JP2007275445A - Clip device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip device for an endoscope in which the connection portions of a plurality of adjacent clips easily and freely bend and can be smoothly passed in a the treating tool passing channel of the endoscope even though the plurality of clips arranged in series in a fore and aft direction are connected with each other and arranged in a flexible sheath. <P>SOLUTION: A flexible wire material 8 is extended rearward from the rear end of the front side clip 3A, a connecting block 82 shaped into a columnar shape or a spherical shape is secured to the tip portion of the same, the connecting block 82 is arranged in a space surrounded by the rear side clip 3B and a front end claw portion 3a of the rear side clip 3B, the plurality of clips 3A, 3B adjacent in a fore and aft direction are connected with the wire material 8 when the rear clip 3B is closed, the connecting block 82 is released from the rear side clip 3B and the plurality of clips 3A, 3B adjacent in a fore and aft direction are separated when the rear clip 3B is opened. <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, a plurality of clips are arranged in series in the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope, and can be moved forward and backward in the axial direction in the flexible sheath. An endoscopic clip device has been devised in which a plurality of clips are sequentially pushed out from the distal end of a flexible sheath with an arranged operation wire so that clipping can be continuously performed (for example, Patent Document 1). .
JP 2002-330972 A

  However, in the conventional endoscope clip apparatus described in Patent Document 1, a plurality of clips arranged in the distal end of the flexible sheath are individually connected to the distal end of the operation wire by a ligation wire or the like. Therefore, the more the clip is located at the rear, the more the ligation wire interferes, and there are many cases where the structure becomes cluttered and does not operate smoothly.

  Therefore, by directly connecting the tip claw portion formed by bending the tip portion of the clip in the closing direction and the connecting hole formed in the rear end portion of the clip adjacent to the front side of the clip in a separable manner. It is conceivable to arrange a plurality of clips in the distal end of the flexible sheath in a concise and orderly manner so that a continuous clipping procedure can be performed with a smooth operation. Regarding the clip device, the applicant of the present invention has previously filed a patent application (Japanese Patent Application No. 2005-334).

  However, the specific configuration is such that the front end claw portion of the clip and the connection hole formed in the rear end portion of the clip adjacent to the front side thereof are directly connected. The connecting portion is difficult to bend freely, and the connecting portion is damaged when the flexible sheath passes through the treatment instrument insertion channel of the endoscope (particularly when passing through the curved portion of the endoscope). There was a fear.

  In view of this, the present invention provides a configuration in which a plurality of clips arranged in series in the front-rear direction are connected to each other and arranged in a flexible sheath, and the connecting portions between the adjacent clips are freely bent. An object of the present invention is to provide an endoscopic clip device that can easily pass through a treatment instrument insertion channel of an endoscope smoothly.

  In order to achieve the above object, an endoscope clip device according to the present invention includes a plurality of clips that can be opened and closed like a bowl and have a tip claw portion that is bent toward the closing direction at the most distal portion. The operation is arranged in series while being constricted in the distal end of the flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope, and can be moved forward and backward in the axial direction in the flexible sheath. In an endoscopic clip device configured such that a plurality of clips are sequentially pushed out from a distal end of a flexible sheath by a wire, a rear clip from a rear end of a front-side clip among a plurality of clips adjacent in the front-rear direction. A space in which a flexible wire is extended and a connecting lump formed in a columnar shape or a spherical shape is attached to the protruding end portion, and the connecting lump is surrounded by a rear clip and a tip claw portion of the rear clip. After placing in When the first clip is closed, a plurality of clips adjacent in the front-rear direction are connected to each other by the wire, and when the rear clip is opened, the connection block is released from the rear clip and adjacent in the front-rear direction. A plurality of matching clips are separated from each other.

  A groove is formed at the tip of the tip claw of the rear clip, and the wire may pass through the groove, and a through-hole is formed in the center of the rear end wall of the front clip. May be formed, and the wire may pass through the through hole.

  Further, the connecting lump may be arranged without rattling in the space surrounded by the rear clip and the tip claw portion of the rear clip, or the connecting lump may be the rear clip and the rear clip. It may be arranged so as to be movable in the front-rear direction in a space surrounded by the tip claw portion.

  Further, the wire may be fixed near the rear end portion of the front clip, and a columnar or spherical stop mass is attached to the front end portion of the wire, and the stop mass is the rear end of the front clip. The part may be engaged in a non-separable manner.

  According to the present invention, a flexible wire is extended rearward from the rear end of the clip on the front side among the plurality of clips adjacent in the front-rear direction, and the connection is formed in a columnar shape or a spherical shape at the protruding end portion. A lump is attached, and the connected lump is arranged in a space surrounded by the rear clip and the tip claw of the rear clip, and when the rear clip is closed, a plurality of adjacent ones in the front-rear direction When the rear clip is opened, the connecting mass is released from the rear clip and the adjacent clips are separated from each other in the front-rear direction. A connecting portion between a plurality of adjacent clips can be easily bent, and can smoothly pass through the treatment instrument insertion channel of the endoscope.

  A flexible sheath in which a plurality of clips, which can be opened and closed like a hook and formed with a tip claw bent in the closing direction at the most distal portion, is inserted into and removed from the treatment instrument insertion channel of the endoscope. A plurality of clips are sequentially pushed out from the distal end of the flexible sheath by an operation wire that is arranged in series while being constricted in the distal end, and is movable in the axial direction in the flexible sheath. In the endoscope clip device thus formed, a flexible wire is extended rearward from the rear end of the front-side clip among a plurality of clips adjacent in the front-rear direction, and the protruding end portion is formed in a columnar shape or a spherical shape. Attach the formed connecting mass and place it in the space surrounded by the rear clip and the tip claw of the rear clip, and when the rear clip is closed, Multiple chestnuts next to each other Ready to flop each other are connected by wire, rear plurality of clips each other adjacent to the longitudinal direction clip is released from the clip of the rear connecting mass and open the are to be separated.

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

  Reference numeral 10 denotes an operation unit, which is flexible by sliding a slide operation member 12 having a proximal end of an operation wire 2 connected to an operation unit main body 11 to which a proximal end of a flexible sheath 1 is connected. The operating wire 2 advances and retreats within the sheath 1, and the clip 3 can be pushed out from the distal end of the flexible sheath 1 to be opened and closed.

  FIG. 1 is a side sectional view of the vicinity of the distal end of an endoscope clip device, and a flexible sheath 1 of this embodiment is formed of a flexible tube such as a tetrafluoroethylene resin tube. . However, you may form with the coil pipe etc. which closely wound the stainless steel wire by the fixed diameter.

  A cylindrical tip chip 7 made of metal or plastic is fixedly attached to the most distal portion of the flexible sheath 1. The distal tip 7 has an inner diameter that is substantially the same as that of the flexible sheath 1.

  The tip of the tip 7 is a tip opening 7a with a slightly narrower diameter, and a plurality of slits 7b are formed in the direction parallel to the axis from the tip of the tip 7 to the rear, for example, at intervals of 120 °. Has been. Therefore, the tip opening 7a portion of the tip tip 7 can be elastically deformed to expand the diameter.

  The tip of the operation wire 2 can be engaged with and disengaged from the second clip 3B which is the rear end clip of the plurality of (two in this embodiment) clips 3A and 3B provided adjacent to each other in the front-rear direction. The connecting member 5 to be connected is fixedly connected 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 the distal end portion of the flexible sheath 1, the clips 3 </ b> A and 3 </ b> B that can be opened and closed in a hook shape are arranged in series in a constricted state, and the plurality of clips 3 are flexed by the operation wire 2. The clip 3 is sequentially pushed out from the distal end of the sheath 1 so that the clip 3 can be 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.

  When the clip 3 is in a single state where no external force is applied, the clip 3 is opened wide as shown in FIG. 8 to be described later, and a short cylindrical fastening ring 4 fitted to the clip 3 so as to be able to advance and retract in the front-rear direction. When moved to the front side, the clip 3 is elastically deformed to the closed state as shown in FIG. 1 and the like, and when moved to the rear side, the clip 3 returns to the opened state by its own elasticity. The clip 3 is elastically deformed into a constricted state by being accommodated in the flexible sheath 1 (or in the distal tip 7). In this embodiment, the clip 3 is constricted by the fastening ring 4. .

  As shown in FIG. 4, a pair of tip claw portions 3 a protruding in the closing direction of the clip 3 are bent and formed at the most distal portion of the clip 3 so as to face each other. A concave groove 3c is formed at the center position of the portion. A similar groove 5c is also formed in the tip claw portion 5a of the connecting member 5.

  The pair of tip claws 3a formed on 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 the closed state. .

  As shown in FIG. 1, the rear end bent-back portion of the clip 3 is a rear end loop portion 3 b having an annularly bulged shape, and as shown in FIG. 5, the rear end wall of the rear end loop portion 3 b. A through-hole 3d is formed in the central portion of each.

  The first clip 3A and the second clip 3B, each configured as such, are connected by a connecting member as shown in FIG. The connecting member of this embodiment is connected to a stop lump 81 made of a cylindrical rigid body at the front and rear ends of a flexible wire 8 such as a piano wire, a super elastic alloy wire or a so-called torque wire, for example. The lump 82 is integrally fixed. However, as shown in FIG. 7, at least one of the stop lump 81 and the connecting lump 82 may be a spherical body.

  As shown in FIG. 8, the stop lump 81 is tightly fitted in the rear end loop portion 3b of the clip 3 so that there is no backlash, and the wire 8 extends through the through hole 3d to the rear of the clip 3. The connecting lump 82 is integrally fixed to the extended end.

  Accordingly, the wire 8 is fixedly connected to the rear end loop portion 3b of the clip 3 at the front end side, and is connected to the extension end of the wire 8 extending rearward from the clip 3 like a tail. Is attached.

  As a result, as shown in FIG. 1, when the clips 3A and 3B are narrowed, the wire rod 8 extending rearward from the first clip 3A has a tip claw of the second clip 3B adjacent to the rear side. The connection lump 82 is housed in the space surrounded by the closed second clip 3B and the tip claw 3a of the second clip 3B, passing loosely through the recessed groove 3c of the portion 3a. It has become.

  In this state, the connecting lump 82 can move in the front-rear direction in the second clip 3B, but the front end claw portion 3a of the second clip 3B further forwards the front of the connecting lump 82 (leftward in FIG. 1). ) Is blocked.

  Therefore, the first clip 3A and the second clip 3B are connected by the wire 8, and the second clip 3B and the connecting member 5 are also connected in the same configuration, and in the connected state, The second clip 3B and the connecting member 5 can freely change directions with respect to the connecting lump 82 formed in a columnar shape or a spherical shape.

  In the endoscope clip device of the embodiment configured as described above, when the operation wire 2 is pushed in from the operation unit 10 side, the tip claw portion 3a of the second clip 3B is moved as shown in FIG. When the rear end loop portion 3b of the first clip 3A is pushed forward from the rear side and the operation wire 2 is pulled from the operation portion 10 side, the tip claw portion 3a of the second clip 3B is connected to the connecting lump 82. The first clip 3 </ b> A is pulled backward by the wire 8 after retreating to a position where it abuts on the wire 8.

  Then, the flexible sheath 1 is passed through the endoscope treatment instrument insertion channel (not shown), and the flexible sheath 1 is bent along the treatment instrument insertion channel as shown in FIG. In this case, the connecting portion between the first clip 3A and the second clip 3B and the connecting portion between the second clip 3B and the connecting member 5 can be freely changed in direction and bent. Therefore, even when the endoscope clip device is a curved portion of an endoscope, the endoscope can be smoothly passed through the treatment instrument insertion channel. In addition, the direction where the connection lump 82 is formed in a spherical shape is more flexible than the case where it is cylindrical.

  When the distal end of the flexible sheath 1 is directed toward the target affected part in the body, the operation wire 2 is strongly pushed from the proximal end side, whereby the two clips 3A and 3B connected in series are flexibly flexible. The first clip 3 </ b> A jumps forward from the distal end opening 7 a of the distal tip 7, and the first clip 3 </ b> A spreads to the maximum extent in front of the flexible sheath 1. After that, by repeating the pulling operation and the pushing operation of the operation wire 2, the clip 3 can be forcibly closed by the fastening ring 4 to make a clipping state in which the target affected area is tightly clamped. Since the operation is described in Patent Document 1 and the like, the illustration and explanation are omitted.

  When such a clipping operation is completed, the second clip 3B is pushed out from the tip of the tip tip 7 so that the second clip 3B is opened. As described above with reference to FIG. Then, the connection lump 82 attached to the rear end of the first clip 3A is disengaged from the second clip 3B, and the first clip 3A can be placed in the body.

  FIG. 9 shows the vicinity of the distal end of the clip device for an endoscope according to the second embodiment of the present invention, and an inward projection 3e for holding the clip 3 in the front-rear direction is directed inward. The connecting lump 82 is sandwiched between the tip claw portion 3a and the inward projection 3e without rattling and cannot move in the front-rear direction.

  With this configuration, a gap is created between the rear end loop portion 3b of the first clip 3A and the front end claw portion 3a of the second clip 3B even when the operation wire 2 is pushed from the operation portion 10 side. As shown in FIG. 10, when the first clip 3A and the second clip 3B are passed through the treatment instrument insertion channel of the endoscope, the connecting portion of the first clip 3A and the second clip 3B can be bent more freely. it can. The connecting member 5 is also formed with a similar inward projection 5e.

  11 and 12 show the vicinity of the distal end of the endoscope clip device according to the third embodiment of the present invention, and the stop lump 81 is formed small enough to be rattled in the rear end loop portion 3b. It is. Even if comprised in this way, the effect similar to the 1st and 2nd Example can be acquired. In addition, the connection part of the 2nd clip 3B and the connection member 5 is comprised similarly.

  FIG. 13 shows the vicinity of the rear end loop portion 3b of the clip 3 according to the fourth embodiment of the present invention. The stopper lump 81 is omitted and the front end portion of the wire 8 is replaced with the rear end loop portion 3b of the clip 3. Directly fixed. Even if comprised in this way, the effect similar to the 1st and 2nd Example can be acquired. The connecting portion between the second clip 3B and the connecting member 5 is similarly configured.

  The present invention is not limited to the above embodiment, and the present invention may be applied to an endoscope clip device in which, for example, three or more clips 3 are arranged in series in the flexible sheath 1. it can.

It is side surface sectional drawing of the tip vicinity of the clip apparatus for endoscopes of 1st Example of this invention. It is side surface sectional drawing in the state where the front-end | tip vicinity of the clip apparatus for endoscopes of 1st Example of this invention curved. It is an external view of the whole structure of the clip apparatus for endoscopes of the 1st Example of this invention. It is a perspective view of the most advanced part of the clip of the 1st example of the present invention. It is a perspective view of the rear-end part of the clip of 1st Example of this invention. It is a perspective view of the connection member for connecting the some clip adjacent to the front-back direction of the clip apparatus for endoscopes of the 1st Example of this invention. It is a perspective view of the other example of the connection member for connecting the some clip adjacent to the front-back direction of the clip apparatus for endoscopes of the 1st Example of this invention. It is side surface sectional drawing of the state which the connection of the some clip adjacent to the front-back direction of the clip apparatus for endoscopes of the 1st Example of this invention removed. It is side surface sectional drawing of the tip vicinity of the clip apparatus for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the state where the front-end | tip vicinity of the clip apparatus for endoscopes of 2nd Example of this invention bent. It is side surface sectional drawing of the tip vicinity of the clip apparatus for endoscopes of the 3rd Example of this invention. It is side surface sectional drawing of the state where the front-end | tip vicinity of the endoscope clip apparatus of 3rd Example of this invention bent. It is a perspective view of the rear-end part of the clip of the 4th Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3 Clip 3A 1st clip (front side clip)
3B Second clip (rear clip)
3a Front end claw portion 3c Concave groove 3b Rear end connecting hole portion 3d Through hole 3e Inward projection 5 Connecting member 8 Wire material 81 Stopping block 82 Connecting block

Claims (7)

A flexible sheath in which a plurality of clips, which can be opened and closed like a hook and formed with a tip claw bent in the closing direction at the most distal portion, is inserted into and removed from the treatment instrument insertion channel of the endoscope. The plurality of clips are sequentially pushed out from the distal end of the flexible sheath by operation wires that are arranged in series while being constricted in the distal end, and are disposed in the flexible sheath so as to be movable back and forth in the axial direction. In the endoscope clip device configured as described above,
A flexible wire is extended rearward from the rear end of the clip on the front side among the plurality of clips adjacent in the front-rear direction, and a connecting lump formed in a columnar shape or a spherical shape is attached to the protruding end portion, and The plurality of clips adjacent to each other in the front-rear direction when the connecting lump is disposed in a space surrounded by the rear clip and the front end claw portion of the rear clip and the rear clip is closed. When the rear clip is opened, the connection mass is released from the rear clip and the plurality of clips adjacent in the front-rear direction are separated from each other. An endoscopic clip device characterized by that.   The endoscope clip device according to claim 1, wherein a groove is formed in a tip portion of a tip claw portion of the rear clip, and the wire passes through the groove.   The endoscope clip device according to claim 1 or 2, wherein a through hole is formed at a center of a rear end wall portion of the front side clip, and the wire passes through the through hole.   The endoscope clip device according to claim 1, 2 or 3, wherein the connecting block is arranged without rattling in a space surrounded by the rear clip and a tip claw portion of the rear clip.   The endoscope clip device according to claim 1, 2 or 3, wherein the connecting lump is movably disposed in the front-rear direction in a space surrounded by the rear clip and a tip claw portion of the rear clip. .   The endoscope clip device according to any one of claims 1 to 5, wherein the wire is fixed in the vicinity of a rear end portion of the front clip.   6. A columnar or spherical stop mass is attached to the tip portion of the wire, and the stop mass engages the rear end portion of the front clip in an inseparable manner. The endoscope clip device according to Item.

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