Endoscopic treatment device

Abstract

A treatment device for an endoscope comprises a clamp unit and a feeder. The clamp unit comprises an arm portion in which a first arm and a second arm are connected at a proximal portion. The feeder comprises a power transmission component and is connected to the clamp unit. The treatment device for an endoscope comprises: a coupling portion provided on one side of the proximal portion and the power transmission component; and an engaged portion provided on the side of the proximal portion and the power transmission component that does not have the coupling portion. The coupling portion comprises: a hook portion capable of entering into the engaged portion and engaging with the engaged portion; a support portion connected to the hook portion; and a protrusion having a size that prevents it from entering into the engaged portion. If a force is applied from the power transmission component while the coupling portion and the engaged portion are engaged, at least one of the hook portion and the support portion is deformed, thereby enabling the coupling of the coupling portion and the engaged portion to be released.

Description

Technical Field

[0001] The present invention relates to an endoscopic treatment device, and more particularly to an endoscopic treatment device including a clip unit for ligating tissue. Background Art

[0002] As a treatment performed using an endoscope, tissue ligation using a clamp unit is known. The clamp unit has a pair of arms. When the arms are pulled a predetermined amount while clamping tissue, the arms are locked while firmly clamping the tissue.

[0003] The clip unit as the treatment part is introduced into the body in a state of being attached to the feeder. Since the clip unit is left in the body in a state of ligating tissue, it is necessary to separate it from the feeder after the pair of arms are locked.

[0004] The clip unit described in Patent Document 1 is characterized in that the proximal ends of a pair of arms are housed in a pressure tube, and the proximal ends of the arms are connected to an operation wire.

[0005] If the arm is pulled out of the pressure tube by a predetermined amount by pulling the operating wire and then disconnecting the arm from the operating wire, the arm is locked in the closed position. Therefore, the closed arm can be opened by pushing the operating wire until the proximal end of the arm is pulled out of the pressure tube by a predetermined amount.

[0006] Prior art literature

[0007] Patent Literature

[0008] Patent Document 1: Japanese Patent No. 5750620 Summary of the Invention

[0009] Problems to be solved by the invention

[0010] The structure described in Patent Document 1 has the advantage that, if the arms clamp tissue at an inappropriate position, the arms can be opened again to clamp the tissue again.

[0011] On the other hand, in order to release the connection between the arm and the operating wire, the operating wire needs to be advanced, so in order to lock the arm for indwelling, two actions, namely pulling and pushing out the operating wire, need to be performed.

[0012] The inventors simplified the operation of disconnecting the arm and the operating wire, solved the newly discovered problem, and thus completed the present invention.

[0013] In view of the above, an object of the present invention is to provide an endoscopic treatment device that can enable re-gripping of tissue and facilitate the placement operation of a treatment portion.

[0014] Solutions for solving problems

[0015] A first aspect of the present invention is an endoscopic treatment apparatus including a clip unit having an arm portion in which a first arm and a second arm are connected at a proximal end portion, and a feeder having a power transmission member and connected to the clip unit.

[0016] The endoscopic treatment device includes: a joint portion provided on one of the proximal end portion and the power transmission member; and an engaged portion provided on the side of the proximal end portion and the power transmission member that does not have the joint portion.

[0017] The engaging portion comprises: a hook portion capable of entering into the engaged portion and engaging with the engaged portion; a supporting portion connected to the hook portion; and a protruding portion having a size that cannot enter into the engaged portion.

[0018] When a force is applied from the power transmission member while the engaging portion and the engaged portion are engaged, at least one of the hook portion and the supporting portion is deformed, thereby releasing the engagement between the engaging portion and the engaged portion.

[0019] A second aspect of the present invention is a clip unit that can be connected to a feeder having a portion to be engaged.

[0020] The clamp unit includes: an arm portion having a first arm and a second arm, and having an engaging portion at a proximal end thereof that can engage with an engaged portion; and a tubular member having a distal opening and a proximal opening, wherein the proximal end of the arm portion is received through the distal opening.

[0021] The engaging portion comprises: a hook portion capable of entering into the engaged portion and engaging with the engaged portion; a supporting portion connected to the hook portion; and a protruding portion having a size that is unable to enter into the engaged portion.

[0022] Another form of the present invention is a clamping device, comprising: a clamp having a plurality of arms and an intermediate component, wherein the intermediate component is inserted into a sliding groove provided in the arm to connect the two arms; a tubular component for accommodating the proximal end portion of the clamp; a connecting component connected to the operating wire on the proximal side and engaged with the intermediate component at a joint on the distal side; a locking structure for locking the arm when the clamp is pulled toward the proximal side by the connecting component for a specified distance, and the clamping device has an abutment portion formed on the side surface of the arm, and during the process of the intermediate component sliding in the sliding groove before the arm is locked, the abutment portion abuts against the joint portion from a direction perpendicular to the axial direction of the intermediate component to suppress deformation of the joint portion.

[0023] The contact portion may be a long convex portion protruding from the side surface of the arm, or may be a stepped portion formed by a portion of the side surface of the arm being raised relative to the area through which the joint portion passes.

[0024] Furthermore, the engaging portion may be a hook engaged with the intermediate member.

[0025] Alternatively, the engaging portion may include two deformable engaging claws facing each other, a receiving hole for receiving the intermediate component and a notch formed between the two engaging claws, the distance between the two engaging claws being less than the outer diameter of the intermediate component, the abutting portion abutting against one of the two engaging claws, and the engaging claw not abutting against the abutting portion having a greater width and / or thickness than the engaging claw abutting against the abutting portion.

[0026] In addition, the locking structure may include: a locking portion provided at the proximal end portion of the arm; and a stopping portion provided at the tubular component, abutting against the locking portion to prevent the clip from opening again.

[0027] Furthermore, the most proximal end of the abutment portion in the longitudinal direction of the arm is formed at a position where the intermediate member is located when the arm is locked.

[0028] Furthermore, the intermediate component is a pin.

[0029] In addition, the clamping device may include a fixed arm and two movable arms, the two movable arms are respectively located on both sides of the fixed arm, and are opened and closed independently relative to the fixed arm, and the two intermediate components connect the movable arm and the fixed arm respectively.

[0030] Effects of the Invention

[0031] According to the present invention, the tissue can be re-gripped, and the placement operation of the treatment portion is simple. BRIEF DESCRIPTION OF THE DRAWINGS

[0032] Figure 1 It is an overall configuration diagram of an endoscopic treatment device according to a first embodiment of the present invention.

[0033] Figure 2 Yes Figure 1 FIG. 1 is a diagram of a clamp unit in an endoscopic treatment device.

[0034] Figure 3 yes Figure 2 Cross-sectional view of the fixture unit.

[0035] Figure 4 yes Figure 2 A cross-sectional view of the fixture unit showing a difference from Figure 3 The cross section in the direction of .

[0036] Figure 5 This is a diagram showing an example of the connection sequence between the slider and the operation wire.

[0037] Figure 6 yes Figure 1 An enlarged cross-sectional view of the clamp mounting portion of an endoscopic treatment device.

[0038] Figure 7 This is an enlarged view of the hook.

[0039] Figure 8 This is an enlarged view of the joint between the hook and the arm.

[0040] Figure 9 This figure shows a state where it becomes difficult to release the connection between the hook and the arm. Figure 1 Endoscopic treatment device.

[0041] Figure 10 It is a diagram showing a modified example of the hook.

[0042] Figure 11 It is a diagram showing a modified example of the hook.

[0043] Figure 12 It is a diagram showing a modified example of the operation portion main body.

[0044] Figure 13 It is a diagram showing the joining portion between the hook and the arm in a modified example.

[0045] Figure 14 It is a side view schematically showing a clamping device according to a second embodiment.

[0046] Figure 15A is a side view of the first connecting member of the second embodiment, Figure 15B It is from Figure 15A The first connecting component is viewed in the direction of arrow S.

[0047] Figure 16 It is from Figure 14 The figure shows a side view of a clamping unit of a second embodiment of a clamping device, viewed from the opposite side.

[0048] Figure 17A This is the side view of the pressure tube. Figure 17B This is a diagram of the pressure pipe as viewed from its axial direction.

[0049] Figures 18A to 18E Schematic diagram showing clamping, locking, and disengagement of the clamping device according to the second embodiment.

[0050] Figure 19 It is a schematic diagram showing a modified example of the contact portion.

[0051] Figure 20 It is a side view of the first connecting member of the third embodiment.

[0052] Figures 21 to 23Schematic diagram showing clamping, locking, and engagement release of the clamping device according to the third embodiment.

[0053] Figure 24 It is a schematic diagram showing a modified example of the connecting member of the third embodiment. DETAILED DESCRIPTION

[0054] First embodiment

[0055] Reference Figures 1 to 9 , describing the first embodiment of the present invention. In the specification, "distal side" refers to Figure 1 In the diagram, “the proximal side” refers to a direction away from the feeder 50 , and “the proximal side” refers to a direction approaching the feeder 50 .

[0056] Figure 1 The diagram shows the appearance of the endoscopic treatment device 1 according to this embodiment. The endoscopic treatment device 1 includes a clip unit 10 placed in the body and a feeder 50 for operating the clip unit 10. The clip unit 10 is attached to the distal end (distal end) of the feeder 50.

[0057] Figure 2 1 is a diagram showing the appearance of the clamp unit 10 . Figure 3 is a cross-sectional view of the clamp unit 10. Figure 2 As shown, the clamp unit 10 includes an arm 20 and a press tube (a tubular member) 30 that houses a portion of the arm 20 .

[0058] The arm portion 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 21 and the second arm 22 are connected at the proximal end portion 20a of the arm portion 20. The proximal end portion 20a is formed in a U shape.

[0059] The arm portion 20 is formed of an alloy or metal. Examples of the material of the arm portion 20 include stainless steel, cobalt-chromium alloy, and nickel-titanium alloy.

[0060] The first arm 21 and the second arm 22 are Figure 2 If the first arm 21 and the second arm 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.

[0061] The pressure tube 30 is a cylindrical component formed of metal or resin. Figure 3 As shown, the proximal end portion 20a of the arm portion 20 is received in the press tube 30. The distal end portion of the arm portion 20 protrudes from the distal end opening 30a of the press tube. The proximal end opening 30b of the press tube 30 is smaller than the distal end opening 30a.

[0062] Figure 4 is different from Figure 3 Observe the inside of the pressure tube 30 from the direction of Figure 4 As shown, the middle portion of each arm of the arm portion 20 is provided with a stopper 23, at which the width direction dimension of each arm 21, 22 becomes larger ( Figure 4 (Only the first arm 21 is shown in the figure). When the first arm 21 and the second arm 22 are brought closer together, each latching portion 23 can pass through the proximal opening 30b. If the first arm 21 and the second arm 22 separate after passing through the proximal opening 30b, the latching portion 23 cannot pass through the proximal opening 30b. As a result, the arm portion 20 can be locked with the pair of arms closed.

[0063] A coil spring 31 is disposed inside the pressure tube 30. The rear end of the coil spring 31 can contact a rear end surface 32 of the pressure tube having a proximal end opening 30b.

[0064] A washer 35 is disposed on the front side of the coil spring 31. The inner diameter of the washer 35 is smaller than the inner diameter of the coil spring 31. The front widths of the first and second arms 21, 22 are wider than their proximal ends, preventing them from entering the washer 35. This allows the washer 35 to contact the front and rear surfaces of the first and second arms 21, 22. This allows the front sides of the first and second arms 21, 22 to remain within the coil spring 31, even without installing a small-diameter mounting ring or the like on the coil spring 31.

[0065] Part of the structure of the arm portion 20 and the pressure tube 30 described above is a known structure disclosed in, for example, PCT International Publication No. 2014 / 181676, but may have the following modifications.

[0066] By varying the bend angle (radius of curvature) of the area outside the compression tube 30 and the area inside the compression tube 30 in the initial state, the opening width of the arm 20 in the initial state can be appropriately varied. While reducing the curvature radius reduces the ability to return to the initial state, varying the thickness of the arm can mitigate this reduction. Furthermore, by using the same components and varying only the curvature radius, multiple product lines with different opening widths in the initial state can be created.

[0067] The arm can be manufactured, for example, by punching and bending a metal plate, but by chamfering the corners that contact the inner surface of the pressure tube after manufacturing, the arm can move smoothly in the pressure tube 30, thereby suppressing wear and damage to the pressure tube caused by the corners.

[0068] like Figure 1 As shown, the feeder 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 .

[0069] The structure of the distal end of the insertion portion 50 will be described later, and a sheath formed of a coil may be used for the portion other than the distal end. When a coil sheath is used, the front and rear end surfaces are preferably flattened by grinding or the like.

[0070] The operating 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 .

[0071] 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. The operation wire 52 can be moved forward and backward in the insertion portion 51 by moving the slider 62 relative to the main body 61.

[0072] The connection form between the operating wire 52 and the slider 62 can be determined appropriately, referring to Figure 5 Let me give you an example.

[0073] First, a block member 101 having a through horizontal hole 101a and a bottomed vertical hole 101b communicating with the horizontal hole 101a is prepared. Figure 5 As shown in (a), the operation wire 52 is passed through the horizontal hole 101a via a tube 102 for preventing buckling.

[0074] like Figure 5 As shown in (b), if the pin 103 is inserted into the vertical hole 101b and the tube 102 and the operating wire 52 are pressed toward the bottom of the vertical hole 101b to perform riveting, a portion of the tube 102 and the operating wire 52 will be bent and enter the vertical hole 101b. Figure 5 As shown in (c) , even if the pin 103 is pulled out, the tube 102 and the operation wire 52 cannot be pulled out from the block member 101 , and the tube 102 and the operation wire 52 are fixed to the block member 101 .

[0075] Then, by assembling the block member to the slider 62 , the tube 102 and the operation wire 52 can be connected to the slider.

[0076] Figure 6 The clamp unit 10 and the feeder 50 are releasably connected by engaging a hook (engaging portion) provided at the distal end of the operating wire 52 with the proximal end (engaged portion) 20a of the arm 20.

[0077] The distal end portion of the insertion portion 51 includes a cylindrical first member 55 and a cylindrical second member 56 attached to the front side of the first member 55 .

[0078] The outer diameter of the rear portion of the second component 56 is smaller than the inner diameter of the first component 55. With the rear portion of the second component 56 inserted into the first component 55, the two components are connected by welding or the like. The inner diameter of the front side of the second component 56 is larger than the outer diameter of the pressure tube 30, and the rear portion of the pressure tube 30 is inserted into the second component. The inner diameter of the rear side of the second component 56 is smaller than that of the front side, and the stepped surface 56a created by the difference in diameter provides support for the rear portion of the pressure tube 30.

[0079] The hook 70 passes through the first component 55 and the second component 56 and enters the press tube 30 , and engages with the proximal end portion 20 a of the arm 20 in the press tube 30 .

[0080] The hook 70 is mounted on a connecting member 76 fixed to the distal end of the operation wire 52 by soldering or the like.

[0081] Figure 7 An enlarged view of the hook 70 is shown. Figure 7 The left side of the figure is a front view of the hook 70, and the right side is a right side view. The front side of the hook 70 includes a hook portion 71 that engages with the arm 20, a support portion 72 extending rearward from the hook portion 71, and a protrusion 73 formed at the boundary between the hook portion 71 and the support portion 72. The support portion 72 extends approximately parallel to the operating wire 52, and the rear surface 71a of the hook portion 71 is approximately perpendicular to the direction in which the support portion 72 extends.

[0082] The hook portion 71 and the support portion 72 have substantially the same thickness ( Figure 7 The distance between the first arm 21 and the second arm 22 in the proximal portion 20a of the arm portion 20 is greater than T1 and less than T2. Figure 8 As shown, the hook portion 71 can enter between the first arm 21 and the second arm 22 and be locked with the proximal end portion 20a. On the other hand, the protrusion 73 interferes with the first arm 21 and the second arm 22 and does not enter between the first arm 21 and the second arm 22.

[0083] The hook 70 having the above-described shape can be manufactured by forging using a plate having a thickness T2 or by metal injection molding (MIM).

[0084] A stopper 53 is attached to the operating wire 52. The stopper 53 is shaped and sized so that it cannot enter the first component 55. Therefore, if the stopper 53 contacts the rear end of the first component 55, the operating wire 52 cannot move further. The outer surface of the stopper 53 is chamfered to minimize interference with the insertion portion 51 during advancement and retraction of the operating wire 52.

[0085] The following describes the operation of the endoscopic treatment device 1 constructed as described above. The endoscopic treatment device 1 is introduced into the body through the channel of the endoscope. To insert the endoscopic treatment device 1 into the endoscope, the user retracts the slider 62 a predetermined amount, inserting the device with the arms 20 closed and unlocked. Alternatively, the clamp unit 10 with the arms 20 closed and the distal end of the insertion portion 51 housed in a separately prepared outer sheath can be inserted into the endoscope.

[0086] When the endoscopic treatment device 1 is extended from the channel opening at the distal end of the endoscope, and the tension on the slider is reduced or the outer sheath is retracted, the arm 20 advances relative to the pressure tube 30 by virtue of its own elastic restoring force and the elastic restoring force of the coil spring 31. As a result, the pair of arms 21 and 22 enter an open position. If the stopper contacts the rear end of the first component 55, the arm 20 is prevented from advancing relative to the pressure tube 30, thereby maintaining the open position and preventing it from falling off the pressure tube 30.

[0087] If the outer sheath is too short, the endoscopic treatment device 1 will suddenly advance due to the elastic restoring force when the outer sheath is retracted. Therefore, it is preferable to use an outer sheath that is slightly shorter than the length of the insertion portion 51 (for example, about 30 mm).

[0088] 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 arm 20 moves backward relative to the pressure tube 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 to close the arms 21 and 22. Before performing the locking operation described later, 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 endoscopic treatment device 1, before performing the locking operation, the clamp unit 10 can be operated by the operating wire 52 to re-clamp the tissue.

[0089] Within the range of movement of the operating wire 52 for re-clamping, at least a portion of the front side of the hook 70 is located on the rear side with a smaller inner diameter inside the second component 56, so the engagement between the hook 70 and the proximal portion 20a will not be released during the re-clamping operation.

[0090] After determining that the tissue between the pair of arms 21 and 22 is suitable for ligation, the user performs a locking operation to secure the arm portion 20 in the closed position. During the locking operation, the user further retracts the slider 62 relative to the main body 61 beyond the range within which re-clamping is possible. As the slider 62 retracts, the operating wire 52 is pulled, and the pair of arms 21 and 22 enter the compression tube 30 in a substantially parallel position, holding the tissue. Furthermore, the locking portions 23 provided on the pair of arms 21 and 22 approach each other, positioning the arms 21 and 22 so that they can pass through the proximal opening 30b of the compression tube 30.

[0091] The pair of locking portions 23, having moved outside the pressure tube 30 through the proximal opening 30b, separate again, becoming unable to pass through the proximal opening 30b. Consequently, the pair of locking portions 23 abut against the proximal end surface of the pressure tube 30, thereby preventing the arm 20 from protruding from the pressure tube 30 and locking the arm 20 in the closed position.

[0092] If the user moves the slider 62 further backward, the arm 20 will move further backward, and the locking portion 23 will move outside the pressing tube 30 through the proximal opening 30b. Then, the locking portion 23 is locked to the proximal end surface of the pressing tube 30, and the arm 20 is locked so that it cannot be opened.

[0093] If the user moves the slider 62 further backward, the front side of the hook 70 is deformed by the pulling force. For example, the hook portion 71 is deformed so that the rear surface 71a and the support portion 72 become nearly parallel, or the support portion 72 is deformed so that the hook portion 71 rotates around the support portion 72.

[0094] As a result, the engagement between the hook 70 and the proximal portion 20 a is released, the pressing tube 30 is detached from the second member 56 , and the clip unit 10 is left indwelling in the tissue.

[0095] After the user pulls the endoscope and the dispenser 50 out of the body, a series of operations are completed.

[0096] In the endoscopic treatment device 1, after the arm 20 is locked, the connection between the arm 20 and the hook 70 can be released simply by further retracting the hook. Therefore, the hook 70 rarely advances after the arm 20 is locked. However, if the user attempts to re-clamp the arm 20 without realizing it is locked, there is a possibility that the hook 70 may be advanced. In this case, even if the hook attempts to advance, the arm cannot advance, potentially causing the longitudinal direction of the arm to become non-parallel to the longitudinal direction of the hook.

[0097] The inventors have found that in this case, if Figure 9 As shown, the hook 700 (this hook is not the hook of the endoscopic treatment device 1) that moves forward may enter between the first arm 21 and the second arm 22 at the proximal end portion 20a of the arm. Figure 9 In the state shown, it becomes significantly difficult to pull the hook 700 outward from the proximal portion 20a.

[0098] After repeated research, the inventors successfully eliminated this possibility by providing the hook 70 with a protrusion 73 of a size and shape that cannot enter between the first arm 21 and the second arm 22. Therefore, even if the user mistakenly advances the hook 70 after the arm 20 is locked, the protrusion 73 will interfere with the proximal end 20a and cannot enter between the first arm 21 and the second arm 22, thus reliably preventing the hook 70 from being locked. Figure 9 The status shown.

[0099] As described above, according to the endoscopic treatment device 1 of this embodiment, re-gripping can be performed using the clamp unit 10, and the connection between the feeder 50 and the clamp unit 10 can be released simply by pulling the operating wire 52, which is easy to operate. Furthermore, as described above, it is possible to reliably prevent the situation where the connection between the feeder 50 and the clamp unit 10 becomes difficult to release due to an operation after the arm is locked.

[0100] In the endoscopic treatment device 1, a first member 55 with a large inner diameter and a second member 56 with a smaller inner diameter are attached to the distal end of the insertion portion 51. This ensures that the second member 56 reliably supports the compression tube 30 and applies the force required to lock the arm. As described above, by flattening the end surfaces of the coil sheath, the feeder 50 can stably withstand large forces, providing more stable support.

[0101] Furthermore, before the arm 20 is locked, the hook 70 is located in the rear portion of the second member having a smaller inner diameter. Therefore, large displacement of the hook 70 due to deformation can be suppressed, and the connection state with the arm can be reliably maintained.

[0102] In addition, after the arm 20 is locked, the hook 70 is located in a wide space within the first member 55, thereby ensuring space for large displacement due to deformation. As a result, the arm and the hook can be smoothly disconnected by pulling the operating wire 52.

[0103] While one embodiment of the present invention has been described above, the scope of protection of the present invention is not limited to the aforementioned embodiment. Various modifications or deletions may be made to the various characteristic elements without departing from the spirit of the present invention. Several examples of modifications are provided below, but these examples are not exhaustive, and other modifications are possible. Two or more of these modifications may also be combined.

[0104] The form of the protrusion is not limited to the above description. Figure 10 In the illustrated modification, the protrusion 73A provided on the hook protrudes only to one side in the width direction (the thickness direction of the plate-like material). In addition to the aforementioned forging or injection molding, the protrusion 73A can also be formed by applying an impact from the opposite side using a punch or the like. When formed using a punch or the like, the opposite side of the protrusion becomes a recessed portion, so the thickness T2 of the protrusion 73A does not necessarily need to be greater than the distance between the first and second arms. However, as long as the protrusion 73A protrudes sufficiently to one side, the same effect can be achieved.

[0105] Furthermore, the position where the protrusion is provided can be changed. Figure 11In the modified example shown, the protrusion 73B provided on the hook is provided at a position rearward of the support portion 72. This configuration can also prevent the entire hook from entering between the first arm and the second arm.

[0106] The power transmission member of the present invention is not limited to the aforementioned wire. For example, when the present invention is applied to a treatment device used under laparoscope, the power transmission member may be a rigid rod.

[0107] In the endoscopic treatment device of the present invention, the structures of the engaging portion and the engaged portion may be reversed. For example, a hook may be provided at the proximal end of the arm, and a U-shaped or ring-shaped structure that the hook can engage with may be provided at the distal end of the sub-operation wire.

[0108] Figure 13 This figure shows a modified example of the arm and the operating wire in which the structures of the joint and the jointed part are reversed. Figure 13 As shown, a hook 70 having a protruding portion 73 is provided at the proximal end 120a of the arm 120, and the hook 70 engages with a U-shaped engaged portion 152a provided at the distal end of the operating wire 152. This structure also produces substantially the same effects as the above embodiment.

[0109] The endoscopic treatment device of the present invention may also be configured such that after the clamp unit is placed, a new clamp unit can be installed to perform the placement operation again. In this case, preferably, the hook is elastically deformed to release the connection with the arm, or the structures of the engaging portion and the engaged portion are reversed as described above. Figure 13 The structure shown is suitable for releasing the connection by plastic deformation of the hook and also for enabling installation of a new clamp unit.

[0110] In the endoscope treatment device of the present invention, when the connection between the feeder and the clamp unit is released, a large force is applied to the main body 61 of the operation portion 60. For example, a cylinder formed of resin or the like can be cut in half, and the two parts having such a shape can be combined into one body by means of a snap or the like, thereby forming the main body 61. In this case, as shown in FIG. Figure 12 In the main body 61A in the shown modified example, a protrusion 612 is set on the first half-cut part 611, so that the protrusion 612 enters the recess 617 set on the second half-cut part 616. In this state, they become one body, which can prevent the first half-cut part 611 and the second half-cut part 616 from being accidentally separated even when a large force acts on the main body.

[0111] Second embodiment

[0112] The endoscope treatment device of this embodiment is a clamping device. Figure 14 As shown, the clamping device includes a clamp unit 10A placed in the body and a feeder 50A for operating the clamp unit 10A.

[0113] The clip unit 10A includes a clip 20A and a press tube (tubular member) 30A that houses a portion of the clip 20A.

[0114] The clip 20A includes a fixed arm 21A located in the center and two movable arms 22Aa and 22Ab located on both sides of the fixed arm 21 A. The movable arms 22Aa and 22Ab can be opened and closed independently of the fixed arm 21A.

[0115] The movable arm 22Aa is rotatably connected to the fixed arm 21A via a first pin 23A1. A first sliding groove 22Aa1 is provided at the proximal end of the movable arm 22Aa. A second pin 24A1 is inserted into the first sliding groove 22Aa1. The second pin 24A1 is connected to the first hook 40Aa1 (first engaging portion) of the first connecting member 40Aa.

[0116] A locking portion 22Aa2 for locking the clip 20A is provided at the proximal end portion of the movable arm 22Aa. Figure 15A 22Aa is a side view of the movable arm. Figure 15A In the embodiment, the locking portion 22Aa2 extends in a direction perpendicular to the longitudinal direction of the movable arm 22Aa. Figure 15B It is from Figure 15A The movable arm 22Aa is viewed in the direction of arrow S in FIG. Figure 15B In the embodiment, the locking portion 22Aa2 extends obliquely in a direction away from the fixed arm 21A when no external force is applied. The locking portion 22Aa2 can be elastically deformed in a direction toward the fixed arm 21A.

[0117] like Figure 16 As shown, the movable arm 22Ab is rotatably connected to the fixed arm 21A via the third pin 23A2. The proximal portion of the movable arm 22Ab is provided with a second sliding groove 22Ab1. The fourth pin 24A2 is inserted into the second sliding groove 22Ab1. The fourth pin 24A2 is connected to the second hook 40Ab1 (second engaging portion) of the second connecting member 40Ab. A locking portion 22Ab2 for locking the clip 20A is provided at the proximal portion of the movable arm 22Ab. The structure of the locking portion 22Ab2 is the same as that of the locking portion 22Aa2, and therefore, repeated description is omitted.

[0118] The pressure tube 30A accommodates the proximal end portion of the fixed arm 21A and the proximal end portions of the movable arms 22Aa and 22Ab. Figure 17A As shown, the distal end of the pressure tube 30A is provided with two grooves 30A1 and 30A2 that are opposite to each other in the circumferential direction of the pressure tube 30A. The movable arms 22Aa and 22Ab pass through the grooves 30A1 and 30A2 respectively when opening and closing. Figure 17BAs shown, inside the pressure tube 30A, stoppers 30A3 and 30A4 are provided at the edges of the grooves 30A1 and 30A2 to abut against the aforementioned stoppers 22Aa2 and 22Ab2. The stoppers 30A3 and 30A4 form flat stopper surfaces at the edges of the grooves 30A1 and 30A2.

[0119] After the locking portions 22Aa2 and 22Ab2 come into contact with the stoppers 30A3 and 30A4, they cannot come out of the grooves 30A1 and 30A2. At this time, the movable arms 22Aa and 22Ab cannot be opened again, and the clip 20A is locked to the pressure tube 30A.

[0120] like Figure 14 As shown, the feeder 50A includes an insertion portion 51A, an operating portion 60A, and operating wires 62Aa and 62Ab. The insertion portion 51A is an elongated component that can be inserted into the body. Its proximal end is connected to the operating portion 60A, and its distal end is detachably connected to the pressure tube 30A. The main body of the operating portion 60A is divided into two parts, each of which is provided with two sliders 61Aa and 61Ab. The proximal ends of the operating wires 62Aa and 62Ab are connected to the sliders 61Aa and 61Ab, respectively. The operating wires 62Aa and 62Ab pass through the inner cavity of the insertion portion 51A, and their distal ends are connected to the first connecting part 40Aa and the second connecting part 40Ab, respectively.

[0121] The first connecting member 40Aa and the second connecting member 40Ab are long members that pass through the pressure tube 30A. The proximal end of the first connecting member 40Aa is connected to the distal end of the operating wire 62Aa. The distal end of the first connecting member 40Aa is provided with a first hook 40Aa1. The first hook 40Aa1 engages with the second pin 24A1 inserted into the first sliding groove 22Aa1 of the movable arm 22Aa. The distal end of the second connecting member 40Ab is provided with a second hook 40Ab1. The second hook 40Ab1 engages with the fourth pin 24A2 inserted into the second sliding groove 22Ab1 of the movable arm 22Ab. The first hook 40Aa1 and the second hook 40Ab1 form a C-shape.

[0122] Next, the operations of clamping, locking, and disengaging the movable arm will be described using the movable arm 22Aa as an example. The operations of the movable arm 22Ab are the same as those of the movable arm 22Aa.

[0123] like Figure 18A As shown, when the movable arm 22Aa is open relative to the fixed arm 21A, the second pin 24A1 is located at the distal end of the first sliding groove 22Aa1. After the target tissue is placed between the movable arm 22Aa and the fixed arm 21A, the slider 61Aa in the operating unit 60A is moved proximally. This pulls the operating wire 62Aa proximally, causing the second pin 24A1 to move proximally within the first sliding groove 22Aa1. This causes the movable arm 22Aa to rotate toward the fixed arm 21A (i.e., in the closing direction).

[0124] As the second pin 24A1 slides toward the proximal end of the first sliding groove 22Aa1, the proximal end of the movable arm 22Aa moves toward the inner cavity of the pressure tube 30A through the groove 30A1. Figure 18B As shown, the locking portion 22Aa2 is pressed by the edge of the groove portion 30A1, so it is moved toward the fixed arm side ( Figure 18B center right) elastic deformation.

[0125] If the locking portion 22Aa2 completely enters the inner cavity of the pressure tube 30A, it is no longer pressed by the edge of the groove portion 30A1, so it returns to the direction away from the fixed arm ( Figure 18C (left side) tilted. Figure 18C As shown, the end of the locking portion 22Aa2 abuts against the stopper portion 30A3 of the pressure tube 30A and cannot come out of the groove portion 30A1. Figure 18D As shown, the movable arm 22Aa is locked and cannot be opened again.

[0126] After the movable arm 22Aa is locked, if the operating wire 62Aa is further pulled toward the proximal side, the second pin 24A1 will move to the proximal end of the first sliding groove 22Aa1. The second pin 24A1 that has reached the proximal end of the first sliding groove 22Aa1 will not move further toward the proximal side, so the reaction force from the second pin 24A1 on the first hook 40Aa1 increases. Figure 18E As shown, if the reaction force received by the first hook 40Aa1 from the second pin 24A1 exceeds a predetermined threshold, the first hook 40Aa1 will be deformed, and the engagement between the first hook 40Aa1 and the second pin 24A1 will be released.

[0127] During actual use of the clamping device, the strength of the first hook 40Aa1 and the second hook 40Ab1 can vary due to manufacturing variations. Consequently, the hooks can deform before the movable arm is locked, potentially releasing the connection between the connecting member and the arm. To prevent this, both movable arms are provided with abutments as described below. The abutments on both movable arms have the same structure, so the movable arm 22Aa will be used as an example for this description.

[0128] like Figure 14 、 Figure 15A 、 Figure 18AAs shown in FIG. 1 , the side surface of the movable arm 22Aa is formed with an abutment portion 22Aa3. The abutment portion 22Aa3 is formed along the first sliding groove 22Aa1 and is spaced a certain distance from the first sliding groove 22Aa1. As the second pin 24A1 slides along the first sliding groove 22Aa1, a portion of the first hook 40Aa1 is positioned between the abutment portion 22Aa3 and the second pin 24A1, and the abutment portion 22Aa3 abuts the first hook 40Aa1 in a direction perpendicular to the axial direction of the second pin 24A1. This prevents the first hook 40Aa1 from deforming due to the reaction force from the second pin 24A1.

[0129] like Figure 15A As shown, the contact portion 22Aa3 is a long strip-shaped convex portion protruding from the side of the movable arm 22Aa. Figure 19 As shown, the contact portion 22Aa3 is a step portion formed by raising a portion (hatched area) of the side surface of the movable arm 22Aa relative to the sliding region of the first hook 40Aa1 .

[0130] like Figure 18D As shown, in the longitudinal direction of the movable arm 22Aa, the most proximal end of the contact portion 22Aa3 is formed at the position where the second pin 24A1 is located when the movable arm 22Aa is locked. After the movable arm 22Aa is locked, while the second pin 24A1 continues to move toward the proximal end of the first sliding groove 22Aa1 and when the second pin 24A1 is located at the proximal end of the first sliding groove 22Aa1, the first hook 40Aa1 no longer contacts the contact portion 22Aa3. Figure 18E As shown, after the movable arm 22Aa is locked, the first hook 40Aa1 is allowed to deform, thereby releasing the engagement with the second pin 24A1.

[0131] Third embodiment

[0132] Compared with the second embodiment, the third embodiment is different in the structures of the first engaging portion and the second engaging portion. Other aspects are the same as the second embodiment.

[0133] Figure 20 40Ba is a side view of the first connecting member 40Ba of the third embodiment. The distal end of the first connecting member 40Ba is provided with a first engaging portion 40Ba1 composed of a first engaging claw 40Ba11 and a second engaging claw 40Ba12.

[0134] The first engaging claw 40Ba11 and the second engaging claw 40Ba12 are disposed opposite to each other, and a receiving hole 40Ba13 and a notch 40Ba14 are formed between the first engaging claw 40Ba11 and the second engaging claw 40Ba12.

[0135] When the first engagement portion 40Ba1 is engaged with the second pin 24B1 , the accommodation hole 40Ba13 can accommodate the second pin 24B1 .

[0136] The distance between the first engagement claw 40Ba11 and the second engagement claw 40Ba12 at the notch 40Ba14 is smaller than the outer diameter of the second pin 24B1. The first engagement claw 40Ba11 and the second engagement claw 40Ba12 have a certain degree of elasticity and can expand relative to each other. Therefore, the second pin 24B1 can be pushed into the receiving hole 40Ba13 through the notch 40Ba14, engaging the first engagement portion 40Ba1 with the second pin 24B1. Conversely, the second pin 24B1 within the receiving hole 40Ba13 can be disengaged from the first engagement portion 40Ba1 through the notch 40Ba14, releasing the engagement between the first engagement portion 40Ba1 and the second pin 24B1.

[0137] The structure of the second connecting member is the same as that of the first connecting member 40Ba, and therefore, repeated description will be omitted.

[0138] In actual use of the clamping device, the strength of the engaging claws can vary due to manufacturing variations. Consequently, the engaging claws can deform before the movable arm is locked, potentially releasing the engagement. To prevent this, both movable arms are provided with abutments as described below. The abutments on both movable arms have the same structure, so the movable arm 22Ba will be used as an example for this description.

[0139] like Figure 21 As shown, abutment portion 22Ba3 is formed on the side of movable arm 22Ba. Abutment portion 22Ba3 is formed along first sliding groove 22Ba1 and spaced a certain distance from first sliding groove 22Ba1. As second pin 24B1 slides along first sliding groove 22Ba1, a portion of first engaging claw 40Ba11 is positioned between abutment portion 22Ba3 and second pin 24B1, and abutment portion 22Ba3 abuts first engaging claw 40Ba11 in a direction perpendicular to the axial direction of second pin 24B1. This prevents deformation of first engaging claw 40Ba11 due to the reaction force from second pin 24B1.

[0140] Similar to the second embodiment, the contact portion 22Ba3 may be a long convex portion protruding from the side of the movable arm 22Ba, or a step portion formed by a portion of the side of the movable arm 22Ba being raised compared to the sliding area of ​​the first engagement claw 40Ba11.

[0141] In the longitudinal direction of the movable arm 22Ba, the most proximal end of the abutment portion 22Ba3 is formed at the position where the second pin 24B1 is located when the movable arm 22Ba is locked. Figure 22As shown, when the movable arm 22Ba is locked, the first engagement claw 40Ba11 is still in contact with the contact portion 22Ba3 .

[0142] After the movable arm 22Ba is locked, while the second pin 24B1 continues to move toward the proximal end of the first sliding groove 22Ba1 and when the second pin 24B1 is located at the proximal end of the first sliding groove 22Ba1, the first engaging claw 40Ba11 no longer abuts against the abutment portion 22Ba3. Figure 23 As shown, after the movable arm 22Ba is locked, the first engagement claw 40Ba11 is allowed to deform, thereby releasing the engagement with the second pin 24B1.

[0143] Preferably, if Figure 24 As shown, by providing the reinforcement portion 40Ba15, the width of the second engagement claw 40Ba12 can be greater than that of the first engagement claw 40Ba11. Since the second engagement claw 40Ba12 does not abut the abutment portion 22Ba3, it is possible that the second engagement claw 40Ba12 may deform before the movable arm 22Ba is locked, causing the engagement with the second pin 24B1 to be released. By providing the reinforcement portion 40Ba15, the second engagement claw 40Ba12, which does not abut the abutment portion 22Ba3, is prevented from deforming before the movable arm 22Ba is locked. Alternatively, or in addition, the second engagement claw 40Ba12 may be thicker than the first engagement claw 40Ba11.

[0144] Description of Reference Numerals

[0145] 1 Endoscopic treatment device

[0146] 10 fixture units

[0147] 20, 120 arms

[0148] 21 First Arm

[0149] 22 Second Arm

[0150] 20a Proximal end portion (engaged portion)

[0151] 30 Pressed tube (tubular component)

[0152] 30a distal opening

[0153] 30b proximal opening

[0154] 50 Feeder

[0155] 51 Insertion

[0156] 52, 152 operating wire (power transmission component)

[0157] 70 hook (joint)

[0158] 71 Hook

[0159] 72 Support Department

[0160] 73, 73A, 73B protrusions

[0161] 152a: Joined portion

Claims

1. A clamping device comprising: A clip having a plurality of arms and a middle component, wherein the middle component is inserted into a sliding groove provided in the arms to connect two of the arms; a tubular member for accommodating the proximal portion of the clip; a connecting member connected to the operating wire at a proximal end and engaged with the intermediate member at a joint portion at a distal end; A locking structure that locks the arm when the clip is pulled toward the proximal end by a predetermined distance via the connecting member. The clamping device is characterized in that The arm has an abutment portion formed on the side surface thereof. When the intermediate component slides in the sliding groove before the arm is locked, the abutment portion abuts against the engaging portion from a direction perpendicular to the axial direction of the intermediate component, thereby suppressing deformation of the engaging portion.

2. The clamping device according to claim 1, characterized in that The contact portion is a long convex portion formed to protrude from the side surface of the arm.

3. The clamping device according to claim 1, wherein: The abutting portion is a stepped portion formed by raising a portion of the side surface of the arm relative to a region where the engaging portion passes.

4. The clamping device according to claim 1, wherein: The engaging portion is a hook engaged with the intermediate member.

5. The clamping device according to claim 1, wherein: The engaging portion includes two deformable engaging claws facing each other. A receiving hole for receiving the intermediate component and a cutout having a distance between the two engaging claws smaller than an outer diameter of the intermediate component are formed between the two engaging claws. The abutment portion abuts against one of the two engagement claws.

6. The clamping device according to claim 5, characterized in that The engagement claw that is not in contact with the contact portion has a width and / or a thickness greater than that of the engagement claw that is in contact with the contact portion.

7. The clamping device according to any one of claims 1 to 6, characterized in that The locking structure comprises: a locking portion, disposed at the proximal end portion of the arm; The stopper is provided on the tubular component and contacts the locking portion to prevent the clip from opening again.

8. The clamping device according to any one of claims 1 to 6, characterized in that In the longitudinal direction of the arm, the most proximal end of the abutment portion is formed at a position where the intermediate member is located when the arm is locked.

9. The clamping device according to claim 1, wherein: The intermediate component is a pin.

10. The clamping device according to any one of claims 1 to 6, characterized in that The clamping device includes a fixed arm and two movable arms, The two movable arms are located on both sides of the fixed arm and can be opened and closed independently of the fixed arm. The two intermediate components connect the movable arm and the fixed arm respectively.

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