Ligation device

Abstract

To provide a ligation device capable of preventing leakage of a medium such as gas or liquid, reliably moving a slider, and reliably separating a ligation ring arranged in front of the slider from the ligation device.SOLUTION: A ligation device 1 includes: an inner cylinder 7 having a distal end portion; an outer cylinder 9 covering an outer periphery of the inner cylinder 7; a slider 5 arranged in between the inner cylinder 7 and the outer cylinder 9 and movable in a long axis direction of the inner cylinder 7; and a balloon 3 capable of pressing the slider 5 toward the distal end portion of the inner cylinder 7.SELECTED DRAWING: Figure 7

Description

Technical Field

[0001] The present invention relates to a ligation device used in a ligation technique that causes mechanical blood flow interruption by ligating an affected part, thereby reducing, eliminating, or thrombosing the affected part.

Background Art

[0002] Conventionally, various ligation devices have been used in ligation techniques for ligating affected parts such as diverticula and aneurysms formed in a patient's digestive tract or the like.

[0003] For example, in Patent Document 1, an outer cylinder 3 provided with ribs on the inner periphery of the tip portion, a slide cylinder 2 provided with ribs on the outer periphery of the rear end portion, an inner cylinder 1 inserted into the inner cavity of the slide cylinder 2, and a slide cylinder 2 It is recognized that an endoscopic ligation kit is described that includes a seal ring 12 attached to the rear end of the outer cylinder 3, the slide cylinder 2, and the inner cylinder 1 to seal the annular space surrounded by the inner cylinder 1, and a tube 5 for feeding fluid into the sealed space sealed by the seal ring 12 (see FIG. 1(b) etc.).

[0004] And according to this endoscopic ligation kit, the fluid fed into the sealed space through the tube 5 presses the slide cylinder 2 forward, and when the slide cylinder 2 is pressed forward, the O-ring 4 provided on the outer periphery of the tip portion of the inner cylinder 1 , will be detached from the endoscopic ligation kit and ligate the venous aneurysm 16 that has been sucked into the endoscopic ligation kit (see the description in paragraph "0022" etc.).

Prior Art Documents

Patent Documents

[0005]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0006] However, in the endoscopic ligation kit described in Patent Document 1 (hereinafter referred to as the "ligation device"), since the slide cylinder 2 is pressed forward by the fluid fed through the tube 5, in addition to the need for a seal ring 12 to seal the annular space surrounded by the outer cylinder 3, the slide cylinder 2 (hereinafter referred to as the "slider") and the inner cylinder 1, there is a problem that even when the seal ring 12 is used, there is a high possibility that the fluid will leak from the sealed space.

[0007] The present invention has been made in response to the above-described problems of the prior art, and an object thereof is to provide a ligation device that can prevent leakage of media such as gas and liquid, reliably move the slider, and reliably detach the ligation ring disposed in front of the slider from the ligation device.

Means for Solving the Problems

[0008] In order to solve the above-described problems, the ligation device according to the first aspect of the present invention includes an inner cylinder having a tip portion, an outer cylinder covering the outer periphery of the inner cylinder, and a slider disposed between the inner cylinder and the outer cylinder and movable in the longitudinal direction of the inner cylinder, and a balloon capable of pressing the slider toward the tip portion of the inner cylinder.

[0009] Further, the second aspect of the present invention is characterized in that, in the ligation device according to the first aspect, the slider includes a storage portion for storing a ligation ring on its inner periphery.

[0010] Further, the third aspect of the present invention is characterized in that, in the ligation device according to the first aspect, the balloon is connected to the base end portion of the slider.

[0011] Further, the fourth aspect of the present invention is characterized in that, in the ligation device according to the second aspect, the balloon is connected to the base end portion of the slider.

[0012] Further, a fifth aspect of the present invention is characterized in that, in the ligation device of the third aspect, the inner peripheral surface of the slider and the outer peripheral surface of the inner cylinder are made smooth.

[0013] Further, a sixth aspect of the present invention is characterized in that, in the ligation device of the third aspect, the outer peripheral surface of the slider and the inner peripheral surface of the outer cylinder are made smooth.

[0014] Further, a seventh aspect of the present invention is characterized in that, in the ligation device of the fourth aspect, the inner peripheral surface of the slider on the proximal end side from the storage portion and the outer peripheral surface of the inner cylinder are made smooth.

[0015] Further, an eighth aspect of the present invention is characterized in that, in the ligation device of the fourth aspect, the outer peripheral surface of the slider and the inner peripheral surface of the outer cylinder are made smooth.

[0016] Furthermore, a ninth aspect of the present invention is characterized in that, in the ligation device of the first aspect or the second aspect, the slider and the inner cylinder, or the slider and the outer cylinder are provided with a stopper for restricting the movement of the slider.

Advantages of the Invention

[0017] According to the ligation device of the first aspect of the present invention, an inner cylinder having a tip portion, an outer cylinder covering the outer periphery of the inner cylinder, a slider disposed between the inner cylinder and the outer cylinder and movable in the longitudinal direction of the inner cylinder, and a balloon capable of pressing the slider toward the tip portion of the inner cylinder are provided. Therefore, leakage of a medium such as gas or liquid can be prevented, the slider can be surely moved, and the ligation ring disposed in front of the slider can be surely detached from the ligation device.

[0018] Further, according to a second aspect of the present invention, in the ligation device of the first aspect, since the slider is provided with a storage portion for storing the ligation ring on its inner circumference, in addition to the effect of the ligation device of the first aspect, even when a plurality of ligation rings are provided, leakage of a medium such as gas or liquid can be prevented, the slider can be reliably moved, and the ligation ring including the ligation ring stored in the storage portion can be reliably detached from the ligation device.

[0019] Further, according to a third aspect of the present invention, in the ligation device of the first aspect, since the balloon is connected to the base end portion of the slider, in addition to the effect of the ligation device of the first aspect, it is possible to prevent the slider from detaching from the ligation device, and since there is no need to provide a stopper on the slider, the outer diameter of the ligation device can be reduced.

[0020] Further, according to a fourth aspect of the present invention, in the ligation device of the second aspect, since the balloon is connected to the base end portion of the slider, in addition to the effect of the ligation device of the second aspect, even when a plurality of ligation rings are provided, it is possible to prevent the slider from detaching from the ligation device, and since there is no need to provide a stopper on the slider, the outer diameter of the ligation device can be reduced.

[0021] Further, according to a fifth aspect of the present invention, in the ligation device of the third aspect, since the inner circumferential surface of the slider and the outer circumferential surface of the inner cylinder are made smooth, in addition to the effect of the ligation device of the third aspect, the outer diameter of the ligation device can be reduced.

[0022] Further, according to a sixth aspect of the present invention, in the ligation device of the third aspect, since the outer circumferential surface of the slider and the inner circumferential surface of the outer cylinder are made smooth, in addition to the effect of the ligation device of the third aspect, the outer diameter of the ligation device can be reduced.

[0023] Further, according to the seventh aspect of the present invention, in the ligation device of the fourth aspect, the inner peripheral surface of the slider on the proximal end side and the outer peripheral surface of the inner cylinder are made smooth from the storage portion. Therefore, in addition to the effects of the ligation device of the fourth aspect, the outer diameter of the ligation device can be reduced.

[0024] Also, according to the eighth aspect of the present invention, in the ligation device of the fourth aspect, the outer peripheral surface of the slider and the inner peripheral surface of the outer cylinder are made smooth. Therefore, in addition to the effects of the ligation device of the fourth aspect, the outer diameter of the ligation device can be reduced.

[0025] Furthermore, according to the ninth aspect of the present invention, in the ligation device of the first aspect or the second aspect, the slider and the inner cylinder, or the slider and the outer cylinder are provided with a stopper for restricting the movement of the slider. Therefore, in addition to the effects of the ligation device of the first aspect or the second aspect, it is possible to prevent the slider from detaching from the ligation device.

Brief Description of the Drawings

[0026]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Embodiments for Carrying Out the Invention

[0027] Hereinafter, embodiments of the present invention will be described with reference to the drawings.

[0028] (First Embodiment) First, the first embodiment of the present invention will be described. Note that the drawings used in this embodiment are exaggerated for easy understanding, and the dimensions are different from the actual dimensions.

[0029] FIG. 1 is an overall view of the ligating device of the first embodiment of the present invention, and FIG. 2 is a longitudinal sectional view of the ligating device.

[0030] As shown in FIGS. 1 and 2, the ligation device 1 of the present embodiment includes a hollow substantially cylindrical inner cylinder 7 having a gap portion 7g1 into which other medical instruments such as an endoscope E (hereinafter simply referred to as "endoscope E") can be inserted, an outer cylinder 9 having an outer diameter of D1 and covering the outer periphery of the inner cylinder 7, a hollow substantially cylindrical slider 5 disposed between the inner cylinder 7 and the outer cylinder 9, a balloon 3 capable of pressing the slider 5 toward the tip of the inner cylinder 7, a long hollow substantially cylindrical tube 6 connected to the proximal end of the balloon 3 for feeding a medium such as gas or liquid (hereinafter, for simplicity of description, "physiological saline" is taken as an example of "medium") into the balloon 3, and a hollow substantially cylindrical connector 8 connected to the proximal end of the tube 6.

[0031] The inner cylinder 7 includes a hollow substantially cylindrical inner cylinder main body portion 7b having a gap portion 7g1 inside, and an inner cylinder tip portion 7a having a substantially circular hollow cross-section and a tip taper shape in which the diameter becomes smaller toward the tip side, which is formed at the tip of the inner cylinder main body portion 7b and has a gap portion 7g2 communicating with the gap portion 7g1. Note that the tip of the inner cylinder tip portion 7a corresponds to the "tip portion" of the inner cylinder 7 of the present invention.

[0032] Further, the inner cylinder 7 is provided with a protruding portion 7c (corresponding to the "stopper" of the present invention) protruding outward of the inner cylinder 7 in order to contact a protruding portion 5d (corresponding to the "stopper" of the present invention) formed on the slider 5 described later and regulate the movement of the slider 5.

[0033] Note that a ring-shaped stopper 2a having an inner diameter smaller than the inner diameter of the inner cylinder main body portion 7b and contacting the tip of the endoscope E to prevent the insertion of the endoscope E is provided on the inner peripheral surface of the inner cylinder 7 in the boundary region between the inner cylinder main body portion 7b and the inner cylinder tip portion 7a.

[0034] The material of the inner cylinder 7 is not particularly limited as long as it is a biocompatible material. Resin materials such as polyethylene, polypropylene, polyester, polyurethane, polyvinyl chloride, polystyrene, acrylic resin, phenolic resin, melamine resin, polyimide, polyamide, polycarbonate, polyethersulfone, polyetheretherketone, polytetrafluoroethylene, etc., metal materials such as stainless steel, cobalt alloy, nickel-titanium alloy, etc., and ceramic materials such as glass and fine ceramics can be used. In this embodiment, polyamide is used.

[0035] In addition, when a colorless and transparent material is used for the inner cylinder 7, even when the endoscope E is inserted into the ligation device 1, the operator can easily perform the procedure without obstructing the field of view of the endoscope E.

[0036] The outer cylinder 9 has a hollow substantially cylindrical shape and covers the outer periphery of the inner cylinder 7 in a state where a gap capable of arranging a slider 5 described later is formed between the outer cylinder 9 and the inner cylinder 7 and is fixed to the inner cylinder 7. As shown in FIG. 2, its tip is located at the tip of the inner cylinder main body portion 7b, and its base end is located near the base end of the inner cylinder main body portion 7b.

[0037] The material of the outer cylinder 9 is not particularly limited as long as it is a biocompatible material. Similar to the inner cylinder 7, resin materials such as polyethylene, polypropylene, polyester, polyurethane, polyvinyl chloride, polystyrene, acrylic resin, phenolic resin, melamine resin, polyimide, polyamide, polycarbonate, polyethersulfone, polyetheretherketone, polytetrafluoroethylene, etc., metal materials such as stainless steel, cobalt alloy, nickel-titanium alloy, etc., and ceramic materials such as glass and fine ceramics can be used. In this embodiment, polyamide is used.

[0038] The slider 5 has a hollow substantially cylindrical shape and is arranged between the inner cylinder 7 and the outer cylinder 9, and is configured to be movable in the longitudinal direction (the left-right direction in FIGS. 1 to 6) of the inner cylinder 7 and the outer cylinder 9 by the operation of a balloon 3 described later.

[0039] Further, the slider 5 is provided at its tip with a first pressing portion 5a for pressing to detach a ligation ring R1, which will be described later, from the ligation device 1.

[0040] Further, the slider 5 is provided, on the inner periphery adjacent to the proximal end side of the first pressing portion 5a, with a second storage portion 5g1 for storing a ligation ring R2, which will be described later, and a second pressing portion 5b for pressing the ligation ring R2 stored in the second storage portion 5g1 to detach it from the ligation device 1.

[0041] Furthermore, the slider 5 is provided, on the inner periphery adjacent to the proximal end side of the second pressing portion 5b, with a third storage portion 5g2 for storing a ligation ring R3, which will be described later, and a third pressing portion 5c for pressing the ligation ring R3 stored in the third storage portion 5g2 to detach it from the ligation device 1.

[0042] Further, the slider 5 is provided with a protruding portion 5d (corresponding to the "stopper" of the present invention) protruding inward to restrict the movement of the slider 5, and a gap portion 5g3 formed between the third pressing portion 5c and the protruding portion 5d.

[0043] The material of the slider 5 is not particularly limited as long as it is a biocompatible material. Similar to the inner cylinder 7 and the outer cylinder 9, resin materials such as polyethylene, polypropylene, polyester, polyurethane, polyvinyl chloride, polystyrene, acrylic resin, phenolic resin, melamine resin, polyimide, polyamide, polycarbonate, polyethersulfone, polyetheretherketone, and polytetrafluoroethylene, metal materials such as stainless steel, cobalt alloy, and nickel-titanium alloy, and ceramic materials such as glass and fine ceramics can be used. In this embodiment, polyamide is used.

[0044] However, since the slider 5 is configured to be movable in the longitudinal direction of the inner cylinder 7 and the outer cylinder 9, it is desirable that the material has excellent slidability with the inner cylinder 7 and the outer cylinder 9.

[0045] The balloon 3 has a balloon tip portion 3a, and is configured to expand and contract by increasing and decreasing its volume due to a change in the pressure of the internal void portion 3g. It includes a bag-shaped balloon main body 3b and a balloon base end portion 3c that has a substantially hollow cylindrical shape, is adjacent to the base end side of the balloon main body 3b, and is connected to the tip of a tube 6 described later. When the balloon main body 3b expands, the balloon main body 3b assumes a substantially hollow cylindrical shape, and is configured such that the slider 5 can be pressed toward the tip portions of the inner cylinder 7 and the outer cylinder 9.

[0046] Note that for the balloon 3, the physiological saline injected from the opening of a connector 8 described later passes through the void portions (lumens) 6g2 and 6g1 of the tube 6 described later and is stored in the void portion 3g inside the balloon 3, and the balloon 3 expands and contracts according to the amount of the stored physiological saline.

[0047] The material of the balloon 3 is not particularly limited as long as it is a biocompatible material, but a material having a certain degree of flexibility is preferable. For example, polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymer, polyesters such as polyethylene terephthalate, polyvinyl chloride, ethylene-vinyl acetate copolymer, crosslinked ethylene-vinyl acetate copolymer, thermoplastic resins such as polyurethane, polyamide, polyamide elastomer, silicone rubber, latex rubber, etc. can be used. In this embodiment, a polyamide elastomer is used.

[0048] The tube 6 has a long, substantially hollow cylindrical shape. Its tip is connected to the balloon base end portion 3c, and its base end is connected to the tip portion of a connector 8 described later. It is used to feed physiological saline into the balloon 3.

[0049] Also, the tube 6 has a tip tapered void portion (lumen) 6g1 formed inside the tip, and a substantially cylindrical void portion (lumen) 6g2 that communicates with the base end side of the void portion (lumen) 6g1.

[0050] The tube 6 is composed of a hollow substantially cylindrical inner layer, an outer layer covering the inner layer, and a braid disposed between the inner layer and the outer layer, and is configured to have a structure excellent in kink resistance and flexibility.

[0051] Also, the material of the tube is not particularly limited as long as it is a biocompatible material, and materials used for general catheter tubes can be used.

[0052] The connector 8 has a hollow substantially cylindrical shape with a void portion 8g inside, the tip thereof is connected to the base end of the tube 6, and an opening for inserting a syringe or the like is formed at the base end of the connector 8.

[0053] Also, the material of the connector is not particularly limited as long as it is a biocompatible material. For example, resin materials such as polycarbonate (PC), polypropylene (PP), polybutylene terephthalate (PBT), polyphenylene sulfide (PPS), and nylon can be used. In this embodiment, polycarbonate (PC) is used.

[0054] Also, at the base ends of the inner cylinder 7, the outer cylinder 9, and the slider 5, a hollow substantially cylindrical support tube 2b for supporting the endoscope E inserted into the void portion 7g1 is provided so as to protrude from the base ends of the inner cylinder 7, the outer cylinder 9, and the slider 5 toward the base end side.

[0055] The ligating ring is a ring-shaped component made of an elastic material like a rubber band, which detaches from the ligating device 1 and ligates affected parts such as diverticula and aneurysms sucked into the inside of the ligating device 1.

[0056] Note that the ligating device 1 of this embodiment includes three ligating rings: a ligating ring R1 that first detaches from the ligating device 1 and ligates the affected part; a ligating ring R2 that subsequently ligates the affected part when the ligation by the ligating ring R1 is not successful; and a ligating ring R3 that finally ligates the affected part when the ligation by the ligating ring R2 is still not successful.

[0057] The materials of the ligation rings R1, R2, and R3 are sufficiently stretchable to be mounted on the outer periphery of the inner cylinder 7, have sufficient ligation force to necrotize the affected part, and are not particularly limited as long as they are biocompatible materials. For example, natural rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, nitrile rubber, butyl rubber, ethylene-propylene rubber, acrylic rubber, fluororubber, silicone rubber and other synthetic rubbers, and thermoplastic elastomers such as styrene-based elastomers, olefin-based elastomers, polyester-based elastomers, polyurethane-based elastomers, and polyamide-based elastomers can be used. In this embodiment, isoprene rubber is used.

[0058] In addition, the materials constituting the ligation rings R1, R2, and R3 may be, for example, gold, platinum, tungsten, alloys containing these elements (such as platinum-nickel alloys, etc.), barium sulfate, bismuth subcarbonate, bismuth trioxide, bismuth oxychloride, bismuth subcarbonate and other radiopaque materials, or may contain powders of these radiopaque materials.

[0059] In addition, the shapes of the ligation rings R1, R2, and R3 are not limited to a hollow shape with a substantially circular cross-section, and may be other hollow shapes such as a rectangular shape. The colors of the ligation rings R1, R2, and R3 are preferably colors that are distinct from the surrounding tissues, such as black.

[0060] Next, the operation of the ligation device 1 having the above-described configuration will be described.

[0061] FIG. 3 is a longitudinal sectional view showing a state in which the ligation device sucks the lesion, FIG. 4 is a longitudinal sectional view showing a state in which the first ligation ring R1 of the ligation device of the first embodiment is mounted on the lesion, FIG. 5 is a longitudinal sectional view showing a state in which the second ligation ring R2 of the ligation device is mounted on the lesion, and FIG. 6 is a longitudinal sectional view showing a state in which the third ligation ring R3 of the ligation device of the first embodiment is mounted on the lesion.

[0062] First, as shown in FIG. 3, with the endoscope E inserted into the gap portion 7g1 of the ligation device 1, the distal end portion of the ligation device 1 is brought close to the affected part L of the patient, and suction is performed through a lumen (not shown) formed in the endoscope E, so that the affected part L of the patient is sucked into the gap portion 7g2 of the distal end portion 7a of the inner cylinder.

[0063] Note that at this stage, the tip of the protrusion 7c of the inner cylinder 7 abuts against the proximal end of the third pressing portion 5c of the slider 5, and the gap portion 5g3 is formed between the protrusion 7c of the inner cylinder 7 and the protrusion 5d of the slider 5 (see FIG. 3).

[0064] Next, a syringe (not shown) is inserted into the gap portion 8g of the connector 8, and physiological saline is fed from the syringe through the gap portion (lumen) 6g1 and the gap portion (lumen) 6g2 of the tube 6 to the gap portion 3g from the balloon base end portion 3c of the balloon 3, thereby expanding the balloon 3.

[0065] When the balloon 3 expands, the balloon tip portion 3a of the balloon 3 presses the proximal end of the protrusion 5d of the slider 5, so that the slider 5 moves toward the distal end side, and the first pressing portion 5a of the slider 5 pushes the ligation ring R1 from the inner cylinder main body 7b to the distal end tapered inner cylinder distal end portion 7a.

[0066] When the ligation ring R1 is pushed out from the inner cylinder main body 7b to the inner cylinder distal end portion 7a, it then automatically detaches from the inner cylinder distal end portion 7a, and as a result, the base of the affected part L is ligated (see FIG. 4).

[0067] On the other hand, if the ligation ring R1 fails to ligate the base of the affected part L, physiological saline is further fed from the syringe through the gap portion (lumen) 6g1 and the gap portion (lumen) 6g2 of the tube 6 to the gap portion 3g from the balloon base end portion 3c of the balloon 3, thereby further expanding the balloon 3.

[0068] When the balloon 3 further expands, the balloon tip 3a of the balloon 3 further presses the base end of the protrusion 5d of the slider 5, so that the slider 5 further moves toward the tip side, and the second pressing part 5b of the slider 5 pushes out the ligation ring R2 stored in the second storage part 5g1 from the inner cylinder main body 7b to the tip tapered inner cylinder tip part 7a.

[0069] When the ligation ring R2 is pushed out from the inner cylinder main body 7b to the inner cylinder tip part 7a, it then automatically detaches from the inner cylinder tip part 7a, and as a result, ligates the base of the affected part L (see Fig. 5).

[0070] Furthermore, when the ligation ring R2 fails to ligate the base of the affected part L, physiological saline is further fed from the syringe through the void part (lumen) 6g1 and the void part (lumen) 6g2 of the tube 6 to the void part 3g from the balloon base end part 3c of the balloon 3, so as to further expand the balloon 3.

[0071] When the balloon 3 further expands, the balloon tip 3a of the balloon 3 further presses the base end of the protrusion 5d of the slider 5, so that the slider 5 further moves toward the tip side, and the third pressing part 5c of the slider 5 pushes out the ligation ring R3 stored in the third storage part 5g2 from the inner cylinder main body 7b to the tip tapered inner cylinder tip part 7a.

[0072] When the ligation ring R3 is pushed out from the inner cylinder main body 7b to the inner cylinder tip part 7a, it then automatically detaches from the inner cylinder tip part 7a, and as a result, ligates the base of the affected part L (see Fig. 6).

[0073] Note that at this stage, the base end of the protrusion 7c of the inner cylinder 7 abuts against the tip of the protrusion 5d of the slider 5, and the void part 5g3 is formed between the protrusion 7c of the inner cylinder 7 and the third pressing part 5c of the slider 5.

[0074] According to the ligation device 1 of the present embodiment, an inner cylinder 7 having a tip portion, an outer cylinder 9 covering the outer periphery of the inner cylinder 7, and a slider 5 disposed between the inner cylinder 7 and the outer cylinder 9 and movable in the longitudinal direction of the inner cylinder 7, and a balloon 3 capable of pressing the slider 5 toward the tip of the inner cylinder 7 are provided. Therefore, leakage of a medium such as gas or liquid can be prevented, the slider 5 can be reliably moved, and the ligation ring R1 disposed in front of the slider 5 can be reliably detached from the ligation device 1.

[0075] Further, according to the ligation device 1 of the present embodiment, the slider 5 is provided with a second storage portion 5g1 or a third storage portion 5g2 for storing the ligation ring R2 or R3 on its inner periphery. Therefore, even when a plurality of ligation rings are provided, leakage of a medium such as gas or liquid can be prevented, the slider 5 can be reliably moved, and the ligation ring including the ligation ring R2 or R3 stored in the second storage portion 5g1 or the third storage portion 5g2 can be reliably detached from the ligation device 1.

[0076] Furthermore, according to the ligation device 1 of the present embodiment, the slider 5 and the inner cylinder 7 are provided with a protrusion 5d and a protrusion 7c for restricting the movement of the slider 5. Therefore, it is possible to prevent the slider 5 from detaching from the ligation device 1.

[0077] (Second Embodiment) Next, a second embodiment of the present invention will be described. Note that the drawings used in the present embodiment are also exaggerated for easy understanding, and the dimensions are different from the actual dimensions.

[0078] FIG. 7 is a longitudinal sectional view of the tip of the ligation device according to the second embodiment, and FIG. 8 is a longitudinal sectional view of the tip showing a state in which the ligation device according to the second embodiment has detached the third ligation ring R3.

[0079] In the present embodiment, since the overall view of the ligation device is the same as that of the first embodiment, the drawing is omitted, and the same members as those in the first embodiment are given the same numbers and the description thereof is omitted.

[0080] The ligation device 10 of this embodiment has different members constituting the stopper compared with the ligation device 1 of the first embodiment. That is, in the ligation device 1 of the first embodiment, the stoppers that regulate the movement of the slider 5 are formed on the slider 5 and the inner cylinder 7, while in the ligation device 10 of this embodiment, the stoppers that regulate the movement of the slider 15 are formed on the slider 15 and the outer cylinder 19.

[0081] As shown in FIGS. 1, 7, and 8, the ligation device 10 of this embodiment includes a hollow substantially cylindrical inner cylinder 17 having an air gap 17g1 into which the endoscope E can be inserted, an outer cylinder 19 having an outer diameter of D2 and covering the outer periphery of the inner cylinder 17, a hollow substantially cylindrical slider 15 disposed between the inner cylinder 17 and the outer cylinder 19, a balloon 3 capable of pressing the slider 15 toward the tip of the inner cylinder 17, a long hollow substantially cylindrical tube 6 connected to the proximal end of the balloon 3 for feeding regulated saline water into the balloon 3, and a hollow substantially cylindrical connector 8 connected to the proximal end of the tube 6.

[0082] The inner cylinder 17 includes a hollow substantially cylindrical inner cylinder main body portion 17b having an air gap 17g1 inside, and an inner cylinder tip portion 17a having a substantially circular hollow cross-section and a tip taper shape in which the diameter becomes thinner toward the tip side, which has an air gap 17g2 formed at the tip of the inner cylinder main body portion 17b and communicating with the air gap 17g1. Note that the tip of the inner cylinder tip portion 17a corresponds to the "tip portion" of the inner cylinder 17 of the present invention.

[0083] Similar to the inner cylinder 7 of the first embodiment, on the inner peripheral surface of the inner cylinder 17, at the boundary region between the inner cylinder main body portion 17b and the inner cylinder tip portion 17a, there is provided a ring-shaped stopper 2a having an inner diameter smaller than the inner diameter of the inner cylinder main body portion 17b, which abuts against the tip of the endoscope E to prevent the insertion of the endoscope E.

[0084] The material of the inner cylinder 17 can be the same material as that of the inner cylinder 7 of the first embodiment, and in this embodiment, polyamide is used.

[0085] In addition, when a colorless and transparent material is used for the inner cylinder 17, even when the endoscope E is inserted into the ligation device 10, the operator can easily perform the procedure without obstructing the field of view of the endoscope E.

[0086] The outer cylinder 19 has a hollow substantially cylindrical shape, covers the outer periphery of the inner cylinder 17 with a gap formed therebetween in which a slider 15 described later can be disposed, and is fixed to the inner cylinder 17. As shown in FIG. 7, the tip thereof is located at the tip of the inner cylinder main body 17b, and the base end thereof is located near the base end of the inner cylinder main body 17b.

[0087] Further, the outer cylinder 19 is provided with a protruding portion 19c (corresponding to the "stopper" of the present invention) protruding inside the outer cylinder 19 in order to contact a protruding portion 15d (corresponding to the "stopper" of the present invention) formed on the slider 15 described later and restrict the movement of the slider 15.

[0088] As the material of the outer cylinder 19, the same material as the outer cylinder 9 of the first embodiment can be used, and in this embodiment, polyamide is used.

[0089] The slider 15 has a hollow substantially cylindrical shape, is disposed between the inner cylinder 17 and the outer cylinder 19, and is configured to be movable in the longitudinal direction (the left-right direction in FIGS. 7 and 8) of the inner cylinder 17 and the outer cylinder 19 by the operation of the balloon 3.

[0090] Further, the slider 15 is provided at its tip with a first pressing portion 15a for pressing to detach the ligation ring R1 from the ligation device 10.

[0091] Further, the slider 15 is provided on its inner periphery with a second storage portion 15g1 for storing the ligation ring R2 and a second pressing portion 15b for pressing to detach the ligation ring R2 stored in the second storage portion 15g1 from the ligation device 10.

[0092] Furthermore, the slider 15 includes, on its inner periphery, a third storage portion 15g2 for storing the ligation ring R3, and a third pressing portion 15c for pressing to detach the ligation ring R3 stored in the second storage portion 15g2 from the ligation device 10.

[0093] Also, the slider 15 includes a protruding portion 15d (corresponding to the "stopper" of the present invention) protruding outward to restrict the movement of the slider 15, and a gap portion 15g3 formed between the third pressing portion 15c and the protruding portion 15d.

[0094] The material of the slider 15 can be the same as that of the slider 5 in the first embodiment, and in this embodiment, polyamide is used.

[0095] However, since the slider 15 is also configured to be movable in the longitudinal direction of the inner cylinder 17 and the outer cylinder 19, it is desirable that the slider 15 be made of a material having excellent slidability with the inner cylinder 17 and the outer cylinder 19.

[0096] Next, the operation of the ligation device 10 having the above-described configuration will be described.

[0097] First, in the same state as shown in FIG. 3, with the endoscope E inserted into the gap portion 17g1 of the ligation device 10, the distal end portion of the ligation device 10 is brought close to the affected part L of the patient, and the affected part L of the patient is suctioned through a lumen (not shown) formed in the endoscope E, so as to suction the affected part L of the patient into the gap portion 17g2 of the distal end portion 17a of the inner cylinder (see FIGS. 3 and 7).

[0098] At this stage, the tip of the protruding portion 19c of the outer cylinder 19 abuts against the proximal end of the third pressing portion 15c of the slider 15, and the gap portion 15g3 is formed between the protruding portion 19c of the outer cylinder 19 and the protruding portion 15d of the slider 15 (see FIG. 7).

[0099] Next, insert a syringe (not shown) into the gap portion 8g of the connector 8, and feed physiological saline from the syringe through the gap portion (lumen) 6g1 and the gap portion (lumen) 6g2 of the tube 6 to the gap portion 3g from the balloon base end portion 3c of the balloon 3, thereby expanding the balloon 3.

[0100] When the balloon 3 expands, the balloon tip portion 3a of the balloon 3 presses the base end of the protrusion 15d of the slider 15, so that the slider 15 moves toward the tip side, and the first pressing portion 15a of the slider 15 pushes out the ligation ring R1 from the inner cylinder main body 17b to the inner cylinder tip portion 17a having a tip tapered shape.

[0101] When the ligation ring R1 is pushed out from the inner cylinder main body 17b to the inner cylinder tip portion 17a, it then automatically detaches from the inner cylinder tip portion 17a, and as a result, ligates the base of the affected part L (see FIG. 4).

[0102] On the other hand, when the ligation ring R1 fails to ligate the base of the affected part L, further feed physiological saline from the syringe through the gap portion (lumen) 6g1 and the gap portion (lumen) 6g2 of the tube 6 to the gap portion 3g from the balloon base end portion 3c of the balloon 3, thereby further expanding the balloon 3.

[0103] When the balloon 3 further expands, the balloon tip portion 3a of the balloon 3 further presses the base end of the protrusion 15d of the slider 15, so that the slider 15 further moves toward the tip side, and the second pressing portion 15b of the slider 15 pushes out the ligation ring R2 stored in the second storage portion 15g1 from the inner cylinder main body 17b to the inner cylinder tip portion 17a having a tip tapered shape.

[0104] When the ligation ring R2 is pushed out from the inner cylinder main body 17b to the inner cylinder tip portion 17a, it then automatically detaches from the inner cylinder tip portion 17a, and as a result, ligates the base of the affected part L (see FIG. 5).

[0105] Furthermore, when the ligation ring R2 fails to ligate the base of the affected part L, physiological saline is further fed from the syringe through the void portions (lumens) 6g1 and 6g2 of the tube 6 to the void portion 3g from the balloon base end portion 3c of the balloon 3, thereby further expanding the balloon 3.

[0106] When the balloon 3 further expands, the balloon tip portion 3a of the balloon 3 further presses the base end of the protrusion 15d of the slider 15, so that the slider 15 further moves toward the tip side, and the second pressing portion 15c of the slider 15 pushes out the ligation ring R3 housed in the third housing portion 15g2 from the inner cylinder main body 17b to the inner cylinder tip portion 17a having a tip taper shape.

[0107] When the ligation ring R3 is pushed out from the inner cylinder main body 17b to the inner cylinder tip portion 17a, it then automatically detaches from the inner cylinder tip portion 17a, and as a result, ligates the base of the affected part L (see FIGS. 6 and 8).

[0108] Note that at this stage, the base end of the protrusion 19c of the outer cylinder 19 abuts against the tip of the protrusion 15d of the slider 15, and the void portion 15g3 is formed between the protrusion 19c of the outer cylinder 19 and the third pressing portion 15c of the slider 15 (see FIG. 8).

[0109] According to the ligation device 10 of the present embodiment, an inner cylinder 17 having a tip portion, an outer cylinder 19 covering the outer periphery of the inner cylinder 17, a slider 15 disposed between the inner cylinder 17 and the outer cylinder 19 and movable in the longitudinal direction of the inner cylinder 17, and a balloon 3 capable of pressing the slider 15 toward the tip portion of the inner cylinder 17 are provided. Therefore, leakage of a medium such as gas or liquid can be prevented, the slider 15 can be reliably moved, and the ligation ring R1 disposed in front of the slider 15 can be reliably detached from the ligation device 10.

[0110] Further, according to the ligation device 10 of the present embodiment, since the slider 15 is provided with a second storage portion 15g1 or a third storage portion 15g2 for storing the ligation ring R2 or R3 on its inner periphery, even when a plurality of ligation rings are provided, leakage of a medium such as gas or liquid can be prevented, the slider 15 can be surely moved, and the ligation ring including the ligation ring R2 or R3 stored in the second storage portion 15g1 or the third storage portion 15g2 can be surely detached from the ligation device 10.

[0111] Furthermore, according to the ligation device 10 of the present embodiment, since the slider 15 and the outer cylinder 19 are provided with a protrusion 15d and a protrusion 19c for restricting the movement of the slider 15, it is possible to prevent the slider 15 from detaching from the ligation device 10.

[0112] (Third Embodiment) Next, a third embodiment of the present invention will be described. Note that the drawings used in this embodiment are also exaggerated for easy understanding, and their dimensions are different from the actual dimensions.

[0113] FIG. 9 is an enlarged longitudinal sectional view of the tip of the ligation device according to the third embodiment, and FIG. 10 is an enlarged longitudinal sectional view of the tip showing a state where the ligation device according to the third embodiment has detached the third ligation ring R3.

[0114] Note that also in this embodiment, since the overall view of the ligation device is the same as that of the first embodiment, the drawing is omitted, the same members as those in the first embodiment are given the same numbers, and the description thereof is omitted.

[0115] The ligation device 20 of the present embodiment is different from the ligation device 1 of the first embodiment and the ligation device 10 of the second embodiment in the presence or absence of a stopper. That is, the ligation device 1 of the first embodiment and the ligation device 10 of the second embodiment are provided with a stopper for restricting the movement of the slider, but the ligation device 20 of the present embodiment is not provided with a stopper for restricting the movement of the slider.

[0116] As shown in FIGS. 1, 9, and 10, the ligation device 20 of the present embodiment includes a hollow substantially cylindrical inner cylinder 27 having a gap portion 27g1 into which the endoscope E can be inserted, a hollow substantially cylindrical outer cylinder 29 having an outer diameter of D3 and covering the outer periphery of the inner cylinder 27, a hollow substantially cylindrical slider 25 disposed between the inner cylinder 27 and the outer cylinder 29, a balloon 23 capable of pressing the slider 25 toward the tip of the inner cylinder 27, a long hollow substantially cylindrical tube 6 connected to the proximal end of the balloon 23 for feeding regulated saline water into the balloon 23, and a hollow substantially cylindrical connector 8 connected to the proximal end of the tube 6.

[0117] Note that, as will be described later, since it is not necessary to provide a stopper for restricting the movement of the slider, the outer diameter D3 of the ligation device 20 of the present embodiment can be made smaller than the outer diameter D1 of the ligation device 1 of the first embodiment and the outer diameter D2 of the ligation device 10 of the second embodiment.

[0118] The inner cylinder 27 includes a hollow substantially cylindrical inner cylinder main body portion 27b having a gap portion 27g1 inside, and a hollow cross-section substantially circular inner cylinder tip portion 27a formed at the tip of the inner cylinder main body portion 27b and having a gap portion 27g2 communicating with the gap portion 27g1, and having a tip taper shape in which the diameter becomes thinner toward the tip side. Note that the tip of the inner cylinder tip portion 27a corresponds to the "tip portion" of the inner cylinder 27 of the present invention.

[0119] Similar to the inner cylinder 7 of the first embodiment, a ring-shaped stopper 2a having an inner diameter smaller than the inner diameter of the inner cylinder main body portion 27b and abutting against the tip of the endoscope E to prevent the insertion of the endoscope E is provided on the inner peripheral surface of the inner cylinder 27 in the boundary region between the inner cylinder main body portion 27b and the inner cylinder tip portion 27a.

[0120] The material of the inner cylinder 27 can be the same material as the inner cylinder 7 of the first embodiment, and in the present embodiment, polyamide is used.

[0121] In addition, when a colorless and transparent material is used for the inner cylinder 27, even when the endoscope E is inserted into the ligation device 20, the operator can easily perform the procedure without obstructing the field of view of the endoscope E.

[0122] The outer cylinder 29 has a hollow substantially cylindrical shape and covers the outer periphery of the inner cylinder 27 in a state where a gap capable of arranging a slider 25 described later is formed between the outer cylinder 29 and the inner cylinder 27, and is fixed to the inner cylinder 27. As shown in FIG. 9, the tip thereof is located at the tip of the inner cylinder main body portion 27b, and the base end thereof is located near the base end of the inner cylinder main body portion 27b.

[0123] As the material of the outer cylinder 29, the same material as the outer cylinder 9 of the first embodiment can be used, and in this embodiment, polyamide is used.

[0124] The slider 25 has a hollow substantially cylindrical shape and is arranged between the inner cylinder 27 and the outer cylinder 29, and is configured to be movable in the longitudinal direction (the left-right direction in FIGS. 9 and 10) of the inner cylinder 27 and the outer cylinder 29 by the operation of a balloon 23 described later.

[0125] Further, the slider 25 is provided at its tip with a first pressing portion 25a for pressing to detach the ligation ring R1 from the ligation device 20.

[0126] In addition, the slider 25 has, on its inner periphery, a second storage portion 25g1 for storing the ligation ring R2, and a second pressing portion 25b for pressing to detach the ligation ring R2 stored in the second storage portion 25g1 from the ligation device 20.

[0127] Furthermore, the slider 25 has, on its inner periphery, a third storage portion 25g2 for storing the ligation ring R3, and a third pressing portion 25c for pressing to detach the ligation ring R3 stored in the third storage portion 25g2 from the ligation device 20.

[0128] The material of the slider 25 can be the same as that of the slider 5 in the first embodiment, and in this embodiment, polyamide is used.

[0129] However, since the slider 25 is also configured to be movable in the longitudinal direction of the inner cylinder 27 and the outer cylinder 29, it is desirable that the material has excellent slidability with the inner cylinder 27 and the outer cylinder 29.

[0130] The balloon 23 has a balloon tip 23a, and is configured to expand and contract by increasing and decreasing its volume due to the change in the pressure of the internal void 23g. It includes a bag-shaped balloon body 23b and a balloon base end 23c that has a hollow substantially cylindrical shape, is adjacent to the proximal end side of the balloon body 23b, and is connected to the tip of the tube 6. When the balloon body 23b expands, the balloon body 23b assumes a hollow substantially cylindrical shape, and is configured to be able to press the slider 25 toward the tips of the inner cylinder 27 and the outer cylinder 29.

[0131] Note that the balloon tip 23a of the balloon 23 in this embodiment is connected to the proximal end of the slider 25 by an adhesive 24 made of a biocompatible material. Even if the slider 25 moves in the longitudinal direction of the inner cylinder 27 and the outer cylinder 29, it will not separate from the balloon 23.

[0132] The material of the adhesive 24 is not particularly limited as long as it is a biocompatible material. For example, acrylic resin adhesives, urethane resin adhesives, epoxy resin adhesives, vinyl chloride resin solvent adhesives, cyanoacrylate adhesives, silicone adhesives, phenolic resin adhesives, etc. can be used. In this embodiment, an acrylic resin adhesive is used.

[0133] Also, the physiological saline injected from the opening of the connector 8 into the balloon 23 is stored in the void 23g inside the balloon 23 through the void (lumen) 6g2 and the void (lumen) 6g1 of the tube 6, and the balloon 23 expands and contracts according to the amount of the stored physiological saline.

[0134] The material of the balloon 23 can be the same as that of the balloon 3 in the first embodiment, and in this embodiment, a polyamide elastomer is used.

[0135] Next, the operation of the ligation device 20 having the above-described configuration will be described.

[0136] First, in the same manner as shown in FIG. 3, with the endoscope E inserted into the gap 27g1 of the ligation device 20, the distal end portion of the ligation device 20 is brought close to the affected part L of the patient, and suction is performed through a lumen (not shown) formed in the endoscope E, so that the affected part L of the patient is suctioned into the gap 27g2 of the distal end portion 27a of the inner cylinder (see FIGS. 3 and 9).

[0137] Next, a syringe (not shown) is inserted into the gap 8g of the connector 8, and physiological saline is fed from the syringe through the gap (lumen) 6g2 and the gap (lumen) 6g1 of the tube 6 to the gap 23g from the balloon base end portion 23c of the balloon 23, thereby expanding the balloon 23.

[0138] When the balloon 23 expands, the balloon tip portion 23a of the balloon 23 presses the base end of the slider 25, so that the slider 25 moves toward the distal end side, and the first pressing portion 25a of the slider 25 pushes the ligation ring R1 from the inner cylinder main body 27b to the distal end tapered inner cylinder distal end portion 27a.

[0139] When the ligation ring R1 is pushed out from the inner cylinder main body 27b to the inner cylinder distal end portion 27a, it then automatically detaches from the inner cylinder distal end portion 27a, and as a result, the base of the affected part L is ligated (see FIG. 4).

[0140] On the other hand, when the ligation ring R1 fails to ligate the base of the affected part L, physiological saline is further fed from the syringe through the gap (lumen) 6g2 and the gap (lumen) 6g1 of the tube 6 to the gap 23g from the balloon base end portion 23c of the balloon 23, thereby further expanding the balloon 23.

[0141] When the balloon 23 further expands, the balloon tip 23a of the balloon 23 further presses the proximal end of the slider 15, causing the slider 25 to move further toward the distal end side. As a result, the second pressing portion 25b of the slider 25 pushes out the ligation ring R2 stored in the second storage portion 25g1 from the inner cylinder main body 27b to the inner cylinder tip portion 27a having a distal end tapered shape.

[0142] When the ligation ring R2 is pushed out from the inner cylinder main body 27b to the inner cylinder tip portion 27a, it then automatically detaches from the inner cylinder tip portion 27a. As a result, the base of the affected part L is ligated (see Fig. 5).

[0143] Furthermore, if the ligation ring R2 fails to ligate the base of the affected part L, physiological saline is further fed from the syringe through the void portion (lumen) 6g2 of the tube 6 and the void portion (lumen) 6g1 to the void portion 23g from the balloon base end portion 23c of the balloon 23, thereby further expanding the balloon 23.

[0144] When the balloon 23 further expands, the balloon tip 2a of the balloon 23 further presses the proximal end of the slider 25, causing the slider 25 to move further toward the distal end side. As a result, the second pressing portion 25c of the slider 25 pushes out the ligation ring R3 stored in the third storage portion 25g2 from the inner cylinder main body 27b to the inner cylinder tip portion 27a having a distal end tapered shape.

[0145] When the ligation ring R3 is pushed out from the inner cylinder main body 27b to the inner cylinder tip portion 27a, it then automatically detaches from the inner cylinder tip portion 27a. As a result, the base of the affected part L is ligated (see Figs. 6 and 10).

[0146] According to the ligation device 20 of the present embodiment, an inner cylinder 27 having a tip portion, an outer cylinder 29 covering the outer periphery of the inner cylinder 27, a slider 25 disposed between the inner cylinder 27 and the outer cylinder 29 and movable in the longitudinal direction of the inner cylinder 27, and a balloon 23 capable of pressing the slider 25 toward the tip portion of the inner cylinder 27 are provided. Therefore, leakage of a medium such as gas or liquid can be prevented, the slider 25 can be reliably moved, and the ligation ring R1 disposed in front of the slider 25 can be reliably detached from the ligation device 20.

[0147] Further, according to the ligation device 20 of the present embodiment, the slider 25 is provided with a second storage portion 25g1 or a third storage portion 25g2 for storing the ligation ring R2 or R3 on its inner periphery. Therefore, even when a plurality of ligation rings are provided, leakage of a medium such as gas or liquid can be prevented, the slider 25 can be reliably moved, and the ligation ring including the ligation ring R2 or R3 stored in the second storage portion 25g1 or the third storage portion 25g2 can be reliably detached from the ligation device 20.

[0148] Further, according to the ligation device 20 of the present embodiment, since the balloon 23 is connected to the base end portion of the slider 25, it is possible to prevent the slider 25 from detaching from the ligation device 20, and since it is not necessary to provide a stopper on the slider 25, the outer diameter of the ligation device 20 can be reduced.

[0149] Further, according to the ligation device 20 of the present embodiment, the inner peripheral surface of the slider 25 on the base end side from the third storage portion 25g2 and the outer peripheral surface of the inner cylinder 27 are made smooth, so that the outer diameter of the ligation device 20 can be reduced.

[0150] Furthermore, according to the ligation device 20 of the present embodiment, the outer peripheral surface of the slider 25 and the inner peripheral surface of the outer cylinder 29 are made smooth, so that the outer diameter of the ligation device 20 can be reduced.

[0151] (Fourth Embodiment) Next, a fourth embodiment of the present invention will be described. Note that the drawings used in this embodiment are also exaggerated for easy understanding, and their dimensions are different from the actual dimensions.

[0152] FIG. 11 is a longitudinally enlarged sectional view of the tip of the ligating device according to the fourth embodiment, and FIG. 12 is a longitudinally enlarged sectional view of the tip showing a state where the ligating device according to the fourth embodiment has released the third ligating ring R3.

[0153] Note that in this embodiment as well, since the overall view of the ligating device is the same as that of the first embodiment, the drawing is omitted, and the same members as those in the first embodiment are given the same numbers, and the description thereof is omitted.

[0154] The ligating device 30 of this embodiment is different from the ligating device 20 of the third embodiment in the presence or absence of a storage portion for storing the ligating ring. That is, the ligating device 20 of the third embodiment is provided with a second storage portion 25g1 and a third storage portion 25g2 for storing the ligating rings R2 and R3, but the ligating device 30 of this embodiment is not provided with a storage portion for storing the ligating ring. Therefore, the ligating ring that the ligating device 30 of this embodiment can ligate is only one of R1.

[0155] As shown in FIGS. 1, 11, and 12, the ligating device 30 of this embodiment includes a hollow substantially cylindrical inner cylinder 37 having a gap portion 37g1 into which the endoscope E can be inserted, an outer cylinder 39 having an outer diameter of D4 and covering the outer periphery of the inner cylinder 37, a hollow substantially cylindrical slider 35 disposed between the inner cylinder 37 and the outer cylinder 39, a balloon 33 capable of pressing the slider 35 toward the tip of the inner cylinder 37, a long hollow substantially cylindrical tube 6 connected to the proximal end of the balloon 33 for feeding regulated saline water into the balloon 33, and a hollow substantially cylindrical connector 8 connected to the proximal end of the tube 6.

[0156] Note that since it is not necessary to provide a stopper for restricting the movement of the slider, the outer diameter D4 of the ligation device 30 of the present embodiment can be made smaller than the outer diameter D1 of the ligation device 1 of the first embodiment and the outer diameter D2 of the ligation device 10 of the second embodiment.

[0157] The inner cylinder 37 includes a hollow substantially cylindrical inner cylinder main body portion 37b having a void portion 37g1 inside, and a hollow cross-section substantially circular inner cylinder tip portion 37a having a void portion 37g2 formed at the tip of the inner cylinder main body portion 37b and communicating with the void portion 37g1, and having a tip tapered shape with a diameter that becomes thinner toward the tip side. Note that the tip of the inner cylinder tip portion 37a corresponds to the "tip portion" of the inner cylinder 37 of the present invention.

[0158] Also, similar to the inner cylinder 7 of the first embodiment, on the inner peripheral surface of the inner cylinder 37, at the boundary region between the inner cylinder main body portion 37b and the inner cylinder tip portion 37a, a ring-shaped stopper 2a with an inner diameter smaller than the inner diameter of the inner cylinder main body portion 37b and abutting against the tip portion of the endoscope E is provided to prevent the insertion of the endoscope E.

[0159] The material of the inner cylinder 37 can be the same material as the inner cylinder 7 of the first embodiment, and in this embodiment, polyamide is used.

[0160] Note that when a colorless and transparent material is used for the inner cylinder 37, even when the endoscope E is inserted into the ligation device 30, the operator can easily perform the procedure without obstructing the field of view of the endoscope E.

[0161] The outer cylinder 39 has a hollow substantially cylindrical shape, covers the outer periphery of the inner cylinder 37 in a state where a gap is formed between the inner cylinder 37 and the slider 35 to be described later, and is fixed to the inner cylinder 37. As shown in FIG. 11, its tip is located at the tip of the inner cylinder main body portion 37b, and its base end is located near the base end of the inner cylinder main body portion 37b.

[0162] The material of the outer cylinder 39 can be the same material as the outer cylinder 9 of the first embodiment, and in this embodiment, polyamide is used.

[0163] The slider 35 has a hollow substantially cylindrical shape, is disposed between the inner cylinder 37 and the outer cylinder 39, and is configured to be movable in the major axis direction (the left - right direction in FIGS. 11 and 12) of the inner cylinder 37 and the outer cylinder 39 by the operation of the balloon 33 described later.

[0164] Further, the slider 35 is provided at its tip with a first pressing portion 35a for pressing to detach the ligation ring R1 from the ligation device 30.

[0165] As the material of the slider 35, the same material as the slider 5 of the first embodiment can be used, and in this embodiment, polyamide is used.

[0166] However, since the slider 35 is also configured to be movable in the major axis direction of the inner cylinder 37 and the outer cylinder 39, it is desirable that the material has excellent slidability with the inner cylinder 37 and the outer cylinder 39.

[0167] The balloon 33 has a balloon tip portion 33a, and is configured to expand and contract by increasing and decreasing the volume due to a change in the pressure of the internal void portion 33g, and includes a bag - shaped balloon body 33b and a balloon base end portion 33c having a hollow substantially cylindrical shape, adjacent to the base end side of the balloon body 33b and connected to the tip of the tube 6. When the balloon body 33b expands, the balloon body 33b has a hollow substantially cylindrical shape and is configured to be able to press the slider 35 toward the tip portions of the inner cylinder 37 and the outer cylinder 39.

[0168] Note that the balloon tip portion 33a of the balloon 33 of this embodiment is connected to the base end of the slider 35 by an adhesive 34 made of a biocompatible material, and the slider 35 does not separate from the balloon 33 even if it moves in the major axis direction of the inner cylinder 37 and the outer cylinder 39.

[0169] As the material of the adhesive 34, the same material as the adhesive 24 of the third embodiment can be used, and in this embodiment, an acrylic resin - based adhesive is used.

[0170] Further, in the balloon 33, the physiological saline injected from the opening of the connector 8 is stored in the cavity 33g in the balloon 33 through the cavities (lumens) 6g2 and 6g1 of the tube 6, and expands and contracts according to the amount of the stored physiological saline.

[0171] The material of the balloon 33 can be the same as that of the balloon 3 in the first embodiment, and in this embodiment, a polyamide elastomer is used.

[0172] Next, the operation of the ligation device 30 having the above-described configuration will be described.

[0173] First, in the state where the endoscope E is inserted into the cavity 37g1 of the ligation device 30, similar to that shown in FIG. 3, the distal end portion of the ligation device 30 is brought close to the affected part L of the patient, and suction is performed through the lumen (not shown) formed in the endoscope E, so that the affected part L of the patient is suctioned into the cavity 37g2 of the distal end portion 37a of the inner cylinder (see FIGS. 3 and 11).

[0174] Next, a syringe (not shown) is inserted into the cavity 8g of the connector 8, and physiological saline is fed from the syringe through the cavities (lumens) 6g2 and 6g1 of the tube 6 into the cavity 33g from the balloon base end portion 33c of the balloon 33, thereby expanding the balloon 33.

[0175] When the balloon 33 expands, the balloon tip portion 33a of the balloon 33 presses the base end of the slider 35, so that the slider 35 moves toward the distal end side, and the first pressing portion 35a of the slider 35 pushes out the ligation ring R1 from the inner cylinder main body 37b to the distal end tapered inner cylinder distal end portion 37a.

[0176] When the ligation ring R1 is pushed out from the inner cylinder main body 37b to the inner cylinder distal end portion 37a, it then automatically detaches from the inner cylinder distal end portion 37a, and as a result, ligates the base of the affected part L (see FIG. 4).

[0177] According to the ligation device 30 of the present embodiment, an inner cylinder 37 having a tip, an outer cylinder 39 covering the outer circumference of the inner cylinder 37, a slider 35 disposed between the inner cylinder 37 and the outer cylinder 39 and movable in the longitudinal direction of the inner cylinder 37, and a balloon 33 capable of pressing the slider 35 toward the tip of the inner cylinder 37 are provided. Therefore, leakage of a medium such as gas or liquid can be prevented, the slider 35 can be surely moved, and the ligation ring R1 disposed in front of the slider 35 can be surely detached from the ligation device 30.

[0178] Further, according to the ligation device 30 of the present embodiment, since the balloon 33 is connected to the base end portion of the slider 35, it is possible to prevent the slider 35 from detaching from the ligation device 30, and since it is not necessary to provide a stopper on the slider 35, the outer diameter of the ligation device 30 can be reduced.

[0179] Further, according to the ligation device 30 of the present embodiment, since the inner peripheral surface of the slider 35 and the outer peripheral surface of the inner cylinder 37 are made smooth, the outer diameter of the ligation device 30 can be reduced.

[0180] Furthermore, according to the ligation device 30 of the present embodiment, since the outer peripheral surface of the slider 35 and the inner peripheral surface of the outer cylinder 39 are made smooth, the outer diameter of the ligation device 30 can be reduced.

[0181] As described above, the ligation devices of various embodiments of the present invention have been described. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the gist thereof.

[0182] For example, in the above-described embodiment, the ligation device has been described as including three or one ligation ring. However, the number of ligation rings is arbitrary and may be one or more. The storage portion provided on the slider may be provided according to the number of ligation rings.

[0183] Also, a slider that does not have a storage part for storing a ligation ring, like the ligation device 30 of the fourth embodiment, can also be applied to the slider 5 in the ligation device 1 of the first embodiment and the slider 15 in the ligation device 10 of the second embodiment.

[0184] Furthermore, the balloon tip 3a of the balloon 3 in the first and second embodiments may be connected to the proximal end of the slider 5 or the proximal end of the slider 15 by an adhesive made of a biocompatible material, similar to the balloon 23 of the third embodiment and the balloon 33 of the fourth embodiment.

[0185] In that case, in addition to the function of the protrusion (stopper), it is possible to further prevent the slider from detaching from the ligation device.

Explanation of Reference Numerals

[0186] 1, 10, 20, 30 ··· Ligation device 3, 23, 33 ··· Balloon 7, 17, 27, 37 ··· Inner cylinder 5, 15, 25, 35 ··· Slider 5d, 7c, 15d, 19c, Protrusion (stopper) 5g1, 5g2, 15g1, 15g2, 25g1, 25g2 ··· Storage part 6 ··· Tube 8 ··· Connector 9, 19, 29, 39 ··· Outer cylinder 24, 34 ··· Adhesive E ··· Endoscope R1, R2, R3 ··· Ligation ring

Claims

1. An inner cylinder having a tip portion, An outer cylinder covering the outer periphery of the inner cylinder, A slider disposed between the inner cylinder and the outer cylinder and movable in the longitudinal direction of the inner cylinder, A balloon capable of pressing the slider toward the tip portion of the inner cylinder, A ligation device characterized by comprising the above.

2. The ligation device according to claim 1, wherein the slider is provided with a storage portion for storing a ligation ring on its inner periphery.

3. The ligation device according to claim 1, wherein the balloon is connected to the base end portion of the slider.

4. The ligation device according to claim 2, wherein the balloon is connected to the base end portion of the slider.

5. The ligation device according to claim 3, wherein the inner peripheral surface of the slider and the outer peripheral surface of the inner cylinder are made smooth.

6. The ligation device according to claim 3, wherein the outer peripheral surface of the slider and the inner peripheral surface of the outer cylinder are made smooth.

7. The ligation device according to claim 4, wherein the inner peripheral surface of the slider on the base end side from the storage portion and the outer peripheral surface of the inner cylinder are made smooth.

8. The ligation device according to claim 4, wherein the outer peripheral surface of the slider and the inner peripheral surface of the outer cylinder are made smooth.

9. The ligation device according to claim 1 or claim 2, wherein the slider and the inner cylinder, or the slider and the outer cylinder are provided with a stopper for restricting the movement of the slider.

Images