JP2017012532A - Clip unit for ligation device and cartridge for clip unit - Google Patents

Abstract

PROBLEM TO BE SOLVED: To facilitate attachment/detachment of an operation wire and a clip unit.SOLUTION: A clip unit 100 for ligation devices includes: a ring 101 fitted to a sheath cap 210 for penetrating an operation wire 340; arms 120 extending from the ring 101 and generating energization force in a direction of opening distal ends; and a cylindrical bobbin 106 fitted to a root part of the arms 120. The clip unit further includes a connector 107 with a U-shaped part that is connected to the operation wire 340 and clamps cylindrical both ends of the cylindrical bobbin 106 to removably hold them.SELECTED DRAWING: Figure 15

Description

  The present invention relates to a clip unit for a ligation device that clips an affected area, and a cartridge for a clip unit that can easily connect the clip to an operation wire of the ligation device.

  In general, a ligation device for endoscopic surgery is guided to a digestive organ through a channel of an endoscope, and opens and closes an arm of a clip unit disposed at the distal end of the ligation device to sandwich an affected part or blood vessel. The clip unit in a state of sandwiching the affected area is separated and left in the body.

  The following patent document is cited as a document describing a technique related to the ligating apparatus including the clip unit according to the conventional technique, and this patent document includes an arm by being fitted to a clip unit having an arm for grasping a living tissue. A fastening member that closes the leg, a connecting member that can be inserted into the fastening member and engages the clip unit, and the clip unit and the fastening member engage to hold the clip arm in a closed leg state. A ligating device technology including a locking portion is described.

JP 2004-73646 A

  The technique described in Patent Document 1 described above is a structure of a connecting member for connecting a clip unit to an operation wire extending from an operation portion, although a protrusion provided on the arm can hold the closed state of the clip arm. Is complicated and long, and there is a problem that the clip unit clipped first when performing a plurality of clip units obstructs the visual field at the time of subsequent treatment.

  An object of the present invention is made in view of such a situation, and a ligation apparatus in which the clip unit is easily connected to an operation wire extending from the ligation apparatus, and the rear end of the separated clip unit does not interfere with the surgical field of view. A clip unit for use is provided.

  In order to achieve the above object, the present invention provides a cylindrical ring fitted to a sheath cap that penetrates the operation wire, and extends in an elongated shape from the inner periphery of the ring in a direction to open the tip. An arm that generates an urging force and a cylindrical bobbin attached to the base of the arm are configured, and the tip of the arm is closed by the ring covering the base of the arm by operating the operation unit. The ligating device clip unit is provided with a connector provided with a U-shaped portion that is connected to the operation wire and that is detachably held by sandwiching both cylindrical ends of the cylindrical bobbin. Features.

  The present invention also provides a sheath cap penetrating the operation wire and having a slit in the longitudinal direction, a cylindrical ring fitted to engage with the inner wall of the sheath cap, An arm that extends from the inside of the inner circumference into a long shape and is expanded toward the tip when no external force is applied, and is folded back with a material having spring properties, and a folded root portion of the arm. A clip unit for a ligation apparatus, comprising: a cylindrical bobbin mounted thereon; and configured to close the tip of the arm by covering the base of the arm with an operation of the operation unit. And a connector provided with a U-shaped portion that is detachably held by sandwiching both ends of the cylindrical bobbin.

  The present invention also provides a sheath cap penetrating the operation wire and having a slit in the longitudinal direction, a cylindrical ring fitted to engage with the inner wall of the sheath cap, A pair of arms extending in a long shape from the inner periphery, a torsion spring wound with a metal wire so as to generate a biasing force in a direction to open the ends of the pair of arms, and winding of the torsion spring A cylindrical bobbin that penetrates and holds the inner periphery of the annular ring, and is configured to close the tips of the pair of arms by covering the roots of the pair of arms by operating the operation unit. A clip unit for a ligation apparatus, which is connected to the operation wire, and provided with a connector provided with a U-shaped portion that sandwiches and holds both ends of the cylindrical bobbin in a cylindrical manner The third feature.

  Further, the present invention provides the clip unit for a ligating apparatus according to the third feature, wherein the torsion spring forms a winding part in which a metal rod is wound a plurality of times and a linear tip part extending from both ends of the winding part, A fourth feature is that the arm is fixed to a tip portion of a torsion spring. In the clip unit for a ligation apparatus according to the third or fourth feature, the arm has a waveform along a short width direction. The fifth feature is that the tip of the torsion spring is fixed to the concave portion of the waveform.

  Further, the present invention provides the clip unit for a ligating apparatus according to any one of the above features, wherein the bobbin has both ends having recesses at both ends of the cylindrical shape, and is connected to the tip of an operation wire extending from the operation portion, A U-shaped connector that detachably holds the bobbin has protrusions that are detachably fitted to the recesses at both ends of the bobbin, and the protrusions of the connector are fitted to the recesses at both ends of the bobbin. The connector is connected to the bobbin by the sixth feature, and in the clip unit for a ligating apparatus having any one of the features described above, the pair of arms extend in the arm closing direction at the ends extending in a long shape and have a tooth shape. The seventh feature is that it has a tooth-like portion.

  The present invention also provides a sheath cap penetrating the operation wire and having a slit in the longitudinal direction, a cylindrical ring fitted to engage with the inner wall of the sheath cap, A pair of arms extending in a long shape from the inner periphery, a torsion spring wound with a metal wire so as to generate a biasing force in a direction to open the ends of the pair of arms, and winding of the torsion spring A clip having a cylindrical bobbin that penetrates and holds the inner periphery of the annular ring, and a U-shaped connector that is connected to the tip of the operation wire and detachably holds the bobbin that penetrates the torsion spring. A cartridge for connecting the bobbin and the connector of the unit, wherein a sheath insertion hole for inserting a sheath into a distal end portion and a guide groove on a side surface are opened, and the sheath insertion hole An upper case and a lower case provided with an internal groove facing each other and holding the clip unit, and a pair of pushers inserted into the guide grooves of the upper case and the lower case, the pair of pushers being an upper case And insert the sheath with the connector attached to the tip from the guide groove of the lower case through the sheath insertion hole, press the pushers at both ends of the case to hold the connector so that the connector does not rotate, An eighth feature is that the clip unit is configured to be connected to the operation wire by being inserted so as to fit into the recesses at both ends of the bobbin.

  The present invention also provides a sheath cap that penetrates an operation wire connected to the operation portion and has a slit opened in the longitudinal direction, and a cylindrical shape that is fitted to engage with the inner wall of the sheath cap. A ring, an arm that extends in a long shape from the inner periphery of the ring, and is folded back by a spring material in a shape that expands toward the tip when no external force is applied; and the arm Provided with a cylindrical bobbin attached to the folded root portion, and a connector provided with a U-shaped portion that is connected to the operation wire and detachably holds the cylindrical both ends of the cylindrical bobbin. A clip unit for a ligation apparatus, wherein the sheath cap is formed in a shape having an inclined surface inclined in a direction to bend toward the operation portion, and an operation wire is provided inside A separator passing, and ninth feature of further comprising a slit which is spread by contact with the inclined surface of the separator by pulling the operating wire to the operation unit direction.

  Furthermore, the present invention provides a sheath cap that penetrates an operation wire connected to an operation portion and has a slit opened in a longitudinal direction, and a cylindrical shape fitted to be engaged with an inner wall of the sheath cap. A ring, an arm that extends in a long shape from the inner periphery of the ring, and is folded back by a spring material in a shape that expands toward the tip when no external force is applied; and the arm Provided with a cylindrical bobbin attached to the folded root of the connector, and a connector having a U-shaped part connected to the operation wire and detachably connected by sandwiching both cylindrical ends of the cylindrical bobbin. A clip unit for a ligation apparatus, in which the bobbin and the connector are connected, the operation wire is drawn to the operation unit side to close the tip of the arm, and the operation wire Is pulled into the operating part side to release the connection, and then again fitted into the bobbin and the connector to be engaged, and the operating wire is pushed into the operating part side from the engaged state to re-engage the ring and the sheath cap. The tenth feature is that the operation wire is drawn to the proximal side from the recombined state and the ring is removed from the base of the arm.

  The clip unit for a ligating apparatus according to the present invention has a bobbin provided at the base of the arm to be opened and closed, and the clip unit is operated by connecting the operation unit and the clip unit using a U-shaped connector that sandwiches the bobbin. It can be easily connected to the wire, and the rear end of the separated clip unit can be prevented from obstructing the surgical field of view.

The figure for demonstrating the ligation apparatus containing the clip unit by the Example of this invention. The figure which shows the opening / closing operation | movement of the clip unit by 2nd Example of this invention. The perspective view which shows the connection state of the clip unit by 2nd Example. The perspective view which shows the isolation | separation state of the clip unit by 2nd Example. The perspective view which shows the state which removed the ring of the clip unit by 2nd Example. The exploded assembly figure of the clip unit tension part by the 2nd example. The figure for demonstrating the arm shape by 2nd Example. The figure for demonstrating the cartridge by 3rd Example of this invention. The exploded assembly figure of the cartridge by the 3rd example. The figure for demonstrating the assembly of the cartridge by 3rd Example. The figure for demonstrating the assembly of the cartridge by 3rd Example. The figure which shows the dimension of the clip unit by 3rd Example. The figure for demonstrating operation | movement of the cartridge by 3rd Example. The figure for demonstrating the clip unit of the leaf | plate spring structure arm by 1st Example of this invention. The figure which shows the state which opened the leaf | plate spring structure arm by 1st Example. The perspective view of the clip unit by 1st Example. The figure which shows the side surface and arm open state of the clip unit by 1st Example. The figure for demonstrating the connection operation | movement of the clip unit by 1st Example.

  Embodiments of a clip unit for a ligating apparatus and a cartridge for a clip unit according to the present invention will be described below.

[Constitution]
The clip unit for a ligation apparatus according to the present embodiment is passed through a treatment instrument guide tube of an endoscope, and is attached to the distal end of a ligation apparatus that sandwiches an arbitrary affected part in a digestive organ and performs hemostasis or the like. As shown in FIG. 1, the ligation apparatus inserted into the endoscope is connected to an operation unit 300 for a doctor or the like to operate the opening and closing of the clip unit 100, and the operation unit 300 via the coupling unit 211. A flexible tubular sheath 200 is connected to an operation wire 340 extending from the slider 320 of the operation unit 300 and penetrating through the sheath 200. The operation of the operation unit 300 by the doctor opens and closes the distal arm. And a clip unit 100.

  The operation unit 300 includes a cylindrical shaft-shaped portion 310 held by a doctor's hand, a slider 320 that is fitted on the outer periphery of the shaft-shaped portion 310 and slides in the axial direction, and a rear end of the shaft-shaped portion 310. A finger ring 330 is attached to the arm. The slider 320 is moved in the longitudinal direction with respect to the shaft-like portion 310 to pull or push the operation wire 340, thereby opening and closing the arm at the tip. For example, a doctor puts the sheath 200 at the affected part in the digestive organ and opens and closes the arm at the distal end to sandwich the affected part, and removes the clip unit 100 from the operation wire while holding the affected part. By doing so, it is configured to perform hemostasis of the affected area.

[Usage example of the leaf spring structure arm of the first embodiment]
The clip unit 100 according to the present embodiment has a sheath cap at the distal end of the sheath 200 as shown in FIG. 14 showing a state of being attached to the sheath, FIG. 15 showing a state of expanding the clip, and FIG. 16 showing a state of being detached from the sheath. A cylindrical ring 101 fitted to 210 and an end projecting from the ring 101 and folded back by a material having a spring property into a shape expanding toward the front (front end direction) when no external force is applied. The formed arm 120 and the bobbin 106 (see FIG. 6) attached to the folded root portion of the arm 120 are connected to the distal end of the operation wire, and the distal U-shaped is configured to hold the bobbin 106 detachably. It is provided with a connector 107 (see FIG. 6). The sheath cap 210 applied to the present embodiment incorporates a separator 150 as will be described later with reference to FIG. 18. The separator 150 is formed in a hemispherical shape having an inclined surface, and the sheath cap 210 and the ring 101 are coupled to each other. Used when canceling. The shape of the separator 150 is not limited to a hemispherical shape.

  Further, the arm 120 according to the present embodiment is formed such that a pair of contact portions 122 that contact in the closed state extend in the closing direction from both sides of the arm, and the contact portions 122 come into contact with the arm in the closed state. It is possible to prevent the arm from being closed more than the affected part is sandwiched and to prevent the plate-like arm from being twisted. FIG. 14 shows a state in which the distal end of the arm 120 is closed by the inner periphery of the sheath cap 210 sandwiching the root portion of the arm 120.

  15A and 15B, the arm 120 according to this embodiment has an R shape in which the shoulder portion of the abutting portion 122 is curved, and this R shape makes it easy to enter the cylinder of the ring 101. Can be put in and out. Further, as shown in FIGS. 15A and 15B, the arm 120 has a cutout portion 125 cut out in the lateral direction on the base side of the contact portion 122 and a projection portion 126 protruding toward the distal end side of the contact portion 122. The ring 101 is configured to be locked to the base portion of the arm 120 by the notch 125 and the protrusion 126.

[Example of use of torsion spring structure arm of second embodiment]
The clip unit 100 is not limited to the one described above, and is fitted into a sheath cap 210 at the distal end of the sheath 200 as shown in FIG. 3 showing the state attached to the sheath and FIG. 4 showing the state removed. A cylindrical ring 101, a pair of arms 102 projecting from the ring 101, and a torsion spring 104 wound so as to generate a biasing force in a direction to open the ends of the pair of arms 102. And a bobbin 106 (FIG. 6) that penetrates and holds the inner circumference of the annular ring wound with the torsion spring 104, and a bobbin 106 that is connected to the tip of the operation wire 340 and penetrates the torsion spring 104. It may be configured to be provided with a U-shaped connector 107 held at the top. FIG. 3 shows a state where the clip unit 100 closes the distal end of the arm 102 by the inner periphery of the sheath cap 210 sandwiching the root portion of the arm 102.

  As shown in FIG. 6, the torsion spring 104 according to this embodiment is formed with a winding portion obtained by winding a metal rod a plurality of times and a linear tip portion 104a extending from both ends of the winding portion. The bobbin 106 has a so-called bobbin shape in which a circular plate is formed at both ends of the cylindrical portion, and is configured to be detachable by engaging the inner walls of the U-shaped portion of the connector 107 with both ends of the bobbin 106. Yes. That is, the bobbin 106 is formed of a cylindrical portion extending in the axial direction and both end portions that are large and removable with respect to the outer peripheral diameter of the cylindrical portion, and the connector 107 is formed on the inner wall of the U-shaped portion. A pair of detachable protrusions 109 are formed in the recesses on both ends of the connector 107, and the inner wall protrusions of the U-shaped portion of the connector 107 are fitted in the recesses on both ends of the bobbin 106, so that both are detachable. Yes. In this embodiment, the connector 107 side is convex and the bobbin 106 side is concave. However, the present invention is not limited to this, and the connector 107 side is concave and the bobbin 106 side is convex. It is also good.

[Description of Ring 101]
As shown in FIG. 13 to be described later, the ring 101 has an annular shape and a concave portion formed on the inner wall, and the sheath cap 210 includes a small diameter portion provided with a convex portion that fits into the concave portion of the inner wall of the ring 101, and the small diameter portion. The ring 101 extends to form a large-diameter portion having the same diameter, and is configured to be connected by inserting and fitting the small-diameter portion of the sheath cap 210 into the inner periphery of the ring 101.

  Further, as shown in FIGS. 7A and 7B, the arm 102 bends in two steps along the short width direction, and the tip end 104a is welded to the concave portion inside the arm of the bending portion. At the same time, a tooth-like part 105 for holding the affected part at the tip part is formed. In the present embodiment, an example in which the tip 104a is welded to one of the concave portions located inside the arm of the curved portion that is curved in two steps is illustrated, but the present invention is not limited to this, for example, You may make it weld to the recessed part located in the arm outer side (surface of the direction which opens an arm) of FIG.7 (b). Further, as shown in FIG. 7 (c), a two-stage waveform is formed in such a manner that the concave portion of the waveform of the arm 102 faces the other arm, and the arm tip 104a is welded to the central concave portion of the curved portion. Also good. In this case, the tip portion 104a of the torsion spring 104 is formed to extend to the central portion of the winding portion. The arm shape is not limited to the shape of the present embodiment, but may be a flat plate shape, and may be a thick plate to increase the restoring force.

  The bobbin 106 that passes through the arm 102 and the torsion spring 104 is attached to the connector 107 as shown in FIG. 6 by inserting the bobbin 106 into a ring around which the torsion spring 104 is wound, and the torsion spring 104. Steps B and C for welding the arm 102 to the spring tip 104a and Step D for removably fitting the bobbin 106 to which the torsion spring 104 and the arm 102 are attached to the protrusion 109 of the U-shaped portion of the connector 107. Done.

  When the torsion spring is used, the clip unit 100 is in a natural state with the ring 101 removed, as shown in FIG. The ring 101 is fitted so as to open and cover the base portion of the arm 102 including the torsion spring 104, and the tip portions of the pair of arms 102 are closed.

  The clip unit 100 according to the present embodiment is attached so as to extend from the sheath cap 210 at the distal end of the sheath 200 in a closed state using a cartridge to be described later, and in this closed state, the doctor operates the endoscope toward the affected area. In a state of being combined, the thumb is placed on the finger ring 330 of the operation unit 300, the slider 320 is gripped so as to be sandwiched between other fingers, and the operation wire 340 is sheathed by pushing the slider 320 against the shaft 310 toward the distal end of the sheath. The distal end of the pair of arms 102 can be opened by moving the distal end of the pair of arms 102 and pushing the connector 107 from the distal ends of the sheath 200 and the sheath cap 210 as shown in FIG.

  The clip unit 100 closes the tip by inserting the arm 102 into the inner diameter of the ring 101 by pulling back the slider 320 in the sheath root direction from the state shown in FIG. Further, by pulling back the slider 320 to a position where the ring 101 hits the projection 103 of the arm 102, the arm 102 can be closed and the tip of the arm 102 can pinch (clip) the affected part as shown in FIG. The protrusion 103 is a stopper for preventing the ring 101 from moving in the arm tip direction. For example, the protrusion 103 is provided with an interval in the arm longitudinal direction, and the ring is fitted between the protrusions. May be.

[Example of an arm structure using a leaf spring according to the first embodiment]
When the leaf spring is used, the arm 120 in the closed state is closed by the ring 101 covering the root portion of the arm 120 as shown in FIG. 17A, and the arm 122 is folded back at the rear end portion. The bobbin 106 is configured to be fitted into the arcuate arm turn-back portion 122. As shown in FIG. 17B, the arm 120 in the opened state with the ring 101 omitted is configured to expand toward the front because no external force is applied.

  In the clip unit 100 according to these embodiments, the sliders 320 are pulled back in the sheath root direction in a state where the distal end of the arm 102 holds and fixes the affected part, so that the protrusion 109 of the connector 107 and the recesses at both ends of the bobbin 106 are separated. The fitting is released, and the affected part can be left in the patient's body while being sandwiched. The clip unit 100 remaining in the body is as small as several millimeters and is naturally discharged from the body by food or the like passing through the digestive organs.

  The clip unit 100 according to the first embodiment of the present invention uses a plate spring by using an arm 120 that is folded back and formed of a material having a spring property in a shape that expands forward when no external force is applied. The large arm 120 can obtain a large biasing force.

  Further, the clip unit 100 according to the second embodiment penetrates the bobbin 106 through the inner periphery of the torsion spring 104 in which a winding portion obtained by winding a metal rod a plurality of times and a linear tip portion 104a extending from both ends of the winding portion are formed. Then, the torsion spring 104 can efficiently apply a large biasing force to the arm 102 by welding the tip 104a of the torsion spring 104 to the corrugated recess of the arm 102.

  In particular, in the second embodiment, the urging force can be transmitted to the arm 102 because it is located at the bottom of the corrugated recess of the arm 102. In addition, since the clip unit 100 according to the present embodiment uses the torsion spring 104 wound as a generation source of the urging force that opens the tip of the arm 102, the urging force is adjusted according to the usage pattern by adjusting the number of turns, for example. Can be adjusted easily.

  Further, in the clip unit 100 according to the second embodiment, as shown in FIG. 12A, the length of the arm 102 portion is about 12 mm and the length of the torsion spring 104 at the rear end portion when the arm 102 is closed by the ring 101. When the arm 102 is opened, the maximum clip opening length at the tip of the arm 102 is 15 mm or more when the arm 102 is opened.

  Accordingly, in the clip unit 100 according to the second embodiment, the protruding portion from the rear end of the arm 102 left in the body is only the torsion spring 104, and as shown in FIG. For example, when performing a large number of clips with a length of about 2.2 mm, the rear end of the clip unit clipped earlier may have a possibility of obstructing the visual field of the operator by 2.2 mm. The field of view during the procedure can be expanded because of the shortening. The reason why the rear end portion can be shortened is that a torsion spring wound with a metal wire is used as a driving source for opening and closing the arm, a bobbin is disposed in the winding of the torsion spring, and the bobbin is sandwiched. This is achieved by connecting the operation unit and the clip unit using a U-shaped connector.

  Furthermore, as shown in FIG. 12B, the clip unit 100 according to the present embodiment is about 15 mm in which the force for opening the arm 102 is urged by the restoring force of the torsion spring 104 as compared with the restoring force of the conventional leaf spring. It can be expanded.

  As described above, the clip unit 100 according to the first and second embodiments of the present invention includes the U-shaped connector 107 provided at the distal end portion of the operation wire 340 and the attachment / detachment mechanism that engages in the U-shape of the connector 107. By configuring this, the length of the portion protruding from the rear end of the clip unit 100 can be shortened, and the visual field at the time of treatment can be enlarged.

  Since the clip unit 100 using the torsion spring according to the second embodiment of the present invention is left in the patient's body as described above, a doctor or the like is required to easily attach the clip unit 100 to the distal end of the ligating apparatus. Next, an embodiment of a clip unit cartridge to which the clip unit 100 can be attached will be described.

  The cartridge according to this embodiment has an external shape that is easy to hold on a human palm. As shown in the exploded view of FIG. 9, a sheath insertion hole 96 for inserting the sheath 200 at the distal end portion and a guide groove 97 on the side surface. An upper case 90 and a lower case 91 provided with an internal groove for holding the clip unit 100 in an opened state, and a pusher 93 inserted into the guide groove 97 of the upper case 90 and the lower case 91, A resilient material repelling member 95 sandwiched between the pusher 93 and the case side surface and a pair of bobbin holders 94 for holding the clip unit 100 in the case. The pair of pushers 93 has a distal end portion 93a slightly in contact with the ring 101 of the clip unit 100 to prevent rotation of the distal end of the U-shaped connector 107 attached to the distal end of the operation wire 340 and prevent the sheath from falling off. It is configured as follows.

  As shown in FIGS. 11A and 11B, the bobbin holder 94 is long so that both ends of the bobbin 106 of the clip unit 100 are sandwiched between the openings at the rear end and the arm 102 in an open state is covered from above and below. It is formed in the substantially rectangular shape extended in a shape.

  As shown in FIG. 10, the cartridge constructed as described above holds the clip unit 100 in the state of being sandwiched (opened) by the bobbin holder 94 in the lower case 91 in the internal groove, and as shown in FIG. A latch provided in the upper case 90 and the lower case 91 is assembled by inserting the pusher 93 and the repulsion member 95 into the guide groove 97 of the lower case 91 and covering the upper case 90 from above as shown in FIG. It is fixed by the mechanism.

  In this cartridge, with the clip unit 100 held inside, the sheath 200 having the connector 107 attached to the tip of the operation wire 340 is inserted from the sheath insertion hole 96, and the pushers 93 at both ends of the case are pushed from both sides. The connector 107 is held so as not to rotate and fall off, the operation cable is pushed in, and the clip unit 100 is ligated by inserting so that the protrusions 109 of the connector 107 that are prevented from rotating fit into the recesses at both ends of the bobbin 106. It connects with the operation wire 340 of an apparatus.

[Clip unit connection operation using torsion spring]
The details of this connection operation are as follows.
(1) First, as shown in FIG. 13 (a), the sheath with the torsion spring 104 wound around and the bobbin 106 housed in the ring 101 is positioned between the sharp end portion 93a of the pusher 93. The connector 107 at the tip of 200 is inserted.
At this time, the tip of the connector 107 is rotationally guided so that the connector U-shaped portion sandwiches both ends of the bobbin 106 by the inclined surface of the sharp tip portion 93a of the pusher 93. (2) Next, FIG. As shown, the connector U-shaped portion is further pushed in, and the connector U-shaped portion engages with the bobbin 107 to connect the tip of the connector 107 to the bobbin 107.
(3) Next, as shown in FIG. 13B, by pulling the operation wire 340 in the sheath 200 toward the front, the ring 101 with the bobbin 106 is detached from between the front end portions 93a of the pusher 93 and pulled out from the cartridge. In addition, the function that the ring 101 is disengaged from between the front end portions 93a of the pusher 93 is formed so that the outer periphery of the ring 101 is slightly touched between the front end portions 93a. Achieved by pusher elastic force or dimensional margin.
(4) Next, by further pulling the operation wire 340 toward the front, the distal end portion of the sheath cab 210 is inserted and fitted into the inner wall of the ring 101, the distal ends of the pair of arms 102 are closed, and the distal ends are closed. The unit 100 can be connected to the tip of the sheath 200.

  Next, the cartridge according to this embodiment stops the pressing of the pushers 93 at both ends of the case, and pulls out the sheath 200 in a state where the pushers 93 are pushed back by the repulsion of the repulsion member 95, whereby the base portion of the arm 102 is the sheath cap 210. The clip unit 100 can be easily connected to the operation wire 340 of the ligating apparatus with the arm 102 closed.

  The cartridge configured as described above can be easily connected to the clip unit 100 in a state where the rotation of the connector 107 that is a connecting member with the operation unit 300 of the clip unit 100 is prevented.

[Clip unit connection operation using leaf spring]
In the third embodiment, the clip unit cartridge in which the clip unit 100 using the torsion spring according to the second embodiment can be attached to the tip of the ligating apparatus has been described. However, the clip unit cartridge is according to the first embodiment. The present invention can also be applied to the clip unit 100 using a leaf spring, and this connecting operation will be described below.

  The sheath cap 201 in the present embodiment is formed in a shape having an inclined surface that is inclined in a direction that is deflated toward the operation portion, and pulls the operation wire 340 in the operation portion direction with the separator 150 penetrating the operation wire 340 inside. Accordingly, a groove-shaped slit S is provided which has a step D whose diameter is reduced so as to be in contact with the inclined surface of the separator and is opened in the longitudinal direction of the cylindrical outer wall.

  As shown in FIG. 18 (a), this connecting operation is performed when the operation wire 340 is moved in the distal direction from the tip of the ring 101 connected to the sheath 210 and the U-shaped portion of the connector 107 is projected from the tip. The step of causing the bobbin 106 connected to the arm 120 to approach the U-shaped portion, the step of fitting the U-shaped portion so as to sandwich both ends of the bobbin 106, as shown in FIG. 18B, and FIG. ), The step of retracting the operation wire 340 and storing the U-shaped portion fitted to the bobbin 106 in the ring 101 allows the clip unit 100 according to the second embodiment to be connected to the operation wire 340 of the ligating apparatus. Can be easily connected.

  The connection according to this embodiment includes a separator 150 provided with an inclined surface in the hand direction (operating portion direction), and a sheath provided with a step D having a slit S as a groove extending in the longitudinal direction to the end and reduced in diameter to the inner diameter. Using the cap 210, the operation wire 340 is strongly pulled back in the hand direction, the inclined surface of the separator 15 abuts against the step D of the sheath cap 210 to widen the slit, and the engagement between the ring 101 and the sheath cap 210 is released. .

  In addition, the clip unit for a ligating apparatus according to each of the above-described embodiments is fitted into the U-shaped connector 107 connected to the distal end side of the operation wire 340 extending from the operation unit, and the U-shape of the connector 107 is fitted into the concave shape by fitting a convex recess. A step of connecting the bobbin 106 and the connector 107 again after the affected part has been ligated, for example, by adopting a configuration in which the bobbin 106 and the connector 107 are connected to each other. In this connection state, the operation wire 340 is pushed in to re-engage the ring 101 and the sheath cap 210, and from this re-engagement state, the operation wire 340 is pulled to the hand side and the ring 101 is removed from the base of the arm 102. The ligation of the affected area by the arm 102 and the arm 102 again. Tip can reopen it (re expansion), if there is a problem with ligation of the affected part, it is also possible to try to ligation again.

90 upper case, 91 lower case, 93 pusher, 94 bobbin holder,
95 rebound member, 96 sheath insertion hole, 97 guide groove,
100 clip unit, 101 ring, 102 arm, 103 protrusion,
104 torsion spring, 104a tip, 105 tooth, 106 bobbin,
107 connector, 109 protrusion, 120 arm, 150 separator,
200 sheath, 211 coupling portion, 210 sheath cap, 300 operation portion,
310 Axial part, 320 Slider, 330 Finger ring, 340 Operation wire 122 Contact part, 125 Notch part, 126 Protrusion part

Claims (10)

A cylindrical ring fitted to a sheath cap penetrating the operation wire inside, an arm extending in a long shape from the inner periphery of the ring, and generating an urging force in a direction to open the tip; and the arm And a cylindrical bobbin attached to the base of the ligation apparatus, the clip unit for a ligating apparatus configured to close the tip of the arm by covering the base of the arm with the ring by the operation of the operation part. ,
A clip unit for a ligating apparatus, characterized in that a connector provided with a U-shaped portion that is connected to the operation wire and that is detachably held by sandwiching both cylindrical ends of the cylindrical bobbin is provided. A sheath cap that penetrates the operation wire and has a slit in the longitudinal direction, a cylindrical ring that is fitted to engage with the inner wall of the sheath cap, and a long length from the inner periphery of the ring An arm that is folded back by a material having a spring property in a shape that expands toward the tip when no external force is applied, and a cylindrical shape that is attached to the folded root portion of the arm A clip unit for a ligating apparatus, comprising a bobbin, and configured to close the tip of the arm by covering the base of the arm with an operation of an operation unit,
A clip unit for a ligating apparatus, characterized in that a connector provided with a U-shaped portion that is connected to the operation wire and that is detachably held by sandwiching both cylindrical ends of the cylindrical bobbin is provided. A sheath cap that penetrates the operation wire and has a slit in the longitudinal direction, a cylindrical ring that is fitted to engage with the inner wall of the sheath cap, and a long length from the inner periphery of the ring A pair of arms extending separately, a torsion spring wound with a metal wire so as to generate an urging force in a direction to open the ends of the pair of arms, and an inner circumference of a ring around which the torsion spring is wound A clip unit for a ligating apparatus, which is configured to close the distal ends of the pair of arms by covering the base portions of the pair of arms by the operation of the operation unit. Because
A clip unit for a ligating apparatus, characterized in that a connector provided with a U-shaped portion that is connected to the operation wire and that is detachably held by sandwiching both cylindrical ends of the cylindrical bobbin is provided. The torsion spring forms a winding part obtained by winding a metal rod a plurality of times and a linear tip part extending from both ends of the winding part,
The clip unit for a ligation apparatus according to claim 3, wherein the arm is fixed to a torsion spring.   The clip unit for a ligation apparatus according to claim 3 or 4, wherein the arm is curved in a wave shape along a short width direction, and a tip portion of a torsion spring is fixed to a concave portion of the wave shape.   The bobbin has both ends having recesses at both ends of the cylindrical shape, and is connected to the tip of an operation wire extending from the operation unit, and a U-shaped connector having a distal end that detachably holds the bobbin is provided on the bobbin. 6. The connector is connected to a bobbin by having protrusions that can be detachably fitted to recesses at both ends, and the protrusions of the connector are fitted with recesses at both ends of the bobbin. A clip unit for a ligation apparatus according to claim 1.   The clip unit for a ligation apparatus according to any one of claims 1 to 6, wherein the pair of arms has a tooth-like portion extending in an arm closing direction at a distal end extending in a long shape and having a tooth shape. A sheath cap that penetrates the operation wire and has a slit in the longitudinal direction, a cylindrical ring that is fitted to engage with the inner wall of the sheath cap, and a long length from the inner periphery of the ring A pair of arms extending separately, a torsion spring wound with a metal wire so as to generate an urging force in a direction to open the ends of the pair of arms, and an inner circumference of a ring around which the torsion spring is wound A bobbin of a clip unit comprising a cylindrical bobbin that passes through and holds a bobbin that is connected to a tip of an operation wire and that detachably holds a bobbin that passes through the torsion spring; and A cartridge for connecting the connector,
An upper case and a lower case in which a sheath insertion hole for inserting a sheath at the distal end portion and a guide groove on the side surface are opened, and an internal groove is provided facing the sheath insertion hole and holding the clip unit;
A pair of pushers inserted into the guide grooves of the upper case and the lower case,
The pair of pushers inserts a sheath with the connector attached to the tip from the guide groove of the upper case and the lower case from the sheath insertion hole, and pushes the pushers at both ends of the case so as not to rotate the connector, A clip unit cartridge characterized in that the clip unit is connected to an operation wire by inserting the projection of the connector, the rotation of which is blocked, into the recesses at both ends of the bobbin. A sheath cap penetrating the operation wire connected to the operation portion and having a slit in the longitudinal direction; a cylindrical ring fitted to engage with the inner wall of the sheath cap; An arm that extends from the inside of the inner circumference into a long shape and is expanded toward the tip when no external force is applied, and is folded back with a material having spring properties, and a folded root portion of the arm. A clip unit for a ligating apparatus, comprising: a cylindrical bobbin attached; and a connector provided with a U-shaped portion that is connected to the operation wire and is detachably held by sandwiching both cylindrical ends of the cylindrical bobbin. Because
The sheath cap is formed in a shape having an inclined surface that is inclined in a direction that is deflated toward the operation portion, and a separator that penetrates the operation wire therein and an inclination of the separator by pulling the operation wire in the operation portion direction. A clip unit for a ligating apparatus, comprising a slit that is pushed out in contact with a surface. A sheath cap penetrating the operation wire connected to the operation portion and having a slit in the longitudinal direction; a cylindrical ring fitted to engage with the inner wall of the sheath cap; An arm that extends from the inside of the inner circumference into a long shape and is expanded toward the tip when no external force is applied, and is folded back with a material having spring properties, and a folded root portion of the arm. A clip unit for a ligating apparatus, comprising: a cylindrical bobbin mounted thereon; and a connector having a U-shaped portion connected to the operation wire and detachably connected by sandwiching both cylindrical ends of the cylindrical bobbin Because
With the bobbin and connector connected, pull the operation wire to the operation unit side to close the tip of the arm, and then pull the operation wire to the operation unit side to release the connection, and then reinsert it into the bobbin and connector. Then, from the engaged state, the operation wire is pushed into the operation portion side to re-engage the ring and the sheath cap, and from the re-coupled state, the operation wire is drawn toward the hand side to extract the ring from the base of the arm. A clip unit for a ligation apparatus, characterized in that it is configured.

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