CN101087564B - Ligation device - Google Patents
Ligation device Download PDFInfo
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- CN101087564B CN101087564B CN2005800444317A CN200580044431A CN101087564B CN 101087564 B CN101087564 B CN 101087564B CN 2005800444317 A CN2005800444317 A CN 2005800444317A CN 200580044431 A CN200580044431 A CN 200580044431A CN 101087564 B CN101087564 B CN 101087564B
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- pressing component
- sheath
- clip
- respect
- ligating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
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- Reproductive Health (AREA)
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- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
A ligation device for ligating a living tissue by a clip, where the ligation deviceis optimal for ligation of a living tissue in a body cavity. The ligation device has a clip (26) opened and closed when a clip claw member (42) is advanced and receded relative to a pressing member (40); a sheath (28) capable of receiving the clip (26) such that the clip claw member (42) is not exposed to the outside; an advancement/recession restriction mechanism (50, 52, 54, 56) for restricting, at the head of the sheath (28), the advancement and recession, relative to the sheath (28), of a pressing member (40) to enable the clip (26) to ligate a living tissue, enabling the advancement and recession, relative to the pressing member (40), of the clip claw member (42) by the advancement and recession of an operation wire (30) relative to the sheath (28); and a release mechanism (66, 74, 76, 78) for releasing at least a part of the clip (26) from the sheath (28) with the living tissue ligated.
Description
Technical field
The present invention relates to a kind of apparatus for ligating that biological tissue is carried out ligation by clip (clip).
Background technology
In the past, used following apparatus for ligating, that is,, endoceliac biological tissue was carried out ligation by clip with endoscope's use that combines.
In the apparatus for ligating of TOHKEMY 2004-121485 communique, clip has a pair of arm of the power that is subjected to expanding out.In addition, will be embedded on the clip so that a pair of arm closure is controlled biological tissue, and utilize and a pair of arm is remained on closure state, thus biological tissue be carried out ligation by pressure pipe by the pressure pipe bag.
In addition, disclose in the apparatus for ligating of 03/030746A1 pamphlet (pamphlet) in the world, be connected with clip at the leading section of coil pipe sheath (coil sheath), this clip has a pair of clip to be opened/closed foot.In addition, the base end part of clip foot is drawn in the coil pipe sheath, make clip foot closure control biological tissue, foot remains on closure state with clip, thus biological tissue is carried out ligation.
In the apparatus for ligating of TOHKEMY 2004-121485 communique, in case will be embedded on the clip by the pressure pipe bag time, just can not open a pair of arm once more, thereby can not control biological tissue again.Thereby there is the probability that can not suitably carry out ligation to biological tissue in the apparatus for ligating of TOHKEMY 2004-121485 communique.
In apparatus for ligating, in order to control biological tissue reliably, on clip, form sharp keen claw usually here.Disclose in the apparatus for ligating of 03/030746A1 pamphlet in the world, clip can't be accommodated in the coil pipe sheath, the claw of clip exposes from the coil pipe sheath.Thereby, under the situation in apparatus for ligating being extended through the passage of endoscope etc., there is claw damage vias inner walls, perhaps claw hangs over the probability that required insertion strength is increased.Thereby the international apparatus for ligating that discloses the 03/030746A1 pamphlet is unsuitable for inserting in the body cavity.
Summary of the invention
The present invention is conceived to above-mentioned problem and finishes, and its objective is provides a kind of apparatus for ligating that is suitable for the ligation of endoceliac biological tissue most.
The apparatus for ligating of one embodiment of the present invention is characterised in that, possess: clip, this clip has biological tissue is carried out ligation and clip tine to be opened/closed and pressing component, described clip tine can be advanced and retreat and is contained in this pressing component in the ground, and described clip tine opens and closes with respect to described pressing component advance and retreat and by the interaction with described pressing component; Sheath, its with described clip can advance and retreat and described clip tine can not be exposed to outside mode and takes in; Operating line, it can extend through in the described sheath with advancing and retreat, and the leading section of this operating line is connected with described clip tine, and this operating line can make described clip advance and retreat with respect to described sheath; The advance and retreat limiting mechanism, in order to carry out ligation to biological tissue by described clip, this advance and retreat limiting mechanism limits described pressing component in the leading section of the described sheath advance and retreat with respect to described sheath, can described clip tine be advanced and retreat with respect to described pressing component by the advance and retreat of described operating line with respect to described sheath; And relieving mechanism, it is carrying out described biological tissue under the state of ligation, and at least a portion of described clip is discharged from described sheath.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that described advance and retreat limiting mechanism has: limit described pressing component with respect to described sheath retreat retreat limiting mechanism; And limit progressive the advance limiting mechanism of described pressing component with respect to described sheath.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that the described limiting mechanism that retreats has: be arranged on and retreat the restriction abutting part in the described pressing component; And be arranged in the described sheath, with the described restriction abutting part butt that retreats that is configured in front, limit described pressing component retreat retreat limit stop.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, described pressing component is can be from the leading section of described sheath outstanding and submerge, the described restriction abutting part that retreats has alar part, this alar part flexibly and can expand out and contract and be arranged in the described pressing component with closing, and under described pressing component is incorporated in situation in the described sheath, contract and close, under the state that described pressing component is given prominence to from described sheath, expand and open, describedly retreat the front end that limit stop is arranged on described sheath, described alar part butt after opening with expansion, thus limit the submerge leading section of described sheath of described pressing component.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, described pressing component and described sheath are barrel shape roughly, the described restriction abutting part that retreats forms by the restriction large-diameter portion that retreats that external diameter in described pressing component increases, and the described limit stop that retreats forms by the restriction sheath minor diameter part that retreats that internal diameter in described sheath reduces.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, advance and retreat with respect to described sheath by making described operating line, described clip is not advanced and retreat with described retreating in the scope that limits sheath minor diameter part butt at the described restriction large-diameter portion that retreats with respect to described sheath, described clip tine is opened and closed by the interaction with described sheath, thereby can carry out interim ligation to biological tissue, limit large-diameter portion and described retreating under the state that limits sheath minor diameter part butt described retreating, by described operating line is retreated with respect to described sheath, described clip tine is retreated with respect to described pressing component, thereby can carry out formal ligation biological tissue.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, biological tissue is being carried out under the situation of formal ligation, and described clip tine is fixed with respect to described pressing component by means of frictional force.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that the described limiting mechanism that advances has: be arranged on the restriction abutting part that advances in the described pressing component; And be arranged in the described sheath, with the described restriction abutting part butt that advances that is configured in rear end side, limit the progressive limit stop of advancing of described pressing component.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, described pressing component and described sheath are barrel shape roughly, the described restriction abutting part that advances forms by the restriction large-diameter portion that advances that external diameter in described pressing component increases, and the described limit stop of advancing forms by the restriction sheath minor diameter part that advances that internal diameter in described sheath reduces.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that the described limiting mechanism that advances has: be arranged on the restriction abutting part that advances in the described pressing component; And be arranged in the described sheath, with the described restriction abutting part butt that advances, limit the progressive limit stop of advancing of described pressing component, described pressing component advance with respect to described sheath and described advance restriction abutting part and the described limit stop butt that advances in, described alar part expansion is opened.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, this apparatus for ligating also possesses the link that the leading section of described operating line and described clip tine are connected with each other, described relieving mechanism has: the 1st fracture portion, it is arranged in the described link, thus can rupture make described clip tine from the fore-end of described operating line from; And the 2nd fracture portion, it is arranged on the front of the described restriction abutting part that advances in described pressing component, thus can rupture make described pressing component front from described sheaths separate.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that described the 2nd fracture portion has the weak frangible portion of other parts of the described pressing component of strength ratio.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, about with the orthogonal cross section of the fore-and-aft direction of described pressing component, the sectional area of described frangible portion is less than the sectional area of other parts of described pressing component.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that described relieving mechanism has: fastening portion, and it is arranged on the rear end side of described the 1st fracture portion in described link; And fastening support portion, it is arranged on the rear end side of described the 2nd fracture portion in described pressing component, by described operating line is retreated with respect to described sheath, thereby described the 1st fracture portion fracture, described link retreats, the fastening of described fastening portion is in described fastening support portion, to described fastening support portion towards the rear end side application of force, thereby the fracture of described the 2nd fracture portion.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, described pressing component is barrel shape roughly, described link is the substantial cylindrical shape, described fastening portion forms by the fastening large-diameter portion that external diameter in described link increases, and described fastening support portion forms by the fastening minor diameter part that internal diameter in described pressing component reduces.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, this apparatus for ligating also possesses the link that the leading section of described operating line and described clip tine are connected with each other, the described limiting mechanism that advances has: the force section, and it is arranged on the leading section of described operating line; And expansion reducing diameter part, but its flexibly and hole enlargement and undergauge be arranged in the described pressing component, by the radial outside application of force of described force section towards described pressing component, thereby hole enlargement forms the described restriction large-diameter portion that advances, described relieving mechanism has: the 1st fracture portion, it is arranged in the described link, thus can rupture make described clip tine from the fore-end of described operating line from; Described force section; And described expansion reducing diameter part, by described operating line is retreated with respect to described sheath, thereby described the 1st fracture portion fracture, described force section retreats into than described expansion reducing diameter part more by rear end side, described expansion reducing diameter part undergauge, described pressing component can be distolateral forward by the described restriction sheath minor diameter part that advances.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that described expansion reducing diameter part has lobe, and this lobe is outstanding towards the radially inner side of described pressing component, and by the radial outside application of force of described force section towards described pressing component.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that above-mentioned pressing component has makes above-mentioned clip tine with respect to the progressive elastic of above-mentioned pressing component.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, by making described operating line retreat, make described clip tine to retreat with respect to described pressing component with respect to described sheath, thereby described elastic produces strain, when discharging described operating line, described elastic makes described clip tine advance with respect to described pressing component by means of resilience force.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that described pressing component has bridge part, this bridge part described clip tine with respect to the progressive situation of described pressing component under, open described clip tine forcibly.
The apparatus for ligating of the preferred embodiment of the present invention is characterised in that, described pressing component is barrel shape roughly, have the switching minor diameter part that internal diameter reduces, described clip tine has a pair of arm of mutual switching, and described a pair of arm has: cross one another at least two cross sections; And the chevron part that between two cross parts, is arranged on the bending shape in each arm, by described clip tine is advanced with respect to described pressing component, described chevron is partly inserted in the described switching minor diameter part, approaching mutually by described switching minor diameter part, thereby described a pair of arm is opened, by described clip tine is retreated with respect to described pressing component, described chevron part is pulled out from described switching minor diameter part and leaves mutually, thus described a pair of arm closure.
Description of drawings
Fig. 1 is the figure of the apparatus for ligating of expression the 1st embodiment of the present invention.
Fig. 2 is the axonometric chart of clip of the apparatus for ligating of expression the 1st embodiment of the present invention.
Fig. 3 is the axonometric chart of formation of bridge part of pressing component of the apparatus for ligating of expression the 1st embodiment of the present invention.
Fig. 4 is used for illustrating based on the profilograph of the taking in operation ligating methods of the apparatus for ligating of the 1st embodiment of the present invention, that clip is taken in sheath.
Fig. 5 is the profilograph that is used for illustrating based on the restriction operation of advance and retreat ligating methods, pressing component of the apparatus for ligating of the 1st embodiment of the present invention.
Fig. 6 is the profilograph of controlling operation ligating methods, biological tissue that is used for illustrating based on the apparatus for ligating of the 1st embodiment of the present invention.
Fig. 7 is the profilograph that is used for illustrating based on separation circuit ligating methods, the clip tine of the apparatus for ligating of the 1st embodiment of the present invention.
Fig. 8 is the profilograph that is used for illustrating based on release process ligating methods, clip of the apparatus for ligating of the 1st embodiment of the present invention.
Fig. 9 illustrates the leading section of the apparatus for ligating of the present invention's the 2nd embodiment, is to be used for illustrating based on the profilograph of the taking in operation ligating methods of this apparatus for ligating, that clip is taken in sheath.
Figure 10 is the profilograph that is used for illustrating based on the restriction operation of advance and retreat ligating methods, pressing component of the apparatus for ligating of the 2nd embodiment of the present invention.
Figure 11 is the profilograph of controlling operation ligating methods, biological tissue that is used for illustrating based on the apparatus for ligating of the 2nd embodiment of the present invention.
Figure 12 is the profilograph that is used for illustrating based on the separation circuit ligating methods of the apparatus for ligating of the 2nd embodiment of the present invention, clip tine and pressing component.
Figure 13 is the profilograph that is used for illustrating based on release process ligating methods, clip of the apparatus for ligating of the 2nd embodiment of the present invention.
Figure 14 is the profilograph of leading section of the apparatus for ligating of expression the 3rd embodiment of the present invention.
Figure 15 is the profilograph of controlling operation ligating methods, biological tissue that is used for illustrating based on the apparatus for ligating of the 3rd embodiment of the present invention.
Figure 16 is the profilograph of leading section of the apparatus for ligating of expression the 4th embodiment of the present invention.
Figure 17 is the profilograph of controlling operation ligating methods, biological tissue that is used for illustrating based on the apparatus for ligating of the 4th embodiment of the present invention.
Figure 18 illustrates the leading section of the apparatus for ligating of the present invention's the 5th embodiment, is the profilograph that is used for illustrating based on the restriction operation of advance and retreat ligating methods, pressing component of this apparatus for ligating.
Figure 19 is the profilograph that is used for illustrating based on progressive restriction operation ligating methods, pressing component of the apparatus for ligating of the 5th embodiment of the present invention.
Figure 20 is profilograph ligating methods, interim ligation operation that is used for illustrating based on the apparatus for ligating of the 5th embodiment of the present invention.
Figure 21 is profilograph ligating methods, formal ligation operation that is used for illustrating based on the apparatus for ligating of the 5th embodiment of the present invention.
Figure 22 is the profilograph that is used for illustrating based on the separation circuit ligating methods of the apparatus for ligating of the 5th embodiment of the present invention, clip tine and pressing component.
Figure 23 is the profilograph that is used for illustrating based on release process ligating methods, clip of the apparatus for ligating of the 5th embodiment of the present invention.
The specific embodiment
Referring to figs. 1 through Fig. 8 the 1st embodiment of the present invention is described.In the apparatus for ligating of present embodiment, clip 26 is installed separably in device body 24.
With reference to Fig. 1, device body 24 has in the passage that is used to extend through endoscope and inserts endoceliac flexible sheath 28.In the present embodiment, sheath 28 forms by the coil pipe of closely reeling (coil).The operating line 30 that is used for operating clip 26 is applied in this sheath 28 free to advance or retreatly.In addition, at the base end part of sheath 28, be connected with the operating portion 32 of the operating operation line 30 that is used to advance and retreat.This operating portion 32 has the elongated operating portion body 34 in front and back, and slide block 36 is provided on this operating portion body 34 free to advance or retreatly.The base end part of operating line 30 is connected on this slide block 36, by making slide block 36 with respect to operating portion body 34 advance and retreat, can make operating line 30 with respect to sheath 28 advance and retreat.In order in the operation of the advance and retreat of slide block 36, to keep operating portion body 34, be equipped with the cyclic finger 38 of taking in the rearward end of operating portion body 34.
With reference to Fig. 1 and Fig. 2, clip 26 is accommodated in the leading section of the sheath 28 of device body 24 free to advance or retreatly.Form in the body of the general cylindrical shape shape of this clip 26 by clip tine 42 being embedded in pressing component 40.The leading section of operating line 30 is connected on this clip tine 42 via link 44, advance and retreat with respect to sheath 28 by making operating line 30, thereby clip tine 42 is advanced and retreat with respect to sheath 28 integratedly with pressing component 40.
Below, restriction pressing component 40 is described at the leading section of the sheath 28 advance and retreat limiting mechanism with respect to the advance and retreat of sheath 28.
At first, progressive the advance limiting mechanism of restriction pressing component 40 with respect to sheath 28 is described.
At the leading section of coil pipe, be fixed with circular backstopping assembly 46 by welding etc., this backstopping assembly 46 has the external diameter external diameter about equally with coil pipe, and has the internal diameter littler than the internal diameter of coil pipe.That is, the front end of sheath 28 is made flange shape, is formed with the sheath minor diameter part 48 that internal diameter reduces at the front end of sheath 28.Utilize the rear end side of this sheath minor diameter part 48 to form the limit stop 50 of advancing.On the other hand, the rearward end at pressing component 40 is formed with the restriction large-diameter portion 52 that advances that external diameter increases.Butt by this advance the restriction large-diameter portion 52 and the limit stop 50 of advancing limits pressing component 40 advancing with respect to sheath 28.
Then, illustrate that restriction pressing component 40 retreats limiting mechanism with respect to what sheath 28 retreated.
The external diameter of the body of pressing component 40 is less than the internal diameter of sheath minor diameter part 48, and pressing component 40 can be outstanding from the front end of sheath 28.In addition, utilize the front formation of sheath minor diameter part 48 to retreat limit stop 54.On the other hand, a plurality of alar parts 56 flexiblely and can expand out and contract and be provided on the pressing component 40 with closing.That is, in pressing component 40, taken in rubber-like alar part 56 in the grooving that extends setting along fore-and-aft direction, at the leading section of grooving, the leading section of alar part 56 is connected with the body of pressing component 40.The rearward end of alar part 56 can be that fulcrum flexibly rotates with the connecting portion of the body of the leading section of this alar part 56 and pressing component 40.In addition, alar part 56 expands under the naturalness that is not applied in external force and opens.
Under pressing component 40 is incorporated in situation in the sheath 28, alar part 56 be subjected to sheath 28 inner peripheral surface active force and to the folded inside of grooving.In addition, under pressing component 40 situation outstanding from the leading section of sheath 28, alar part 56 expands out by means of elasticity.Alar part 56 after opening by this expansion and the butt that retreats limit stop 54 limit pressing component 40 retreating with respect to sheath 28.
In addition, the length dimension of the central axis direction of sheath minor diameter part 48 is shorter than the length between the rear end face of front end face and the alar part 56 of expansion after opening of the restriction large-diameter portion 52 that advances of pressing component 40 slightly.That is, make clip 26 with respect to sheath 28 progressive situations under, in advance restriction large-diameter portion 52 and limit stop 50 butts that advance of pressing component 40, alar part 56 expands to be opened.
Below, the switching mechanism of clip tine 42 is described.
The leading section of operating line 30 is had the form that semi-cylindrical portion 64, great circle cylindrical portion 66 and roundlet cylindrical portion 68 roughly are connected in turn coaxially from front with the link 44 that clip tine 42 couples together, and this link 44 is incorporated in the pressing component 40.Semi-cylindrical portion 64 has the shape of the external diameter cylindrical shape about equally of external diameter and great circle cylindrical portion 66 being used the side after the plane that comprises central shaft is cut apart.In addition, the outstanding engaging support portion 70 that is provided with tear-drop shaped (teardrop) on the planar portions of semi-cylindrical portion 64, holding section 58 volumes of clip tine 42 are established and are installed on this engaging support portion 70.In addition, in the rearward end of great circle cylindrical portion 66, form the taper that reduces towards the rear end side external diameter, be connected with roundlet cylindrical portion 68 in the rearward end of this taper, this roundlet cylindrical portion 68 has the external diameter littler than the external diameter of great circle cylindrical portion 66.In addition, the leading section of operating line 30 is connected the base end part of roundlet cylindrical portion 68 by bonding, welding etc.Here, pressing component 40 with respect to the confined situation of the advance and retreat of sheath 28 under, by making operating line 30, thereby link 44, be that clip tine 42 is with respect to pressing component 40 advance and retreat with respect to sheath 28 advance and retreat.
At the leading section of pressing component 40, set up bridge part 72 along diametric(al) in the mode of crossing front opening.Front opening is bridged portion 72 and is divided into two, and a pair of arm 60 of clip tine 42 extends through this a pair of separating in the mouth respectively sliding freely.In addition, with respect to the advancing of pressing component 40, a pair of arm 60 is subjected to the active force of bridge part 72 and opens by clip tine 42, thereby clip tine 42 is opened.In addition, as shown in Figure 3, bridge part 72 can form by giving prominence to the long plate shape sheet bending to the inside that is provided with along central axis direction symmetrically about central shaft on the front end face of pressing component 40.On the other hand, with respect to the retreating of pressing component 40, clip tine 42 is drawn in the pressing component 40 by clip tine 42, thereby clip tine 42 is by pressing component 40 and closure.
Below, the relieving mechanism that the leading section from sheath 28 is discharged clip 26 describes.
As mentioned above, clip tine 42 couples together by link 44 with the leading section of operating line 30.In addition, in the semi-cylindrical portion 64 of link 44, the part between engaging support portion 70 and the great circle cylindrical portion 66 can rupture, and forms the 1st fracture portion 74.In addition, make its intensity tender, also can form the 1st fracture portion 74 by reduced diameter with semi-cylindrical portion 64.Be limited with respect to retreating of sheath 28 and clip tine 42 is drawn under the situation in the pressing component 40 fully at pressing component 40, further advance and retreat with respect to sheath 28 by making operating line 30, thus 74 fractures of the 1st fracture portion.
In addition, advancing between restriction large-diameter portion 52 and the alar part 56 of pressing component 40, be formed with the 2nd fracture portion 76 that to rupture.The 2nd fracture portion 76 forms by the frangible portion of weak strength, about with the orthogonal cross section of the central axis direction of pressing component 40, the sectional area of frangible portion is less than the sectional area of the body of pressing component 40.In the present embodiment, form frangible portion, still, also can wait and form frangible portion by the formation grooving by the wall thickness attenuation that makes pressing component 40.Rear end side in the 2nd fracture portion 76 is formed with the fastening minor diameter part 78 that internal diameter reduces with respect to the body of pressing component 40.In addition, under the situation of the 1st fracture portion 74 fractures, by operating line 30 is retreated with respect to sheath 28, thereby as the taper fastening of the rear end side of the great circle cylindrical portion 66 of fastening large-diameter portion in the fastening minor diameter part 78 of pressing component 40, to the distolateral backward application of force of fastening minor diameter part 78, thereby make 76 fractures of the 2nd fracture portion.
Then, with reference to Fig. 4 to Fig. 8, the ligating methods based on the biological tissue of the apparatus for ligating of present embodiment is described.In the present embodiment, apparatus for ligating and endoscope are combined use.
With reference to Fig. 4, clip 26 is installed in the leading section of sheath 28 in the mode that is contained fully.Under this installment state, clip tine 42 can not be exposed to the outside, and the inner peripheral surface of the alar part 56 of pressing component 40 by sheath 28 flexibly contracts to close and be folded in the grooving.In addition, clip tine 42 is configured in foremost position with respect to pressing component 40, though 72 pairs of clip tines 42 of bridge part so that its mode application of force of opening to greatest extent, this clip tine 42 is flexibly closed by the inner peripheral surface of sheath 28.
Then, sheath 28 is extended through in the passage that inserts endoceliac endoscope, make the leading section of sheath 28 give prominence to and in body cavity, insert from the leading section of passage.In addition, under endoscopic observation, the leading section of sheath 28 is moved near the of ligation object position A of biological tissue.In addition, also can utilize the passage of endoscope's guiding device in addition that sheath 28 is inserted in body cavity.
With reference to Fig. 5, in operating portion 32, slide block 36 is advanced with respect to operating portion body 34, thereby clip 26 is advanced with respect to sheath 28 by operating line 30, make clip 26 outstanding from the leading section of sheath 28.At this moment, limit stop 50 butts that advance of advance the restriction large-diameter portion 52 and the sheath minor diameter part 48 of pressing component 40, restriction pressing component 40 is outstanding further from the leading section of sheath 28.Simultaneously, by making pressing component 40 outstanding from the leading section of sheath 28, thereby the restriction based on the inner peripheral surface of sheath 28 is disengaged, the alar part 56 of pressing component 40 expands to be opened, expand alar part 56 and sheath 28 after opening front end retreat limit stop 54 butts, thus, the submerge leading section of sheath 28 of restriction pressing component 40.In addition, the inner peripheral surface of sheath 28 is disengaged the application of force of clip tine 42, thereby clip tine 42 is opened to greatest extent.
With reference to Fig. 6, the sheath 28 of apparatus for ligating is pressed into respect to endoscope, under endoscopic observation, the leading section of clip tine 42 is pressed into the ligation object position A of biological tissue.Then, slide block 36 is retreated with respect to the operating portion body 34 of apparatus for ligating.Consequently, clip tine 42 retreats with respect to pressing component 40 by operating line 30, and clip tine 42 is drawn in the pressing component 40, and clip tine 42 is by pressing component 40 closures.In addition, the claw 62 puncture ligation object position A of clip tine 42, biological tissue is controlled by clip tine 42.By clip tine 42 is drawn in the pressing component 40 fully, thereby clip tine 42 is closed fully, and biological tissue is by ligation.
In the ligation of hemostasis purpose,, but under the situation of suitably ligation, just can not solve bleeding problems, here, so need carry out ligation again if, then can solve bleeding problems to suitably ligation of ligation object position A.Under the situation of carrying out ligation again, slide block 36 is advanced with respect to the operating portion body 34 of apparatus for ligating.Consequently, clip tine 42 advances with respect to pressing component 40 by operating line 30, thereby clip tine 42 is subjected to the active force of bridge part 72 and opens.Like this, ligation object position A is released.Afterwards, carry out aforesaid operations repeatedly, till suitably ligation object position A being carried out ligation.
With reference to Fig. 7, ligation object position A is drawn in state in the pressing component 40 fully by suitably ligation, clip tine 42 under, slide block 36 is retreated with respect to operating portion body 34.Consequently, the 1st fracture portion 74 fractures of link 44, clip tine 42 separates with operating line 30.
With reference to Fig. 8, after 74 fractures of the 1st fracture portion, slide block 36 is retreated with respect to operating portion body 34.Consequently, great circle cylindrical portion 66 fastenings of link 44 are in the fastening minor diameter part 78 of pressing component 40, the distolateral backward application of force of 66 pairs of fastening minor diameter parts 78 of great circle cylindrical portion, thereby the fracture of the frangible portion of pressing component 40.Like this, the front of pressing component 40 from the fore-end of sheath 28 from.
Afterwards, sheath 28 is extracted with respect to endoscope, the leading section of clip 26 from sheath 28 discharged.Here, clip tine 42 is installed in the pressing component 40 by means of frictional resistance, remains on closed state.Thereby this clip 26 is retained in the body cavity with the state to the A ligation of ligation object position.
Thereby the apparatus for ligating of present embodiment can obtain following effect.In the apparatus for ligating of present embodiment, clip 26 can not be exposed to outside mode with clip tine 42 and be incorporated in the sheath 28, by sheath 28 being run through the passage of endoscope etc., thereby inserts in body cavity.Thereby, can prevent vias inner walls by 42 damages of clip tine, and, can avoid clip tine 42 to hang over required insertion strength is increased.In addition, clip tine 42 is with respect to pressing component 40 advance and retreat, open and close by interaction with pressing component 40, in order to carry out ligation by 26 pairs of biological tissues of clip, advance and retreat limiting mechanism restriction pressing component 40 is in the leading section of sheath 28 advance and retreat with respect to sheath 28, can make clip tine 42 with respect to pressing component 40 advance and retreat by the advance and retreat of operating line 30 with respect to sheath 28.Thereby, can carry out ligation again by 42 couples of ligation object position A of clip tine.Like this, the apparatus for ligating of present embodiment is suitable for the ligation of endoceliac biological tissue most.
In addition, in the apparatus for ligating of present embodiment, by making slide block 36 advancing with respect to operating portion body 34, thereby clip 26 is outstanding from the leading section of sheath 28, clip tine 42 is opened, and then, retreats with respect to operating portion body 34 by making slide block 36, thereby clip tine 42 closures, clip 26 is released from the leading section of sheath 28.Like this, the direction of action of the direction of operating of the base end part of apparatus for ligating and the leading section of apparatus for ligating is consistent each other, can carry out the operation intuitively of apparatus for ligating.
In addition, in the clip 26 of the apparatus for ligating of present embodiment, clip tine 42 with respect to pressing component 40 progressive situations under, clip tine 42 is bridged portion 72 and opens forcibly.Under the situation that does not form this bridge part 72, only open clip tine 42, thereby be difficult to open reliably clip tine 42, still by clip tine 42 is applied the power that its expansion is opened, in the present embodiment, can open clip tine 42 reliably.
Fig. 9 to Figure 13 illustrates the 2nd embodiment of the present invention.Be marked with identical label for having, and omit explanation it with the structure of the 1st embodiment said function.
Below, the progressive relieving mechanism that advances limiting mechanism and release clip 26 that limits pressing component 40 is described.
In the rearward end of pressing component 40, but flexibly and hole enlargement and undergauge ground be formed with and expand reducing diameter part 80.The expansion reducing diameter part 80 that is in the hole enlargement state has the external diameter bigger than the internal diameter of sheath minor diameter part 48, has and the above-mentioned same function of restriction large-diameter portion 52 (referring to figs. 1 through Fig. 8) of advancing.On the other hand, the expansion reducing diameter part 80 that is in the undergauge state equates to have the external diameter littler than the internal diameter of sheath minor diameter part 48 substantially with the external diameter of the body of the general cylindrical shape shape of pressing component 40, can pass through sheath minor diameter part 48.
Expanding reducing diameter part 80 has towards the outstanding protuberance 84 of the radially inner side of pressing component 40.In addition, at the leading section of operating line 30, integratedly or split ground be formed with the roughly columned force section 86 of external diameter greater than the external diameter of operating line 30.In addition, different with the 1st embodiment, on link 44, do not form roundlet cylindrical portion 68 (referring to figs. 1 through Fig. 8), the leading section of force section 86 is connected the rearward end of great circle cylindrical portion 66 by bond, mechanically connect or welding etc.This force section 86 is inserted in the pressing component 40, to the radial outside application of force of lobe 84 towards pressing component 40, will expand reducing diameter part 80 and remain on the hole enlargement state.Here, the length of the central axis direction of force section 86 is configured to, and when clip tine 42 is opened and closed with respect to pressing component 40 advance and retreat, is in the radially inner side of lobe 84 all the time, remains on the hole enlargement state and will expand reducing diameter part 80.In addition, after the 1st fracture portion 74 fracture of link 44, when make operating line 30 with respect to sheath 28 retreat, when pressing component 40 is extracted force section 86, the application of force of the 86 pairs of lobe 84 in force section is disengaged, and expands reducing diameter part 80 and is maintained at the undergauge state.
Below, the switching mechanism of clip tine 42 is described.The clip tine 42 of present embodiment has a pair of arm 60 cross one another two cross sections 88.Between these two cross parts 88, each arm 60 is formed chevron part 90 by bending.On the other hand, the leading section of pressing component 40 becomes flange shape, at the leading section of pressing component 40, is formed with the switching minor diameter part 92 of internal diameter less than the internal diameter of the body of pressing component 40.In the present embodiment, the front and back end portion that opens and closes minor diameter part 92 makes step shape respectively, still, also can be other shapes such as inclined-plane (slope) shape.Here, the distance between each chevron part 90 of width of clip 26 is under the naturalness that is not applied in external force, internal diameter greater than the switching minor diameter part 92 of pressing component 40, but, both can be greater than the internal diameter of the body of pressing component 40, also can be less than the internal diameter of the body of pressing component 40.In addition, advance with respect to pressing component 40 by making clip tine 42, thereby each chevron part 90 is inserted in the switching minor diameter part 92, approaching mutually towards the radially inner side of pressing component 40, the front of a pair of arm 60 is opened.On the other hand, retreat with respect to pressing component 40 by making clip tine 42, thus each chevron part 90 extracted from opening and closing minor diameter part 92, leave the front closure of a pair of arm 60 mutually towards the radial outside of pressing component 40.
Then, with reference to Fig. 9 to Figure 13, the ligating methods based on the biological tissue of the apparatus for ligating of present embodiment is described.Below, to the operation same, omit detailed explanation with the 1st embodiment.
With reference to Fig. 9, clip 26 is accommodated in the leading section of sheath 28, the leading section of sheath 28 is inserted in the body cavity, be configured in ligation object position A near.
With reference to Figure 10, the 86 pairs of juts 84 in the force section of the leading section of operating line 30 are maintained at the hole enlargement state towards the radial outside application of force of pressing component 40 thereby expand reducing diameter part 80.Under this state, make clip 26 outstanding from the leading section of sheath 28, by the advance and retreat limiting mechanism, restriction pressing component 40 is with respect to the advance and retreat of the leading section of sheath 28.In addition, advance with respect to operating portion body 34 by making slide block 36, thereby clip tine 42 is advanced with respect to pressing component 40 by operating line 30.Consequently, the chevron part 90 of each arm 60 of clip tine 42 is inserted and is opened and closed minor diameter part 92, and approaching mutually towards the radially inner side of pressing component 40, the front of a pair of arm 60 is opened.
With reference to Figure 11, the leading section of clip tine 42 is pressed into the ligation object position A of biological tissue.Then, slide block 36 is retreated with respect to the operating portion body 34 of apparatus for ligating, thereby clip tine 42 is retreated with respect to pressing component 40 by operating line 30.Consequently, the chevron part 90 of each arm 60 of clip tine 42 is extracted from open and close minor diameter part 92, leaves the front closure of a pair of arm 60 mutually towards the radial outside of pressing component 40.Like this, biological tissue is by ligation.Can not suitably carry out carrying out above-mentioned opening and closing operations repeatedly under the situation of ligation to ligation object position A, up to ligation object position A by till the ligation suitably.
With reference to Figure 12, ligation object position A is drawn in state in the pressing component 40 fully by suitably ligation, clip tine 42 under, slide block 36 is retreated with respect to operating portion body 34, thereby make the 1st fracture portion 74 fractures of link 44, clip tine 42 is separated with operating line 30.And, after 74 fractures of the 1st fracture portion, slide block 36 is retreated with respect to operating portion body 34.Consequently, the force section 86 of the leading section of operating line 30 is extracted from pressing component 40, and the application of force of the 86 pairs of lobe 84 in force section is disengaged, and expands reducing diameter part 80 and flexibly shifts to the undergauge state, and can pass through sheath minor diameter part 48.Like this, pressing component 40 from the fore-end of sheath 28 from.
With reference to Figure 13, sheath 28 is extracted with respect to endoscope, the leading section of clip 26 from sheath 28 discharged.
Thereby the apparatus for ligating of present embodiment can obtain following effect.In the switching mechanism of the clip tine 42 of present embodiment, by clip tine 42 is advanced with respect to pressing component 40, thereby the chevron part 90 of each arm 60 of clip tine 42 is inserted in the switching minor diameter part 92 of pressing component 40, approaching mutually by opening and closing minor diameter part 92, a pair of arm 60 is opened.On the other hand, retreat with respect to pressing component 40, thereby chevron part 90 is extracted from switching minor diameter part 92 and is left a pair of arm 60 closures mutually by making clip tine 42.Thereby, even under the situation of the switching of carrying out clip tine 42 repeatedly, regardless of the material of clip tine 42, what can prevent that plastic deformation by clip tine 42 from causing opens reducing of width, can carry out the switching of clip tine 42 enduringly repeatedly.
In addition, in the relieving mechanism of the clip 26 of present embodiment, by slide block 36 is retreated with respect to operating portion body 34, thereby force section 86 is pulled out from pressing component 40 by operating line 30, the application of force of the 86 pairs of lobe 84 in force section is disengaged, expand reducing diameter part 80 and flexibly shift, and can pass through sheath minor diameter part 48 to the undergauge state.Like this, carry out separating between the leading section of pressing component 40 and sheath 28 by means of strain, compare, can separate reliably, simultaneously, can reduce required operation strength with carry out this isolating situation by plastic deformation.
Figure 14 and Figure 15 illustrate the 3rd embodiment of the present invention.Be marked with identical label to having, and omit explanation it with the structure of the 1st embodiment said function.
With reference to Figure 14, the pressing component 40 of present embodiment has the clip of making tine 42 with respect to pressing component 40 progressive elastic.This elastic forms by the leaf spring of giving prominence on the inner peripheral surface that is arranged on pressing component 40 94.This leaf spring 94 both can form with pressing component 40, also can form with pressing component 40 splits ground and couple together with pressing component 40 by bond, mechanically be connected or welding etc.Same with the 1st embodiment, clip tine 42 is configured in foremost position with respect to pressing component 40, and leaf spring 94 is provided in the position of rearward end of the great circle cylindrical portion 66 of link 44.In addition, make operating line 30 retreat, make with respect to sheath 28 under the situation that link 44 retreats with respect to pressing component 40, leaf spring 94 is strain by means of the taper of the great circle cylindrical portion 66 of link 44, makes link 44 progressive resilience forces thereby produce.
Then, with reference to 14 and Figure 15, the ligating methods based on the biological tissue of the apparatus for ligating of present embodiment is described.Below, for the operation same, omit detailed explanation with the 1st embodiment.
Thereby the apparatus for ligating of present embodiment can obtain following effect.Via operating line 30 forward operation of slide block 36 with respect to the operation body passed in the structure of link 44, can not make link 44 progressive situations reliably thereby exist because of relaxing of operating line 30 can not fully pass to operating physical force link 44.In the apparatus for ligating of present embodiment, the elastic force by means of the leaf spring 94 of pressing component 40 makes clip tine 42, link 44 and operating line 30 advance with respect to pressing component 40 or sheath 28.Thereby, link 44 is advanced, thereby can open and close clip tine 42 reliably.
In addition, only, just can link 44 automatically be advanced with respect to pressing component 40 by means of the elastic force of leaf spring 94 by removing operating physical force to slide block 36.Thereby, do not need to carry out the forward operation of slide block 36 with respect to operation body 34, can carry out the operation of apparatus for ligating very easily.
In addition, the elastic of present embodiment is also applicable to the 2nd embodiment.
Figure 16 and Figure 17 illustrate the 4th embodiment of the present invention.Be marked with identical label for having, and omit explanation it with the structure of the 3rd embodiment said function.
The elastic of present embodiment is formed by helical spring 96.This helical spring 96 between the front end face of the fastening minor diameter part 78 of the leading section of the taper of the great circle cylindrical portion 66 of link 44 and pressing component 40, in be contained in the pressing component 44 and be contained in outward on the link 44.Under the situation that the operating physical force to slide block 36 is disengaged, clip tine 42 is configured in foremost position with respect to pressing component 40, and helical spring 96 is not compressed.In addition, retreat with respect to sheath 28, link 44 is retreated with respect to pressing component 40, thereby helical spring 96 is produced and makes link 44 progressive resilience forces by the compression of the front end face of the leading section of taper and fastening minor diameter part 78 by making operating line 30.Based on the ligating methods of the biological tissue of the apparatus for ligating of present embodiment, identical with ligating methods based on the biological tissue of the apparatus for ligating of the 3rd embodiment.
In the present embodiment, use helical spring 96, therefore, use the situation of leaf spring 94 to compare like that, can obtain big elastic force reliably with the 3rd embodiment as elastic.Thereby, can apply big power to link 44 is distolateral forward, can open clip tine 42 reliably.
Figure 18 to Figure 22 illustrates the 5th embodiment of the present invention.Be marked with identical label for having, and omit explanation it with the structure of the 1st embodiment said function.
Below, the advance and retreat limiting mechanism that the advance and retreat to pressing component 40 limit is described.
The sheath minor diameter part 48 of present embodiment is configured in apart from the rear end side of the front end preset distance of sheath 28.This sheath minor diameter part 48 by from the outer peripheral face side to sheath 28 extruding (Collapse The) so that it forms to radially inner side is outstanding, perhaps, connect miscellaneous part by inner peripheral surface and form at sheath 28.The sheath minor diameter part 48 of present embodiment limits the sheath minor diameter part and retreats restriction sheath minor diameter part performance function as advancing.That is, utilize the rear end side of sheath minor diameter part 48 to form the progressive limit stop 50 of advancing that limits pressing component 40.On the other hand, utilize the front of sheath minor diameter part 48 form restriction pressing component 40 retreat retreat limit stop 54.In addition, the leading section of pressing component 40 is made flange shape, retreats restriction large-diameter portion 98 what the leading section of pressing component 40 was formed with that external diameter increases.In addition, by make pressing component 40 retreat restriction large-diameter portion 98 and sheath minor diameter part 48 retreat limit stop 54 butts, thereby restriction pressing component 40 retreating with respect to sheath 28.
Here, under the situation of advance restriction large-diameter portion 52 and limit stop 50 butts that advance of sheath minor diameter part 48 of pressing component 40, pressing component 40 is positioned at foremost position with respect to sheath 28, and the position of this pressing component 40 is called the front end restriction site.In addition, the length between the limit stop 50 of advancing of the front end of sheath 28 and sheath minor diameter part 48, and the length between the front end face of the leading section of pressing component 40 and the restriction large-diameter portion 52 that advances is about equally or shorter slightly than it.That is, be configured at pressing component 40 under the situation of front end restriction site, the leading section of pressing component 40 is configured in the position of sheath 28 front ends, or outstanding from the front end of sheath 28 slightly.On the other hand, under the situation that retreats limit stop 54 butts that retreats restriction large-diameter portion 98 and sheath minor diameter part 48 of pressing component 40, pressing component 40 is positioned at the position of rearmost end with respect to sheath 28, and the position of this pressing component 40 is called the rear end restriction site.
Be configured at pressing component 40 under the situation of front end restriction site, by operating line 30 is advanced with respect to sheath 28, thereby clip tine 42 advances with respect to pressing component 40, by operating line 30 is retreated with respect to sheath 28, thereby pressing component 40 retreats with respect to sheath 28 integratedly with clip tine 42.On the other hand, be configured at pressing component 40 under the situation of rear end restriction site, by operating line 30 is retreated with respect to sheath 28, thereby clip tine 42 retreats with respect to pressing component 40, by operating line 30 is advanced with respect to sheath 28, thereby pressing component 40 advances with respect to sheath 28 integratedly with clip tine 42.Under pressing component 40 is configured in situation between front end restriction site and the rear end restriction site, by making operating line 30 with respect to sheath 28 advance and retreat, thereby pressing component 40 and clip tine 42 be integratedly with respect to sheath 28 advance and retreat, clip tine 42 be subjected to sheath 28 inner peripheral surface active force and open and close.
Then, with reference to Figure 18 to Figure 22, the ligating methods based on the apparatus for ligating of present embodiment is described.Below, for the operation same, omit detailed explanation with the 1st embodiment.
With reference to Figure 18, clip 26 is installed in the leading section of sheath 28, slide block 36 is retreated with respect to operating portion body 34.Consequently, clip 26 retreats with respect to sheath 28, pressing component 40 is configured in the rear end restriction site, and then clip tine 42 retreats with respect to pressing component 40, and clip tine 42 can not be exposed to outside mode with clip tine 42 and be incorporated in the sheath 28.Under this state, the leading section of sheath 28 is inserted in the body cavity, be configured in biological tissue ligation object position A near.
With reference to Figure 19, slide block 36 is advanced with respect to operating portion body 34, thereby clip 26 is advanced with respect to sheath 28, pressing component 40 is disposed at the front end restriction site, and then, clip tine 42 is advanced with respect to pressing component 40 and be configured in foremost position, open clip tine 42 to greatest extent.
With reference to Figure 20, the leading section of clip tine 42 is pressed into after the ligation object position A, slide block 36 is retreated with respect to operating portion body 34.Consequently, clip 26 retreats with respect to sheath 28, and clip tine 42 is by the inner peripheral surface closure of sheath 28, and ligation object position A is by interim ligation.Can not suitably carry out carrying out ligation again under the situation of interim ligation here.That is, slide block 36 is advanced with respect to operating portion body 34, thereby clip 26 is advanced with respect to sheath 28, remove the application of force of the inner peripheral surface of sheath 28, open clip tine 42, discharge ligation object position A clip tine 42.Then, carry out interim ligation once more.
With reference to Figure 21, suitably carrying out transferring to formal ligation under the situation of interim ligation.That is, slide block 36 is retreated with respect to operating portion body 34, thereby clip 26 is retreated with respect to sheath 28, pressing component 40 is disposed at the rear end restriction site.And then, slide block 36 is retreated with respect to operating portion body 34, same with the 1st embodiment, position A carries out formal ligation to the ligation object.
With reference to 22 and Figure 23, same with the 1st embodiment, with clip tine 42 from the fore-end of operating line 30 from, simultaneously, with pressing component 40 from the fore-end of sheath 28 from, with clip 26 from the fore-end of sheath 28 from.
Thereby the apparatus for ligating of present embodiment can obtain following effect.As the 1st embodiment, under the situation that retreats limiting mechanism of the alar part 56 that use can flexibly be moved as pressing component 40, in the leading section that clip 26 is accommodated in sheath 28, with alar part 56, be folded under the state of pressing component 40, the elasticity meeting deterioration of alar part 56, thereby make under pressing component 40 situation outstanding from the leading section of sheath 28, alar part 56 can not expand out fully, and existence can not be brought into play fully as the situation that retreats the function of limiting mechanism.In the present embodiment, owing to use the fixed limiting mechanism that retreats that retreats restriction large-diameter portion 98 as pressing component 40, so, can avoid above-mentioned situation to take place, can limit retreating of pressing component 40 reliably.
In addition, owing to also need to keep biological tissue is carried out the state of ligation from sheath 28 front end after separatings at clip 26, so, between clip tine 42 and pressing component 40, need frictional force to a certain degree for clip tine 42 and pressing component 40 are fastened each other reliably.But, if frictional force is excessive, then can hinder clip tine 42 with respect to the advancing of pressing component 40, also might hinder clip tine 42 to expand and open.In the present embodiment, in the interim ligation that might carry out repeatedly, by making clip 26 carry out the switching of clip tine 42, thereby can avoid opening because of the frictional force between clip tine 42 and the pressing component 40 hinders clip tine 42 to expand with respect to sheath 28.
Claims (21)
1. apparatus for ligating, itself and endoscope are used in combination, and it is characterized in that, and this apparatus for ligating possesses:
Clip (26), it has: clip tine (42), carry out ligation to biological tissue and also can open and close; And pressing component (40), described clip tine (42) can be advanced and retreat and is contained in this pressing component (40) in the ground, and described clip tine (42) opens and closes with respect to described pressing component (40) advance and retreat and by the interaction with described pressing component (40);
Sheath (28), its with described clip (26) can advance and retreat and described clip tine (42) can not be exposed to outside mode and takes in;
Operating line (30), it can extend through in the described sheath (28) with advancing and retreat, and the leading section of this operating line (30) is connected with described clip tine (42), and this operating line (30) can make described clip (26) advance and retreat with respect to described sheath (28);
Advance and retreat limiting mechanism (50,52,54,56; 50,54,56,80,86; 50,52,54,98), in order to carry out ligation to biological tissue by described clip (26), this advance and retreat limiting mechanism limits described pressing component (40) in the leading section of described sheath (28) advance and retreat with respect to described sheath (28), can described clip tine (42) be advanced and retreat with respect to described pressing component (40) by the advance and retreat of described operating line (30) with respect to described sheath (28); And
Relieving mechanism (66,74,76,78; 74,80,86), it is carrying out described biological tissue under the state of ligation, and at least a portion of described clip (26) is discharged from described sheath (28).
2. apparatus for ligating according to claim 1 is characterized in that, described advance and retreat limiting mechanism (50,52,54,56; 50,54,56,80,86; 50,52,54,98) have: limit described pressing component (40) with respect to described sheath (28) retreat retreat limiting mechanism (54,56; 54,98); And limit progressive the advance limiting mechanism (50,52 of described pressing component (40) with respect to described sheath (28); 50,80,86).
3. apparatus for ligating according to claim 2 is characterized in that, the described limiting mechanism (54,56 that retreats; 54,98) have: be arranged on retreating in the described pressing component (40) and limit abutting part (56; 98); And be arranged in the described sheath (28), with the described restriction abutting part (56 that retreats that is configured in front; 98) butt, limit described pressing component (40) retreat retreat limit stop (54).
4. apparatus for ligating according to claim 3 is characterized in that,
Described pressing component (40) is can be from the leading section of described sheath (28) outstanding and submerge,
The described restriction abutting part that retreats has alar part (56), this alar part (56) flexibly and can expand out and contract and be arranged in the described pressing component (40) with closing, and under described pressing component (40) is incorporated in situation in the described sheath (28), contract and close, under the state that described pressing component (40) is given prominence to from described sheath (28), expand and open
Describedly retreat the front end that limit stop (54) is arranged on described sheath (28), described alar part (56) butt after opening with expansion limits the leading section that described pressing component (40) submerges described sheath (28).
5. apparatus for ligating according to claim 3 is characterized in that,
Described pressing component (40) and described sheath (28) are barrel shape roughly,
The described restriction abutting part that retreats forms by the restriction large-diameter portion (98) that retreats that external diameter in described pressing component (40) increases,
The described limit stop (54) that retreats forms by the restriction sheath minor diameter part that retreats that internal diameter in described sheath (28) reduces.
6. apparatus for ligating according to claim 5 is characterized in that,
Advance and retreat with respect to described sheath (28) by making described operating line (30), described clip (26) is not advanced and retreat with described retreating in the scope that limits sheath minor diameter part (48) butt at the described restriction large-diameter portion (98) that retreats with respect to described sheath (28), described clip tine (42) is opened and closed by the interaction with described sheath (28), thereby can carry out interim ligation to biological tissue
Retreat under the state that limits sheath minor diameter part (48) butt with described at the described restriction large-diameter portion (98) that retreats, by described operating line (30) is retreated with respect to described sheath (28), described clip tine (42) is retreated with respect to described pressing component (40), thereby can carry out formal ligation biological tissue.
7. apparatus for ligating according to claim 6 is characterized in that, biological tissue is being carried out under the situation of formal ligation, and described clip tine (42) is fixing with respect to described pressing component (40) by means of frictional force.
8. apparatus for ligating according to claim 2 is characterized in that, the described limiting mechanism that advances (50,52; 50,80,86) have: be arranged on the restriction abutting part (52 that advances in the described pressing component (40); 80,86); And be arranged in the described sheath (28), with the described restriction abutting part (52 that advances that is configured in rear end side; 80,86) butt limits the progressive limit stop of advancing (50) of described pressing component (40).
9. apparatus for ligating according to claim 8 is characterized in that,
Described pressing component (40) and described sheath (28) are barrel shape roughly,
The described restriction abutting part that advances forms by the restriction large-diameter portion that advances that external diameter in described pressing component (40) increases,
The described limit stop of advancing (50) forms by the restriction sheath minor diameter part that advances that internal diameter in described sheath (28) reduces.
10. apparatus for ligating according to claim 4 is characterized in that,
The described limiting mechanism that advances (50,52) has: be arranged on the restriction abutting part (52) that advances in the described pressing component (40); And be arranged in the described sheath (28), with described restriction abutting part (52) butt that advances, limit the progressive limit stop of advancing (50) of described pressing component (40),
Described pressing component (40) advance with respect to described sheath (28) and described advance restriction abutting part (52) and the described limit stop of advancing (50) butt in, described alar part (56) expands to be opened.
11. apparatus for ligating according to claim 8 is characterized in that,
This apparatus for ligating also possesses the link (44) that the leading section of described operating line (30) and described clip tine (42) are connected with each other,
Described relieving mechanism (66,74,76,78) has: the 1st fracture portion (74), it is arranged in the described link (44), thus can rupture make described clip tine (42) from the fore-end of described operating line (30) from; And the 2nd fracture portion (76), it is arranged on the front of the described restriction abutting part (52) that advances in described pressing component (40), thus the front that makes described pressing component (40) that can rupture is separated from described sheath (28).
12. apparatus for ligating according to claim 11 is characterized in that, described the 2nd fracture portion (76) has the weak frangible portion of other parts of the described pressing component of strength ratio (40).
13. apparatus for ligating according to claim 12 is characterized in that, about with the orthogonal cross section of the fore-and-aft direction of described pressing component, the sectional area of described frangible portion (76) is less than the sectional area of other parts of described pressing component (40).
14. apparatus for ligating according to claim 11 is characterized in that,
Described relieving mechanism (66,74,76,78) has: fastening portion (66), and it is arranged on the rear end side of described the 1st fracture portion (74) in described link (44); And fastening support portion (78), it is arranged on the rear end side of described the 2nd fracture portion (76) in described pressing component (40),
By described operating line (30) is retreated with respect to described sheath (28), thereby described the 1st fracture portion (74) fracture, described link (44) retreats, described fastening portion (66) fastening is in described fastening support portion (78), to described fastening support portion (78) towards the rear end side application of force, thereby described the 2nd fracture portion (76) fracture.
15. apparatus for ligating according to claim 14 is characterized in that,
Described pressing component (44) is barrel shape roughly, and described link (44) is the substantial cylindrical shape,
The fastening large-diameter portion formation that described fastening portion increases by external diameter in described link (44),
Described fastening support portion forms by the fastening minor diameter part (78) that internal diameter in described pressing component (40) reduces.
16. apparatus for ligating according to claim 9 is characterized in that,
This apparatus for ligating also possesses the link (44) that the leading section of described operating line (30) and described clip tine (42) are connected with each other,
The described limiting mechanism that advances (50,80,86) has: force section (86), and it is arranged on the leading section of described operating line (30); And expand reducing diameter part (80), but its flexibly and hole enlargement and undergauge be arranged in the described pressing component (40), by described force section (86) the radial outside application of force towards described pressing component (40), but thereby hole enlargement forms the described restriction large-diameter portion that advances,
Described relieving mechanism (74,80,86) has: the 1st fracture portion (74), it is arranged in the described link (44), thus can rupture make described clip tine (42) from the fore-end of described operating line (30) from; Described force section (86); And described expansion reducing diameter part (80), by described operating line (30) is retreated with respect to described sheath (28), thereby described the 1st fracture portion (74) fracture, described force section (86) retreats into than described expansion reducing diameter part (80) more by rear end side, described expansion reducing diameter part (80) undergauge, described pressing component (40) can be distolateral forward by the described restriction sheath minor diameter part (48) that advances.
17. apparatus for ligating according to claim 16, it is characterized in that, described expansion reducing diameter part (80) has lobe (84), this lobe (84) is outstanding towards the radially inner side of described pressing component (40), and by described force section (86) the radial outside application of force towards described pressing component (40).
18. apparatus for ligating according to claim 1 is characterized in that, described pressing component (40) has can make described clip tine (42) with respect to the progressive elastic (94 of described pressing component (40); 96).
19. apparatus for ligating according to claim 18 is characterized in that, retreats, makes described clip tine (42) to retreat with respect to described pressing component (40) by making described operating line (30) with respect to described sheath (28), described elastic (94; 96) produce strain, when discharging described operating line (30), described elastic (94; 96) by means of resilience force described clip tine (42) is advanced with respect to described pressing component (40).
20. apparatus for ligating according to claim 1, it is characterized in that, described pressing component (40) has bridge part (72), this bridge part (72) described clip tine (42) with respect to the progressive situation of described pressing component (40) under, open described clip tine (42) forcibly.
21. apparatus for ligating according to claim 1 is characterized in that,
Described pressing component (40) is barrel shape roughly, has the switching minor diameter part (92) that internal diameter reduces,
Described clip tine (42) has a pair of arm (60) of mutual switching,
Described a pair of arm (60) has: cross one another at least two cross sections (88); And the chevron part (90) that between two cross parts (88), is arranged on the bending shape in each arm (60),
By described clip tine (42) is advanced with respect to described pressing component (40), described chevron part (90) is inserted in the described switching minor diameter part (92), approaching mutually by described switching minor diameter part (92), thereby described a pair of arm (60) is opened, by described clip tine (42) is retreated with respect to described pressing component (40), described chevron part (90) is pulled out from described switching minor diameter part (92) and leaves mutually, thus described a pair of arm (60) closure.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP374333/2004 | 2004-12-24 | ||
| JP2004374333 | 2004-12-24 | ||
| JP232253/2005 | 2005-08-10 | ||
| JP2005232253A JP4758173B2 (en) | 2004-12-24 | 2005-08-10 | Ligation device |
| PCT/JP2005/023652 WO2006068242A1 (en) | 2004-12-24 | 2005-12-22 | Ligation device |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2009102211275A Division CN101695452B (en) | 2004-12-24 | 2005-12-22 | Ligation apparatus |
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| CN101087564A CN101087564A (en) | 2007-12-12 |
| CN101087564B true CN101087564B (en) | 2010-06-02 |
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| CN2005800444317A Active CN101087564B (en) | 2004-12-24 | 2005-12-22 | Ligation device |
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| JP (1) | JP4870139B2 (en) |
| CN (1) | CN101087564B (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9492176B2 (en) | 2011-11-11 | 2016-11-15 | Jian Zhu | Clamping and ligation device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101606856B (en) * | 2009-07-07 | 2011-12-28 | 中国人民解放军第三军医大学第二附属医院 | Biological tissue clamp device |
| JP5486983B2 (en) * | 2010-03-29 | 2014-05-07 | 富士フイルム株式会社 | Ligation device |
| JP5588711B2 (en) * | 2010-03-30 | 2014-09-10 | 富士フイルム株式会社 | Ligation device |
| JP5343113B2 (en) * | 2011-09-15 | 2013-11-13 | 富士フイルム株式会社 | Clip unit and ligating apparatus using the same |
| JP5480454B1 (en) | 2012-07-20 | 2014-04-23 | オリンパスメディカルシステムズ株式会社 | Hemostatic clip |
| US20140088616A1 (en) * | 2012-09-24 | 2014-03-27 | Boston Scientific Scimed, Inc. | Release mechanism for hemostatic clip |
| JP5927365B1 (en) * | 2014-08-19 | 2016-06-01 | オリンパス株式会社 | Medical treatment tool |
| CN105310738B (en) * | 2014-12-24 | 2017-12-26 | 石益海 | A kind of tear-away clamping device of three-clove style |
| EP3366236B1 (en) * | 2015-10-23 | 2021-10-13 | Hangzhou Ags Medtech Co., Ltd. | Ligation device |
| JP6274233B2 (en) * | 2016-02-23 | 2018-02-07 | 住友ベークライト株式会社 | Clip cartridge system |
| JP6663992B2 (en) | 2016-07-11 | 2020-03-13 | オリンパス株式会社 | Endoscope treatment tool |
| CN111163702B (en) * | 2017-10-02 | 2024-01-30 | 波士顿科学国际有限公司 | Device and method for tissue retraction |
| WO2020121394A1 (en) * | 2018-12-11 | 2020-06-18 | オリンパス株式会社 | Medical device |
| CN113194850A (en) * | 2018-12-28 | 2021-07-30 | 奥林巴斯株式会社 | Ligation device and engagement method |
| JP7183854B2 (en) * | 2019-02-20 | 2022-12-06 | 住友ベークライト株式会社 | Endoscope clip device |
| CN112704535B (en) * | 2019-10-25 | 2022-11-25 | 苏州英途康医疗科技有限公司 | Clamping device and surgical operation instrument |
| CN214414866U (en) * | 2019-11-14 | 2021-10-19 | 杭州安杰思医学科技股份有限公司 | Multiple treatment device for endoscope |
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| JPS63288147A (en) * | 1987-05-21 | 1988-11-25 | Olympus Optical Co Ltd | Clip device |
| JPH08126648A (en) * | 1994-11-02 | 1996-05-21 | Olympus Optical Co Ltd | Treatment instrument for endoscope |
| JP3776529B2 (en) * | 1996-02-29 | 2006-05-17 | オリンパス株式会社 | Clip device |
| GB9722203D0 (en) * | 1997-10-21 | 1997-12-17 | Univ London | Surgical clip |
| JP4080708B2 (en) * | 2001-06-19 | 2008-04-23 | ペンタックス株式会社 | Endoscopic clip device |
| JP3914462B2 (en) * | 2001-11-15 | 2007-05-16 | ペンタックス株式会社 | Endoscopic clip device |
| JP4311953B2 (en) * | 2003-02-20 | 2009-08-12 | Ｈｏｙａ株式会社 | Endoscopic clip device |
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- 2008-11-20 JP JP2008296824A patent/JP4870139B2/en active Active
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| JP特开2004-121485A 2004.04.22 |
| JP特开2004-305231A 2004.11.04 |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9492176B2 (en) | 2011-11-11 | 2016-11-15 | Jian Zhu | Clamping and ligation device |
Also Published As
| Publication number | Publication date |
|---|---|
| CN101087564A (en) | 2007-12-12 |
| JP4870139B2 (en) | 2012-02-08 |
| JP2009072611A (en) | 2009-04-09 |
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