JP4095464B2 - 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, the clip device for an endoscope is fitted with a clip closing cylinder for keeping the openable / closable clip in a closed state in a portion on the rear end side of the clip, and in an axial direction in a flexible sheath. The front end of the operation wire inserted and retracted is connected to the rear end of the clip.
[0003]
Then, by pulling the operation wire from the proximal end side after the clip is opened, the clip is drawn into the clip-closed cylinder at the distal end portion of the flexible sheath and closed.
[0004]
However, in order to place the clip in such a closed state in the body, it is necessary to release the connection state between the clip and the operation wire at the end of a series of operations and to remove the clip from the operation wire.
[0005]
Therefore, in the old model, when the operation wire is pulled and the clip is pulled into the closed tube cylinder and closed, the operation wire is pushed backward to release the connection with the clip. However, the operation is troublesome.
[0006]
Therefore, conventionally, by placing a member with low mechanical strength at the connection between the clip and the operation wire, the operation wire is pulled with a stronger force after the operation wire is pulled and the clip is pulled into the closed cylinder. Then, the connection portion between the clip and the operation wire was released so that the connection portion was broken (for example, Patent Document 1).
[0007]
[Patent Document 1]
JP2002-191609
[0008]
[Problems to be solved by the invention]
However, if a structure is adopted in which the connecting portion between the clip and the operation wire is broken by pulling the operation wire strongly, it is necessary not only to increase the number of parts but also to prevent damage to the low-strength portion during assembly. As a result, the assembly work takes time and costs are high, and the disposal of the broken connecting member is cumbersome and difficult to handle.
[0009]
Therefore, an object of the present invention is to provide an endoscopic clip device that can manufacture a connecting portion between a clip and an operation wire with a simple structure at low cost and is easy to handle.
[0010]
[Means for Solving the Problems]
In order to achieve the above object, the clip device for an endoscope according to the present invention has a clip closing cylinder for keeping the openable / closable clip closed, and is fitted on the rear end portion of the clip. The distal end of the operation wire, which is inserted in the flexible sheath so as to be movable back and forth in the axial direction, is detachably connected to the rear end portion of the clip, and the operation wire is pulled from the proximal end side to be flexible. In the clip apparatus for an endoscope configured so that the clip is pulled and closed in the clip closing cylinder at the distal end portion of the sheath, and the connection state between the clip and the operation wire is released by pulling the operation wire. The rear end portion of the clip is formed in a cylindrical shape with the rear open, and a connecting member that can be inserted into and removed from the cylindrical portion is attached to the distal end of the operation wire. Then, the engagement click portion that elastically clicks and engages is formed in the cylindrical portion, and the operation wire is pulled from the base end side, whereby the engagement between the engagement click portion and the connecting member is released elastically. Thus, the connection state between the clip and the operation wire is released.
[0011]
Note that the structure can be simplified if the engagement click portion is formed integrally with the cylindrical portion by a portion obtained by cutting the cylindrical portion from behind with a slit. In addition, when the clip closing cylinder is fitted to the rear end portion of the clip, engagement / disengagement of the engagement click portion with respect to the connecting member is regulated by the clip closing cylinder, and the clip is pulled into the clip closing cylinder. Accordingly, when the engagement click portion with respect to the connecting member is not restricted by the clip closing cylinder, the operation can be made more stable and reliable.
[0012]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
2 and 3 show the indwelling clip unit 10, FIG. 2 is a side sectional view of the indwelling clip unit 10, and FIG. 3 is a front view of the indwelling clip unit 10 as viewed from the front.
[0013]
In this embodiment, the three clip claws 11 are elastically deformed in the vicinity of the rear end portion A thereof so as to open and close with the vicinity of the rear end portion A as a base point at intervals of approximately 120 ° around the central axis. It arrange | positions at the extended shape and is mutually connected in the cylindrical connection part 12 (cylindrical part) provided in the rear-end part.
[0014]
FIG. 4 shows a single part formed with such a clip claw 11 and a cylindrical connecting portion 12, and the cylindrical connecting portion 12 is a pipe material such as a superelastic alloy or a stainless steel pipe having spring properties. It is a cylindrical thing using the raw material which consists of as it is, and the rear end side (upper edge part in FIG. 4) is open | released.
[0015]
The three clip claws 11 are connected to the cylindrical connecting portion 12 from the same material pipe as the cylindrical connecting portion 12 so that all the clip claws 11 are connected to the cylindrical connecting portion 12 at the rear end A. In the normal state, each is bent at the rear end portion A so that the front end side is widened, and the front end portion of each clip claw 11 is bent inwardly in a hook shape.
[0016]
Reference numeral 13 denotes an engagement click part for engaging with a connecting member 5 described later, and the cylindrical connecting part 12 is cut from the rear side by a pair of parallel slits so as to form a leaf spring. It is integrally formed with the shape connecting portion 12 and the clip claw 11.
[0017]
In the vicinity of the rear end of the engagement click portion 13, as shown in FIG. 2, which is a cross-sectional view, an inward protrusion 13 a that protrudes inward is formed. In this embodiment, the engagement click portions 13 are formed at three positions at intervals of 120 °, but may be formed at least at one position.
[0018]
As shown in FIGS. 2 and 3, a clip closing cylinder 15 made of, for example, a stainless steel pipe, which is another part constituting the indwelling clip unit 10, is slidable in the axial direction in the cylindrical connecting portion 12. The clip claw 11 is held in a closed state by moving the clip closing cylinder 15 from the cylindrical connecting portion 12 side to the state where it covers the clip claw 11.
[0019]
As shown in FIG. 5 illustrating the VV cross section in FIG. 2, the cross-sectional shape of the cylindrical connecting portion 12 is formed in an elliptical shape, and the outer diameter of the ellipse side is that of the clip-closed cylindrical body 15. The outer diameter dimension on the short circle side is larger than the inner diameter and smaller than the inner diameter of the clip closing cylinder 15.
[0020]
And the cylindrical connection part 12 and the clip closing cylinder 15 are slid relatively by inserting in the clip closing cylinder 15 in the state which elastically deformed the cylindrical connection part 12 in the radial direction. However, it is elastically frictionally engaged so that a certain amount of force needs to be applied.
[0021]
In this way, the clip closing cylinder 15 is fitted from the rear to the cylindrical connecting part 12 that connects all the three clip claws 11 in a continuous manner on the rear end A side, and the indwelling clip A unit 10 is configured.
[0022]
FIG. 1 shows a ready-to-use state in which the indwelling clip unit 10 is loaded at the distal end portion of the endoscope clip device. A cylindrical closed tube receiver 3 is fixed to the tip of a flexible sheath 2 made of, for example, a coil pipe in which a stainless steel wire is tightly wound with a certain diameter at the tip of the endoscope clip device. The clip cylinder 15 is supported by the cylinder receiver 3.
[0023]
The clip closing cylinder 15 is loosely fitted in the closed cylinder receiver 3 in the latter half, and the step portion formed in the intermediate part of the clip closing cylinder 15 abuts on the front end of the closed cylinder receiver 3. Thus, the clip closed cylinder 15 is prevented from entering the closed cylinder receiver 3 from the state shown in FIG.
[0024]
An operation wire 4 is inserted through the sheath 2 so as to be movable back and forth in the axial direction, and the operation wire 4 can be moved forward and backward from an operation portion (not shown) connected to the base end of the sheath 2.
[0025]
A connecting member 5 that can be engaged and disengaged from the rear side with respect to the cylindrical connecting portion 12 is connected and fixed to the distal end of the operation wire 4 when the clip closing cylindrical body 15 is not covered.
[0026]
The connecting member 5 has a front half formed in a columnar shape with a rounded head and is loosely fitted into the cylindrical connecting portion 12. A constricted portion 5a with which the protrusion 13a is engaged is formed.
[0027]
As a result, as shown in FIG. 1, when the clip closing cylinder 15 covers the engagement click part 13, the engagement click part 13 and the constricted part 5 a are not disengaged, and the clip closing cylinder 15 When the cover is not covered, the inward projection 13a and the constricted portion 5a can be engaged and disengaged by elastically deforming the engagement click portion 13 outward.
[0028]
6 is an outer tube made of, for example, a tetrafluoroethylene resin tube or the like, which is fitted over the entire length of the sheath 2 so as to be able to advance and retreat in the axial direction independently from the operation unit side, as shown in FIG. The clip claw 11 is elastically deformed at the rear end A to be in a constricted state by being fitted to the clip claw 11 part.
[0029]
FIGS. 6 to 9 show the procedure for attaching the indwelling clip unit 10 until the endoscope clip device is put into the use ready state shown in FIG.
First, as shown in FIG. 6, on the indwelling clip unit 10 side, the clip closing cylinder 15 is slid forward so that the engagement click portion 13 is exposed (the clip claw 11 is thereby closed). In this state, the connecting member 5 is protruded from the opening of the closed cylindrical receptacle 3 attached to the distal end of the sheath 2 so that the rear end of the cylindrical connecting portion 12 is exposed.
[0030]
Then, as shown in FIG. 7, when the connecting member 5 is inserted into the cylindrical connecting portion 12 from the rear, the inward projection 13a interferes with the outer peripheral surface of the connecting member 5, but the engaging click portion 13 is outside. The connecting member 5 enters the cylindrical connecting portion 12 by being elastically deformed into the state of being pushed and spread.
[0031]
As shown in FIG. 8, when the inward projection 13a reaches the position of the constricted portion 5a as shown in FIG. 8, the engagement click portion 13 returns to the original unexpanded shape by its own elasticity, and the inward projection 13a Engage in a state of falling into the constricted portion 5a.
[0032]
Therefore, as shown in FIG. 9, by sliding the clip closing cylinder 15 rearward, the clip closing cylinder 15 covers the engagement click portion 13 so that the inner protrusion 13a and the constricted portion 5a are engaged. At the same time, the clip claw 11 is not covered with the clip closing cylinder 15, and the clip claw 11 has a shape that expands due to its own elasticity.
[0033]
As a result, the indwelling clip unit 10 is connected to the connecting member 5 so as not to be detached, so that the operation wire 4 is pulled toward the hand until the clip closing cylinder 15 is received by the closing cylinder receiver 3. 1 (or by pushing the sheath 2) and pushing the outer tube 6 to a position where it covers the clip claw 11, the clip claw 11 is in a ready state for use, as shown in FIG. Then, it is passed through the treatment instrument insertion channel of the endoscope.
[0034]
FIGS. 10 to 13 show the state of use in the body. The tip of the endoscope clip device protrudes from the treatment instrument insertion channel of the endoscope, and as shown in FIG. When the clip nail 11 is directed to the affected part 100, the outer tube 6 is pulled backward with respect to the sheath 2 (or the sheath 2 is pushed forward with respect to the outer tube 6), whereby the clip nail 11 is caused by its own elasticity. It becomes an open shape.
[0035]
Therefore, when the affected part 100 is surrounded by the tips of the three clip claws 11, as shown in FIG. 11, the operation wire 4 is pulled from behind with respect to the sheath 2 (or the sheath 2 with respect to the operation wire 4). ).
[0036]
As a result, the clip claw 11 is fitted into the clip closed cylinder 15 pressed by the closed cylinder receiver 3 from the rear end A side, the clip claw 11 is narrowed, and the affected part 100 can be clipped. Further, in accordance with the operation, the engagement click portion 13 moves to a position where it has come out of the rear end of the clip closing cylinder 15.
[0037]
Therefore, when the operation wire 4 is further strongly pulled backward with respect to the sheath 2 (or the sheath 2 is pushed strongly), the clip closing cylinder 15 is not covered with the portion of the engagement click portion 13. Therefore, as shown in FIG. 12, the engagement click portion 13 is elastically deformed outward, and the engagement between the constricted portion 5a of the connecting member 5 and the inner protrusion 13a of the engagement click portion 13 is released.
[0038]
Therefore, as shown in FIG. 13, the sheath 2 and the outer tube 6 are pulled together and the indwelling clip unit 10 is indwelled in a state where the affected part 100 is clipped, and the clip-closed cylinder 15 is connected to the cylinder. Since the portion 12 is frictionally engaged, the clipping state is maintained without the clip closing cylinder 15 being detached.
[0039]
The present invention is not limited to the above-described embodiment. For example, the number of clip claws 11 may be any number, and the sheath 2 and the outer tube 6 may be formed of a superelastic alloy pipe or the like. Further, the operation wire 4 may be not only a single wire or a stranded wire but also a hollow tube-like one.
[0040]
【The invention's effect】
According to the present invention, the rear end portion of the clip is formed in a cylindrical shape with the rear opened, and a connecting member that can be inserted into and removed from the cylindrical portion is attached to the distal end of the operation wire. Since the engagement click part that makes the click engagement elastically is formed in the cylindrical part, the connection part between the clip and the operation wire can be manufactured at a low cost with a simple structure, and it can be broken and discarded Since there are no members to be generated, handling is very easy.
[Brief description of the drawings]
FIG. 1 is a side sectional view of an endoscope clip device according to an embodiment of the present invention in a preparation state for use.
FIG. 2 is a side partial sectional view of an indwelling clip unit according to an embodiment of the present invention.
FIG. 3 is a front view of the indwelling clip unit according to the embodiment of the present invention as viewed from the front.
FIG. 4 is a perspective view of an integrated part of a clip claw, a cylindrical connecting portion, and an engaging click portion according to an embodiment of the present invention.
5 is a cross-sectional view taken along line VV in FIG. 2 of the indwelling clip unit according to the embodiment of the present invention.
6 is a side cross-sectional view showing a procedure for attaching an indwelling clip unit until the endoscope clip device according to the embodiment of the present invention is in a ready state for use shown in FIG. 1; FIG.
7 is a side cross-sectional view showing a procedure for attaching an indwelling clip unit until the endoscope clip device according to the embodiment of the present invention is in a ready state for use shown in FIG. 1; FIG.
8 is a side cross-sectional view showing a procedure for attaching an indwelling clip unit until the endoscope clip device according to the embodiment of the present invention is in a ready state for use shown in FIG. 1. FIG.
9 is a side cross-sectional view showing a procedure for attaching an indwelling clip unit until the endoscope clip device according to the embodiment of the present invention is in a ready state for use shown in FIG. 1; FIG.
FIG. 10 is a side sectional view showing a state when the endoscope clip device of the embodiment of the present invention is used.
FIG. 11 is a side cross-sectional view showing a state when the endoscope clip device of the embodiment of the present invention is used.
FIG. 12 is a side cross-sectional view showing a state when the endoscope clip device of the embodiment of the present invention is used.
FIG. 13 is a side cross-sectional view showing a state when the endoscope clip device of the embodiment of the present invention is used.
[Explanation of symbols]
2 sheath 3 closed cylinder receiver 4 operation wire 5 connecting member 5a constricted part 6 outer tube 10 indwelling clip unit 11 clip claw 12 cylindrical connecting part (cylindrical part)
13 Engagement click part 13a Inward projection 15 Clip closing cylinder

Claims (2)

An operation in which a clip closing cylinder for keeping the openable / closable clip in a closed state is fitted on the rear end portion of the clip, and is inserted and disposed in the flexible sheath so as to be movable back and forth in the axial direction. The tip of the wire is detachably connected to the rear end portion of the clip, and the clip is pulled into the clip-closed cylinder at the tip of the flexible sheath by pulling the operation wire from the proximal end side. In the endoscope clip device configured to be closed and further pulled by pulling the operation wire, the connection state between the clip and the operation wire is released.
The rear end portion of the clip is formed in a cylindrical shape with the rear open, and a connecting member that can be inserted into and removed from the cylindrical portion from the rear is attached to the tip of the operation wire, and the connecting member is attached to the connecting member. On the other hand, an engagement click portion that elastically clicks and engages is formed in the cylindrical portion, and the operation wire is pulled from the base end side, whereby the engagement click portion and the connecting member are engaged. When the clip and the operation wire are released elastically and the connection state between the clip and the operation wire is released, and the clip closing cylinder is fitted to the rear end portion of the clip, the engagement click with respect to the connection member is performed. Engagement / disengagement of the engagement click portion with respect to the connecting member is performed as the clip closing cylinder as the engagement / disengagement of the portion is regulated by the clip closing cylinder and the clip is pulled into the clip closing cylinder. Endoscopic clipping device being characterized in that the so that a state which is not restricted by. The endoscope clip device according to claim 1, wherein the engagement click portion is formed integrally with the cylindrical portion by a portion obtained by cutting the cylindrical portion from behind with a slit.

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