JP2003153909A - Clip device for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a clip device for an endoscope capable of performing a clipping procedure smoothly at all times, even if used repeatedly, by ensuring the cutting of cordlike member connecting a clip to an operating wire. SOLUTION: The clip device for an endoscope is so formed that the cordlike member 5 is cut as the clip 2 is drawn into a clip closing ring 6 by the operation of drawing the operating wire 3 from in front, with the clip 2 held closed after being opened and closed. A cord cutting means 7 for cutting the cordlike member 5 is provided on the engaging part of the clip 2 engaging the cordlike member 5.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a clip device for an endoscope which is used by passing through a treatment tool insertion channel of an endoscope and used for hemostasis, ligation or marking in the body.

[0002]

2. Description of the Related Art In general, a clip device for an endoscope has a clip closing ring, which is disposed adjacent to the rear side of the clip and is detachably connected to a distal end of a flexible sheath, so that the clip device is inserted into the flexible sheath. By pulling from a hand side an operation wire that is inserted and arranged to be movable back and forth in the axial direction, the clip is drawn into the clip closing ring, opened and closed, and then held in a closed state.

In such a clip device for an endoscope, it is necessary to separate the clip from the operation wire at the end of a series of operations, and there are various modes for connecting / disconnecting the clip and the operation wire for that purpose. Has been adopted.

As one of the modes, when the clip and the operation wire are connected by a string-like member and the operation wire is strongly pulled, the clip is held in the closed state and then formed on the distal end portion of the operation wire. There is one in which the string-shaped member is cut at the cut string portion.

[0005]

The string-shaped member for connecting the clip and the operation wire needs to have such strength as not to be cut until the clip firmly bites into the mucous membrane of the body and remains in the indwelling state. The part must be sharp enough to reliably cut such string-like members.

Therefore, if the string cutting portion becomes gradually dull by repeatedly using the clip device several times, when the operation wire is pulled, it becomes uncertain to cut the string-like member subsequent to the opening / closing operation of the clip. , Clipping treatment may not be performed smoothly.

Therefore, the present invention is
An object of the present invention is to provide a clip device for an endoscope, in which a string-shaped member that connects a clip and an operation wire is surely cut so that a clipping procedure can always be performed smoothly.

[0008]

In order to achieve the above object, the clip device for an endoscope of the present invention has a clip closing ring disposed adjacent to the rear side of the clip at the distal end of the flexible sheath. The operation wire and the clip, which are detachably connected and are inserted through the flexible sheath so as to be able to advance and retreat in the axial direction, are connected by a string-like member. By pulling the operation wire from the hand side, In a clip device for an endoscope, which is configured such that a clip is drawn into a clip closing ring, opened and closed, and then held in a closed state, and the string-shaped member is cut, a string for cutting the string-shaped member. The cutting means is provided at an engaging portion on the clip side with respect to the string-shaped member.

It should be noted that the clip has a plurality of arms that can be opened and closed and that are connected to each other at the base end, and a core bar is arranged inside the plurality of arms, and the string cutting means is provided on the core bar. It may be formed.

Alternatively, the clip has a plurality of openable and closable arms connected to each other at the base end thereof, and a string cutting means is formed at the base end connection of the clip having the plurality of arms connected to each other. May be.

[0011]

Embodiments of the present invention will be described with reference to the drawings. FIG. 2 shows the entire configuration of a clip device for an endoscope. The clip 2 is, for example, a coil pipe-shaped flexible sheath 1 in which a stainless steel wire is closely wound with a certain diameter.
It is attached to the tip of.

An operating wire 3 whose tip is connected to a clip 2 is inserted through the sheath 1 so as to be able to move forward and backward in the axial direction, and the outer surface of the sheath 1 is, for example, a tetrafluoroethylene resin tube or a superelastic alloy tube. Flexible outer tube 1
0 is loosely fitted so that it can move back and forth in the axial direction.

In FIG. 2, the clip 2 has a portion near the proximal end housed in the distal end of the outer tube 10, and has a plurality of (for example, three) arm portions 2a in an open state and inward at each distal end thereof. The claw-shaped portion 2b formed so as to project toward is visible.

An operating portion 20 connected to the base end of the sheath 1.
Has a finger hook 23a attached to the other end side of the operating portion main body 23 to which the proximal end of the sheath 1 is connected, and a slider 22 to which the proximal end of the operating wire 3 is connected slides in the axial direction with respect to the operating portion main body 23. It is configured to be freely attached.

FIG. 3 is an enlarged view of the distal end portion of the endoscope clip device of this embodiment, and the outer tube is so arranged that the clip 2 in the closed state is almost completely housed in the outer tube 10. 10 is pushed a little forward.

The clip 2 is formed by bending, for example, a stainless steel plate for a spring to form a single connection, and the three arm portions 2a connected to each other at the base end connecting portion 2d are
They are arranged at equal intervals (that is, approximately 120 ° intervals) so that they can be opened and closed in a radial manner without crossing each other.

At a position near the base end of each arm portion 2a, an opening / closing drive portion 2c is formed in which a bulging portion 2c2 bulging outward is formed immediately behind the constricted portion 2c1 constricted inward. And
The arm portion 2a is opened and closed by deforming the opening / closing drive portion 2c.

The operation wire 3 axially advanced and retracted by the slider 22 arranged on the operation portion 20 is arranged at the axial position of the sheath 1, and the tip of the operation wire 3 is located rearward from the clip 2. The clip connecting hook 4 that engages with the extending clip connecting string 5 (string-shaped member) is attached.

In the clip connecting hook 4, the distal end of the operation wire 3 is connected and fixed to the rear half portion by soldering or the like, and an annular clip connecting string is formed in a concave portion 4a formed in a side surface portion of the front half portion. 5 are adapted to be engaged.

The clip connecting string 5 of this embodiment is formed of, for example, a stainless steel stranded wire or a single wire, and is formed into an annular shape by bundling both end portions of one string through one pipe 5a. Has been formed.

A base of a clip closing ring 6 for pressing and deforming the bulging portion 2c2 of the clip 2 from the outer surface side is attached to the front side portion of the ring receiving cylinder 8 fixed to the distal end of the sheath 1 by soldering or the like. The part near the edge is fitted so that it can be engaged and disengaged.

A clip mandrel 9 is inserted in the arm portion 2a from the opening / closing drive portion 2c of the clip 2 to the base end connecting portion 2d. A portion of the clip core metal 9 located inside the constricted portion 2c1 of the clip 2 is formed into a thin cylindrical shape (small diameter portion 9a).

The portion of the clip core metal 9 rearward of the small diameter portion 9a is formed in a circular cross-sectional shape thicker than the small diameter portion 9a so that the clip core metal 9 does not come out of the inside of the clip 2. .

The clip connecting string 5 is passed through a string passing hole 9b formed in the vicinity of the rear end portion of the clip core metal 9, and the clip closing ring 6 is fitted on the outer surface of the base end connecting portion 2d of the clip 2. It is locked there by frictional force.

In this way, as shown in FIG.
Clip 2, clip connecting string 5, clip closing ring 6
The clip core metal 9 is configured as one unit that can be joined / separated with respect to the sheath 1 and the operation wire 3.

The string passing hole 9b is formed obliquely, for example, at an angle of about 45 ° in the front-rear direction, and the rear edge of the opening near the front is a string cutting edge 7 (string cutting means).
When the clip connecting string 5 is strongly pulled rearward, the clip connecting string 5 is cut at the contact portion with the string cutting edge 7.

When using such an endoscope clip device, the front end of the endoscope clip device passed through a treatment tool insertion channel of the endoscope (not shown) is in front of the affected part to be clipped. When guided to, the outer tube 10 is retracted rearward and the operation wire 3 is pulled from the operation section 20 side, as shown in FIG. Then, the bulging portion 2c2 of the clip 2 is drawn into the clip closing ring 6 and deformed, so that the arm portion 2a is largely opened.

Then, the operation wire 3 is further connected to the operation section 20.
When pulled to the side, as shown in FIG. 1, a part of the expanded portion of the arm portion 2a of the clip 2 is pulled into the clip closing ring 6 and narrowed, and the tip of each arm portion 2a is retracted. The claw-shaped portion 2b of the above pierces the mucous membrane in a state of wrapping the affected area 100, and the state is maintained.

Then, if the operating wire 3 is pulled more strongly toward the operating portion 20, the clip connecting string 5 is cut at the contact portion with the string cutting edge 7 and the clip connecting string 5 and the clip 2 are separated from each other. By pulling the sheath 1 rearward, the ring receiving tube 8 and the clip closing ring 6 are separated.

In this way, the clip 2 in the state in which it is forcibly closed by the clip closing ring 6 allows the affected area 100 to be left in the body in a clipped state.

The present invention is not limited to the above embodiment, and for example, as shown in FIG. 6, the string cutting edge 7 may be provided in the base end connecting portion 2d of the clip 2 or the like.

The number of arms 2a of the clip 2 may be two or four or more.

[0033]

According to the clip device for an endoscope of the present invention, the string cutting means for cutting the string-like member that pulls the clip is provided at the clip-side engaging portion with respect to the string-like member. Even if the use of the clip device for endoscope is repeated, the string cutting means becomes new together with the clip every time, so that the string-like member connecting the clip and the operation wire is surely cut, and the clipping treatment is performed. It can always be done smoothly.

[Brief description of drawings]

FIG. 1 is a side cross-sectional view of a state in which a clip is opened and closed in a clip device for an endoscope according to a first embodiment of the present invention, a state of transition from a closed state to an indwelling state.

FIG. 2 is an external view showing the overall configuration of the endoscope clip device according to the first embodiment of the present invention.

FIG. 3 is a side sectional view of the distal end portion of the endoscope clip device according to the first embodiment of the present invention.

FIG. 4 is a partial cross-sectional view showing a clip unit of the endoscope clip device according to the first embodiment of the present invention.

FIG. 5 is a side sectional view showing an open state in the opening / closing operation of the clip of the endoscope clip device of the first embodiment of the present invention.

FIG. 6 is a side cross-sectional view of a state in which the clip device of the second embodiment of the present invention moves from the closed state to the indwelling state in the opening / closing operation of the clip.

[Explanation of symbols]

1 sheath 2 clips 2a Arm 2d base end connection 3 operation wire 5 Clip connection string (string member) 6 clip closing ring 7 String cutting edge (string cutting means) 9 clip core metal 9b String through hole 10 mantle 20 Operation part

Claims (3)

[Claims] 1. A clip closing ring disposed adjacent to the rear side of the clip is detachably connected to the distal end of a flexible sheath and is inserted through the flexible sheath so as to be axially movable back and forth. The operated operation wire and the clip are connected by a string-like member, and by pulling the operation wire from the proximal side, the clip is pulled into the clip closing ring, opened and closed, and then closed. In the clip device for an endoscope, which is held and is configured to cut the string-like member, a string cutting means for cutting the string-like member is provided on the clip-side engaging portion with respect to the string-like member. A clip device for an endoscope, which is provided in the. 2. The clip has a plurality of openable and closable arms connected to each other at a base end thereof, a core metal is arranged at a position inside the plurality of arms, and the string cutting means is provided. The clip device for an endoscope according to claim 1, which is formed on the core metal. 3. The clip has a plurality of openable and closable arm portions connected to each other at a base end portion thereof, and the string cut at the base end connection portion of the clip having the plurality of arm portions connected to each other. The clip device for an endoscope according to claim 1, wherein the means is formed.