Endoscope suture system

Abstract

To enable provision of a treatment instrument for an endoscope with improved safety and operability.SOLUTION: An endoscope suture system comprises: a suture needle 31; a suture thread 32 having one end attached to the suture needle 31 and the other end having a thread stop part, the suture thread having an external surface on which anchors are formed; an endoscope body 10 including a cylindrical endoscope channel 14; a sheath 21 that is provided ao as to be inserted into the endoscope channel 14 and movable forward and backward and is formed in a long cylindrical shape; an operation wire 22 that is inserted into the sheath 21 and is provided so as to be movable forward and backward in the extension direction of the sheath 21; an operation part 23 that is attached to the base end of the operation wire 22 to move the operation wire 22 forward and backward; and a grip part 24 that is attached to the tip of the operation wire 22 and is capable of gripping / releasing the suture thread 32. The grip part 24 has a structure that is capable of taking a projection state projecting from the sheath 21 and a retracted state of being retracted and housed in the sheath 21 and is capable of gripping the suture thread 32 at least in the retracted state.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] This invention relates to an endoscopic suturing system for suturing suture targets such as biological tissues under observation by an endoscope.

Background Art

[0002] Conventionally, an endoscopic needle holder for grasping and manipulating a suture needle when operating on a site within a body cavity under observation by an endoscope has been provided (see Patent Document 1). By using this endoscopic needle holder, suturing can be performed in endoscopic surgery.

[0003] However, the conventional endoscopic needle holder has drawbacks such as the need for movement in a direction perpendicular (lateral direction) to the axis of the endoscope and complex operations, difficulty in adjusting the depth of the suture needle, and time-consuming suture needle replacement operations. Therefore, advanced skills are required for proper use, and there is a problem of lack of versatility.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] In view of the above problems, an object of this invention is to provide an endoscopic suturing system with improved operability.

Means for Solving the Problems

[0006] The present invention relates to a suture needle, a suture thread having one end attached to the suture needle and a thread stop at the other end, with a loop formed on the outer surface between the one end and the other end, an endoscope body having a tubular endoscope channel, a sheath formed in a long tubular shape and inserted into the endoscope channel and provided so as to be movable forward and backward in the extending direction of the endoscope channel, an operation wire inserted into the sheath and provided so as to be movable forward and backward in the extending direction of the sheath, an operation part attached to the base end of the operation wire for moving the operation wire forward and backward, and a gripping part attached to the tip of the operation wire and capable of gripping / releasing the suture thread. The gripping part can take a protruding state protruding from the sheath and a retracted state retracted and accommodated in the sheath, and is configured to be able to grip the suture thread at least in the retracted state. The endoscope suture system is characterized by this.

Advantages of the Invention

[0007] According to the present invention, an endoscope suture system with improved operability can be provided.

Brief Description of the Drawings

[0008]

Figure 1

Figure 2

Figure 3A

Figure 3B

Figure 4A

Figure 4B

Figure 5

Figure 6

Figure 7

Figure 8

Mode for Carrying Out the Invention

[0009] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a schematic explanatory drawing showing an example of the overall configuration of the endoscope suturing system 1 of the present invention. FIG. 2 is a schematic explanatory drawing showing an example of the configuration of the endoscope treatment instrument 20.

[0010] As shown in FIG. 1, the endoscope suturing system 1 is a system for suturing a suture target such as a living tissue under observation by an endoscope, and includes an endoscope main body 10, an endoscope treatment instrument 20, and a suture thread unit 30. Although details will be described later, the endoscope treatment instrument 20 is configured to be insertable (insertable) into the endoscope main body 10.

[0011] The endoscope main body 10 has a longitudinal axis (longitudinal direction) and is generally formed in a substantially cylindrical shape. The endoscope main body 10 includes an insertion portion 11 provided at one end (tip portion) in the longitudinal direction and inserted into the body cavity of a living body, an operation portion 12 provided at the other end (rear end portion or base end portion) in the longitudinal direction, and a treatment instrument introduction portion 13 provided between the insertion portion 11 and the operation portion 12 (on the proximal end side of the insertion portion 11). The treatment instrument introduction portion 13 is configured to extend in a direction inclined at a predetermined angle with respect to the longitudinal direction (obliquely with respect to the longitudinal direction).

[0012] The insertion portion 11 has an imaging portion 111, an active bending portion 112, and a flexible portion 113. The imaging portion 111, the active bending portion 112, and the flexible portion 113 are arranged in this order from the tip of the insertion portion 11. Inside the insertion portion 11, an endoscope channel 14, which is a cylindrical internal space communicating from the treatment instrument introduction portion 13 and through which the endoscope treatment instrument 20 is inserted, is provided. A tip opening 14a, which is one opening of the endoscope channel 14, is formed at the tip of the insertion portion 11, and a rear end opening 14b, which is the other opening of the endoscope channel 14, is formed at the rear end of the treatment instrument introduction portion 13. The distal opening 14a is the part facing the object to be sutured, and the imaging unit 111 is disposed adjacent to this distal opening 14a.

[0013] The imaging unit 111 has, for example, an image sensor and a focus lens, etc., and performs imaging by converting imaging light, which is visible light captured by the image sensor, into an electrical signal. Examples of the image sensor include solid-state image sensors such as a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor.

[0014] The image sensor of the imaging unit 111 is disposed so as to face the object to be sutured. Therefore, the imaging unit 111 can image, within the same field of view, the site to be treated (suturing site) in the object to be sutured from the distal end of the insertion unit 11 and the distal end portion (the gripping portion 24 described later) of the endoscopic treatment instrument 20 in a state where the endoscopic treatment instrument 20 protrudes from the distal opening 14a of the endoscopic channel 14.

[0015] The active bending portion 112 can be actively bent according to the operation of the operation unit 12 by the operator. The flexible portion 113 is a tubular portion having flexibility. The operation unit 12 has a grip, which is a portion gripped by the operator, and an input unit that receives an operation input for bending the active bending portion 112 in the vertical, horizontal, and lateral directions. Further, a communication cable 121 is connected to the side surface of the operation unit 12. The communication cable 121 is a cable for outputting the image captured by the imaging unit 111 to the outside, and is, for example, a universal cable. By connecting the communication cable 121 to a display device such as a liquid crystal display, the image captured by the imaging unit 111 can be displayed in real time. Therefore, the user of the endoscopic suturing system 1 can work while observing the situation of the suturing site and the distal end portion (gripping portion 24) of the endoscopic treatment instrument 20.

[0016] As shown in FIGS. 1 and 2, the endoscopic treatment instrument 20 includes a sheath 21, an operation wire 22 inserted through the sheath 21, an operation unit 23 for operating the operation wire 22, and a gripping portion 24 attached to the tip of the operation wire 22.

[0017] The sheath 21 is formed of a flexible material having flexibility such as resin, and is formed in an overall long cylindrical shape. For example, the sheath 21 is formed in a long cylindrical shape and has a cylindrical internal space. A tip opening 21a, which is one opening of the sheath 21, is formed at the tip of the sheath 21. However, the tip portion of the sheath 21 including the tip opening 21a may be formed of a hard material such as a metal material.

[0018] The outer diameter of the sheath 21 is smaller than the inner diameter of the endoscopic channel 14 of the endoscope body 10. Therefore, the sheath 21 is configured to be movable relative to the endoscopic channel 14 (endoscope body 10) in the extending direction of the endoscopic channel 14 (the extending direction of the sheath 21). Specifically, the sheath 21 is configured to be able to advance and retreat in the extending direction of the endoscopic channel 14 within the endoscopic channel 14 and to be rotatable about the axis of the sheath 21. For this reason, the tip portion (gripping portion 24) of the sheath 21 can protrude from the tip opening 14a or be buried inside the sheath 21 by changing the relative position of the sheath 21 with respect to the endoscopic channel 14. Further, when the tip opening 21a of the sheath 21 is made to protrude with respect to the tip opening 14a, the tip opening 21a (gripping portion 24 described later) of the sheath 21 can enter the imaging field of the imaging unit 111.

[0019] The operating wire 22 is made of a material having a certain degree of flexibility and capable of transmitting an axial operating force. For example, the operating wire 22 is a wire rope or the like formed of a stranded wire obtained by spirally twisting a plurality of wires (cables) made of a metal material such as stainless steel. The outer diameter of the operating wire 22 is smaller than the inner diameter of the sheath 21. Therefore, the operating wire 22 is configured to be movable relative to the sheath 21 in the extending direction of the sheath 21 (the extending direction of the operating wire 22).

[0020] The operating portion 23 has a cylindrical main body 23a connected to the sheath 21 and a cylindrical slider 23b provided so as to cover the outer peripheral surface of the main body 23a. The main body 23a and the slider 23b are formed to extend in the extending direction of the endoscope channel 14 and have a double cylinder structure that is relatively slidable. For this reason, the slider 23b is connected to the main body 23a so as to be able to move forward and backward, and can move forward and backward along the axial direction of the main body 23a (the extending direction of the endoscope channel 14).

[0021] The rear end portion of the operating wire 22 is attached to the slider 23b through the internal spaces of the sheath 21 and the main body 23a. Therefore, when the slider 23b moves forward and backward along the main body 23a, the operating wire 22 moves forward and backward along the longitudinal axis (longitudinal direction) of the sheath 21 or the endoscope channel 14 in conjunction with the slider 23b. That is, the operating wire 22 can move forward and backward in the extending direction of the sheath 21 within the sheath 21. Specifically, when the slider 23b is moved to the distal end side, the operating wire 22 can be moved (pushed out) to the distal end side of the sheath 21, and when the slider 23b is moved to the rear end side, the operating wire 22 can be moved (pulled in) to the rear end side of the sheath 21. Further, when the slider 23b is rotated, the operating wire 22 rotates integrally, and thereby the gripping portion 24 described later also rotates integrally with the operating wire 22.

[0022] Therefore, the user of the endoscopic suturing system 1 can perform a suturing procedure (suturing treatment) for suturing a suture target such as a biological tissue under observation by an endoscope by operating the operation unit 23 (slider 23b) to move the operation wire 22 forward and backward or rotate it. Note that the rotation ranges of the holding portion 24 and the operation wire 22 may be configured without particular restrictions, but may be configured to be less than two rotations (less than 720°), or less than one rotation (less than 360°), etc., and restricted to less than a predetermined rotation angle to prevent over-rotation. By doing so, it is possible to prevent the suture thread 32 from getting entangled inside due to excessive rotation of the holding portion 24 and the operation wire 22 inside the sheath 21.

[0023] The holding portion 24 has a function of holding the suture unit 30. The specific configuration of the holding portion 24 is not particularly limited, but the holding portion 24 of the present invention is configured to be able to take a posture protruding from the sheath 21 (protruding state) and a posture retracted and accommodated in the sheath 21 (retracted state).

[0024] FIG. 3A is an explanatory diagram showing an example of the configuration of the holding portion 24 in the protruding state. FIG. 3B is an explanatory diagram showing an example of the configuration of the holding portion 24 in the retracted state. Hereinafter, the configuration of the holding portion 24 in one embodiment will be described with reference to FIGS. 3A and 3B.

[0025] As shown in FIGS. 3A and 3B, in the present embodiment, the holding portion 24 is formed of an elastically deformable plate member (clip). The holding portion 24 of the present embodiment has a connecting plate portion 24a bent in a substantially U shape and a pair of arm plate portions 24b integrally extending from both ends of the connecting plate portion 24a. The pair of arm plate portions 24b are formed in a substantially V shape or a substantially inverted V shape so as to gradually separate from the base end portion toward the tip end portion in a state where no external force acts.

[0026] The outer dimensions of the connecting plate portion 24a are set to a size that can be accommodated in the sheath 21. Also, the width dimensions of each arm plate portion 24b are also set to a size that can be accommodated in the sheath 21. That is, the gripping portion 24 is set to a size that can be accommodated in the sheath 21 in a state where each arm plate portion 24b is folded.

[0027] At the tip of each arm plate portion 24b (the end on the opposite side of the connecting plate portion 24a), claw portions 24c are integrally formed respectively. Each claw portion 24c is formed by being bent inward so as to face each other at the tip of each arm plate portion 24b. Also, each claw portion 24c is arranged at different positions in the front-rear direction (the extending direction of the sheath 21). Therefore, each claw portion 24c is configured to overlap in the front-rear direction in a state where each arm plate portion 24b is folded.

[0028] The connecting plate portion 24a, the pair of arm plate portions 24b, and the pair of claw portions 24c that constitute the gripping portion 24 are formed by bending and plastically deforming one thin and elongated plate material made of an elastic body. Although not particularly limited, as the material constituting the gripping portion 24, a metal material such as stainless steel having an elastic restoring force is used.

[0029] Also, in a state where no external force is applied, the gripping portion 24 is in a state where the pair of arm plate portions 24b are opened in a substantially V shape as they approach the tip, and the pair of claw portions 24c are in a separated state. Therefore, as shown in FIG. 3A, in a state where the gripping portion 24 protrudes from the tip of the sheath 21 (protruding state), since no external force for regulation is applied in particular, the pair of arm plate portions 24b are in an opened state (open state).

[0030] On the one hand, as shown in FIG. 3B, in the state where the gripping portion 24 is drawn into the sheath 21 (drawn-in state), each arm plate portion 24b is pressed (regulated) by the inner surface (inner wall) of the sheath 21 and elastically deformed, and each arm plate portion 24b is folded and assumes a posture close to parallel to each other (becomes a closed state). In this drawn-in state, the respective claw portions 24c are in a state of overlapping each other. When the suture unit 30 is positioned between the respective claw portions 24c in the drawn-in state, the suture unit 30 is in a state of being sandwiched by the respective claw portions 24c, that is, in a state of being gripped by the gripping portion 24.

[0031] As described above, the relative position of the gripping portion 24 with respect to the sheath 21 changes by the operation wire 22. Therefore, when the operation wire 22 is moved (drawn in) toward the rear end side in the protruding state, the gripping portion 24 is gradually drawn into the sheath 21. At this time, each arm plate portion 24b gradually closes. On the other hand, when the operation wire 22 is moved (projected) toward the front end side in the drawn-in state, each arm plate portion 24b gradually opens.

[0032] FIG. 4A is an explanatory diagram showing an example of the configuration of the suture unit 30. FIG. 4B is an explanatory diagram showing another example of the configuration of the suture unit 30. As shown in FIGS. 4A and 4B, the suture unit 30 has a suture needle 31 and a suture 32. The suture unit 30 can also be referred to as a suture-with-needle unit in which a suture needle is attached in advance to the tip of the suture 32.

[0033] The suture needle 31 is a needle for passing the suture thread 32 in a bidirectional manner from one side to the other side and from the other side to one side through an object to be sutured such as biological tissue. As the suture needle 31, a needle linearly formed as a whole as shown in Fig. 4A (straight needle) or a needle with a straight proximal end and a curved (forceps curve) distal end as shown in Fig. 4B (curved tip needle) can be used. The suture needle 31 can also be at least partially curved or bent. In this case, the suture needle 31 can have a straight or curved proximal end, and the angle between the straight or tangent line at the distal end and the straight or tangent line at the proximal end can be less than 90 degrees, preferably 60 degrees or less, more preferably 45 degrees or less, and suitably 30 degrees or less. Also, the distal end portion of the suture needle 31 may have flexibility and may be configured such that the shape of the distal end portion can be switched between a linear shape and a curved shape. For example, a wire (wire for needle deformation) with one end fixed to the distal end portion can be separately provided, and the distal end portion of the suture needle 31 can be curved by pulling in the wire for needle deformation. The thickness of the suture needle 31 is formed smaller than the inner diameter of the sheath 21. Also, the length of the proximal end portion of the suture needle 31 that is at least drawn into the sheath 21 can be 2 times or more, preferably 3 times or more, and suitably 4 times or more the thickness of the suture needle 31. Although not shown, a through-hole (perforation hole) for passing the suture thread 32 is formed at the proximal end portion of the suture needle 31. The configuration of the through-hole of the suture needle 31 does not particularly need to be limited. For example, the through-hole of the suture needle 31 can be formed as a spring hole (spring mechanism hole) or a normal hole (ordinary hole). Note that the distal end portion of the suture needle 31 becomes the distal end portion of the suture thread unit 30.

[0034] The suture 32 has a thread stop portion 32a at its proximal end, and the distal end is attached to the sewing needle 31. The form of the thread stop portion 32a is not particularly limited, but it may be formed thicker or wider than the main body portion of the suture 32 (the portion between the proximal end and the distal end). For example, the thread stop portion 32a can be configured in a loop shape (circular ring shape, elliptical ring shape, or oval ring shape) as shown in FIG. 4A, or can be configured by a fixing tab (such as a Laplace tie) as shown in FIG. 4B. The thickness (diameter) of the suture 32 is less than half of the inner diameter of the sheath 21, and is formed to be thinner (diameter) than the inner diameter of the sheath 21 including the width of the anchor 32b in a state where it is bent or curved in the middle and doubled.

[0035] Also, a plurality of returns (anchors) 32b are formed on the outer surface of the suture 32 between the proximal end (thread stop portion 32a) and the distal end. The anchor 32b is configured to gradually increase outward in the radial direction (the radial direction of the suture 32) as viewed from the direction in which the sewing needle 31 advances (from the front end side to the rear end side). There is little resistance in the direction in which the sewing needle 31 advances and there is no obstacle to needle insertion. Also, once the suture 32 is passed through the suture object, the anchor 32b has a function of biting into and fixing to the suture object. Therefore, the suture 32 of the present embodiment does not require knots with respect to the suture object.

[0036] Furthermore, a mark portion 32c is formed at a position a predetermined distance (for example, 5 to 20 mm) away from the distal end (the portion attached to the sewing needle 31) on the suture 32. The mark portion 32c is configured in a visible manner, such as being given an appropriate color different from the color of the suture 32 other than the mark portion 32c. In the present embodiment, no anchor 32b is formed in the mark portion 32c, but an anchor 32b may be formed in the mark portion 32c.

[0037] As the material of the suture 32, either a degradable (absorbable) material or a non-degradable (non-absorbable) material may be used, but since there is no need to pull out the thread, it is preferable to use a degradable material.

[0038] Further, the suture unit 30 (suture needle 31 and suture 32) is preferably configured to be insertable into the sheath 21. From this perspective, it is preferable that the outer diameter of the thread stop portion 32a of the suture 32 is set to a size that can be accommodated in the sheath 21. Also, the suture needle 31 is a straight needle, and it is preferable that the outer diameter of the suture needle 31 is set to a size that can be accommodated in the sheath 21.

[0039] FIG. 5 is an explanatory diagram showing an operation example of the endoscopic treatment instrument 20 in the protruding state. FIG. 6 is an explanatory diagram showing an operation example of the endoscopic treatment instrument 20 in the retracted state. Hereinafter, with reference to FIGS. 5 and 6, an operation example of the endoscopic treatment instrument 20 of the present invention will be described.

[0040] As described above, the operation wire 22 can advance and retreat in the sheath 21 in the extending direction of the sheath 21, and the state of the gripping portion 24 can be transitioned between a protruding state in which the gripping portion 24 protrudes from the distal end portion of the sheath 21 as shown in FIG. 5 and a retracted state in which the gripping portion 24 is retracted into the sheath 21 as shown in FIG. 6.

[0041] Here, when transitioning to the retracted state (the state of FIG. 6) when a part of the suture 32 (preferably the marking portion 32c) is positioned between each arm plate portion 24b or each claw portion 24c in the protruding state (the state of FIG. 5), that is, when the operation wire 22 is retracted into the sheath 21, the suture 32 is sandwiched between the claw portions 24c when each arm plate portion 24b gradually closes, and the suture unit 30 is retracted into the sheath 21 while being gripped by the gripping portion 24. However, in the retracted state, at least the distal end portion of the suture needle 31 is exposed from the distal end opening 21a of the sheath 21 (the state of FIG. 6). At this time, the proximal end portion of the suture needle 31 is accommodated in the sheath 21 and is aligned in the same direction as the extending direction of the sheath 21. Therefore, in the retracted state, the suture needle 31 protrudes straight from the distal end opening 21a of the sheath 21 and the distal end opening 14a of the endoscope channel 14.

[0042] With the relative position between the sheath 21 and the operating wire 22 (suture needle 31) fixed in the inserted state, the sheath 21 is moved in the distal direction of the endoscope channel 14, whereby the suture needle 31 can be protruded from the endoscope body 10. By this protruding operation, the suture needle 31 can be stabbed into a suture target such as a biological tissue (suture site). At this time, since the protruding direction of the suture needle 31 is the same as the imaging direction of the imaging unit 111, the user of the endoscope suturing system 1 can keep the suture needle 31 protruding straight while observing the situation between the suture site and the distal portion (grasping portion 24 and suture needle 31) of the endoscope treatment instrument 20, and stab and suture the suture needle 31 into the suture site.

[0043] Therefore, with respect to an appropriate position from the perspective of treatment on the suture target, by performing the protruding operation in a state where the active bending portion 112 is bent so as to face an appropriate direction from the perspective of treatment (the direction through which the suture thread 32 should pass from the perspective of treatment), the suture needle 31 and the suture thread 32 can be passed through the suture target at an appropriate position and direction. After passing the suture needle 31 and the suture thread 32 through the suture target, the suture thread 32 (suture thread unit 30) is once released by transitioning the grasping portion 24 to the protruding state, and then the suture thread 32 can be pulled by transitioning the grasping portion 24 to the retracted state so as to grasp the suture thread 32. By adjusting the position of the endoscope treatment instrument 20 with respect to the suture target and pulling the suture thread 32 to a predetermined position, the suture thread 32 can be fixed to the suture target at a desired position. In this way, by performing a forward and backward movement for repeatedly transitioning the grasping portion 24 between the protruding state and the retracted state, and grasping and moving the suture thread 32 or releasing the suture thread 32 in the process, the suture target such as a biological tissue can be sutured under the observation of the endoscope.

[0044] With the above configuration, according to the present invention, by simply repeating the forward and backward movement of the sheath 21 with respect to the endoscope body 10 and the forward and backward movement of the operation wire 22 (grip portion 24) with respect to the sheath 21, a suturing procedure can be performed under the endoscope. That is, according to the present invention, a suturing procedure under the endoscope can be performed only by a linear operation (manipulation), and an endoscope treatment tool with improved operability can be provided. In this suturing procedure, since the suture needle 31 can be inserted and sutured in the direction of the forward and backward movement of the sheath 21, it is easy to operate as an endoscope operation, and the suturing procedure can be performed as long as the endoscope operation can be performed without being proficient in the operation of the endoscope suture system 1.

[0045] Further, if the suture thread 32 is gripped by the grip portion 24 and drawn into the sheath 21, the tip of the suture needle 31 is set in a suturable state protruding from the tip of the sheath 21, so that the setting / release can be easily performed any number of times, and the suturing procedure can be performed smoothly. Specifically, 1. The suture thread 32 is gripped and drawn in by the grip portion 24, 2. The suture needle 31 is pierced into the suturing target and protruded to the other side of the suturing target, 3. The suture needle 31 and the suture thread 32 are released, 4. The tip side of the suture needle 31 protruding to the other side of the suturing target is gripped by the grip portion 24, 5. The gripped suture needle 31 is pulled to pass the suture thread 32 to the connection target near the end, 6. The operations from 1. above are repeated again to continue suturing Such an operation can be easily and quickly performed.

[0046] In particular, by performing suturing by operating in the protruding direction of the sheath 21, the curved needle is not directly gripped and sutured in the rotational direction of the sheath 21, so that suturing can be easily performed without the difficulty of gripping the position of the curved needle.

[0047] In addition, since the suture needle 31 can be set in the suturing system by gripping and pulling in the suture thread 32 without directly gripping the suture needle 31, it is not necessary to be precise about the gripping position, gripping angle, etc., and the suturing system can be easily prepared in a short time, and the total time of the suturing procedure can be significantly shortened.

[0048] In addition, the gripping range can be anywhere between the suture needle 31 side of the suture thread 32 and the marking portion 32c, and the gripping angle is not limited, so appropriate gripping can be easily executed in a short time.

[0049] Further, according to the present invention, the gripping portion 24 is formed of a plate member that elastically deforms. In the protruding state, the pair of arm plate portions 24b are opened by the elastic force and the claw portions 24c of each other are separated. In the retracted state, it is restricted by the inner surface of the sheath 21 and elastically deformed, and the pair of arm plate portions 24b are closed and the claw portions 24c of each other overlap. Therefore, the suturing procedure under the endoscope can be performed only by a linear operation using the elastic restoring force of the gripping portion 24, and an endoscope treatment tool with improved operability can be provided.

[0050] Furthermore, according to the present invention, the suture thread unit 30 (suture needle 31 and suture thread 32) can be inserted into the sheath 21, so that the suture thread unit 30 can be carried into the body cavity through the sheath 21 (Through The Scope (TTS)), and an improvement in workability can be expected. In particular, if the suture needle 31 is a straight needle, it is easy to realize TTS, and the sheath 21 and the endoscope main body 10 can also be miniaturized, and a further improvement in workability can be expected.

[0051] The endoscopic suturing system of this invention corresponds to the endoscopic suturing system 1 of the above-described embodiment. Similarly hereinafter, the suture needle corresponds to the suture needle 31, the suture thread corresponds to the suture thread 32, the thread stop portion corresponds to 32a, the endoscopic body corresponds to the endoscopic body 10, the endoscopic channel corresponds to the endoscopic channel 14, the sheath corresponds to the sheath 21, the operating wire corresponds to the operating wire 22, the operating portion corresponds to the operating portion 23, the gripping portion corresponds to the gripping portion 24, the arm plate portion corresponds to the arm plate portion 24b, the claw portion corresponds to the claw portion 24c, and the closing portion corresponds to the closing portion 24d. However, this invention is not limited to this embodiment and can be other various embodiments. Also, the specific configurations and the like mentioned in the above-described embodiment are examples, and can be appropriately changed according to the actual product.

[0052] For example, as shown in FIG. 7, the gripping portion 24 may have a closing portion (auxiliary connecting portion) 24d that connects a pair of arm plate portions 24b on the tip side of the connecting plate portion 24a. In this case, when the gripping portion 24 transitions from the protruding state to the retracted state, the closing portion 24d closes the space on the back side (connecting plate portion 24a) of the gripping portion 24, and it is possible to prevent the suture thread 32 from entering the back side of the closing portion 24d. Therefore, it is possible to prevent or suppress the suture thread 32 from entering the back side of the gripping portion 24 more than necessary, and it is possible to prevent or suppress the suture thread 32 from getting entangled.

[0053] Also, the specific configuration of the gripping portion 24 does not need to be particularly limited. For example, as shown in FIG. 8, the gripping portion 24 may be configured by a structure that mechanically opens and closes, such as biopsy forceps having a pair of clamps 24e that can be opened and closed, without being restricted by the sheath 21. Even in this case, similar to the above-described embodiment, since the suturing procedure under the endoscope can be performed only by a linear operation (manipulation), it is possible to provide a treatment tool for an endoscope with improved operability. Note that the pair of clamps 24e may be of a single-opening type in which only one of the clamps 24e opens and closes, or may be of a double-opening type in which both of the clamps 24e open and close.

Industrial Applicability

[0054] The present invention can be used in the industry of manufacturing an endoscopic suturing system for suturing an object to be sutured such as a living tissue under observation with an endoscope.

Explanation of Signs

[0055] 1…Endoscopic treatment system 10…Endoscope body 14…Endoscope channel 20…Endoscopic treatment instrument 21…Sheath 22…Operating wire 23…Operating part 24…Gripping part 24a…Connecting plate part 24b…Arm plate part 24c…Claw part 24d…Blocking part 30…Suturing thread unit 31…Suturing needle 32…Suturing thread 32a…Thread stopping part

Claims

1. A suture needle and a suture having one end attached to the suture needle, a suture stopper at the other end, and a barb formed on an outer surface between the one end and the other end; An endoscope body having a cylindrical endoscope channel; a sheath formed in a long cylindrical shape, the sheath being inserted into the endoscope channel and capable of moving forward and backward in an extension direction of the endoscope channel; An operating wire that is inserted through the sheath and is provided so as to be movable forward and backward in the extension direction of the sheath; an operation unit attached to a proximal end of the operation wire and configured to move the operation wire forward and backward; a gripping portion attached to a distal end of the operating wire and capable of gripping / releasing the suture; The gripping portion is The suture can be grasped at least in the retracted state. Endoscopic suturing system.

2. The gripping portion has a pair of arm plate portions and claw portions formed at the respective tips of the pair of arm plate portions, and is formed of an elastically deformable plate member, In the protruding state, the gripping portion is configured such that the pair of arm plate portions open due to an elastic force and the claw portions are separated from each other, and in the retracted state, the gripping portion is restricted by the inner surface of the sheath and elastically deforms, so that the pair of arm plate portions close and the claw portions overlap each other. The endoscopic suturing system of claim 1.

3. A blocking portion is further provided to block the space behind the gripping portion. The endoscopic suturing system of claim 2.

4. The suture needle and the suture thread are configured to be insertable through the sheath. The endoscopic suturing system according to claim 1 , 2 or 3 .

5. The suture needle is a straight needle formed in a straight line as a whole. The endoscopic suturing system of claim 4.

Images