JP2005192734A - Clamping device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clamping device preventing the falling of a connecting member in a space formed by a clamping member, easily pointing the clamping member in the direction of an object portion, surely clamping the object portion and easily controlling to pull an anchor. <P>SOLUTION: This clamping device is provided with the clamping member 10 clamping the object portion inside the object, the anchor 30 pulling the clamping member, the connecting member 20 connecting the clamping member to the anchor, and an hollow tubular introduction tube 70 introduced inside the object with at least one parts of the clamping member and the connecting member retained inside. The clamping member is provided with a connecting base 11 for connecting the connecting member, at least two arms 12 and 13 extending from the connecting base, and claws 14 and 15 extending from the tips of the respective arms and clamping the object portion inside the object. The arms are provided with energizing parts 12b and 13b, when the clamping member is inserted into the introduction tube, abutting on the inner wall of the introduction tube and threadingly engaging the claws with each other. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a grasping apparatus for grasping a lesioned part of a patient using an anchor that can be guided by a magnetic field or gravity when the lesioned part is excised under endoscopic observation.

    As a conventional gripping device, there is a gripping device 300 as shown in FIG. The gripping device 300 includes a clip (grip member) 310, a connecting member 320, a magnetic anchor 330, and an introduction tube 370.

    As shown in FIGS. 13 to 15, the clip 310 is formed by bending a metal member having elasticity to form a connection base part 311, arm parts 312 and 313, and gripping parts 314 and 315. The gripping part 314 and the gripping part 315 are substantially rectangular, and one side of each of the gripping part 314 and the gripping part 315 is a tip part 314a and a tip part 315a facing each other, and when the tip part 314a and the tip part 315a are brought into contact with each other, the boundary is a straight line Become. In the natural state where no force is applied from the outside, the clip 310 is separated from the grip portion 314 and the grip portion 315 by its elasticity, and when the arm portion 312 and the arm portion 313 are urged to approach each other, the grip portion 314 An object can be gripped between the gripping portion 315 and the gripping portion 315.

    A connecting member 320 having flexibility for connecting the clip 310 and the magnetic anchor 330 is inserted inside the connecting base 311. The magnetic anchor 330 connected to the end of the connecting member 320 is made of a ferromagnetic material, and can be controlled by suction using a magnetic induction member such as an electromagnet or a permanent magnet. The connecting member 320 coupled to the clip 310 is introduced into the clip receiving tube 340 from the hole 341, led out from the slit 342, and coupled to the hole 331 of the magnetic anchor 330. Since the clip 310 and the magnetic anchor 330 are thus connected via the connecting member 320, the clip 310 can be pulled in a desired direction by controlling the magnetic anchor 330 to be attracted by an external magnetic field.

    As shown in FIGS. 12 to 15, the connected clip 310, the connecting member 320, the magnetic anchor 330, and the clip receiving tube 340 are formed using a hollow cylindrical introduction tube 370 in a state in which these are arranged inside the patient ( Object) Introduced into the body. When the clip 310 is inserted into the introduction tube 370, the arm portions 312 and 313 come into contact with the inner wall 370a. For this reason, an urging force that causes the arm portion 312 and the arm portion 313 to approach each other works, and the grip portion 314 and the grip portion 315 are brought closer to each other than the natural state.

The clip 310, the connecting member 320, and the magnetic anchor 330 are led out from the introduction tube 370 into the patient by operating the insertion coil 371 and the operation wire 380. The insertion coil 371 is fixed to a restriction tube 372 into which the clip receiving tube 340 is fitted, and the operation wire 380 is connected to a pulling member 382 hooked on the connection base portion 311 via a hook portion 381. Therefore, the clip receiving tube 340 can be moved relative to the introduction tube 370 by operating the insertion coil 371. Further, the clip 310 can be moved relative to the clip receiving tube 340 by operating the operation wire 380. When the coupling base 311 is pulled into the clip receiving tube 340 by the relative movement of the clip 310 with respect to the clip receiving tube 340, the arm portion 312 is brought into contact with the inner wall 348 of the clip receiving tube 340 from the base 311c to the bent portions 311a and 311b. The arm portions 312 and 313 move in the direction of opening to each other, and are drawn into the clip receiving tube 340 while being in contact with the hole 341 of the clip receiving tube 340 from the bent portions 311a and 311b to the arm portions 312 and 313. The urging forces approaching each other act, and the gripping portion 314 and the gripping portion 315 can be closed.
Japanese Utility Model Publication 4-26091

  In the gripping device 300 described above, when the insertion coil 371 and the operation wire 380 are operated to push the clip 310 and the magnetic anchor 330 from the introduction tube 370 toward the lesioned part 102 of the patient 101, as shown in FIG. The connecting member 320 may enter the space 316 surrounded by the arm portions 312, 313 and the grip portions 314, 315 from the gap between the grip portion 314 and the grip portion 315.

    In such a state, since the weight of the magnetic anchor 330 is applied to the clip 310, it is difficult to correctly direct the clip 310 to the lesioned part 102. Furthermore, as shown in FIG. 17, when the connecting member 320 enters the space 316, the clip 310 cannot be sufficiently drawn into the clip receiving tube 340, and the gap between the grip portion 314 and the grip portion 315 can be reduced. It becomes difficult and grip of 102 becomes insufficient. Further, since the connecting member 320 that should originally be led out from the opening 340a behind the clip receiving tube 340 is guided to the magnetic anchor 330 side via the front of the clip receiving tube 340, the clip 310, the clip receiving tube 340, the connection The member 320 and the magnetic anchor 330 do not become linear, and the control of the pulling direction by the magnetic anchor 330 becomes difficult. Further, the connecting member 320 may be cut by the grip portion 314 and the grip portion 315.

  In order to solve the above problems, in the gripping device of the present invention, at least a gripping member that grips a target portion inside a target object, an anchor that pulls the gripping member, a connecting member that connects the gripping member and the anchor, A hollow tubular introduction tube that is introduced into the object while holding a part of the gripping member and the coupling member inside, and the gripping member extends at least from the coupling base to which the coupling member is coupled, There are two arms and a claw that extends from the tip of each arm and grips the target part inside the object, and the arm contacts the inner wall of the introduction tube when the gripping member is inserted into the introduction tube It is characterized by providing the urging | biasing part which meshes | engages a nail | claw part with each other.

  The urging portion is a bent portion provided by bending a predetermined position of the arm portion, and the bent portion is configured such that the arm portion is separated from the claw portion toward the bent portion when the claw portion is engaged. Preferably it is.

  The urging portion has a substantially rectangular outer surface, and at least one of the sides of the urging portion abuts against the inner wall of the introduction tube, whereby the claw portions can be engaged with each other.

  The urging portion has a substantially hemispherical shape, and the claw portions can be engaged with each other by contacting the inner wall of the introduction tube.

  The urging portion is preferably formed so as to protrude outward in a substantially hemispherical shape at a predetermined position on the outer surface of the arm portion.

  It is preferable that one of the claw portions includes a convex portion that protrudes toward the opposing claw portion, and the opposing claw portion includes a concave portion that receives the convex portion.

  When the anchor is a magnetic body, power can be applied by an external magnetic field.

  It is preferable that the introduction tube is inserted into the insertion portion of the endoscope and introduced into the object.

  According to the present invention, since a part of the gripping member comes into contact with the inner wall of the introduction tube, the gripping member can be surely engaged with each other, so that the connecting member does not fall into the space formed by the gripping member. It is possible to provide a gripping device that can be easily directed in the direction of the target part, can reliably grip the target part, and can easily perform anchor traction control.

First Embodiment (FIGS. 1 to 7)
Hereinafter, a first embodiment according to the present invention will be described in detail with reference to the drawings. As shown in FIG. 1, the gripping device 1 according to the first embodiment includes a clip (gripping member) 10, a connecting member 20, a magnetic anchor (anchor) 30, and an introduction tube 70. In the following description, the left side (magnetic anchor 30 side) of FIG. 1 is the front, and the right side (clip receiving tube 40 side) is the rear.

(1) Configuration As shown in FIGS. 1 to 3, the clip 10 is formed by bending a metal member having elasticity to form a connection base portion 11, arm portions 12 and 13, and claw portions 14 and 15. The connecting base 11 is provided with a bent portion 11a and a bent portion 11b at both ends of a substantially V-shaped base portion 11c obtained by bending a rod-shaped portion. From both ends (bending portions) 11a and 11b of the connecting base portion 11, plate-like arm portions 12 and 13 having the same shape extend so that the bottom surface 12a and the bottom surface 13a face each other and are gradually separated from each other. The arm portions 12 and 13 are provided with bent portions (biasing portions) 12b and 13b at the same position in the longitudinal direction, and the bottom surface 12a and the bent portions 12b and 13b are directed toward the tip portions 12c and 13c. The bottom surface 13a gradually approaches.

    From the tip portions 12c and 13c of the arm portions 12 and 13, a claw portion 14 and a claw portion 15 that are oriented so that the tip portions 14a and 15a face each other extend. In the state where no force is applied from the outside, the clip 10 has its tip portion 14a and tip portion 15a separated by elasticity, and when the arms 12 and 13 are urged to approach each other, the claw portion 14 and the claw portion The object can be held between 15 and 15.

    As shown in FIG. 3, the distal end portion 14a is formed with a V-shaped recess 14a1 that is recessed in a V-shape toward the arm portion 13, and the distal end portion 15a is formed in a V-shape projecting in a V-shape toward the distal end portion 14a. A convex portion 15a1 is formed, and when the distal end portion 14a and the distal end portion 15a come into contact with each other, the concave portion 14a1 and the convex portion 15a1 mesh with each other without gaps. In a state where the concave portion 14a1 and the convex portion 15a1 are engaged with each other, the bottom surface 12a and the bottom surface 13a are gradually separated from the claw portion 14 and the claw portion 15 side toward the bent portions 12b and 13b, and are connected from the bent portion 12b and the bent portion 13b. The bottom surface 12a and the bottom surface 13a gradually approach each other toward the base 11 side. In addition, if the recessed part 14a1 and the convex part 15a1 can mutually mesh | engage, it can replace with V shape, for example, can also be made into semicircle shape and a rectangular shape, and the number may be two or more. Moreover, you may provide a convex part in the front-end | tip part 14a side, and a recessed part in the front-end | tip part 15a side.

    A connecting member 20 having flexibility for connecting the clip 10 and the magnetic anchor 30 is inserted inside the connecting base portion 11. As the connecting member 20, for example, a surgical suture, a fishing line, or a metal wire can be used.

    The magnetic anchor 30 connected to the end of the connecting member 20 is made of a ferromagnetic material, and can be attracted and controlled by using a magnetic induction member such as an electromagnet or a permanent magnet. As the magnetic material used for the magnetic anchor 30, magnets such as platinum magnets, rare earth magnets, terbium / dysprosium / iron alloys can be used in addition to pure iron and iron alloys. The magnetic anchor 30 is provided with a hole 31 at one end of which the end of the connecting member 20 can be inserted and fixed.

    Since the clip 10 and the magnetic anchor 30 are connected via the connecting member 20 as described above, the clip 10 can be pulled in a desired direction by controlling the magnetic anchor 30 to be attracted by an external magnetic field. The magnetic anchor 30 can be pulled using gravity, and the clip 10 may be pulled by gravity using an anchor made of a non-magnetic material instead of the magnetic anchor 30.

    The connecting member 20 connected to the clip 10 is connected to the magnetic anchor 30 via a cylindrical clip receiving tube (gripping member receiving tube) 40 penetrating from the front surface to the rear surface. Specifically, the connecting member 20 coupled to the connecting base portion 11 is introduced into the clip receiving tube 40 through the hole 41 formed in the front surface of the clip receiving tube 40 and is formed in the side surface of the clip receiving tube 40. It is led out from the slit 42 and coupled to the hole 31 of the magnetic anchor 30. The clip receiving tube 40 can be formed of, for example, a stainless pipe, a plastic tube, or a superelastic alloy, and the rear surface is open. The slit 42 is open at the rear end with the predetermined position 43 as the front end in a direction parallel to the center line of the clip receiving tube 40 (a line connecting the centers of the substantially circular cross sections). The movement of the connecting member 20 inserted into the slit 42 to the clip 10 side (front side) is regulated by a predetermined position 43. Further, the outer diameter of the clip receiving tube 40 differs before and after the step 45 provided at a position shifted from the predetermined position 43 to the rear side. That is, the outer diameter of the large-diameter portion (front portion) 46 on the front side of the step portion 45 is set larger than the outer diameter of the small-diameter portion (rear portion) 47 on the rear side of the step portion 45.

    The clip 10, the connecting member 20, the magnetic anchor 30, the clip receiving tube 40, and the pulling member 82 connected as described above are inside the patient (target) 101 (see FIG. 6) using the hollow cylindrical introduction tube 70. To be introduced. 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 distal end rigid portion 60 of the insertion portion, as shown in FIGS. When the clip 10 is inserted into such an introduction pipe 70, the bent portion 12b and the bent portion 13b come into contact with the inner wall 70a, whereby the tip portion 14a and the tip portion 15a can be engaged with each other. This is because the distance between the outer surfaces of the bent portion 12b and the bent portion 13b when the tip portion 14a and the tip portion 15a mesh with each other is the same as the diameter of the inner wall 70a. This meshing state can be maintained while the clip 10 moves in the introduction tube 70 while the bent portion 12b and the bent portion 13b are in contact with the inner wall 70a. The distance between the outer surfaces of the bent portion 12b and the bent portion 13b when the tip portion 14a and the tip portion 15a are engaged may be slightly larger than the diameter of the inner wall 70a. In this case, since the introduction tube 70 has flexibility, the clip 10 can be inserted into the introduction tube 70 in a state where the distal end portion 14a and the distal end portion 15a are engaged with each other.

    On the inner wall 70a of the introduction tube 70, an insertion coil 71 is disposed that can move relative to the introduction tube 70 in the longitudinal direction of the introduction tube 70. A restriction tube 72 is fixed to the distal end of the insertion coil 71 with an adhesive, solder, solder or the like. The regulation tube 72 is provided with a stepped portion 73, and the outer diameter of the front portion 74 of the stepped portion 73 is substantially the same as the inner diameter of the introduction tube 70. On the other hand, the outer diameter of the rear portion 75 whose outer diameter is smaller than that of 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 on the same plane.

    On the other hand, the inner diameter of the front portion 74 is set larger than the inner diameter of the rear portion 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 and inner 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 restriction tube 72, and the movement of the clip receiving tube 40 is restricted by the stepped portion 45 coming into contact with the distal end surface 72 a of the restriction tube 72. Here, since the predetermined position 43 is disposed in front of the stepped portion 45 in the direction of the center line of the clip receiving tube 40, the clip receiving tube 40 is regulated until the stepped portion 45 and the tip end surface 72a contact each other. Even if it is inserted into 72, the slit 42 is not completely covered by the restriction tube 72. Accordingly, even in this state, the connecting member 20 can extend from the clip receiving tube 40 to the outside.

    An operation wire 80 is disposed in the insertion coil 71 and the restriction tube 72 so as to be movable relative to the insertion coil 71 and the restriction tube 72. A hook portion 81 is fixed to the distal end of the operation wire 80 by an adhesive, solder, solder, or the like. The insertion coil 71 and the operation wire 80 are sufficiently longer than the introduction tube 70, and the rear end portion 71 a of the insertion coil 71 further extends from the introduction tube 70 projecting outward from the forceps insertion port 91, and the rear of the operation wire 80. The end 80a further extends from the insertion coil 71 (FIG. 4).

    A pin 81 a extending upward is formed at the center of the hook portion 81. The pin 81a is fitted into a hole 82b provided at the rear end of a plate-like traction member 82 with a hook portion 82a provided at the tip thereof hooked to the coupling base 11, thereby causing the hook portion 81, the traction member 82, And the connection base 11 is couple | bonded. Further, the hook portion 82a is hooked on the connecting base portion 11, and the rear end portion 80a is pulled backward to introduce the connecting base portion 11 into the clip receiving tube 40 while contacting the inner periphery 48 of the clip receiving tube 40. Can do. In this state, when the operation wire 80 is pulled, the arm portion 12 and the arm portion 13 move in the opening direction until both ends (bent portions) 11a and 11b of the connection base portion 11 are introduced into the clip receiving tube 40, When the operation wire 80 is further pulled, a part of each of the arm portion 12 and the arm portion 13 can be introduced into the clip receiving tube 40. When a part of the arm part 12 and the arm part 13 is introduced into the clip receiving tube 40 in this way, the arm part 12 and the arm part 13 are elastically deformed, and the claw part 14 and the claw part 15 gradually approach each other. In addition, it is possible to realize a state in which the distal end portion 14a and the distal end portion 15a mesh with each other without a gap. This meshing state can be realized when the arm portion 12 and the arm portion 13 are introduced into the clip receiving tube 40 to a position closer to the connecting base portion 11 than the bent portion 12b and the bent portion 13b, and the tip portion 14a and the tip portion 15a are formed. If they are engaged with no gap, the arm portion 12 and the arm portion 13 can no longer be introduced into the clip receiving tube 40.

  Further, by providing the claw portion 14 and the claw portion 15 with the concave portion 14a1 and the convex portion 15a1, respectively, the tip portion 14a and the tip portion 15a are close to each other as well as the tip portion 14a and the tip portion 15a are engaged with each other. Even in this state, the possibility that the connecting member 20 enters the inside of the space 16 surrounded by the arm part 12, the arm part 13, the claw part 14, and the claw part 15 can be extremely reduced.

(2) Introduction Operation into Patient Body In the grasping apparatus 1 of the present invention, the clip 10 and the magnetic anchor 30 connected by the connecting member 20 are introduced into the patient body (inside the object) by the endoscope in the body. This is done by introducing the distal end hard part 60 of the insertion part. As shown in FIG. 1, the distal end rigid portion is inserted with an introduction tube 70 in which a magnetic anchor 30 is disposed at the distal end, and a clip 10 coupled to the interior by a coupling member 20 is disposed. The clip 10 is disposed with the claw portions 14 and 15 facing the front side.

    The clip 10 and the magnetic anchor 30 are arranged in the introduction tube 70 by introducing the clip 10 and the magnetic anchor 30 in a state where the clip 10 and the magnetic anchor 30 are connected from the hole 41 to the slit 42 via the connecting member 20 passed through the clip receiving tube 40. This is done by inserting it into the tube 70.

    Before the insertion, the insertion coil 71, the regulation tube 72, the operation wire 80, and the hook portion 81 that are connected or linked in advance are introduced so that at least the tip of the hook portion 81 extends from the introduction tube 70. The tube 70 is inserted. Next, by inserting the hole 82b of the pulling member 82 into the pin 81a of the hook 81 extending from the introduction tube 70, and pulling the rear end 80a extending from the forceps insertion port 91 in this state, the clip 10 is pulled. Then, the connecting member 20 is inserted into the introduction tube 70. At this time, the clip receiving tube 40 associated with the clip 10 and the magnetic anchor 30 is inserted into the restriction tube 72 disposed in the introduction tube 70, and the step 45 of the clip receiving tube 40 and the distal end surface 72a of the restriction tube 72 are connected. By abutting, the movement of the clip receiving tube 40 is restricted and finished.

    As shown in FIG. 2, the predetermined position 43, which is the end position of the slit 42, is disposed at a position on the front side in the direction of the center line of the clip receiving tube 40 with respect to the stepped portion 45 of the clip receiving tube 40. Therefore, even if the clip receiving tube 40 is inserted into the restriction tube 72 until the front end surface 72a of the restriction tube 72 comes into contact with the stepped portion 45, the slit 42 is open without being closed by the restriction tube 72. . Therefore, the connecting member 20 that connects the clip 10 and the magnetic anchor 30 can extend from the slit 42 to the outside of the clip receiving tube 40 at the predetermined position 43. Further, since the connecting member 20 has a sufficient length so as not 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 in a straight line.

The clip 10 and the magnetic anchor 30 connected by the connecting member 20 are introduced into the patient 101 as follows.
First, after the distal end rigid portion 60 is introduced into the body, the regulating tube 72 is urged forward by operating the rear end portion 71a. As a result, the clip receiving tube 40 in which the stepped portion 45 is in contact with the distal end surface 72a is pushed forward, and the inner peripheral wall of the hole 41 is brought into contact with the connecting base 11 along with this, whereby the clip 10 is also attached forward. The tip of the clip 10 comes into contact with the rear end of the magnetic anchor 30. When the restriction tube 72 is further urged forward from this state, the magnetic anchor 30 whose rear end is fitted to the leading end of the introduction tube 70 is detached, and a part of the connecting member 20 is pulled out of the introduction tube 70 (FIG. 5). ). At this time, the claw portion 14 and the claw portion 15 are also out of the introduction tube 70, but the bent portion 12b and the bent portion 13b are still in contact with the inner wall 70a. Is retained. Therefore, the connecting member 20 does not enter the space 16.

    When the restriction tube 72 is further urged forward, the clip 10, the clip receiving tube 40, and the restriction tube 72 are exposed from the distal end of the introduction tube 70 into the body of the patient 101, as shown in FIG. While 40 is arranged in a straight line in the longitudinal direction of the introduction tube 70, the magnetic anchor 30 hangs down due to gravity. At this time, since the arm portion 12 and the arm portion 13 are out of the clip receiving tube 40, the connecting member 20 whose position is regulated by the predetermined position 43 does not fall into the space 16. Further, if the distal rigid portion 60 is disposed toward the lesioned portion 102, the introduction tube 70 disposed in the distal rigid portion 60 also faces the lesioned portion 102, so that the tip of the clip 10 can be easily directed toward the lesioned portion 102. it can. When the bent portion 12b and the bent portion 13b are led out of the introduction tube 70, the arm portion 12 and the arm portion 13 return to a state where they are separated from each other by their elasticity, and the claw portion 14 and the claw portion 15 are opened. It becomes.

The clip 10 is attached to the lesioned part 102 as follows (FIG. 7).
The clip 10 with the claw part 14 and the claw part 15 opened is moved toward the lesioned part 102 by moving the introduction tube 70, the insertion coil 71, the restriction tube 72, and the operation wire 80 together, and the tip of the clip 10 is desired. When the clip 10 is closed when the position is reached, the lesioned part 102 can be grasped by the clip 10. In order to close the clip 10, the operation wire 80 is moved relative to the insertion coil 71 and the restriction tube 72 to pull the operation wire 80 so that the rear ends of the coupling base 11 and the arms 12 and 13 are moved. Pull into the clip receiving tube 40. The rear end portions of the arm portions 12 and 13 drawn into the clip receiving tube 40 abut on the inner wall of the clip receiving tube 40, so that they bend toward each other, so that the tip portions 14 and 15 approach each other. As a result, the distal end side of the clip 10 exposed from the clip receiving tube 40 is closed.

  Next, by operating the operation wire 80, the hook portion 82 a is stretched and the hooking portion 82 is released from the connection base portion 11, and the clip 10 and the magnetic anchor 30 connected via the clip receiving tube 40 and the connection member 20 are released. Separating the insertion coil 71, the restriction tube 72, the operation wire 80, and the introduction tube 70 including the hook portion 81 in a state in which the pulling member 82 is fitted thereinto to complete the attachment of the clip 10 to the lesioned portion 102. To do.

(3) Step of excision Next, the excision process of the lesioned part 102 using the grasping device 1 will be described.
First, physiological saline is injected from the periphery of the lesioned part 102 with an injection needle inserted into the submucosal layer (not shown), and the lesioned part 102 is lifted from the proper muscle layer (not shown).

    On the other hand, a magnetic induction member (not shown) made of an electromagnet is arranged at a preset position outside the patient 101. When set in this way, the lesioned part 102 is lifted by the attractive force between the magnetic induction member and the magnetic anchor 30. When the amount of lifting of the lesioned part 102 is insufficient or too large, adjustment is performed by shifting the position of the magnetic induction member or weakening the magnetic field generated by the magnetic induction member.

    Subsequently, an incision tool such as a high-frequency knife is introduced into the body from the forceps channel 61, and the lesioned part 102 is excised together with the mucous membrane from the end. At this time, since the lesioned part 102 is lifted by the clip 10, the excised part can be sufficiently taken, and the already excised lesioned part 102 can also be prevented from falling on the intrinsic muscle layer. Further, since the excised lesioned part 102 can be further lifted by gradually shifting the position of the magnetic guide member (not shown), it is easy to confirm the tip position of the high-frequency knife and the excision work can be performed smoothly. .

  Further, when the excision work is finished, the magnetic anchor 30 is attracted to the magnetic induction member in a state where the clip 10 holds the lesioned part 102, so that the lesioned part 102 can be prevented from being lost. When the excised lesion part 102 is recovered, the magnetic anchor 30, the clip 10, the connecting member 20, the clip receiving tube 40, and a part of the lesion part 102 are hooked with grasping forceps, and current is supplied to the magnetic induction member. Then, it is recovered by removing the endoscope as it is. Thereafter, treatments such as suturing and disinfection are performed.

Second Embodiment (FIGS. 8 and 9)
Next, a second embodiment of the present invention will be described. The gripping device 100 of the second embodiment is different from the first embodiment in that a clip 110 is provided instead of the clip 10 of the first embodiment. Other configurations are the same as those of the first embodiment, and the same reference numerals are used for the same members.

    As shown in FIG. 8, the clip 110 is formed by bending a metal member having elasticity to form a connection base 111, arm portions 112 and 113, and claw portions 114 and 115. The connection base 111 is provided with a bent portion 111a and a bent portion 111b at both ends of a substantially V-shaped base portion 111c obtained by bending a rod-shaped portion. From both ends (bent portions) 111a and 111b of the connection base 111, plate-like arm portions 112 and 113 having the same shape extend so that the bottom surface 112a and the bottom surface 113a face each other and gradually separate from each other. The arm portions 112 and 113 are provided with substantially rectangular contact portions (biasing portions) 112b and 113b at the same positions in the longitudinal direction. The abutting portions 112b and 113b have stepped portions 112b1 and 112b2 and stepped portions 113b1 and 113b2 with respect to the arm portion 112 and the portions of the arm portion 113 from the abutting portions 112b and 113b to the end portions 112c and 113c. Protruding to Therefore, the contact portions 112b and 113b have a substantially rectangular shape, and when the clip 110 is disposed inside the introduction tube 70, at least one of these sides contacts the inner wall 70a.

    From the end portions 112c and 113c of the arm portions 112 and 113, claw portions 114 and 115 are provided so that the tip portion 114a and the tip portion 115a face each other. When the clip 110 is not applied with an external force, the tip 114a and the tip 115a are separated by elasticity, and when the arm 112 and the arm 113 are urged to approach each other, the claw 114 An object can be held between the nail portion 115 and the nail portion 115.

    As shown in FIG. 9, the distal end portion 114a is formed with a V-shaped concave portion 114a1 that is recessed in a V shape toward the arm portion 113, and the distal end portion 115a is formed in a V shape that projects in a V shape toward the distal end portion 114a. A convex portion 115a1 is formed, and when the distal end portion 114a and the distal end portion 115a come into contact with each other, the concave portion 114a1 and the convex portion 115a1 mesh with each other without gaps. In a state where the concave portion 114a1 and the convex portion 115a1 are engaged with each other, portions of the arm portion 112 and the arm portion 113 from the end portion 112c and the abutting portion 113c to the abutting portion 112b and the abutting portion 113b are substantially parallel to each other. The part 112b and the contact part 113b are also substantially parallel.

With such a configuration, when the clip 110 is disposed inside the introduction pipe 70, each side of the contact portion 112b and the contact portion 113b and the inner wall 70a come into contact with each other. Can be reliably applied with a biasing force for causing the claw portion 114 and the claw portion 115 to mesh with each other.
Other operations, effects, and modifications are the same as those in the first embodiment.

Third Embodiment (FIGS. 10 and 11)
Next, a third embodiment of the present invention will be described. The gripping device 200 according to the third embodiment is different from the first embodiment in that a clip 210 is provided instead of the clip 10 according to the first embodiment. Other configurations are the same as those of the first embodiment, and the same reference numerals are used for the same members.

    As shown in FIG. 10, the clip 210 is formed by bending a metal member having elasticity to form a connection base portion 211, arm portions 212 and 213, and claw portions 214 and 215. The connecting base 211 is provided with a bent portion 211a and a bent portion 211b at both ends of a substantially V-shaped base portion 211c formed by bending a rod-shaped portion. From both ends 211a and 211b of the connection base 211, plate-like arm portions 212 and 213 having the same shape extend so that the bottom surface 212a and the bottom surface 213a face each other and gradually separate from each other. The arm portions 212 and 213 are provided with bent hemispherical contact portions (biasing portions) 212b and 213b at the same positions in the longitudinal direction. The contact portions 212b and 213b protrude outward in a hemispherical shape from the arm portion 212 and the portions of the arm portion 213 from the contact portions 212b and 213b to the tip portions 212c and 213c. The hemispherical contact portions 212b and 213b can also be formed in a hemispherical shape by plating, melting, or the like on the outer surfaces of the arm portions 212 and 213.

From the tip portions 212c and 213c of the arm portions 212 and 213, claw portions 214 and 215 that are oriented so that the tip portion 214a and the tip portion 215a face each other extend. In a state where no external force is applied to the clip 210, the tip end portion 214a and the tip end portion 215a are separated by elasticity, and when the arm portion 212 and the arm portion 213 are urged to approach each other, An object can be gripped between the claw portion 215 and the object.

    As shown in FIG. 11, a V-shaped recess 214a1 that is recessed in a V shape toward the arm portion 213 is formed in the distal end portion 214a, and a V shape that protrudes in a V shape toward the distal end portion 214a is formed in the distal end portion 215a. A convex portion 215a1 is formed, and when the distal end portion 214a and the distal end portion 215a come into contact, the concave portion 214a1 and the convex portion 215a1 mesh with each other without gaps. In a state where the concave portion 214a1 and the convex portion 215a1 are engaged with each other, portions of the arm portion 212 and the arm portion 213 from the tip portion 212c and the tip portion 213c to the contact portion 212b and the contact portion 213b are substantially parallel to each other. 212b and the contact part 213b are also substantially parallel.

With such a configuration, when the clip 210 is disposed inside the introduction tube 70, the contact portion 212b, the contact portion 213b, and the inner wall 70a come into contact with each other, so that the arm portion 212 and the arm portion 213 are mutually connected. An urging force for bringing the claw portion 214 and the claw portion 215 into engagement can be reliably applied. Further, since the abutting portion 212b and the abutting portion 213b are hemispherical, the operating resistance can be lowered when the clip 210 is moved in the introduction tube 70 while abutting them on the inner wall 70a. Therefore, the insertion of the clip 210 into the introduction tube 70 and the introduction of the clip 210 into the patient 101 reduce the damage to the inner wall 70a, thereby improving the durability of the introduction tube 70 and performing these operations. It can be done smoothly.
Other operations, effects, and modifications are the same as those in the first embodiment.

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 the improvement or the idea of the present invention.

FIG. 3 is a partial cross-sectional view when the gripping device according to the first embodiment of the present invention is arranged along the horizontal direction, and is a partial cross-sectional view taken along a plane extending through the central axis of the introduction pipe in the vertical direction. is there. FIG. 2 is a partial cross-sectional view of the gripping device of FIG. 1 cut along a plane extending in the horizontal direction through the central axis of the introduction tube. It is a partial sectional view seen from the III-III line of Drawing 1 showing the state where the clip concerning a 1st embodiment of the present invention meshed in the introduction pipe. 1 is an overview diagram showing an overall configuration of an endoscope according to a first embodiment of the present invention. It is a partial cross section figure which shows the state which exposed a part of clip of the holding | gripping apparatus of FIG. 1, and a magnetic anchor to the exterior of an introductory tube. FIG. 2 is a partial cross-sectional view showing a state in which the magnetic anchor, clip, connecting member, and clip receiving tube of the gripping device of FIG. 1 are exposed to the outside of the introduction tube. It is an external view which shows the state which hold | gripped the lesioned part with the clip concerning 1st Embodiment of this invention. It is a partial sectional view when the gripping device according to the second embodiment of the present invention is arranged along the horizontal direction, and is a partial sectional view cut along a plane extending through the central axis of the introduction pipe in the vertical direction. is there. FIG. 9 is a partial cross-sectional view taken along line IX-IX in FIG. 8 showing a state in which a clip according to a second embodiment of the present invention is engaged in an introduction tube. It is a partial cross section view when the gripping device according to the third embodiment of the present invention is arranged along the horizontal direction, and is a partial cross section view cut along a plane extending through the central axis of the introduction pipe in the vertical direction. is there. It is a partial sectional view seen from the XI-XI line of Drawing 10 showing the state where the clip concerning a 3rd embodiment of the present invention meshed in the introduction pipe. FIG. 6 is a partial cross-sectional view when a conventional gripping device is arranged along a horizontal direction, and is a partial cross-sectional view cut along a plane extending through a central axis of an introduction pipe in a vertical direction. It is a partial cross section figure which shows the structure of a magnetic anchor, a clip, a connection member, a traction member, and a clip receiving tube among the conventional holding devices. It is a partial cross section figure seen from the XIV-XIV line | wire of FIG. 12 which shows the state of the clip in the introduction pipe | tube of the conventional holding | gripping apparatus. It is a partial cross section figure when the conventional holding | grip apparatus is arrange | positioned along a horizontal direction, Comprising: It is a figure which shows the state which is pushing out a clip and a magnetic anchor. FIG. 13 is a partial cross-sectional view showing a state in which a part of the clip and the magnetic anchor of the gripping device of FIG. 12 are exposed to the outside of the introduction tube. It is an external view which shows the state which hold | gripped the lesioned part with the clip of the conventional holding | gripping apparatus.

Explanation of symbols

1 gripping device 10 clip (gripping member)
11 Connecting Base 12 Arm 12b Bent Part (Biasing Part)
13 Arm part 13b Bending part (biasing part)
14 Claw part 14a Tip part 14a1 Concave part 15 Claw part 15a Tip part 15a1 Convex part 16 Space 20 Connecting member 30 Magnetic anchor (anchor)
40 Clip receiving tube (gripping member receiving tube)
41 Hole portion 42 Slit 70 Introduction tube 71 Insertion coil 72 Restriction tube 80 Operation wire 90 Endoscope 100 Grasping device 101 Patient (object)
102 Lesions (target site)
110 clips (gripping members)
111 connection base 112 arm 112b substantially rectangular contact part (biasing part)
113 arm part 113b substantially rectangular contact part (biasing part)
114 Claw 114a Tip 114a1 Concave 115 Claw 115a Tip 115a1 Convex 116 Space 200 Gripping device 210 Clip (gripping member)
211 connecting base 212 arm 212b hemispherical contact portion (biasing portion)
213 Arm part 213b Hemispherical contact part (biasing part)
214 Claw 214a Tip 214a1 Concave 215 Claw 215a Tip 215a1 Convex 216 Space

Claims (8)

A gripping member for gripping a target part inside the target;
An anchor that pulls the gripping member;
A connecting member that connects the gripping member and the anchor;
A hollow tubular introduction pipe that is introduced into the object while holding at least a part of the gripping member and the connecting member inside,
The gripping member includes a coupling base to which the coupling member is coupled, at least two arms extending from the coupling base, and a claw that extends from the respective distal ends of the arms and grips a target portion inside the object. Have
The gripping device according to claim 1, wherein the arm portion includes a biasing portion that meshes the claw portions with each other by contacting the inner wall of the introduction tube when the gripping member is inserted into the introduction tube. The urging portion is a bent portion provided by bending a predetermined position of the arm portion, and the bent portion moves away from the claw portion toward the bent portion when the claw portion is engaged. The gripping device according to claim 1, which is configured to do so. The gripping device according to claim 2, wherein the urging portion has a substantially rectangular outer surface, and at least one of the sides abuts on the inner wall of the introduction tube to engage the claw portions with each other. The gripping device according to claim 2, wherein the urging portion has a substantially hemispherical shape, and the claw portions are engaged with each other by contacting the inner wall of the introduction tube. The gripping device according to claim 1, wherein the biasing portion is formed to protrude outward in a substantially hemispherical shape at a predetermined position on the outer surface of the arm portion. The one of the said nail | claw parts is provided with the convex part which protrudes toward the nail | claw part which opposes, and the said nail | claw part which opposes is provided with the recessed part which receives the said convex part. Gripping device. The gripping device according to claim 1, wherein the anchor is made of a magnetic material and is powered by an external magnetic field. The grasping device according to claim 1, wherein the introduction tube is inserted into an insertion portion of an endoscope and introduced into the object.

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