CN120392209A

CN120392209A - A clamp device and a control method thereof

Info

Publication number: CN120392209A
Application number: CN202410139944.0A
Authority: CN
Inventors: 姚锋; 韩春琦
Original assignee: Hangzhou Anjisi Medical Science And Technology Co ltd
Current assignee: Hangzhou Anjisi Medical Science And Technology Co ltd
Priority date: 2024-01-31
Filing date: 2024-01-31
Publication date: 2025-08-01

Abstract

Embodiments of the present disclosure provide a clip apparatus and a method of controlling the same. The clip apparatus comprises a sheath comprising a channel, a clip arm comprising at least two clip portions comprising a locked state, and a locking member for limiting relative displacement of the at least two clip portions in the locked state, the locking member being released from the sheath with the at least two clip portions after locking the at least two clip portions.

Description

Clip apparatus and control method thereof

Technical Field

The present disclosure relates to the field of medical devices, and in particular, to a clip device and a method for controlling the same.

Background

An endoscope hemostatic clip is a medical instrument used for hemostasis in endoscopic surgery. It is commonly used in surgical procedures on internal organs such as the gastrointestinal tract, esophagus, etc., to control bleeding and maintain a clear surgical field. These clip instruments play a key role in endoscopic surgery, helping to reduce surgical complications and improving the safety and effectiveness of the surgery. The design of the hemostatic clip of the endoscope needs to consider the special requirements of the endoscopic surgery, and allows a surgeon to accurately operate in a narrow surgery space, but in actual clinical surgery, the hemostatic clip has risks of damaging tissues around a wound, incorrect positioning of the wound and the like.

Disclosure of Invention

One or more embodiments of the present disclosure provide a clip instrument comprising a sheath including a channel, a clip arm including at least two clip portions and at least two extension portions releasably connected to the clip portions, and a locking member releasably disposed within the channel of the sheath and between the at least two extension portions for mating with the at least two clip portions to place the at least two clip portions in a locked state.

One or more embodiments of the present disclosure provide a clip apparatus, including a sheath tube, a clip arm, wherein the sheath tube includes a channel, the clip arm includes at least two clip portions, a clip space is formed between the at least two clip portions, a locked portion is disposed on a side of the clip portion facing the clip space, and a locking member is releasably disposed in the channel of the sheath tube, and is configured to cooperate with the locked portion to enable the at least two clip portions to be in a locked state.

One or more embodiments of the present disclosure provide a clip instrument including a sheath including a channel and a retaining structure, a clip arm including at least two clip portions, a locking member releasably disposed within the channel of the sheath by the retaining structure, the locking member for locking the at least two clip portions, the clip arm including an operative state in which the locking member engages the retaining structure and is disposed within the channel of the sheath, and a release state in which the clip portion and the locking member are disengaged from the retaining structure and are disposed outside the channel of the sheath.

One or more embodiments of the present disclosure provide a method for controlling a clip apparatus, where the method is applied to the clip apparatus according to any one of the embodiments above, and the method includes controlling at least two clamping portions of a clamping arm to open, controlling the at least two clamping portions of the clamping arm to close, controlling the clamping arm to move from a distal end to a proximal end, the at least two clamping portions cooperating with a locking member to lock the at least two clamping portions, wherein the at least two clamping portions actuate the locking member to release from a sheath when the clamping arm moves from the distal end to the proximal end, and controlling the at least two clamping portions and the locking member to release from the sheath.

According to the clip device of the above embodiment, the locking member is provided in the sheath channel, so that the size of the locking member is reduced, and the size of the locking member after being matched with the clamping portion is also smaller. In some embodiments, the extension and locking member are provided to effectively improve the operative field of view of the procedure and reduce the difficulty of the procedure. In some embodiments, the locked portion is disposed on a side of the clamping portion facing the clamping space, so that the space outside the clamping portion is not occupied, and the clamping portion is more compact and small in structure after being closed, so that the surgical field of view blocked by the clamping portion is reduced. In some embodiments, the locking member is engaged with the sheath by a retaining structure, and the clip portion is not in contact with the locking member when the clip portion performs the opening or closing operation, and movement of the clip portion or other member (e.g., extension portion, etc.) does not affect the connection stability of the locking member.

Drawings

The present specification will be further elucidated by way of example embodiments, which will be described in detail by means of the accompanying drawings. The embodiments are not limiting, in which like numerals represent like structures, wherein:

FIG. 1 is an exemplary block diagram of a clip instrument according to some embodiments of the present disclosure;

FIG. 2 is an exemplary block diagram of a clip apparatus according to some embodiments of the present disclosure;

FIG. 3 is a second exemplary block diagram of a clip apparatus according to some embodiments of the present disclosure;

FIG. 4 is an exemplary block diagram III of a clip instrument according to some embodiments of the present disclosure;

FIG. 5 is an exemplary exploded view of a clamp arm and transport section shown in accordance with some embodiments of the present disclosure;

FIG. 6 is a partial cross-sectional view of a clamp arm and a transport section according to some embodiments of the present disclosure;

FIG. 7A is an exemplary block diagram of a clamp shown in accordance with some embodiments of the present disclosure;

FIG. 7B is an exemplary side view of a grip shown according to some embodiments of the present disclosure;

FIG. 7C is an exemplary block diagram of a clamp portion according to other embodiments of the present disclosure;

FIG. 8A is an exemplary block diagram of a locking element according to some embodiments of the present disclosure;

FIG. 8B is a partial cross-sectional view of a locking element according to some embodiments of the present disclosure;

FIG. 9A is an exemplary block diagram illustrating the engagement of a locking member with a clamping portion according to some embodiments of the present disclosure;

FIG. 9B is a cross-sectional view of a locking element mated with a clip portion as shown in some embodiments of the present disclosure;

FIG. 10 is an exemplary block diagram of a distal end of a sheath according to some embodiments of the present disclosure;

FIG. 11A is an exemplary block diagram illustrating the engagement of a locking element with a sheath according to some embodiments of the present disclosure;

FIG. 11B is a cross-sectional view of a locking element shown mated with a sheath according to some embodiments of the present disclosure;

FIG. 12A is an exemplary block diagram of a clip arm locking process shown in accordance with some embodiments of the present disclosure;

FIG. 12B is an exemplary block diagram II of a clip arm locking process shown in accordance with some embodiments of the present description;

FIG. 12C is an exemplary block diagram III of a clip arm locking process shown in accordance with some embodiments of the present description;

FIG. 12D is an exemplary block diagram of a clip arm locking process shown in accordance with some embodiments of the present description;

FIG. 13 is an exemplary block diagram of a distal end of a sheath according to other embodiments of the present disclosure;

FIG. 14A is an exemplary block diagram illustrating the engagement of a locking element with a sheath according to other embodiments of the present disclosure;

FIG. 14B is a cross-sectional view of a locking element mated with a sheath according to other embodiments of the present disclosure;

FIG. 15A is an exemplary block diagram of a clip arm locking process according to other embodiments of the present disclosure;

FIG. 15B is an exemplary block diagram II of a clip arm locking process according to other embodiments of the present disclosure;

FIG. 15C is an exemplary block diagram III of a clip arm locking process according to other embodiments of the present disclosure;

FIG. 16 is an exemplary block diagram of an extension shown in accordance with some embodiments of the present description;

FIG. 17A is an exemplary block diagram of a clamp portion mated with an extension portion shown in accordance with some embodiments of the present disclosure;

FIG. 17B is a second exemplary block diagram of a clamp portion mated with an extension portion, wherein the locked portion is hidden, according to some embodiments of the present disclosure;

FIG. 17C is an exemplary side view of a clip portion mated with an extension portion shown in accordance with some embodiments of the present disclosure;

FIG. 18 is an exemplary block diagram of a first tube of a sheath according to some embodiments of the present disclosure;

FIG. 19 is an exemplary block diagram of a second tube of a sheath according to some embodiments of the present disclosure;

FIG. 20 is an exemplary block diagram of the first tube, second tube, and locking member mating shown according to some embodiments of the present disclosure;

FIG. 21 is an exemplary block diagram of a second tube of a sheath according to other embodiments of the present disclosure;

FIG. 22 is an exemplary block diagram of the first tube, second tube, and locking member mating according to other embodiments of the present disclosure;

FIG. 23A is an exemplary block diagram I of a clamp arm of a clamp apparatus shown in an open state according to some embodiments of the present disclosure;

FIG. 23B is an exemplary block diagram second of a clamp arm of a clamp apparatus shown in an open state according to some embodiments of the present disclosure;

FIG. 24A is an exemplary block diagram of a clip arm of a clip instrument shown in a closed state according to some embodiments of the present disclosure;

FIG. 24B is a partial cross-sectional view of a clip arm of a clip instrument shown in a closed state according to some embodiments of the present disclosure;

FIG. 25A is an exemplary block diagram illustrating release of a locking element from a sheath according to some embodiments of the present disclosure;

FIG. 25B is a partial cross-sectional view of a lock and sheath release shown according to some embodiments of the present disclosure;

FIG. 26A is an exemplary block diagram of a clamp shown in a pre-lock state according to some embodiments of the present disclosure;

FIG. 26B is an enlarged partial view of the clamp shown in some embodiments in FIG. 26A in a pre-lock state;

FIG. 27A is an exemplary block diagram of a clip arm in a locked state according to some embodiments of the present disclosure;

FIG. 27B is a partial cross-sectional view of a clip arm shown in a locked state according to some embodiments of the present disclosure;

FIG. 27C is an enlarged view of a portion of the clip arm shown in some embodiments in FIG. 27B in a locked state;

FIG. 28A is a first exemplary block diagram illustrating release of a clip and lock from a sheath according to some embodiments of the present disclosure;

FIG. 28B is a partial cross-sectional view of the clip and lock released from the sheath according to some embodiments of the present disclosure;

FIG. 28C is an exemplary block diagram I illustrating release of a clip and lock from a sheath according to some embodiments of the present disclosure;

Fig. 29 is an exemplary flowchart of a method of controlling a clip instrument according to some embodiments of the present disclosure.

The reference numerals are:

10. clip apparatus, 20, clamping space.

100. The clamping arm comprises a clamping arm body, 110, a clamping part, 110-1, a first clamping part, 110-2, a second clamping part, 111, a first connecting structure, 120, an extending part, 121, a triggering part, 122, a second connecting structure, 130, a locked part, 131, a fixing part, 132, a suspending structure, 133, a first limiting structure, 134, a second limiting structure and 135, and an actuating part.

200. The device comprises a conveying part, 210, a sheath tube, 211, a resisting structure, 211-1, a first resisting structure, 211-2, a second resisting structure, 212, an abutting part, 213, a first pipe fitting, 214, a second pipe fitting, 215, a guide groove, 216, a guide sliding block, 220, a mandrel, 230, a fixed section, 240 and a rotating section.

300. Control part 310, fixed handle 320, sliding handle.

400. The locking element 410, the accommodating cavity 411, the far end opening 412, the side opening 420, the first stopping structure 430, the second stopping structure 440, the contact part 450, the first matching part 460 and the second matching part.

Detailed Description

In order to more clearly illustrate the technical solutions of the embodiments of the present specification, the drawings that are required to be used in the description of the embodiments will be briefly described below. It is apparent that the drawings in the following description are only some examples or embodiments of the present specification, and it is possible for those of ordinary skill in the art to apply the present specification to other similar situations according to the drawings without inventive effort. Unless otherwise apparent from the context of the language or otherwise specified, like reference numerals in the figures refer to like structures or operations.

It will be appreciated that "system," "apparatus," "unit" and/or "module" as used herein is one method for distinguishing between different components, elements, parts, portions or assemblies at different levels. However, if other words can achieve the same purpose, the words can be replaced by other expressions.

As used in this specification and the claims, the terms "a," "an," "the," and/or "the" are not specific to a singular, but may include a plurality, unless the context clearly dictates otherwise. In general, the terms "comprises" and "comprising" merely indicate that the steps and elements are explicitly identified, and they do not constitute an exclusive list, as other steps or elements may be included in a method or apparatus.

A flowchart is used in this specification to describe the operations performed by the system according to embodiments of the present specification. It should be appreciated that the preceding or following operations are not necessarily performed in order precisely. Rather, the steps may be processed in reverse order or simultaneously. Also, other operations may be added to or removed from these processes.

Clip instruments are common surgical instruments that are used in endoscopes. During surgery, the clip instrument serves to stop bleeding by occluding the tissue wound. Conventional clip instruments include a sheath, a clamping portion and a receiving tube, with the clamping portion closing and moving proximally from the distal end until locked into the receiving tube after the clamping portion clamps tissue, the clamping portion and receiving tube being released from the sheath and held in a wound position.

Because the length of the clamping part and the length of the containing tube are longer, the traditional clamp instrument can shield the visual field around the wound in a narrow operation space, and the risks of damaging surrounding tissues, clamping errors and the like caused by poor visual line of an operator are caused. Especially in the case that a single operation requires releasing a plurality of clamping portions, the clamping portions and the receiving tube block most of the visual field, resulting in an increase in operation difficulty.

In view of this, in some embodiments of the present disclosure, it is desirable to provide a clip apparatus that reduces the size of the clip portion that remains in the body by disposing a locking member between a plurality of clip portions, or by reducing the length of the clip portion, or the like, so as to reduce the view blocked by the clip portion, and enable an operator to view the surgical field comprehensively and clearly, thereby avoiding the risk of damaging surrounding tissues, clipping errors, and the like, and improving the safety of the operation.

FIG. 1 is an exemplary block diagram of a clip instrument 10 according to some embodiments of the present disclosure.

As shown in fig. 1, in some embodiments, the clip instrument 10 includes a clip arm 100, a delivery portion 200, and a control portion 300. The control section 300 is provided at the proximal end of the delivery section 200, and the clip arm 100 is provided at the distal end of the delivery section 200. Reference to "proximal" and "distal" in the embodiments herein may refer to directions along the axial direction of the clip device 10 (e.g., the direction of extension of the sheath 210 of the delivery portion 200 within the endoscopic channel), where the side facing the operator is "proximal" and the side facing the body where treatment is performed is "distal", and "proximal" and "distal" may also refer to portions of the structure that lie in the respective directions, and should not be construed as referring to only ends.

In some application scenarios, the delivery portion 200 has good trafficability, and the delivery portion 200 and the distal clip arm 100 thereof enter the human body through the endoscope working channel to approach the tissue to be clamped, wherein the tissue refers to the organ tissue of the human body or other living bodies. The control unit 300 is located outside the human body or other living body, and the user controls the arm 100 to perform a surgical operation by manipulating the control unit 300, for example, the arm 100 may clamp a wound of tissue to keep the wound closed, thereby assisting in wound healing.

In some embodiments, delivery portion 200 includes a sheath 210 and a mandrel 220, with mandrel 220 disposed within the channel of sheath 210 and extending axially along sheath 210, the proximal end of mandrel 220 being coupled to control portion 300, and the distal end of mandrel 220 being coupled to clip arm 100. Reference to "axial" and "radial" in the embodiments herein may refer to directions, where the "radial" direction is perpendicular to the "axial" direction, or the axial direction is the direction in which the channels of the sheath 210 extend, and the radial direction is perpendicular to the direction in which the channels of the sheath 210 extend.

In some embodiments, sheath 210 may be flexible and bendable in any direction. In some embodiments, the control portion 300 is composed of a fixed handle 310 and a sliding handle 320, the sliding handle 320 is axially slidable relative to the fixed handle 310, the distal end of the sliding handle 320 is fixedly connected to the proximal end of the mandrel 220, and a user controls the axial movement of the sliding handle 320 along the axial direction of the fixed handle 310 to control the axial movement of the mandrel 220 within the channel of the sheath 210 in vitro, so that the clip arm 100 performs corresponding surgical operations, such as opening, closing, locking, releasing, and the like.

An exemplary clip apparatus 10 is provided in accordance with a first embodiment of the present disclosure, and the clip apparatus 10 of the first embodiment is described below with reference to fig. 2-17C.

Fig. 2 is an exemplary block diagram of a clip instrument 10 according to some embodiments of the present disclosure.

As shown in FIG. 2, in some embodiments, the clip instrument 10 includes a sheath 210, a clip arm 100, and a lock 400.

In some embodiments, sheath 210 includes a channel. In some embodiments, the sheath 210 channel is configured to receive a control structure such as the mandrel 220, and to receive at least a portion of the clip arm 100 (e.g., the extension 120), the locking member 400, and the like.

In some embodiments, the clip arm 100 includes at least two clip portions 110 and at least two extension portions 120, the extension portions 120 being releasably connected to the clip portions 110. In this case, the term "releasably connected" in the embodiment of the present specification may mean that the two members are kept connected when a predetermined condition is satisfied (for example, when an external force is applied to be smaller than a predetermined threshold value), and released from each other to be separated when the predetermined condition is not satisfied (for example, when the external force is applied to be larger than the predetermined threshold value).

In some embodiments, the clamping portion 110 includes a first clamping portion 110-1 and a second clamping portion 110-2. When the clamping portion 110 is in the open state, the distal end of the first clamping portion 110-1 and the distal end of the second clamping portion 110-2 are separated, and the extension 120 may cause the proximal end of the first clamping portion 110-1 and the proximal end of the second clamping portion 110-2 to also be separated, thereby enabling a sufficiently large span for the clamping portion 110 to clamp more tissue. When the clamping portion 110 is locked, the distal end of the first clamping portion 110-1 and the distal end of the second clamping portion 110-2 abut against each other (or abut against the clamped tissue) to be closed, and the proximal end of the first clamping portion 110-1 and the proximal end of the second clamping portion 110-2 also abut against each other to be closed. In some embodiments, after clip portion 110 is locked, extension 120 can be released from clip portion 110, extension 120 and sheath 210 can be withdrawn from the endoscope channel, and clip portion 110 and the locking portion can remain in the body. By releasably connecting the clip portion 110 to the extension portion 120, the extension portion 120 and the delivery portion 200, which do not contact tissue, are withdrawn to the outside, and the clip portion 110 having a smaller size is retained in the body, so that the size of the clip portion 110 retained in the body can be reduced, and the surgical field of view blocked by the clip portion 110 can be reduced.

In some embodiments, a locking member 400 is releasably disposed within the channel of the sheath 210 and between the at least two extensions 120, the locking member 400 being configured to cooperate with the at least two clamping portions 110 to place the at least two clamping portions 110 in a locked condition. In some embodiments, lock 400 is releasably engaged with sheath 210, and lock 400 is capable of releasing from sheath 210 and out of the channel of sheath 210 when subjected to an external force. In some embodiments, at least two passageways are formed between the outside of lock 400 and the inner wall of the sheath 210 channel, each passageway allowing extension 120 to pass from within sheath 210 channel to outside of sheath 210 channel. The locking piece 400 is arranged in the channel of the sheath 210, so that the size of the locking piece 400 is reduced, the size of the locking piece 400 after being matched with the clamping part 110 is also smaller, compared with the traditional clamping part 110, the retention length of the locking piece 400 and the clamping part 110 can be reduced by 30% -70%, the operation visual field of an operation is effectively improved, the operation difficulty is reduced, in addition, the locking piece 400 is arranged on the inner side of the extending part 120, the problem that the opening angle of the extending part 120 is limited is solved, namely, the opening angle of the extending part 120 is not limited by the locking piece 400, and the clamping part 110 obtains a larger clamping space 20.

Fig. 3 is an exemplary block diagram of a clip apparatus 10 according to other embodiments of the present disclosure.

As shown in fig. 3, in some embodiments, the clip instrument 10 includes a sheath 210, a clip arm 100, and a lock 400.

In some embodiments, sheath 210 includes a channel. In some embodiments, the sheath 210 channel is configured to receive control structures such as the mandrel 220, and to receive at least a portion of the clip arm 100, the locking member 400, and the like.

In some embodiments, the clamping arm 100 includes at least two clamping portions 110, a clamping space 20 is formed between the at least two clamping portions 110, and a locked portion 130 is disposed on a side of the clamping portion 110 facing the clamping space 20. In some embodiments, the clip arm 100 includes an open state in which the at least two clip portions 110 are spaced apart from one another to allow tissue to enter the clip space 20, and a closed state in which the at least two clip portions 110 are adjacent one another to confine tissue within the reduced clip space 20 to effect closure of a tissue wound.

In some embodiments, the locking member 400 is releasably disposed within the channel of the sheath 210, and the locking member 400 is configured to cooperate with the locked portion 130 to place at least two of the clamping portions 110 in a locked state. Since the locked portion 130 is disposed on the side of the clamping portion 110 facing the clamping space 20, that is, the locking member 400 locks the locked portion 130 on the inner sides of at least two clamping portions 110, the space outside the clamping portions 110 is not occupied, and the clamping portions 110 are more compact and small in structure after being closed, so that the surgical field of view blocked by the clamping portions 110 is reduced.

Fig. 4 is an exemplary block diagram of a clip instrument 10 according to further embodiments of the present disclosure.

As shown in fig. 4, in some embodiments, the clip instrument 10 includes a sheath 210, a clip arm 100, and a lock 400.

In some embodiments, the clip arm 100 includes at least two clip portions 110. In some embodiments, the locking member 400 is used to lock at least two clamping portions 110. The at least two clamping portions 110 clamp the tissue wound by opening, closing, or the like.

In some embodiments, sheath 210 includes a retaining structure 211, and lock 400 is releasably disposed within the channel of sheath 210 by retaining structure 211. In some embodiments, the abutment structure 211 is capable of limiting movement of the lock 400 along the axial direction of the sheath 210, the abutment structure 211 being configured to fail to limit proximal-to-distal movement of the lock 400 due to fracture, displacement, or deformation, enabling the lock 400 to be released from the sheath 210.

In some embodiments, clip arm 100 includes an operational state in which lock 400 is engaged with retaining structure 211 and is located within the channel of sheath 210, and a release state in which lock 400 is disengaged from retaining structure 211 and is located outside the channel of sheath 210. Wherein the operating state refers to a state in which the clip arm 100 can be controlled by the spindle 220, including but not limited to an opened state, a closed state, a locked state, etc. of the clip arm 100, and the released state refers to a state in which the clip portion 110 and the locking piece 400 are separated from the sheath 210 as separate components.

By locating the locking element 400 within the channel of the sheath 210, the locking element 400 is more compact, reducing the space occupied by the locking element 400 and reducing obstruction of the surgical field of view. The locking member 400 is engaged with the sheath 210 through the catching structure 211, and when the clamping portion 110 performs an opening or closing operation, the clamping portion 110 is not in contact with the locking member 400, and movement of the clamping portion 110 or other members (e.g., the extension portion 120, etc.) does not affect the connection stability of the locking member 400.

Some exemplary configurations of the clip instrument 10 of the first embodiment are described in detail below in conjunction with fig. 5-17C. It should be noted that various combinations and modifications of the features of the embodiments described below and above may be made by those skilled in the art in the light of the present description, which combinations and modifications are still within the scope of the present description. In addition, some of the embodiments described below are for illustration and description only, and do not limit the scope of applicability of the present description.

Fig. 5 is an exploded view of an exemplary configuration of the clip arm 100 and the delivery section 200 shown in accordance with some embodiments of the present description. Fig. 6 is a partial cross-sectional view of the clip arm 100 and the delivery section 200 shown in accordance with some embodiments of the present description.

As shown in fig. 5 and 6, the clip arm 100 includes a sheath 210, at least two clip portions 110, at least two extension portions 120, and a lock 400. In some embodiments, the locking element 400 is releasably disposed within the channel of the sheath 210. In some embodiments, the clamp 110 and the extension 120 are releasably connected. In some embodiments, the grip portion 110 and the extension portion 120 are integrally formed.

In some embodiments, the clip arm 100 is in an open state with at least two clip portions 110 spaced apart from each other, and the distal end of the extension 120 extends out of the channel of the sheath 210, such that the clip portions 110 are positioned out of the channel of the sheath 210. The locking member 400 is located between at least two of the extensions 120 and the locking portion is releasably engaged with the sheath 210 by the retaining structure 211.

In some embodiments, where the clip arm 100 is in a closed state, at least two clip portions 110 are adjacent to each other and in contact with the locking member 400, the extension 120 is retracted within the sheath 210 channel, and at least two clip portions 110 remain outside the sheath 210 channel. In the process of operating the clamping part 110 to clamp the tissue, the clamping part 110 is always positioned outside the channel of the sheath 210, so that the distal end of the sheath 210 can be prevented from contacting the tissue, and the clamping stability of the tissue in the clamping space 20 is improved.

In some embodiments, the clip arm 100 is in a locked state, with at least two clip portions 110 mated with the locking member 400, e.g., the proximal end of the clip portion 110 or the locked portion 130 forming a positive engagement with the locking member 400, such that the at least two clip portions 110 are locked. After at least two of the clamping portions 110 are closed, the locking member 400 is released from the sheath 210, allowing the locking member 400 to be distally removed from the sheath 210. In some embodiments, when the clamping arm 100 is in the locked state, the locking member 400 is located between at least two clamping portions 110, so that the locking member 400 does not occupy the space outside the clamping portions 110, and the shielding of the clamping portions 110 from the surgical field is reduced.

In some embodiments, clip arm 100 is in a released state, and after locking member 400 locks at least two clip portions 110, the entire clip is released from the distal end of sheath 210 and retained at the tissue wound site, and the sheath 210 and other components are withdrawn from the body.

In some embodiments, sheath 210 includes a fixed segment 230 and a rotating segment 240, a proximal end of rotating segment 240 being rotatably coupled to a distal end of fixed segment 230, rotating segment 240 being configured to rotate about the sheath 210 axis. In some embodiments, one of the rotating section 240 and the stationary section 230 is provided with an annular groove, and the other is provided with a slider, the annular slider and the annular groove being slidably engaged to enable rotation of the rotating section 240 relative to the stationary section 230. In some embodiments, an annular groove extends in the circumferential direction of the sheath 210, and an annular slider is embedded within the annular groove for limiting axial displacement of the rotating segment 240 and the stationary segment 230 relative to the sheath 210. In some embodiments, operation of the handle controls rotation of the spindle 220, which rotation of the spindle 220 rotates the clamp arm 100 and the rotating section 240 simultaneously relative to the stationary section 230. By providing the rotation section 240 to enable the clip arm 100 to rotate about the axis of the sheath 210, the closing direction of the at least two clip portions 110 can be more easily adjusted to be consistent with the closing direction of the tissue wound, thereby improving the accuracy of clipping the tissue wound.

In some embodiments, sheath 210 is an integrally formed structure, which is convenient to process and cost effective.

Fig. 7A is an exemplary block diagram of a clamp 110 according to some embodiments of the present disclosure. Fig. 7B is an exemplary side view of the clamping portion 110 shown in accordance with some embodiments of the present description. Fig. 7C is an exemplary block diagram of the clamping portion 110 according to other embodiments of the present disclosure. Fig. 8A is an exemplary block diagram of a lock 400 according to some embodiments of the present disclosure. Fig. 8B is a partial cross-sectional view of a lock 400 according to some embodiments of the present disclosure. Fig. 9A is an exemplary block diagram illustrating locking of a locking member 400 with a clamping portion 110 according to some embodiments of the present disclosure. Fig. 9B is a cross-sectional view of a locking member 400 locked with a clamping portion 110 according to some embodiments of the present disclosure.

As shown in fig. 7A-9B, in some embodiments, the clamping portion 110 includes a locked portion 130 and the locking member 400 is configured to mate with the locked portion 130. In some embodiments, the locking member 400 includes a receiving cavity 410, where the receiving cavity 410 is configured to receive the locked portions 130 of the at least two clamping portions 110, such that the locked portions 130 of the at least two clamping portions 110 remain closed. In some embodiments, the receiving cavity 410 is provided at the distal end of the locking member 400 and has a distal opening 411, and when the locked portion 130 moves from the distal end to the proximal end, the receiving cavity 410 is accessed from the distal opening 411.

In some embodiments, the locked portion 130 includes a fixed portion 131 and a hanging structure 132, the hanging structure 132 being disposed in a gap with the clamping portion 110 by the fixed portion 131, the hanging structure 132 being located within the receiving cavity 410 when the clamping arm 100 is locked. One side of the fixing portion 131 is connected to a side edge of the clamping portion 110, and the other side is connected to the suspension structure 132, so that the suspension structure 132 maintains a gap with the clamping portion 110. In some embodiments, the two sides of the accommodating cavity 410 of the locking member 400 are provided with side openings 412, when the locked portion 130 is matched with the locking member 400, the side openings 412 of the accommodating cavity 410 are away from the fixing portion 131, so that the suspension structure 132 of the locked portion 130 can be located in the accommodating cavity 410, and the distal end portion of the locking member 400 is located in the gap between the suspension structure 132 and the clamping portion 110, so that the locking member 400 can lock the locked portion 130 between at least two clamping portions 110 without occupying the outer space of the clamping portion 110.

In some embodiments, the receiving cavity 410 of the locking member 400 is configured to enable the suspension structure 132 of the locked portion 130 of the at least two clamping portions 110 to remain in a mutually conforming state, maintaining the at least two clamping portions 110 in a stable locked state.

In some embodiments, the locked portion 130 includes a first limiting structure 133, and the locking member 400 includes a first stop structure 420, and the first limiting structure 133 cooperates with the first stop structure 420 to limit the relative movement of the clamping portion 110 and the locking member 400 in the first direction. The first direction includes a direction indicated by an arrow D1 in fig. 9A, for example, a width direction of the clamping portion 110. By restricting the relative movement of the clamping portions 110 and the locking member 400 in the first direction, the at least two clamping portions 110 can be maintained in a relatively stationary state in the first direction such that no opposite side rotation of the at least two clamping portions 110 occurs.

In some embodiments, the first stop structure 133 includes a stop pin and the first stop structure 420 includes a stop slot configured to mate with the stop slot. In some embodiments, the stop pin protrudes from the proximal end of the suspension structure 132, and the stop slot is recessed from the bottom wall of the proximal end of the receiving cavity 410, such that the stop slot is capable of limiting the circumference of the stop pin after the stop pin is inserted into the stop slot.

In some embodiments, the locked portion 130 includes a second limit structure 134, the locking member 400 includes a second limit structure 430, and the second limit structure 134 cooperates with the second limit structure 430 to limit the relative movement of the clamping portion 110 and the locking member 400 in a second direction, which is not parallel to the first direction, and illustratively, the second direction includes a direction indicated by an arrow D2 in the drawing, such as a length direction of the clamping portion 110. By restricting the relative movement of the clamping portions 110 and the locking member 400 in the second direction, the at least two clamping portions 110 can be maintained in a relatively stationary state in the second direction. The locking member 400 locks the clamping part 110 in a plurality of directions by a plurality of stopper structures, improving the stability of the clamping part 110 clamping tissue.

In some embodiments, the second stop structure 134 includes a locking tab and the second stop structure 430 includes at least two locking recesses, the locking tab being configured to spring into the locking recess when aligned with the locking recess. In some embodiments, the locking spring is disposed on the suspension structure 132, and the proximal end of the locking spring is connected to the suspension structure 132, the distal end includes a bending portion, the bending portion bends from the suspension structure 132 toward the clamping portion 110, the locking recess is disposed on a side wall of the accommodating cavity 410, and when the locking spring moves from the distal end to the proximal end, the bending portion of the locking spring springs into the locking recess to form a limit.

In some embodiments, the locking member 400 includes a contact portion 440, the contact portion 440 being located on the distal side of the second stop structure 430, the contact portion 440 being configured to provide a feedback resistance to alert an operator to the locked state. In some embodiments, the distal end face of the lock 400 is configured as a contact 440.

In some embodiments, the clip arm 100 includes a pre-lock state and a final lock state.

In the pre-locked state, the second limiting structure 134 of the locked portion 130 abuts against the contact portion 440 of the locking member 400, and generates a feedback resistance that prevents the clamping portion 110 from moving from the distal end to the proximal end. In some embodiments, the second limiting structure 134 includes a locking spring, the distal bent portion of the locking spring abuts against the contact portion 440 of the locking member 400 before entering the accommodating cavity 410, and the contact portion 440 generates a feedback resistance to the locking spring, and the feedback resistance is fed back to the operator through the mandrel 220, so as to prompt the operator that the clamping portion 110 is about to enter the locked state. In some embodiments, after the operator senses the feedback resistance, he can confirm the clamping condition of the clamping portion 110 on the tissue again, if the clamping portion 110 does not clamp the tissue normally, the mandrel 220 is pushed from the proximal end to the distal end, so that the clamping portion 110 is turned from the closed state to the open state, and the tissue is clamped again, if the clamping portion 110 clamps the tissue normally, the mandrel 220 is pulled from the distal end to the proximal end, so that the locking spring is stressed to deform, the bending portion passes over the contact portion 440 and enters the accommodating cavity 410 to be matched with the locking recess, and the clamping portion 110 enters the final locking state. By providing the contact portion 440 and the second stop structure 430 to provide a feedback resistance, the operator can be prompted to confirm the tissue occlusion prior to locking, reducing surgical error.

In the final locked state, the second limiting structure 134 cooperates with the second stopping structure 430 beyond the contact portion 440, the first limiting structure 133 cooperates with the first stopping structure 420, and the at least two clamping portions 110 are locked.

Fig. 10 is an exemplary block diagram of the distal end of sheath 210, according to some embodiments of the present disclosure. Fig. 11A is an exemplary block diagram illustrating the engagement of locking element 400 with sheath 210 according to some embodiments of the present disclosure. Fig. 11B is a cross-sectional view of the locking element 400 shown mated with the sheath 210 in accordance with some embodiments of the present disclosure.

As shown in fig. 8A, 8B, and 10-11B, in some embodiments, the sheath 210 or the rotating section 240 of the sheath 210 is of an integrally formed construction, making processing easier. In some embodiments, sheath 210 includes at least one retaining structure 211, retaining structure 211 being used to retain lock 400 within the channel of sheath 210.

In some embodiments, sheath 210 includes a first abutment structure 211-1 and lock 400 includes a first engagement portion 450, with first abutment structure 211-1 engaging first engagement portion 450 for limiting distal-to-proximal movement of lock 400 relative to sheath 210, allowing lock 400 to be maintained in a desired position, such as distal sheath 210.

In some embodiments, the first abutment structure 211-1 includes a stop step protruding radially inward, and the proximal surface of the locking member 400 constitutes the first engagement portion 450, with which the proximal surface is in abutting engagement. In some embodiments, the stop steps include, but are not limited to, at least two protrusions, bars disposed radially along the sheath 210, and the like.

In some embodiments, the sheath 210 includes a second abutment structure 211-2 and the lock 400 includes a second mating portion 460, the second abutment structure 211-2 being releasably coupled to the second mating portion 460 for limiting proximal to distal movement of the lock 400 relative to the sheath 210. After the locking member 400 locks the at least two clamping portions 110, the second retaining structure 211-2 is separated from the second engaging portion 460, and the locking member 400 is released from the sheath 210.

In some embodiments, the second retaining structure 211-2 includes a limiting dome, a distal end of the limiting dome is connected to the inner wall of the sheath 210, a proximal end protrudes radially inward from the inner wall of the sheath 210, and the locking member 400 includes a distally facing limiting surface for mating with the limiting dome. In some embodiments, the limiting surface of the locking element 400 includes a bottom surface of the accommodating cavity 410, and the limiting spring is disposed corresponding to the side opening 412 of the accommodating cavity 410 of the locking element 400, so that the limiting spring can be matched with the bottom surface of the accommodating cavity 410. In some embodiments, the stop surface of the locking element 400 includes a surface at the distal end of the locking element 400.

As shown in connection with fig. 7A, 7C, in some embodiments, the clip arm 100 includes an actuation portion 135, the actuation portion 135 being configured to actuate the release of the second retaining structure 211-2 and the second mating portion 460 upon distal-to-proximal movement, releasing the locking element 400 from the sheath 210. Wherein, the actuating portion 135 refers to a component or a part that can directly or indirectly cause the second resisting structure 211-2 and the second matching portion 460 to release. By providing the actuation portion 135 to actuate the release of the locking member 400 from the sheath 210, disturbances to the locking member 400 during movement of other components or parts can be avoided, reducing the risk of accidental release of the locking member 400.

In some embodiments, the actuating portion 135 is provided on the locked portion 130, and illustratively, the actuating portion 135 is provided on the suspension structure 132 of the locked portion 130, and the actuating portion 135 includes an edge portion of at least one side of the suspension structure 132. In some embodiments, one side edge of the suspension structure 132 constitutes the actuation portion 135. In some embodiments, the two side edges of the suspension structure 132 constitute the actuation portion 135.

In some embodiments, during the process of the locked portion 130 of the clamping portion 110 entering the locking member 400, the actuating portion 135 pushes the limiting spring from the distal end to the proximal end, so that the limiting spring is deformed, displaced or broken and the limiting surface is released, and the locking member 400 and the sheath 210 are released. In some embodiments, the proximal end of the limit dome cooperates with the limit surface, and after the suspension structure 132 of the locking portion enters the accommodating cavity 410, the actuating portion 135 pushes the limit dome to deform or displace radially outward relative to the sheath 210, so that the limit dome and the limit surface are released.

In some embodiments, after the proximal end of the limiting spring is matched with the limiting surface, in the radial direction of the sheath 210, the distance between the first limiting structure 133 and the actuating portion 135 is greater than the distance between the first stopping structure 420 and the limiting spring, and after the actuating portion 135 enters the locking member 400, the limiting spring can be radially outwards spread along the sheath 210, so that the limiting spring is separated from the limiting surface.

In some embodiments, the first limiting structure 133 and the first stopping structure 420 of the clamping portion 110 are matched, and after the second limiting structure 134 and the second stopping structure 430 are matched, the clamping portion 110 is locked with the locking member 400, and after the actuating portion 135 of the clamping portion 110 pushes the limiting elastic sheet to release from the limiting surface, the locking member 400 is released from the sheath 210. In some embodiments, when the first limiting structure 133 and the first stopping structure 420 are matched, and the second limiting structure 134 and the second stopping structure 430 are matched, and the actuating portion 135 pushes the limiting spring plate to release from the limiting surface, the locking piece 400 is released from the sheath 210 while being locked with the clamping portion 110. In some embodiments, after the actuating portion 135 pushes the limiting spring to release from the limiting surface, and then the first limiting structure 133 and the first stopping structure 420 are engaged, the second limiting structure 134 and the second stopping structure 430 are engaged, the locking member 400 is locked with the clamping portion 110 after being released from the sheath 210.

Fig. 12A-12D are exemplary block diagrams of a clip arm 100 locking process according to some embodiments of the present disclosure. In this process, the locking member 400 is released from the sheath 210 while being locked with the grip 110.

In some embodiments, the second retaining structure 211-2 of the sheath 210 includes a limit tab configured as a linear type that extends obliquely inward from the distal end to the proximal end of the sheath 210.

As shown in fig. 12A and 12B, the clip arm 100 is in a pre-locked state, the second limiting structure 134 of the locked portion 130 abuts against the contact portion 440, the actuating portion 135 of the clip portion 110 is located at the distal end of the second retaining structure 211-2 of the sheath 210, and the proximal end of the second retaining structure 211-2 is engaged with the second engaging portion 460 of the locking member 400.

As shown in fig. 12C and 12D, the clamping portion 110 is moved from the distal end to the proximal end, the clamping arm 100 is switched from the pre-locking state to the locking state, the first limiting structure 133 of the locked portion 130 is engaged with the first stop structure 420 of the locking member 400, the second limiting structure 134 of the locked portion 130 is engaged with the second stop structure 430 of the locking member 400, and at the same time, the actuating portion 135 of the clamping portion 110 is moved to the proximal end of the second retaining structure 211-2 of the sheath 210, and the proximal end of the second retaining structure 211-2 is spread to the second engaging portion 460 of the locking member 400 to release, and the locking member 400 is released from the sheath 210.

Fig. 13 is an exemplary block diagram of the distal end of sheath 210 according to other embodiments of the present disclosure. Fig. 14A is an exemplary block diagram illustrating the engagement of locking element 400 with sheath 210 according to other embodiments of the present disclosure. Fig. 14B is a cross-sectional view of a locking element 400 mated with sheath 210 according to other embodiments of the present disclosure.

As shown in fig. 13-14B, in some embodiments, the second retaining structure 211-2 of the sheath 210 includes a limiting dome, the limiting dome being configured as a fold line, the limiting dome of the fold line including a sloped section and a flat section, a proximal end of the sloped section being connected to a distal end of the flat section, wherein the junction of the sloped section and the flat section is configured as a inflection point. In some embodiments, an angled section extends obliquely inward from the distal end of the sheath 210 to the proximal end, a flat section is disposed parallel to the axis of the sheath 210, and the proximal end of the flat section is configured to mate with the second mating portion 460 of the lock 400.

Fig. 15A to 15C are exemplary block diagrams of a locking process of the clip arm 100 according to other embodiments of the present specification. In this process, the locking member 400 is released from the sheath 210 and then locked to the clamping portion 110.

As shown in fig. 15A, the clip arm 100 is in the pre-locked state, the second limiting structure 134 of the locked portion 130 abuts against the contact portion 440, the actuating portion 135 of the clip portion 110 moves to the distal end of the second retaining structure 211-2 of the sheath 210, and the proximal end of the second retaining structure 211-2 is engaged with the second engaging portion 460 of the locking member 400.

As shown in fig. 15B, the clip portion 110 is moved from the distal end to the proximal end, and the locking member 400 is released from the sheath 210. After the actuating portion 135 is moved proximally from the distal end, the flat section of the second retaining structure 211-2 is deformed or displaced radially outwardly of the sheath 210 by pressing the inflection point of the second retaining structure 211-2, releasing the proximal end of the second retaining structure 211-2 from the second mating portion 460 of the locking element 400 and releasing the locking element 400 from the sheath 210. At this time, the first limiting structure 133 of the locked portion 130 is not yet engaged with the first stopping structure 420 of the locking member 400, and the second limiting structure 134 of the locked portion 130 is not yet engaged with the second stopping structure 430 of the locking member 400.

As shown in fig. 15C, the clamping portion 110 continues to move from the distal end to the proximal end, the clamping arm 100 is switched from the pre-locking state to the locking state, the first limiting structure 133 of the locked portion 130 cooperates with the first stop structure 420 of the locking member 400, the second limiting structure 134 of the locked portion 130 cooperates with the second stop structure 430 of the locking member 400, and the clamping portion 110 is locked with the locking member 400.

In some embodiments, the locking member 400 is locked with the clamping portion 110 and then released from the sheath 210. In some embodiments, the second mating portion 460 of the locking element 400 includes a limit recess disposed on a side of the locking element 400 facing the extension 120. The second retaining structure 211-2 of the sheath 210 includes a resilient pin disposed on a sidewall of the sheath 210 adjacent to the extension 120. The extension 120 is formed with an axially extending relief groove for relief of the resilient pin. The spring pin passes through the relief slot of extension 120 to engage the limit recess of locking member 400, releasably connecting locking member 400 to sheath 210. After the locking member 400 is locked with the clamping portion 110, the extension portion 120 continues to move from the distal end to the proximal end, so that the end portion of the escape groove of the extension portion 120 actuates the elastic pin, and the elastic pin deforms, displaces or breaks to release from the limit recess, at which time the locking member 400 and the sheath 210 are released.

Fig. 16 is an exemplary block diagram of an extension 120 according to some embodiments of the present description. Fig. 17A is an exemplary block diagram of a clamp portion 110 mated with an extension portion 120, according to some embodiments of the present disclosure. Fig. 17B is a second exemplary block diagram of the engagement of the clamping portion 110 with the extension portion 120, wherein the locked portion 130 is hidden, according to some embodiments of the present disclosure. Fig. 17C is an exemplary side view of the clamp portion 110 mated with the extension portion 120, as shown in some embodiments of the present disclosure.

In some embodiments, the extension portion 120 or the clamping portion 110 includes a trigger portion 121, and the trigger portion 121 is configured to trigger the extension portion 120 and the clamping portion 110 to release when a force greater than a predetermined force value is applied in a first direction, wherein the first direction is not parallel to a movement direction of the extension portion 120, and wherein a direction indicated by an arrow D1 in the first direction is shown in the drawing. In some embodiments, the first direction may include a width direction of the grip 110. In other embodiments, the first direction may also include a direction that is angled from the width direction of the clamping portion 110. In the process that the extension part 120 drives the clamping part 110 to move from the distal end to the proximal end, when the clamping part 110 is operated to lock and the locking piece 400 is operated to release from the sheath 210, a pulling force along the movement direction of the extension part 120 is generated between the extension part 120 and the clamping part 110, and by arranging the triggering part 121, the extension part 120 can be released from the clamping part 110 only when triggered by the triggering part 121, so that accidental falling of the extension part 120 and the clamping part 110 caused by the pulling force along the movement direction can be avoided, and the operation risk is reduced.

In some embodiments, a clamping space 20 is formed between at least two clamping portions 110, a side of the clamping portion 110 facing the clamping space 20 is provided with a first connection structure 111, and a distal end of the extension portion 120 includes a second connection structure 122, and the first connection structure 111 and the second connection structure 122 are releasably connected. In some embodiments, the first connection structure 111 includes, but is not limited to, a slot, a limiting protrusion, a buckle, etc. protruding from the clamping portion 110 to the clamping space 20, and the second connection structure 122 includes, but is not limited to, a hook, a resilient limiting arm, etc. In some embodiments, the first connecting structure 111 is disposed in a gap between the suspending structure 132 of the locked portion 130 and the clamping portion 110, so that the clamping portion 110 is more compact in structure, which is beneficial to miniaturizing the clamping portion 110.

In some embodiments, the second connecting structure 122 includes two resilient arms, each resilient arm including a distal portion, a middle portion, and a proximal portion, the middle portion of the resilient arm being configured as a groove. The first connection structure 111 includes a buckle configured as a U-shaped structure protruding toward the clamping space 20. The two elastic arms penetrate the buckle to enable the buckle to be matched in the groove of the middle part, and the far end part and the near end part limit the buckle respectively to enable the clamping part 110 to be connected with the extending part 120.

In some embodiments, the inner side of the distal end of the groove is in contact with the distal surface of the buckle, and both the inner side of the distal end of the groove and the distal surface of the buckle are perpendicular to the axial direction of the extension 120, and the axial direction of the extension 120 may be the direction indicated by the arrow D2 in fig. 17B. When the extension part 120 moves from the distal end to the proximal end, the inner side surface of the distal end of the groove and the distal end surface of the buckle form a limit, so that the clamping part 110 and the extension part 120 are kept in a connected state, and the clamping part 110 and the extension part 120 are prevented from being accidentally separated due to mutual pulling caused by axial force.

In some embodiments, the inner side of the proximal end of the groove is in contact with the proximal surface of the buckle, and both the inner side of the proximal end of the groove and the proximal surface of the buckle are perpendicular to the axial direction of the extension 120, and the axial direction of the extension 120 may be the direction indicated by the arrow D2 in fig. 17B. When the extension part 120 moves from the proximal end to the distal end, the inner side surface of the proximal end of the groove and the proximal end surface of the buckle form a limit, so that the clamping part 110 and the extension part 120 maintain a connection state, and accidental separation of the clamping part 110 and the extension part 120 caused by mutual pulling due to axial force is avoided.

In some embodiments, the triggering portion 121 is disposed on the first connecting structure 111 or the second connecting structure 122, and the distal end of the sheath 210 includes an abutment portion 212, where the abutment portion 212 is used to drive the triggering portion 121, so that one of the first connecting structure 111 and the second connecting structure 122 breaks, deforms or displaces to release from the other. In some embodiments, the triggering portion 121 includes a slope disposed at a proximal end of the elastic arm, and the slope is configured to abut against the abutting portion 212, and the force applied by the abutting portion 212 to the slope can deform the two elastic arms to approach each other, so that the buckle is disengaged from the groove of the elastic arm, and the extending portion 120 is released from the clamping portion 110. In some embodiments, abutment 212 includes, but is not limited to, an end face at the distal end of sheath 210 or a protrusion provided at the distal end of sheath 210.

A second embodiment of the present disclosure provides an exemplary clip apparatus 10, and the clip apparatus 10 of the second embodiment is described below with reference to fig. 18 to 22. In the following, only the portions of the clip apparatus 10 of the second embodiment that differ from the clip apparatus 10 of the first embodiment will be described, and the remaining portions that are not mentioned are referred to the exemplary embodiment of the clip apparatus 10 of the first embodiment.

Fig. 18 is an exemplary block diagram of a first tube 213 of a sheath 210 according to some embodiments of the present disclosure. Fig. 19 is an exemplary block diagram of a second tube 214 of sheath 210 according to some embodiments of the present disclosure. Fig. 20 is an exemplary block diagram illustrating the cooperation of the first tube 213, the second tube 214, and the locking member 400 according to some embodiments of the present disclosure.

As shown in fig. 18-20, in some embodiments, the sheath 210 or the rotating section 240 of the sheath 210 is a split-molded structure. In some embodiments, sheath 210 includes at least one retaining structure 211, retaining structure 211 being used to retain lock 400 within the channel of sheath 210.

In some embodiments, sheath 210 includes a first tube 213 and a second tube 214, with first tube 213 axially movably mated with second tube 214. In some embodiments, one of the first tube 213 and the second tube 214 includes a guide groove 215 extending in an axial direction, the other includes a guide slider 216, the guide slider 216 is slidably engaged with the guide groove 215 for restricting circumferential displacement between the first tube 213 and the second tube 214, preventing relative rotation of the first tube 213 and the second tube 214 from affecting an internal structure thereof, and the guide groove 215 restricts a stroke range of the guide slider 216, i.e., a range of movement of the first tube 213 and the second tube 214 in the axial direction is restricted within a reasonable range, preventing the first tube 213 and the second tube 214 from being separated from each other.

In some embodiments, the first tube 213 is disposed at the proximal end of the second tube 214, and the outer diameter of the first tube 213 is equal to the inner diameter of the second tube 214, such that the second tube 214 is sleeved outside the first tube 213, and the second tube 214 does not interfere with the components (e.g., the locking member 400, the extension 120, etc.) in the first tube 213 when the second tube 214 moves axially relative to the first tube 213. In some embodiments, the first tube 213 and the second tube 214 are held relatively stationary by static friction, and the first tube 213 and the second tube 214 are relatively displaced when subjected to an external axial force greater than the static friction.

As shown in connection with fig. 8A and 8B, in some embodiments, sheath 210 includes a first abutment structure 211-1 and lock 400 includes a first engagement portion 450, with first abutment structure 211-1 engaging first engagement portion 450 for limiting distal-to-proximal movement of lock 400 relative to sheath 210 to enable lock 400 to remain in a desired position, such as distal sheath 210.

In some embodiments, the first retaining structure 211-1 is disposed inside the first tube 213. The first abutment structure 211-1 includes a stop step protruding radially inward, and a proximal end surface of the locking member 400 constitutes a first engagement portion 450, with which the proximal end surface is in abutting engagement. In some embodiments, the stop steps include, but are not limited to, at least two protrusions, bars disposed radially along the sheath 210, and the like.

In some embodiments, the sheath 210 includes a second abutment structure 211-2 and the locking member 400 includes a second mating portion 460, the second abutment structure 211-2 being releasably coupled to the second mating portion 460 for limiting proximal-to-distal movement of the locking member 400 relative to the sheath 210 such that the locking member 400 can be released from the sheath 210 after locking the at least two clamping portions 110.

In some embodiments, the second retaining structure 211-2 is disposed on the second tube 214. In some embodiments, the second retaining structure 211-2 includes a stop tab, a proximal end of the stop tab is connected to the second tube member 214, a distal end protrudes radially inward from an inner wall of the second tube member 214, and the second engagement portion 460 of the locking element 400 includes a distally facing stop surface for engaging the stop tab.

In some embodiments, the actuation portion 135 is configured to actuate distal to proximal movement of the second tube 214 relative to the first tube 213, causing the second retaining structure 211-2 to deform, displace or fracture and release from the second mating portion 460. In some embodiments, the actuating portion 135 includes a proximal surface of the clamping portion 110, and when the extending portion 120 drives the clamping portion 110 to move proximally from the distal end, the proximal end of the clamping portion 110 abuts against the distal surface of the second tube member 214 and pushes the second tube member 214 to move proximally from the distal end relative to the first tube member 213, and the limiting tab has a tendency to move proximally relative to the locking member 400, such that the limiting tab is forced to deform, displace or break and release from the limiting surface of the locking member 400, and the locking member 400 and the sheath 210 are released.

In some embodiments, the distance between the second abutment structure 211-2 and the distal end of the second tube 214 is configured such that the locking member 400 is released from the second tube 214 while the locking member 400 is locked with the grip 110. For example, when the second tube 214 is connected to the locking member 400, the distal end of the locking member 400 can be exposed at the distal end of the second tube 214. When the locked portion 130 contacts the locking member 400, the actuating portion 135 of the clamping portion 110 contacts the distal end of the second tube member 214, and when the clamping portion 110 continues to move from the distal end to the proximal end, the first limiting structure 133 of the locked portion 130 cooperates with the first stopping structure 420 of the locking member 400, the second limiting structure 134 of the locked portion 130 cooperates with the second stopping structure 430 of the locking member 400, the clamping portion 110 is locked with the locking member 400, and at the same time, the actuating portion 135 drives the second tube member 214 to move from the distal end to the proximal end, so that the second resisting structure 211-2 is separated from the second cooperating portion 460 of the locking member 400, and the locking member 400 is released from the sheath tube 210.

Fig. 21 is an exemplary block diagram of a second tube 214 of a sheath 210 according to other embodiments of the present disclosure. Fig. 22 is an exemplary structural view showing the cooperation of the first tube 213, the second tube 214, and the locking member 400 according to other embodiments of the present specification.

As shown in fig. 18, 21 and 22, in some embodiments, the distance between the second abutment structure 211-2 and the distal end of the second tube member 214 is configured such that the locking member 400 locks with the clamping portion 110 after the locking member 400 is released from the second tube member 214. For example, when the second pipe 214 is connected to the locking member 400, the locking member 400 is integrally accommodated inside the second pipe 214. When the clamping portion 110 is closed, the actuating portion 135 of the clamping portion 110 is first contacted with the distal end of the second tube 214, and the actuating portion 135 drives the second tube 214 to move from the distal end to the proximal end, so that the second resisting structure 211-2 is separated from the second matching portion 460 of the locking member 400, and the locking member 400 is released from the sheath 210. The clamping part 110 continues to move from the distal end to the proximal end, so that the first limiting structure 133 of the locked part 130 is matched with the first stopping structure 420 of the locking piece 400, the second limiting structure 134 of the locked part 130 is matched with the second stopping structure 430 of the locking piece 400, and the clamping part 110 is locked with the locking piece 400.

Fig. 23A-28C are exemplary block diagrams illustrating the operation of the clip instrument 10 according to some embodiments of the present disclosure. This procedure may be applied to any of the first embodiment of the clip apparatus 10 and the second embodiment of the clip apparatus 10.

As shown in fig. 23A and 23B, the clip arm 100 is in an open state. In some embodiments, the operation portion controls the mandrel 220 to move from the proximal end to the distal end, and the mandrel 220 drives the extension portion 120 and the clamping portion 110 to move from the proximal end to the distal end, so that the distal end of the extension portion 120 extends out of the channel of the sheath 210, at least two clamping portions 110 are far away from each other in an open state, and a clamping space 20 for clamping tissue is formed between at least two clamping portions 110.

As shown in fig. 24A and 24B, the clip arm 100 is in a closed state. In some embodiments, the operating portion controls the mandrel 220 to move proximally from the distal end, and the mandrel 220 drives the extension portion 120 and the clamping portion 110 to move proximally from the distal end, such that the distal end of the extension portion 120 is retracted into the channel of the sheath 210, the at least two clamping portions 110 are in a closed state, and the tissue is clamped between the at least two clamping portions 110.

As shown in fig. 25A and 25B, the locking member 400 is released from the sheath 210. In some embodiments, sheath 210 includes a first tube 213 and a second tube 214, the proximal end of grip 110 abuts against the surface of the distal end of second tube 214 and pushes second tube 214 proximally from the distal end relative to first tube 213, the stop tab has a tendency to move proximally relative to lock 400, such that the stop tab is forced to deform, displace or break away from the stop surface of lock 400, and lock 400 is released from sheath 210.

As shown in fig. 26A and 26B, in some embodiments, after the locking member 400 is released from the sheath 210, the clamping portion 110 enters a pre-locked state. In some embodiments, the operating portion controls the distal-to-proximal movement of the spindle 220, the second stop structure 134 of the locked portion 130 abuts the contact portion 440 of the locking member 400, and creates a feedback resistance that resists distal-to-proximal movement of the clamping portion 110. After the operator feels the feedback resistance, he can confirm the clamping condition of the clamping part 110 on the tissue again, if the clamping part 110 does not clamp the tissue normally, the mandrel 220 is pushed from the proximal end to the distal end, so that the clamping part 110 is turned from the closed state to the open state, and the tissue is clamped again, if the clamping part 110 clamps the tissue normally, the mandrel 220 is pulled from the distal end to the proximal end, so that the locking spring is stressed to deform, the bending part passes over the contact part 440 and enters the accommodating cavity 410 to be matched with the locking recess, and the clamping part 110 enters the final locking state.

As shown in fig. 27A to 27C, the clip arm 100 is in a locked state. In some embodiments, the operation portion control spindle 220 continues to move from the distal end to the proximal end, the second limit structure 134 of the locked portion 130 engages the second limit structure 430 of the locking member 400 beyond the contact portion 440, the first limit structure 133 of the locked portion 130 engages the first limit structure 420 of the locking member 400, and the at least two clamping portions 110 are locked.

As shown in fig. 28A to 28C, the clip 110 and the lock 400 are released from the sheath 210. In some embodiments, the extension 120 continues to move from the distal end to the proximal end, and the abutting portion 212 of the sheath 210 abuts against the triggering portion 121, so that the triggering portion 121 triggers the first connecting structure 111 or the second connecting structure 122 to break, deform or displace to release from the other, and at this time, the extension 120 and the clamping portion 110 are released. Extension 120 is retracted within sheath 210 and withdrawn from the body, and clamp 110 and lock 400 remain at the tissue wound site, assisting in tissue wound closure.

A third embodiment of the present disclosure provides a method of controlling a clip apparatus 10, which is applied to the clip apparatus 10 shown in any of the above embodiments.

Fig. 29 is an exemplary flowchart of a method of controlling the clip instrument 10 according to some embodiments of the present disclosure.

As shown in fig. 29, in some embodiments, the method of controlling the clip instrument 10 includes a flow 2900. In some embodiments, flow 2900 may be performed by an operator and include the steps of:

at step 2910, at least two clamping portions 110 of the clamp arm 100 are controlled to open.

In some embodiments, the operation portion controls the mandrel 220 to move from the proximal end to the distal end, and the mandrel 220 drives the extension portion 120 and the clamping portion 110 to move from the proximal end to the distal end, so that the distal end of the extension portion 120 extends out of the channel of the sheath 210, at least two clamping portions 110 are far away from each other in an open state, and a clamping space 20 for clamping tissue is formed between at least two clamping portions 110.

At step 2920, at least two clamping portions 110 of the clamp arm 100 are controlled to close.

In some embodiments, the operating portion controls the mandrel 220 to move proximally from the distal end, and the mandrel 220 drives the extension portion 120 and the clamping portion 110 to move proximally from the distal end, such that the distal end of the extension portion 120 is retracted into the channel of the sheath 210, the at least two clamping portions 110 are in a closed state, and the tissue is clamped between the at least two clamping portions 110.

At step 2930, the clip arm 100 is controlled to move from the distal end to the proximal end, the at least two clamping portions 110 are engaged with the locking member 400, so that the at least two clamping portions 110 are locked, wherein when the clip arm 100 moves from the distal end to the proximal end, the at least two clamping portions 110 actuate the locking member 400 to release from the sheath 210.

In some embodiments, the method of controlling the clip apparatus further comprises controlling the abutment of the clamping portions 110 with the distal ends of the locking members 400 before the at least two clamping portions 110 are locked, such that the locking members 400 generate a feedback resistance to the clamping portions 110, and the clamping portions 110 are pre-locked with the locking members 400. In the pre-lock state, the clamping portion 110 of the clamping arm 100 includes a second limiting structure 134, and the second limiting structure 134 abuts the contact portion 440 of the locking member 400 and generates a feedback resistance that prevents the clamping portion 110 from moving distally to proximally. In some embodiments, the second limiting structure 134 includes a locking spring, and in the process of moving the clip arm 100 from the distal end to the proximal end, the distal bending portion of the locking spring abuts against the contact portion 440 of the locking member 400 before entering the accommodating cavity 410, so that the contact portion 440 generates a feedback resistance to the locking spring, and the feedback resistance is fed back to the operator through the mandrel 220, so as to prompt the operator that the clip 110 is about to enter the locked state.

In some embodiments, after the operator senses the feedback resistance, he can confirm the clamping condition of the clamping portion 110 on the tissue again, if the clamping portion 110 does not clamp the tissue normally, the mandrel 220 is pushed from the proximal end to the distal end, so that the clamping portion 110 is turned from the closed state to the open state, and the tissue is clamped again, if the clamping portion 110 clamps the tissue normally, the mandrel 220 is pulled from the distal end to the proximal end, so that the locking spring is stressed to deform, the bending portion passes over the contact portion 440 and enters the accommodating cavity 410 to be matched with the locking recess, and the clamping portion 110 enters the final locking state. By providing the contact portion 440 and the second stop structure 430 to provide a feedback resistance, the operator can be prompted to confirm the tissue occlusion prior to locking, reducing surgical error.

In some embodiments, the operating portion controls the first stop structure 133 of the at least two clamping portions 110 to cooperate with the first stop structure 420 of the locking member 400 to limit the relative movement of the clamping portions 110 and the locking member 400 in the first direction. In some embodiments, the direction indicated by arrow D1 in FIG. 9A is included, such as the width direction of the clamping portion 110.

In some embodiments, the operating portion controls the second limit structure 134 of the at least two clamping portions 110 to cooperate with the second limit structure 430 of the locking member 400 to limit the relative movement of the clamping portions 110 and the locking member 400 in a second direction, wherein the second direction is non-parallel to the first direction. In some embodiments, the direction indicated by arrow D2 in FIG. 9A is included, such as the length of the clamping portion 110. In some embodiments, after the clamping portion 110 is pre-locked with the locking member 400, the operating portion controls the mandrel 220 to move from the distal end to the proximal end, the mandrel 220 drives the clamping portion 110 to move from the distal end to the proximal end, the second limiting structure 134 of the clamping portion 110 is engaged with the second stopping structure 430 of the locking member 400 beyond the contact portion 440, and the first limiting structure 133 of the locked portion 130 is engaged with the first stopping structure 420 of the locking member 400, so that at least two clamping portions 110 are locked.

In some embodiments, the operating portion controls the actuating portion 135 of the clamping portion 110 to actuate the release of the second abutment structure 211-2 of the sheath 210 and the second mating portion 460 of the locking member 400, wherein the second abutment structure 211-2 is releasably coupled to the second mating portion 460 for limiting proximal-to-distal movement of the locking member 400 relative to the sheath 210.

In some embodiments, sheath 210 or rotating section 240 of sheath 210 is of unitary construction. In some embodiments, the operating portion controls the clamping portion 110 to move proximally from the distal end, the actuating portion 135 of the clamping portion 110 moves to the proximal end of the second abutment structure 211-2 of the sheath 210, expanding the proximal end of the second abutment structure 211-2 to release the second engagement portion 460 of the locking member 400, such that the locking member 400 is released from the sheath 210.

In some embodiments, sheath 210 or rotating section 240 of sheath 210 includes first tube 213 and second tube 214, with first tube 213 and second tube 214 being axially movably connected. In some embodiments, the operating portion controls the gripping portion 110 to move proximally from the distal end, with the actuating portion 135 of the proximal end of the gripping portion 110 abutting against the end surface of the distal end of the second tube 214. The control actuator 135 continues to move distally and proximally and pushes the second tube member 214 distally and proximally relative to the first tube member 213, causing the second abutment 211-2 of the sheath 210 to deform, displace or fracture and release from the second mating portion 460 of the lock 400 when the lock 400 is released from the sheath 210.

In some embodiments, the operating portion controls the locking of the at least two clamping portions with the locking member before, simultaneously with, or after the release of the locking member with the sheath.

In some embodiments, the second retaining structure 211-2 of the sheath 210 is configured in a position such that the actuating portion 135 actuates the second retaining structure 211-2 to deform, displace or break away from the locking member 400 before the at least two clamping portions 110 engage the locking member 400. In some embodiments, the operating part controls the locking member 400 to be separated from the sheath tube 210 first so that the locking member 400 is in a separated state, and then controls the at least two clamping parts 110 to be locked with the locking member 400 in a separated state.

In some embodiments, the second retaining structure 211-2 is configured such that when at least two clamping portions 110 are mated with the locking member 400, the actuating portion 135 actuates the second retaining structure 211-2 to deform, displace or break away from the locking member 400. In some embodiments, the operating portion controls the locking member 400 to be separated from the sheath 210 while controlling the locking of the at least two clamping portions 110 with the locking member 400.

In some embodiments, the second retaining structure 211-2 is configured such that, after the at least two clamping portions 110 are engaged with the locking member 400, the actuating portion 135 actuates the second retaining structure 211-2 to deform, displace or break away from the locking member 400. In some embodiments, the operating portion controls the at least two clamping portions 110 to cooperate with the locking member 400 such that the at least two clamping portions 110 are in a locked state. Then, the operating part controls the locking member 400 to be separated from the sheath 210.

Step 2940, controlling the release of at least two clips 110 from sheath 210.

In some embodiments, the operating portion controls the extension to release from the clip portion, which in turn controls the extension to retract the sheath, releasing the clip portion and locking member together from the sheath.

In some embodiments, the operating portion controls the extension portion 120 of the clip arm 100 to move from distal to proximal, such that the extension portion 120 or the trigger portion 121 of the clip portion 110 abuts against the abutment portion 212 of the sheath 210, the abutment portion 212 being capable of generating a compressive force on the trigger portion 121.

In some embodiments, the operating portion controls the extension portion 120 to move further from the distal end to the proximal end, and the trigger portion 121 is forced in a first direction to separate the first connection structure 111 of the clamping portion 110 from the second connection structure 122 of the extension portion 120, and the extension portion 120 is released from the clamping portion 110, wherein the first direction is non-parallel to the movement direction of the extension portion 120. In some embodiments, the first direction is perpendicular or at other angles to the direction of movement of the extension 120.

In some embodiments, the operating portion controls the extension 120 to withdraw the sheath 210 such that the at least two clamping portions 110 are released out of the sheath 210 with the locking member 400, and the at least two clamping portions 110 and the locking member 400 are released from the sheath 210. Sheath 210 and extension 120 are withdrawn from the body and at least two clamps 110 and locks 400 remain in the body to aid in wound healing.

The possible beneficial effects of the embodiment of the application include but are not limited to:

(1) The locking piece is arranged in the sheath channel, so that the size of the locking piece is reduced, the size of the locking piece after being matched with the clamping part is also smaller, and compared with the traditional clamping part, the retention length of the locking piece and the clamping part can be reduced by 30% -70%, the operation visual field of an operation is effectively improved, the operation difficulty is reduced, in addition, the locking piece is arranged on the inner side of the extending part, the problem that the opening angle of the extending part is limited is solved, namely, the opening angle of the extending part is not limited by the locking piece, so that the clamping part obtains a larger clamping space.

(2) The locked part is arranged on one side of the clamping part facing the clamping space, namely the locking piece locks the locked part on the inner sides of at least two clamping parts, so that the space outside the clamping parts is not occupied, the structure of the closed clamping part is more compact and small, and the operation vision shielded by the clamping part is reduced.

(3) The locking piece is matched with the sheath tube through the resisting structure, the clamping part is not contacted with the locking piece when the clamping part performs opening or closing operation, and the connection stability of the locking piece is not affected by the movement of the clamping part or other components (such as the extending part and the like).

(4) The rotating section is arranged to enable the clamping arm to rotate around the axis of the sheath tube, so that the closing direction of at least two clamping parts can be adjusted more conveniently to be consistent with the closing direction of the tissue wound, and the accuracy of clamping the tissue wound is improved.

(5) By arranging the contact part and the second stop structure to form feedback resistance, an operator can be prompted to confirm the tissue clamping condition before locking, and surgical errors are reduced.

(6) By arranging the actuating part to actuate the locking piece to release from the sheath, the locking piece can be prevented from being disturbed by other parts or parts in the moving process, and the risk of unexpected release of the locking piece is reduced.

(7) Through setting up the trigger part, make extension just can release with clamping part when receiving the trigger part to trigger, can avoid making the unexpected whereabouts that both produced because of the pulling force along the direction of motion between extension and the clamping part, reduce the operation risk.

It should be noted that, the advantages that may be generated by different embodiments may be different, and in different embodiments, the advantages that may be generated may be any one or a combination of several of the above, or any other possible advantages that may be obtained.

While the basic concepts have been described above, it will be apparent to those skilled in the art that the foregoing detailed disclosure is by way of example only and is not intended to be limiting. Although not explicitly described herein, various modifications, improvements, and adaptations to the present disclosure may occur to one skilled in the art. Such modifications, improvements, and modifications are intended to be suggested within this specification, and therefore, such modifications, improvements, and modifications are intended to be included within the spirit and scope of the exemplary embodiments of the present invention.

Meanwhile, the specification uses specific words to describe the embodiments of the specification. Reference to "one embodiment," "an embodiment," and/or "some embodiments" means that a particular feature, structure, or characteristic is associated with at least one embodiment of the present description. Thus, it should be emphasized and should be appreciated that two or more references to "an embodiment" or "one embodiment" or "an alternative embodiment" in various positions in this specification are not necessarily referring to the same embodiment. Furthermore, certain features, structures, or characteristics of one or more embodiments of the present description may be combined as suitable.

Likewise, it should be noted that in order to simplify the presentation disclosed in this specification, and thereby aid in understanding one or more embodiments, various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of the preceding description of the embodiments of the present specification. This method of disclosure does not imply that the subject matter of the present description requires more features than are set forth in the claims. Indeed, less than all of the features of a single embodiment disclosed above.

Finally, it should be understood that the embodiments described in this specification are merely illustrative of the principles of the embodiments of this specification. Other variations are possible within the scope of this description. Thus, by way of example, and not limitation, alternative configurations of embodiments of the present specification may be considered as consistent with the teachings of the present specification. Accordingly, the embodiments of the present specification are not limited to only the embodiments explicitly described and depicted in the present specification.

Claims

1. A clip instrument, comprising:

a sheath, the sheath comprising a channel;

a clip arm comprising at least two clip portions and at least two extension portions, the extension portions being releasably connected to the clip portions;

the locking piece is arranged in the channel of the sheath tube in a releasable mode and is positioned between the at least two extending parts, and the locking piece is used for being matched with the at least two clamping parts to enable the at least two clamping parts to be in a locking state.

2. The clip apparatus of claim 1, wherein the locking member is located between the at least two clamping portions when the clip arms are in the locked state.

3. The clip instrument of claim 1, wherein the extension or the grip portion includes a trigger portion configured to trigger release of the extension from the grip portion when subjected to a force in a first direction that is non-parallel to a direction of movement of the extension and greater than a predetermined force value.

4. The clip apparatus of claim 3, wherein a clamping space is formed between the at least two clamping portions, a side of the clamping portion facing the clamping space being provided with a first connection structure, a distal end of the extension portion including a second connection structure, the first connection structure and the second connection structure being releasably connected;

The triggering part is arranged on the first connecting structure or the second connecting structure, the distal end of the sheath tube comprises an abutting part, and the abutting part is used for driving the triggering part, so that one of the first connecting structure and the second connecting structure is broken, deformed or displaced to be released from the other.

5. The clip apparatus of claim 1, wherein the clip arms include an open state in which a distal portion of the extension extends outside the sheath, the at least two clip portions being remote from each other, and a closed state in which the extension is within the sheath, the at least two clip portions being proximate to each other.

6. The clip apparatus of claim 1, wherein the sheath includes a first abutment structure, the locking member includes a first mating portion, the first abutment structure mates with the first mating portion for limiting distal to proximal movement of the locking member relative to the sheath, and/or;

the sheath includes a second retaining structure, and the locking member includes a second mating portion, the second retaining structure being releasably coupled to the second mating portion for limiting proximal to distal movement of the locking member relative to the sheath.

7. The clip instrument of claim 6, wherein the clip arm includes an actuation portion configured to actuate the second retaining structure to release from the second mating portion upon distal to proximal movement, releasing the locking member from the sheath.

8. The clip apparatus of claim 7, wherein the second retaining structure comprises a limit tab, a distal end of the limit tab being connected to an inner wall of the sheath, a proximal end protruding radially inward from the inner wall of the sheath, the locking member comprising a distally facing limit surface for engagement with the limit tab;

The actuating part is arranged on the clamping part, the actuating part pushes the limiting elastic piece from the far end to the near end, so that the limiting elastic piece is deformed, displaced or broken to be separated from the limiting surface, and the locking piece is released from the sheath tube.

9. The clip apparatus of claim 7, wherein the sheath comprises a first tube member and a second tube member, the first tube member axially movably engaged with the second tube member, the first retaining structure being disposed on an inner side of the first tube member, the second retaining structure being disposed on the second tube member, the actuation portion being configured to actuate distal-to-proximal movement of the second tube member relative to the first tube member to deform, displace or fracture the second retaining structure and release the second engagement portion.

10. A clip instrument, comprising:

a sheath, the sheath comprising a channel;

The clamping arm comprises at least two clamping parts, a clamping space is formed between the at least two clamping parts, and a locked part is arranged on one side of the clamping part facing the clamping space;

The locking piece is arranged in the channel of the sheath tube in a releasable mode and is used for being matched with the locked part to enable the at least two clamping parts to be in a locking state.

11. The clip apparatus of claim 10, wherein the locking member is located between the at least two clamping portions when the clip arms are in the locked state.

12. The clip apparatus of claim 10 or 11, wherein the locking member includes a receiving cavity for receiving the locked portions of the at least two clip portions;

The locked part comprises a fixed part and a suspension structure, the suspension structure is arranged with the clamping part in a clearance way through the fixed part, and the suspension structure is positioned in the accommodating cavity when the clamping arm is locked.

13. The clip instrument of claim 10, wherein the locked portion includes a first stop feature, the locking member includes a first stop feature, the first stop feature cooperating with the first stop feature to limit relative movement of the clip portion and the locking member in a first direction, and

The locked part comprises a second limiting structure, the locking piece comprises a second stopping structure, the second limiting structure is matched with the second stopping structure to limit the relative movement of the clamping part and the locking piece in a second direction, and the second direction is not parallel to the first direction.

14. The clip apparatus of claim 13, wherein the locking member includes a contact portion located distally of the second stop structure, the clip arms including a pre-lock state and a final-lock state;

In the pre-locking state, the second limiting structure is abutted with the contact part and generates feedback resistance for preventing the clamping part from moving from the distal end to the proximal end;

In the final locking state, the second limiting structure is matched with the second stopping structure beyond the contact part, the first limiting structure is matched with the first stopping structure, and the at least two clamping parts are locked.

15. The clip apparatus of claim 10, wherein the sheath includes a first abutment structure, the locking member includes a first mating portion, the first abutment structure mates with the first mating portion for limiting distal to proximal movement of the locking member relative to the sheath, and/or;

16. The clip instrument of claim 15, wherein the clip arm includes an actuation portion configured to actuate the second retaining structure to release from the second mating portion upon distal to proximal movement, releasing the locking member from the sheath.

17. The clip apparatus of claim 16, wherein the second retaining structure comprises a limit tab, a distal end of the limit tab being connected to an inner wall of the sheath, a proximal end protruding radially inward from the inner wall of the sheath, the locking member comprising a distally facing limit surface for engagement with the limit tab;

the actuating part is arranged on the locked part, the actuating part pushes the limiting elastic piece from the far end to the near end, so that the limiting elastic piece is deformed, displaced or broken to be separated from the limiting surface, and the locking piece is released from the sheath tube.

18. The clip apparatus of claim 16, wherein the sheath comprises a first tube member and a second tube member, the first tube member axially movably engaged with the second tube member, the first retaining structure being disposed on an inner side of the first tube member, the second retaining structure being disposed on the second tube member, the actuation portion being configured to actuate distal-to-proximal movement of the second tube member relative to the first tube member to deform, displace or fracture the second retaining structure and release the second engagement portion.

19. A clip instrument, comprising:

A sheath comprising a channel and a retaining structure;

The clamping arm comprises at least two clamping parts;

the locking piece is arranged in the channel of the sheath tube in a releasable way through the resisting structure and is used for locking the at least two clamping parts;

The clip arm includes an operative state in which the locking member is engaged with the retaining structure and is located within the sheath channel, and a released state in which the clip portion and the locking member are disengaged from the retaining structure and are located outside the sheath channel.

20. The clip apparatus of claim 19, wherein the operating states include an open state in which the at least two clip portions are spaced apart from each other and located outside the sheath channel, and a closed state in which the at least two clip portions are adjacent to each other and in contact with the locking member, the at least two clip portions being located outside the sheath channel.

21. The clip apparatus of claim 19, wherein the operating condition includes a locked condition in which the at least two clamping portions engage the locking member, the locking member being released from the sheath.

22. The clip apparatus of claim 19, wherein the retaining structure comprises a first retaining structure, the locking member comprises a first mating portion, the first retaining structure mates with the first mating portion for limiting distal to proximal movement of the locking member relative to the sheath;

The retaining structure includes a second retaining structure, the locking member includes a second mating portion, and the second retaining structure is releasably coupled to the second mating portion for limiting proximal to distal movement of the locking member relative to the sheath.

23. The clip instrument of claim 22, wherein the clip arm includes an actuation portion configured to actuate the second retaining structure to release from the second mating portion upon distal to proximal movement, releasing the locking member from the sheath.

24. The clip apparatus of claim 23, wherein the second retaining structure comprises a limit tab, a distal end of the limit tab being connected to an inner wall of the sheath, a proximal end protruding radially inward from the inner wall of the sheath, the locking member comprising a distally facing limit surface for engagement with the limit tab;

25. The clip apparatus of claim 23, wherein the sheath comprises a first tube member and a second tube member, the first tube member being axially movably engaged with the second tube member, the first retaining structure being disposed on an inner side of the first tube member, the second retaining structure being disposed on the second tube member, the actuation portion being configured to actuate distal-to-proximal movement of the second tube member relative to the first tube member to deform, displace or fracture the second retaining structure and release the second engagement portion.

26. The clip instrument of claim 19, wherein the sheath comprises a fixed segment and a rotating segment, a proximal end of the rotating segment being rotatably coupled to a distal end of the fixed segment, the rotating segment being configured to rotate about the sheath axis.

27. A method of controlling a clip apparatus as claimed in any one of claims 1 to 26, the method comprising:

Controlling at least two clamping parts of the clamping arm to be opened;

controlling the at least two clamping portions of the clamping arm to be closed;

Controlling the clamping arm to move from the distal end to the proximal end, wherein the at least two clamping parts are matched with the locking piece to lock the at least two clamping parts, and when the clamping arm moves from the distal end to the proximal end, the at least two clamping parts actuate the locking piece to release from the sheath;

controlling the release of the at least two clips from the sheath.

28. The method of controlling a clip instrument of claim 27, wherein prior to locking the at least two clamping portions, the method further comprises:

And controlling the clamping part to abut against the distal end of the locking piece, so that the locking piece generates feedback resistance to the clamping part, and the clamping part and the locking piece are pre-locked.

29. The method of claim 27, wherein the at least two clamping portions actuating the locking member and sheath release comprises:

And the actuating part of the clamping part is controlled to actuate the second resisting structure of the sheath tube to release the second matching part of the locking piece, wherein the second resisting structure is in releasable connection with the second matching part and is used for limiting the movement of the locking piece from the proximal end to the distal end relative to the sheath tube.

30. The method of controlling a clip instrument of claim 29, wherein the method further comprises:

Before, simultaneously with or after controlling the locking piece to be released from the sheath, controlling the at least two clamping parts to be locked with the locking piece;

Wherein the second retaining structure is arranged at a position where the actuating part actuates the second retaining structure to deform, displace or break away from the locking member before, simultaneously with or after the at least two clamping parts are engaged with the locking member.

31. The method of controlling a clip apparatus of claim 27, wherein controlling the release of the at least two gripping portions from the sheath comprises:

Controlling the extension part of the clamping arm to move from the distal end to the proximal end, so that the trigger part of the extension part or the clamping part is abutted with the abutting part of the sheath tube;

The method comprises the steps of controlling the extension part to continuously move from the far end to the near end, enabling the first connecting structure of the clamping part to be separated from the second connecting structure of the extension part by the force of the trigger part in a first direction, and enabling the extension part to be released from the clamping part, wherein the first direction is not parallel to the movement direction of the extension part;

Controlling the extension to withdraw the sheath so that the at least two clamping portions and the locking member are released together out of the sheath channel.