JPH10277046A - Ligation tool for medical use - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a ligation tool for medical use capable of performing sure and appropriate ligation treatment at a loop part for ligation without adding a special component and without cutting a tissue. SOLUTION: In this ligation tool 2 for the medical use provided with a flexible wire material 21 for forming the loop part 23 for the ligation and a stopper 22 to which the wire material is forcibly fitted for tightening the loop part 23 and ligating the tissue by moving the stopper 22 to the tip side of the loop part 23, the cross sectional shape of the wire material 21 for forming the loop part 23 for the ligation is formed in an almost flat shape long in a vertical direction orthogonally crossed with a plane formed by the loop part 23.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical ligature, and more particularly to a medical ligature having a loop for ligating a diseased tissue with a flexible wire.

[0002]

2. Description of the Related Art A conventional medical ligature is formed by bending a flexible wire into a loop, bundling both ends of the wire, pressing it into a cylindrical stopper, and moving the stopper toward the distal end. The part is reduced in diameter to ligate the diseased tissue. In using this medical ligature, it is transendoscopic, that is, it is introduced into the body through a treatment instrument insertion channel of the endoscope, and a loop portion is hung on a diseased tissue portion in the body to reduce the diameter thereof. Tighten the affected tissue. Because this ligation stops the blood flow of the diseased tissue,
If the ligated state is maintained for several days, the diseased tissue will be necrotic and the diseased tissue will fall off after a few days. At this time, the medical ligature also falls off at the same time and is naturally discharged from the anus.

[0003]

[Problems to be solved by the invention]

(Problems of the prior art) In a conventional medical ligature, since a flexible wire forming a ligature loop having a perfect circular cross-sectional shape is used, it is strengthened by the ligature loop. When the diseased tissue portion is tightly bound, the force is concentrated on one portion of the tissue, so that it may be bitten and cut off the tissue. Therefore, in actual use, it is difficult to adjust the ligating force with a sufficiently strong force, and a high degree of skill has been required of the operator. If a special component is added to the flexible wire forming the ligating loop portion to restrict the amount of binding, a new drawback arises in that the number of components increases and the configuration becomes complicated.

(Purpose) The present invention has been made in view of the above-mentioned problems. The purpose of the present invention is to secure a ligating loop portion without cutting a tissue without adding a special part. Another object of the present invention is to provide a medical ligating device capable of performing an appropriate ligating procedure.

[0005]

[Means for Solving the Problems]

(Means) The present invention has a flexible wire forming a ligating loop portion, and a stopper into which the wire material is press-fitted, and moves the stopper toward the distal end side of the loop portion to form the loop portion. A medical ligating device configured to tighten and ligate a tissue, wherein a cross-sectional shape of a wire forming the ligating loop portion is formed into a substantially flat shape that is long in a vertical direction perpendicular to a plane formed by the loop portion. It is. (Operation) The cross-sectional shape of the wire forming the ligating loop is
By forming it into a substantially flat shape that is long in the vertical direction perpendicular to the plane formed by the loop portion, the area in contact with the tissue increases, and the tissue is less likely to be cut even when a strong force is applied during binding.

[0006]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A medical ligating apparatus according to a first embodiment of the present invention will be described with reference to FIGS. FIG.
(A) is an explanatory view showing the configuration near the distal end of the medical ligating device, and FIG. 1 (b) is a view taken along line X-X in FIG. 1 (a).
FIG. 2 is a cross-sectional view of a wire portion along a line, and FIG. 2 is an explanatory diagram of a ligated state of a medical ligating device.

[0007] The medical ligating apparatus 1 includes a ligating tool 2 to be placed in the body and an operating device 3 for guiding the ligating tool 2 into the body to ligate a tissue. The operation device 3 includes an insertion section 11 and a hand-side operation section (not shown). The insertion portion 11 includes a sheath 13 and the sheath 13.
An operation wire 14 is inserted into the inner hole so as to be able to advance and retreat, and a hook 15 having an outer diameter that is slidable into the sheath 13 is attached to the distal end of the operation wire 14.
The hook 15 has a hook-shaped hook 16 for detachably engaging the ligature 2. The opening of the hook 16 of the hook 15 is closed by the inner surface of the sheath 13 when the hook 15 is pulled into the sheath 13.

Next, the structure of the ligature 2 will be described. The ligature 2 is an endless flexible wire (wire) 21
And a cylindrical stopper 22 which bundles the two intermediate portions of the flexible wire 21 and press-fits and fits into the bundled portion. The ligating loop portion 23 is formed by the loop portion located on the side, while the hook mounting loop portion 24 is formed by the loop portion of the flexible wire 21 located closer to the proximal end side than the stopper 22.

The flexible wire 21 is a material made of, for example, a synthetic resin or a metal. As the synthetic resin, for example, nylon or polyolefin is used, and as the metal, for example, stainless steel is used. The flexible wire 21 has a rectangular cross-sectional shape having a long side at the center of the ligating loop 23 (see FIG. 1).
(A)). The long side located on the center side of the loop is a linear portion, and serves as a contact surface 25 that comes into contact when ligating the tissue. That is, the cross-sectional shape of the flexible wire forming the ligating loop portion 23 was formed into a substantially flat shape that was long in the vertical direction perpendicular to the plane formed by the loop portion 23. Therefore, the thickness in the direction parallel to the plane formed by the loop portion 23 is small, and the contact surface 2 that contacts the tissue to be ligated is formed.
5 increases.

The ligating loop 23 and the hook mounting loop 24 are made of different materials, and the ligating loop 24
The material of the hook mounting loop portion 24 may be connected to the end of the wire. In this case, the portion having the irregular cross-sectional shape as described above may be at least only the ligating loop portion 23.

The operation of the medical ligating apparatus 1 will be described below. First, the hook mounting loop portion 24 of the ligature 2 is hung on the hook 16 of the hook 15 with the hook 15 protruding from the distal end opening of the sheath 13. Thereafter, the operation wire 14 is pulled, and the hook mounting loop portion 24 of the ligating device 2 is drawn into the sheath 13. Then, as shown in FIG.

In this state, the insertion portion 11 is introduced into the body through a transendoscopic, that is, a treatment tool insertion channel of the endoscope, and a ligation loop is attached to the root of the target polyp-like lesion tissue portion 26 in the body. The operation wire 14 is pulled by the operation of the hand operation unit 12 by hooking the unit 23, and the hook 15 is retracted. Then, the ligature 2 is connected to the sheath 1 by the hook 15.
However, the stopper 22 is stopped by its rear end abutting against the distal end of the sheath 13.
The ligation loop portion 23 is reduced in diameter to bind the diseased tissue portion 26 as shown in FIG. By this ligation, the diseased tissue part 2
Blood flow to 6 stops. Thereafter, when the hook 15 is again projected from the distal end opening of the sheath 13, the hook 1
The hook-attached loop portion 24 is disengaged from 6, and only the ligature 2 is left in the body. The above operation completes the binding of the diseased tissue portion 26 in the body.

In this ligated state, if the ligature 2 is left in the body for several days, the diseased tissue part 26 will be necrotic and the diseased tissue part 26 will fall out several days later. At this time, the ligature 2 also falls off at the same time, and is naturally discharged from the anus, for example.

Since the material of the flexible wire 21 of the ligating device 2 of the medical ligating apparatus 1, especially the material of the ligating loop 23, has a rectangular cross-sectional shape having a long side at the center of the loop, the lesion is not affected. The area of the contact surface 25 that contacts the tissue portion 26 is large. For this reason, even when the pulling force of the hook 15 is strong, it is easy to satisfactorily bind the diseased tissue portion 26 without cutting it.

In this regard, since the cross-sectional shape of the wire 27 of the conventional ligating device is a perfect circle as shown in FIG. 6, when the ligated loop portion strongly binds the diseased tissue portion 26, the tissue 1 The power is concentrated too much in the place,
There is a risk of cutting the tissue, it is difficult to adjust the force when ligating with a sufficiently strong force during actual use, and a high degree of skill has been required of the surgeon, but according to this embodiment,
This defect has been eliminated, and the ligation loop portion 23 can perform a reliable and appropriate ligation procedure.

In the above embodiment, the cross-sectional shape of the flexible wire 21 in the ligating loop portion 23 is a rectangle having a long side at the center of the loop, but the present invention is not limited to this shape. For example, as shown in FIG. 3, an oblong shape having rounded ends 31 at both ends, an elliptical shape as shown in FIG. 4, and a gourd shape as shown in FIG. What is necessary is just to be the substantially flat cross section shape which has a long side, and these can also obtain the same effect as the above embodiment.

[Supplementary Notes] It has a flexible wire forming a ligating loop portion, and a stopper into which the wire is press-fitted. By moving the stopper toward the distal end of the loop portion, the loop portion is tightened to ligate tissue. In the medical ligation tool, the cross-sectional shape of the wire forming the ligation loop portion,
A medical ligature characterized by being formed in a substantially flat shape that is long in a vertical direction perpendicular to a plane formed by the loop portion.

2. A ligating loop made of a flexible wire, a cylindrical stopper press-fitted into the ligated loop in a state where the flexible wire is bundled, and formed closer to the base end than the stopper, A hook attachment portion to which the towing hook can be detachably attached, wherein a cross-sectional shape of the wire forming the ligating loop portion is formed to be long in a direction orthogonal to a plane formed by the loop portion. Medical ligature. 3. The medical ligating device according to any one of the additional items 1 and 2, wherein the wire forming the ligating loop has a cross-sectional shape partially having a straight portion toward the center of the loop. 4. 2. The medical ligating device according to claim 1, wherein the wire forming the ligating loop has an oval cross section. 5. 2. The medical ligating device according to claim 1, wherein a cross-sectional shape of a wire forming the ligating loop is elliptical. 6. 2. The medical ligating device according to claim 1, wherein the wire forming the ligating loop has a gourd-shaped cross section.

[0019]

As described above, the medical ligating device according to the present invention has a cross-sectional shape of a wire forming a ligating loop portion.
Since it is formed in a substantially flat shape that is long in a direction perpendicular to the plane formed by the loop portion, the area of the contact surface that contacts the diseased tissue portion to be ligated can be increased without adding any special parts. Therefore, even when the binding force is strong, it becomes easy to bind sufficiently sufficiently without cutting the tissue.

[Brief description of the drawings]

FIG. 1A is an explanatory view showing a configuration of a portion near a distal end portion of a medical ligation device according to a first embodiment, and FIG.
Middle, sectional drawing of a wire part along the XX arrow line.

FIG. 2 is an explanatory view of a ligating state of a tissue by a ligating device of the medical ligating device.

FIG. 3 is an explanatory view of a ligating state of a tissue by another ligating device.

FIG. 4 is an explanatory view of a ligating state of a tissue by another ligating device.

FIG. 5 is an explanatory view of a ligating state of a tissue by another ligating device.

FIG. 6 is an explanatory view of a state of ligating a tissue by a conventional ligating device.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Ligation device for medical use, 2 ... Ligation tool, 3 ... Operation device, 11
.. Insertion part, 13 sheath, 14 operation wire, 15 hook, 21 flexible wire, 22 stopper 23 ligating loop part, 24 hook mounting loop part, 25 contact surface, 26 … The affected tissue.

Claims (1)

[Claims] A flexible wire forming a ligating loop portion, and a stopper press-fitting the wire member, wherein the stopper is moved toward the tip of the loop portion to tighten the loop portion. In a medical ligating device adapted to ligate a tissue, a cross-sectional shape of a wire forming the ligating loop portion is formed in a substantially flat shape that is long in a vertical direction perpendicular to a plane formed by the loop portion. Medical ligature.