Treatment device, treatment part and method for disconnecting power transmission component

Abstract

A treatment instrument comprises: a retention unit, the retention unit comprising a treatment portion and a tubular component capable of accommodating at least the proximal portion of the treatment portion; an actuating portion comprising a connector connected to the treatment portion and a power transmission component connected to the connector; the treatment instrument further comprises: a locking mechanism, which locks the treatment portion relative to the tubular component by pulling the treatment portion through the connector; a constraint mechanism, which applies a constraint that prevents the connection between the treatment portion and the connector from being released before the treatment portion is locked and within the specified moving range of the connector, and does not apply the constraint after the treatment portion is locked and outside the specified moving range of the connector. The treatment instrument of the present invention can simplify the indwelling operation of the treatment portion, and improves the reliability and safety of the operation through the constraint mechanism.

Description

Technical Field

[0001] The present invention relates to a treatment instrument, and more particularly to a treatment instrument for ligating tissue. The present invention also relates to a method for disconnecting a treatment portion and a power transmission component in the treatment instrument. Background Art

[0002] As a known treatment method using an endoscope, ligation using a treatment instrument having a treatment unit such as a clamp unit is known. The clamp unit has a pair of arms. When the pair of arms clamps tissue, if the pair of arms is pulled a predetermined amount, the pair of arms will be locked in a state of firmly clamping the tissue.

[0003] The clip unit is introduced into the body in a state in which it is attached to the actuator. Since the clip unit remains in the body in a state in which the tissue is ligated, the pair of arms need to be separated from the actuator after being locked.

[0004] The clip unit described in Patent Document 1 can house the proximal ends of a pair of arms in a pressure tube. The proximal ends of the arms are connected to an operation wire.

[0005] By pulling the operating wire, the proximal end of the arm is pulled out of the compression tube by a predetermined amount, thereby releasing the connection between the arm and the operating wire, and the arm is locked in a closed state. Therefore, before the proximal end of the arm is pulled out of the compression tube by a predetermined amount, the closed arm can be opened by advancing the operating wire.

[0006] Prior art literature

[0007] Patent Document 1: Japanese Patent Publication No. 5750620 Summary of the Invention

[0008] The advantage of the structure described in Patent Document 1 is that, in situations such as when the arm grips tissue in an inappropriate position, the arm can be opened again to re-grasp the tissue. However, to release the connection between the arm and the operating wire, the operating wire must be advanced. Therefore, to lock the arm and retain it in place, the operating wire must be both pulled and advanced.

[0009] In view of the above circumstances, an object of the present invention is to provide a treatment instrument that allows for simple placement of a treatment portion.

[0010] The treatment instrument of the present invention includes: a retention unit, which includes a treatment part and a tubular component capable of accommodating at least the proximal end of the treatment part; an actuating part, which includes a connector connected to the treatment part and a power transmission component connected to the connector. The treatment instrument is characterized in that it also includes: a locking mechanism, which pulls the treatment part through the connector to lock the treatment part relative to the tubular component; a constraint mechanism, which applies a constraint to prevent the connection between the treatment part and the connector from being released before the treatment part is locked and within the specified moving range of the connector, and does not apply the constraint after the treatment part is locked and outside the specified moving range of the connector.

[0011] The present invention also provides a method for disconnecting a disposal part and a power transmission component in a disposal instrument, the disposal instrument comprising: a retention unit, the retention unit comprising the disposal part and a tubular component capable of accommodating at least the proximal portion of the disposal part; an actuating part, the actuating part comprising a connector connected to the disposal part and the power transmission component connected to the connector, the connection disconnection method being characterized in that the disposal part is pulled by the connector to lock the disposal part relative to the tubular component; before locking and within the specified moving range of the connector, a constraint is applied to prevent the connection between the disposal part and the connector from being disconnected, and after locking and outside the specified moving range of the connector, the constraint is not applied.

[0012] According to the present invention, the placement operation of the treatment portion can be simplified, and the reliability and safety of the operation are improved by the restraint mechanism. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 It is a schematic diagram of the overall structure of the treatment instrument according to the first embodiment.

[0014] Figure 2 The clamp unit of the treatment instrument according to the first embodiment is shown.

[0015] Figure 3 It is a cross-sectional view of the clamp unit according to the first embodiment.

[0016] Figure 4 is a cross-sectional view of the clamp unit of the first embodiment, with the viewing direction being the same as Figure 3 different.

[0017] Figure 5 This is an enlarged cross-sectional view of the clamp mounting portion of the first embodiment.

[0018] Figure 6 This is an enlarged view of the hook.

[0019] Figure 7This is a partial cross-sectional view showing the use of the treatment instrument according to the first embodiment.

[0020] Figure 8 This is a partial cross-sectional view showing the use of the treatment instrument according to the first embodiment.

[0021] Figure 9 This is a partial cross-sectional view showing the use of the treatment instrument according to the first embodiment.

[0022] Figure 10 This is an enlarged view of the connection portion between the operating wire and the arm portion in the treatment instrument according to the first embodiment.

[0023] Figure 11 This is an enlarged cross-sectional view of a clip attachment portion in a modified example of the treatment instrument according to the first embodiment.

[0024] Figure 12 yes Figure 11 A partial cross-sectional view of the usage process of the modified example.

[0025] Figure 13 It is an enlarged cross-sectional view of a clip mounting portion of a treatment instrument according to a second embodiment.

[0026] Figure 14 This is a partial cross-sectional view showing the use of the treatment instrument according to the second embodiment.

[0027] Figure 15 This is a partial cross-sectional view showing the use of the treatment instrument according to the second embodiment.

[0028] Figure 16 This is a partial cross-sectional view when a modified example of the treatment instrument according to the second embodiment is used.

[0029] Figure 17 It is a schematic structural diagram of a treatment device according to a third embodiment.

[0030] FIG18(a) is a side view of the tubular member of the third embodiment, showing a side with a tube wall groove, and FIG18(b) is a side view of the tubular member of the third embodiment, showing a side with a tube wall pin hole. Figures 18(c) to 18(e) This is a side view of a tubular member according to a modified example of the third embodiment, showing a surface where a pin hole is formed in the tube wall.

[0031] Figure 19 It is a side view of the hook portion of the third embodiment.

[0032] 20( a ) and 20 ( b ) are side views of the first arm and the second arm, respectively.

[0033] Figures 21(a) to 21(d) It is a diagram for explaining the operation of the treatment instrument according to the third embodiment. DETAILED DESCRIPTION

[0034] To make the objectives, technical solutions and advantages of the present invention more clear, the embodiments of the present invention will be described in further detail below with reference to the accompanying drawings.

[0035] In the specification of the present application, the proximal side refers to a side closer to an operator who operates a treatment instrument, and the distal side refers to a side farther from the operator who operates the treatment instrument.

[0036] First embodiment

[0037] Reference Figures 1 to 12 , the first embodiment of the present application is described.

[0038] Figure 1 This is an overall structural diagram of a treatment instrument according to a first embodiment. The treatment instrument according to this embodiment is a ligation device 1. The ligation device comprises a clamp unit (indwelling unit) 10 placed in the body and an actuator 50 for operating the clamp unit 10. The clamp unit 10 is attached to the distal end of the actuator 50.

[0039] Figure 2 The external appearance of the clamp unit 10 is shown. Figure 3 is a cross-sectional view of the clamp unit 10. Figure 2 As shown, the clip unit 10 includes a clip (treatment portion) 20 and a tubular member 30 that houses a portion of the clip 20 .

[0040] The clamp 20 has a pair of arms, namely a first arm 21 and a second arm 22. The first arm 21 and the second arm 22 have claws 21a and 22a at their distal ends, respectively. Figure 3 As shown, the first arm portion 21 and the second arm portion 22 are integrally connected at the proximal end portion 20a of the clamp 20. The proximal end portion 20a is formed in a U shape.

[0041] The clamp 20 is formed of an alloy or metal, such as stainless steel, cobalt-chromium alloy, nickel-titanium alloy, etc.

[0042] The first arm 21 and the second arm 22 are Figure 2 The initial state shown is in the open state. If the first arm portion 21 and the second arm portion 22 approach each other from the initial state, a force will be generated to return to the initial state due to the elastic force of the material.

[0043] The tubular member 30 is a cylindrical member formed of metal, resin, etc. Figure 3 As shown, the proximal end portion 20a of the clamp 20 is received in the tubular member 30. The distal end portion of the clamp 20 protrudes from the distal opening 30a of the tubular member 30. The proximal opening 30b of the tubular member 30 is smaller than the distal opening 30a.

[0044] Figure 4 From Figure 3 The interior of the tubular component 30 is observed from different directions. Figure 4 As shown, a stopper 23 is provided in the middle of each arm of the clamp 20, and the width of each arm 21, 22 becomes larger at the stopper 23 ( Figure 4 Only the first arm 21 is shown. As the first and second arms 21, 22 approach each other, each latch 23 can pass through the proximal opening 30b. If the first and second arms 21, 22 separate after passing through the proximal opening 30b, the latch 23 will no longer pass through the proximal opening 30b. As a result, the clamp 20 is locked with the pair of arms closed.

[0045] A coil spring 31 may be disposed within the tubular member 30. The front end of the coil spring 31 may contact the rear surfaces of the first arm portion 21 and the second arm portion 22. The rear end of the coil spring 31 may contact the rear end surface 32 of the tubular member 30 having the proximal end opening 30b. Alternatively, the tubular member 30 may not have a coil spring 31 disposed therein.

[0046] like Figure 1 As shown, the actuator 50 includes an elongated insertion portion 51 , an operation wire (power transmission member) 52 passing through the insertion portion 51 , and an operation portion 60 connected to the insertion portion 51 .

[0047] As the insertion portion 51 , for example, a sheath formed of a coil can be used.

[0048] The operation portion 60 includes a main body 61 connected to the insertion portion 51 and a slider 62 slidably mounted relative to the main body 61 .

[0049] A twisted wire made of metal single wires can be used as the operation wire 52. The proximal end of the operation wire 52 is connected to the slider 62. When the slider 62 is moved relative to the main body 61, the operation wire 52 can be moved forward and backward in the insertion portion 51.

[0050] Figure 5 This is an enlarged cross-sectional view of the distal end portion of the actuator 50 to which the clip unit 10 is attached. A hook portion (connector) 70 that engages with the clip unit 10 is fixed to the distal end of the operation wire 52 .

[0051] Figure 6 1 is an enlarged view of the hook portion 70 . The hook portion 70 includes a connecting member 71 connected to the operation wire 52 and a pair of jaws 72 attached to the connecting member 71 .

[0052] The connecting member 71 is fixed to the distal end of the operating wire 52 by welding or the like. The pair of jaws 72 are identical in shape and size, and are pivotally supported on the connecting member 71 with claws 73 provided at their distal ends facing each other. Specifically, the pair of jaws 72 can move toward and away from each other by rotating about a shaft 76 passing through the connecting member.

[0053] Each jaw 72 has a locking surface 73a at the rear end of the claw portion 73. The locking surface 73a is a surface to which the proximal end portion 20a of the clamp 20 is locked, and is formed in a U-shape to fit the proximal end portion 20a of the clamp 20. Figure 6 In the side view of the hook portion 70 shown on the right side of FIG. 1 , each engaging surface 73 a is inclined toward the distal end of the jaw 72 .

[0054] The shape of the locking surface 73a is not limited to the U-shape, and may also be a trapezoid or a rectangle.

[0055] The size of the distal end portion 72a of each jaw 72 in the opening and closing direction (the direction in which the jaws 72 approach and separate from each other) gradually decreases as it approaches the distal end. Figure 6 As shown in the front view of the hook portion 70 on the left, the hook portion 70 has substantially the same dimensions in the opening and closing directions except for the distal end portion 72a.

[0056] like Figure 5 As shown, the proximal portion 20a of the clamp 20 is clamped by the jaw member 72 of the hook 70, and the operating wire 52 is connected to the clamp unit 10. When the operating wire 52 is connected to the clamp unit 10, the majority of the hook 70 is located within the tubular member 30, and the proximal portion 20a engages with the retaining surface 73a. The hook 70 is slightly smaller than the coil spring 31 in overall dimensions, allowing it to move within the coil spring 31 without interfering with the coil spring 31.

[0057] like Figure 5 As shown, a rigid guide tube 55 is mounted at the distal end of the insertion portion 51. The inner diameter of the distal end of the guide tube 55 is larger than the outer diameter of the tubular member 30, allowing the tubular member 30 to pass through. The rear end of the guide tube 55 is inserted into the insertion portion 51 and secured thereto by welding or the like.

[0058] A restraining member 57 is disposed within the guide tube 55 to prevent unintended disconnection between the proximal portion 20a and the hook portion 70. The restraining member 57 has a minimum inner diameter at a small-diameter portion (disconnection prevention portion) 58. The inner diameter of the small-diameter portion 58 is smaller than the inner diameter of the proximal opening 30b of the tubular member 30 and slightly larger than the maximum dimension of the pair of jaws 72 in the opening and closing direction.

[0059] A stopper 53 is attached to the operating wire 52. The shape and size of the stopper 53 are set so that it cannot enter the guide tube 55. Therefore, after the stopper 53 contacts the rear end of the guide tube 55, the operating wire 52 cannot move forward further.

[0060] The following describes the operation of using the ligation device 1 constructed as described above. The ligation device 1 is introduced into the body through the channel of an endoscope. To insert the ligation device 1 into the endoscope, the user retracts the slider 62 a predetermined amount, inserting the device with the clamp 20 closed and unlocked. Alternatively, the clamp unit 10 and the distal end of the insertion portion 51 can be inserted into the endoscope while the clamp 20 is closed and housed within a separately prepared outer sheath.

[0061] By protruding the ligation device 1 from the channel opening at the distal end of the endoscope and then reducing the pulling force of the slider or retracting the outer sheath, the clamp 20 advances relative to the tubular member 30 by virtue of its own elastic restoring force and that of the coil spring 31. As a result, the clamp 20 assumes an open position, with the pair of arms 21 and 22 open. Once the stopper contacts the rear end of the guide tube 55, the clamp 20 is unable to advance relative to the tubular member 30, maintaining its open position and preventing it from falling off the tubular member 30.

[0062] If the user moves the slider 62 backward relative to the main body 61, the operating wire 52 and the hook 70 are pulled, and the clamp 20 moves backward relative to the tubular member 30. As a result, the pair of arms 21 and 22 are closed. The user can ligate the tissue by placing the tissue between the pair of arms 21 and 22 and closing the pair of arms 21 and 22. Before the locking operation described later is performed, the pair of arms 21 and 22 can be transitioned from the closed state to the open state again by moving the slider 62 forward relative to the main body 61. Therefore, in the ligation device 1, before the locking operation is performed, the clamp unit 10 can be operated by the operating wire 52 to repeatedly grasp the tissue.

[0063] Within the range of movement of the operating wire 52 capable of repeated grasping, the distal end portion of the pair of jaws 72 located closer to the distal end than the distal end portion 72 a is located within the small-diameter portion 58 . Therefore, the engagement between the hook portion 70 and the proximal end portion 20 a is not released during repeated grasping operations.

[0064] After determining that the tissue between the pair of arms 21 and 22 can be ligated, the user performs a locking operation to secure the clamp 20 in the closed position. During the locking operation, the user further retracts the slider 62 relative to the main body 61, exceeding the range of repeated gripping. As the slider 62 retracts, the operating wire 52 is pulled, and the pair of arms 21 and 22, while clamping the tissue, enter the tubular member 30 in a substantially parallel position. Furthermore, the locking portions 23 provided on the pair of arms 21 and 22 approach each other, reaching a position that allows passage through the proximal opening 30b of the tubular member 30.

[0065] After passing through the proximal opening 30b and moving outside the tubular member 30, the pair of locking portions 23 separate again, becoming positioned so as to be unable to pass through the proximal opening 30b. Consequently, the pair of locking portions 23 abut against the proximal end surface of the tubular member 30, preventing the clamp 20 from protruding from the tubular member 30, thereby locking the clamp 20 and maintaining its closed configuration.

[0066] During the locking operation, the proximal portion 20a and the hook portion 70 are able to move through the proximal opening 30b to the outside of the tubular member 30. The operation of the hook portion 70 at this time will be described in detail below.

[0067] When the pair of jaws 72 gripping the proximal portion 20a are pulled, the proximal portion 20a tends to move along the inclined engaging surface 73a toward the distal end of the jaw 72. This forces the pair of jaws 72 to separate and open. However, the pair of jaws 72 cannot separate sufficiently within the tubular member 30 to release the engagement between the proximal portion 20a and the hook portion 70, and thus the engagement between the proximal portion 20a and the hook portion 70 is not released within the tubular member 30.

[0068] The pulled jaw member 72 gradually retreats, as shown in FIG. Figure 7 As shown, the jaws 72 enter the interior of the guide tube 55. Within the guide tube 55, the claws 73 of the pair of jaws 72 can separate to the extent that the proximal portion 20a and the hook portion 70 are disengaged. However, because the restraining member 57 is disposed on the distal end of the guide tube 55, when the jaws 72, excluding the distal end, are positioned within the small-diameter portion 58, the pair of jaws 72 cannot fully separate, and the proximal portion 20a and the hook portion 70 remain engaged.

[0069] If the jaw member 72 is further retracted, the hook portion 70 is withdrawn from the tubular member 30. Figure 8 As shown, the hook portion 70 moves as a whole to the inner space of the guide tube 55. Subsequently, the proximal portion 20a also moves to the outside of the tubular member 30 through the proximal opening 30b of the tubular member 30. Figure 8 In the illustrated state, the pair of jaws 72 cannot be fully separated due to the small-diameter portion 58 , and the engagement between the proximal portion 20 a and the hook portion 70 cannot be released.

[0070] That is, the restraint member 57 prevents the claw portion 73 of the jaw 72 from being displaced in a direction away from the long axis of the tubular member 30 and from being detached from the proximal end portion 20 a .

[0071] If the user further retracts the slider 62, the clamp 20 further retracts, and the locking portion 23 moves through the proximal opening 30b and out of the tubular member 30. At this time, the portion of the jaw 72 other than the distal end passes through the small-diameter portion 58, and the distal end 72a of the jaw 72 reaches the small-diameter portion 58.

[0072] Since the distal end portions 72a of the pair of jaw members 72 are smaller in the opening and closing direction, if the distal end portions 72a are located in the small diameter portion 58, a space for the pair of jaw members 72 to separate from each other is created in the small diameter portion 58. Figure 9 As shown, due to the force exerted by the locking surface 73a from the proximal end portion 20a of the clamp, the claws 73 of the pair of jaws 72 separate from the proximal end portion 20a within the guide tube 55, thereby releasing the engagement between the proximal end portion 20a and the hook portion 70. Furthermore, the locking portion 23 is locked to the proximal end surface of the tubular member 30, locking the clamp 20 so that it cannot be opened. The tubular member 30 is removed from the guide tube 55, and the clamp unit 10 is left indwelling in the tissue.

[0073] When the user pulls the endoscope and the actuator 50 out of the body, a series of operations are completed.

[0074] As described above, according to the ligation device of this embodiment, due to the size and positional relationship between the small-diameter portion 58 and the jaw member 72 of the actuator 50, and the locking portion 23 and the proximal portion 20a of the clamp 20 of the clamp unit 10, the engagement between the proximal portion 20a and the hook portion 70 is never released until the clamp is locked.

[0075] The ligation device 1 enables the clamp unit 10 to repeatedly grasp tissue, and the connection between the actuator 50 and the clamp unit 10 can be released simply by pulling the operating wire 52, making the operation simple.

[0076] Because the inner diameter of the small-diameter portion 58 is smaller than that of the proximal opening 30b, the primary contact and friction with the hook 70 occurs only within the small-diameter portion 58 within the guide tube, not within the tubular member 30. If friction or snagging occurs between the tubular member 30 and the hook 70, it can cause a jam, a phenomenon in which the clamp cannot be opened again even with the retaining portion 23 positioned within the tubular member 30. If this jam occurs, even if the operating wire is pushed forward to open the clamp, the entire clamp, along with the operating wire, will advance relative to the guide tube, making it difficult to release the jam.

[0077] As described above, in the ligation device 1 of this embodiment, the engagement between the proximal portion 20a and the hook portion 70 is never released before the clamp is locked, so it is difficult to get stuck.

[0078] If the contact and friction with the hook 70 is transmitted between the hook 70 and the guide tube 55, the forward pushing operation of the operating wire will apply a force to move the hook 70 forward relative to the guide tube 55, so it is easy to release it if it gets stuck.

[0079] Furthermore, even if the inner diameter of the small-diameter portion 58 and the inner diameter of the proximal opening 30b are the same, by, for example, making the hook portion 70 tapered at the distal end, the primary contact and friction can be generated only at the small-diameter portion 58, thereby achieving the same effect. Specifically, when the small-diameter portion 58 and the hook portion 70 are in contact, the outer diameter of the portion of the hook portion 70 located at the proximal opening can be smaller than the inner diameter of the proximal opening.

[0080] The hook portion 70 may be slightly opened when in contact with the small-diameter portion 58. In this case, as long as the distal end portion of the hook portion 70 does not move outside the radial range of the proximal opening, it is possible to prevent the hook from getting stuck.

[0081] In order to achieve the above-mentioned hooking action, the relationship between the distance D1 between the rear end of the distal end 72a where the jaw member 72 begins to reduce in size and the locking surface 73a in the axial direction of the cylindrical shape of the guide tube 55, the distance D2 between the front end of the locking portion 23 and the front end of the proximal end 20a in the axial direction of the cylindrical shape of the tubular member 30, and the distance D3 between the rear end of the reduced diameter portion having a locking function in the proximal end opening 30b and the rear end 58b of the small diameter portion 58 in the axial direction of the cylindrical shape of the guide tube 55 is important. Distances D1 to D3 are Figure 10 Shown.

[0082] D2-D1 <D3(1)

[0083] That is, by setting the dimensions of each portion to satisfy the above formula (1), it is possible to ensure that the portion of the jaw 72 excluding the distal end portion 72 a is located in the small diameter portion 58 until the locking portion 23 is retracted outside the tubular member 30 .

[0084] Furthermore, in the jaw 72, increasing the distance from the shaft member 76 to the distal end portion 72a reduces the opening angle of the pair of jaws when they are separated. As a result, when the jaw 72 is advanced to repeatedly grasp the clamp, it is less likely to interfere with the proximal opening 30b of the tubular member 30.

[0085] In the present embodiment, the hook portion 70 is not limited to having a pair of jaws. Figure 11 The hook portion 70A shown has only one jaw member 72. Such a hook portion 70A is provided by the same arrangement, as Figure 12 As shown, it is also possible to prevent the engagement between the hook portion 70A and the clamp 20 from being released before the locking portion 23 moves out of the tubular member 30 .

[0086] When only one jaw is provided, balance adjustment can be performed as needed to offset the proximal end portion of the clamp and the engaging surface of the jaw from the central axis of the tubular member and the guide tube, thereby releasing the connection between the clamp and the jaw more smoothly.

[0087] The claw portion of this embodiment does not need to have a distal end portion where the size in the opening and closing direction gradually decreases. If the size of the claw portion in the opening and closing direction up to the distal end is the same, it can be set based on Formula 1 with the distal end of the claw portion as a reference.

[0088] In the present embodiment, the tubular member 30 may not enter the guide tube 55 but may only be in contact with the guide tube 55 .

[0089] In addition, the stopper 53 can be set at other positions. For example, the position where the slider 62 interferes with the main body 61 and cannot move forward can be used as the position where the stopper is located. Furthermore, the stopper can also be not set.

[0090] In this embodiment, the tubular member does not necessarily need to be provided with a coil spring. That is, the clamp is advanced without the aid of a coil spring, but only by the advancement of the operating wire.

[0091] The locking of the clamp and the tubular component can also be carried out at a position other than the proximal opening. Under this form, by making the connecting piece be located in the tubular component during being locked, it is possible to prevent the clamp from getting stuck.

[0092] Second embodiment

[0093] Reference Figures 13 to 16 , a second embodiment of the present application will be described. The same structures as those already described will be denoted by the same reference numerals to omit repeated descriptions.

[0094] Figure 13 1 is a cross-sectional view showing the periphery of the guide tube 55 of the actuator 150 according to this embodiment. The guide tube 55 is not provided with the restraining member 57 .

[0095] The operating wire 52 and the clip 20 are connected by a hook 170. The hook 170 includes a connecting member 71 and a pair of jaws 172. Each jaw 172 is connected to the connecting member 71 by a leaf spring-shaped link 175. The pair of jaws 172 can be separated by deformation of the link 175.

[0096] Each jaw element 172 includes a claw portion 173 and a retaining surface 173a. Unlike the first embodiment, the retaining surface 173a can be perpendicular or substantially perpendicular to the longitudinal direction of the guide tube. Alternatively, as in the first embodiment, the retaining surface 173a can be inclined toward the distal end of the jaw element. As in the first embodiment, the dimension of the distal end portion 172a in the opening and closing direction gradually decreases as it approaches the distal end.

[0097] In this embodiment, Figure 10 The relationship between the aforementioned distances D1 and D2 shown above satisfies the following formula 2. Since the restraining member 57 is not present, the distance D3 does not exist in this embodiment.

[0098] D1>D2(2)

[0099] In the ligation device of this embodiment having the actuator 150, the hook 170 and the clamp 20 satisfy the equation 2, as shown in FIG. Figure 14 As shown, even after the proximal end portion 20a has moved outside the tubular member 30, the portion of the jaw 172 other than the distal end portion 172a remains within the tubular member 30 while the locking portion 23 is within the tubular member 30. Consequently, the edge of the proximal opening 30b inhibits the jaw 172 from opening, releasing the connection between the restraining hook 170 and the clamp 20.

[0100] After the distal end portion 172a of each jaw member 172 reaches the proximal opening 30b, each claw portion 173 rotates due to the force received from the proximal end portion 20a, and the distal end portions 172a separate from each other. Then, each link 175 deforms, causing the pair of jaw members 172 to further separate, as shown in FIG. Figure 15 As shown, the engagement between the hook 170 and the clamp 20 is released. At this time, the locking portion 23 can be completely moved outside the tubular component 30, and the clamp separated from the hook 170 is locked.

[0101] Similar to the first embodiment, this embodiment enables repeated tissue grasping by the clamp unit, and the connection between the actuator and the clamp unit can be released simply by pulling the operating wire 52, making the operation simpler and less prone to jamming.

[0102] In addition, the edge of the proximal opening functions as a connection release preventing portion, so there is no need to provide a restraining member 57, thereby simplifying manufacturing.

[0103] As long as Expression 2 is satisfied, the present embodiment may adopt a structure in which the hook portion 70 is rotatably attached to a pair of jaws.

[0104] On the contrary, if Formula 1 is satisfied, the structure of the hook portion 170 can also be applied to the first embodiment.

[0105] In the present embodiment, the hook portion 170 may not have a pair of jaw members. Figure 16 The hook portion 170A shown has only one jaw member 172. By satisfying Expression 2, the connection with the clamp 20 can be released in the same manner.

[0106] In this embodiment, the connection between the hook portion 170 and the clamp 20 can be released by breaking the connecting rod 175. In this embodiment, the edge of the proximal opening 30b inhibits movement of the connecting rod 175 away from the longitudinal axis of the tubular member 30. By applying appropriate force to the connecting rod 175, it breaks at the appropriate time. This embodiment is applicable to both cases with a pair of jaws and cases with a single jaw.

[0107] Furthermore, the location where the break occurs is not limited to the connector, but may also be a power transmission component.

[0108] The claw portion of this embodiment does not need to have a distal end portion where the size in the opening and closing direction gradually decreases. If the size of the claw portion in the opening and closing direction is the same up to the distal end, the size can be set based on Formula 2 with the distal end of the claw portion as a reference.

[0109] In this embodiment, the tubular member does not necessarily need to be provided with a coil spring. That is, the clamp is advanced without the aid of a coil spring, but only by the advancement of the operating wire.

[0110] The clamp and the tubular member can be locked at a position other than the proximal opening. In this configuration, the clamp can be prevented from getting stuck by positioning the connector within the tubular member until the connector is locked.

[0111] Third embodiment

[0112] Regarding the third embodiment of the present invention, refer to Figure 17 to Figure 2 1 for explanation.

[0113] Figure 17 1 is an overall structural diagram of the treatment instrument of this embodiment. The treatment instrument 1C includes a clip unit (indwelling unit) 10C and an actuator 50C. The clip unit 10C is left indwelling in the body after treatment, and the actuator 50C is used to operate the clip unit 10C.

[0114] [Fixture unit]

[0115] The clip unit 10C includes a clip 20C as a treatment portion and a tubular member 30C capable of accommodating at least a proximal end portion of the clip 20C.

[0116] [Fixture]

[0117] The clamp 20C includes two arms 21C and 22C. The two arms 21C and 22C are connected to each other so as to be rotatable via a first pin 24 and a second pin 25. The clamp 20C can be opened and closed by rotating the two arms 21C and 22C relative to each other.

[0118] [Tubular parts]

[0119] As shown in Figures 18(a) and 18(b), the tubular member 30C is hollow and cylindrical, with a distal opening 30a and a proximal opening 30b. The tubular member 30C has two opposing wall grooves 30c for the two arms 21C and 22C to pass through when the arms 21C and 22C are open. Furthermore, the tubular member 30C has a wall pin hole 30d for the second pin 25 to be inserted into the wall.

[0120] The tubular member 30C is further formed with a stopper 30e for locking the arms 21C and 22C. When a protrusion, described later, formed on the arms 21C and 22C moves proximally within the tubular member 30C and passes over the stopper 30e, the stopper 30e engages with the protrusion, preventing it from moving distally, thereby locking the arms 21C and 22C in the closed position.

[0121] The stopper 30e may be located on the inner wall surface of the tubular component 30C or the proximal opening 30b.

[0122] As shown in FIG. 18( b ), the stopper portion 30 e may be an inner wall surface step portion formed by the inner diameter of the tubular member 30C becoming larger on the proximal end side of the stopper portion 30 e .

[0123] Alternatively, as shown in FIG. 18( c ), the stopper portion 30 e may be an edge portion of the proximal opening 30 b of the tubular member 30C.

[0124] Alternatively, as shown in Figures 18(d) and 18(e), the stopper 30e may be a convex portion protruding from the inner wall surface of the tubular member 30C or the proximal opening 30b toward the axial center of the tubular member 30C. The convex portion may be continuous or discontinuous in its circumferential direction.

[0125] [Actuating unit]

[0126] The actuator 50C includes an operating wire 52C and a hook portion 70C. The operating wire 52C is inserted into an elongated insertion tube 51C. A connector 56 at the distal end of the insertion tube 51C is inserted into the proximal end of the tubular member 30C, interlocking and connecting the two. Alternatively, the insertion tube 51C may omit the connector 56 and directly interlock with the proximal end of the tubular member. The distal end of the operating wire 52C is connected to the hook portion 70C, while the proximal end of the operating wire 52C is connected to the slider 62 of the operating unit 60. The operating unit 60 and slider 62 are identical to those of the first embodiment and will not be described in detail.

[0127] [Hook]

[0128] Two hooks 70C may be provided. Figure 17 As shown, the proximal end of the hook portion 70C is connected to the operating wire 52C. The front ends of the two hook portions 70C are respectively engaged with the two ends of the first pin 24, and the two arm portions 21C and 22C are located between the two hook portions 70C.

[0129] like Figure 19 As shown, the hook portion 70C includes a hook claw 70Ca at the distal end and a hook body 70Cb located proximal to the hook claw 70Ca. The hook claw 70Ca and the hook body 70Cb have the same width. The proximal end of the hook body 70Cb is connected to the operating wire 52C via a hook shaft 70Cc. The hook shaft 70Cc is smaller in width than the hook body 70Cb, but may also be the same width as the hook body 70Cb.

[0130] The hook portion 70C is formed of a long plate material, a portion of which is removed from the distal end of the plate material to form a hook claw 70Ca, and the remaining portion of the plate material to form a hook body 70Cb and a hook rod 70Cc. Preferably, the hook portion 70C is formed of a metal material.

[0131] [Arm]

[0132] The structures of the arms 21C and 22C will be described in detail with reference to Figures 20(a) and 20(b). Figure 20(a) is a side view of the arm 21C as viewed from the side where the hook portion corresponding to the arm 21C is located, and Figure 20(b) is a side view of the arm 22C as viewed from the side where the hook portion corresponding to the arm 22C is located.

[0133] As shown in Figures 20(a) and 20(b), the two arm portions 21C and 22C respectively have pin holes 21Ca and 22Ca, long grooves 21Cb and 22Cb, arms 21Cc and 22Cc, claws 21Cd and 22Cd, protrusions 21Ce and 22Ce, arm step portions 21Cf and 22Cf, and notch portions 21Cg and 22Cg.

[0134] Pin holes 21Ca and 22Ca are located near the proximal ends of arms 21C and 22C, through which first pin 24 is inserted, thereby rotatably connecting arms 21C and 22C. Arms 21C and 22C rotate relative to each other about first pin 24. The outer diameter of first pin 24 can be smaller than the inner diameter of pin holes 21Ca and 22Ca.

[0135] As can be seen from Figures 20(a) and 20(b), elongated slots 21Cb and 22Cb extend obliquely along the length of the arms 21C and 22C, allowing the second pin 25 to be inserted and slidably therethrough, thereby movably connecting the two arms 21C and 22C. The second pin 25 is disposed in the tubular member 30C through a pin hole 30d in the tubular wall. When the first pin 24 is moved within the tubular member 30C by operation of the actuator 50, the second pin 25 slides along the elongated slots 21Cb and 22Cb, enabling the two arms 21C and 22C to open and close.

[0136] The arms 21Cc and 22Cc extend distally from the arm portions 21C and 22C, respectively. Claws 21Cd and 22Cd are provided at the distal ends of the arms 21Cc and 22Cc, respectively, for gripping tissue.

[0137] Protrusions 21Ce and 22Ce protrude radially from the proximal ends of the arms 21C and 22C, respectively, within the tubular member 30C. When the protrusions 21Ce and 22Ce move proximally within the tubular member 30C and pass over the stopper 30e, the stopper 30e engages with the protrusions 21Ce and 22C, preventing distal movement and thereby locking the arms 21C and 22C.

[0138] Arm steps 21Cf and 22Cf are formed on the side surfaces of the arms 21C and 22C, respectively, where the hook portion 70C is located. On the arms 21C and 22C, the arm steps 21Cf and 22Cf extend along at least a portion of the periphery of the region where the hook portion 70C engages with the first pin 24. The arm steps 21Cf and 22Cf prevent deformation of the claw 70Ca of the hook portion 70C. For example, in Figures 20(a) and 20(b), the shaded area represents the region where the hook portion 70C engages with the first pin 24. The arm steps 21Cf and 22Cf, indicated by thick black lines, extend along the periphery of this shaded area.

[0139] The arm steps 21Cf and 22Cf may be formed continuously as shown in Figures 20(a) and 20(b), or may be formed intermittently. Furthermore, the arm steps 21Cf and 22Cf may be formed only in the portion indicated by the thick black lines in Figures 20(a) and 20(b), as long as the arm steps 21Cf and 22Cf can prevent the hook 70Ca from deforming.

[0140] In Figures 20(a) and 20(b), the arm steps 21Cf and 22Cf can be formed by increasing the thickness of the region adjacent to the shaded area (i.e., the region where the hook portion 70C engages with the first pin 24). For example, the arm steps 21Cf and 22Cf can be formed by stacking a plate material of the same shape in the region adjacent to the shaded area. Alternatively, the arm steps 21Cf and 22Cf can be formed by a raised portion extending along the periphery of the shaded area.

[0141] The thickness of the hook portion 70C can be greater than the height of the arm steps 21Cf and 22Cf, and can be higher than the arm steps on the side of the arm. Alternatively, the thickness of the hook portion 70C can be equal to the height of the arm steps 21Cf and 22Cf, and can be flush with the arm steps on the side of the arm.

[0142] In Figures 20(a) and 20(b), notches 21Cg and 22Cg are formed on the opposite side of the protrusions 21Ce and 22Ce of the region (i.e., the shaded area) where the hook portion 70C engages with the first pin 24. In Figure 20(a), the protrusion 21Ce is located at the top, and the notch 21Cg is formed below the shaded area. In Figure 20(b), the protrusion 22Ce is located at the bottom, and the notch 22Cg is formed above the shaded area.

[0143] The notches 21Cg and 22Cg are designed so that when the notches 21Cg and 22Cg move in contact with the tubular member 30C, the edges of the hook 70C contact and are supported by the tubular member 30C at the notches 21Cg and 22Cg.

[0144] [Action of the treatment equipment]

[0145] Below, refer to Figures 21(a) to 21(d) , explaining the action of the treatment device.

[0146] As shown in FIG. 21( a ), in the initial state, the first pin 24 is located at a distal position close to the second pin 25 , and the two arm portions 21C and 22C are in an open state.

[0147] From the state shown in Figure 21(a), pulling the operating wire 52C causes the first pin 24 to move proximally, closing the two arms 21C and 22C, as shown in Figure 21(b). The stopper 30e is a stepped portion on the inner wall of the tubular member 30C formed by increasing the inner diameter of the tubular member 30C proximally. As the stopper 30e moves proximally, the protrusion 21Ce moves from the tubular wall groove 30c of the tubular member 30C into the cavity formed by the inner wall of the tubular member 30C, abutting the upper inner wall of the tubular member 30C. Due to the inner wall reaction force generated by the abutment of the protrusion 21Ce, the arm 21C abuts the lower inner wall of the tubular member 30C (i.e., the support portion 30f) at the notch 21Cg. At this point, the lower surface of the hook 70C is also supported by the support portion 30f of the tubular member 30C. Due to the support provided by the support portion 30f, the hook 70Ca is pushed against the first pin 24 from below, preventing downward relative movement. In this state, the combined action of the arm step 21Cf and the support portion 30f prevents the hook 70Ca from easily displacing relative to the arm 21C, even when it is pulled by the reaction force of the first pin 24. This prevents deformation of the hook 70Ca.

[0148] Continue pulling the operating wire 52C from the state shown in Figure 21(b). As shown in Figure 21(c), the protrusion 21Ce passes over the stopper 30e of the tubular member 30C toward the proximal end. This engages the stopper 30e, locking the clamp. Simultaneously with the clamp's locking, the upward movement of the protrusion 21Ce creates a gap between the support 30f and the lower surface of the hook 70C, allowing the hook 70C to move downward relative to the arm 21C, releasing the restraint mechanism.

[0149] In this state, as shown in FIG21(d), when the operating wire 52C is further pulled so that the hook 70Ca is further subjected to the reaction force of the first pin 24, the hook 70Ca is deformed and pulled out through the gap below, and the connection between the hook portion 70C and the first pin 24 is released.

[0150] In this embodiment, before the clamp is locked and the protrusions 21Ce and 22Ce abut the inner wall surface of the tubular member 30C, the arm step and the support portion cooperate to prevent the hook portion 70C from being released from the connection with the first pin 24. Locking the clamp causes the protrusions 21Ce and 22Ce to no longer abut the inner wall surface of the tubular member 30C. The deflection of the protrusions 21Ce and 22Ce creates a gap between the hook portion and the support portion, releasing the constraint that maintains the connection between the hook portion 70C and the first pin 24.

[0151] Therefore, locking the clamp 20C and releasing the connection between the hook portion 70C and the first pin 24 only requires a single pulling operation, simplifying operation. Furthermore, due to the presence of the restraining mechanism, the connection between the hook portion 70C and the first pin 24 is not released until the clamp 20C and the tubular member 30C are locked, thereby improving operational reliability and safety.

[0152] After the hook portion 70C is disconnected from the first pin 24 , the withdrawal wire 52C and the insertion tube 51C are further pulled to release the engagement between the tubular member 30C and the connection portion 56 of the insertion tube 51C, and the tubular member 30C and the insertion tube 51C are separated.

[0153] [Modification]

[0154] exist Figures 21(a) to 21(d)In the illustrated embodiment, the stopper 30e is a stepped portion on the inner wall of the tubular member 30C formed by increasing the inner diameter of the tubular member 30C proximal to the stopper 30e. In this modified example, the stopper 30e may be the edge of the proximal opening 30b of the tubular member 30C, as shown in Figure 18(c). In this case, the insertion tube can be wrapped around the tubular member 30C from the outside, with the hook 70C maintaining the connection. When the protrusions 21Ce and 22Ce have not yet been pulled out of the proximal opening 30b of the tubular member 30C and are still in contact with the inner wall of the tubular member 30C, the inner wall of the tubular member 30C opposite the protrusions 21Ce and 22Ce serves as a support 30f, supporting the hook 70C.

[0155] Alternatively, the stopper portion 30e may be a protrusion 30e that projects from the inner wall surface or the proximal opening 30b of the tubular member 30C toward the axial center of the tubular member 30C, as shown in FIG18(d) or FIG18(e). When the protrusions 21Ce and 22Ce abut against the protrusion 30e before they pass over it, the protrusion 30e on the opposite side of the tubular member 30C from the protrusions 21Ce and 22Ce serves as a support portion 30f, supporting the hook portion 70C.

[0156] Furthermore, in the third embodiment described above, the support portion 30f partially supports the lower surface of the hook portion 70C in the notch portion. However, the dimensions of the support portion 30f and the notch portion in the longitudinal direction of the tubular member 30C can be appropriately adjusted so that the support portion 30f supports the hook portion 70C in the entire notch portion, thereby increasing the range of support for the hook portion 70C.

[0157] Furthermore, the thickness of the hook portion 70C can be greater than the height of the arm steps 21Cf and 22Cf, extending beyond the arm steps on the side of the arm. The inner wall of the tubular member 30C can be configured to support the portion of the hook portion 70C that extends beyond the arm steps on both sides of the tubular wall groove 30c. In this case, the support portion 30f can include the inner wall of the tubular member 30C that supports the portion of the hook portion 70C that extends beyond the arm steps.

[0158] Furthermore, the indwelling device of the present application is not limited to a clamp, and may be, for example, a snare wire described in Japanese Patent No. 4981157 that can be indwelled in the body in a ligated state.

[0159] The power transmission component of the present application is not limited to wires. For example, when the technical solution of the present application is applied to a treatment instrument used under laparoscope, the power transmission component can be a hard rod.

[0160] The technical solution of the present application can be used to install a ligation device using an indwelling unit.

[0161] The above describes the various embodiments of the present application. The scope of protection of the present application is not limited to the above embodiments, and the various elements may be changed, replaced, deleted, etc. within the scope of the spirit and purpose of the present application. In addition, the features of the various embodiments may be appropriately combined within the scope of the spirit and purpose of the present application.

Claims

1. A treatment device, characterized in that: include: a placement unit comprising a treatment portion and a tubular member capable of accommodating at least a proximal portion of the treatment portion; an actuating portion, the actuating portion comprising a connecting piece connected to the treatment portion and a power transmission component connected to the connecting piece, The treatment part is a clamp having two arms rotatably connected by a first pin, the first pin being inserted through a pin hole located at a proximal end portion of the arm. The connecting member is a hook portion, the hook portion is engaged with the first pin, and includes a hook claw on the distal end side. The treatment instrument is characterized in that it further includes: a locking mechanism comprising a protrusion and a stopper, wherein the protrusion protrudes from the arm portion in a radial direction of the tubular member, and the stopper is formed on the tubular member and blocks the protrusion from moving toward the distal end after the protrusion passes over the stopper toward the proximal end; a constraint mechanism that applies a constraint to prevent the connection between the treatment portion and the connector from being released before the treatment portion is locked and within a specified range of movement of the connector, and does not apply the constraint after the treatment portion is locked and outside the specified range of movement of the connector, the constraint mechanism comprising: an arm step portion formed along at least a portion of a periphery of the arm portion where the hook portion is located, to prevent deformation of the hook claw; The support portion is located inside the tubular member and supports the hook portion from a side opposite to the protrusion when the protrusion contacts the inner wall surface of the tubular member before the clamp is locked.

2. The treatment device according to claim 1, characterized in that The clamp includes long slots formed in the two arm portions and a second pin inserted through the long slots.

3. The treatment device according to claim 1, characterized in that The outer diameter of the first pin is smaller than the inner diameter of the pin hole.

4. The treatment device according to claim 1, characterized in that Two hooks are provided, and the two arm portions are located between the two hooks.

5. The treatment device according to claim 1, characterized in that The hook portion is formed of a metal material.

6. The treatment device according to claim 1, characterized in that The hook portion includes a hook body located on a proximal end side of the hook claw.

7. The treatment device according to claim 6, characterized in that The hook claw and the hook body have the same width.

8. The treatment device according to claim 7, characterized in that The hook portion further includes a hook rod connecting the hook body and the power transmission component, and a width of the hook rod is smaller than or equal to that of the hook body.

9. The treatment device according to claim 1, characterized in that The stopper portion is a stepped portion on the inner wall surface of the tubular member, and is formed by increasing the inner diameter of the tubular member on the proximal end side of the stopper portion.

10. The treatment device according to claim 1, characterized in that The stopper portion is an edge portion of the proximal opening of the tubular component.

11. The treatment device according to claim 1, characterized in that: The stopper portion is a convex portion protruding from the inner wall surface or the proximal end opening of the tubular member toward the axial center side of the tubular member, and the convex portion is continuous or discontinuous in the circumferential direction.

12. The treatment device according to claim 1, wherein: The arm portion is provided with a notch portion on a side opposite to the protruding portion in a region where the hook portion is located, and the supporting portion supports the hook portion at least partially in the notch portion.

13. The treatment device according to claim 1, characterized in that The arm step portion is formed by an adjacent region having a greater thickness than a region where the hook portion is located.

14. The treatment device according to claim 1, characterized in that The arm step portion is formed by a raised portion raised along at least a portion of a periphery of a region where the hook portion is located.

15. The treatment device according to claim 1, wherein The supporting portion is an inner wall surface of the tubular member.

16. The treatment device according to claim 1, characterized in that The support portion is the stopper portion of the tubular member, The stopper portion is a convex portion that protrudes from the inner wall surface or the proximal end opening of the tubular member toward the axial center side of the tubular member.

17. The treatment device according to claim 1, characterized in that The thickness of the hook portion is greater than the height of the arm step portion, The support portion includes an inner wall surface of the tubular member that supports a portion of the hook portion that is higher than the arm step portion.

18. The treatment device according to claim 1, characterized in that After the clamp is locked, a gap exists between the hook portion and the support portion, and the constraint is released.

19. The treatment device according to claim 1, characterized in that The power transmission component is a wire or a rod.

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