JP2022088695A - Endoscope clip - Google Patents

Abstract

To provide an endoscope clip which can be properly used according to a situation of a treatment object portion, and is easy to use.SOLUTION: An endoscope clip 1 comprises: a tube body 4 having opened both ends; a first arm 5 having a first substrate 6 arranged in the tube body 4, extending from the first substrate 6 and arranged projectingly from the one end opening of the tube body 4; a second arm 7 having a second substrate 8 arranged in the tube body 4, extending from the second substrate 8 and arranged projectingly from the one end opening of the tube body 4 so as to face the first arm 5; and an engaging part 20 for engaging the first substrate 6 with the tube body 4. The second substrate 8 moves in a long axis direction from the one end opening to the other end opening of the tube body 4 to store the second arm 7 in the tube body 4 in a state that the first substrate 6 is engaged with the tube body 4 by the engaging part 20.SELECTED DRAWING: Figure 3

Description

The present invention relates to an endoscopic clip used when ligating a living tissue or the like.

For example, there are clips described in Patent Documents 1 and 2 as clips for performing a closure of an opening formed in a living tissue and a hemostasis treatment, which are inserted into the body using an endoscopic device. In the clip described in Patent Document 1, a pair of arms arranged facing each other are pressed against the mucous membrane, the clips are brought close to each other while maintaining this state, and the mucous membrane is sandwiched to ligate the treatment target site. I do. The clip described in Patent Document 2 pushes one arm against the mucous membrane around the affected area and pulls one arm toward the other arm fixed while maintaining this state, thereby moving the mucous membrane to the other arm side. Attract and ligate the treatment target site.

Japanese Patent No. 4512725 Japanese Patent No. 6084347

Here, since the clip described in Patent Document 1 needs to press a pair of arms against the mucous membrane with equal force, it is not suitable for treating a side wall or the like where it is difficult to press with equal force. Further, when the opening of the clip is too large for the size of the treatment target site, the clip described in Patent Document 2 pulls the mucous membrane more than necessary to close the clip opening, and the treatment target site. Cannot be treated properly. Therefore, the surgeon needs to use the above-mentioned clips properly according to the condition of the treatment target site, but it is difficult to determine the condition inside the body in advance and select the clip. In addition, if the initial use is planned and the treatment with the clip inserted in the patient's body cannot be performed, the clip must be removed once and replaced with a different clip, which takes time and effort for the surgeon and requires surgery. There is a problem that it becomes complicated.

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide an endoscopic clip that can be appropriately used depending on the situation of a treatment target site.

The endoscope clip of the present invention includes a tube body having both ends open and a first substrate arranged in the tube body, and is arranged so as to extend from the first substrate and project from one end opening of the tube body. A first arm and a second arm having a second substrate arranged in the tube, extending from the second substrate and projecting from one end opening of the tube and facing the first arm, and a second arm. The second substrate is provided with a locking portion for locking the first substrate to the tube, and the second substrate is one end of the tube with the locking portion locking the first substrate to the tube. It is characterized in that the second arm can be accommodated in the pipe body by moving in the long axis direction from the opening toward the other end opening.

With the above configuration, the endoscope clip of the present invention moves the second substrate in the longitudinal direction of the tube while the first substrate is locked to the tube, so that the second arm is arranged with respect to the first arm. You can change it. Therefore, if the treatment is performed in the first treatment mode in which the first arm and the second arm face each other without moving the second substrate, the mucous membrane around the affected area is sandwiched between the first arm and the second arm to perform the ligation treatment. be able to. Further, if the second substrate is moved in the longitudinal direction of the tubular body to accommodate the second arm in the tubular body and the treatment is performed in the second treatment mode in which the first arm and the second arm are separated from each other, the first arm can be moved. The ligation procedure can be performed by pulling to the second arm side and pulling the mucous membrane in one direction. Therefore, the endoscope clip of the present invention can be configured in either the first treatment form or the second treatment form desired by the operator according to the treatment target site, which saves the operator's labor and is easy to use. Can provide a good clip.

As a specific embodiment of the endoscope clip of the present invention, there is further mentioned to include a stop mechanism for temporarily stopping the movement of the second substrate from one end opening to the other end opening of the tube body. can.

With the above configuration, the movement of the second substrate can be temporarily stopped by the stop mechanism. Therefore, for example, if the movement of the second substrate is stopped at an arbitrary position desired by the operator, the operator can stop the movement of the first arm. The opening width between the second arm and the second arm can be adjusted to be the optimum opening width for the treatment target site, and a more convenient endoscope clip can be provided.

According to the present invention, it is possible to provide an easy-to-use endoscope clip that can be appropriately used depending on the situation of the treatment target site.

FIG. 3 is a cross-sectional view in which the endoscope clip of the present embodiment is inserted into the first insertion tube. The cross-sectional view which sent out the endoscope clip of this embodiment from a 1st insertion tube. The perspective view of the endoscope clip in the 1st treatment form. The developed view of the endoscope clip in the 1st treatment form. Sectional drawing of the endoscope clip in the 1st treatment form. The perspective view when the endoscope clip of this embodiment performs a rope splicing procedure. FIG. 3 is a cross-sectional view of the endoscope clip of the present embodiment when performing a rope splicing procedure. Sectional view of the body of the endoscope clip remaining in the patient's body. The perspective view of the endoscope clip in the 2nd treatment form. Sectional drawing of the endoscope clip in the 2nd treatment form. Sectional drawing of an endoscope clip provided with a stop mechanism. Perspective view of the endoscope clip in another embodiment. Sectional drawing of the endoscope clip in another embodiment. Perspective view of the endoscope clip in another embodiment.

The endoscope clip of the present invention will be described in detail below with reference to the drawings.

The endoscope clip of the present invention is for performing a ligation procedure in a patient's body, and is used by connecting to an endoscope operating unit which is an external device (not shown).

The endoscope operation unit includes an endoscope body (not shown) that is inserted into the patient's body, a treatment tool 100 shown in FIG. 1 that is inserted into the endoscope body and used, an image pickup device (not shown), and an image pickup device (not shown). It is equipped with a light source device.

The endoscope body is made of a flexible material and has a tubular shape, and is provided with a plurality of insertion passages inside the endoscope body. In the present embodiment, the first insertion passage for inserting the treatment tool 100, the second insertion passage in which the image pickup device for displaying the image inside the patient on an external monitor arranged outside the body is arranged, and the inside of the patient are operated. A third insertion passage is provided in which a light source device for viewing by a person is arranged.

As shown in FIGS. 1 and 2, the treatment tool 100 is arranged outside the patient's body with an insertion tube 101 inserted into the first insertion passage, an operation wire 102 inserted into the insertion tube 101, and an operator. The operation main body 103 for performing an operation of pushing out or pulling the operation wire 102 is provided.

The insertion tube 101 is made of a flexible material, and is configured so that the outer diameter is smaller than the inner diameter of the first insertion passage. Further, the operation wire 102 is inserted into the tube, and the endoscope clip 1 connected to the operation wire 102 is arranged at the tip thereof.

As shown in FIGS. 1 and 2, the operation wire 102 is provided with a hook to which the endoscope clip 1 is connected at the tip thereof, and the operation body 103 is connected to the end thereof. The hook is provided with a first arrowhead hook 102a at the tip thereof and a second arrowhead hook 102b having the same shape in the opposite direction at a certain distance. The first arrowhead hook 102a and the second arrowhead hook 102b are connected via an operation wire 102.

As shown in FIGS. 1 and 2, the operation main body 103 includes a slider 103a, and by sliding the slider 103a, an operation of pushing out or pulling the operation wire 102 is performed, and the insertion tube 101 is included in the present embodiment. It is configured to move the endoscope clip 1 forward and backward.

As shown in FIGS. 3, 4, and 5, the endoscope clip 1 of the present embodiment has a connection portion 3 for connecting the endoscope clip main body 2 and the endoscope clip main body 2 to the treatment tool 100. And.

As shown in FIGS. 3, 4, and 5, the endoscope clip main body 2 includes a tube body 4 having both ends open, and a first substrate 6 arranged in the tube body 4, from the first substrate 6. It is provided with a first arm 5 that is stretched and is arranged so as to project from one end opening of the tube body 4, and a second base 8 that is arranged in the tube body 4, and is extended from the second base 8 and one end opening of the tube body 4. It is provided with a second arm 7 which is arranged so as to protrude from the first arm 5 and faces the first arm 5.

As shown in FIGS. 3 and 4, the tubular body 4 has a substantially cylindrical shape, and is configured by using a material such as plastic. The outer diameter of the tube 4 is configured to have an outer diameter smaller than that of the insertion tube 101. In the following, for the sake of explanation, one end opening in which the first arm 5 and the second arm 7 are arranged so as to project is referred to as a tip, and the other end opening in which the connection portion 3 is arranged is referred to as a terminal.

At the positions facing each other at the substantially central portion of the outer peripheral surface of the tubular body 4, a pair of substantially rectangular protrusions 4a in a plan view that are inclined so that the outer diameter expands toward the end, and a tubular body when the protrusions 4a are pressed. A pair of tube hole portions 4b having a substantially rectangular shape in a plan view are provided so as to be flush with the outer peripheral surface of 4. The protrusion 4a is configured such that its outer diameter is larger than the outer diameter of the insertion tube 101 when no force is applied.

The inner surface of the tubular body 4 is configured so that the inner diameter gradually expands from the tip to the end, and is divided into three regions according to the size of the inner diameter as shown in FIG. These three regions are a first region r1 arranged near the tip of the tubular body 4, a third region r3 arranged near the end, and a second region arranged between the first region r1 and the third region r3. It is r2. The inner diameter of the first region r1 is configured to be smaller than the inner diameter of the second region r2, and the inner diameter of the second region r2 is configured to be smaller than the inner diameter of the third region r3. Therefore, a step is provided at the boundary between the first region r1 and the second region r2, and a step is also provided at the boundary between the second region r2 and the third region.

Further, at the end of the tubular body 4, as shown in FIGS. 3 and 4, a notch 4c forming a substantially arc shape is provided at a part of the open end of the tubular body 4. This notch 4c forms an opening sufficiently larger than the hooking portion 11b described later.

As shown in FIGS. 3, 4, and 5, the first arm 5 is formed by bending a long thin metal plate, and the first base 6 is arranged on the tube body 4. A first stretched portion 5a that stretches from the first substrate 6 and protrudes from one end opening of the tubular body 4, and a first curved portion 5b in which the tip of the first stretched portion 5a is curved inward. The first substrate 6, the first stretched portion 5a, and the first curved portion 5b are configured by using the same member.

As shown in FIGS. 4 and 5, the first substrate 6 is stretched in parallel with the major axis direction of the tubular body 4 and is connected to the end of the first stretched portion 5a, and the first connecting portion 6a and the first connecting portion 6a. It is provided with a first bent portion 6b which is connected to and bent into a substantially U shape.

The first bent portion 6b has elasticity and is arranged in the second region r2 of the pipe body 4 in a state where both ends of the bent portion press the inner surface of the pipe body 4, and the tip of the first bent portion 6b is the first region r1. The step formed between the second region r2 and the second region r2 prevents the first region r1 from being invaded.

The first bent portion 6b presses the inner surface of the tubular body 4 by its elastic force to lock the first substrate 6 to the tubular body 4. Therefore, in the present embodiment, the first bent portion 6b is the locking portion 20 according to the claim.

The first stretched portion 5a is stretched in an oblique direction with respect to the long axis direction of the tubular body 4 so as to expand from the opening. Further, in the present embodiment, the first curved portion 5b is provided with a mountain-shaped convex portion 9 at the tip portion thereof.

As shown in FIGS. 4 and 5, the second arm 7 is formed by bending a long thin metal plate, and has a second base 8 arranged on the tube body 4 and a second base 8 and the like. It includes a second stretched portion 7a that stretches from the second substrate 8 and protrudes from one end opening of the tubular body 4, and a second curved portion 7b in which the tip of the second stretched portion 7a is curved inward. The second substrate 8, the second stretched portion 7a, and the second curved portion 7b are configured by using the same member.

The second substrate 8 has a substantially U-shape connected to a second connecting portion 8a that extends parallel to the major axis direction of the tubular body 4 and is connected to the end of the second extending portion 7a, and a second connecting portion 8a. It is provided with a second bent portion 8b that is bent in a straight line.

The second bent portion 8b has elasticity and is arranged in the second region r2 of the tubular body 4 in a state where both ends of the bent portion press the inner surface of the tubular body 4. At this time, the first bent portion 6b and the second bent portion 8b are arranged in the second region r2, but the first bent portion 6b is arranged on the tip end side of the pipe body 4, and the second bent portion 8b is a pipe body. It is arranged on the terminal side of 4. Therefore, the first substrate 6 and the second substrate 8 are arranged in this order from the tip end to the end of the tube body 4.

The second stretched portion 7a is stretched in an oblique direction with respect to the long axis direction of the tubular body 4 so as to face the first stretched portion 5a and spread from the opening. Further, in the present embodiment, the second curved portion 7b is provided with a valley-shaped recess 10 at the tip portion thereof. The concave portion 10 fits into the convex portion 9 provided in the first curved portion 5b.

As shown in FIGS. 3, 4, and 5, the connection portion 3 is inserted and arranged at the end of the tube body 4, and has a traction portion 11 that pulls the first substrate 6 toward the end end side of the tube body 4 and a tube. It is provided with a connecting member 12 that is arranged in contact with the end of the body 4 and is connected to the treatment tool 100.

The traction portion 11 is inserted into the tubular body 4 and arranged, and is provided at a third extending portion 11a extending from one end surface of the connecting member 12 in the longitudinal direction of the tubular body 4 and at the tip of the third extending portion 11a. A hook portion 11b is provided.

The third stretched portion 11a is composed of a thin plate having a width sufficiently smaller than the inner diameter of the tubular body 4, and is arranged in close proximity along the inner side surface of the tubular body 4. Therefore, with the third extension portion 11a arranged in the tube body 4, the second substrate 8 can move in the long axis direction of the tube body 4 in the second region r2 and the third region r3 of the tube body 4. Space is formed.

The hook portion 11b is made of the same member as the third stretched portion 11a, and has a shape in which the tip of the third stretched portion 11a is bent at a substantially right angle to the stretching direction. Since the hooking portion 11b is arranged on the tip end side of the tubular body 4 with respect to the first bent portion 6b, the first bent portion 6b is arranged in a state of being caught by the hooking portion 11b.

The connecting member 12 has a substantially cylindrical shape, and is configured such that its outer diameter is larger than the outer diameter of the tubular body 4. A traction portion 11 is arranged on one end surface, and a connecting hole portion 13 into which the first arrowhead hook 102a provided at the tip of the operation wire 102 of the treatment tool 100 is inserted and locked is provided on the other end surface. .. The connecting hole portion 13 communicates with the first opening portion 13a and the first opening portion 13a, which are provided in a substantially central portion and have an outer diameter larger than that of the first arrowhead hook 102a, and the connecting member 12 is divided into two symmetrical portions. It is provided with a second opening 13b which is divided into two parts. The width of the second opening 13b is set to be sufficiently smaller than the outer diameter of the first arrowhead hook 102a.

Since the divided bodies divided by the second opening 13b are configured to be elastically deformable in the radial direction of the cylinder, the first arrowhead hook 102a elastically deforms the divided body in the radial direction to form the first opening. Invade up to 13a. Then, when the first arrowhead hook 102a penetrates to the first opening 13a, the split body returns to its original position due to the elastic force. Here, the second arrowhead hook 102b is arranged close to the connecting member 12, and the operation wire 102 connecting between the first arrowhead hook 102a and the second arrowhead hook 102b is arranged in the second opening 13b. To. With the above configuration, the first arrowhead hook 102a stays in the first opening 13a, and the operation wire 102 is connected to the connecting member 12.

Hereinafter, the treatment operation using the endoscope clip 1 in the present embodiment will be described.

When performing a rope splicing procedure on the affected part of the patient's body, the surgeon attaches the treatment tool 100 to which the endoscope clip 1 is connected to the first insertion passage of the endoscope body already arranged in the patient's body. insert. Here, the endoscope clip 1 is connected to the treatment tool 100 by connecting the connecting member 12 to the operation wire 102 as described above, as shown in FIG.

When the treatment tool 100 inserted into the first insertion passage protrudes from the first insertion passage and enters the patient's body, the operator slides the slider 103a of the operation body 103 to clip the endoscope as shown in FIG. The main body 2 is sent out from the insertion tube 101.

At this time, the pair of protrusions 4a provided on the outer peripheral surface of the tube 4 of the endoscope clip 1 travels in the insertion tube 101 in a state of being housed in the tube hole 4b, respectively, and the endoscope clip main body. When 2 is sent out from the insertion tube 101, the protrusion 4a is urged from the tube hole 4b by its elastic force and expands larger than the outer diameter of the insertion tube 101, and the protrusion 4a is the open end of the insertion tube 101. Contact with. Therefore, this protrusion 4a prevents the endoscope clip main body 2 from invading the insertion tube 101 again.

Further, as shown in FIG. 1, the first arm 5 and the second arm 7 pass through the insertion tube 101 in a pressed state. Then, when the endoscope clip main body 2 is sent out from the insertion tube 101, as shown in FIG. 2, it is urged by the elastic force and spreads in the patient's body, and the first arm and the second arm 7 face each other. Place in the state.

From here, the endoscope clip 1 of the present embodiment performs one of the following two treatment operations depending on the treatment target site.

<First treatment mode>
First, the treatment operation in the first treatment mode of the endoscope clip 1 of the present embodiment will be described. Here, the first treatment mode refers to the state shown in FIGS. 2 to 5 in which the first arm 5 and the second arm 7 are arranged so as to face each other as described above.

The surgeon presses the first curved portion 5b of the first arm 5 against the mucous membrane around the affected portion and arranges the second curved portion 7b of the second arm 7 with the affected portion sandwiched between the affected portion and the affected portion facing the first curved portion 5b. Place by pressing against the surrounding mucosa.

Then, when the operator slides the slider 103a to pull the operation wire 102 while the first curved portion 5b and the second curved portion 7b are pressed against the mucous membrane, the hooking portion 11b moves toward the end of the tubular body 4. The first bent portion 6b caught on the hooked portion 11b and the second bent portion 8b pushed by the first bent portion 6b move in the long axis direction toward the end of the tubular body 4. At the same time, since the first stretched portion 5a and the second stretched portion 7a are accommodated in the tubular body 4, the opening widths of the first arm 5 and the second arm 7 are gradually narrowed, and the first curved portion 5b and the first curved portion 5b are accommodated. 2 The mucous membrane pressed by the curved portion 7b comes close to each other.

After that, when both the first stretched portion 5a and the second stretched portion 7a are housed in the tubular body 4, the convex portion 9 and the second curved portion 7b of the first curved portion 5b are shown in FIGS. 6 and 7. The recess 10 is fitted and spliced while sandwiching the mucous membrane pressed by the first curved portion 5b and the mucous membrane pressed by the second curved portion 7b.

At this time, when the first bent portion 6b and the second bent portion 8b move in the long axis direction toward the terminal side of the tubular body 4, the second region r2 and the third region r3 of the tubular body 4 are shown in FIG. It passes through the step provided between and. At this time, since both ends of the first bent portion 6b and the second bent portion 8b press the inner surface of the pipe body 4, when the first bent portion 6b and the second bent portion 8b pass through the step, the elastic force thereof causes the inner diameter of the third region r3 of the pipe body 4 to be reached. It is urged to spread and press the inner surface of the third region r3. Therefore, the first bent portion 6b and the second bent portion 8b cannot move to the tip side due to the step, and the first curved portion 5b and the second curved portion 7b are fixed by splicing the mucous membrane.

When the first curved portion 5b and the second curved portion 7b are fixed by splicing the mucous membrane, the operator further slides the slider 103a to pull the operation wire 102. At this time, since the protrusion 4a abuts on the open end of the insertion tube 101 and the endoscope clip main body 2 cannot enter the insertion tube 101, only the connection portion 3 is towed. By pulling the connecting portion 3, the first bent portion 6b and the second bent portion 8b hooked on the hook portion 11b and the hook portion 11b are also pulled at the same time. When the hooking portion 11b moves to the end of the tubular body 4, the hooking portion 11b is pulled out from the notch 4c by moving the third extending portion 11a in the radial direction of the tubular body 4. At this time, the first bent portion 6b and the second bent portion 8b stay in the pipe body 4 to be arranged by pressing the inner surface of the pipe body 4, and the first base 6 and the second base 8 are fixed to the pipe body 4. To.

After that, when the operator further slides the slider 103a to pull the operation wire 102, the connecting portion 3 moves through the insertion tube 101 and is discharged to the outside of the patient's body, and as shown in FIG. 8, the endoscope clip main body. 2 is placed in the body with the affected part tied.

<Second treatment mode>
Next, the treatment operation in the second treatment mode of the endoscope clip 1 of the present embodiment will be described.

When the treatment target site is larger than the opening between the first arm 5 and the second arm 7, or when the treatment target site is on the side wall or the like, the operator puts the tip of the second curved portion 7b of the second arm 7 on the mucous membrane. Press on. Here, since a space is formed in the second region r2 and the third region r3 of the tubular body 4, the second bent portion 8b moves in this space in the long axis direction toward the end of the tubular body 4. At the same time, the second extending portion 7a of the second arm 7 is housed in the tubular body 4, and the second curved portion 7b is separated from the first curved portion 5b. At this time, since the first bent portion 6b presses and arranges the inner surface of the second region r2 of the tubular body 4, the first substrate 6 is locked to the tubular body 4. (The first bent portion 6b is the locking portion 20 as claimed.) Therefore, the first arm 5 is in a state of being locked by the locking portion 20 (the first bent portion 6b in the present embodiment). Only the 2 arms 7 are housed in the tube 4.

When the second bent portion 8b moves in the long axis direction toward the terminal side of the tubular body 4, it passes through the step between the second region r2 and the third region r3 of the tubular body 4. Since both ends of the second bent portion 8b are pressed against the inner surface of the tubular body 4 and arranged, the second bent portion 8b is urged and spreads to the inner diameter of the third region r3 when passing through the step. Therefore, the second bent portion 8b cannot move from the end end of the tube body 4 toward the tip end due to the step.

As a result, in the endoscope clip 1 of the present embodiment, as shown in FIGS. 9 and 10, the second arm 7 is housed in the tube body 4, and the first arm 5 and the second arm 7 are separated from each other. , The second treatment mode is such that the second curved portion 7b and the first curved portion 5b are separated from each other.

When the endoscope clip 1 is in the second treatment mode, the operator presses the first curved portion 5b against the mucous membrane around the treatment target site and slides the slider 103a to pull the operation wire 102. At this time, the hooking portion 11b of the towing portion 11 connected to the operation wire 102 moves in the long axis direction toward the terminal side of the pipe body 4, so that the first bent portion 6b caught on the hooking portion 11b becomes a pipe. It moves in the long axis direction toward the terminal side of the body 4. Therefore, the first stretched portion 5a is housed in the tubular body 4, and the first curved portion 5b approaches the second curved portion 7b while pulling the mucous membrane.

After that, when the first stretched portion 5a is completely accommodated in the tubular body 4, the mucous membrane pulled by the first curved portion 5b is sandwiched between the first curved portion 5b and the second curved portion 7b, and the first curved portion 5b is sandwiched between the first curved portion 5b and the second curved portion 7b. The convex portion 9 of the 5b and the concave portion 10 of the second curved portion 7b are fitted and tied while sandwiching the mucous membrane pulled by the first curved portion 5b.

At this time, when the first bent portion 6b moves in the long axis direction toward the terminal side of the tubular body 4 as shown in FIG. 10, the second region r2 and the third region r3 of the tubular body 4 become the same as described above. It passes through the steps provided between them. Therefore, the first bent portion 6b is urged to expand to the inner diameter of the third region r3, and the first bent portion 6b cannot enter the second region r2 due to the step.

Therefore, as shown in FIGS. 7 and 8, the first curved portion 5b and the second curved portion 7b are fixed in a state where the mucous membrane is spliced. The operator further slides the slider 103a to pull the operation wire 102 to pull out the hook portion 11b from the notch 4c. At this time, since the first bent portion 6b presses and arranges the inner surface of the tube body 4, it stays in the tube body 4, and the first substrate 6 is fixed to the tube body 4.

After that, when the operator further slides the slider 103a to pull the operation wire 102, the connecting portion 3 moves through the insertion tube 101 and is discharged to the outside of the patient's body, and as shown in FIG. 8, the endoscope clip main body. 2 is placed in the body with the affected part tied.

The endoscope clip 1 of the present embodiment configured as described above has the following special effects.

That is, the endoscope clip 1 of the present embodiment can move the second substrate 8 in the long axis direction of the tube body 4 to change the position of the second arm 7 with respect to the first arm 5. Therefore, if the treatment is performed in the first treatment mode in which the first arm 5 and the second arm 7 face each other, the mucous membrane around the affected area can be sandwiched between the first arm 5 and the second arm 7 to perform the ligation treatment. ..

Further, if the second substrate 8 is moved in the major axis direction of the tubular body 4 and the second arm 7 is accommodated in the tubular body 4, the first arm 5 and the second arm 7 are separated from each other to form a second treatment mode. be able to. If the treatment is performed in this second treatment mode, the ligation treatment can be performed by pulling the first arm 5 toward the second arm 7 side and pulling the mucous membrane in one direction. Therefore, the endoscope clip 1 of the present embodiment can be configured as either the first treatment mode or the second treatment mode desired by the operator depending on the treatment target site, and the prediction or clip of the treatment target site can be performed. It is possible to provide an easy-to-use clip without the trouble of the operator such as exchanging the clip.

Further, since the convex portion 9 and the concave portion 10 that are fitted to each other are provided in the first curved portion 5b and the second curved portion 7b, the mucous membrane can be more easily grasped.

Further, when the second arm 7 moves in the major axis direction of the tubular body 4, the first arm is fixed by the locking portion 20 (in the present embodiment, the first bent portion 6b is made of an elastic member. , The first bent portion 6b presses and locks the inner surface of the tubular body 4). Therefore, the second bent portion 8b is moved in the longitudinal direction toward the end of the tubular body 4 in a state where the first arm is securely locked to the tubular body 4 by the first bent portion 6b to obtain the second treatment mode. be able to.

In addition, by gradually changing the inner diameter of the tubular body 4 to provide the first region r1, the second region r2, and the third region r3, the first bent portion 6b is arranged by pressing the inner surface of the tubular body 4. The second bent portion 8b is urged to expand on the inner diameter of each region, and the step provided at the boundary of the region makes it impossible to enter the region arranged on the tip end side of the tubular body 4 with respect to the region. Therefore, it is possible to reliably prevent the first bent portion 6b and the second bent portion 8b from being pulled out from the tip of the tubular body 4.

Further, the endoscope clip of the present invention may be configured as follows.

That is, as shown in FIG. 11, the endoscope clip 1 of the present embodiment corresponds to the movement toward the end of the tube 4 of the second substrate 8 (corresponding to the "movement from one end opening to the other end opening" in the claim. A stop mechanism 30 may be provided to temporarily stop the operation.

The stop mechanism 30 matches a plurality of first convex portions 31 provided in the long axis direction on the inner peripheral surface of the tubular body 4 and a first convex portion 31 provided on the second connecting portion 8a of the second substrate 8. A plurality of second recesses 32 are provided.

The first convex portion 31 is provided in the second region r2 and the third region r3 of the tubular body 4, and is continuously formed on the surface facing the second connecting portion 8a.

The second recesses 32 are formed at regular intervals in the long axis direction on the surface of the second connecting portion 8a facing the pipe body 4.

The above-mentioned tying measures for the endoscope clip 60 will be described. When the operator uses the second treatment mode, the tip of the second curved portion 7b of the second arm 7 is pressed to accommodate the second substrate 8 in the tube body 4, and the second substrate 8 is provided in the second connecting portion 8a. The second concave portion 32 and the first convex portion 31 provided on the tube body 4 are fitted to each other, and the movement toward the end of the second substrate 8 is stopped.

Here, when the opening widths of the first arm 5 and the second arm 7 are the desired size of the operator, the operator stops pressing the tip of the second curved portion 7b and slides the slider 103a. The operation wire 102 is towed to pull the first arm 5 toward the second arm 7.

On the other hand, if the opening widths of the first arm 5 and the second arm 7 are not the size desired by the operator, the operator further presses the tip of the second curved portion 7b. Then, the second concave portion 32 of the second connecting portion 8a and the first convex portion 31 provided on the tubular body 4 are disengaged, and the second substrate 8 further moves to the terminal side of the tubular body 4. At this time, since the first convex portion 31 is formed up to the third region r3 of the tubular body 4, the second concave portion 32 is fitted into the first convex portion 31 different from the previous one, and the second substrate 8 moves. It will be stopped.

In this way, the operator presses the second curved portion 7b until the opening widths of the first arm 5 and the second arm 7 have a desired size, and slides the slider 103a at the desired position to obtain the first. The arm 5 is pulled toward the second arm 7.

In the endoscope clip 60 of the second embodiment configured as described above, the second substrate 8 can be temporarily stopped by the stop mechanism 30, so that the second substrate 8 can be temporarily stopped at an arbitrary position desired by the operator. If the movement of the endoscope is stopped, the operator can adjust the opening width between the first arm 5 and the second arm 7 so as to be the optimum opening width for the treatment target site, and the endoscope clip is more convenient to use. 1 can be provided.

The present invention is not limited to the above-mentioned configuration.

An annular cover 40 may be arranged at the tip of the tube as shown in FIG. If the cover 40 is arranged, the contact portion when the first arm 5 and the second arm 7 are taken in and out can be reinforced. The cover 40 is preferably made of a metal member. Further, if the tube body 4 and the cover 40 are configured to be flush with each other on the outer surface and the inner surface in the state where the cover 40 is arranged, the tube body 4 can be smoothly moved in the insertion tube 101.

The step provided between the second region and the third region may be configured at an acute angle in the axial cross-sectional view of the tubular body. In this case, the first bent portion and the second bent portion are caught on the step formed at an acute angle, so that the first bent portion and the second bent portion can be reliably prevented from coming off the pipe body.

Further, the locking portion may be formed by the traction portion. In this case, a third extending portion may be curved so that the hooking portion is close to the inner side surface of the tubular body inside the tubular body. With this configuration, the first bent portion that is hooked on the hooked portion is pressed against the inner surface of the tubular body, so that the second substrate is directed toward the end of the tubular body with the traction portion locked to the first substrate. Can be moved.

Further, as shown in FIG. 13, a contact portion 6c may be provided as a locking portion in which the tip of the first bent portion 6b is further bent inward. As a result, the contact portion 6c is arranged closer to the tip end side of the tubular body 4 than the hook portion 11b, so that the first substrate 6 is securely locked by the contact portion 6c as long as the hook portion 11b does not move, and the second The substrate 8 can be moved toward the end of the tube 4.

As a configuration in which the connection portion 3 is removed from the endoscope clip main body 2, a notch 50 may be provided in the third extension portion 11a of the traction portion 11 as shown in FIG. With this configuration, when the operator slides the slider to pull the operation wire, the third stretched portion 11a is sheared by the notch 50 of the third stretched portion 11a, and the traction portion 11 is clipped to the endoscope. It can be separated from the main body 2.

The configuration of the stop mechanism is not limited to the above, and the shapes, positions, intervals, etc. of the first convex portion and the second concave portion can be appropriately changed.

Further, the first convex portion and the second concave portion constituting the stop mechanism are not formed on the tubular body or the second substrate itself, but are formed as separate bodies and then incorporated into the tubular body or the second substrate. There may be.

Further, the structure of the stop mechanism is not limited to the first convex portion and the second concave portion, and may be configured by, for example, arranging a sheet or the like that causes friction between the second substrate and the tube body.

In addition, the material and shape of the second substrate are changed so that the frictional force differs between the surface facing the first substrate and the surface facing the tubular body, so that the frictional force of the second substrate with respect to the first substrate can be reduced. The stop mechanism may be configured by making the frictional force of the two substrates smaller than the frictional force with respect to the tubular body. With this configuration, the first substrate can be moved in a state where the second substrate is reliably stopped in the tube, and the second substrate is reliably prevented from moving in conjunction with the movement of the first substrate. can do.

The positional relationship between the first bent portion and the second bent portion in the tube is not limited to the above embodiment. For example, the second bent portion may be arranged on the tip end side of the tubular body, and the first bent portion may be arranged on the terminal end side of the tubular body. In this case, a hole can be provided in the first bent portion so that the second bent portion can pass through the hole. Further, the first bent portion and the second bent portion may be arranged in parallel in the tube. In this case, the hooking portion may be arranged in each of the first bending portion and the second bending portion.

The present invention can be modified in various ways without contrary to the gist thereof.

1 ... Endoscope clip 4 ... Tube 5 ... 1st arm 6 ... 1st base 7 ... 2nd arm 8 ... 2nd base 20 ... Locking part

Claims (2)

A tube with both ends open,
A first arm having a first substrate arranged in the tube, extending from the first substrate and projecting from one end opening of the tube, and a first arm.
A second arm having a second substrate arranged in the tube, extending from the second substrate and protruding from one end opening of the tube and facing the first arm, and a second arm.
A locking portion for locking the first substrate to the tube is provided.
The second arm moves in the long axis direction from one end opening to the other end opening of the tube body in a state where the locking portion locks the first substrate to the tube body. An endoscope clip characterized by being able to be accommodated in the tube. The endoscope clip according to claim 1, further comprising a stop mechanism for temporarily stopping the movement of the second substrate from one end opening to the other end opening of the tube body.

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