JP2003126099A - Endoscopic clip - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscopic clip tat can be easily attached or detached and is capable of easily conducing suture and easier to be separated after suturing tissues. SOLUTION: The clip unit to be equipped with the clipping device is composed of the clip which has a pair of holding sections and the clip fastening ring for opening and closing the clip, and has a hole to be joined with the hook at a posterior end of the clip whose partial opening makes it easier to separate the clip thereby eliminating the residue after separation.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope clip which is inserted endoscopically into a body cavity to ligate an affected area.

[0002]

2. Description of the Related Art Conventionally, a clip device for ligating an affected area is used for hemostasis of a bleeding site through an endoscope, prevention of perforation / bleeding after mucosal resection, and marking of a lesion site. As such a clip device, for example, Japanese Utility Model Laid-Open No. 2-6011 is known.

As shown in FIG. 3, this clip device is composed of a clip device body 50 and a clip unit 51 which is detachably attached to the clip device body 50. Furthermore, this clip unit 51 is a clip 52
And a connecting member 53 and a clip tightening ring 54.

The clip 52 is formed by bending a thin metal strip material at the central portion, and a base end portion 60 is formed at the bent portion. Further, the pair of arm portions 61a and 61b extending from the base end portion 60 of the clip 52 are respectively bent inward at an angle of about 90 degrees at the distal end portions thereof to clamp and ligate, for example, a ligation site of a biological tissue. Clamping portions 62a and 62b are formed. Further, the clip 52 is provided with arms 61a, 6 in the direction of separating the holding portions 62a, 62b from each other.
Elasticity is provided to expand 1b.

Further, the clip unit 51 holds the base end portion 60 of the clip 52 and holds the clip 52.
The clip tightening ring 54 capable of covering the arm portions 61a and 61b of the clip 52 and the hook 63 provided at the tip end thereof are hooked on the base end portion 60 of the clip 52 to thereby fix the base end portion 6 of the clip 52.
0 and a connecting member 53 that is detachably engaged.

On the other hand, the clip device main body 50 is provided with an introducing tube 70 made of a flexible tube which can be inserted into a forceps hole (not shown) of an endoscope, and is inserted into the introducing tube so as to be movable back and forth, and the distal end thereof is inserted. A coil sheath 71 having a connecting ring 72 attached and fixed thereto, and an operation wire 73 inserted in the coil sheath so as to be able to move back and forth.

A hook 74 is attached to the tip of the operation wire 73. The pin 7 is vertically attached to the tip of the hook 73.
5 is projectingly provided so that it can be detachably engaged with an engaging hole 76 provided at the base end of the connecting member 53. The engagement hole 76 is a long hole 76a extending in the longitudinal direction,
The large-diameter hole 7 formed at the end of the elongated hole 76a in the hook 63 direction.
6b and.

To attach the clip unit 51 to the clip device main body 50, as shown in FIG. 3A, the head of the pin 75 of the hook 74 is fitted into the large diameter hole 76b of the connecting member 53 of the clip unit 51, In this state, the clip unit 51 is pulled to the tip side. Then, the elongated hole 76 a of the engagement hole 76 of the connecting member 53 fits into the neck portion of the pin 75 of the hook 74. In this state, the operation wire 73 is pulled toward the hand side to draw the hook 74 into the connecting ring 72, and the proximal end side of the clip tightening ring 54 on the clip unit 51 side is fitted into the connecting ring 72 to be fixed. Is.

When grasping a living tissue using the clip device having the above structure, first, the introducing tube 70 is pushed out to the coil sheath 71, and the clip 52 is housed in the introducing tube 70. Next, the clip device is introduced into the living body cavity through the forceps hole of the endoscope, and then the coil sheath 71 is inserted.
The clip 52 is pushed out with respect to 0, the clip 52 is protruded from the introduction pipe 70, and the arms 61a and 61b of the clip 52 are expanded. After that, the operation wire 73 is pulled rightward in the drawing to pull the hook 74 toward the hand side, and the proximal end portion 60 of the clip 52 is pulled into the clip tightening ring 54. As a result, the base end portion 60 of the clip 52 is crushed, and as a result, the arm portions 61a and 61b of the clip 52 are opened to the maximum.
In this state, when the clip 52 is pressed against the living tissue that requires clipping and the operation wire 73 is further pulled toward the hand side, the arm portions 61a and 61b of the clip 52 are pulled into the clip tightening ring 54, so that the gripping portion. 6
2a and 62b are for sandwiching a living tissue. After that, by further pulling the operation wire 73 toward the hand side, the clip 52 is driven deep into the living tissue and the connecting member 53
The hook 63 is stretched so that the connecting member 53 becomes the clip 52.
As a result, the clip 52 and the clip tightening ring 54 are left in the body.

By the way, in the above-described clip device, the connecting member 53 remains in the clip device main body 50 while being engaged with the operation wire 73. This connecting member 53 is used to attach the next clip unit 51 to the operating wire 7.
However, the long hole 76a of the engaging hole 76 of the connecting member 53 fits into the neck portion of the pin 75 of the hook 74 of the operation wire 73 and cannot be easily removed. is there. Also,
The distal end of the connecting member 53 is deformed to a fully extended state when disengaged from the clip base end portion 60, and since it cannot be easily disengaged, the operator may be injured when detached. On the contrary, if the engagement between the connecting member 53 and the pin 75 of the hook 74 is loosened so that the clip unit 51 can be easily detached, when the clip unit 51 is attached to the clip device main body 50, it takes a lot of time and effort to attach it. However, there is a problem in that the connecting member 53 falls into the body after being separated from the clip 52. There is also known a clip device that does not use a connecting member as in Japanese Patent Laid-Open No. 60-103946, but there is a problem that the clip may drop during operation because the clip and the operation wire are easily separated. It was

[0011]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and its purpose is to:
(EN) It is an object of the present invention to provide a clip device which is safe for an operator and a patient, in which the clip does not easily fall off, the clip and the operation wire can be easily separated, and the deformation during the separation is suppressed.

[0012]

That is, the present invention is as follows.
(1) An introduction tube that can be inserted into a living body cavity through a forceps hole of an endoscope, an operation tube that is inserted into the introduction tube so as to be movable back and forth, and a hook that is inserted into the operation tube so as to be movable forward and backward A clip unit which is attached to a clip device composed of an operation wire and ligates a biological tissue. The clip unit is composed of a clip having a pair of holding parts and a clip tightening ring for opening and closing the clip. An endoscope clip having an engaging hole for engaging with the hook, and a part of the engaging hole is opened, and (2) clip tightening ring is formed of transparent resin. (1) The endoscope clip according to (1), (3) Only the tip portion of the clip tightening ring is made of metal (1)
Alternatively, it is the clip for an endoscope according to (2).

[0013]

BEST MODE FOR CARRYING OUT THE INVENTION The present invention will be described in detail below with reference to the drawings. FIG. 1 is a clip unit showing an embodiment of the present invention. FIG. 2 shows the tip of the main body of the clip device for mounting the clip unit of the present invention. The clip device of this embodiment has an introduction tube 21 that can be inserted into a living body cavity through a forceps hole (not shown) of an endoscope. The introduction tube is formed of a flexible tube made of Teflon (R) or the like and having good slipperiness. A flexible operation tube 22 having a short tube 23 made of stainless steel at its tip is inserted into the introduction tube 21 so as to be movable back and forth. The short tube 23 made of stainless steel is fitted with a clip tightening ring 2 described later. Further, an operation wire 24 having a torque transmitting property is inserted into the operation tube 22 so as to be able to move back and forth.
A hook 25 provided with a pin 26 that is detachably engaged with the rear end of the clip 1 described later is attached to the front end of 4.

The clip 1 is formed by bending a thin strip of stainless steel plate material at approximately the center and forming the bent portion as a base end portion 3. The strip members extending from the base end portion 3 spread in the direction away from each other and then intersected with each other, forming a loop 5 between the base end portion 3 and the intersection portion 4. The loops 5 are formed so as to be wider than the inner diameter of the clip tightening ring 2 described later. Further, the strip plate material extending from the intersecting portion 4 spreads in the direction in which it is separated again, and finally the tip portions are bent so as to face each other to form the holding portion 6. The width of the strip plate is narrower than the inner diameter of the clip tightening ring 2 from the base end portion 3 to the crossing portion 4 and is wider than the inner diameter of the clip tightening ring 2 between the crossing portion 4 and the tip. . The proximal end portion 3 is provided with an elliptical hole 8 into which the pin 26 provided at the distal end of the operation wire 24 described above is locked, and follows the hole 7 having a diameter larger than the pin diameter so that the pin 26 can be easily inserted. . The elliptical hole 8 is formed to be slightly narrower than the pin diameter so that the pin cannot move freely so that a close contact state can be obtained. Further, the oblong hole 8 is followed by a slit 9 and is open at the end. The slit 9 is a passage for pulling out the pin, and the ease of pulling out the pin varies depending on the slit width, the slit length, and the thickness of the strip plate material.

The clip 1 is inserted into the clip tightening ring 2 on the proximal end 3 side, and contacts the clip tightening ring 2 at the loop 5 portion of the clip 1. By fixing this contact portion with the fixing agent 10 such as silicon rubber, it becomes possible to handle the clip unit as a unit.

Next, the operation of this embodiment will be described. First, the operation tube 22 is projected from the introduction tube 21, then the operation wire 24 is projected from the operation tube 22, and the clip unit is attached to the hook 25 of the operation wire 24. In this attachment method, the pin 26 provided on the hook 25 is inserted into the large hole 7 provided at the base end portion 3 of the clip 1 and then fitted into the elliptical hole 8. At this time, the base end portion 3 of the clip 1 is positioned inside the clip tightening ring 2 so as not to project from the clip tightening ring 2 after the clipping so as to be in a dangerous state. Since the space is narrow and the orientation of the base end portion 3 can be determined by the orientation of the tip of the clip, it can be easily attached even if the inside is not visible. It is also preferable that the clip tightening ring 2 is formed of a transparent resin so that the inside can be seen. In this case, in order to suppress deformation of the clip tightening ring 2 during tightening, the clip tightening ring 2
It is also preferable that only the tip portion of is made of metal.

After the clip unit is attached to the operation wire 24, the operation wire 24 is drawn into the operation tube 22 and the clip tightening ring 2 is fitted into the short tube 3 at the tip of the operation tube 22. After the insertion, the operation wire 24 should not be retracted any further. Next, the operation pipe 22 is connected to the introduction pipe 2
1 and retract the clip 1 completely into the introduction tube 21. Then, after introducing the introduction tube 21 into the living body cavity through a forceps hole (not shown) of the endoscope, the operation wire 24
The operation tube 22 is projected from the introduction tube 21, and then the operation wire 24 is projected from the operation tube 22 in the same manner as when the clip unit is attached to the clip 11, and the clip 11 is exposed in the body cavity. After that, when the operation wire 24 is pulled into the operation tube 22, the loop portion 5 of the clip 1 is pulled into the clip tightening ring 2, and the tip side from the intersecting portion 4 is gradually opened.

When clip 1 is fully opened, clip 1
Is pressed against the ligation site. Operation wire 2 in this state
When 4 is drawn into the operation tube 22, the strip plate material that has been separated is drawn into the clip tightening ring 2, so that the holding portion 6 holds the ligated portion. Since the tip end side of the clip 1 is provided with a portion wider than the inner diameter of the clip tightening ring 2, the clip tightening ring 2 is larger than that.
The operation wire 24 and the clip unit connecting portion, which are not pulled in and are provided with the weakest pull-out strength, come off. The disengagement mechanism is for the pin 26 of the operation wire 24 to open the slit 9 at the proximal end of the clip. Since the clip tightening ring 2 holds down the loop portion 5 and the like of the clip 1, it does not come off from the clip 1 and is left inside the body together with the clip 1.

[0019]

According to the present invention, since the clip can be easily attached at the time of attaching the clip and the clip and the operation wire can be easily separated, and the deformation at the time of separation is suppressed,
The effect that the clip operation that is safe for the operator and the patient becomes possible is obtained.

[Brief description of drawings]

FIG. 1A is a side sectional view of a clip unit showing an embodiment of the present invention, and FIG. 1B is a sectional view taken along the line AA ′ of FIG.

FIG. 2 is a cross-sectional view of the tip side of a clip device body for mounting the clip unit of the present invention.

3A is a perspective view showing a method of attaching the clip unit and the main body of the clip device in the conventional clip device, FIG. 3B is a sectional view of the tip side after the clip unit is attached in FIG. 3A, and FIG. It is a top view which shows the connection member of b).

[Explanation of symbols]

1 clip 2 Clip tightening ring 3 base end 4 intersections 5 loop section 6 clamping part 7 large holes 8 oval holes 9 slits 10 Fixative 21 Introduction tube 22 Control tube 23 Short tube 24 operation wire 25 hooks 26 pin 50 clip device body 51 clip units 52 clips 53 Connection member 54 Clip tightening ring 60 base end 61a, 61b arm 62a, 62b clamping part 63 hooks 70 Introductory pipe 71 coil sheath 72 Connection ring 73 Operation wire 74 hook 75 pin 76 Engagement hole 76a long hole 76b Large diameter hole

Claims (3)

[Claims] 1. An introduction tube which can be inserted into a living body cavity through a forceps hole of an endoscope, an operation tube which is inserted into the introduction tube so as to be able to move forward and backward, and a hook which is inserted into the operation tube so as to be able to move forward and backward and hooked at a distal end portion. A clip unit which is attached to a clip device consisting of an operation wire provided with and ligates a biological tissue,
The clip unit consists of a clip with a pair of clamping parts and a clip tightening ring that opens and closes the clip.
An endoscope clip having an engaging hole for engaging with the hook at a rear end of the clip, and a part of the engaging hole is opened. 2. The clip for an endoscope according to claim 1, wherein the clip tightening ring is made of a transparent resin. 3. The clip for an endoscope according to claim 1, wherein only the tip portion of the clip tightening ring is made of metal.