JP7630393B2 - Ligation Device - Google Patents

Description

The present invention relates to a ligation device.

Conventionally, ligation devices have been used to ligate diverticula, aneurysms, etc. formed in the human digestive tract, etc. (see, for example, Patent Documents 1 and 2). Patent Documents 1 and 2 disclose a technique for detaching the ligation ring by injecting a fluid using a fluid injection means in a device structured such that a sliding tube is disposed between an inner tube with a ligation ring attached and an outer tube, and a small hole is provided at the rear end of the airtight space to connect to a fluid tube.

JP 2001-170061 A JP 2002-253555 A

In the fluid-driven ligation device described in Patent Documents 1 and 2, it is possible to use a so-called split slide tube that is divided into two or more pieces. When manufacturing a ligation device using a split slide tube, if adhesive is applied to the contact surfaces of each split mold and the slide tube is assembled, there is a risk that the adhesive will overflow inside the slide tube and the slide tube will be bonded to other parts such as the inner tube. For this reason, a certain level of proficiency is required in applying the adhesive, and there is a risk that the manufacturing efficiency will decrease, such as the manufacturing time being longer and the defect rate becoming higher.

The present invention has been made to solve at least some of the problems described above, and aims to provide a technique that makes it easier to assemble a sliding tube in a fluid-driven ligation device.

The present invention has been made to solve at least some of the above problems, and can be realized in the following form.

(1) According to one aspect of the present invention, a ligation device is provided. The ligation device includes an approximately cylindrical inner cylinder body, an approximately cylindrical outer cylinder body that is attached to the inner cylinder body with a gap therebetween so as to surround the outer periphery of the inner cylinder body, a approximately cylindrical slider that is disposed in the gap so as to surround the outer periphery of the inner cylinder body and is movable relative to the inner cylinder body along the axial direction of the inner cylinder body by a fluid flowing into the gap, and at least one ligation ring that is attached to surround the outer periphery of the inner cylinder body and is movable relative to the inner cylinder body together with the relative movement of the slider and is detachable from the tip of the inner cylinder. The slider has a first part that is a substantially arc-shaped body, a second part that is a substantially arc-shaped body and that is connected to the first part in the circumferential direction of the slider, and a joining member that is arranged from the outer circumferential surface of the first part to the outer circumferential surface of the second part and joins the first part to the second part, the first part having at least one of a recess and a through hole that opens onto the outer circumferential surface and a first fitting portion into which at least a portion of the joining member fits, and the second part having at least one of a recess and a through hole that opens onto the outer circumferential surface and a second fitting portion into which at least a portion of the joining member fits.

According to this configuration, the first part and the second part are joined by a joining member from the outer circumferential surface side of the first part and the second part. Therefore, compared to the case where the first part and the second part are joined by applying adhesive to the contact surface between the first part and the second part, adhesion between the slider and other parts due to overflow of adhesive can be suppressed, so that the application of adhesive does not require skill and the assembly of the slider can be made easier. In addition, for example, it is possible to join the first part and the second part by a joining member without using adhesive, so that adhesion between the slider and other parts can be prevented when no adhesive is used. Therefore, it can contribute to improving manufacturing efficiency, such as shortening the manufacturing time of products and reducing the defect rate. Here, "fitting" is a concept that includes "fitting tightly" and "fitting loosely".

(2) In the ligation device of the above embodiment, the slider may further have at least one annular groove extending circumferentially on the inner peripheral surface, and the ligation ring may be positioned within the annular groove. In this way, the relative movement of the ligation ring accompanying the relative movement of the slider can be more appropriately performed.

(3) The ligation device of the above embodiment may include a plurality of the ligation rings, the plurality of ligation rings including a first ligation ring disposed distal to the slider and a second ligation ring disposed within the annular groove. In this way, the detachment of the plurality of ligation rings can be easily and appropriately controlled, for example, by detaching the first ligation ring and then detaching the second ligation ring after a period of time.

(4) In the ligation device of the above embodiment, the first fitting portion and the second fitting portion may each be groove-shaped, and the first fitting portion and the second fitting portion may be connected to each other. In this way, the contact area between the first part and the second part and the joining member is increased, thereby improving the joining property between the first part and the second part.

(5) In the ligation device of the above embodiment, the joining member may have a first joining member extending substantially along the circumferential direction of the slider, and a second joining member connected to the first joining member and extending substantially along the axial direction of the slider. In this way, not only can the joining between the first part and the second part be prevented from being released against the circumferential force generated in the slider by the first joining member, but the slider can also be reinforced against the axial moment of the slider.

(6) The ligation device of the above embodiment may further include a tube that communicates with the gap. In this way, for example, by connecting a syringe to the tube, fluid can be easily supplied to the gap.

The present invention can be realized in various forms, such as a method for manufacturing a ligation device.

FIG. 1 is an explanatory diagram illustrating a schematic external configuration of a ligation device according to a first embodiment. FIG. 2 is an explanatory view illustrating a schematic cross-sectional configuration of the ligation device according to the first embodiment. FIG. 2 is an explanatory view illustrating an enlarged schematic cross-sectional configuration of the ligation device according to the first embodiment. FIG. 1 is an explanatory diagram of a method of using the ligation device. FIG. 2 is an explanatory diagram illustrating a schematic external configuration of a slider. FIG. 2 is an explanatory diagram illustrating a schematic cross-sectional configuration of a slider. 11A and 11B are diagrams illustrating a method of mounting a slider. 13 is an explanatory diagram illustrating an outline of the external configuration of a slider according to a second embodiment; FIG. 13 is an explanatory diagram illustrating an external configuration of a slider according to a third embodiment. FIG. 13 is an explanatory diagram illustrating an external configuration of a slider according to a fourth embodiment. FIG. 13 is an explanatory diagram illustrating an external configuration of a slider according to a fifth embodiment. FIG. 13 is an explanatory diagram illustrating an external configuration of a slider according to a sixth embodiment; FIG. 13 is an explanatory diagram illustrating an external configuration of a slider according to a seventh embodiment. FIG. FIG. 23 is an explanatory diagram illustrating a schematic cross-sectional configuration of a slider according to a seventh embodiment. 13 is an explanatory diagram illustrating an external configuration of a slider according to an eighth embodiment. FIG. FIG. 13 is an explanatory diagram illustrating a schematic cross-sectional configuration of a slider according to an eighth embodiment. FIG. 19 is an explanatory diagram illustrating a cross-sectional configuration of a ligation device using a slider according to an eighth embodiment. FIG. 13 is an explanatory diagram illustrating a cross-sectional configuration of a ligation device according to a ninth embodiment. FIG. 23 is an explanatory diagram illustrating an enlarged schematic cross-sectional configuration of a ligation device according to a tenth embodiment. FIG. 23 is an explanatory diagram illustrating an enlarged schematic cross-sectional configuration of a ligation device according to an eleventh embodiment.

First Embodiment
FIG. 1 is an explanatory diagram that shows a schematic external configuration of the ligation device 100 of the first embodiment. FIG. 2 is an explanatory diagram that shows a schematic cross-sectional configuration of the ligation device 100 of the first embodiment. FIG. 3 is an explanatory diagram that shows an enlarged schematic cross-sectional configuration of the ligation device 100 of the first embodiment. FIG. 2 and FIG. 3 show a cross section taken along line A-A in FIG. 1. FIG. 1 and FIG. 2 show a state in which a syringe 200 is connected to the ligation device 100. FIG. 3 shows a state in which the ligation device 100 is attached to an endoscope 300. Note that in FIG. 3, the endoscope 300 is shown in an external view for convenience, and is not shown in a cross-sectional view (this also applies to the following figures).

The ligation device 100 is used to ligate diseased areas such as diverticula and aneurysms formed in the digestive tract of a patient. The ligation device 100 comprises an inner cylinder 10, a slider 20, an outer cylinder 30, a ligation ring 40, and a tube 50 (Figs. 1 and 2). The ligation device 100 is a fluid-driven ligation device that is driven by the pressure of a fluid (e.g., air) supplied by a syringe 200 connected to the tube 50.

In FIG. 1, the axis passing through the center of the inner cylinder 10 of the ligation device 100 is represented by the axis LO (dotted line). In this example, the axis LO coincides with the axis passing through the centers of the inner cylinder 10, the slider 20, and the outer cylinder 30. However, the axis LO may differ from the central axes of the inner cylinder 10, the slider 20, and the outer cylinder 30. FIG. 1 illustrates XYZ axes that are mutually perpendicular. The X axis corresponds to the longitudinal direction (length direction) of the ligation device 100, and the Y axis and Z axis correspond to the radial direction of the ligation device 100. The left side (-X axis direction) of FIG. 1 is called the "tip side" of the ligation device 100 and each component, and the right side (+X axis direction) of FIG. 1 is called the "base side" of the ligation device 100 and each component. For the ligation device 100 and each of its components, the end located on the distal side is referred to as the "distal end," and the distal end and its vicinity are referred to as the "distal portion." The end located on the proximal side is referred to as the "proximal end," and the proximal end and its vicinity are referred to as the "proximal portion." These points are the same in Figure 1 and subsequent figures.

The inner cylinder 10 is generally hollow and generally cylindrical, and has a first cylinder 12 that tapers toward the tip, and a cylindrical second cylinder 14 of generally constant diameter. The first cylinder 12 is integrally formed with the second cylinder 14, connected to the tip side of the second cylinder 14. The ligation device 100 is attached to the tip of the endoscope 300, as described below. An annular stopper 16 is provided on the inner circumference of the tip of the second cylinder 14 of the inner cylinder 10. When the endoscope 300 is inserted into the inner cylinder 10 from the base end side of the second cylinder 14 of the inner cylinder 10 and the tip of the endoscope 300 abuts against the stopper 16, the ligation device 100 is positioned appropriately relative to the endoscope 300 (FIG. 3). For example, in the case of endoscopic band ligation (EBL), an endoscopic hemostasis procedure for colonic diverticular bleeding, the diverticulum is aspirated via the endoscope 300, and the diverticulum is inverted so that it forms a convex shape toward the endoscope 300, and the diverticulum is positioned inside the first tube portion 12.

The material constituting the inner cylinder body 10 is not particularly limited, and may be, for example, a metal material, a resin material, or a ceramic material. Examples of metal materials include stainless steel, titanium, and nickel-titanium alloys. Examples of resin materials include, for example, polyethylene, polypropylene, polyvinyl chloride, polystyrene, acrylic resin, phenolic resin, melamine resin, polyimide, polyamide, polycarbonate, polyethersulfone, polyetheretherketone, or polytetrafluoroethylene. Examples of ceramic materials include, for example, glass and fine ceramics.

As described below, since a ligation ring 40 is attached to the inner cylinder 10, it is preferable that the material constituting the inner cylinder 10 is strong enough to withstand the pressure caused by the attachment of the ligation ring 40 and is also biocompatible. In addition, the material constituting the inner cylinder 10 may be a translucent material (e.g., polypropylene, polycarbonate, polyethersulfone, polyimide, acrylic resin, etc.) to maintain a wide field of view during treatment.

The outer cylinder 30 is a hollow, generally cylindrical body with a larger diameter than the inner cylinder 10, and is disposed with a gap S between it and the inner cylinder 10 so as to surround the outer periphery of the inner cylinder 10. As shown in FIG. 3, a generally annular fixing member 60 is disposed on the base end side of the outer cylinder 30, and the outer cylinder 30 and the fixing member 60 are bonded with an adhesive, and the fixing member 60 and the inner cylinder 10 are bonded with an adhesive, so that the outer cylinder 30 is attached to the outer periphery of the inner cylinder 10. The base end side of the gap S between the outer cylinder 30 and the inner cylinder 10 is closed by the fixing member 60. A through hole communicating with the gap S is formed in the fixing member 60, and a tube 50 (described later) is inserted into the through hole. As a result, the tube 50 communicates with the gap S.

The material constituting the external cylinder body 30 is not particularly limited, and for example, the materials exemplified as the material of the internal cylinder body 10 can be used. The material constituting the external cylinder body 30 preferably has the strength to withstand the pressure of the fluid and biocompatibility, as described below. The adhesive material is also not particularly limited, and for example, an acrylic resin adhesive, a urethane resin adhesive, an epoxy resin adhesive, a polyvinyl chloride resin solvent adhesive, a cyanoacrylate adhesive, a silicone adhesive, or a phenol resin adhesive can be used. Similarly, the adhesive material preferably has the strength to withstand the pressure of the fluid and biocompatibility.

The slider 20 is a hollow, generally cylindrical member with a larger diameter than the inner cylinder 10 and a smaller diameter than the outer cylinder 30, and is disposed in the gap S between the inner cylinder 10 and the outer cylinder 30 so as to surround the outer periphery of the inner cylinder 10. The slider 20 is movable relative to the inner cylinder 10 along the axis LO direction of the inner cylinder 10 (the X-axis direction in the figure) by a fluid (e.g., air) that flows into the gap S via the tube 50. An annular groove 22 extending circumferentially is formed on the inner peripheral surface of the slider 20. The slider 20 will be described in detail later.

The seal member 70 is substantially annular and is movable within the gap S along the axis LO direction (X-axis direction) while abutting against the inner circumference of the outer cylinder body 30 and the outer circumference of the inner cylinder body 10. In other words, the seal member 70 is slidable along the inner peripheral surface of the outer cylinder body 30 and the outer peripheral surface of the inner cylinder body 10. The seal member 70 abuts against the inner circumference of the outer cylinder body 30 and the outer circumference of the inner cylinder body 10, thereby keeping the space surrounded by the seal member 70, the fixing member 60, the inner cylinder body 10, and the outer cylinder body 30 (described later) airtight.

The material constituting the sealing member 70 is not particularly limited as long as it can make the space airtight, and elastic materials such as natural rubber, synthetic rubber, and thermoplastic elastomers can be used. Examples of synthetic rubber include isoprene rubber, butadiene rubber, styrene-butadiene rubber, nitrile rubber, butyl rubber, ethylene-propylene rubber, acrylic rubber, fluororubber, and silicone rubber. Examples of thermoplastic elastomers include styrene-based elastomers, olefin-based elastomers, polyester-based elastomers, polyurethane-based elastomers, and polyamide-based elastomers. It is preferable that the material constituting the sealing member 70 is also biocompatible.

The ligation ring 40 is attached so as to surround the outer periphery of the inner cylindrical body 10, can move relative to the inner cylindrical body 10 together with the relative movement of the slider 20, and can be detached from the tip of the inner cylindrical body 10. The ligation device 100 of this embodiment includes two ligation rings 40 (a first ligation ring 41 and a second ligation ring 42). The first ligation ring 41 is located on the tip side of the slider 20, and the second ligation ring 42 is located in an annular groove 22 formed on the inner peripheral surface of the slider 20.

The material constituting the ligation ring 40 is not particularly limited as long as it is sufficiently stretchable to be attached to the inner cylindrical body 10, has sufficient ligation force to necrotize the affected area, and is biocompatible. For example, the materials exemplified as the materials of the seal member 70 can be used. The material constituting the ligation ring 40 may be, for example, gold, platinum, tungsten, alloys containing these elements (e.g., platinum-nickel alloys, etc.), radiopaque materials such as barium sulfate, bismuth subcarbonate, bismuth trioxide, bismuth oxychloride, bismuth subcarbonate, or materials containing powder of these radiopaque materials. The vertical cross-sectional shape of the ligation ring 40 (the shape that appears on a cross section along the axis LO direction of the inner cylindrical body 10 when attached to the outer periphery of the inner cylindrical body 10) is not limited to a circle, and may be another shape such as a rectangle. The color of the ligation ring 40 is preferably a color such as black that stands out from the surrounding tissue.

The tube 50 passes through the fixing member 60 and communicates with the gap S between the inner cylinder body 10 and the outer cylinder body 30. When the ligation device 100 is in use, for example, a syringe 200 is connected to the base end of the tube 50 (FIGS. 1 and 2), and a gaseous fluid such as air is sent to the gap S. The tip of the tube 50 is inserted into the through hole of the fixing member 60 and is fixed to the fixing member 60 in an airtight state.

The material from which the tube 50 is made is not particularly limited, and may be, for example, polyethylene, polypropylene, polyvinyl chloride, fluororesin, etc. It is preferable that the material from which the tube 50 is made is also biocompatible.

Figure 4 is an explanatory diagram of a method of using the ligation device 100. An example of ligating a diverticulum formed on the wall of the large intestine will be described below. First, the surgeon inserts the endoscope 300 equipped with the ligation device 100 into the large intestine to observe the inside of the large intestine. At this time, as shown in Figure 4 (A), the slider 20 is positioned at the most proximal end side, that is, at a position where the seal member 70 abuts against the fixing member 60. The surgeon identifies the bleeding diverticulum, brings the endoscope 300 and the ligation device 100 close to the diverticulum, aspirates the diverticulum through the forceps hole, and inverts the diverticulum so that it has a convex shape toward the endoscope 300, and positions the diverticulum inside the first tube portion 12.

The surgeon etc. operates the syringe 200 (FIGS. 1 and 2) to release the fluid toward the slider 20 through the tube 50. The fluid applies pressure to the base end side of the seal member 70 arranged at the base end of the slider 20, and moves the slider 20 and the seal member 70 forward (FIG. 4(B)). The fluid accumulates in the space between the seal member 70, the outer cylinder 30, the inner cylinder 10, and the fixing member 60, which is formed as the slider 20 and the seal member 70 advance, and continues to apply pressure to the base end side of the seal member 70. As a result, when the slider 20 moves the distance L1 toward the tip side of the inner cylinder 10, the ligation ring 41 located on the tip side of the slider 20 moves to the first cylinder portion 12 of the inner cylinder 10. As described above, since the first cylinder portion 12 is reduced in diameter toward the tip, the first ligation ring 41 moves toward the tip along the inclined surface of the first cylinder portion 12 while reducing in diameter. Then, the first ligation ring 41 detaches from the tip of the first tubular portion 12 and ligates the diverticulum that has been sucked into the first tubular portion 12.

If there is another diverticulum to be ligated in the large intestine, the surgeon etc. ligates the diverticulum in the same manner. Specifically, as described above, the surgeon etc. positions the inverted diverticulum in the first tube portion 12 of the ligation device 100, and operates the syringe 200 to release fluid through the tube 50 toward the slider 20, and moves the slider 20 further toward the tip. Then, the second ligation ring 42 moves in conjunction with the movement of the slider 20, and the second ligation ring 42 moves toward the tip on the inclined surface of the first tube portion 12 while reducing in diameter. The second ligation ring 42 then detaches from the tip of the first tube portion 12, and ligates the diverticulum sucked into the first tube portion 12.

Then, the surgeon etc. removes the endoscope 300 equipped with the ligation device 100 from the large intestine. The ligated diverticulum then undergoes necrosis and is discharged from the body together with the first ligation ring 41 and the second ligation ring 42. If there is only one diverticulum to be ligated, the surgeon etc. ligates the diverticulum with the first ligation ring 41, and then removes the endoscope 300 equipped with the ligation device 100 from the large intestine.

Figure 5 is an explanatory diagram that shows a schematic external configuration of the slider 20. Figure 6 is an explanatory diagram that shows a schematic cross-sectional configuration of the slider 20. Figure 6(A) shows the A-A cross section in Figure 5, and Figure 6(B) shows the B-B cross section in Figure 5.

As shown in Figures 5 and 6, the slider 20 is hollow and approximately cylindrical, and includes a slider body 290 and a joining member 230. The slider body 290 is composed of a first part 210 and a second part 220, each of which is an arc body. When the first part 210 and the second part 220 are connected in the circumferential direction by contacting the first contact surface 219 of the first part 210 and the second contact surface 229 of the second part 220, they become approximately cylindrical. In other words, the first part 210 and the second part 220 are obtained by splitting the approximately cylindrical slider body 290 in half along a plane including the central axis of the slider body 290.

The first part 210 has a tip-side first fitting portion 211, which is a groove-shaped recess that opens on the outer circumferential surface 218, and a base-side first fitting portion 212 (FIG. 5). The opening shape of the tip-side first fitting portion 211 is a planar linear shape that extends approximately along the circumferential direction. The base-side first fitting portion 212 has a first portion 214 whose opening shape is a planar linear shape that extends approximately along the circumferential direction, and a second portion 213 connected to the first portion 214 and whose opening shape is a planar linear shape that extends approximately along the axis LO direction of the slider 20. In the following description, when there is no need to distinguish between the tip-side first fitting portion 211 and the base-side first fitting portion 212, they are also simply referred to as "first fitting portions."

The second part has a tip-side second fitting portion 221, which is a groove-shaped recess that opens into the outer circumferential surface 228, and a base-side second fitting portion 222 (Figure 5). The opening shape of the tip-side second fitting portion 221 is a planar linear shape that extends approximately along the circumferential direction. The base-side second fitting portion 222 has a first portion 224 whose opening shape is a planar linear shape that extends approximately along the circumferential direction, and a second portion 223 connected to the first portion 224 and whose opening shape is a planar linear shape that extends approximately along the axis LO direction of the slider 20. In a state where the first part 210 and the second part 220 are connected in the circumferential direction, i.e., in a state where the slider body 290 is formed, the tip side first fitting portion 211 and the tip side second fitting portion 221 communicate with each other to form the tip side fitting portion 201, and the base side first fitting portion 212 and the base side second fitting portion 222 communicate with each other to form the base side fitting portion 202. In a state where the first part 210 and the second part 220 are connected in the circumferential direction, the tip side second fitting portion 221 and the base side second fitting portion 222 are symmetrical to the tip side first fitting portion 211 and the base side first fitting portion 212, respectively, with the first contact surface 219 and the second contact surface 229 as boundaries. In the following description, when there is no need to distinguish between the distal second fitting portion 221 and the proximal second fitting portion 222, they are simply referred to as the "second fitting portion."

The material constituting the slider body 290 is not particularly limited, but it is preferable that the material has excellent sliding properties with the inner cylinder body 10 and the outer cylinder body 30 and is biocompatible. For example, the materials exemplified as the material for the inner cylinder body 10 can be used. The material constituting the slider body 290 may be a translucent material (e.g., polypropylene, polycarbonate, polyethersulfone, polyimide, acrylic resin, etc.) in order to maintain a wide field of view during treatment.

In this embodiment, the slider 20 has a tip-side joining member 231 and a base-side joining member 232 as the joining member 230. The tip-side joining member 231 is substantially linear in plan view and is disposed from the outer peripheral surface 218 of the first part 210 to the outer peripheral surface 228 of the second part 220, and its entirety is engaged with the tip-side first fitting portion 211 and the tip-side second fitting portion 221 (FIG. 6A). The base-side joining member 232 has a first joining member 234 that is substantially linear in plan view and extends substantially along the circumferential direction of the slider 20, and two second joining members 233 that are substantially linear in plan view and connected to the first joining member 234 and extend substantially along the axial direction of the slider 20. As shown in FIG. 5, the base-side joining member 232 has a substantially U-shaped planar shape. The base end joining member 232, like the tip end joining member 231, is disposed from the outer circumferential surface 218 of the first part 210 to the outer circumferential surface 228 of the second part 220, and is entirely fitted into the base end first fitting portion 212 and the base end second fitting portion 222 (FIG. 6B). In the slider 20, the slider body 290 has the tip end fitting portion 201 and the base end fitting portion 202 shown in FIG. 5 on the back side (positive side of the Y axis), and the tip end joining member 231 and the base end joining member 232 are fitted into these fitting portions, respectively (FIG. 6). As shown in FIG. 6, the tip end joining member 231 is fitted into the tip end fitting portion 201, and the base end joining member 232 is fitted into the base end fitting portion 202, whereby the first part 210 and the second part 220 are joined together. In this embodiment, the tip-side joining member 231 fits tightly (interlocks) with the tip-side fitting portion 201 with almost no gaps, and the base-side joining member 232 fits tightly (interlocks) with the base-side fitting portion 202 with almost no gaps, so that the first part 210 and the second part 220 are joined by the joining member 230 without the use of adhesive.

The material constituting the joining member 230 is not particularly limited, but it is preferable that it has excellent sliding properties with the external cylinder body 30 and is biocompatible. In addition, a material having a hardness sufficient to adequately reinforce the slider body 290 is preferable. For example, styrene-based resin, fluororesin, etc. can be used. In addition, ultraviolet-curing resin, thermosetting resin, etc. may be used, and uncured resin may be poured into the tip-end fitting portion 201 and the base-end fitting portion 202, and cured by irradiating light or heat.

Figure 7 is an explanatory diagram of a method for attaching the slider 20. First, the manufacturer prepares the inner cylindrical body 10, the first ligation ring 41, the second ligation ring 42, the first part 210, the second part 220, the tip-side joining member 231, and the base-side joining member 232. Then, as shown in Figure 7 (A), the first ligation ring 41 and the second ligation ring 42 are attached to the outer periphery of the second cylindrical portion 14 of the inner cylindrical body 10. At this time, the first ligation ring 41 is positioned closer to the tip side than the second ligation ring 42 and spaced apart from the second ligation ring 42.

Next, the manufacturer places the first part 210 and the second part 220 on the second cylindrical portion 14 of the inner cylindrical body 10 from the outside of the inner cylindrical body 10 (FIG. 7(A)), and connects the first part 210 and the second part 220 in the circumferential direction by contacting the first contact surface 219 and the second contact surface 229 to form the slider body 290 (FIG. 7(B)). At this time, the second ligating ring 42 is positioned within the annular groove 22 formed on the inner circumferential surfaces 217, 218 of the first part 210 and the second part 220, and the first ligating ring 41 is positioned on the tip side of the slider body 290.

Then, the manufacturer fits the tip-side joint member 231 into the tip-side fitting portion 201 of the slider body 290, and fits the base-side joint member 232 into the base-side fitting portion 202. This causes the slider 20 to be attached so as to surround the outer periphery of the inner cylinder body 10 (Figure 7 (C)).

As described above, according to the ligation device 100 of this embodiment, the first part 210 and the second part 220 are joined by the joining member 230 from the outer circumferential surface side of the first part 210 and the second part 220. For example, when the first part 210 and the second part 220 are joined by applying adhesive to the contact surface (first contact surface 219 and second contact surface 229) between the first part 210 and the second part 220, the adhesive may overflow from the contact surface, the first part 210 and the second part 220 may be bonded to the inner cylindrical body 10, and the slider may not be able to move relative to the inner cylindrical body 10. In addition, since the thickness of the first part 210 and the second part 220 is thin, the area of the contact surface (first contact surface 219 and second contact surface 229) between the first part 210 and the second part 220 is small, and it is difficult to obtain sufficient adhesive strength without a certain level of skill in applying the adhesive. In contrast, in the ligation device 100 of the present embodiment, as described above, the first part 210 and the second part 220 are joined by the joining member 230 from the outer circumferential surface side of the first part 210 and the second part 220. This makes it easier to assemble the slider 20 without requiring the skill of a manufacturer, etc., compared to when the first part 210 and the second part 220 are joined by applying an adhesive to the contact surface between the first part 210 and the second part 220. In addition, since the first part 210 and the second part 220 are joined without using an adhesive, adhesion between the slider 20 and the internal cylinder body 10 can be prevented. This contributes to improving manufacturing efficiency, such as shortening the manufacturing time of products and reducing the defective rate.

The ligation device 100 also includes two ligation rings 40. If the ligation device includes only one ligation ring, for example, if ligation fails or if there are multiple treatment sites, after using one ligation ring, the ligation device must be removed from the body together with the endoscope, a ligation ring must be attached, and the ligation device must be reinserted into the body together with the endoscope to perform ligation. In contrast, the ligation device 100 of this embodiment includes two ligation rings 40, so that the number of times the ligation device 100 is inserted and removed from the patient's body can be reduced, and the physical burden on the patient can be reduced.

The slider 20 of this embodiment has one annular groove 22 extending circumferentially on the inner circumferential surfaces 217, 218, and the second ligation ring 42 is located in the annular groove 22. Therefore, the timing of detachment of the two ligation rings 40 can be appropriately set, for example, by detaching the second ligation ring 42 with a time interval after the detachment of the first ligation ring 41. For example, when there are two colonic diverticula, it is relatively easy to first ligate one colonic diverticula with the first ligation ring 41, and then ligate the other colonic diverticula with the second ligation ring 42.

In addition, in the slider 20 of this embodiment, the tip side first fitting portion 211 and the tip side second fitting portion 221 are each groove-shaped, and the tip side first fitting portion 211 and the tip side second fitting portion 221 are connected to each other. Similarly, the base end side first fitting portion 212 and the base end side second fitting portion 222 are each groove-shaped, and the base end side first fitting portion 212 and the base end side second fitting portion 222 are connected to each other. Therefore, the contact area between the first part 210 and the second part 220 and the joining member 230 is increased, and the joining property between the first part 210 and the second part 220 can be improved.

Furthermore, in this embodiment, the base end side joining member 232 has a first joining member 234 that extends approximately along the circumferential direction of the slider 20, and a second joining member 233 that is connected to the first joining member 234 and extends approximately along the axial line LO direction of the slider 20. Therefore, the base end side joining member 232 not only prevents the joining of the slider body 290 from being released against the circumferential force generated in the slider body 290, but also reinforces the slider body 290 against the axial moment of the slider 20.

The ligation device 100 includes a tube 50 that communicates with the gap S. Therefore, by connecting, for example, a syringe 200 to the tube 50, fluid can be easily supplied to the gap S.

Second Embodiment
8 is an explanatory diagram showing a schematic external configuration of the slider 20A of the second embodiment. The slider 20A of the second embodiment differs from the slider 20 of the first embodiment in the number and shape of the joining members, and the shape of the fitting portion into which the joining members are fitted. In the embodiment described below, the same components as those of the slider of the embodiment described above are given the same reference numerals, and the preceding description is referred to. Note that the slider of the embodiment described below can be used in place of the slider 20 in the ligation device 100 of the first embodiment.

The slider 20A has a slider body 290A and two joining members 230A. As with the slider body 290 of the first embodiment, the slider body 290A is composed of a first part 210A, which is an arc-shaped body obtained by splitting the slider body 290A in half along a plane including the central axis of the slider body 290A, and a second part 220A.

The first part 210A has a groove-shaped first fitting portion 215 that opens on the outer circumferential surface 218, and the second part 220A has a groove-shaped second fitting portion 225 that opens on the outer circumferential surface 228 (Figure 8). The opening shape of the first fitting portion 215 is a planar approximately quarter elliptical arc shape. The opening shape of the second fitting portion 225 is a planar approximately quarter elliptical arc shape. In a state in which the first part 210A and the second part 220A are connected in the circumferential direction, that is, in a state in which the slider body 290A is formed, the first fitting portion 215 and the second fitting portion 225 communicate with each other to form the fitting portion 205. In a state in which the first part 210A and the second part 220A are connected in the circumferential direction, the second fitting portion 225 has a surface-symmetric shape with respect to the first fitting portion 215, with the first contact surface 219 and the second contact surface 229 as boundaries. The opening shape of the fitting portion 205 is a roughly semi-elliptical arc shape that is convex toward the base end.

The joining member 230A has a substantially semi-elliptical planar shape, is disposed from the outer peripheral surface 218 of the first part 210A to the outer peripheral surface 228 of the second part 220A, and is entirely fitted into the first fitting portion 215 and the second fitting portion 225. In the slider 20A of this embodiment, as in the first embodiment, the slider body 290A also has a fitting portion 205 on the back side (positive side of the Y axis), and the joining member 230A is fitted into this fitting portion.

In the slider 20A of this embodiment, the first part 210A and the second part 220A are joined from the outer circumferential surface side of the first part 210A and the second part 220A by the joining member 230A. Therefore, as in the first embodiment, it is possible to easily assemble the slider 20A to the internal cylinder body 10.

In addition, because the joining member 230A has a planar, generally semi-elliptical arc shape, it not only prevents the joining of the slider body 290A from being released by resisting the circumferential force acting on the slider body 290A, but also reinforces the slider body 290A against the axial moment of the slider 20A.

In the ligation device 100 of the first embodiment, even if the slider 20A of this embodiment is used instead of the slider 20, the same effect as in the first embodiment can be achieved.

Third Embodiment
9 is an explanatory diagram showing a schematic external configuration of a slider 20B according to the third embodiment. The slider 20B according to the third embodiment differs from the slider 20A according to the second embodiment in the shape of the joining member and the shape of a fitting portion 205B of a slider body 290B.

The slider 20B has a slider body 290B and two joining members 230B. As with the slider body 290A of the second embodiment, the slider body 290B is composed of a first part 210B, which is an arc-shaped body obtained by splitting the slider body 290B in half along a plane including the central axis of the slider body 290B, and a second part 220B.

The first part 210B has a groove-shaped first mating portion 215B opening on the outer circumferential surface 218, and the second part 220B has a groove-shaped second mating portion 225B opening on the outer circumferential surface 228 (Figure 9). The opening shape of the first mating portion 215B is a straight line shape oblique to the first contact surface 219 in a plan view. The opening shape of the second mating portion 225B is a straight line shape oblique to the second contact surface 229 in a plan view. When the first part 210B and the second part 220B are connected in the circumferential direction, i.e., when the slider body 290B is formed, the first mating portion 215B and the second mating portion 225B communicate with each other to form the mating portion 205B. When the first part 210B and the second part 220B are connected in the circumferential direction, the second fitting portion 225B has a surface symmetrical shape to the first fitting portion 215B across the first contact surface 219 and the second contact surface 229. The opening shape of the fitting portion 205B is a generally V-shaped planar shape that is convex toward the base end.

The joining member 230B has a generally V-shaped planar shape and is disposed from the outer peripheral surface 218 of the first part 210B to the outer peripheral surface 228 of the second part 220B, with the entirety of the joining member 230B engaging with the first mating portion 215B and the second mating portion 225B. In this embodiment, as in the second embodiment, the slider body 290B also has a mating portion 205B on the back side (positive side of the Y axis), and the joining member 230B is engaged with this mating portion. The slider 20B of the third embodiment can also achieve the same effects as the second embodiment described above.

Fourth Embodiment
10 is an explanatory diagram illustrating a schematic external configuration of a slider 20C according to the fourth embodiment. The slider 20C according to the fourth embodiment differs from the slider 20A according to the second embodiment in the shape of the joining member and the shape of a fitting portion 205C of a slider body 290C.

The slider 20C has a slider body 290C and two joining members 230C. Similar to the slider body 290A of the second embodiment, the slider body 290C is composed of a first part 210C, which is an arc-shaped body obtained by splitting the slider body 290C in half along a plane including the central axis of the slider body 290C, and a second part 220C.

The first part 210C has a groove-shaped first fitting portion 215C that opens to the outer circumferential surface 218, and the second part 220C has a groove-shaped second fitting portion 225C that opens to the outer circumferential surface 228 (FIG. 10). The opening shapes of the first fitting portion 215C and the second fitting portion 225C are approximately T-shaped in plan view. When the first part 210C and the second part 220C are connected in the circumferential direction, that is, when the slider body 290C is formed, the first fitting portion 215C and the second fitting portion 225C communicate with each other to form the fitting portion 205C. When the first part 210C and the second part 220C are connected in the circumferential direction, the second fitting portion 225C has a surface-symmetric shape with respect to the first fitting portion 215C, with the first contact surface 219 and the second contact surface 229 as the boundaries. The opening shape of the fitting portion 205C is roughly H-shaped in plan view.

The joining member 230C has a first joining member 234C that is substantially linear in plan view and extends substantially along the circumferential direction of the slider 20C, and two second joining members 233C that are substantially linear in plan view and extend substantially along the axial direction of the slider 20C, which are connected to the first joining member 234C. As shown in FIG. 10, the joining member 230C is substantially H-shaped in plan view. The joining member 230C is disposed from the outer peripheral surface 218 of the first part 210C to the outer peripheral surface 228 of the second part 220C, and the entirety of the joining member 230C is fitted into the first fitting portion 215C and the second fitting portion 225C. In this embodiment, as in the second embodiment, the slider body 290C also has a fitting portion 205C on the back side (Y-axis positive side), and the joining member 230C is fitted into this fitting portion. The slider 20C of the fourth embodiment can achieve the same effects as the second embodiment described above.

Fifth Embodiment
Fig. 11 is an explanatory diagram showing a schematic external configuration of a slider 20D of the fifth embodiment. In Fig. 11, for ease of explanation, the slider 20D is simplified to have a hollow cylindrical shape. The slider 20D of the fifth embodiment differs from the slider 20A of the second embodiment in the shape of the joining member, the configuration of a slider body 290D, and the shape of a fitting portion 205D.

The slider 20D has a slider body 290D and two joining members 230D. Unlike the slider bodies of the first to fourth embodiments, the slider body 290D is composed of a first part 210D, a second part 220D, and a third part 240D, which are arc-shaped bodies obtained by dividing the slider body 290D into three parts along a plane including the central axis of the slider body 290D. That is, when the first part 210D and the second part 220D are connected in the circumferential direction by contacting the first contact surface 219 of the first part 210D and the second contact surface 229 of the second part 220D, the second part 220D and the third part 240D are connected in the circumferential direction by contacting the second contact surface 229 of the second part 220D and the third contact surface 249 of the third part 240D, and the third part 240D and the first part 210D are connected in the circumferential direction by contacting the third contact surface 249 of the third part 240D and the first contact surface 219 of the first part 210D, the shape becomes approximately cylindrical.

The first part 210D has a groove-shaped first fitting portion 215D that opens to the outer peripheral surface 218, the second part 220D has a groove-shaped second fitting portion 225D that opens to the outer peripheral surface 228, and the third part 240D has a groove-shaped third fitting portion 245D that opens to the outer peripheral surface 248 (FIG. 11). The opening shapes of the first fitting portion 215D, the second fitting portion 225D, and the third fitting portion 245D are planar linear shapes that extend approximately along the circumferential direction. The second fitting portion 225D is formed from one second contact surface 229 of the second part 220D to the other second contact surface 229. When the first part 210D, the second part 220D, and the third part 240D are connected in the circumferential direction, i.e., when the slider body 290D is formed, the first fitting portion 215D and the second fitting portion 225D, and the second fitting portion 225D and the third fitting portion 245D communicate with each other to form the fitting portion 205D. The opening shape of the fitting portion 205D is a substantially linear shape in plan view.

The joining member 230D has a planar, generally linear shape and is disposed from the outer peripheral surface 218 of the first part 210D across the second part 220D to the outer peripheral surface 248 of the third part 240D, and is entirely fitted into the first fitting portion 215D, the second fitting portion 225D, and the third fitting portion 245D.

In addition, in the slider body 290D, a planar, substantially linear fitting portion (not shown) is formed that communicates when the first part 210D and the third part 240D are connected in the circumferential direction. A planar, substantially linear joining member (not shown) is disposed from the outer peripheral surface 218 of the first part 210D to the outer peripheral surface 248 of the third part 240D, and fits into the fitting portion. In this way, the first part 210D, the second part 220D, and the third part 240D are joined together to form the substantially cylindrical slider 20D.

The slider 20D of the fifth embodiment can achieve the same effects as the second embodiment described above. Furthermore, in the slider 20D of this embodiment, the slider body 290D is composed of three parts, and therefore the circumferential length of the annular groove (not shown) of each part is shorter than in the first to fourth embodiments. Therefore, when mounting the slider 20D to the inner cylindrical body 10 to which the ligation ring 40 is attached, it is easier to place the second ligation ring 42 in the annular groove than in the first to fourth embodiments.

Sixth Embodiment
Fig. 12 is an explanatory diagram showing a schematic external configuration of a slider 20E of the sixth embodiment. In Fig. 12, similar to Fig. 11, for ease of explanation, the slider 20E is illustrated simplified to a hollow cylindrical shape. The slider 20E of the sixth embodiment differs from the slider 20A of the second embodiment in the shape of a joining member 230E, the configuration of a slider body 290E, and the shape of a fitting portion 205E.

The slider 20E has a slider body 290E and two joining members 230E. The slider body 290E is composed of a first part 210E and a second part 220E. Unlike the first to fifth embodiments, the first part 210E and the second part 220E are arc-shaped bodies obtained by splitting the slider body 290E in half along a plane that intersects the central axis of the slider body 290E at an angle. In other words, when the first part 210E and the second part 220E are connected in the circumferential direction by contacting the first contact surface 219 of the first part 210E and the second contact surface 229 of the second part 220E, they become approximately cylindrical.

The first part 210E has a groove-shaped first fitting portion 215E that opens to the outer circumferential surface 218, and the second part 220E has a groove-shaped second fitting portion 225E that opens to the outer circumferential surface 228 (FIG. 12). The opening shapes of the first fitting portion 215E and the second fitting portion 225E are planar and linear, extending approximately along the circumferential direction. When the first part 210E and the second part 220E are connected in the circumferential direction, that is, when the slider body 290E is formed, the first fitting portion 215E and the second fitting portion 225E communicate with each other to form the fitting portion 205E. The opening shape of the fitting portion 205E is planar and approximately linear.

The joining member 230E has a planar, generally linear shape and is disposed from the outer peripheral surface 218 of the first part 210E to the second part 220E, with the entirety of the joining member 230E fitting into the first fitting portion 215E and the second fitting portion 225E.

The slider body 290E also has the first mating portion 215E and the second mating portion 225E shown in FIG. 12 on the back side (positive side of the Y axis), and a joining member 230E is fitted into this mating portion (not shown). This joins the first part 210E and the second part 220E to form a substantially cylindrical slider 20E. The slider 20E of the sixth embodiment can also achieve the same effects as the second embodiment described above.

Seventh Embodiment
FIG. 13 is an explanatory diagram that shows a schematic external configuration of the slider 20F of the seventh embodiment. FIG. 14 is an explanatory diagram that shows a schematic cross-sectional configuration of the slider 20F. FIG. 14(A) shows the A-A cross section in FIG. 13, and FIG. 14(B) shows the B-B cross section in FIG. 13. As shown in FIG. 13, the external configuration of the slider 20F of this embodiment is similar to that of the slider 20 of the first embodiment. The slider 20F of the seventh embodiment differs from the slider 20A of the first embodiment mainly in that the outer surface of the joining member 230F protrudes outward from the outer peripheral surface 218 and the outer peripheral surface 228 of the slider body 290F.

The slider 20F has a slider body 290F and four joining members 230F, similar to the slider 20 of the first embodiment. The slider body 290F is composed of a first part 210F and a second part 220F. As in the first embodiment, the first part 210F and the second part 220F are arc bodies in the shape of the slider body 290F divided in half along a plane including the central axis of the slider body 290F. That is, when the first part 210F and the second part 220F are connected in the circumferential direction by contacting the first contact surface 219 of the first part 210F and the second contact surface 229 of the second part 220F, they become approximately cylindrical.

The first part 210E has a tip side first fitting portion 211F, a base side first fitting portion 212F, and a base side first fitting portion 214F, which are through holes that open to the outer peripheral surface 218 and the inner peripheral surface 217 (FIG. 13). The opening shapes of the tip side first fitting portion 211F, the base side first fitting portion 212F, and the base side first fitting portion 214F are approximately circular in plan view. In the following description, when there is no need to distinguish between the tip side first fitting portion 211F, the base side first fitting portion 212F, and the base side first fitting portion 214F, they are also simply referred to as "first fitting portions."

The second part has a tip-side second fitting portion 221F, a base-side second fitting portion 222F, and a base-side second fitting portion 224F, which are through holes that open to the outer peripheral surface 218 and the inner peripheral surface 217 (FIG. 13). The opening shapes of the tip-side second fitting portion 221F, the base-side second fitting portion 222F, and the base-side second fitting portion 224F are approximately circular in plan view. In the following description, when the tip-side second fitting portion 221F, the base-side second fitting portion 222F, and the base-side first fitting portion 224F are not distinguished from each other, they are also simply referred to as "second fitting portions." Thus, in the slider 20F of this embodiment, the first fitting portion and the second fitting portion are each a through hole, and the first fitting portion and the second fitting portion are not connected to each other.

The planar shape of the joining member 230F in the slider 20F of this embodiment is similar to that of the joining member 230 in the first embodiment. However, in this embodiment, the joining member 230F has a protrusion that protrudes toward the slider body 290F. In detail, the tip side joining member 231F has a tip side first protrusion 251F that fits into the tip side first fitting portion 211F and a tip side second protrusion 252F that fits into the tip side second fitting portion 221F. The base-side joint member 232F has a base-side first protrusion 261F that fits into the base-side first fitting portion 213F, a base-side first protrusion 271F that fits into the base-side first fitting portion 214F, a base-side second protrusion 262F that fits into the base-side second fitting portion 223F, and a base-side second protrusion 272F that fits into the base-side second fitting portion 224F. As shown in FIG. 14, in this embodiment, a part (protrusion) of the joint member 230F fits into the first fitting portion and the second fitting portion, so that the first part 210F and the second part 220F are joined by the joint member 230F.

As shown in FIG. 14, the slider body 290F also has a similar fitting portion and connection member on the back side (positive Y-axis side) of the surface shown in FIG. 13. This allows the first part 210F and the second part 220F to be joined together to form a substantially cylindrical slider 20F. The slider 20F of the seventh embodiment can also achieve the same effects as the second embodiment described above.

Eighth Embodiment
FIG. 15 is an explanatory diagram that shows the external configuration of the slider 20G of the eighth embodiment. FIG. 16 is an explanatory diagram that shows the cross-sectional configuration of the slider 20G. FIG. 16 shows the A-A cross section in FIG. 15. FIG. 17 is an explanatory diagram that shows the cross-sectional configuration of the ligation device 100G using the slider 20G. FIG. 17 shows a cross section corresponding to the B-B cross section in FIG. 16, and corresponds to FIG. 4 in the first embodiment. As shown in FIG. 15, the external configuration of the slider 20G of this embodiment is similar to the slider 20F of the seventh embodiment (FIG. 14). The slider 20G of the eighth embodiment is different from the slider 20F of the seventh embodiment in the shapes of the first contact surface 219 and the second contact surface 229, and in that the slider 20G does not include the annular groove 22.

As shown in Figures 15 and 16, the first contact surface 219G of the first component 210G and the second contact surface 229G of the second component 220G are stepped and engage with each other. Therefore, compared to the sliders of the first to seventh embodiments, the first component 210G and the second component 220G can be easily connected in the circumferential direction. This further improves manufacturing efficiency by shortening manufacturing time and reducing the defective rate.

17, in the ligation device 100G of this embodiment, as described above, the slider 20G does not have an annular groove on the inner peripheral surface 217. Therefore, the two ligation rings 40 are disposed on the distal side of the slider 20G (FIG. 17(A)). In the ligation device 100G of this embodiment, as in the first embodiment, the slider 20G is moved by a distance L1 toward the distal side by air (fluid) supplied through the tube 50, so that the first ligation ring 41 on the distal side moves to the first cylindrical portion 12 of the inner cylindrical body 10 and detaches from the distal end of the first cylindrical portion 12 (FIG. 17(B)). Furthermore, the slider 20G is moved by a distance L1 toward the distal side by air (fluid) supplied through the tube 50, so that the remaining first ligation ring 41 moves to the first cylindrical portion 12 of the inner cylindrical body 10 and detaches from the distal end of the first cylindrical portion 12. Thus, although the slider 20G does not have an annular groove on its inner circumferential surface, in the ligation device 100G, two ligation rings 40 are placed distal to the slider 20G, and the amount of movement of the slider 20G is controlled, allowing the two ligation rings 40 to be used at the appropriate timing.

Ninth embodiment
Fig. 18 is an explanatory diagram showing a schematic cross-sectional configuration of a ligation device 100H of a ninth embodiment. Fig. 18 shows a longitudinal section of the ligation device 100H, and corresponds to Fig. 4 in the first embodiment. The ligation device 100H of this embodiment differs from the ligation device 100 of the first embodiment in that the slider 20H has two annular grooves 22 on its inner circumferential surface and the ligation device 100H has three ligation rings 40.

As shown in FIG. 18(A), in the ligation device 100H of this embodiment, one ligation ring 40 (first ligation ring 41) is disposed distally of the slider 20G, and the remaining two ligation rings 40 (second ligation ring 42) are disposed one in each of the two annular grooves 22.

In the ligation device 100H of this embodiment, as in the first embodiment, the slider 20H is moved a distance L1 toward the tip side by air (fluid) supplied through the tube 50, so that the first ligation ring 41 moves to the first tubular portion 12 of the inner cylinder 10 and detaches from the tip of the first tubular portion 12 (FIG. 18(B)). Furthermore, the slider 20H is moved toward the tip side by the air (fluid) supplied through the tube 50, so that the second ligation ring 42 on the tip side moves a distance that allows it to move to the first tubular portion 12, so that the second ligation ring 42 on the tip side moves to the first tubular portion 12 of the inner cylinder 10 and detaches from the tip of the first tubular portion 12. Furthermore, air (fluid) supplied through the tube 50 moves the slider 20H toward the distal end and the second ligation ring 42 on the proximal end by a distance that allows it to move toward the first tubular portion 12, so that the second ligation ring 42 on the proximal end moves toward the first tubular portion 12 of the inner tubular body 10 and detaches from the distal end of the first tubular portion 12. In this way, the slider 20H has two annular grooves 22 on its inner circumferential surface, and the ligation device 100H has three ligation rings 40, so that the detachment timing of the three ligation rings 40 can be appropriately determined.

Tenth Embodiment
Fig. 19 is an explanatory diagram showing an enlarged schematic cross-sectional configuration of the ligation device 100I of the tenth embodiment. Fig. 19 shows a longitudinal section of the ligation device 100I and corresponds to Fig. 3 in the first embodiment. The ligation device 100I of this embodiment differs from the ligation device 100 of the first embodiment in the configuration of the inner cylinder body 10I.

As shown in FIG. 19, the inner cylinder body 10I includes a first cylindrical portion 12I and a second cylindrical portion 14I. In this embodiment, the first cylindrical portion 12I and the second cylindrical portion 14I are configured as separate parts and are joined to each other by an adhesive. The joining of the first cylindrical portion 12I and the second cylindrical portion 14I is not limited to bonding with an adhesive, and can be joined by various known methods. For example, the first cylindrical portion 12I may be joined by fitting the end of the second cylindrical portion 14I side of the first cylindrical portion 12I to the end of the second cylindrical portion 14I side of the first cylindrical portion 12I. Alternatively, the first cylindrical portion 12I may be joined by forming a screw thread on the end of the second cylindrical portion 14I side of the first cylindrical portion 12I and the end of the second cylindrical portion 14I side of the first cylindrical portion 12I, and the end of the second cylindrical portion 14I side of the first cylindrical portion 12I may be joined by screwing the end of the second cylindrical portion 14I side of the first cylindrical portion 12I to the end of the second cylindrical portion 14I side of the first cylindrical portion 12I.

In this embodiment, the first cylindrical portion 12I and the second cylindrical portion 14I are formed from different materials. The materials from which the first cylindrical portion 12I and the second cylindrical portion 14I are formed are not particularly limited, but a material with high rigidity and airtightness can be used as the material from which the second cylindrical portion 14I is formed. In this way, the rigidity and airtightness of the second cylindrical portion 14I can be further improved.

Eleventh Embodiment
Fig. 20 is an explanatory diagram showing an enlarged schematic cross-sectional configuration of the ligation device 100J of the 11th embodiment. Fig. 20 shows a longitudinal section of the ligation device 100J, and corresponds to Fig. 19 in the 10th embodiment. The ligation device 100J of this embodiment has an inner cylinder body 10J and a stopper 16J instead of the inner cylinder body 10I and the stopper 16 in the ligation device 100I of the 10th embodiment.

20, the inner cylindrical body 10J includes a first cylindrical portion 12I and a second cylindrical portion 14J. That is, the inner cylindrical body 10J of this embodiment has a second cylindrical portion 14J instead of the second cylindrical portion 14I in the inner cylindrical body 10I of the tenth embodiment. The second cylindrical portion 14J of this embodiment has a smaller inner diameter than the second cylindrical portion 14I of the tenth embodiment. Therefore, the second cylindrical portion 14J can be attached to an endoscope 300J having a smaller outer diameter than the endoscope 300 used in the tenth embodiment while ensuring airtightness. As a result, the ligation device 100J can be attached to the endoscope 300J.

In the ligation device 100J of this embodiment, the first tube portion 12I and the second tube portion 14J are configured as separate parts. The outer diameter of the second tube portion 14J is the same as the outer diameter of the second tube portion 14I of the tenth embodiment. Therefore, by replacing the inner tube body 10I and the stopper 16 in the ligation device 100I of the tenth embodiment with the inner tube body 10J and the stopper 16J, the ligation device 100J can be attached to an endoscope 300J having an outer diameter smaller than that of the endoscope 300 without changing other parts. The first tube portion 12I and the second tube portion 14J may be formed of the same material or different materials. The first tube portion 12I and the second tube portion 14J can be joined by various known methods such as bonding with an adhesive, fitting, and screwing.

In this way, by configuring the first and second cylindrical portions as separate parts and preparing multiple types of second cylindrical portions with the same outer diameter but different inner diameters as the second cylindrical portions, multiple types of ligation devices corresponding to multiple types of endoscopes with different outer diameters can be configured without changing the shape (type) of the parts other than the second cylindrical portion. For example, when configuring a ligation device corresponding to multiple types of endoscopes with different outer diameters using an inner cylindrical portion in which the first and second cylindrical portions are integrally formed, the type (inner diameter) of the inner cylindrical portion is changed to correspond to the outer diameter of the endoscope, and the types (inner diameters) of the slider, outer cylindrical portion, ligation ring, fixing member, and sealing member are also changed, and multiple types of each part are prepared to correspond to the outer diameter of the endoscope. In contrast, in the ligation device 100J of this embodiment, the outer diameter of the second tube portion 14J remains the same as that of the second tube portion 14I of the tenth embodiment, and only the inner diameter is made smaller, so that the slider 20, the outer tube body 30, the ligation ring 40, the fixing member 60, and the sealing member 70 of the ligation device 100I of the tenth embodiment can be used as they are without modification. This makes it possible to suppress an increase in the number of types of each part, which contributes to cost reduction.

In addition, the first tube portion affects the endoscopic field of view, but is not related to the size of the endoscope to which the ligation device is attached, so it is preferable that the shape (diameter) of the first tube portion be constant regardless of the size of the endoscope.

<Modifications of this embodiment>
The present invention is not limited to the above-described embodiment, and can be embodied in various forms without departing from the spirit and scope of the invention. For example, the following modifications are also possible.

- In the above embodiment, a ligation device having a substantially circular cross-sectional shape is exemplified, but the cross-sectional shape of the ligation device may be a shape that includes a substantially circular arc, such as a substantially elliptical or egg-shaped cross-sectional shape.

- In the above embodiment, an example was shown in which the shape of the inner cylindrical body 10 narrows toward the tip, but the shape of the inner cylindrical body 10 is not limited to the above embodiment. For example, the inner cylindrical body 10 may be a hollow, generally cylindrical shape with a substantially constant diameter from the base end to the tip. However, when the inner cylindrical body 10 narrows toward the tip, as in the above embodiment, this is preferable because the ligation ring 40 is easily detached from the inner cylindrical body 10.

- In the above embodiment, an example is shown in which the first part and the second part are joined by a joining member without using an adhesive, but an adhesive may be used. For example, in the first embodiment, when the adhesive is put into the groove-shaped first fitting portion and the second fitting portion to join the first part 210 and the second part 220 to the joining member 230, the area on which the adhesive can be applied can be increased compared to the case in which the adhesive is applied to the first contact surface 219 and the second contact surface 229 to join the first part 210 and the second part 220, and therefore the strength can be improved. In addition, since the adhesive is put into the groove-shaped first fitting portion and the second fitting portion, it is possible to suppress overflow of the adhesive, and it is possible to suppress adhesion to the inner cylindrical body 10 and the ligation ring 40. Note that, when an adhesive is used, the joining member may be loosely fitted into the first fitting portion and the second fitting portion (there may be a slight gap between the joining member and the first fitting portion and the second fitting portion).

- In the above embodiment, an example is shown in which the slider body is composed of two parts, a first part and a second part, and an example is shown in which the slider body is composed of three parts, a first part, a second part, and a third part, but the slider body may be composed of four or more parts.

- In the above embodiment, an example in which the ligation device has two ligation rings and an example in which the ligation device has three ligation rings are shown. However, the number of ligation rings is not limited to the above embodiment. For example, the ligation device may have one ligation ring, or may have four or more ligation rings.

- In the above embodiment, examples are shown in which the inner circumferential surface of the slider does not have an annular groove, has one annular groove, and has two annular grooves, but three or more annular grooves may also be provided.

- In the above embodiment, when the slider has an annular groove 22, an example is shown in which the ligation ring 40 is disposed on the tip side of the slider and within the annular groove 22, but the arrangement of the ligation ring 40 is not limited to the above embodiment. For example, a configuration in which the ligation ring is not disposed on the tip side of the slider may be used.

- In the seventh embodiment, an example was shown in which the slider body 290 has the tip side first fitting portion 211F, tip side second fitting portion 221F, base side first fitting portion 213F, base side second fitting portion 223F, base side first fitting portion 214F, and base side second fitting portion 224F, which are through holes, but at least one of these fitting portions may be a bottomed hole (not through, but opening to the outer peripheral surface 218 or 228). This is preferable because, for example, when an adhesive is used, it is possible to prevent the adhesive from leaking and bonding to other components.

- In the seventh embodiment, an example in which each protrusion fits into the first fitting portion and the second fitting portion is shown as an example in which a part of the joining member fits into the first fitting portion and the second fitting portion, but this is not limited to this. For example, a part of the joining member 230 in the slider 20 of the first embodiment may fit into the tip side fitting portion 201, and the joining member 230 may protrude outward from the slider body 290.

- The configuration of the joining member is not limited to the above embodiment, and various forms can be applied. For example, two or more planar linear joining members such as the tip-side joining member 231 in the first embodiment may be arranged spaced apart from each other in the axis LO direction (X-axis direction). Also, for example, instead of the base-end joining member 232 in the slider 20 of the first embodiment, the joining member 230A of the second embodiment, the joining member 230B of the third embodiment, the joining member 230C of the fourth embodiment, etc. may be used.

- In the above embodiment, an example was shown in which the ligation device includes a tube 50, but the ligation device does not have to include a tube 50. For example, the fixing member 60 in the first embodiment may have a through hole through which a tube can be inserted and removed, and may be configured not to include a tube 50.

Although this aspect has been described above based on the embodiment and modified examples, the embodiment of the above-mentioned aspect is intended to facilitate understanding of this aspect and does not limit this aspect. This aspect may be modified or improved without departing from the spirit and scope of the claims, and equivalents are included in this aspect. Furthermore, if a technical feature is not described as essential in this specification, it may be deleted as appropriate.

Reference Signs List 10, 10I, 10J... Inner cylinder body 12, 12I... First cylinder portion 14, 14I, 14J... Second cylinder portion 16, 16J... Stopper 20, 20A to 20H... Slider 22... Annular groove 30... Outer cylinder body 40... Ligation ring 41... First ligation ring 42... Second ligation ring 50... Tube 60... Fixing member 70... Sealing member 100, 100G, 100H, 100I, 100J... Ligation device 200... Syringe 201... Distal side fitting portion 202... Base end side fitting portion 205, 205B to 205E... Fitting portion 210, 210A to 210G... First part 211, 211F... Distal side first fitting portion 212, 212F, 213F, 214F, 224F...base end side first fitting portion 213, 223...second part 214, 224...first part 215, 215B to 215E...first fitting portion 217, 218...inner circumferential surface 218, 228, 248...outer circumferential surface 219, 219G...first contact surface 220, 220A to 220G...second part 221, 221F...tip side second fitting portion 222, 222F, 223F, 224F...base end side second fitting portion 225, 225B to 225E...second fitting portion 229, 229G...second contact surface 230, 230A to 230F...joint member 231, 231F...tip side joining member 232, 232F...base end side joint member 233, 233C...second joint member 234, 234C...first joint member 240D...third part 245D...third fitting portion 249...third contact surface 251F...tip side first protrusion 252F...tip side second protrusion 261F, 271F...base end side first protrusion 262F, 272F...base end side second protrusion 290, 290A to 290F...slider body 300, 300J...endoscope L1...distance LO...axis S...gap

Claims (6)

1. A ligation device comprising:
A substantially cylindrical inner cylinder body;
an outer cylindrical body that is substantially cylindrical and is attached to the inner cylindrical body with a gap therebetween so as to surround an outer periphery of the inner cylindrical body;
a slider having a substantially cylindrical shape, disposed in the gap so as to surround an outer periphery of the internal cylindrical body, and movable relative to the internal cylindrical body along the axial direction of the internal cylindrical body by a fluid flowing into the gap;
At least one ligation ring attached to surround an outer periphery of the internal cylindrical body, movable relative to the internal cylindrical body along with the relative movement of the slider, and detachable from a tip of the internal cylindrical body;
Equipped with
The slider includes:
A first part that is a substantially arcuate body;
a second part that is a substantially arcuate body and is connected to the first part in a circumferential direction of the slider;
a joining member disposed from an outer circumferential surface of the first component to an outer circumferential surface of the second component to join the first component and the second component,
the first component has at least one of a recess and a through hole opening on an outer circumferential surface thereof, and a first fitting portion into which at least a portion of the joining member is fitted;
the second component has at least one of a recess and a through hole opening on an outer circumferential surface thereof, and has a second fitting portion into which at least a part of the joining member is fitted;
Ligating devices. 10. The ligating device of claim 1,
The slider includes:
At least one annular groove extending circumferentially along the inner circumferential surface is further provided,
The ligation ring is positioned within the annular groove.
Ligating devices. 3. The ligation device of claim 2,
A plurality of said ligation rings are provided,
The plurality of ligation rings include:
A first ligation ring disposed distally of the slider;
a second ligation ring disposed within the annular groove;
Including,
Ligating devices. A ligating device according to any one of claims 1 to 3,
The first fitting portion and the second fitting portion are each groove-shaped, and the first fitting portion and the second fitting portion are in communication with each other.
Ligating devices. A ligating device according to any one of claims 1 to 4,
The joining member is
a first joining member extending substantially along a circumferential direction of the slider;
a second joint member connected to the first joint member and extending substantially along the axial direction of the slider;
Ligating devices. A ligating device according to any one of claims 1 to 5,
Further comprising a tube communicating with the gap.
Ligating devices.

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