JP4070964B2 - Endoscopic clip device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope clip device that is used through a treatment instrument insertion channel of an endoscope to perform hemostasis, ligation, marking, or the like in the body.
[0002]
[Prior art]
In general, as shown in FIG. 6, the clip device for an endoscope has a clip 2 having a pair of arms 2a that are opened and closed by deforming the proximal end connecting portion 2c, and is arranged near the distal end of a sheath (not shown). A claw-like portion 2b bent inward is formed at each tip of the arm portion 2a.
[0003]
Further, a clip closing ring 6 for deforming the proximal end connecting portion 2c of the clip 2 so as to close the arm portion 2a is disposed in the distal end of the sheath so as to be detachable from the sheath.
[0004]
Then, by pushing the clip closing ring 6 over the proximal end connecting portion 2c of the clip 2 with the operation movement transmitting member inserted and disposed in the sheath, the arm portion 2a is closed, and as shown in FIG. The clip 2 can be placed in the affected area while the part 2b is stuck in the mucous membrane.
[0005]
[Problems to be solved by the invention]
However, in the conventional endoscope clip device, the angle formed by the claw-shaped portion 2b with respect to the arm portion 2a is a right angle or an obtuse angle (for example, Japanese Patent Publication No. 8-17778). When an external force is applied, the nail-like portion 2b comes out of the mucous membrane, and the clip 2 is detached from the affected area 100 relatively easily.
[0006]
SUMMARY OF THE INVENTION An object of the present invention is to provide an endoscopic clip device having a good indwelling property in which an indwelling clip does not easily fall off from an affected part due to an external force or the like.
[0007]
[Means for Solving the Problems]
In order to achieve the above object, the clip device for an endoscope of the present invention has a clip formed so that a pair of arms connected at the base end side open and close by deforming the vicinity of the base end connecting portion. And a clip closing ring that keeps the arm closed by engaging in the vicinity of the proximal end coupling portion of the clip is disposed in the vicinity of the distal end of the sheath so as to be detachable from the sheath. Endoscopic clip device in which an operation motion transmitting member for engaging a clip closing ring in an unengaged state near the proximal end coupling portion of the clip by remote operation from the proximal end side of the sheath is inserted in the sheath In FIG. 3, a claw-shaped portion that protrudes inwardly at an acute angle with respect to the arm portion is formed to protrude from each tip of the pair of arm portions of the clip.
[0008]
In addition, it is very preferable that the angle formed by the nail-shaped portion with respect to the arm portion is in the range of 30 ° to 60 ° because the nail-like portion is easily stuck into the mucous membrane and is not easily removed.
[0009]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 shows the overall configuration of the endoscope clip device, in which a clip 2 is disposed at the distal end portion of a flexible sheath 1 made of, for example, a tetrafluoroethylene resin tube.
[0010]
In FIG. 2, the clip 2 is housed in the distal end of the sheath 1 at the proximal end, and has a pair of arms 2 a in an open state and a claw-like shape projecting inwardly at each distal end. Part 2b is visible.
[0011]
The operation unit 20 connected to the base end of the sheath 1 has a slider 22 slidably attached to a main body shaft 23 having a finger hook 23a attached to the end, and the base end cylindrical body 21 of the sheath 1 is connected to the main body shaft 23 and The slider 22 is configured to be slidable independently of the slider 22.
[0012]
FIG. 1 shows the distal end portion of the sheath 1 in an enlarged manner. In this figure, the clip 2 that is in a natural state when no external force is applied (that is, a state where the pair of arm portions 2a are parallel) is shown in FIG. It is almost completely drawn into the sheath 1.
[0013]
The clip 2 is formed, for example, by bending a stainless steel plate for a spring and the like, and a claw-like part 2b that is bent inwardly from each tip part of the pair of arm parts 2a is formed with respect to the arm part 2a. The angle θ formed is an acute angle (that is, less than 90 °).
[0014]
The base end sides of the pair of arm portions 2a are connected by a base end connecting portion 2c formed in an approximately 360 ° ring shape, and the arm portion 2a is opened and closed by deforming the base end connecting portion 2c. To do.
[0015]
An operation wire 3 that is advanced and retracted in the axial direction by the slider 22 disposed in the operation unit 20 is disposed at the axial position of the sheath 1 so as to be movable back and forth in the axial direction. A clip connecting hook 4 that can be engaged with and disengaged is attached via a connecting member 5.
[0016]
As shown in FIG. 1, the clip connecting hook 4 has a distal end portion with a large outer diameter passed through a connecting hole 2 d formed at the base end of the base end connecting portion 2 c of the clip 2 to prevent the clip connecting hook 4 from coming off. Thus, the clip 2 is connected.
[0017]
Then, as shown in FIG. 4 to be described later, the clip connecting hook 4 is extracted from the connecting hole 2d by elastic deformation so as to narrow the slit formed in the axial direction of the clip connecting hook 4, and connected to the clip 2 The state can be released.
[0018]
A clip closing ring 6 for deforming the proximal end connecting portion 2c of the clip 2 is disposed in the distal end of the sheath 1. The clip closing ring 6 is formed in a short cylinder shape whose inner diameter on the proximal end side is narrower than that on the distal end side, and the proximal end connecting portion 2 c of the clip 2 is deformed by being pulled into the clip closing ring 6.
[0019]
The ring receiving member 8 in which the base end portion of the clip closing ring 6 is detachably fitted is attached to the tip of the ring extrusion coil 7 composed of a closely wound coil of, for example, a stainless steel wire connected to the main body shaft 23 of the operation unit 20. It is fixed.
[0020]
In the endoscope clip apparatus configured as described above, the sheath 1 is passed through a treatment instrument insertion channel of an endoscope (not shown) so that the clip 2 protrudes forward from the distal end of the sheath 1. The closing ring 6 is pushed out from the operation unit 20 side (or the operation wire 3 is pulled from the operation unit 20 side).
[0021]
Then, first, as shown in FIG. 3, the base end connecting portion 2 c of the clip 2 is pulled into the clip closing ring 6 and deformed, so that the pair of arm portions 2 a is changed to an open state. .
[0022]
In this state, when the affected part is positioned between the pair of arms 2a and the clip closing ring 6 is pushed out from the operation unit 20 side, the proximal end connecting portion 2c is further deformed and the clip closing ring as shown in FIG. The tip of 6 pushes the pair of arm portions 2a of the clip 2 from the back side, whereby the pair of arm portions 2a are closed in parallel, and the nail-like portion 2b is stuck into the mucous membrane of the affected area 100.
[0023]
In addition, the base end connecting portion 2c of the clip 2 is deformed into a state in which the base end connecting portion 2c of the clip 2 is fitted into the narrow inner diameter portion on the base end side of the clip closing ring 6 so as to be crushed. It will be in a state where it can escape.
[0024]
Therefore, by removing the clip connecting hook 4 from the clip 2 and pulling the entire portion on the sheath 1 side toward the hand side, the clip 2 bites into the mucous membrane of the affected area 100 together with the clip closing ring 6 as shown in FIG. Detained in the attached state.
[0025]
In this indwelling state, the angle θ formed by the claw-like part 2b of the clip 2 piercing the mucous membrane of the affected part 100 with respect to the arm part 2a is an acute angle. Therefore, even if an external force acts in the direction in which the clip 2 is detached from the affected part 100 The clip 2 is not easily detached from the mucous membrane because the hook-like portion 2b is engaged with the mucous membrane in a hook-like shape.
[0026]
When the angle θ formed between the claw-like portion 2b and the arm portion 2a is close to 90 °, the claw-like portion 2b is easily removed from the mucous membrane, and when it is close to 0 °, it is difficult to pierce the mucous membrane, and θ is 30 ° to 60 °. When it is within the range, it is most preferable because it is easy to stick and difficult to come off.
[0027]
【The invention's effect】
According to the present invention, the clip can be easily placed, and the claw-shaped portion that protrudes inwardly at an acute angle with respect to the arm portion from each tip of the pair of arm portions of the clip is formed to protrude, The clip during placement does not easily fall off from the affected area due to the action of external force or the like, and excellent placement can be obtained.
[Brief description of the drawings]
FIG. 1 is a side sectional view of a distal end portion of an endoscope clip device according to an embodiment of the present invention.
FIG. 2 is an external view showing an overall configuration of an endoscope clip device according to an embodiment of the present invention.
FIG. 3 is a side cross-sectional view showing an open state in the opening and closing operation of the clip of the endoscope clip device according to the embodiment of the present invention.
FIG. 4 is a side cross-sectional view showing a closed state in the opening / closing operation of the clip of the endoscope clip device according to the embodiment of the present invention.
FIG. 5 is a side sectional view showing an indwelling state of the clip of the endoscope clip device according to the embodiment of the present invention.
FIG. 6 is a side cross-sectional view showing an indwelling state of a clip of a conventional endoscope clip device.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Sheath 2 Clip 2a Arm part 2b Claw-shaped part 2c Base end connection part 3 Operation wire (operation movement transmission member)
4 clip connecting hook 5 connecting member 6 clip closing ring 7 ring extrusion coil (operation motion transmission member)
20 Operation unit

Claims (2)

A pair of arms connected at the base end side are opened and closed by deforming the vicinity of the base end connecting portion, and the arm portion by engaging near the base end connecting portion of the clip A clip closing ring that maintains the closed state of the clip, and is disposed in the vicinity of the distal end of the sheath so as to be detachable from the sheath. In an endoscope clip device in which an operation motion transmission member that is engaged with the vicinity of the proximal end coupling portion of the clip by remote operation from the proximal end side is inserted and disposed in the sheath.
A claw-shaped portion that is inwardly directed at an acute angle with respect to the arm portion from each tip of the pair of arm portions of the clip is formed to project at an angle of 30 ° to 60 ° with respect to the arm portion, and the claw-shaped portion A clip device for an endoscope, characterized in that a cut end surface of a tip of the endoscope is formed with a gap between an inner surface of the arm part in a direction substantially perpendicular to the arm part . 2. The endoscope clip device according to claim 1, wherein the clip is formed by bending a plate material having a spring property, and the claw-like portion is formed by bending a distal end portion of the arm portion inward .

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