JP2000102541A - Tissue ligating instrument for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a tissue ligating instrument for endoscope capable of surely ligating a sufficient quantity of tissue in a state that the continuous ligating function of the tissue is satisfied while keeping the observation visual field. SOLUTION: A plurality of elastic ligating rings 23-27 are fitted in a state that they are expanded to an outer periphery of a tubular member 12 mounted on a distal end of an endoscope, one thread like code 14 having the knots 30a-34a respectively engaged with the elastic ligating rings 23-27 is mounted, this thread like code 14 is extended from a distal opening end side of the tubular member 12 to a proximal side operating part of the endoscope through the tubular member 12, and the elastic ligating rings 23-27 are successively removed from the distal opening end of the tubular member 12 in order from one located at the distal side by drawing one thread like code 14, whereby the tissue is ligated.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a tissue ligating apparatus for an endoscope for continuously ligating a plurality of living tissue parts during gastric or esophageal varices treatment, polyp or mucosal resection.

[0002]

2. Description of the Related Art Conventionally, as a tissue ligating device capable of continuously ligating a living tissue in a body cavity, for example,
There is one disclosed in U.S. Pat. No. 5,462,559. As shown in FIG.
A tubular hood member b attachable to the distal end a of the insertion portion of the endoscope; a plurality of elastic ligating rings c0 to c9 supported in an expanded state on the outer peripheral surface of the hood member b; And a plurality of thread-like cords e and f which can be inserted into the lumen d of the section and all of which overlap under the above-mentioned ligating rings c0 to c9. The proximal portions of the thread-like cords e and f extend through the lumen d of the endoscope to the operation section of the endoscope.

[0003] An operator inserts an insertion portion of an endoscope into a body cavity,
The distal end of the hood member b is brought close to the target site, and a living tissue is sucked into the hood member b by applying a suction action through the lumen d of the endoscope. Then, by simultaneously pulling the plurality of thread cords e and f toward the proximal side, the elastic ligating rings c0 to c9 are sequentially dragged toward the distal side from the one located on the distal side of the hood member b.
A plurality of living tissue portions are individually ligated by detaching from the hood member b in the order of the distal side.

[0004]

The above U.S. Pat.
In the tissue ligation device disclosed in Japanese Patent No. 2,559,
Since the plurality of thread-like cords e and f are arranged so as to pass through the inside of the hood member b, the plurality of thread-like cords e and f are reflected in the observation image area of the endoscope, which hinders observation. In addition, the observation lens g of the endoscope is not usually on the center axis, but is deviated toward the outer peripheral direction to face the lumen d.
Here, if there is only one thread cord, the hood member b
By installing the thread-like cord and the observation lens g axisymmetrically when attaching to the distal end of the insertion portion of the endoscope, reflection of the thread-like cord can be minimized.

However, in a conventional tissue ligating apparatus,
Since a plurality of thread-like cords e and f need to be used, the thread-like cords e and f are arranged axially symmetrically with respect to the center of the hood member b. Therefore, as shown in FIG.
Are located immediately above the observation lens g, and at least the thread-like cord e obstructs the observation visual field. Further, when a living tissue is sucked into the hood member b, a plurality of thread-like cords e and f hinder a sufficient amount of tissue from being drawn in, making it difficult to securely ligate the tissue. There was a problem of becoming.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and an object of the present invention is to provide an endoscope with a good observation field of view while satisfying the function of continuous ligation of living tissue. In addition, it is an object of the present invention to provide a tissue ligating device for an endoscope that can reliably ligate a sufficient amount of living tissue.

[0007]

SUMMARY OF THE INVENTION The present invention relates to a tissue ligating apparatus for an endoscope, which is used in combination with an endoscope and ligates a part of a tissue in a body with an elastic ligating ring. A tubular member attachable to the distal end, having a distal open end, and capable of incorporating a portion of the tissue therein from the distal open end; A plurality of elastic ligating rings, and a portion passing through the tubular member from the outer periphery of the tubular member through the distal opening end side and extending to a proximal operation portion of the endoscope. A flexible wire element provided with a plurality of engaging members separately engaged with the respective elastic ligating rings on a portion located on the outer periphery of the tubular member; and a proximal end of the flexible wire element. And the flexible wire element is pulled by pulling the flexible wire element. Those provided with the operation means for tripping the said tubular member in order from one located the resilient ligature rings for locking the child distally.

[0008] The operator guides the endoscope to a target site in the body cavity, supplies water through the lumen of the endoscope as needed, and cleans the periphery of the target site. Then, after confirming the target site, the distal end of the tubular member is brought into contact with the target site, and a negative pressure is applied through the lumen of the endoscope, for example, to aspirate the living tissue into the tubular member. Then, by pulling the flexible wire element toward the proximal side, the distalmost elastic ligature ring expanded and held on the outer periphery of the tubular member is sent to the distal side of the tubular member, and is removed from the tubular member. When the flexible wire element is further pulled toward the proximal side, the elastic ligature rings are sequentially disengaged from the tubular member from the distal side, and continuous ligations of a plurality of living tissues are performed.

[0009]

DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] A first embodiment of the present invention will be described with reference to FIGS. (Structure) FIG. 1 is an explanatory view showing a state in which a tissue ligating device 2 for an endoscope is mounted on an endoscope 1. The endoscope 1 has an operation portion 3 and an insertion portion 4 connected thereto. A lumen 6 extending from the insertion opening 5 of the operation portion 3 to the distal end of the insertion portion 4 penetrates the operation portion 3 and the insertion portion 4. Is provided. Lumen 6 at insertion part 4
Penetrates parallel to the axial direction of the insertion portion 4. The opening of the distal end of the lumen 6 is not located on the center axis of the insertion section 4, but is displaced to the opposite side to the observation lens (observation window) 7. FIG.
As shown in the figure, the lumen 6
And the observation lens 7 are disposed at axially symmetric positions.

The tissue ligating apparatus 2 for an endoscope has a hood-like tubular member 12 fitted on a distal end portion 11 of an insertion portion 4 of the endoscope 1.
And is detachably attached to the distal end portion 11 of the insertion portion 4 using the Further, the tissue ligating device 2 for an endoscope has a soft thread-like cord 14 as one flexible wire element, and the thread-like cord 14 passes through the lumen 6 of the endoscope 1 to operate the operation unit. 3 and is detachably connected to a cord operating device 18 which is fixedly attached to the insertion opening 5.

At the proximal end of the cord 14 is fixed a spherical fixed end 19 which can be fixedly connected to the cord operating device 18. The thread cord 14 is divided into a first portion 14 a located on the outer periphery of the tubular member 12 and a second portion 14 b disposed inside the endoscope 1 from inside the tubular member 12. The second portion 14b is disposed on the outer peripheral surface of the tubular member 12 so as to overlap with a plurality of elastic ligating rings 23 to 27 described later.

The outer periphery of the tubular member 12 is formed to have a slightly tapered tip end, and a plurality of elastic ligature rings 23 to 27 are fitted around the outer periphery of the tubular member 12 in an expanded state. The second portion 14b is sandwiched and overlapped, and is engaged with the thread cord 14. The elastic ligating rings 23 to 27 are arranged side by side in the longitudinal (axial) direction of the tubular member 12 at a constant interval by leaving a slight gap therebetween.

On the other hand, a series of longitudinally spaced nodes 30a-34a and nodes 30b-34b are provided at the first portion 14a of the thread-like cord 14 disposed on the outer periphery of the tubular member 12.
Are fixed alternately at intervals. These clauses 30
a to 34a, 30b to 34b are all thread-like cords 14;
It is formed into a spherical shape having a diameter larger than the diameter of the elastic ligating rings 23 to 27 and has an anchoring function for locking the elastic ligating rings 23 to 27 from behind.

As shown in FIG. 4, when five elastic ligating rings 23 to 27 are mounted, a set of nodes 30a and 30b is located between the elastic ligating rings 23 and 24, Nodes 31a, 3 between rings 24, 25
1b, the set of nodes 32a, 32b is located between the elastic ligating rings 25, 26, and the elastic ligating rings 26, 2
7, a set of nodes 33a, 33b is located, and after the elastic ligating ring 27, a set of nodes 34a, 34b is located. Then, each set of nodes 30a, 30b, 31a, 31b, 32
a, 32b, 33a, 33b, 34a, 34b respectively have elastic ligating rings 23-2 adjacent to the distal side.
7 is in a standby position. In such a positional relationship, each of the sets has a corresponding elastic ligating ring 23 to
27 are separately engaged with each other.

That is, each of the nodes 30a to 34a and 30b to 3
4b,... Are the elastic ligating rings 2 with which they are engaged.
3 to 27 are located on the proximal end side (hand side).
When the cord 14 is pulled by the cord operating device 18 as described later, a sliding operation is given on the outer periphery of the tubular member 12, and the elastic ligating rings 23-
27 are sequentially removed from the distal end (distal end) of the tubular member 12 in the order in which they are arranged.

A thread-like cord 14 sandwiched under the elastic ligating rings 23 to 27 on the outer periphery of the tubular member 12
Is located along the longitudinal direction of the tubular member 12 and passes under the elastic ligating rings 23 to 27 at the shortest distance. Also, between the elastic ligating rings 23 to 27, a set of nodes 30a located therebetween
, And a portion that is wound between the outer periphery of the tubular member 12 and 30b.
There is a portion extending from −34b to the proximal side and existing in a slack state. First, the length of the slack portion 35 of the thread-like cord 14 located between the elastic ligating rings 23 and 24 is longer than the distance from the distal end 28 of the tubular member 12 to the elastic ligating ring 24. Next, the length of the slack portion 36 of the cord 14 located between the elastic ligating rings 24, 25 is longer than the distance from the distal end 28 of the tubular member 12 to the elastic ligating ring 25. Further, the length of the slack portion 37 of the thread-like cord 14 located between the elastic ligating rings 25 and 26 is longer than the distance from the distal end 28 of the tubular member 12 to the elastic ligating ring 26. The length of the slack portion 38 of the thread-like cord 14 located between the elastic ligating rings 26 and 27 is longer than the distance from the distal end 28 of the tubular member 12 to the elastic ligating ring 27.

Therefore, the slack portions 35, 36, 3
When any of the elastic ligature rings 23 to 26 except for the last elastic ligature ring 27 is moved toward the distal side of the tubular member 12,
Until disengaged from the distal end 28 of the tubular member 12, the thread cord 14 does not pull the next elastic ligature ring 24-27 and does not move another elastic ligature ring 24-27 to be continued. .

The nodes 30a and 30b, 31a and 31
b, 32a and 32b, 33a and 33b, 34a and 34b
Are arranged on the outer peripheral surface of the tubular member 12 at positions that are 180 degrees diagonally separated from each other.

Incidentally, the elastic ligating rings 23 to 27
Is made of a material such as polyisoprene rubber or natural rubber so that it can be expanded to the outer diameter of the tubular member 12 and has a sufficient shrinkage and restoring force to ligate the living tissue off the outer periphery of the tubular member 12. Once formed, the dimensions in the restored, shrunk form typically have an inner diameter of 1.5 to 2 mm and an outer diameter of 4 to
It is formed in a range of 6 mm.

The tubular member 12 has sufficient supporting strength so that it does not deform even when the plurality of elastic ligating rings 23 to 27 are fitted. Further, it is formed of a resin having a level of transparency that does not hinder observation by the endoscope 1, for example, a material such as polycarbonate, polystyrene, and acrylic resin.

Further, the thread cord 14 is made of a flexible material having a sufficient strength against a pulling force required for removing the elastic ligating rings 23 to 27 from the tubular member 12, for example, an outer diameter of 0.2. It is formed of a polyamide, polyester thread, stainless wire or the like having a thickness of about 0.5 mm.

On the other hand, as shown in FIGS. 5 to 7, the cord operating device section 18 has an operating section main body 41. The operating section main body 41 has a winding handle 42 and the endoscope 1 described above.
The operation shaft 3 is provided with a mounting shaft 43 that can be fitted and engaged with the opening of the insertion opening 5 in the operation unit 3. A winding drum 45 is connected to a shaft 44 to which the winding handle 42 is fixed. A flange 46 is formed at one end of the winding drum 45, and a plurality of locking teeth 47 are cut out at a part of the outer periphery of the flange 46. A claw 48 that meshes with and engages with the locking teeth 47 is fixed to the operation section main body 41. The claw 48 is made of an elastic piece, and one end of the claw 48 is connected to a pin 50 attached to the operation section main body 41. The pawl 48 is adapted to engage only with the shoulder 49 of the locking tooth 47. The direction of the shoulder 49 and the thread cord 14
The winding handle 42 can rotate in the direction C, but cannot rotate in the reverse direction. However, this cancellation is possible.

A water supply mouthpiece 51 communicating with the inside of the mounting shaft 43 is fixed to the operation section main body 41, and a water supply syringe can be attached to an open end of the water supply mouthpiece 51, as shown in FIG. As described above, the seal 52 for preventing water leakage at the time of water supply is attached to the opening end by the screw ring 53.

(Operation) The manufacturer squeezes a plurality of, here three elastic ligatures while sandwiching the first portion 14a consisting of the distal end portion of the thread cord 14 around the outer periphery of the tubular member 12 of the tissue ligating device 2. The rings 23 to 25 are overlapped and fitted. At this time, as described above, each elastic ligating ring 23
, And after the last elastic ligating ring 25, each set of nodes 30a to 32a, 30b to 32b is arranged (see FIG. 4).

The operator attaches the tubular member 12 of the tissue ligating device 2 to the distal end portion 11 of the insertion portion 4 of the endoscope 1 by fitting the same, and attaches the thread-like cord 14 to the lumen 6 of the endoscope 1.
Then, the fixed end 19 of the proximal end of the thread cord 14 is pulled out from the insertion opening 5 of the operation section 3 of the endoscope 1. At this time, as shown in FIG. 3, the position of the thread-like cord 14 in the tubular member 12 is made to coincide with the deviation direction A of the distal end opening of the lumen 6. Therefore, the observation lens 7 is located on the opposite side. As a result, the thread-like cord 14 does not appear in the field of view of the endoscope 1.

The fixed end 19 of the thread cord 14 is fixed to the winding drum 45 of the cord operating unit 18, and thereafter the cord operating unit 18 is attached to the operating unit 3 of the endoscope 1.
Then, the insertion section 4 of the endoscope 1 is inserted into the lesion 55 while observing the inside of the body cavity, and as shown in FIG.
Is positioned in contact with the mucous membrane around the lesion 55. If a clot or mucus adheres to the periphery of the lesion 55 and obstructs the observation of the lesion 55, a device such as a syringe (not shown) is attached to the water supply nozzle 51. Then, water is pumped through the lumen 6 of the endoscope 1 to remove and adhere the attached matter.

With the distal end 28 of the tubular member 12 positioned in contact with the mucous membrane around the lesion 55, the surgeon applies suction through the lumen 6 of the endoscope 1 so that the inside of the tubular member 12 is removed. The pressure in the cavity is reduced, and the lesion 55 is placed in the tubular member 1.
Pull into 2. At this time, there is only one thread cord 14, and since it is deviated from the central axis of the tubular member 12 inside the tubular member 12, it hardly hinders the retraction movement of the lesion 55.

Next, when the operator rotates the take-up handle 42 of the cord operating device 18, the take-up drum 45 rotates to follow up, and the thread cord 14 is taken up on the outer periphery of the take-up drum 45. At this time, a pulling force acts on the thread-like cord 14, and a reaction acts to rotate the winding drum 45 in a direction opposite to the winding direction C, but the claw 48 engages with the shoulder 49 of the locking teeth 47. Therefore, the winding drum 45 does not rotate in the reverse direction.

As described above, by winding the thread-like cord 14 on the winding drum 45, the node 30a engaged with the first elastic ligating ring 23 located at the most distal side as shown in FIG. As it moves distally, the portion 23a of the first elastic ligating ring 23 is slid to the distal end 28 of the tubular member 12.

By further winding the cord 14, the remaining portion 23b of the first elastic ligating ring 23 also comes off the distal end 28 of the tubular member 12 as shown in FIG. Then, the entire first elastic ligating ring 23 is fitted on the root portion of the lesion 55, contracts by its own restoring action to the diameter before expansion, and ligates the lesion 55.

While the first elastic ligating ring 23 is being transferred by the joint 30b of the thread-like cord 14, the next elastic ligating ring 24
The slackened portion 35 of the thread-like cord 14 located between them is linearized to absorb the movement amount of the thread-like cord 14, and the tensile force of the thread-like cord 14 is reduced to the next set of nodes 31.
It does not act on a and 31b. Thus, until the first elastic ligating ring 23 is disengaged from the distal end 28 of the tubular member 12, the subsequent elastic ligating rings 24-27 do not act at all, and the subsequent elastic ligating rings 24-27 follow. It does not move on the tubular member 12.

Subsequently, the operator moves the endoscope 1 to another lesion 55 and aspirates and retracts the lesion 55 into the tubular member 12. Then, after confirming the lesion site with the endoscope 1, the thread-like cord 14 is wound around the winding drum 4 as described above.
5, the second elastic ligating ring 24 engaged with the nodes 31a, 31b is displaced in the distal direction,
The lesion 55 is ligated off the distal end 28 of the tubular member 12.

Subsequently, by the same operation as described above, the nodes 32a to 34a, 32b to 34b, and the third and fourth elastic ligating rings 25 to 27 are respectively sequentially drawn out, and a total of five ligating rings 25 to 27 are continuously drawn. The affected part 55 can be ligated.

(Effect) In this embodiment, the thread cord 14
Is only one, and the nodes 30a-34a, 30b-
By engaging two elastic ligating rings 23-27 with each other, the elastic ligating rings 23-27 can be securely connected from the distal end 28 of the tubular member 12 without impairing the operation of the elastic ligating rings 23-27. The lesion 55 can be removed and ligated. In addition, since there is only one thread cord 14 at the time of observation, reflection in the field of view of the endoscope 1 can be suppressed to a minimum. Further, when the lesioned part 55 is sucked and drawn into the inside of the tubular member 12,
Is less likely to interfere with a sufficient amount of tissue to be aspirated, making reliable ligation difficult.

[Second Embodiment] A second embodiment of the present invention will be described with reference to FIGS. The same components as those in the first embodiment described above are denoted by the same reference numerals, and description thereof will be omitted.

(Construction) In the second embodiment, the thread-like cord 14 is not loosened between the elastic ligating rings 23 to 27 and is tightly wound around the outer peripheral surface of the tubular member 12. (See FIG. 12). In the above-described first embodiment, the slack portions 35 to 38 are used.
Is formed to secure the length from the distal end 28 of the tubular member 12, but in the second embodiment,
The length is secured by being wound around the outer peripheral surface of the tubular member 12 (in FIG. 12, a winding portion indicated by a dotted line is a corresponding portion).

(Operation) When the thread-like cord 14 is wound on the winding drum 45 of the cord operating unit 18, the first elastic ligating ring 23 located at the most distal side is connected to the nodes 30a, 30b engaged with the first elastic ligating ring 23. With the continuous movement in the distal direction, the tubular member 12 is moved to the distal end 28 and detached in the same manner as in the above-described embodiment, and the ligated portion 55 is ligated.
At this time, especially when the rear joint 30b is moved,
The portion of the thread cord 14 following the node 30b is the tubular member 1
It can be solved from the outer circumference of 2. This prevents the second elastic ligating ring 24 from being pulled. Therefore, while the first elastic ligating ring 23 is moving, the second elastic ligating ring 24 and the following elastic ligating rings 25 to 27
Rests on the tubular member 12 and does not move.

Subsequently, the next lesion 55 is taken into the tubular member 12 and moved, and the thread cord 14 is wound around the winding drum 45.
The next nodes 31a and 31b are
The second elastic ligating ring 24 is caught on the second elastic ligating ring 24 and is moved and removed from the tubular member 12 to ligate the next lesion 55. Hereinafter, nodes 32a to 34
A, 32b to 34b, and the rings 25 to 27 are sequentially operated in the same manner as described above, so that the lesion 55 can be continuously ligated.

(Effect) Since the thread cord 14 does not exist in a loose state between the elastic ligating rings 23 to 27, the insertability of the endoscope 1 is not impaired, and there is little hindrance to observation.

<Supplementary Notes> Used in combination with an endoscope, in an endoscope tissue ligating device for ligating a part of the tissue in the body with an elastic ligating ring, it can be attached to the distal end of the endoscope, the distal open end Having a tubular member capable of taking in a part of the tissue from the distal open end thereof, a plurality of elastic ligating rings fitted in an expanded state on the outer periphery of the tubular member, and The portion passing through the tubular member via the distal open end side is one, and extends to the proximal operation portion of the endoscope, and the portion located on the outer periphery of the tubular member includes A flexible wire element provided with a plurality of engagement members separately engaging with each of the elastic ligating rings; and a connectable to a proximal end of the flexible wire element and towing the flexible wire element. The elastic ligating ring that locks to the engaging element is located on the distal side The endoscopic tissue suturing device characterized by comprising an operation means for tripping the said tubular member in order from the.

2. 2. The tissue ligating device for an endoscope according to claim 1, wherein a plurality of engaging elements engaging with each of the elastic ligating rings are fixed in the middle of the flexible wire element. 3. Item 2 is characterized in that two engaging elements which engage with one of the elastic ligating rings are disposed at a position separated by an angle of 180 ° on the peripheral surface of the tubular member. The tissue ligating device for an endoscope according to claim 1. 4. The length of the flexible wire element from one after the one or more engaging elements engaging the distal elastic ligating ring to the engaging element engaging the next elastic ligating ring from the next elastic ligating ring The tissue ligating device for an endoscope according to any one of claims 1 to 3, wherein the length is equal to or longer than a length up to a distal end of the tubular member, and the portion is loosely loose.

5. 1 to engage the distal elastic ligating ring
The length of the flexible wire element from the one after one or more engaging elements to the engaging element engaging the next elastic ligating ring is equal to or greater than the length from the next elastic ligating ring to the distal end of the tubular member. The tissue ligating device for an endoscope according to any one of claims 1 to 3, wherein the portion is wound around the outer periphery of the tubular member. 6. The tissue for an endoscope according to any one of claims 1 to 5, wherein a portion of the flexible wire element on the outer periphery of the tubular member is sandwiched between an outer peripheral surface of the tubular member and an elastic ligating ring. Ligation device. 7. 7. The tissue ligating device for an endoscope according to any one of claims 1 to 6, wherein the flexible wire element is a single wire over its entire length.

[0043]

As described above, the present invention comprises only one flexible wire element which is provided with an engaging element which engages with the elastic ligating ring and which detaches the elastic ligating ring from the distal end of the tubular member. Therefore, it is possible to minimize the reflection of the flexible line element into the field of view during observation, and when the tissue is taken into the tubular member, the flexible line element becomes a hindrance, and There is no such thing as not being able to take in an amount of tissue or making reliable ligation difficult. In addition, the flexible wire element is provided with an engagement member that engages with an elastic ligating ring, whereby the elastic ligating ring is pulled off from the distal opening end of the tubular member. The elastic ligature ring can be reliably pulled off from the end, and the tissue can be ligated reliably.

[Brief description of the drawings]

FIG. 1 is a schematic structural explanatory view showing a state in which a tissue ligating device for an endoscope according to a first embodiment is mounted on an endoscope.

FIG. 2 is a perspective view of the tissue ligating device for an endoscope mounted on a distal end portion of the endoscope.

FIG. 3 is an explanatory view of the tissue ligating device for an endoscope as viewed from the front.

FIG. 4 is a longitudinal sectional view of the endoscope tissue ligation device mounted on the distal end of the endoscope.

FIG. 5 is a side view of a cord operating device of the tissue ligating device for an endoscope.

FIG. 6 is a plan view of a cord operating device of the tissue ligating device for an endoscope.

FIG. 7 is a vertical cross-sectional view of the cord operating device taken along the line DD in FIG. 5;

FIG. 8 is an explanatory diagram of an operation procedure when a lesion is ligated by the tissue ligating device for an endoscope.

FIG. 9 is an explanatory diagram of an operation procedure when a lesion is ligated by the tissue ligating device for an endoscope.

FIG. 10 is an explanatory view of an operation procedure when a lesion is ligated by the tissue ligating device for an endoscope.

FIG. 11 is an explanatory diagram of an operation procedure when a lesion is ligated by the tissue ligating device for an endoscope.

FIG. 12 is a perspective view of a tissue ligating device for an endoscope according to a second embodiment.

FIG. 13 is an explanatory diagram of an operation procedure when ligating a lesion by the endoscope ligating device.

FIG. 14 is an explanatory diagram of an operation procedure when ligating a lesion by the tissue ligating device for an endoscope.

FIG. 15 is an explanatory diagram of an operation procedure when ligating a lesion by the tissue ligating device for an endoscope.

FIG. 16 is an explanatory diagram of an operation procedure when a lesion is ligated by the tissue ligating device for an endoscope.

FIG. 17 is a cross-sectional view of a use state of a conventional tissue ligating device for an endoscope.

FIG. 18 is a front view of a conventional ligating device for an endoscope.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Tissue ligation apparatus for endoscopes, 3 ... Operation part,
4 insertion section, 5 insertion slot, 6 lumen, 7 observation lens, 11 tip of insertion section, 12 tubular member, 13
Adapter part, 14 ... thread-like cord, 18 ... cord operating device part, 23-27 ... elastic ligating ring, 28 ... distal end of tubular member, 30a-34a ... node, 30b-34b ... node, 42
... winding handle, 45 ... winding drum, 55 ... lesion.

Claims (1)

[Claims] 1. A tissue ligating device for an endoscope, which is used in combination with an endoscope and ligates a part of a tissue in a body with an elastic ligating ring, wherein the device can be attached to a distal end of the endoscope. A tubular member having a distal open end and capable of capturing a portion of the tissue therein from the distal open end; a plurality of elastic ligating rings fitted in an expanded state around the outer periphery of the tubular member; A single portion passes through the tubular member from the outer periphery of the member via the distal opening end side and extends to the proximal operation portion of the endoscope, and is located on the outer periphery of the tubular member. A flexible wire element having a plurality of engaging members separately engaged with each of the elastic ligating rings; a flexible wire element connectable to a proximal end of the flexible wire element; By pulling the wire element, the elastic ligature ring locked to the above-mentioned engaging element is moved away. Operating means for sequentially pulling out of the tubular member from the one located on the distal side, the tissue ligating device for an endoscope.