Clip unit for ligation device

Abstract

To provide a clip unit for ligation device that has a multi-limb arm part that expands three-dimensionally, grasps an affected area P with two arms that close first, grasps the affected area P with increased grasping force by closing the remaining arms from a direction different from the direction in which the arms are closed first, performs hemostasis and the like, and can be separated and remain within a body cavity.SOLUTION: A clip unit for ligation device includes: a multi-limb arm part 11 that has projecting claws 12a-14a and extends three-dimensionally; a connection object part 16; and a tightening ring 17 to be in a state of being fitted to a base end part of the multi-limb arm part 11 at the first tightening position A. At the second tightening position B, the tightening ring 17 can close the first arm 12 and the second arm 13 to sandwich an affected area P. At the third tightening position C, the tightening ring can tighten the third arm 14 in a state of being closed together with the first arm 12 and the second arm 13, and can sandwich the affected area P from a different direction. The clip unit can perform hemostasis and the like by sandwiching the affected area P, and can be separated and remain within digestive organs.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to a clip unit for a ligation device which is provided as a distal end member of a ligation device, an endoscopic treatment tool which is passed through a channel of an endoscope, guided to a position facing any affected area in the digestive organs, and used to clamp the affected area to stop bleeding or the like, and which is inserted into a body cavity of a living body to clamp the affected area to stop bleeding or the like, and which is then detached and left inside the digestive organs. [Background technology]

[0002] A ligation device generally comprises an operating section located closer to the base end than the channel of the endoscope, a flexible inner sheath connected to the operating section via a connecting section, a flexible outer sheath fitted from the distal end position of the connecting section to the distal end position of the inner sheath, a operating wire extending distally from the slider of the operating section and inserted into the vicinity of the distal end of the inner sheath, a disconnecting device provided at the inner distal end of the inner sheath, and a clip unit having an arm section that can be in an open state due to elasticity and in a closed state when tightened by a tightening ring, and a base end that is chucked by the disconnecting device.

[0003] The clip unit is set in a position where the open arm portions can clamp the affected area inside the digestive organ, and when the inner sheath is moved forward by operating the operating unit, the fastening position of the fastening ring at the tip of the inner sheath is moved forward, causing the arm portions to close and clamp the affected area inside the digestive organ, and in this state the detaching tool is released from the ligation device, leaving it inside the digestive organ.

[0004] Examples of clip units of conventional ligation devices include those disclosed in Patent Documents 1 and 2.

[0005] The clip unit described in Patent Document 1 has sharp protrusions near the claws at the tips of the pair of arm plates. When, for example, both sides of a mucosal defect after removal of a tumor or the like are sutured together, the protrusions pierce the mucosa, allowing the claws of the pair of arm plates to pull together both sides of the mucosal defect without slipping on the mucosa. The pair of claws grasp both sides of the pulled-in mucosal defect, allowing the defect to be sutured. This makes it possible to close the wound if the size of the wound is within the range reached by the spread of the two arms.

[0006] The clip unit described in Patent Document 2 includes an arm with a claw at its tip, an arm tip leg with a claw at its tip that opens wide relative to the arm, and an arm branch leg that branches off halfway from the arm tip leg and has a claw at its tip that opens narrower relative to the arm. As the clamping ring is moved toward the arm tip, the gap between the small opening of the arm and the arm branch leg narrows to clamp one edge of the opening of the wound, and by moving this clamped edge of the opening of the wound toward the other edge and moving the clamping ring toward the arm tip to a position beyond the branching point, it is possible to easily ligate a large wound. In this way, one wall of the affected area that is in a hole state after the lesion is excised is clamped, and the clamped wall is moved to the other wall and the walls are sutured together so that the affected area is not exposed after suturing. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] JP 2015-8858 A [Patent Document 2] JP 2017-176335 A Summary of the Invention [Problem to be solved by the invention]

[0008] The clip unit described in Patent Document 1 is used to stop bleeding by gripping blood vessels. This clip unit may be able to suture a wound that is a relatively small hole, but when suturing a wound (hole) of a lesion, a method of suturing both sides of the hole of the lesion is required, whereas in a surgical operation, thread is used to suture the hole. Therefore, it is difficult to apply this clip unit to suturing a wound of a relatively large lesion. If one claw is used to hook one wall surface and move it to the other wall surface, and then the other claw is used to hook the other wall surface and suture the two walls of the hole of the lesion.

[0009] The clip unit described in Patent Document 2 clamps one wall of the wound with an arm and an arm branch and then moves it to the other wall of the wound. However, this places a significant load on the arm and arm branch, so the arm and arm branch need to have great strength and springiness.

[0010] In addition, in the clip unit described in Patent Document 2, it is important that the arm, the arm tip leg, and the arm branch leg have sufficiently high spring properties in the following respects. That is, in terms of configuration, the opening width of the arm and the arm branch leg is half that of the clip unit described in Patent Document 1, and in addition, in order to pass the endoscope, the arm, the arm tip leg, and the arm branch leg are inserted into the flexible sheath in a closed state, but if the spring properties are poor, the opening width of the arm and the arm branch leg will inevitably be reduced after this insertion. There is a problem that the opening width does not return to a fully open state due to the spring properties and is reduced, resulting in a situation in which the width for gripping the wall surface of the affected area cannot be guaranteed. In order to avoid this, special metals such as selection of metal materials with high spring properties and special manufacturing methods are required. The three-pronged arm, which has an arm, arm end leg, and arm branch leg, can only be manufactured by pressing, as laser cutting or etching will cause it to weaken at high temperatures and sulfuric acid will affect the material, causing it to lose its springiness. Furthermore, the pressing process is complex and it may not be possible to ensure the opening width between the arm and the arm end leg, making it difficult to manufacture.

[0011] The present invention has been made in consideration of the above circumstances, and has an object to provide a clip unit for a ligation device, which has a multi-limbed arm section with an opening and closing structure that spreads in three dimensions, and which first grasps the affected area with two arms that open and close, and then closes the remaining one or two arms to overlap the affected area from different directions to bend and grasp the affected area, thereby increasing the grasping force and allowing it to be retained within a body cavity. [Means for solving the problem]

[0012] In order to achieve the above-mentioned object, a first aspect of the present invention is a clip unit for a ligation device that is detachably held by a release tool provided at the tip of a ligation device that is inserted through a channel of an endoscope and inserted into a body cavity of a living body to grasp an affected area and perform hemostasis, etc., and that is detached and left inside the body after treatment.

[0013] A first aspect of the present invention is a multi-limbed arm section in which three or four elastic wires are formed into different required shapes, and the base ends of the wires are stacked and integrated together to form three or four arms that extend three-dimensionally from the base ends to the tip side, and each arm has a claw that projects from the tip of the arm in the direction in which the arm is closed, a connected section in which two of the three or four elastic wires extend further in the proximal direction from the base ends and are connected in a loop shape, the connected section having a chuck hole for being chucked by the connection release tool, and a fastening ring that is fitted over the multi-limbed arm section and whose fastening position can be moved in the tip direction by operating the ligation device, The clamping ring is In a first fastening position which is an initial position, the fastening member is fitted onto the base end portion of the multi-limbed arm portion, Between the first clamping position and the second clamping position, which is moved a required distance in the distal direction, the spread of two of the three or four arms is gradually increased. Therefore, at the second clamping position, the two arms are clamped so as to close together, Between the second clamping position and a third clamping position which is moved a required distance further toward the tip, the remaining one or two of the three or four arms are gradually wider, so that at the third clamping position, the remaining one or two arms are overlapped and closed on the two arms which were previously closed together.

[0014] The second aspect of the present invention has the same configuration as the first aspect of the present invention, as well as: In the first fastening position, the position at which the arms are closed approximately coincides with an extended center line of the sheath center on the distal side of the distal end of the inner sheath of the ligation device.

[0015] The third aspect of the present invention has the same configuration as the second aspect of the present invention, but further comprises: the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions open so as to be able to close each other on a first plane passing through the extended center line, and the third arm is in a position open so as to be able to close each other on a second plane passing through the extended center line and perpendicular to the first plane, The clamping ring is configured to clamp the first arm and the second arm together when moving from the first clamping position to the second clamping position, and to further clamp the third arm together when moving to the third clamping position.

[0016] The fourth aspect of the present invention has the same configuration as the second aspect of the present invention, as well as: the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions where they are open so as to be able to close each other on a first plane passing through the extended center line, and the third arm is in a position where they are open so as to be able to close on a second plane passing through the extended center line and in a direction having an intersecting angle of 30-60° with respect to the first plane, The clamping ring is configured to clamp the first arm and the second arm together when it moves from the first clamping position to the second clamping position, and to clamp the third arm together when it moves to the third clamping position.

[0017] The fifth aspect of the present invention has the same configuration as the second aspect of the present invention, as well as: the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the clamping ring is in the first clamping position, the first arm is in an open position so as to be able to close on a first plane passing through the extended center line, the second arm is in an open position so as to be able to close on a second plane passing through the extended center line, and the third arm is in an open position so as to be able to close on a third plane passing through the extended center line, The clamping ring is configured to clamp the first arm and the second arm together when it moves from the first clamping position to the second clamping position, and to clamp the third arm together when it moves to the third clamping position.

[0018] The sixth aspect of the present invention has the same configuration as the second aspect of the present invention, as well as: the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the fastening ring is in the first fastening position, the first arm coincides with the extended center line and extends unrotatably, the second arm is in an open position so as to be capable of closing on a first plane passing through the extended center line, and the third arm is in an open position so as to be capable of closing on a second plane passing through the extended center line, The clamping ring is configured to clamp the second arm to close against the non-pivotable first arm when moving from the first clamping position to the second clamping position, and to clamp the third arm to close against the non-pivotable first arm when moving to the third clamping position.

[0019] The seventh aspect of the present invention is, in addition to the configuration of the second aspect of the invention, the multi-limbed arm unit includes a first arm, a second arm, a third arm, and a fourth arm, When the clamping ring is in the first clamping position, the first arm is in an open position so as to be able to close on a first plane passing through the extended center line, the second arm is in a open position so as to close on a second plane passing through the extended center line, the third arm is in a open position so as to close on a third plane passing through the extended center line, and the fourth arm is in a open position so as to close on a fourth plane passing through the extended center line, The clamping ring is configured to clamp the first arm and the second arm together when it moves from the first clamping position to the second clamping position, and to clamp the third arm and the fourth arm together when it moves to the third clamping position.

[0020] The eighth aspect of the present invention has the same configuration as the second aspect of the present invention, as well as: the multi-limbed arm unit includes a first arm, a second arm, a third arm, and a fourth arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions where they are open so as to be able to close relative to each other on a first plane passing through the extended center line, the third arm is in a position where they are open so as to be able to close relative to each other on a second plane passing through the extended center line, and the fourth arm is in a position where they are open so as to be able to close relative to each other on a third plane passing through the extended center line on the same side as the second plane with respect to the first plane, The clamping ring is configured to clamp the first arm and the second arm together when it moves from the first clamping position to the second clamping position, and to clamp the third arm and the fourth arm together when it moves to the third clamping position. Effect of the Invention

[0021] According to the present invention, it is possible to provide a clip unit for a ligation device in which the affected area is grasped with two arms of a multi-limbed arm portion having an opening and closing structure that spreads in three dimensions, and then the remaining one or two arms are closed to overlap the affected area from different directions to bend and grasp the affected area, thereby increasing the grasping force and allowing it to be retained within a body cavity. [Brief description of the drawings]

[0022] [Figure 1] FIG. 1A is an exploded oblique view showing the overall schematic configuration of a ligation device including a clip unit according to a first embodiment of the present invention, FIG. 1B is an enlarged cross-sectional view of the tip portion of the ligation device including a disconnecting tool that chucks the clip unit, and FIG. 1C is an enlarged cross-sectional view of the tip portion of the ligation device with the clip unit chucked by the disconnecting tool. [Diagram 2] FIG. 1 is a plan view of a clip unit according to a first embodiment of the present invention, in which FIG. 1A is a plan view of the clip unit in an open state, FIG. 1B is a view from the tip side, FIG. 1C is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to third arms are open, FIG. 1D is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring, and FIG. 1E is a perspective view showing a state in which the fastening ring is in a third fastening position and the first FIG. 3 is an oblique view showing the state in which arms 3 are clamped and closed by a clamping ring; FIG. 4 is an oblique view showing the state in which arms 1 to 3 are open, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area; FIG. 4 is a view showing the state in which arms 1 to 3 are closed relative to the affected area; FIG. 5 is a view showing the state in which arms 1 to 3 are closed, and arms 3 to 3 are further closed, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area. [Diagram 3]FIG. 1A shows a clip unit according to a first embodiment of the present invention, in which FIG. 1A shows a state in which the clip unit is chucked to a ligation device, the fastening ring is in a first fastening position, and the clip unit is open; FIG. 1B shows a state in which the clip unit is retracted into the tip of the ligation device in the first stage, and the fastening ring is in a second fastening position; and FIG. 1C shows a state in which the clip unit is retracted into the tip of the ligation device in the second stage, and the fastening ring is in a third fastening position. [Figure 4] FIG. 2 is a clip unit hook according to a second embodiment of the present invention; FIG. 2A is a plan view of the clip unit in an open state; FIG. 2B is a view from the tip side; FIG. 2C is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to third arms are open; FIG. 2D is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring; and FIG. 2E is a perspective view showing a state in which the fastening ring is in a third fastening position and the first FIG. 3 is an oblique view showing the state in which arms 3 are clamped and closed by a clamping ring; FIG. 4 is an oblique view showing the state in which arms 1 to 3 are open, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area; FIG. 4 is a view showing the state in which arms 1 to 3 are closed relative to the affected area; FIG. 5 is a view showing the state in which arms 1 to 3 are closed, and arms 3 to 3 are further closed, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area. [Diagram 5]FIG. 3 is a clip unit hook according to a third embodiment of the present invention; FIG. 3A is a plan view of the clip unit in an open state; FIG. 3B is a view from the tip side; FIG. 3C is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to third arms are open; FIG. 3D is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring; and FIG. 3E is a perspective view showing a state in which the fastening ring is in a third fastening position and the first FIG. 3 is an oblique view showing the state in which arms 3 are clamped and closed by a clamping ring; FIG. 4 is an oblique view showing the state in which arms 1 to 3 are open, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area; FIG. 4 is a view showing the state in which arms 1 to 3 are closed relative to the affected area; FIG. 5 is a view showing the state in which arms 1 to 3 are closed, and arms 3 to 3 are further closed, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area. [Figure 6] FIG. 4 is a clip unit hook according to a fourth embodiment of the present invention; (A) is a plan view of the clip unit in an open state; (B) is a view from the tip side; (C) is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to third arms are open; (D) is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring; and (E) is a perspective view showing a state in which the fastening ring is in a third fastening position and the first FIG. 3 is an oblique view showing the state in which arms 3 are clamped and closed by a clamping ring; FIG. 4 is an oblique view showing the state in which arms 1 to 3 are open, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area; FIG. 4 is a view showing the state in which arms 1 to 3 are closed relative to the affected area; FIG. 5 is a view showing the state in which arms 1 to 3 are closed, and arms 3 to 3 are further closed, showing the orientation and moving direction of the claws at the tips of arms 1 to 3 relative to the affected area. [Figure 7]5 is a clip unit hook according to a fifth embodiment of the present invention; (A) is a plan view of the clip unit in an open state; (B) is a view from the tip side; (C) is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to fourth arms are open; (D) is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring; and (E) is a perspective view showing a state in which the fastening ring is in a third fastening position and the third and fourth arms are fastened. FIG. 1 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 2 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 3 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 4 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 5 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 6 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the third and fourth arms; FIG. 7 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed [Figure 8] 6 is a clip unit hook according to a sixth embodiment of the present invention; (A) is a plan view of the clip unit in an open state; (B) is a view from the tip side; (C) is a perspective view showing a state in which the fastening ring of the clip unit is in a first fastening position and the first to fourth arms are open; (D) is a perspective view showing a state in which the fastening ring is in a second fastening position and the first and second arms are fastened and closed by the fastening ring; and (E) is a perspective view showing a state in which the fastening ring is in a third fastening position and the third and fourth arms are fastened. FIG. 1 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 2 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 3 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 4 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 5 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the first and second arms; FIG. 6 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed together with the third and fourth arms; FIG. 7 is an oblique view showing the state in which the arms are tightened by an attachment ring and closed DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0023] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A clip unit for a ligation device according to an embodiment of the present invention will now be described with reference to the drawings.

[0024] [Ligation device] Fig. 1(A) shows an exploded perspective view showing the general configuration of the ligation device 1. Fig. 1(B) and Fig. 1(C) are partial detailed views. The ligation device 1 is passed through a channel of an endoscope and clamps biological tissue, for example, any affected area in the digestive organs, to stop bleeding, etc.

[0025] The ligation device 1 is equipped at its tip with clip units 10, 10A-10E for a ligation device according to the first to sixth embodiments of the present invention described below, which perform ligation operations by operating the operating portion 2. The clip units are clamped to the affected area to stop bleeding, etc., and then separated so as to be left inside the digestive organs. Therefore, the general configuration of the ligation device 1 will be described first.

[0026] The ligation device 1 has an operating unit 2 that is operated by a doctor or the like, and the tip portion of this operating unit 2 is inserted into the channel of the endoscope, and the outer sheath 5, inner sheath 4, connection release tool 7, and clip unit 10 are protruded toward the tip of the channel and inserted to any affected area in the digestive tract.

[0027] The ligation device 1 includes an operating section 2, a male tubular connecting section 3a provided at the tip of a tubular shaft section 2a of the operating section 2, a female tubular connecting section 3b connected to the male tubular connecting section 3a by fitting or screwing, a flexible inner sheath 4 extending forward integrally from the tip surface of the female tubular connecting section 3b, a flexible outer sheath 5 that is fitted over the outside of the inner sheath 4 and is slidable, an operating wire 6 that is connected to the slider 2b of the operating section 2 and is inserted so as to extend inside the tip of the inner sheath 4, a connection release tool 7 that is housed within the tip of the inner sheath 4 and has a base end connected to the tip of the operating wire 6, and a clip unit 10 that has a base end connected to the connection release tool 7 by chuck.

[0028] A large-diameter cylindrical knob portion 5a is fitted and fixed to the proximal end of the outer sheath 5, and a doctor can grasp the knob portion 5a with his fingers and push and pull it in the axial direction to slide the outer sheath 5 relative to the inner sheath 4. The inner sheath 4 includes an inner sheath body 4a made, for example, by tightly winding a stainless steel wire having a rectangular cross section, and a retaining tube 4b made, for example, of a stainless steel pipe that is extended and connected to the tip of the inner sheath body 4a.

[0029] As shown in Figs. 1(B) and 1(C), the retaining cylinder 4b has a fastening ring receiving portion 4b1 capable of receiving the fastening ring 17 inside the tip thereof, and has a chuck drawn portion 4b2 behind it.

[0030] The operating unit 2 is composed of a cylindrical shaft portion 2a, a predetermined length from the base end of which is divided into two by a diametric slit 2a1, a slider 2b that fits over the outer peripheral surface of the base end side of the cylindrical shaft portion 2a and has a diameter connecting portion 2b1 inserted through the slit 2a1 and slides in the axial direction, and a finger ring 2c attached to the base end of the cylindrical shaft portion 2a. The slider 2b has a finger hook portion 2b2.

[0031] The disconnecting tool 7 is a molded body having spring properties, the base end of which is closed and positioned inside the inner sheath 4. The disconnecting tool 7 is a bifurcated arm having a closed base end, which is connected to the tip of the operating wire 6 and which gradually opens wider distally from the base end, with inward-facing chuck jaws at each tip.

[0032] When the inner sheath 4 is moved forward, the connection release tool 7 is adapted so that, when the chuck narrowing portion 4b2 of the inner sheath body 4a comes into contact with the inner sheath 4, external pressure from the chuck narrowing portion 4b2 acts to close the bifurcated arms while increasing the restoring force, whereby the pair of inwardly facing chuck claws 7a, 7b can chuck the connectable portion 16 of the clip unit 10 in a state in which they embrace it.

[0033] In the ligation device 1, a doctor can slide the slider 2b in the distal direction by hooking his or her fingers on the finger ring 2c and the finger hook portion 2b2 of the slider 2b and shortening the distance between the finger ring 2c and the finger hook portion 2b2, thereby moving the inner sheath 4 in the distal direction to a position where it covers the connection release tool 7 (see FIG. 1(C)), and further to a position where it covers the clip unit 10. In addition, a doctor can hook his or her fingers on the finger ring 2c and push or pull it in the distal or proximal direction to move the entire device forward or backward.

[0034] The configurations of the operation unit 2 and the connection release tool 7 are not limited to those described above.

[0035] [Configuration of clip unit 10 according to the first embodiment] As shown in FIGS. 2 and 3, the clip unit 10 for a ligation device has a multi-limbed arm portion 11, a connected portion 16, and a fastening ring 17.

[0036] The multi-limbed arm section 11 is made of three elastic wire rods each formed into a different required shape, with the base ends overlapping and integrated by welding or the like, and is made up of a first arm 12, a second arm 13, and a third arm 14 that extend three-dimensionally from the base ends to the tip side, and has claws 12a-14a protruding from the tip of each arm in the direction in which the arms close. For example, a stainless steel wire with an outer diameter of 1 mm is selected as the elastic wire rod.

[0037] The claws 12a-14a are bent at about 90° from each arm. The claws 12a-14a are arranged so that the first to third arms 12-14 are located at different tip positions, so that the first to third arms 12-14 pass each other back and forth when they close together, allowing the first to third arms 12-14 to close closer together. The claws 12a-14a are necessary to hook and hold the affected area P in place.

[0038] The connected portion 16 extends further in the base direction from the base ends of two of the three elastic wires (in this embodiment, the first arm 12 and the second arm 13), is connected in a loop shape, and has a chuck hole 16a for being chucked by the connection release tool 7.

[0039] In the initial position, the first fastening position A, the fastening ring 17 is fitted over the base end of the multi-limbed arm section 11 (the part where three elastic wires are stacked and integrated by welding or the like), and can be moved in two stages toward the tip to the second fastening position B and the third fastening position C by operating the ligation device 1.

[0040] The clamping ring 17 may be a cylindrical molded body having a required diameter and not expanding in diameter, and although it is cylindrical in the illustrated example, it may be a square tube or may be coiled. The clamping ring 17 is formed by cutting a stainless steel pipe having an inner diameter of 3 mm into a short piece, for example.

[0041] At the second fastening position B, the closed position of the first arm 12 and the second arm 13 approximately coincides with an extension line L of the sheath center line beyond the tip of the inner sheath 4 of the ligation device (hereinafter referred to as the extended center line).

[0042] The fastening ring 17 is shaped so that the third arm 14 gradually widens relative to the closed first arm 12 and second arm 13 between the second fastening position B and the third fastening position C, which is moved a required distance further toward the tip, so that at the third fastening position C, the remaining arm (third arm 14) is overlapped and closed on the two arms that were previously closed.

[0043] [3D arrangement and closing movement of the first to third arms 12-14] When the clamping ring 17 is in the first clamping position A, the first arm 12 and the second arm 13 are in two positions open and capable of closing relative to each other on a first plane f1 passing through the extended center line L, and the third arm 14 is in a position open and capable of closing relative to each other on a second plane f2 passing through the extended center line L and perpendicular to the first plane f1.

[0044] When the clip unit 10 is guided to a position facing the affected area P in the digestive tract, the fastening ring 17 has a shape in which the first arm 12 and the second arm 13 gradually widen between the first fastening position A and the second fastening position B, which is moved a required distance in the distal direction, and the third arm 14 is shaped to follow the extended center line L.

[0045] As a result, when the clip unit 10 is guided to a position facing the affected area P in the digestive tract, the fastening ring 17 closes the first arm 12 and the second arm 13 relative to each other on a first plane f1 passing through the extended center line L when it moves from the first fastening position A to the second fastening position B, and when it reaches the second fastening position B, it can be fastened into a closed state that approximately coincides with the extended center line L, thereby clamping the affected area P.

[0046] Furthermore, the fastening ring 17 is shaped such that the width of the third arm 14 gradually increases relative to the closed first arm 12 and second arm 13 between the second fastening position B and the third fastening position C.

[0047] As a result, when the fastening ring 17 moves from the second fastening position B to the third fastening position C, the third arm 14 closes on the second plane f2 passing through the extended center line L, and when the fastening ring 17 reaches the third fastening position C, the third arm 14 is fastened to a closed state with the first arm 12 and the second arm 13, thereby overlapping and clamping the affected area P from different directions, and by clamping the affected area P, hemostasis can be performed, and the affected area P can be separated and left in the digestive organs.

[0048] [Configuration of clip unit 10A according to the second embodiment] As shown in FIG. 4, a clip unit 10A for a ligation device has a multi-limbed arm portion 11A, a connected portion 16A, and a fastening ring 17A.

[0049] The multi-limbed arm section 11A is made of three elastic wires each formed into a different required shape, with the base ends overlapping and integrated by welding or the like, and is made up of a first arm 12A, a second arm 13A, and a third arm 14A that extend three-dimensionally beyond the base ends, and has claws 12a-14a protruding from the tip of each arm in the direction in which the arms close. The claws 12a-14a have the same configuration and function as those in the first embodiment.

[0050] The connected portion 16A and the fastening ring 17A have the same configuration and function as those in the first embodiment.

[0051] [3D arrangement and closing operation of the first to third arms 12A-14A] In this embodiment, unlike the first embodiment, when the fastening ring 17A is in the first fastening position A, the first arm 12A and the second arm 13A are in two open positions capable of closing relative to each other on a first plane f1 passing through the extended center line L, and the third arm 14A is in a position open and capable of closing relative to each other on a second plane f2 passing through the extended center line L and in a direction forming an intersecting angle of 30-60° with respect to the first plane f1.

[0052] The fastening ring 17A is shaped so that the width of the first arm 12A and the second arm 13A gradually increases between the first fastening position A and the second fastening position B, which is moved a required distance in the tip direction, and the third arm 14A is shaped to follow the extended center line L.

[0053] As a result, when the clip unit 10A is guided to a position facing the affected area P in the digestive tract, the fastening ring 17A closes the first arm 12A and the second arm 13A relative to each other on a first plane f1 passing through the extended center line L when it moves from the first fastening position A to the second fastening position B, and when it reaches the second fastening position B, it can be fastened into a closed state that approximately coincides with the extended center line L, thereby clamping the affected area P.

[0054] Furthermore, the fastening ring 17A is shaped such that the width of the third arm 14A gradually increases relative to the closed first arm 12A and second arm 13A between the second fastening position B and the third fastening position C.

[0055] As a result, when the fastening ring 17A moves from the second fastening position B to the third fastening position C, the third arm 14A closes on the second plane f2 passing through the extended center line L, and when the fastening ring 17A reaches the third fastening position C, the third arm 14A is fastened to a closed state with the first arm 12A and the second arm 13A to overlap and clamp the affected area P from different directions, and by clamping the affected area P, bleeding can be stopped, etc., and the affected area P can be separated and left in the digestive organs.

[0056] [Configuration of clip unit 10B according to the third embodiment] As shown in FIG. 5, a clip unit 10B for a ligation device has a multi-limbed arm portion 11B, a connected portion 16B, and a fastening ring 17B.

[0057] The multi-limbed arm section 11B is made of three elastic wires each formed into a different required shape, with the base ends overlapping and integrated by welding or the like, and is made up of a first arm 12B, a second arm 13B, and a third arm 14B that extend three-dimensionally beyond the base ends, and has claws 12a-14a protruding from the tip of each arm in the direction in which the arms close. The claws 12a-14a have the same configuration and function as those in the first embodiment.

[0058] The connected portion 16B and the fastening ring 17B have the same configuration and function as those in the first embodiment.

[0059] [3D configuration and closing operation of the first to third arms 12B-14B] In this embodiment, unlike the first embodiment, when fastening ring 17B is in first fastening position A, first arm 12B is in an open position capable of closing on a first plane f1 passing through extended center line L, second arm 13B is in a second plane f2 passing through extended center line L, and third arm 14B is in a third plane f3 passing through extended center line L. The intersection angle between first plane f1 and second plane f2 is, for example, 120°, and the intersection angle between first plane f1 and third plane f3 is also 120°.

[0060] The fastening ring 17B is shaped so that the first arm 12B and the second arm 13B gradually widen between the first fastening position A and the second fastening position B, which is moved a required distance in the tip direction, and the third arm 14B is shaped to follow the extended center line L.

[0061] As a result, when the clip unit 10B is guided to a position facing the affected area P in the digestive tract, the fastening ring 17B closes the first arm 12B and the second arm 13B relative to each other on a first plane f1 passing through the extended center line L when it moves from the first fastening position A to the second fastening position B, and when it reaches the second fastening position B, it can be fastened into a closed state that approximately coincides with the extended center line L, thereby clamping the affected area P.

[0062] Furthermore, the fastening ring 17B is shaped such that the width of the third arm 14B gradually increases relative to the closed first arm 12B and second arm 13B between the second fastening position B and the third fastening position C.

[0063] As a result, when the tightening ring 17B moves from the second tightening position B to the third tightening position C, the third arm 14B closes on the second plane f2 passing through the extended center line L, and when the tightening ring 17B reaches the third tightening position C, the third arm 14B is tightened so that it is closed against the first arm 12B and the second arm 13B, thereby overlapping and clamping the affected area P from different directions, and by clamping the affected area P, it is possible to stop bleeding, etc.

[0064] [Configuration of clip unit 10C according to the fourth embodiment] As shown in FIG. 6, a clip unit 10C for a ligation device has a multi-limbed arm portion 11C, a connected portion 16C, and a fastening ring 17C.

[0065] The multi-limbed arm section 11C is made of three elastic wires each formed into a different required shape, with the base ends overlapping and integrated by welding or the like, and is made up of a first arm 12C, a second arm 13C, and a third arm 14C that extend three-dimensionally beyond the base ends, and has claws 12a-14a protruding from the tip of each arm in the direction in which the arms close. The claws 12a-14a have the same configuration and function as those in the first embodiment.

[0066] The connected portion 16C and the fastening ring 17C have the same configuration and function as those in the first embodiment.

[0067] [3D configuration and closing operation of the first to third arms 12C-14C] In this embodiment, unlike the first embodiment, when the fastening ring 17 is in the first fastening position A, the first arm 12C coincides with the extended center line L and extends unswingably, the second arm 13C is in an open position capable of closing on a first plane f1 passing through the extended center line L, and the third arm 14C is in an open position capable of closing on a second plane f2 passing through the extended center line L. The first plane f1 and the second plane f2 intersect at an angle of, for example, 90°.

[0068] Between the first fastening position A and the second fastening position B of the fastening ring 17C, the first arm 12C and the third arm 14C are shaped to be aligned along the extended center line L, and the spread of the second arm 13C relative to the first arm 12C and the third arm 14C gradually increases.

[0069] As a result, when the clip unit 10C is guided to a position facing the affected area P in the digestive tract, the fastening ring 17C closes the second arm 13C on a first plane f1 passing through the extended center line L relative to the first arm 12C, which is immobile along the extended center line L, when it moves from the first fastening position A to the second fastening position B, so that when it reaches the second fastening position B, it can be fastened to a state in which it is approximately aligned and closed relative to the first arm 12C, thereby clamping the affected area P.

[0070] Furthermore, between the second fastening position B and the third fastening position C of the fastening ring 17C, the width of the third arm 14C gradually increases relative to the stationary first arm 12C.

[0071] As a result, when the fastening ring 17C moves from the second fastening position B to the third fastening position C, the third arm 14C closes on the second plane f2 passing through the extended center line L, and when the fastening ring 17C reaches the third fastening position C, it tightens against the immovable first arm 12C in a closed state to overlap and clamp the affected area P from different directions, thereby stopping bleeding, etc., and allowing the affected area to be separated and left in the digestive organs.

[0072] [Configuration of clip unit 10D according to the fifth embodiment] As shown in FIG. 7, a clip unit 10D for a ligation device has a multi-limbed arm portion 11D, a connected portion 16D, and a fastening ring 17D.

[0073] The multi-limbed arm section 11D is made of first arm 12D, second arm 13D, third arm 14D, and fourth arm 15D, which are formed by molding four elastic wires into different required shapes, stacking the base ends of the first arm 12D, second arm 13D, third arm 14D, and fourth arm 15D, which extend three-dimensionally from the base ends to the tip side of the first arm 12D, second arm 13D, third arm 14D, and fourth arm 15D, and has claws 12a-15a protruding from the tip of each arm in the direction in which the arms close. The claws 12a-15a have the same configuration and function as those in the first embodiment.

[0074] The connected portion 16D and the fastening ring 17D have the same configuration and function as those in the first embodiment. Since the base end of multi-limbed arm portion 11D is made up of four overlapping elastic wires, the inner diameter of fastening ring 17D is set to be slightly larger than the inner diameter of fastening ring 17 in the first embodiment.

[0075] [The three-dimensional arrangement and closing movement of the first to fourth arms 12D-15D] In this embodiment, unlike the first embodiment, when the fastening ring 17D is in the first fastening position A, the first arm 12D is in an open position capable of closing on a first plane f1 passing through the extended center line L, the second arm 13D is in a second plane f2 passing through the extended center line L, the third arm 14D is in a third plane f3 passing through the extended center line L, and the fourth arm 15D is in a fourth plane f3 passing through the extended center line L.

[0076] The intersection states of the first to fourth planes f1-f4 are, for example, such that the first plane f1 and the second plane f2 intersect at 120-150°, the third plane f3 and the fourth plane f4 intersect with the first plane f1 and the second plane f2 in a line symmetrical manner, the second plane f2 and the third plane f3 intersect at 30-60°, and the fourth plane f4 intersects with the first plane f1 at 30-60°.

[0077] Between the first fastening position A and the second fastening position B of the fastening ring 17D, the first arm 12D and the second arm 13D gradually increase in width, while the third arm 14D and the fourth arm 15D are aligned along the extended center line L and have not yet expanded.

[0078] As a result, when the clip unit 10D is guided to a position facing the affected area P in the digestive tract, the first arm 12D closes on a first plane f1 passing through the extended center line L and the second arm 13D closes on a second plane f2 passing through the extended center line L when the fastening ring 17D moves from the first fastening position A to the second fastening position B, so that when the fastening ring 17D reaches the second fastening position B, the first arm 12D and the second arm 13D can be fastened in a closed state substantially coinciding with the extended center line L, thereby sandwiching the affected area P. The claws 12a, 13a overlap at the front and rear in the direction of the extended center line L.

[0079] Furthermore, between the second fastening position B and the third fastening position C of the fastening ring 17D, the first arm 12D and the second arm 13D are closed together along the extended center line L, and the width of the third arm 14D and the fourth arm 15D relative to the first arm 12D and the second arm 13D gradually increases.

[0080] As a result, when the fastening ring 17D moves from the second fastening position B to the third fastening position C, the third arm 14D closes on the third plane f3 passing through the extended center line L, and the fourth arm 15D closes on the fourth plane f4 passing through the extended center line L, and when the fastening ring 17D reaches the second fastening position B, the third arm 14D and the fourth arm 15D overlap the first arm 12D and the second arm 13D in the closed position and are fastened in a closed state, so that the affected part P is overlapped and sandwiched from different directions, bleeding can be stopped, and the affected part P can be separated and left in the digestive organs. The claws 14a and 15a overlap each other in the front and rear at the tip side of the claws 12a and 13a in the direction of the extended center line L.

[0081] [Configuration of clip unit 10E according to the sixth embodiment] As shown in FIG. 8, a clip unit 10E for a ligation device has a multi-limbed arm portion 11E, a connected portion 16E, and a fastening ring 17E.

[0082] The multi-limbed arm section 11E is made of four elastic wires each formed into a different required shape, and the base ends of the wires are stacked and integrated by welding or the like, forming a first arm 12E, a second arm 13E, a third arm 14E, and a fourth arm 15E that extend three-dimensionally from the base ends to the tip side, and has claws 12a-15a protruding from the tip of each arm in the direction in which the arms close. The claws 12a-15a have the same configuration and function as those in the first embodiment.

[0083] The connected portion 16E and the fastening ring 17E have the same configuration and function as those in the first embodiment. The inner diameter of the fastening ring 17E is set to be the same as the inner diameter of the fastening ring 17D of the fifth embodiment.

[0084] [3D configuration and closing operation of the first to fourth arms 12E-15E] In this embodiment, unlike the first embodiment, when the fastening ring 17E is in the first fastening position A, the first arm 12E and the second arm 13E are in a position open to both sides of each other so as to be capable of closing on a first plane f1 passing through the extended center line L, the third arm 14E is in a position open to be capable of closing on a second plane f2 passing through the extended center line L, and further the fourth arm 15E is in a position open to be capable of closing on a third plane f3 passing through the extended center line L on the same side of the first plane f1 as the second plane f2.

[0085] Regarding the intersection state of the first to fourth planes f1-f4, for example, the first plane f1 and the second plane f2 intersect at 45-60°, and the first plane f1 and the third plane f2 intersect at 120-135°.

[0086] Between the first fastening position A and the second fastening position B of the fastening ring 17E, the first arm 12E and the second arm 13E gradually widen, while the third arm 14E and the fourth arm 15E are aligned along the extended center line L and have not yet widened.

[0087] As a result, when the clip unit 10E is guided to a position facing the affected area P in the digestive tract, the first arm 12E and the second arm 13E of the fastening ring 17E close relative to each other on a first plane f1 passing through the extended center line L when the clip unit 10E moves from the first fastening position A to the second fastening position B, and when the fastening ring 17E reaches the second fastening position B, the first arm 12E and the second arm 13E can be fastened to a closed state substantially coinciding with the extended center line L, thereby sandwiching the affected area P. The claws 12a, 13a overlap at the front and rear in the direction of the extended center line L.

[0088] Furthermore, between the second fastening position B and the third fastening position C of the fastening ring 17E, the first arm 12E and the second arm 13E are closed together along the extended center line L, and the width of the third arm 14E and the fourth arm 15E relative to the first arm 12E and the second arm 13E gradually increases.

[0089] As a result, when the fastening ring 17E moves from the second fastening position B to the third fastening position C, the third arm 14E closes on the third plane f3 passing through the extended center line L, and the fourth arm 15E closes on the fourth plane f4 passing through the extended center line L, and when the fastening ring 17E reaches the third fastening position C, the third arm 14E and the fourth arm 15E are closed to the first arm 12E and the second arm 13E, respectively, and the affected area P is overlapped and sandwiched from different directions, bleeding can be stopped, and the affected area P can be separated and left in the digestive organs. The claws 14a and 15a overlap the claws 14a and 15a in the direction of the extended center line L at the front and rear ends.

[0090] As described above, according to the clip unit for a ligation device of this embodiment, it is possible to provide a clip unit for a ligation device that has a multi-limbed arm portion having arms that are made of three or four elastic wires that can be opened and closed, and that first closes the two arms to hold the affected area in a closed state, and then closes the remaining arms from a direction different from the previous closing direction to increase the gripping force and clamp the affected area in a three-dimensionally bent state, thereby stopping bleeding, etc., and can then be separated and retained in a body cavity. [Explanation of symbols]

[0091] 1...Ligation device 2...Operation unit 2a...Cylinder shaft part 2a1...slit 2b…Slider 2b1…Diameter connection part 2b2…Finger rest part 2c... Finger ring 3a…Male tubular connector 3b…Female cylindrical connection part 4…Inner sheath 4a…Inner sheath body 4b…Holding cylinder 4b1…Tightening ring receiving section 4b2…Chuck drawing section 5…Outer sheath 5a…Knob part 6…Operation wire 7…Uncoupling tool 7a, 7b...Chuck jaws 10, 10A-10E…Clip unit 11, 11A-11E…Multi-limb arm section 12A-12E…First arm 13A-13E…Second arm 14A-14E…Third arm 15D, 15E…4th arm 12a-15a…Claws 16, 16A-16E…Connected part 16a...Chuck hole 17, 17A-17E…Tightening ring A…First tightening position (initial position) B…Second tightening position C…Third tightening position f1...first plane f2…Second plane f3…the third plane f4...fourth plane L…Extension center line P…affected area

Claims

1. A clip unit for a ligation device is detachably held by a release tool provided at a distal end of the ligation device, which is inserted into a channel of an endoscope and into a body cavity of a living body to grasp an affected area and perform hemostasis or the like, and is detached and left inside the body after treatment, a multi-limbed arm section, comprising three or four arms each of which is made of three or four elastic wires each formed into a different required shape, each base end of which is stacked and integrated, the ends of which extend three-dimensionally beyond the base end, the multi-limbed arm section having a claw protruding from the tip of each arm in the direction in which the arm is closed; a connected portion in which two of the three or four elastic wires extend further in a proximal direction from the proximal end portion and are connected in a loop shape to have a chuck hole for being chucked by the connection release tool; a fastening ring that is fitted to the multi-limb arm portion and whose fastening position can be moved toward the distal end by operating the ligation device; The clamping ring is In a first fastening position which is an initial position, the fastening member is fitted onto the base end portion of the multi-limbed arm portion, Between the first clamping position and the second clamping position, which is moved a required distance in the distal direction from the first clamping position, the spread of two of the three or four arms gradually increases. Therefore, at the second clamping position, the two arms are clamped so as to be closed together, Between the second clamping position and a third clamping position which is moved a required distance further in the distal direction from the second clamping position, the remaining one or two of the three or four arms are gradually expanded, so that at the third clamping position, the remaining one or two arms are clamped so as to overlap and close on the two previously closed arms. A clip unit for a ligation device, comprising:

2. In the first fastening position, the position where the arms are closed approximately coincides with an extended center line of the sheath center on the distal side of the inner sheath tip of the ligation device. The clip unit for a ligation device according to claim 1 .

3. the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions open so as to be able to close relative to each other on a first plane passing through the extended center line, and the third arm is in a position open so as to be able to close relative to each other on a second plane passing through the extended center line and perpendicular to the first plane, The clamping ring clamps the first arm and the second arm together when moving from the first clamping position to the second clamping position, and further clamps the third arm together when moving to the third clamping position. The clip unit for a ligation apparatus according to claim 2 .

4. the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions where they are open so as to be able to close each other on a first plane passing through the extended center line, and the third arm is in a position where they are open so as to be able to close on a second plane passing through the extended center line and in a direction having an intersecting angle of 30-60° with respect to the first plane, The clamping ring clamps the first arm and the second arm together when moving from the first clamping position to the second clamping position, and clamps the third arm together when moving to the third clamping position. The clip unit for a ligation apparatus according to claim 2 .

5. the multi-limbed arm unit includes a first arm, a second arm, and a third arm, when the clamping ring is in the first clamping position, the first arm is in an open position so as to be able to close on a first plane passing through the extended center line, the second arm is in an open position so as to be able to close on a second plane passing through the extended center line, and the third arm is in an open position so as to be able to close on a third plane passing through the extended center line, The clamping ring clamps the first arm and the second arm together when moving from the first clamping position to the second clamping position, and clamps the third arm together when moving to the third clamping position. The clip unit for a ligation apparatus according to claim 2 .

6. the multi-limbed arm unit includes a first arm, a second arm, and a third arm, When the fastening ring is in the first fastening position, the first arm coincides with the extended center line and extends unswingably, the second arm is in an open position so as to be capable of closing on a first plane passing through the extended center line, and the third arm is in an open position so as to be capable of closing on a second plane passing through the extended center line, When the fastening ring moves from the first fastening position to the second fastening position, the fastening ring fastens the second arm so as to close against the non-pivotable first arm, and when the fastening ring moves to the third fastening position, the fastening ring fastens the third arm so as to close against the non-pivotable first arm. The clip unit for a ligation apparatus according to claim 2 .

7. the multi-limbed arm unit includes a first arm, a second arm, a third arm, and a fourth arm, When the clamping ring is in the first clamping position, the first arm is in an open position so as to be able to close on a first plane passing through the extended center line, the second arm is in a second plane passing through the extended center line, the third arm is in a third plane passing through the extended center line, and the fourth arm is in a fourth plane passing through the extended center line, The clamping ring clamps the first arm and the second arm together when moving from the first clamping position to the second clamping position, and clamps the third arm and the fourth arm together when moving to the third clamping position. The clip unit for a ligation apparatus according to claim 2 .

8. the multi-limbed arm unit includes a first arm, a second arm, a third arm, and a fourth arm, When the clamping ring is in the first clamping position, the first arm and the second arm are in two positions open so as to be able to close relative to each other on a first plane passing through the extended center line, the third arm is in a position open so as to be able to close relative to each other on a second plane passing through the extended center line, and the fourth arm is in a position open so as to be able to close relative to each other on a third plane passing through the extended center line on the same side of the first plane as the second plane, The clamping ring clamps the first arm and the second arm together when moving from the first clamping position to the second clamping position, and clamps the third arm and the fourth arm together when moving to the third clamping position. The clip unit for a ligation apparatus according to claim 2 .

Images