JP2007283080A - Clip for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip for an endoscope which can surely let a clip tightening ring retreat to the rear side parallel part of a clip member and return the clip member to a prescribed fully opened state by releasing a force pushing the clip tightening ring from behind if the clip member is in the stage before being brought to a prescribed fully closed state. <P>SOLUTION: In this clip for the endoscope, the clip member 1 is formed in the shape bent in the direction to expand to a middle arc-like part 1d side with an angle change (θ) at the boundary section X between a rear side parallel part 1c and the middle arc-like part 1d. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope clip that is indwelled in a body in order to perform hemostasis from a luminal organ mucosa.

In general, the clip for the endoscope is bent back at the rear end portion, and when no external force is applied, the clip member is formed of a material having a spring property so as to expand toward the front, and It is configured by an annular clip fastening ring that is fitted on the clip member and moved from the rear side to the front side of the clip member to elastically deform the clip member to forcibly close it (for example, Patent Document 1).
Japanese Patent Publication No.8-17778

  When performing clipping operation in the body under endoscopic observation, the clip in the opened state is brought close to the affected area by remote control, and the affected area is clamped by the clip, and then the clip tightening ring at the distal end of the sheath The clip is closed by pushing forward, but it may be better to repeat the clipping operation during the clipping operation because the orientation and position of the clip are insufficient. However, in many conventional endoscope clips, once the clip clamping ring is pushed forward at the distal end portion of the sheath, the clip member is plastically deformed and the clipping operation cannot be redone. In many cases, it was completed as it was.

Therefore, as shown in FIG. 11, the clip member 1 is provided with a rear rear parallel portion 1 c and an intermediate arc-shaped portion 1 d that spreads outward from the front end portion of the rear parallel portion 1 c. It is conceivable to form a front arm portion 1e extending forward from the tip portion of the intermediate arc-shaped portion 1d (Japanese Patent Application No. 2006-95692).
The rear parallel portion 1c is a portion where the clip member 1 maintains a predetermined fully open state when the clip tightening ring 2 is fitted thereon as shown in FIG. 11, and the intermediate arc-shaped portion 1d is When the clip tightening ring 2 is pushed to move forward from the back with the clip tightening ring 2 fitted thereto, the clip member 1 is gradually elastically deformed to the closed state, and the pushing force from the rear against the clip tightening ring 2 Is released, the clip member 1 expands due to the elasticity of the clip member 1 so as to return the clip tightening ring 2 to the rear, and the front arm 1e has the clip tightening ring 2 as shown by a two-dot chain line. The clip member 1 is brought into a predetermined fully closed state by being fitted on. With this configuration, while the clip tightening ring 2 is in a state of being fitted on the intermediate arcuate portion 1d, the elasticity of the clip member 1 can be achieved by releasing the pressing force from the rear of the clip tightening ring 2. As a result, the clip fastening ring 2 is returned to the rear in an attempt to return the intermediate arc-shaped portion 1d to the original expanded state.

  However, the force to return the clip tightening ring 2 to the rear is a repulsive force mainly generated from the intermediate arcuate portion 1d elastically deformed in a state constricted by the clip tightening ring 2, so that the clip tightening ring 2 is When returning to near the rear end position of the arcuate portion 1d, the force to return the clip fastening ring 2 backward becomes very weak, and the clip fastening ring 2 is moved to the rear side as shown by a two-dot chain line in FIG. When the relative movement between the clip member 1 and the clip clamping ring 2 is lost before the parallel portion 1c is completely returned, the clip member 1 is not sufficiently opened, and the clipping performance is significantly deteriorated. was there. Such a phenomenon occurs when the clip holding wire 4 is pulled backward by bending the bending portion of the endoscope while the clip device is passed through the treatment instrument insertion channel of the endoscope. Etc. also occurred.

  The present invention has been made to solve such a problem. If the clip member is in a stage before being fully closed, a force for pushing the clip clamping ring from the rear side is released. An object of the present invention is to provide an endoscope clip in which the clip tightening ring can be reliably retracted to the rear parallel portion of the clip member and the clip member can be returned to the fully opened state.

  The clip for endoscope of the present invention is a clip member formed of a material having a spring property so that it is bent back at the rear end portion and has a shape that expands toward the front when no external force is applied. And an annular clip fastening ring that is fitted to the clip member and moved from the rear side to the front side of the clip member to elastically deform the clip member to forcibly close the clip member. In the mirror clip, the clip member is formed in a straight line in the front-rear direction at the rear portion of the clip member so that the clip member is in a predetermined fully open state when the clip fastening ring is fitted thereto. The rear parallel part and the tip of the rear parallel part are formed in an arc shape and spread outward, and the clip tightening ring is moved from the rear to the front with the clip fastening ring fitted there. When pressed, the clip member is elastically deformed to the closed state gradually, and if the pushing force from the back against the clip tightening ring is released, it will spread by the elasticity of the clip member and return the clip tightening ring to the rear. An intermediate arc-shaped portion that extends forward from the distal end portion of the intermediate arc-shaped portion, and a clip fastening ring is fitted therein, whereby the clip member is in a predetermined fully closed state, and And the clip member is formed in a shape bent at a boundary portion between the rear parallel portion and the intermediate arc-shaped portion so as to expand toward the intermediate arc-shaped portion with an angle change.

In addition, it is good for the bending angle in the boundary part of the rear side parallel part of a clip member and an intermediate | middle circular arc-shaped part to be in the range of 5 degrees-30 degrees, and the clip clamping ring is not covered by the rear side parallel part. In the state, it may be formed in a shape that gradually widens toward the front side, and may be in a state of being straight and parallel in the front-rear direction by fitting the clip fastening ring.
Further, a step in which the intermediate arc-shaped portion side is increased outward may be formed between the tip end portion of the rear parallel portion of the clip member and the rear end portion of the intermediate arc-shaped portion, You may form in the shape of the slope which makes an obtuse angle with respect to each of the surface of the rear side parallel part, and the surface of the rear-end part of an intermediate | middle circular arc part. Further, the clip fastening ring may be formed in a coil shape.

  According to the endoscope clip of the present invention, the clip member is formed in a shape bent at the boundary portion between the rear side parallel portion and the intermediate arc-shaped portion so as to expand toward the intermediate arc-shaped portion side with an angle change. Therefore, if the clip member is in a stage before being fully closed, the clip clamping ring can be moved to the rear parallel part of the clip member by releasing the force that pushes the clip clamping ring from the rear. The clip member can be reliably retracted and returned to the predetermined fully open state.

Embodiments of the present invention will be specifically described below with reference to the drawings.
1 and 2 are a side partial sectional view and a plan partial sectional view of an endoscope clip constituted by a clip member 1 and a clip fastening ring 2. FIG. The clip clamping ring 2 is shown in cross section. The clip member 1 is used to clamp the tip portion 1a in a state where the tip portion 1a is bitten into the living tissue in order to perform hemostasis and the like, and clip fastening for forcibly maintaining the clip member 1 in a closed state. The ring 2 is fitted in a state of covering the rear part (right side in the drawing) of the intermediate part of the clip member 1.

  The clip member 1 is formed by bending a plate material having a spring property such as a stainless steel plate for a spring by pressing or the like, and the rear end portion 1b is bent back in a substantially U shape in parallel, so that an external force is applied. The front-side front arm portion 1c is formed in a shape that expands in a “C” shape toward the front when not applied. The clip tightening ring 2 is formed of, for example, a metal coil in which a stainless steel wire for a spring is closely wound in a circular cross-sectional shape with a constant diameter by a plurality of turns (for example, 5 to 10 turns). However, it may be formed in a rough winding or may be formed of a pipe material or the like.

  As shown in FIGS. 1 and 2, the clip member 1 has a rear end 1b so that the clip member 1 is in a predetermined fully open state when the clip fastening ring 2 is fitted there. A rear parallel part 1c formed in parallel to the front-rear direction at the rear part of the clip member 1 toward the front straight (left side in the figure), and outwardly drawn from the tip of the rear parallel part 1c An intermediate arc-shaped portion 1d extending toward the front and a front arm portion 1e extending forward from the tip portion of the intermediate arc-shaped portion 1d are formed.

  In the portion near the rear end of the rear side parallel portion 1c, a retraction stopper R is formed to restrict the clip tightening ring 2 from retreating further by making the width of the clip member 1 slightly wider than the width of the rear side parallel portion 1c. Has been. The width of the rear parallel portion 1c is formed so as to be slightly inscribed in the clip tightening ring 2 that is retracted to the retreat stopper R position, as shown in FIG. 3 illustrating the AA cross section in FIG. Yes.

  As shown in FIG. 2, the intermediate arc-shaped portion 1d is formed with the same width as the rear parallel portion 1c, and the front arm portion 1e is formed wider than that. A is a boundary portion between the intermediate arc-shaped portion 1d and the front arm portion 1e. However, a portion in the vicinity of the rear end of the front arm portion 1e adjacent to the boundary portion A is a tightening ring locking portion B in which the clip tightening ring 2 is tightly fitted and locked. The width of the tightening ring locking portion B is narrower than the front arm portion 1e closer to it, and wider than the intermediate arc-shaped portion 1d, and the front end portion of the tightening ring locking portion B is clip tightened. This is a forward stopper portion F that completely prevents the tip of the ring 2 from coming into contact and moving further forward.

  As shown in FIG. 1, the clip tightening ring 2 is fitted on the intermediate arc-shaped portion 1 d that is formed in an arc shape that spreads outward so as to move from the rear to the front. When pushed, the clip member 1 is elastically deformed so as to gradually close. And if the pushing force from the back with respect to the clip fastening ring 2 is cancelled | released, the intermediate | middle circular arc-shaped part 1d will spread according to the elasticity of the clip member 1, and it will act so that the clip fastening ring 2 may be returned back.

  The clip member 1 according to this embodiment has a shape in which the boundary portion X between the rear parallel portion 1c and the intermediate arc-shaped portion 1d is bent in a direction spreading toward the intermediate arc-shaped portion 1d with a change in angle (the bending angle θ). ). That is, as shown in FIG. 1, the center position O of the arc of radius r forming the intermediate arc-shaped portion 1d is the rear parallel portion 1c at the boundary portion X between the rear parallel portion 1c and the intermediate arc-shaped portion 1d. It is in a position that is bent backward by an angle θ with respect to a straight line orthogonal to. The bending angle θ is preferably in the range of about 5 ° to 30 °, for example. Note that the radius of the intermediate arc-shaped portion 1d may not be constant, such as an elliptical arc instead of a perfect circular arc.

  The clip member 1 configured in this manner is in a state of being passed through the clip tightening ring 2, and if the clip tightening ring 2 is positioned in the rear parallel portion 1 c, the clip member 1 is predetermined. Fully open. When an external force is applied to the clip tightening ring 2 to move the clip tightening ring 2 from the rear parallel portion 1c to the intermediate arcuate portion 1d closer to the front, the clip member 1 gradually closes. If the pressing force on the clip tightening ring 2 is released before the clip tightening ring 2 reaches the tightening ring locking portion B, the clip member 1 tries to return to the original expanded state by its own elasticity. The clip fastening ring 2 is returned to the rear side of the clip member 1 again by the force.

  The clip member 1 is formed in a shape bent at a boundary portion X between the rear side parallel portion 1c and the intermediate arc-shaped portion 1d so as to expand toward the intermediate arc-shaped portion 1d with an angle change. While the attaching ring 2 is in the region of the intermediate arc-shaped portion 1d, the elastic force of the intermediate arc-shaped portion 1d that attempts to return the clip tightening ring 2 backward acts on the clip tightening ring 2 reliably. As a result, the entire clip tightening ring 2 is always returned to the rear parallel portion 1c, and the clip member 1 is in a predetermined fully open state shown in FIG.

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

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

  A cylindrical clip holding base 10 formed of a rigid body such as a stainless steel pipe material or a hard plastic material is brazed to the distal end of the flexible sheath 3 in series with the flexible sheath 3, and laser A fastening ring holding hole 11 for holding the clip fastening ring 2 in a loosely surrounding state is formed at the most distal end portion of the clip holding base 10 by being fixed integrally by welding or adhesion. . The clamping ring holding hole 11 is formed in a circular cross-sectional shape with a diameter into which the clip clamping ring 2 is loosely inserted, and the innermost end of the clamping ring holding hole 11 has a slightly narrower diameter. The contact surface 11a with which the rear end surface of the clip tightening ring 2 contacts is formed facing forward.

  The clip holding base 10 is formed with a clip holding hole 12 that is connected to the rear side of the fastening ring holding hole 11 and holds a portion near the rear end of the clip member 1. The clip holding hole 12 holds the clip member 1 so as to loosely surround the vicinity of the rear end 1b of the clip member 1 protruding rearward from the clip fastening ring 2 when the clip member 1 is expanded. The clip connecting member 4A connected to the tip of the clip holding wire 4 by the connecting ring 4B is formed of a material having spring property in a tweezers shape in which the tip 4a is bent inward, and the flexible sheath 3 (and the clip In the holding base 10), it is elastically deformed in a constricted state and engages with the rear end 1b of the clip member 1, but when protruding from the front end of the clip holding base 10, as shown in FIG. It expands and the engagement with the clip member 1 is released.

  Returning to FIG. 4, reference numeral 5 denotes a flexible outer tube made of, for example, a fluororesin tube or the like loosely fitted on the flexible sheath 3. The distal end of the outer tube 5 is usually at a position slightly retracted from the distal end of the flexible sheath 3. However, if the outer tube 5 is pushed forward by the operation portion on the hand side, as shown in FIG. When the outer tube 5 is retracted rearward, the clip member 1 can be elastically deformed in a state where the distal end portion of the outer tube 5 is covered with the clip member 1 and the clip member 1 is narrowed. Return to the original expanded state shown.

  When performing the endoscopic clipping operation by passing the endoscope clip device configured in this way through the treatment instrument guide tube of the endoscope, first, as shown in FIG. 5, the clip connecting member 4A The clip member 1 is engaged with the rear end 1b of the clip member 1 and the outer tube 5 is pushed forward to insert the clip member 1 into a treatment instrument guide tube of an endoscope (not shown) with the clip member 1 in a squeezed state. Then, in the body, the tip of the clip device protrudes from the tip of the endoscope, and the outer tube 5 is retracted rearward as shown in FIG. Let the affected part 100 face.

  Then, by a remote operation from an operation unit (not shown) connected to the proximal end of the flexible sheath 3, as shown in FIG. The clip tightening ring 2 is pushed forward from the rear toward the front with respect to the clip member 1 and fitted into the intermediate arc-shaped portion 1d, and the clip member 1 is gradually closed. It will become. However, as described in paragraph [0018], if the clip clamping ring 2 is before engaging the clamping ring locking portion B, the flexible sheath 3 is retracted backward. As shown in FIG. 4, the entire clip tightening ring 2 is reliably returned to the position where it engages with the rear parallel portion 1c, and the clip member 1 returns to the predetermined fully opened state again. Therefore, if the clip orientation or position is insufficient during the clipping operation, or if the clip member 1 is semi-closed due to unnecessary traction force acting on the clip holding wire 4, the clip The member 1 can be returned to the predetermined fully opened state, and the clipping operation can be performed again from the beginning.

  Then, if the affected part 100 can be correctly picked by the front arm 1e of the clip member 1, it is flexible until the clip tightening ring 2 is engaged with the tightening ring locking part B as shown in FIG. When the clip sheathing ring 3 is pushed in and moved to a position where the clip clamping ring 2 hits the advance stopper F, further advancement of the clip clamping ring 2 is completely prevented and the clip member 1 is tightly closed. The fully-closed state is reached, and the affected part 100 can be clipped by the distal end portion 1a of the clip member 1, and subsequently, as shown in FIG. By removing the clip connecting member 4A from the rear end 1b, the clip member 1 that is forcibly closed by the clip tightening ring 2 can be placed in the body.

  In addition, this invention is not limited to the above-mentioned embodiment, For example, as FIG. 9 shows, the clip fastening ring 2 is not covered by the rear side parallel part 1c of the clip member 1. As shown in FIG. In a state, it is formed in a shape that gradually widens toward the front side, and is configured to be elastically deformed and become straight and parallel in the front-rear direction as shown in FIG. May be. By doing so, the action of returning the clip fastening ring 2 from the intermediate arcuate portion 1d side to the rear parallel portion 1c side becomes more reliable.

  Further, as shown in FIG. 10, the intermediate arcuate portion 1d side is outward between the front end portion of the rear parallel portion 1c of the clip member 1 and the rear end portion of the intermediate arcuate portion 1d (boundary portion X). A step that is higher may be formed. By doing so, the entire clip tightening ring 2 can easily be reliably returned from the intermediate arcuate portion 1d side to the rear parallel portion 1c side. However, in order to allow the clip tightening ring 2 to smoothly move from the rear side parallel part 1c to the intermediate arcuate part 1d side, the level difference between the surface of the rear parallel part 1c and the rear part of the intermediate arcuate part 1d. It is good to form in the shape of the slope which makes an obtuse angle (for example, about 135 degrees) with respect to each of the surface of an edge part. In FIG. 10, the step of the boundary portion X is shown large for easy understanding, but the size of the step may be about 0.05 to 0.2 mm.

The side surface fragmentary sectional view of the clip for endoscopes of the 1st Embodiment of this invention. The plane fragmentary sectional view of the clip for endoscopes of the 1st embodiment of the present invention. Sectional drawing of the state cut | disconnected by the AA of FIG. 1 of the clip for endoscopes of the 1st Embodiment of this invention. The side sectional view of the tip part of the clip device for endoscopes in which the clip member of a 1st embodiment of the present invention is in a predetermined full open state. The side sectional view of the tip part of the clip device for endoscopes in the state where the mantle tube of the 1st embodiment of the present invention moved forward. The side sectional view of the tip part of the clip device for endoscopes in the state where the clip clamp ring of the 1st embodiment of the present invention moved forward. The side sectional view of the tip part of the clip device for endoscopes where the clip member of a 1st embodiment of the present invention is made into the predetermined fully closed state by a clip clamping ring. The side sectional view in the state where the clip member of the 1st embodiment of the present invention was detained in the body. The side surface fragmentary sectional view of the state by which the clip member and clip clamping ring of the clip for endoscopes of the 2nd Embodiment of this invention were decomposed | disassembled. The side view of the clip member of the 3rd Embodiment of this invention. Side surface sectional drawing of the conventional clip for endoscopes. Side surface sectional drawing of the front-end | tip part of the use condition of the conventional clip for endoscopes.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Clip member 1c ... Rear side parallel part 1d ... Intermediate | middle circular arc-shaped part 1e ... Front side arm part 2 ... Clip clamping ring 3 ... Flexible sheath B ... Tightening ring latching | locking part X ... Boundary part (theta) ... Bending angle

Claims (6)

When the rear end portion is bent back and no external force is applied, a clip member formed of a material having a spring property so as to have a shape expanding toward the front, and is fitted on the clip member In an endoscope clip provided with an annular clip tightening ring that elastically deforms the clip member by moving it from the rear side to the front side of the clip member to forcibly close the clip member,
The clip member is formed in a straight line in the front-rear direction at the rear portion of the clip member so that the clip member is in a predetermined fully open state when the clip fastening ring is fitted thereto. A rear parallel part;
When the clip fastening ring is pushed so as to move from the rear to the front in a state where the clip fastening ring is fitted there, the arc is drawn from the front end portion of the rear side parallel portion. An intermediate that acts to elastically deform the clip member in a closed state and expands by the elasticity of the clip member to return the clip tightening ring to the rear if the pushing force from the rear to the clip fastening ring is released. An arcuate part;
A front arm portion that extends forward from a tip portion of the intermediate arc-shaped portion and the clip fastening ring is fitted thereto to form the clip member in a predetermined fully closed state is formed,
An internal view characterized in that the clip member is formed in a shape bent at a boundary portion between the rear parallel portion and the intermediate arc-shaped portion so as to expand toward the intermediate arc-shaped portion with an angle change. Mirror clip.   The endoscope clip according to claim 1, wherein a bending angle in a boundary portion between the rear parallel portion and the intermediate arc-shaped portion of the clip member is in a range of 5 ° to 30 °. clip.   The endoscope clip according to claim 1 or 2, wherein the rear parallel portion is formed in a shape that gradually expands toward the front side when the clip fastening ring is not fitted. An endoscope clip that is in a straight and parallel state in the front-rear direction when the fastening ring is fitted.   The endoscope clip according to claim 1, 2, or 3, wherein the intermediate arc-shaped portion is provided between a front end portion of the rear parallel portion of the clip member and a rear end portion of the intermediate arc-shaped portion. A clip for an endoscope in which a step is formed with the side heightened outward.   5. The endoscope clip according to claim 4, wherein the step is formed in a slope shape that forms an obtuse angle with respect to each of the surface of the rear parallel portion and the surface of the rear end portion of the intermediate arc-shaped portion. Endoscopic clip.   The endoscope clip according to any one of claims 1 to 5, wherein the clip fastening ring is formed in a coil shape.

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