CN219126882U

CN219126882U - Bending sheath and clamp device conveying device

Info

Publication number: CN219126882U
Application number: CN202320222612.XU
Authority: CN
Inventors: 钱兆琛; 李鹭; 郑炜; 李联喜; 韩乌恩; 杨凡
Original assignee: Kerimaji Beijing Medical Technology Co ltd
Current assignee: Kerimaji Beijing Medical Technology Co ltd
Priority date: 2023-01-31
Filing date: 2023-01-31
Publication date: 2023-06-06
Anticipated expiration: 2033-01-31

Abstract

The utility model provides a bending regulating sheath and a clamp conveying device, and relates to the technical field of medical appliances; the three-way bending adjusting structure comprises a main bending adjusting component and a two-way swing control component; the main bending component controls the front end of the bending sheath tube to deflect towards the first direction or recover to a state before deflecting towards the first direction; the bidirectional swing control assembly controls the deflection of the forward end of the buckle accommodating sheath in a second direction or a third direction opposite to the second direction. The forceps holder conveying device comprises the bending adjusting sheath. The utility model at least relieves the technical problem that in the prior art, after the forceps holder is conveyed into a human body through the outer tube and the connecting rod, the forceps holder is difficult to ensure to be positioned at the middle position of a gap between two valve leaflets.

Description

Bending sheath and clamp device conveying device

Technical Field

The utility model relates to the technical field of medical equipment, in particular to a bending sheath adjusting and clamping device conveying device.

Background

In transcatheter interventions, a bend-regulating sheath structure is often used to regulate the degree of curvature of the forward end of the catheter passing through the bend-regulating sheath, so that the catheter inside the bend-regulating sheath adapts to the tortuous vessels to reach the lesion site. For example:

Transcatheter mitral valve clamping (MitraClip) is a minimally invasive catheter interventional procedure for patients with severe mitral regurgitation and high risk of surgery, and is currently the first interventional procedure for treating part of severe mitral regurgitation. Specifically, the transcatheter mitral valve clamping (MitraClip) is based on similar technical principles under the inspired of surgical repair of the limbic mitral valve, and uses a special mitral valve clamping device (Clip) to reach the heart through the blood vessel of the human body, and clamps the middle parts of two leaves of the mitral valve under three-dimensional ultrasonic guidance, so that the mitral valve changes from a large single hole to a small double hole in the systole, thereby reducing mitral regurgitation. Briefly, the method comprises the following steps: the device is sent into the heart through the human blood vessel by the catheter mitral valve repair technology, the wound is very small, the heart is not damaged, the heart beats normally in the operation process, the support of extracorporeal cardiopulmonary circulation is not needed, the patient recovers faster, the patient can be discharged after 2-3 days of operation, and the patient can participate in daily activities within 1 week of operation.

In the prior art, various specific structures of the forceps include, for example, the forceps in patent mitral forceps and mitral forceps delivery device (patent application publication No. CN113940791 a) and patent mitral forceps and mitral forceps delivery device (patent application publication No. CN 113940792A), the forceps delivery device corresponding to the forceps at least needs to include an operating handle, an outer tube and a connecting rod, the operating handle at least includes a handle housing, a first upper arm traction wire handle and a second upper arm traction wire handle, and the specific usage mode can refer to the related descriptions in the patent CN113940791a and the patent CN113940792A publication, wherein the "inner tube" in the patent CN113940792A is the middle sleeve in the present application and the "patent CN113940791a", the "handle housing" in the patent CN113940791a and the patent CN113940792A is the "main handle housing" in the present application, and the present application is designed for the forceps in the patent CN113940791a and the patent CN 113940792A.

However, during actual use, the applicant has found that at least the following problems remain with existing gripper delivery devices:

firstly, when the forceps holder is conveyed into a human body through the outer tube and the connecting rod of the forceps holder conveying device, the outer tube can be stretched into the bending sheath by means of the common bending sheath, the forceps holder is adjusted to be perpendicular to the valve She Pingmian, but the forceps holder is difficult to ensure to be positioned at the middle position of a gap between two valve leaves, and two groups of clamping arms of the forceps holder clamp parts of two valve leaves, usually one valve leaf clamps less than the other valve leaf, so that the forceps holder is easy to separate from one valve leaf in the postoperative activity of a patient, and the patient needs to perform re-operation, such as untimely re-operation, and fatal danger is caused;

secondly, after the forceps holder is conveyed into the human body through the outer tube and the connecting rod by the forceps holder conveying device, the forceps holder is difficult to ensure to be positioned at the middle position between two leaves of the mitral valve along the direction of the involution edge;

the two points lead the operation effect to completely depend on the degree of purity of the doctor technology, so the operation effect is not ideal.

Disclosure of Invention

The utility model aims to provide a bending sheath and a clamp conveying device, which at least solve the technical problem that in the prior art, after the clamp conveying device conveys a clamp into a human body through an outer tube and a connecting rod of the clamp conveying device, the clamp is difficult to be positioned at the middle position of a gap between two valve leaflets.

In order to achieve the above purpose, the embodiment of the present utility model adopts the following technical scheme:

in a first aspect, an embodiment of the present utility model provides a bending sheath, including a bending handle and a bending sheath tube, where the bending handle includes a bending main housing and a three-way bending structure, the rear end of the bending sheath tube is connected to the front end of the bending main housing, and a lumen of the bending sheath tube is communicated with an inner cavity of the bending main housing;

the three-way bending adjusting structure comprises a main bending adjusting component and a two-way swing control component;

the main bending adjusting assembly comprises a side branch handle and a first bending adjusting wire; the side branch handle is arranged on one side of the bending main shell, and the inner cavity of the side branch handle is communicated with the inner cavity of the bending main shell; the first bending wire penetrates through the bending main shell and the side branch handle, the front end of the first bending wire is connected to the front end pipe wall of the bending sheath pipe, and the rear end of the first bending wire is fixed on the side branch handle in a mode of being capable of adjusting the fixed length; the first bending wire can be pulled backwards or released forwards by adjusting the length of the rear end of the first bending wire fixed on the side branch handle, so that the front end of the bending sheath tube is controlled to deflect towards a first direction or recover to a state before deflection towards the first direction;

The bidirectional swing control assembly comprises a second bending regulating wire, a third bending regulating wire, a bending regulating sheath tube transmission assembly and a bending regulating sheath tube driving part;

the bending sheath tube transmission assembly is arranged in the inner cavity of the bending main shell, the bending sheath tube driving part is arranged on the bending main shell, one part of the bending sheath tube driving part is positioned outside the bending main shell, the other part of the bending sheath tube driving part is connected with the bending sheath tube transmission assembly, and the rear end of the second bending wire and the rear end of the third bending wire are respectively connected with the bending sheath tube transmission assembly;

the front ends of the second bending wire and the third bending wire are respectively connected to the front end pipe wall of the bending sheath pipe, projection points of the front ends of the first bending wire, the second bending wire and the third bending wire on the same radial circumference line of the bending sheath pipe are respectively positioned at three vertexes of an isosceles triangle taking a connecting line between the front ends of the second bending wire and the third bending wire as a bottom line, and projection points of the front ends of the second bending wire and the third bending wire on the same radial circumference line are respectively positioned on the same diameter of a circle where the same radial circumference line is positioned;

The bend-adjusting sheath driving part is configured to control the bend-adjusting sheath transmission assembly to act, so that under one working condition, the second bend-adjusting wire is pulled backwards and the third bend-adjusting wire is released forwards, so that the front end of the bend-adjusting sheath deflects towards a second direction, and under another working condition, the second bend-adjusting wire is released forwards and the third bend-adjusting wire is pulled backwards, so that the front end of the bend-adjusting sheath deflects towards a third direction opposite to the second direction.

The bent sheath tube front end of the bent sheath can be bent towards three different directions, so that the multi-angle adjustment requirement of the intervention tube inside the bent sheath can be met, and the effects of obviously improving the operation efficiency and the operation positioning accuracy in various intervention operations are achieved.

Especially in the case of transcatheter mitral clamping described in the background section, facing the situation when the clamp delivery device delivers the clamp into the human body through its outer tube and connecting rod, while the outer tube can be inserted into the bending sheath by means of a common bending sheath, the clamp is adjusted to be perpendicular to the valve She Pingmian, but it is difficult to ensure that the clamp is positioned in the middle of the gap between the two leaflets, and in the part where the two sets of arms of the clamp the two leaflets, usually the part where one leaflet clamps the other leaflet clamps the part of the other leaflet, so that in the patient's postoperative activity the clamp is easily released from one of the leaflets, and the patient needs to perform a re-operation, such as a re-operation is not timely, and the patient has a dangerous problem:

The bending adjusting sheath provided by the embodiment is matched with a main control handle connecting pipe assembly as shown in the figure for use, and the main control handle connecting pipe assembly at least comprises a main handle shell, a first upper clamping arm traction wire handle, a second upper clamping arm traction wire handle, an outer sleeve, a middle sleeve and a connecting rod; the distal end of the first upper clamp arm traction wire handle and the distal end of the second upper clamp arm traction wire handle are both connected to the main handle shell, and the inner cavities are both communicated with the inner cavity of the main handle shell; the proximal end of the outer sleeve is fixedly connected to the main handle shell and is communicated with the inner cavity of the main handle shell; the proximal end of the middle sleeve is fixedly connected inside the outer sleeve, a stay wire channel which is communicated with the proximal end and the distal end of the outer sleeve is arranged between the middle sleeve and the outer sleeve, the distal end of the middle sleeve extends out of the outer sleeve, and the distal end of the middle sleeve is provided with a mounting part which is used for being in threaded connection or clamped connection with the proximal end of the fixing seat of the clamp; the connecting rod sequentially passes through the middle sleeve, the outer sleeve and the main handle shell from the distal end to the proximal end, and the wall of the distal end of the connecting rod is provided with a threaded connecting part which is used for being in threaded connection with the proximal end of the driving rod of the jaw device; the bending of the distal end of the bending sheath tube can be controlled by adjusting the length of the first bending wire, and then the distal end of the outer sleeve passing through the bending sheath tube is bent so as to further bend the distal end of the middle sleeve and the distal end of the connecting rod correspondingly, so that the function of adjusting the angle of the clamp device can be achieved, and the clamp device is axially aligned to the plane of the valve annulus; then, the second bending wire and the third bending wire are adjusted to adjust the middle position of the gap between the two valve leaflets, so that the areas of the two groups of clamping arms of the clamping device for clamping the two valve leaflets are equivalent as much as possible, the problem that the clamping device is slowly separated from one valve leaflet in the postoperative activity of a patient is reduced, and the postoperative effect is improved.

In an alternative implementation manner of this embodiment, preferably, the main bending component further includes a control knob component, where the control knob component includes a rotating rod and a rotating rod mating nut, and an external thread is provided on a peripheral wall of a front end of the rotating rod;

the rear end of the side branch handle is provided with an opening communicated with the inner cavity of the side branch handle, the front end of the rotary rod stretches into the side branch handle from the opening, the rotary rod pairing nut is arranged in the side branch handle, the rotary rod pairing nut is sleeved and connected with the outside of the rotary rod in a threaded manner, and the rear end of the first bending wire is fixed to the rotary rod pairing nut;

the inner wall of the side branch handle and the outer peripheral wall of the rotary rod pairing nut are provided with buckling limiting structures which can be buckled mutually, so that the rotary rod pairing nut can only slide back and forth relative to the side branch handle and cannot rotate relative to the side branch handle under the working condition that the rotary rod rotates relative to the side branch handle.

Further preferably, an annular limiting protrusion extending along the circumferential direction of the side branch handle is arranged on the inner wall of the rear end opening of the side branch handle, an annular limiting groove is arranged on the outer circumferential surface of the rear end of the rotary rod, and the annular limiting protrusion and the annular limiting groove are mutually buckled.

In an alternative implementation manner of this embodiment, more preferably, the bending adjustment sheath driving part includes a bending adjustment driving rod and a bending adjustment knob; the bending sheath tube transmission assembly comprises a first bending threaded rod, a first bending nut piece, a second bending threaded rod, a second bending nut piece, a first bending bevel gear, a second bending bevel gear, a third bending bevel gear and a fourth bending bevel gear;

the front-back direction is taken as the axial direction:

the bidirectional swing control assembly further comprises a bending adjusting installation seat fixedly installed in the inner cavity of the bending adjusting main shell, the bending adjusting installation seat comprises a bending adjusting front plate, a bending adjusting axial connecting pipe and a bending adjusting rear plate, the bending adjusting front plate and the bending adjusting rear plate extend along the radial plane of the bending adjusting main shell and are fixed on the inner wall of the bending adjusting main shell, and the bending adjusting axial connecting pipe is connected with the bending adjusting front plate and/or the bending adjusting rear plate;

the two ends of the first bending threaded rod and the two ends of the second bending threaded rod are respectively rotatably installed on the bending front plate and the bending rear plate, the first bending nut piece is in threaded sleeve joint with the outer part of the first bending threaded rod, the second bending nut piece is in threaded sleeve joint with the outer part of the second bending threaded rod, a first limit rail and a second limit rail which extend along the axial direction of the bending axial connecting pipe are arranged on the pipe wall of the bending axial connecting pipe, the first bending nut piece is axially limited on the first limit rail, the second bending nut piece is axially limited on the second limit rail, the rear end of the second bending nut piece is connected with the first bending nut piece, and the rear end of the third bending nut piece is connected with the second bending nut piece;

The bending driving rod penetrates through the side wall of the bending main shell in the radial direction and is rotatably arranged on the bending mounting seat, the first bending bevel gear and the second bending bevel gear are fixed at the position of the bending driving rod in the inner cavity of the bending main shell at intervals, the third bending bevel gear is fixed at the rear end of the first bending threaded rod and meshed with the first bending bevel gear, and the fourth bending bevel gear is fixed at the rear end of the second bending threaded rod and meshed with the second bending bevel gear; the first bending bevel gear, the second bending bevel gear, the third bending bevel gear, the fourth bending bevel gear, the first bending threaded rod and the second bending threaded rod are configured to drive the first bending nut piece to slide forwards relative to the first bending threaded rod and drive the second bending nut piece to slide backwards relative to the second bending threaded rod under the condition that the bending driving rod rotates forwards; under the condition that the bending driving rod reversely rotates, the first bending nut piece is driven to slide backwards relative to the first bending threaded rod, and the second bending nut piece is driven to slide forwards relative to the second bending threaded rod;

The bending adjusting knob is arranged outside the bending adjusting main shell and connected to the part of the bending adjusting driving rod, which is positioned outside the bending adjusting main shell, and is used for driving the bending adjusting driving rod to rotate in the forward direction or the reverse direction.

Further:

preferably, in the bending adjustment installation seat, the middle part of the bending adjustment front plate and the middle part of the bending adjustment rear plate are respectively provided with a perforation.

Preferably, in the bending adjusting installation seat, the bending adjusting axial connecting pipe comprises a front pipe integrally connected with the rear end of the bending adjusting front plate and a rear pipe integrally connected with the bending adjusting rear plate, and the front pipe and the rear pipe are mutually sleeved.

Preferably, the first bending adjusting nut member and the second bending adjusting nut member are respectively provided with at least two wire penetrating holes, and the rear ends of the corresponding bending adjusting wires are fixed on the corresponding bending adjusting nut members in a knotting mode after sequentially penetrating through the at least two wire penetrating holes.

Preferably, in the bending adjustment mounting seat: the first limit track and the second limit track are respectively a first raised line and a second raised line which are symmetrically arranged on the outer pipe wall of the bending axial connecting pipe by taking the axial central axis of the bending axial connecting pipe as a symmetrical axis and extend along the axial direction of the bending axial connecting pipe; the outer peripheral surface of the first bending nut piece is provided with a first groove, and the outer peripheral surface of the second bending nut piece is provided with a second groove; the first raised strips and the first grooves are mutually buckled, and the second raised strips and the second grooves are mutually buckled.

In a second aspect, embodiments of the present utility model provide a jaw apparatus delivery device; specifically, the jaw apparatus delivery device includes a main handle take over assembly; the main control handle connecting pipe assembly at least comprises a main handle shell, a first upper clamping arm traction wire handle, a second upper clamping arm traction wire handle, an outer sleeve, a middle sleeve and a connecting rod; the distal end of the first upper clamp arm traction wire handle and the distal end of the second upper clamp arm traction wire handle are both connected to the main handle shell, and the inner cavities are both communicated with the inner cavity of the main handle shell; the proximal end of the outer sleeve is fixedly connected to the main handle shell and is communicated with the inner cavity of the main handle shell; the proximal end of the middle sleeve is fixedly connected inside the outer sleeve, a stay wire channel which is used for communicating the proximal end and the distal end of the outer sleeve is arranged between the middle sleeve and the outer sleeve, the distal end of the middle sleeve extends out of the outer sleeve, and the distal end of the middle sleeve is provided with a mounting part which is used for being connected with or clamped with the proximal end of a fixing seat of the clamp; the connecting rod sequentially passes through the middle sleeve, the outer sleeve and the main handle shell from the distal end to the proximal end, and a threaded connection part for being in threaded connection with the proximal end of the driving rod of the jaw device is arranged on the wall of the distal end of the connecting rod;

It is further important: the jaw apparatus delivery device further comprising a buckle sheath of any of the preceding embodiments; the outer sleeve penetrates through the bending main shell and the bending sheath tube in the bending sheath, and the outer sleeve can rotate relative to the bending main shell and the bending sheath tube in the bending sheath.

Because the jaw apparatus conveying device provided by the embodiment of the utility model comprises the bending adjustment sheath provided by the first aspect, the jaw apparatus conveying device provided by the embodiment of the utility model can achieve all the beneficial effects achieved by the bending adjustment sheath provided by the first aspect.

In an alternative implementation of the present embodiment, it is preferable that the gripper delivery device further includes an outer sleeve swing control assembly;

the outer sleeve swinging control assembly comprises a first outer sleeve control wire, a second outer sleeve control wire, an outer sleeve swinging transmission assembly and an outer sleeve swinging driving part; the front ends of the first outer sleeve control wire and the second outer sleeve control wire are respectively connected to the pipe wall of the front end of the outer sleeve, and projection points of the front ends of the first outer sleeve control wire and the second outer sleeve control wire on the same radial circumferential line of the outer sleeve are respectively positioned on the same diameter of a circle where the same radial circumferential line is positioned; the rear end of the first outer sleeve control wire and the rear end of the second outer sleeve control wire are respectively connected with the outer sleeve swing transmission assembly, the outer sleeve swing transmission assembly is arranged in the inner cavity of the main handle shell, the outer sleeve swing driving part is arranged in the main handle shell, one part of the outer sleeve swing driving part is positioned outside the main handle shell, and the other part of the outer sleeve swing driving part is connected with the outer sleeve swing transmission assembly;

The outer sleeve swing driving part is configured to control the outer sleeve swing transmission assembly to act, so that under a first working condition, the first outer sleeve control wire is pulled back and the second outer sleeve control wire is released forwards, so that the front end of the outer sleeve deflects towards a first direction, and under a second working condition, the first outer sleeve control wire is released forwards and the second outer sleeve control wire is pulled back, so that the front end of the outer sleeve deflects towards a second direction opposite to the first direction.

Drawings

In order to more clearly illustrate the embodiments of the present utility model or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present utility model, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.

Fig. 1 is a schematic diagram of the overall structure of a bending sheath according to an embodiment of the present utility model;

FIG. 2 is an exploded view of the portion A of the buckle accommodating sheath shown in FIG. 1;

FIG. 3 is a schematic view showing the internal structure assembly of the portion A of the bending sheath shown in FIG. 1;

FIG. 4 is a schematic diagram of an assembly structure of a bending sheath driving unit in the bidirectional swing control unit in the bending sheath shown in FIG. 1;

fig. 5 is a distribution diagram of projection points of the front ends of the first bending wire, the second bending wire and the third bending wire in the bending sheath on the same radial circumference line of the bending sheath according to the embodiment of the present utility model;

FIG. 6 is an isometric view of the overall structure of a jaw apparatus delivery device according to an embodiment of the present utility model when used with an auxiliary support;

FIG. 7 is an exploded view of FIG. 6;

FIG. 8 is an enlarged view of a portion of the structure of the portion B in FIG. 6;

FIG. 9 is an exploded view of the part of the structure of FIG. 7 at the location C;

FIG. 10 is a partial cross-sectional view of the structure of portion D of FIG. 7;

FIG. 11 is a diagram showing the construction of the assembly structure of the outer sleeve swing control assembly, the inner and outer sleeve swing transmission assembly, the outer sleeve swing driving rod and the outer sleeve swing transmission assembly mounting seat in the jaw conveyer according to the embodiment of the present utility model;

FIG. 12 is an assembled block diagram of the structure of FIG. 11 at another view angle;

fig. 13 is a schematic view of the overall structure of a release handle after a connecting rod in a gripper conveying device is adjusted in the handle according to an embodiment of the present utility model.

Icon: 100-a primary steering handle take over assembly; 11-a main handle housing; 110-an outer sleeve swing transmission assembly mounting seat; 111-mounting a front plate; 112-mounting a rear plate; 113-an axial drive connection tube; 1131-front connection tube; 1132-a rear connection tube; 1-an outer sleeve swing driving rod; 2-an outer sleeve swing knob; 3-a first transmission threaded rod; 4-a first drive nut member; 5-a second transmission threaded rod; 6-a second drive nut member; 7-a first drive bevel gear; 8-a second drive bevel gear; 9-a third drive bevel gear; 10-a fourth drive bevel gear; 12-an outer sleeve; 13-a middle sleeve; 14-connecting rods; 15-connecting rod adjusting handle; 151-a post-adjustment nut; 152-post-adjusting the externally threaded tube; 1521-extending a round tube; 153-rear release handle; 154-limiting pin shafts; 16-a unidirectional rotation limiting structure; 1601-first concave-convex surface; 1602-second concave-convex surface; 161-limiting a rotating shaft; 162-limiting tube; 163-compression spring; 200-bending the sheath; 21-a bending handle; 211-bending a main shell; 212-side branch handles; 2121-annular spacing projections; 213-a first bending wire; 214-a second bending wire; 215-a third bending wire; 22-bending the sheath; 230-bending adjusting installation seats; 231-bending front plate; 232-bending a rear plate; 233-bending the axial connecting pipe; 2331-front tube; 2332-rear tube; 240-a control knob assembly; 241-a rotating rod; 2411-an annular limiting groove; 242-a swivel-rod mating nut; 250-bending driving rod; 251-a bending knob; 252-a first bending threaded rod; 253-a first bend adjustment nut member; 254-a second bending threaded rod; 255-a second bending nut member; 256-a first bevel bend-adjusting gear; 257-a second bevel gear; 258-third bevel gear; 259-fourth bevel gear; 300-front-rear adjustment assembly; 31-a nut; 32-an externally threaded tube; 321-a limiting pin accommodating hole; 33-a locking member; 310-stress relief structure; 311-connecting pipes; 3111-displacement chute; 312-limiting pins; 400-auxiliary bracket; 500-an introducer sheath assembly; 510-an introducer sheath handle; 520-an introducer sheath; 530-auxiliary cannula fitting.

Detailed Description

For the purpose of making the objects, technical solutions and advantages of the embodiments of the present utility model more apparent, the technical solutions of the embodiments of the present utility model will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present utility model, and it is apparent that the described embodiments are some embodiments of the present utility model, but not all embodiments of the present utility model. The components of the embodiments of the present utility model generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the utility model, as presented in the figures, is not intended to limit the scope of the utility model, as claimed, but is merely representative of selected embodiments of the utility model. All other embodiments, which can be made by those skilled in the art based on the embodiments of the utility model without making any inventive effort, are intended to be within the scope of the utility model.

It should be noted that: like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures.

In the description of the present utility model, it should be noted that, directions or positional relationships indicated by terms such as "proximal", "distal", "front", "rear", "inner", "outer", etc., are directions or positional relationships based on those shown in the drawings, or are directions or positional relationships conventionally put in use of the inventive product, are merely for convenience of describing the present utility model and simplifying the description, and are not indicative or implying that the apparatus or element to be referred to must have a specific direction, be configured and operated in a specific direction, and thus should not be construed as limiting the present utility model. Furthermore, the terms "first," "second," and the like, are used merely to distinguish between descriptions and should not be construed as indicating or implying relative importance.

In particular, in the present utility model, the end of the medical device close to the operator is the proximal end of the medical device during surgery, and the end of the medical device entering the blood vessel of the patient is the distal end of the medical device (the front end of the medical device is the distal end, and the rear end of the medical device is the proximal end).

Furthermore, the terms "horizontal," "vertical," and the like do not denote a requirement that the component be absolutely horizontal or overhang, but rather may be slightly inclined. As "horizontal" merely means that its direction is more horizontal than "vertical", and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.

In the description of the present utility model, it should also be noted that, unless explicitly specified and limited otherwise, the terms "disposed," "mounted," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present utility model will be understood in specific cases by those of ordinary skill in the art.

Some embodiments of the present utility model are described in detail below with reference to the accompanying drawings. The following embodiments and features of the embodiments may be combined with each other without conflict.

Example 1

The present embodiment provides a bending sheath 200, referring to fig. 1 to 5, the bending sheath 200 includes a bending handle 21 and a bending sheath tube 22, the bending handle 21 includes a bending main housing 211 and a three-way bending structure, the rear end of the bending sheath tube 22 is connected to the front end of the bending main housing 211, and the lumen of the bending sheath tube 22 is communicated with the inner cavity of the bending main housing 211.

The three-way bending adjusting structure comprises a main bending adjusting component and a bidirectional swing control component, wherein:

The main bending assembly includes a side branch handle 212 and a first bending wire 213; the side branch handle 212 is arranged on one side of the bending main shell 211, and the inner cavity of the side branch handle is communicated with the inner cavity of the bending main shell 211; the first bending wire 213 passes through the bending main housing 211 and the side branch handle 212, the front end of the first bending wire 213 is connected to the front end pipe wall of the bending sheath pipe 22, and the rear end of the first bending wire 213 is fixed on the side branch handle 212 in a manner of being capable of adjusting the fixed length; by adjusting the length of the rear end of the first bending wire 213 fixed to the side branch handle 212, the first bending wire 213 can be pulled back or released forward, so as to control the front end of the bending sheath 22 to deflect towards the first direction or return to a state before deflecting towards the first direction;

the bidirectional swing control assembly comprises a second bending wire 214, a third bending wire 215, a bending sheath transmission assembly and a bending sheath driving part. The bending sheath transmission assembly is installed in the inner cavity of the bending main housing 211, the bending sheath driving part is installed on the bending main housing 211, one part of the bending sheath driving part is located outside the bending main housing 211, the other part of the bending sheath driving part is connected with the bending sheath transmission assembly, and the rear ends of the second bending wire 214 and the third bending wire 215 are respectively connected with the bending sheath transmission assembly. The front ends of the second bending wire 214 and the front ends of the third bending wire 215 are respectively connected to the front end pipe wall of the bending sheath pipe 22, and as shown in fig. 5, the projection points of the front ends of the first bending wire 213, the front ends of the second bending wire 214 and the front ends of the third bending wire 215 on the same radial circumference line of the bending sheath pipe 22 are respectively at three vertexes of an isosceles triangle with the connecting line between the front ends of the second bending wire 214 and the front ends of the third bending wire 215 as the bottom line, and the projection points of the front ends of the second bending wire 214 and the front ends of the third bending wire 215 on the same radial circumference line are respectively on the same diameter of the circle where the same radial circumference line is located. The bending sheath driving part is configured to control the bending sheath driving assembly to act, so that under one working condition, the second bending wire 214 is pulled back and the third bending wire 215 is released forward to deflect the front end of the bending sheath 22 towards the second direction, and under another working condition, the second bending wire 214 is released forward and the third bending wire 215 is pulled back to deflect the front end of the bending sheath 22 towards the third direction opposite to the second direction.

The front end of the bending sheath tube 22 of the bending sheath 200 provided in this embodiment can be bent in three different directions, so as to meet the requirement of multi-angle adjustment of the intervention tube inside the bending sheath 200, and the bending sheath tube has the effect of obviously improving the operation efficiency and the operation positioning accuracy in various intervention operations.

the bending adjustment sheath 200 provided in this embodiment is used in cooperation with the main control handle adapter assembly 100 shown in fig. 6, where the main control handle adapter assembly 100 at least includes a main handle housing 11, a first upper arm traction wire handle, a second upper arm traction wire handle, an outer sleeve 12, a middle sleeve 13, and a connecting rod 14; the distal end of the first upper clamp arm traction wire handle and the distal end of the second upper clamp arm traction wire handle are both connected to the main handle shell 11, and the inner cavities are both communicated with the inner cavity of the main handle shell 11; the proximal end of the outer sleeve 12 is fixedly connected to the main handle shell 11 and is communicated with the inner cavity of the main handle shell 11; the proximal end of the middle sleeve 13 is fixedly connected inside the outer sleeve 12, a stay wire channel for communicating the proximal end and the distal end of the outer sleeve 12 is arranged between the middle sleeve 13 and the outer sleeve 12, the distal end of the middle sleeve 13 extends out of the outer sleeve 12, and the distal end of the middle sleeve 13 is provided with a mounting part for being in threaded connection or clamped with the proximal end of a fixing seat of the clamp; the connecting rod 14 sequentially passes through the middle sleeve 13, the outer sleeve 12 and the main handle shell 11 from the distal end to the proximal end, and the distal end pipe wall of the connecting rod 14 is provided with a threaded connection part for being in threaded connection with the proximal end of the driving rod of the jaw; the distal end bending of the bending sheath tube 22 can be controlled by adjusting the length of the first bending wire 213, and then the distal end bending of the outer sleeve tube 12 passing through the bending sheath tube 22 is carried out, so that the distal end of the middle sleeve tube 13 and the distal end of the connecting rod 14 are further carried out to correspondingly bend, thereby achieving the function of adjusting the angle of the forceps holder so as to axially align the forceps holder with the plane of the valve annulus; then, the second bending wire 214 and the third bending wire 215 are adjusted to adjust the middle position of the gap between the two valve leaflets of the forceps holder, so that the areas of the two groups of clamping arms of the forceps holder for clamping the two valve leaflets are equivalent as much as possible, the problem that the forceps holder is slowly separated from one valve leaflet in the postoperative activity of a patient is reduced, and the postoperative effect is improved.

With continued reference to fig. 1-4, in some alternative implementations of the present embodiment, it is preferable that the main bending assembly further includes a control knob assembly 240, where the control knob assembly 240 includes a rotary rod 241 and a rotary rod mating nut 242, and an outer thread is provided on a front peripheral wall of the rotary rod 241; the rear end of the side branch handle 212 is provided with an opening communicated with the inner cavity of the side branch handle 212, the front end of the rotary rod 241 stretches into the side branch handle 212 from the opening, the rotary rod pairing nut 242 is arranged in the side branch handle 212, the rotary rod pairing nut 242 is sleeved and connected with the outside of the rotary rod 241 in a threaded manner, and the rear end of the first bending wire 213 is fixed on the rotary rod pairing nut 242; the inner wall of the side branch handle 212 and the outer peripheral wall of the rotary rod pairing nut 242 are provided with buckling limiting structures which can be buckled with each other, so that under the working condition that the rotary rod 241 rotates relative to the side branch handle 212, the rotary rod pairing nut 242 can only slide back and forth relative to the side branch handle 212 but cannot rotate relative to the side branch handle 212, when the rotary rod 241 is rotated forward or backward relative to the side branch handle 212, the rotary rod pairing nut 242 can slide forward or backward relative to the side branch handle 212 respectively, the length of the rear end of the first bending adjustment wire 213 fixed to the side branch handle 212 is adjusted, and the first bending adjustment wire 213 is released forward or pulled backward; of course, the specific fixing manner of the rear end of the first bending wire 213 to the side branch handle 212 is not limited to this manner, and the rear end of the first bending wire 213 may be manually pulled or released by screwing a rear cover to the rear end of the side branch handle 212, and the rear end of the first bending wire 213 may be screwed to the rear end of the side branch handle 212 by using the rear cover after being adjusted in place, or other fixing manners may be adopted.

Further preferably, but not limited to, an inner wall at the rear end opening of the side branch handle 212 is provided with an annular limiting protrusion 2121 extending along the circumferential direction of the side branch handle 212, the rear end outer circumferential surface of the rotary rod 241 is provided with an annular limiting groove 2411, and the annular limiting protrusion 2121 and the annular limiting groove 2411 are mutually buckled as a guiding sliding rail structure.

In addition, in the present embodiment, there are various alternative structures of the bending sheath driving part and the bending sheath driving assembly, for example, but not limited to, as shown in fig. 1 to 4, the bending sheath driving part includes a bending driving rod 250 and a bending knob 251; the turn-down sheath transmission assembly includes a first turn-down threaded rod 252, a first turn-down nut member 253, a second turn-down threaded rod 254, a second turn-down nut member 255, a first turn-down bevel gear 256, a second turn-down bevel gear 257, a third turn-down bevel gear 258, and a fourth turn-down bevel gear 259. The front-back direction is taken as the axial direction: the bidirectional swing control assembly further comprises a bending installation seat 230 fixedly installed in the inner cavity of the bending main housing 211, wherein the bending installation seat 230 comprises a bending front plate 231, a bending axial connecting pipe 233 and a bending rear plate 232, the bending front plate 231 and the bending rear plate 232 extend along the radial plane of the bending main housing 211 and are fixed on the inner wall of the bending main housing 211, and the bending axial connecting pipe 233 is connected to the bending front plate 231 and/or the bending rear plate 232. The two ends of the first bending threaded rod 252 and the two ends of the second bending threaded rod 254 are respectively rotatably installed on the bending front plate 231 and the bending rear plate 232, the first bending nut 253 is in threaded sleeve joint with the outside of the first bending threaded rod 252, the second bending nut 255 is in threaded sleeve joint with the outside of the second bending threaded rod 254, a first limit rail and a second limit rail which extend along the axial direction of the bending axial connecting pipe 233 are arranged on the pipe wall of the bending axial connecting pipe 233, the first bending nut 253 is axially limited on the first limit rail, the second bending nut 255 is axially limited on the second limit rail, the rear end of the second bending wire 214 is connected with the first bending nut 253, and the rear end of the third bending wire 215 is connected with the second bending nut 255. The bending driving rod 250 passes through the side wall of the bending main shell 211 along the radial direction and is rotatably arranged on the bending mounting seat 230, the first bending bevel gear 256 and the second bending bevel gear 257 are fixed at intervals at the position of the bending driving rod 250 in the inner cavity of the bending main shell 211, the third bending bevel gear 258 is fixed at the rear end of the first bending threaded rod 252 and is meshed with the first bending bevel gear 256, and the fourth bending bevel gear 259 is fixed at the rear end of the second bending threaded rod 254 and is meshed with the second bending bevel gear 257; the first bevel gear 256, the second bevel gear 257, the third bevel gear 258, the fourth bevel gear 259, the first threaded rod 252, and the second threaded rod 254 are configured to drive the first nut 253 to slide forward relative to the first threaded rod 252 and the second nut 255 to slide backward relative to the second threaded rod 254 when the driving rod 250 rotates forward; in the case of the reverse rotation of the bending driving lever 250, the first bending nut member 253 is driven to slide backward with respect to the first bending threaded rod 252, and the second bending nut member 255 is driven to slide forward with respect to the second bending threaded rod 254. The bending knob 251 is disposed outside the bending main housing 211 and connected to a portion of the bending driving rod 250 located outside the bending main housing 211, for driving the bending driving rod 250 to rotate in a forward or reverse direction.

In order not to interfere with the passage of the outer sleeve 12, the middle sleeve 13 and the connecting rod 14 through the bending main housing 211, in an alternative implementation of this embodiment, preferably, the bending mounting base 230 is provided with perforations in the middle of the bending front plate 231 and in the middle of the bending rear plate 232, respectively.

In addition, in order to facilitate assembly, in an alternative implementation manner of the present embodiment, it is preferable that, in the bending adjustment mounting seat 230, the bending adjustment axial connection pipe 233 includes a front pipe 2331 integrally connected to the rear end of the bending adjustment front plate 231 and a rear pipe 2332 integrally connected to the bending adjustment rear plate 232, the front pipe 2331 and the rear pipe 2332 are mutually sleeved, and mutually sleeved parts can be mutually clamped or in interference connection, so as to increase the connection firmness.

In addition, in an alternative implementation manner of this embodiment, more preferably, at least two wire holes are respectively provided on the first bending nut member 253 and the second bending nut member 255, and the rear end of the corresponding bending wire is fixed to the corresponding bending nut member in a manner of sequentially passing through the at least two wire holes and then knotting.

In addition, in this embodiment, preferably, the bending adjustment mounting seat 230: the first limit track and the second limit track are respectively a first convex strip and a second convex strip which are symmetrically arranged on the outer pipe wall of the bending axial connecting pipe 233 by taking the axial central axis of the bending axial connecting pipe 233 as a symmetrical axis and extend along the axial direction of the bending axial connecting pipe 233; the outer circumferential surface of the first bending nut 253 is provided with a first groove, and the outer circumferential surface of the second bending nut 255 is provided with a second groove; the first raised strips are buckled with the first grooves, and the second raised strips are buckled with the second grooves.

Example two

This embodiment provides a jaw apparatus delivery device comprising a buckle sheath 200 as provided in any of the alternative embodiments of the first embodiment.

Specifically, the jaw apparatus delivery device includes a main steering handle take over assembly 100; the main control handle adapter assembly 100 at least comprises a main handle housing 11, a first upper clamp arm traction wire handle, a second upper clamp arm traction wire handle, an outer sleeve 12, a middle sleeve 13 and a connecting rod 14; the distal end of the first upper clamp arm traction wire handle and the distal end of the second upper clamp arm traction wire handle are both connected to the main handle shell 11, and the inner cavities are both communicated with the inner cavity of the main handle shell 11; the proximal end of the outer sleeve 12 is fixedly connected to the main handle shell 11 and is communicated with the inner cavity of the main handle shell 11; the proximal end of the middle sleeve 13 is fixedly connected inside the outer sleeve 12, a stay wire channel for communicating the proximal end and the distal end of the outer sleeve 12 is arranged between the middle sleeve 13 and the outer sleeve 12, the distal end of the middle sleeve 13 extends out of the outer sleeve 12, and the distal end of the middle sleeve 13 is provided with a mounting part for being in threaded connection or clamped with the proximal end of a fixing seat of the clamp; the connecting rod 14 sequentially passes through the middle sleeve 13, the outer sleeve 12 and the main handle shell 11 from the distal end to the proximal end, and the distal end pipe wall of the connecting rod 14 is provided with a threaded connection part for being in threaded connection with the proximal end of the driving rod of the jaw;

It is further important: the outer sleeve 12 passes through the buckle main housing 211 and the buckle sheath tube 22 in the buckle sheath 200, and the outer sleeve 12 can rotate relative to the buckle main housing 211 and the buckle sheath tube 22 in the buckle sheath 200.

Since the clip transporting device provided in this embodiment includes the bending sheath 200 described in the first embodiment, the clip transporting device provided in this embodiment can achieve all the advantages achieved by the bending sheath 200 in the first embodiment, and more specific structures and effects that can be achieved can be obtained by referring to the optional or preferred embodiments in the first embodiment.

In particular, in the case of the transcatheter mitral valve clamping operation described in the background section, after the clamp device is delivered into the human body through its outer tube and the connecting rod, it is difficult to ensure that the clamp device is located at the middle position between the two leaflets of the mitral valve in the direction of the coaptation edge, so that the surgical effect is completely dependent on the degree of purity of the doctor's technique, and thus, the surgical effect is not very ideal:

in an alternative implementation manner of the present embodiment, preferably, based on the structure of the main control handle adapter assembly 100, an outer sleeve swing control assembly is additionally provided to control the outer sleeve 12 to swing along the direction of the butt edge between two leaves of the mitral valve, so as to help the front end of the outer sleeve 12 to carry the front end of the middle sleeve 13 and the front end of the connecting rod 14 to deviate to reach the position relatively centered between the butt edge between the two leaves of the mitral valve, and further improve the positioning accuracy of the input position of the forceps holder.

Specifically, in this embodiment, the outer sleeve swing control assembly includes a first outer sleeve control wire, a second outer sleeve control wire, an outer sleeve 12 swing transmission assembly, and an outer sleeve swing driving portion; the front ends of the first outer sleeve control wire and the second outer sleeve control wire are respectively connected to the front pipe wall of the outer sleeve 12, and the projection points of the front ends of the first outer sleeve control wire and the second outer sleeve control wire on the same radial circumferential line of the outer sleeve 12 are respectively positioned on the same diameter of the circle where the same radial circumferential line is positioned; the rear end of the first outer sleeve control wire and the rear end of the second outer sleeve control wire are respectively connected with an outer sleeve 12 swing transmission assembly, the outer sleeve 12 swing transmission assembly is arranged in the inner cavity of the main handle shell 11, the outer sleeve swing driving part is arranged in the main handle shell 11, one part of the outer sleeve swing driving part is positioned outside the main handle shell 11, and the other part of the outer sleeve swing driving part is connected with the outer sleeve 12 swing transmission assembly; the outer sleeve swing driving part is configured to control the outer sleeve 12 swing transmission assembly to act, so that under a first working condition, the first outer sleeve control wire is pulled backwards and the second outer sleeve control wire is released forwards to deflect the front end of the outer sleeve 12 towards a first direction, and under a second working condition, the first outer sleeve control wire is released forwards and the second outer sleeve control wire is pulled backwards to deflect the front end of the outer sleeve 12 towards a second direction opposite to the first direction; the whole structure is simple, convenient and easy to control.

Among them, there are various alternative structures of the driving part and the transmission assembly, for example, but not limited to, as shown in fig. 6 to 12, and particularly referring to fig. 9, 11 and 12, it is preferable that the driving part includes an outer sleeve swing driving lever 1 and an outer sleeve swing knob 2; the transmission assembly comprises a first transmission threaded rod 3, a first transmission nut member 4, a second transmission threaded rod 5, a second transmission nut member 6, a first transmission bevel gear 7, a second transmission bevel gear 8, a third transmission bevel gear 9 and a fourth transmission bevel gear 10. The front-back direction is taken as the axial direction: the outer sleeve swing control assembly further comprises an outer sleeve swing transmission assembly mounting seat 110 fixedly mounted in the inner cavity of the main handle shell 11, the outer sleeve swing transmission assembly mounting seat 110 comprises a front mounting plate 111, an axial transmission connecting pipe 113 and a rear mounting plate 112, the front mounting plate 111 and the rear mounting plate 112 extend along the radial plane of the main handle shell 11 and are fixed on the inner wall of the main handle shell 11, and the axial transmission connecting pipe 113 is connected with the front mounting plate 111 and/or the rear mounting plate 112. The two ends of the first transmission threaded rod 3 and the two ends of the second transmission threaded rod 5 are respectively rotatably installed on the installation front plate 111 and the installation rear plate 112, the first transmission nut piece 4 is in threaded sleeve joint with the outside of the first transmission threaded rod 3, the second transmission nut piece 6 is in threaded sleeve joint with the outside of the second transmission threaded rod 5, a first axial limit rail and a second axial limit rail are arranged on the pipe wall of the axial transmission connecting pipe 113, the first transmission nut piece 4 is axially limited on the first axial limit rail, and the second transmission nut piece 6 is axially limited on the second axial limit rail, wherein. By "axial limit" it is meant that the first drive nut member 4 and the second drive nut member 6 are each only slidable back and forth relative to the respective axial limit track and are not rotatable; the rear end of the first outer sleeve control wire is connected to the first transmission nut member 4, and the rear end of the second outer sleeve control wire is connected to the second transmission nut member 6. The outer sleeve swing driving rod 1 passes through the side wall of the main handle shell 11 in the radial direction and is rotatably arranged on the outer sleeve swing transmission assembly mounting seat 110, the first transmission bevel gear 7 and the second transmission bevel gear 8 are fixed at intervals at the position of the outer sleeve swing driving rod 1 in the inner cavity of the main handle shell 11, the third transmission bevel gear 9 is fixed at the rear end of the first transmission threaded rod 3 and is meshed with the first transmission bevel gear 7, and the fourth transmission bevel gear 10 is fixed at the rear end of the second transmission threaded rod 5 and is meshed with the second transmission bevel gear 8; the first transmission bevel gear 7, the second transmission bevel gear 8, the third transmission bevel gear 9, the fourth transmission bevel gear 10, the first transmission threaded rod 3 and the second transmission threaded rod 5 are arranged in a rotation direction, so that under the condition that the outer sleeve swinging driving rod 1 rotates in the forward direction, the outer sleeve swinging driving rod 1 can drive the first transmission nut piece 4 to slide forwards relative to the first transmission threaded rod 3 and drive the second transmission nut piece 6 to slide backwards relative to the second transmission threaded rod 5; in the case of the reverse rotation of the outer sleeve swing driving rod 1, the outer sleeve swing driving rod 1 can drive the first transmission nut piece 4 to slide backwards relative to the first transmission threaded rod 3 and drive the second transmission nut piece 6 to slide forwards relative to the second transmission threaded rod 5; the outer sleeve swing knob 2 is arranged outside the main handle shell 11 and connected to the outer sleeve swing driving rod 1 at the position outside the main handle shell 11 and is used for driving the outer sleeve swing driving rod 1 to rotate forward or backward.

In order not to interfere with the passage of the outer sleeve 12, the middle sleeve 13 and the connecting rod 14 through the main handle housing 11, in an alternative implementation of this embodiment, preferably, in the outer sleeve swing transmission assembly mount 110, the middle of the mounting front plate 111 and the middle of the mounting rear plate 112 are provided with perforations, respectively.

In addition, in order to facilitate assembly, in an alternative implementation manner of the present embodiment, it is preferable that, in the outer sleeve swing transmission assembly mounting seat 110, the axial transmission connection pipe 113 includes a front connection pipe 1131 integrally connected to a rear end of the mounting front plate 111 and a rear connection pipe 1132 integrally connected to a front end of the mounting rear plate 112, the front connection pipe 1131 and the rear connection pipe 1132 are mutually sleeved, and mutually sleeved parts can be mutually clamped or connected in an interference manner, so as to increase connection firmness.

In addition, in an alternative implementation manner of this embodiment, it is preferable that at least two control wire holes are respectively provided on the first transmission nut member 4 and the second transmission nut member 6, and the rear ends of the corresponding control wires are fixed to the corresponding nut members in a manner of sequentially passing through the at least two control wire holes and then knotting.

In addition, in this embodiment, preferably, the outer sleeve swing transmission assembly mounting seat 110 comprises: the first axial limit rail and the second axial limit rail are respectively a first axial convex strip and a second axial convex strip which are symmetrically arranged on the outer pipe wall of the axial transmission connecting pipe 113 by taking the axial central axis of the axial transmission connecting pipe 113 as a symmetrical axis; the outer peripheral surface of the first transmission nut member 4 is provided with a first buckling groove, and the outer peripheral surface of the second transmission nut member 6 is provided with a second buckling groove; the first axial convex strip is buckled with the first buckling groove, and the second axial convex strip is buckled with the second buckling groove.

In addition, the following problems remain during implantation of the jaw: in the prior art, the pushing and withdrawing positions of the wallet device are regulated in an integral manner by moving the conveyor, the operation technical requirement of a doctor is very high in the regulation process, and a little attention is paid to the operation, so that a plurality of moving distances are caused, and the operation is completed quickly, and the jaw device is placed in a designated position as accurately as possible, so that the operation has obvious adverse effect.

In contrast, in an alternative implementation of the present embodiment, a front-to-back adjustment assembly 300 is further provided for pushing forward or retracting the main steering handle take-over assembly 100 back with respect to the bending sheath 200 to assist in intraoperative positioning of the main steering handle take-over assembly 100 as described above.

As shown in fig. 9, the front-rear adjustment assembly 300 includes a nut 31, an externally threaded tube 32, and a locking member 33; one of the distal circumferential surface of the nut 31 and the proximal circumferential surface of the bending main housing 211 of the bending handle 21 is provided with a circumferential limit groove, the other is provided with a limit protrusion, and the limit protrusion is limited inside the circumferential limit groove so that the nut 31 can rotate relative to the bending main housing 211 of the bending handle 21; the distal end of the external threaded tube 32 is threaded inside the nut 31 and the external threaded tube 32 extends into the lumen of the bending main housing 211 of the bending handle 21, and the outer sleeve 12 in the main operating handle adapter assembly 100 sequentially passes through the external threaded tube 32, the bending main housing 211 of the bending handle 21 and the bending sheath 22 from the proximal end to the distal end. The locking member 33 is mounted to the externally threaded tube 32 to lock the outer sleeve 12 to the externally threaded tube 32 in the locked state and unlock the outer sleeve 12 to the externally threaded tube 32 in the unlocked state; in the locked state, the nut 31 is turned relative to the bending main housing 211 of the bending handle 21, so that the main steering handle adapter assembly 100 can be pushed forward or retracted backward relative to the bending sheath 200.

In operation, the main control handle adapter assembly 100 can be rotated relative to the external threaded tube 32 in the unlocking state, the external sleeve 12 is locked to the external threaded tube 32 after the main control handle adapter assembly is rotated in place, and the distal end of the bending sheath tube 22 is controlled to bend by adjusting the length of the first bending wire 213, so that the distal end of the external sleeve 12 penetrating through the bending sheath tube 22 is bent, and the distal end of the middle sleeve 13 and the distal end of the connecting rod 14 are correspondingly bent, so that the function of adjusting the angle of the clamp can be achieved, and the clamp is axially aligned to the plane of the valve annulus; in addition, according to the pushing distance of the clamp device, the clamp device is controlled to enter the adjusting mode above or below the mitral valve leaflet, and the nut 31 is rotated in the locking state that the outer sleeve 12 is locked on the outer threaded tube 32, so that the main control handle connecting tube assembly 100 is pushed forwards or retracted backwards relative to the bending sheath 200, the adjusting mode is simple and convenient, the adjusting precision is higher, the requirement on the operation technical level of a doctor in the adjusting process can be reduced, the moving distance is ensured to be more accurate, and the clamp device has a great positive effect on accurately placing the clamp device at a specified position as far as possible, and the clamp device is beneficial to rapidly completing the operation, so that the operation risk is reduced.

In this embodiment, the locking member 33 has various locking structures, including, but not limited to, as shown in fig. 6 to 11, the locking member 33 is a screw, a locking threaded hole penetrating through the wall of the external threaded tube 32 is provided on the proximal wall of the external threaded tube 32, the screw is screwed into the locking threaded hole, and in the locked state, the screw is screwed into the locking threaded hole to tightly lock the external sleeve 12 to the external threaded tube 32, and when the unlocked state needs to be switched, the screw is unscrewed.

With continued reference to fig. 9, in some alternative implementations of the present embodiment, it is preferable that the fore-aft adjustment assembly 300 further includes a stress relief structure 310, where the stress relief structure 310 is configured to enable the outer sleeve 12 to move forward and backward relative to the outer threaded tube 32 while rotating relative to the outer threaded tube 32 when the locking member 33 is in the unlocked state and the main control handle adapter assembly 100 rotates relative to the outer threaded tube 32 to fine adjust the angle of the clamp, so as to relieve friction and torsion stress between the outer tube wall of the outer sleeve 12 and the inner tube wall of the bending sheath 22 when the outer sleeve 12 and the bending sheath 22 rotate relative to each other, so as to achieve at least the following advantages: (1) Avoiding the breakage of the outer sleeve 12 or the bending sheath tube 22 during multiple rotations, and prolonging the service life of the clamp conveying device; (2) When the locking member 33 is in the locked state, the nut 31 is rotated, so that the outer sleeve 12 is prevented from rotating relative to the bending sheath tube 22 while moving forward and backward under the frictional torsion stress between the outer sleeve 12 tube wall and the inner tube wall of the bending sheath tube 22 in the process of pushing the main control handle adapter assembly 100 forward or retracting backward relative to the bending sheath tube 200, thereby affecting the positioning accuracy of the clamp.

In particular, the stress relief structure 310 may include, but is not limited to, a connecting tube 311 and a stop pin 312 as shown in fig. 9; the proximal end of the connection tube 311 is fixedly connected to the distal end of the main handle housing 11 and communicates with the inner cavity of the main handle housing 11, and the outer sleeve 12 passes through the connection tube 311. A displacement chute 3111 extending circumferentially and in a wave shape is arranged on the outer tube wall at the distal end of the connecting tube 311; a stopper pin accommodating hole 321 is provided in the wall of the externally threaded pipe 32, one end of the stopper pin 312 is positioned inside the displacement chute 3111 and the other end extends into the stopper pin accommodating hole 321. And preferably, but not limited to, the stop pin 312 includes at least a first stop pin and a second stop pin that are symmetrical about a central axis of the externally threaded tube 32. When the main handle adapter assembly 100 is rotated with respect to the male pipe 32 in the unlocked state, the connecting pipe 311 is rotated with respect to the male pipe, and the connecting pipe 311 is moved back and forth with respect to the male pipe 32 along the displacement chute 3111.

In this embodiment, the two lower arms of the clamping device are controlled to open and close, the connecting rod 14 needs to be pushed and pulled by the relative middle sleeve 13, so that the outer sleeve of the clamping device can be driven to swing the driving rod 1 to move back and forth, and for conveniently pushing and pulling the connecting rod 14 by the relative middle sleeve 13, preferably, referring to fig. 10, the main control handle connecting tube assembly 100 further comprises a connecting rod adjusting handle 15, and the connecting rod adjusting handle 15 comprises a rear adjusting nut 151, a rear adjusting external threaded tube 152 and a rear locking member (not shown). One of the distal end circumferential surface of the rear adjustment nut 151 and the proximal end circumferential surface of the main handle housing 11 is provided with a circumferential limit groove, and the other is provided with a limit projection which is limited inside the circumferential limit groove so that the rear adjustment nut 151 can rotate relative to the main handle housing 11; the distal end of the rear adjustment externally threaded tube 152 is screwed into the interior of the rear adjustment nut 151 and the rear adjustment externally threaded tube 152 extends into the inner cavity of the main handle housing 11, and the connecting rod 14 passes through the rear adjustment externally threaded tube 152 and is locked to the rear adjustment externally threaded tube 152 by the rear locking member. In the locked state, the rear adjusting nut 151 is rotated relative to the main handle housing 11, so that the connecting rod 14 can be pushed forward or retracted backward relative to the outer sleeve 12 and the middle sleeve 13.

Further preferably, in this embodiment, as shown in fig. 10 and 12, the connecting rod adjusting handle 15 further includes a rear release handle 153; the distal end of the connecting rod 14 is fixedly connected to the rear release handle 153; the proximal end of the rear adjusting external threaded tube 152 is fixedly connected with an extension circular tube 1521, the distal end of the shell of the rear release handle 153 is sleeved outside the extension circular tube 1521 and the rear release handle 153 can rotate relative to the extension circular tube 1521; and, a unidirectional rotation limiting structure 16 is provided between the rear release handle 153 and the rear adjustment external threaded tube 152, and the unidirectional rotation limiting structure 16 is configured to allow the rear release handle 153 to unidirectional rotate in the opposite rotation direction relative to the rear adjustment external threaded tube 152, with the rotation direction of the threaded connection portion at the distal end of the connecting rod 14 when rotating away from the proximal end of the outer sleeve swing driving rod 1 of the jaw. The unidirectional rotation limiting structure 16 mainly rotates the connecting rod 14 in the opposite direction relative to the middle sleeve 13 so as to avoid misoperation of the connecting rod 14 after the forward rotation relative to the middle sleeve 13 when the connecting rod 14 is separated from the proximal end of the outer sleeve swing driving rod 1 of the clamp. Preferably, but not limited to, a limiting pin 154 is further disposed between the housing of the rear release handle 153 and the rear adjustment externally threaded tube 152, the limiting pin 154 is detachably mounted between the housing of the rear release handle 153 and the rear adjustment externally threaded tube 152, and the limiting pin 154 fixes the housing of the rear release handle 153 and the rear adjustment externally threaded tube 152 together when the connecting rod 14 does not need to be withdrawn, so as to avoid misoperation of the reverse rotation connecting rod 14 during operation, and the jaw is separated from the distal end of the connecting rod 14; when the connecting rod 14 needs to be separated from the proximal end of the outer sleeve swing driving rod 1 of the forceps, the handle 153 can be released after the limiting pin 154 is removed and reversely rotated relative to the middle sleeve 13, so that the connecting rod 14 is reversely rotated to separate the connecting rod 14 from the proximal end of the outer sleeve swing driving rod 1 of the forceps.

In this embodiment, it is further preferable that the one-way rotation limiting structure 16 includes a limiting rotation shaft 161, a limiting tube 162 and a compression spring 163 provided inside the housing of the rear release handle 153, as shown in fig. 13. The proximal end fixedly connected with of back regulation external screw thread pipe 152 extends pipe 1521, the distal end suit of the casing of back release handle 153 is outside in extending pipe 1521, extend the proximal end face of pipe 1521 and form the first unsmooth face 1601 that is formed by a plurality of spacing grooves head and tail connection, the spacing groove link up the pipe wall that extends pipe 1521 along the radial of extending pipe 1521, the spacing groove is including the first junction surface that connects gradually along the anti-rotation, second junction surface and third junction surface, the contained angle of first junction surface and second junction surface towards the proximal end side is greater than 0 degree and less than or equal to 90 degrees, the contained angle of second junction surface and third junction surface towards the proximal end side is greater than 90 degrees and less than 180 degrees. The distal end side of the limit shaft 161 is inserted into the proximal end lumen of the extension barrel 1521, and the proximal end of the limit shaft 161 is connected to the housing of the rear release handle 153. The extension round tube 1521, the limit tube 162 and the compression spring 163 are sleeved outside the limit rotating shaft 161 from the distal end to the proximal end in sequence; the distal end surface of the stopper tube 162 forms a second concave-convex surface 1602 that engages with the proximal end surface of the extension tube 1521. Under the condition that the rear release handle 153 reversely rotates, the limit rotating shaft 161 and the limit tube 162 both rotate synchronously with the shell of the rear release handle 153, and the compression spring 163 makes the limit tube 162 always slide towards the distal direction relative to the limit rotating shaft 161, so that the second concave-convex surface 1602 and the first concave-convex surface 1601 mutually buckle with each other in movement trend.

In an alternative implementation of this embodiment, it is preferable that the main control handle adapter assembly 100 further includes a locking piece traction wire handle, wherein a distal end of the locking piece traction wire handle is connected to a proximal end of the main handle housing 11, and an inner cavity of the locking piece traction wire handle is communicated with an inner cavity of the main handle housing 11, and with reference to patent CN113940791a and patent CN113940792a, two ends of a traction wire that is threaded on a locking piece on the jaw device may be threaded out of the locking piece traction wire handle and then fixed or pressed to the locking piece traction wire handle by a handle rear cover, and a locking state of the locking piece is adjusted by releasing or pulling the traction wire.

In addition, in order to easily introduce the distal end of the bending sheath 22 of the distal end-mounted feeder into the auxiliary device feeding tube during the operation, preferably, as shown in fig. 11 and 12, an outer guiding sheath assembly 500 is sleeved outside the bending sheath 22 of the present embodiment, the outer guiding sheath assembly 500 includes an outer guiding sheath handle 510, an outer guiding sheath 520 and an auxiliary cannula joint 530, the rear end of the outer guiding sheath 520 is connected to the outer guiding sheath handle 510 to be used as an operation guiding tube, and the auxiliary cannula joint 530 can slide back and forth along the bending sheath 22 to the distal end portion of the bending sheath 22 so that the clamping device is sleeved inside the clamping device, thereby facilitating the rapid introduction of the distal end of the bending sheath 22 of the distal end-mounted feeder into the inner cavity of the outer guiding sheath handle 510 and the outer guiding sheath 520, and protecting the clamping device during the assembly.

Referring to fig. 1, in an alternative implementation of the present embodiment, the jaw apparatus further comprises an auxiliary support 400; the auxiliary support 400 includes a chassis and a bracket attached to the chassis for supporting each handle housing for use by an operator.

Finally, it should be noted that:

1. in the present specification, "and/or" means "and/or" preceding structure is provided simultaneously or alternatively with "and/or" following structure;

2. in the present specification, each embodiment is described in a progressive manner, and each embodiment is mainly described by differences from other embodiments, and identical and similar parts between the embodiments are only required to be seen with each other; the above embodiments in the present specification are only for illustrating the technical solution of the present utility model, and are not limiting; although the utility model has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the utility model.

Claims

1. A bending sheath (200), characterized by: the bending adjusting handle (21) comprises a bending adjusting main shell (211) and a three-way bending adjusting structure, the rear end of the bending adjusting sheath (22) is connected to the front end of the bending adjusting main shell (211), and the lumen of the bending adjusting sheath (22) is communicated with the inner cavity of the bending adjusting main shell (211);

the main bending component comprises a side branch handle (212) and a first bending wire (213); the side branch handle (212) is arranged on one side of the bending main shell (211) and the inner cavity of the side branch handle is communicated with the inner cavity of the bending main shell (211); the first bending wire (213) passes through the bending main shell (211) and the side branch handle (212), the front end of the first bending wire (213) is connected to the front end pipe wall of the bending sheath pipe (22), and the rear end of the first bending wire (213) is fixed on the side branch handle (212) in a mode of being capable of adjusting the fixed length; by adjusting the length of the rear end of the first bending wire (213) fixed on the side branch handle (212), the first bending wire (213) can be pulled backwards or released forwards, so that the front end of the bending sheath tube (22) is controlled to deflect towards a first direction or recover to a state before deflecting towards the first direction;

The bidirectional swing control assembly comprises a second bending regulating wire (214), a third bending regulating wire (215), a bending regulating sheath transmission assembly and a bending regulating sheath driving part;

the bending sheath transmission assembly is arranged in the inner cavity of the bending main shell (211), the bending sheath driving part is arranged on the bending main shell (211), one part of the bending sheath driving part is positioned outside the bending main shell (211), the other part of the bending sheath driving part is connected with the bending sheath transmission assembly, and the rear ends of the second bending wire (214) and the third bending wire (215) are respectively connected with the bending sheath transmission assembly;

the front ends of the second bending wire (214) and the third bending wire (215) are respectively connected to the front end pipe wall of the bending sheath pipe (22), and projection points of the front ends of the first bending wire (213), the second bending wire (214) and the third bending wire (215) on the same radial circumference line of the bending sheath pipe (22) are respectively positioned at three vertexes of an isosceles triangle taking a connecting line between the front ends of the second bending wire (214) and the third bending wire (215) as a bottom line, and the projection points of the front ends of the second bending wire (214) and the third bending wire (215) on the same radial circumference line are respectively positioned on the same diameter of a circle where the same radial circumference line is positioned;

The bending sheath drive is configured to control actuation of the bending sheath drive assembly to pull back on the second bending wire (214) and release the third bending wire (215) forward under one condition to deflect the forward end of the bending sheath (22) toward a second direction, and to pull back on the second bending wire (214) and pull back on the third bending wire (215) under another condition to deflect the forward end of the bending sheath (22) toward a third direction opposite the second direction.

2. The buckle-accommodating sheath (200) according to claim 1, characterized in that: the main bending component further comprises a control knob component (240), the control knob component (240) comprises a rotary rod (241) and a rotary rod pairing nut (242), and an external thread is arranged on the outer peripheral wall of the front end of the rotary rod (241);

the rear end of the side branch handle (212) is provided with an opening communicated with the inner cavity of the side branch handle (212), the front end of the rotary rod (241) stretches into the side branch handle (212) from the opening, the rotary rod pairing nut (242) is arranged in the side branch handle (212), the rotary rod pairing nut (242) is sleeved and connected with the outside of the rotary rod (241) in a threaded manner, and the rear end of the first bending wire (213) is fixed on the rotary rod pairing nut (242);

The inner wall of the side branch handle (212) and the outer peripheral wall of the rotary rod pairing nut (242) are provided with buckling limiting structures which can be buckled mutually, so that the rotary rod pairing nut (242) can only slide forwards and backwards relative to the side branch handle (212) and cannot rotate relative to the side branch handle (212) under the working condition that the rotary rod (241) rotates relative to the side branch handle (212).

3. The buckle-accommodating sheath (200) according to claim 2, characterized in that: the inner wall of the rear end opening part of the side branch handle (212) is provided with an annular limiting protrusion (2121) extending along the circumferential direction of the side branch handle (212), the outer circumferential surface of the rear end of the rotary rod (241) is provided with an annular limiting groove (2411), and the annular limiting protrusion (2121) and the annular limiting groove (2411) are mutually buckled.

4. The buckle-accommodating sheath (200) according to claim 1, characterized in that: the bending sheath driving part comprises a bending driving rod (250) and a bending knob (251); the bending sheath tube transmission assembly comprises a first bending threaded rod (252), a first bending nut piece (253), a second bending threaded rod (254), a second bending nut piece (255), a first bending bevel gear (256), a second bending bevel gear (257), a third bending bevel gear (258) and a fourth bending bevel gear (259);

The front-back direction is taken as the axial direction:

the bidirectional swing control assembly further comprises a bending installation seat (230) fixedly installed in the inner cavity of the bending main shell (211), the bending installation seat (230) comprises a bending front plate (231), a bending axial connecting pipe (233) and a bending rear plate (232), the bending front plate (231) and the bending rear plate (232) extend along the radial plane of the bending main shell (211) and are fixed on the inner wall of the bending main shell (211), and the bending axial connecting pipe (233) is connected to the bending front plate (231) and/or the bending rear plate (232);

the two ends of the first bending threaded rod (252) and the two ends of the second bending threaded rod (254) are respectively rotatably installed on the bending front plate (231) and the bending rear plate (232), the first bending nut piece (253) is in threaded sleeve joint with the outer part of the first bending threaded rod (252), the second bending nut piece (255) is in threaded sleeve joint with the outer part of the second bending threaded rod (254), a first limiting track and a second limiting track which extend along the axial direction of the bending axial connecting pipe (233) are arranged on the pipe wall of the bending axial connecting pipe (233), the first bending nut piece (253) is axially limited on the first limiting track, the second bending nut piece (255) is axially limited on the second limiting track, the rear end of the second bending wire (214) is connected with the first bending nut piece (253), and the rear end of the third bending wire (215) is connected with the second bending nut piece (255);

The bending driving rod (250) penetrates through the side wall of the bending main shell (211) in the radial direction and is rotatably arranged on the bending mounting seat (230), the first bending bevel gear (256) and the second bending bevel gear (257) are fixed at a position, in the inner cavity of the bending main shell (211), of the bending driving rod (250), the third bending bevel gear (258) is fixed at the rear end of the first bending threaded rod (252) and is meshed with the first bending bevel gear (256), and the fourth bending bevel gear (259) is fixed at the rear end of the second bending threaded rod (254) and is meshed with the second bending bevel gear (257); the first bending bevel gear (256), the second bending bevel gear (257), the third bending bevel gear (258), the fourth bending bevel gear (259), the first bending threaded rod (252) and the second bending threaded rod (254) are configured to drive the first bending nut member (253) to slide forwards relative to the first bending threaded rod (252) and drive the second bending nut member (255) to slide backwards relative to the second bending threaded rod (254) under the condition that the bending driving rod (250) rotates forwards; under the condition that the bending driving rod (250) reversely rotates, the first bending nut piece (253) is driven to slide backwards relative to the first bending threaded rod (252), and the second bending nut piece (255) is driven to slide forwards relative to the second bending threaded rod (254);

The bending adjusting knob (251) is arranged outside the bending adjusting main housing (211) and connected to a part of the bending adjusting driving rod (250) positioned outside the bending adjusting main housing (211), and is used for driving the bending adjusting driving rod (250) to rotate forwards or reversely.

5. The bending sheath (200) according to claim 4, wherein in the bending mount (230), a middle portion of the bending front plate (231) and a middle portion of the bending rear plate (232) are respectively provided with perforations.

6. The bending sheath (200) according to claim 4, wherein the bending axial connection tube (233) in the bending mount (230) comprises a front tube (2331) integrally connected to the rear end of the bending front plate (231) and a rear tube (2332) integrally connected to the bending rear plate (232), and the front tube (2331) and the rear tube (2332) are mutually sleeved.

7. The bending sheath (200) according to claim 4, wherein the first bending nut member (253) and the second bending nut member (255) are respectively provided with at least two wire holes, and the rear ends of the corresponding bending wires are fixed to the corresponding bending nut members in such a manner that the rear ends of the corresponding bending wires are sequentially threaded through the at least two wire holes and then knotted.

8. The bending sheath (200) according to claim 4, wherein the bending mount (230) is:

The first limit track and the second limit track are respectively a first raised line and a second raised line which are symmetrically arranged on the outer pipe wall of the bending axial connecting pipe (233) by taking the axial central axis of the bending axial connecting pipe (233) as a symmetrical axis and extend along the axial direction of the bending axial connecting pipe (233);

the outer peripheral surface of the first bending nut piece (253) is provided with a first groove, and the outer peripheral surface of the second bending nut piece (255) is provided with a second groove;

the first raised strips and the first grooves are mutually buckled, and the second raised strips and the second grooves are mutually buckled.

9. A jaw apparatus delivery device comprising a main handle take over assembly (100); the main control handle connecting pipe assembly (100) at least comprises a main handle shell (11), a first upper clamping arm traction wire handle, a second upper clamping arm traction wire handle, an outer sleeve (12), a middle sleeve (13) and a connecting rod (14); the distal end of the first upper clamp arm traction wire handle and the distal end of the second upper clamp arm traction wire handle are both connected to the main handle shell (11) and the inner cavity is communicated with the inner cavity of the main handle shell (11); the proximal end of the outer sleeve (12) is fixedly connected to the main handle shell (11) and is communicated with the inner cavity of the main handle shell (11); the proximal end of the middle sleeve (13) is fixedly connected to the inside of the outer sleeve (12), a stay wire channel for communicating the proximal end and the distal end of the outer sleeve (12) is arranged between the middle sleeve (13) and the outer sleeve (12), the distal end of the middle sleeve (13) extends out of the outer sleeve (12), and the distal end of the middle sleeve (13) is provided with an installation part for being in threaded connection or clamped connection with the proximal end of a fixing seat of the clamp; the connecting rod (14) sequentially penetrates through the middle sleeve (13), the outer sleeve (12) and the main handle shell (11) from the far end to the near end, and a threaded connection part for being in threaded connection with the near end of the driving rod of the clamp device is arranged on the wall of the far end of the connecting rod (14);

The method is characterized in that:

the jaw apparatus delivery device further comprising a buckle sheath (200) of any one of claims 1 to 8;

the outer sleeve (12) passes through the bending main housing (211) and the bending sheath tube (22) in the bending sheath (200), and the outer sleeve (12) can rotate relative to the bending main housing (211) and the bending sheath tube (22) in the bending sheath (200).

10. The jaw apparatus transport device of claim 9, wherein: the clamp conveying device further comprises an outer sleeve swing control assembly;

the outer sleeve swinging control assembly comprises a first outer sleeve control wire, a second outer sleeve control wire, an outer sleeve swinging transmission assembly and an outer sleeve swinging driving part; the front ends of the first outer sleeve control wire and the second outer sleeve control wire are respectively connected to the front end pipe wall of the outer sleeve (12), and projection points of the front ends of the first outer sleeve control wire and the second outer sleeve control wire on the same radial circumferential line of the outer sleeve (12) are respectively positioned on the same diameter of a circle where the same radial circumferential line is positioned; the rear end of the first outer sleeve control wire and the rear end of the second outer sleeve control wire are respectively connected with the outer sleeve swing transmission assembly, the outer sleeve swing transmission assembly is arranged in the inner cavity of the main handle shell (11), the outer sleeve swing driving part is arranged in the main handle shell (11), one part of the outer sleeve swing driving part is positioned outside the main handle shell (11), and the other part of the outer sleeve swing driving part is connected with the outer sleeve swing transmission assembly;

The outer sleeve swing driving part is configured to control the outer sleeve swing transmission assembly to act, so that under a first working condition, the first outer sleeve control wire is pulled backwards and the second outer sleeve control wire is released forwards to enable the front end of the outer sleeve (12) to deflect towards a first direction, and under a second working condition, the first outer sleeve control wire is released forwards and the second outer sleeve control wire is pulled backwards to enable the front end of the outer sleeve (12) to deflect towards a second direction opposite to the first direction.