JP2650724B2 - Biological tissue clip device - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a clipping device for a living tissue in which a living tissue in a living cavity is clipped and placed.

[Related Art] Conventionally, an affected part in a body cavity is often treated or treated with a high-frequency treatment tool, such as a biopsy for excision of a lesion in a body cavity with a high-frequency snare or cauterization of a cancerous part with a high-frequency treatment tool.

However, in general, it is difficult to resect a smooth lesion with a high-frequency snare, and in such a case, a strip biopsy in which the smooth lesion is pinched with clamping forceps or the like, picked up, and resected with a high-frequency snare can be considered. .

Further, when cauterizing a site of cancer, there is a demand that a clip is used as a mark of the site.

[Problems to be Solved by the Invention] However, the clipping device for living tissue conventionally known in Japanese Utility Model Publication No. 53-20957 is not originally used for the above-mentioned purpose of use, but on the other hand, its own material is Since the clip is made of metal, even if it is used for the above-mentioned purpose, there is a risk that a high-frequency current flows through the clip and the mucous membrane of the clipped portion is perforated.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and an object of the present invention is to provide a safe living tissue clip device that can prevent danger caused by high-frequency current even when a clip is used.

Means and Action for Solving the Problems In order to solve the above problems, a clipping device for a living tissue of the present invention includes an insertion tube which is inserted into and removed from a body cavity through a channel of an endoscope. An operation tube inserted into the insertion tube so as to be able to advance and retreat, an operation wire inserted into the operation tube so as to be able to advance and retreat and having a hook attached to the tip, and a holding tube detachably attached to the operation tube When,
A clip which is detachably attached to the hook and has an electrically insulating property which is closed by pulling the operation wire toward the hand side and pulling it into the holding tube.

According to this clipping device for living tissue, the clip is formed to be electrically insulative, so that it is safe to use it together with a high-frequency treatment instrument.

Embodiment FIG. 1 to FIG. 8 show an embodiment of the present invention. The insertion tube 1 of the clip device main body shown in FIGS. 1 and 2 is formed of a flexible tube material such as ethylene tetrafluoride resin. The insertion tube 1 is thick and flexible so that it can be inserted into an insertion channel of an endoscope (not shown) so as to be able to advance and retreat. Inside the insertion tube 1, an operation tube 3 as a flexible operation member having a connecting ring 2 made of a stainless steel single tube attached to the end thereof is inserted to be able to advance and retreat. Further, an operation wire 4 made of a stainless steel stranded wire or the like is inserted into the operation tube 3 so as to be able to advance and retreat.

The distal end of the operation wire 4 has a locking hole 6 of a connecting plate 5 described later.
A hook 7 is provided for detachably engaging the hook 7. One end of the hook 7 is cut off on one side, and the cut surface is provided with a locking pin 8 projecting in a direction perpendicular to the longitudinal direction of the operation wire 4. The locking pin 8 has a circular head 8a which is larger than the long hole 6a of the locking hole 6 formed in the connecting plate 5 described later and has a smaller diameter than the large diameter hole 6b.
The stem 8b has a diameter smaller than 6a.

An operation unit (not shown) is provided at the proximal end of the insertion tube 1. The operation unit is connected to the operation tube 3 and the operation wire 4, and these are individually advanced and retracted with respect to the insertion tube 1. Are provided.

The connecting plate 5 has a locking hole 6 at the rear end for locking to the locking pin 8 of the hook 7, and the long hole 6a is located rearward and the large-diameter hole 6b is located forward and continuous. It is formed. Further, a J-shaped hook 11 is formed at the front end of the connecting plate 5 so as to be detachably engaged with a clip 12 described later.
The connecting plate 5 is formed by punching a thin stainless steel plate.

On the other hand, the clip 12 is configured as shown in FIG. 3 and FIG. That is, a thin band-shaped plate made of stainless steel is bent in the middle thereof, and the bent portion serves as a base end portion 12a. The spread (interval) of the base portions of the arms 12b, 12b extending from the base end portion 12a is described below as a holding tube. 13 is formed to be larger than the inner diameter to form the fitting portion 12c. Further, the arms 12b, 12b intersect and extend beyond the fitting portion 12c, and the foremost portions are bent so as to face each other to constitute a holding portion 12d. Then, as shown in FIG. 4, the holding portion 12d is elastically urged to expand in a natural state.

Further, the holding tube 13 is provided with a step 13a by making the diameter of the rear outer periphery smaller than that of the front end portion, and this rear small diameter portion 13b
The distal end of the connecting ring 2 attached to the distal end of the operation tube 3 is detachably and closely fitted.

The surfaces of the clip 12 and the holding tube 13 are coated with an electrical insulating material such as tetrafluoroethylene resin. Therefore, the clip 12 and the holding tube 13 are electrically insulated by the insulating coatings 15,15.

The connecting plate 5 is attached to the base end 12a of the clip 12.
The hook 11 is hooked and locked. In this state, the connecting plate 5 is inserted into the holding tube 13 from the larger outer diameter, and the fixing agent 16 is filled into the holding tube 13 and temporarily fixed. It is. A cassette type clip assembly by three parties in this state
17 are composed.

Next, the operation when the clip device is used will be described. First, the cassette type clip assembly 17 is attached to the hook 7 on the side of the clip device body. In this mounting method, the locking pin 8 is inserted into the large diameter hole 6b of the locking hole 6 of the connecting plate 5, and the clip assembly 17 is pulled forward. As a result, the stem 8b of the locking pin 8 fits into the long hole 6a of the locking hole 6, so that it does not easily come off. In this state, the operation wire 4 is pulled, and the holding tube 13 is fitted into the connecting link 2. Further, the operation tube 3 and the operation wire 4 are simultaneously pulled toward the user, and the clip assembly 17 is housed inside the distal end portion of the insertion tube 1. At this time, the arm 12b of the clip 12
12b is pressed by the inner wall of the insertion tube 1,
As shown in FIG. 1 and FIG.

When this preparation is completed, it is introduced into the body cavity through the insertion channel of the endoscope. Then, the position is determined toward the living tissue 19 such as an affected part by observation with an endoscope, and the operation tube 3 is pushed out as shown in FIG. 5, whereby the clip assembly 17 protrudes from the distal end of the insertion tube 1. Then, the clip 12 is released from the restraint by the insertion tube 1, and the holding portion 12d expands to the maximum size.

Here, as shown in FIG.
The operation wire 4 is pulled toward the user while the living tissue portion 19 is to be clamped inside the living tissue portion 19, and the holding tube 13 is fitted to the fitting portions 12b, 12b of the clip 12. Let it. Thereby, as shown in FIG. 6, the holding portion 12d of the clip 12 is closed, and the living tissue portion 19 is held.
Further, by pulling the operation wire 4 toward the user, the hook portion 11 of the connecting plate 5 is stretched as shown in FIGS. 6 and 7, and the clip 12 is released from the connecting plate 5. Since the holding tube 13 presses the arm portions 12b of the clip 12, the holding tube 13 is retained in the body together with the clip 12 without falling out of the clip 12, as shown in FIG.

With such a procedure, the clip 12 is clipped to a target portion. For example, as shown in FIG.
And the living tissue 22 is excised with a high-frequency current.

At this time, the clips 12, 12 and the holding tubes 13, 13 have electrical insulation due to the insulating coatings 15, 15. In particular, since the clips 12, 12 have electrical insulation,
No high-frequency current flows through here. Therefore, it is possible to prevent the portion clipped by the clips 12, 12 from being pierced by the high-frequency current, and to safely remove the living tissue 22. This effect can be applied not only to a strip biopsy in which a lesion site is picked up by the clip 12 and excised by the high-frequency snare 21, but also to various usage purposes such as when an irradiation site is used as a mark. Further, the number of clips 12 to be used is not limited to one or two.

The present invention is not limited to the above embodiments. For example, the holding tube may be formed of an electrically insulating material such as resin or ceramic.

[Effects of the Invention] As described above, since the clip device of the present invention is formed so as to be electrically insulated from the clip, the clip device may perforate the mucous membrane of a living body even when used in combination with a high-frequency treatment instrument. No, it can be used safely.

[Brief description of the drawings]

The drawings show an embodiment of the present invention. FIG. 1 is a plan sectional view of the tip portion, FIG. 2 is a side sectional view of the tip portion, FIG. 3 is a plan sectional view of the clip assembly, FIG. 4 is a side sectional view of the clip assembly, FIGS. 5 and 6 are side sectional views of the used state, FIG. 7 is a plan sectional view of the used state, and FIG. It is a perspective view of. 1 ... insertion tube, 2 ... connecting ring, 3 ... operating tube, 4 ... operating wire, 5 ... connecting plate, 7 ... hook,
8 Lock pin, 11 Hook, 12 Clip, 13
Presser tube, 12d ... Nipping part, 15 ... Coating, 19 ...
Living tissue section.

Claims (1)

(57) [Claims] 1. An insertion tube which is inserted into and removed from a living body cavity through a channel of an endoscope, an operation tube which is inserted into and retracted from the insertion tube, and which is movable into and out of the operation tube. And a holding tube detachably attached to the operating tube, and a holding tube detachably attached to the operating tube, and the operating wire detachably attached to the hook and pulled toward the hand side to be drawn into the holding tube. And a clip having electrical insulation that closes by closing the clip.