CN214157434U - Safety mechanism and hemostatic clamp with same - Google Patents
Safety mechanism and hemostatic clamp with same Download PDFInfo
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- CN214157434U CN214157434U CN202021094622.2U CN202021094622U CN214157434U CN 214157434 U CN214157434 U CN 214157434U CN 202021094622 U CN202021094622 U CN 202021094622U CN 214157434 U CN214157434 U CN 214157434U
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Abstract
The utility model relates to a safety mechanism and hemostatic clamp that has safety mechanism, safety mechanism has the main part, and is located the through-hole that supplies hemostatic clamp control line distal end side release portion to pass in the main part, wherein, safety mechanism restriction the release of control line distal end side is worked as to the removal of distal end side the release penetrates during the through-hole, the through-hole can radially take place deformation at least. The utility model discloses still including having safety mechanism's hemostatic clamp, hemostatic clamp is including the handle that is located the near-end side, the clip subassembly of distal end side, and be located handle and clip subassembly between the sheath pipe and be located the control line in the sheath pipe, sheath pipe distal end has the fixing base, the control line distal end has the release, wherein, the clip subassembly includes two at least arm lock and holder, the arm lock can be relative the holder removes between opening structure and closed structure. By using the safety mechanism, the movement of the control line is limited, and serious consequences such as tissue tearing, incapability of releasing the clamp and the like are avoided.
Description
Technical Field
The utility model relates to a hemostatic clamp in tissue closure for minimally invasive surgery, which belongs to the field of medical devices.
Background
The existing hemostatic clamp is fed through an endoscope working channel to perform hemostatic or clamping operation on a wound surface, the aim of hemostatic clamping is achieved by mainly mechanically compressing blood vessels and surrounding tissues through the clamp, the hemostatic principle is similar to surgical blood vessel suture or ligation, the hemostatic clamp belongs to a mechanical method, and coagulation, denaturation and necrosis of mucous membrane tissues are not caused. After the metal hemostatic clamp is used for treatment, granuloma is formed in the local tissue inflammation process, and the granuloma falls off automatically and is discharged out of the body through a digestive tract. The operation has the advantages of small injury, high hemostasis speed, low incidence of re-bleeding, few complications, definite curative effect and the like.
In the prior art, when a doctor repeatedly pulls and pushes a control line, the locking state of a clamp assembly is difficult to accurately judge, when the clamp assembly is in a half-locking state which is not completely locked, an elastic clamp body is not completely locked but cannot be unfolded again due to a large distance of entering an internal channel of the clamp body, and at the moment, when the doctor wants to unfold the elastic clamp body to reposition a hemostasis part, the opening and closing state of the clamp at the moment cannot be accurately judged, the control line is pushed to a far end again, so that a clamp seat is pushed out from a release chamber of a fixed seat, and the clamp is in the half-locking state at the moment, so that the clamp seat cannot be opened to reselect the hemostasis position, and on the other hand, more importantly, when the doctor pulls the control line again, the fixed seat is difficult to accurately guide the clamp seat to the hemostasis clamp locking position due to separation or half separation of the clamp seat, at this time, there are technical problems that the clip body excessively enters the clip seat, the control wire is difficult to release from the release hole, and the like, and further, there are serious consequences that the tissue is torn, the clip cannot be released, and the like.
In view of this, the present invention is especially provided.
SUMMERY OF THE UTILITY MODEL
Hemostatic clamp exists and causes the tissue to tear, can't release technical problem such as clip based on prior art exists, the utility model provides an insurance mechanism, its characterized in that: the safety mechanism has:
a main body part, and
a through hole in the main body part for the hemostatic clamp control wire distal release part to pass through,
wherein the safety mechanism restricts movement of the release portion on the distal end side of the control wire to the distal end side.
Preferably, the through hole is deformable at least in a radial direction when the relief portion penetrates into the through hole.
Preferably, when the release portion is located at the distal end of the safety mechanism, the proximal end of the release portion may abut against the distal end face of the safety mechanism.
Preferably, the through-hole inner wall has a protrusion protruding inward, and the proximal end of the release portion may abut on a distal end face of the protrusion.
Preferably, the radial section shape of the protruding part is selected from one or more of the following modes: a straight line segment, a bent line segment with at least one inflection point, an arc line segment and a spiral line segment.
Preferably, the protrusion tip side has at least one inflection point, and the inflection point has an arc-shaped chamfered structure.
Preferably, the periphery of the distal end surface of the safety mechanism is circular or a regular polygon with arc-shaped chamfer.
Preferably, the release portion has a diameter-variable portion whose radial width decreases from a proximal side to a distal side, and a proximal end of the diameter-variable portion is abuttable against a distal end surface of the safety mechanism.
Preferably, the outer circumferential surface of the diameter-variable portion is selected from the following manners: the radial distance is a conical surface gradually reduced from the near end side to the far end side, a step surface with the radial distance gradually reduced from the near end side to the far end side, and a concave-convex surface with the radial distance reduced from the near end side to the far end side.
The utility model also provides a hemostatic clamp with safety mechanism, include:
a handle at a proximal side, a clip assembly at a distal side, and a sheath between the handle and the clip assembly and a control wire in the sheath, the sheath distal end having a retaining base, the control wire distal end having a release, wherein the clip assembly comprises:
at least two clamp arms;
a clamp base, said clamp arm being movable relative to said clamp base between an open configuration and a closed configuration;
the safety mechanism is arranged on the near end side of the fixed seat.
Preferably, the safety mechanism is formed separately or integrally with the fixing seat.
Preferably, the safety mechanism proximal face has a sheath abutment supporting a sheath distal face.
Drawings
Fig. 1 is an overall view of a hemostatic clamp according to embodiment 1 of the present invention;
figure 2 is a cross-sectional view of a hemostatic clip assembly according to example 1 of the present invention;
fig. 3 is a force diagram during the release process of the hemostatic clamp according to embodiment 1 of the present invention;
FIG. 4 is a perspective view of the safety mechanism in embodiment 2 of the present invention;
fig. 5 is a front view of the distal end surface of the safety mechanism in embodiment 2 of the present invention;
FIG. 6 is a perspective view of the safety mechanism in embodiment 3 of the present invention;
FIGS. 7a-7f are schematic radial cross-sectional views of alternative embodiments of the safety mechanism protrusion of the present invention;
FIGS. 8a-8d are schematic radial end views of alternative configurations of the protrusions of the safety mechanism of the present invention;
FIGS. 9a-9c are schematic views of alternative configurations of the peripheral profile of the distal surface of the safety mechanism of the present invention;
fig. 10 is a partial schematic view of a control line release part in embodiment 1 of the present invention;
fig. 11 is a partial schematic view of a control line release part in embodiment 4 of the present invention;
FIGS. 12a-12b are schematic views of alternative shapes of the diameter-changing portion of the releasing portion of the present invention;
fig. 13 is a partial view of an alternative form of a release portion of a control wire in embodiment 5 of the present invention.
Description of reference numerals:
100-clamp body, 101-clamp arm, 102-transition connecting part, 105-release hole, 200-clamp seat, 201-holding piece, 300-fixing seat, 301-safety mechanism, 3011-protruding part, 3012-sheath tube abutting part, 3013-through hole, 302-release chamber, 3021-release chamber side wall clamping groove, 400-control line, 401-release part, 4011-release end, 4012-diameter-changing part, 500-sheath tube and 600-handle
Detailed Description
The technical contents of the present invention will be described in detail with reference to the accompanying drawings and specific embodiments.
Embodiments of the present invention will be described in detail below with reference to examples, but those skilled in the art will understand that the following examples are only for illustrating the present invention and should not be construed as limiting the scope of the present invention.
Some terms referred to in the present invention will be explained. Proximal refers to the end near the operator outside the body; distal refers to the end of the tissue to be closed that is located within the body; axial refers to the direction extending along the longitudinal axis of the hemostatic clip control wire; radial refers to the direction extending perpendicular to the axial direction; circumferential means a circumferential direction in a circumferential direction around the axial direction.
Example 1
As shown in fig. 1-3, in this embodiment, the hemostatic clamp has a handle 600 at a proximal side, a clip assembly at a distal side, a sheath 500 between the handle 600 and the clip assembly 100, and a control wire 400 in the sheath 500, the sheath 500 having a holder 300 at a distal end, and the control wire 400 having a release 401 at a distal end. Wherein the clip assembly comprises: a clamp body 100 having two clamp arms 101 and a transition connection 102 connecting the proximal ends of the two clamp arms 101; a cartridge 200 having an internal passage capable of restricting the path of travel of the clip body 100, the proximal side of the cartridge being releasably connectable to the fixed base. The holder 200 has a retainer 201 on the proximal side, the holder 300 has an open release chamber 302 on the distal side, the retainer 201 is naturally releasably engaged with the locking slot 3021 on the distal side of the release chamber 302 at the distal end, when the clip 100 is in the locked state, the retainer 201 is biased radially outwardly by the proximal end, the distal end of the retainer 201 is released from the locking slot 3021 on the distal side of the release chamber 302, and finally the clamped tissue clip 100 locked in the holder 200 is released together with the holder.
The transition connection portion 102 has a release hole 105, the release portion 401 located at the distal end of the control wire 400 is releasably connected to the release hole 105, the proximal end of the control wire 400 is fixedly connected to a slider structure in the handle, and the slider structure in the handle 600 is moved longitudinally to drive the control wire 400 to move longitudinally, so as to change the elastic clamp body 100 between the open position and the closed position. When the clip is locked, the control wire continues to move proximally, and the release end 4011 at the distal end of the control wire is released from the release hole 105.
The safety mechanism of the present invention will be described in detail below. As shown in fig. 2 to 3, a safety mechanism 301 is disposed on the proximal side of the fixing base 300, and the safety mechanism 301 has a main body portion having a through hole for passing a release portion 401 at the distal end of the control wire 400 therethrough, and the through hole is radially deformable when the release portion passes through the through hole. By providing the safety mechanism 301 having the above-described structure on the proximal end side of the holder, it is possible to restrict the movement of the release portion 401 on the control wire 400 to the distal end side.
Specifically, as shown in fig. 10, in this embodiment 1, the safety mechanism 301 has three inwardly projecting protrusions 3011 at equal intervals in the circumferential direction on the inner wall of the through hole of the main body, and the proximal end side of the control wire releasing portion 401 has a diameter changing portion 4012 whose radial width decreases toward the distal end side. When the maximum radial width R of the proximal end side of the diameter-variable portion 4012lWhen the position is at the far end of the safety mechanism, the diameter-variable part can be abutted against the far end face of the safety mechanism, and when the control line pulls the diameter-variable partIn the process of moving towards the near end and penetrating through the through hole of the safety mechanism, the through hole is deformed at least in the radial direction, and the maximum radial width R of the near end of the reducing part 4012lAfter the position moves to the proximal side and exceeds the proximal end face of each protrusion 3011, interference and/or barb fit between the diameter-variable portion 4012 and each protrusion 3011 is realized.
The protruding part 3011 of the present invention has elasticity, and when the control wire is pulled toward the proximal end during the operation, when the distance between the vertexes of the protrusions 3011 is expanded by the pressing of the reducing portion 4012 at the proximal end of the releasing portion 401, and the reducing portion 4012 is pulled until the proximal end face thereof exceeds the proximal end face of the protrusion 3011, the control wire is pushed distally, since the maximum radial width of the proximal end of the reducing portion 4012 is greater than the minimum radial distance of the limited shape between the top ends of the protrusions 3011 (to enable the proximal end of the releasing portion to abut against the distal end face of the safety mechanism), the reducing portion 4012 abuts against the protrusions 3011, since the pushing force of the flexible control wire to the distal end side of the diameter-variable portion during pushing is difficult to resist the abutting force to the proximal end side of the diameter-variable portion by the safety mechanism, so that the control wire can not push out the reducing part 4012 to the far side any more, and finally the movement direction of the control wire is limited by the safety mechanism 301.
The purpose of setting up this insurance mechanism lies in: in the prior art, when a doctor repeatedly pulls and pushes a control line, the locking state of a clamp assembly is difficult to accurately judge, when the clamp assembly is in a half-locking state which is not completely locked, an elastic clamp body is not completely locked but cannot be unfolded again due to a large distance of entering an internal channel of the clamp body, and at the moment, when the doctor wants to unfold the elastic clamp body to reposition a hemostasis part, the opening and closing state of the clamp at the moment cannot be accurately judged, the control line is pushed to a far end again, so that a clamp seat is pushed out from a release chamber of a fixed seat, and the clamp is in the half-locking state at the moment, so that the clamp seat cannot be opened to reselect the hemostasis position, and on the other hand, more importantly, when the doctor pulls the control line again, the fixed seat is difficult to accurately guide the clamp seat to the hemostasis clamp locking position due to separation or half separation of the clamp seat, at this time, there are technical problems that the clip body excessively enters the clip seat, the control wire is difficult to release from the release hole, and the like, and further, there are serious consequences that the tissue is torn, the clip cannot be released, and the like. The utility model discloses an add insurance mechanism 301 at the fixing base near-end, when the control line was to the near-end pulling, the clip had been in back under the half lock state, established the control line can only be to the near-end pulling and can't be once more to the control line one way movement's of distal end side removal insurance mechanism to solved among the prior art because the operator can't the accurate judgement clip switching state and caused the tissue to tear, the unable technical problem that releases of clamp body.
In the present embodiment, the safety mechanism 301 is a separate component and is fixed between the fixing base 300 and the sheath 500 by bonding, welding, or the like, but according to actual needs or in view of simplifying the processing steps, the safety mechanism 301 may be integrally formed on the proximal end side of the fixing base 300 and the end surface abutting against the sheath 500, so that the technical effect of simplifying the processing steps can be achieved.
It should be noted that the U-shaped elastic clip structure is taken as an example in this embodiment to schematically explain the operation principle of the safety mechanism, and the safety mechanism described in the present invention can be applied to any type of clip structure in the art, such as an 8-shaped elastic clip, a pivoting type (the clip is pivotally connected to the holder) clip, and the like.
Example 2
As shown in fig. 4 and 5, the structure of the safety mechanism 301 in embodiment 1 is changed, in embodiment 2, the outer periphery of the distal end surface of the safety mechanism 301 is a regular triangle, and in order to fit with the side wall of the channel of the fixing seat inserted sheath, each vertex angle of the triangle is subjected to arc chamfering treatment. The through hole 3013 is arranged in the center of the safety mechanism, each protruding part 3011 which is located on the inner wall of the through hole 3013 and protrudes radially has a bend which deflects towards the proximal side, and this structure can enable the reducing part 4012 at the proximal side of the control wire releasing part 401 to pass through the safety mechanism 301 more smoothly when sliding towards the distal side, and after the part with the maximum radial length of the reducing part 4012 exceeds the proximal end face of the protruding part 3011, a higher abutting force can be provided, the control wire can be prevented from moving towards the distal end again to the maximum extent, and therefore a better safety effect is achieved. In this embodiment, the proximal surface of the safety mechanism 301 has the sheath abutting portion 3012 disposed at circumferentially equal intervals, so that when the safety mechanism is independently processed, the safety mechanism has higher adaptability to the fixing base and the sheath, and the fixing base and the sheath can still be stably connected to each other.
Example 3
The structure of the safety mechanism 301 in embodiment 1 is changed. In this embodiment 3, the distal end face of the safety mechanism has a circular structure, 6 protrusions 3011 protruding radially inward are disposed on the inner peripheral wall of the safety mechanism 301 at equal intervals, the protrusions extend radially, and the 6 protrusions provide more reliable limiting capability, so as to better ensure the one-way movement of the control line. Simultaneously, the terminal surface of the near-end of safety mechanism 301 has the ring shape terminal surface with the adaptation of sheath pipe distal end face to the near-end of safety mechanism 301 and distal end face fully butt respectively with sheath pipe, fixing base, the reliable and stable connectivity of lifting means, and then ensure safety mechanism's validity.
Of course, as a deformation mode of the protruding portion, a radial groove may be formed on the through hole side wall of the safety mechanism, and a technical effect that the through hole can be deformed in the radial direction in the process that the releasing portion abuts and passes through the through hole can be obtained.
Further, as shown in fig. 7 to 9, an alternative structure example of the structure of the protrusion 3011 of the present invention is shown.
As shown in fig. 7, the radial sectional shape of the protrusion 3011 may be selected from a straight line segment extending radially as shown in fig. 7a, an arc-shaped segment curved toward the proximal side as shown in fig. 7b, a segment end having a curved chamfer as shown in fig. 7c, a segment end having an arc-shaped segment extending toward the proximal side as shown in fig. 7d, a segment end having an arc-shaped segment curved toward the distal side and the distal side in this order as shown in fig. 7e, and a spiral segment having two inflection points at the segment end as shown in fig. 7 f. The protrusion 3011 shown in fig. 7a is simple to machine; as shown in fig. 7b-7d, the protrusion 3011 and the release portion of the control wire have a small friction force, and the hand feeling is smoother during pulling; as shown in fig. 7e-7f, the projection 3011 is made to provide better resistance to the release portion moving to the distal side and the safety performance is better due to the special arc structure.
As shown in fig. 8, the top end side of the protrusion 3011 has at least one inflection point, and the inflection point has an arc-shaped chamfer structure, specifically, as shown in fig. 8a-c, the protrusion is in the shape of an approximate regular quadrangle, an isosceles trapezoid or an equilateral triangle, which is simple to process and more reliable and firm in connection with the safety mechanism body; as shown in fig. 8d, the distal end of the protrusion has two protruding apexes, which provides a higher fit for the outer surface profile of the release portion of the control wire, thereby improving the reliability of the use of the safety mechanism.
As shown in fig. 9, according to the requirement of adaptability of the internal structure of the actual fixing seat for accommodating the sheath notch, the outer periphery of the distal end surface of the safety mechanism 301 may be a quadrilateral as shown in fig. 9a, a pentagon as shown in fig. 9b, or an 8-deformation as shown in fig. 9c, and in order to improve the reliable contact with the arc-shaped inner wall, the polygon structure preferably has an arc-shaped chamfer.
Example 4
As shown in fig. 11, the structure of the reducing portion 4012 at the proximal end of the release portion of the control wire in example 1 is changed. The warp portion is the bulge loop structure of circumference encircleing the control line surface in this embodiment, and after bulge loop structure distal end face exceeded insurance mechanism 301's near-end face, because the limiting displacement of bulge loop, the control line can't move to the distal end side again, has realized the effect of restriction control line unidirectional movement. In this embodiment, the release portion 401 at the distal end of the control wire is easy to manufacture, and has a good effect of resisting the control wire from moving distally again.
Further, as shown in fig. 12, an alternative structure example of the structure of the diameter varying section of the present invention is shown. The outer peripheral surface of the diameter-changing portion may be a portion having a radial distance from the proximal end side (i.e., a portion having the maximum radial distance R) as shown in FIG. 12alPosition of) a step surface whose gradient decreases toward the distal end side, or as shown in fig. 12b, a radial distance from the proximal end side (by having the maximum radial distance R)lThe position of the control line) to the wave surface which is reduced towards the far end side, and the technical effect of limiting the unidirectional movement of the control line can be better achieved. As an alternative to the undulating surface having a radial distance that decreases from the proximal side to the distal side, the reducing structure outer surface may have, for example, serrations, protrusions, dimples, frostingAnd the like, concave-convex surface structures known in the art to increase surface friction.
Example 5
As an alternative, the proximal end of the release portion in the present invention may not have a diameter-varying portion whose radial width decreases toward the distal end, as shown in fig. 13, the proximal end side of the control wire releasing portion has a cylindrical configuration with substantially the same radial width, the operator can also be provided with a mechanical feedback of the abutment position when the safety mechanism contacts the proximal end of the release portion at a radially varying position, in which case, because the radial width of the cylinder is larger than the aperture of the through hole of the safety mechanism, the near end of the release part can be abutted against the far end surface of the safety mechanism, when the control wire is pulled to the near end, the through hole of the safety mechanism is pressed by the cylindrical part at the near end side of the releasing part to deform and form interference fit with the cylindrical part, at this time, due to the interference fit between the safety mechanism and the cylindrical side wall of the release part, the flexible control line is difficult to resist the pushing force to the far-end side and deform, and finally the technical effect of preventing the control line from being pushed out to the far-end side can be achieved.
Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; such modifications and substitutions do not depart from the spirit and scope of the present invention.
Claims (11)
1. A safety mechanism, characterized by: the safety mechanism has:
a main body part, and
a through hole in the main body part for the hemostatic clamp control wire distal release part to pass through,
the safety mechanism limits the release part at the far end side of the control wire to move towards the far end side, and when the release part penetrates into the through hole, the through hole can deform at least in the radial direction.
2. A safety mechanism according to claim 1, wherein: when the release part is located at the far end of the safety mechanism, the near end of the release part can abut against the far end face of the safety mechanism.
3. A safety mechanism according to claim 2, wherein: the inner wall of the through hole is provided with a protruding part protruding inwards, and the proximal end of the release part can abut against the distal end face of the protruding part.
4. A safety mechanism according to claim 3, wherein: the radial section shape of the protruding part is selected from one or more of the following modes: a straight line segment, a bent line segment with at least one inflection point, an arc line segment and a spiral line segment.
5. A safety mechanism according to claim 3, wherein: the top end side of the protruding part is provided with at least one inflection point, and the inflection point is provided with an arc-shaped chamfer structure.
6. A safety mechanism according to any of claims 1 to 5, wherein: the periphery of the far end face of the safety mechanism is circular or a regular polygon with an arc chamfer.
7. A safety mechanism according to any of claims 1 to 5, wherein: the release portion has a diameter-variable portion whose radial width decreases from a proximal side to a distal side, and a proximal end of the diameter-variable portion is abuttable against a distal end surface of the safety mechanism.
8. A safety mechanism according to claim 7, wherein: the outer peripheral surface of the diameter-variable portion is selected from the following modes: the radial distance is a conical surface gradually reduced from the near end side to the far end side, a step surface with the radial distance gradually reduced from the near end side to the far end side, and a concave-convex surface with the radial distance reduced from the near end side to the far end side.
9. A hemostatic clip with a safety mechanism, comprising:
a handle at a proximal side, a clip assembly at a distal side, and a sheath between the handle and the clip assembly and a control wire in the sheath, the sheath distal end having a retaining base, the control wire distal end having a release, wherein the clip assembly comprises:
at least two clamp arms;
a clamp base, said clamp arm being movable relative to said clamp base between an open configuration and a closed configuration;
the method is characterized in that:
the proximal end of the holder is provided with a safety mechanism according to any one of claims 1 to 8.
10. The hemostatic clip of claim 9, wherein: the safety mechanism is formed separately or integrally with the fixed seat.
11. The hemostatic clip of claim 9, wherein: the proximal end face of the safety mechanism has a sheath abutting portion that supports the distal end face of the sheath.
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202021094622.2U CN214157434U (en) | 2020-06-12 | 2020-06-12 | Safety mechanism and hemostatic clamp with same |
| DE112021001209.6T DE112021001209T5 (en) | 2020-06-12 | 2021-05-24 | Hemostatic clamp and locking mechanism |
| PCT/CN2021/095591 WO2021249174A1 (en) | 2020-06-12 | 2021-05-24 | Hemostatic clip and safety mechanism |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202021094622.2U CN214157434U (en) | 2020-06-12 | 2020-06-12 | Safety mechanism and hemostatic clamp with same |
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| Publication Number | Publication Date |
|---|---|
| CN214157434U true CN214157434U (en) | 2021-09-10 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN202021094622.2U Active CN214157434U (en) | 2020-06-12 | 2020-06-12 | Safety mechanism and hemostatic clamp with same |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113855147A (en) * | 2021-11-04 | 2021-12-31 | 南微医学科技股份有限公司 | Pushing mechanism and hemostatic clamp |
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2020
- 2020-06-12 CN CN202021094622.2U patent/CN214157434U/en active Active
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113855147A (en) * | 2021-11-04 | 2021-12-31 | 南微医学科技股份有限公司 | Pushing mechanism and hemostatic clamp |
| WO2023077896A1 (en) * | 2021-11-04 | 2023-05-11 | 南微医学科技股份有限公司 | Pushing mechanism and hemostat |
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