WO2021156930A1 - アプリケータおよび結紮装置 - Google Patents

アプリケータおよび結紮装置 Download PDF

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Publication number
WO2021156930A1
WO2021156930A1 PCT/JP2020/004050 JP2020004050W WO2021156930A1 WO 2021156930 A1 WO2021156930 A1 WO 2021156930A1 JP 2020004050 W JP2020004050 W JP 2020004050W WO 2021156930 A1 WO2021156930 A1 WO 2021156930A1
Authority
WO
WIPO (PCT)
Prior art keywords
connector
diameter portion
power transmission
transmission member
arm
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2020/004050
Other languages
English (en)
French (fr)
Japanese (ja)
Inventor
利博 吉井
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to CN202512001406.2A priority Critical patent/CN121570213A/zh
Priority to CN202080095466.8A priority patent/CN115038392B/zh
Priority to PCT/JP2020/004050 priority patent/WO2021156930A1/ja
Priority to JP2021575122A priority patent/JP7508490B2/ja
Publication of WO2021156930A1 publication Critical patent/WO2021156930A1/ja
Priority to US17/879,448 priority patent/US12440220B2/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227—Spring clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/128—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00336—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00862—Material properties elastic or resilient

Definitions

  • the present invention relates to an applicator, more specifically, an applicator to which an indwelling device for ligating tissue is attached, and a ligation device provided with this applicator.
  • Ligation using an indwelling device such as a clip unit is known as a procedure performed using an endoscope.
  • the clip unit has a pair of arms. When the pair of arms is pulled by a predetermined amount with the pair of arms sandwiching the tissue, the pair of arms are locked with the tissue strongly tightened.
  • the clip unit is introduced into the body while being attached to the applicator. Since the clip unit is placed in the body with the tissue ligated, it must be separated from the applicator after the pair of arms are locked.
  • the operator closes the pair of arms, tightens the target tissue, and confirms that the ligation is sufficient while checking the gripping position. If it is determined that the ligation is insufficient, the pair of arms is opened to release the tightening of the target tissue, and the ligation operation is performed again. Then, when it is determined that the ligation is sufficient, the arm is locked. At this time, the operator recognizes the gap in competence because the operating force (locking force) required to lock the arm of the clip unit is significantly larger than the force required to ligate the target tissue. It is possible to operate without accidentally locking the arm.
  • the amount of operating force (locking force) required to lock the arm of the clip unit changes depending on the reaction force received from the target tissue sandwiched by the arm. The harder the target tissue, the greater the locking force.
  • the operating force (release force) required for releasing the connection is usually set to be larger than the locking force. Further, from the viewpoint of securing the above-mentioned gap, the locking force may be set even larger.
  • the release force is set based on the locking force when the arm sandwiches a tissue of average hardness, the connection is released even though the lock is not completed when the arm sandwiches a hard tissue. There is a possibility that This possibility can be eliminated by setting the release force based on the lock force when the arm sandwiches a hard tissue, but the release force becomes very large and may be difficult to operate.
  • an object of the present invention is to provide an applicator capable of reliably ligating a hard tissue using an indwelling device and easily detecting that the connection has been released.
  • the first aspect of the present invention is an applicator to which an indwelling device that can be indwelled in a subject is mounted.
  • the applicator is placed at a position where it comes into contact with the connector, which is detachably connected to the indwelling device, the power transmission member which is connected to the connector and moves the connector, and the power transmission member is pulled to contact the connector.
  • It has an auxiliary member. The auxiliary member deforms the connector when it comes into contact with the connector to release the connection between the connector and the indwelling device, and after the disconnection, the power transmission member is further pulled to form an opening through which the connector can pass. ..
  • the second aspect of the present invention is a ligation device including an applicator according to the first aspect and an indwelling device indwelled in a subject.
  • a detainable indwelling device that can be placed in a subject, a connector that is detachably connected, a power transmission member that is connected to the connector and for moving the connector, and a power transmission member are towed.
  • This is a method for disconnecting an indwelling device in a ligation device having an auxiliary member arranged at a position where the connector comes into contact with the connector.
  • the power transmission member is towed to bring the connector into contact with the auxiliary member.
  • the connector is deformed and the connector is separated from the indwelling device.
  • the auxiliary member is formed with an opening through which the connector can pass, and the connector is moved to the proximal end side of the auxiliary member.
  • a hard tissue can be reliably ligated using an indwelling device, and it can be easily detected that the connection has been released.
  • FIG. 1 It is an overall block diagram of the ligation apparatus which concerns on 1st Embodiment of this invention. It is a figure which shows the clip unit of the ligation apparatus. It is sectional drawing of the clip unit. It is sectional drawing of the clip unit, and shows the sectional view in the direction different from FIG. It is an enlarged cross-sectional view of the clip attachment site in the ligation device. It is a schematic diagram which shows one process of the operation of breaking the connection between an arm and a hook in the ligation device. It is a schematic diagram which shows one process of the disconnection operation of an arm and a hook. It is a figure which shows one process of the operation which a hook is pulled out from a guide pipe.
  • FIG. 1 is a diagram showing the appearance of the ligation device 1 which is the medical device of the present embodiment.
  • the ligation device 1 includes a clip unit (indwelling device) 10 to be indwelled in the body and an applicator 50 for operating the clip unit 10.
  • the clip unit 10 is attached to the tip (distal end) of the applicator 50.
  • FIG. 2 is a diagram showing the appearance of the clip unit 10.
  • FIG. 3 is a cross-sectional view of the clip unit 10.
  • the clip unit 10 includes an arm portion 20 and a holding pipe 30 in which a part of the arm portion 20 is housed.
  • the arm portion 20 has a pair of arms of a first arm 21 and a second arm 22.
  • the first arm 21 and the second arm 22 have claws 21a and 22a at their tips, respectively.
  • the first arm 21 and the second arm 22 are connected at the base end portion 20a of the arm portion 20.
  • the base end portion 20a is formed in a U shape.
  • the arm portion 20 is made of an alloy or metal. Examples of the material of the arm portion 20 include stainless steel, cobalt-chromium alloy, and nickel-titanium alloy.
  • the first arm 21 and the second arm 22 are expanded in the initial state shown in FIG. When the first arm 21 and the second arm 22 approach each other from the initial state, the elastic force of the material causes an urging force to return to the initial state.
  • the holding pipe 30 is a tubular member made of metal, resin, or the like. As shown in FIG. 3, the base end portion 20a of the arm portion 20 is housed in the holding pipe 30. The tip of the arm portion 20 projects from the tip opening 30a of the holding pipe. The base end opening 30b of the holding pipe 30 is smaller than the tip end opening 30a.
  • FIG. 4 is a view of the inside of the holding pipe 30 as viewed from a direction different from that of FIG.
  • a locking portion 23 is provided in the middle portion of each arm of the arm portion 20, and the dimensions of the locking portions 23 in the width direction of the arms 21 and 22 are increased (in the locking portion 23). Only the first arm 21 is visible in FIG. 4).
  • Each locking portion 23 can pass through the base end opening 30b when the first arm 21 and the second arm 22 approach each other. If the first arm 21 and the second arm 22 are separated from each other after passing through the base end opening 30b, the locking portion 23 cannot pass through the base end opening 30b. As a result, the arm portion 20 is locked with the pair of arms closed.
  • a coil spring 31 is arranged inside the holding pipe 30.
  • the front end of the coil spring 31 can come into contact with the rear surfaces of the first arm 21 and the second arm 22.
  • the rear end of the coil spring 31 can come into contact with the rear end surface 32 of the holding pipe having the base end opening 30b.
  • the basic structures of the arm portion 20 and the holding tube 30 described above are known and are disclosed, for example, in PCT International Publication 2014/181676.
  • the applicator 50 includes an elongated insertion portion 51, an operation wire (power transmission member) 52 passed through the insertion portion 51, and an operation portion 60 connected to the insertion portion 51.
  • a sheath formed of a coil can be used.
  • the operation unit 60 has a main body 61 connected to the insertion unit 51 and a slider 62 slidably attached to the main body 61.
  • the operation wire 52 for example, a stranded wire made of a metal wire can be used.
  • the base end portion of the operation wire 52 is connected to the slider 62. When the slider 62 is moved with respect to the main body 61, the operation wire 52 can be moved back and forth in the insertion portion 51.
  • FIG. 5 is an enlarged cross-sectional view of the tip of the applicator 50 to which the clip unit 10 is mounted.
  • a hook (connector) 70 that engages with the clip unit 10 is fixed to the tip of the operation wire 52.
  • the tip end portion of the operation wire 52 enters the holding pipe 30, and the hook 70 and the base end portion 20a of the arm portion 20 are engaged with each other.
  • the external dimension of the hook 70 is slightly smaller than the inner diameter of the coil spring 31, and can move inside the coil spring 31 without interfering with the coil spring.
  • the hook 70 has a rear portion 71 connected to the operation wire 52 and a front portion 72 that engages with the proximal end portion 20a.
  • the rear portion 71 is formed in a spindle shape that gradually shrinks as it approaches both ends in the front-rear direction, and has a bottomed hole 71a that opens at the rear end.
  • the tip of the operation wire 52 has entered the hole 71a.
  • the operation wire 52 and the hook 70 are connected by, for example, brazing. In the present embodiment, the hook 70 and the operation wire 52 are connected while maintaining a coaxial state.
  • the front portion 72 has a pair of engaging arms 73 and 74.
  • the engaging arms 73 and 74 sandwich the arm portion 20 from a direction orthogonal to the opening / closing direction of the arm portion 20.
  • the engaging arm 73 has a claw portion 75 that comes into contact with the arm portion 20, and a plate-shaped portion 76 that connects the claw portion 75 and the rear portion 71.
  • the engaging arm 74 has a claw portion 77 and a plate-shaped portion 78, and has the same shape as the engaging arm 73.
  • the engaging arms 73 and 74 are provided at positions symmetrical with respect to the central axis X1 of the hook 70.
  • a hard guide pipe (auxiliary member) 55 is attached to the tip of the insertion portion 51.
  • the inner diameter of the region on the tip end side of the guide pipe 55 is larger than the outer diameter of the holding pipe 30, and the holding pipe 30 can enter.
  • the guide pipe 55 has a reduced diameter portion 55a whose inner diameter gradually decreases as it approaches the proximal end, and the inner diameter of the small diameter portion 55b on the proximal end side of the reduced diameter portion 55a is approximately equal to the minimum inner diameter of the reduced diameter portion 55a. It is the same.
  • the outer dimension of the rear portion 71 of the hook 70 is smaller than the inner diameter of the small diameter portion 55b, and the maximum outer dimension of the front portion 72 defined by the claw portions 75 and 77 is larger than the inner diameter of the small diameter portion 55b.
  • the small diameter portion 55b is formed thinner than the reduced diameter portion 55a.
  • the insertion portion 51 and the guide pipe 55 are joined by welding or the like at the reduced diameter portion 55a. As a result, there is a gap between the small diameter portion 55b and the insertion portion 51.
  • a stopper (not shown) is attached to the operation wire 52. Since the shape and dimensions of the stopper are set so that they cannot enter the guide pipe, when the stopper comes into contact with the rear end of the guide pipe, the operation wire cannot move forward any further.
  • the operation of the ligation device 1 configured as described above when used will be described.
  • the ligation device 1 is introduced into the body via the endoscopic channel.
  • the user retracts the slider 62 by a predetermined amount and inserts the ligating device 1 in a closed and unlocked state.
  • the clip unit 10 in which the arm portion 20 is closed and the tip end portion of the insertion portion 51 may be inserted into the endoscope in a state of being housed in a separately prepared outer sheath.
  • the arm portion 20 When the ligation device 1 is projected from the channel opening at the tip of the endoscope to reduce the pulling force of the slider or retract the outer sheath, the arm portion 20 has its own elastic restoring force and the elastic restoration of the coil spring 31. Due to the force, it advances with respect to the holding tube 30. As a result, the pair of arms 21 and 22 are in an open form. When the stopper comes into contact with the rear end of the guide pipe 55, the arm portion 20 cannot advance with respect to the holding pipe 30, so that the arm portion 20 does not fall off from the holding pipe 30 and holds the open form.
  • the operation wire 52 is pulled and the arm portion 20 retracts with respect to the holding pipe 30.
  • the pair of arms 21 and 22 are closed. It becomes.
  • the user can ligate the tissue by locating the tissue between the pair of arms 21 and 22 and closing the pair of arms 21 and 22.
  • the pair of arms 21 and 22 can be changed from the closed form to the open form again. Therefore, in the ligation device 1, the clip unit 10 can be operated by the operation wire 52 to re-grasp the tissue until the lock operation is performed. As shown in FIG.
  • a regulating portion 58 having an inner diameter slightly larger than the outer diameter of the hook 70 is provided in the guide pipe 55.
  • the regulating portion 58 prevents the base end portion 20a and the hook 70 from being unintentionally disconnected.
  • the engaging arms 73 and 74 need to be separated by a certain distance or more, but the engaging arm 73 and the engaging arm are included in the regulating portion 58. There is not enough space to separate it from 74. As a result, the engagement between the hook 70 and the base end portion 20a is not released until the engaging arms 73 and 74 pass through the regulating portion 58, and the engaged state is preferably maintained.
  • the user When it is determined that the tissue located between the pair of arms 21 and 22 may be ligated, the user performs a locking operation for fixing the arm portion 20 in the closed form.
  • the lock operation the user further retracts the slider 62 with respect to the main body 61 beyond the range in which the slider 62 can be re-grasped.
  • the operation wire 52 is pulled, and the pair of arms 21 and 22 enter the holding pipe 30 in substantially parallel with each other sandwiching the tissue.
  • the locking portions 23 provided on the pair of arms 21 and 22 approach each other and have a positional relationship in which they can pass through the base end opening 30b of the holding pipe 30.
  • the pair of locking portions 23 that have passed through the base end opening 30b and moved out of the holding pipe 30 are separated again when the force received from the operation wire 52 weakens, and are in a positional relationship in which they cannot pass through the base end opening 30b.
  • the pair of locking portions 23 come into contact with the edge of the base end opening 30b to prevent the arm portion 20 from protruding from the holding pipe 30, and the arm portion 20 is locked to maintain the closed form.
  • the base end portion 20a and the hook 70 move out of the holding pipe 30 through the base end opening 30b, but the engagement state between the base end portion 20a and the hook 70 is preferably held by the regulating portion 58. Will be done.
  • the user further retracts the slider 62 after the arm portion 20 is locked, the engagement between the base end portion 20a and the hook 70 is released, and the clip unit 10 is separated from the applicator 50.
  • the operation of the hook 70 at the time of disconnection will be described in detail.
  • the claw portions 75 and 77 rotate about the connection portion with the plate-shaped portion, respectively.
  • the tip ends of the claws 75 and 77 move in a direction away from each other and separate from the base end 20a of the arm. In this way, the connection between the hook 70 and the arm portion 20 is released.
  • the tip portions of the plate-shaped portion 76 and the plate-shaped portion 78 approach each other, and the claw portions 75 and 77 further enter the small diameter portion 55b.
  • the small diameter portion 55b is thin and has a gap between it and the insertion portion 51, the small diameter portion 55b is deformed toward the inner surface of the insertion portion 51 by receiving the force when the front portion 72 of the hook 70 enters.
  • the small diameter portion 55b passes through the front portion 72 while being deformed so as to increase the inner diameter.
  • an opening Op through which the hook 70 can pass is formed in the small diameter portion 55b.
  • the inner diameter of the opening Op is larger than the inner diameter of the small diameter portion 55b before deformation.
  • the hook 70 passes through the opening Op, exits from the base end opening of the guide pipe 55, and moves toward the hand side of the guide pipe 55.
  • the hook 70 comes out of the guide pipe 55, the external force that opposes the pulling of the operation wire 52 does not act on the hook 70, so that the force required to retract the slider 62 is greatly reduced and the operation of the slider 62 becomes lighter. .. Therefore, the user can easily perceive that the clip unit 10 has been separated from the applicator 50.
  • the user removes the endoscope and the applicator 50 from the body, a series of procedures is completed.
  • the arm of the clip unit 10 is locked even when ligating a hard tissue due to the dimensional relationship between the regulation portion 58 and the claw portions 75 and 77. It is prevented that the clip unit 10 and the applicator 50 are disconnected from each other before the clip unit 10 is disconnected.
  • the claws 75 and 77 are opened and the connection between the clip unit 10 and the applicator 50 is released. Therefore, the user can release the connection simply by continuously retracting the slider 62, and the force required at that time can be made smaller than the force required when locking the arm.
  • the hook 70 after the connection is released can be pulled out from the guide pipe 55 through the opening Op formed in the small diameter portion by deforming the small diameter portion 55b so as to increase the inner diameter.
  • the operation of the slider 62 becomes significantly lighter, and the user can easily perceive that the clip unit 10 has been separated from the applicator 50.
  • the clip unit 10 can be reliably placed in a state where the hard tissue is sandwiched, and the ease of operation can be achieved at the same time.
  • FIG. 9 shows the relationship between the traction amount of the operation wire 52 and the generated force.
  • the force N increases again because the locking portion 23 needs to deform the arm portion in order to get over the base end opening. Once the lock is complete, the power N drops once. Subsequently, the force N increases again in the region R4 until the connection between the arm portion and the hook is released. Mechanically, if the maximum force value N2 in the region R4 is equal to or less than the maximum force value N1 in the region R3, the connection with the hook may be released before the arm portion is locked, and the tissue may not be ligated. be.
  • the disconnection is physically suppressed, and the rear end portion of the claw portions 75, 77 is the reduced diameter portion 55a of the guide pipe 55.
  • the maximum force value N2 is set to the maximum force value N1 or less, and the connection with the hook is released before the arm part is locked, depending only on the rigidity of the claw part. Preventing without doing.
  • the force N gradually increases, but the small diameter portion 55b is easily deformed to form an opening Op, so that the maximum region R5 is formed.
  • the competence value does not exceed the maximum competence value N1.
  • the force N rapidly decreases, so that the user is disengaged from the connection between the arm and the hook, that is, the clip unit is applied. It is easy to recognize that it has been separated from the data.
  • FIG. 10 is a diagram showing the periphery of the guide pipe 550 of the applicator 150 according to the present embodiment.
  • the guide pipe 550 is composed of two members, a first member 551 having a regulating portion 58 and a reduced diameter portion 55a, and a second member 552 having a small diameter portion 550b.
  • FIG. 11 is an external view of the guide pipe 550.
  • the second member 552 has a tubular shape, and its outer peripheral surface is divided by a slit 552a extending parallel to its own axis.
  • the second member 552 has a C-shaped cross-sectional shape, and the outer peripheral surfaces facing each other with the slit 552a interposed therebetween can approach and separate from each other.
  • the front portion of the second member 552 engages with the rear portion of the first member 551 from the outside, whereby the first member 551 and the second member 552 are integrated.
  • the front portion 72 of the hook 70 when the front portion 72 of the hook 70 enters the small diameter portion 550b, the front portion 72 pushes the second member 552 from the inside. As a result, the outer peripheral surfaces of the second member 552 facing the slit 552a are separated from each other. When the separation distance becomes a predetermined value or more, the engagement between the first member 551 and the second member 552 is disengaged, and the second member 552 is separated from the first member 551. As a result, an opening larger than the inner diameter of the small diameter portion 550b is formed at the rear end of the first member 551, so that the hook can be smoothly pulled out from the guide pipe 550.
  • the applicator 150 of the present embodiment can achieve both the reliable placement of the clip unit with the hard tissue sandwiched between them and the ease of operation.
  • the first member and the second member may be formed of the same material or may be formed of different materials.
  • the second member is made of a material that is more easily deformed than the first member, the thickness of the second member may be greater than or equal to that of the first member.
  • the shape of the first member and the shape of the second member may be formed by one member 553, and the slit 552a may be extended on the outer peripheral surface of the first member.
  • the slit may be not linear as long as the outer peripheral surface of the small diameter portion is divided.
  • regulatory members and guide pipes are not essential.
  • a regulating portion may be provided in a part of the guide pipe, or a reduced diameter portion or a small diameter portion may be formed by molding the tip portion of the sheath constituting the insertion portion.
  • an opening may be formed by tearing a part of the guide pipe or the like.
  • the cross-sectional shape of the lumen of the small diameter portion is not limited to a circle, and may be a polygon such as a square.
  • the indwelling device according to the present invention is not limited to the clip unit described above.
  • it may be a snare wire that can be placed in the body in a ligated state as described in Japanese Patent No. 4981157.
  • the power transmission member according to the present invention is not limited to the above-mentioned wire.
  • the power transmission member may be a hard rod.
  • the auxiliary member according to the present invention does not have to have a small diameter portion.
  • the power transmission member is towed and the connector deforms the base end portion of the reduced diameter portion to form an opening in the auxiliary member.
  • the present invention can be applied to an applicator used by attaching an indwelling device.
  • Ligature device 10
  • Clip unit (indwelling device) 20 Arm part 21 First arm 22 Second arm 50
  • Applicator 51
  • Insertion part 52
  • Operation wire power transmission member
  • Guide pipe auxiliary member
  • Reduced diameter part 55b
  • 550b Small diameter part
  • Hook 75, 77 Claw 552a Slit

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
PCT/JP2020/004050 2020-02-04 2020-02-04 アプリケータおよび結紮装置 Ceased WO2021156930A1 (ja)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CN202512001406.2A CN121570213A (zh) 2020-02-04 2020-02-04 供给器及结扎装置
CN202080095466.8A CN115038392B (zh) 2020-02-04 2020-02-04 供给器及结扎装置
PCT/JP2020/004050 WO2021156930A1 (ja) 2020-02-04 2020-02-04 アプリケータおよび結紮装置
JP2021575122A JP7508490B2 (ja) 2020-02-04 2020-02-04 結紮装置
US17/879,448 US12440220B2 (en) 2020-02-04 2022-08-02 Applicator and ligation device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2020/004050 WO2021156930A1 (ja) 2020-02-04 2020-02-04 アプリケータおよび結紮装置

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US17/879,448 Continuation US12440220B2 (en) 2020-02-04 2022-08-02 Applicator and ligation device

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Publication Number Publication Date
WO2021156930A1 true WO2021156930A1 (ja) 2021-08-12

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PCT/JP2020/004050 Ceased WO2021156930A1 (ja) 2020-02-04 2020-02-04 アプリケータおよび結紮装置

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US (1) US12440220B2 (https=)
JP (1) JP7508490B2 (https=)
CN (2) CN121570213A (https=)
WO (1) WO2021156930A1 (https=)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024182582A1 (en) * 2023-03-02 2024-09-06 Merit Medical Systems, Inc. Medical grasping device with slide actuator

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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US20220370076A1 (en) 2022-11-24

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