Source: https://patents.google.com/patent/WO2003053256A1/en
Timestamp: 2020-01-23 14:23:25
Document Index: 731809810

Matched Legal Cases: ['art 1', 'art 1', 'art 2', 'art 1', 'art 2', 'art 2', 'art 1', 'art 1']

WO2003053256A1 - Clip device for endoscope and clip for endoscope for use therein - Google Patents
Clip device for endoscope and clip for endoscope for use therein Download PDF
WO2003053256A1
WO2003053256A1 PCT/JP2002/013032 JP0213032W WO03053256A1 WO 2003053256 A1 WO2003053256 A1 WO 2003053256A1 JP 0213032 W JP0213032 W JP 0213032W WO 03053256 A1 WO03053256 A1 WO 03053256A1
PCT/JP2002/013032
2001-12-13 Priority to JP2001-379431 priority Critical
2001-12-13 Priority to JP2001379431 priority
2002-02-14 Priority to JP2002036107 priority
2002-02-14 Priority to JP2002-36107 priority
2002-10-04 Priority to JP2002-292848 priority
2002-10-04 Priority to JP2002292847 priority
2002-10-04 Priority to JP2002292848 priority
2002-10-04 Priority to JP2002-292847 priority
2002-12-12 Application filed by Sumitomo Bakelite Company Limited filed Critical Sumitomo Bakelite Company Limited
2003-07-03 Publication of WO2003053256A1 publication Critical patent/WO2003053256A1/en
A clip device for endoscope in which a trouble that a clip can not be reopened when it is closed once and operation must be performed under half-open state of clip is improved. The clip device for endoscope characterized by comprising a clipping means having a pair of arm parts capable of open/close operation, an operating means for opening/closing the arm parts of the clipping means while holding them, a securing means for securing the arm in closed state after the arm parts are closed, and means for disposing the securing means on the outside of the arm part.
Clip art for an endoscope used in the clipping device and for it bright fine manual endoscope
The present invention relates to a clip device for an endoscope. For example, in endoscopic, about a clip for use in Tarippu device and the clip unit is found using the marking or the like to clarify the area to be treated of ligation and excision like bleeding part of the living body tissue.
To bleeding body cavity, a method of ligating a bleeding site by introducing endoscopic clips are frequently used, as such clip, for example, Japanese Utility Model 5 3 2 0 9 5 7 No. It disclosed in Japanese. The present invention, connected at the rear end a pair of clamping pieces, to cross them from one another at an intermediate portion, and a clip form the shape of each inclined surface around the outer surface of the cross section, and fitted to the clip, the clip a fastener which is sliding on the inclined surface to the opening and closing operation of the clips, the is composed of a introducer to slide the fastener.
This thing is to manipulate the opening and closing of the pair of clamping pieces by extruding Te cowpea the fastener into introducer. In detail, a pair between fasteners of the rear end and the intersection of the clip when sliding, a state in which the pair of clamping pieces can grasp tissue open to a maximum, then, to the tissue to be clipped pressing the clamping pieces, when slide fastener to the front of the intersection, a pair of clamping pieces are clipped tissue closed.
The force, and, in this thing, because it can not only operation to push the fasteners to the front, had the disadvantage that can not be opened once again Once you close the clip. Further, in order to clip opens the maximum, but shall be stopped just before the intersection of clip fastener, it is difficult to adjust the position by the sliding resistance of the fastener, the point at which the clip is opened to the maximum It will be passed through, there is a case where the clip must perform the operation while not completely opened sufficiently.
Further, the clip device is hooked in the clip rear hook with a pull cord of, and moves into the fastener to intersection of clip is fixed by pulling the pull cord, the pair - _
A state in which the second clamping pieces can grasp tissue open to maximum, and then pressing the pair of clamping pieces to Kuribbingu to Baie-out tissue, the clip further moves within fastener by pulling the pull cord again, a pair of sandwiching Kata to clip the organization closed.
And to force the clip device, because a closing a series of operations pulling the pull cord, which intersection of the clip into the fastener ever fall once returns to the previous state entering the intersection it can not be, that is the clip you have closed once had the disadvantage that can not be opened again. To open the clip to maximize Although must be stopped fasteners just before the intersection of the clip, the sliding resistance of the fastener, can not adjust the position, passes through the point where the clip is opened to the maximum by want Les ,, If the clip must perform the operation in a state that does not fit open enough is rarely.
Further, JP-B-6 3 - to 6 0 1 6 discloses a method of loading a clip into the clip applying device is disclosed. Shall for clips to be fixed is engaged with the hook provided a base end portion of the clip into the clip applying device, during loading, unless a complicated operation that is subjected to full-click holding the clip in one hand It not, had become a time-consuming task for the familiar and not the surgeon for this operation.
An object of the present invention is, once and can not be opened again Once you close the clip, that clip is to provide a Kuribbingu apparatus with improved Rere U problem and must be carried out the operation in a state that does not fit open enough It is in.
Another object of the present invention is to provide a method for easily loading the clip is to shorten the loading time.
The present invention provides Kuribbingu hand stage having a pair of arms which can be opened and closed operation, operating means for opening and closing the arm portion to hold the arm portion of Kuribbingu means, closing the arm after closing the arm portion is a clip device for an endoscope according to Toku徵 that at least is composed of means for arranging the securing means to the outside of the fixing means 及 Pi arm portion for fixing in a state.
In endoscopic clip apparatus described above, the arm portion of Kuribbingu means preferably a This width is coupled with a continuous small a connexion base over part or all of the arm portion.
In endoscopic clip apparatus described above, fixing means and Kuritsubingu unit is pre-arranged in small holes provided on the pre Ichito, it is preferable to load the subsequent device.
The present invention provides a clip for use in endoscopic Kuribbingu device is a clip for an endoscope which mechanism is attached for fixing the endoscope Kuribbingu device to the arm portion of Kriz flop.
Furthermore, the present invention is an endoscopic clipping device with the clip above the endoscope.
The present invention also empty member, outer member covering said hollow member, said outer member connected to a control member in which an arm portion comprising at least one pair of elastic bodies on the tip, the clip, and Kuribbingu is composed of a securing means for securing the clip after comprises means can be fixed to the arm portion to said clip, said by moving the control member connected to a member of the outer side in the axial direction it is endoscopic Kuribbingu and wherein the arm portion is opened and closed.
Further, the present invention is a hollow member having an arm portion comprising at least one pair of elastic bodies on the tip, the outer member covering said hollow member, said outer member connected to a control member, the clip, and after Kuribbingu is composed of a securing means for securing said clip, said arm portion by said comprising means can be fixed to the clip to the arm portion to move said control member connected to said outer member in the axial direction endoscopic Kuribbingu apparatus characterized by but opening and closing,
Figure 1 is a diagram showing an outline of Kuritsubingu device as a first embodiment of the present invention, a is an overall view, b is an enlarged view of a connecting portion of Kuritsubingu means and operating means.
Figure 2 is a diagram for explaining the Kuribbingu means according to the invention.
Figure 3 is a diagram of order to explain another embodiment of the operating means Kuritsubingu apparatus according to the present invention, state a is that closed Kuribbingu means, further b are views showing a state in which Kuribbingu hand stage is open is there. Figure 4 is a diagram showing a set state to play Bok fixing means and Kuribbingu means. Figure 5 is a diagram showing the cross section of the play Bok when set in the plate fixing means and Kuribbingu means.
6 is a diagram of the order a to d is that describing a method of loading a clip to the endoscopic clip device.
Figure 7 is a diagram showing a state in which the loading of Kuribbingu means.
Figure 8 is a diagram for explaining how to the loading of the fixing means and Kuribbingu means in one operation.
Figure 9 is a view for explaining how to use the Taribbingu device according to the invention. Figure 1 0 is a view showing an endoscopic clip comprising a first embodiment of the present invention.
Figure 1 1 is a diagram showing an endoscopic clip comprising a second embodiment of the present invention.
Figure 1 2 is a diagram showing a clip for an endoscope comprising a third embodiment of the present invention.
Figure 1 3 is a cross sectional view illustrating a state in which the endoscopic clip attached to the endoscopic Kuribbingu apparatus of the present invention, (a) a diagram showing a state in which the endoscopic clip is closed, (b) is a diagram showing a state where the endoscopic clip is opened.
Hereinafter, with reference to examples, the present invention will be described in detail. Figure 1 is a diagram illustrating a clip device for an endoscope which is a first embodiment of the present invention, a is an overall view, and b is an enlarged view of a connecting portion of the clipping means and the operating means. Figure 2 is a diagram showing an embodiment of Kuritsubingu means, FIG. 3 is a diagram showing another example of the operating means of the present invention, a is a state and b Kriz Bing means is closed open Kuribbingu means and a state has. Figure 4 is a diagram showing the set state to the plate fixing means and Kuribbingu means. Figure 5 is a sectional view of the plate when set to play Bok fixing means and Taribbingu means, FIG 6- to d is for an endoscope according to the present invention - for explaining a method of loading a clip into the clip applying device it is a diagram. Figure 7 is a diagram showing a state like that the loading of the clipping means, FIG 8 is a diagram for explaining a method for loading a fixing means and Kuribbingu means in a single operation, a to e in FIG. 9 it is a diagram for explaining how to use the endoscopic clipping device according to the present invention.
Clipping device clipping means 1 (1), operating means (2) comprises a fixed hand stages (3) and fastening means (3) from pushing the tube (1 1) for sliding forward.
Clipping means (1), as shown in FIG. 2, for example, formed from plate-shaped metal, a pair of arm portions (5), and these are connected by connecting portions of the rear end (6). Connecting portion (6), for example, it is preferable to adopt a structure such as a hinge, simply either joined by means of welding or the like § over arm portions, bent folded into the shape shown a single metal plate formed and may also be used. End of the arm portion (5) is bent inwardly at a constant angle to bite into the tissue.
In order to fit the arm portion (5) to Tsu main provided below to operating arm (7) (10), the width of the connecting portion (6) is smaller than the width of the arm portion (5), the arms some constituting part (5), or take the width continuously decreases structure towards the direction towards the connecting portion (6) from the arm portion (5) throughout.
Operating means (2) consists of a combination of a pair of operating arms as shown in FIG. 1 (7) and sheath (8). Operation at the rear end of the arm (7) is connected to a wire (15) for doing the opening and closing operation of the operating arm (7), the line operating arm opening and closing operation of remotely operating arm (7) (7 ), for example, those formed by joining the rear end of the two dogleg shaped plate panel can be used. While this compound is a normally-open state, the sheath (8) of the bore accommodating them and when the operation arm (7) becomes closed by elastic deformation, and slide operating arm (7) in front sheath issuing from (8), the spring stress of the operating arm (7), the open state is restored with Misao Sakuude (7).
Operating means for opening and closing the arms (7) is not limited to this, for example, an alternative embodiment the connexion may, as shown in FIG. In this embodiment, a pair of operating arm which is connected at the rear end (7) is disposed within the sheath (8) across the sheath rods provided in the diameter direction of the lumen (8) (1 2) that. Operating arm (7) and slide forward operating arm
Connecting portion and the closer to the rod (12) operating arm (7) (7) opens (Figure 3 b of state), the operating arm is retracted (7) is closed (FIG. 3 a state of). Have been illustrated two embodiments, the present invention is such a limitation to this embodiment of the operating means (2) les. Operating arm (7) tip Tsu menu (1 0) is provided in the, can be fixed in a state capable of inserting in desorption inside the arm portion (5) of Tsu menu (1 0) of the clipping means (1) having that structure. Further, the operating arm of the base part (9), the consolidated portion of the clipping means (1) (6) is inserted and fixed in a removable state. That is, Kuritsupin grayed means (1) includes a pair of operating arms of the operating means (2) (7), and is fixed to the operating means (2) at three points of the base (9), the sheath operating means (2) by out from (8), to open and close the arm portions of the clipping means (1) to (5).
Fixing means (3) is arranged on the outer periphery of the sheath (8) tip, the sheath (8) pushing the tube (1 1) provided outside the side of and slide forward performing extrusion. After grasping the tissue with the arm portions of the clipping means (1) (5), fixing means (3) and slide forward to place the arms of the clipping means (1) (5), the clipping means ( 1) fixed in a closed state.
It will now be described loading fixing means and Kuribbingu means.
4, as 5 shown in, clipping means (1), fixing means (3) is pre-set to a small hole (2 2) provided in the plates (2 1). Some small holes are step is provided, the clipping means (1), fixing means (3) is held in a state of One abutting the step. When carrying plate covers the upper surface of the pre-chromatography preparative (2 1) with plate covers (23), the plate (2 1) from the clipping means (1), that the fixed means (3) falls off To prevent.
Here, briefly explaining the method of loading Taribbingu means according to the invention using Figure 6 _ to d, to the effect of the present invention more clearly.
The sheath (8) in a state where the operation closed means (2) push the plate preset fixing means (2 1) (3) (Figure 6- a), fixing means (5) the sheath (8) to the loading on the outer periphery (Fig 6_b). Then, the sheath (8) pushing the plate (2 1) preset clipping means (1), in the sheath Tsu main (1 0) of the retract and operation being arms (8) (7) Ryoichi arm portion of the clipping means (1) (5) was crowded sliding (Figure 6- c), complete the loading (Figure 6- d). Figure 7 is a clipping means (1) and the operating arm (7) which the loading is completed, showing a state of Tsu main (1 0). Although not shown here, on the outer periphery of the sheath (8) fixing means (5) it is the loading. Width arm of the connecting portion of the clipping means (1) (6) (5) smaller than the width of the arm portion over some or the whole constituting the arm portion (5) (5) connecting section (6) inside for continuously width toward smaller structure, connecting portions of the clipping means (1) (6) direction Tsu menu (1 0) only arm (5) from (arrow in the figure) inserted in, it is possible to fix is ​​fitted.
Thus, the fixing means of the sheath (8) According to the present invention the plate (2 1) to only presses (3), it is possible to the loading of the clipping means (1). Also, fixing means (3), the loading of the clipping means (1) may be rather performed separately, a plurality of steps on the plate (2 1) of small holes (2 2), press once it is also possible to complete the loading in the write operation.
Here, we describe the procedures for using the endoscopic clip apparatus according to the present invention by a to e in FIG. 9, to clarify the effects of the present invention.
After fixing means (3) was loaded onto the sheath (8) in a state where the operation closed means (2), is loaded into the clipping means (1) operating means (2) (Fig. 9 a). At this time, along with chestnut arm of Bbingu means (1) (5) is inserted into the inside of the operating arm Tsu menu (1 0) provided at the tip (7), connecting part (6) is operating means (2 ) inserted into the base (9) of the.
After determining the site to be Kuribbingu endoscopically, we introduce a device according to the invention. Opening the operating arm (7) is slid forward operating arm (7), since the arm portions of the clipping means (1) (5) is opened, Ru pressed against the tissue to be treated in this state. Then, close the arm to retract the operating arm (7) (5), ligating the tissue
(Figure 9 b and c). At this time, if insufficient effect of ligation, again, if the slide operating arm (7) forward, since the arm portion (5) is open, it is possible to start over again and again clipping operation .
Once satisfactory clipping can be tightened arm to slide the pushing tube (1 1) to the front arm portion covered fixing means (3) to (5) (5) (Fig. 9 d). If exit pull the Thereafter wires (1 5) and pushing the tube (1 1) together, the clipping means (1) is released from the operating means (2), Kriz Bing is completed (Fig. 9 e). Clipping means (1) is maintained for 1 week from several days in a state of ligating tissue. Then organization is necrotic, fall off naturally along with the necrotic part, is directly discharged to the outside of the body.
Next, with reference to examples, illustrating the clip for an endoscope used in the clipping device for an endoscope according to the present invention. 1 0, 1 1 is a view showing a clip for an endoscope, which is an embodiment of FIG. 1. 2 present invention. Figure 1 3 is a sectional view showing a state of attaching the endoscopic clip to the endoscopic Kuritsubingu apparatus of the present invention.
10, the arms of the clip for an endoscope (3 1) and (38) in a ring-shaped fixing portion 1 (37) is provided, there the clip is fixed by passing the arm (35) of the clipping device it is possible to open and close. Arm (35), the provided middle wider summer, the predetermined distance or more structure that Do One that does not enter into the fixed part 1 (37).
Figure 1 1 is, the arms of the clip for an endoscope (3 1) (38) in an opening of the fixed part 1 (3 7), there arm (35) of the fixed part 2 that is inflated distal (39 ) was inserted City fixed, is fixed by moving to the side and narrow summer, it has a closing structure capable.
Figure 12 is changing the width in the arm portion of the clip for an endoscope (31) (38) bent portion, by utilizing the difference in level is provided with the fixed part 1 (37). Arm (32) is that has a structure for opening and closing the fixed part 2 (39) so that it can grip the solid tough 1 (37).
The fixing portion is described in 1 (37), the fixed part 2 (39), even if the mounting of the Kriz flop for endoscopes (31) and arm (35) opposite the fixed opening and closing can der that.
Further, the Kuribbingu apparatus of the present invention as shown in FIG. 1 3, and the clip (21) for grasping tissue, the clip (31) arms (35) for opening and closing a completion over arm stop tube (32 ), a cylindrical tube made of a hollow member for fixing the arm (35) (3 3), a cylindrical tube (33) the control member (34) power composed for manipulating.
It described principle for opening and closing operation of the apparatus. Clips (31) arms (35) for fixed said opening and closing is made of a material causing elastic deformation, it is mounted so as to be normally open state as shown in FIG. 1 (b) 3. This arm (3
3) using the arm stop tube (32) to the closed state.
For opening and closing arm (35), it is necessary to move the arm stop tube (32) in the axial direction, which is joined to the control member (34) at junction (36), the control member ( 34) performed by moving in the axial direction. The control member (34) is in communication the interior of the circular cylinder tube (33), it may be through an external cylindrical tube (33). During its shape of the control member (34), all forms if Re shape der capable control arm stop tube (32).
By using the operation principles described above, the clip (3 1) for opening and closing the operation becomes possible regardless the position of the clip (31) change. Also contrary to the control member (3
4) fixed by moving the cylindrical tube (33) and that is similar to moving the clip (31) it is also possible to perform et closing.
It will now be described securing means to arm (37). An example of a fixing method to § over arm (35) of the clip (31), as shown in FIG. 10, the clip (2 1) provided with a ring-shaped (37), which is passed through the arm (35) by, it is possible to fix the clip. In Figure 1 0, the clip (31) is provided with a ring-shape on the side, but may be provided on the arm (35) side to the opposite.
Although in the form of a fastening means to arm (37), fitting it in the figure is a ring which utilizing irregularities, such as adhesives, clips (31) fixed can means to the arm (35) there if does not matter at all.
Will be described clip fixing means after being Kuribbingu.
Methods utilizing panel elastic clip (31) can be mentioned as an example. This opens the clip (31) using a force to open the arms (35) in fabricating; then, clipped closed clip (3 1), the clipped ends, the clip (31) using a restoring force, it is close ones.
Further, the clip (31) for fixing, it is also possible method of providing a separate ring of fixing. This provided a ring at the tip of the arm stop tube (32), the arm stop tube (32) projecting from the arm (35), a method of fixing the fixing ring to the clip (3 1), arm stop tube (32 ) periphery in which fixed ring, the method and the like that out press this arm stop tube (32) and a cylindrical tube (33) with pushing tube covering the.
Illustrating the operation procedure of Kuribbingu apparatus using a clip for an endoscope according to the present invention are described below.
In the closed state of the arms (35) as shown in FIG. 13 (a), the loading clip endoscopy (3 1) to the fixed part 1 (37). After determining the site to be clipped under endoscope incidentally, to introduce the device. Moving the control member (34) to the rear § over arm stop tube (32) is also moved rearward, since the arm (35) and clip the endoscope (3 1) is opened as shown in FIG. 13 (b) , pressed against the tissue to be treated in this state. One Ide, to advance the control member (34) closes the arms (35), ligating the tissue. At this time, if insufficient effect of ligation, again, if the move control member (34) rearward, arm (35) can be redone as many times clipping operation will open.
Once satisfactory clipping can, by further moving the control member (34) forward, the arm stop tube (32) by a clip for an endoscope (3 1) is tighten, clip fixing means (shown not) is fixed by. Endoscopic Kriz flop (31), because it is fixed to the tissue, the arm from the fixed part 1 (37) and moves the entire clipping device rearward (32) is disengaged.
Clip endoscope (31) is maintained about a week from a few days in a state of ligating tissue. Then the tissue is necrotic, fall off naturally with necrotic portion, it is directly discharged to the outside of the body.
As apparent by the above, an endoscopic clipping device according to the present invention, together can be again any number of times Kuribbingu operation for freely opening and closing a clip, it is possible to easily load the clip, the endoscope ligation and the bleeding site of the living tissue under a very effective as a clip device for use in marking to clarify the area where the dissection treatment or the like.
1. clip having a pair of arms which can be opened and closed operation, operation means for holding the § over arm portions of the clip to open and close the arm portions, with closed § over beam after closing the arm portion fixing means for fixing, and an endoscopic clipping device, characterized in that it is constructed from means to place the fixing means on the outside of the arm portion.
2. The hollow member having an arm portion composed of a pair of elastic members at the distal end, the outside of the member for opening and closing the arms covering the hollow member, said outer member connected to the control member, the opening and closing operation can clip having an arm portion is, and is composed of a securing means for securing the clips after Kuribbingu, and characterized in that the arms are opened and closed by moving the control member connected to the outer member in the axial direction clip for an endoscope to
3. The endoscopic clipping device according to claim 1 or 2, wherein a fixed can means the arm portion to the arm portion of the clip.
4. The endoscopic Tarippu device according to any one of claims 1-3 having means capable fixed arm to the arm portion.
5. arm of Tarippu the endoscopic clip equipment of claim 1 any force, wherein the width is connected at the base Te continuously small Kuna' over part or all of the arm portion.
6. arm of Tarippu is, due to the elasticity of the clip material, or by attaching a separate elastic arm portion, endoscopic always according to any one of claims 1 to 5 in which the arm portion is closed with clips alone clip device.
7. fixing means and the clip are previously arranged in small holes provided on the plate, endoscopic clipping device according to any one of claims 1 to 6 for the loading to the device after it.
PCT/JP2002/013032 2001-12-13 2002-12-12 Clip device for endoscope and clip for endoscope for use therein WO2003053256A1 (en)
JP2001-379431 2001-12-13
JP2001379431 2001-12-13
JP2002036107 2002-02-14
JP2002-36107 2002-02-14
JP2002292847 2002-10-04
JP2002-292848 2002-10-04
JP2002292848 2002-10-04
JP2002-292847 2002-10-04
US10/498,162 US7357805B2 (en) 2001-12-13 2002-12-12 Clip device for endoscope and clip for endoscope for use therein
JP2003554018A JP4116567B2 (en) 2001-12-13 2002-12-12 Endoscope clip device and endoscope clip used therefor
WO2003053256A1 true WO2003053256A1 (en) 2003-07-03
ID=27482727
PCT/JP2002/013032 WO2003053256A1 (en) 2001-12-13 2002-12-12 Clip device for endoscope and clip for endoscope for use therein
US (1) US7357805B2 (en)
JP (1) JP4116567B2 (en)
WO (1) WO2003053256A1 (en)
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2002-12-12 WO PCT/JP2002/013032 patent/WO2003053256A1/en active Application Filing
2002-12-12 JP JP2003554018A patent/JP4116567B2/en not_active Expired - Fee Related
2002-12-12 US US10/498,162 patent/US7357805B2/en active Active
JP4116567B2 (en) 2008-07-09
JPWO2003053256A1 (en) 2005-04-28
US7357805B2 (en) 2008-04-15
US20050049618A1 (en) 2005-03-03
JP4071441B2 (en) 2008-04-02 Suture fixation system
ES2361689T3 (en) 2011-06-21 Stents insertion system with traction-compression kinematics.
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