JP4412943B2 - Endoscopic clip device - Google Patents

Description

  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.

  In general, the clip device for an endoscope is connected to a clip disposed at the distal end portion of the flexible sheath so that the distal end of the operation wire inserted in the flexible sheath so as to be movable forward and backward in the axial direction can be used. By performing a pulling operation from the proximal end side of the flexible sheath, the operation wire and the clip can be disconnected after the clip is changed from the open state to the closed state.

The clip of such an endoscopic clip device is formed so as to be openable and closable by a spring material, and pulled into the closed cylinder by being pulled from behind by an operation wire, and is in this state. (For example, Patent Document 1 and Patent Document 2).
JP2002-191609 Japanese Utility Model Publication 4-26091

  However, in the configuration in which the clip is pulled back from the rear by the operation wire as described above and pulled into the closed cylinder, the clip is retracted backward while closing, so that the clipping state for the affected part tends to be shallow. In addition, once the clip closing operation is entered, the clip cannot be returned to its original open state, so it cannot be undone, and a clip placed in the body in an incomplete clipping state falls off within a short period of time. It was not unusual to end up.

  Therefore, the present invention can perform deep clipping on the affected area, and if it is likely to be incomplete clipping even once the clip closing operation is entered, the clip is dropped over a long period of time by redoing in the middle. An object of the present invention is to provide an endoscopic clip device capable of reliably clipping so as not to occur.

  In order to achieve the above object, an endoscope clip device according to the present invention has a distal end of an operation wire, which is inserted and disposed in a flexible sheath so as to be able to advance and retreat in the axial direction, at the distal end portion of the flexible sheath. When the operating wire is pulled from the proximal end side of the flexible sheath and the clip is changed from the open state to the closed state, the connection between the operating wire and the clip is released. In an endoscope clip device configured to be capable of being bent, a clip is formed so that it can be opened and closed in a bowl shape, and is bent in the center so that it is not deformable. It is constituted by a drive member that can be deformed into a bent shape in the same direction as the hook-shaped member at the inner position of the hook-shaped member through a straight state from a bent shape of Each of the hook-shaped member and the drive member Engage in the vicinity of the end and pull the central part of the drive member from the back with the operation wire, so that the drive member is bent from a reverse shape to a straight state, and the hook-like member is opened. Thus, by further pulling the operation wire, the drive member is changed from a straight state to a dogleg shape so that the hook-like member is closed.

  In addition, the nail | claw part engaged with respect to clipping object may be formed by bending the front-end | tip of a bowl-shaped member inward. Further, the vicinity of both ends of the hook-shaped member and the vicinity of both ends of the driving member may be engaged through a constricted portion formed on one side through a through hole formed on the other side.

  Further, the tip of the operation wire may be separably connected to the drive wire connected to the central portion of the drive member, and in this case, the through hole for allowing the operation wire to pass is provided at the center of the bowl-shaped member. If the operating wire is pulled until the driving member is in the shape of a letter like the hook-shaped member and the hook-shaped member is closed, the driving wire is inserted into the through-hole. The state where the hook-shaped member is closed may be maintained by being locked.

  According to the present invention, by pulling the central portion of the driving member from the rear by the operation wire, the driving member is changed from a bent shape to a reverse shape, and the hook-shaped member is opened. By further pulling the operation wire from the rear, the drive member changes from a straight state to a dogleg shape and the saddle-like member is closed, so that the saddle-like member can be opened and closed almost without moving back and forth. Therefore, if the clip can be clipped sufficiently deeply to the affected area, and if clipping is likely to be incomplete even after entering the clip closing operation, repeat the process halfway, and the clip will remain for a long time. Clipping can be surely done so as not to drop off.

  The clip is straight from the shape of the hook-shaped member formed in the shape of a non-bendable shape at the center so as to open and close in the shape of a hook, and from the bent shape of the reverse shape to the hook-shaped member. A drive member that can be deformed in a state of being bent in a dogleg shape in the same direction as the hook-shaped member at the inner position of the hook-shaped member through the state is configured to engage in the vicinity of both ends, and the center portion of the drive member Can be pulled from behind by an operation wire.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 1 and FIG. 2 are a perspective view and a side sectional view of the vicinity of the distal end of an endoscopic clip device. 1 is a coil pipe or tetrafluoride formed by tightly winding a stainless steel wire with a constant diameter A flexible sheath made of a flexible tube such as an ethylene resin tube.

  A cylindrical distal tip 1a made of a hard material is fixed to the distal end of the flexible sheath 1, and an operation wire 2 is inserted into the flexible sheath 1 so as to be movable back and forth in the axial direction. The inner diameter dimension of the distal tip 1a is set to a dimension within a range in which a flange-shaped member 3A described later does not enter. As the operation wire 2, a coil pipe, a metal rope, or the like can be used, and the operation wire 2 is pulled by an operation unit (not shown) connected to the proximal end of the flexible sheath 1.

  On the front side of the distal end opening of the distal end tip 1a of the flexible sheath 1, a hook-shaped member 3A formed in a bent shape at the center and a reverse-shaped shape opposite to the hook-shaped member 3A. A clip configured by combining the drive member 3B bent in a bent shape is disposed, and a claw portion 3a that engages with a clipping target is formed by bending the tip of the hook-shaped member 3A inward.

  The hook-shaped member 3A and the driving member 3B are passed through the through holes 4 formed in the vicinity of both ends of the hook-shaped member 3A so that the constricted portions 5 formed in the vicinity of both ends of the driving member 3B are not detached. In this state, it is movably engaged with some backlash. However, the through hole 4 may be formed in the driving member 3B, and the constricted portion 5 may be formed in the flange-shaped member 3A.

  Reference numeral 6 denotes a hard drive wire that is connected to the drive member 3B so as to surround the central portion of the drive member 3B, and extends rearward. The end of the drive wire 2 and the tip of the operation wire 2 are connected by the joint pipe 7. ing. Therefore, the operation wire 2 is connected to the drive member 3 </ b> B via the joint pipe 7 and the drive wire 6.

  The joint pipe 7 is a taper pipe whose outer diameter is gradually narrowed rearward. The drive wire 6 is firmly fixed to the front half by silver brazing or the like, and the operation wire 2 is adhesive or the like on the rear half. Is fixed with a predetermined strength or less.

  A through hole 8 through which the operation wire 2 passes loosely is formed at the center of the hook-shaped member 3A. The diameter of the through-hole 8 is set to a dimension that is larger than the minimum outer diameter of the joint pipe 7 and smaller than the maximum diameter, and that the middle part of the joint pipe 7 is tightly fitted. The hook-shaped member 3A configured as described above can be elastically deformed at the center so as to open and close like a hook. However, it may be plastically deformed.

  On the other hand, only the central part of the driving member 3B is annealed or processed with chemicals or made thinner than other parts, and is formed so that it can be bent freely at that part, and the reverse shown in FIG. 1 and FIG. From the state bent in the shape of a dogleg to the straight state shown in FIG. 3, it is deformed to the state bent in the shape of a dogleg in the same direction as the hook-shaped member 3A as shown in FIG. 4 and FIG. Can do.

  In the endoscope clip device according to the embodiment configured as described above, the operation wire 2 is pushed forward and the driving member 3B has a bowl shape as shown in FIGS. 1 and 2 during use preparation. The hook-shaped member 3A is in a closed state in a reverse letter shape opposite to that of the member 3A.

  Then, when an affected area to be clipped is found by passing through a treatment instrument insertion channel of an endoscope (not shown), the operation wire 2 is pulled from the hand side as shown in FIG. The rear end abuts on the tip tip 1a, the drive member 3B is in a straight state, and the hook-like member 3A is in the most open state.

  Then, as shown in FIG. 4, when the operation wire 2 is further pulled from the hand side, the drive member 3B becomes like a bowl-like member 3A inside the bowl-like member 3A and has a bowl-like member 3A. Is closed, and the claw portion 3a formed at the tip of the bowl-shaped member 3A is in a state where it has bitten the affected area 100 to be clipped. However, if it seems that incomplete clipping will occur in the middle of the process, it is possible to return to the open state shown in FIG. 3 and start over.

  When the hook-shaped member 3A is reliably clipped to the affected part 100, as shown in FIG. 5, by further pulling the operation wire 2 from the hand side, the joint pipe 7 bites into the through hole 8 and is fixed thereto. Is done.

  As a result, the closed state of the hook-shaped member 3A is maintained. Subsequently, the adhesion between the tip of the operation wire 2 and the joint pipe 7 is broken, the operation wire 2 is separated from the drive wire 6, and the clips 3A and 3B are inserted into the body. Detained.

  The present invention is not limited to the above-described embodiment. For example, separation of the operation wire 2 and the drive wire 6 after clipping may be performed by releasing mechanical engagement or cutting the operation wire 2. It does not matter.

It is a perspective view of the tip vicinity part of the clip device for endoscopes of the example of the present invention in the use preparation state. It is side surface sectional drawing of the front-end | tip vicinity part in the use preparation state of the clip apparatus for endoscopes of the Example of this invention. It is side surface sectional drawing of the front-end | tip vicinity part of the state which the clip of the endoscope clip apparatus of the Example of this invention opened most. It is side surface sectional drawing of the front-end | tip vicinity part of the state which the clip of the clip apparatus for endoscopes of the Example of this invention closed and was clipped to the affected part. It is side surface sectional drawing of the front-end | tip vicinity part of the clip retention state of the clip apparatus for endoscopes of the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3A Cage-like member 3B Drive member 4 Through-hole 5 Constriction part 6 Drive wire 7 Joint pipe 8 Through-hole

Claims (6)

A distal end of an operation wire that is inserted into the flexible sheath so as to be capable of moving forward and backward in the axial direction is connected to a clip disposed at a distal end portion of the flexible sheath, and the operation wire is connected to a proximal end of the flexible sheath. Endoscopic clip configured so that the connection between the operation wire and the clip can be removed after the clip is changed from the open state to the closed state by pulling from the side. In the device
A straight shape from a state where the clip is bent and deformed at the center so as to be opened and closed in a hook shape, and a bent shape opposite to the hook shape. And a drive member that can be deformed in a state of being bent in a dogleg shape in the same direction as the hook-like member at an inner position of the hook-like member, and the hook-like member and the drive member are Engage in the vicinity of both ends,
By pulling the central portion of the driving member from the rear by the operation wire, the driving member is turned straight from the bent state to the state where the hook-shaped member is opened. by further pulling the operating wire, Ri Do the state in which the beak member is closed becomes shaped Raku or the driving member is upright,
In a state where both end portions of the driving member are engaged in the vicinity of the respective tips of the pair of hooks forming the hook-shaped member, and the driving member is in an inverted letter shape, the driving member Protrudes toward the front from between the front ends of the pair of hook pieces, and the driving member and the hook-like member as a whole form a substantially rhombus shape .   The clip device for an endoscope according to claim 1, wherein a claw portion that engages with a clipping target is formed by bending a tip of the hook-shaped member inward.   The endoscope according to claim 1 or 2, wherein the vicinity of both ends of the hook-shaped member and the vicinity of both ends of the driving member are engaged through a constricted portion formed on one side through a through hole formed on the other side. Clip device.   The endoscope clip device according to claim 1, 2, or 3, wherein a distal end of the operation wire is detachably connected to a drive wire connected to a central portion of the drive member.   The endoscope clip device according to claim 4, wherein a through-hole for allowing the operation wire to pass therethrough is formed in a central portion of the bowl-shaped member.   When the operation wire is pulled until the drive member has a dogleg shape similar to the hook-like member and the hook-like member is closed, the drive wire is locked in the through hole. The endoscope clip device according to claim 5, wherein the closed state of the hook-like member is maintained.

Images