Endoscopic treatment tools

Abstract

To provide an endoscopic treatment instrument capable of surely controlling a position in a longitudinal axis direction of a connecting part of a linear object to be attached to a clip, according to each operation.SOLUTION: An endoscopic treatment instrument comprises a cylindrical body, a linear object 20 having a connecting part, and a handle 40, where the handle 40 includes a handle body 50 and a slider 60 and the handle body 50 has a first part 51 and a second part 52 facing each other, and satisfies the following item (1) and / or (2). (1) The first part 51 has a first thick wall portion 51a protruding inward, and the first thick wall portion 51a and a first inner support portion 61 of the slider 60 come into contact with each other, so that the slider 60 receives press-fit resistance. (2) The second part 52 has a second thick wall portion 52a protruding inward, and the second thick wall portion 52a and a second inner support portion 62 of the slider 60 come into contact with each other, so that the slider 60 receives press-fit resistance.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to an endoscopic treatment tool used to grasp a treatment target such as a lesion under an endoscope. [Background technology]

[0002] Endoscopic procedures such as endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) can sometimes cause bleeding during the procedure. One method for stopping such bleeding, or bleeding from lesions in body cavities such as the digestive tract, is to ligate the bleeding site with a clip and perform pressure hemostasis. In this case, the clip is attached to the distal end of the endoscopic treatment tool, and its opening and closing is controlled by operating a handle located on the proximal end of the endoscopic treatment tool.

[0003] As such an endoscopic treatment tool, for example, Patent Document 1 discloses one in which a clip is operated by pushing and returning a handle. Also, Patent Document 2 discloses an endoscopic treatment tool in which a slider locking portion is provided on the handle body, and the position at which the slider is locked by the locking portion can be controlled when the slider is moved axially relative to the handle body. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2004 / 082488 [Patent Document 2] International Publication No. 2020 / 105253 Summary of the Invention [Problem to be solved by the invention]

[0005] In an endoscopic treatment instrument, by operating a handle on the proximal side, it is possible to attach a clip to the distal end of the instrument, insert and remove the clip attached to the distal end from the cylindrical body, control the opening and closing of the clip to grasp an object to be treated, and detach the clip from the endoscopic treatment instrument after grasping. These operations require the surgeon to appropriately control the longitudinal position of the connecting part of the linear object attached to the clip according to each operation. However, with conventional endoscopic treatment instruments, it has sometimes been difficult to operate the handle reliably.

[0006] Therefore, the present invention aims to provide an endoscopic treatment tool that can reliably control the longitudinal position of the connecting part of a linear object attached to a clip in accordance with each operation by operating the handle on the hand side to gently move the slider connected to the linear object in the longitudinal direction as needed. [Means for solving the problem]

[0007] One embodiment of the endoscopic treatment instrument of the present invention that can solve the above-mentioned problems is an endoscopic treatment instrument having a distal side and a proximal side in the longitudinal axis direction, a cylindrical body, a linear object that is disposed in the inner cavity of the cylindrical body and has a connecting portion that is connected to a medical clip, and a handle that is provided on the proximal side of the cylindrical body and the linear object, wherein the handle has a handle main body connected to the proximal end of the cylindrical body, and a slider to which the proximal end of the linear object is connected and that is movable in the longitudinal axis direction relative to the handle main body, and the connecting portion can be accommodated within the cylindrical body by pulling the slider from the distal side to the proximal side, and the handle main body has a first part and a second part that extend in the longitudinal axis direction and face each other, and satisfies at least one of the following (1) and (2). (1) The first part has a first thick part that protrudes inward, and the slider has a first inner support part that faces the inside of the first part, and when the slider is moved in the longitudinal axis direction relative to the handle body, the first thick part and the first inner support part come into contact with each other, causing the slider to experience press-in resistance. (2) The second portion has a second thick portion that protrudes inward, and the slider has a second inner support portion that faces the inside of the second portion, and when the slider is moved in the longitudinal axis direction relative to the handle body, the second thick portion and the second inner support portion come into contact with each other, causing the slider to experience press-in resistance.

[0008] Because the above-mentioned endoscopic treatment tool satisfies (1) and / or (2), linear objects can be moved gently by moving the slider in the longitudinal direction relative to the handle body. This makes it possible to easily and reliably perform operations such as attaching a clip to the tip of the endoscopic treatment tool, controlling the position of the connecting part relative to the cylindrical body when the clip is attached, controlling the opening and closing of the clip to grasp the treatment object, and detaching the clip from the endoscopic treatment tool after grasping. Furthermore, because the thick-walled portion is provided inside the first and / or second parts, the operability of the handle can be improved without affecting the outer diameter of the endoscopic treatment tool.

[0009] The above-mentioned endoscopic treatment tool preferably satisfies at least one of the following (3) and (4). (3) When the above (1) is satisfied, the distal end of the connecting portion is not housed within the cylindrical body when the first thick portion and the first inner support portion are in contact with each other. (4) When the above (2) is satisfied, the distal end of the connecting portion is not housed within the cylindrical body when the second thick portion and the second inner support portion are in contact with each other.

[0010] The above-mentioned endoscopic treatment tool preferably satisfies at least one of the following (5) and (6). (5) When the above (1) is satisfied, at least a portion of the connecting portion is housed within the cylindrical body when the first thick portion and the first inner support portion are in contact with each other. (6) When the above (2) is satisfied, at least a portion of the connecting portion is housed within the cylindrical body when the second thick portion and the second inner support portion are in contact with each other.

[0011] The handle body has a stop portion where at least a part of the slider abuts against at least a part of the outer surface of the handle body to stop the slider from moving in the proximal direction, and when the slider is stopped from moving by the stop portion, the entire connecting portion is contained within the cylindrical body, and it is preferable that the endoscopic treatment tool satisfies at least one of the following (7) and (8). (7) When the above (1) is satisfied, the length of the first thick portion in the longitudinal axis direction is longer than the length of the stop portion. (8) When the above (2) is satisfied, the length of the second thick portion in the longitudinal axis direction is longer than the length of the stop portion. In this case, the stopping portion is preferably a convex portion provided on the outer surface of the first part and / or the second part, or alternatively, the stopping portion may be a concave portion provided on the outer surface of the first part and / or the second part. [Effects of the Invention]

[0012] According to the above-described endoscopic treatment instrument, by operating the handle on the proximal side, the slider connected to the linear object can be moved gently in the longitudinal direction as needed, and the longitudinal position of the connecting part of the linear object attached to the clip can be reliably controlled in accordance with each operation. As a result, by operating the handle on the proximal side, it is possible to easily and reliably perform operations such as attaching the clip to the tip of the endoscopic treatment instrument, controlling the position of the connecting part with respect to the cylindrical body when the clip is attached, controlling the opening and closing of the clip to grasp the treatment object, and detaching the clip from the endoscopic treatment instrument after grasping. [Brief explanation of the drawings]

[0013] [Figure 1] 1 is an example of an overall view of an endoscopic treatment tool according to an embodiment of the present invention; [Figure 2] 3 shows another example of an overall view of an endoscopic treatment tool according to an embodiment of the present invention. [Figure 3] 1 illustrates a plan view of a distal end of a linear object and a clip according to an embodiment of the present invention. [Figure 4]2 is a cross-sectional view of the handle portion of the endoscopic treatment tool shown in FIG. 1 in the longitudinal axis direction. [Figure 5] 5 illustrates another example of the cross-sectional view shown in FIG. 4. [Figure 6] 1 shows an example of a side view of the distal end portion of an endoscopic treatment tool when a clip is attached in one embodiment of the present invention. [Figure 7] 1 shows an example of a side view of a distal end portion of an endoscopic treatment tool in a clip standby state in one embodiment of the present invention. [Figure 8] 1 shows an example of a side view of a distal end portion of an endoscopic treatment tool in a state where a clip can be gripped and operated in one embodiment of the present invention. [Figure 9] 10 is a longitudinal axial cross-sectional view of a handle portion of an endoscopic treatment tool according to another embodiment of the present invention. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0014] The present invention will be described below based on the embodiments, but the present invention is not limited to the following embodiments, and can be implemented with appropriate modifications within the scope of the above and below-described intent, and all such modifications are included within the technical scope of the present invention. In addition, hatching and component symbols may be omitted in each drawing for convenience. In such cases, reference should be made to the specification or other drawings. The dimensions of various components in the drawings may differ from actual dimensions, as priority is given to helping understand the features of the present invention.

[0015] An embodiment of the endoscopic treatment tool of the present invention will be described with reference to FIGS. 1 to 5. However, the present invention is not limited to the embodiment shown in the drawings. FIG. 1 shows an example of an overall view of an endoscopic treatment tool according to one embodiment of the present invention, illustrating a state in which the connecting portion of a linear object to which a clip is attached is exposed from the distal end of a cylindrical body. FIG. 2 shows another example of an overall view of an endoscopic treatment tool according to one embodiment of the present invention, illustrating a state in which the connecting portion of a linear object from which a clip has been removed is disposed within the cylindrical body. FIG. 3 shows a plan view of the distal end of a linear object and a clip according to one embodiment of the present invention. FIG. 4 shows a cross-sectional view of the handle portion of the endoscopic treatment tool shown in FIG. 1 in the longitudinal axis direction, and is a cross-sectional view parallel to the paper surface. FIG. 5 shows another example of the cross-sectional view shown in FIG. 4, illustrating an example in which a thick portion is provided at a different position from that shown in FIG. 4.

[0016] As shown in FIG. 1 , an endoscopic treatment tool 1 according to an embodiment of the present invention has a distal side and a proximal side in the longitudinal axis direction x, and includes a cylindrical body 10, a linear object 20 disposed within the lumen of the cylindrical body 10 and having a connecting portion 22 connected to a medical clip 30, and a handle 40 provided on the proximal side of the cylindrical body 10 and the linear object 20. In the present invention, the longitudinal axis direction x refers to the direction in which the cylindrical body 10 and the linear object 20 extend. The proximal side in the longitudinal axis direction x refers to the side closer to the operator using the endoscopic treatment tool 1, and is the side on which the handle 40 is disposed. The distal side in the longitudinal axis direction x refers to the side opposite the proximal side, i.e., the side of the treatment target. In FIGS. 1 and 2 , the left side of the figure refers to the distal side, and the right side refers to the proximal side. In this specification, the medical clip 30 may be simply referred to as the clip 30.

[0017] When performing treatment using the endoscopic treatment tool 1, the clip 30 is connected to the connecting portion 22 provided at the distal end of the linear object 20, and the endoscopic treatment tool 1 with the linear object 20 placed in the lumen of the tubular body 10 is inserted into the forceps channel of the endoscope. When inserting the endoscopic treatment tool 1 into the forceps channel, it is preferable that the clip 30 is in a state in which it cannot be clipped. The linear object 20 with the clip 30 connected thereto is transported through the forceps channel to the vicinity of the treatment object, and then the handle 40 on the hand side is operated to control the opening and closing of the clip 30, thereby allowing the treatment object to be grasped by the clip 30.

[0018] As shown in FIG. 3 , the medical clip 30 preferably comprises a clip body 31 and a ring 32. The clip body 31 preferably has a connecting portion at its proximal end that connects both arms, and is configured so that the distal side can be opened and closed using the proximal end as a fulcrum. When the clip 30 is in an open state, the ring 32 is disposed around the proximal end of the clip body 31, and the clip 30 can be closed by moving the ring 32 distally of the clip body 31. At this time, the clip 30 can be configured so that the clip 30 is connected to the connecting portion 22 of the linear object 20 and the linear object 20 is moved proximally relative to the cylindrical body 10, whereby the ring 32 comes into contact with the cylindrical body 10 and is pushed distally, and the ring 32 moves distally of the clip body 31, thereby closing the clip 30. This allows the clip 30 to grasp the treatment target. After the clip 30 has grasped the object to be treated, the linear object 20 can be pulled further proximally to detach the connecting portion 22 of the linear object 20 from the clip 30, and the clip 30, still grasping the object to be treated, can be left inside the body.

[0019] The size of the clip 30 may be appropriately set depending on the purpose, taking into consideration the size of the connecting portion 22 to which the clip 30 is connected and the inner diameter of the cylindrical body 10. When the clip 30 is closed, the length of the clip body 31 in the longitudinal axis direction x is preferably 7.0 mm or more and 20 mm or less. The clip body 31 is preferably formed so that at least a portion of it can be housed in the cylindrical body 10 when the clip 30 is closed.

[0020] The clip body 31 is formed, for example, by connecting two members arranged opposite each other. Alternatively, the clip body 31 may be formed by bending a single member. Examples of materials that can be used to form the clip body 31 include Ni-Ti alloys and stainless steels such as SUS301, SUS303, SUS304, and SUS601. Of these, stainless steel is preferred as the material for the clip body 31. This allows the clip body 31 to have biocompatibility and high elasticity.

[0021] The cross-sectional shape of the ring 32 perpendicular to the longitudinal axis direction x is not particularly limited, and may be, for example, a circle, an oval, a polygon, etc. Alternatively, the cross-sectional shape of the ring 32 perpendicular to the longitudinal axis direction x may be a C-shape with a notch, or the ring 32 itself may be a coil formed by spirally winding a wire.

[0022] The length of the ring 32 in the longitudinal axis direction x is preferably 0.5 mm or more and 3.0 mm or less, for example. The outer diameter of the ring 32 is preferably larger than the inner diameter of the cylindrical body 10, and the inner diameter of the ring 32 is preferably smaller than the outer diameter of the cylindrical body 10.

[0023] The ring 32 may be made of the same material as the clip body 31. Among these, the material of the ring 32 preferably includes stainless steel.

[0024] The linear object 20 preferably has a connecting portion 22 at its distal end for connecting to the clip 30, and a proximal end of the linear object 20 is connected to the slider 60 of the handle 40. The linear object 20 can be composed of one or more members. The linear object 20 may be solid or hollow having a lumen extending along the longitudinal axis direction x, but is preferably solid. By making the linear object 20 solid, the rigidity of the linear object 20 can be increased without increasing the outer diameter of the linear object 20. This improves the insertability of the endoscopic treatment tool 1. The linear object 20 may be a solid wire or a twisted wire formed by twisting together single wires. A single wire can be easily manufactured, while a twisted wire can increase the strength of the linear object 20, making it easier to transmit an operation from the operator's side to the distal portion of the endoscopic treatment tool 1, including the clip 30 and the connecting portion 22. The cross section of the linear object 20 perpendicular to the longitudinal axis direction x may have, for example, a circular shape, an elliptical shape, a polygonal shape, or a shape that is a combination of these.

[0025] Examples of materials constituting the linear object 20 include metals such as stainless steels such as SUS301, SUS303, SUS304, and SUS631, and carbon steel; polyamide resins such as nylon; polyolefin resins such as PP and PE; polyester resins such as PET, aromatic polyether ketone resins such as PEEK; polyimide resins; and synthetic resins such as fluorine-based resins such as PTFE, PFA, and ETFE. Among these, stainless steel is preferred as the material constituting the linear object 20. By making the linear object 20 out of stainless steel, the strength of the linear object 20 can be ensured while improving biocompatibility.

[0026] Although not shown, the linear object 20 may have a coating layer on its surface. Examples of the coating layer include fluororesins such as PTFE, PFA, ETFE, and tetrafluoroethylene-hexafluoropropylene copolymer (FEP). By having the coating layer on the linear object 20, it is possible to reduce friction on the surface of the linear object 20, thereby increasing the slidability and increasing the strength of the linear object 20.

[0027] The method for forming a coating layer on the linear object 20 may be any method that allows the material forming the coating layer to cover the surface of the linear object 20, and for example, a dipping method, a spraying method, a fluidized bed method, a kneader coater method, etc. may be used.

[0028] The length of the linear object 20 in the longitudinal axis direction x can be selected appropriately taking into consideration the distance from the forceps port of the endoscope to the treatment target area, and can be, for example, 1000 mm or more and 3000 mm or less.

[0029] The outer diameter of the linear object 20 is preferably 100 μm or more, more preferably 200 μm or more, and even more preferably 300 μm or more. When the lower limit of the outer diameter of the linear object 20 is within the above range, the rigidity of the linear object 20 can be increased. Furthermore, the outer diameter of the linear object 20 is preferably 900 μm or less, more preferably 800 μm or less, and even more preferably 700 μm or less. When the upper limit of the outer diameter of the linear object 20 is within the above range, the insertability of the endoscopic treatment tool 1 can be improved.

[0030] As shown in FIG. 3 , the linear object 20 has a connecting portion 22 on the distal side that connects to the medical clip 30. The medical clip 30 can be attached to the linear object 20 by connecting the medical clip 30 to the connecting portion 22. The linear object 20 preferably has a configuration in which the outer diameter of the connecting portion 22 is larger than the outer diameter of the portion other than the connecting portion 22. This stabilizes the connection between the connecting portion 22 and the medical clip 30. The connecting portion 22 may be formed integrally with the linear object 20, or the linear object 20 may be composed of a linear object main body 21 and the connecting portion 22 which is a separate member, and the connecting portion 22 may be attached to the distal side of the linear object main body 21.

[0031] The shape of the connecting portion 22 is not particularly limited as long as it can be connected to the clip 30, but the cross-sectional shape of the connecting portion 22 perpendicular to the longitudinal axis direction x can be, for example, circular, elliptical, polygonal, or a combination of these.

[0032] When the connecting portion 22 is attached to the linear object main body 21 as a separate member, the above description of the material constituting the linear object 20 can be referred to for the materials constituting the linear object main body 21 and the connecting portion 22. Even when the connecting portion 22 is attached to the linear object main body 21 as a separate member, it is preferable that the material of the connecting portion 22 is the same as the material of the linear object main body 21. When the material of the connecting portion 22 is the same as the material of the linear object main body 21, the connection between the connecting portion 22 and the linear object main body 21 can be strengthened, making it difficult for the connecting portion 22 to come off the linear object main body 21. As a result, the durability of the endoscopic treatment tool 1 can be improved.

[0033] When the connecting portion 22 is a separate member, the connecting portion 22 and the linear object main body 21 can be fixed to each other by, for example, mechanical fixing such as screws, crimping, fitting, press-fitting, etc.; fusion; welding; adhesion using adhesives, tape, etc. Among these, it is preferable that the connecting portion 22 is fixed to the linear object main body 21 by welding. This can increase the bonding strength between the connecting portion 22 and the linear object main body 21.

[0034] As shown in FIGS. 1 and 2 , the linear object 20 is disposed within the cylindrical body 10. A portion of the linear object 20 may be exposed from the distal or proximal end of the cylindrical body 10. The proximal end of the cylindrical body 10 is preferably connected to the handle body 50 of the handle 40. The cylindrical body 10 and the handle body 50 may be connected immovably or rotatably. The cylindrical body 10 preferably has a good balance of flexibility to bend along the shape of the body cavity and rigidity to reliably reach the treatment target site. The cylindrical body 10 is preferably made of a biocompatible material. The cylindrical body 10 may be a coil body made of metal or synthetic resin, a cylindrical body with multiple short cylindrical joint pieces axially connected to allow rotation, a cylindrical body made of synthetic resin, or a combination thereof. For the types of metals and synthetic resins, see the above description of the materials constituting the linear object 20.

[0035] As shown in FIGS. 1 and 2 , the endoscopic treatment tool 1 preferably further includes an outer tube 70. The cylindrical body 10 is disposed in the inner cavity of the outer tube 70, and the outer tube 70 is preferably formed to be slidable within a specific range relative to the cylindrical body 10. Specifically, the outer tube 70 is preferably formed to be movable in the longitudinal axis direction x between a position where the distal end of the outer tube 70 is distal to the distal end of the cylindrical body 10 and a position where the distal end of the outer tube 70 is proximal to the distal end of the cylindrical body 10. To enable such movement operation on the proximal side of the endoscopic treatment tool 1, the outer tube 70 preferably extends to the proximal portion of the endoscopic treatment tool 1. In this case, the proximal end of the outer tube 70 may be formed as an outer grip 71. If the proximal end of the outer tube 70 is formed as the outer grip 71, the outer tube 70 can be moved in the longitudinal axis direction x by operating the outer grip 71. The outer cylinder 70 and the outer grip 71 may be integrally formed, or the proximal end of the outer cylinder 70 may be configured to be connected to the outer grip 71.

[0036] For example, by pushing the outer grip 71 from the proximal side toward the distal side, the outer tube 70 can be moved distally relative to the tubular body 10. This allows the distal end of the tubular body 10 to be housed within the outer tube 70. At this time, if a clip 30 is connected to the connecting portion 22 of the linear object 20 disposed within the tubular body 10, the connecting portion 22 located at the distal end of the tubular body 10 can be housed within the outer tube 70, and the proximal end of the clip 30 can be housed within the outer tube 70. Furthermore, by pushing the outer grip 71 from the proximal side toward the distal side, the distal portion of the clip 30 located distal to the distal end of the tubular body 10 can also be housed within the outer tube 70, allowing the entire clip 30 to be housed within the outer tube 70. If the endoscopic treatment tool 1 is delivered to the treatment site in this state, it is possible to prevent the clip 30 from damaging the forceps channel or internal tissue other than the lesion during delivery. After transporting it to the treatment site, pulling the outer grip 71 from the distal side toward the proximal side moves the outer tube 70 toward the proximal side relative to the cylindrical body 10, thereby exposing the clip 30 from the outer tube 70 and allowing the grasping operation to begin.

[0037] It is preferable that the outer cylinder 70 has a good balance of both flexibility to bend along the shape of the body cavity and rigidity to reliably reach the treatment target site. For the material constituting the outer cylinder 70, please refer to the description of the material constituting the cylindrical body 10 above. In particular, a cylindrical body made of a synthetic resin is preferably used as the outer cylinder 70, and the outer cylinder 70 is preferably made of a transparent or translucent material so that the user can visually confirm the positional relationship between the outer cylinder 70 and the cylindrical body 10. From the viewpoint of slipperiness, it is preferable that the synthetic resins constituting the cylindrical body 10 and the outer cylinder 70 are made of different materials.

[0038] The outer grip 71 can be made up of one or more members. Examples of materials that can be used to make the outer grip 71 include synthetic resins such as polyolefin resins such as PP and PE, polyester resins such as PET, polycarbonate resins, ABS resins, and polyurethane resins.

[0039] The handle 40 has a handle body 50 connected to the proximal end of the cylindrical body 10, and a slider 60 connected to the proximal end of the linear object 20 and movable in the longitudinal axis direction x relative to the handle body 50. The ability of the slider 60 to move in the longitudinal axis direction x relative to the handle body 50 includes the ability to change the relative positional relationship between the slider 60 and the handle body 50 in the longitudinal axis direction x. It is preferable that the slider 60 be slidable in the longitudinal axis direction x relative to the handle body 50.

[0040] The proximal end of the cylindrical body 10 and the handle main body 50 may be directly or indirectly connected, and the proximal end of the linear object 20 and the slider 60 may be directly or indirectly connected.

[0041] When the clip 30 is not connected to the connecting portion 22, the connecting portion 22 can be housed within the tubular body 10 as shown in Fig. 2 by pulling the slider 60 from the distal side toward the proximal side relative to the handle body 50. In other words, when the connecting portion 22 is exposed from the tubular body 10, pulling the slider 60 from the distal side toward the proximal side causes the linear object 20 connected to the slider 60 to move from the distal side toward the proximal side relative to the tubular body 10, and as a result, the connecting portion 22 of the linear object 20 moves toward the proximal side relative to the tubular body 10, so that the connecting portion 22 can be housed within the tubular body 10.

[0042] Conversely, when the connecting portion 22 is housed within the cylindrical body 10, pushing the slider 60 from the proximal side toward the distal side relative to the handle body 50 causes the linear object 20 connected to the slider 60 to move from the proximal side toward the distal side relative to the cylindrical body 10, and as a result, the connecting portion 22 of the linear object 20 moves distally relative to the cylindrical body 10, thereby making it possible for the connecting portion 22 to become partially or completely exposed from within the cylindrical body 10. In this state, the clip 30 can be connected to the connecting portion 22, and the clip 30 can be positioned near the distal end of the cylindrical body 10.

[0043] The slider 60 can be made up of one or more members. For the material that makes up the slider 60, the description of the material that makes up the outer grip 71 can be referred to.

[0044] As shown in Figures 1, 2, 4, and 5, the handle body 50 has a first part 51 and a second part 52 extending in the longitudinal axis direction x and facing each other, and the endoscopic treatment tool 1 satisfies at least one of the following (1) and (2). (1) The first portion 51 has a first thick portion 51a that protrudes inward, and the slider 60 has a first inner support portion 61 that faces the inside of the first portion 51. When the slider 60 is moved in the longitudinal axis direction x relative to the handle body 50, the first thick portion 51a and the first inner support portion 61 come into contact with each other, causing the slider 60 to experience press-in resistance. (2) The second portion 52 has a second thick portion 52a that protrudes inward, and the slider 60 has a second inner support portion 62 that faces the inside of the second portion 52. When the slider 60 is moved in the longitudinal axis direction x relative to the handle body 50, the second thick portion 52a and the second inner support portion 62 come into contact with each other, causing the slider 60 to experience press-in resistance.

[0045] It is preferable that at least a portion of the slider 60 is disposed outside the handle body 50. This makes it easier to operate the slider 60. It is also preferable that the first inner support portion 61 and / or the second inner support portion 62 of the slider 60 are disposed inside the first portion 51 and second portion 52 that face each other.

[0046] The handle body 50 may be configured with the first section 51 and the second section 52 as separate members facing each other, such as plate-shaped members, or, for example, the first section 51 and the second section 52 as facing portions of a tubular member. The tubular shape may be any shape, such as a cylinder, a rectangular prism, or a polygonal prism. Regardless of the shape, the endoscopic treatment tool 1 has a configuration in which at least a portion of the slider 60 is formed on the outside of the handle body 50, and the first inner support section 61 faces the inside of the first section 51 and / or the second inner support section 62 faces the inside of the second section 52. When the first section 51 and the second section 52 are facing each other on a tubular member, it is preferable that the first section 51 and the second section 52 are not continuous in the circumferential direction of the tubular member. This makes it easier to achieve the above-described configuration of the endoscopic treatment tool 1.

[0047] Here, the inside of the first part 51 refers to the side of the first part 51 facing the second part 52, and the inside of the second part 52 refers to the side of the second part 52 facing the first part 51. Furthermore, the outside of the first part 51 refers to the side opposite the inside of the first part 51, the outside of the second part 52 refers to the side opposite the inside of the second part 52, and the outside of the handle body 50 refers to the outside of the first part 51 and / or the outside of the second part 52.

[0048] 4 and 5, the first portion 51 may have a first thick portion 51a, and the second portion 52 may have a second thick portion 52a. In this case, the first thick portion 51a and the second thick portion 52a are preferably disposed at the same position in the longitudinal axis direction x. When the first part 51 has a first thick part 51a and the second part 52 has a second thick part 52a, in a cross section perpendicular to the longitudinal axis direction x, the distance between the first part 51 and the second part 52 at the position where the first thick part 51a and the second thick part 52a are arranged is preferably 0.95 times or less, more preferably 0.9 times or less, even more preferably 0.85 times or less, or may be 0.8 times or less, and is preferably 0.4 times or more, more preferably 0.5 times or more, and even more preferably 0.6 times or more, the distance between the first part 51 and the second part 52 at a position other than the first thick part 51a and the second thick part 52a. The thicknesses of the first portion 51 and the second portion 52 in the first thick portion 51a and the second thick portion 52a are greater than the thicknesses of the first portion 51 and the second portion 52 at positions other than the first thick portion 51a and the second thick portion 52a, respectively, so that the distance between the first portion 51 and the second portion 52 in the first thick portion 51a and the second thick portion 52a can be within the above range. The thicknesses of the first portion 51 and the second portion 52 in the first thick portion 51a and the second thick portion 52a, respectively, may be different or the same along the longitudinal axis direction x.

[0049] Although not shown, only the first portion 51 may have a first thick portion 51a that protrudes inward. In this case, in a cross section perpendicular to the longitudinal axis direction x, the distance between the first portion 51 and the second portion 52 at the first thick portion 51a is preferably 0.98 times or less, more preferably 0.95 times or less, even more preferably 0.90 times or less, or may be 0.85 times or less, or is preferably 0.4 times or more, more preferably 0.5 times or more, and even more preferably 0.6 times or more, the thickness of the first portion 51 at the first thick portion 51a being thicker than the thickness of the first portion 51 at positions other than the first thick portion 51a, so that the distance between the first portion 51 and the second portion 52 at the first thick portion 51a can be within the above range. The thickness of the first portion 51 in the first thick portion 51a may be different or the same along the longitudinal axis direction x.

[0050] Although not shown, only the second portion 52 may have a second thick portion 52a that protrudes inward. In this case, in a cross section perpendicular to the longitudinal axis direction x, the distance between the first portion 51 and the second portion 52 at the second thick portion 52a is preferably 0.98 times or less, more preferably 0.95 times or less, even more preferably 0.90 times or less, or may be 0.85 times or less, or is preferably 0.4 times or more, more preferably 0.5 times or more, and even more preferably 0.6 times or more, the thickness of the second portion 52 at the second thick portion 52a being thicker than the thickness of the second portion 52 at positions other than the second thick portion 52a, so that the distance between the first portion 51 and the second portion 52 at the second thick portion 52a can be within the above range. The thickness of the second portion 52 at the second thick portion 52a may be different or the same along the longitudinal axis direction x.

[0051] The length of the first thick portion 51a and the second thick portion 52a in the longitudinal axis direction x may be set appropriately depending on the length of the clip 30 in the longitudinal axis direction x and the shape thereof, and is, for example, preferably 3% or more of the length of the first portion 51 and the second portion 52, respectively, more preferably 5% or more, even more preferably 10% or more, and preferably 50% or less, more preferably 40% or less, even more preferably 30% or less.

[0052] In this way, because the endoscopic treatment tool 1 has the first thick portion 51a and / or the second thick portion 52a, when the slider 60 is moved in the longitudinal axis direction x relative to the handle body 50, the first thick portion 51a comes into contact with the first inner support portion 61 and / or the second thick portion 52a comes into contact with the second inner support portion 62, and the slider 60 is subjected to press-fit resistance. As a result, when the slider 60 is moved in the longitudinal axis direction x relative to the handle body 50, the linear object 20 connected to the slider 60 can be moved gently in the longitudinal axis direction x. As a result, by operating the slider 60, it is possible to easily and reliably connect the clip 30 to the linear object 20 and operate the clip 30.

[0053] The position of the first thick portion 51a and / or the second thick portion 52a in the longitudinal axis direction x determines in which operation the slider 60 experiences press-fit resistance. For example, to reliably perform the operation of exposing the connecting portion 22 of the linear object 20 from the distal end of the cylindrical body 10 and connecting it to the clip 30, the first thick portion 51a and / or the second thick portion 52a may be provided in the distal portion of the first portion 51 and / or the second portion 52, respectively, as shown in FIG. 4. Furthermore, to reliably control the position of the connecting portion 22 with respect to the cylindrical body 10 in a state where the clip 30 is attached before gripping the object to be gripped, the first thick portion 51a and / or the second thick portion 52a may be provided near the center of the first portion 51 and / or the second portion 52, respectively, as shown in FIG. Alternatively, in order to reliably control the opening and closing of the clip 30 to grasp the object to be treated, or to detach the clip 30 from the connecting portion 22 after grasping, a first thick portion 51a and / or a second thick portion 52a (not shown) may be provided in the proximal portion of the first portion 51 and / or the second portion 52, respectively.

[0054] Therefore, although only one first thick portion 51a and / or one second thick portion 52a may be provided in the longitudinal axis direction x, it is preferable that a plurality of first thick portions 51a are provided spaced apart in the longitudinal axis direction x. When a plurality of first thick portions 51a are provided spaced apart in the longitudinal axis direction x, the number is preferably two or more, more preferably three or more, and preferably five or less, and more preferably four or less. When a plurality of second thick portions 52a are provided spaced apart in the longitudinal axis direction x, the number is preferably two or more, more preferably three or more, and preferably five or less, and more preferably four or less. When both first thick portions 51a and second thick portions 52a are provided spaced apart in the longitudinal axis direction x, the respective numbers may be the same or different.

[0055] The first inner support portion 61 and the second inner support portion 62 may be made of an elastic material, which makes it easier to move the slider 60 in the longitudinal axis direction x even when the first thick portion 51a and the second thick portion 52a are present, and makes it easier to receive press-fit resistance.

[0056] The first thick portion 51a protrudes inward from the first portion 51, and the second thick portion 52a protrudes inward from the second portion 52, thereby achieving the above-mentioned effect without affecting the outer diameter of the handle body 50. This improves the insertability of the endoscopic treatment tool 1.

[0057] The endoscopic treatment tool 1 preferably satisfies at least one of the following (3) and (4). (3) When the above condition (1) is satisfied, the distal end 22d of the connecting portion 22 is not housed within the cylindrical body 10 when the first thick portion 51a and the first inner support portion 61 are in contact with each other. (4) When the above condition (2) is satisfied, the distal end 22d of the connecting portion 22 is not housed within the cylindrical body 10 when the second thick portion 52a and the second inner support portion 62 are in contact with each other.

[0058] The above will be described with reference to FIG. 6. FIG. 6 shows the positional relationship between the connecting portion 22 and the cylindrical body 10, together with the clip 30, when the slider 60 is located at the distal portion of the handle body 50. When the slider 60 is located at the distal portion of the handle body 50, as shown in FIG. 6, the distal end 22d of the connecting portion 22 is not housed within the cylindrical body 10, and the connecting portion 22 is located distal to the distal end of the cylindrical body 10. In this state, the connecting portion 22 and the clip 30 can be connected. At this time, by satisfying the above (3) and / or (4), the slider 60 can receive press-fit resistance at the distal portion of the handle body 50. As a result, the movement of the slider 60 in the longitudinal axis direction x at the distal portion of the handle body 50 can be made gentle, making it easier to reliably connect the connecting portion 22 and the clip 30.

[0059] The endoscopic treatment tool 1 preferably satisfies at least one of the following (5) and (6). (5) When the above condition (1) is satisfied, at least a portion of the connecting portion 22 is housed within the cylindrical body 10 when the first thick portion 51a and the first inner support portion 61 are in contact with each other. (6) When the above condition (2) is satisfied, at least a portion of the connecting portion 22 is housed within the cylindrical body 10 when the second thick portion 52a and the second inner support portion 62 are in contact with each other.

[0060] The above will be explained with reference to Figures 7 and 8. Figures 7 and 8 show the positional relationship between the connecting part 22 and the cylindrical body 10, together with the clip 30, when the slider 60 is located near the center of the handle body 50.

[0061] By positioning the slider 60 near the center of the handle body 50, as shown in FIG. 7, the proximal end 22p of the connecting portion 22 is housed within the cylindrical body 10, and the clip 30 connected to the connecting portion 22 can be present near the distal end of the cylindrical body 10. This state can be said to be suitable for the clip 30 to be in a standby state before gripping. The standby state is a state in which the clip 30 can immediately perform a gripping operation. At this time, the distal end 22d of the connecting portion 22 may be exposed from the cylindrical body 10.

[0062] 8, by positioning the slider 60 near the center of the handle body 50, the distal end 22d of the connecting portion 22 is housed within the cylindrical body 10, i.e., the entire connecting portion 22 may be housed within the cylindrical body 10. In this case, if the clip 30 is composed of the clip body 31 and the ring 32, it is preferable that the proximal end of the ring 32 abuts against the distal end of the cylindrical body 10. This allows the clip 30 to be in a state where it can begin a grasping operation.

[0063] When performing treatment using the endoscopic treatment tool 1, it is preferable to insert the clip 30 into the forceps channel of the endoscope with the clip 30 in a standby state and transport the clip 30 to the vicinity of the treatment target. After transport, the slider 60 is slightly pulled proximally in the longitudinal axis direction x relative to the handle body 50, thereby changing the clip 30 from the standby state to a state in which a grasping operation can be started. At this time, by satisfying the above (5) and / or (6), the slider 60 is subjected to press-fit resistance, and therefore the movement of the slider 60 when it is slightly pulled proximally in the longitudinal axis direction x relative to the handle body 50 can be made gentle, making it easier to perform the operation reliably.

[0064] The endoscopic treatment tool 1 may satisfy the above (1) and / or (2) throughout the entire process of moving the slider 60 proximally relative to the handle body 50 from the state shown in Fig. 7 to the state shown in Fig. 8. That is, the first thick portion 51a and / or the second thick portion 52a may be provided throughout the entire section in which the slider 60 moves proximally relative to the handle body 50 in the longitudinal axis direction x from the standby state to a state in which a grasping operation can be started. This makes it easier to make the movement of the slider 60 gentler during the process from the standby state to a state in which a grasping operation can be started.

[0065] The handle body 50 has a stop portion 500 at which at least a portion of the slider 60 abuts against at least a portion of the outer surface of the handle body 50, stopping the slider 60 from moving in the proximal direction, and when the slider 60 is stopped from moving by the stop portion 500, the entire connecting portion 22 is contained within the cylindrical body, and it is preferable that the endoscopic treatment tool 1 satisfies at least one of the following (7) and (8). (7) When the above condition (1) is satisfied, the length La of the first thick portion 51a is longer than the length L of the stopper portion 500 in the longitudinal axis direction x. (8) When the above condition (2) is satisfied, the length La of the second thick portion 52a is longer than the length L of the stop portion 500 in the longitudinal axis direction x.

[0066] The above will be explained with reference to Fig. 9. Fig. 9 is a cross-sectional view of the handle 40 of an endoscopic treatment tool 1 according to another embodiment of the present invention, taken along the longitudinal axis direction x. As shown in Fig. 9, the handle main body 50 preferably has a stop portion 500 where at least a part of the slider 60 abuts against at least a part of the outer surface of the handle main body 50, stopping the movement of the slider 60 in the proximal direction.

[0067] When the slider 60 is pulled from the distal side to the proximal side of the stop portion 500, at least a portion of the slider 60 comes into contact with the stop portion 500 and is stopped at the stop point P, and by further applying a traction force of a predetermined level or more to the slider 60, the stop is released and the slider 60 can move in the proximal direction. Figure 9 shows a state in which the slider 60 comes into contact with the stop portion 500 and is stopped at the stop point P.

[0068] When the movement of the slider 60 is stopped by the stopper 500, it is preferable that the entirety of the connecting portion 22 is housed within the cylindrical body 10. In other words, it is preferable that the positional relationship between the connecting portion 22, the clip 30, and the cylindrical body 10 is such that the clip 30 can start a gripping operation, as shown in FIG.

[0069] With the above-described configuration, the user can sense that the clip 30 is in a state where the gripping operation can be started by the sensation of a part of the slider 60 abutting against the stop portion 500.

[0070] In the above aspect, the endoscopic treatment tool 1 further has the first thick portion 51a and / or the second thick portion 52a. In this case, the first thick portion 51a and / or the second thick portion 52a are preferably provided near the center of the handle body 50. This allows the slider 60 to move slowly in the longitudinal axis direction x, ensuring a reliable transition from a standby state of the clip 30 to a state in which a grasping operation can be started.

[0071] When the above condition (1) is satisfied, it is preferable that the length La of the first thick portion 51a in the longitudinal axis direction x is longer than the length L of the stopping portion 500. Furthermore, when the above condition (2) is satisfied, it is preferable that the length La of the second thick portion 52a in the longitudinal axis direction x is longer than the length L of the stopping portion 500. With this configuration, it becomes easier to distinguish between the sensation the user feels when the slider 60 is stopped by the stopping portion 500 and the sensation the user feels when the slider 60 is subjected to press-fit resistance by the first thick portion 51a and the second thick portion 52a, making it easier to grasp the state of the clip 30 more accurately.

[0072] The length La of the first thick portion 51a and / or the second thick portion 52a is preferably at least 1.2 times the length L1 of the stopping portion 500, more preferably at least 1.5 times, even more preferably at least 2 times, particularly preferably at least 3 times, and is preferably at most 20 times, more preferably at most 15 times, and even more preferably at most 10 times.

[0073] By setting the length La of the first thick portion 51a and / or the second thick portion 52a within the above range, the movement of the slider 60 from the standby state of the clip 30 to the state where it can be gripped can be made more effective and gradual.

[0074] The stopping portion 500 is preferably a protrusion 500a provided on the outer surface of the first portion 51 and / or the second portion 52. In this case, a protrusion may also be provided on the surface of the slider 60 facing the outer surface of the first portion 51 and / or the second portion 52, and the slider 60 may be stopped by the stopping portion 500 when the protrusion and the protrusion 500a come into contact with each other. Alternatively, a recess may be provided on the surface of the slider 60 facing the outer surface of the first portion 51 and / or the second portion 52, and the slider 60 may be stopped by the stopping portion 500 when the recess and the protrusion 500a come into contact with each other.

[0075] 9, the stop portion 500 may be provided only on the outer surface of the first portion 51. Alternatively, although not shown, the stop portion 500 may be provided only on the outer surface of the second portion 52, or may be provided on both the outer surface of the first portion 51 and the outer surface of the second portion 52. In either case, a convex portion or a concave portion that can come into contact with the stop portion 500 may be provided on the surface of the slider 60 that faces the first portion 51 and / or the second portion 52 on which the stop portion 500 is provided.

[0076] Alternatively, although not shown, the stop portion 500 may be a recess provided on the outer surface of the first portion 51 and / or the second portion 52. In this case, a protrusion may be provided on the surface of the slider 60 facing the outer surface of the first portion 51 and / or the second portion 52, and the protrusion may come into contact with a recess provided as the stop portion 500, thereby causing the slider 60 to be stopped by the stop portion 500.

[0077] When the endoscopic treatment tool 1 includes the outer tube 70, it is preferable that the clip 30 can be placed inside the outer tube 70 by moving the outer tube 70 distally relative to the cylindrical body 10, and that the clip 30 is exposed from the distal end of the outer tube 70 by moving the outer tube 70 proximally relative to the cylindrical body 10. It is also preferable that the clip 30 can be inserted and removed from the cylindrical body 10 in this manner when the slider 60 is stopped by the stopper 500. The outer tube 70 may be moved relative to the cylindrical body 10, for example, by manually moving an outer grip 71 connected to the proximal end of the outer tube 70 in the longitudinal axis direction x. [Explanation of symbols]

[0078] 1: Endoscopic treatment tools 10: Cylinder 20: Linear object 21: Linear object body 22:Connection part 22d: Distal end of the connection 22p: proximal end of the joint 30: Clip 31: Clip body 32: Ring 40: Handle 50: Handle body 51: Part 1 51a: 1st thick part 52: Part 2 52a: 2nd thick part 60: Slider 61:First inner support part 62:Second inner support part 70: Outer cylinder 71: Outer grip 500: Stop part 500a: Convex part La: Length of the first thick portion and / or the second thick portion L: Length of stop P: Stop point

Claims

1. having a distal side and a proximal side in a longitudinal direction, An endoscopic treatment instrument having a cylindrical body, a linear object disposed in an inner cavity of the cylindrical body and having a connecting portion to be connected to a medical clip, and a handle provided on a proximal side of the cylindrical body and the linear object, the handle has a handle body connected to a proximal end of the cylindrical body, and a slider to which a proximal end of the linear object is connected and which is movable in the longitudinal axis direction relative to the handle body, and the connecting part can be housed in the cylindrical body by pulling the slider from the distal side toward the proximal side, The handle body has a first portion and a second portion extending in the longitudinal axis direction and facing each other, An endoscopic treatment tool that satisfies both of the following (1) and (2). (1) The first portion has a first thick portion that protrudes inward, and the slider has a first inner support portion that faces the inside of the first portion. When the slider is moved in the longitudinal axis direction relative to the handle body, the first thick portion and the first inner support portion come into contact with each other, causing the slider to experience press-fit resistance. (2) The second portion has a second thick portion that protrudes inward, and the slider has a second inner support portion that faces the inside of the second portion, and when the slider is moved in the longitudinal axis direction relative to the handle body, the second thick portion and the second inner support portion come into contact with each other, causing the slider to experience press-in resistance.

2. The endoscopic treatment tool according to claim 1, which satisfies at least one of the following (3) and (4): (3) When the above (1) is satisfied, the distal end of the connecting portion is not housed within the cylindrical body when the first thick portion and the first inner support portion are in contact with each other. (4) When the above (2) is satisfied, the distal end of the connecting portion is not housed within the cylindrical body when the second thick portion and the second inner support portion are in contact with each other.

3. The endoscopic treatment tool according to claim 1, which satisfies at least one of the following (5) and (6): (5) When the above (1) is satisfied, at least a portion of the connecting portion is housed within the cylindrical body when the first thick portion and the first inner support portion are in contact with each other. (6) When the above condition (2) is satisfied, at least a portion of the connecting portion is housed within the cylindrical body when the second thick portion and the second inner support portion are in contact with each other.

4. The handle body has a stop portion where at least a portion of the slider abuts against at least a portion of an outer surface of the handle body to stop the slider from moving in the proximal direction, When the movement of the slider is stopped by the stop portion, the entire connecting portion is housed within the cylindrical body, The endoscopic treatment tool according to any one of claims 1 to 3, which satisfies at least one of the following (7) and (8): (7) When the above (1) is satisfied, the length of the first thick portion in the longitudinal axis direction is longer than the length of the stop portion. (8) When the above (2) is satisfied, the length of the second thick portion in the longitudinal axis direction is longer than the length of the stop portion.

5. The endoscopic treatment tool according to claim 4, wherein the stop portion is a convex portion provided on an outer surface of the first portion and / or the second portion.

6. The endoscopic treatment tool according to claim 4, wherein the stop portion is a recess provided on an outer surface of the first portion and / or the second portion.

Images