Clamp and clamp device

Abstract

The clamp (1) of the present application comprises a fixed arm (2) and two movable arms (3) which are opened and closed independently on both sides of the fixed arm (2). The clamp (1) has a first region (2d) which is flexible and deformable in the opening and closing direction B on at least one of the two movable arms (3) and the fixed arm (2). The clamp and clamp device according to the present application can prevent the tissue from slipping off the arm and reliably clamp the tissue.

Description

Technical Field

[0001] This invention relates to clamps and clamping devices. Background Technology

[0002] In endoscopic treatment, an endoscopic treatment instrument is used, which employs clamps capable of ligating and hemostasis of the treated resected portion. The clamps of the endoscopic treatment instrument are locked in place within the lumen, clamping the resected portion.

[0003] The endoscopic treatment device described in Patent Document 1 has a clamp on the front end side including a fixed arm and two movable arms. The surgeon operates the two operating parts (handles) to open and close the two movable arms independently, thereby enabling ligation of the treated resected part, etc.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: Description of Chinese Patent Application Publication No. 111481304 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] However, with the clamp described in Patent Document 1, if the clamping force is weak when pulling the treated excised portion or other tissue held by the clamp closer, the tissue may slip off the arm. When the clamping force of the arm is increased to hold the tissue, although the tissue is less likely to slip off the arm, it may cause tissue tearing or loss.

[0009] The present invention was made in consideration of such circumstances, and its object is to provide a clamp and clamping device that can prevent tissue from slipping off the arm and can reliably hold the tissue.

[0010] Solution for solving the problem

[0011] To address the aforementioned issues, the present invention proposes the following methods.

[0012] According to a first aspect of the invention, the clamp includes a fixed arm and two movable arms located on both sides of the fixed arm and opening and closing independently of the fixed arm, wherein, in the opening and closing direction, at least one of the two movable arms or the fixed arm has a first region that is flexibly deformable.

[0013] Invention Effects

[0014] The clamp and clamping device according to the present invention can prevent tissue from slipping off the arm and can reliably clamp the tissue. Attached Figure Description

[0015] Figure 1 This is a diagram showing the overall structure of the clamping device according to the first embodiment of the present invention.

[0016] Figure 2 This diagram shows the clamping device in the closed state.

[0017] Figure 3 This diagram shows the first movable arm of the handling section of the clamping device in the open state, viewed from the left side in the thickness direction.

[0018] Figure 4 This diagram shows the second movable arm of the handling section of the clamping device in its open state, viewed from the right side in the thickness direction.

[0019] Figure 5 This is a diagram showing the first movable arm of the handling section of the clamping device.

[0020] Figure 6 This is a diagram showing the second movable arm of the handling section of the clamping device.

[0021] Figure 7 This is a diagram showing the fixed arm of the handling section of the clamping device.

[0022] Figure 8 This is a diagram showing the traction component of the feeder of the clamping device.

[0023] Figure 9 This is a schematic diagram showing the first movable arm of the treatment section of the clamping device opening and bringing the treatment section closer to the tissue being clamped.

[0024] Figure 10 This is a schematic diagram showing the first movable arm of the treatment section of the clamping device in a closed state, clamping the tissue.

[0025] Figure 11 This diagram schematically illustrates a state in which the first movable arm of the clamping device holds the tissue while the second movable arm opens, bringing the clamping device closer to the held tissue.

[0026] Figure 12 This diagram schematically shows the second movable arm of the treatment section of the clamping device closed, with the treatment section held by the tissue and the treatment section remaining in place by the clamping device.

[0027] Figure 13 This diagram shows the handling section of the clamping device according to the second embodiment of the present invention in the closed state.

[0028] Figure 14This is a schematic diagram showing the first movable arm of the treatment section of the clamping device opening and bringing the treatment section closer to the tissue being clamped.

[0029] Figure 15 This is a schematic diagram showing the first movable arm of the treatment section of the clamping device in a closed state, clamping the tissue.

[0030] Figure 16 This diagram schematically illustrates a state in which the first movable arm of the clamping device holds the tissue while the second movable arm opens, bringing the clamping device closer to the held tissue.

[0031] Figure 17 This diagram schematically shows the second movable arm of the treatment section of the clamping device closed, with the treatment section held by the tissue and the treatment section remaining in place by the clamping device.

[0032] Figure 18 These are explanatory diagrams of other variations of the handling section of the clamping device of the present invention.

[0033] Figure 19 These are explanatory diagrams of other variations of the handling section of the clamping device of the present invention.

[0034] Figure 20 These are explanatory diagrams of other variations of the handling section of the clamping device of the present invention.

[0035] Figure 21 These are explanatory diagrams of other variations of the handling section of the clamping device of the present invention. Detailed Implementation

[0036] (First Implementation)

[0037] Reference Figures 1 to 12 The clamping device (endoscopic treatment device) 100 of the first embodiment of the present invention will be described. Figure 1 This is a diagram showing the overall structure of the clamping device (endoscopic treatment device) 100 according to the first embodiment of the present invention.

[0038] In the embodiments or variations described below, corresponding structures are marked with the same symbols, and repeated descriptions are sometimes omitted. Furthermore, in the following descriptions, expressions such as "parallel," "orthogonal," "center," and "coaxial," indicating relative or absolute configurations, not only strictly indicate such configurations but also indicate a state of relative displacement by tolerance or angle or distance to achieve the same function. Additionally, the term "patient" as used in this specification includes any living organism and includes the term "subject." A patient can be a human or an animal.

[0039] [Clamping device (endoscopic treatment instrument) 100]

[0040] Figure 1 This diagram shows the overall structure of the clamping device (endoscopic treatment instrument) 100. The clamping device 100 includes a treatment unit (clamp) 1 and a feeder 200. Additionally, the feeder 200 includes a traction member 5 (see reference 5). Figure 8 ), Operation line (line) 6 (reference) Figure 8 The clamping device 100 includes a handling section 1, a sheath 7, and an operating section 8. In the following description, the side of the clamping device 100 along its length A is defined as the front end side (far end side) A1 of the clamping device 100, and the side of the clamping device 100 with the operating section 8 of the feeder 200 is defined as the base end side (proximal end side) A2 of the clamping device 100. In the clamping device 100, the handling section 1, the traction member 5 of the feeder 200, the operating line 6, the sheath 7, and the operating section 8 are arranged sequentially from the front end side A1 to the base end side A2.

[0041] The clamping device 100 is used, for example, with an endoscope (not shown). More specifically, in the clamping device 100, the surgeon operates the operating part 8 of the feeder 200 to insert the sheath 7 and the treatment part 1 provided at the front end A1 of the sheath 7 into the treatment instrument channel formed on the endoscope, thereby enabling the treatment part 1 to be guided to the vicinity of the biological tissue within the lumen to be treated, and to treat the biological tissue. In this embodiment, the endoscope used with the clamping device 100 can also be various flexible endoscopes.

[0042] [Disposal Section (Clamping Fixture) 1]

[0043] Figure 2 This diagram shows the closed state of the handling section 1 of the clamping device 100.

[0044] Treatment unit (clamp) 1 is a clamp used for treating patients, such as preventing tissue bleeding, closing perforations and achieving hemostasis, suturing internal injuries, marking lesions and traction (mucosal protrusions), and other surgical procedures. Treatment unit 1 is detached from the supply device 200 by the operator and remains in the lumen. Figure 2 As shown, the processing unit 1 includes a fixed arm 2, a movable arm 3, and a clamp holding member 4. Here, the movable arm 3 has a first movable arm 31 and a second movable arm 32 that open and close relative to the fixed arm 2. The first movable arm 31 and the second movable arm 32 are disposed on both sides of the fixed arm 2, sandwiching the fixed arm 2, and are arms that open independently in opposite directions.

[0045] The direction in which the movable arm 3 of the processing unit 1 opens and closes relative to the fixed arm 2 is defined as the opening / closing direction B or the up / down direction B. The direction in which the first movable arm 31 opens away from the fixed arm 2 is defined as the upper side B1. Furthermore, the direction in which the second movable arm 32 opens away from the fixed arm 2 is defined as the lower side B2. The direction orthogonal to the length direction A and the opening / closing direction B is defined as the thickness direction C or the left / right direction C.

[0046] [Fixed Arm 2]

[0047] Figure 7 This is a diagram showing the fixing arm 2 of the handling section 1 of the clamping device 100. (See diagram below.) Figure 2 and Figure 7 As shown, the fixed arm 2 is a rod-shaped component disposed between the movable arms 3 along the length direction A. The fixed arm 2 has a rod portion 20A formed on the front end side A1 and a connecting portion 20B formed on the base end side A2.

[0048] For example, the 20A rod section Figure 7 As shown, it is a generally rod-shaped component made of a biocompatible material. The entire outer surface of the rod portion 20A is exposed, allowing it to contact tissue. The rod 20A has a front end portion 2a and a rod-shaped portion 2b.

[0049] The front end portion 2a is provided at the front end of the rod-shaped portion 2b. Compared with the rod-shaped portion 2b, the front end portion 2a is formed into a roughly circular plate shape with a larger diameter than that of the rod-shaped portion 2b. Therefore, by hanging the front end portion 2a on the biological tissue, the fixing arm 2 can be locked onto the biological tissue.

[0050] The rod-shaped portion 2b is a generally cylindrical rod-shaped component with a front end portion 2a at the front end. The rod-shaped portion 2b has a rod front end portion 2c, a rod central portion 2d, a rod base end portion 2e, a first opposing surface 25, a second opposing surface 26, and a plurality of protrusions 27.

[0051] The front end portion (second region) 2c is part of the rod-shaped portion 2b and is provided on the front end side A1 of the rod-shaped portion 2b. The front end portion 2c is formed of a metal material (second material) with a higher elastic modulus than the central portion 2d of the rod. As the metal material of the front end portion 2c, titanium such as 64 titanium alloy (Ti-6AL-4V), stainless steel such as SUS301, SUS304-CSP, and SUS316 are preferably used.

[0052] The central portion (first region) 2d of the rod is part of the rod-shaped portion 2b and is located at the center of the rod-shaped portion 2b in the longitudinal direction A. The central portion 2d is located closer to the base end side A2 than the front end portion 2c of the rod. The elastic modulus of the central portion 2d is lower than that of the front end portion 2c of the rod, allowing it to flex. For example, when the clamped tissue applies a load to the fixing arm 2, the central portion 2d flexes in the direction of the applied load. Then, the flexed central portion 2d has the elasticity to firmly clamp the tissue without causing tissue damage or tearing due to a force that repels in the direction opposite to the applied load. The central portion 2d can also be a leaf spring or the like. The central portion 2d is preferably made of a metal material (first material) that has the elasticity to flex. As the metal material for the flexing central portion 2d, materials such as cobalt-chromium alloy (e.g., cobalt-based alloy (sproun)), cobalt-chromium-iron alloy (e.g., Ergiro alloy), and stainless steel such as SUS304-CSP are preferred.

[0053] The base end (second region) 2e is a part of the rod-shaped portion 2b and is disposed on the base end side A2 of the rod-shaped portion 2b. The base end 2e is located closer to the base end side A2 than the front end 2c and the central portion 2d. The elastic modulus of the base end 2e is approximately the same as that of the front end 2c, but higher than that of the central portion 2d. Like the front end 2c, the base end 2e is preferably made of a metallic material (second material), such as titanium (Ti-6AL-4V), SUS301, SUS304-CSP, or SUS316 stainless steel.

[0054] The base end of the front end portion 2c of the rod is connected and joined to the front end of the front end of the central portion 2d of the rod, A2. The base end of the central portion 2d of the rod is connected and joined to the front end of the front end of the base end portion 2e of the rod, A1. In this embodiment, the connecting portions of the front end portion 2c, the central portion 2d, and the base end portion 2e of the rod are integrated by means of metal bonding to form a rod-shaped portion 2b. In addition, the connecting portions of the front end portion 2c, the central portion 2d, and the base end portion 2e of the rod are more firmly joined together by overlapping and metal bonding in the thickness direction C or the opening and closing direction R. Therefore, peeling is unlikely to occur at the connecting portions. There is no particular limitation on the order of overlapping in the connecting portions. In addition, the end faces of the connecting sides of the connecting portions of the front end portion 2c, the central portion 2d, and the base end portion 2e of the rod are preferably formed as bevels. With this structure, the stress acting on the connecting portions is properly dispersed, making it difficult for stress to concentrate in specific locations. Therefore, even if different metal materials are used to form the rod-shaped part 2b at the front end 2c, the central part 2d, and the base end 2e, the surgical operator can use the clamp device 100 without worrying about the peeling of the connecting parts.

[0055] Here, there are no particular restrictions on the materials used for the rod tip 2c, the central portion 2d, and the base end 2e. The rod tip 2c, the central portion 2d, and the base end 2e can each be made of metal, or they can be made of resins other than metals. As resin materials, resins with moderate elasticity, high rigidity, thermoplasticity, or suitability for sterilization, such as polyphthalamide (PPA), polyamide (PA), polyetheretherketone (PEEK), LCP (liquid crystal polymer), acrylonitrile butadiene styrene (ABS), and polyphenylene sulfide (PPS), are preferred. Furthermore, the connection between the rod tip 2c, the central portion 2d, and the base end 2e is not limited to a metal connection. For example, if the connection between the rod tip 2c, the central portion 2d, and the base end 2e is made of the same type of material as a metal connection, they can be integrally formed by spot welding, laser welding, resistance welding, brazing, riveting, etc. When the connecting parts of the front end 2c, the central part 2d, and the base end 2e of the rod are made of different types of materials such as metal and resin, they can be integrally formed by means of fusion or insert molding using heat, ultrasound, laser, and high frequency.

[0056] The first opposing surface 25 is formed on the rod-shaped portion 2b and is the surface opposite to the first movable arm 31 of the upper side B1 provided in the opening and closing direction B.

[0057] The second opposing surface 26 is formed on the rod-shaped portion 2b and is the surface opposite to the second movable arm 32 provided on the lower side B2 in the opening and closing direction B.

[0058] like Figure 7 As shown, multiple protrusions 27 are protrusions provided on the fixed arm 2. Each protrusion 27 has a first protrusion 27a provided on the first opposing surface 25 and a second protrusion 27b provided on the second opposing surface 26. The first protrusion 27a protrudes from the first opposing surface 25 toward the first movable arm 31 positioned at the upper side B1 in the opening / closing direction B. The second protrusion 27b protrudes from the second opposing surface 26 toward the second movable arm 32 positioned at the lower side B2 in the opening / closing direction B.

[0059] A connecting portion 20B is provided at the base end A2 of the rod portion 20A. The connecting portion 20B is plate-shaped, and its thickness direction is approximately aligned with the thickness direction C. Here, in the thickness direction C, the direction further to one side than the connecting portion 20B is designated as the left side C1. Conversely, in the thickness direction C, the direction further to one side than the connecting portion 20B and opposite to the left side C1 is designated as the right side C2. The connecting portion 20B connects the fixed arm 2 and the movable arm 3, the clamp holding member 4 (described later), and the traction member 5. Figure 7 As shown, the connecting part 20B has a through hole 21, a through hole 22, a locking groove 23 and a tail part 24.

[0060] The through hole 21 is a hole that penetrates the connecting portion 20B along the thickness direction C. The through hole 21 is formed on the front end side A1 of the connecting portion 20B. The first rotating pin 211 engages with the through hole 21 from the left side C1.

[0061] The through hole 22 is a hole that penetrates the connecting portion 20B along the thickness direction C. The through hole 22 is formed on the front end side A1 of the connecting portion 20B. The through hole 22 is located at approximately the same position as the through hole 21 in the length direction A. The second rotating pin 221 engages with the through hole 22 from the right side C2.

[0062] The engaging groove 23 is a groove extending along the length direction A of the connecting portion 20B. The engaging groove 23 is a groove that penetrates the connecting portion 20B along the thickness direction C.

[0063] Tail portion 24 is formed on the base end side A2 of the connecting portion 20B of the fixed arm 2. Tail portion 24 is connected to the clamp retainer 4 described later.

[0064] [Active Arm 3]

[0065] Figure 3 This is a diagram showing the first movable arm 31 of the handling section 1 of the clamping device 100 in the open state, viewed from the left side C1 in the thickness direction C. Figure 4 This is a diagram showing the second movable arm 32 of the handling section 1 of the clamping device 100 in the open state, viewed from the right side C2 in the thickness direction C. Figure 5 This is a diagram showing the first movable arm 31 of the handling section 1 of the clamping device 100. Figure 6 This is a diagram showing the second movable arm 32 of the handling section 1 of the clamping device 100. (See diagram below.) Figures 2 to 6 As shown, the movable arm 3 has a first movable arm 31 and a second movable arm 32. The first movable arm 31 is disposed on the upper side B1 of the fixed arm 2 in the opening and closing direction B. The second movable arm 32 is disposed on the lower side B2 of the fixed arm 2 in the opening and closing direction B. The first movable arm 31 and the second movable arm 32 can perform opening and closing actions independently.

[0066] like Figure 2 , Figure 3 and Figure 5 As shown, the first movable arm 31 is configured to open and close towards the front end A1 of the fixed arm 2 in the opening / closing direction B, at its upper side B1. Specifically, the first movable arm 31 is rotatably mounted relative to the fixed arm 2 via a first rotating pin 211 disposed in the first through hole 313. The first movable arm 31 has a first sliding groove 310, a first engaging portion 311, a first through hole 313, and a first arm portion 312.

[0067] like Figure 5 As shown, the first sliding groove 310 is disposed on the base end side A2 of the first movable arm 31. The first sliding groove 310 engages with the first sliding pin 511, which will be described later.

[0068] The first engaging portion 311 is an elastic member provided on the base end side A2 of the first movable arm 31, which is elastic in the opening and closing direction B. The first engaging portion 311 is, for example, a leaf spring. When the first movable arm 31 is closed relative to the fixed arm 2, the first engaging portion 311 is housed inside the clamp retainer 4. Specifically, as... Figure 3 As shown, with the first movable arm 31 open relative to the fixed arm 2, the first engaging portion 311 is located outside the clamp holding member 4, which will be described later. On the other hand, as... Figure 2 As shown, when the first movable arm 31 is closed relative to the fixed arm 2, the first engaging portion 311 is housed inside the clamp retainer 4. When the first movable arm 31 is closed relative to the fixed arm 2, the length L1 of the first engaging portion 311 in the opening / closing direction B is approximately the same as or slightly larger than the inner diameter of the clamp retainer 4.

[0069] In this embodiment, when the first movable arm 31 changes from a closed state relative to the fixed arm 2 in the opening / closing direction B to an open state, the first engaging portion 311 rotates together with the first movable arm 31 and enters the interior of the clamp holder 4 from its base end. During the process of the first engaging portion 311 entering the interior of the clamp holder 4, in order not to damage the inner circumferential surface of the clamp holder 4, it is preferable that the portions of the first engaging portion 311 that contact the clamp holder 4 are rounded, chamfered, or otherwise treated.

[0070] The first through hole 313 is a hole that passes through the first movable arm 31 along the thickness direction C. The first through hole 313 is positioned on the left side C1 of the through hole 21 provided in the fixed arm 2 in the thickness direction C, and engages with the first rotating pin 211. The first rotating pin 211 connects the first through hole 313 and the through hole 21. According to this structure, the first movable arm 31 can rotate relative to the fixed arm 2 about the first through hole 313.

[0071] like Figure 5 As shown, the first arm 312 is formed, for example, from resin or metal, into a generally cup-shaped form by slightly bending a plate-like component. Here, the thickness direction of the first arm 312 is approximately aligned with the opening / closing direction B. By rotating relative to the fixed arm 2 along the opening / closing direction B, the first arm 312 can approach the front end 2a of the fixed arm 2 from its front end, thus clamping biological tissue. For example, the front end of the first arm 312 can be formed into a claw shape to reliably clamp biological tissue. However, the shape of the first arm 312 is not limited to that of this embodiment, and it can also be configured according to various conventional structures. The first arm 312 has a first clamping surface 312a and a first outer surface 312b.

[0072] The first clamping surface 312a is the inner surface that contacts the tissue in the opening / closing direction B and is opposite to the fixing arm 2.

[0073] The first outer surface 312b is a surface disposed on the opposite side of the first clamping surface 312a in the opening and closing direction B.

[0074] In the opening / closing direction B, the first arm portion 312 has a recess on the first clamping surface 312a side and an expanded portion with rounded corners on the first outer surface 312b side. Therefore, when the tissue is clamped by the first movable arm 31 and the fixed arm 2, the tissue is housed in the recessed portion of the first movable arm 31.

[0075] like Figure 2 , Figure 4 and Figure 6 As shown, the second movable arm 32 is configured to open and close towards the lower side B2 of the fixed arm 2 in the opening and closing direction B. Specifically, the second movable arm 32 is configured to open and close relative to the fixed arm 2 in the opposite direction to the first movable arm 31 via a second rotating pin 221 provided in the second through hole 323. The second movable arm 32 has a second sliding groove 320, a second engaging portion 321, a second through hole 323, and a second arm portion 322.

[0076] like Figure 6 As shown, the second sliding groove 320 is disposed on the base end side A2 of the second movable arm 32. The second sliding groove 320 engages with the second sliding pin 521, which will be described later.

[0077] The second engaging portion 321 is an elastic member located on the base end side A2 of the second movable arm 32 and elastic in the opening and closing direction B. The second engaging portion 321 is, for example, a leaf spring. When the second movable arm 32 is closed relative to the fixed arm 2, the second engaging portion 321 is housed inside the clamp retainer 4. Specifically, as... Figure 4 As shown, with the second movable arm 32 open relative to the fixed arm 2, the second engaging portion 321 is located outside the clamp holding member 4, which will be described later. On the other hand, as... Figure 2 As shown, when the second movable arm 32 is closed relative to the fixed arm 2, the second engaging portion 321 is housed inside the clamp retainer 4. When the second movable arm 32 is closed relative to the fixed arm 2, the length L2 of the second engaging portion 321 in the opening / closing direction B is approximately the same as or slightly larger than the inner diameter of the clamp retainer 4.

[0078] In this embodiment, when the second movable arm 32 changes from a closed state to an open state relative to the fixed arm 2 in the opening / closing direction B, the second engaging portion 321 rotates together with the second movable arm 32, entering the interior of the clamp holder 4 from its base end. During the process of the second engaging portion 321 entering the interior of the clamp holder 4, in order not to damage the inner circumferential surface of the clamp holder 4, it is preferable to treat the portions of the second engaging portion 321 that contact the clamp holder 4 with rounded corners or chamfers.

[0079] The second through hole 323 is a hole that passes through the second movable arm 32 along the thickness direction C. The second through hole 323 is positioned to the right (C2) of the through hole 21 in the fixed arm 2, and engages with the second rotating pin 221. The second rotating pin 221 connects the second through hole 323 and the through hole 22. With this structure, the second movable arm 32 can rotate relative to the fixed arm 2 about the second through hole 323.

[0080] The second arm 322 is formed, for example, from resin or metal into a generally cup-shaped form by slightly bending a plate-like component. Here, the thickness direction of the second arm 322 is approximately aligned with the opening / closing direction B. By rotating relative to the fixed arm 2 along the opening / closing direction B, the front end of the second arm 322 approaches the front end 2a of the fixed arm 2, enabling it to clamp biological tissue. Similar to the first arm 312, the front end of the second arm 322 can also be formed into a claw shape, for example, to reliably clamp biological tissue. However, the shape of the second arm 322 is not limited to that of this embodiment, and it can be configured according to various conventional structures. The second arm 322 has a second clamping surface 322a and a second outer surface 322b.

[0081] The second clamping surface 322a is the inner side of the surface that contacts the tissue in the opening / closing direction B and is opposite to the fixing arm 2.

[0082] The second outer surface 322b is a surface disposed on the opposite side of the second clamping surface 322a in the opening and closing direction B.

[0083] like Figure 6 As shown, the second arm 322 has a recess on the side of the second clamping surface 322a and an expanded portion with rounded corners on the side of the second outer surface 322b in the opening / closing direction B. Therefore, when the tissue is clamped by the second movable arm 32 and the fixed arm 2, the tissue is contained in the recessed portion of the second movable arm 32.

[0084] [Clamp Retainer 4]

[0085] like Figure 2As shown, the clamp holder 4 is a tube with a long axis and formed into a cylindrical shape. In this embodiment, the clamp holder 4 is arranged along the length direction A. The clamp holder 4 is configured to accommodate at least the base ends of the movable arm 3 and the fixed arm 2 when they are in the closed state. In addition, when the clamping device 100 is rotated circumferentially, the clamp holder 4 rotates together with the first movable arm 31 and the second movable arm 32.

[0086] The clamp holder 4 has a groove 41. The groove 41 is the front end side A1 of the clamp holder 4 and is formed on the upper side B1 and the lower side B2 in the opening and closing direction B. The groove 41 is, for example, a slit formed from the front end toward the base end side A2, and has a first engagement portion 311 of the first movable arm 31 and a second engagement portion 321 of the second movable arm 32, which can enter the interior of the clamp holder 4 to a certain extent.

[0087] The clamp holder 4 may also have engaging holes (not shown) formed on the base end side A2 for engaging a pair of tail portions 24 of the fixing arm 2. Thus, the fixing arm 2 is mounted on the clamp holder 4. The fixing arm 2 and the clamp holder 4 may also be integrally formed.

[0088] The clamp retainer 4 has an inner diameter that is the same as or slightly shorter than the length L1 of the first engaging portion 311 and the length L2 of the second engaging portion 321. The clamp retainer 4 can internally house the first engaging portion 311 and the second engaging portion 321. When the first movable arm 31 rotates downwards to the lower side B2 in the opening / closing direction B, the first engaging portion 311 enters the interior of the clamp retainer 4 from the slot 41. Similarly, when the second movable arm 32 rotates upwards to the upper side B1 in the opening / closing direction B, the second engaging portion 321 enters the interior of the clamp retainer 4 from the slot 41. Before the first engaging portion 311 is locked by engaging with the clamp retainer 4, the first movable arm 31 can be reopened relative to the fixed arm 2. Likewise, before the second engaging portion 321 is locked by engaging with the clamp retainer 4, the second movable arm 32 can be reopened relative to the fixed arm 2.

[0089] With the first engaging portion 311 housed inside the clamp holder 4, if the first engaging portion 311 is further pulled to the base end side A2, it abuts against the inner circumferential surface of the clamp holder 4, undergoes elastic deformation, and locks itself inside the clamp holder 4. Similarly, with the second engaging portion 321 housed inside the clamp holder 4, when the second engaging portion 321 is further pulled to the base end side A2, it abuts against the inner circumferential surface of the clamp holder 4, undergoes elastic deformation, and locks itself inside the clamp holder 4. This maintains the first movable arm 31 and the second movable arm 32 in a closed state relative to the fixed arm 2. Furthermore, the clamp holder 4 can lock only one of the first engaging portion 311 or the second engaging portion 321 initially.

[0090] [Supply Unit 200]

[0091] The feeder 200 is the part of the clamping device 100 that is not placed inside the cavity, except for the handling section 1. For example... Figure 1 and Figure 8 As shown, the feeder 200 includes a traction component 5, an operating line 6, a sheath 7, and an operating section 8.

[0092] [Traction Component 5]

[0093] Figure 8 This is a diagram showing the traction component 5 of the feeder 200 of the clamping device 100. (See diagram below.) Figure 8 As shown, the traction component 5 includes a first traction component 51 and a second traction component 52. Furthermore, since the first traction component 51 and the second traction component 52 have substantially the same structure, the illustration of the second traction component 52 is omitted.

[0094] The first traction component 51 is disposed on the left side C1 relative to the connecting portion 20B of the fixed arm 2. The first traction component 51 connects its front end portion 51a to the base end side A2 of the first movable arm 31. In addition, the base end side A2 of the first traction component 51 is connected to the front end portion of the first operating line 61. The first traction component 51 has a first sliding pin hole 510 and a first sliding pin 511 at its front end portion.

[0095] The first sliding pin hole 510 is a hole provided on the front end portion 51a of the first traction member 51. The first sliding pin hole 510 can engage with the first sliding pin 511. The first sliding pin hole 510 has a cutout portion 512 on the front end side A1.

[0096] The first sliding pin 511 connects the first sliding pin hole 510, the first sliding groove 310 of the first movable arm 31, and the engaging groove 23. By sliding the first sliding member 812 of the operating part 8 along the length direction A, the first sliding pin 511 can move forward and backward along the first sliding groove 310 and the engaging groove 23. When the first sliding pin 511 moves forward towards the front end side A1 along the first sliding groove 310 and the engaging groove 23, the first movable arm 31 rotates about the first rotating pin 211 to open in the opening / closing direction B, becoming open relative to the fixed arm 2. When the first sliding pin 511 retracts towards the base end side A2 along the first sliding groove 310 and the engaging groove 23, the first movable arm 31 rotates about the first rotating pin 211 to close in the opening / closing direction B, becoming closed relative to the fixed arm 2. Thus, the first movable arm 31 can open and close relative to the fixed arm 2 in the opening / closing direction B. Here, the closed state of the first movable arm 31 relative to the fixed arm 2 includes a state where the distance between the front end of the first movable arm 31 and the front end of the fixed arm 2 is approximately zero. In this state, the first movable arm 31 and the fixed arm 2 clamp the biological tissue to be disposed of between the first movable arm 31 and the fixed arm 2.

[0097] The second traction member 52 is disposed on the right side C2 relative to the connecting portion 20B of the fixed arm 2. The second traction member 52 connects its front end portion 52a to the base end side A2 of the second movable arm 32. In addition, the base end side A2 of the second traction member 52 is connected to the front end portion of the second operating line 62. The second traction member 52 has a second sliding pin hole 520 and a second sliding pin 521 at its front end portion 52a.

[0098] The second sliding pin hole 520 is provided at the front end 52a of the second traction component 52, and is a hole through which the second sliding pin 521 can engage. The second sliding pin hole 520 has a cutout 522 on the front end side A1.

[0099] The second sliding pin 521 connects the second sliding pin hole 520, the second sliding groove 320 of the second movable arm 32, and the engaging groove 23. The second sliding pin 521 slides along the length direction A via the second sliding member 822 of the operating part 8, thereby enabling it to move forward and backward along the second sliding groove 320 and the engaging groove 23. When the second sliding pin 521 advances towards the front end side A1 along the second sliding groove 320 and the engaging groove 23, the second movable arm 32 rotates about the second rotating pin 221 to open in the opening / closing direction B, becoming open relative to the fixed arm 2. When the second sliding pin 521 retracts towards the base end side A2 along the second sliding groove 321 and the engaging groove 23, the second movable arm 32 rotates about the second rotating pin 221 to close in the opening / closing direction B, becoming closed relative to the fixed arm 2. Thus, the second movable arm 32 can open and close relative to the fixed arm 2 in the opening / closing direction B. Here, the so-called closed state of the second movable arm 32 relative to the fixed arm 2 includes a state in which the distance between the front end of the second movable arm 32 and the front end of the fixed arm 2 is approximately zero. In this state, the biological tissue to be disposed of is clamped between the front end of the second movable arm 32 and the front end of the fixed arm 2.

[0100] With the first movable arm 31 closed relative to the fixed arm 2 and the first engaging portion 311 locked inside the clamp retainer 4, the first sliding member 812 of the operating part 8 slides further towards the base end side A2. As a result, the cut portion 512 deforms or breaks, disengaging from the first sliding pin 511. The first traction member 51 disengages from the connected fixed arm 2 and the first movable arm 31. Furthermore, with the second movable arm 32 closed relative to the fixed arm 2 and the second engaging portion 321 locked inside the clamp retainer 4, the second sliding member 822 of the operating part 8 further slides towards the base end side A2. As a result, the cut portion 522 deforms or breaks, disengaging from the second sliding pin 521. The second traction member 52 disengages from the connected fixed arm 2 and the second movable arm 32. When the first traction component 51 and the second traction component 52 leave the fixed arm 2, the first movable arm 31 and the second movable arm 32, the clamping device 100 can retain the treatment part 1, which has the fixed arm 2, the movable arm 3 and the clamping retainer 4, in the cavity while clamping the tissue.

[0101] [Operation Line 6]

[0102] like Figure 8 As shown, the operation line 6 has a first operation line 61 and a second operation line 62. Furthermore, since the first operation line 61 and the second operation line 62 have approximately the same structure, the illustration of the second operation line 62 is omitted.

[0103] The first operating line 61 connects its front end to the base end of the first traction member 51. The base end of the first operating line 61 is fixed to the first sliding member 812 of the operating part 8. The first operating line 61 is inserted into the sheath 7 in a retractable manner. The first operating line 61 may be formed, for example, from a single metal wire or stranded wire. In addition, the outer peripheral surface of the first operating line 61 may be covered by a non-conductive component or the like. The first operating line 61 is fixed to the first traction member 51 by various known methods, such as bonding or welding. The first operating line 61 slides through the first sliding member 812 of the operating part 8 mounted at the base end, enabling the first traction member 51 to move forward or backward.

[0104] The front end of the second operating line 62 is connected to the base end of the second traction member 52. The base end of the second operating line 62 is fixed to the second sliding member 822 of the operating part 8. The second operating line 62 is inserted into the sheath 7 in a retractable manner. The second operating line 62 may be formed of a single metal wire or stranded wire, for example. In addition, the outer peripheral surface of the second operating line 62 may be covered by a non-conductive component or the like. The second operating line 62 is fixed to the second traction member 52 by various known methods, such as bonding or welding. The second operating line 62 slides through the second sliding member 822 of the operating part 8 mounted at the base end, which allows the second traction member 52 to move forward or backward.

[0105] [jacket]

[0106] Sheath 7, for example, Figure 1 As shown, the sleeve 7 extends along the length direction A and is a long strip component capable of being inserted into a tube lumen. The sleeve 7 is formed of an insulating material, such as a fluoropolymer like PTFE (polytetrafluoroethylene) or a resin material like HDPE (high-density polyethylene). The sleeve 7 is flexible and can easily change shape within the tube lumen along the curved shape of the tube structure, etc., and is configured to be able to be inserted into and removed from the clamping device 100 (not shown). The base end 7b of the sleeve 7 is connected to the operating part 8, and the front end 7a is connected to the base end of the clamp holding member 4. Furthermore, a first operating line 61 and a second operating line 62 are inserted into the sleeve 7.

[0107] [Control Unit (Handle) 8]

[0108] like Figure 1 As shown, the operation unit 8 includes a front end portion 80a, a first operation portion 81, and a second operation portion 82. Figure 1 As shown, the front end portion 80a is connected to the base end portion 7b of the sheath 7. In this embodiment, in the operating portion 8, the first operating portion 81 and the second operating portion 82, which are connected to the front end portion 80a, branch off from each other in a direction approximately consistent with the opening and closing direction B. The first operating portion 81 and the second operating portion 82 extend from the front end portion 80a toward the base end side A2 along the upper side B1 and lower side B2 of the vertical direction B.

[0109] The first operating part 81 has a first operating part body 811, a first sliding member 812, and a finger rest 813.

[0110] The first operating unit body 811 operates the first traction member 51 and the first movable arm 31 via the first operating line 61. The first operating unit body 811 of the first operating unit 81 is formed as a rod extending along the length direction A.

[0111] The first sliding member 812 is slidable along the length direction A and is retractably disposed in the first operating part body 811. The base end of the first operating line 61 is fixed to the first sliding member 812. The first sliding member 812 is inserted through the first operating part body 811. When the first sliding member 812 moves forward and backward along the length direction A along the first operating part body 811, the first operating line 61 and the first traction member 51 fixed at the front end of the first operating line 61 move forward and backward along the length direction A. Furthermore, when the first traction member 51 moves forward and backward along the length direction A, the first sliding pin 511 of the first traction member 51 moves forward and backward along the first sliding groove 310. Thus, the first movable arm 31 opens in the opening and closing direction B with the first rotating pin 211 as the center. According to this structure, when the first sliding member 812 moves forward and backward along the length direction A along the first operating part body 811, the first movable arm 31 can be driven to perform an opening and closing operation in the opening and closing direction B.

[0112] The finger-attaching portion 813 is a generally annular finger-attaching portion formed on the base end side A2 of the first operating part body 811.

[0113] The second operating part 82 has a second operating part body 821, a second sliding member 822, and a finger rest 823.

[0114] The second operating unit body 821 operates the second traction component 52 and the second movable arm 32 via the second operating line 62. The second operating unit body 821 of the second operating unit 82 is formed as a rod extending along the length direction A.

[0115] The second slider 822 is configured to slide and retract along the length direction A within the second operating part body 821. The base end of the second operating line 62 is fixed to the second slider 822. The second slider 822 is inserted through the second operating part body 821. When the second slider 822 retracts along the length direction A along the second operating part body 821, the second operating line 62 and the second traction member 52 fixed to the front end of the second operating line 62 retract along the length direction A. Furthermore, when the second traction member 52 retracts along the length direction A, the second sliding pin 521 of the second traction member 52 retracts along the second sliding groove 320. Consequently, the second movable arm 32 opens in the opening / closing direction B with the second rotating pin 221 as the center. According to this structure, when the second slider 822 retracts along the length direction A along the second operating part body 821, the second movable arm 32 can be driven to perform an opening / closing operation in the opening / closing direction B.

[0116] The finger-attaching portion 823 is a generally annular finger-attaching portion formed on the base end side A2 of the second operation part body 821.

[0117] [Operation and function of clamping device 100]

[0118] Next, refer to Figures 9-12The operation and function of the clamping device 100 will be explained. In this embodiment, as an example of how to use the clamping device 100, the treatment of wounds in internal tissues will be explained.

[0119] Figure 9 This is a schematic diagram showing the state in which the first movable arm 31 of the treatment section 1 of the clamping device 100 is opened, bringing the treatment section 1 close to the tissue being clamped. Figure 10 This is a diagram that schematically shows the state in which the first movable arm 31 of the treatment section 1 of the clamping device 100 is closed and clamps the tissue. Figure 11 This diagram schematically shows the state in which the first movable arm 31 of the treatment section 1 of the clamping device 100 clamps tissue while the second movable arm 32 is opened, bringing the treatment section 1 close to the clamped tissue. Figure 12 This is a schematic diagram showing the second movable arm 32 of the treatment section 1 of the clamping device 100, in a state where the treatment section 1 is held in the tissue and the treatment section 1 is left in the clamping device 100.

[0120] (Prepare)

[0121] As a preparatory step, the surgeon (not shown) identifies wounds in the body's tissues using known methods. Specifically, the surgeon inserts the insertion portion of an endoscope (not shown) into the digestive tract, such as the esophagus, stomach, duodenum, or large intestine, through a natural opening in the lumen (e.g., the patient's mouth), and while observing images obtained from the endoscope's imaging portion, identifies pore-like defects T formed in the tissue D within the lumen to be treated.

[0122] (Insert step)

[0123] The surgeon inserts the clamping device 100 into the endoscope channel, causing the clamping device 100 to protrude from the front opening of the endoscope channel. The surgeon then moves the processing unit 1, located on the front side A1 of the clamping device 100, to the vicinity of the defect T.

[0124] (Configuration Steps)

[0125] like Figure 9As shown, the surgeon opens and closes the first movable arm 31, which approaches the first portion Ta of the defect T to be treated. More specifically, when the surgeon slides the first sliding member 812 towards the front end A1 in the longitudinal direction A, the first traction member 51 moves towards the front end A1. As the first sliding pin 511 connected to the first traction member 51 advances, the first movable arm 31 rotates about the first rotating pin 211 as the center of rotation. The first movable arm 31 rotates towards the upper side B1 in the opening and closing direction B, such that the first arm portion 312 of the front end A1 moves away from the fixed arm 2. As a result, the first movable arm 31 is in an open state relative to the fixed arm 2, and can clamp the first portion Ta of the defect T to be treated. In this state, the surgeon moves the first movable arm 31 and the fixed arm 2, which are in the open state, toward the first portion Ta of the defect T to be clamped, so that the first portion Ta is located between the first movable arm 31 and the fixed arm 2.

[0126] (Clamping steps)

[0127] exist Figure 10 If the surgeon can confirm that the first portion Ta of the defect T is located between the first movable arm 31 and the fixed arm 2, the first traction member 51 is moved towards the base end side A2 by pulling the first sliding member 812 of the first operating part 81. Consequently, when the first sliding pin 511 connected to the first traction member 51 retracts, the first arm portion 312 of the first movable arm 31 rotates towards the lower side B2 of the fixed arm 2 in the opening / closing direction B. As a result, the first movable arm 31 is closed relative to the fixed arm 2, clamping the first portion Ta of the defect T. At this time, the first portion Ta of the defect T is clamped by the first movable arm 31 and the fixed arm 2, and enters the vicinity of the connection between the central part 2d of the rod-shaped part 2b of the fixed arm 2 and the base end 2e.

[0128] As the surgeon pulls the first slider 812 toward the base side A2, the first engaging portion 311 formed on the base side A2 of the first movable arm 31 also rotates in the opening / closing direction B around the first rotating pin 211. As a result, the first engaging portion 311 enters the groove 41 formed on the clamp holder 4 and is housed inside the clamp holder 4. Thus, the first part Ta of the defect T is clamped by the first movable arm 31 and the fixed arm 2. In this state, while the surgeon is pulling the first slider 812 toward the base side A2, the first part of the defect T remains clamped by the first movable arm 31 and the fixed arm 2. However, by operating the operating part 8 again, the surgeon can rotate the first movable arm 31, causing it to move to an open state relative to the fixed arm 2, thereby re-clamping the first part Ta of the defect T.

[0129] (Traction Steps)

[0130] exist Figure 11 During the procedure, while maintaining the first portion Ta of defect T held between the first movable arm 31 and the fixed arm 2, the surgeon moves the entire treatment unit 1 to the vicinity of the second portion Tb of defect T, which is to be ligated with the first portion Ta of defect T. Throughout this process, the surgeon keeps the first movable arm 31 and the fixed arm 2 closed.

[0131] (Configuration Steps)

[0132] When the surgeon confirms that the treatment unit 1 has reached the vicinity of the second portion Tb of the defect T, the second movable arm 32, which is close to the second portion Tb of the defect T to be treated, is opened and closed. More specifically, when the surgeon slides the front end side A1 of the second slider 822 upward in the length direction A, the second traction member 52 moves towards the front end side A1. When the second sliding pin 521 connected to the second traction member 52 advances, the second movable arm 32 rotates about the second rotating pin 221 as the center of rotation. The second movable arm 32 rotates towards the lower side B2 in the opening and closing direction B, such that the second arm portion 322 of the front end side A1 moves away from the fixed arm 2. As a result, the second movable arm 32 is in an open state relative to the fixed arm 2, and is able to clamp the second portion Tb of the defect T to be treated.

[0133] (Arm deformation steps)

[0134] exist Figure 11 In this procedure, the surgeon tilts the front end A1 of the clamp 1 slightly upwards towards the upper side B1 in the opening / closing direction B, so that the second part Tb of the defect T to be clamped is positioned between the second movable arm 32 and the fixed arm 2, which are in the open state. Thus, the second movable arm 32 is positioned below the second part Tb of the defect T on the lower side B2. At this time, because the front end 2c of the rod of the fixed arm 2 rotates upwards towards the upper side B1 as the clamp 1 tilts, the root of the first part Ta of the defect T is pressed into the upper side B1. The first part Ta of the defect T applies a load to the lower side B2 relative to the fixed arm 2 in order to return to its original position. However, the central portion 2d of the rod-shaped portion 2b of the fixed arm 2 can flex and deform. By deforming the central portion 2d of the rod-shaped portion 2b, the fixed arm 2 can release the load applied to the lower side B2 by the first part Ta of the defect T.

[0135] (Clamping steps)

[0136] like Figure 12As shown, if the surgeon can confirm that the second part Tb of the defect T is located between the second movable arm 32 and the fixed arm 2, the second traction member 52 is moved towards the base end side A2 by pulling the second sliding member 822 of the second operating part 82. Consequently, when the second sliding pin 521 connected to the second traction member 52 retracts, the second arm portion 322 of the second movable arm 32 rotates towards the upper side B1 of the fixed arm 2 in the opening / closing direction B. As a result, the second movable arm 32 is closed relative to the fixed arm 2, clamping the second part Tb of the defect T. At this time, the second part Tb of the defect T is clamped by the second movable arm 32 and the fixed arm 2, and enters the vicinity of the connection between the central part 2d of the rod-shaped portion 2b of the fixed arm 2 and the base end 2e of the rod. The first part Ta and the second part Tb of the defect T are pressed into the upper side B1 or the lower side B2 by the clamping force. However, the central part 2d of the rod-shaped portion 2b of the fixed arm 2 can bend and deform, thereby adjusting the force in the opening / closing direction B. Therefore, even without pulling the first slider 812 and the second slider 822 to adjust the clamping force of the first part Ta and the second part Tb of the defect T, the surgeon can still distribute the force applied to the tissue D and maintain the clamping force.

[0137] As the surgeon pulls the second slider 822 toward the base end A2, the second engaging portion 321 formed on the base end A2 of the second movable arm 32 also rotates in the opening / closing direction B around the second rotating pin 221. As a result, the second engaging portion 321 enters the groove 41 formed on the clamp holder 4 and is housed inside the clamp holder 4. Thus, the second part Tb of the defect T is clamped by the second movable arm 32 and the fixed arm 2. In this state, while the surgeon is pulling the second slider 822 toward the base end A2, the second part Tb of the defect T remains clamped by the second movable arm 32 and the fixed arm 2. However, the surgeon can also rotate the second movable arm 32 by operating the operating part 8 again, and can move the second movable arm 32 to an open state relative to the fixed arm 2, thus re-clamping the second part Tb of the defect T.

[0138] Subsequently, when the first slider 812 of the operating unit 8 further retracts towards the base end A2 in the length direction A, the clamp retainer 4 engages the first engaging portion 311 of the first movable arm 31 inside the clamp retainer 4, locking it in a manner where the first movable arm 31 remains closed. Furthermore, when the second slider 822 of the operating unit 8 further retracts towards the base end A2 in the length direction A, the clamp retainer 4 engages the second engaging portion 321 of the second movable arm 32 inside the clamp retainer 4, locking it in a manner where the second movable arm 32 remains closed.

[0139] (Detention Procedure)

[0140] Through the above processing, such as Figure 12 As shown, the first part Ta and the second part Tb of the defect T, which are to be treated, are held by the treatment unit 1. In this state, the surgical operator moves the first traction member 51 and the second traction member 52 toward the base end side A2 by pulling the first slider 812 of the first operation unit 81 and the second slider 822 of the second operation unit 82 further toward the base end side A2.

[0141] In this embodiment, the first traction component 51 and the second traction component 52 are detachably engaged with the first sliding pin 511 and the second sliding pin 521, respectively. For example, by pulling the first traction component 51 towards the base side A2, the incision portion 512 of the first traction component 51 deforms or breaks, and the first sliding pin 511 is pulled out from the first sliding pin hole 510, thus releasing the engagement. Similarly, by pulling the second traction component 52 towards the base side A2, the incision portion 522 of the second traction component 52 deforms or breaks, and the second sliding pin 521 is pulled out from the second sliding pin hole 520, thus releasing the engagement. Furthermore, the specific structure of the engagement between the first traction component 51 and the second traction component 52 and the first sliding pin 511 and the second sliding pin 521 is not limited to this embodiment.

[0142] When the surgeon applies a force exceeding a predetermined value to move the first traction component 51 and the second traction component 52 toward the base end A2, as described above, the engagement between the first traction component 51 and the second traction component 52 and the first sliding pin 511 and the second sliding pin 521 is released. Consequently, with the first movable arm 31 and the fixed arm 2 clamping the first portion Ta of the defect T and the second movable arm 32 and the fixed arm 2 clamping the second portion Tb of the defect T, the disposal section 1 of the clamping device 100 is retained within the lumen.

[0143] The surgeon then operates the operating part 8 of the clamping device 100 to remove the sheath 7 from the patient's body, thus ending the treatment of the patient.

[0144] In this embodiment, the treatment section 1 of the clamping device 100 can block the defect T of the tissue D that is the object of treatment by means of the above structure.

[0145] Furthermore, in this embodiment, since the central portion 2d of the rod-shaped portion 2b of the fixed arm 2 can bend and deform, the load applied to the fixed arm 2 and the movable arm 3 can be reduced. Therefore, even if the treatment unit 1 clamps the tissue too forcefully with the fixed arm 2 and the movable arm 3, it can clamp the tissue without damaging or tearing it.

[0146] Furthermore, in this embodiment, the flexed central portion 2d of the rod has an elasticity sufficient to prevent tissue breakage or tearing due to a force repelling it in the direction opposite to the applied load, thus enabling a firm clamping action. Therefore, when the tissue is pulled closer, the central portion 2d flexes and deforms appropriately, allowing the tissue to be clamped without slipping.

[0147] Furthermore, in this embodiment, for example, as described above, when the surgeon tilts the clamp 1, the first portion Ta of the defect T pressed into the upper B1 applies a load to the lower B2 relative to the fixed arm 2 in order to return to its original position. At this time, since the central portion 2d of the rod of the fixed arm 2 can also flex and deform, the fixed arm 2 can release the load applied to the lower B2 by the first portion Ta of the defect T by flexing and deforming the central portion 2d of the rod-shaped portion 2b. Therefore, the surgeon can treat the defect T during the operation without fine-tuning the clamping force of the movable arm 3 of the clamp 1 of the clamp device 100.

[0148] Furthermore, the arm deformation step of this embodiment can also play a role in the clamping step. For example, when the defect T of tissue D held by the first movable arm 31 or the second movable arm 32 and the fixed arm 2 is subjected to a load on the clamp 1 in order to restore its original shape, the fixed arm 2 can release the load applied to the clamp 1 by flexing the central portion 2d of the rod-shaped portion 2b. Therefore, the clamp 1 can properly clamp the tissue without damaging or tearing it.

[0149] The first embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the scope of the present invention are also included. In addition, the constituent elements shown in the above embodiment and the following variations can be appropriately combined to form the invention.

[0150] Next, refer to Figures 13 to 17 The second embodiment of the present invention will be described. In the following description, structures identical to those already described will be labeled with the same reference numerals and repeated descriptions will be omitted. Furthermore, the following embodiments differ from the first embodiment in that the fixed arm and the movable arm are different. Therefore, the following description will focus on the differences from the first embodiment. Figure 13 This is a diagram showing the closed state of the handling section (clamp) 1A of the clamping device 100A according to the second embodiment of the present invention. Figure 14 This is a schematic diagram showing the state in which the first movable arm 31A of the treatment section 1A of the clamping device 100A is opened, bringing the treatment section 1A close to the tissue being clamped. Figure 15This is a diagram that schematically shows the state in which the tissue is clamped by the first movable arm 31A of the handling section 1A of the clamping device 100A. Figure 16 This diagram schematically shows the state in which the first movable arm 31A of the treatment section 1A of the clamping device 100A clamps tissue while the second movable arm 32A is opened, bringing the treatment section 1A close to the clamped tissue. Figure 17 This is a schematic diagram showing the second movable arm 32A of the treatment section 1A of the clamping device 100A, in a state where the treatment section 1A is held by the tissue and the treatment section 1A is left in place by the clamping device 100A.

[0151] The clamping device 100A of the second embodiment of the present invention includes a processing unit (clamp) 1A and a feeder 200. Here, since the feeder 200 is the same as that in the first embodiment, the description and illustrations are omitted.

[0152] like Figure 13 As shown, the processing unit 1A includes a fixed arm 2A, a movable arm 3A, and a clamp holder 4. The clamp holder 4 is the same as in the first embodiment, so its description is omitted.

[0153] like Figure 13 As shown, the fixed arm 2A has a rod portion 20A and a connecting portion 20B. Furthermore, the rod portion 20A has a front end portion 2a and a rod-shaped portion 2Ab. The connecting portion 20B and the front end portion 2a are the same as in the first embodiment, therefore their description is omitted.

[0154] Compared to the first embodiment, the rod-shaped portion 2Ab is identical in structure to the rod-shaped portion 2b except that it lacks the rod tip 2c, the rod center portion 2d, and the rod base end 2e. The rod-shaped portion 2Ab is integrally formed, for example, using the same metal material (second material) as the rod tip 2c and rod base end 2e of the first embodiment.

[0155] like Figure 13 As shown, the movable arm 3A has a first movable arm 31A that opens and closes at the upper side B1 in the opening and closing direction B, and a second movable arm 32A that opens and closes at the lower side B2 in the opening and closing direction B, relative to the fixed arm 2. The first movable arm 31A and the second movable arm 32A can perform opening and closing actions independently.

[0156] The first movable arm 31A has a first sliding groove 310, a first engaging portion 311, a first through hole 313, and a first arm portion 312A. The first sliding groove 310, the first engaging portion 311, and the first through hole 313 are the same as in the first embodiment, so their description is omitted.

[0157] like Figure 13As shown, the first arm portion 312A is formed, for example, from resin or metal, into a generally cup-shaped form by slightly bending a plate-like component. Similar to the first embodiment, the thickness direction of the first arm portion 312A is approximately aligned with the opening / closing direction B. The first arm portion 312A can clamp biological tissue by rotating relative to the fixed arm 2 along the opening / closing direction B. The first arm portion 312A has a first arm front end portion 31c, a first arm central portion 31d, a first arm base end portion 31e, a first clamping surface 312a, and a first outer surface 312b. The first clamping surface 312a and the first outer surface 312b are the same as in the first embodiment, and therefore their description is omitted.

[0158] like Figure 13 As shown, the front end portion (second region) 31c of the first arm is part of the first arm portion 312A and is disposed on the front end side A1 of the first arm portion 312A. The front end portion 31c of the first arm is formed of a metal material (second material) with a higher elastic modulus than the central portion 31d of the first arm. As the metal material of the front end portion 31c of the first arm, the metal material (second material) described in the first embodiment is preferably used, for example.

[0159] like Figure 13 As shown, the central portion (first region) 31d of the first arm is part of the first arm portion 312A and is located at the center of the first arm portion 312A. The central portion 31d of the first arm is located at a position closer to the base end A2 than the front end portion 31c of the first arm. The elastic modulus of the central portion 31d of the first arm is lower than that of the front end portion 31c of the first arm, allowing it to flex and deform. For example, when the held tissue applies a load to the movable arm 3A, the central portion 31d of the first arm flexes in the direction of the applied load. Then, the flexed central portion 31d of the first arm can have the elasticity to firmly hold the tissue without damaging or tearing it due to a force that repels it in the direction opposite to the direction of the applied load. The central portion 31d of the first arm can also be a leaf spring or the like. The central portion 31d of the first arm is preferably made of a metal material (first material) with flexible elasticity as described in the first embodiment.

[0160] like Figure 13 As shown, the first arm base end portion (second region) 31e is part of the first arm portion 312A and is disposed on the base end side A2 of the first arm portion 312A. The first arm base end portion 31e is located closer to the base end side A2 than the first arm front end portion 31c and the first arm central portion 31d. The elastic modulus of the first arm base end portion 31e is approximately the same as that of the first arm front end portion 31c and is higher than that of the first arm central portion 31d. The first arm base end portion 31e is preferably made of the same metal material (second material) as the first arm front end portion 31c.

[0161] The base end of the base end side A2 of the first arm's front end portion 31c is connected and joined to the front end of the front end side A1 of the first arm's central portion 31d. The base end of the base end side A2 of the first arm's central portion 31d is connected and joined to the front end of the front end side A1 of the first arm's base end portion 31e. In this embodiment, the first arm portion 312A is formed by metal bonding, integrating the connecting portions of the first arm's front end portion 31c, the first arm's central portion 31d, and the first arm's base end portion 31e. Furthermore, the connecting portions of the first arm's front end portion 31c, the first arm's central portion 31d, and the first arm's base end portion 31e are firmly joined together by overlapping and metal bonding in the thickness direction C or the opening / closing direction R. Therefore, peeling at the connecting portions is almost nonexistent. There is no particular limitation on the order of overlap in the connecting portions. In addition, the end faces of the connecting sides of the connecting portions of the first arm's front end portion 31c, the first arm's central portion 31d, and the first arm's base end portion 31e are preferably formed as bevels. This structure allows for the proper dispersion of stress acting on the connecting portion, preventing stress concentration in specific areas. Therefore, even if the first arm portion 312A is formed using different metal materials for the anterior end 31c, the central portion 31d, and the basal end 31e, the surgical operator can use the clamping device 100A without worrying about the dissection of the connecting portion.

[0162] Here, there are no particular limitations on the materials used for the front end portion 31c, the central portion 31d, and the base end portion 31e of the first arm. The front end portion 31c, the central portion 31d, and the base end portion 31e of the first arm can be made of metal, or they can be made of materials other than metal, such as resin. As a resin material, resins with moderate elasticity, high rigidity, thermoplasticity, or suitability for sterilization, such as polyphthalamide (PPA), polyamide (PA), polyetheretherketone (PEEK), LCP (liquid crystal polymer), acrylonitrile butadiene styrene (ABS), and polyphenylene sulfide (PPS), are preferred. Furthermore, the connecting portions of the front end portion 31c, the central portion 31d, and the base end portion 31e of the first arm are not limited to metal bonding. For example, if the connecting portions of the front end portion 31c, the central portion 31d, and the base end portion 31e are made of the same type of material as metals, they can be integrally formed by spot welding, laser welding, resistance welding, brazing, riveting, etc. When the connecting parts of the front end 31c of the first arm, the central part 31d of the first arm, and the base end 31e of the first arm are made of different types of materials such as metal and resin, they can also be integrally formed by fusion or insert molding using heat, ultrasound, laser, and high frequency.

[0163] The second movable arm 32A has a second sliding groove 320, a second engaging portion 321, a second through hole 323, and a second arm portion 322A. The second sliding groove 320, the second engaging portion 321, and the second through hole 323 are the same as in the first embodiment, so their description is omitted.

[0164] like Figure 13 As shown, the second arm portion 322A is formed, for example, from resin or metal, into a generally cup-shaped form by slightly bending the plate-like component. Similar to the first embodiment, the thickness direction of the second arm portion 322A is approximately aligned with the opening / closing direction B. The second arm portion 322A can clamp biological tissue by rotating relative to the fixed arm 2 along the opening / closing direction B. The second arm portion 322A has a second arm front end portion 32c, a second arm central portion 32d, a second arm base end portion 32e, a second clamping surface 322a, and a second outer surface 322b. The first clamping surface 312a and the second outer surface 322b are the same as in the first embodiment, and therefore their description is omitted.

[0165] like Figure 13 As shown, the front end portion (second region) 32c of the second arm is part of the second arm portion 322A and is disposed on the front end side A1 of the second arm portion 322A. The front end portion 32c of the second arm, like the front end portion 31c of the first arm, is formed using a metal material (second material) with a high elastic modulus.

[0166] like Figure 13 As shown, the central portion (first region) 32d of the second arm is part of the second arm portion 322A and is located at a position closer to the base end A2 than the front end portion 32c of the second arm. The elastic modulus of the central portion 32d of the second arm is lower than that of the front end portion 32c of the second arm, allowing it to flex. For example, when the clamped tissue applies a load to the movable arm 3A, the central portion 32d of the second arm flexes in the direction of the applied load. Then, the flexed central portion 32d of the second arm has the elasticity to firmly clamp the tissue without damaging or tearing it due to a force that repels it in the direction opposite to the direction of the applied load. The central portion 32d of the second arm can also be a leaf spring or the like. Like the central portion 31d of the first arm, the central portion 32d of the second arm is preferably made of a metal material (first material) with flexible elasticity.

[0167] like Figure 13 As shown, the base end portion (second region) 32e of the second arm is part of the second arm portion 322A, and is located closer to the base end side A2 than the front end portion 32c and the central portion 32d of the second arm. The elastic modulus of the base end portion 32e of the second arm is approximately the same as that of the front end portion 32c of the second arm. In addition, the base end portion 32e of the second arm is preferably made of the same metal material (second material) as the front end portion 32c of the second arm.

[0168] The base end of the front end portion 32c of the second arm is connected to the front end of the central portion 32d of the second arm via a base end side A2. The base end of the central portion 32d of the second arm is connected to the front end of the base end portion 32e of the second arm via a base end side A1. In this embodiment, the second arm portion 322A is formed by integrally connecting the connecting portions of the front end portion 32c, the central portion 32d, and the base end portion 32e of the second arm via a metal bonding process. Since the connecting portions and materials of the second arm portion 322A have the same structure as the first arm portion 312A described above, their descriptions are omitted.

[0169] [Operation and function of clamping device 1 00A]

[0170] In this embodiment, Figures 14 to 17 The actions and use of the first implementation method Figures 9 to 12 The actions of the clamping devices described are the same, so the description of the actions is omitted. Please refer to [link / reference]. Figures 14 to 17 The function of the clamping device 100A in this embodiment will be explained.

[0171] exist Figure 14 In the same manner as in the first embodiment, the surgical operator opens and closes the first movable arm 31A, which is close to the first portion Ta of the defect T to be treated, and moves the first movable arm 31A and the fixed arm 2A, which are in the open state, toward the first portion Ta of the defect T. Then, the surgical operator positions the first portion Ta between the first movable arm 31A and the fixed arm 2A.

[0172] exist Figure 15 In this procedure, the surgeon pulls the first slider 812 of the first operating part 81, causing the first movable arm 31A to rotate downwards towards the B2 in the opening / closing direction B, clamping the first portion Ta of the defect T. At this time, for example, if the surgeon pulls the first slider 812 excessively, the first movable arm 31A clamps the first portion Ta too forcefully. The clamped first portion Ta applies a load to the first movable arm 31A and the fixed arm 2A in order to return to its original position. However, the central portion 31d of the first arm of the first movable arm 31A can flex and deform. Therefore, by flexing and deforming the central portion 31d of the first arm upwards towards the B1, the first movable arm 31A can release the load applied to the upper B1 by the first portion Ta of the defect T.

[0173] exist Figure 16 During the procedure, the operator moves the entire treatment unit 1A to the vicinity of the second part Tb of the defect T, while maintaining the first part Ta of the defect T clamped by the first movable arm 31 and the fixed arm 2. At this time, the first part Ta applies a load to the first movable arm 31A and the fixed arm 2A in order to return from the moved position to its original position. However, in... Figure 15The central portion 31d of the first arm of the first flexible arm 31A has the elasticity to firmly clamp the tissue without damaging or tearing it due to a force that repels it in the direction opposite to the applied load. Therefore, when the tissue is pulled closer, the central portion 31d of the first arm flexes and deforms appropriately, clamping the tissue without slipping. The surgeon opens and closes the second flexible arm 32A, which is close to the second portion Tb of the defect T, and moves the second flexible arm 32A and the fixed arm 2A, which are in the open state, toward the second portion Tb of the defect T. Then, the surgeon positions the second portion Tb between the second flexible arm 32A and the fixed arm 2A.

[0174] exist Figure 17 In this process, the surgeon pulls the second slider 822 of the second operating part 82, causing the second movable arm 32A to rotate downwards towards the B2 in the opening / closing direction B, clamping the second portion Tb of the defect T. At this time, for example, if the surgeon pulls the second slider 822 excessively, the second movable arm 32A will clamp the second portion Tb too forcefully. The clamped second portion Tb applies a load to the second movable arm 32A and the fixed arm 2A in order to return to its original position. However, the central portion 32d of the second arm of the second movable arm 32A can flex and deform. Therefore, by flexing and deforming the central portion 32d downwards towards the B2, the second movable arm 32A can release the load applied to the lower side B2 by the second portion Tb of the defect T.

[0175] In this embodiment, similar to the first embodiment described above, since the central portion 31d of the first arm of the first movable arm 31A and the central portion 32d of the second arm of the second movable arm 32A can flex and deform, the load applied to the first movable arm 31A and the second movable arm 32A can be reduced after deformation occurs when the defect T of the tissue is clamped. Therefore, the processing unit 1A can adjust the clamping force applied to the tissue held by the fixed arm 2A and the movable arm 3A, making it difficult for the tissue to slip off and eliminating the risk of damage or tearing of the tissue.

[0176] The second embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the scope of the present invention are also included. In addition, the constituent elements shown in the above embodiment and the following variations can be appropriately combined to form the invention.

[0177] (Modified Example)

[0178] The clamping device 100 of the first embodiment described above has a rod-shaped central portion 2d in the center of the rod-shaped portion 2b of the fixing arm 2, which is capable of bending and deformation, but this is not particularly limited. For example, such as Figure 18As shown, the rod-shaped portion 2b of the fixed arm 2, with its front end (first region) 2Bc, can also be flexed. In this case, the rod-shaped portion 2Bc is preferably made of a flexible metal material (first material). According to this structure, the clamp 1 has a flexibly deformable region on the front end side A1 of the fixed arm 2. Therefore, when the clamp 1 clamps tissue, the rod-shaped portion 2Bc on the front end side A1 of the fixed arm 2 flexes, reducing the load applied to the movable arm 3 and the fixed arm 2 by the tissue, while the base end side A2 does not flex, thus firmly holding the tissue. Furthermore, as... Figure 19 As shown, the rod-shaped portion 2b of the fixing arm 2 can also be flexed and deformed at its base end (first region) 2Be. According to this structure, the clamp 1 has a region capable of flexure and deformation on the base end side A2 of the fixing arm 2. Therefore, when the clamp 1 clamps tissue, since the rod-shaped portion 2Be of the base end side A2 of the fixing arm 2 flexes and deforms, even if the more brittle tip touches the rod-shaped portion 2Be towards the base end side A2 of the tissue, the risk of tissue damage can be reduced. Furthermore, although the clamp device 100A of the second embodiment described above has a first arm central portion 31d capable of flexure and deformation at the center of the first arm portion 312A and a second arm central portion 32d capable of flexure and deformation at the center of the second arm portion 322A, it is not particularly limited. Similar to the first embodiment, the first arm front end 31c, the first arm base end 31e, the second arm front end 32c, or the second arm base end 32e can also be flexed and deformed.

[0179] Furthermore, in the second embodiment, the central portion (first region) 31d of the first arm of the first movable arm 31A and the central portion (first region) 32d of the second arm of the second movable arm 32A can also be formed from thinner wall portions, for example. Figure 20 As shown, the first arm front end portion 31Cc and the first arm base end portion 31Ce of the first arm portion 312C, or the second arm front end portion 32Cc and the second arm base end portion 32Ce of the second arm portion 322C, are designated as the second region. Figure 20As shown, the second region has a second thickness in the plate thickness direction of the first arm portion 312C and the second arm portion 322C, i.e., in the opening / closing direction B. Here, since the first movable arm 31C and the second movable arm 32C have substantially the same structure, the illustration of the second movable arm 32C is omitted. The central portion 31Cd of the first arm of the first movable arm 31C and the central portion 32Cd of the second arm of the second movable arm 32CC are designated as the first region. The first region is formed by a thin-walled portion (first thickness) that is thinner in the opening / closing direction B than the second thickness of the second region. Therefore, even if the first movable arm 31C as a whole or the second movable arm 32C as a whole is formed of the same material, only the first region is formed as a thin-walled portion, making it more prone to flexural deformation than the second region. Thus, the same effect as the above-described embodiment can be obtained. Furthermore, since the first movable arm 31C as a whole or the second movable arm 32C as a whole can be formed of the same material, the number of parts related to the manufacture of the clamping device can be reduced. Furthermore, since the first movable arm 31C or the second movable arm 32C does not have a connecting portion, the surgical operator can use the clamping device without worrying about the disintegration of the connecting portion. Moreover, the above-described modifications are not limited to movable arms. The first region (e.g., the central portion 2d of the rod) of the fixed arm 2 in the first embodiment can also be formed from a thin-walled portion (first thickness) that is thinner than the second thickness of the second region (e.g., the front end portion 2c of the rod or the base end portion 2e of the rod). In this case, the clamping device can also achieve the same effect as the above-described embodiment.

[0180] Furthermore, the first movable arm 31A and the second movable arm 32A in the second embodiment may, for example, have a region that can be bent and a region that does not bend, thereby having a first region that can flex and a second region that does not flex. Figure 21As shown, the first arm portion 312D of the first movable arm 31D includes a first arm front end portion (second region) 31Dc, a first arm central portion (first region) 31Dd, and a first arm base end portion (second region) 31De. The first arm front end portion 31Dc and the first arm base end portion 31De have a bent portion (rigidity reinforcement portion) 31f, which is formed by bending one end in the thickness direction C from the contact surface in contact with the tissue using the first movable arm 31D and the fixed arm 2A. Here, the contact surface in this embodiment is the first clamping surface 312a described in the first embodiment. The front end of the bent portion 31f protrudes towards the lower side B2 in the opening / closing direction B away from the first clamping surface 312a. Therefore, the bent portion 31f strengthens rigidity in the opening / closing direction B. On the other hand, the first arm central portion 31Dd does not have a bent portion 31f. For example, if the first movable arm 31D is formed of a material that can be flexibly deformed (first material), the first arm central portion 31Dd will undoubtedly also flex and deform. However, the bending portion 31Dc and the base portion 31De of the first arm suppress flexural deformation through the bending portion 31f. Therefore, no flexural deformation occurs compared to the central portion 31Dd of the first arm. Thus, the clamping device can achieve the same effect as the above embodiment. In addition, in the above modified example, it can also be formed on the second movable arm. Furthermore, the contact surface is not limited to the first clamping surface 312a. Moreover, the direction in which the front end of the bending portion faces is not particularly limited, and it may not face the opening and closing direction. Furthermore, the second region can be a structure that does not flexurally deform compared to the first region by having a bending portion (rigid reinforcement). In addition, in the first embodiment, by having a region that is partially bent and a region that is not bent, it is possible to have a first region that flexurally deforms and a second region that does not flexurally deform. For example, the second region (e.g., the front portion 2c and the base portion 2e of the rod) may also have a bending portion (rigid reinforcement) formed by bending one end in the thickness direction C from the contact surface that contacts the tissue. In this case, the first region (e.g., the central portion 2d of the rod) does not have a bending portion (rigid reinforcement).

[0181] Furthermore, the flexible and deformable first region of the present invention can be disposed on all of the first movable arm, the second movable arm, and the fixed arm, or at least on any one of them. Additionally, the first region can be the entire region of the movable arm or the fixed arm, or it can be a part of the movable arm or the fixed arm as described in the above embodiments.

[0182] In any of the above embodiments, the clamp and clamping device according to the present invention can prevent tissue from slipping off the arm and can reliably clamp the tissue.

[0183] Explanation of reference numerals in the attached figures

[0184] 100, 100A, 100B clamping devices

[0185] 200 feeders

[0186] 1.1A Processing Section (Clamping Fixture)

[0187] 2.2A Fixed Arm

[0188] 20A pole section

[0189] 20B Connector

[0190] 2a Front end

[0191] 2b, 2Ab rod-shaped part

[0192] The front end of rod 2c (second region)

[0193] The front end of rod 2Bc (first region)

[0194] Central part of the 2D rod (first region)

[0195] 2e Rod base end (second region)

[0196] 2Be rod base end (first region)

[0197] 25 First Opposite Side

[0198] 26 Second Opposite Side

[0199] 27. Protrusion

[0200] 3. 3A, 3C, 3D movable arms

[0201] 31, 31A, 31B First movable arm

[0202] 312, 312A, 312B First Arm

[0203] The anterior end of the first arm (second region) of 31c, 31Cc, and 31Dc

[0204] Central part (first region) of the first arm of 31d, 31Cd, and 31Dd

[0205] 31e, 31Ce, 31De First arm base end (second region)

[0206] 31f Bending section (rigid reinforcement section)

[0207] 32, 32A, 32B Second Movable Arm

[0208] 322, 322A, 322B Second Arm

[0209] The anterior end (second region) of the second arm of 32c, 32Cc, and 32Dc

[0210] Central part of the second arm (first region) of 32d, 32Cd, and 32Dd

[0211] 32e, 32Ce, 32De Second arm base end (second region)

[0212] 4. Fixture retainer

[0213] 5 Traction components

[0214] 6. Operation lines (lines)

[0215] 7. Sheath

[0216] 8. Operations Department

[0217] 81 First Operations Department

[0218] 82 Second Operations Section

[0219] A. Length direction

[0220] A1 front end

[0221] A2 basement side

[0222] B. Opening / closing direction (up / down direction)

[0223] B1 upper side

[0224] B2 lower side

[0225] C represents the thickness direction (left-right direction).

[0226] Organization D

[0227] T-defect.

Claims

1. A clamp, comprising: Fixed arm; and Two movable arms are located on either side of the fixed arm and open and close independently of the fixed arm. In the opening and closing direction, at least one of the two movable arms or the fixed arm has a first region capable of flexing and deformation and a second region that is less prone to flexing compared to the first region. The second region has a rigid reinforcing portion formed by bending one end of the second region in the opening / closing direction.

2. The clamp according to claim 1, wherein the first region is formed on a portion of at least one of the two movable arms or the fixed arm.

3. The clamp according to claim 1, wherein the first region is disposed on the front end side or the base end side in the length direction of the fixed arm.

4. The clamp according to claim 1, wherein the first region is disposed at the center of the two movable arms in the length direction.

5. The clamp according to any one of claims 1 to 4, wherein the first region is a thin-walled portion that is thinner than the second region in the opening and closing direction.

6. The clamp according to any one of claims 1 to 4, wherein the rigid reinforcement is bent in a direction away from the contact surface and reinforces the rigidity, the contact surface being the surface that contacts the tissue held by the fixed arm and the two movable arms.

7. The clamp according to any one of claims 1 to 4, wherein the first region has a first thickness in the opening and closing direction, and the second region has a second thickness in the opening and closing direction that is thicker than the first thickness.

8. The clamp according to any one of claims 1 to 4, wherein the first region is formed of a first material capable of elastic deformation, and the second region is formed of a second material different from the first region.

9. The clamp according to claim 8, wherein the first material is resin and the second material is metal.

10. The clamp according to claim 8, wherein the first material is a metal and the second material is a metal that is more elastic than the first material.

11. The fixture according to claim 9 or 10, wherein the first material and the second material are joined together by fusion or insert molding.

12. A clamping device, comprising: A clamp having a fixed arm and two movable arms located on both sides of the fixed arm and opening and closing independently relative to the fixed arm; as well as A feeder having a connecting part, a wire, a sheath, and an operating part connected to the clamp. In the opening and closing direction, the clamp has a first region capable of flexing and deformation and a second region that is less prone to flexing compared to the first region on at least one of the two movable arms or the fixed arm. The second region has a rigid reinforcing portion formed by bending one end of the second region in the opening / closing direction.

13. The clamping device according to claim 12, wherein the first region is formed on a portion of at least one of the two movable arms or the fixed arm.

14. The clamping device according to claim 12, wherein the first region is disposed on the front end side or the base end side in the length direction of the fixed arm.

15. The clamping device according to claim 12, wherein the first region is disposed at the center of the two movable arms along the length direction.

16. The clamping device according to any one of claims 12 to 15, wherein the first region is a thin-walled portion that is thinner than the second region in the opening and closing direction.

17. The clamping device according to any one of claims 12 to 15, wherein the rigid reinforcement is bent in a direction away from the contact surface and reinforces the rigidity, the contact surface being the surface that contacts the tissue held by the fixed arm and the two movable arms.

18. The clamping device according to any one of claims 12 to 15, wherein the first region has a first thickness in the opening and closing direction, and the second region has a second thickness in the opening and closing direction that is thicker than the first thickness.

19. The clamping device according to any one of claims 12 to 15, wherein the first region is formed of a first material capable of elastic deformation, and the second region is formed of a second material different from the first region.

20. The clamping device according to claim 19, wherein the first material is resin and the second material is metal.

21. The clamping device according to claim 19, wherein the first material is a metal and the second material is a metal that is more elastic than the first material.

22. The clamping device according to claim 20 or 21, wherein the first material and the second material are joined together by fusion or insert molding.

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