JP2007275269A - Clip device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip device for an endoscope with an excellent moving performance by which the opening and closing movement of clips can be smoothly carried out adopting a single constitution in which each clip opens when external force does not act and the clip can smoothly go forward and backward and rotate when the clips are present in a sheath. <P>SOLUTION: In the clip device for the endoscope which keeps each of clips 3A, 3B open in a single condition that the external force does not act, and the clips 3A, 3B elastically deformed into the condition that the clips 3A, 3B are closed when fastening rings 4 covering the clips 3A, 3B so as to freely go forward and rearward are moved to the front sides of the clips 3A, 3B, and the clips 3A, 3B return to the opening condition with the elasticity of the same when the fastening rings 4 are moved rearward of the clips, the clips 3A, 3B are fully closed by the fastening rings 4 when the clips are present in the sheath 1. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope clip device that is used through a treatment instrument insertion channel of an endoscope in order to perform hemostasis or marking in a living body or the like.

  Clipping treatment for hemostasis and marking in a luminal organ etc. is performed by passing the clip device through the treatment instrument insertion channel of the endoscope. If it is pulled out from the treatment instrument insertion channel of the endoscope and reloaded with a clip, the operation becomes too complicated.

Therefore, an operation wire arranged in series in a state where a plurality of clips are constricted in the distal end of the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope, and is movable in the axial direction in the sheath. An endoscopic clip device has been devised that is configured so that a plurality of clips can be sequentially pushed out from the distal end of the sheath and each clip can be opened once and then closed (for example, Patent Document 1).
JP 2002-330972 A

  However, in the conventional endoscope clip device as described in Patent Document 1, each clip is formed in a shape that is lightly closed in a single state where no external force is applied. Since the clip is plastically deformed by moving the fastening ring fitted so as to be able to advance and retreat in the front-rear direction of the clip, it is difficult to smoothly open and close the clip.

  Therefore, each clip is open in a single state where no external force acts, and if the clamp ring is moved closer to the front side of the clip, the clip will be elastically deformed to the closed state, and if it is moved closer to the rear side, the clip will be elastic by itself. By adopting the configuration of returning to the opened state by the step, the opening and closing operation of the clip can be performed smoothly. Regarding such an endoscope clip device, the applicant of the present application has applied for a patent as Japanese Patent Application No. 2005-334.

  However, if a configuration is adopted in which each clip opens in a single state where no external force acts, when the clip is in the sheath, the clip tries to open in the sheath due to its own elasticity. A frictional resistance is generated in each of the clips connected in the sheath, so that there is a problem that the advancing / retreating and rotating operations of the clips become awkward and may not operate smoothly.

  Therefore, the present invention adopts a configuration in which each clip is opened in a single state where no external force is applied so that the clip can be smoothly opened and closed, and at the same time, when the clip is in the sheath, the clip is smoothly advanced and retracted. An object of the present invention is to provide an endoscopic clip device with excellent operation performance that can be rotated.

  In order to achieve the above object, in the endoscope clip device of the present invention, a plurality of clips that can be opened and closed in a hook shape by being elastically deformed are inserted into and removed from the treatment instrument insertion channel of the endoscope. A plurality of clips were sequentially pushed out from the tip of the sheath by the operation wires arranged in series in a state of being constricted in the tip of the sheath and being freely moved back and forth in the axial direction in the sheath, and each clip was once opened. Endoscopic clip device configured to be able to be closed later, wherein each clip is open in a single state where no external force is applied, and a fastener ring that is movably fitted to the clip is attached to the front side of the clip In an endoscopic clip device, the clip is elastically deformed in a closed state when moved toward the back, and the clip returns to the open state by its own elasticity when moved toward the rear side. When the clip is in the sheath is obtained as in the state in which the clip is fit closed by the collar.

  When the clip is in the sheath, the clamp ring fitted to the clip may be located near the front end of the advance / retreat range with respect to the clip, and when the clip is closed by the clamp ring, It is preferable that the distal end portion of the tube is narrowed to a size that does not contact the inner peripheral surface of the sheath.

  Further, the clip may be provided with a clamp ring locking means for detachably and elastically locking the clamp ring at the front end position of the advancing / retreating range with respect to the clip, and the clamp ring is clipped by the clamp ring locking means. May be click-locked.

  The fastening means for locking the ring may be formed by forming a step in the width direction near the tip of the clip, or formed by forming a protrusion protruding outward on the back near the tip of the clip. It may be.

  Further, the fastener ring may be formed in an oval shape or a circular cross-sectional shape. Alternatively, the fastener ring may be formed in a non-circular cross-sectional shape that can be deformed in the radial direction. In this case, the fastener ring has a cross section in which each central portion of the four sides of the square protrudes outwardly in a V shape. It may be formed in a shape.

  Further, the vicinity of the distal end opening of the sheath is formed in a shape divided by a plurality of slits, and the fastening ring may pass through the distal end opening while elastically expanding the distal end opening. The ring may be moved to the rear side of the clip before passing through the distal end opening of the sheath.

  In addition, a connecting member that can be freely attached to and detached from the rear end portion of the clip at the rear end position of the plurality of clips is attached to the distal end portion of the operation wire, and on the inner peripheral surface side of the sheath on the back of the connecting member A spherical protrusion protruding toward the surface may be provided.

  In addition, a tip claw portion that is bent toward the closing direction of each clip is formed at the tip portion of each clip, and a connecting hole having a dimension and shape that can be inserted and engaged with the tip claw portion opens the opening surface in the opening / closing direction of each clip. Are formed at the rear end portion of each clip in the direction parallel to each other, and the plurality of clips are alternately rotated by 90 ° in the direction around the axis in the sheath by engaging the front end claw portion of the adjacent clip and the connecting hole. You may make it connect directly, changing direction.

  According to the present invention, each clip is open in a single state where no external force is applied, and the clip is elastically deformed in a closed state when a fastener ring that is fitted to the clip is movably moved toward the front side of the clip. Since the clip returns to its open state by its own elasticity when moved toward the rear side, the clip can be opened and closed smoothly, and when the clip is in the sheath, the clip is Since it is in the closed state, the clip can be smoothly advanced and retracted and rotated.

  A plurality of clips that can be opened and closed in a hook shape by being elastically deformed are arranged in series in a state where each clip is constricted in the distal end of the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. An endoscopic clip device configured such that a plurality of clips are sequentially pushed out from a distal end of a sheath by an operation wire arranged so as to be movable forward and backward in an axial direction, and each clip can be closed once opened. Each clip is open in a single state where no external force is applied, and when the clamp ring fitted to the clip is moved forward and backward, the clip is elastically deformed to the closed state and moved to the rear side. In an endoscopic clip device that returns to the open state by its own elasticity when moved, when the clip is in the sheath, the clip is So that has become Jikira state.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 shows the overall configuration of an endoscopic clip device. An operation wire 2 advances and retreats in an axial direction in a flexible sheath 1 that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). It is freely inserted through the entire length.

  Reference numeral 10 denotes an operation unit. By operating the slide operation member 12 having the proximal end of the operation wire 2 connected to the operation unit main body 11 to which the proximal end of the sheath 1 is connected, the operation wire is operated in the sheath 1. 2 can advance and retreat, and the clip 3 can be pushed out from the distal end of the sheath 1 to be opened and closed.

  FIG. 1 is a side cross-sectional view of the vicinity of the distal end of an endoscope clip device, and FIG. 2 is a cross-sectional view illustrating a II-II cross section in FIG. It is formed of a flexible tube such as a tube. However, you may form with the coil pipe etc. which closely wound the stainless steel wire by the fixed diameter.

  A cylindrical tip 7 made of metal or plastic is fixedly attached to the most distal portion of the sheath 1. The distal tip 7 is formed so that the inner diameter dimension thereof is substantially the same as that of the sheath 1, and is regarded as constituting a part of the sheath 1.

  The tip end portion of the tip 7 is a tip opening 7a with a slightly narrower diameter, and a plurality of slits 7b are also shown in FIG. Thus, for example, it is formed at intervals of 120 ° (may be intervals of 90 °). Therefore, the tip opening 7a portion of the tip tip 7 can be elastically deformed to expand the diameter.

  A connecting member 5 that is detachably connected to the second clip 3 </ b> B is fixedly connected to the distal end of the operation wire 2 via a connecting pipe 6. A pair of leading end claw portions 5a similar to a leading end portion of the clip 3 to be described later are bent at the leading end portion of the connecting member 5 so as to face each other.

  In addition, a spherical protrusion 5 b that protrudes toward the inner peripheral surface of the sheath 1 protrudes from the back of the connecting member 5, so that the connecting member 5 does not fluctuate in the sheath 1 and the inner periphery of the sheath 1. Large frictional resistance and catching are prevented from occurring with the surface.

  A plurality of (two in this embodiment) clips 3 (3A, 3B) that can be opened and closed in a hook-like manner are arranged in series in the distal end portion of the sheath 1, and are operated in series. A plurality of clips 3 are sequentially pushed out from the distal end of the sheath 1 by the wire 2, and the clips 3 are once opened and then closed.

  Each clip 3 is formed in a shape that can be opened and closed like a bowl toward the front by bending back a single plate material having a spring property such as a stainless steel plate on the rear end side and elastically deforming it. ing.

  In a single state where no external force is applied, the clip 3 is wide open as shown in FIG. 11 and the like which will be described later, and the fastening ring 4 fitted to the clip 3 so as to be able to move forward and backward is moved closer to the front side of the clip 3. When moved to the position, the clip 3 is elastically deformed to the closed state as shown in FIG. 12 and the like, and when moved to the rear side, the clip 3 is returned to the opened state by its own elasticity as shown in FIG. .

  Returning to FIG. 1, a pair of front end claw portions 3 a that protrude in the closing direction of the clip 3 are bent and formed at the most distal end portion of the clip 3. Further, the rear end bending return portion of the clip 3 is formed in a shape in which a rear end connecting hole portion 3b having a dimension shape in which the front end claw portion 3a can be inserted and engaged freely swells in an annular shape. The opening surface of the rear end connecting hole 3 b is parallel to the opening / closing direction of the clip 3.

  The pair of tip claws 3a formed in each clip 3 is formed by slightly shifting the folding position in the front-rear direction so that they do not collide with each other when the clip 3 is in a closed state, The rear end connecting hole portion 3b is formed in such a size that such a pair of front end claw portions 3a can be loosely passed and rotated inside.

  And a pair of front-end | tip nail | claw part 3a of the 2nd clip 3B is loosely inserted in the rear-end connection hole 3b of the 1st clip 3A, and the 1st clip 3A and the 2nd clip 3B are the sheath 1's. Directly connected by changing the direction around the axis by 90 °, the pair of front end claw portions 5a of the connecting member 5 are connected so as to be loosely inserted into the rear end connecting hole portion 3b of the second clip 3B.

  The fastening ring 4 for forcibly closing the clip 3 is formed in a substantially oval cross-sectional shape as shown in FIG. 2, and the clip 3 is passed therethrough. However, the cross-sectional shape of the ring 4 may be a circle or the like.

  As shown in the plan view of the second clip 3B in FIG. 1, the clip 3 is slightly narrower than the other portions only in the advance / retreat range of the fastening ring 4 (front end position 3f to rear end position 3e). The clip 4 is formed so that the clip 4 is fitted on the portion, and the clip 3 is formed wider than the inner diameter of the clamp ring 4 in the vicinity of both front and rear ends so that the clamp ring 4 cannot deviate from a predetermined advance / retreat range. .

  The outer diameter size of the fastening ring 4 is formed so as to be larger than the distal end opening 7a although it is loosely inserted into the distal tip 7. Therefore, when the fastening ring 4 is pushed forward from the rear to the front (from right to left in FIG. 1) in the tip tip 7, the tip surface 4d of the fastening ring 4 hits the tip back surface 7d of the tip tip 7. Then stop.

  When the fastening ring 4 is further strongly pressed from behind, it passes through the tip opening 7a while elastically expanding the tip opening 7a of the tip tip 7 divided by the plurality of slits 7b, and is pushed forward. It is supposed to be. The wall surface around the tip opening 7a of the tip back surface 7d of the tip chip 7 is formed in a slope shape of about 45 degrees so that such movement can be performed smoothly. Further, the rear end surface 4e of the fastening ring 4 pushed forward is brought into contact with a portion around the tip opening 7a of the tip surface 7e of the tip tip 7.

  In the endoscope clip device of the embodiment configured as described above, according to the present invention, when the clip 3 is in the sheath 1, the fastening ring 4 is positioned in the vicinity of the front end of the advancing / retreating range with respect to each of the clips 3A and 3B. As a result, the clips 3A and 3B are closed by the ring 4 and the tips of the clips 3A and 3B are narrowed to a size that does not contact the inner peripheral surface of the sheath 1. Yes. However, the clip 3 is slightly in contact with the inner peripheral surface of the sheath 1 by being slightly inclined in the sheath 1.

  As a result, when the clips 3A and 3B are in the sheath 1, the clips 3A and 3B are not caught by the inner peripheral surface of the sheath 1, and the clips 3 are removed by remote operation via the operation wire 2. It can be smoothly advanced and retracted and rotated.

  It should be noted that the collar 4 is elastically clicked to the clip 3 such as click locking so that the state where the collar 4 is positioned at or near the front end position 3f of the advance / retreat range with respect to the clip 3 can be maintained to some extent. The clip 3 may be provided with a fastening means for locking.

  4 and 5 are a side view and a plan view of the clip 3 as an example, in which a step 3c is formed in the width direction in the vicinity of the tip of the clip 3 to form a fastening ring locking means. 6 and 7 are a side view and a plan view of another example of the clip 3, and a projection 3d projecting outward is formed on the back part near the tip of the clip 3 to form a fastening means for fastening the ring. Is. 4 to 7 illustrate a state in which the clip 3 is forcibly closed.

  When the endoscope clip device configured as described above is used, as shown in FIG. 1, the clips 3 </ b> A and 3 </ b> B are completely closed by the fastening ring 4 in the sheath 1 (that is, as shown in FIG. 1). An endoscope (not shown) in a state in which the fastening ring 4 is positioned near the front end of the advance / retreat range with respect to the clip 3 and the tip portion of the clip 3 is constricted to a size that does not contact the inner peripheral surface of the sheath 1). Is passed through the treatment instrument insertion channel.

  Then, when the distal end of the sheath 1 is directed toward the target affected part in the body, the operation wire 2 is pushed strongly from the proximal end side, thereby two clips 3A connected in series as shown in FIG. , 3B move forward in the sheath 1, and the first clip 3A jumps forward from the tip opening 7a of the tip tip 7. Then, since the outer diameter of the fastening ring 4 is formed larger than the diameter of the tip opening 7 a of the tip tip 7, the tip surface 4 d of the fastening ring 4 collides with the tip back surface 7 d around the tip opening 7 a of the tip tip 7. Thereby, the clamp ring 4 is left in the distal tip 7 and moves backward relative to the first clip 3A.

  As a result, as shown in FIG. 9, the first clip 3 </ b> A is maximally spread in front of the sheath 1. When the fastening ring 4 is moved to the rear end position 3e of the advance / retreat range with respect to the first clip 3A, the fastening ring 4 is pushed forward by the first clip 3A, as shown in FIG. The fastening ring 4 passes while being elastically deformed so as to expand the tip opening 7 a of the tip tip 7.

  As shown in FIG. 11, the first clip 3 </ b> A and the fastening ring 4 are pushed forward from the tip tip 7, but the rear end connecting hole 3 b of the first clip 3 </ b> A is formed on the tip tip 7. By abutting on the outer edge of the tip opening 7a, it stops once at that position. At that time, the fastening ring 4 is located at the rear end of the advance / retreat range with respect to the first clip 3A, and the first clip 3A is maximally spread by its own elasticity. In this state, the first clip 3A is targeted. Can be pressed against the affected area.

  Accordingly, as shown in FIG. 12, when the operation wire 2 is pulled toward the proximal end, the rear end surface 4e of the fastening ring 4 is in contact with the portion around the distal end opening 7a of the distal end surface 7e of the distal end tip 7. Then, the latter half of the most advanced clip 3A is pulled into the sheath 1, the fastening ring 4 moves to a position closer to the front and back of the clip 3 and the first clip 3A is forcibly closed by the fastening ring 4. As a result, the target affected area is tightly sandwiched, and the operation wire 2 cannot be further pulled.

  Then, as shown in FIG. 13, the first clip 3 </ b> A is pushed to the tip of the tip 7 while pushing the operation wire 2 strongly toward the tip to widen the tip opening 7 a of the tip 7. If the second clip 3B is pushed forward from the opening 7a and further pushed out from the tip opening 7a of the tip 7 to some extent, the second clip 3B is opened, so that the first clip 3A and the second clip 3B are opened. As shown in FIG. 14, the first clip 3A is left in the body with the target affected area clipped, and then the second clip 3B is used to perform the clipping operation for the next target affected area. Ready to do.

  In addition, this invention is not limited to the said Example, For example, the cross-sectional shape of the ring 4 is shown in FIG. 15, and each center part of four sides of a square protrudes outward in V shape. It may be formed into a non-circular cross-sectional shape that can be deformed in the radial direction, such as a cross-sectional shape that has been obtained.

It is side surface sectional drawing of the front-end | tip vicinity of the clip apparatus for endoscopes of the Example of this invention. It is II-II sectional drawing in FIG. 1 of the clip apparatus for endoscopes of the Example of this invention. It is an external view of the whole structure of the clip device for endoscopes of the example of the present invention. It is a side view of the 1st modification of the clip of the clip device for endoscopes of the example of the present invention. It is a top view of the 1st modification of the clip of the clip device for endoscopes of the example of the present invention. It is a side view of the 2nd modification of the clip of the clip device for endoscopes of the example of the present invention. It is a top view of the 2nd modification of the clip of the clip device for endoscopes of the example of the present invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing which shows operation | movement at the time of use of the clip apparatus for endoscopes of the Example of this invention. It is sectional drawing of the modification of the fastener ring of the clip apparatus for endoscopes of the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Sheath 2 Operation wire 3 (3A, 3B) Clip 3a Front-end | tip nail | claw part 3b Rear-end connection hole part 3c Level | step difference (ring-fastening locking means)
3d Projection (Clamping means for fastening ring)
4 Fastening ring 4d Front end surface 4e Rear end surface 5 Connecting member 5b Projection 7 Front end tip 7a Front end opening 7b Slit 7d Front end back surface 7e Front end surface

Claims (15)

A plurality of clips that can be opened and closed in a hook shape by being elastically deformed are arranged in series in a state where each clip is constricted in the distal end of the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. The clip for endoscope which is configured such that the plurality of clips are sequentially pushed out from the distal end of the sheath by an operation wire arranged so as to be movable back and forth in the axial direction, and the clips can be closed once opened. A device,
Each of the clips is open in a single state where no external force acts, and when the clamp ring fitted to the clip is moved forward and backward, the clip is elastically deformed into a closed state, and the rear In the endoscope clip device, when the clip is moved to the side, the clip returns to the open state by its own elasticity.
An endoscopic clip device characterized in that when the clip is in the sheath, the clip is closed by the fastener ring.   The endoscope clip device according to claim 1, wherein when the clip is in the sheath, the fastening ring fitted to the clip is positioned near a front end of an advance / retreat range with respect to the clip.   The endoscope clip device according to claim 1 or 2, wherein in a state where the clip is completely closed by the fastening ring, a tip portion of the clip is narrowed to a size that does not contact the inner peripheral surface of the sheath. 4. The clip according to any one of claims 1 to 3, wherein a fastening ring locking means is provided on the clip for releasably and elastically locking the clamp ring at a front end position of an advance / retreat range with respect to the clip. Endoscopic clip device.   The endoscope clip device according to claim 4, wherein the fastener ring is click-locked to the clip by the fastener locking means.   The endoscope clip device according to claim 4 or 5, wherein the fastening means for locking is formed by forming a step in the width direction in the vicinity of the tip of the clip.   The endoscope clip device according to claim 4 or 5, wherein the fastener locking means is formed by forming a protrusion protruding outward on a back portion near the tip of the clip. The endoscope clip device according to any one of claims 1 to 7, wherein the ring is formed in an oval cross-sectional shape. The endoscope clip device according to any one of claims 1 to 7, wherein the ring is formed in a circular cross-sectional shape. The endoscope clip device according to any one of claims 1 to 7, wherein the fastener ring is formed in a non-circular cross-sectional shape that is deformable in a radial direction. The clip device for an endoscope according to claim 10, wherein each of the central portions of the four sides of the square is formed in a cross-sectional shape protruding in a V shape.   The vicinity of the distal end opening of the sheath is formed in a shape divided by a plurality of slits, and the fastener ring passes through the distal end opening while elastically expanding the distal end opening. The endoscope clip device according to the section.   13. The endoscope clip device according to claim 12, wherein the fastener ring is moved to the rear side of the clip before passing through the distal end opening of the sheath.   A connecting member detachably attached to a rear end portion of the clip at a rear end position of the plurality of clips is attached to a distal end portion of the operation wire, and an inner peripheral surface of the sheath is provided on a back portion of the connecting member. The endoscopic clip device according to any one of claims 1 to 13, wherein a spherical protrusion protruding toward the side is provided. A tip claw portion that is bent toward the closing direction of each clip is formed at the tip portion of each clip, and a connecting hole having a dimension and shape that can be inserted and engaged with the tip claw portion opens the opening surface of each clip. The plurality of clips are formed in the direction around the axis in the sheath by engaging the front end claw portion of the adjacent clip and the connecting hole formed in the rear end portion of each clip in a direction parallel to the opening / closing direction. The endoscope clip device according to any one of claims 1 to 14, wherein the clip device is directly connected by alternately changing the direction by 90 °.

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