JP2004254886A - Clip device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip device for an endoscope capable of easily adjusting the advance and retreat operation of an operation wire inclusive of fine adjustment to perform accurate clipping without requiring a complicated structure such as a ratchet or the like in an operation part. <P>SOLUTION: The clip device for the endoscope is constituted so that clips 11 and 12 arranged at the leading end of a flexible sheath 2 are held in a closed state by performing the pulling operation of the operation wire 4 which is inserted and arranged in the flexible sheath 2 so as to freely advance and retreat in its axial direction, from the operation part 20 connected to the base end of the flexible sheath 2 and the clips 11 and 12 held in the closed state are separated from the flexible sheath 2 and the operation wire 4. The operation part 20 is provided with a rotary operation wheel 22 rotationally operated around its axial line to allow the base end part of the flexible sheath 2 and the base end of the operation wire 4 to advance and retreat relatively in the axial direction. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL 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 to perform hemostasis, ligation or marking in a body.
[0002]
[Prior art]
Generally, the clip device for an endoscope is configured such that a clip disposed at a distal end of a flexible sheath is pulled from a proximal end side of an operation wire that is inserted through the flexible sheath so as to be able to advance and retreat in the axial direction. The clip held in the closed state and thus held in the closed state can be separated from the flexible sheath and the operating wire.
[0003]
An operation unit for pulling the operation wire is connected to the base end of the flexible sheath, and the conventional operation unit slides a finger hook directly connected to the base end of the operation wire in the axial direction. A ratchet mechanism or the like for stopping the operation halfway is added (for example, Patent Document 1).
[0004]
[Patent Document 1]
JP-A-2002-191609
[0005]
[Problems to be solved by the invention]
The operation of clipping the affected part in the body with the endoscope clip device is a remote operation using a clip device passed through the treatment instrument insertion channel of the endoscope. On the other hand, in order to perform accurate clipping, a delicate opening / closing operation of the clip is often required.
[0006]
However, as described above, in the structure in which the finger hook directly connected to the base end of the operation wire is slid in the axial direction, fine adjustment of the advance / retreat operation of the operation wire cannot be performed, so that clipping is incomplete. There are many cases where you do not get. In addition, since a ratchet mechanism and the like are provided, the structure of the operation unit is complicated and difficult to handle in operation.
[0007]
Thus, the present invention provides an endoscope that can easily adjust the advance / retreat operation of the operation wire including fine adjustment to perform accurate clipping, and does not require a complicated structure such as a ratchet in the operation unit. It is an object to provide a clip device.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, a clip device for an endoscope according to the present invention includes an operation wire in which a clip disposed at a distal end of a flexible sheath is disposed so as to be able to advance and retreat in the axial direction within the flexible sheath. Is held in a closed state by being pulled from an operation unit connected to the proximal end of the flexible sheath, and the clip thus held in the closed state is separated from the flexible sheath and the operation wire. In the endoscope clip device configured so as to be able to rotate, the operation section is rotated about the axis to relatively move the proximal end of the flexible sheath and the proximal end of the operation wire in the axial direction. A rotary operation wheel for moving forward and backward is provided.
[0009]
In addition, the clip device for an endoscope of the present invention is characterized in that the outer sheath capable of moving back and forth in the axial direction is covered over the entire length of the flexible sheath, and the clip disposed at the distal end of the flexible sheath is a flexible sheath. The operation wire, which is inserted and retracted in the axial direction so as to be able to advance and retreat in the axial direction, is held in a closed state by being pulled by an operation section connected to the base end of the flexible sheath, and thus held in the closed state In the endoscope clip device configured to be able to separate the clip that has been set from the flexible sheath and the operation wire, the operation portion is rotated around an axis so that the base end portion of the flexible sheath A first rotating operation wheel for relatively moving the proximal end of the operating wire in the axial direction and a proximal end of the mantle tube by rotating around the axis. Advancing and retracting relative to the axial direction Thereby it is provided with a second rotational operating wheel.
[0010]
The clip is closed by moving the operation wire toward the proximal end relative to the flexible sheath, and conversely, by moving the operation wire toward the distal end relative to the flexible sheath. May be opened.
[0011]
Further, an operation wire rotating operation wheel for rotating the operation wire around the axis without moving the operation wire in the axial direction with respect to the flexible sheath may be provided.
[0012]
BEST MODE FOR CARRYING OUT THE INVENTION
An embodiment of the present invention will be described with reference to the drawings.
FIG. 2 shows the entire configuration of the endoscope clip device. For example, a flexible sheath 2 formed by tightly winding a stainless steel wire with a fixed diameter, such as an ethylene tetrafluoride resin tube or the like, is used. The outer tube 6 made of a flexible tube is loosely covered.
[0013]
The operating section 20 is connected to the base end side, and the closed cylindrical body receiver 3 for mounting the indwelling clip unit 10 is arranged at the distal end side. Note that the flexible sheath 2 and the mantle tube 6 may be formed of a superelastic alloy pipe or the like. Reference numeral 10 denotes an indwelling clip unit.
[0014]
FIG. 3 shows an indwelling clip unit 10. In this embodiment, three clip claws 11 made of, for example, a superelastic alloy or a springy stainless steel material elastically deform the vicinity of their rear ends A. As a result, they are arranged in a shape spread at approximately 120 ° intervals around the center axis so as to open and close around the rear end A near the base point, and are connected to each other at a cylindrical connecting portion 12 provided at the rear end. ing. The rear end of the cylindrical connecting portion 12 is open.
[0015]
Reference numeral 13 denotes an engagement click portion for engaging with a connecting member 5 described later. The engaging click portion is formed by cutting the cylindrical connecting portion 12 from behind by a pair of parallel slits so as to form a leaf spring. It is formed integrally with the connection part 12 and the clip claw 11. In the vicinity of the rear end of the engagement click portion 13, an inward projection 13a protruding inward is formed.
[0016]
Another component of the indwelling clip unit 10, a clip closing tubular body 15 made of, for example, a stainless steel pipe, is fitted to the tubular connecting portion 12 from the rear so as to be slidable in the axial direction. On the outer peripheral surface of the clip closing cylinder 15, a circumferential groove 15 a for engaging with the inner projection 3 a of the closing cylinder receiver 3 is formed.
[0017]
The tubular connecting portion 12 and the clip closing cylinder 15 are elastically frictionally engaged with each other so that a certain amount of force needs to be applied to slide the clip closing cylinder 15 relatively. The clip claw 11 is elastically deformed and held in a closed state by moving the clip claw 11 from the connecting portion 12 side.
[0018]
In this manner, the clip closing tubular body 15 is fitted from the rear to the tubular connecting portion 12 that connects all of the three clip claws 11 at the rear end A side, and the indwelling clip A unit 10 is configured.
[0019]
Returning to FIG. 2, the closed cylindrical body receiver 3 attached to the distal end of the flexible sheath 2 is formed in a shape obtained by cutting off a cylindrical member fitted on the clip closed cylindrical body 15 by half a circumference, On the inner peripheral surface of the distal end portion of the closed cylindrical body receiver 3, an inner convex portion 3a that engages with the circumferential groove 15a on the outer peripheral surface of the clip closed cylindrical body 15 is formed so as to protrude over a half circumference.
[0020]
As a result, the clip closing cylinder 15 can be disengaged from the side with respect to the closing cylinder receiver 3, and the inner projection 3 a of the closing cylinder receiver 3 is fitted into the circumferential groove 15 a of the clip closing cylinder 15. As a result, the two step portions come into contact with each other, and as shown in FIG. 4 and the like to be described later, the clip closing cylinder 15 is engaged with the closing cylinder receiver 3 in a state in which it cannot move in the axial direction.
[0021]
FIG. 7 shows a ready-to-use state in which the indwelling clip unit 10 is mounted on the distal end portion of the endoscope clip device, and the outer tube 6 is fitted to the clip claws 11.
[0022]
The closed cylindrical body receiver 3 is fixed to the distal end of the flexible sheath 2 by brazing or the like, and the operation wire 4 is inserted and arranged in the flexible sheath 2 so as to be able to advance and retreat in the axial direction. The operation wire 4 can be advanced and retracted in the axial direction relative to the flexible sheath 2 from the operation section 20 connected to the proximal end of the flexible sheath 2.
[0023]
At the tip of the operation wire 4, a connecting member 5 that is detachable from the rear with respect to the tubular connecting portion 12 when the clip closing tubular body 15 is not covered with the engagement click portion 13 is connected and fixed. .
[0024]
The connecting member 5 has a front half portion formed in a cylindrical shape with a rounded head, which is loosely fitted into the cylindrical connecting portion 12, and an intermediate portion formed on the engaging click portion 13. A constricted portion 5a with which the projection 13a is engaged is formed.
[0025]
As a result, when the clip 15 is covered with the clip 15, the engagement between the click 13 and the constricted portion 5 a is not released, and when the clip 15 is not covered, By elastically deforming the engagement click portion 13 outward, the inward protrusion 13a and the constricted portion 5a can be disengaged.
[0026]
FIGS. 4 to 6 show the procedure for attaching the indwelling clip unit 10 until the endoscope clip device is brought into the ready-to-use state shown in FIG. 7, and before that, shown in FIG. As described above, on the indwelling clip unit 10 side, the clip closing cylinder 15 is slid forward to the extent that the engagement click portion 13 is exposed, thereby keeping the clip claw 11 closed.
[0027]
Then, as shown in FIG. 4, the inner convex portion 3a of the closing cylinder receiver 3 is fitted into the circumferential groove 15a of the clip closing cylinder 15 from the side, and as shown in FIG. When the operation wire 4 is relatively pushed into the flexible sheath 2, the inward projection 13a interferes with the outer peripheral surface of the connecting member 5, but the engaging click portion 13 is elastically deformed to be pushed outward. As a result, the connecting member 5 enters the cylindrical connecting portion 12.
[0028]
In this manner, when the inward protrusion 13a reaches the position of the constricted portion 5a as shown in FIG. 6, the engagement click portion 13 returns to its original unexpanded shape due to its own elasticity, and the inward protrusion 13a It engages in a state where it has fallen into the constricted portion 5a.
[0029]
Therefore, by pushing the mantle tube 6 forward from the proximal end side, as shown in FIG. 7, the mantle tube 6 is in a ready-to-use state in which the mantle tube 6 is entirely covered. Passed through.
[0030]
8 to 11 show a use state in the body, in which the distal end portion of the endoscope clip device protrudes from the treatment tool insertion channel of the endoscope, and as shown in FIG. The clip nail 11 is turned to the affected part 100.
[0031]
Then, by pushing the operation wire 4 forwardly into the flexible sheath 2 (or pulling the flexible sheath 2 toward the proximal end side with respect to the operation wire 4), the clip claw 11 is turned into a clip-closing tubular body. It comes out of 15 and becomes an open shape due to its own elasticity. At the same time, the clip closing cylinder 15 covers the engagement click portion 13 so that the engagement with the connecting member 5 is not released.
[0032]
Then, when the affected part 100 is surrounded by the tips of the three clip claws 11, as shown in FIG. 9, the operation wire 4 is pulled from behind with respect to the flexible sheath 2 (or the operation wire 4 is pulled). To push the flexible sheath 2).
[0033]
As a result, the clip claw 11 is fitted into the clip closing cylinder 15 held by the closing cylinder receiver 3 from the rear end A side, and the clip claw 11 is narrowed, so that the affected part 100 can be clipped. Further, with the operation, the engagement click portion 13 moves to a position where it comes out of the rear end of the clip closing cylinder 15.
[0034]
However, when the clipping state at that time is incomplete, the operation wire 4 is pushed forward again into the flexible sheath 2 (or the flexible sheath 2 is inserted into the operation wire 4 at the base end). (By pulling to the side), the clip claw 11 is opened by its own elasticity.
[0035]
A step formed on the outer peripheral surface of the connecting member 5 so that when the operating wire 4 is pushed in, the connecting member 5 at the distal end does not push out the cylindrical connecting portion 12 from the inside of the cylindrical body 15 with the clip closed. Abuts on the rear end of the clip closing cylinder 15 to stop the forward movement of the connecting member 5.
[0036]
When the clipping state of the affected part 100 is satisfied, the operation wire 4 is pulled strongly against the flexible sheath 2 (or the flexible sheath 2 is strongly pushed in), and the engagement click part is formed. Since the clip closing tubular body 15 is not covered with the portion 13, the engaging click portion 13 is elastically deformed outward as shown in FIG. The engagement click portion 13 is disengaged from the inner projection 13a.
[0037]
Then, the distal end portion of the flexible sheath 2 and the mantle tube 6 is slightly swung right and left, so that the indwelling clip unit 10 is indwelled in a state where the affected part 100 is clipped as shown in FIG. The clip pawl 11 pressed by the engaging clip closing cylinder 15 maintains the closed state.
[0038]
Returning to FIG. 2, the operation unit 20 for performing the above-described operation includes a first rotation operation wheel 22 and a second rotation operation wheel 23 that are rotatable around an axis with respect to the operation unit main body 21. Are arranged side by side in the axial direction.
[0039]
FIG. 1 shows a configuration of such an operation unit 20, in which an operation unit main body 21 is fixed to a base end of the operation wire 4, and a male screw portion 21a is formed on an outer peripheral portion of an intermediate portion thereof. A holding ring 21b is formed at the tip.
[0040]
The sheath base end cap 24 fixed to the base end of the flexible sheath 2 is formed in a cylindrical shape in which the front half of the operation section main body 21 is loosely inserted, and a male screw is provided on the outer periphery of the intermediate portion. A portion 24a is formed, and a flange 24b is formed at the protruding end.
[0041]
The first rotary operation wheel 22 independently rotatably disposed around the axis on the operation unit 20 includes a female screw portion 22a screwed with the male screw portion 21a of the operation portion main body 21, and a sheath base end cap. The operation wheel portion 22b, which is rotatable around the axis while the movement in the axial direction is restricted with respect to the flange portion 24b, is integrally screwed and connected.
[0042]
Further, a rod 25 protruding in a direction parallel to the axis from a flange portion 24b of the sheath base end cap 24 is loosely inserted into a through hole 26 formed in the operation unit body 21 in a direction parallel to the axis, and The rotation around the relative axis between the base end cap 24 and the operation section main body 21 is prevented.
[0043]
As a result, the operation unit main body 21 is held by holding the operation unit main body 21 (or by holding the mantle tube base end cap 27 and the like) and rotating the first rotary operation wheel 22 around the axis. And the sheath base end cap 24 relatively move in the axial direction without rotating around the axis, and the operation wire 4 and the flexible sheath 2 relatively move in the axial direction.
[0044]
Therefore, the relative axial movement between the operation wire 4 and the flexible sheath 2 can be easily performed with fine adjustment, and the adjustment state does not change even if the hand is released from the first rotary operation wheel 22. Therefore, it is not necessary to provide a ratchet mechanism or the like.
[0045]
An outer tube base end cap 27 fixed to the base end of the outer tube 6 is formed in a cylindrical shape in which the front half of the sheath base end cap 24 is loosely inserted, and a flange 27b is formed at the protruding end. Have been. 28 is a flexible buckling tube.
[0046]
The second rotary operation wheel 23, which is independently rotatable around the axis, is provided with a female screw portion 23 a screwed with the male screw portion 24 a of the sheath base end cap 24, and an outer tube base. The operation ring 23b, which is rotatable around the axis while the axial movement is restricted with respect to the flange 27b of the end cap 27, is integrally screwed and connected.
[0047]
Further, a rod 29 protruding in a direction parallel to the axis from the flange portion 27b of the outer tube base end cap 27 is loosely inserted through a through hole 30 formed in the sheath base end base 24 in a direction parallel to the axis. The relative axis between the mantle tube base cap 27 and the sheath base cap 24 is blocked.
[0048]
As a result, one or both of the operation unit main body 21 and the first rotary operation wheel 22 are held (or the outer tube base end cap 27 and the like may be held), and the second rotary operation wheel 23 is By rotating around, the sheath base mouthpiece 24 and the mantle tube base mouthpiece 27 relatively advance and retreat in the axial direction without rotating around the axis, and the flexible sheath 2 and the mantle tube 6 move along the axis. Move relatively in the direction. Therefore, the relative axial movement between the flexible sheath 2 and the mantle tube 6 can be easily performed with fine adjustment.
[0049]
FIG. 12 shows the structure of the operation unit 20 of the clip device for an endoscope according to the second embodiment of the present invention. An operation wire rotating operation wheel in which a wire connection member 31a fixed to an end and an operation wheel member 31b rotatable around an axis in a state where movement in the axial direction with respect to the operation portion main body 21 is regulated are integrally screwed and connected. 31.
[0050]
As a result, since the operation wire rotating operation wheel 31 directly connected to the operation wire 4 is rotatable around the axis with respect to other members, the clip claw 11 connected to the tip of the operation wire 4 can be moved from the hand side as necessary. It can be rotated about an axis.
[0051]
Further, as shown in FIG. 13 showing the XIII-XIII cross section, the operation section main body 21, the first rotary operation wheel 22, and the mantle tube base end 27 are each fitted with a non-circular cross-sectional shape such as a regular hexagon. In addition, since the rotation about the axis is regulated, the rods 25 and 29 of the first embodiment are not required. The other parts are the same as those of the first embodiment.
[0052]
The present invention is not limited to the above embodiment. For example, in the above embodiment, the rotational motion of each of the rotary operation wheels 22 and 23 is changed to the axial movement by screwing a male screw and a female screw. However, a cam mechanism or the like may be used instead.
[0053]
The operating wire 4 may be not only a single wire or a stranded wire, but also a hollow tube-shaped one, and the structure of the indwelling clip unit 10 and the connecting structure between the indwelling clip unit 10 and the closed cylinder receiver 3. Etc. may take any form.
[0054]
【The invention's effect】
According to the present invention, the operation unit is provided with a rotating operation wheel that relatively rotates and reciprocates the base end of the flexible sheath and the base end of the operation wire in the axial direction by rotating around the axis. By rotating the rotating operation wheel, the operation wire can be easily adjusted, including fine adjustment, to advance and retreat the operation wire, and accurate clipping can be performed. In addition, a complicated structure such as a ratchet is provided in the operation unit. Excellent operability can be obtained without the need.
[Brief description of the drawings]
FIG. 1 is a side sectional view of an operation unit of an endoscope clip device according to a first embodiment of the present invention.
FIG. 2 is a perspective view showing the entire configuration of the endoscope clip device according to the first embodiment of the present invention.
FIG. 3 is a side partial sectional view of the indwelling clip unit according to the first embodiment of the present invention.
4 is a side cross-sectional view showing a procedure of attaching the indwelling clip unit until the endoscope clip device according to the first embodiment of the present invention is brought into a use preparation state shown in FIG. 7;
FIG. 5 is a side sectional view showing a procedure for attaching the indwelling clip unit until the endoscope clip device according to the first embodiment of the present invention is brought into a use preparation state shown in FIG. 7;
FIG. 6 is a side cross-sectional view showing a procedure for attaching the indwelling clip unit until the endoscope clip device according to the first embodiment of the present invention is brought into a use preparation state shown in FIG.
FIG. 7 is a side sectional view of a distal end portion of the endoscope clip device according to the first embodiment of the present invention in a use preparation state.
FIG. 8 is a side sectional view showing a state of a distal end portion when the endoscope clip device of the first embodiment of the present invention is used.
FIG. 9 is a side sectional view showing a state of a distal end portion when the endoscope clip device according to the first embodiment of the present invention is used.
FIG. 10 is a side sectional view showing a state of a distal end portion when the endoscope clip device according to the first embodiment of the present invention is used.
FIG. 11 is a side sectional view showing a state of a distal end portion when the endoscope clip device according to the first embodiment of the present invention is used.
FIG. 12 is a side sectional view of an operation unit of the endoscope clip device according to the second embodiment of the present invention.
13 is a sectional view of the clip device for an endoscope according to the second embodiment of the present invention, taken along the line XIII-XIII in FIG.
[Explanation of symbols]
2 Flexible sheath 4 Operation wire 6 Mantle tube 10 Indwelling clip unit 11 Clip claw 12 Cylindrical connecting part 20 Operation part 21 Operation part main body 21a Male screw part 22 First rotation operation wheel 22a Female screw part 23 Second rotation Operation wheel 23a Female screw portion 24 Sheath base end base 27 Mantle tube base end base 31 Operation wire rotation operation wheel

Claims (4)

A clip disposed at a distal end of the flexible sheath pulls an operation wire inserted and disposed in the flexible sheath so as to be able to advance and retreat in the axial direction from an operation section connected to a base end of the flexible sheath. The clip device for an endoscope which is configured to be held in a closed state by doing so and to be able to separate the clip held in such a closed state from the flexible sheath and the operation wire. ,
The operating unit is provided with a rotating operating wheel for relatively moving the proximal end of the flexible sheath and the proximal end of the operating wire forward and backward in the axial direction by rotating around the axis. Endoscope clip device. An outer tube capable of moving in the axial direction is entirely covered with the flexible sheath, and a clip disposed at the distal end of the flexible sheath is inserted through the flexible sheath so as to be movable in the axial direction. The operation wire is held in a closed state by being pulled from an operation section connected to the proximal end of the flexible sheath, and the clip thus held in the closed state is connected to the flexible sheath with the flexible sheath. In an endoscope clip device configured to be able to be separated from the operation wire,
A first rotating operation wheel for relatively moving the base end of the flexible sheath and the base end of the operation wire relatively in the axial direction by rotating the operation part around the axis; A second rotating operation wheel for relatively moving the proximal end of the flexible sheath and the proximal end of the mantle tube in the axial direction by rotating the endoscope. Mirror clip device. The clip is closed by moving the operation wire proximally with respect to the flexible sheath, and conversely, the operation wire is moved distally with respect to the flexible sheath. The clip device for an endoscope according to claim 1 or 2, wherein the clip can be opened. 4. The endoscope according to claim 1, further comprising an operation wire rotating operation wheel for rotating the operation wire around the axis without moving the operation wire in the axial direction with respect to the flexible sheath. Clip device.

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