JP5045484B2 - Endoscope clip attachment - Google Patents

Description

  The present invention relates to an endoscope clip mounting tool for mounting a clip for performing hemostasis and the like using an endoscope to a connecting hook at the tip of an endoscope treatment tool.

  A clip device as a treatment instrument for an endoscope is configured to stop hemostasis by operating a clip disposed at a distal end of a sheath that is passed through a treatment instrument guide tube of an endoscope from an operation unit attached to a rear end of the sheath. It is an apparatus used for indwelling a body tissue for gripping or marking. Therefore, the clip is configured to be separable with respect to the sheath. Generally, a connection hook that is detachable with respect to a connection portion formed at the rear end portion of the clip is provided on the operation wire passed through the sheath. It is attached to the tip.

  Various types of connection hooks have been devised so far to be engaged with and disengaged from the connection portion of such a clip, but in a state of opening in a generally C shape toward the front due to its own elasticity. Biased and bent inwardly is often used because of its simple structure and reliable connection and disconnection with the clip. .

  By the way, the clip and the connecting hook as a whole are about 1 cm or less, and the connecting portion and the tip of the hook are as small as about 1 mm or less, so the operation of connecting the connecting portion of the clip to the connecting hook is a very fine operation, The connecting operation is not easy, and the connecting operation takes a long time. In particular, clips are often used at multiple locations during a single treatment, and once clipping is performed, the sheath is temporarily removed from the treatment instrument guide tube of the endoscope and a new clip is quickly attached to the connection hook. Therefore, it is necessary to move to the next clipping operation, and it is required to facilitate such connection work and to shorten the work time.

  As a conventional endoscope clip fitting for such a request, a guide groove for guiding the connecting hook in the opening / closing direction is formed in a direction perpendicular to the tail portion of the clip storing groove into which the clip is inserted from the head. It is known that the connecting hook is connected to the connecting portion of the clip by closing the connecting hook along the guide groove (see, for example, FIGS. 32 and 33 of Patent Document 1 below).

  However, even with a conventional endoscope clip fixture, it is necessary to pick up a very small connecting hook with a fingertip and place it along a thin guide groove. If you are not a person who has done so, or if you are wearing sterilized gloves, such detailed work is very difficult and still not enough.

The present invention has been made in view of such points, and the connection work between the clip and the connection hook can be performed extremely easily and reliably even by an unskilled person or a person wearing sterile gloves. An object is to provide a clip fixture.
WO2004 / 082488 pamphlet

  According to the present invention, there is provided an endoscope clip attachment tool for attaching a clip for performing hemostasis or the like using an endoscope to a connection hook at the distal end of an endoscope treatment instrument, and the clip attachment tool at the distal end. A clip storage portion for storing a clip having a substantially C-shaped arm portion, a clip having a connection portion detachably connected to the connection hook on the base end side of the arm portion, and a rear end A guide portion for guiding a connecting hook at the tip of the endoscope treatment tool from a rear end opening provided on the side, and the guide portion has a cross-sectional shape in front of the rear end opening. The direction of the connecting hook passed therethrough in the direction in which the clip is housed in the clip housing portion is detachable from the connecting portion of the clip housed in the clip housing portion. Gradually flattened to guide A guide hole is formed, and a projection for locking the clip housed in the clip housing portion at a predetermined position in a substantially C shape is formed in the clip housing portion. A clip fixture is provided.

  In the endoscope clip mounting tool according to the present invention, the protrusion can be provided so as to lock the tip of the clip. In this case, the arm portion includes an arm main body and a gripping portion that is bent toward the closing direction at the tip of the arm main body and grips a body tissue or the like, and the protrusion is connected to the tip of the gripping portion. The clip can be provided so as to abut against the clip. Further, in these cases, the shape of the protrusion may be set so that the clip is unlocked by the elastic deformation of the clip accompanying the closing operation of the clip stored in the clip storage portion. it can.

  According to the clip holder for an endoscope of the present invention, when the connection hook of the endoscope treatment tool is inserted from the rear end opening of the hook guide hole, the direction of the connection hook is disengaged from the connection part of the clip. Since it is corrected in the possible direction, the connection work between the clip and the connection hook can be performed very easily and reliably even by an unskilled person or a person wearing sterile gloves.

  In addition, since the clip storage portion has a protrusion for locking the clip, even when vibration or the like is applied or the tip of the connection hook interferes with the connection portion due to the connection work, Movement in the clip storage portion and change in posture are suppressed, and the position of the connecting portion is stably held at an appropriate position for connection with the connecting hook, so that the connection can be reliably performed.

  Embodiments of the present invention will be specifically described below with reference to the drawings.

[Schematic configuration of endoscopic treatment tool]
First, the configuration of a clip device that is an endoscope treatment tool as an object to which a clip is attached using the endoscope clip attachment tool according to the embodiment of the present invention will be described. FIG. 1 is a front view showing a schematic configuration of the endoscope treatment tool of the present embodiment, and FIG. 2 is a cross-sectional view taken along the line AA of FIG.

  The clip device 20 includes a connecting hook 21, an inner sheath (inner tube) 22, an operation wire 23 (see FIG. 2), an outer sheath (outer tube) 24, a reinforcing tube 25, a slider 26, a first base 27, and a first operation. The unit 28, the second base 29, and the second operation unit 30 are provided.

  The connecting hook 21 has a pair of arm portions made of an elastic body arranged in a substantially C shape toward the tip, and is in an open (open) state and a closed leg (closed) in cooperation with the inner sheath. Two states can be taken. The distal end portion of the arm portion of the connection hook 21 is bent inward (towards each other) and serves as a grip portion for gripping and connecting a connection portion 11a of the clip 10 described later. The proximal end portion of the connecting hook 21 is attached to the distal end of an operation wire 23 (see FIG. 2) that is slidably inserted into the inner sheath 22. The inner sheath 22 is slidably inserted into the outer sheath 24, and the vicinity of the proximal end portion side of the outer sheath 24 is inserted into the reinforcing tube 25 and is integrally fixed to the reinforcing tube 25.

  The reinforcing tube 25 is integrally fixed to the slider 26, and the first base 27 is inserted and disposed inside the slider 26. The slider 26 can slide with respect to the first base 27 so as to be positioned between a position moved to the distal end side and two positions moved to the proximal end side. The slider 26 can be slid by operating the lock portion 27a to release the lock. A first operating portion 28 is integrally fixed to the first base 27, and an operation wire 23 is fixed. A second base 29 is slidably held on the first base 27, and the inner sheath 22 is fixed to the second base 29. In addition, 26a is a water injection (liquid) port.

  When the first operation unit 28 and the second operation unit 30 are operated so as to be separated from each other, the inner sheath 22 is drawn into the operation wire 23, and the connecting hook 21 at the distal end of the operation wire 23 is moved from the distal end of the inner sheath 22. It protrudes and opens into a substantially C shape by its own elasticity. When the first operation unit 28 and the second operation unit 30 are operated so as to be close to each other, the operation wire 23 is drawn into the inner sheath 22, and the connection hook 21 at the tip of the operation wire 23 enters the inner sheath 22. However, the legs are gradually closed and buried in the inner sheath 22 so that the legs are completely closed.

  When the slider 26 is slid to the position on the proximal end side with respect to the first base 27, the inner sheath 22 can be protruded from the distal end of the outer sheath 24, and conversely, the slider 26 is distal to the first base 27. When slid to the side position, the tip of the inner sheath 22 can be accommodated (buried) in the outer sheath 24.

[Clip configuration]
FIG. 3 is a plan view showing the configuration of the clip in the open leg state, and FIG. 4 is a plan view showing the configuration of the clip in the closed leg state.

  The clip 10 includes an arm portion 11 and a clip fastening ring 12. The arm portion 11 is formed of an elastic metal plate or the like. The arm portion 11 has a connecting portion 11a to be connected to the connecting hook 21 on the base end portion side, and is arranged so as to open in a substantially C shape toward the tip. The arm portion 11 is provided. The arm portion 11 includes an arm main body and a gripping portion 11b that is bent toward the inside (that is, the closing direction) at the tip of the arm main body to grip a body tissue or the like.

  The connecting portion 11a is formed in a substantially U shape (or may be annular or the like), and an annular clip fastening ring 12 is slidably fitted to the connecting portion 11a. The clip tightening ring 12 is formed of a short metal pipe material, a coil material, or the like, and as shown in FIG. 3, in a state where it is arranged at a position closer to the rear (base end side) with respect to the arm portion 11. The arm portion 11 is in an open state, and the arm portion 11 is moved by moving the clip tightening ring 12 to the front side (front end side) as shown in FIG. It is forcibly closed.

[Configuration of clip attachment]
FIG. 5 is a perspective view showing the overall configuration of the clip fixture according to the embodiment of the present invention, FIG. 6 is a perspective view of the half of the fixture that also constitutes the clip fixture, and FIG. 7 is the overall configuration of the clip fixture. Similarly, FIG. 8 is a longitudinal sectional view showing the overall structure of the clip fixture.

  This clip fixture is configured by integrating a pair of fixture halves 1, 1 together at their mating surfaces and engaging them. The pair of fixture halves 1, 1 have substantially the same shape in this embodiment. The pair of fixture halves 1 and 1 may not necessarily have the same shape as long as they are formed in opposing shapes, but it is only necessary to prepare one type of molding die, from the viewpoint of manufacturing man-hours and manufacturing costs. The same shape is preferred.

  The fixture half 1 is formed from a molded product made of a plastic material. As best shown in FIG. 6, the fitting half 1 is engaged with the mating fitting half 1 to be mated with the engaging hooks 2 and 2, the hook stoppers 3 and 3, and the engaging rod. 4 and 4 and engaging holes (or grooves) 5 and 5. The engagement hook 2 engages with a corresponding hook stop 3 of the counterpart fixture half 1 as shown in FIG. 9, and the engagement rod 4 fits into a corresponding engagement hole 5 of the counterpart fixture half 1. By engaging as shown by 10, the pair of fixture halves 1, 1 are integrally fixed.

  As shown in FIG. 7, the clip 10 is stored in an open state at a position near the tip in the clip holder for an endoscope assembled by engaging the pair of fitting halves 1 and 1 with each other. A clip storage portion 6 is formed. The clip storage portion 6 includes an arm storage portion 6a formed in a generally rhombus shape in which the arm portion 11 of the clip 10 is disposed, and a substantially cylindrical tubular portion 6b in which the connection portion 11a of the clip 10 is disposed. ing. The clip 10 is housed in the clip housing 6 in a natural shape without being elastically deformed.

  The clip storage portion 6 is formed to be recessed by approximately half of the thickness of the clip 10 from the mating surface of each of the fixture halves 1 and 1, and the clip 10 is loosely swallowed as a whole, and is opened in a substantially C shape. It has a side wall (refer to reference numeral 6c in FIG. 25 described later) formed in a shape substantially along the back surface of the arm portion 11 that is provided. As for the clip 10, the back surface of the arm part 11 is arrange | positioned along this side wall. Note that the wall surface on the front end side of the clip storage portion 6 (in FIG. 7, the left side when the longitudinal direction of the clip mounting tool is set to the left and right) only needs to be formed in a range that does not hinder the closing operation of the clip 11. A fan shape or the like as indicated by a two-dot chain line in FIG.

  A pair of clip locking projections 14 and 14 (see FIGS. 6 and 7) for locking the clip 10 in an open state are stored in the clip storage unit 6 or in the vicinity thereof. Through holes 15 and 15 (see FIGS. 5, 6 and 7) formed so that a part of the arm portion 11 of the clip 10 crosses, and protrusions 16 and 16 for preventing hook entry (see FIGS. 6 and 8). These are described later.

  A portion closer to the rear end than the clip storage portion 6 of the clip holder for endoscope is a guide portion for guiding the connecting hook 21, and the guide portion is pushed forward from the inner sheath 22. In this state, a hook guide hole 8 is formed in the connecting portion 11a of the clip 10 to guide the connecting hook 21 that is separable from the rear toward the connecting portion 11a. In addition, a sheath guide hole 9 for guiding the distal end of the outer sheath 24 to the front of the clip storage portion 6 is also formed in the clip holder for an endoscope. These are each formed in the mating surface portion of the fixture half 1.

  As shown in FIG. 11, the hook guide hole 8 is extracted at the front end stopper portion 8b located at the boundary between the rear end opening 8a side and the cylindrical portion 6b of the front clip storage portion 6. As it goes to the side, it is formed in a gradually flat cross-sectional shape so as to correct the direction of the connecting hook 21 passed through the connecting hook 21 so as to be able to be retained and removed with respect to the connecting portion 11a of the clip 10. The shape of the rear end opening portion 8a of the hook guide hole 8 is formed in a circular or substantially oval shape that allows the connecting hook 21 in an open state to be inserted with a sufficient margin. The connecting hook 21 is formed in a narrow width so that the connecting hook 21 is fitted with little play in a direction orthogonal to the connecting portion 11a of the clip 10.

  As a result, as shown in FIG. 5, when the connecting hook 21 of the clip device 20 is inserted into the hook guide hole 8 from the rear end opening portion 8 a side, the tip position of the connecting hook 21 is indicated by a symbol (a ), (B), (c), and (d), as shown in the sectional view of each part in FIG. 12, the direction of the connecting hook 21 is on the rear end opening part 8a side. Even in such a case, it is gradually corrected in a direction perpendicular to the connecting portion 11a of the clip 10.

  As shown in FIG. 13, when the distal end of the connecting hook 21 comes into contact with the stopper portion 8b at the distal end of the hook guide hole 8 and stops, the inner sheath 22 with respect to the operation wire 23 as shown in FIG. (Or pulling the operation wire 23 backward with respect to the inner sheath 22), that is, by operating the first operation unit 28 and the second operation unit 30 in FIG. The connection hook 21 gradually enters the inner sheath 22 while being elastically deformed, and closes the connection hook 21 to grip the connection portion 11 a of the clip 10.

  In this way, the operator gradually inserts the connecting hook 21 from the rear end opening 8a of the hook guide hole 8 without adjusting the posture of the connecting hook 21 with respect to the connecting portion 11a of the clip 11, and gradually becomes flat. Due to the inner surface of the hook guide hole 8 formed in the above, the posture is corrected to be suitable for gripping and coupling with respect to the coupling portion 11a of the clip 10. Therefore, the operation of connecting the clip 10 to the connection hook 11a can be performed very easily and reliably even by an unskilled person or a person wearing sterile gloves.

  Next, as shown in FIG. 15, when the connecting portion 11 a of the clip 10 is further advanced so as to be pulled into the inner sheath 22, and the tip of the inner sheath 22 comes into contact with the clip tightening ring 12, the inner sheath 22. Since the outer sheath 24 is pushed forward along the sheath guide hole 9 (the slider 26 in FIG. 1 is slid to the position on the tip side with respect to the first base 27). ) The sheath guide hole 9 is set to have an inner diameter that allows the outer sheath 24 to be smoothly inserted, and is formed so as to pass straight through the clip holder for an endoscope. However, the most distal portion of the sheath guide hole 9 only needs to be in front of the clip storage portion 6 and does not have to penetrate the endoscope clip attachment.

  As a result, as shown in FIG. 16, the outer sheath 24 gradually covers the arm portion 11 as the outer sheath 24 advances, and the locking of the distal end portion of the arm portion 11 with respect to the protrusion 14 is self-elasticity of the arm portion 11. The arm portion 11 is released by deformation, enters the distal end of the outer sheath 24 while elastically deforming, and closes the leg. As shown in FIG. 17, the distal end of the outer sheath 24 reaches a position ahead of the distal end of the clip 10. Then, the clip 10 is completely accommodated in a state where the clip 10 is closed in the outer sheath 24. In this way, the outer sheath 24 can be easily and reliably covered with the clip 10 connected to the connection hook 21.

  When the attachment work of the clip 10 to the clip device 20 (connection hook 21) is simply summarized, first, the connection hook 21 is opened from the rear end opening 8a of the clip holder for an endoscope loaded with the clip 10. After the insertion, the inner sheath 22 is advanced, the connecting hook 21 is closed, and then the outer sheath 24 is pushed in. Thus, the clip 10 is attached to the clip device 20, and finally the clip is attached. All operations are completed by pulling out the clip device 20 from the tool. Thus, the attachment work is extremely easy.

[Protrusions for clip locking]
Next, the clip locking projection 14 will be described. 18 and 19 are enlarged views of the main part of FIG. 7. FIG. 18 shows a state in which no clip is loaded, and FIG. 19 shows a state in which a clip is loaded.

  In the arm storage portion 6a of the clip storage portion 6, there are provided a pair of clip locking projections 14 and 14 that lock the arm portion 11 of the clip 10 in an open state. The protrusion 14 is provided such that the tip of the grip portion 11b formed by bending the vicinity of the tip of the arm portion 11 of the clip 10 abuts on the side surface (locking surface 14a). The clip 10 is locked at a predetermined position in the clip storage portion 6 in a predetermined posture by the side wall 6c along which the arm portion 11 of the arm storage portion 6a is disposed and the projection 14. In this state, the base end portion side of the clip 10 is disposed on the cylindrical portion 6 b of the clip storage portion 6 with a part of the coupling portion 11 a of the clip 10 protruding into the hook guide hole 8.

  Further, the protrusion 14 that locks the tip of the gripping portion 11b can reliably lock the clip 10, and the size and orientation of the locking surface 14a so that the arm portion 11 of the clip 10 does not hinder the closing. Is set, and the side surface 14b continuous with the locking surface 14a is an arcuate curved surface that protrudes outward. After the connecting portion 11 a of the clip 10 is connected to the connecting hook 21, the outer sheath 24 is advanced from the state shown in FIG. 15 to the state shown in FIG. 16, and the clip 10 is accommodated in the outer sheath 24. Further, since the arm portion 11 is slightly elastically deformed, the locking of the protrusion 14 at the tip of the gripping portion 11b with respect to the locking surface 14a is released, so that the clip 10 does not become a hindrance when the leg is closed. Yes.

  The shape of the protrusion 14 is not limited to the shape shown in the figure, and the clip 10 can be reliably locked, and other shapes can be used as long as the arm portion 11 of the clip 10 does not hinder the closing. The shape may also be

  According to the clip holder for an endoscope of this embodiment, since the clip locking projection 14 as described above is provided, the clip 10 is stably held in the clip storage portion 6 at a predetermined position and posture. This is a case where vibration is applied to the clip attachment tool during transportation of the clip attachment tool for endoscope loaded with the clip 10 or attachment work to the clip device 20 (connection hook 21). Even in this case, changes in the position and posture of the clip 10 loaded in the storage unit 6 are suppressed, and the clip 10 can be reliably attached to the clip device 20. Even when the rear end portion of the coupling portion 11a of the clip 10 is pressed by the distal end of the clip device 20 (the distal end of the coupling hook 21, the inner sheath 22 or the outer sheath 24) during the mounting operation, the clip 10 is suppressed, and the clip 10 can be attached to the clip device 20 with certainty.

[Protrusions for preventing hook entry]
Next, the protrusion 16 for preventing hook entry will be described with reference to FIG. 18, FIG. 19, FIG. 21, and FIG. 21 is an enlarged view of the main part of FIG. 8, and FIG. 22 is a cross-sectional view taken along the line BB of FIG.

  As shown in these drawings, when the connecting hook 21 is inserted into the inner wall of the cylindrical portion 6b where the proximal end portion side of the clip 10 of the clip storage portion 6 is disposed through the hook guide hole 8, A pair of protrusions 16 and 16 for preventing the connection hook 21 from entering the cylindrical portion 6b beyond the connection portion 11a are provided so as to face each other.

  The rear end portion (the end portion on the hook guide hole 8 side) of the protrusion 16 stops the connecting hook 21 inserted into the hook guide hole 8 at a position where the connecting portion 11a of the clip 10 can be retained or removed. 8b is provided. The protrusion 16 protrudes toward the central axis of the tubular portion 6b, and the protrusion amount (height) is that the dimension between the distal ends of the opposing protrusions 16 and 16 is approximately the same as the outer diameter of the outer sheath 24. The dimension is set slightly larger than this.

  The rear end portion of the protrusion 16 may be a flat surface continuous to the stopper portion 8b, or may be a curved surface having a convex rear end side. The upper surface of the protrusion 16 (the surface on the central axis side of the cylindrical portion 6b) is assumed to be a flat surface here, but may be a curved surface that is convex or concave toward the central axis of the cylindrical portion 6b. . Here, the shape of the upper surface of the protrusion 16 (the shape seen from the central axis side of the cylindrical portion 6b) is an isosceles triangle having an apex angle disposed on the front end side (the storage portion 6 side). However, it may be an isosceles triangle having an apex angle arranged on the rear end side, or may be another shape such as a square, a rectangle, a rhombus, or an ellipse. Here, although two protrusions 16 are provided so as to face each other, one protrusion 16 may be provided corresponding to only one of the stopper portions 8b.

  FIG. 20 is an enlarged vertical cross-sectional view of the main part of the clip mounting tool when the hook intrusion prevention protrusion 16 as described above is not provided for comparison. As shown in FIG. 13, when the connecting hook 21 at the tip of the inner sheath 22 is inserted in a state of being opened to a natural state, the tip of the connecting hook 21 abuts against the stopper portion 8b, and the above-described operation is performed. The connecting portion 11a of the clip 10 can be easily and reliably gripped.

  However, when the connecting hook 21 slightly enters the inner sheath 22 and is in a half-open leg state, the tip of the connecting hook 21 may enter the cylinder upper portion 6b as shown in FIG. In this state, it is possible to push the inner sheath 22 further, so that the inner sheath 22 enters further and exceeds the clip fastening ring 12 of the clip 10. There is a risk that the connection cannot be realized, resulting in a mounting failure.

  In the present embodiment, since the protrusion 16 for preventing hook entry as described above is provided, as shown in FIG. 21, even if the connecting hook 21 is in the half-opened state, the connecting hook 21 is in the cylindrical portion 6b. As shown in FIG. 14, the connecting portion 11a of the clip 10 can be properly gripped.

[Penetration window for clip loading confirmation]
Next, the through window 15 for checking clip loading will be described. As shown in FIGS. 5, 18, and 19, a pair of through windows 15, 15 penetrating in the vertical direction (a direction orthogonal to the paper surface in FIGS. 18 and 19) are provided in the clip storage portion 6 and its vicinity. Is provided. These through windows 15 and 15 are formed such that a part of the corresponding arm portion 11 of the clip 10 housed in the clip housing portion 6 crosses (see FIG. 19).

  In this embodiment, the through window 15 includes a substantially rectangular through hole (first portion) 15a formed on the inner side from the side wall 6c with which the back surface of the arm portion 11 of the clip 10 of the arm storage portion 6a is brought into contact. And a substantially rectangular through hole (second portion) 15b formed outward from the side wall 6c. That is, it has a shape in which a relatively large rectangle and a small rectangle are combined with a portion that the arm portion 11 crosses as a boundary.

  Note that the shape of the through window 15 is not limited to such a shape, and may be, for example, a single rectangle, a circle (oval), a triangle, or the like as long as the arm portion 11 of the clip 10 is crossed. The shape of these, or the shape which combined these may be sufficient. Further, two or more through windows 15 may be formed for each of the pair of arm portions 11 of the clip 10.

  In the present embodiment, since the through windows 15 as described above are provided, whether or not the clip 10 is loaded in the clip storage portion 6 by viewing through the through windows 15 from the outside of the clip fixture. Can be easily confirmed. As a result, it is possible to easily determine whether the clip 10 is an unused clip fixture loaded with the clip 10 or a used clip fixture that does not store the clip 10, and a clip that has been used by mistake is detected. Use of the fixture is prevented. As will be described later, the through window 15 is also used for assembling the clip attachment.

[Assembly of clip fitting]
Next, an assembling operation of the clip mounting tool including the loading of the clip 10 into the clip storage unit 6 will be described. FIG. 23 is a plan view showing a configuration of an assembly jig used for the assembly work, and FIG. 24 is a cross-sectional view taken along the line CC of FIG. FIG. 25 is a plan view showing a state where the fixture half piece is supported by the assembly jig, and FIG. 26 is a plan view showing a state where the clip is loaded on the fixture half piece supported by the assembly jig.

  The assembly jig (jig main body) 31 has a support portion 32 formed in a concave shape for supporting a surface opposite to the mating surface with the other half of the fixture half 1 that forms a pair of fixture half pieces 1. ing. As shown in the figure, four protrusions 33a, 33a, 33b, and 33b are disposed on the support portion 32 as positioning protrusions. These protrusions 33a and 33b are each formed in a tapered shape, and are disposed so as to face upward (in a direction orthogonal to the paper surface in FIG. 23).

  The protrusion 33a is located on the inner side of the portion of the arm portion 11 of the clip 10 of the through-window 15 of the fixture half 1 that crosses in a state where the fixture half 1 is supported by the support portion 32 of the jig 31. It is arranged at a position corresponding to the through hole (first part) 15a which is a part, and the projection 33b is outside the part where the part of the arm part 11 of the clip 10 of the through window 15 of the fixture half 1 crosses. It is arrange | positioned in the position corresponding to the through-hole (2nd part) 15b which is this part.

  When the fixture half 1 is supported by the support portion 32 of the assembly jig 31 with the mating surfaces facing upward, as shown in FIG. 25, the protrusion 33a penetrates the through hole 15a, and the protrusion 33b passes through the through hole 15b. The fixture half piece 1 is positioned by the support portion 32 and the projections 33a and 33b. In this state, as shown in FIG. 26, with the clip 10 in the natural state (open leg state), the arm portion 11 is formed with the protrusion 33a and the protrusion 33b so that the base end side is positioned on the cylindrical portion 6b. When inserted in the portion between the two, the clip 10 is guided by these projections 33a and 33b, and the clip 10 is arranged with the back surface of the arm portion 11 along the side wall 6c, and the tip of the grip portion 11b is for clip locking. It is set at an appropriate position locked to the protrusion 14.

  Next, the mating fitting half 1 of the mating counterpart is faced down and the engaging hooks 2 of one fitting half 1 are engaged with the hook stoppers 3 of the other fitting half 1, respectively, By engaging the engagement rod 4 of one fixture half piece 1 with the engagement hole 5 of the other fixture half piece 1, both are integrally fixed. At this time, since the clip 10 is positioned by the protrusions 33a and 33b, the position and posture thereof do not change, and the assembly is completed with the clip 10 loaded in an appropriate position.

  By assembling the clip attachment using such an assembly jig 31, the assembly operation is facilitated and the assembly can be performed in a short time.

  The embodiment described above is described for facilitating the understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the embodiment described above is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

It is a front view which shows the external appearance of the treatment tool (clip apparatus) for endoscopes of embodiment of this invention. It is sectional drawing along the AA line of FIG. It is a top view which shows the structure of the clip of the open leg state of embodiment of this invention. It is a top view which shows the structure of the clip of the closed leg state of embodiment of this invention. It is a perspective view of the clip attachment tool for endoscopes of the embodiment of the present invention. It is a perspective view which shows the fixture half piece and clip which comprise the clip fixture for endoscopes of embodiment of this invention. It is a cross-sectional view of the clip holder for an endoscope according to the embodiment of the present invention. It is a longitudinal cross-sectional view of the clip attachment tool for internal mirrors of embodiment of this invention. It is sectional drawing to which the principal part of the clip attachment tool for endoscopes of embodiment of this invention was expanded. It is sectional drawing to which the principal part of the clip attachment tool for endoscopes of embodiment of this invention was expanded. It is a schematic diagram of the hook guide hole of the clip attachment tool for endoscopes of the embodiment of the present invention. It is a figure which shows the change of the attitude | position of a connection hook when a connection hook is inserted in the hook guide hole of the clip mounting tool for endoscopes of embodiment of this invention. It is a longitudinal cross-sectional view which shows the state which the connection hook contact | abutted to the stopper part in the clip attachment tool for endoscopes of embodiment of this invention. It is a longitudinal cross-sectional view which shows the state which the connection hook hold | gripped the connection part of the clip within the clip holder for endoscopes of embodiment of this invention. It is a cross section which shows the state by which the connection part of the clip was drawn in in the inner sheath within the clip attachment tool for endoscopes of embodiment of this invention. It is a cross-sectional view showing an initial state in which an outer sheath is put on the clip in the clip holder for an endoscope according to the embodiment of the present invention. It is a cross-sectional view which shows the state by which the clip was completely accommodated in the outer sheath in the clip attachment tool for endoscopes of embodiment of this invention. It is the figure which expanded the principal part in the clip non-loading state of the clip mounting tool for endoscopes of embodiment of this invention. It is the figure which expanded the principal part in the clip loading state of the clip mounting tool for endoscopes of embodiment of this invention. It is a longitudinal cross-sectional view which shows the malfunction when not providing the protrusion for a hook approach prevention. It is a figure which shows the state by which the approach of the connection hook was blocked | prevented by the protrusion for hook entry prevention in the clip attachment tool for endoscopes of embodiment of this invention. It is sectional drawing along the BB line of FIG. It is a top view which shows the principal part of the assembly jig used for the assembly of the clip attachment tool for endoscopes of embodiment of this invention. It is sectional drawing along CC line of FIG. It is a figure for demonstrating the assembly operation | work of the clip attachment tool for endoscopes of embodiment of this invention, Comprising: It is a top view which shows the state which supported the fixture half piece on the assembly jig. It is a figure for demonstrating the assembly operation | work of the clip mounting tool for endoscopes of embodiment of this invention, Comprising: It is a top view which shows the state which loaded the clip to the fixture half piece supported by the assembly jig.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Fixture half piece 6 ... Clip accommodating part 6a ... Arm accommodating part 6b ... Cylindrical part 6c ... Side wall 8 ... Hook guide hole 8a ... Rear end opening part 8b ... Stopper part 9 ... Sheath guide hole 10 ... Clip 11 ... Arm part 11a ... connecting portion 11b ... gripping portion 12 ... clip clamping ring 14 ... clip locking projection 14a ... locking surface 15 ... clip loading confirmation or positioning through windows 15a, 15b ... through holes 16 ... hook entry prevention Projection 31 ... assembly jig 32 ... support portions 33a, 33b ... positioning projection

Claims (4)

An endoscope clip mounting tool for mounting a clip for performing hemostasis or the like using an endoscope to a connecting hook at the distal end of an endoscope treatment tool,
An arm portion formed in a substantially C shape toward the tip, and a clip storage portion for storing a clip having a connecting portion detachably connected to the connecting hook on the base end side of the arm portion; ,
A guide portion for guiding a connecting hook at the tip of the endoscope treatment tool from a rear end opening provided on the rear end side;
As the cross-sectional shape of the guide portion moves from the rear end opening portion side toward the boundary portion side with the front clip storage portion, the direction of the connecting hook passed therethrough is changed to the clip storage portion. A hook guide hole is formed which is gradually flattened so as to guide in an detachable direction with respect to the connecting portion of the clip housed in the clip,
A projection for locking the clip housed in the clip housing part at a predetermined position in a substantially C shape is formed in the clip housing part.   The endoscope clip mounting tool according to claim 1, wherein the protrusion is provided so as to lock a tip portion of the clip. The arm portion includes an arm main body and a gripping portion that grips a body tissue or the like that is bent toward the closing direction at the tip of the arm main body.
The endoscope clip mounting tool according to claim 2, wherein the protrusion is provided so as to abut on a distal end of the grip portion and to lock the clip.   4. The shape of the protrusion is set so that the clip is released from being locked by elastic deformation of the clip that accompanies a closing leg operation of the clip stored in the clip storage portion. The clip holder for endoscopes described in 1.

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