JP2010246663A - Clip device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip device for an endoscope, capable of securely setting the limit of expanding of a pair of open/close arms, and as a result, capable of improving the operability and durability. <P>SOLUTION: A clip 10 includes the pair of open/close arms 11 formed of independent members to be opened/closed forward in a beak shape by rotating around a spindle 14; a tail 15 for linking, supporting the spindle 14 to extend rearward therefrom; and a fastening ring 18 through which a rear-side portion of the pair of open/close arms 11 is inserted. A fastening ring stopper 15x for restraining the fastening ring 18 from moving rearward to a prescribed extent or further relative to the open/close arms 11 is formed in the tail 15 for linking, so that the possible expanding angle of the pair of open/close arms 11 is limited to the prescribed extent or smaller. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope clip device used through a treatment instrument insertion channel of an endoscope.

  In general, in an endoscope clip device, a clip having a pair of opening and closing arms that can be opened and closed like a bowl toward the front and a fastener ring through which a rear portion of the opening and closing arms is passed is formed by a flexible sheath. It is arranged in a constricted state in the vicinity of the tip.

  Then, by pushing the clip forward from the distal end of the flexible sheath with an operation wire disposed in the flexible sheath so as to be movable back and forth in the axial direction, the positional relationship between the pair of opening and closing arms and the fastening ring is changed. The pair of opening and closing arms are once opened and then closed, and then the connection between the clip and the operation wire can be released (for example, Patent Documents 1 and 2).

  In addition, in a so-called continuous clip device in which a plurality of clips are arranged in series, each clip is provided with a connecting tail portion that extends rearward, and supports a pair of opening and closing arms rotatably. The axis | shaft is supported by the tail part for connection (for example, patent document 3, 4).

JP2002-191609 JP 2006-87537 A JP2008-1119068 JP2008-302097

  When clipping the affected part mucosa etc. in the body with a clip and placing the clip in the body, first press the paired opening and closing arms against the affected mucous membrane with the pair of opening and closing arms opened. An operation to close is performed.

  However, when the open / close arm fully expanded is pressed against the affected mucous membrane, if the open / close arm does not expand any further, the force is applied when the force to further expand the open / close arm is applied from the affected mucosa side. The opening / closing arm may break.

  Therefore, in the conventional endoscopic clip device described in Patent Document 4 and the like, when an external force for further expanding the opening / closing arm acts from the mucosa side of the affected part which is the counterpart of clipping, the opening / closing arm is expanded. As a result, the clamp ring is retracted freely, so that the open / close arm can be greatly expanded.

  However, if the open / close arm is extended too freely, the tissue that the open / close arm grips when clipping the affected mucosa becomes too large, and a large amount of operating force is required to grip the affected mucosa, resulting in reduced operability during gripping operation. There is a risk of causing damage to the members.

  The present invention can reliably set the expansion limit of a pair of opening and closing arms with a simple configuration that does not cause an increase in cost, and as a result, can improve the operability and durability. The purpose is to provide.

  In order to achieve the above-described object, the endoscope clip device of the present invention is formed by individual members so as to open and close like a bowl toward the front by rotating around a support shaft. A pair of opening and closing arms, a connecting tail that supports the supporting shaft and extends rearward therefrom, and a rear portion of the pair of opening and closing arms are passed through and moved forward relative to the opening and closing arms. A clip having a clamp ring that forcibly closes the pair of opening and closing arms and opens by moving backward, is disposed in a state where the clip is constricted in the vicinity of the distal end of the flexible sheath. After the clip is pushed forward from the distal end of the flexible sheath with an operation wire arranged so as to be movable back and forth in the axial direction, the pair of opening and closing arms are opened with the fastening ring, and then the pair of opening and closing arms are retracted with respect to the fastening ring One by one In the endoscopic clip device configured to close the open / close arm of the endoscope and then release the connection between the clip and the operation wire, the clamp ring is prevented from moving backward with respect to the open / close arm more than a certain amount. A ring retraction stopper is formed on the coupling tail, thereby restricting the expandable angle of the pair of opening and closing arms to a certain level or less.

  The connecting tail portion integrally includes a pair of parallel stay portions that support the support shaft and a connecting ring formed by connecting the pair of stay portions on the rear end side, and the stay portion is within the fastening ring. The ring retraction stopper may be formed by the edge portion of the stay portion.

  According to the present invention, since the fastening ring retraction stopper for restricting the movement of the fastening ring to the rear with respect to the opening / closing arm is formed on the coupling tail portion, the expansion limit of the pair of opening / closing arms is increased. Therefore, it is possible to surely set with a simple configuration that does not cause an inconvenience, and as a result, it is possible to improve the operability and durability during the clipping procedure.

It is side surface sectional drawing (II sectional drawing in FIG. 5) of the state which the clip concerning the Example of this invention expanded. It is side surface sectional drawing of the front-end | tip vicinity of the clip apparatus for endoscopes which concerns on the Example of this invention. It is a disassembled perspective view of the clip concerning the example of the present invention. It is side surface sectional drawing of the front-end | tip vicinity of the clip apparatus for endoscopes of the state which the clip concerning the Example of this invention was extruded from the front-end | tip of a sheath, and was expanding. It is a top view in the state where the clip concerning the example of the present invention expanded.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 2 shows the vicinity of the distal end of an endoscopic clip device. Reference numeral 1 denotes a flexible sheath made of a flexible tube such as a tetrafluoroethylene resin tube. It can be freely inserted into and removed from the treatment instrument insertion channel of the mirror.

  A distal end cap 2 is attached to the distal end of the flexible sheath 1. The tip cap 2 is formed, for example, in a shape in which the inner diameter of the most distal portion is slightly narrowed, and is divided from the tip side by a plurality of slits formed in a direction parallel to the axis.

  As a result, the distal end cap 2 expands when the clip 10 to be described later is lightly stopped when the clip 10 is pushed forward from the inside of the flexible sheath 1 and when the clip 10 is further strongly pushed out. It has the elasticity to return to the original state after passing through.

  An operation wire 4 that can be arbitrarily advanced and retracted from an operation unit (not shown) connected to the proximal end side of the flexible sheath 1 is inserted and disposed in the flexible sheath 1. The connecting ring 5 is fixedly connected to each other.

  A plurality of clips 10 are arranged in series in the vicinity of the distal end of the flexible sheath 1. As shown in FIG. 3, which is an exploded perspective view, the clip 10 has a pair of opening / closing arms 11 formed of independent members, and a tip claw portion formed at the tip of each opening / closing arm 11. 12 is bent so as to face inward and face each other.

  A shaft hole 13 is formed in the vicinity of the rear end of each open / close arm 11, and a support shaft 14 is passed through the shaft hole 13, and the pair of open / close arms 11 is relatively rotatable about the shaft hole 13. Are connected to each other. As a result, the pair of opening / closing arms 11 can freely open and close in a bowl shape toward the front by rotating around the support shaft 14.

  Reference numeral 15 denotes a connecting tail portion that extends from the position of the support shaft 14 toward the rear of the clip 10, and an annular connecting ring 15 a that controls connection with the operation wire 4 is formed at the rear end portion.

  The connecting tail 15 is formed independently as a member independent of the opening / closing arm 11. The connecting tail 15 is not directly connected to the operation wire 4, but is connected to the operation wire 4 via the rear clip 10, a connection clip 20 described later, or the like.

  The connecting tail portion 15 is formed with a pair of parallel stay portions 15s having a shape in which the vicinity of the rear end portion of the opening / closing arm 11 is loosely sandwiched, and the pair of stay portions 15s is connected to the rear end portion side by a connecting ring 15a. They are connected to each other and formed as a unit.

  Support holes 16 through which the support shaft 14 is inserted and supported are formed in both of the pair of stay portions 15s, and the stay portion 15s and the pair of opening / closing arms 11 are rotatably connected by the support shaft 14. It is in the state.

  Reference numeral 18 is a known ring for forcibly opening and closing the pair of opening and closing arms 11, and in a standby state, as shown in FIG. 2, it is loosely fitted near the base of the opening and closing arm 11. ing. The stay portion 15 s of the coupling tail portion 15 is also arranged in a state of being passed through the fastening ring 18.

  When the fastening ring 18 is moved rearward relative to the opening / closing arm 11 from this state, the fastening ring 18 drives the drive cam 11a formed at the rear end of the opening / closing arm 11, and the opening / closing arm 11 is expanded. It is made into the open state (refer FIG. 4).

  When the fastening ring 18 is moved forward relative to the opening / closing arm 11, the opening / closing arm 11 is forcibly closed by the fastening ring 18. As shown in FIG. 4, when the coupling tail 15 is pulled back into the flexible sheath 1 after the fastening ring 18 is pushed forward of the distal end base 2, the rear end surface of the fastening ring 18 is an opening of the distal end base 2. Since it cannot contact the outer surface of the part and return to the open / close arm 11, such a forced closing operation is performed.

  Within the vicinity of the distal end of the flexible sheath 1, the connecting tail portion 15 of the clip 10 positioned on the front side of the two clips 10, 10 positioned in the front-rear direction, and the opening / closing arm 11 of the clip 10 positioned on the rear side. And are connected. Specifically, the front end claw portion 12 of the open / close arm 11 of the rear clip 10 in the closed state is engaged with the connecting ring 15a positioned at the rear end of the front clip 10. .

  Reference numeral 20 denotes a connecting clip connected so as not to be separated into the connecting ring 5, and has the same configuration as the clip 10 except that there is no fastening ring 18, and the clip 10 positioned on the front side in the same manner as the other clips 10. It is connected with.

  All the clips 10 and 20 connected in this way are closed in the flexible sheath 1 as shown in FIG. 2, and the flexible sheath 1 is in this state in the endoscope treatment instrument insertion channel. Is inserted and removed.

  Then, as shown in FIG. 4, the clip 10 is pushed out from the distal end of the flexible sheath 1 toward the affected mucous membrane to be clipped, and the pair of opening and closing arms 11 are expanded by the ring 18, and then the affected mucosa is applied. Pressed.

  At that time, when the bulge of the affected part mucous membrane is larger than the opening of the pair of opening and closing arms 11, the opening and closing arm 11 is further expanded while retracting the ring 18 by the external force received from the affected part mucous membrane side. The arm 11 is not damaged.

  However, if the open / close arm 11 is expanded too freely, the tissue gripped by the open / close arm 11 becomes too large, and a large amount of operating force is required for gripping the affected mucous membrane. There is a risk of inviting.

  Therefore, as shown in FIGS. 3 and 1, in the present invention, a fastening ring retraction stopper 15 x that restricts the fastening ring 18 from moving backward with respect to the opening / closing arm 11 is formed on the coupling tail 15. ing.

  FIG. 1 illustrates a II cross section (a cross section of the stay portion 15 s) in FIG. 5, which is a plan view of the clip 10 in an expanded state, at a position eccentric to the side from the center of the fastening ring 18. It is sectional drawing of a cross section.

  The fastening ring retraction stopper 15x is formed by widening the edge of the stay portion 15s (here, gradually widening up and down as it goes rearward), and the fastening ring 18 moves back to the right in FIG. Then, as shown by A, when it comes into contact with the fastening ring retraction stopper 15x, further retraction of the fastening ring 18 with respect to the coupling tail 15 is prevented, and thereby a pair of opening and closing contacts with the front end edge of the fastening ring 18 The expandable angle of the arm 11 is restricted to a certain value or less.

  In this way, the expansion limit of the pair of opening / closing arms 11 can be reliably set with a simple configuration that does not increase the cost, and the operability and durability of the clipping procedure for grasping the affected mucous membrane can be improved. it can.

  When a mucous membrane tissue or the like is sandwiched between the pair of opening / closing arms 11 as described above, the operation wire 4 is slightly pulled back to the proximal end side, and the clip 10 is forcibly closed by the action of the fastening ring 18, whereby a pair of opening / closing arms is obtained. Clipping is performed in which 11 is fixed in a state where the mucosal tissue is sandwiched, and when the connection between the cutting edge clip 10 and the second clip 10 is released, the cutting edge clip 10 is placed in the body.

  The present invention is not limited to the above-described embodiment. For example, the present invention may be applied to a single-shot endoscope clip device having only one clip 10.

DESCRIPTION OF SYMBOLS 1 Flexible sheath 4 Operation wire 10 Clip 11 Opening / closing arm 14 Support shaft 15 Connection tail part 15s Stay part 15x Ring retraction stopper 18 Ring ring

Claims (2)

A pair of open / close arms formed of independent members so as to open and close like a bowl toward the front by rotating around the support shaft, and support the support shaft and extend backward from there The connecting tail and the rear part of the pair of opening / closing arms are passed through, and the pair of opening / closing arms is forcibly closed by moving forward relative to the opening / closing arm, and moves backward. And a clip having a clamp ring that is opened by the operation wire disposed in a state where the clip is constricted in the vicinity of the distal end of the flexible sheath, and the operation wire disposed in the flexible sheath so as to be movable forward and backward in the axial direction. After the clip is pushed forward from the distal end of the flexible sheath and the pair of opening / closing arms is opened with the clamp ring, the pair of opening / closing arms is retracted with respect to the clamp ring, thereby the pair of opening / closing arms with the clamp ring. Opening To close the arms, then the endoscopic clip device configured to be able to solve the connection between the clip and the operating wire,
A ring retraction stopper for restricting movement of the clamp ring backward with respect to the open / close arm is formed on the coupling tail portion, thereby restricting an expandable angle of the pair of open / close arms to a predetermined value or less. An endoscopic clip device characterized by the above.   The connecting tail portion integrally includes a pair of parallel stay portions that support the support shaft, and a connecting ring formed by connecting the pair of stay portions on the rear end side, and the stay portion includes the fastening portion. The endoscope clip device according to claim 1, wherein the clip device is disposed in a state of being passed through an annulus, and wherein the ring retraction stopper is formed by an edge of the stay part.

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