JP2007167400A - Holder - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a holder providing sufficient traction force by an anchor and shortening a coupling member. <P>SOLUTION: The holder comprises a holder member for holding a target region inside an object, the anchor for towing the holder member and the coupling member coupling the holder member and the anchor. The anchor has a storage part for storing the distal end of a cylindrical introduction pipe, and the holder member and the coupling member coupled to the anchor are stored in the introduction pipe. The introduction pipe, whose distal end is stored in the storage part, is inserted into an insertion part of an endoscope to be introduced into the object. <P>COPYRIGHT: (C)2007,JPO&INPIT

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 FIGS. The gripping device 300 includes a clip (grip member) 310, a connecting member 320, and a magnetic anchor 330.

As shown in FIG. 10, the clip 310 is formed by bending a metal member having elasticity to form a connection base 311, arm portions 312 and 313, and gripping portions 314 and 315. 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 And the grip portion 315 can approach each other and grip an object therebetween.

A connection member 320 having flexibility for connecting the clip 310 and the magnetic anchor 330 is inserted through the connection 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. The connecting member 320 coupled to the clip 310 is once introduced into the clip receiving tube 340 and then coupled to 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.

The clip 310, the connecting member 320, the magnetic anchor 330, and the clip receiving tube 340 connected to each other are introduced into the patient (object) body using a hollow cylindrical introduction tube 370 in which they are arranged. 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 body by operating the insertion coil 371 and the operation wire 380. The insertion coil 371 is fixed to a restriction tube 372 in which the clip receiving tube 340 is fitted, and the operation wire 380 is connected to a pulling member 382 hooked to the connection base 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, and the clip 310 is moved relative to the clip receiving tube 340 by operating the operation wire 380. be able to. When the connection base 311 is drawn into the clip receiving tube 340 by the relative movement of the clip 310 with respect to the clip receiving tube 340, the connecting base 311 contacts the inner wall of the clip receiving tube 340, so that the arm portion 312 and the arm portion 313 are mutually connected. The approaching urging force works, and the grasping portion 314 and the grasping portion 315 can be closed, whereby the lesioned portion 102 of the patient 101 can be grasped.
JP 2004-105247 A JP 2005-192735 A

Since the grasping device 300 may be introduced into a narrow tissue in the patient body, it is desired that the grasping device 300 be a small one having a short overall length without reducing the traction force by the anchor.

On the other hand, the gripping device 300 described above, once introduced into the patient body, once the coupling member 320 coupled to the coupling base 311 is inserted into the clip receiving tube 340 in the introduction tube 370, and then the magnetic anchor Since it becomes the structure connected with 330, the connection member 320 will become long. Furthermore, since the traction force by the magnetic anchor 330 depends on its volume, it is difficult to reduce the size of the magnetic anchor 330 so that the entire magnetic anchor 330 can be inserted into the introduction tube 370. The anchor 330 is held in a state exposed to the outside at the tip of the introduction tube 370. Therefore, in the configuration in which the position at the time of introduction into the patient is connected to the magnetic anchor 330 that is fixed, and the clip receiving tube 340 is inserted and folded back, the connecting member 320 must be long, and the grasping device 300 causes the lesion to be affected. It is conceivable that it may be difficult to sufficiently hold and lift.

In order to solve the above-described problem, a gripping device of the present invention includes a gripping member that grips a target portion inside a target object, an anchor that pulls the gripping member, and a connecting member that connects the gripping member and the anchor. The anchor includes an accommodating portion that accommodates the distal end portion of the cylindrical introduction tube therein, the gripping member connected to the anchor and the coupling member are accommodated in the introduction tube, and the distal end portion is accommodated in the accommodating portion. It is characterized by being inserted into the insertion portion of the endoscope and introduced into the object.

The gripping device further includes a traction separating member coupled to the gripping member, and a hollow cylindrical gripping part receiving tube having a slit in which the rear part of the gripping member is received in the front part and the rear end part is opened. When the gripping member is held in front of the gripping member receiving tube, the traction separating member is guided to the outside from the rear end portion of the gripping member receiving tube, and the connecting member is guided to the outside of the gripping member receiving tube through the slit. The anchors are preferably arranged so as to be positioned in front of the gripping member.

It is preferable that the introduction pipe is provided with a rigid reinforcing member at the distal end portion, and the reinforcing member may be a cylindrical member fixed to the inner periphery or the outer periphery of the distal end portion. Further, the reinforcing member can be a cylindrical member extending from the front end of the tip portion.

The housing portion may be a concave portion that is recessed from the rear end portion of the anchor toward the inside, and the housing portion has a width that is smaller than the outer diameter of the introduction tube and larger than the width of the gripping member. It is good that the escape part provided with is continuously provided. In addition, when the gripping device is introduced into the object, it is preferable that at least the distal end portion of the gripping member is in the accommodating portion.

The anchor is preferably made of a magnetic material and powered by an external magnetic field.

According to the present invention, since the anchor is provided with the accommodating portion that accommodates the distal end portion of the introduction tube, the anchor volume is not reduced, so that a sufficient traction force can be realized, and further, the connecting member is shortened. It is possible to provide a gripping device that can handle the above.

Hereinafter, embodiments according to the present invention will be described in detail with reference to the drawings.
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, and a magnetic anchor (anchor) 30. 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. In the first embodiment, the clip 10 and the connecting member 20 are coupled via the clip receiving tube 40, but the present invention is a type in which the clip 10 and the connecting member 20 are directly coupled without using the clip receiving tube 40. The present invention can also be applied to other gripping devices.

(1) Configuration As shown in FIGS. 1, 2, and 6, the clip 10 is formed of a connecting base portion 11, arm portions 12 and 13, and tip gripping portions 14 and 15 by bending an elastic metal member. Is. The connecting base portion 11 formed by bending a rod-shaped member has a U-shaped portion 11a and contact portions 11b and 11c that are spread outward from both ends of the U-shaped portion 11a and then approach each other (see FIG. 6). From the end portions 11b1 and 11c1 of the contact portions 11b and 11c, 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 gradually separate from each other. . The arm portions 12 and 13 are provided with bent portions 12b and 13b at the same position in the longitudinal direction. When the clip 10 is not applied with an external force (hereinafter referred to as a natural state), the bent portions 12b and 13b are provided. The bottom surface 12a and the bottom surface 13a are substantially parallel to the front end portions 12c and 13c from 13b. From the distal end portions 12c and 13c of the arm portions 12 and 13, respectively, distal end gripping portions 14 and 15 extending toward the distal end portion 13c and the distal end portion 12c respectively extend. Three or more arms can be provided.

In the clip 10 having the above configuration, when a force for biasing the abutting portion 11b and the abutting portion 11c is applied to each other, the bending angle before and after that changes, so that the arm portion 12 and the arm portion 13 are outside. (See FIG. 6). When a force for urging the arm portion 12 and the arm portion 13 to approach each other is further applied from this state, the bending angle of the arm portion 12 and the arm portion 13 changes so that the interval between the arm portion 12 and the arm portion 13 is narrowed. In this way, the object can be gripped between the tip gripping portion 14 and the tip gripping portion 15 by urging the arm portion 12 and the arm portion 13 so as to approach each other.

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 having a circular cross section in the front-rear direction, 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 includes a concave portion (accommodating portion) 33 that is recessed in a substantially circular cross-sectional shape from the rear end 31 toward the inside. In front of the recess 33, a fixing hole portion 35 that can fix the connecting member 20 to the magnetic anchor 30 by inserting an end portion of the connecting member 20 and coupling the connecting member 20 inside is provided continuously. The inner diameter of the recess 33 is substantially the same as the outer diameter of the introduction tube 70, and can accommodate and hold the distal end portion 70 b of the introduction tube 70. The recess 33 can have any shape as long as the introduction tube 70 can be accommodated therein. The recess 33 may be configured as a hole that penetrates the magnetic anchor 30. In this case, the connecting member 20 can be fixed to the inner surface of the through hole by adhesion, solder, brazing, or the like. If the magnetic anchor 30 can be inserted through the insertion portion of the endoscope, its outer shape can be set arbitrarily, so that it can have the same volume as that of the conventional magnetic anchor. The same traction force as the anchor can be realized.

Since the clip 10 and the magnetic anchor 30 are connected via the connecting member 20, 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 portion 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. The magnetic anchor 30 is coupled to the magnetic anchor 30 by being led out from the slit 42 and inserted into the fixing hole 35 from the concave portion 33 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 toward the clip 10 (front side) is restricted at 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. Further, a loop wire (traction separating member) 82 having one end hooked on the U-shaped portion 11 a of the connection base portion 11 is provided so as to extend from the rear end of the clip receiving tube 40 through the clip receiving tube 40. Yes.

The clip 10, the connecting member 20, the magnetic anchor 30, the clip receiving tube 40, and the loop wire 82 connected as described above are obtained by using the hollow cylindrical introduction tube 70 for the patient (object) 101 (see FIGS. 4 to 6). ) Is introduced into the body. 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 FIG.

In the longitudinal direction of the introduction tube 70, an insertion coil 71 that is movable relative to the introduction tube 70 is disposed along the inner wall 70 a 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 of the small diameter portion 47 and the inner diameter of the inner wall 48 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 when the stepped portion 45 abuts against the distal end surface 76 of the restricting 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 restricted to the restriction tube 72 until the stepped portion 45 and the front end surface 76 contact each other. Even if inserted, 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. 3).

A metal loop wire 82 is passed through the U-shaped portion 11a. The loop wire 82 is hooked on a recess 81 a provided at the center of the hook portion 81. The loop wire 82 may be made of a material other than metal as long as it is cut when pulled by a strong force of a predetermined level or more. The clip 10 having one end inserted into the clip receiving tube 40 is pulled into the clip receiving tube 40 while pulling the operation wire 80 to the rear side so that each portion abuts against the inner wall of the clip receiving tube 40 and is elastically deformed. Can be inserted.

Specifically, by pulling the operation wire 80 rearward, the contact portion 11b and the contact portion 11c contact each other along the inner wall 48 from the hole portion 41 of the clip receiving tube 40 so as to approach each other. When bent, the arm portion 12 and the arm portion 13 are separated from each other and the clip 10 is opened. When the operation wire 80 is further pulled rearward, the portions from the end portion 11b1 to the bent portion 12b and the portions from the end portion 11c1 to the bent portion 13b of the arm portion 12 and the arm portion 13 gradually become holes in the clip receiving tube 40. The portion 41 bends inward so as to approach each other while abutting along the inner wall 48. Then, the arm part 12 and the arm part 13 approach each other, and the clip 10 is in a closed state.

In addition, the clip 10 and the loop wire 82 can be rotated with respect to the clip receiving tube 40 before the operation wire 80 is pulled rearward and in the state where the contact portion 11 b is not pulled into the clip receiving tube 40. It is. For this reason, even if the connecting member 20 intersects the closed tip gripping portion 14 and the tip gripping portion 15, the clip 10 and the loop wire 82 are rotated with respect to the clip receiving tube 40 by operating the operation wire 80. Thus, the crossing state can be canceled.

(2) Introduction operation into patient body In the grasping device 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 60 is inserted with an introduction tube 70 in which the distal end portion 70 b is accommodated in the recess 33 of the magnetic anchor 30 and the clip 10 connected by the connecting member 20 is inserted. The The clip 10 is disposed with the tip gripping portion 14 and the tip gripping portion 15 facing the front side. By adopting such an arrangement, the connecting member 20 can be shortened by the amount that accommodates the distal end portion 70 b of the introduction tube 70 in the recess 33. Furthermore, it is preferable that the tip gripping portions 14 and 15 and a part of the arm portions 12 and 13 enter the recess 33 in the introduction tube 70 because the connecting member 20 can be shortened.

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, the loop wire 82 is coupled to the hook portion 81 extending from the introduction tube 70, and the clip 10 and the connecting member 20 are pulled by pulling the rear end portion 80a extending from the forceps insertion port 91 in this state. Insert into 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 stepped portion 45 of the clip receiving tube 40 and the distal end surface 76 of the restriction tube 72 are connected. The movement of the clip receiving tube 40 is restricted by the contact.

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 restricting tube 72 until the tip surface 76 of the restricting tube 72 hits the stepped portion 45, the slit 42 is open without being closed by the restricting 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. When the insertion operation is completed, the magnetic anchor 30, the clip 10, and the clip receiving tube 40 are arranged in a substantially 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, the distal end rigid portion 60 is introduced into the body, and then the restriction tube 72 is urged forward by operating the rear end portion 71a of the insertion coil 71. As a result, the clip receiving tube 40 in which the stepped portion 45 is in contact with the distal end surface 76 is pushed forward, and accordingly, the inner peripheral wall of the hole 41 abuts on the connection base portion 11 and the clip 10 is also urged forward. Then, the tip gripping portions 14 and 15 of the clip 10 come into contact with the bottom wall 33 a of the concave portion 33 of the magnetic anchor 30. When the restriction tube 72 is further urged forward from this state, the magnetic anchor 30 is disengaged from the distal end portion 70b of the introduction tube 70, and as shown in FIGS. 4 and 5, the clip 10, the clip receiving tube 40, and the restriction tube 72 are The tip of the introduction tube 70 is exposed into the patient 101, and the clip 10 and the clip receiving tube 40 are arranged in a straight line in the longitudinal direction of the introduction tube 70, while the magnetic anchor 30 hangs down due to gravity.

The clip 10 is attached to the lesioned part 102 as follows.
First, in order to open the tip gripping portion 14 and the tip gripping portion 15, the operation wire 80 is moved relative to the insertion coil 71 and the restriction tube 72 to pull the operation wire 80 and contact the contact portion 11 b. The contact portion 11 c is pulled into the clip receiving tube 40. Since the abutting portion 11b and the abutting portion 11c that have been pulled in contact with the inner wall 48 of the clip receiving tube 40, they are bent in a direction approaching each other. When the contact portion 11b and the contact portion 11c are bent in this way, the arm portion 12 and the arm portion 13 are bent so as to be separated from each other, and as a result, the distal end side of the clip 10 exposed from the clip receiving tube 40 is opened. (FIG. 6).

The clip 10 thus opened is moved toward the lesioned part 102 by moving the insertion coil 71, the restriction tube 72 and the operation wire 80 together (in the direction of the arrow in FIG. 6), and the tip of the clip 10 is desired. By closing the clip 10 at the position, the lesioned part 102 can be gripped 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 and bend from the ends 11 b 1 and 11 c 1 of the arm portions 12 and 13. The portion between the portions 12 b and 13 b is gradually drawn into the clip receiving tube 40. The portions of the arms 12 and 13 that are drawn into the clip receiving tube 40 are bent toward each other because they contact the inner wall of the clip receiving tube 40. Along with this, the bottom surface 12a and the bent portion 12b are bent so as to approach each other, and as a result, the distal end side of the clip 10 exposed from the clip receiving tube 40 is closed (FIG. 7).

Next, the clip 10 and the magnetic anchor 30 connected via the clip receiving tube 40 and the connecting member 20 are separated from the introduction tube 70 in which the insertion coil 71, the restriction tube 72, the operation wire 80 and the hook portion 81 are housed. Then, the attachment of the clip 10 to the lesioned part 102 is completed. This separation operation is performed by pulling the operation wire 80 strongly to cut the loop wire 82 hung on the recess 81a, and then retracting the insertion coil 71, the restriction tube 72, the operation wire 80, and the hook portion 81.

(3) The step of excision will be described, and the excision step 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. The lesioned part 102 is lifted by the attractive force between the magnetic induction member and the magnetic anchor 30. When the lift amount of the lesioned part 102 is insufficient or too large, the position is adjusted 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 through a forceps channel (not shown), 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, by gradually shifting the position of the magnetic guide member (not shown), the excised lesioned part 102 can be further lifted, so that the tip position of the high-frequency knife can be easily confirmed and the excision work can be performed smoothly. it can.

When the excision work is finished, the magnetic anchor 30 is attracted to the magnetic guiding 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
The gripping device 110 according to the second embodiment shown in FIG. 8 is different from the first embodiment in that an escape portion 137 is continuously provided from a recess (accommodating portion) 133 of a magnetic anchor 130 instead of the magnetic anchor 30. Other configurations are the same as those of the first embodiment, and the same reference numerals are used for the same members.

The magnetic anchor (anchor) 130 is made of the same material as the magnetic anchor 30 of the first embodiment, has the same outer shape with a substantially circular cross section in the front-rear direction, and has a concave portion 133 having the same shape as the concave portion 33 of the magnetic anchor 30. Is formed. The recess 133 is formed with an escape portion 137 that is recessed from the recess 133 toward the outer periphery 132 of the magnetic anchor 130 over the entire length in the front-rear direction. The escape portion 137 has a circumferential width W (FIG. 8B) in the cross-sectional direction orthogonal to the magnetic anchor 130 that is smaller than the outer diameter of the introduction tube 70 and larger than the width of the bottom surfaces 12 a and 13 a. Yes. Further, the escape portion 137 may be provided to the outer periphery 132 or a plurality of relief portions 137 may be provided continuously from the recess 133. The connecting member 20 is the same as in the first embodiment in that the connecting member 20 is inserted from the recess 133 of the magnetic anchor 130 into the fixing hole 135 and coupled to the magnetic anchor 130.

When such a relief portion 137 is provided, the clip 10 is accommodated in the introduction tube 70 while the tip gripping portions 14 and 15 and part of the arm portions 12 and 13 of the clip 10 are allowed to escape into the relief portion 137. Since the distal end portion 70b of the 70 can be accommodated in the recess 133, the connecting member 20 can be further shortened compared to the gripping device 1 of the first embodiment, and the accommodating operation is facilitated. Further, when the clip 10 protrudes from the introduction tube 70 in the process of moving the magnetic anchor 130 and the clip 10 in contact with each other relative to the introduction tube 70 in order to introduce the magnetic anchor 130 into the patient 101, the clip Since 10 can escape through the escape portion 137, it is possible to avoid supporting the heavy magnetic anchor 130 by only a part of the clip 10 and to prevent the clip 10 from being deformed or damaged.
Other operations, effects, and modifications are the same as those in the first embodiment.

<Third Embodiment>
The third embodiment shown in FIG. 9 is different from the first embodiment in that a reinforcing member 177 made of a hard material is fixed to the inner periphery of the distal end portion 170b of the introduction pipe 170 instead of the introduction pipe 70. Other configurations are the same as those of the first embodiment, and the same reference numerals are used for the same members.

The reinforcing member 177 is a hollow substantially cylindrical member made of a hard material (for example, a metal material such as stainless steel, aluminum, titanium, etc., ceramic, hard resin, hard rubber), and the outer periphery thereof is the inner periphery (inner wall) of the tip portion 170b. For example, it is fixed by adhesion, press-fitting, or welding. The inner diameter of the reinforcing member 177 is substantially the same as the inner diameter of the introduction pipe 70 of the first embodiment, and the inside of the clip 10, the clip receiving pipe 40, the insertion coil 71, and the restriction pipe 72 can be inserted in the same manner as the introduction pipe 70. It is. With this configuration, when the distal end portion 170 b is accommodated in the recess 33, the distal end portion 170 b of the flexible introduction tube 170 is bent by the weight of the magnetic anchor 30, and the magnetic anchor 30 is removed from the introduction tube 170. It is possible to prevent the clip 10 housed inside or deformed from being deformed or damaged due to the introduction pipe 170 being deformed. The reinforcing member 177 may have its inner periphery fixed to the outer periphery of the tip portion 170b. Further, the reinforcing member 177 can be extended by being fixed to the tip of the tip portion 170b by, for example, adhesion, press fitting, or welding.
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 cut along a plane extending through the central axis of the introduction pipe in the horizontal 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 vertical direction through the central axis of the introduction tube. 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 the clip and magnetic anchor of the holding apparatus of FIG. 2 to the exterior of the introduction pipe. FIG. 2 is a partial cross-sectional view illustrating a state in which the clip and the magnetic anchor are exposed to the outside of the introduction tube in the gripping device of FIG. 1. FIG. 2 is a partial cross-sectional view showing a state where a clip is opened in the gripping device of FIG. 1. It is a figure which shows the state which hold | gripped the lesioned part with the clip concerning 1st Embodiment of this invention. (A) is a fragmentary sectional view when the holding | grip apparatus which concerns on 2nd Embodiment of this invention is arrange | positioned along a horizontal direction, Comprising: It cut | disconnected by the surface extended in the horizontal direction through the central axis of an introduction pipe | tube. Sectional drawing, (b) is a rear view of the magnetic anchor according to the second embodiment as seen from the rear, (c) shows the state when the introduction pipe is accommodated in the magnetic anchor, and (a) is seen from below. FIG. It is a partial sectional view when the gripping device according to the third embodiment of the present invention is arranged along the horizontal direction, and is a partial sectional view taken along a plane extending through the central axis of the introduction pipe in the horizontal direction. is there. FIG. 10 is a partial cross-sectional view when a conventional gripping device is arranged along the horizontal direction, and is a partial cross-sectional view cut along a plane extending through the central axis of the introduction pipe in the horizontal direction. It is a figure which shows the state which hold | gripped the lesioned part with the conventional clip.

Explanation of symbols

1 gripping device 10 clip (gripping member)
DESCRIPTION OF SYMBOLS 11 Connection base part 12 Arm part 13 Arm part 14 Tip holding part 15 Tip holding part 20 Connecting member 30 Magnetic anchor (anchor)
33 Concave part (accommodating part)
35 Fixing hole 40 Clip receiving tube (grip receiving tube)
42 Slit 70 Introducing tube 70b Tip 82 Loop wire (traction separation member)
90 Endoscope 101 Patient (object)
102 Lesions (target site)
110 Gripping Device 130 Magnetic Anchor (Anchor)
133 Concave part (accommodating part)
135 Fixing hole portion 137 Escape portion 170 Introducing tube 170b Tip portion 177 Reinforcing member

Claims (10)

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;
The anchor includes an accommodating portion for accommodating the distal end portion of the cylindrical introduction tube therein,
The gripping member and the connection member connected to the anchor are accommodated in the introduction tube, and the distal end portion is accommodated in the accommodation portion, and is inserted into the insertion portion of the endoscope and introduced into the object. A gripping device. A pulling and separating member coupled to the gripping member; and a hollow cylindrical gripping portion receiving tube having a slit in which a rear portion of the gripping member is received in a front portion and a rear end portion is opened. Is held in front of the gripping member receiving tube, the pulling / separating member is guided to the outside from the rear end portion of the gripping member receiving tube, and the connecting member is moved to the outside of the gripping member receiving tube through the slit. The gripping device according to claim 1, wherein each of the anchors is guided so as to be positioned in front of the gripping member. The gripping device according to claim 1, wherein the introduction pipe includes a rigid reinforcing member at the tip portion. The gripping device according to claim 3, wherein the reinforcing member is a cylindrical member fixed to an inner periphery of the tip portion. The gripping device according to claim 3, wherein the reinforcing member is a cylindrical member fixed to the outer periphery of the tip portion. The gripping device according to claim 3, wherein the reinforcing member is a cylindrical member extending from a front end of the tip portion. The gripping device according to any one of claims 1 to 6, wherein the housing portion is a concave portion that is recessed from the rear end portion of the anchor toward the inside. The gripping device according to claim 7, wherein an escape portion having a width smaller than an outer diameter of the introduction pipe and larger than a width of the gripping member is continuously provided in the housing portion. The gripping device according to claim 7 or 8, wherein at least a distal end portion of the gripping member is in the housing when being introduced into the object. The gripping device according to claim 1, wherein the anchor is made of a magnetic material and is powered by an external magnetic field.

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