JP4046983B2 - Endoscopic clip device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope clip device that is used through a treatment instrument insertion channel of an endoscope to perform hemostasis, ligation, marking, or the like in the body.
[0002]
[Prior art]
In general, a clip device for an endoscope has a clip closing ring disposed adjacent to the rear side of the clip so as to be detachably connected to the distal end of the flexible sheath, and can move forward and backward in the axial direction in the flexible sheath. By pulling the operation wire inserted through the handle from the hand side, the clip is drawn into the clip closing ring, opened and closed, and held in a closed state.
[0003]
In such an endoscopic clip device, it is necessary to detach the clip from the operation wire at the end of a series of operations, and various modes are employed for the connection / separation structure of the clip and the operation wire for that purpose. Yes.
[0004]
As one of the modes, when the clip and the operation wire are connected by a string-like member and the operation wire is pulled strongly, the clip is held in a closed state, and then the string formed at the distal end portion of the operation wire. There is one in which the string-like member is cut at the cut portion.
[0005]
[Problems to be solved by the invention]
The string-like member that connects the clip and the operation wire needs to be strong enough not to be cut until the clip is firmly inserted into the mucous membrane in the body and is left in place. It is necessary to have a sharpness that can be surely cut.
[0006]
Therefore, when the clip device is repeatedly used several times and the string cutting portion gradually becomes dull, when the operation wire is pulled, the string member following the opening / closing operation of the clip becomes uncertain, and the clipping treatment May not be able to be performed smoothly.
[0007]
Accordingly, the present invention provides an endoscopic clip device in which a string-like member that connects a clip and an operation wire is surely cut even when the use is repeated, so that clipping can be performed smoothly. With the goal.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the clip device for an endoscope of the present invention has a clip closing ring disposed adjacent to the rear side of the clip removably connected to the distal end of the flexible sheath, and is also possible. The operation wire and the clip, which are inserted in the flexible sheath so as to be able to advance and retract in the axial direction, are connected by a string-like member, and the clip is pulled into the clip closing ring by pulling the operation wire from the hand side. In an endoscopic clip device configured to be held in a closed state after being opened and closed and to be cut, the cord cutting means for cutting the string member is clipped to the string member. It is provided in the engaging portion on the side.
[0009]
The clip has a plurality of freely openable and closable arms connected to each other at the base end, the cored bar is disposed at a position inside the plurality of arms, and the string cutting means is formed on the cored bar. May be.
[0010]
Alternatively, the clip has a plurality of openable and closable arm portions connected to each other at the base end portion, and the string cutting means is formed at the base end connection portion of the clip where the plurality of arm portions are connected to each other. Good.
[0011]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 shows the entire configuration of the endoscope clip device, and the clip 2 is attached to the distal end of a coiled pipe-like flexible sheath 1 in which, for example, a stainless steel wire is tightly wound with a constant diameter. .
[0012]
An operation wire 3 whose tip is connected to the clip 2 is inserted and disposed in the sheath 1 so as to be able to advance and retreat in the axial direction. The outer surface of the sheath 1 is made of, for example, a tetrafluoroethylene resin tube or a superelastic alloy tube. A flexible outer tube 10 is loosely fitted so as to be movable back and forth in the axial direction.
[0013]
In FIG. 2, the clip 2 is housed in the distal end of the outer tube 10 at a portion near the proximal end, and a plurality of (for example, three) arm portions 2 a in an open state and the distal ends thereof inward. The protruding nail-like part 2b is visible.
[0014]
The operation unit 20 connected to the base end of the sheath 1 has a finger hook 23a attached to the other end side of the operation unit main body 23 to which the base end of the sheath 1 is connected, and a slider 22 to which the base end of the operation wire 3 is connected. Is configured to be slidable in the axial direction with respect to the operation unit main body 23.
[0015]
FIG. 3 is an enlarged view of the distal end portion of the clip device for an endoscope of this embodiment, and the outer tube 10 is a little so that the clip 2 in the closed state is almost completely accommodated in the outer tube 10. It has been pushed forward.
[0016]
The clip 2 is formed, for example, by bending a spring stainless steel plate or the like, and the three arm portions 2a connected to each other at the base end connecting portion 2d can be opened and closed radially without crossing each other. They are arranged at equal intervals (that is, at intervals of approximately 120 °).
[0017]
At the position near the base end of each arm portion 2a, an opening / closing drive portion 2c is formed in which a bulging portion 2c2 bulging outward is formed in a portion immediately after the constricted portion 2c1 that is bound inward. The arm part 2a is opened and closed by deforming the opening / closing drive part 2c.
[0018]
The operation wire 3 that is moved back and forth in the axial direction by the slider 22 disposed in the operation unit 20 is disposed at the axial position of the sheath 1, and extends backward from the clip 2 to the distal end of the operation wire 3. A clip connecting hook 4 that is engaged with the clip connecting string 5 (string member) is attached.
[0019]
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 the annular clip connecting string 5 is engaged with the recess 4a formed in the side portion of the front half. It comes to match.
[0020]
The clip connecting string 5 of this embodiment is formed of, for example, a stainless steel stranded wire or a single wire, and is formed in an annular shape by binding both ends of one string through one pipe 5a. Yes.
[0021]
The distal portion of the ring receiving tube 8 fixed to the distal end of the sheath 1 by soldering or the like is near the proximal end of the clip closing ring 6 for pressing and deforming the bulging portion 2c2 of the clip 2 from the outer surface side. The part is detachably fitted.
[0022]
Further, a clip metal core 9 is inserted and arranged inside the arm portion 2a from the opening / closing drive portion 2c of the clip 2 to the proximal end connecting portion 2d. The clip metal core 9 is formed in a thin cylindrical shape with a portion located inside the constricted portion 2c1 of the clip 2 (thin diameter portion 9a).
[0023]
The rear portion of the clip metal core 9 from the narrow diameter portion 9 a is formed in a circular cross-sectional shape that is thicker than the small diameter portion 9 a, so that the clip metal core 9 does not come out from the inside of the clip 2.
[0024]
The clip connecting string 5 is passed through a string passing hole 9b formed in the vicinity of the rear end portion of the clip metal core 9, and the clip closing ring 6 is fitted on the outer surface of the base end connecting portion 2d of the clip 2 by friction force. It is locked there.
[0025]
In this way, as shown in FIG. 4, the clip 2, the clip connecting string 5, the clip closing ring 6, and the clip metal core 9 are in a single unit shape that can be coupled / separated with respect to the sheath 1 and the operation wire 3. It is configured.
[0026]
The string passing hole 9b is formed obliquely with an angle of, for example, about 45 ° in the front-rear direction, and the rear edge of the front opening forms a string cutting edge 7 (string cutting means). When the clip connecting string 5 is strongly pulled backward, the clip connecting string 5 is cut at the contact portion with the string cutting edge 7.
[0027]
When using such an endoscopic clip device, the tip of the endoscopic clip device passed through a treatment instrument insertion channel (not shown) of the endoscope is guided to the front of the affected area to be clipped. Then, as shown in FIG. 5, the outer tube 10 is retracted rearward and the operation wire 3 is pulled from the operation unit 20 side. Then, the bulging portion 2c2 of the clip 2 is drawn into the clip closing ring 6 and deformed, so that the arm portion 2a is greatly opened.
[0028]
When the operation wire 3 is further pulled toward the operation unit 20, a part of the expanded portion of the arm 2 a of the clip 2 is drawn into the clip closing ring 6 as shown in FIG. 1. The nail-like part 2b at the tip of each arm part 2a is stuck into the mucous membrane so as to wrap around the affected part 100, and the state is maintained.
[0029]
Then, if the operation wire 3 is further pulled toward the operation unit 20 side, the clip connecting string 5 is cut at the contact portion with the string cutting edge 7 so that the clip connecting string 5 and the clip 2 are separated, and the sheath By pulling 1 backward, the ring receiving tube 8 and the clip closing ring 6 are separated.
[0030]
In this way, the affected part 100 can be placed in the body in a clipped state by the clip 2 in a state of being forcibly closed by the clip closing ring 6.
[0031]
Figure 6 is a reference example of the present invention, is provided with a cord cutting edge 7 on the clip 2 of the basal end connecting portion 2d, and the like.
[0032]
In addition, this invention is not limited to the said Example, The number of the arm parts 2a of the clip 2 may be two, and four or more may be provided.
[0033]
【The invention's effect】
According to the clip device for an endoscope of the present invention, the cord cutting means for cutting the string-like member that pulls the clip is provided in the engagement portion on the clip side with respect to the string-like member. Even if the clip device is used repeatedly, the string cutting means is renewed with the clip every time, so that the string-like member connecting the clip and the operation wire is surely cut and the clipping procedure is always performed smoothly. Can do.
[Brief description of the drawings]
FIG. 1 is a side cross-sectional view showing a state in which a state of transition from a closed state to an indwelling state in a clip opening / closing operation of an endoscopic clip device according to a first embodiment of the present invention is shown.
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 side sectional view of the distal end portion of the endoscope clip device according to the first embodiment of the present invention.
FIG. 4 is a partial cross-sectional view showing a clip unit of the endoscope clip device according to the first embodiment of the present invention.
FIG. 5 is a side cross-sectional view showing an open 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 of a state in which the clip device for an endoscope according to a reference example of the present invention transitions from a closed state to an indwelling state in a clip opening / closing operation.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Sheath 2 Clip 2a Arm part 2d Base end connection part 3 Operation wire 5 Clip connection string (string-like member)
6 Clip closing ring 7 String cutting edge (string cutting means)
9 Clip core 9b String passage hole 10 Mantle tube 20 Operation part

Claims (1)

A clip closing ring disposed adjacent to the rear side of the clip is detachably connected to the distal end of the flexible sheath, and is inserted into the flexible sheath so as to be movable back and forth in the axial direction; the clip and are not connected by string-like member, by traction of the operation wire from the proximal side, the clip is held in closed jaws are pulled into the clip closed in a ring, the cord-like member In an endoscopic clip device configured to be cut,
The clip has a plurality of freely openable and closable arms connected to each other at the base end, and a core bar is disposed at a position inside the plurality of arms , and the string for cutting the string-like member An endoscopic clip device characterized in that a cutting means is formed on the cored bar .

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