JP2007130408A - Clip apparatus for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip apparatus for an endoscope capable of stabilizing the attitude of a clip in the state of being projected from the distal end of a sheath to the front and opened at all times and smoothly guiding the clip to the state of accurately clipping a lesion. <P>SOLUTION: A clip holding base 10 for holding the clip 1 is provided to the distal end of the sheath 3. On the clip holding base 10, a tightening ring holding hole 11 for holding a clip tightening ring 2 in a surrounding state is formed at the most distal end. Also, a clip holding hole 12 for holding the part near the rear end of the clip 1 projected from the inside of the clip tightening ring 2 to the rear in the surrounding state in the state of the clip 1 is opened is formed successively on the rear side of the tightening ring holding hole 11. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an endoscope clip device that is passed through a treatment instrument guide tube of an endoscope and used for hemostasis treatment or the like in the body.

In general, the clip device for an endoscope is a distal end of a sheath in which a cylindrical clip fastening ring is fitted to a clip formed of a material having a spring property and passed through a treatment instrument guide tube of the endoscope. When the tip of the operation wire inserted in the sheath is engaged with the rear end of the clip and pulled, the clip tightening ring abuts on the tip of the sheath and is pushed out toward the clip in the distal direction. The clip is forcibly placed in the closed state, and then the clip between the operation wire and the clip is disengaged so that the clip tightening ring is fitted and the closed clip is placed in the body. (For example, Patent Documents 1 and 2).
Japanese Utility Model Publication 4-26091 JP 2002-191609 A

When performing clipping operation in the body under endoscopic observation, close the clip with the clip tightening ring after the clip in the open state is brought close to the affected part by remote control and the affected part is pinched correctly. It is necessary to perform an operation.
However, in a conventional endoscope clip device, a clip tightening ring is fitted to the rear end portion of the clip, and the clip tightening ring is loosely engaged with the distal end of the sheath. Therefore, the clip posture is unstable when the clip protrudes forward from the distal end of the sheath and is open, and the posture of the clip held in the state of projecting from the distal end of the endoscope into the observation visual field is slightly operated. In some cases, the operation of guiding the clip to the state where the affected part is pinched easily is troublesome.

  The present invention has been made to solve such a problem, and the posture of the clip protruding forward from the distal end of the sheath is always stable, and the clip can be smoothly inserted in a state in which the affected part is accurately pinched. An object of the present invention is to provide an endoscopic clip device that can be guided to the above.

  The endoscope clip device of the present invention is fitted to a clip formed of a material having a spring property in a shape expanded toward the front when no external force is applied, and to be covered with the clip from behind. A cylindrical clip clamping ring for forcibly closing the clip and forcing the clip by abutting the clip clamping ring at the tip and pushing the clip clamping ring toward the clip tip And a sheath that is closed to the sheath, and is inserted into the sheath so as to be movable in the axial direction relative to the sheath, and the distal end portion is detachably connected to the rear end portion of the clip near the distal end of the sheath. In the endoscope clip device provided with the clip holding member, a clip holding base for holding the clip is provided at the distal end of the sheath. The clamp holding base is formed with a clamping ring holding hole that holds the clip clamping ring in a state surrounding the clip clamping ring, and a clip that protrudes rearward from the clip clamping ring when the clip is expanded. A clip holding hole for holding the portion near the rear end is formed continuously to the rear side of the tightening ring holding hole.

  The abutting surface that abuts the rear end surface of the clip clamping ring from the rear may be formed at the rear end portion of the clamping ring holding hole, and the inner diameter of the clip holding hole is only near the tip portion than other portions. It may be formed small. Further, the clip may be bent back into a substantially U-shaped semi-annular shape at the rear end, or may be bent back into a substantially α-shaped loop.

  According to the endoscope clip device of the present invention, the clip holding base provided at the distal end of the sheath holds the clamping ring holding hole that surrounds the clip clamping ring, and the clip in the expanded state. The clip holding hole that holds the portion near the rear end of the clip that protrudes rearward from the inside of the fastening ring is provided, so that the posture of the clip in the state of protruding forward from the distal end of the sheath is opened. It is always stable and the clip can be smoothly guided to the state where the affected part is pinched accurately.

Embodiments of the present invention will be specifically described below with reference to the drawings.
FIG. 1 is a side sectional view of the distal end portion of the endoscope clip device, and FIG. 2 is a plan sectional view.
Reference numeral 1 denotes a clip that maintains a state in which a living tissue is picked to perform hemostasis and the like, and a clip tightening ring 2 for maintaining the clip 1 in a closed state is slightly rearward from an intermediate portion of the clip 1 It is attached so that it covers the part.

  3 is a flexible sheath for pushing the clip clamping ring 2 toward the distal end of the clip 1 so that the clip 1 is forcibly closed by abutting the distal end of the clip clamping ring 2. The clip holding wire 4 (clip holding member) detachably connected to the rear end portion of the clip 1 by the clip connecting member 4A is inserted into the flexible sheath 3 so as to be slidable in the axial direction. . The proximal end portions of the flexible sheath 3 and the clip holding wire 4 reach an operation portion (not shown) and are relatively advanced and retracted in the operation portion.

  Reference numeral 5 denotes a flexible outer tube made of, for example, a fluororesin tube or the like loosely fitted on the flexible sheath 3. The distal end of the outer tube 5 is usually at a position slightly retracted from the distal end of the flexible sheath 3, but if the outer tube 5 is pushed forward by the operation portion on the hand side, as shown in FIG. Then, the distal end portion of the outer tube 5 is covered with the clip 1, and the clip 1 can be elastically deformed into a narrowed state.

  Returning to FIGS. 1 and 2, the clip 1 is formed by bending a spring-like member such as a stainless steel plate for a spring by pressing or the like, and the rear end has a substantially U-shaped semi-annular shape. The outer tube 5 is formed in a shape that is bent back in parallel and expanded from the middle portion to the front when no external force is applied, and the outer tube 5 is pushed forward as shown in FIG. When the clip 1 is covered, the clip 1 is elastically deformed so that the distal end portion 1a is closed. When the outer tube 5 is retracted backward, the clip 1 returns to the original expanded state shown in FIG. . The “substantially U-shaped semi-annular shape” includes a shape in which the flat portion 1c is located at the bent back end portion of the clip 1 as shown in FIG.

  The clip tightening ring 2 is formed in a cylindrical shape by a rigid body such as a stainless pipe material or hard plastic, and is fitted to the clip 1 from the rear (that is, the clip 1 is clipped from the front from the clip tightening ring 2). And is disposed so as to surround a portion near the rear end of the clip 1. In this state, the clip 1 expands to a state where the tip is opened by its own elasticity, and a portion near the rear end of the clip 1 protrudes rearward from the rear end of the clip tightening ring 2. As shown, when the clip clamping ring 2 is pushed forward with respect to the clip 1, the clip 1 is forcibly closed by the clip clamping ring 2.

  1 and 2 again, the flexible sheath 3 is formed of, for example, a coil pipe in which a stainless steel wire having a flat cross-sectional shape is tightly wound. Therefore, it has the characteristic that it has soft flexibility but is hardly compressed by external force. However, it may be formed of a coil pipe having a circular cross section or a synthetic resin tube such as a strong fluororesin tube or PEEK (polyether ether ketone) resin.

  A cylindrical clip holding base 10 formed of a rigid body such as a stainless pipe material or a hard plastic material is brazed or bonded in series to the flexible sheath 3 at the distal end of the flexible sheath 3. A fastening ring holding hole 11 for holding the clip fastening ring 2 in a loosely surrounding state is formed at the most distal end portion of the clip holding base 10.

  The tightening ring holding hole 11 is formed in a circular cross-sectional shape having a diameter into which the clip tightening ring 2 is loosely inserted, as shown in FIG. 5 showing a cross section taken along line AA in FIG. As shown in FIGS. 1 and 2, the innermost end of the tightening ring holding hole 11 is slightly narrowed in diameter, and the contact surface 11a with which the rear end surface of the clip tightening ring 2 contacts is forward. It is in a state of being formed to face. Since the clip 1 is urged in the expanding direction by its own elasticity, the clip 1 is elastically pressed against the inner surface of the clip fastening ring 2 from the inside.

  Further, the clip holding base 10 is formed with a clip holding hole 12 that is connected to the rear side of the fastening ring holding hole 11 and holds a portion near the rear end of the clip 1. The clip holding hole 12 is a clip that protrudes rearward from the inside of the clip tightening ring 2 when the clip 1 is expanded, as shown in FIG. 6 which shows a cross section taken along line BB in FIG. 1, the front end portion 12 a of the clip holding hole 12 adjacent to the rear side of the fastening ring holding hole 11 is formed to have a slightly narrow diameter, and The two outer edges are in light contact.

  With such a configuration, the contact area of the clip 1 with the clip holding hole 12 can be reduced, and the resistance when the clip 1 slides can be reduced. However, as shown in FIG. 9, the shape of the clip holding hole 12 may be a parallel hole in which the inner diameter of the portion into which the clip 1 enters is uniform. This is easier in manufacturing parts, and can be manufactured at low cost.

  With the above-described configuration, the clip device for an endoscope according to the present embodiment has the clip fastening ring 2 and the portion near the rear end of the clip 1 held by the clip holding base 10 as shown in FIG. The clip 1 disposed so as to pass through the clip tightening ring 2 is elastically pressed against the inner surface of the clip tightening ring 2 by its own elasticity. As a result, since the posture of the clip 1 in the state of protruding forward from the tip of the clip holding base 10 at the tip of the flexible sheath 3 is always stable and does not wobble, the clip 1 is put in a state where the affected part is pinched accurately. It can be guided smoothly.

  The clip connecting member 4A connected to the tip of the clip holding wire 4 by the connecting ring 4B is formed of a material having spring property in a tweezers shape whose tip is bent inward, and the flexible sheath 3 (and the clip holding member). In the base 10), as shown in FIG. 2, it is elastically deformed and engaged with the rear end portion 1b of the clip 1, but when protruding from the front end of the clip holding base 10, FIG. As shown, it expands to disengage from the clip 1.

Therefore, as a procedure for using the endoscope clip apparatus, the rear end portion 1b of the clip 1 is engaged with the clip connecting member 4A pushed out from the front end of the clip holding base 10 as shown in FIG. Then, the clip holding wire 4 is pulled toward the hand side, so that the clip 1 is expanded at the distal end of the flexible sheath 3 as shown in FIG.
Next, as shown in FIG. 3, the outer tube 5 is pushed forward to make the clip 1 in a squeezed state, and is inserted into a treatment instrument guide tube of an endoscope (not shown). Then, in the body, the tip of the endoscope clip device protrudes from the tip of the endoscope, and the outer tube 5 is retracted rearward as shown in FIG. Let it face the affected area. At this time, in the present invention, the clip 1 does not wobble in a state where the head 1 is shaken obliquely, and a stable posture can always be maintained.

  Then, as shown in FIG. 4, the clip tightening ring 2 moves from the rear to the front with respect to the clip 1 by pushing the flexible sheath 3 forward relative to the clip holding wire 4. The clip 1 is forcibly closed by being pushed out, and the affected mucous membrane is clipped at the tip 1a of the clip 1 by positioning the affected mucous membrane between the clips 1 at that time. The flexible sheath 3 is retracted rearward, the clip connecting member 4A is removed from the clip 1 as shown in FIG. 7, and the clip 1 that is forcibly closed by the clip tightening ring 2 is placed in the body. be able to.

When the apparatus is pulled out from the treatment instrument guide tube of the endoscope, the clip holding wire 4 is pulled toward the hand side, and the clip connecting member 4A is accommodated in the clip holding hole 12.
In addition, this invention is not limited to the above-mentioned Example, For example, the rear-end part 1b of the clip 1 may be formed in the loop shape which cross | intersected substantially alpha shape, as FIG. 10 shows.

Side surface sectional drawing of the front-end | tip part of the clip apparatus for endoscopes of the Example of this invention. The plane sectional view of the tip part of the clip device for endoscopes of the example of the present invention. Side surface sectional drawing of the front-end | tip part of the state in which the clip was closed with the outer tube of the clip apparatus for endoscopes of the Example of this invention. The side sectional view of the tip part in the state where the clip of the clip device for endoscopes of the example of the present invention was forcibly closed. Sectional drawing of the state cut | disconnected by the AA of FIG. 1 of the clip apparatus for endoscopes of the Example of this invention. Sectional drawing of the state cut | disconnected by the BB line of FIG. 1 of the clip apparatus for endoscopes of the Example of this invention. Side surface sectional drawing of the state by which the clip of the clip apparatus for endoscopes of the Example of this invention is attached or detached. Side surface sectional drawing which shows the modification of the rear-end part shape of the clip of the Example of this invention. Side surface sectional drawing which shows the modification of the shape of the clip holding | maintenance hole of the Example of this invention. Side surface sectional drawing which shows the modification of the clip shape of the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Clip 1b ... Rear-end part 2 ... Clip clamping ring 3 ... Flexible sheath 4 ... Clip holding wire (clip holding member)
5 ... outer tube 10 ... clip holding base 11 ... clamping ring holding hole 11a ... contact surface 12 ... clip holding hole 12a ... most advanced part

Claims (5)

A clip formed of a springy material in a shape that expands forward when no external force is applied;
A cylindrical clip clamping ring that is fitted in a state of covering the clip from behind and forcibly closing the clip;
A sheath for forcibly closing the clip by abutting the clip clamping ring at a distal end portion and pushing the clip clamping ring toward the distal end of the clip;
A clip holding member that is inserted and arranged in the sheath so as to be movable in the axial direction relative to the sheath, and the tip portion of the clip is detachably connected to the rear end portion of the clip in the vicinity of the tip of the sheath In the endoscope clip device provided,
A clip holding base for holding the clip is provided at the distal end of the sheath;
The clip holding base is formed with a clamping ring holding hole for holding the clip clamping ring in a state of surrounding the clip clamping ring, and in a state where the clip is expanded, from the inside of the clip clamping ring to the rear. A clip device for an endoscope, wherein a clip holding hole for holding a portion of the protruding clip near a rear end is formed continuously to a rear side of the fastening ring holding hole.   2. The endoscope clip device according to claim 1, wherein a contact surface that contacts a rear end surface of the clip tightening ring from the rear is formed at a rear end portion of the tightening ring holding hole. Clip device.   The endoscope clip device according to claim 1 or 2, wherein an inner diameter of the clip holding hole is formed smaller than other portions only in the vicinity of the tip portion.   The endoscope clip device according to claim 1, 2, or 3, wherein the clip is bent back into a substantially U-shaped semi-annular shape at a rear end portion.   The endoscope clip device according to claim 1, 2, or 3, wherein the clip is bent back into a substantially α-shaped loop shape at a rear end portion.

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