JP2004298429A - Device for holding endoscope, and method for introducing endoscope treatment apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope holding device by which time and labor for attaching a magnetic anchor to a lesion part is reduced and burden on a patient and an operator is relieved. <P>SOLUTION: The device includes: a holding member for holding an objective part in an object; the magnetic anchor consisting of a magnetic material; a connection member for connecting the holding member to the magnetic anchor; a traction and separating means connected to the holding member; and a hollow and cylindrical holding member receiving tube whose end part receives part of the rear part of the holding member and which has slits with an open rear end. When the holding member is held at one end part of the holding member receiving tube, the traction and separating means is guided from the rear end part of the receiving tube to an outer part, the connection member is guided to the outer part of the receiving tube via the slits, and the magnetic anchor is positioned in front of the holding member. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

[0001]
【Technical field】
The present invention relates to an endoscope gripping device and an endoscope treatment tool for gripping a patient's lesion using a magnetic anchor that can be guided by a magnetic field when the lesion is resected under endoscopic observation. About the introduction method.
[0002]
[Prior art and its problems]
2. Description of the Related Art As one mode of an operation using an endoscope, there has been conventionally known a method in which a lesion is lifted and resected using a magnetic anchor. In this method, a magnetic anchor and a clip for grasping a lesion are separately introduced into a patient, and then the magnetic anchor and the clip are connected by a connecting member using grasping forceps inserted from a forceps channel, and this is connected to the lesion. It was used to grasp the lesion during resection. However, in this example, connecting the magnetic anchor and the clip and attaching the clip to the lesion require time and labor, and place a burden on the patient and the operator.
[0003]
In order to improve this, there has been an example in which a magnetic anchor 201 and a clip 203 previously connected by a connecting member 205 are used as shown in FIG. In this example, while the clip 203, the connecting member 205, and a part of the magnetic anchor 201 are arranged in the introduction tube 235, the introduction tube 235 is passed through a forceps channel of an endoscope, so that the magnetic anchor 201 and the clip 203 are removed. Was introduced into the patient's body. The introduction tube 235 can remove the rear end portion 35a side by pulling the cut string 237 provided on the rear outer periphery thereof (FIG. 15B), and is exposed by removing the rear end portion 35a side. By pushing the flexible pushing rod 239 into the introduction tube 235, the magnetic anchor 201, the connecting member 205 and the clip 203 are pushed out into the patient.
[0004]
However, in this example, after the magnetic anchor 201 and the clip 203 connected by the connecting member 205 are introduced into the body, it is necessary to attach the clip 203 to the lesion using the grasping forceps inserted from the forceps channel. For this reason, it takes time and effort to attach the clip 203 to the lesion, which places a burden on the patient and the operator.
[0005]
[Patent Document]
Japanese Patent Application No. 2002-268239
[0006]
[Object of the invention]
Therefore, an object of the present invention is to introduce an endoscope grasping device and an endoscope treatment tool that can reduce the time and labor required for attaching a magnetic anchor to a lesion and reduce the burden on patients and operators. It is to provide a method.
[0007]
Summary of the Invention
In order to solve the above problems, in the endoscope gripping device of the present invention, a gripping member that grips a target portion inside a target object, an anchor that pulls the gripping member, and connects the gripping member and the anchor A coupling member, traction separation means coupled to the gripping member, and a hollow cylindrical gripping member receiving tube having a slit with an open rear end for receiving a rear part of the gripping member at an end. When the gripping member is held at one end of the gripping member receiving tube, the pulling and separating means is guided to the outside from the rear end of the gripping member receiving tube, and the connecting member is guided to the outside of the gripping member receiving tube via the slit. The magnetic anchor is positioned in front of the gripping member.
[0008]
In view of the present invention as a method, an endoscope treatment tool in which a gripping member for gripping a target portion inside a target object and an anchor for pulling the gripping member is connected to the target object through the endoscope by an endoscope. An endoscope treatment instrument introduction method to be introduced, wherein a rear part of a gripping member is received at a front end portion, and a hollow cylindrical gripping member receiving tube having a slit whose rear end portion is opened is prepared. The towing / separating means connected to the member is guided to the outside from the rear end of the holding member receiving tube, and the connecting member is guided to the outside of the holding member receiving tube through the slit to hold the holding member at one end of the holding member receiving tube. Step, having an operation wire capable of independently towing operation inside, preparing an introduction tube to be inserted through the forceps channel of the endoscope, hooking the towing separation means on the hook portion at the tip of the operation wire, Attach the gripping member receiving tube to the tip of the introduction tube Attachment step, in a state where the anchor is positioned in front of the gripping member, pulls the operation wire to the introduction tube to cut the traction separation means, and disconnects the endoscope treatment tool and the gripping member receiving tube from the distal end of the introduction tube. Releasing.
[0009]
The rear end of the grasping member receiving tube is detachable from the distal end of the introduction tube inserted through the forceps channel of the endoscope, and an operation wire that can be independently pulled and pulled is inserted into the introduction tube. It is preferable that a hook portion for hooking the traction separating means is formed at the tip of the operation wire.
[0010]
In the gripping member receiving tube, a small diameter portion to be inserted into the introduction tube is formed by a step portion at an intermediate portion in the longitudinal direction, and a front end portion of the open slit at the rear end portion reaches the front of the step portion. Is preferred.
[0011]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The endoscope gripping device 1 according to the present embodiment includes a clip (grip member) 10, a magnetic anchor 30, a connecting member 20, and the like.
[0012]
(1) Configuration
As shown in FIGS. 1 to 3, the clip 10 fixes one end in the longitudinal direction of each of the long plate-like members 11, 12, 13 having the same shape to the outer diameter of the base end 10 a having a substantially circular shape. This is an elastic member formed by: The plate-like members 11, 12, and 13 are arranged at intervals of 120 degrees in the outer diameter of the base end portion 10a, and extend parallel to each other with the bottom surface facing inward. The clip 10 may have two or three or more plate members as long as the clip 10 can grasp the lesion.
[0013]
On the other hand, claw portions 11a, 12a, and 13a bent inward are formed at the other end portion not fixed to the base end portion 10a. Therefore, when the plate-like members 11, 12, and 13 are urged to approach each other, the target object can be sandwiched between the claw portions 11a, 12a, and 13a.
[0014]
In addition, at the same position in the longitudinal direction of each of the plate members 11, 12, and 13, the protrusions 11b, 12b, and 13b project outward from the front and rear portions by bending the plate members 11, 12, and 13. And inclined portions 11c, 12c, 13c which spread outward again from the front ends of the convex portions 11b, 12b, 13b narrowed inward, and claw portions 11a, 12a, 13a from the front ends of the inclined portions 11c, 12c, 13c. The end portions 11d, 12d, and 13d extending to are provided.
[0015]
In this configuration, when a force that urges the convex portions 11b, 12b, and 13b inwardly is applied, the bending angle before and after the convex portions 11b, 12b, and 13b changes, so that the inclined portions 11c, 12c, and 13c and the tip portions 11d, 12d, and 13d are formed. Spread outward (Fig. 3). In the state where the convex portions 11b, 12b, and 13b are urged inward, when a force that further urges the inclined portions 11c, 12c, and 13c and the tip portions 11d, 12d, and 13d inward is applied, the inclined portion The bending angles of the 11c, 12c, 13c and the tip portions 11d, 12d, 13d change so that the intervals between them are reduced.
[0016]
A flexible connecting member 20 for connecting the clip 10 and the magnetic anchor 30 is inserted inside the clip 10. As the connection member 20, for example, a surgical suture, a fishing line, and a metal wire can be used.
[0017]
The magnetic anchor 30 connected to the end of the connecting member 20 is made of a ferromagnetic material, and can be suction-controlled by using a magnetic guiding member such as an electromagnet or a permanent magnet. As a magnetic material used for the magnetic anchor 30, in addition to pure iron and an iron alloy, a magnet such as a platinum magnet, a rare earth magnet, and a terbium / dysprosium / iron alloy can be used. The magnetic anchor 30 is provided at one end thereof with a hole 31 into which the end of the connecting member 20 can be inserted and fixed.
[0018]
Since the clip 10 and the magnetic anchor 30 are connected via the connecting member 20 in this manner, the clip 10 can be pulled in a desired direction by controlling the suction of the magnetic anchor 30.
[0019]
In the vicinity of the base end 10a, the plate-like members 11, 12, 13 are inserted into a substantially cylindrical clip receiving tube (gripping member receiving tube) 40 having an inner diameter with which the outer surface thereof can contact. I have. At this time, at least a part of the rear portions 11 e, 12 e, and 13 e of the plate members 11, 12, and 13 are received in the large-diameter portion 46. The clip receiving tube 40 can be formed of, for example, a stainless pipe, a plastic tube, or a superelastic alloy, and a pair of slits 41 and 42 are provided at positions facing each other in the radial direction. The slits 41 and 42 are arranged such that, in a direction parallel to the center line of the clip receiving tube 40 (the line connecting the centers of the substantially circular cross sections), the predetermined position 43 shifted to the side where the clip 10 is inserted is set as the front end, and It extends to an end 44 and its rear end is open. The number of slits may be one.
[0020]
The connecting member 20 fixed to the magnetic anchor 30 is introduced into the clip receiving tube 40 through the slits 41 and 42, and is passed through the base end 10a. With this configuration, the clip 10 and the magnetic anchor 30 are connected via the clip receiving tube 40.
[0021]
The rear ends of the slits 41 and 42 are pulled out to the end 44 (open), but the front ends are not pulled out to the front end of the clip receiving tube 40 and are stopped at a predetermined position 43 on the way. I have. With this configuration, the movement of the connecting member 20 inserted into the slits 41 and 42 from the end portion 44 toward the clip 10 (front side) is regulated by the predetermined position 43. On the other hand, the movement of the connecting member 20 toward the end portion 44 (rear side) is regulated by the base end portion 10 a of the clip 10 inserted into the clip receiving tube 40.
[0022]
Further, the outer diameter of the clip receiving tube 40 differs before and after a step 45 provided at a position shifted rearward from the predetermined position 43. That is, the outer diameter of the large-diameter portion (front portion) 46 on the front side of the step portion 45 is set smaller than the outer diameter of the small-diameter portion (rear portion) 47 on the rear side of the step portion 45.
[0023]
A metal loop wire (traction separation means) 50 is passed through the base end 10a. The loop wire 50 may be made of a material other than metal as long as it is cut when pulled by a predetermined or more strong force. The clip 10, one end of which is inserted into the clip receiving tube 40, is pulled inward by the loop wire 50, so that each portion sequentially contacts the inner wall of the clip receiving tube 40 and is elastically deformed. Can be inserted into
[0024]
Specifically, when the protrusions 11b, 12b, and 13b abut against the inner wall of the clip receiving tube 40 by pulling the loop wire 50 rearward, the protrusions 11b, 12b, and 13b move inward so as to approach each other. Bend. As a result, the distal ends 11d, 12d, and 13d are separated from each other, and the clip 10 is in an open state. When the loop wire 50 is further pulled rearward, the inclined portions 11c, 12c, and 13c abut against the inner wall of the clip receiving tube 40, and the inclined portions 11c, 12c, and 13c bend inward so as to approach each other. Then, the tips 11d, 12d, and 13d approach each other, and the clip 10 is in a closed state.
[0025]
The clip 10, the connecting member 20, the magnetic anchor 30, the clip receiving tube 40, and the loop wire 50 connected as described above are introduced into the patient (object) 101 using the hollow cylindrical introducing tube 70. In addition, the clip 10, the connecting member 20, the magnetic anchor 30, the clip receiving tube 40, and the loop wire 50 form an endoscope treatment tool according to the present invention.
[0026]
The introduction tube 70 is made of a flexible material, and is inserted from the forceps insertion port 91 of the endoscope 90 into the forceps channel 61 of the distal end rigid portion 60 as shown in FIGS. An insertion coil 71 that is relatively movable with respect to the introduction tube 70 is disposed on the inner wall of the introduction tube 70 in the longitudinal direction of the introduction tube 70. A regulating tube 72 is fixed to the distal end of the insertion coil 71 on the distal end rigid portion 60 side with an adhesive, solder, brazing, or the like. The regulating pipe 72 is provided with a step 73, and the outer diameter of the front portion 74 of the step 73 is substantially the same as the inner diameter of the introduction pipe 70. On the other hand, the outer diameter of the rear portion 75 having a smaller outer diameter than the front portion 74 is substantially the same as the inner diameter of the hollow cylinder formed by the insertion coil 71. Therefore, when the insertion coil 71 is fixed to the outer periphery of the rear portion 75, the outer periphery of the hollow cylinder formed by the insertion coil 71 and the outer periphery of the front portion 74 are substantially flush.
[0027]
On the other hand, the inner diameter of the front part 74 is set to be larger than the inner diameter of the rear part 75. Further, the inner diameter of the front portion 74 and the inner diameter of the rear portion 75 are substantially the same as the outer diameter of the large diameter portion 46 and the outer diameter of the small diameter portion 47 of the clip receiving tube 40, respectively. For this reason, the clip receiving tube 40 can be inserted into the restricting tube 72, and the movement of the clip receiving tube 40 is restricted by the step 45 contacting the distal end surface 76 of the restricting tube 72. Here, in the direction of the center line of the clip receiving tube 40, since the predetermined position 43 is disposed on the front side of the step portion 45, the clip receiving tube 40 is moved to the regulating tube 72 until the step portion 45 and the step portion 73 come into contact with each other. Even if it is inserted into the inside, the slits 41 and 42 are not completely covered by the regulating pipe 72. Therefore, even in this state, the connecting member 20 can extend from inside the clip receiving tube 40 to the outside.
[0028]
An operation wire 80 provided with a hook portion 81 at a distal end is disposed in the insertion coil 71 and the regulation tube 72 so as to be relatively movable with respect to the insertion coil 71 and the regulation tube 72. The hook 81 has a rear end fixed to the operation wire 80 by an adhesive, solder, brazing, or the like. The operation wire 80 is sufficiently longer than the introduction tube 70, and a rear end portion 80a extends from the introduction tube 70 protruding outside from the forceps insertion port 91. A central portion of the hook portion 81 is a concave portion 82. The end of the loop wire 50 is hooked on the concave portion 82 and the operation wire 80 is pulled, so that the clip 10 is connected to the clip receiving tube 40 via the loop wire 50. Can be pulled into. The operation wire 80 is pulled by pulling the rear end portion 80 a extending from the endoscope 90.
[0029]
On the other hand, the position of the magnetic anchor 30 is controlled by a magnetic anchor guiding device 110 having a magnetic guiding member 112 that controls the suction of the magnetic anchor 30 outside the body of the patient 101 (powers the magnetic anchor 30). The magnetic guiding member 112 is configured by disposing an electromagnet 112c having a structure in which a coil is wound around an iron core on a base 112a (FIG. 6).
[0030]
As shown in FIG. 6, the magnetic guide member 112 includes an electromagnet 112c slidably provided on a frame / rail (in-plane moving mechanism) 114 arranged so as to surround the bed 116 on which the patient 101 lies. It is placed facing the patient. The frame / rail 114 is composed of two U-shaped rails 114a and 114b arranged in parallel in one plane, and two XY stages (one-way moving mechanism) in parallel with the width direction of the floor plate 116a of the bed 116. ) 119. The XY stage 118 is relatively movable in a direction orthogonal to the plane on which the frame / rail 114 is provided. With the above configuration, the magnetic guide member 112 can move between the two XY stages 118 and 119 by the base 112a rubbing against the frame / rail 114. The magnetic guiding member 112 is disposed on the rail 114a on the side closer to the patient 101 among the two parallel rails 114a and 114b of the frame / rail 114.
[0031]
On a rail 114b of the frame / rail 114 remote from the patient 101, a counterweight 120 for maintaining the weight balance of the entire frame / rail 114 is slidably arranged on the rail 114b. The position of the counterweight 120 changes according to the position of the magnetic guide member 112. For example, when the magnetic guiding member 112 is in front of the patient 101, the counterweight 120 is arranged on the back of the patient 101. When the magnetic guiding member 112 is on the back of the patient 101, the counterweight 120 is placed in front of the patient 101. To balance the weight of the entire frame / rail 114.
[0032]
By arranging the magnetic guiding member 112, the XY stages 118 and 119, the frame / rail 114, and the like as described above, the magnetic guiding member 112 can be arranged at an optimal position for excision of a lesion (target site) 130. it can. Therefore, in order to lift the lesion so that the lesion can be easily removed, the magnetic anchor 30 can be suctioned (powered), and the magnetic anchor 30 and the clip 10 can be arranged at appropriate positions.
[0033]
(2) Preparation for resection
As shown in FIG. 6, prior to performing a resection using the endoscope gripping device 1 according to the present invention, first, the patient 101 who has been subjected to local anesthesia is laid on the bed 116. At this time, the frame / rail 114 is retracted by the XY stages 118 and 119 to the side where the head 101a of the patient 101 comes, and the magnetic guide member 112 and the counterweight 120 are arranged at predetermined positions. When the patient 101 lies on the bed 116, the XY stages 118 and 119 are operated to place the frame / rail 114 in front of the patient's lesion, and then rubbed on the frame / rail 114 to cause the magnetic guide member to move. Position 112 at the start of the resection.
[0034]
(3) Introducing the magnetic anchor 30 and the clip 10 into the body
In the endoscope gripping device 1 of the present invention, the clip 10 and the magnetic anchor 30 are introduced into the body by introducing the rigid end portion 60 of the endoscope into the body. The magnetic anchor 30 is inserted into the distal end rigid portion 60 at the distal end, and the introduction tube 70 in which the clip 10 is disposed is inserted after the magnetic anchor 30. The clip 10 is arranged with the claw portions 11a, 12a, 13a facing the distal end side of the distal end rigid portion 60.
[0035]
The arrangement of the clip 10 and the magnetic anchor 30 in the introduction pipe 70 is performed as follows (FIGS. 7 and 8).
The clip 10 and the magnetic anchor 30 are inserted into the introduction tube 70 in a state where the clip 10 and the magnetic anchor 30 are connected via the connecting member 20 passed through the clip receiving tube 40 from the slits 41 and 42. At the time of insertion, the loop wire 50 previously passed through the clip 10 is hung on the concave portion 82 of the hook portion 81 fixed to the tip of the operation wire 80 passed through the introduction tube 70. In this state, the clip receiving tube 40 associated with the clip 10 and the magnetic anchor 30 is inserted into the regulating tube 72 arranged in the introduction tube 70. This insertion operation ends when the step 45 of the clip receiving tube 40 and the step 73 of the regulating tube 72 abut on each other, whereby the movement of the clip receiving tube 40 is restricted. As shown in FIG. 8, in the gripping device for an endoscope of the present invention, the clip 10 is inserted following the clip receiving tube 40, and then a part of the magnetic anchor 30 is inserted. Since the predetermined position 43 which is the end position of the slits 41 and 42 is located at a position on the front side in the direction of the center line of the clip receiving tube 40 with respect to the step 45 of the clip receiving tube 40, Even if the clip receiving tube 40 is inserted into the regulating tube 72 until the 45 and the step 73 abut, the slits 41 and 42 are open at the predetermined position 43 without being closed by the regulating tube 72. Therefore, the connecting member 20 that connects the clip 10 and the magnetic anchor 30 can extend from the slits 41 and 42 to the outside of the clip receiving tube 40 at the predetermined position 43. In addition, since the connecting member 20 has a length sufficient to prevent the magnetic anchor 30 from being disposed in front of the clip 10, the magnetic anchor 30, the clip 10, and the clip receiving tube 40 are completed when the insertion operation is completed. Are arranged on a straight line.
[0036]
The clip 10 and the magnetic anchor 30 are introduced into the patient 101 as follows (FIGS. 9 and 10).
First, after the distal end rigid portion 60 is introduced into the body, the regulating tube 72 is urged forward by operating the operation wire 80. As a result, the clip receiving tube 40 in which the step portion 45 is in contact with the step portion 73 is pushed forward, and accordingly, the clip 10 whose one end is pressed into the clip receiving tube 40 also advances forward, and The front end contacts the rear end of the magnetic anchor 30 (FIG. 9). When the regulating pipe 72 is further urged forward from this state, the magnetic anchor 30 having the rear end fitted to the front end of the introduction pipe 70 comes off. When the regulating tube 72 is further urged forward, as shown in FIG. 10, the clip 10, the clip receiving tube 40 and the regulating tube 72 are exposed from the distal end of the introduction tube 70 into the body of the patient 101, and the clip 10 and the clip receiving tube 70 are received. While the tube 40 is arranged in a straight line in the longitudinal direction of the introduction tube 70, the magnetic anchor 30 hangs down by gravity. Therefore, if the distal end rigid portion 60 is arranged toward the lesioned portion 130, the introduction tube 70 disposed in the distal end rigid portion 60 also faces the lesioned portion 130, so that the distal end of the clip 10 can be easily directed to the lesioned portion 130. it can.
[0037]
The clip 10 is attached to the lesion 130 as follows (FIGS. 11 to 14). 11 and 12, the plate member 12 is omitted for convenience of explanation.
[0038]
First, in order to open the tips 11d, 12d, and 13d, the operation wire 80 is relatively moved with respect to the insertion coil 71 and the restriction tube 72, so that the operation wire 80 is pulled and the protrusions 11b, 12b, and 13b are pulled. Pull into clip receiving tube 40. The protrusions 11b, 12b, and 13b drawn into the control pipe 72 abut on the inner wall of the clip receiving pipe 40, and therefore bend in directions approaching each other. By bending the projections 11b, 12b, 13b in this manner, the tips 11d, 12d, 13d bend so as to be separated from each other, and as a result, the tip of the clip 10 exposed from the clip receiving tube 40 is opened ( (FIG. 11).
[0039]
The clip 10 thus opened is moved toward the lesion 130 by integrally moving the insertion coil 71, the regulating tube 72, and the operation wire 80. When the tip of the clip 10 comes to a desired position, the clip 10 is removed. By closing, the lesion portion 130 can be gripped by the clip 10. To close the clip 10, the operating wire 80 is pulled by moving the operating wire 80 relatively to the insertion coil 71 and the regulating tube 72, and the inclined portions 11 c, 12 c, and 13 c are inserted into the clip receiving tube 40. Pull in. The inclined portions 11c, 12c, and 13c drawn into the clip receiving tube 40 are bent toward each other to come into contact with the inner wall of the clip receiving tube 40, so that the tip portions 11d, 12d, and 13d approach each other. As a result, the distal end side of the clip 10 exposed from the clip receiving tube 40 is closed (FIG. 12).
[0040]
Next, the clip 10 and the magnetic anchor 30 connected via the clip receiving tube 40 and the connecting member 20, the insertion coil 71, the control tube 72, the operation wire 80, and the introduction tube 70 having the hook portion 81 therein are included. The clip 10 is separated and the attachment to the lesion 130 is completed. In this separating operation, the operation wire 80 is strongly pulled to cut the loop wire 50 hooked on the hook portion 81 (FIG. 13), and then the insertion coil 71, the regulating tube 72, the operation wire 80 and the hook portion 81 are retracted. (FIG. 14).
[0041]
(4) Steps of resection
The step of excision of the lesion 130 using the magnetic anchor guiding device 110 configured as described above will be described.
[0042]
First, physiological saline is injected from the periphery of the lesion 130 with an injection needle inserted into the submucosal layer (not shown), and the lesion 130 is raised from the proper muscle layer (not shown).
[0043]
On the other hand, the magnetic guiding member 112 is arranged at a preset position near the lesion 130. With this setting, the lesion 130 is lifted by the suction force between the magnetic guiding member 112 and the magnetic anchor 30. If the amount of lifting of the lesion 130 is insufficient or too large, the adjustment is performed by shifting the position of the magnetic guide member 112 or weakening the magnetic field generated by the magnetic guide member 112.
[0044]
Subsequently, an incision tool such as a high-frequency scalpel is introduced into the body through the forceps channel 61, and the lesion 130 is excised from the end together with the mucous membrane. At this time, since the diseased part 130 is lifted by the clip 10, a resected portion can be sufficiently obtained, and the already resected diseased part 130 can be prevented from falling on the proper muscle layer. In addition, by gradually shifting the position of the magnetic guiding member 112, the resected part 130 can be further lifted, so that the position of the distal end of the high-frequency knife can be easily confirmed and the resection operation can be performed smoothly.
[0045]
When the resection operation is completed, the magnetic anchor 30 is drawn to the magnetic guiding member 112 with the clip 10 gripping the lesion 130, so that the loss of the lesion 130 can be prevented. When recovering the excised lesion 130, a current is supplied to the magnetic guiding member 112 in a state where the magnetic anchor 30, the clip 10, the connecting member 20, the clip receiving tube 40, and a part of the lesion 130 are hooked with grasping forceps. Stop supply and collect by removing the endoscope. Thereafter, procedures such as suturing and disinfection are performed.
[0046]
Note that the magnetic anchor 30 may be pulled using gravity.
[0047]
Although the present invention has been described with reference to the above embodiment, the present invention is not limited to the above embodiment, and can be improved or changed within the scope of the purpose of improvement or the concept of the present invention.
[0048]
【The invention's effect】
As described above, according to the present invention, it is possible to introduce the magnetic anchor and the gripping member connected in advance by the connecting member into the inside of the target object, and to attach to the target site when the endoscope gripping device is introduced. It can be carried out. For this reason, there is no need to connect the magnetic anchor and the gripping member inside the object, and it is not necessary to attach the gripping member to the target site using separate gripping forceps after placing the gripping member inside the object once. Therefore, the time and labor required for these operations can be reduced, and the burden on the patient and the operator can be reduced.
[Brief description of the drawings]
FIG. 1 is a partial cross-sectional view showing a configuration of a magnetic anchor, a clip, a connecting member, a loop wire, and a clip receiving tube according to an embodiment of the present invention.
FIG. 2 is a side view showing a configuration of a magnetic anchor, a clip, a connecting member, and a clip receiving tube according to the embodiment of the present invention.
FIG. 3 is a front view showing a state in which the clip according to the embodiment of the present invention is opened.
FIG. 4 is a partial cross-sectional view showing a configuration of an introduction pipe, an insertion coil, a coil restriction pipe, a hook, and an operation wire according to the embodiment of the present invention.
FIG. 5 is an outline view showing an overall configuration of an endoscope according to the embodiment of the present invention.
FIG. 6 is a schematic view of an arrangement of a bed on which a patient is placed, a magnetic guiding member, and the like when resected of a lesion according to an embodiment of the present invention viewed from the patient's head side.
FIG. 7 is a view showing a state in which the clip receiving tube according to the embodiment of the present invention is received by the coil restricting tube.
FIG. 8 is a view showing a state in which the introduction tube into which the clip according to the embodiment of the present invention is inserted is received in the forceps channel.
FIG. 9 is a view showing a state in which a part of the introduction tube according to the embodiment of the present invention is exposed to the outside of the forceps channel.
FIG. 10 is a view showing a state in which the clip and the magnetic anchor according to the embodiment of the present invention are exposed outside the introduction tube.
FIG. 11 is a partial cross-sectional view showing a state where the clip according to the embodiment of the present invention is opened.
FIG. 12 is a partial cross-sectional view showing a closed state of the clip according to the embodiment of the present invention.
FIG. 13 is a side view showing a state where a part of the loop wire according to the embodiment of the present invention is cut off.
FIG. 14 is a side view showing a state in which the clip according to the embodiment of the present invention is separated from the introduction tube, the coil regulating tube, and the hook portion.
15A and 15B are views showing the inside of a conventional introduction tube into which a magnetic anchor and a clip are inserted, wherein FIG. 15A shows a state in which the magnetic anchor and the clip are arranged in the introduction tube, and FIG. 15B shows a rear end side of the introduction tube. (C) is a diagram showing a state in which the magnetic anchor and the clip are pushed out of the introduction tube by pushing in the flexible pushing rod.
[Explanation of symbols]
10 clips (gripping members)
11e rear
12e rear
13e rear
20 Connecting members
30 magnetic anchor
40 clip receiving tube (gripping member receiving tube)
41 slit
42 slit
44 rear end
45 Step
46 Front
50 Loop wire (traction separation means)
70 Introductory tube
72 Regulatory tube
80 Operation wire
101 Patient (object)
130 Lesions (target site)

Claims (4)

A gripping member that grips a target portion inside the target object,
An anchor for pulling the gripping member,
A connecting member that connects the grip member and the anchor,
A traction separation member coupled to the gripping member,
A hollow cylindrical gripping portion receiving tube having a slit with an open rear end portion for receiving a rear portion of the gripping member at a front portion,
With
When the gripping member is held at the front part of the gripping member receiving tube, the towing separation member is guided to the outside from the rear end of the gripping member receiving tube, and the connecting member receives the gripping member receiving through the slit. An endoscope gripping device, wherein the anchor is guided outside the tube to position the anchor in front of the gripping member. A rear end of the gripping member receiving tube is detachable from a distal end of an introduction tube that is inserted through a forceps channel of an endoscope, and an operation wire that can be independently pulled is inserted into the introduction tube. 2. The endoscope gripping device according to claim 1, wherein a hook portion for hooking the traction separating means is formed at a tip of the operation wire. The gripping member receiving tube has a small-diameter portion to be inserted into the introduction tube by a step portion at an intermediate portion in the length direction, and a front end portion of the slit that is opened at the rear end portion has a front end portion of the step portion. The gripping device for an endoscope according to claim 2, wherein the gripping device reaches forward. An endoscope treatment tool for introducing an endoscope treatment tool, in which a gripping member for gripping a target portion inside an object and an anchor for pulling the gripping member by a connecting member, into the object via an endoscope. The introduction method,
A rear part of the gripping member is received at a front end, and a hollow cylindrical gripping member receiving tube having a slit with an open rear end is prepared, and the traction separating means coupled to the gripping member is gripped by the gripping member. Guiding the connecting member to the outside of the gripping member receiving tube through the slit to hold the gripping member at one end of the gripping member receiving tube, and guiding the connecting member to the outside through the slit.
An operation wire having an independently towable operation wire therein is provided, and an introduction tube to be inserted through a forceps channel of an endoscope is prepared. Mounting the gripping member receiving tube at the distal end of the tube;
With the anchor positioned in front of the grasping member, the operation wire is pulled toward the introduction tube to cut the traction separation unit, and the endoscope treatment tool and the grasping member receiving tube are released from the distal end of the introduction tube. Steps to
A method for introducing an endoscopic treatment instrument in endoscopy, comprising:

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