KR101110597B1 - Clip, clip unit and clip apparatus for the treatment of wound - Google Patents

Abstract

The present invention relates to therapeutic clips, clip units and clip devices that are applicable to suture or removal of large areas of tissue damage and at the same time ensure access precision to the target (site to be treated).
As one form for realizing this, this invention is the 1st arm part and 2nd arm part which crimp | bonded with each other with the target interposed; A ring portion connecting one end portion of the first arm portion and the second arm portion to each other; A first subordinate arm portion articulated to the other end of the first arm portion; And it provides a therapeutic clip comprising a second subordinate arm portion articulated to the other end of the second arm portion.

Description

Therapeutic clips, clip units and clip devices {CLIP, CLIP UNIT AND CLIP APPARATUS FOR THE TREATMENT OF WOUND}

FIELD OF THE INVENTION The present invention relates to therapeutic clips, clip units and clip devices, and more particularly, to therapeutic clips, clip units and clip devices used for suturing or removing tissue in endoscopic surgery.

As an apparatus for suturing a wounded area (hereinafter referred to as a "wound") in endoscopic surgery, for example, as disclosed in Patent 10-0815378 is inserted through the treatment instrument insertion channel of the endoscope to operate through Techniques for closing wounds by clip units are known.

In general, the clip unit (a) of the conventional structure as disclosed in Korean Patent No. 10-0815378 is a device structure for which the tissue structure is to be used for suture of a narrow wound.

However, in actual medical procedures, a wound having a large tissue damage may need to be closed, so a clip unit suitable for such a procedure is desired.

For example, the narrow wound of the "A" region as shown in Fig. 1A was applied to the conventional wound clip unit (a) to sew the wound by pinching the edge of the wound. For wide wounds, the arm (b) of the clip unit (a) cannot completely cover the edges of the wound, which leads to the problem of finding alternative methods for closure.

On the other hand, when the arm (b) of the clip unit (a) is further extended to apply this problem, as shown in Figure 1b the radius of rotation for the operation of the instrument (endoscope) (c) is narrowed to the wound site There was a problem that the accuracy of the approach is significantly reduced.

SUMMARY OF THE INVENTION The present invention has been conceived in view of the above-described problems, and provides a therapeutic clip, a clip unit, and a clip device that can be applied to suture or removal of a site having wide tissue damage and at the same time secure access accuracy to a site to be treated. It is for that purpose.

In order to achieve the above object, a preferred embodiment of the present invention, the first arm portion and the second arm portion which is pressed against each other with a target (site to be treated) therebetween; A ring portion connecting one end portion of the first arm portion and the second arm portion to each other; A first subordinate arm portion articulated to the other end of the first arm portion; And it provides a therapeutic clip comprising a second subordinate arm portion articulated to the other end of the second arm portion.

According to a preferred embodiment, the therapeutic clip comprises: a first elastic member connected between the first arm portion and the first subordinate arm portion to provide a force to spread the first arm portion and the first subordinate arm portion; And a second elastic member connected between the second arm part and the second subordinate arm part to provide a force that is spread between the second arm part and the second subordinate arm part.

According to a preferred embodiment, the first elastic member and the second elastic member may be any one of an elastic rubber, a torsion spring.

According to a preferred embodiment, one end of the first elastic member and the second elastic member is at least one of an adhesive method, a thermocompression method, a high frequency attachment method, a photopolymerization method, and a bolt fixing method. The second arm may be attached to each other and the other end is attached to the first and second subordinate arm respectively.

According to a preferred embodiment, when the first subordinate arm portion and the second subordinate arm portion are deployed, respectively, an extension direction of the first subordinate arm portion and the second subordinate arm portion extends the first arm portion and the second arm portion, respectively. It can be comprised so that the shape may deviate from a direction.

According to a preferred embodiment, the first subordinate arm portion and the second subordinate arm portion each include a plurality of joints jointed with each other, each of which can be connected to an elastic member that provides a force that is apart from each other.

According to a preferred embodiment, the plurality of nodes may be in the form of folded inwardly between the first arm portion and the second arm portion, respectively.

According to a preferred embodiment, the therapeutic clip comprises: a first catching portion projecting from one of the first arm portion and the first subordinate arm portion to the other; And a second catching part protruding from one of the second arm part and the second subordinate arm part toward the other.

According to a preferred embodiment, a first inclined surface is formed on a side of the first engaging portion in contact with the first arm portion or the first dependent arm portion, and the second arm portion or the second slave portion of the second locking portion is formed. The second inclined surface may be formed on the side of the side that is in contact with the arm.

In addition, in order to achieve the above object, another preferred embodiment of the present invention, the first arm portion and the second arm portion which is pressed against each other with a target therebetween; A ring portion connecting one end portion of the first arm portion and the second arm portion to each other; First and second slot portions respectively formed at the other ends of the first arm portion and the second arm portion; A first subordinate arm portion, one end of which is inserted into the first slot portion; A first elastic member interposed between the first slot portion and the first subordinate arm portion to transmit an elastic force; A second subordinate arm portion, one end of which is inserted into the second slot portion; And a second elastic member interposed between the second slot portion and the second subordinate arm portion to transmit an elastic force.

According to a preferred embodiment, the first subordinate arm portion and the second subordinate arm portion may further include a first engaging jaw at one end portion inserted into the first slot portion and the second slot portion, respectively, and the first The slot portion and the second slot portion may further include a second locking jaw coupled to the first locking jaw therein, respectively.

In addition, in order to achieve the above object, another preferred embodiment of the present invention, the first arm portion and the second arm portion which is pressed against each other with a target interposed between, and one end of the first arm portion and the second arm portion to each other A therapeutic clip comprising a ring portion, a first subordinate arm portion articulated to the other end of the first arm portion, and a second subordinate arm portion articulated to the other end of the second arm portion; A connection member connected to the ring portion of the treatment clip; And it provides a therapeutic clip unit comprising a compression tube is inserted into the connection member is connected to the ring portion.

In addition, another preferred embodiment of the present invention in order to achieve the above object, a clip unit having the above-described characteristics, a wire connected to the connecting member of the therapeutic clip constituting the clip unit, and inserted into the endoscope to Provided is a therapeutic clip device comprising a clip unit and a tubular body that is a passage of the connecting member.

1A and 1B are views for explaining problems when applying a clip unit of a conventional structure.
Figure 2 is a perspective view schematically showing the structure of the treatment clip according to a first embodiment of the present invention.
3A and 3B are side and perspective views, respectively, showing enlarged joint portions of the treatment clip of FIG.
4 is a view schematically showing the structure of a clip unit to which the treatment clip according to the first embodiment of the present invention is applied.
5A to 5E are diagrams for explaining a gripping (pinching) operating mechanism of a clip unit to which a therapeutic clip according to a first embodiment of the present invention is applied.
6A and 6B are side and perspective views, respectively, showing enlarged joint portions of the treatment clip according to the second embodiment of the present invention.
Figure 7a is a perspective view schematically showing the structure of the treatment clip according to a third embodiment of the present invention, Figure 7b is a view showing a state in which the cascade of the cascade constituting the clip of Figure 7a all upright.
FIG. 8A is a perspective view schematically showing another structure of the treatment clip according to the third embodiment of the present invention, and FIG. 8B is a view showing a state in which the cascades of the multi-stage dependent components constituting the clip of FIG. 8A are all upright.
9A is a perspective view schematically illustrating a structure of a treatment clip according to a fourth embodiment of the present invention, and FIG. 9B is a view showing a state in which the first subordinate arm part and the second subordinate arm part constituting the clip of FIG. 9A are upright. .
FIG. 10A is a perspective view schematically illustrating a structure of a treatment clip according to a fifth embodiment of the present invention, and FIG. 10B is a view illustrating a state in which a first subordinate arm portion and a second subordinate arm portion constituting the clip of FIG. 10A are deployed. 10C is a view for explaining an operation process of the clip of FIG. 10A.
11A to 11E are diagrams illustrating a use state of a clip unit to which a therapeutic clip is applied according to a preferred embodiment of the present invention.

[First Embodiment]

Figure 2 is a perspective view showing the structure of a treatment clip according to a first embodiment of the present invention, Figures 3a and 3b is an enlarged side and perspective view of each of the joint portion of the treatment clip of FIG.

First, referring to FIG. 2, the treatment clip 10 according to a preferred embodiment of the present invention includes a first arm portion 100 which picks up one edge of a tissue portion to be a target (site to be treated) and the other side of the portion to be treated. The first arm 100 and the second arm 200 are bent to the lower portion where the first arm 100 and the second arm 200 are connected to each other. The part 300 is formed. In addition, each of the first arm portion 100 and the second arm portion 200 constituting the treatment clip 10, the first subordinate arm portion 110 and the second subordinate arm portion 210 that are foldable are respectively connected. It is installed. The treatment clip 10 may be made of, for example, a metal plate such as a leaf spring material.

The first arm part 100 and the second arm part 200 have elastic forces in the directions spaced apart from each other by the characteristics of the clip structure (for example, the ring part structure and the main body which is an elastic material).

In addition, the first subordinate arm portion 110 and the second subordinate arm portion 210 are each of the first arm portion 100 and the second arm portion 200 by the elastic members 130 and 230 (for example, elastic rubber) which will be described later. ) Is forced to stand in the direction of extension. Here, the force to be erected refers to the first arm part 100 from the state in which the first subordinate arm part 110 and the second subordinate arm part 210 are folded inside the first arm part 100 and the second arm part 200, respectively. And a force to be converted to a state parallel to or in a state close to the extension direction of the second arm part 200.

On the other hand, in the figure (FIG. 2), the state in which the upright operation | movement of each other is restrict | limited by the 1st subordinate arm part 110 and the 2nd subordinate arm part 210 contacting each other is shown.

That is, in the treatment clip 10 according to the preferred embodiment of the present invention, as the separation distance between the first arm part 100 and the second arm part 200 increases, the first subordinate arm part 110 and the second subordinate arm part At the moment when the contact state between 210 is released, each subordinate arm part 110 and 210 is made to stand upright while rotating about the hinge shafts 120 and 220 according to the elastic force of the elastic members 130 and 230.

Meanwhile, in the drawings related to the embodiments of FIGS. 2 to 9, the first arm part 100 and 100 ″, the first subordinate arm parts 110 and 110 ′ and 110 ′ ″ and the second arm part ( 200, 200 '' and the second subordinate arm portions 210, 210 ', 210' '' are shown to form a pivoting structure around the hinge shafts 120, 220, but the treatment clip 10 of the present invention , 10 ', 10' ', 10' '' 'are not necessarily limited to this structure. That is, the treatment clips 10, 10 ′, 10 ″, 10 ″ ″ of the present invention may include the first arm 100, 100 ″ and the first subordinate arm 110, 110 ′, 110 ′ ″. ) And the second arm 200, 200 ″ and the second subordinate arm 210, 210 ′, 210 ′ ″ may include all types of joint-joined structures. However, in the following description, for the sake of convenience, the therapeutic clips 10, 10 ′, 10 ″, 10 ″ ″ will be described as an example in which a joint joint is formed by the hinge axes 120 and 220.

3A and 3B, the joint structure of the treatment clip 10 according to the first preferred embodiment of the present invention will be described in detail. The first subordinate arm 110 may be formed by the hinge shaft 120. An elastic member 130 is hinged to the first arm 100 and is provided between the first arm 100 and the first subordinate arm 110 to provide a force for rotating the first subordinate arm 110. It is.

According to a preferred embodiment, the elastic member 130 may be a belt-type elastic rubber having an elastic recovery force.

According to a preferred embodiment, the elastic member 130 is at least one of the adhesive method, thermocompression method, high frequency attachment method, photopolymerization method, bolt fixing method one end is attached to the first arm portion 100 and the other end is first It may be attached to the subordinate arm 110. For example, adhesive bonding is fixed to the hinge portion of the first arm portion 100 by thermocompression bonding in one way, and the other end of the elastic member 130 is similarly fixed to the first subordinate arm portion 110. The elastic member 130 may be installed between the first arm part 100 and the first subordinate arm part 110 by adhesive fixing to the hinge portion of the hinge. In addition, as another embodiment, the elastic member 130 may be installed and fixed at one end and the other end of the first arm 100 and the first subordinate arm 110 by the bolt fixing method. .

At the hinge side end of the first subordinate arm part 110, a locking part 111 is formed to extend further to a length beyond the hinge axis 120.

The locking portion 111 acts as a hinge stopper for regulating the rotational motion of the first subordinate arm portion 110 within a predetermined angle range. The lower end surface of the latching part 111 in the hinge side direction is interviewed with one side surface of the first arm part 100 when the first subordinate arm part 110 is completely upright, whereby further rotation is restricted.

According to a preferred embodiment, an inclined surface 113 is formed at a lower end surface in the hinge side direction of the catching part 111 so that the first subordinate arm part 110 stands up at a desired angle with the first arm part when the first subordinate arm part 110 is completely upright. Formed. Accordingly, the upright angle of the first subordinate arm part 110 can be adjusted. For example, in order to widen the width of the first arm 100 and the first subordinate arm 110, the inclined surface 113 is formed to have a gentle angle, and the first arm 100 and the first subordinate arm part ( In order to narrow the width of the 110, the inclined surface 113 may be formed to have a steep angle.

Meanwhile, in the drawings related to the embodiments of FIGS. 3 to 9 attached to the present specification, the locking parts 111 and 111 ′ are shown to be formed in the first subordinate arm parts 110, 110 ′ and 110 ′ ″. The treatment clip 10, 10 ', 10' ', 10' '' 'of the present invention is not necessarily limited to this structure. That is, the treatment clip 10, 10 ′, 10 ″, 10 ″ ″ of the present invention includes a locking portion for restricting rotation of the first subordinate arm parts 110, 110 ′, 110 ″ ″ of the first arm part. (100, 100 ''). However, hereinafter, for convenience, the locking parts 111 and 111 ′ will be described with an example formed on the first subordinate arm parts 110, 110 ′ and 110 ′ ″.

Since the joint structure between the second arm part 200 and the second subordinate arm part 210 is the same as the joint structure between the first arm part 100 and the first subordinate arm part 110 described above, the hinge axis 120 described above is described. The detailed structures of the elastic rubber (belt-type elastic rubber) 130 and the locking portion 111 may be similarly applied to the second arm 200 and the second subordinate arm 210.

4 is a view illustrating a clip unit and a clip device to which a treatment clip is applied according to a preferred embodiment of the present invention.

The clip unit 1 according to the preferred embodiment of the present invention includes a first arm part 100 (including the first subordinate arm part 110) and a second arm part 200 (the second subordinate arm part constituting the clip 10). And control the operation of the clip 10 to ultimately grip the edge of the “site to be treated” (ie, pinch).

Further, the clip devices 1 and 2 according to the preferred embodiment of the present invention are devices in which the clip unit 1 and the clip unit operating device 2 for operating the clip unit 1 are combined. Here, the clip unit operating device 2 is inserted into the treatment instrument insertion channel of the endoscope 3 while being connected to the clip unit 1 to directly control the operation of the clip unit 1.

In addition, the "site to be treated" includes a tissue site in which a suture procedure is to be performed for a wound or the like and a tissue site in which a removal procedure is to be removed for a cancer cell or the like. In the following description, the clip unit 1 will be described by taking an example of a case where a wound occurs and a suture procedure is required for convenience of explanation, but the clip unit 1 of the present invention can be applied to not only tissue suture procedure but also tissue removal procedure.

The clip unit 1 includes a treatment clip 10, a connection member 20 for hanging the hook portion 300 of the treatment clip 10, and a connection member 20 for the loop portion of the treatment clip 10. It includes the pressure pipe 30 to be inserted into the state 300.

The connection member 20 is a member that enters and retracts the inside of the cylindrical press tube 30. At the front end of the connecting member 20, a hook structure 21 for hanging the ring portion 300 of the clip 10 is formed. In the figure (FIG. 4), the hook structure 21 which hung the ring part 300 is shown in the state into which the predetermined depth drawn in the press pipe 30. In addition, at the base end of the connecting member 20, a binding structure (not shown) connected to the connecting mechanism 2c of the clip unit operating device 2 is formed. In FIG. 4, the state in which the cone-shaped connection mechanism 2c formed in the front-end | tip of the wire 2a of the clip unit operating device 2 is connected to the binding structure (not shown) of the connection member 20 is shown.

The pressure pipe 30 is formed in a cylindrical shape as a whole, and a locking structure 31 capable of protruding and recessing is formed on the outer circumferential surface of the body. The locking structure 31 restricts the pressure pipe 30 from entering the pipe 2b after passing through the pipe 2b of the clip unit operating device 2.

5A to 5E are diagrams for explaining a gripping (picking) operating mechanism of the clip unit 1 to which the treatment clip 10 is applied according to a preferred embodiment of the present invention.

As shown in Fig. 5A, in accordance with the user's operation, the clip unit 1 is connected to the connecting mechanism 2c formed at the tip of the wire 2a constituting the clip unit operating device 2, and thus the tube 2b. Is penetrated and penetrates into the patient's organs. At this time, the first arm part 100 and the second arm part 200 of the treatment clip 10 are substantially parallel, and each of the first subordinate arm part 110 and the second subordinate arm part 210 is the first arm part 100. ) And the second arm 200 are folded into the inside. On the other hand, in the state of FIG. 5A, the locking structure 31 formed on the outer circumferential surface of the pressing tube 30 of the clip unit 1 is pressed by the tube body 2b and recessed.

Next, as shown in FIG. 5B, when the wire 2a of the clip unit operating device 2 is pushed to the tip end side of the tube 2b according to the user's operation, the clip unit 1 is the tube 2b. After passing through the tip of the discharged to the outside of the tube (2b). At this time, as the treatment clip 10 is completely released from the tubular body 2b, the first arm part 100 and the second arm part 200 are opened by the elastic force of the material forming the clip 10. However, since the first subordinate arm 110 and the second subordinate arm 210 are in contact with each other, the upright operation of each other is restricted (that is, still folded). Meanwhile, in the state of FIG. 5B, the locking structure 31 formed on the outer circumferential surface of the pressure pipe 30 of the clip unit 1 protrudes out as it is discharged to the outside of the pipe body 2b.

Next, as shown in FIG. 5C, when the wire 2a of the clip unit operating device 2 is pulled toward the user side according to the user's operation, the clip unit 1 connected to the wire 2a is also pulled toward the user side. The hooking structure 31 which protrudes on the outer circumferential surface of the pressure pipe 30 is caught by the front end of the clip unit operating device 2 and the tubular body 2b, whereby the pressure pipe 30 of the clip unit 1 is a tubular body ( 2b) no further entry into the interior is regulated. The treatment clip 10 in FIG. 5C is the same as in FIG. 5B.

Next, as shown in FIG. 5D, in the state where the press pipe 30 of the clip unit 1 is restricted from entering the inside of the pipe body 2b by the locking structure 31 which protrudes outward, Therefore, when the wire 2a of the clip unit operating device 2 is further pulled toward the user side, the connecting member 20 of the clip unit 1 connected to the wire 2a is further pulled toward the user side (at this time, the pressure pipe 30 is still regulated to enter the inside of the tubular body 2b), the ring portion 300 of the treatment clip 10 is forcibly drawn into the pressing tube 30. Accordingly, the first arm part 100 and the second arm part 200 of the clip 10 become wider than the state of FIG. 5C and are folded inside the first arm part 100 and the second arm part 200. While the first subordinate arm 110 and the second subordinate arm 210 are in contact with each other, the first subordinate arm 110 and the second subordinate arm 210 are momentarily erected by the elastic force of the elastic member 130.

Next, as shown in Fig. 5E, when the wire 2a of the clip unit operating device 2 is further pulled toward the user side according to the user's operation, the connecting member of the clip unit 1 connected to the wire 2a ( 20 is also pulled further toward the user side (the pressure tube 30 is still regulated to enter the inside of the tubular body 2b), the lower part of the first arm part 100 and the lower part of the second arm part 200 It is forcibly drawn into the pressure pipe 30. As the lower part of the first arm part 100 and the lower part of the second arm part 200 are forced to the inside of the pressure pipe 30, the first arm part 100 and the second arm part 200 are moved close to each other (that is, Taken home, house). As the lower part of the first arm part 100 and the lower part of the second arm part 200 are forced into the pressure pipe 30 more, the first arm part 100 and the second arm part 200 are completely parallel to each other. In this case, the gripping force (ie, the clamping force) between the first subordinate arm 110 and the second subordinate arm 210 is maximized.

The clip unit 1 to which the therapeutic clip 10 is applied according to the preferred embodiment of the present invention may take an operation (ie, a pinching operation) of gripping an edge of a region to be treated according to the above-described operations of FIGS. 5A to 5E. have. In particular, the treatment clip 10 according to the preferred embodiment of the present invention is folded when approaching the site to be treated, and then expands as a ratio at the stage immediately before the operation of picking up the edge of the site to be treated. ) And the second subordinate arm 210 are very useful for suturing or removing large areas of tissue damage.

Second Embodiment

6A and 6B are side and perspective views, respectively, showing enlarged joint portions of the treatment clip according to the second preferred embodiment of the present invention.

In the therapeutic clip 10 'according to the second preferred embodiment of the present invention, only the joint structure of the clip 10' is different from the above-described first embodiment, and the rest of the structure is the same as the first embodiment. .

Hereinafter, the treatment clip 10 'according to the second preferred embodiment of the present invention will be described with reference to FIGS. 6A and 6B. Here, the difference from the first embodiment described above (that is, the clip 10') will be described. Will be described, and the same matters as in the above-described first embodiment will be omitted.

As shown in FIGS. 6A and 6B, the joint structure of the treatment clip 10 ′ according to the second preferred embodiment of the present invention includes a first arm part with a hinge axis 120 of the first subordinate arm part 110 ′. It is hinged to the (100), the force on the outer peripheral surface of the hinge axis 120 to rotate the first subordinate arm portion 110 'in a direction away from the first arm portion 100 and the first subordinate arm portion 110'. An elastic member 130 'to be provided is provided. According to a preferred embodiment, the elastic member 130 ′ may be a torsion spring.

The hinge side end of the first subordinate arm portion 110 'is formed with a latching portion 111' that extends further to a length beyond the hinge axis 120.

The engaging portion 111 'acts as a hinge stopper for regulating the rotational operation of the first subordinate arm portion 110' within a predetermined angle range. The lower end surface in the hinge side direction of the engaging portion 111 ′ is interviewed with one side surface of the first arm portion 100 when the first subordinate arm portion 110 ′ is completely upright, whereby further rotation is prohibited.

According to a preferred embodiment, the lower end surface of the latching portion 111 'in the hinge side direction when the first subordinate arm portion 110' is completely upright, the inclined surface shaved to stand up at a desired angle with the first arm portion 100 ( 113 ') is formed. Accordingly, the upright angle of the first subordinate arm part 110 ′ can be adjusted.

The joint structure between the second arm part 200 and the second subordinate arm part (not shown) may be configured in the same manner as the joint structure between the first arm part 100 and the first subordinate arm part 110 ′. In other words, the detailed structure of the hinge shaft 120, the elastic member 130 ′, and the locking portion 111 ′ may be equally applied to the joint structure between the second arm 200 and the second subordinate arm part (not shown). Can be.

[Third Embodiment]

FIG. 7A is a perspective view schematically illustrating a structure of a treatment clip according to a third exemplary embodiment of the present invention, and FIG. 7B is a view showing a state in which the cascades of the multi-stage dependent components constituting the clip of FIG. 7A are all upright.

The therapeutic clip 10 ″ according to the third preferred embodiment of the present invention has the first fact that the first subordinate arm 110 and the second subordinate arm 210 in the first embodiment are composed of a multi-stage segment. It differs from the embodiment only, and the rest of the structure is the same as that of the first embodiment.

Hereinafter, a treatment clip 10 ″ according to a third preferred embodiment of the present invention will be described with reference to FIGS. 7A and 7B, but here, a difference from the first embodiment described above (that is, a multi-stage node) will be described. The first subordinate arm portion and the second subordinate arm portion configured) will be described mainly, and the descriptions of the same matters as those of the above-described first embodiment will be omitted.

In addition, since the therapeutic clip 10 '' according to the third preferred embodiment of the present invention is characterized in that the first subordinate cancer part and the second subordinate cancer part are composed of a multi-stage segment, those skilled in the art will appreciate that the first subordinate cancer part is one of those skilled in the art. And it will be understood that the second subordinate dark portion may consist of at least three stages. 7A and 7B show an example in which the first subordinate arm part and the second subordinate arm part are each composed of four steps, but the treatment clip 100 ″ according to the third preferred embodiment of the present invention is shown. 8A and 8B, of course, the first subordinate arm part and the second subordinate arm part may be configured in three stages, respectively.

As shown in FIG. 7A, the first sub-node 110a is hinged by a hinge shaft 120a on the side of the first arm 100 of the treatment clip 10 ″ according to the third preferred embodiment of the present invention. Is hinged to the arm portion 100, the second subordinate body (110b) is hinged to the first subordinate body (110a) by the hinge axis (120b), and performing the operation of directly picking up the site to be treated The third subordinate body 110c is hinged to the second subordinate arm portion 110b by the hinge axis 120c.

According to a preferred embodiment, each of the hinge shaft (120a ~ 120c) in the vicinity of each of the two hinged joints (110-110a, 110a-110b, 110b-110c) elastic member for transmitting the rotational force (not shown May be installed.

Further, in accordance with a preferred embodiment, the hinge side ends of each of the first to third subordinate nodes 110a to 110c are each latched portions (not shown) extending further in length beyond the respective hinge axes 120a to 120c. H) may be formed. Each engaging portion (not shown) here acts as a hinge stopper for regulating the rotational operation of each of the first to third subordinate bodies 110a to 110c within a predetermined angle range.

In addition, the multi-stage dependent nodes 210a to 210c on the second arm part 200 side may be configured in the same manner as the structures of the multi-stage dependent nodes 110a to 110c on the side of the first arm part 100 described above.

In the therapeutic clip 10 ″ according to the third preferred embodiment of the present invention, the multi-stage subordinate nodes 110a to 110c and 210a to 210c have the first arm part 100 and the second arm when approaching the site to be treated. It is folded inside the arm part 200 (ie, multi-stage dependent nodes 110a-110c, 210a-210c are folded into the inner side of the first arm part 100 and the second arm part 200) to be treated. Since the structure adopts a multi-stage upright structure at the stage just before the operation of picking up the edge of the site, it is very useful for suturing or removing a site having a relatively large width of tissue damage.

In FIG. 7B, the multi-stage dependent nodes 110a to 110c and 210a to 210c of the first arm part 100 side and the second arm part 200 side of the treatment clip 10 ″ according to the third preferred embodiment of the present invention. ) Are all upright.

[Fourth Embodiment]

FIG. 9A is a perspective view showing the structure of the treatment clip 10 '' 'according to the fourth preferred embodiment of the present invention, and FIG. 9B is a first dependent arm portion 110 constituting the treatment clip 10' ''. '') And the second slave arm 210 '' are erected to stand upright.

First, referring to FIG. 9A, the treatment clip 10 ′ ″ according to the fourth preferred embodiment of the present invention includes a first arm portion 100 ′ which picks up one edge of a portion to be treated (hereinafter, “target”). The second arm part 200 ′ picks up the other edge of the target, and the first arm part 100 ′ and the second arm part 100 ′ and the second arm part 200 ′ are connected to each other. Arm portions 200 'are each bent to form a ring portion 300'. In addition, slots 140 and 240 for inserting subordinate arm portions are formed at respective ends of the first arm portion 100 'and the second arm portion 200' constituting the treatment clip 10 '. Each slot portion 140 of the first arm portion 100 'and the slot portion 240 of the second arm portion 200' are each of the first subordinate arm portion 110 " 2 slave arm 210 ''.

Such a treatment clip 10 '' 'may be made of a metal plate such as a leaf spring material.

The first arm part 100 ′ and the second arm part 200 ′ have elastic force in the direction spaced apart from each other by the characteristics of the clip structure (eg, the ring part structure and the main body of the elastic material).

In addition, the first subordinate arm portion 110 '' and the second subordinate arm portion 210 '' extend from the respective slot portions 140 and 240 and are connected to the elastic members 145 and 245 (for example, elastic rubber). ) Is subjected to a force in a direction to be inserted into the slot of the slave arm insertion slot portion (140, 240).

Meanwhile, in the drawing (FIG. 9A), the first slave arm 110 ″ and the second slave arm 210 ″ abut each other, so that each slave arm 110 ″ and 210 ″ may be inserted into the slot 140. The state in which the operation to be inserted into the slot of 240 is regulated is shown.

That is, as the separation distance between the first arm part 100 'and the second arm part 200' increases due to the operation of the clip unit operating device 2 or the like, the first subordinate arm part 110 '' and the second subordinate arm part ( At the moment when the contact state of 210 "is released, each subordinate arm part 110", 210 "is inserted into the slot of the slot part 140, 240 by the elastic force of the elastic member 145, 245, and makes it stand upright. do.

According to a preferred embodiment, the slave arm insertion slot 140 is the first bent portion 141 and the first bent portion (141) which is the outermost bent portion of the end of the leaf spring member forming the first arm portion 100 '. The internal space (slot) may be formed by the second bent portion 143 formed to be spaced apart from the 141 by a predetermined distance. Similarly, the slave arm insertion slot portion 240 includes a first bent portion 241, an outermost bent portion of the end of the leaf spring member forming the first arm portion 200 ′, and a first bent portion 241. It can be configured to form an internal space (slot) by the second bent portion 243 formed to be spaced apart by a predetermined distance.

Further, according to a preferred embodiment, each of the first subordinate arm portion 110 ″ and the second subordinate arm portion 210 ″ in the slot of the slave arm insertion slot portion 140, 240 is a slot portion 140, One or more locking jaws 144 and 244 may be formed to restrict deviation after being fitted into the inside of the 240. For example, the locking projections 144 and 244 may be formed in a structure in which a width thereof increases toward the bottom surface of the slot.

In addition, according to a preferred embodiment, each of the first subordinate arm portion 110 ″ and the second subordinate arm portion 210 ″ has different latching jaws 142 and 242 having a structure that is caught by the engaging jaws 144 and 244. Each can be formed.

In addition, according to a preferred embodiment, the elastic members 145 and 245 may be adhesively fixed to the bottom surface of the slot formed in the slots 140 and 240, and may be adhesively fixed to the inner wall surface of the slot.

Next, referring to FIG. 9B, an operation in which the first subordinate arm 110 ″ and the second subordinate arm 210 ″ of the treatment clip 10 ′ ″ according to the fourth exemplary embodiment of the present invention stands upright. In the following description, the first slave arm 110 '' and the second slave arm 210 '' are respectively dependent arm portions by elastic members 145 and 245 extending from and connected to the respective slot portions 140 and 240, respectively. Receives a force in a direction to be inserted into the slot of the insertion slot portion 140,240.

However, when the opening angles of the first arm part 100 'and the second arm part 200' are small, the first subordinate arm part 110 '' and the second subordinate arm part 210 '' are in contact with each other. Upright operation (operation fitted to the slots 140 and 240) is regulated.

On the other hand, as the separation distance between the first arm part 100 'and the second arm part 200' increases due to the operation of the clip unit operating device 2 or the like, the first subordinate arm part 110 '' and the second subordinate arm part ( At the moment when the abutment state of the 210 '' is released, the first subordinate arm portion 110 '' and the second subordinate arm portion 210 '' are drawn by the respective elastic members 145 and 245 to form the slot portion 140. , 240). This state is shown in FIG. 9B.

The treatment clip 10 ′ ″ according to the fourth preferred embodiment of the present invention is folded when approaching the site to be treated, and then slot portions 140 and 240 as a step just before the operation of picking up the edge of the site to be treated. The first subordinate arm portion 110 " and the second subordinate arm portion 210 ", which are fitted (upright), are employed, so that they are very useful for suturing or removing large areas of tissue damage.

[Fifth Embodiment]

FIG. 10A is a perspective view schematically illustrating a structure of a treatment clip according to a fifth exemplary embodiment of the present invention, and FIG. 10B illustrates respective dependent arm parts 110 ′ ″ and 210 ′ ″ constituting the clip of FIG. 10A. This fully expanded state is shown and FIG. 10C is a figure which shows the operation state of the clip of FIG. 10A.

As shown in FIG. 10A, respective ends of the first arm part 100 ″ and the second arm part 200 ″ constituting the treatment clip 10 ″ ″ according to the fifth preferred embodiment of the present invention. The first subordinate arm portion 110 '' 'and the second subordinate arm portion 210' '' which are connected in a structure that can be deployed in an inclined direction as viewed from the side are respectively provided. The other configuration is the same as the treatment clip 10 of the first embodiment.

In this case, the first subordinate arm 110 '' 'and the second subordinate arm 210' '' are the hinge axes 120 'and 220', respectively, in terms of a structure that can be deployed in an inclined direction when viewed from the side. In the fully deployed state, the extension direction of the first subordinate arm 110 '' 'and the second subordinate arm 210' '' as viewed from the side is the first arm 100 '' and the second arm 200 '') Is shifted by a predetermined angle, and the first slave arm 110 '' 'and the second slave arm 210' '' are folded along the respective hinge axes 120 ', 220'. In the side view, the extension direction of the first subordinate arm 110 '' 'and the second subordinate arm 210' '' extends from the first arm 100 '' and the second arm 200 ''. It refers to a structure superimposed on one another in a direction.

In addition, the extending direction of the first subordinate arm portion 110 ′ ″ and the second subordinate arm portion 210 ′ ″ may be defined by the extending direction of the first arm portion 100 ″ and the second arm portion 200 ″. The shift of the angle of the angle is that the first subordinate arm 110 '' 'and the second subordinate arm 210' '' are the first arm 100 '' and the second arm 200 '' as viewed from the side. It means to achieve an arbitrary angled form from 0 ° to 180 °. Meanwhile, as described above, the angles of bending of the first subordinate arm 110 '' 'and the second subordinate arm 210' '' may be implemented by changing the structures of the hinge axes 120 'and 220'. same. For example, when the hinge shafts 120 'and 220' are installed in an inclined form by 45 °, the angles of bending of the first slave arm 110 '' 'and the second slave arm 210' '' are also 45 degrees. ° is achieved. Similarly, by changing the structures of the hinge axes 120 'and 220', respectively, the angles at which the first subordinate arm 110 '' 'and the second subordinate arm 210' '' are 60 °, 90 degrees and 120 degrees can be formed.

Meanwhile, in FIG. 10A, the hinge shaft 120 ′ in which each joint portion of the first arm portion 100 ″ and the second arm portion 200 ″ constituting the treatment clip 10 ″ ″ is tilted about 45 °. It is formed by).

10B shows that the first subordinate arm 110 '' 'and the second subordinate arm 210' '' of the therapeutic clip 10 '' '' according to the fifth embodiment of the present invention are respectively the first arm The state developed from 100 ″ and the second arm 200 ″ is shown.

That is, the treatment clip 10 ″ ″ according to the fifth embodiment of the present invention has a first dependency as the separation distance between the first arm 100 ″ and the second arm 200 ″ increases. At the moment when the contact between the arm portion 110 '' 'and the second subordinate arm portion 210' '' is released, each of the subordinate arm portions 110 '' 'and 210' '' is formed of the elastic members 130 and 230. It is deployed while rotating around the hinge shaft (120 ', 220') according to the elastic force of the. In addition, when each subordinate arm part 110 '' ', 210' '' is fully developed from the first arm part 100 '' and the second arm part 200 '', the first subordinate arm part (viewed from the side) 110 '' 'and the extending direction of the second subordinate arm portion 210' '' are shifted from the extending direction of the first arm portion 100 '' and the second arm portion 200 '' by a predetermined angle S. .

The therapeutic clip 10 '' '' according to the fifth preferred embodiment of the present invention adopts a structure that is folded when approaching the site to be treated and developed as a rain at the stage just before the operation of picking up the edge of the site to be treated. Therefore, it is very useful for suturing or removing large areas of tissue damage.

In particular, the therapeutic clip 10 ″ ″ according to the fifth preferred embodiment of the present invention includes a first slave arm 110 ′ ″ and a second slave arm 210 ′ ″ in its deployed state. ) Is bent from the first arm portion 100 '' and the second arm portion 200 '' by a predetermined angle S, so that a wound formed at a location difficult to access by a conventional treatment clip Suitable for the treatment of the site. For example, even in the case of the wound portion 4 located in the vertical lower portion of the treatment clip 10 '' '' as shown in FIG. 10C, when the treatment clip 10 '' '' of the present embodiment is used. In the structure of the first subordinate arm portion 110 '' 'and the second subordinate arm portion 210' '', which are bent by a predetermined angle S, the wound site can be easily removed without greatly rotating the endoscope 3. Can be gripped. Thereby, the operating radius curable by the endoscope 3 can be widened.

[Use of Clip Unit]

11A to 11E are views for explaining a use state of a clip unit to which a therapeutic clip according to an exemplary embodiment of the present invention is applied.

As shown in Fig. 11A, the clip unit 1 is attached to the clip unit operating device 2 operated by being inserted into the treatment instrument insertion channel of the endoscope 3 and penetrates into the patient's organ. At this time, each of the first subordinate arm part 110 and the second subordinate arm part 210 is folded into the first arm part 100 and the second arm part 200.

Next, as shown in FIG. 11B, the endoscope 3 is operated to bring the clip unit 1 near the site 4 to be treated in the organ. At this time, since each of the first subordinate arm 110 and the second subordinate arm 210 is still folded into the first arm 100 and the second arm 200, the endoscope 3 may be operated even in a narrow space. It is easy to

Next, as shown in FIG. 11C, after bringing the clip unit 1 closer to the front surface of the portion 4 to be treated, the clip unit operating device 2 is operated to operate the first slave arm 110 and the first slave arm 110. Each of the two subordinate arm portions 210 is erected. At this time, since the effect of extending the first arm portion 100 and the second arm portion 200 by a length in which the first subordinate arm portion 110 and the second subordinate arm portion 210 stand up occurs, the width of the portion 4 to be treated Even in this large case, the edge of the portion 4 can be easily folded.

Next, as shown in FIG. 11D, the clip unit operating device (not shown) operates the clip in a state in which the first slave arm 110 and the second slave arm 210 cut the edge of the portion 4 to be treated. The clip unit 1 is detached from the unit operating device 2.

Next, as shown in FIG. 11E, after a predetermined time has elapsed, the wound site 4 is naturally closed about a position closed by the first subordinate arm 110 and the second subordinate arm 210. In addition, the tissue 41 collapsed and necrosed by the first subordinate arm 110 and the second subordinate arm 210 is separated from the wound site 4 and then discharged out of the body through the bowel movement with the clip unit 1. do.

10: treatment clip 100: first female part
110: first slave arm 111: engaging portion
120: hinge axis 130: elastic member
200: second arm portion 210: second dependent arm portion
220: hinge axis 300: ring portion

Claims (13)

A first arm part and a second arm part pressed against each other with the target therebetween;
A ring portion connecting one end portion of the first arm portion and the second arm portion to each other;
A first subordinate arm portion articulated to the other end of the first arm portion; And
The therapeutic clip comprising a second subordinate arm portion articulated to the other end of the second arm portion. The method of claim 1,
A first elastic member connected between the first arm part and the first subordinate arm part to provide a force that the first arm part and the first subordinate arm part open to each other; And
And a second elastic member connected between the second arm portion and the second subordinate arm portion to provide a force to spread the second arm portion and the second subordinate arm portion. The method of claim 2,
The first elastic member and the second elastic member is a therapeutic clip of any one of an elastic rubber, a torsion spring. The method of claim 2,
One end of the first elastic member and the second elastic member are attached to the first arm portion and the second arm portion by at least one of an adhesive method, a thermocompression method, a high frequency attachment method, a photopolymerization method, and a bolt fixing method. A therapeutic clip, the other end of which is attached to the first and second subordinate cancer portions, respectively. The method of claim 1,
In the case where the first subordinate arm part and the second subordinate arm part are respectively deployed, the extending directions of the first subordinate arm part and the second subordinate arm part have a form shifted from the extending direction of the first arm part and the second arm part, respectively. Treatment clip, characterized in that. The method of claim 1,
The first subordinate arm portion and the second subordinate arm portion each include a plurality of joints jointed with each other,
Each clip is a therapeutic clip connected by an elastic member that provides a force to break apart. The method according to claim 6,
Each of the plurality of nodes is a therapeutic clip folded inwardly between the first arm portion and the second arm portion. The method of claim 1,
A first catching part protruding from one of the first arm part and the first subordinate arm part toward the other; And
And a second locking portion protruding from one of the second arm portion and the second subordinate arm portion toward the other. The method of claim 8,
A first inclined surface is formed on a surface of the first engaging portion in contact with the first arm portion or the first subordinate arm portion.
The treatment clip of claim 2, wherein a second inclined surface is formed on a surface of the second catching portion that is in contact with the second arm portion or the second subordinate arm portion. A first arm part and a second arm part pressed against each other with the target therebetween;
A ring portion connecting one end portion of the first arm portion and the second arm portion to each other;
First and second slot portions respectively formed at the other ends of the first arm portion and the second arm portion;
A first subordinate arm portion, one end of which is inserted into the first slot portion;
A first elastic member interposed between the first slot portion and the first subordinate arm portion to transmit an elastic force;
A second subordinate arm portion, one end of which is inserted into the second slot portion; And
And a second elastic member interposed between the second slot portion and the second subordinate arm portion to transmit an elastic force. The method of claim 10,
The first subordinate arm portion and the second subordinate arm portion further include a first engaging jaw at one end portion inserted into the first slot portion and the second slot portion, respectively, and the first slot portion and the second slot portion The treatment clip further comprises a second locking jaw respectively coupled to the first locking jaw therein. A first arm portion and a second arm portion compressed to each other with a target interposed therebetween, a ring portion connecting one end portion of the first arm portion and the second arm portion to each other, and a first subordinate arm portion jointly bonded to the other end of the first arm portion And a treatment clip including a second subordinate arm portion articulated to the other end of the second arm portion.
A connection member connected to the ring portion of the treatment clip; And
And a compression tube inserted into the connection member in a state in which it is connected to the ring portion. The therapeutic clip unit according to claim 12,
A wire connected to the connection member of the treatment clip;
And a tubular body inserted into the endoscope to serve as a passage for the clip unit and the connecting member.

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