Clamp device

Abstract

The jig device is provided with: a jig unit having an arm that opens and closes in the front direction; a wire member connected to the clamp unit; and a sheath through which the wire member penetrates, the sheath extending in the longitudinal axis direction, the clip unit being detachably connected to a front end portion of the sheath, and the clip unit being detachably connected to the front end portion of the sheath. The jig unit is transitionable between a first configuration in which the front surface direction of the arm is oriented in the same direction as the longitudinal axis direction and a second configuration in which the front surface direction of the arm is oriented in a direction intersecting the longitudinal axis direction.

Description

Technical Field

[0001] This invention relates to clamping devices. This application claims priority based on U.S. Provisional Application No. 63 / 583,011, filed in the United States on September 15, 2023, the contents of which are incorporated herein by reference. Background Technology

[0002] In endoscopic treatment, medical instruments such as clamps are used to manipulate biological tissues. These instruments are introduced to the treatment site via a feeder (insertion device) that passes through a channel in the endoscope.

[0003] Patent Document 1 describes a clamping device for treating biological tissue. In the clamping device described in Patent Document 1, the control line of the control clamp has a curved portion. By bending the curved portion of the control line, the clamp connected to the control line moves significantly and comes into contact with the tissue.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: U.S. Patent Application Publication No. 2021 / 030425 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] However, since medical devices such as clamps are used in narrow lumens, it is expected that they not only come into contact with the tissue, but also properly grip the tissue in the confined space.

[0009] In view of the above, the object of the present invention is to provide a clamping device that can properly grasp tissues in narrow spaces such as lumens.

[0010] Solution for solving the problem

[0011] The clamping device of the first technical solution of the present invention comprises: a clamping unit having an arm that opens and closes in a frontal direction; a wire member connected to the clamping unit; and a sheath through which the wire member passes, the sheath extending along a length axis direction, the clamping unit being detachably connected to the front end of the sheath, and the clamping unit being able to change between a first configuration in which the frontal direction of the arm is oriented in the same direction as the length axis direction and a second configuration in which the frontal direction of the arm is oriented in a direction intersecting the length axis direction.

[0012] The effects of the invention

[0013] The clamping device of the present invention can properly grip tissues in narrow spaces such as lumens. Attached Figure Description

[0014] Figure 1 This is a diagram showing the clamping device of the first embodiment.

[0015] Figure 2 This is a perspective view of the clamping unit of the feeder loaded into the aforementioned clamping device.

[0016] Figure 3 This is a perspective view of the clamp unit loaded into the aforementioned feeder.

[0017] Figure 4 This is a cross-sectional view of the front end of the aforementioned clamping device.

[0018] Figure 5 This is a diagram representing a clamp that is locked in a closed position.

[0019] Figure 6 This is a diagram showing the shape transformation of the aforementioned fixture unit.

[0020] Figure 7 This is a diagram showing the aforementioned clamp unit that approaches and treats tissue via a tangential approach.

[0021] Figure 8 This is a diagram showing the aforementioned clamping unit after a pair of arms have swung.

[0022] Figure 9 This is a diagram illustrating the locking steps of the aforementioned clamping unit.

[0023] Figure 10 This is a diagram illustrating the separation steps of the aforementioned fixture unit.

[0024] Figure 11 This is a diagram showing a modified example of the connector of the aforementioned clamping device.

[0025] Figure 12 This is a diagram showing other variations of the above-mentioned connector.

[0026] Figure 13 This is a diagram showing other variations of the above-mentioned connector.

[0027] Figure 14 This is a diagram showing other variations of the above-mentioned connector.

[0028] Figure 15 This is a diagram showing the clamping device according to the second embodiment.

[0029] Figure 16 This is a cross-sectional view of the front end of the aforementioned clamping device.

[0030] Figure 17 This is a diagram showing the change in shape of the clamping unit of the aforementioned clamping device.

[0031] Figure 18 This is a diagram showing the aforementioned clamp unit that approaches and treats tissue via a tangential approach.

[0032] Figure 19 This is a diagram showing the aforementioned clamping unit after a pair of arms have swung.

[0033] Figure 20 This is a diagram illustrating the locking steps of the aforementioned clamping unit.

[0034] Figure 21 This is a diagram illustrating the separation steps of the aforementioned fixture unit.

[0035] Figure 22 This is a diagram showing a modified example of the pressure tube of the aforementioned clamping unit.

[0036] Figure 23 This is a diagram illustrating the aforementioned modified example of the pressure tube.

[0037] Figure 24 This diagram illustrates the technique of using an outer protective sleeve.

[0038] Figure 25 This diagram illustrates the technique of using the aforementioned outer sheath.

[0039] Figure 26 This diagram illustrates the technique of using the aforementioned outer sheath.

[0040] Figure 27 This diagram illustrates the technique of using the aforementioned outer sheath.

[0041] Figure 28 This is a diagram showing the clamping device of the third embodiment.

[0042] Figure 29 This is a diagram showing the aforementioned fixture components.

[0043] Figure 30 This is a diagram illustrating another way of representing the flexible component of the aforementioned clamping device.

[0044] Figure 31 This is a diagram representing another method described above.

[0045] Figure 32 This is a diagram showing a deformation example of the bending member of the aforementioned clamping device.

[0046] Figure 33 The figure shows other variations of the aforementioned bending member.

[0047] Figure 34 The figure shows other variations of the aforementioned bending member.

[0048] Figure 35The figure shows other variations of the aforementioned bending member. Detailed Implementation

[0049] (First Implementation)

[0050] Reference Figures 1 to 10 The first embodiment of the present invention will be described.

[0051] Figure 1 This is a diagram showing the clamping device 300 of this embodiment.

[0052] The clamping device (clamping system, endoscope treatment device) 300 includes a clamping unit 100, a connector (connecting structure) 150, and a feeder 200. The clamping unit 100 is loaded into the feeder 200, which is able to pass through the endoscope, and is guided to the treatment position.

[0053] Alternatively, the clamping device 300 can be refilled with clamping unit 100 in the feeder 200. In this case, the user can remove the used clamping unit 100 from the feeder 200 and refill the unused clamping unit 100 in the feeder 200.

[0054] In the following description, the clamping unit 100 side in the length direction A of the clamping device 300 is designated as the front end side (far side) A1 of the clamping device 300, and the operating part 240 side of the feeder 200 is designated as the base end side (proximal side) A2 of the clamping device 300.

[0055] [Supply Unit 200]

[0056] Figure 2 This is a perspective view of the clamp unit 100 loaded into the feeder 200.

[0057] The feeder (clamp unit introduction device) 200 includes a sheath 220, an operating line 230, and an operating section 240. The feeder 200, for example, extends through the instrument passage of an endoscope and is used in conjunction with the endoscope. Therefore, the sheath 220 is formed to be sufficiently longer than the length of the instrument passage of the endoscope. The sheath 220 is flexible and bends accordingly to the curvature of the insertion portion of the endoscope.

[0058] The sheath 220 has a front end head 221, a front side coil 222, and a hand-side coil 224, and is formed into a slender tubular shape. The front side coil 222 is disposed on the front end side of the sheath 220. Alternatively, the front side coil 222 and the hand-side coil 224 can be integrated.

[0059] Figure 3 This is a perspective view of the clamp unit 100 loaded into the feeder 200. Figure 3The connector 150 is omitted from the illustration. The front end head (front portion) 221 is cylindrical and positioned at the front end of the front coil 222. An engaging portion 225 is formed at the front end of the front end head 221. The engaging portion 225 is a protrusion that protrudes outward in a radial direction R perpendicular to the length direction A. The engaging portion 225 is provided along the entire circumference of the front end head 221 in the circumferential direction C.

[0060] The operating line (power transmission component) 230 passes through the sheath 220 and is mounted on the clamp unit 100 and the operating section 240. For example... Figure 3 As shown, the operating line 230 can protrude from the front end head (front end portion) 221 toward the front end side. The operating line 230 moves forward and backward in the front end head (front end portion) 221 along the length axis L of the sheath 220 to transmit power to the clamp 2 of the clamp unit 100.

[0061] The operating unit 240 includes an operating unit body 241, a slider 242, and a thumb ring 248. The operating unit body 241, slider 242, and thumb ring 248 are, for example, injection molded from resin material. The operating unit body 241 includes a slit portion 241a and a rotary handle 241b located at the front end. The slit portion 241a supports the slider 242 so that it can move forward and backward.

[0062] The slider 242 is mounted in a manner that allows it to move forward and backward along the longitudinal axis of the operating part body 241, and the base end of the operating line 230 is mounted on the slider 242. By moving the slider 242 along the operating part body 241, the operating line 230 moves forward and backward relative to the sheath 220.

[0063] The thumb ring 248 is mounted on the base of the operating part body 241 in such a way that it can rotate about the length axis of the operating part body 241.

[0064] [Clamping Unit 100]

[0065] Figure 4 This is a cross-sectional view of the front end of the clamping device 300.

[0066] The clamp unit 100 is loaded onto the front end (front end) 221 of the sleeve 220 of the feeder 200 via a connector (connecting structural member) 150. The clamp unit 100 includes a clamp 2, a pressure tube (tubular member) 3, and a bending member 4.

[0067] The clamp (clamping arm) 2 has a pair of arms 21 and a support portion 28 supporting the pair of arms 21. The support portion 28 is mounted on the front end of the bending member 4.

[0068] A pair of arms 21 can open and close in the forward direction F, and can change between an open state and a closed state. The pair of arms 21 can swing in the swing direction Q. The pair of arms 21 change the forward direction F by swinging (see reference). Figure 6 ).like Figure 2 and Figure 3 As shown, the position of a pair of arms 21 whose frontal direction F is approximately aligned with the length axis direction L of the sheath 220 is called the "initial position" of the pair of arms 21.

[0069] A pair of arms 21 has a first arm 211 and a second arm 212. For example... Figure 2 and Figure 3 As shown, when the first arm 211 and the second arm 212 are positioned on either side of the central axis O1 in the length direction A, in the "initial position" without swinging. Furthermore, the clamp 2 may also have three or more arms.

[0070] The first arm 211 and the second arm 212 have a claw 22, a gripping part 23, a sliding part 24 and an engaging part 25 extending from the front end side A1 toward the base end side A2.

[0071] The claw 22 is formed by bending the front ends of the first arm 211 and the second arm 212 inward. The gripping part 23 is formed in a flat plate shape and is the part that grips the tissue. The sliding part 24 is the part that elastically deforms when the pair of arms 21 are pulled into the pressure tube 3.

[0072] The engaging portion 25 is a part that can engage with the inner circumferential surface of the pressure tube 3. The engaging portion 25 is a protrusion that protrudes from the sliding portion 24. Specifically, the engaging portion 25 protrudes to both sides in a vertical direction perpendicular to the length direction A and the opening and closing direction P of the pair of arms 21.

[0073] Figure 5 This is a diagram showing clamp 2 locked in a closed state.

[0074] The engaging portion 25 and the inner circumferential surface of the pressure tube 3 constitute a locking mechanism that locks the clamp 2 into a closed state. When the pair of arms 21 are locked into a closed state using the locking mechanism, the pair of arms 21 cannot return to the open state. Furthermore, the locking mechanism is not limited to the combination of the engaging portion 25 of the clamp 2 and the inner circumferential surface of the pressure tube 3, and may be other structures.

[0075] The support portion 28 supports a pair of arms 21 (first arm 211 and second arm 212) so that they can be opened and closed freely in the opening and closing direction P. The pair of arms 21 supported by the support portion 28 are subjected to force in an open position. Therefore, the pair of arms 21 of the clamp 2 have a self-expanding force relative to the opening and closing direction P.

[0076] The support portion 28 has a separation portion 29 on the base end side A2, which is detachably connected to the front end member 41 of the bending member 4. For example, the separation portion 29 may be a fracture portion that breaks when a fracture force greater than a specified force caused by pulling is applied. Alternatively, the separation portion 29 may be a deformable portion formed in the shape of a hook or the like, which separates from the front end member 41 through plastic deformation.

[0077] The clamping tube (tubular member) 3 is a cylindrical member capable of accommodating at least a portion of the clamp 2. The clamping tube 3 has an internal space 38 for the clamp 2 to move in and out along the length direction A. The clamping tube 3 can fix the clamp 2, which is pulled into the internal space 38, into a closed state.

[0078] A locking portion 32 is formed at the base end of the pressure tube 3. The locking portion 32 is a protrusion that protrudes outward in a radial direction R perpendicular to the length direction A. The locking portion 32 is provided along the entire circumference of the pressure tube 3 in the circumferential direction C.

[0079] The bending member 4 supports the pair of arms 21 so that they can swing (rotate) around a rotation axis RO that is approximately perpendicular to the length direction A. In this embodiment, the swing direction (rotation direction) Q of the pair of arms 21 around the rotation axis RO is approximately the same as the opening and closing direction P of the pair of arms 21. That is, the plane through which the pair of arms 21 swings (the plane through which the swinging pair of arms 21 passes) is approximately the same as the plane through which the pair of arms 21 open and close (the plane through which the opening and closing pair of arms 21 passes).

[0080] When at least one of the first arm 211 and the second arm 212 comes into contact with biological tissue, or when a predetermined force is applied to at least one of the first arm 211 and the second arm 212, the bending member 4 causes the pair of arms 21 to swing. Otherwise, the support portion 28 does not cause the pair of arms 21 to swing.

[0081] The bending member 4 has a front end member 41, a base end member 42, and a hinge (rotating part) 43 that connects the front end member 41 and the base end member 42 to be rotatable. The base end member 42 is mounted to the operating line 230 in a non-separable manner.

[0082] The hinge (rotating part) 43 connects the front end member 41 and the base end member 42 in such a way that the base end member 42 rotates relative to the base end member 42 in the swing direction (rotation direction) Q.

[0083] [Connector (connecting component) 150]

[0084] The connector (connecting component) 150 connects the crimp tube 3 and the sheath 220 in a separable manner. The connector 150 connects the crimp tube 3 and the sheath 220 by forming a gap (interval) G in the longitudinal axial direction L between the crimp tube 3 and the sheath 220. The connector 150 is formed in a cylindrical shape and has a cylindrical part 151, a front end engaging part 152 and a base end engaging part 153.

[0085] The front engagement portion 152 is provided at the front end of the cylindrical portion 151 and is a protrusion that protrudes inward in a radial direction R perpendicular to the length direction A. The front engagement portion 152 is provided around the entire circumference of the cylindrical portion 151 along the circumferential direction C. By engaging the front engagement portion 152 with the engagement portion 32 of the pressure tube 3, the connector 150 is connected to the pressure tube 3.

[0086] The base-end engaging portion 153 is provided at the base end of the cylindrical portion 151 and is a protrusion that protrudes inward in a radial direction R perpendicular to the length direction A. The base-end engaging portion 153 is provided around the entire circumference of the cylindrical portion 151 along the circumferential direction C. The connector 150 is connected to the sheath 220 by engaging the base-end engaging portion 153 with the engaging portion 225 of the sheath 220.

[0087] At least one of the front end portion and the base end portion of the connector 150 is deformable (elastic deformation, plastic deformation). Through the deformation of the connector 150, the pressure tube 3 and the sheath 220 can be separated.

[0088] Figure 6 This is a diagram showing the change in shape of the fixture unit 100.

[0089] The clamp unit 100 is capable of Figure 2 and Figure 3 The straight line shape shown (first shape) and Figure 6 The transition between the swinging patterns shown (second pattern) is shown.

[0090] like Figure 2 and Figure 3 As shown, the straight line configuration (first configuration) is the configuration of a clamping unit 100 in which the frontal direction F of a pair of arms 21 faces the same direction as the length axis L of the sheath 220.

[0091] like Figure 6 As shown, the swinging form (second form) is the configuration of the clamp unit 100 with the front direction F of the pair of arms 21 facing the direction intersecting the longitudinal axis direction L of the sheath 220. When a predetermined force is applied to at least one of the first arm 211 and the second arm 212, the clamp unit 100 swings in the swinging direction Q and changes to the swinging form (second form). Specifically, the pair of arms 21 swing in the swinging direction Q, and the pressure tube 3 in contact with the pair of arms 21 moves relative to the sheath 220. When the clamp unit 100 is at least in a straight form (first form), a gap (interval) G in the longitudinal axis direction L is formed between the engaging portion 32 of the pressure tube 3 connected by the connector 150 and the engaging portion 225 of the sheath 220. Therefore, the pressure tube 3 can tilt relative to the direction intersecting the longitudinal axis direction L of the sheath 220. Furthermore, when the clamp unit 100 is in the second configuration, the engaging portion 32 of the pressure tube 3 and the engaging portion 225 of the sheath 220, which are connected by the connector 150, can also come into contact.

[0092] like Figure 4 As shown, the gaps G positioned across the operation line 230 are designated as the first gap G1 and the second gap G2. When the fixture unit 100 is in a straight line configuration (first configuration), the first distance D1 (distance between the first gaps G1) of the first gap G1 is approximately the same as the second distance D2 (distance between the second gaps G2). Figure 6 As shown, when the clamping unit 100 is in a swinging state (second state), the first distance D1 and the second distance D2 are different. Specifically, when the clamping unit 100 changes from a straight state (first state) to a swinging state (second state), one of the first distance D1 and the second distance D2 increases, and the other of the first distance D1 and the second distance D2 decreases.

[0093] The clamp unit 100 can also change from a swinging form (second form) to a straight form (first form).

[0094] [Action and function of clamping device 300]

[0095] Next, refer to Figures 7 to 10 The operation and function of the clamp device 300 are explained.

[0096] <Approach Steps>

[0097] The surgeon inserts the clamp unit 100, loaded in the feeder 200, into the body through the endoscope channel. The surgeon moves the endoscope and sheath 220 to bring the clamps 2 of the clamp unit 100 close to the tissue T, which is the treatment area.

[0098] Methods for bringing the clamp unit 100 close to the treatment area include at least frontal approach and tangential approach. In frontal approach, the surgeon manipulates the endoscope and sheath 220 to position the clamp unit 100 so that its longitudinal direction A is substantially perpendicular to the surface of the treatment area. In tangential approach, the surgeon manipulates the endoscope and sheath 220 to position the clamp unit 100 along its longitudinal direction A along the surface of the treatment area.

[0099] <Tangent Approach>

[0100] Figure 7 This diagram illustrates a clamp unit 100 used for tangential approach to treat tissue T. The surgeon approaches the clamp unit 100, which is in a straight line configuration, towards the tissue T, the treatment area, using tangential approach. The surgeon hooks the claw 22 of the first arm 211 onto the mucosa located on the endoscopic side (near the anterior side) of the first mucosa M1 and the second mucosa M2, which are situated on either side of the center of the tissue T. Figure 7The middle part is the first mucosa M1).

[0101] Figure 8 This diagram illustrates the clamp unit 100 after the pair of arms 21 have swung. The surgeon further approaches the clamp unit 100, whose claws 22 are hooked onto the first mucosa M1, closer to the tissue T, which is the treatment area. Specifically, the surgeon advances the feeder 200 relative to the endoscope's passage. Alternatively, the surgeon presses the clamp unit 100 further into the tissue T by advancing the endoscope. As a result, Figure 8 As shown, a pair of arms 21 swing about the rotation axis RO, and the clamping unit 100 is in a swinging configuration. When the second arm 212 contacts the second mucosa M2, the pair of arms 21 are configured with the frontal direction F facing the front of the tissue T, which is the treatment area. The first mucosa M1 and the second mucosa M2 are held by the pair of arms 21.

[0102] <Traction Steps>

[0103] The user retracts the operating line 230 by moving the slider 242 backward along the operating body 241. The curved member 4 connected to the operating line 230 pulls the clamp 2. By pulling the clamp 2 towards the base end side A2, a pair of arms 21 are pulled into the pressure tube 3, and the pair of arms 21, which engage with the front opening 3a, gradually close. If the traction force of the operating line 230 is released in this state, the clamp 2 returns to the open state while moving towards the front end side A1 due to the self-expanding force of the pair of arms 21. The user can return the pair of arms 21 to the open state and re-grip the tissue T (reopen).

[0104] <Locking Steps>

[0105] Figure 9 This is a diagram illustrating the locking steps of the clamp unit 100.

[0106] The surgeon retracts the operating line 230 by moving the slider 242 back along the operating part body 241. When the clamp 2 is pulled into the predetermined position of the pressure tube 3, the engaging part 25, which serves as a locking mechanism, engages with the inner circumferential surface of the pressure tube 3, locking the pair of arms 21 into a closed state. When the pair of arms 21 is locked into the closed state, the pair of arms 21 cannot return to the open state.

[0107] <Separation Steps>

[0108] Figure 10 This is a diagram illustrating the separation steps of the fixture unit 100.

[0109] The surgeon further pulls on clamp 2. A pulling force is applied to the separation portion 29 of clamp 2, causing it to break. As a result, clamp 2 separates from bending member 4. Then, the compression tube 3 separates from sheath 220 by deforming connector 150. The surgeon retracts sheath 220, leaving clamp 2 and compression tube 3 in place inside the body, with the first mucosa M1 and the second mucosa M2 ligated.

[0110] According to the clamping device 300 of this embodiment, tissue T can be properly gripped in a lumen. Even when treating tissue T by approaching it tangentially, the clamping unit 100 can be swung relative to the sheath 220 to position the pair of arms 21 facing the front of the tissue T, which is the treatment area. Because the clamping unit 100 swings relative to the sheath 220, it is easy to position the clamping unit 100 facing the front of the tissue T even in a narrow lumen.

[0111] 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 spirit of the present invention are also included. Furthermore, the constituent elements shown in the embodiments and variations can be appropriately combined to form a configuration.

[0112] (Variation Example 1-1)

[0113] Figure 11 This is a diagram showing connector 150A as a modified example of connector 150.

[0114] The connector 150A has a cylindrical portion 151, a front engagement portion 152A, and a base engagement portion 153. The front engagement portion 152A is mounted to the pressure tube 3 in a non-separable manner. The pressure tube 3 and the connector 150A may also be formed as a single unit.

[0115] (Variations 1-2)

[0116] Figure 12 This is a diagram showing connector 150B, a modified example of connector 150.

[0117] The connector 150B has a cylindrical portion 151, a front engagement portion 152, and a base engagement portion 153B. The base engagement portion 153B is mounted to the front-side coil 222 of the sheath 220 in a non-separable manner. The front-side coil 222 of the sheath 220 and the connector 150B may also be formed as a single unit.

[0118] (Variations 1-3)

[0119] Figure 13 This is a diagram showing connector 150C, a modified example of connector 150.

[0120] The connector 150C has a cylindrical portion 151 and a base engagement portion 153B. The connector 150C does not have a front engagement portion 152. The front-side coil 222 of the sheath 220 and the connector 150C may also be formed as one piece.

[0121] (Variations 1-4)

[0122] Figure 14 This is a diagram showing a modified example of connector 150D.

[0123] In the above embodiment, the connector 150 is disposed on the outer side of the pressure tube 3 and the front end head 221 in the radial direction R. On the other hand, the connector 150D is disposed on the inner side of the pressure tube 3 and the front end head 221 in the radial direction R. The connector 150D has a cylindrical portion 151, a front end engaging portion 152D, and a base end engaging portion 153D.

[0124] The front engagement portion 152D is provided at the front end of the cylindrical portion 151 and is a protrusion that protrudes outward in a radial direction R perpendicular to the length direction A. The front engagement portion 152D engages with the engagement portion 32D that protrudes inward in a radial direction R at the base end of the pressure tube 3.

[0125] The base-end engaging portion 153D is provided at the base end of the cylindrical portion 151 and is a protrusion that protrudes outward in a radial direction R perpendicular to the length direction A. The base-end engaging portion 153D engages with the engaging portion 225D that protrudes inward in a radial direction R at the front end of the sheath 220.

[0126] (Second Implementation)

[0127] Reference Figures 15 to 21 The second embodiment of the present invention will be described. In the following description, structures that are common to the structures already described will be labeled with the same reference numerals and repeated descriptions will be omitted.

[0128] Figure 15 This is a diagram showing the clamping device 300B of this embodiment.

[0129] The clamping device (clamping system, endoscope treatment device) 300B includes a clamping unit 100 and a feeder 200B. The clamping unit 100 is loaded into the feeder 200B, which can pass through the endoscope, and is guided to the treatment position.

[0130] The feeder (clamp unit introduction device) 200B includes a sheath 220B, an operating line 230, and an operating section 240. Similar to the feeder 200 of the first embodiment, the feeder 200B extends, for example, through the endoscope's treatment instrument passage and is used in combination with the endoscope.

[0131] The sheath 220B differs from the sheath 220 of the first embodiment in its front end. The sheath 220B has a front end tapered portion 226, a front end side coil 222, and a hand-side side coil 224, and is generally formed into an elongated tubular shape. The front end tapered portion 226 is disposed on the front end side of the sheath 220.

[0132] Figure 16 This is a cross-sectional view of the front end of the clamping device 300B.

[0133] The front tapered portion 226 is inclined relative to the longitudinal axis L of the sheath 220, and is formed into a tapered shape with a reduced diameter towards the front end A1. The pressure tube 3 is fitted into the front tapered portion 226. Specifically, the front end of the front tapered portion 226 is inserted into the internal space 38 of the pressure tube 3 from the base end opening 3b.

[0134] Figure 17 This is a diagram showing the change in shape of the fixture unit 100.

[0135] The clamp unit 100 is capable of Figure 16 The straight line shape shown (first shape) and Figure 17 The transition between the swinging patterns shown (second pattern) is shown.

[0136] When a predetermined force is applied to at least one of the first arm 211 and the second arm 212, the clamping unit 100 swings in the swing direction Q and changes to a swinging configuration (second configuration). Specifically, the pair of arms 21 swing in the swing direction Q, and the pressure tube 3, which is in contact with the pair of arms 21, moves relative to the sheath 220. When the clamping unit 100 is at least in a straight configuration (first configuration), a radial gap (space) G is formed between the inner circumferential surface 3c of the pressure tube 3 and the front end tapered portion 226 of the sheath 220. Therefore, the pressure tube 3 can tilt relative to a direction intersecting the longitudinal axis direction L of the sheath 220.

[0137] The clamp unit 100 can also change from a swinging form (second form) to a straight form (first form).

[0138] [Operation and function of clamp device 300B]

[0139] Next, refer to Figures 18 to 21 The operation and function of the clamp device 300B are explained.

[0140] <Approach Steps>

[0141] The surgeon inserts the clamp unit 100, loaded in the feeder 200B, into the body through the endoscope channel. The surgeon moves the endoscope and sheath 220B so that the clamps 2 of the clamp unit 100 are close to the tissue T, which is the treatment area.

[0142] <Tangent Approach>

[0143] Figure 18 This diagram illustrates a clamp unit 100 used for tangential approach to treat tissue T. The surgeon approaches the clamp unit 100, which is in a straight line configuration, towards the tissue T, the treatment area, using tangential approach. The surgeon hooks the claw 22 of the first arm 211 onto the mucosa located on the endoscopic side (near the anterior side) of the first mucosa M1 and the second mucosa M2, which are situated on either side of the center of the tissue T. Figure 18 The middle part is the first mucosa M1).

[0144] Figure 19 This diagram illustrates the clamp unit 100 after the pair of arms 21 have swung. The surgeon further approaches the clamp unit 100, whose claws 22 are hooked onto the first mucosa M1, closer to the tissue T, which is the treatment area. Specifically, the surgeon advances the feeder 200B relative to the endoscope's passage. Alternatively, the surgeon presses the clamp unit 100 further into the tissue T by advancing the endoscope. As a result, Figure 19 As shown, a pair of arms 21 swing about the rotation axis RO, and the clamping unit 100 is in a swinging configuration. When the second arm 212 contacts the second mucosa M2, the pair of arms 21 are configured with the frontal direction F facing the front of the tissue T, which is the treatment area. The first mucosa M1 and the second mucosa M2 are held by the pair of arms 21.

[0145] <Traction Steps>

[0146] The user retracts the operating line 230 by moving the slider 242 backward along the operating body 241. The curved member 4 connected to the operating line 230 pulls the clamp 2. By pulling the clamp 2 towards the base end side A2, a pair of arms 21 are pulled into the pressure tube 3, and the pair of arms 21, which engage with the front opening 3a, gradually close. If the traction force of the operating line 230 is released in this state, the clamp 2 returns to the open state while moving towards the front end side A1 due to the self-expanding force of the pair of arms 21. The user can return the pair of arms 21 to the open state and re-grip the tissue T (reopen).

[0147] <Locking Steps>

[0148] Figure 20 This is a diagram illustrating the locking steps of the clamp unit 100.

[0149] The surgeon retracts the operating line 230 by moving the slider 242 back along the operating part body 241. When the clamp 2 is pulled into the predetermined position of the pressure tube 3, the engaging part 25, which serves as a locking mechanism, engages with the inner circumferential surface of the pressure tube 3, locking the pair of arms 21 into a closed state. When the pair of arms 21 is locked into the closed state, the pair of arms 21 cannot return to the open state.

[0150] <Separation Steps>

[0151] Figure 21 This is a diagram illustrating the separation steps of the fixture unit 100.

[0152] The surgeon further pulls on clamp 2. A pulling force is applied to the separation portion 29 of clamp 2, causing it to break. As a result, clamp 2 separates from bending member 4. The surgeon retracts sheath 220, leaving clamp 2 and compression tube 3 in place inside the body, with the first mucosa M1 and the second mucosa M2 ligated.

[0153] According to the clamping device 300B of this embodiment, tissue T can be properly gripped in a lumen. Even when treating tissue T by approaching it tangentially, the clamping unit 100 can be swung relative to the sheath 220B to position the pair of arms 21 facing the front of the tissue T, which is the treatment area. Because the clamping unit 100 swings relative to the sheath 220B, it is easy to position the clamping unit 100 facing the front of the tissue T even in a narrow lumen.

[0154] 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 spirit of the present invention are also included. Furthermore, the constituent elements shown in the embodiments and variations can be appropriately combined to form a configuration.

[0155] (Variation Example 2-1)

[0156] Figure 22 and Figure 23 This is a diagram showing a modified example of the compression tube 3C.

[0157] The crimp tube 3C has a base-end tapered portion 33 on the base-end side. The base-end tapered portion 33 is formed into a shape that tapers at the tip towards the base-end side A2. The base end of the base-end tapered portion 33 is inserted into the sheath 220. When the clamp unit 100 is at least in a straight line configuration (first configuration), a radial gap (space) G is formed between the outer peripheral surface 3d of the crimp tube 3C and the inner peripheral surface of the sheath 220. Therefore, the crimp tube 3C can be tilted relative to a direction intersecting the longitudinal axis direction L of the sheath 220.

[0158] (Variation Example 2-2)

[0159] Figures 24 to 27 This diagram illustrates the use of the outer sheath 260. Alternatively, the feeder 200 may also include the outer sheath 260. For example... Figure 24 As shown, by positioning the outer sheath 260 outside the sheath 220 and the pressure tube 3C, the outer sheath 260 can maintain the clamp unit 100 in a straight line configuration (first configuration). Figure 25 As shown, by causing the pressure tube 3C to protrude from the outer sheath 260 towards the front end A1, the clamp unit 100 can be transformed into a swinging form (second form). Figure 26 and Figure 27 As shown, the locking and separation steps are performed with the pressure tube 3C protruding from the outer sheath 260 toward the front end A1.

[0160] (Third implementation method)

[0161] Reference Figures 28 to 31 The third embodiment of the present invention will now be described. In the following description, structures that are common to those already described will be marked with the same reference numerals and repeated descriptions will be omitted.

[0162] Figure 28 and 29 This is a diagram showing the clamping device 300C of this embodiment.

[0163] The clamping device (clamping system, endoscope treatment device) 300C includes a clamping unit 100, a flexible member 160, and a feeder 200.

[0164] The flexible member 160 connects the pressure tube 3 and the sheath 220 in a separable manner. The flexible member 160 is formed in a cylindrical shape and is flexible. The flexible member 160 is, for example, a bellows, a tube, or a tube that has been helically cut using a laser. Because the flexible member 160 is flexible, the pressure tube 3 can tilt relative to the direction intersecting the longitudinal axis L of the sheath 220.

[0165] Figure 30 and Figure 31 This diagram shows a flexible member 160B, which is another form of the flexible member 160. The flexible member 160B connects the pressure tube 3 and the sheath 220 in a separable manner. The flexible member 160 is, for example, a hinge structure. Because the flexible member 160B is flexible, the pressure tube 3 can tilt relative to a direction intersecting the longitudinal axis direction L of the sheath 220.

[0166] According to the clamping device 300C of this embodiment, tissue T can be properly gripped in a lumen. Even when treating tissue T by approaching it tangentially, the clamping unit 100 can be swung relative to the sheath 220 to position the pair of arms 21 facing the front of the tissue T, which is the treatment area. Because the clamping unit 100 swings relative to the sheath 220, it is easy to position the clamping unit 100 facing the front of the tissue T even in a narrow lumen.

[0167] The third 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 spirit of the present invention are also included. Furthermore, the constituent elements shown in the embodiments and variations can be appropriately combined to form a configuration.

[0168] (Variation Example 3-1)

[0169] Figure 32 This is a diagram showing a modified example of bending member 4B.

[0170] The bending member 4B supports a pair of arms 21 so that they can swing (rotate) around a rotation axis RO that is approximately perpendicular to the length direction A. The swing direction (rotation direction) Q of the pair of arms 21 around the rotation axis RO is approximately orthogonal to the opening and closing direction P of the pair of arms 21. In this case, the clamping unit can switch between a straight configuration (first configuration) in which the frontal direction F of the pair of arms 21 faces the same direction as the length axis direction L, and a swing configuration (second configuration) in which the frontal direction F of the pair of arms 21 swings in a direction approximately orthogonal to the opening and closing direction P while the frontal direction F of the pair of arms 21 swings in a direction intersecting the length axis direction L.

[0171] Figure 33 This is a diagram showing a modified example of bending member 4C.

[0172] The bending member 4C is a ball joint that supports a pair of arms 21 so that they can swing (rotate) around a ball 43C. The swing direction (rotation direction) Q of the pair of arms 21 around the ball 43C is arbitrary. In this case, the clamping unit can switch between a straight configuration (first configuration) in which the frontal direction F of the pair of arms 21 faces the same direction as the length axis direction L, and a swing configuration (second configuration) in which the arms 21 swing in any direction and face a direction intersecting the frontal direction F of the pair of arms 21.

[0173] Figure 34 This is a diagram showing a modified example of bending member 4D.

[0174] The bending member 4D is an elastic member such as rubber. The swing direction (rotation direction) Q of the pair of arms 21 with the bending member 4D as the center of rotation is arbitrary. In this case, the clamping unit can switch between a straight shape (first shape) in which the frontal direction F of the pair of arms 21 faces the same direction as the length axis direction L, and a swing shape (second shape) in which it swings in any direction and faces the direction intersecting the frontal direction F of the pair of arms 21.

[0175] Figure 35 This is a diagram showing a modified example of bending member 4E.

[0176] The bending member 4E is a hook provided at the front end of the operating line 230. Similar to the first embodiment, the swing direction (rotation direction) Q of the clamp 2 is approximately the same as the opening and closing direction P of the pair of arms 21. In this case, the clamp unit can switch between a straight configuration (first configuration) where the frontal direction F of the pair of arms 21 faces the same direction as the length axis direction L, and a swing configuration (second configuration) where the frontal direction F of the pair of arms 21 swings in a direction approximately the same as the opening and closing direction P, while the frontal direction F of the pair of arms 21 faces a direction intersecting the length axis direction L.

[0177] Explanation of reference numerals in the attached figures

[0178] 300, 300B, 300C, Clamping devices (clamping systems, endoscope treatment instruments); 200, 200B, Feeders (clamping unit introduction devices); 220, 220B, Sheaths; 221, Front end head (front end); 225, Engaging part; 226, Front tapered part; 230, Operating line (power transmission component); 240, Operating part; 100, Clamping unit; 2, Clamp (clamping arm); 21, A pair of arms; 29, Separation part; 3, 3C, Pressure tube (tubular component); 32, Engaging part; 33, Base tapered part; 4, Bending part.

Claims

1. A clamping device, wherein, This clamping device has the following features: A clamping unit having an arm that opens and closes in the front direction; Line component, which is connected to the clamp unit; as well as A sheath through which the wire member passes, the sheath extending along its length axis. The clamping unit is detachably connected to the front end of the sheath. The clamping unit is capable of changing between a first configuration in which the frontal direction of the arm faces the same direction as the length axis and a second configuration in which the frontal direction of the arm faces a direction intersecting the length axis.

2. The clamping device according to claim 1, wherein, The clamping device includes a connecting member that detachably connects the front end of the sheath and the clamping unit. When the clamping unit is in the first configuration, a gap is formed between the front end of the sheath connected by the connecting member and the clamping unit in the direction of the length axis.

3. The clamping device according to claim 2, wherein, The gap has a first gap and a second gap. The first gap and the second gap are arranged radially on the wire member at positions separated from the wire member. When the clamping unit is in the first configuration, the first distance of the first gap and the second distance of the second gap are approximately the same. When the clamping unit is in the second configuration, the first distance is different from the second distance.

4. The clamping device according to claim 3, wherein, When the clamping unit changes from the first form to the second form, one of the first distance and the second distance increases.

5. The clamping device according to claim 4, wherein, When the clamping unit changes from the first form to the second form, the other of the first distance and the second distance decreases.

6. The clamping device according to claim 2, wherein, The connecting component is mounted to the clamp unit in a manner that prevents it from being separated.

7. The clamping device according to claim 2, wherein, The connecting component is installed at the front end of the sheath in a non-separable manner.

8. The clamping device according to claim 2, wherein, The clamping unit has at least a partial tubular member capable of receiving the arm. The connecting member detachably connects the front end of the sheath and the tubular member.

9. The clamping device according to claim 1, wherein, The clamping unit has at least a partial tubular member capable of receiving the arm. The front end of the sheath is fitted into the tubular member. When the clamping unit is in the first configuration, a radial gap is formed between the front end of the sheath and the tubular member.

10. The clamping device according to claim 9, wherein, At least a portion of the tapered portion formed at the front end of the sheath is inserted into the tubular member.

11. The clamping device according to claim 9, wherein, At least a portion of the tapered portion formed at the base end of the tubular member is inserted into the front end of the sheath.

12. The clamping device according to claim 1, wherein, The clamping device includes a flexible member that detachably connects the front end of the sheath and the clamping unit. The flexible member is flexible.

13. The clamping device according to claim 1, wherein, The clamping unit has at least a partial tubular member capable of receiving the arm. The clamping device also has an outer sheath disposed at the front end of the sheath and on the outside of the tubular member.

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