JP2020065637A - Lumen detention clip - Google Patents

Abstract

To provide a lumen detention clip which can accurately identify a lesion.SOLUTION: A lumen detention clip 1 includes a clip body 2 made of a non-magnetic substance. A magnetic body 3 is attached to a hook part 23 which is a part of the clip body 2.SELECTED DRAWING: Figure 1A

Description

  The present invention relates to an intraluminal indwelling clip that can be attached as a marker to a lesion site in a living body lumen.

  For example, when a lesion occurs in a living body lumen such as a digestive tract, a surgical operation is performed to surgically excise the lesion by laparotomy or laparoscopic surgery. In these procedures, in order to identify a lesion site, an endoscope may be inserted into a living body lumen before surgery, and marking may be performed by attaching a clip to the lesion site or in the vicinity thereof to make a mark. is there. By performing the marking in this way, the surgeon confirms the position of the clip placed in the body lumen (hereinafter referred to as “intraluminal placement clip”) from the abdominal cavity side at the time of surgery, and the position is formed at that position. The affected lesion can be surgically excised.

  As a method of confirming the position of the indwelling clip from the abdominal cavity side, for example, Patent Document 1 discloses a method using a metal sensor (proximity sensor). According to Patent Document 1, by scanning the metal sensor along the surface of the living body lumen from the abdominal cavity side, the position of the intraluminal indwelling clip can be easily confirmed based on the output signal of the metal sensor. .

  However, in recent years, an intraluminal indwelling clip made of a non-magnetic material has been widely used from the viewpoint of safety in a high magnetic field environment assuming that a patient undergoes an MRI (Magnetic Resonance Imaging) test. Therefore, it is difficult to detect the position of the intraluminal indwelling clip with high detection sensitivity by the proximity sensor, and the marked lesion site may not be accurately specified from the abdominal cavity side.

International Publication No. 99/02098 Pamphlet

  The present invention has been made in view of such circumstances, and an object thereof is to provide an intraluminal indwelling clip that enables accurate identification of a lesion site.

That is, in order to achieve the above object, the intraluminal indwelling clip according to the present invention,
An intraluminal indwelling clip having a clip body made of a non-magnetic material,
A magnetic material is provided on a part of the clip body.

  In the intraluminal indwelling clip according to the present invention, a magnetic body is provided in a part of the clip body. Therefore, when the proximity sensor is scanned along the surface of the living body lumen from the abdominal cavity side, when the proximity sensor approaches the indwelling position of the intraluminal clip, only the clip body made of a non-magnetic material is placed. Can be surely detected by the proximity sensor. Therefore, the position of the intraluminal clip can be detected with high detection sensitivity, and the lesion site can be accurately specified.

  Further, in the intraluminal indwelling clip according to the present invention, since the clip main body is made of a non-magnetic material and only a part of the clip main body is provided with the magnetic material, a patient in whom the intraluminal indwelling clip is placed is Safety can be ensured even in a high magnetic field environment such as when undergoing an MRI examination.

  Also, since the magnetic body can be attached to the existing clip, it is possible to attach the intraluminal indwelling clip using a general-purpose clip device without impairing the operation feeling familiar with the existing clip. is there.

  Preferably, the magnetic body is provided on the surface of the clip body. With such a configuration, the magnetic body is integrally (directly) attached to the clip body, and the magnetic body that can be easily detected by the proximity sensor is located near the surface of the clip body. Therefore, the detection error of the position of the intraluminal indwelling clip by the proximity sensor can be minimized.

The clip body is
A pair of arm plate portions arranged so that the mutual distance becomes wider toward the tip portion in the state where no external force acts,
A connecting plate portion connecting the base end portions of the arm plate portions,
A tightening ring that is slidably attached from the connecting plate portion along the arm plate portion and that slides toward the tip end side of the arm plate portion to close the tip ends of the pair of arm plate portions so as to approach each other. ,
And a claw portion provided so as to correspond to each other at each tip end portion of the arm plate portion,
The magnetic body may be attached to at least one surface of the arm plate portion, the connecting plate portion, the tightening ring, and the claw portion.

  Preferably, the magnetic body is provided on the outer surface of the claw portion. With such a structure, when the mucous membrane at the lesion site or in the vicinity thereof is clamped by the nail portion, the magnetic body is pressed toward the outer side (abdominal cavity side) of the mucous membrane. Therefore, it is possible to effectively increase the detection sensitivity of the position of the intraluminal indwelling clip when the proximity sensor is scanned from the abdominal cavity side, and it is possible to more accurately specify the lesion site.

FIG. 1A is an overall schematic view of an intraluminal indwelling clip according to a first embodiment of the present invention in a state where an arm plate portion is opened. FIG. 1B is an overall schematic view of a state where the arm plate portion of the intraluminal indwelling clip is closed. FIG. 1C is an overall schematic diagram when FIG. 1B is viewed from another direction. FIG. 2A is an overall schematic view of an intraluminal indwelling clip according to a second embodiment of the present invention in a state where an arm plate portion is opened. FIG. 2B is an overall schematic view of the intraluminal indwelling clip with the arm plate portion closed. FIG. 2C is an overall schematic diagram when FIG. 2B is viewed from another direction. FIG. 3A is an overall schematic view of an intraluminal indwelling clip according to a third embodiment of the present invention in a state where an arm plate portion is opened. FIG. 3B is an overall schematic view of a state where the arm plate portion of the intraluminal indwelling clip is closed. FIG. 3C is an overall schematic diagram when FIG. 3B is viewed from another direction. FIG. 4A is an overall schematic view of a modified example of the intraluminal indwelling clip shown in FIG. 3A in a state where the arm plate portion is opened. FIG. 4B is an overall schematic view of a state where the arm plate portion of the intraluminal indwelling clip is closed. FIG. 4C is an overall schematic diagram when FIG. 4B is viewed from another direction. FIG. 5 is a schematic view showing an example of use of the intraluminal indwelling clip shown in FIG. 1A. FIG. 6 is a schematic view showing an example of use of the intraluminal indwelling clip shown in FIG. 3A.

  Hereinafter, the present invention will be described based on the embodiments shown in the drawings.

First Embodiment As shown in FIG. 1A, an intraluminal indwelling clip 1 according to a first embodiment of the present invention includes a clip body 2 and a magnetic body 3. The intraluminal indwelling clip 1 is attached endoscopically to a lesion site in a living body lumen such as a digestive tract or the vicinity thereof, and is used for marking the lesion site.

  The clip body 2 includes a connecting plate portion 21, a pair of arm plate portions 22 and a tightening ring 24. The connecting plate portion 21 has a substantially U-shaped bent shape, and connects the base end portions 22a and 22a (see FIG. 1B) of the pair of arm plate portions 22 and 22, respectively. As shown in FIG. 1A, a connection hole 25 is formed inside the connection plate portion 21, and a tip of a clip device (not shown) for delivering the intraluminal indwelling clip 1 into a living body lumen is engaged. It is possible to combine them.

  The pair of arm plate portions 22, 22 are arranged so that the mutual distance becomes wider toward the tip end portion in the state where no external force acts, and the arm plate portions 22, 22 are opened in a substantially V shape toward the tip end side. The U-shaped end portions of the connecting plate portion 21 are continuously and integrally formed.

  The tightening ring 24 is a ring-shaped member that is fitted onto the connecting plate portion 21 on the base end side of the arm plate portion 22. The tightening ring 24 is slidably attached from the connecting plate portion 21 along the arm plate portion 22 and is slid toward the tip end side of the arm plate portion 22, thereby bringing the tip ends of the pair of arm plate portions 22, 22 closer to each other. It is possible to make it close like this.

  A claw portion 23 is integrally formed at the tip of each arm plate portion 22. The claw portions 23 are provided so as to correspond to the respective tip portions of the arm plate portions 22, and are bent toward the inside (that is, the closing direction) at the tip ends of the arm plate portions 22 to be bent. There is. In addition, you may form the recessed notch in the intermediate part of the front-end | tip of each nail | claw part 23.

  The connecting plate portion 21, the pair of arm plate portions 22, and the pair of claw portions 23 that form the clip body 2 are formed by bending and forming one thin and slender plate material. The plate thickness of the plate material forming the clip body 2 is not particularly limited, but is preferably 0.10 to 0.30 mm.

  As the plate material, a metal plate having elasticity is preferable, and for example, a stainless steel plate is used. As this stainless steel plate, a non-magnetic stainless steel plate such as an austenitic stainless steel plate (for example, SUS302, SUS304, SUS304L, SUS316, SUS316L, SUS317L, SUS32L, SUS347, SUS309, SUS310S) is preferable. By configuring the clip body 2 using a non-magnetic material, safety can be ensured even in a high magnetic field environment such as when a patient in which the intraluminal clip 1 is placed undergoes an MRI examination. The clip body 2 having excellent workability and corrosion resistance can be configured.

  Further, in the present embodiment, the tightening ring 24 is also made of metal, and the material thereof is not particularly limited, and may be made of the same metal as the clip body 2, or a metal different from the clip body 2. It may be composed of. Further, the tightening ring 24 may be made of a non-metallic material.

  As shown in FIG. 1B, the arm plate portions 22 each have a base end portion 22a and a grip portion 22b. A through hole 22c is formed in each of the grip portions 22b of each arm plate portion 22. These through holes 22c are formed without impairing the desired strength of the arm plate portion 22 (holding portion 22b). These through holes 22c are formed from the viewpoint of adjusting the elasticity (repulsive force) when the arm plate portion 22 is closed by the tightening ring 24.

  The tightening ring 24 slidably fitted in the connecting plate portion 21 is formed of a substantially cylindrical ring member. However, the tightening ring 24 may be formed of a spring formed by winding a wire rod into a coil. The tightening ring 24 has the connecting plate portion 21 inserted through the guide hole inside thereof, and moves (slides) in the axial direction between the outer circumference of the connecting plate portion 21 and the outer circumference of the base end portion 22a of the arm plate portion 22. It is mounted (externally fitted) as much as possible. In addition, the connecting plate portion 21 is formed with a stopper projection 21a so that the tightening ring 24 does not come off to the outside of the connecting plate portion 21.

  As shown in FIG. 1A, when the tightening ring 24 is arranged on the rear side of the arm plate portion 22 (close to the coupling plate portion 21), the arm plate portion 22 is opened (opened) by its own elasticity. It has become. If necessary, as shown in FIG. 1C, by moving (sliding) the tightening ring 24 to a position closer to the tip of the base end portion 22a shown in FIG. 1B (closer to the gripping portion 22b shown in FIG. 1B), the arm is moved. The plate portion 22 can be in a closed (closed) state.

  As shown in FIGS. 1A to 1C, the magnetic body 3 is attached to a part of the clip body 2 (the outer surface of the claw portion 23 in the present embodiment). In the present embodiment, the magnetic body 3 is attached to the outer surface of each of the pair of claw portions 23, 23, but the magnetic body 3 may be attached only to the outer surface of either one of the claw portions 23. In the following description, the inner surface corresponds to the surface on which the pair of arm plate portions 22, 22 face each other, and the outer surface corresponds to the surface on the opposite side to the inner surface.

  As shown in FIG. 1C, the pair of claw portions 23, 23 are capable of meshing with each other, and at least the claw portion 23 located on the outer side in a meshed state (in the present embodiment, a pair of claw portions disposed on the left and right sides). It is preferable that the magnetic body 3 is attached to the outer surface of the claw portion 23) arranged on the right side of the claw portions 23, 23. The magnetic body 3 is attached to the outer surface of the claw portion 23 by adhesion, insert molding, or the like.

  In this embodiment, the shape of the magnetic body 3 is substantially the same as the outer surface shape of the claw portion 23. That is, the magnetic body 3 is formed so as to cover substantially the entire surface of the claw portion 23, and the outer peripheral shape of the magnetic body 3 substantially matches the outer peripheral shape of the claw portion 23. As shown in FIG. 1A, the thickness of the magnetic body 3 is substantially uniform along the first extending direction D1 from the base end side to the tip end side of the claw portion 23. Further, as shown in FIG. 1B, the thickness of the magnetic body 3 is substantially uniform along the second extending direction D2 which is perpendicular to the first extending direction D1.

  Examples of the material forming the magnetic body 3 include materials that are magnetic bodies (ferromagnetic bodies) such as iron, cobalt, nickel, or alloys thereof, stainless steel, and ferrite, and preferably stainless steel is used. .

  Examples of the stainless steel forming the magnetic body 3 include martensitic stainless steel (for example, SUS403, SUS410, SUS420, SUS431, SUS440, etc.), ferritic stainless steel (for example, SUS405, SUS430, SUS434, etc.), austenite / ferrite series. (Dual phase) stainless steel (for example, SUS329J4L, etc.) is preferably used.

  In the present embodiment, the magnetic body 3 is formed by molding the above-mentioned magnetic material into a desired shape (for example, the outer surface shape of the claw portion 23). The thickness of the magnetic body 3 is not particularly limited, but is preferably about the same as the thickness of the clip body 2, and is 0.05 to 0.30 mm.

  The magnetic body 3 may have a magnetic thin film formed on the outer surface of the claw portion 23. The magnetic thin film can be formed by using the above-mentioned magnetic material and performing, for example, sputtering or vapor deposition.

  Next, a method of using the intraluminal indwelling clip 1 of the present invention will be described with reference to the drawings, taking as an example the case of excision of a lesion site in a living body lumen such as a digestive tract by laparotomy. .

  First, as shown in FIG. 5, an endoscope 6 and a clip device (not shown) are used to mark a tumor (lesion site) 4b generated inside the lumen 4 in the living body with the intraluminal indwelling clip 1. The indwelling indwelling clip 1 is conveyed to the inside of the lumen 4 by using, for example.

  Then, the intraluminal indwelling clip 1 is placed around the tumor 4b, and the arm plate portion 22 of the intraluminal indwelling clip 1 is opened by its own elasticity (see FIG. 1A).

  Then, the clip device (not shown) is operated to move the tightening ring 24 of the indwelling indwelling clip 1 to the distal end side of the arm plate portion 22 to close the arm plate portion 22 (see FIG. 1C). As a result, the mucous membrane 4a around the tumor 4b is clamped by the claw portions 23 of the intraluminal placement clip 1, and the magnetic body 3 is pressed against the mucosa 4a around the tumor 4b, while the intraluminal placement clip 1 is pressed. Are attached around the tumor 4b.

  Next, if necessary, other intraluminal indwelling clips 1 are sequentially attached around the tumor 4b in the same manner as described above, and the plurality of intraluminal indwelling clips 1 surround the circumference of the tumor 4b. In this embodiment, two intraluminal indwelling clips 1 are attached around the tumor 4b, but three or more or one intraluminal indwelling clip 1 may be attached around the tumor 4b. .

  After the marking is performed as described above, a laparotomy is performed. At that time, after the abdomen of the patient is opened, the proximity sensor 8 is scanned along the outer wall of the lumen 4 from the abdominal cavity side, and the placement position (marking position) of the intraluminal placement clip 1 is searched. The proximity sensor 8 is a so-called inductive type proximity sensor that generates a magnetic field to generate an induced current in an object to be detected and detects the induced current by generating a magnetic field from the viewpoint of detecting the magnetic body 3 with high sensitivity. A sensor is preferably used.

  Here, since the magnetic body 3 is attached to the surface of the clip body 2 (the outer surface of the claw portion 23 in the present embodiment), when the proximity sensor 8 approaches the placement position of the intraluminal placement clip 1, the proximity sensor 8 approaches the placement position. A large induction current is generated in the magnetic body 3 by the magnetic field generated by the sensor 8. Therefore, by detecting the change (for example, heat loss generated in the magnetic body 3) caused by this induced current by the detection principle of the proximity sensor 8 used, the position of the intraluminal clip 1 is detected with high detection sensitivity. The position of the tumor 4b generated inside the lumen 4 can be accurately specified from the abdominal cavity side. With this, the operator can remove the lumen 4 (the mucous membrane 4a around the tumor 4b) with the use of the incision tool after specifying the position of the tumor 4b. The resected tumor 4b can be discharged out of the body together with the intraluminal indwelling clip 1. Examples of the incision tool include a high-frequency knife (electric knife), an ultrasonic knife, and a normal knife (scalpel).

  In the present embodiment, the clip body 2 is made of a non-magnetic material, and the magnetic body 3 smaller than the clip body 2 is attached only to a part (the claw portion 23) of the clip body 2, so that the intraluminal clip It is possible to ensure safety even in a high magnetic field environment such as when a patient in which 1 is placed undergoes an MRI examination.

  In addition, since the magnetic body 3 can be attached to an existing clip, a general-purpose clip device is used, and the intraluminal indwelling clip 1 is placed inside the lumen 4 without impairing the operation feeling familiar with the existing clip. It can be attached.

  Further, in the present embodiment, the magnetic body 3 is attached to the surface of the clip body 2 (the surface of the claw portion 23 in the present embodiment). With such a configuration, the magnetic body 3 is integrally (directly) attached to the clip body 2, and the magnetic body 3 that is easily detected by the proximity sensor 8 is located near the surface of the clip body 2. It will be. Therefore, the detection error of the position of the intraluminal indwelling clip 1 by the proximity sensor 8 can be minimized.

  In particular, in this embodiment, the magnetic body 3 is attached to the outer surface of the claw portion 23. With such a configuration, when the mucous membrane 4a around the tumor 4b is sandwiched by the claw portions 23, the magnetic body 3 is pressed toward the outer side (abdominal cavity side) of the mucous membrane 4a. The proximity sensor 8 on the abdominal side facilitates detection. Therefore, the detection sensitivity of the position of the intraluminal indwelling clip 1 by the proximity sensor 8 can be effectively enhanced, and the position of the tumor 4b can be more accurately specified.

Second Embodiment An intraluminal indwelling clip 1A of the present embodiment shown in FIGS. 2A to 2C has the same configuration and operational effect as those of the above-described first embodiment except the points described below. In the following description, description of common parts is omitted, and common members are denoted by common reference numerals in the drawings.

  As shown in FIG. 2A, in the present embodiment, a magnetic body 3A is attached to a part of the clip body 2 (the outer surface of the arm plate portion 22 in the present embodiment). In the present embodiment, the magnetic body 3A is attached only to the outer surface of one arm plate portion 22 of the pair of arm plate portions 22, 22, but the magnetic body 3A is provided on the outer surface of both arm plate portions 22. You can do it. The magnetic body 3A is attached to the outer surface of the arm plate portion 22 by adhesion, insert molding, or the like.

  As shown in FIG. 2B, in the present embodiment, the shape of the magnetic body 3A corresponds to the outer surface shape of the grip portion 22b of the arm plate portion 22, and is substantially rectangular (frame shape or ring shape). 3 A of magnetic bodies are provided in the holding part 22b so that the circumference | surroundings of the through-hole 22c may be surrounded (so that the through-hole 22c may not be closed). Preferably, the magnetic body 3A covers a region of about 50 to 100% of the outer surface of the grip portion 22b. In the present embodiment, the magnetic body 3A covers a region of about 100% of the outer surface of the grip portion 22b, and the outer peripheral (outer surface) shape of the magnetic body 3A substantially matches the outer peripheral (outer surface) shape of the grip portion 22b. ing. In the present embodiment, only one magnetic body 3A is attached to the one arm plate portion 22, but two or more magnetic bodies may be attached. Note that in FIG. 2B, the magnetic body 3A is shown by the hatched portion for easy understanding.

  As shown in FIG. 2A, the thickness of the magnetic body 3A is determined by a third extending direction D3 (the first extending direction D1 shown in FIG. 1A and the first extending direction D1 shown in FIG. 1B) from the base end side to the tip end side of the arm plate portion 22. 2 is substantially uniform along the direction (perpendicular to the extending direction D2). Although not shown in detail, the thickness of the magnetic body 3 along the second extending direction D2 shown in FIG. 2B is also substantially uniform.

  Also in this embodiment, the same effect as that of the first embodiment can be obtained. In addition, in this embodiment, since the magnetic body 3A is provided on the arm plate portion 22, it is possible to make the outer shape of the magnetic body 3A larger than that of the magnetic body 3 in the first embodiment. . Therefore, as compared with the magnetic body 3 in the first embodiment, the proximity sensor 8 can easily detect the magnetic body 3A, and the proximity sensor 8 can effectively enhance the detection sensitivity of the position of the intraluminal indwelling clip 1. The position of 4b (see FIG. 5) can be specified more accurately.

Third Embodiment An intraluminal indwelling clip 1B of the present embodiment shown in FIGS. 3A to 3C has the same configuration and operational effect as those of the above-described first embodiment except the points described below. In the following description, description of common parts is omitted, and common members are denoted by common reference numerals in the drawings.

  As shown in FIG. 3A, in the present embodiment, the magnetic body 3B is indirectly attached to a part of the clip body 2 (the arm plate portion 22 in the present embodiment). That is, a string-shaped hook member (connecting member) 35 is passed through the through hole 22c of the arm plate portion 22, and one end of the magnetic body 3B is attached to the hook member 35.

  The hook member 35 may be made of the same material as the magnetic body 3B, or may be made of a material different from the magnetic body 3B. Further, the hook member 35 may be formed integrally with the magnetic body 3B, or may be joined to one end of the magnetic body 3B by means such as adhesion. By connecting the hook member 35 to the through hole 22c of the arm plate portion 22 through the string-shaped hook member 35, the magnetic body 3B can be swung freely to the grip portion 22b (see FIG. 3B) of the arm plate portion 22. It can be attached to.

  In the present embodiment, the magnetic body 3B preferably has an elongated shape (substantially columnar shape) in the longitudinal direction, and its outer diameter is preferably equal to or smaller than the outer diameter of the tightening ring 24. This is because the magnetic body 3B can be housed inside the outer sheath (not shown) of the clip device together with the tightening ring 24. The cross-sectional shape of the magnetic body 3B is not particularly limited, and may be a substantially circular shape, an elliptical shape, or a polygonal shape of a triangle or more.

  A loop member 37 as an engaging member that can engage with the auxiliary clip 7 shown in FIG. 6, for example, is joined to the other end of the magnetic body 3B in the longitudinal direction via an adapter member 36. The loop member 37 may be formed integrally with the material forming the magnetic body 3B without using the adapter member 36. The loop member 37 is preferably composed of a flexible cord-shaped member having a restoring force that tends to return to the original shape (or a shape close to the original shape) when being bent. The maximum outer diameter of the loop of the loop member 37 is preferably larger than the maximum outer diameter of the cross section of the magnetic body 3B. This is to facilitate gripping with the auxiliary clip 7 shown in FIG.

  As the loop member 37, for example, a surgical bioabsorbable thread (suture thread) made of a biodegradable or absorbable polymer material can be used. The loop member 37 may be a thread, wire, or the like that does not have bioabsorbability, but it may be necessary to cut the loop member at the time of collection, so it is preferable to use a material made of a material that does not cause inconvenience in cutting. Instead of the loop member 37, for example, an engaging member formed in a ring shape (annular ring shape, elliptical ring shape, oval ring shape, or the like) made of a thermoplastic polymer material or the like may be provided.

  Next, a method of using the intraluminal indwelling clip 1 of the present invention will be described with reference to the drawings. As shown in FIG. 6, first, the intraluminal indwelling clip 1B is attached to the mucous membrane 4a around the tumor 4b in the same manner as in the first embodiment.

  Next, using an endoscope (not shown), a clip device (not shown), etc., the auxiliary clip 7 is conveyed to the inside of the lumen 4, and is placed in the vicinity of the loop member 37 of the intraluminal indwelling clip 1B. . Then, by operating the clip device, the loop member 37 is grasped by the pair of arm plate portions 72, 72 of the auxiliary clip 7, and the loop member 37 is separated from the placement position of the intraluminal placement clip 1B along the circumference of the tumor 4b, Attach the auxiliary clip 7.

  As a result, the magnetic body 3B is pressed against the mucous membrane 4a along the circumference of the tumor 4b, and the position of the tumor 4b can be marked. As a result, it is possible to increase the detection sensitivity of the position of the intraluminal clip 1B by the proximity sensor 8 (not shown) on the abdominal cavity side. Therefore, also in the present embodiment, the position of the tumor 4b can be accurately specified, as in the first embodiment.

  It should be noted that the present invention is not limited to the above-described embodiment, but can be variously modified within the scope of the present invention.

  In each of the above-described embodiments, the lumen in which the intraluminal indwelling clip is used is not particularly limited, and examples thereof include an in vivo lumen such as a digestive tract, a trachea, and a bladder.

  For example, in the above-described first and second embodiments, an example in which the magnetic bodies 3 and 3A are provided in the claw portion 23 or the arm plate portion 22 is shown, but on the surface of the connecting plate portion 21 or the tightening ring 24. It may be provided.

  In each of the above-described embodiments, a thick portion or a thin portion may be locally formed on the magnetic bodies 3 to 3B. For example, in the first embodiment, a thickness gradient (inclination) is formed along the first extending direction D1 (see FIG. 1A) or the second extending direction D2 (see FIG. 1B) of the claw portion 23. May be. Further, in the second embodiment described above, a thickness gradient (inclination) may be formed along the second extending direction D2 or the third extending direction D3 (see FIG. 2A) of the grip portion 22b.

  In the first and second embodiments described above, the magnetic bodies 3 and 3A are provided on the outer surface of the clip body 2, but may be provided on the inner surface. In this case, for example, in the first embodiment, the thickness of the magnetic body 3 located on the outer surface side of the claw portion 23 may be larger than the thickness of the magnetic body 3 located on the inner surface side of the claw portion 23. Further, in the second embodiment, the thickness of the magnetic body 3A located on the outer surface side of the arm plate portion 22 may be thicker than the thickness of the magnetic body 3A located on the inner surface side of the arm plate portion 22.

  In the first embodiment, the magnetic body 3 may be formed on a part of the outer surface of the claw portion 23. For example, the magnetic body 3 may be formed only on the outer surface located on the proximal end side of the claw portion 23 (or the outer surface located on the tip end portion of the claw portion 23).

  In the first embodiment, the shape of the magnetic body 3 may be different from the outer surface shape of the claw portion 23. For example, when the magnetic body 3 is viewed from above (a direction perpendicular to the outer surface of the claw portion 23), the shape is a triangle, a quadrangle, another polygon, a circle, an ellipse, a ring, or another shape. Good. This also applies to the magnetic body 3A in the second embodiment.

  Further, in the first embodiment described above, a part of the magnetic body 3 may protrude from the outer surface of the claw portion 23 to the outside. For example, the magnetic body 3 may be formed so that a part of the magnetic body 3 protrudes toward the arm plate portion 22 side so as to straddle the outer surface of each of the claw portion 23 and the arm plate portion 22. Alternatively, the magnetic body 3 may be formed so that a part of the magnetic body 3 extends over the inner surface of the claw portion 23 so as to straddle the outer surface and the inner surface of the claw portion 23.

  Similarly, in the second embodiment, a part of the magnetic body 3A may be protruded from the outer surface of the arm plate portion 22 to the outside. For example, the magnetic body 3A may be formed so that a part of the magnetic body 3A protrudes toward the claw portion 23 side and extends over the outer surface of each of the arm plate portion 22 and the claw portion 23. Alternatively, the magnetic body 3A may be formed so that a part of the magnetic body 3A extends over the inner surface of the arm plate portion 22 so as to straddle the outer surface and the inner surface of the arm plate portion 22.

  With such a configuration, the magnetic bodies 3 and 3A are firmly fixed to the clip body 2 and are unlikely to fall off. In addition, the volumes of the magnetic bodies 3 and 3A are increased, and the detection sensitivity of the position of the intraluminal indwelling clip 1, 1A by the proximity sensor 8 can be further enhanced.

  Further, in the second embodiment, part of the inner surface of the magnetic body 3A may enter the inside of the through hole 22c formed in the grip portion 22b and engage with the through hole 22c. Alternatively, the outer peripheral shape of the magnetic body 3A may be substantially matched with the outer peripheral shape of the through hole 22c, and the magnetic body 3A may be embedded inside the through hole 22c. With such a configuration, the magnetic body 3A is firmly fixed to the arm plate portion 22 and is unlikely to fall off.

  As shown in FIGS. 4A to 4C, in the third embodiment, the loop member 37 may be omitted from the intraluminal indwelling clip 1B. Also in this case, similarly to the example shown in FIG. 3A to FIG. 3C, the magnetic body 3B is provided with a part of the clip body 2 (in the present embodiment, a through hole formed in the arm plate portion 22) via the hook member 35. 22c). Therefore, the effect shown in the third embodiment can be obtained by attaching the intraluminal indwelling clip 1B around the tumor 4b (see FIG. 6) inside the lumen 4.

  In the above-described embodiment, the method of excising the tumor 4b (see FIGS. 5 and 6) generated inside the lumen 4 by laparotomy using the intraluminal indwelling clip 1 is described. However, laparoscopic surgery is performed. In this case, the intraluminal indwelling clip 1 can be used.

  In the above embodiment, the application example of the present invention to the intraluminal indwelling clip 1 having the through hole 22c has been shown, but the present invention may be applied to the intraluminal indwelling clip not having the through hole 22c. .

1, 1A, 1B ... Intraluminal indwelling clip 2 ... Clip body 21 ... Connection plate part 22 ... Arm plate part 22a ... Base end part 22b ... Gripping part 22c ... Through hole 23 ... Claw part 24 ... Tightening ring 3, 3A , 3B ... Magnetic material 35 ... Hook member 36 ... Adapter member 37 ... Loop member 4 ... Lumen 4a ... Mucous membrane 4b ... Tumor 6 ... Endoscope 7 ... Auxiliary clip

Claims (4)

An intraluminal indwelling clip having a clip body made of a non-magnetic material,
An intraluminal indwelling clip, wherein a magnetic material is provided in a part of the clip body.   The intraluminal indwelling clip according to claim 1, wherein the magnetic body is provided on a surface of the clip body. The clip body is
A pair of arm plate portions arranged so that the mutual distance becomes wider toward the tip portion in the state where no external force acts,
A connecting plate portion connecting the base end portions of the arm plate portions,
A tightening ring that is slidably attached from the connecting plate portion along the arm plate portion and that slides toward the tip end side of the arm plate portion to close the tip ends of the pair of arm plate portions so as to approach each other. ,
And a claw portion provided so as to correspond to each other at each tip end portion of the arm plate portion,
The intraluminal indwelling clip according to claim 2, wherein the magnetic body is provided on at least one surface of the arm plate portion, the connecting plate portion, the tightening ring, and the claw portion. .   The intraluminal indwelling clip according to claim 3, wherein the magnetic body is provided on an outer surface of the claw portion.

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