JP2000287981A - Indwelling clip in cavity in living body - Google Patents

Abstract

PROBLEM TO BE SOLVED: To only continuously push a clip without pulling an operating wire to several steps when the clip pinches tissues of a living body and is indwelt in a cavity in the living body. SOLUTION: A clip 1 which is freely removably mounted on the apex part 3a of an operating pipe 3 which can be inserted into a cavity in a living body and is pushed out of the operating pipe by means of an operating wire 4 freely back and forth inserted into this operating pipe is provided and the clip has a closing and contracting way in a direction of closing the apex part of a pair of arm bodies 1b extending from the base end part 1a and a guiding rib 6 formed on the inside face of the apex part of the operating pipe is fitted between facing faces 5a of projected parts 5 provided on the side parts of these arm bodies and in addition, these arm bodies are extended in the direction separating the apex parts of the arm bodies by means of a width-extending rib 7 formed continuously to this guiding rib and after the arm bodies pass through this width-extending rib, the arm bodies close together based on the closing and contracting way.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an in-vivo indwelling clip used for hemostasis or marking of a treatment site in a living body cavity.

[0002]

2. Description of the Related Art Conventionally, as this kind of in-vivo indwelling clip, for example, a clip disclosed in Japanese Utility Model Publication No. 4-26091 and a clip disclosed in Japanese Patent Publication No. 8-17778 are known. .

As shown in FIGS. 16 and 17, these conventional in-vivo indwelling clips have a base end 21a, and a holding portion 21c is provided at the end of a pair of arm bodies 21b extending from the base end 21a. A clip 21 which is formed and has an open expansion property for expanding the arm body 21b in a direction in which the holding portions 21c are separated from each other, and a distal end of an operation tube 23 which is inserted into an introduction tube 22 which can be inserted into a living body cavity so as to advance and retreat. Removably attached to,
A clip tightening ring 21d for closing the clipping portion 21c of the clip 21 by being fitted to and attached to the arm body 21b of the clip 21, and can be inserted through the tightening ring 21d to engage with the clip 21. And a connecting member 25 removably engaging with a hook 24a attached to the tip of an operating wire 24 which is inserted into the operating tube 23 so as to be able to advance and retreat.
A deformable hook 26 is provided at the connection end with the clip 1 and is engaged with the clip 21.

[0004] The conventional in-vivo indwelling clip configured as described above is inserted into the living body cavity through a forceps channel of an endoscope in a state of being housed in the introduction tube 22.
The operation tube 23 is pushed out to the introduction tube 22, and the clip 2
1 is pushed out of the introduction tube 22. The arm body 21b of the clip 21 expands because it is provided with an open learning property.
Thereafter, by pulling the operation wire 24 toward the user, the base end 2 of the clip 21 is inserted into the clip tightening ring 21d.
1a is crushed and retracted. As a result, FIG.
As shown in FIG. 8, the arm 21b of the clip 21 is opened.

With the arm 21b of the clip 21 open, the clip 21 is pressed against a living tissue S that requires clipping. In this state, when the operating wire 24 is further pulled forward, the arm 21b of the clip 21 hits the opening of the clip tightening ring 21d and is drawn into the clip tightening ring 21d.
Is closed, and the holding portion 21c holds the living tissue S.

Then, by pulling the operation wire 24 further forward, as shown in FIGS.
5 is extended, and the clip 21 is connected to the connecting member 2.
Deviate from 5. Since the clip tightening ring 21d presses the arm 21b of the clip 21, FIG.
As shown in (2), the clip 21 does not come off, and is placed together with the clip 21 in the body cavity.

[0007]

However, in the conventional clip to be placed in a living body cavity, the living tissue S
When the arm 21b of the clip 21 is opened, the arm 2
When pulling 1b into the clip tightening ring 21d,
The operation wire 2 is divided into three stages when the hooks 26 of the connecting member 25 are extended to detach the clip 21 from the connecting member 25.
4 must be pulled toward the user, and this operation is troublesome, and when the hook 26 of the third-stage connecting member 25 is extended, the operating wire 24 must be pulled toward the user with a considerable force. And the operability was very poor.

Further, in the conventional indwelling clip in a living body cavity, as shown in FIG.
When opening 1b and pressing against the living tissue S requiring clipping, the clip 21 may swing because the base end 21a of the clip 21 is merely hooked on the hook 26 of the connecting member 25. However, there is a problem that it may not be possible to properly press against the living tissue S that requires the above.

[0009] In a conventional indwelling clip in a living body cavity,
Since only one piece is housed in the introduction tube 22 and inserted into the body cavity through the forceps channel of the endoscope, each time one portion of the living tissue S is clipped, the introduction tube 22
Is pulled out of the forceps channel of the endoscope, and the introduction tube 2 is
2 has to be stored again and inserted again into the body cavity through the forceps channel, which has a problem that this operation is very troublesome. Moreover, in order to re-store the new in-vivo indwelling clip in the introduction tube 22, the connection member 25 remaining after engaging with the hook 24a at the tip of the operation wire 24 is removed.
The connecting member 25 of the new in-vivo indwelling clip has to be engaged with 4a, and there is a problem that this operation is also very troublesome.

Accordingly, the present invention is to solve the problem of the above-mentioned conventional in-vivo indwelling clip, and when the living tissue is sandwiched and indwelled in the living body cavity, the operation wire is pulled in several steps. Even if it does not need to be kept pressed, even when the clip arm is opened and pressed against the living tissue that needs clipping, the clip does not swing and can be pressed well against the living tissue that needs clipping It is intended to provide an indwelling clip in a living body cavity.

Further, according to the present invention, two pieces of the living tissue can be clipped at a plurality of places in the living tissue by inserting the two pieces into the body cavity through the forceps channel of the endoscope in a state where two pieces are housed in the introduction tube as necessary. In this case, it is convenient to use a new clip in the living body cavity. An object of the present invention is to provide an in-vivo indwelling clip that does not require a complicated operation such as a need to engage members.

[0012]

Therefore, the clip for indwelling in a living body cavity according to the present invention is provided with an operating tube 3 which can be inserted into the living body cavity.
The clip 1 is detachably attached to the distal end portion 3a of the base member 1 and is pushed out of the operation tube 3 by an operation wire 4 inserted into the operation tube 3 so as to be able to move forward and backward. It has a closing behavior in the direction of closing the distal ends of the pair of extending arms 1b, and between the opposing surfaces 5a of the protrusions 5 provided on the sides of the arms 1b.
The guide rib 6 formed on the inner surface of the distal end portion 3a of the operation tube 3 is fitted, and the wide end rib 7 formed continuously with the guide rib 6 separates the distal end of the arm body 1b. The arms 1b are expanded in the direction, and after passing through the widening ribs 7, the arms 1b are closed by their closing behavior.

[0013] In the in-vivo indwelling clip according to the present invention, two clips may be attached to the distal end of the operation tube.

Further, in the in-vivo indwelling clip of the present invention, a notch may be provided at a distal end portion of the operation tube so that the expanded arm body can enter.

[0015]

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, an embodiment of a clip to be placed in a living body cavity according to the present invention will be described in detail with reference to the drawings.

The in-vivo indwelling clip 1 of the present invention is detachably attached to a distal end portion 3a of an operating tube 3 which is inserted into an introducing tube 2 which can be inserted into a living body cavity so as to be able to advance and retreat. It is configured to be pushed out of the operation tube 3 by an operation wire 4 inserted thereinto so as to be able to advance and retreat. Although the operation tube 3 is inserted into the introduction tube 2 so as to be able to advance and retreat, the operation tube 3 may be omitted. The clip 1 has a closing behavior in a direction to close the distal ends of the pair of arms 1b extending from the base end 1a, and projecting portions provided on both sides of the arms 1b. The guide rib 6 formed on the inner surface of the operation tube 3 opposite to the distal end portion 3a is fitted between the opposing surfaces 5a. Further, the widened ribs 7 formed continuously with the guide ribs 6 expand the arm bodies 1b in a direction in which the distal ends of the arm bodies 1b are separated from each other. Moreover, after passing through the widening rib 7, the arm 1b is closed by its closing behavior.

The clip 1 is preferably made of a metal such as stainless steel or a titanium alloy. A long body of such a metal is bent at a central portion, and the bent portion is bent at the base end 1.
a, the distal end of the arm body 1b is bent so as to be opposed to form a holding portion 1c. The upper and lower surfaces and both side surfaces of the arm body 1b are curved or flat. Further, an opposing surface 5a of the projecting portion 5 provided on a part of both side surfaces of the arm body 1b has a flat central portion and both end portions have inclined surfaces. The pipe 3 has a curved surface along the inner peripheral surface. Although only one clip 1 is normally mounted on the distal end portion 3a of the operation tube 3, FIGS.
As shown in FIG.

The introduction tube 2 is made of a flexible tube made of a tetrafluoroethylene resin or the like, and can be inserted into a living body cavity using, for example, a channel of an endoscope. In addition,
The introduction tube 2 is for preventing damage to the channel of the endoscope and the living body cavity. The proximal end of the introduction tube 2 is connected to an operation device (not shown) on the hand side.

The operation tube 3 is a flexible tube formed by tightly winding a stainless steel wire, and a straight tube 8 made of a stainless steel short tube or the like is attached at the tip. The guide ribs 6 are formed on opposed inner surfaces, and the widening ribs 7 are formed continuously from the guide ribs 6. It is preferable that the guide rib 6 has a linear shape and its outer peripheral surface is a curved surface.
Is formed with an inclined surface 7a which expands toward the distal end of the operation tube 3. Further, it is preferable that the widening rib 7 is formed at the forefront of the operation tube 3. However, when the arm 1 b of the clip 1 is expanded, the arm 1 b is moved from the distal end of the operation tube 3. As long as it is within the protruding range, it may be formed at a position deeper from the tip of the operation tube 3. In this case, an arm 1b of the clip 1 is attached to the distal end 3a of the operation tube 3.
In order not to hinder the expansion of the arm, a notch 9 into which the expanded arm body 1b enters can be provided as shown in FIGS. The proximal end of the operation tube 3 is connected to an operation device (not shown) on the hand side.

The operation wire 4 is a flexible member made of a stainless steel wire or the like, and a push body 10 is attached to a distal end of the operation wire 4. The pressing body 10 has a holding hole 10a for holding the base 1a of the clip 1. Further, the proximal end of the operation wire 4 is connected to an operation device (not shown) on the hand side.

In order to use the in-vivo indwelling clip of the present invention configured as described above, the following is performed.

First, when the operating wire 4 is pulled backward by the operating device, the operating wire 4 is pulled into the operating tube 3. In this state, the clip 1 is attached to the operation tube 3 from the tip of the operation tube 3 using tweezers or the like.
Insert In this case, the projecting portion 5 of the clip 1 is prevented from contacting the widening rib 7 of the operation tube 3 so that the clip 1
Is inserted into the operation tube 3 from the base end 1a side of the base end 1a.
In the holding hole 10a of the pressing body 10 of the operation wire 4,
By rotating the clip 1 in the operation tube 3, the facing surface 5a of the projecting portion 5 of the clip 1 as shown in FIGS.
In between, the guide rib 6 on the inner surface of the straight pipe 8 of the operation pipe 3 is fitted. When two clips 1 are attached to the distal end portion 3a of the operation tube 3, these second clips 1 are rotated by using tweezers or the like, as shown in FIGS. 6 and 10. The guide rib 6 on the inner surface of the straight tube 8 of the operation tube 3 is fitted between the facing surfaces 5a of the protrusions 5 of the clip 1.

Next, when the operating wire 4 is advanced by pushing the operating wire 4 toward the distal end by the operating device, the clip 1 is pushed by the advance of the operating wire 4, and the projecting portion 5 of the clip 1 The clip 1 advances to the front end side along the line. When the operation wire 4 is continuously pushed toward the distal end, the projecting portion 5 of the clip 1 is
The arm 1b is expanded by the expanding rib 7 in a direction to separate the holding portion 1c at the distal end of the arm 1b by the expanding rib 7, as shown in FIG. In this case, in the case where two clips 1 are attached to the distal end portion 3a of the operation tube 3, the first clip 1 is pushed by the second clip 1 which is pushed similarly by the advance of the operation wire 4. The projecting portion 5 is guided along the guide rib 6 of the operation tube 3, and the clip 1 advances to the distal end side.
When the operation wire 4 is continuously pushed toward the distal end, the projecting portion 5 of the first clip 1 is moved to the guide rib 6 of the operation tube 3.
The arm 1b is expanded by the expanding rib 7 in a direction in which the holding portion 1c at the distal end of the arm 1b is separated by the expanding rib 7, as shown in FIG. It is needless to say that the arm body 1b expands if the second clip 1 is the same as the one with only one clip attached to the distal end portion 3a of the operation tube 3 described above.

In order not to hinder the expansion of the arm 1b of the clip 1, the expanded arm 1b
Is inserted into the notch 9 of the operating tube 3 at the tip 3a.
First, the operating device introduces the introduction pipe 2
Is pulled backwards or the operating tube 3 is advanced toward the distal end, a part of the distal end 3a of the operating tube 3 projects from the introducing tube 2. In this state, if the same operation as described above is performed, the arm body 1b is expanded as shown in FIGS.

Finally, when the operating wire 4 is further pushed toward the distal end in a state where the arm body 1b is expanded, the space between the opposing surfaces 5a of the protrusions 5 of the clip 1 is opened.
After passing over this expanding rib 7, the arm 1b
Is closed due to its closing behavior, so that the clip 1 is pushed out of the operation tube 3 at the same time that the holding portion 1c of the arm 1b holds the living tissue S as shown in FIG. Therefore, the clip 1 is provided with the holding portion 1 of the arm 1b.
The living tissue S is placed in the body cavity with the living tissue S sandwiched in c.

[0026]

As described above, the in-vivo indwelling clip of the present invention is constructed as described above. Therefore, when the living tissue is sandwiched and indwelled in the living body cavity, the operating wire is pulled in several steps. Even if it does not need to be kept pressed, even when the clip arm is opened and pressed against the living tissue that needs clipping, the clip does not swing and can be pressed well against the living tissue that needs clipping It became something.

Further, the in-vivo indwelling clip according to the present invention is inserted into the living body cavity through the forceps channel of the endoscope in a state where two clips are stored in the introduction tube as necessary. This is convenient when clipping multiple places in the tissue, and even if a new one is to be stored back in the introduction tube, the hook at the tip of the operation wire must be removed, and the remaining connecting member must be removed. This eliminates the need for complicated work such as the necessity of engaging the connecting member of the new in-vivo indwelling clip.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a state where an arm body of an in-vivo indwelling clip according to the present invention is closed.

FIG. 2 is a perspective view showing a state in which an arm body of the in-vivo indwelling clip according to the present invention is expanded.

FIG. 3 is a longitudinal sectional view showing one embodiment of the in-vivo indwelling clip of the present invention.

4 is a longitudinal sectional view showing a distal end portion of an operation tube inserted into an introduction tube insertable into a body cavity in a state where the in-vivo indwelling clip shown in FIG. 4 is not attached.

FIG. 5 is a perspective view showing a distal end portion of the operation tube shown in FIG.

FIG. 6 is a longitudinal sectional view showing another embodiment of the in-vivo indwelling clip of the present invention.

FIG. 7 is a longitudinal sectional view showing still another embodiment of the in-vivo indwelling clip of the present invention.

8 is a vertical cross-sectional view showing a distal end portion of an operation tube inserted into an introduction tube insertable into a living body cavity in a state where the in-vivo indwelling clip shown in FIG. 7 is not attached.

9 is a perspective view showing a distal end portion of the operation tube shown in FIG.

FIG. 10 is a longitudinal sectional view showing still another embodiment of the in-vivo indwelling clip of the present invention.

11 is a longitudinal sectional view showing a state in which the arm body of the in-vivo indwelling clip of the present invention shown in FIG. 3 is expanded.

12 is a longitudinal sectional view showing a state in which the arm body of the in-vivo indwelling clip of the present invention shown in FIG. 6 is expanded.

13 is a longitudinal sectional view showing a state where the arm body of the in-vivo indwelling clip of the present invention shown in FIG. 7 is expanded.

14 is a longitudinal sectional view showing a state in which the arm body of the in-vivo indwelling clip of the present invention shown in FIG. 10 is expanded.

FIG. 15 is an explanatory diagram showing a state where a living tissue is sandwiched by the in-vivo indwelling clip of the present invention.

FIG. 16 is a longitudinal sectional view showing an example of a conventional in-vivo indwelling clip.

FIG. 17 is a sectional view taken along the line AA of FIG. 16;

FIG. 18 is a longitudinal sectional view showing a state where an arm body of a conventional in-vivo indwelling clip is expanded.

FIG. 19 is a longitudinal sectional view showing a state where hooks of the connecting member are stretched.

20 is a sectional view taken along line BB of FIG. 19;

FIG. 21 is an explanatory view showing a state where a living tissue is sandwiched by a conventional indwelling clip in a body cavity.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Clip 1a Base end part 1b Arm body 3 Operation tube 4 Operation wire 5 Projection part 5a Opposing surface 6 Guide rib 7 Widening rib

Claims (3)

[Claims] 1. A clip which is detachably attached to a distal end portion of an operation tube which can be inserted into a living body cavity, and which is pushed out of the operation tube by an operation wire which is inserted into and retracted from the operation tube. The operating tube has a closing behavior in a direction to close the distal ends of the pair of arms extending from the base end, and is provided between the opposing surfaces of the protrusions provided on the side portions of these arms. The guide ribs formed on the inner side surfaces of the distal ends of the arm members are fitted, and the widened ribs formed continuously with the guide ribs are used to expand the arm members in a direction for separating the distal ends of the arm members. And the arm body is closed by its closing behavior after passing through the widening rib. 2. The indwelling clip for living tissue according to claim 1, wherein two clips are attached to a distal end portion of an operation tube. 3. The indwelling clip for living tissue according to claim 1, wherein a notch is provided at a distal end portion of the operation tube so that the expanded arm body can enter.