Source: https://patents.google.com/patent/WO2004008975A1/en
Timestamp: 2019-06-17 06:58:35
Document Index: 630311016

Matched Legal Cases: ['arts 7', 'art 1', 'art 1', 'art 2', 'art 2', 'art 3', 'art 1']

WO2004008975A1 - Clip operation device - Google Patents
Clip operation device Download PDF
WO2004008975A1
WO2004008975A1 PCT/JP2003/009048 JP0309048W WO2004008975A1 WO 2004008975 A1 WO2004008975 A1 WO 2004008975A1 JP 0309048 W JP0309048 W JP 0309048W WO 2004008975 A1 WO2004008975 A1 WO 2004008975A1
PCT/JP2003/009048
2003-07-16 Application filed by Olympus Corporation filed Critical Olympus Corporation
2004-01-29 Publication of WO2004008975A1 publication Critical patent/WO2004008975A1/en
A clip operation device, wherein an operation wire (9) inserted into a flexible sheath (4) so as to be moved forward and backward is detachably connected to a clip (6) disposed near the tip of the sheath (4), and formed to provide such a degree of flexibility that can follow up the varying shape of the sheath (4) for inserting the operation wire (9) therein.
Clip operating device
The present invention relates to click Li class tap operation device or clip device according to the treatment target living tissue or the like in living body cavity.
Used with an endoscope, is a clip device for hemostasis bleeding body cavity site, the actual fair 4 one 2 6 0 9 1 JP Ya Sho 6 3 - 6 0 1 6 No. disclosed in Japanese there are things you have.
Actual fair 4 one 2 6 0 9 1 No. those disclosed publication, Remind as in FIG. 2 3, the full-click 5 2 which is attached to the operation wire 5 1 tip that 揷通 the sheath 5 in 0 via the connecting plate 5 4 is a structure to hook the clip 5 3. Further, JP-B-6 3 - 6 0 1 6 No. those disclosed in Japanese is a structure in earthenware pots by hooking the hook was attached to the tip of the operation wire Ya directly clip.
Be of any type, the distal end of the operating wire Ya, connect the rigid coupling member such as full-click or connecting plate, against the connecting member of the hard, leaving a clip disposed on the distal end of the sheath possible to Attach to have to jar'll be mounted. And advancing and retracting the operation wire, Ru can be opened and closed and the operation of separation of data Clip.
This type of clip device will that we use to guide through channel of an endoscope into the body cavity. It is usually used in combination with a direct view type endoscope. However, depending on the treatment site within the body cavity in direct view endoscope in this case there may not Ku spear treatment operation is very is used in combination with Let's Do lateral vision endoscope shown in FIG. 2 3.
Side-view type endoscope 5 6, Ri your equipped with a forceps raiser device 5 7 on the tip open mouth portion of the channel, Ri by the forceps raising unit 5 7 of this, clip device 5 8 It was raising, to jar by inducing a clip equipment 5 8 at the treatment site within the body cavity.
In side-view type endoscope 5 6 This good cormorants, for elevating bending the use tech Clip device 5 8 a forceps raising unit 5 7, near the vicinity of the distal end of the clip device 5-8 in a state that especially strongly bent.
Above JP-B 6 3 - 6 0 1 Do you I shown in 6 JP and actual fair 4 one 2 6 0 9 1 discloses, in clip device, before end of the inlet tube, the clip mounted and is introduced into the body cavity, to then manipulate the clip Ri by the operation wire, it has become the jar by leaving the clip from the connecting member of the operating wire. Rigid connecting member off click and connecting plate or the like on the operation wire Ya tip operation process of leaving the opening and closing operation or the operation wire Karak Clip of the clip is, in the sheath together with the operating wire move, eventually moves into the sheath behind.
However, when using a side-view type endoscope is allowed sharply bent strongly, especially sheath vicinity of the distal end portion of the clip device by forceps raising unit 5 7. Therefore, part of the rigid connecting member of the hook and the connecting plate or the like, not easily caught by the bent portion of the sheath. Further, full-click or part of the rigid coupling member of the coupling plate or the like, difficult to pass through the bent portion of the sheet over the scan to smoothly a series of operations up to withdrawal operation from the gripping operation clips are securely there is that you can not have a child that is in Katsusu Meuse. Situation Do you Yo this is not limited to when used in combination with side-view type endoscope is to obtain that also occurs if there is no used in combination with direct-view or perspective-type endoscope.
Further, even in direct-view or perspective endoscope, there is equipped with a forceps raising device. Like also to curve the insertion portion itself forceps raising device equipped city endoscope, a situation which bent portion the sheath occurs get Ri Oko. In particular, thin in clip device using a sheath regardless of the format of the endoscope to be used Te combination, the rigid connecting member of the full-click and connecting plate or the like to small bending piece portion of the sheath parts tends takes Hikitsu liable Do Ri can not pass through the bending portion portion of the rigid connecting member to the scan mu's.
In the present invention, clips disposed near inlet tip - operating means coupled to the clip some Iwaku Li Ppuyuni' preparative operations reliably and quickly by (data re Ppuyu Tsu preparative included) the clip operating device or clip device was to jar by Ru can be an object of the present invention and provides child.
The present invention, the distal end of the flexible Wa Lee Ya having a flexibility which is movably 揷通 the introduction pipe of 揷入, flexible in raw cavity Therefore, the introduction tube tip the clips disposed constitutes a connecting portion for connecting the disengagement available-, the connecting portion is a clip manipulation device having a capable of following flexible deformation of the inlet tube.
The present invention relates to insertable flexible introducing means into the raw body cavity, inserted through the elongated means retractably moved, the said elongate means, click Li disposed at a distal end portion of the introduction means Tsu Ri removably coupleable der the flop, and, said elongate means is a clip manipulation device having a more flexible degree that can follow the deformation of the introducing means.
The present invention is 揷通 retractably move the insertable flexible inlet tube into the raw body cavity, the gripping operation of the click re class tap disposed at the distal end portion of the inlet tube and disengagement of clip an operating member for performing the operation, is connected at one end to the distal end of the operating member, the other end was connected detachably to said motor Clip had flexibility that can follow the deformation of the inlet tube allowed click to and a FLEXIBLE connecting member is a Clip operation equipment.
The present invention, the connecting member to the distal end of the movably 揷通 been operating member to the introduction pipe of 揷入, flexible in raw cavity provided, extending from the clip, the deformation of the inlet tube Wai ya to have a flexibility that can follow a clip manipulation device which is connected to the connecting member.
Figure 1 is a perspective view showing the second clip operation apparatus according to a first embodiment, FIG near the tip portion of the clip operating device according to the first embodiment.
Figure 3 is diagram of a use state of the clip operating device according to the first embodiment.
Figure 4 is diagram of the use state of the clip operating device according to the first embodiment.
Figure 5 A - FIG. 5 D is a diagram operation will be described when using the clip operation equipment according to the second embodiment.
Figure 6 is a diagram of the vicinity of the leading end portion of the clip operating device according to the third embodiment.
Figure 7 is a diagram of the use state of the clip operating device according to the third embodiment.
Figure 8 A 及 Pi Figure 8 B is a diagram depicting the vicinity of the tip portion of the data Clip operating device according to the fourth embodiment.
Figure 9 A and Figure 9 B is a diagram depicting the vicinity of the tip portion of the clip operating device according to the fourth embodiment.
Figure 1 0 is a diagram depicting the vicinity of the tip portion of the clip operating device according to the fourth embodiment.
Figure 1 1 is a diagram depicting the use state of the vicinity of the leading end portion of the clip operating device according to the fourth embodiment.
Figure 1 2 A and FIG. 1 2 B is a diagram depicting the use state of the vicinity of the leading end portion of the motor Clip operating device according to the fourth embodiment.
Figure 1 3 is a diagram depicting the state of use of the vicinity of the leading end portion of the clip operating device according to the fourth embodiment.
1 4 is a diagram of the vicinity of the leading end portion of the clip operating device according to the fifth embodiment.
Figure 1 5 is a diagram of the use state of the vicinity of the leading end portion of the clip operating device according to the fifth embodiment.
Figure 1 6 is a diagram of the vicinity of the leading end portion of the clip operating device according to the sixth embodiment.
Figure 1 7 is a diagram of the use state of the vicinity of the leading end portion of the clip operating device according to the sixth embodiment.
Figure 1 8 is a diagram of the use state of the vicinity of the leading end portion of the clip operating device according to the sixth embodiment. Figure 1 9 is a diagram of the vicinity of the leading end portion of the clip operating device according to the sixth embodiment.
2 0 Figure in the use state of the vicinity of the leading end portion of the clip operating device according to the sixth embodiment.
Figure 2 1 is a diagram of the vicinity of the leading end portion of the clip operating device according to the seventh embodiment.
2 2, illustration of the use state of the vicinity of the leading end portion of grips operating device according to the seventh embodiment.
2 3, FIG near the tip portion of the conventional clip apparatus.
With reference to FIG. 1 to FIG. 4, will be described clip operation apparatus according to a first embodiment of the present invention.
Clip operation device 1 according to this embodiment has the 揷入 portion 2 and the operation unit 3 Remind as in FIG.揷入 unit 2 includes, for example, made of a resin flexible tube sheath 4, Ru consists coil sheath 5 of the inlet pipe of the flexible inserted through the this tube sheath 4. A tube sheath 4 of this, Coil Rushisu 5 is relatively longitudinal direction Hesurai de possible correlation. The proximal end of Coil Rushisu 5 is connected to the main body 3 a of the operation portion 3. Further, the base end outer periphery of Ju Bushisu 4, abuts the distal end of the body 3 a is possible that cylindrical scan Settsu path 4 b is fixedly provided.
Remind as in FIG. 2, the tip of Coil Rushisu 5 click V Ppuyu Stevenage DOO 6 are assembled. Child of another Li Ppuyuni' door 6 stop tube 8 force that consists of the other Clip 7. Clip 7 bending a thin strip plate material made of stearyl down less in the middle portion, the bent portion and a proximal portion 7 a, the part following this base portion 7 a, the inner diameter of the stop tube 8 also forms a pair of Hamado portion 7 b of the wide frequency than. Fitting portions of the strip plate material extending to et the pivot portion 7 b cross each other, the piece portions of the two ribbon sheet extending from the intersection of its forms a pair of arms 7 c. Et al of the tip portions of the arm portions 7 c by bending the power sale by intends orientation if each other, the bent portions of both this and clamping unit 7 d. Then, the pair of arm portions 7 c, is clamping portion 7 d mutually oriented to each other, Remind as in FIG. 2, expansion behavior is given in earthenware pots by Open.
Remind as in FIG. 2, the base end portion of the clip 7 is substantially J-shape bent off click shaped engaging portion 7 e is formed by projecting rearward . The locking portion 7 e constitutes the consolidated portion releasably connected to the distal end of the operation wire 9 inserted through the coil sheath 5. Locking portions 7 e is connected to the distal end of the operation wire Ya 9 of the operating means to be described later. The engagement portion 7 e bent into a substantially J-shape at a predetermined value or more driving force, can and drove the operating wire 9, Ri by its pulling force, straight Nobepi operation Wa I catcher 9 mosquito ゝ be et al released.
Remind as in FIG. 2, the operation wire 9 is bent folding single flexible Wa I catcher member into two, the two Wa I catcher portion of the returned folded to the hand side, the operating means Configure. The distal loop portion formed Ri by the and this bending fold the single flexible wire catcher member and the connecting portion (connecting means). That is, the operation wire 9, the distal loop portion, connecting portions for engaging with the (connecting means) the locking portion 7 e of the clip 7. Operation Wa Lee Ya 9 with end loops portion returned folding of the flexible wire Ya member directly constitute Oh Ru connection of flexibility. Since the operation loop leading edge portion of wire and 9 of this is a connecting portion to hook into the locking portion 7 e, it forms a connecting member with flexibility by the wire member in the distal end loop portion of the operation wire 9. Connection of this, it carp Rushisu 5 of the said inlet pipe, has the flexibility normally, Ru can follow the deformation, such as to put Ri obtain curvature or bending piece.
Then, the clip 7 is mounted in place in the vicinity of the tip of Coil Rushisu 5. The proximal portion of the clip 7, fitted to Coil Le sheath tip 5 abutting the pressing tube 8 to a, in its holding tube 8, filled with a filler such as shea re co down, which I Ri, data Clip 7 is instrumentation wearing in a state of being temporarily fixed to the co-Yi Rushisu tip 5 a to.
The proximal portion of the operating ring i ya 9 exits Ri through the inside Coil Roussy scan 5 of the insertion portion 2 reaches the front and rear provided in the operation portion 3 to the dynamic freely slider 3 b, the scan line that is connected to da 3 b. Me other this, the engaging portion 7 e force clips 7, on the rear of the operation wire Ya 9 located et Coil Rushisu 5 is the connecting portion for engaging the clip 7 including, there is no hard part.
The click Li Ppuyuni' DOO 6 is located at the tip of Coil Rushisu 5. Even Ri good tube sheath 4, Ri by the and this advancing on coil sheath 5, a click re Ppuyuni' DOO 6, accommodated in the distal end of the tube sheath 4. From the loading state of this, Remind as in FIG. 2, to be sampled horn 4 b abuts against the main body 3 a of the operation unit 3, when retracting the tube sheath 4, Coil Rushisu 5 及 Pi click Li Ppuyuni' DOO the tip portion 6 is exposed to the outside protruding from the previous end of the tube sheath 4. Ni will this Yo, be sampled Tsu path 4 b is come and abut against the main body 3 a of the operation unit 3, the distal end portion of the coil sheath 5, the exposed portion 5 b which is projecting from the distal end of the tube sheath 4.
Next, the operation of the apparatus according to the first embodiment. First, click re Ppuyuni' preparative 6 while housed in the tube sheath 4, the 揷入 portion 2 of the clip manipulation device 1, through the lateral vision endoscope 1 0 Channel 1 in 0 a a shown in FIG. 3 to induce in the body.
Remind as in FIG. 3, the endoscope 1 0 force ゝ al, and projects the leading end of the insertion portion 2 of the clip manipulation device 1, it is retracted Chu Bushisu 4 of the operating member, scan the door Tsu path 4 b, is brought into contact with the distal end of the main body 3 a of the operation portion 3. When, click re Ppuyuni' DOO 6, none of the exposed portions 5 b of 及 beauty Koinoreshisu 5 protrudes from the distal end of the tube sheath 4.
In this condition, Remind as in Figure 3, the endoscope 1 0 of forceps raising equipment 1 0 b to work raising. To the, Coil Rushisu 5 of the exposed portions 5 b are forceps raising device 1 O b to I Ri centrally bent to cause the upper limbs, click Li Ppuyuni' DOO 6, the endoscope 1 0 in the observation field of view penetrate. In here, the exposed portions 5 b the length of the Coil Rushisu 5 is long enough to be bent in forceps raising equipment 1 0 b. For this reason, the middle portion of the exposed portions 5 b while it is bent by the forceps raising unit 1 0 b, Ru can firmly fixed to the elevation state.
Remind as in FIG. 3, induces click re Ppuyuni' DOO 6 to the affected area 1 1 in the body, performing the pull KuMisao operation the scan line Da 3 b in the operation unit 3 on the base end side. Ri by this operation, the operation wire 9 is pulled, retracted proximally. If, Remind as in FIG. 3, fitting pivot portion 7 b clips 7 is crushed by the pressing tube 8 is drawn into the stop tube 8, the pair of clamping portions 7 of the clip 7 d is rather large expansion in an outward direction.
In a state where the pair of clamping portions 7 d of this clip 7 is expanded, pushing the clamping portion 7 d of a pair to the affected area 1 1, anyway, and this pull rather the slider 3 b proximally It causes the rear retraction towing the operation wire 9 by. If, Remind as in FIG. 4, the proximal portion of the arm portion 7 c of the clip 7 is drawn up inside stop tube 8, the arm portion 7 c of the clip 7 closes, the affected area 1 1 to grip the.
Ni will Yo this, the affected area 1 1 in a state sandwiched by clips 7, pulling the slide Lee Da 3 b on the base end side, Ru retracted by pulling the operating wire 9. Tractive force when retracting the operation wire Ya 9, since strong than ever, the engaging portion 7 e of the clip 7, the distal end of the operation wire 9 has been engaged is, Ni will by shown in FIG. 4 , elongation deformed, the engaging portion 7 e Ca ゝ et operation wire 9 is disengaged. Is released from the engagement of the clip 7 and the operation wire ya 9, click Li Ppuyuni' door 6, operation Wai ya 9 force, is et withdrawal 'release. Remind as in FIG. 4, click Li Ppuyuni' DOO 6, while sandwiching the affected area 1 1, it is placed in the body.
Click Li Ppuyu - In the final stage Tsu bets 6 is disengaged from the operation wire 9, the engaging portion 7 e of the clip 7, Remind as in FIG. 4, but extends Ryakujika Ray, the locking It does not protrude out of the end parts 7 e of the tip stop tube 8. For this reason, there is no and this hurt the body wall or the like by extending after leaving full-click-shaped engaging portion 7 e.
This embodiment, including the connecting portion of the tip formed by the operation wire Ya 9 located behind the engaging portion 7 e of the clip 7, Ri Ah flexible, there is no hard section. Therefore, the operation word Lee Ya 9 in the course of a series of clips Operations with an and this rather pull the proximal side, hardly Ri scratching the portion of the coil sheath 5 which is bent in forceps raising device 1 0 b , Ru can and child to move the coil sheath 5 to smoothly. Operating the coil sheath 5 wire 9 can be back and forth rapidly, it is possible smoothly operation is. In particular, even if the bending strongly coil sheath 5 Ri by the forceps KoOkoshi on the device 1 0 the side-viewing endoscope 1 0, side-view type endoscope without the arc movement in the coil sheath within 5 is inhibited mirror 1 0 Demoku Clip operating device 1 Ru can be operated reliably and quickly.
The invention of this embodiment, since was configurations with clips or click Li Ppuyuni Tsu releasably flexibility or degree connection means that can at follow the shape of the inlet pipe connecting against the bets, introduced even in the tube if flexion connecting means rather difficulty caught during introduction tube, Ru can trigger moves the introduced tract smoothly.
Further, Ri by the operating means of the operating wire 9, can and was driven at a predetermined value or more traction, the engaging portion releasing from the operation means Ri by its pulling force to the clip or click Li Ppuyuni' DOO because provided, to eliminate the rigid region formed in the operation unit side, or Ru line can reduce. Therefore, the introduction pipe is hardly caught the connecting means even in if the bent state, it is the this to move the introduced tract smoothly. (Second Embodiment)
For clip operation apparatus will be described according to a second embodiment of the invention with reference to FIGS. 5 A to Figure 5 D.
Clip operating device 1 2 of the present embodiment has a Do Let 's described below configuration.揷入 portion 2 of the clip manipulation device 1 2, sheath member corresponding to the tube sheath 4 is set to the coil sheath 1 3. The tip of the coil sheath 1 3 This is the Koi Rushisu 1 3 of internal diameter by Ri also reduced diameter cylindrical tip 1 4 is fixed Closing arranged coaxially.
Operation wire 1 5 for connecting to click Li Ppuyuni' DOO 6, was placed in the coil sheath 1 3, while 揷通 a sheath-shaped push member 1 7 to be described later, is guided to the proximal through the coil sheath 1 3 ing.
The operation wire 1 5, Ri Na constitute return folded flexible wire on the way, to form flexible consolidated portion (connecting means) by the folding return the distal portion, the loop portion 1 of the cutting edge against the 5 a, data re Ppuyu - you engaged detachably locking portions 7 e of Tsu bets 6.
The click Li Ppuyuni' DOO 6, the clip 7 formed similarly to the first embodiment described above, a-ring 1 6 tightening molded Ri by such a resin or metal having sufficient strength and elasticity that consists of. -Ring 1 6 tightening an elastic deformed to project and retract outward, resilient projections and to foldable a pair or multiple number of vanes 1 6 a, 1 6 a 'on the outer peripheral portion and Aru. Is the elastic protrusions of this, not only the wing-like projections may be-rings or the like of the elastic protruding orbiting the-ring 1 6 tightening.
Wherein the rear end of the clip 7, the engaging portion 7 e is provided for by a wire connecting portion are, Ru. The loop portion of the engagement portion 7 e operation wire 1 5 (connecting portion) 1 5 a is Ru coupled engaged detachably. Similarly DOO The engagement portion 7 e also also for the first embodiment, a configuration for connecting detachably the end loops of the operation wire 9 that 揷通 to Koi Rushisu 5. The locking portion 7 e is come to have led the operation wire 9 of the operation means to be described later at a predetermined value or more traction release by its traction Rinobepi, the operation wire 9.
Further, the coil sheath 1 3, the flexible pushing member 1 7 is provided which surrounds the Ri peripheral operation wire Ya 1 5. Push member 1 7 is fixed to the operating wire 1 5 at hand side.
In the present embodiment, the operation wire Ya 1 5 located rearward from the locking portion 7 e of the clip 7, no rigid parts. These other than construction is the same as the first embodiment described above.
Next, the operation of the apparatus according to the present embodiment. Also not a, Remind as in FIG. 5 A, folded folding wings 1 6 a of Li tightening ring 1 6, 1 6 a ', to accommodate the click re Ppuyuni' DOO 6 in the coil sheath 1 3. The 揷入 portion 2 of the clip manipulation device 1 in a state of accommodating the click re Ppuyuni' DOO 6 through the channel of an endoscope introduced into the body cavity.
Then, Remind as in FIG. 5 B, Ri by the scan line Da 3 b of the operation unit 3, to advance the pusher member 1 7, click Li Ppuyuni Tsu DOO 6 Koi Rushisu 1 3 of the tip collar 且 shove . To and, swelling it to fold folded wings 1-ring 1 6 tightening had 6 a, 1 6 a ', it returns to its original shape.
5 Remind as and C, pull the operation wire 1 5 with the coil sheath 1 3, when the slightly retracted-ring 1 6 tightening, blade 1 6 a, 1 6 a 'is engaged with the distal tip 1 4 OK, no more, no retreat back. Coil Rushisu 1 3, leaving distal tip 1 4 retracts.
The Coil Rushisu 1 3, while being retracted from distal tip 1 4, Ri by the forceps raising unit of the endoscope, appropriate force boss, the clip 7 toward the diseased part 1 1 of the body cavity Induce. Its to, the clips 7 in the affected area 1 1 in the press and with the state, pull the slider 3 b to the proximal side, and to pull the operation wire ya 1 5, Ni will by shown in Figure 5 C , Hamado portion 7 b of the clip 7 is drawn into clamping Tsukeri ring 1 6, thereby expanding the clip 7 to crush the fit dynamic portion 7 b.
Operation wire 1 5 causes a is retracted al, gripping the pull in data Clip 7 arms 7 base to-ring 1 6 tightening c of clip 7 closes, the affected area 1 1 be able to. Its to the affected area 1 1 in a state sandwiched by clips 7, the make retracted by pulling the operating wire Ya 1 5, the Yo U shown in FIG. 5 D, the locking portion of the clip 7 7 e and is deformed linearly Shinpi, solved the engagement between the operation wire 1 5 tip connecting portion, click re Ppuyuni' DOO 6, detached from 揷入 unit 2, clip 7, Fig. Remind as the 5 D is indwelling leave affected part 1 1 is sandwiched.
According to this embodiment, in addition to the same advantages as the first embodiment in cormorants I described above, protrusion of the coil sheath 1 3 Power et click Li Ppuyuni' DOO 6, and, clips operations, the operation unit since it is possible only in three of the scan line da 3 b, operation is simple, a gutter cormorant effect force s.
Referring to FIGS. 6 and 7, will be described clip operation apparatus according to a third embodiment of the present invention.
Clip operation device 1 8 of the living tissue of the present embodiment is of Do arrangement would Yo follows.揷入 portion of clip manipulation device 1 8 2 has the same configuration as the first embodiment described above. The inside coil sheath 5 of 揷入 unit 2 Remind as in FIG. 6, are then 揷通 the operation wire 1 9. Click Li Ppuyuni' DOO 6, the clip 7, comprising stop tube 2 0 and mosquitoes ゝ et having a small diameter portion 2 0 a to be described later.
Although clip 7 is substantially the same configuration as that of the first embodiment described above, in the present embodiment, instead of providing the engaging portion 7 e, click Li Tsu loop of the base end portion 7 a of the flop 7 moiety Ri name as a wire connection locking portion, for locking through distal wire ya portion of the operation wire ya 1 9 in the loop portion.
Remind as in FIG. 6, the operation tip portion of the wire 1 9 returns folded rearwardly and through the flexible such wire Ya members one to the loop portion of the base end portion 7 a of the clip 7, and et to the return the wire portion folded backwards. the combined Ri remaining was operating wire 1-9 original portion of the twist, and bind to form a twist Ri mating portion 1-9 a. The twist Ri mating portion 1 9 most wire members, comprising a weak portion.
Since it is this Yo I Do arrangement, Ru can and this forming part of the hard portion without the flexible connecting member over the click Li Tsu proximal end 7 a force et rear of the operation wire 1-9 flop 7. The carp Rushisu the tip of the 5 only set the tubular tip 2 1, the tip portion of this tip 2 1 fitted to the small diameter portion 2 0 a formed on the rear end outer periphery of the stop tube 2 0 combined, the rear end portion of the tip 2 1 fit the fitted to the distal end outer periphery of the coil sheath 5. Other configurations withdrawal form the first according to c present embodiment is similar to that of the embodiment device click Li Ppuyuni' bets 6 described above is different from that of the first embodiment described above. That is, in this embodiment shaped state by pulling the operating wire 1 9, close the clip 7, while holding the affected area 1 1, if you pulling strongly operating wire 1 9 is al, twisted Ri combined part (Week 'POI emissions g) with loose wire parts of 1 9 a, out data re Tsu proximal end 7 a force et operation wires 1-9 flop 7, leaving click Li Ppuyuni' bets 6 from the operation wire 1 9 you. Operation Wai Ya 1 9, when you traction at a predetermined value or more traction wire portion of the twisted section 1 9 a is loosened, the twisting unit 1 9 a is loosened in traction coupling to leave the clip 7 constitute a part. And others are substantially the same configuration as the first embodiment described above.
According to this embodiment, it is that you use in the same manner as the first embodiment, the same operation and effect. Further, by the present embodiment lever, in addition to the effects of the first embodiment, since not provided with the locking portion out thrust rearward clip 7, since covering a locking portion extending rearwardly the Ri unnecessary der and this to increase the length of the stop tube 2 0, minute its, Ru can shorten the length of the stop tube 2 0. In addition, the tip 2 1 and stop tube 2 0 provided at the tip of the coil sheath 5 is fitted, there is no and this to click Li Ppuyuni' DOO 6 tilts, gutter cormorants effect.
Referring to FIG. 8 A through FIG. 1 3, it will be described engagement Ru clip operation apparatus in the fourth embodiment of the present invention.
Clip operation apparatus 2 2 biological tissue of the present embodiment is of Do arrangement will by described below. Remind as in FIG. 8 A, 揷入 unit 2 Coil Rushisu 2 3 forces, Ri Rana, the tip of Coil Rushisu 2 3 This, tip 2 4 is installed in the fixed . The distal tip 2 4 This, clip mounting portion to which the to removably accommodate the clips controlling the opening and closing and plastic deformation of the clip is formed. That is, Remind as in FIG. 8 B, the inner wall of the tip chip 2 4, a pair of slope portions 2 4 a is a cormorants I away from each other about the tip side and arranged line symmetrically in the vertical formed by Rereru. A pair of slope portions 2 4 a This continues until halfway from the previous end of the distal tip 2 4. Figure Remind as in 8 A, the portion located on the Ri rear side by the rear edge of the slope portion 2 4 a, followed by the rear edge of the slope portion 2 4 a, the large-diameter hole 2 4 It has become a b. The rear end of the slope portion 2 4 a, to form a pair of convex portions 2 4 c. Protrusions 2 4 c This is formed utilizing the projecting edge of the border to move to the hole 2 4 b of the slope portion 2 4 a force et large diameter.
Remind as in FIG. 8 A, the tip 2 4, scan Li Tsu Miyako 2 4 d is provided with the open mouth on one side. The slope part 2 4 a, the scan Ri by the and the child to use the re-Tsu door 2 4 d, Ru can attach and detach the clip 2 5 from the portion of the tip switch-up 2 4 to the side. Also Remind as in Figure 9 A, using the scan Li Tsu Doo 2 4 d, it is also confirmation of the loading work and loading state of the clip 2 5.
Remind as in FIG. 8 A, wherein the clip 2 5 by bending a thin strip plate material made of stainless steel in the middle portion, the bent portion, the proximal portion 2 5 a, the proximal portion 2 5 a force ゝ Luo arms 2 5 b is in the form that gives extension. Distal ends of the arms 2 5 b is in fold bent in a direction facing each other, this both you and sandwiching unit 2 5 c. Then, the clip 2 5 than that shown in FIG. 9 A, Ni will the clamping portion 2 5 c Yo open Ku, shown in c Figure 8 A that is granted expansion behavior in the proximal portion 2 5 a in earthenware pots by, the arms 2 5 b of the base end 2 5 a vicinity of the data Clip 2 5, fits the convex portions 2 4 c is, it engageable ability recess 2 5 d is provided It is to Rereru.
Operation wire 1 9 formed by the third embodiment and the flexible connecting portions of the wire Ya destination end portion similarly to the aforementioned (connecting means). That - Wai Ya distal portion of the operation wire 1 9, bending folding piercing the loop portion of the clip 2 5 at the proximal end 2 5 a, the bent wire part, led to the rear, left the twist mating portion 1 9 a bound by twisting the original wire part was. Therefore, there is no hard segment from clip 2 5 at the proximal end 2 5 a on the rear of the operation wire 1 9 in this embodiment.
The Coil Rushisu 2 3, the body 3 is connected to a manipulation wire 1 9 of the operation unit 3 is connected to the slider 3 b.
Next, the operation of the apparatus according to the present embodiment will be described. First, Remind as in FIGS. 8 A and FIG. 8 B, fitted with a proximal portion of the arms 2 5 b clips 2 5 to a state of being housed in the distal tip 2 4, in this state induces in the body cavity through the channel of the endoscope 揷入 portion 2 of the clip manipulation device 1 2. The operation unit 3 causes of the scan line da 3 b a a little bit forward, to a little advance the clip 2 5 loosen the operation wire ya 1 9. To the, Remind as in FIGS. 9 A and FIG. 9 B, clip 2 5, Ri by it themselves spreading behavior of the arms 2 5 b are opened rather. On the other hand, if the argument rather than the scan line da 3 b to the proximal side, clip 2 5 arm part 2 5 b is only write to enter the distal tip 2 4 of the arms 2 5 b outer surface of the slope part contrary to expanded learning resistance in contact with the 2 4 a, arms 2 5 b clips 2 5 is controlled in earthenware pots by you close (see FIG. 1 0 及 Pi Figure 1 1).
Therefore, by operating the forceps raising unit of the endoscope, Remind as in FIG. 1 1, the portion of the clip 2 5 induces the affected area 1 1 in a body cavity. Their to, to advance the operating wire 1 9, open the clip 2 5, it is pressed against the affected area 1 1. Other Clip 2 5 in the state in which pressed against the affected area 1 1, rather than pull the operation wire 1 9 Ri by the slider. That this shall, clip 2 5 close Remind as in Figure 1, to grip the affected area 1 1. This and can, click Li Tsu proximal end 2 5 a of the flop 2 5 plastically deformed Ri by the protrusions 2 4 c of the tip switch-up 2 4, after passing through the convex portion 2 4 c is convex portion 2 4 fitted in the recess 2 5 d of c force S clip 2 5, to lock the clip 2 5.
In this locked state, retracting the are al operating wire 1 9, Remind as in FIG. 1 2, twist Ri mating portion 1 9 a is 〖Magureru. Procedure wire 1 9 base end 2 5 a force of motor Clip 2 5, et disengaged.
Clip 2 5 will cormorants by Ru can be released into the distal tip 2 4 of the scan Li Tsu Doo 2 4 d force, et al side person. Remind as in FIG. 1 3, disengaged from the distal end chip 2 4 while sandwiching the affected area 1 1, Ru can trigger indwelling clip 2 5 in the body.
According to this embodiment, the same effect as the first embodiment can be obtained. Because without the clip 2 5 stop tube 8 from the like, the number of parts is rather small, it becomes cormorants I can be manufactured at a low cost, also to do so trough cormorant effect. In addition, Ru can simplify the operation. Further, since the arms 2 5 b of clip 2 5 is fitted narrowing enters the tip 2 4, for example, when the upper forceps, and Units clip 2 5, Koirushi over scan 1 3 Ru can prevent the deviation between.
Referring to FIG. 1 4 及 Pi Figure 1 5, will be described a fifth embodiment engaging torque Clip operating device of the present invention.
Clip operation apparatus 2 6 biological tissue of the present embodiment, the third embodiment described above, the form of the operation wire 2 7 differs. Operation Wai Ya 2 7 of the present embodiment includes a drive wire 2 7 a positioned proximally connecting portion which is connected through the connecting portions 2 7 b at the tip of the drive wire Ya 2 7 a this (Consolidated It is constituted by the folding back yarn 2 7 c of the unit). A connecting portion for engaging a folded back yarn 2 7 c portion of the tip Le one-flop of this the clip 7. Yarn 2 7 c is locked by passing a portion returning Ri that occasion the (connecting portion) proximal end of the clip 7 (engaging portion) to 7 a. Yarn 2 7 c is can be constant over load is Cor pressurized, that occasion Ri return wire portion is cut becomes weak 'POI down bets, to release the clip 7. The connecting portion 2 7 b is Ri That also Ri by exposed portions 5 b of the coil sheath 5 is located behind the drive wire Ya 2 7 a of the said operating means flexible in the clip 7 with you connecting yarn 2 7 c of the connecting member having a was placed the connecting portions 2 7 b at a position spaced appropriately length from the tip of the Coil Rushisu 5.
Incidentally, the rigid portion may be provided in a very small area by solid adhesive material or the like for the purpose of bundling the yarn portion on the folded yarn 2 7 c. The tip of the coil sheath 5, the same stop tube 2 8 in the first embodiment are abutting. Other than the above configuration Ru similar der the first embodiment described above.
Next, the operation of the apparatus according to the present embodiment will be described. In the present embodiment, withdrawal action of click Li Ppuyuni' DOO 6 is different from the case of the third embodiment described above. In this embodiment driven the drive wire 2 7 a, the clip 7 closed Ji, gripping the affected area 1 1. In gripping this condition, when pulling the drive wire 2 7 a to the al, cut the thread 2 7 c by traction above a predetermined value of that disengages proximal end 7 a force et clips 7. Click Li Ppuyuni' bets 6 is separated from the operation wire 2 7. Effects of the present embodiment is on purpose similar third embodiment forms described above. Moreover, even when connection of the hard, you can use the side mistake co-loop. Further, even if the connection portion of the rigid, in a state in which the action of the upper clamp raising stand on the side mistake Cope, it can use to smoothly.
Incidentally, withdrawal means wire Ya portions of the present embodiment is cut, releasing the clip 7 is also applicable to the first embodiment described above. And loosened third wire Ya portions of the twist Ri mating portion 1 9 a in the embodiment described above, can also this to utilize what data re Tsu operation from the proximal end 7 a of the flop 7 Wa I turbocharger 1 9 disengages that.
(Sixth Embodiment) Referring to FIG. 1 6 to 2 0, is described in the sixth embodiment engaging torque Clip operating device of the present invention.
Clip operation apparatus 2 9, 3 1 in this embodiment, from that of the first embodiment described above, the operation wire 3 0, the locking structure of the clip 7 is different.
That is, first, clip operation apparatus 2 9 Remind as in FIG. 1 6, and the drive wire 3 0 a portion where the operation wire 3 0 is positioned on the proximal side, the distal end of the drive wire Layer 3 0 a and a connecting portion 3 O b is connected through the folded back wire 3 0 c to. That is, the folding-back wire 3 0 c is folded-back distal end portion, which is minutes Department of flexible connecting member for connecting over the engaging portion 7 e of the clip 7. The folding-back wire 3 0 c is relatively long. Therefore, beyond the range the connecting section 3 0 b is also includes a reduced range corresponding to the movable range area corresponding to the raising device of the endoscope, the distance L from the tip of the clip 7 3 O also located behind Ri by position a of mm. Therefore, Remind as in FIG. 1 6 and 1 7, part of the connection part 3 0 b is always located in the tube sheath 4, one 且, exposed and protrude forward from the distal end of the tube sheath 4 there is no and this.
Remind as in FIG. 1 9, but also clip operation apparatus 3 1 is configured similarly, the clip operating device 3 1, the root portion of the folded-back distal end portion of the folded-back wire 3 0 c and binding, it supersedes any, the tip end side portion, the point of the loop-shaped portion are different. To cormorants by multiplying the loop portion to the locking portion 7 e of the clip 7.
Next, the operation of the apparatus according to the present embodiment will be described. Used in the procedure shown in FIG. 1. 6 to FIG 8. This usage is similar to the first embodiment, in this process, the connecting portion 3 0 b of the operation wire 3 0 in the range from the tip of the motor Clip 7 to position A of the rear 3 0 mm there is no and the child to enter within. Further, the distance L to the rear from the clip 7 tip does not pass through the range of 3 0 mm.従Tsu Te, also the connecting portion 3 0 b is be one hard part, there is no problem. In other words, the rigid connection portion 3 0 b is because there is no and this passing through the coil sheath 5 which is bent in forceps raising device 1 0, there is no and this movement of the operation wire 3 0 is inhibited. Further, since it is possible with this in operation Wa I catcher 3 0 part (proximal portion) thick drive wire 3 0 a, thereby improving the transmission performance of force by the operation wire 3 ◦.
Note that clip operation apparatus 3 1 shown in FIG. 1 9 is a variation of the clip operating device 2-9 according to the sixth embodiment described above. The clip manipulation device 3 1, operation method at the time of withdrawal of the click Li Ppuyuni Tsu DOO 6 different from that of the clip operating device 2-9 according to a sixth embodiment. That is, Remind as 2 0, after clip 7 grips the patient part 1 1, to advance the operating wire 3 0, by projecting the folding-back wire Layer 3 0 c from Koirushi over scan 5, that occasion Ri return wire 3 0 c tip was engaging portion 7 e Ca ゝ et outside clips 7, click re Ppuyu - placing a Tsu bets 6 into the body.
Connecting portion 3 0 b also operating wire Layer 3 0 In this detachment operation process is not a child to enter the range from the tip of the clip 7 to the position A of the rear 3 0 mm.
According to this embodiment, since the connecting portion 3 0 b is hard portion has a distance L backward from clip 7 tip does not pass through the range of 3 0 mm, the first embodiment the same effect can be obtained . Also, transfer of by Ri force and child is improved In addition to the operating wire 3 0 thick drive wire 3 a portion of the 0 a.
Referring to FIG 1 及 Pi Figure 2 2 will be described with the seventh embodiment engaging torque Clip operating device of the present invention.
Click Li Ppuyu two Tsu preparative 6 used in the clip operation apparatus 3 2 of the present embodiment Remind as in FIG. 2 1, the clip 7, were subjected to the proximal end of the clip 7 Yes consist with fLEXIBLE connecting member is a flexible Rupuwai Layer 3 3 of stop tube 8. The operation wire 3 4 tip of the operating means, the full-click 35 provided in the full-click 35, removably attach the connecting plate 3 6, the operation wire Layer 3 4 to connecting plate 3 6, and the power sale by coupling the click re Ppuyu two Tsu DOO 6 and through the loop wire 3 3. Connecting plate 3 6 by forming a J section 3 6 a of a deformable locking means at its front end portion. To J section 3 6 a for locking this, hooking the proximal portion of the loop wire 3 3, connecting detachably the full click 35 to the connecting plate 3 6. Tip distance from rearward L of the full-click 35 and the connecting plate 3 6 in the same manner as has been described above data Clip 7 is positioned behind Ri by position A of 3 0 mm, from the distal end of the tube sheath 4 has become cormorants'm not exposed to protrude.
Next, it describes the operation Nitsu clips operating device 3 2 according to the present embodiment. Remind as in FIG. 2 2, after gripping the affected area 1 1 in clip 7, when the operation wire 3 4 rather strongly pull to the al, extends the J section 3 6 a of the connecting plate 3 6, the locked state of the loop 3 3 out to be released, click Li Ppuyuni' door 6 is disengaged. Then, clip unit 6 is placed in the body. Effects of this embodiment are the same as the sixth embodiment described above predicate.
The present invention is not be to be limited to the embodiments described above can also be applied to other forms.
The present invention, because I a configuration in which there is clip or click Li Ppuyuni' flexibility than the extent of the connecting means Ru can follow the shape of the inlet pipe connected to disengagement available-to preparative, inlet tube if even in the bent state difficult Ri connecting means scratching, Ru can trigger moves the introduced tract smoothly.
The present invention, Ri by said operating means, can and have been dynamic drive with a predetermined value or more driving force, the clip or click Li Ppuyuni' preparative an engagement portion for releasing from by Ri said operating means to the drive force the provided force ゝ al. the line can reduce the rigid region of the operating means side, and Therefore, this the inlet tube to move the hard introduction tube catching connecting means even in the bent state smoothly to 佴can.
Further, the present invention, the clip or click Li Ppuyuni' with connecting the door, come to have been driven at a predetermined value or more driving force, the Ri by the driving force of its clip or click Li Ppuyuni' DOO coupling means for releasing solution from the flexible to be of a hardly caught the connecting means even in bending piece state inlet tube if, Ru can trigger moves the introduced tract smoothly.
The present invention, because ligated at a position spaced apart appropriately length from the distal end of the introducing tube via a connection having a flexible on the clip or click Li Ppuyuni' DOO, be in if flexion introduction pipe even hardly caught the member coupling latching means, Ru can trigger moves the introduced tract smoothly.
According to the present invention, both can and reliably and quickly row of cormorants this operation of the operating means coupled to the clip or click Li Ppuyuni' bets are placed on the inlet tube tip.
The present invention, the clip or click Li Ppuyuni' preparative via a connecting member having a concatenated flexible to the clip or click Li Ppuyuni' preparative well as connected to the operation means, said connection from member and the operation means distal end of the inlet pipe, is connected by a locking means arranged at a position spaced appropriately length, and said locking means said operation means is driven by the driving force of a predetermined value or more It said connecting member because is obtained by the power sale by releasing the coupling of the operating means can, even in if flexion introduction pipe member coupling latching means hardly caught in the introduction pipe.
5 冃 required of
1. Raw vivo to 揷入 possible flexible inlet pipe (5) and the inlet pipe (5) having a movably 揷通 softness in a flexible wire (9) When,
Provided at the distal end portion of the wire Ya (9), thereby releasably connecting the inlet pipe (5) clip (7) disposed at the distal end portion of the deformation of the inlet tube (5) a connecting portion having a can follow flexibility,
Clip operating device equipped with a.
2. The coupling portion has the loop portion Returned folding wire Ya (9), the loop portion of this, the clip (7) connecting the first aspect of the clip manipulation device .
3. The wire Ya (9) is provided with the folded portion connected click on Clip (7), formed by the least part also on either side of the wire portion which is folded back, the clip (7) a strong pulling force capable of being released, can and drove the wire (9) had a cowpea was weak portion cormorants I loosened, a clip operation apparatus according to claim 1.
4. The coupling portion is a strong tractive force capable of being released the clip (7), can and drove the wire (9), having Huy Ichiku unit breaking, the click re claim 1 Tsu flop operation device.
5. inlet tube 揷入, flexible in producing the body cavity (5), said inlet pipe (5) having a movably inserted softness in a flexible wire (9) ,
It said inlet pipe (5) disposed at the distal end of clip (7) having a full-click (7 e),
The set only et is the tip portion of the word i Ya (9), thereby detachably connected to the full-click (7 e) of the clip (7), follow the deformation of the inlet tube (5) a connecting portion having a flexibility capable, clip operation apparatus having a.
6. The clip (7), when you pulling said wire (9), Ri proximal end to be of 該Ku Clip (7), the click Li Tsu operating the up (7) It includes a clip stop tube (8) to the stop tube (8), the full-click (7 e) is deformed, from said word Lee ya (9), the full-click (7 e ) can and is out, the full Tsu cover the click (7 e), clip operation apparatus according to claim 5.
7. The inlet pipe (5) provided at a tip of the click Li Tsu to removably accommodate flop (7), to come to operate the wire Ya (9), said clip (7) click Li for controlling the opening and closing and plastic deformation Tsu equipped flop mounting portion (2 4), clip operation apparatus according to claim 1.
8. The clip attachment section (2 4), said clip to escape the after the (7) is plastically deformed clip (7) S Li Tsu preparative (2 4 d) equipped with a, clip operation apparatus of a living tissue according to claim 7.
9 and. Insertable flexible endogenous body cavity introducing means (5), wherein the 揷通 retractably moving the introduction means (5), said introduction means moves relative to said introducing means (5) ( 5) Ri linked capable der leaving the clip (7) which is placed at the tip of the, and, have a more flexible degree that can follow the deformation of the introducing means (5), an elongated means for performing a withdrawal operation of the click Li Tsu grasping operation and the clips of the flops (7) (7),
Clip operation device provided with.
1 0. The elongated unit had a flexible wire (9), clip operation apparatus according to claim 9.
1 1 insertable flexible inlet tube. Raw body cavity (5), is 揷通 retractably move in the inlet pipe (5) in, to move relative to said inlet pipe (5), the inlet a tube (5) operating member for disengagement operation of the gripping operation 及 Pi clip (7) of the clip which is disposed at the distal end (7) of (2 7 a),
Has one end and the other end, the one end, and connected to the distal end of said operating member (2 7 a), the other end, and releasably coupled to said clip (7), said inlet tube ( flexible connecting member having a flexibility that can follow the deformation of 5) and (2 7 b),
1 2. The connecting member (2 7 b) includes a flexible wire Ya, together with the provided at the distal end portion of wire and connects the click Li Tsu releasability detachably flop (7), the inlet a connecting portion having a follow-up available-flexibility to deformation of the tube (5),
The had claim 1 1 clips the operating device.
1 3. The coupling portion is formed by said wire, a strong tractive force capable of being released the clip (7), said operating member
(2 7 a) can and drove, it has a weak portion where the wire is broken, according to claim 1 2 clips operating device.
1 4. The wire, said clip (7) to flashing folding connecting portion, which is smaller and also thus forms a part of both sides of the wire portion returned folding, the operating member (2 7 a) can tow it was with had a cowpea was weak portion cormorants by loosened, clip operation apparatus according to claim 1 2.
1 5 揷入 possible flexible inlet tube. Raw body cavity (5), is 揷通 movably to said inlet pipe (5) in the introduction is moved relative to the inlet pipe (5) a tube (5) gripping operation and the click Li Tsu operating member for releasing de operations flop (7) of the clip which is disposed at the distal end (7) of (2 7 a),
Provided at the distal end of said operating member (2 7 a), the click extends from Clip (7), is connected to a wire having a flexibility that can follow the deformation of the inlet tube (5), said click Li Tsu performs gripping operation of flop (7), a strong tractive force capable of being released the clip (7), when you pulling said operating member (2 7 a), the click Li class tap (7 ) coupling member capable withdrawal and (2 7 b),
1 6. The inlet pipe provided with a (5) 揷通 retractably flexible Ju one Bushisu (4), the tube sheath (4) in, is disposed at the distal end portion of the inlet pipe (5) click the clip (7), and a housing configurable, clip operation apparatus according to claim 1.
1 7. The clip (7) is, while projecting from the tube sheath (4), located behind the clip (7) and exposed from the distal end of the tube sheath (4) said inlet tube
The portion of the region of (5) to form a curved raised top, clip operation apparatus according to claim 1 6.
PCT/JP2003/009048 2002-07-19 2003-07-16 Clip operation device WO2004008975A1 (en)
EP03741426A EP1523946B1 (en) 2002-07-19 2003-07-16 Clip operation device
DE60325365A DE60325365D1 (en) 2002-07-19 2003-07-16 Clip-operationsgerät
US10/803,672 US20040176784A1 (en) 2002-07-19 2004-03-18 Clip manipulating device
US10/803,672 Continuation US20040176784A1 (en) 2002-07-19 2004-03-18 Clip manipulating device
WO2004008975A1 true WO2004008975A1 (en) 2004-01-29
JPS636016A (en) 1986-06-26 1988-01-12 Shin Kobe Electric Mach Co Ltd Production of flame-retarding resin composition for laminate
See also references of EP1523946A1 *
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