JP4338420B2 - Endoscope gripping device - Google Patents

Description

[0001]
【Technical field】
The present invention relates to an endoscopic grasping apparatus and an endoscopic treatment for grasping a lesioned part of a patient by using a magnetic guiding means that can be guided by a magnetic field when the lesioned part is excised under endoscopic observation. It relates to a method for introducing ingredients.
[0002]
[Prior art and its problems]
As one aspect of the operation using an endoscope, there has been conventionally known a method of lifting and excising a lesion using a magnetic guiding means (magnetic anchor) . In this method, the magnetic guiding means and the clip for gripping the lesion are separately introduced into the patient, and then the magnetic guiding means and the clip are connected by the connecting member using the grasping forceps inserted from the forceps channel. It was used to grasp the lesion during resection of the lesion. However, in this example, it takes time and labor to connect the magnetic guiding means and the clip, and to attach the clip to the lesioned part, which puts a burden on the patient and the operator.
[0003]
In order to improve this, as shown in FIG. 15, there has been an example in which the magnetic guiding means 201 and the clip 203 previously connected by the connecting member 205 are used. In this example, the clip 203, the connecting member 205, and a part of the magnetic guiding means 201 are arranged in the introducing tube 235, and the introducing tube 235 is passed through the forceps channel of the endoscope, thereby causing the magnetic guiding means 201 and The clip 203 has been introduced into the patient. The introduction pipe 235 can be removed on the rear end 35a side by pulling a cut string 237 provided on the outer periphery of the introduction pipe 235 (FIG. 15B), and is exposed by removing the rear end 35a side. By pushing the flexible pushing rod 239 into the introduction tube 235, the magnetic guiding means 201, the connecting member 205, and the clip 203 are pushed out into the patient.
[0004]
However, in this example, after the magnetic guiding means 201 and the clip 203 connected by the connecting member 205 are introduced into the body, it is necessary to attach the clip 203 to the lesioned part using the grasping forceps inserted from the forceps channel. For this reason, it takes time and labor to attach the clip 203 to the lesioned part, which puts a burden on the patient and the operator.
[0005]
[Patent Literature]
Japanese Patent Application No. 2002-268239 Specification
OBJECT OF THE INVENTION
Therefore, an object of the present invention is to reduce the time and labor required to attach the magnetic guiding means to the lesioned part, and to reduce the burden on the patient and the operator, and an endoscope treatment tool. It is to provide an introduction method.
[0007]
Summary of the Invention
In order to solve the above problems, the endoscope gripping device of the present invention has a hollow cylindrical shape, and its rear end portion is detachable from the distal end portion of the introduction tube inserted through the forceps channel of the endoscope. A gripping part receiving tube and a plurality of claw parts, and the claw part is closed after the claw part is opened by relative movement backward in the gripping part receiving pipe, and the target part inside the object is closed by the closed claw part. A gripping member that is capable of gripping, a magnetic guiding means that is made of a magnetic material and is attracted by a magnetic force generated outside the object, a connecting member that connects the gripping member and the magnetic guiding means, and the gripping member The gripping member can be engaged with a distal end portion of an operation wire inserted into the introduction tube so as to be relatively movable, and the operation wire is pulled rearward while being engaged with the operation wire. The gripper receiving tube Rearwardly moved relative against, is characterized in that and a pulling separating member for cutting when it is pulled further by the operation wire after the pawl portion is closed.
[0008]
[0009]
It is preferable that a hook portion for hooking the pulling / separating means is formed at the tip of the operation wire .
[0010]
The gripping member receiving tube is formed with a small-diameter portion to be inserted into the introduction tube by a step portion at an intermediate portion in the length direction , the rear end portion of the gripping portion receiving tube being opened, and the connection It has a slit that allows the magnetic guiding means to be positioned in front of the gripping member by inserting a member, and the front end portion of the slit that is open at the rear end portion reaches the front of the stepped portion. preferable.
[0011]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments according to the present invention will be described in detail with reference to the drawings. The endoscope gripping apparatus 1 according to the present embodiment includes a clip (grip member) 10, a magnetic guiding means 30, a connecting member 20, and the like.
[0012]
(1) Configuration As shown in FIGS. 1 to 3, the clip 10 has one end in the longitudinal direction of each of the long plate-like members 11, 12, 13 having the same shape with respect to the outer diameter of the substantially circular base end portion 10a. It is an elastic member formed by fixing the part. The plate-like members 11, 12, and 13 are arranged at intervals of 120 degrees on the outer diameter of the base end portion 10a, and extend in parallel with each other with the bottom face inward. Note that the clip 10 may have two plate-like members or three or more plate-like members as long as the lesioned part can be grasped.
[0013]
On the other hand, claw portions 11a, 12a, and 13a bent inward are formed at the other end portion that is not fixed to the base end portion 10a. For this reason, if the plate-shaped members 11, 12, and 13 are energized so as to approach each other, the object can be held between the claw portions 11a, 12a, and 13a.
[0014]
Further, at the same position in the longitudinal direction of each of the plate-like members 11, 12, 13, the convex portions 11 b, 12 b, 13 b projecting outward from the front and rear portions by bending the plate-like members 11, 12, 13. And the inclined portions 11c, 12c, 13c that spread outward again from the front ends of the convex portions 11b, 12b, 13b narrowed inward, and the claw portions 11a, 12a, 13a from the front ends of the inclined portions 11c, 12c, 13c. Leading end portions 11d, 12d, and 13d are provided.
[0015]
In this configuration, when a force that biases the convex portions 11b, 12b, and 13b inward is applied, the bending angle before and after the change changes, so that the inclined portions 11c, 12c, and 13c and the tip portions 11d, 12d, and 13d are Spread outward (Fig. 3). When a force for urging the inclined portions 11c, 12c, 13c and the tip end portions 11d, 12d, 13d inward is applied in a state where the convex portions 11b, 12b, 13b are urged inward, this time, the inclined portions The bending angles of 11c, 12c, and 13c and tip portions 11d, 12d, and 13d change so that the interval between them is narrowed.
[0016]
A flexible connecting member 20 for connecting the clip 10 and the magnetic guiding means 30 is inserted inside the clip 10. As the connecting member 20, for example, a surgical suture, a fishing line, or a metal wire can be used.
[0017]
The magnetic induction means 30 connected to the end portion of the connection member 20 is made of a ferromagnetic material, and can be attracted and controlled by using a magnetic induction member such as an electromagnet or a permanent magnet. As a magnetic material used for the magnetic induction means 30, magnets such as platinum magnets, rare earth magnets, terbium / dysprosium / iron alloys can be used in addition to pure iron and iron alloys. The magnetic guiding means 30 is provided with a hole portion 31 into which one end portion of the connecting member 20 can be inserted and fixed.
[0018]
Since the clip 10 and the magnetic guiding means 30 are connected via the connecting member 20 as described above, the clip 10 can be pulled in a desired direction by controlling the magnetic guiding means 30 by suction.
[0019]
In the vicinity of the base end portion 10a, the plate-like members 11, 12, 13 are inserted into a substantially cylindrical clip receiving tube (gripping member receiving tube) 40 having an inner diameter with which the outer surface can abut. Yes. At this time, at least a part of the rear portions 11 e, 12 e, 13 e of the plate-like members 11, 12, 13 is received in the large diameter portion 46. The clip receiving tube 40 can be formed of, for example, a stainless steel pipe, a plastic tube, or a superelastic alloy, and a pair of slits 41 and 42 are provided at positions facing each other in the radial direction. The slits 41 and 42 are guided by a predetermined position 43 shifted toward the insertion side of the clip 10 in the direction parallel to the center line of the clip receiving tube 40 (a line connecting the centers of the substantially circular cross sections). It extends to the side end 44, and its rear end is open. There may be one slit.
[0020]
The connecting member 20 fixed to the magnetic guiding means 30 is introduced into the clip receiving tube 40 through the slits 41 and 42 and is passed through the proximal end portion 10a. With this configuration, the clip 10 and the magnetic guiding means 30 are connected via the clip receiving tube 40.
[0021]
The slits 41 and 42 have rear end portions that are open to the end portion 44 (open), but the front end portions are not extended to the front end of the clip receiving tube 40 and are stopped at a predetermined position 43 in the middle. Yes. With this configuration, the movement of the connecting member 20 inserted into the slits 41 and 42 from the end 44 side to the clip 10 side (front side) is regulated by the predetermined position 43. On the other hand, the movement of the connecting member 20 toward the end 44 (rear side) is regulated by the proximal end 10 a of the clip 10 inserted into the clip receiving tube 40.
[0022]
Further, the outer diameter of the clip receiving tube 40 differs before and after the step 45 provided at a position shifted from the predetermined position 43 to the rear side. That is, the outer diameter of the large-diameter portion (front portion) 46 on the front side of the step portion 45 is set smaller than the outer diameter of the small-diameter portion (rear portion) 47 on the rear side of the step portion 45.
[0023]
A metal loop wire (traction separation means) 50 is passed through the base end portion 10a. The loop wire 50 may be made of a material other than metal as long as it is cut when pulled with a strong force of a predetermined level or more. The clip 10 having one end inserted into the clip receiving tube 40 is pulled into the clip receiving tube 40 while pulling the loop wire 50 rearward so that each portion abuts against the inner wall of the clip receiving tube 40 and is elastically deformed. Can be inserted.
[0024]
Specifically, when the convex portions 11b, 12b, and 13b abut against the inner wall of the clip receiving tube 40 by pulling the loop wire 50 to the rear side, the convex portions 11b, 12b, and 13b are inward so as to approach each other. Bend. Thereby, the front end portions 11d, 12d, and 13d are separated from each other, and the clip 10 is opened. When the loop wire 50 is further pulled rearward, the inclined portions 11c, 12c, 13c abut against the inner wall of the clip receiving tube 40, and the inclined portions 11c, 12c, 13c bend inward so as to approach each other. Then, the tip portions 11d, 12d, and 13d approach each other, and the clip 10 is in a closed state.
[0025]
The clip 10, the connecting member 20, the magnetic guiding means 30, the clip receiving tube 40, and the loop wire 50 connected as described above are introduced into the patient (object) 101 using the hollow cylindrical introduction tube 70. . The clip 10, the connecting member 20, the magnetic guiding means 30, the clip receiving tube 40 and the loop wire 50 form an endoscope treatment tool according to the present invention.
[0026]
The introduction tube 70 is made of a flexible material, and is inserted from the forceps insertion port 91 of the endoscope 90 into the forceps channel 61 of the distal end rigid portion 60 as shown in FIGS. On the inner wall of the introduction pipe 70, an insertion coil 71 is disposed that can move relative to the introduction pipe 70 in the longitudinal direction of the introduction pipe 70. A restriction tube 72 is fixed to the distal end of the insertion coil 71 on the distal end hard portion 60 side by an adhesive, solder, solder, or the like. The regulation tube 72 is provided with a stepped portion 73, and the outer diameter of the front portion 74 of the stepped portion 73 is substantially the same as the inner diameter of the introduction tube 70. On the other hand, the outer diameter of the rear portion 75 whose outer diameter is smaller than that of the front portion 74 is substantially the same as the inner diameter of the hollow cylinder formed by the insertion coil 71. Therefore, when the insertion coil 71 is fixed to the outer periphery of the rear portion 75, the outer periphery of the hollow cylinder formed by the insertion coil 71 and the outer periphery of the front portion 74 are substantially on the same plane.
[0027]
On the other hand, the inner diameter of the front portion 74 is set larger than the inner diameter of the rear portion 75. Furthermore, the inner diameter of the front portion 74 and the inner diameter of the rear portion 75 are substantially the same as the outer diameter of the large diameter portion 46 and the small diameter portion 47 of the clip receiving tube 40, respectively. For this reason, the clip receiving tube 40 can be inserted into the restricting tube 72, and the movement of the clip receiving tube 40 is restricted when the stepped portion 45 abuts against the distal end surface 76 of the restricting tube 72. Here, since the predetermined position 43 is disposed in front of the stepped portion 45 in the direction of the center line of the clip receiving tube 40, the clip receiving tube 40 is restricted until the stepped portion 45 and the stepped portion 73 come into contact with each other. Even if inserted, the slits 41 and 42 are not completely covered by the restriction tube 72. Accordingly, even in this state, the connecting member 20 can extend from the clip receiving tube 40 to the outside.
[0028]
In the insertion coil 71 and the regulation tube 72, an operation wire 80 having a hook portion 81 provided at the tip is disposed so as to be movable relative to the insertion coil 71 and the regulation tube 72. The hook portion 81 has a rear end fixed to the operation wire 80 by an adhesive, solder, solder, or the like. The operation wire 80 is sufficiently longer than the introduction tube 70, and the rear end portion 80 a extends from the introduction tube 70 protruding outward from the forceps insertion port 91. A central portion of the hook portion 81 is a concave portion 82, and the clip wire 10 is clipped through the loop wire 50 by pulling the operation wire 80 by hooking the end portion of the loop wire 50 to the concave portion 82. Can be pulled in. The operation wire 80 is pulled by pulling the rear end 80a extending from the endoscope 90.
[0029]
On the other hand, the position of the magnetic guiding means 30 is controlled by a magnetic guiding device 110 having a magnetic guiding member 112 that controls the magnetic guiding means 30 outside the body of the patient 101 (powers the magnetic guiding means 30). In the magnetic induction member 112, an electromagnet 112c having a structure in which a coil is wound around an iron core is disposed on a base body 112a (FIG. 6).
[0030]
As shown in FIG. 6, the magnetic induction member 112 has an electromagnet 112c slidable on a frame / rail (in-plane moving mechanism) 114 disposed so as to surround the bed 116 on which the patient 101 lies. It is placed so as to face the patient. This frame / rail 114 is composed of two U-shaped rails 114a and 114b arranged in parallel in one plane, and two XY stages (one-way moving mechanism) are parallel to the width direction of the floor plate 116a of the bed 116. ) 119. The XY stage 118 is relatively movable in a direction perpendicular to the plane on which the frame / rail 114 is provided. With the above configuration, the magnetic guiding member 112 can move between the two XY stages 118 and 119 by the base 112a sliding on the frame / rail 114. The magnetic guiding member 112 is disposed on the rail 114a on the side close to the patient 101 of the two parallel rails 114a and 114b of the frame / rail 114.
[0031]
A counterweight 120 for maintaining the weight balance of the entire frame / rail 114 is disposed on the rail 114b on the side far from the patient 101 of the frame / rail 114 so as to be slidable on the rail 114b. The counterweight 120 changes its position according to the position of the magnetic induction member 112. For example, when the magnetic guiding member 112 is in front of the patient 101, the counterweight 120 is disposed on the back of the patient 101, and when the magnetic guiding member 112 is on the back of the patient 101, the counterweight 120 is on the front of the patient 101. To balance the weight of the entire frame / rail 114.
[0032]
As described above, by arranging the magnetic guiding member 112, the XY stages 118 and 119, the frame / rail 114, and the like, the magnetic guiding member 112 can be disposed at an optimum position for excision of the lesion (target site) 130. it can. Therefore, in order to lift the lesioned part so that it can be easily excised, the magnetic guiding means 30 can be attracted (powered), and the magnetic guiding means 30 and the clip 10 can be arranged at appropriate positions.
[0033]
(2) Preparation for Execution of Resection As shown in FIG. 6, prior to performing resection using the endoscope grasping apparatus 1 according to the present invention, first, a patient 101 who has undergone local anesthesia is placed on a bed 116. Lay on top. At this time, the frame / rail 114 is retracted to the side where the head 101a of the patient 101 comes by the XY stages 118 and 119, and the magnetic guiding member 112 and the counterweight 120 are arranged at predetermined positions. When the patient 101 lies on the bed 116, the XY stages 118, 119 are operated to place the frame / rail 114 in front of the patient's lesion and then rubbed on the frame / rail 114. 112 is placed in the position at the start of the resection.
[0034]
(3) Operation for introducing the magnetic guiding means 30 and the clip 10 into the body In the endoscope gripping device 1 of the present invention, the clip 10 and the magnetic guiding means 30 are introduced into the body at the distal end of the endoscope. This is done by introducing the hard part 60. The distal end rigid portion 60 is inserted with the magnetic guiding means 30 at the distal end and the introduction pipe 70 with the clip 10 disposed inside the magnetic guiding means 30. The clip 10 is disposed with the claw portions 11 a, 12 a, and 13 a facing the distal end side of the distal end rigid portion 60.
[0035]
The clip 10 and the magnetic guiding means 30 are arranged in the introduction pipe 70 as follows (FIGS. 7 and 8).
The clip 10 and the magnetic guiding means 30 are inserted into the introduction tube 70 in a state where the clip 10 and the magnetic guiding means 30 are connected to each other via the connecting member 20 passed through the clip receiving tube 40 from the slit 41 and the slit 42. At the time of insertion, the loop wire 50 that has been passed through the clip 10 in advance is hooked on the concave portion 82 of the hook portion 81 that is fixed to the distal end of the operation wire 80 that is inserted into the introduction tube 70. In this state, the clip receiving tube 40 linked to the clip 10 and the magnetic guiding means 30 is inserted into the regulating tube 72 arranged in the introduction tube 70. This insertion operation ends when the step 45 of the clip receiving tube 40 abuts the step 73 of the restricting tube 72 and the movement of the clip receiving tube 40 is restricted. As shown in FIG. 8, in the endoscope gripping apparatus of the present invention, the clip 10 is inserted after the clip receiving tube 40, and then a part of the magnetic guiding means 30 is inserted. The predetermined position 43 which is the end position of the slits 41 and 42 is disposed at a position on the front side in the direction of the center line of the clip receiving tube 40 with respect to the stepped portion 45 of the clip receiving tube 40. Even if the clip receiving tube 40 is inserted into the restricting tube 72 until 45 and the stepped portion 73 abut each other, the slits 41 and 42 are not closed by the restricting tube 72 but are opened at the predetermined position 43. Therefore, the connecting member 20 that connects the clip 10 and the magnetic guiding means 30 can extend from the slits 41 and 42 to the outside of the clip receiving tube 40 at the predetermined position 43. Further, since the connecting member 20 has a sufficient length so as not to prevent the magnetic guiding means 30 from being placed in front of the clip 10, the magnetic guiding means 30, the clip 10, and the clip receiving portion are completed when the insertion operation is completed. Tube 40 is arranged in a straight line.
[0036]
The clip 10 and the magnetic guiding means 30 are introduced into the patient 101 as follows (FIGS. 9 and 10).
First, the distal end rigid portion 60 is introduced into the body, and then the control tube 72 is urged forward by operating the operation wire 80. As a result, the clip receiving tube 40 in which the step 45 is in contact with the step 73 is pushed forward, and the clip 10 whose one end is press-fitted into the clip receiving tube 40 also advances forward. The front end contacts the rear end of the magnetic guiding means 30 (FIG. 9). When the regulating pipe 72 is further urged forward from this state, the magnetic guiding means 30 having the rear end fitted to the leading end of the introducing pipe 70 is removed. When the restricting tube 72 is further urged forward, the clip 10, the clip receiving tube 40, and the restricting tube 72 are exposed from the distal end of the introduction tube 70 into the body of the patient 101, as shown in FIG. While the tube 40 is arranged in a straight line in the longitudinal direction of the introduction tube 70, the magnetic guiding means 30 hangs down due to gravity. Therefore, if the distal rigid portion 60 is disposed toward the lesioned portion 130, the introduction tube 70 disposed in the distal rigid portion 60 also faces the lesioned portion 130. Therefore, the tip of the clip 10 can be easily directed to the lesioned portion 130. it can.
[0037]
The clip 10 is attached to the lesioned part 130 as follows (FIGS. 11 to 14). 11 and 12, the plate-like member 12 is omitted for convenience of explanation.
[0038]
First, in order to open the distal end portions 11d, 12d, and 13d, the operation wire 80 is moved relative to the insertion coil 71 and the restriction tube 72 to pull the operation wire 80 so that the convex portions 11b, 12b, and 13b are moved. Pull into the clip receiving tube 40. Since the convex portions 11b, 12b, and 13b drawn into the restriction tube 72 abut against the inner wall of the clip receiving tube 40, they bend in a direction approaching each other. Since the protrusions 11b, 12b, and 13b are bent in this way, the tip portions 11d, 12d, and 13d are bent away from each other, and as a result, the tip end side of the clip 10 exposed from the clip receiving tube 40 is opened ( FIG. 11).
[0039]
The clip 10 opened in this way is moved toward the lesioned part 130 by moving the insertion coil 71, the restriction tube 72, and the operation wire 80 together. When the tip of the clip 10 reaches a desired position, the clip 10 is moved. By closing, the lesioned part 130 can be grasped by the clip 10. In order to close the clip 10, the operation wire 80 is moved relative to the insertion coil 71 and the restriction tube 72 to pull the operation wire 80 so that the inclined portions 11 c, 12 c, 13 c are moved into the clip receiving tube 40. Pull in. The inclined portions 11c, 12c, and 13c drawn into the clip receiving tube 40 abut on the inner wall of the clip receiving tube 40, so that they bend toward each other, and the tip portions 11d, 12d, and 13d approach each other accordingly. As a result, the distal end side of the clip 10 exposed from the clip receiving tube 40 is closed (FIG. 12).
[0040]
Next, the clip 10 and the magnetic guiding means 30 connected through the clip receiving tube 40 and the connecting member 20, the introduction tube 70 including the insertion coil 71, the restriction tube 72, the operation wire 80, and the hook portion 81 therein, And the attachment of the clip 10 to the lesioned part 130 is completed. In this separation operation, the operation wire 80 is pulled strongly to cut the loop wire 50 hung on the hook portion 81 (FIG. 13), and then the insertion coil 71, the restriction tube 72, the operation wire 80 and the hook portion 81 are retracted. (FIG. 14).
[0041]
(4) Excision Step The excision process of the lesioned part 130 using the magnetic guidance device 110 configured as described above will be described.
[0042]
First, physiological saline is injected from the periphery of the lesioned part 130 with an injection needle inserted into the submucosal layer (not shown), and the lesioned part 130 is lifted from the proper muscle layer (not shown).
[0043]
On the other hand, the magnetic guiding member 112 is arranged at a preset position near the lesioned part 130. When set in this way, the lesioned part 130 is lifted by the attractive force between the magnetic guiding member 112 and the magnetic guiding means 30. When the amount of lifting of the lesioned part 130 is insufficient or too large, adjustment is performed by shifting the position of the magnetic guiding member 112 or weakening the magnetic field generated by the magnetic guiding member 112.
[0044]
Subsequently, an incision tool such as a high-frequency knife is introduced into the body through the forceps channel 61, and the lesioned part 130 is excised from the end together with the mucous membrane. At this time, since the lesioned part 130 is lifted by the clip 10, the excised part can be taken sufficiently, and the already excised lesioned part 130 can also be prevented from falling on the intrinsic muscle layer. Moreover, since the excised lesioned part 130 can be further lifted by gradually shifting the position of the magnetic guiding member 112, it is easy to confirm the distal end position of the high-frequency knife, and the excision work can be performed smoothly.
[0045]
Further, when the excision work is finished, the magnetic guiding means 30 is attracted to the magnetic guiding member 112 in a state where the clip 10 holds the lesioned part 130, so that the lesioned part 130 can be prevented from being lost. When recovering the excised lesion part 130, the current to the magnetic induction member 112 with the magnetic guiding means 30, the clip 10, the connecting member 20, the clip receiving tube 40, and a part of the lesion part 130 hooked with gripping forceps is applied. The supply is stopped and the endoscope is removed as it is. Thereafter, treatments such as suturing and disinfection are performed.
[0046]
The magnetic guiding means 30 may be pulled using gravity.
[0047]
Although the present invention has been described with reference to the above embodiment, the present invention is not limited to the above embodiment, and can be improved or changed within the scope of the purpose of the improvement or the idea of the present invention.
[0048]
【The invention's effect】
As described above, according to the present invention, the magnetic guiding means and the gripping member that are connected in advance by the connecting member can be introduced into the object, and are attached to the target site when the endoscope gripping device is introduced. Can also be done. For this reason, it is not necessary to connect the magnetic guiding means and the gripping member inside the object, and it is not necessary to attach the gripping member to the target site using a separate gripping forceps after the gripping member is once placed inside the object. . Therefore, the time and labor required for these operations can be reduced, and the burden on the patient and the operator can be reduced.
[Brief description of the drawings]
FIG. 1 is a partial cross-sectional view showing configurations of a magnetic guiding unit , a clip, a connecting member, a loop wire, and a clip receiving tube according to an embodiment of the present invention.
FIG. 2 is a side view showing a configuration of magnetic guiding means , a clip, a connecting member, and a clip receiving tube according to an embodiment of the present invention.
FIG. 3 is a front view showing a state in which a clip according to an embodiment of the present invention is opened.
FIG. 4 is a partial cross-sectional view illustrating configurations of an introduction tube, an insertion coil, a coil regulation tube, a hook portion, and an operation wire according to the embodiment of the present invention.
FIG. 5 is an overview diagram showing an overall configuration of an endoscope according to an embodiment of the present invention.
FIG. 6 is a schematic view of the arrangement of a bed on which a patient is placed, a magnetic guiding member, and the like when performing excision of a lesion portion according to an embodiment of the present invention, as viewed from the patient's head side.
FIG. 7 is a view showing a state where a clip receiving tube according to an embodiment of the present invention is received by a coil restricting tube.
FIG. 8 is a view showing a state where an introduction tube in which a clip according to an embodiment of the present invention is inserted is received in a forceps channel.
FIG. 9 is a view showing a state where a part of the introduction tube according to the embodiment of the present invention is exposed to the outside of the forceps channel.
FIG. 10 is a view showing a state in which the clip and the magnetic guiding means according to the embodiment of the present invention are exposed to the outside of the introduction tube.
FIG. 11 is a partial cross-sectional view showing a state in which the clip according to the embodiment of the invention is opened.
FIG. 12 is a partial cross-sectional view showing a state in which the clip according to the embodiment of the present invention is closed.
FIG. 13 is a side view showing a state in which a part of the loop wire according to the embodiment of the present invention is cut.
FIG. 14 is a side view showing a state in which the clip according to the embodiment of the present invention is separated from the introduction pipe, the coil regulation pipe, and the hook portion.
15A and 15B are views showing the inside of a conventional magnetic guiding means and an introduction pipe into which a clip is inserted, in which FIG. 15A is a state in which the magnetic guiding means and the clip are arranged in the introduction pipe, and FIG. 15B is a rear end of the introduction pipe. (C) is a diagram showing a state in which the magnetic guiding means and the clip are pushed out of the introduction pipe by pushing in the flexible pushing rod.
[Explanation of symbols]
10 clips (gripping members)
11e Rear portion 12e Rear portion 13e Rear portion 20 Connecting member 30 Magnetic guiding means 40 Clip receiving tube (gripping member receiving tube)
41 Slit 42 Slit 44 Rear end 45 Stepped portion 46 Front 50 Loop wire (traction separation means)
70 Introduction tube 72 Restriction tube 80 Operation wire 101 Patient (object)
130 Lesions (target site)

Claims (3)

A gripping part receiving tube that has a hollow cylindrical shape, and a rear end part of which is detachable from a distal end part of an introduction tube that is inserted through a forceps channel of an endoscope;
A gripping member that has a plurality of claw portions, and closes after the claw portion is opened by relative movement backward in the gripping portion receiving tube, and is capable of gripping a target portion inside the object by the closed claw portion ; ,
Magnetic induction means made of a magnetic material and attracted by a magnetic force generated outside the object;
A connecting member that connects the gripping member and the magnetic guiding means ;
By engaging with the gripping member and engaging with the distal end portion of the operation wire inserted in the introduction tube so as to be relatively movable, the operation wire is pulled backward while being engaged with the operation wire. A traction separating member that moves when the gripping member is moved relative to the gripping part receiving tube backward and is further pulled by the operation wire after the claw part is closed ;
An endoscope gripping device comprising: The endoscope gripping device according to claim 1 , wherein a hook portion for hooking the traction separation means is formed at a distal end of the operation wire . The gripping member receiving tube is formed with a small-diameter portion that is inserted into the introduction tube by a step portion at an intermediate portion in the length direction,
The gripping part receiving tube has a slit whose rear end is opened and the magnetic guiding means can be positioned in front of the gripping member by inserting the connecting member;
The endoscope gripping apparatus according to claim 2, wherein a front end portion of the slit with the rear end portion opened reaches a front portion of the stepped portion.

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