JPH0511842Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention is directed to a ratchet mechanism in an endoscopic treatment instrument, more specifically, to temporarily attach an operating member to the operating body of an endoscopic treatment instrument. The present invention relates to a ratchet mechanism for fixing objects.

[Prior Art] In endoscopic treatment instruments such as grasping forceps and clipping devices, it has been conventional to maintain the tip of the forceps and the clip in a closed state. There is a desire to prevent it from falling off, and in order to satisfy such a desire, as shown in Japanese Utility Model Publication No. 54-21436, the main body of the operating section is provided with a serrated blade whose blade faces toward the rear end of the operating section. A ratchet part consisting of a plurality of locking pawls is provided, and an operating wire is connected to the slider, which is an operating member slidably disposed on the main body of the operating part, for locking the ratchet part. A locking claw is provided that is biased so as to be engaged in a 1:1 correspondence with the claw, and is pressed against the biasing force,
A ratchet mechanism is adopted in which an operation button is provided to release the locking claw, and this ratchet mechanism prevents the locking claw from latching to the locking claw unless the operation button is pressed. A slider has been proposed in which the slider is temporarily integrated with the main body of the operating section, and the tip of the forceps and the clip are immovable. Furthermore, as shown in Japanese Utility Model Publication No. 56-22881, the ratchet claws are used to maintain the gripping state, and a rotary operating body is used to further ensure fine operation of the operating wire. Some proposals have also been made to make this possible.

[Problems to be solved by the invention] However, the provisional maintenance means using the ratchet mechanism as described above is not suitable for improving the operability of treatment instruments that require delicate operation, such as clip devices. The serrated locking pawl in the ratchet mechanism needs to be finely formed.
However, since the main body of the operation part on which the ratchet mechanism is usually formed is a molded product, if the serrated locking pawls formed on it are made too fine, it will be difficult to process the mold, and it will also be difficult to perform the molding process. Furthermore, there was a problem in that the cost increased significantly.

Therefore, in view of the above-mentioned problems, the purpose of the present invention is to provide a method for finely moving an operating member consisting of a slider without changing the size of the serrated locking pawl provided on the main body of the operating section. To provide a ratchet mechanism in an endoscopic treatment tool that allows the following to be performed.

[Means and effects for solving the problem] In order to achieve the above object, the present invention has a ratchet portion formed integrally in the longitudinal direction, which is made up of a plurality of locking pawls having a serrated cross-sectional shape. an operating section main body, an operating member slidably fitted to the operating section main body and movable forward and backward in the longitudinal direction of the operating section main body; a locked member that is attached to the operating member and is formed with a locked claw that is normally biased to lock onto a part of the ratchet t portion; In the ratchet mechanism of an endoscopic treatment instrument that temporarily fixes the operating member to the operating section main body by locking the formed locking claw to the ratchet section, the locking of the ratchet section is performed. The to-be-latched member has a to-be-latched claw portion formed with a finer pitch than the pitch of the working claw.

[Example] Hereinafter, the present invention will be explained based on the illustrated example.

FIG. 2 is a perspective view showing the overall configuration of a clip device, which is an endoscopic treatment instrument to which the ratchet mechanism of the present invention is applied.

As is well known, this clip device is inserted into a body cavity by passing through a forceps channel of an endoscope.
A clip detachably attached to the distal end clips the affected area and the clip is left in place.The clip device consists of a distal end 1 from which a clip 8 projects, and a flexible sheath for insertion into a body cavity. The main parts thereof are composed of a section 2 and an operation section 3 for moving the clip 8 forward, backward, and detached from the tip section 1.

As shown in detail in FIGS. 4A and 4B, the tip 1 includes a clip 8, a presser tube 9, and a connecting plate 1.
A cassette-type clip 11 made of 0 and a coil sheath 6 fitted into a flexible tube sheath 12.
It consists of a pipe 7 attached to the tip of the operating wire 4 and a hook 5 attached to the tip of the operating wire 4, and the clip 8 of the cassette type clip 11
The hook portion 8b and the hook 5 are detachably connected via the connecting plate 10. The clip 8 is formed by folding a thin metal plate into a paper sandwich shape and crossing the clips in the middle, and the hook portion 8 is attached to the rear of the ring portion 8a.
b is integrally formed.

The body cavity insertion section 2 is composed of a coil sheath 6 through which the operating wire 4 is inserted, and a flexible tube sheath 12 into which the coil sheath 6 is inserted so as to be movable forward and backward.
As shown in FIG. 2, the proximal end of the tube joint 15 is fixed to the distal end of the tube joint 15. A locking mechanism (not shown) is provided at the rear end of the tube joint 15, and when the tube joint 15 is pulled toward the operator's hand, it is fixed to the operation section main body 13. Tube fitting 1
It is designed to be unlocked by a lock release button 16 provided at 5.

The operating section 3 includes a coil sheath 6 whose distal end side is inserted into the tube sheath 12 so as to be able to move forward and backward.
(See Fig. 4) The rear end portion is connected, and as shown in Figs. 2 and 3, a ratchet portion 13A consisting of a plurality of serrated locking pawls 13a inclined rearward and downward is provided on the lower surface of the proximal side. An operating section body 13 made of a resin mold and having a finger ring 14 rotatably attached to the end thereof, and a slider that slides forward and backward with respect to the operating section main body 13. It is composed of a member 17. As shown in FIG. 3, the operating member 17 is formed into a pincushion shape by pasting together an upper slider piece 17a and a lower slider piece 17b, which are divided into upper and lower parts. Connection pipe 1 attached to the end of wire 4
8 is sandwiched and fixed. Further, inside the rear side of the operating member 17, a claw 13 is provided at a position facing a part of the plurality of locking claws 13a.
A metal locking pawl 20 biased by a coil spring 19 is interposed so as to mesh with the locking pawl 20a. This locking claw 20 is disengaged from the locking claw 13a by pressing a release button 21 integrated with the claw 20 against the elasticity of the coil spring 19. It's summery.

1A and 1B are enlarged views of essential parts of a ratchet mechanism showing a first embodiment of the present invention. In this embodiment, the pitch of the locking pawls 20 is 1/2 of the pitch P of the locking pawls 13a of the ratchet portion 13A.

Next, the operation of the endoscope clip device to which the ratchet mechanism of this embodiment configured as described above is applied will be explained. First, as shown in FIG.
0 to the tip of the operating wire 4 via the hook 5, and the operating wire 4 integrated with the hook 5 is pulled toward the user's hand to bring it into the state shown in FIG. Thereafter, the lock release button 16 of the tube joint 15 is pressed to release the lock and project it toward the distal end, the tube sheath 12 is advanced, and the cassette-type clip 11 is inserted into the tube sheath 12. Then, the clip 8 is
1-A and 1-B, the scissor-shaped tip of the clip 8 is closed, and the tube sheath 12 is closed.
stored inside. In this state, through the channel of the endoscope that has already been inserted into the body cavity,
The tip 1 of the clip device is introduced into the body cavity. Then, under observation with an endoscope, it is guided to the vicinity of a patient such as a bleeding site in a body cavity or a marking target site. Next, the tube joint 15 is pulled toward the user until it is locked, causing the cassette-type clip 11 to protrude from the distal end of the tube sheath 12. Then, the clip 8 is shown in Fig. 4 A, B, Fig. 5 1-A,
As shown in B, it returns to its original state. Afterwards,
This time, carefully pull the operating member 17 to widen the cassette-type clip 11 to the state shown in FIG. 5-2-A and B. That is, when the operating wire 4 is pulled by the operating member 17, the ring portion 8a of the clip 8 is drawn into the presser tube 9 and crushed, thereby causing the tip of the clip 8 to widen. .

Next, when the clip 8 is pressed against the tissue to be clipped in the open state and the operating member 17 is pulled toward the user in this state, the clip 8 is further drawn into the presser tube 9, and as shown in FIG. 5, 3-A. , B, the clip 8 is closed to properly grip the tissue. Then, by further pulling the operating member 17 toward the user's hand, the hook portion 8b of the clip 8 is extended, and the engagement with the connecting plate 10 is released. Then, the clip 8 is shown in FIG. 5, 4-A,
As shown in B, the device is placed in the body while grasping the tissue.

The clip device is operated as described above, but since the operating section 3 is equipped with the ratchet mechanism in this embodiment, it is possible to accidentally push the operating member 17 toward the distal end and drop the cassette-type clip 11. Prevents it from being put away.

In this case, as shown in FIGS. 1A and 1B, the pitch of the locking pawl 20 is 1/2 of the pitch P of the locking pawl 13a of the ratchet portion 13A, so The pitch width for stopping is also P/2. Therefore, the pitch width is half that of the conventional device shown in FIGS. The sliding operation position of the operating member 17 relative to the operating section main body 13 can be adjusted in detail from the above. The ratchet mechanism can easily release the locking claw 20 of the locking claw 13a by pressing the ratchet release button 21.

Generally, when operating such a clip device, even if the operating member 17 is carefully pulled, the
It is extremely difficult to achieve states A and B, and if the pitch of the ratchet is coarse, the operating member 17 will be pulled too much with too much force, resulting in the clip 8 closing before grasping the tissue. According to this embodiment, the pitch of the metal locking pawls 20 is set to 1/2 that of the resin molded locking pawls 13a, making it difficult to process and making it impossible to reduce the pitch width. Without changing the locking pawl 13a, it is possible to provide a ratchet mechanism with extremely high operability and a fine pitch width of 1/2. Note that the ratchet mechanism in this example is as follows:
The present invention is not limited to a clip device as in the case of this embodiment, but can be applied to all treatment instruments having an operating section equipped with a ratchet mechanism, such as grasping forceps. Further, the pitch of the claws of the above-mentioned locked claws 20 is 1/1/2 with respect to the locking claws 13a of the ratchet part.
The pitch is not limited to 2, but may be a finer pitch such as 1/3, 1/4, etc.

Next, a ratchet mechanism showing a second embodiment of the present invention will be explained based on FIG. The operating section to which the ratchet mechanism of this embodiment is applied is constructed almost the same as the operating section of the clipping device shown in FIG. 1 above. Therefore, the same components will be designated by the same reference numerals, and their explanations will be omitted, and only the essential parts of the ratchet mechanism will be described. The ratchet mechanism in this embodiment is approximately the same as the ratchet mechanism in the previous embodiment shown in FIGS. Whereas the ratchet portion 13A consisting of the locking pawl 13a is provided in only one row in the longitudinal direction, in this embodiment, the ratchet portion provided on the lower surface of the operating portion main body 13 has two parallel ratchet portions, that is, Multiple locking claws 1
3b and a plurality of locking pawls 13c, and these parallel ratchet portions are arranged so that the respective pitches between the respective locking pawls 13b and the locking pawls 13c are as shown in FIG. They are each made half a pitch apart from each other. In addition, the above-mentioned locking claw 1
3b and the locking claw 13c, the locking claw 20 is made to mesh with the locking claw 13b and the locking claw 13c at a ratio of 1:1, respectively.

As shown by the solid line in FIG. 6, the ratchet mechanism in the second embodiment configured as described above is such that when the locking pawl 20 is engaged with one of the locking pawls 13b, the ratchet mechanism of the second embodiment is configured as shown in FIG. The locked claw 20 is in a floating state at an intermediate position with respect to the claw 13c. Also,
When the operating member 17 is pulled toward you, the locking pawl 20 is now floating at an intermediate position with respect to one of the locking pawls 13b, as shown by the dashed line, and the other locking pawl 13b is in a floating state. It is in a state of engagement with the claw 13c. Therefore, as can be seen from the above operations, as a result, compared to the conventional example shown in FIGS. becomes.

Therefore, according to the second embodiment, similarly to the first embodiment, the locking pawls 13b and 13c in the ratchet portion made of resin mold, which is difficult to process, are
The pitch width of the ratchet can be halved without changing the size of the pawl, and the same effect as in the first embodiment can be obtained.
It goes without saying that the ratchet mechanism in this embodiment is not limited to the clip device, but can be applied to any treatment instrument that has an operating section with a ratchet mechanism, such as grasping forceps.

Next, a ratchet mechanism showing a third embodiment of the present invention will be explained based on FIGS. 7 and 8. The ratchet mechanism in this embodiment is similar to those in the first and second embodiments, and is applied to grasping forceps, clipping devices, etc., and only the ratchet mechanism is different, and the other structures are completely the same. It is. Therefore, the same constituent members are simply given the same reference numerals and their explanations will be omitted. FIG. 7 is a rear view showing the ratchet section provided on the back surface of the operating section main body 13 with the operating member 17 removed.

The ratchet mechanism in this third embodiment has a ratchet portion in which a plurality of locking pawls are arranged in a row in the longitudinal direction, and two rows of pawls are arranged in parallel with the pitch of the pawls being shifted, and two sets are provided in parallel. be. That is, two sets of the locking claws 13a in the first embodiment and the locking claws 13b and 13c in the second embodiment are arranged in parallel.
a' consists of two parallel locking claws 13d and 13e, and these locking claws 13d and 13e are further connected to locking claws 13b' and 13e, respectively.
It consists of two parallel ratchet pawls: c' and locking pawls 13b'' and 13c''. Then, the locking claws 13b'', 13b'' and the locking claws 13c', 13
c'' are shifted by half a pitch from each other as shown in FIG. ) are adapted to engage with the locking pawl 13a' on a one-to-one basis.

The action and effect of the ratchet mechanism in this embodiment constructed in this manner are completely the same as those of the ratchet mechanism in the second embodiment, as is clear from the construction. The third embodiment is applied, for example, to a ratchet mechanism having two operating wires, each of which is configured to be slid by a separate operating member.

[Effects of the invention] As explained above, according to the invention, the pitch of the ratchet mechanism as a whole can be reduced without reducing the size of the ratchet claw made of a difficult-to-process material, and it is possible to improve the accuracy of endoscopic procedures. It is possible to provide a ratchet mechanism that can significantly improve the operability of the tool.

[Brief explanation of the drawing]

FIGS. 1A and 1B are enlarged views of the main parts of a pawl in a locked state in a ratchet mechanism according to a first embodiment of the present invention, and FIGS. 1C and D show a pawl in a locked state in a conventional ratchet mechanism. Figure 2 is an enlarged view of the main parts shown.
FIG. 3 is a perspective view of a clip device to which the ratchet mechanism of the present invention is applied, and FIG. 4 is an enlarged cross-sectional view of the operating member in the clip device shown in FIG.
is an enlarged longitudinal cross-sectional view of the tip of the clipping device shown in Fig. 2, Fig. 4B is an enlarged cross-sectional view, and Fig. 5 1-
A to 4-B are operational views for explaining the operation of the clip in the clip device shown in FIG. A line diagram showing,
FIG. 7 is a plan view showing the ratchet part provided on the operating body of the ratchet mechanism showing the third embodiment of the present invention, and FIG. 8 shows the engagement of the locking pawl of the ratchet part in FIG. FIG. 13... Operating unit main body, 13A... Ratchet part, 13a, 13b, 13c, 13a', 13b',
13c', 13b'', 13c''...Locking claw, 17...
Operation member (slider), 20...Locked claw.

Claims (1)

[Scope of Claim for Utility Model Registration] An operating unit body in which a ratchet portion consisting of a plurality of locking pawls having a serrated cross-sectional shape is integrally formed in the longitudinal direction, and the operating unit body is slidably fitted into the operating unit body. has been,
An operating member that moves forward and backward in the longitudinal direction of the operating section main body; and an operating member that is attached to the operating member so as to be engaged with and disengaged from the ratchet part, and is normally engaged with a part of the ratchet part. a locked member on which a biased locked pawl is formed; the operating member is actuated by locking the locked pawl formed on the locked member to the ratchet portion; In the ratchet mechanism of an endoscopic treatment instrument that is temporarily fixed to the operation section main body, the ratchet mechanism has a locking claw portion formed with a finer pitch relative to the pitch of the locking claw of the ratchet portion. A ratchet mechanism in an endoscopic treatment instrument, characterized by comprising a stop member.