Generally , the proximal retraction of the drive wire 22 and the driver 48 causes the flanges 56, 58 of the driver 48 to engage the pins 80 at the proximal ends of the connections 68, 70. In particular, as also clear from Figures 5 and 6, flange 56 will engage pin 80 of the first connection 68, and flange 58 will engage pin 80 of the second connection 70. As connections 68, 70 are pulled proximally (to the right on the page) the housing 42 presses connections 68, 70 (and / or jaws 44, 46) and causes them to rotate each other to apprehend the T fabric between them. Depending on their orientation towards the patient and the floor, the jaws 44, 46 can also naturally collapse towards each other. As shown in Figure 11, the additional proximal retraction of the drive wire 22 and the driver 48 will cause the jaws 44, 46 to move longitudinally in a proximal direction (to the right on the page in Figure 11).
    [036] In order for the medical device 40 to serve as a gripper and maintain its hold on the T tissue, or to hold the grasp of two layers of tissue against each other, the jaws 44, 46 can be locked in position and the wire drive 22 of the medical system 20 disconnected from the medical device 40. As shown in Figure 12, the interior of housing 42 also defines a driver guide surface 88 (which drives driver 48) that has a proximal portion 88p and a distal portion 88d . The proximal portion 88p of the driver guide surface 88 has a width (measured up and down on the page in Figure 12) that is greater than a width of the distal portion 88d of the driver guide surface 88. The driver guide surface 88 can be formed by opposite surfaces or C-shaped channels in the housing 42. The transition between the proximal portion 88p and the distal portion 88d defines a shoulder 89, and in particular two shoulders 89a, 89b on opposite sides of the housing 42. The shoulders 89a, 89b are dimensioned and positioned to engage the locking tabs 52 located on the driver 48.
    [037] As shown in Figure 12, when the driver 48 is located within the distal portion 86d of the third guide surface 86, the locking tabs 52 are radially forced inwardly in frictional engagement with the extended head 32 and / or the drive wire 22. In other words, the socket 50 formed by the driver 48 that receives the distal head 32 has an entrance that is narrowed by the deflection into the locking tabs 52. In this state depicted in Figure 12, the drive wire 22 is firmly engaged with driver 48 and therefore the first and second jaws 44, 46. When drive wire 22 and driver 48 are retracted proximally, for example, by seizing the fabric as shown in Figure 11, the proximal end of the driver 48 is received within the proximal portion 88p of the third guide surface 88, which has a greater width that allows outward movement of the locking tabs 52. Consequently, in the retracted state o in Figure 13, the locking tabs 52 can be loosely and detachably connected to the distal head 32 of the drive wire 22. As such, the additional proximal movement of the drive wire 22 and its distal head 32 can be used to remove the distal head 32 from the socket 50 of the driver 48. At the same time, the locking tabs 52 move radially outwardly and in engagement with the shoulders 89a, 89b to lock the device 40 in a state where the fabric T is trapped between the jaws 44, 46. The flaps 52 can deform plastic to that outward position to maintain the closed configuration of the jaws. In the event of the natural elasticity of the T-fabric tending to pull the jaws 44, 46 out of the housing towards its extended position, the locking tabs 52 will confine the shoulders 89 of the drive guide surface of the housing 42 to prevent further distal movement or the rotation of the jaws 44, 46.
    [038] Now returning to Figures 14 and 15, by means of the still further proximal retraction of the drive wire 22 and the distal head 32 (to the right on the page), the enlarged distal head 32 (or another enlarged portion of the drive wire 22 ) will confine the connection block 26, which is slidably fixed within the distal end 23 of the catheter 24. Sufficient proximal force on the drive wire 22 will overcome the frictional fixation between the connection block 26 and the proximal end of the housing 42, thus moving the connection block 26 proximally to retract the connection block 26 within the tubular connector 24, as shown in Figure 15. The catheter 24 can be used to provide a counter force in the housing 42 while proximally retracting the drive wire 22 and connection block 26. Consequently, drive wire 22, catheter 24 and connection block 26 can be completely disconnected from medical device 40, thereby leaving the first and the second jaws 44, 46 and the housing 42 in a state that has the T tissue trapped between the jaws 44, 46 and retained in vivo. The connection block 26 is retained at the distal end 24 of the catheter 24 by means of the pins 30, which are positioned within the recessed area 27 to engage the proximal and distal ends of the connection block 26 and limit its longitudinal movement.
    [039] The elongated catheter 24 (or other elongated tubular member such as a sheath, tube, scope or the like), which slidably covers the drive wire 22, extends proximally along it to a proximal end of the system 20 , and is of a suitable length to place the device 40 at any desired location within the body, while the proximal ends of the drive wire 22 and the catheter 24 are positioned outside the body for use by the medical professional. Control knobs (not shown) to control the relative translation of the drive wire 22 and catheter 24 are well known in the art, and can be used at the proximal end of system 20. Additional modalities of the connection / disconnection mechanisms and the medical system 20 can be found in copendent Order no. U.S. 61 / 391,878 and Order no. US. 61 / 391,881, the disclosures of which are incorporated by this document by reference in their entirety.
    [040] The aforementioned description of various embodiments of the invention has been presented for purposes of illustration and description. It is not intended to be complete or to limit the invention to the precise modalities described. Numerous modifications or variations are possible in the light 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 to allow, therefore, an individual with common skill in the technique to use the invention in various modalities and with several modifications, as they are suitable for particular use contemplated. Such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted according to the scope to which they are attributed in a clear, legal and correct manner.
    权利要求:
    Claims (15)
    [0001]
    1. Medical device (40) for engaging a tissue, the medical device (40) characterized by the fact that it comprises: a housing (42) that defines an internal passage and a longitudinal geometric axis that extends between the proximal and distal ends of the housing (42), the housing (42) defining a claw guide surface, a first connecting guide surface and a second connecting guide surface, each of the guide surfaces extending longitudinally between the proximal and distal ends of the guide surfaces ; a first claw (44) slidably connected to the housing (42), the first claw (44) having proximal and distal ends (64, 60), in which the first claw (44) is slidably received inside the internal passage for longitudinal movement along the grapple guide surface; a second claw (46) slidably and pivotably connected to the housing (42), the second claw having proximal and distal ends (66, 62), in which the second claw (46) is slidably received inside the inner passage for longitudinal movement along the grapple guide surface; a first connection (68) having first and second ends, where the first end is pivotably attached to the first claw (44), where the second end is slidably and pivotably attached to the housing (42) for longitudinal movement along the first connecting guide surface; a second connection (70) having first and second ends, the first end of which is fixed to the second claw (46), the second end of which is slidably and pivotably fixed to the housing (42) for longitudinal movement along the second connecting guide surface; and a driver (48) operatively connected to the first and second jaws (44, 46), the longitudinal movement of the driver (48) moving the first and second jaws (44, 46) longitudinally along the guide surface claw and moves the second ends of the first and second connections (68, 70) along the first and second connecting guide surfaces, where the longitudinal movement of the driver (48) rotates the first and second claws (44, 46) in relation to the housing (42) when the second ends of the first and second connections (68, 70) reach the distal ends of the first and second connecting guide surfaces.
    [0002]
    2. Medical device (40) according to claim 1, characterized in that the proximal ends (64, 66) of the first and second jaws (44, 46) are slidably and pivotably attached to the housing (42).
    [0003]
    Medical device (40) according to claim 2, characterized in that the proximal ends (64, 66) are pivotably attached to the housing (42) around a shared claw pivot geometric axis.
    [0004]
    4. Medical device (40), according to claim 3, characterized by the fact that it still comprises a claw piercing pin (49) that pivotably connects the proximal ends (64, 66) of both the first and the from the second claws (44, 46) to the housing (42).
    [0005]
    5. Medical device (40), according to claim 4, characterized by the fact that the claw guide surface is defined by opposing claw slits (96) formed in the housing (42), with the claw slits (86) ) opposite receive opposite ends of the claw pivot pin (49).
    [0006]
    Medical device (40) according to claim 1, characterized in that the jaw guide surface is located between the first and the second connecting guide surfaces.
    [0007]
    7. Medical device (40) according to claim 1, characterized by the fact that the first ends of the first and second connections are pivotably fixed to an intermediate point of the first and second jaws (44, 46), respectively.
    [0008]
    8. Medical device (40) according to claim 1, characterized in that the second ends of the first and second connections (68, 70) are slidably and pivotably connected to the housing (42).
    [0009]
    9. Medical device (40) according to claim 1, characterized by the fact that the driver (48) is engaged with the proximal ends of the first and second jaws (44, 46) when the driver (48) is moved distally .
    [0010]
    10. Medical device (40) according to claim 1, characterized by the fact that the driver (48) is engaged at the second ends of the first and second connections (68, 70) when the driver (48) is moved proximally .
    [0011]
    11. Medical device (40) according to claim 1, characterized by the fact that the driver (48) includes a distal end to engage the first and second jaws (44, 46), the distal end of the driver being (48) includes a first flange (56) that engages the proximal end of the first jaw (44) and is shaped to allow rotation of the first jaw (44) with respect to the first flange (56) while engaged, where the distal end of the driver (48) includes a second flange (58) which engages the proximal end of the second claw (46) and is shaped to allow rotation of the second claw (46) with respect to the second flange (58) while engaged.
    [0012]
    Medical device (40) according to claim 1, characterized by the fact that the housing (42), the first connection (68) and the first claw (44) are pivotable in relation to each other, and in which the housing (42), the second connection (70) and the second claw (46) are pivotable in relation to each other, and in which the second ends of the first and second connections (68, 70) are longitudinally slidable in relation to the proximal ends of the first and second jaws (44, 46), through which the distance between the second and proximal ends (64, 66) determines the rotation of the first and second jaws (44, 46) between a closed configuration and an open configuration.
    [0013]
    13. Medical device (40) according to claim 1, characterized by the fact that it also comprises a first connecting pivot pin (80) that pivotably connects the second end of the first connection (68) to the housing (42 ), and which further comprises a second connecting pivot pin (80) which pivotably connects the second end of the second connection (70) to the housing (42), and the first connection guide surface is defined by first slots opposite connecting links (82) formed in the housing (42), and the second connecting guide surface is defined by second opposing connecting slots (84) formed in the housing (42), and the first connecting slits (82) ) opposing ends receive opposite ends of the first link pivot pin (80), and where the second opposing link slots (84) receive opposite ends of the second link pivot pin (80).
    [0014]
    14. Method for operating a medical device (40), the method characterized by the fact that it comprises the steps of: providing the medical device (40) comprising a housing (42), first and second claws (44, 46), first and second connections (68, 70) and an actuator (48), in which the first and second claws (44, 46) are slidably and pivotably connected to the housing (42), the first and second connections (68, 70) are slidably and pivotably connected to the housing (42), the first and second connections (68, 70) are pivotably attached to the first and second claws (44, 46), respectively, and the driver (48 ) is operationally connected to the first and second jaws (44, 46); advancing the actuator (48) distally to transfer the first and second jaws (44, 46) and the first and second connections (68, 70) distally in relation to the housing (42); limit the distal translation of the first and second connections (68, 70) while further advancing the actuator (48) distally to rotate the first and second jaws (44, 46) in relation to the housing (42); and retracting the actuator (48) proximally to rotate the first and second jaws (44, 46) in relation to the housing (42).
    [0015]
    15. Method, according to claim 14, characterized by the fact that the medical device (40) still comprises an elongated drive wire (22) selectively connected to the driver (48) for longitudinal movement with it, and that it also comprises the step of detaching the drive wire (22) from the driver (48).
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    同族专利:
    公开号 | 公开日
    US8858588B2|2014-10-14|
    CN103200883A|2013-07-10|
    CN103200883B|2015-08-26|
    WO2012051188A3|2012-07-26|
    WO2012051188A2|2012-04-19|
    AU2011316684B2|2014-10-30|
    BR112013008755A2|2020-10-06|
    EP2627263B1|2016-12-07|
    US20120089176A1|2012-04-12|
    JP2013544126A|2013-12-12|
    DK2627263T3|2017-03-06|
    JP5602953B2|2014-10-08|
    AU2011316684A1|2013-05-02|
    EP2627263A2|2013-08-21|
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    法律状态:
    2020-10-20| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2020-10-27| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-03-16| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-04-27| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 11/10/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US39187510P| true| 2010-10-11|2010-10-11|
    US61/391,875|2010-10-11|
    US12/971,873|2010-12-17|
    US12/971,873|US8771293B2|2009-12-22|2010-12-17|Medical devices with detachable pivotable jaws|
    PCT/US2011/055780|WO2012051188A2|2010-10-11|2011-10-11|Medical devices with detachable pivotable jaws|
    [返回顶部]