JP3917465B2 - Endoscopic clip device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscopic clip device that is used through a treatment instrument insertion channel of an endoscope and is placed in the body in a closed state in order to perform hemostasis, ligation, marking, or the like in the body.
[0002]
[Prior art]
In general, the clip device for an endoscope is a distal end of a sheath in which a clip that can be opened and closed and a clip closing member for holding the clip in a closed state are inserted into and removed from a treatment instrument insertion channel of the endoscope. Placed in the part.
[0003]
Then, a connecting member made of a string-like body or the like that extends rearward from the clip and is connected to the operation wire by pulling the operation wire inserted and arranged in the sheath so as to be movable back and forth in the axial direction from the hand side. Is drawn into the distal end portion of the sheath, so that the clip is opened and then closed, and the closed state is held by the clip closing member.
[0004]
In that state, the string-like body is cut by the pulling force of the operation wire, and the connection state between the clip and the connection member is released, and the clip held in the closed state by the clip closing member is separated from the sheath and enters the body. Detained.
[0005]
[Problems to be solved by the invention]
In the conventional endoscope clip device as described above, after the clip is placed, the connection member released from the connection with the clip may enter the sheath as far as it will go, and check the state. Maintenance has always been necessary, and management has been troublesome.
[0006]
Therefore, the present invention provides an endoscopic clip device that can simplify daily maintenance by preventing a connecting member that has been disconnected from the clip from entering the sheath more than a certain amount. With the goal.
[0007]
[Means for Solving the Problems]
In order to achieve the above object, the clip device for an endoscope of the present invention is provided with a clip that can be freely opened and closed and a clip closing member for holding the clip in a closed state at the distal end of the sheath, By pulling the pulling member inserted in the sheath so as to be movable back and forth in the axial direction from the hand side, the connecting member extending rearward from the clip and connected to the pulling member is drawn into the distal end portion of the sheath. In the clip device for an endoscope configured so that the clip is closed after the clip is opened, the closed state is held by the clip closing member, and the connection state between the clip and the connection member is released. The connecting member intrusion restricting means is provided for restricting the intrusion from a certain range within the tip portion.
[0008]
The connecting member may be a string-like body, and may be cut after being held by the clip closing member by being pulled by the pulling member.
[0009]
Further, the connecting member intrusion restricting means may be provided at the tip portion of the pulling member connected to the connecting member or in the vicinity thereof, and the connecting member intrusion restricting means may be formed by a sheath.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 shows the overall configuration of the endoscope clip device. For example, the clip 1 is disposed at the tip of a flexible outer tube 2 made of a tetrafluoroethylene resin tube or a superelastic alloy tube. .
[0011]
In FIG. 2, the clip 1 is housed in the distal end of the outer tube 2 at the proximal end, and the arm portion 1 a that is open to some extent and the distal claw that is formed projecting inward at each distal end thereof. Part 1d is visible.
[0012]
An outer tube 2 that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown) is loosely fitted on a flexible sheath 7 formed of, for example, a coil pipe that is tightly wound with a stainless steel wire with a constant diameter. , Can move forward and backward in the axial direction.
[0013]
The operation unit 20 connected to the base end of the flexible sheath 7 has a slider 23 in which the base end of the operation wire 3 (traction member) is connected to a main body shaft 21 having a finger hook 22 attached to the end. Are slidably attached so that the operation wire 3 can be pulled in the axial direction.
[0014]
Further, the proximal end tubular body 24 of the outer tube 2 is slidably arranged independently of the main body shaft 21, and the outer tube 2 is inserted into the outer tube 2 from the water supply inlet 25 protruding from the proximal end tubular body 24. The liquid can be sent to
[0015]
FIG. 1 shows a distal end portion of an endoscopic clip device in a state where the clip 1 is closed and pulled into the outer tube 2. The clip 1 is formed, for example, by bending a stainless steel plate for a spring and the like, and the three arm portions 1a connected to each other at the base end portion 1b can be opened and closed radially without crossing each other. It arrange | positions at the space | interval (namely, about 120 degree space | interval).
[0016]
At the position near the base end of each arm portion 1a, an opening / closing drive portion 1c is formed in which a bulging portion 1c2 that bulges outward in an arc shape is formed at a portion immediately after the constricted portion 1c1 constricted inward. The arm part 1a is opened and closed by deforming the opening / closing drive part 1c.
[0017]
An operation wire 3 (traction member) that is advanced and retracted in the axial direction by the above-described slider 23 disposed in the operation unit 20 is disposed at the axial position of the outer tube 2, and the distal end of the operation wire 3 is rearward from the clip 1. A clip connecting hook 4 that can be engaged and disengaged with respect to the clip connecting wire 5 extending in the direction is fixed.
[0018]
The clip connecting hook 4 has the tip of the operation wire 3 connected and fixed to the rear half by soldering or the like, and a string-like clip connecting wire 5 (connected to the concave portion 4a formed in the side portion of the front half. Member) can be engaged and disengaged.
[0019]
The clip connecting wire 5 of this embodiment is formed in an annular shape by bundling both ends of one flexible string-like wire and inserting them into the bundling pipe 5a and fixing them together.
[0020]
The rear half of the clip connecting hook 4 is formed so that the maximum gap between the inner surface of the flexible sheath 7 is smaller than the wire diameter of the clip connecting wire 5 and the inner portion of the flexible sheath 7 is deeper than that. The connecting member intrusion restricting means 40 restricts the clip connecting wire 5 from entering the inside.
[0021]
Reference numeral 6 denotes a clip closing ring (clip closing member) for pressing and deforming the bulging portion 1c2 of the clip 1 from the outer surface side, and is attached to the ring receiving cylinder 8 fixed to the most distal end portion of the flexible sheath 7. On the other hand, it is arranged to be freely disengaged from the front.
[0022]
Further, a clip metal core 9 is inserted and arranged inside the arm portion 1a from the opening / closing drive portion 1c of the clip 1 to the base end portion 1b. The clip metal core 9 is formed in a thin cylindrical shape at the inside of the constricted portion 1c1 (thin diameter portion 9a), and the rear portion is formed in a thick cylindrical shape that cannot pass through the constricted portion 1c1 portion. The clip 1 is prevented from coming out from the inside of the arm portion 1a.
[0023]
As shown in FIG. 3, the clip 1 portion of the endoscope clip device configured in this way constitutes one unit together with the clip connecting wire 5, the clip closing ring 6, and the clip metal core 9.
[0024]
The clip connecting wire 5 is loosely passed between the base end 1b of the clip 1 and the rear end face of the clip core 9 and extends rearward. The clip closing ring 6 is an outer surface of the base end 1b of the clip 1 And is locked there by frictional force.
[0025]
In use, when the mantle tube 2 is retracted rearward from the setting state shown in FIG. 1 and then the operation wire 3 is pulled toward the operation unit 20 side, as shown in FIG. The arm 1a is greatly opened by being pulled into the clip closing ring 6 and deformed.
[0026]
Next, when the operation wire 3 is pulled further strongly toward the operation unit 20, a part of the expanded portion of the arm 1 a of the clip 1 is pulled into the clip closing ring 6 as shown in FIG. 5. The tip claw 1d at the tip of each arm 1a pierces the mucous membrane so as to wrap the affected area.
[0027]
The clip connecting hook 4 of this embodiment is formed with an acute angle portion 4b for cutting the clip connecting wire 5 by being strongly pressed against the clip connecting wire 5, and a series of pulling operation of the operation wire 3 to the operation unit 20 side. At the end of the operation, the clip connecting wire 5 is strongly pressed against the acute angle portion 4b of the clip connecting hook 4 and cut.
[0028]
The clip connecting wire 5 cut in this way is detached from the clip 1 by being pulled by the clip connecting hook 4 as shown in FIG. 6, and the distal end portion of the flexible sheath 7 is shown in FIG. Drawn into.
[0029]
However, since the second half of the clip connecting hook 4 is the connecting member intrusion restricting means 40 that does not form a gap enough to pass the clip connecting wire 5 between the inner surface of the flexible sheath 7, the clip connecting wire 5 It does not enter into the flexible sheath 7 beyond the clip connecting hook 4.
[0030]
Therefore, the clip connecting wire 5 can be reliably removed from the clip connecting hook 4 by pushing the operating wire 3 from the operation unit 20 side so that the clip connecting hook 4 protrudes from the distal end of the flexible sheath 7. .
[0031]
In addition, this invention is not limited to the said Example, For example, as FIG. 8 shows, the connection member which does not form the clearance gap which only the clip connection wire 5 penetrates between the inner surfaces of the flexible sheath 7 The intrusion restricting means 40 may be formed of an independent member and fixed to the operation wire 3 in the vicinity of the rear side of the clip connecting hook 4. As shown in FIG. The operation wire 3 may be connected by using it.
[0032]
Further, as shown in FIG. 10, the operation wire 3 may be formed to have a large diameter from the proximal end side to the vicinity of the distal end and may be used as the connecting member intrusion restricting means 40. Reference numeral 41 denotes a brazing portion connecting the wires.
[0033]
Further, as shown in FIG. 11, the inner diameter of the rear of the flexible sheath 7 is made smaller so that a gap through which the clip connecting wire 5 passes between the inner surface of the clip connecting hook 4 is not allowed. The means 40 may be used.
[0035]
【The invention's effect】
According to the present invention, the connecting member intrusion restricting means for restricting the connecting member extending rearward from the clip and connected to the pulling member from entering a predetermined range in the distal end portion of the sheath is provided. As a result, the connection member released from the connection state with the clip does not enter the sheath more than a certain amount, so there is no need to check the connection member in the sheath one by one, greatly simplifying daily maintenance. be able to.
[Brief description of the drawings]
FIG. 1 is a side sectional view of a distal end portion of an endoscope clip device according to a first embodiment of the present invention.
FIG. 2 is an external view showing the overall configuration of the endoscope clip device according to the first embodiment of the present invention.
FIG. 3 is a plan partial sectional view of a unit of a clip portion of the endoscope clip device according to the first embodiment of the present invention.
FIG. 4 is a side cross-sectional view showing an open state in the opening and closing operation of the clip of the endoscope clip device according to the first embodiment of the present invention.
FIG. 5 is a side sectional view showing a closed state in the opening / closing operation of the clip of the endoscope clip device according to the first embodiment of the present invention.
FIG. 6 is a side cross-sectional view showing an operation after clipping of the endoscope clip device according to the first embodiment of the present invention;
FIG. 7 is a side cross-sectional view showing a state in the sheath after clipping of the clip device for an endoscope according to the first embodiment of the present invention.
FIG. 8 is a side sectional view showing a state in the sheath after clipping of the clip device for an endoscope according to the second embodiment of the present invention.
FIG. 9 is a side sectional view showing a state in a sheath after clipping of an endoscope clip apparatus according to a third embodiment of the present invention.
FIG. 10 is a side cross-sectional view showing a state in a sheath after clipping of an endoscope clip apparatus according to a fourth embodiment of the present invention.
FIG. 11 is a side sectional view showing a state in a sheath after clipping of an endoscope clip apparatus according to a fifth embodiment of the present invention.
[Explanation of symbols]
1 Clip 1a Arm 2 Outer tube 3 Operation wire (traction member)
4 clip connection hook 5 clip connection wire (connection member)
5a Bundling pipe 6 Clip closing ring (clip closing member)
7 Flexible sheath 20 Operation unit 40 Connecting member intrusion restricting means

Claims (3)

A clip provided to be openable and closable and a clip closing member for holding the clip in a closed state are arranged at the distal end portion of the sheath, and a pulling member inserted in the sheath so as to be movable back and forth in the axial direction is at hand. By pulling from the side, the connecting member that extends rearward from the clip and is connected to the pulling member is drawn into the distal end portion of the sheath, and the clip is opened and then closed. In the endoscope clip device configured to be held by the clip closing member and to release the connection state between the clip and the connection member,
The connecting member is a string-like body, and is pulled by the pulling member so that the clip is cut after being held closed by the clip closing member,
An endoscopic clip device, characterized in that connecting member intrusion restricting means is provided for restricting the connecting member from entering a depth within a predetermined range in the distal end portion of the sheath. The connecting member entrance preventing means, the connecting member said traction member at the tip portion or an endoscopic clipping device of claim 1 Symbol mounting is provided in the vicinity portion coupled relative. The connecting member entrance preventing means, endoscopic clipping device of claim 1 Symbol placement is formed by the sheath.

Images