TRACTION APPARATUS AND TRACTION RING FOR TRACTION APPARATUS

Abstract

A traction apparatus, comprising a clip portion (2) and a traction portion (1), the traction portion containing a closed traction structure (11); the closed traction structure being made from an elastic material; the clip portion comprising a main clip body (23, 25) and a clip arm (24, 26); the main clip body being capable of passing through a biopsy channel (4) of an endoscope (3), the clip arm being capable of clip the closed traction structure. Also disclosed is a traction ring used for the traction apparatus, the traction ring being a single closed traction structure or being formed by connecting several closed traction structures, the traction ring being made from an elastic material.

Claims

1. A traction apparatus, wherein the traction apparatus comprises a clip portion and a traction portion; the traction portion contains a closed traction structure; the closed traction structure is made of an elastic material; the clip portion comprises a main clip body and a clip arm; the main clip body is capable of passing through a biopsy channel of an endoscope; and the clip arm is capable of clip the closed traction structure.

2. The traction apparatus according to claim 1, wherein the closed traction structure is made of silicon rubber or a thermoplastic elastomer.

3. The traction apparatus according to claim 1, wherein the clip portion comprises one, two, or more closed traction structures.

4. The traction apparatus according to claim 3, wherein an elastic connection structure is provided between two or more closed traction structures.

5. The traction apparatus according to claim 4, wherein the elastic connection structure is an elastic linear structure.

6. The traction apparatus according to claim 4, wherein the elastic connection structure is an elastic ring structure.

7. The traction apparatus according to claim 1, wherein the closed traction structure is a combination of one or more of round shape, triangular shape, rhombic shape, or square shape.

8. The traction apparatus according to claim 1, wherein the closed traction structure is capable of being elastically deformed by moving the main clip body of the clip portion.

9. The traction apparatus according to claim 1, wherein the traction portion further comprises a connection ring which is a ring structure arranged on an outer edge position of the closed traction structure, configured to be sleeved on the clip arm.

10. The traction apparatus according to claim 9, wherein the inner diameter of the connection ring is smaller than or equals to the width of the clip arm so as to be sleeved on the clip arm closely to improve the connecting stability.

11. The traction apparatus according to claim 9, wherein the connection ring is arranged on the outer edge position at one side of the closed traction structure.

12. The traction apparatus according to claim 1, wherein the clip portion further comprises inner thorns, which is provided protrusively on the clip arm towards the clipping direction of the clip arm to avoid the sliding of the clip portion on the clip arm.

13. The traction apparatus according to claim 12, wherein the ends of the inner thorns arranged on two clip arms that open and close towards each other are provided with serrated structures matching each other.

14. A traction ring used for a traction apparatus, wherein the traction ring is formed by connecting one or more closed traction structures, and the traction ring is made of an elastic material.

15. The traction ring according to claim 14, wherein an elastic connection structure is provided between two or more closed traction structures.

16. The traction ring according to claim 15, wherein the elastic connection structure is an elastic linear structure.

17. The traction ring according to claim 15, wherein the elastic connection structure is an elastic ring structure.

18. The traction ring according to claim 14, wherein the closed traction structure is a combination of one or more of round shape, triangular shape, rhombic shape, or square shape.

19. The traction ring according to claim 14, wherein the traction portion further comprises a connection ring which is a ring structure arranged on an outer edge position of the closed traction structure, configured to be sleeved on the clip arm.

20. The traction ring according to claim 19, wherein the inner diameter of the connection ring is smaller than or equals to the width of the clip arm so as to be sleeved on the clip arm closely to improve the connecting stability.

21. The traction ring according to claim 19, wherein the connection ring is arranged on an outer edge at one side of the closed traction structure.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0022] FIG. 1A is a sectional view and a front view of a traction portion including two annular closed traction structures.

[0023] FIG. 1B is a schematic diagram of a traction portion including three annular closed traction structures.

[0024] FIG. 1C is a schematic diagram of a traction portion including four annular closed traction structures.

[0025] FIG. 1D is a sectional view and a front view of a triangular closed traction structure.

[0026] FIG. 2 is a schematic diagram showing cooperating of a clip portion and a traction portion with each other.

[0027] FIG. 3 is a schematic diagram of entering a clip portion and a traction portion into a biopsy channel of an endoscope.

[0028] FIG. 4 is a schematic diagram of clip a nidus by using a first clip portion and an annular closed traction structure under guidance of an endoscope.

[0029] FIG. 5 is a schematic diagram of clip a nidus by using a second clip portion and an annular closed traction structure under guidance of an endoscope.

[0030] FIG. 6 is a schematic diagram of separating a nidus by a clip portion and an annular closed traction structure cooperating with each other.

[0031] FIG. 7 is a schematic diagram of separating a nidus in a narrow space by using a traction apparatus.

[0032] FIG. 8 is a schematic diagram of connecting an elastic linear structure between annular closed traction structures.

[0033] FIG. 9A to FIG. 9C are schematic diagrams of reducing a wound surface of a nidus by using a traction apparatus when the wound surface of the nidus is relatively large.

[0034] FIG. 10 is a schematic diagram of the structure of the traction portion with connection ring.

[0035] FIG. 11 is a schematic diagram of the structure of the clip portion with inner thorns.

LIST OF REFERENCE NUMBERS

[0036] 1 Traction portion [0037] 11 Closed traction structure [0038] 12 Connection ring [0039] 2 Clip portion [0040] 21 First clip portion [0041] 22 Second clip portion [0042] 23 Main clip body [0043] 24 Clip arm [0044] 25 Main clip body [0045] 26 Clip arm [0046] 27 Inner thorn [0047] 3 Endoscope [0048] 4 Biopsy channel [0049] 5 Nidus [0050] 6 Mucosa layer [0051] 7 Muscular layer [0052] 8 Mucosa layer at an opposite side of a lumina

DETAILED DESCRIPTION OF THE EMBODIMENTS

[0053] To make objectives, technical solutions, and advantages of the present application clearer, the present application is further described in detail below with reference to the accompanying drawings and the embodiments. It should be understood that the specific embodiments described herein are merely used to explain the present application, and are not used to limit the present application.

[0054] In the following, the end of the endoscope that is close to the operator is defined as the proximal end, and the end far away from the operator is defined as the distal end.

[0055] FIG. 1A to FIG. 1D and FIG. 8 are schematic diagrams of different types of closed traction structures. FIG. 1A is a schematic diagram of a traction portion 1 including two annular closed traction structures, wherein two annular structures are connected in a closed manner to form a traction portion 1 with a closed traction structure. FIG. 1B and FIG. 1C are schematic diagrams of a traction portion 1 including three annular closed traction structures and four annular closed traction structures. FIG. 1D is a sectional view and a front view of a triangular closed traction structure. As shown in FIG. 8, the traction portion 1 may also be mounted with an elastic linear structure in the closed traction structure. Both the closed traction structure and the elastic linear structure may have elastic deformation, so that a nidus 5 is completely separated from a mucosa layer 6. Such a structure is particularly suitable for a case in which the nidus 5 is relatively large. A closed traction structure 11 may be made of an elastic material. The elastic material may be silicon rubber or a thermoplastic elastomer. There may be one, two, or more closed traction structures. During actual use, according to different sizes of niduses, different types of traction portions may be selected to conduct the stretching and separating, being suitable for the traction operations of a mucosa, a tissue, an organ, and the like.

[0056] In the following, an operation process in which a traction apparatus in the present application is used to stretch and separate a mucosa is described by using an example in which the traction portion is merely composed of a closed traction structure. During an actual operation process, an electric knife may be inserted nearby a tissue having a lesion through a biopsy channel of an endoscope, making marks around a position having a lesion. After the marks are made, liquid is injected though the electric knife or an external syringe, so that the tissue having a lesion swells, and a liquid buffer layer, that is, a water cushion, is formed under the mucosa.

[0057] As shown in FIG. 2 to FIG. 6, FIG. 2 is a schematic diagram showing the cooperating of a clip portion 2 and a traction portion 1 with each other. The clip portion 2 includes clip main bodies 23 and 25 and clip arms 24 and 26. After the mucosa is pre-separated within the body, the electric knife is taken out, and the clip arm 24 of the clip portion 2 of the traction apparatus is enabled. The clip arm 24 clips one end of the closed traction structure 11 of the traction portion 1.

[0058] As shown in FIG. 3 and FIG. 4, after a first clip portion 21 and the closed traction structure 11 are placed in a biopsy channel 4 of an endoscope 3 and reach the distal end of the biopsy channel 4, by observing from an eye lens of the endoscope 3, the clip arm 24 of the first clip portion 21 is opened to clip one side of the pre-separated nidus 5 and one end of the closed traction structure 11 at the same time. At this time, a proximal end and a distal end of the main clip body 23 of the first clip portion 21 are separated, so that the distal end of the main clip body of the first clip portion 21 and the closed traction structure 11 are left in the body, and the main clip body 23 is taken out.

[0059] As shown in FIG. 5, after a second clip portion 22 is inserted into the biopsy channel 4 of the endoscope and reaches the distal end of the biopsy channel 4, by observing from the eye lens of the endoscope 3, a clip arm 26 of the second clip portion 22 is opened to clip the other end of the closed traction structure 11, and to stretch to the other side of the pre-separated nidus 5 under the guidance of the endoscope. Subsequently, the proximal end and the distal end of the main clip body 25 of the second clip portion 22 are separated, so that the distal end of the main clip body of the second clip portion 22 and the closed traction structure 11 are left in the body.

[0060] Because the closed traction structure 11 is elastic, during a cutting process of an operation, the cut nidus 5 is everted due to elastic force of the traction portion 1. With progress of a cutting operation, the cut nidus 5 is constantly pulled up to be gradually separated from a muscular layer 7, until being completely pulled up. In this way, the nidus 5 is completely separated. According to such a traction manner, the nidus 5 is cut and is everted at the same time, thereby widening the surgical field. A blood vessel under the mucosa may be found when looking directly from the endoscope, and bleeding may be avoided. In this way, the operation becomes more convenient and safer, and the operation time is shortened.

[0061] If the nidus 5 is too large, the number of clip portions 2 and closed traction structures may be increased, so that the cut nidus 5 is completely pulled up; or as shown in FIG. 8, the traction portion 1 having an elastic linear structure may be selected, so that the range of elastic deformation of the entire traction portion 1 is increased to stretch a nidus 5 with a relatively large area.

[0062] As shown in FIG. 4 and FIG. 7, when the nidus 5 is relatively large while the space is relatively small, for example, an ESD operation is performed in an intestine, one side of the nidus 5 may be cut first. As shown in FIG. 4, the nidus 5 is clipped by using the clip arm 24 of the first clip portion 21. The second clip portion 22 is fed in by the endoscope 3. By observing from the eye lens of the endoscope 3, the clip arm 26 of the second clip portion 22 clips a mucosa layer 8 at an opposite side of an intestinal canal. The clip arm 26 of the second clip portion 22 is closed. Under of the action of elastic force of the closed traction structure 11, the cut nidus 5 is constantly pulled up with progress of the cutting operation, thus keeping the surgical field and facilitating the operation.

[0063] As shown in FIG. 9A to FIG. 9C, when a wound surface of the nidus 5 is relatively large, the observation and guidance operation is performed by the endoscope 3. One side of the wound surface of the nidus 5 and one end of the closed traction structure 11 are clipped first by using the clip arm 24 of the first clip portion. The other side of the wound surface of the nidus 5 and the other end of the closed traction structure 11 are further clipped by using the clip arm 26 of the second clip portion. Due to the elastic force of the closed traction structure 11, both sides of the wound surface of the nidus 5 are pulled inward, so that the wound surface of the nidus 5 is reduced. In this way, the wound surface of the nidus 5 is further closed by clip.

[0064] In some embodiments of the present application, as shown in FIG. 10, the traction portion 1 further includes a connection ring 12, which is a ring structure arranged on the outer edge position of the closed traction structure 11. The connection ring 12 may be sleeved on the clip arm 24, and therefore, the inner space area of the connection ring 12 is smaller compared with the more convenient and safer closed traction structure 11.

[0065] For example, when the closed traction structure 11 is a round structure, the inner diameter of the connection ring 12 shall be smaller than the diameter of the circle formed by the closed traction structure 11. During the actual application, the closed traction structure 11 with a larger inner area generates the main elastic force action, and in this way such a structure may realize the traction of the wound tissue. On the other hand, the connection ring 12 with a smaller inner area is sleeved on the clip arm 24, so that the traction portion 1 is not easy to drop off from the clip arm 24 when the traction portion 1 is moved in the surgical area and in the endoscope channel driven by the clip arm 2, and the surgical success rate is improved.

[0066] The connection ring 12 may be made of elastic material, so that the connection ring 12 is able to be sleeved on the clip arm 24 by using the elasticity of the connection ring 12. In some embodiments, the inner diameter of the connection ring 12 is smaller than or equals to the width of the clip arm 24 so as to be closely sleeved on the clip arm, so that the connecting stability is improved.

[0067] The width of the clip arm refers to total width of the clip arm 24 at the thinnest position. The physical quantity referred to by the width of the clip arm 24 is different according to different shape of the clip arm 24. For example, when the cross-section shape of the clip arm 24 is rectangular, the width of the clip arm 24 refers to the length of long side of the rectangle. When the cross-section shape of the clip arm 24 is circular, the width of the clip arm 24 refers to the diameter of the circle. When the cross-section shape of the clip arm 24 is polygonal, the width of the clip arm 24 refers to the diagonal line of the cross polygon or the distance between two most distant vertices.

[0068] When the inner diameter of the connection ring 12 is smaller than or equals to the width of the clip arm 24, the connection ring 12 may be expanded when the connection ring is sleeved on the clip arm 24, so that the connection ring 12 is deformed and an elastic force for shrinking the connection ring 24 inward is generated. By the elastic force of the connection ring 12, the connection ring 12 may be closely sleeved on the clip arm 24, which increases the frictional force between the contact surfaces of the connection ring 12 and the clip arm 24, so that the connection ring 12 is not easy to slide on the clip arm 24, increasing the connection stability between the traction portion 1 and the clip portion 2.

[0069] Additionally, the clip arm 24 is generally made of a hard material such as metal, while the elastic material making the connection ring 12 is generally a soft material such as silicon rubber. Therefore, the frictional coefficient between the hard material and the soft material is large, which further increases stability. In some embodiments, the connection ring 12 may be made of an elastic material the same as the material of the closed traction structure 11, and may be formed an integral structure with the closed traction structure 11 so as to facilitate the forming processes.

[0070] During an actual surgical procedure, by sleeving the connection ring 12 on the clip arm 24 and driving the traction portion 1 through the endoscope channel by the clip portion 2, the traction portion 1 may be delivered to the operation position. Therefore, the connection ring 12 may be sleeved on the clip arm 24 only before delivering it to the surgical area. That is, the connection ring 12 may be arranged on an outer edge position at one side of the closed traction structure 11. During the surgical process, the connection ring 12 may be sleeved on the clip arm 24 at one side, and is delivered to the surgical area; while on the other side, the traction to the tissue may be realized by directly clipping the closed traction structure 11 with the clip arm 24. Because the inner area of the closed traction structure 11 is larger, it is convenient for completing the clipping operation at the surgical area.

[0071] Moreover, in order to further increase the stability of the connection position, the shape of the inner side of the connection ring 12 may be adapted to the shape of clip arm 24 or the shape of a part of the clip arm 24. That is, the shape of the inner area of the connection ring 12 is the same as the cross-section shape of the clip arm 24. For example, the connection ring 12 is a circular ring structure, and the cross-section shape of the clip arm 24 is circular. The shape of the inner area of the connection ring 12 is rectangular, and the cross-section shape of the clip arm 24 is also rectangular. By the adaptive shapes, the contact area between the inner side of the connection ring 12 and the outer surface of the clip arm 24 may be increased, which is favorable for maintaining the connection stability. Moreover, after the closed traction structure 11 is deformed by stretching, the adaptive shapes may relieve the reverse between the connection ring 12 and clip 24, further increasing the stability of the connection position.

[0072] As a cooperative action member, the structure of the clip portion 2 should be suitable for maintaining connection stability. For example, the two clip arms 24 of the clip portion 2 may be arranged symmetrically on the same pivot shaft, and when the two arms 24 are closed. A closed ring area is formed for clipping tissues and making the traction portion 1 be clipped between the two arms, avoiding the dropping off of the traction portion 1 from the inside of the two clip arms 24.

[0073] For example, a guiding groove is arranged in the area close to the pivot shaft and on the two clip arms 24 of the clip portion 2. The guiding groove may be formed as a corner-shaped structure, wherein in the direction from the proximal end to the distal end, the groove has a preset inclination angle with respect to the extending direction of the clip arm 24 first, and then gradually becomes parallel (or nearly parallel) with respect to the extending direction of the clip arm 24, and has a depth in the direction parallel (or nearly parallel) to the extending direction of the clip arm 24. A pivot shaft is arranged in the guiding groove. During the surgical proceeding, the pivot shaft may move in the guiding groove. When the pivot shaft moves at the inclination position, the two clip arms 24 gradually open or close. When the pivot shaft moves at the parallel (or nearly parallel) position, the two clip arms are in a completely closed state, and the closed state is locked by preset distance in depth, so that the two clip arms are maintained in a stable closed state, avoiding the drop off of the traction portion 1 from the two clip arms.

[0074] In some embodiments of the present application, the clip portion further includes inner thorns. As shown in FIG. 11, the inner thorn 27 may be provided at any position between two ends of the clip arms 24 according to operation requirements. For example, the inner thorn may be provided at the position close to the distal end of the clip arm 24, so that when the clip arms 24 clip tissues, the inner thorn may also be able to clip a part of the tissues, making the clip process more stable. The inner thorn 27 may be provided protrusively on the clip arm 24 towards the clipping direction of the clip arm 24, so as to avoid the sliding of the traction portion 1 on the clip arm 24.

[0075] The traction portion 1 is most easy to drop off from the distal end of the two clip arms 24. When the inner thorn 27 is provided protrusively on the clip arm 24, the inner thorn 27 may block the traction portion 1 in the direction that the traction portion 1 slides to the distal end, which further relieves the drop off of the traction portion 1 from the clip arm 24.

[0076] In some embodiments, the distal ends of two clip arms 24 may be provided with serrated structures matching each other. The structures matching each other enable the distal ends of the two clip arms 24 to enter each other a distance, so that the tissues may be clipped between the two clip arms 24. Correspondingly, the inner thorns 27 on the two clip arms 24 may also be provided serrated structures matching each other. For example, the inner thorn 27 on one clip arm 24 is provided with convex teeth, while the inner thorn 27 on the other clip arm 24 is provided concave teeth, wherein the two structures match each other to form a closed area, avoiding the traction portion 1 from dropping off from the two clip arms 24.

[0077] Merely preferable implementations of this application are described above, so that a person skilled in the art can understand or implement the invention of this application. Various modifications to these embodiments and combinations of these embodiments are obvious to a person skilled in the art. General principles defined in this specification may be achieved in other embodiments without departing from the spirit or scope of this application. Therefore, this application would not be limited to these embodiments shown in this specification, but should be conform to a widest scope consistent with the principle and novelty features disclosed in this specification.