JP2015192724A - Hold releasing device of body tissue holding member - Google Patents

Abstract

PROBLEM TO BE SOLVED: To achieve the facilitation of hold releasing operation of a clip detained inside a body and the simplification of a device configuration in a hold releasing device of the clip.SOLUTION: A hold releasing device releases the hold (grip) of a clip 1 having a pair of arm plate parts 11, 12 arranged in a substantially V shape and a connection plate part 13 for connecting the arm plate parts. The device comprises: a sheath 22; a drive wire 23 inserted slidably into the sheath; an extrusion member 24 fixed integrally with the distal end of the drive wire 23; and a guide member 21 fixed to the tip of the sheath. The guide member guides the movement of the extrusion member extruded from the distal end of the sheath, and has an inner wall 21a which accommodates a base end part of the arm plate parts, to which the connection plate part and a ring are externally fitted, from the side to the inside. At its end, the guide member has a locking claw 23c for locking a portion of the distal end side of the ring, and the base end part of the guide member is fixed integrally with the distal end of the sheath.

Description

  The present invention relates to a holding release device for a body tissue holding member that releases the holding of the body tissue holding member placed in the living body while holding the body tissue to the body tissue by an operation from outside the body.

  An endoscopic clip as one of body tissue holding members used for treatment such as hemostasis, marking, or stitching using an endoscope is tightened as shown in Patent Document 1, for example. By moving (sliding) the ring, the pair of arm plate portions are brought close to each other, and the medical device grips the body tissue at or near the distal end portion of the arm plate portion.

  Such an endoscope clip is attached to the distal end of a catheter tube (clip device) that is passed through the treatment instrument guide tube of the endoscope, guided to the body tissue to be treated, and then the catheter tube By the operation from the operation unit provided at the proximal end, the body tissue (mucosa) is grasped and removed from the catheter tube and placed in the body.

  After achieving the purpose of treatment such as hemostasis, there is a case where the grasp of the body tissue by the clip placed in the living body is released and the clip is taken out of the body. Clip removal devices such as those disclosed have been proposed. This device includes a pair of ring holding arms that open and close to hold a clamping ring that closes the clip, and a clip that pushes the clip forward relative to the clamping ring held by the ring holding arm. A clip push-out member, and with the clip holding member holding the tightening ring, the clip push-out member pushes the clip relatively forward from the tightening ring, thereby releasing the clip from the body tissue by its own elasticity. It is what I did.

JP 2009-189705 A JP 2007-125264 A

  However, in the conventional clip removing device, it is necessary to hold the clamping ring that closes the clip by closing the pair of ring holding arms that are opened in a substantially C shape in the vicinity of the clip to be removed. There is a problem that it is difficult to properly hold the tightening ring.

  Also, if the clip is not properly positioned while holding the tightening ring, when the clip is pushed out by the pushing member, the clip will come off the ring holding arm and the holding operation will need to be repeated again. There is a problem that it may require.

  Further, in order to open and close the ring holding arm, two tubular members, an inner sheath (flexible sheath) to which the ring holding arm is fixed and an outer sheath (outer tube) are required. There is a problem that it is complicated, it is difficult to meet the demand for smaller and thinner devices, and the cost is high.

  The present invention has been made in view of the above points, and provides a body tissue holding member holding and releasing device that can easily and properly release the body tissue holding member, has a simple configuration, and is inexpensive. The purpose is to do.

The body tissue holding member that is the object of holding release of the body tissue holding member holding release device according to the present invention,
A holding part having a first part and a second part arranged so that one end sides thereof are close to each other and the other end side is separated;
A connecting portion that connects the one end of the first part and the one end of the second part;
Slide between the release position that is externally fitted to the connecting portion and the holding position that is externally fitted to the first part and the second part by pulling the first part and the second part into the inside. And a ring arranged in a possible manner.

In the body tissue holding member holding release device according to the present invention, the ring of the body tissue holding member placed in the body in a state where the ring is set at the holding position is operated from the holding position by operating the ring from outside the body. A device that slides to a release position,
A tubular sheath;
A drive wire slidably inserted into the sheath;
A pusher member integrally secured to the distal end of the drive wire;
An operating portion provided at a proximal end of the sheath and sliding the drive wire within the sheath;
The pushing member pushed out from the distal end of the sheath guides the movement of the pushing member in the direction along the center axis of the sheath, and the first portion and the second portion to which the connecting portion and the ring are externally fitted are guided. An inner wall that guides movement in the direction along the central axis in a state where the portion is accommodated from the side to the inside, and a locking claw that locks a part of the end portion on the holding portion side of the ring in this state It has a guide member which is provided at the distal end thereof and whose proximal end portion is integrally fixed to the distal end of the sheath.

  In the body tissue holding member release device according to the present invention, the guide member is formed of a substantially half-cylindrical semi-cylindrical member, and the locking claw is integrated so as to close the tip of the semi-cylindrical member. A member formed by forming a substantially semicircular cut portion having an inner diameter slightly smaller than the outer diameter of the ring on a substantially semicircular plate-like member provided on the ring can be used.

  In the body tissue holding member release device according to the present invention, the body tissue holding member to be held and released is arranged in a substantially C shape so as to open toward the tip, For an endoscope having a pair of arm plate portions including the first portion and the second portion on the end side as the holding portion, and gripping a part of the body tissue with the pair of arm plate portions. A clip can be exemplified.

  In the body tissue holding member release device according to the present invention, the body tissue holding member to be held and released includes a wire including the first part at one end and the second part at the other end. An example of an endoscopic snare that has a ligating loop in a substantially loop shape as the holding portion and ligates a part of the body tissue.

  According to the holding release device for a body tissue holding member according to the present invention, the first portion and the second portion where the connecting portion and the ring of the body tissue holding member placed in the body are externally fitted are guided from the side. When the push-out member is pushed out of the sheath tip while being accommodated along the inner wall of the member and so that a part of the end of the ring can be locked by the lock claw, the push-out member It moves in the direction along the central axis of the sheath while being guided by the inner wall, and presses the proximal end portion of the connecting portion. Since a part of the end of the ring is locked by the locking claw, the first part and the second part move relative to the ring so that the ring reaches the connecting part. The holding of the body tissue holding member is released.

  As described above, the first portion and the second portion where the coupling portion of the body tissue holding member and the ring are externally fitted and the second portion are accommodated and arranged along the inner wall of the guide member, and the push-out member is simply pushed out. Since the holding of the body tissue holding member can be released, the operation is very simple.

  Moreover, since the pushing part is guided to the inner wall of the guide member and the first part and the second part in which the connecting part of the body tissue holding member and the ring are externally fitted, and the pushing member, they should be arranged in an appropriate positional relationship. In addition, since the mutual posture can be maintained properly even when the push-out member is pushed out, troubles such as the body tissue holding member coming off from the guide member can be reduced.

  Furthermore, since the number of movable parts is small (a mechanism for opening and closing the ring holding arm as in the prior art is not necessary and only one sheath is required), the configuration is simple, and the device is small and small in diameter. And cost reduction.

It is a top view which shows the structure in the open leg state of the clip for endoscopes as a holding | maintenance release object of the holding | maintenance release apparatus of embodiment of this invention. It is a top view which shows the structure in the closed leg state of the clip for endoscopes as a holding | maintenance release object of the holding | maintenance release apparatus of embodiment of this invention. It is a top view which shows the whole structure of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention. It is sectional drawing along the AA line of FIG. It is the perspective view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state which accommodated the extrusion member in the sheath. It is the perspective view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state which extruded the extrusion member inside the guide member. It is the top view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state before holding | maintenance cancellation | release. It is the side view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state before holding | maintenance cancellation | release. It is the top view which expanded the front-end | tip part of the holding | maintenance cancellation | release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state under holding release. It is the side view which expanded the front-end | tip part of the holding | maintenance cancellation | release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state under holding release. It is the top view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state after holding release. It is the side view which expanded the front-end | tip part of the holding | maintenance release apparatus of the body tissue holding member of embodiment of this invention, and is a figure which shows the state after holding | maintenance cancellation | release. It is a top view which shows the structure of the snare for endoscopes as a holding | maintenance release object of the holding | maintenance release apparatus of embodiment of this invention.

  Hereinafter, a medical clip holding (holding) releasing device (clip remover) as an embodiment of a holding release device for a body tissue holding member according to the present invention will be described in detail with reference to the drawings.

  FIG. 1 and FIG. 2 are a plan view in an open leg state and a plan view in a closed leg state of an endoscope clip (medical clip) that is an object of holding release of the holding release device of the present embodiment. The endoscope clip 1 includes a pair of arm plate portions 11 and 12 and a connecting plate portion 13 bent into a substantially U shape. The pair of arm plate portions 11 and 12 correspond to the holding portion according to the present invention, and the connecting plate portion 13 corresponds to the connecting portion according to the present invention. A tightening ring 14 that opens and closes the pair of arm plate portions 11 and 12 is slidably fitted to the connecting plate portion 13. The tightening ring 14 corresponds to a ring according to the present invention.

  The pair of arm plate portions 11 and 12 are arranged so as to open (legs open) in a substantially square shape as they go to the tip of each other. A part on the base end side of the arm plate part 11 (base end part 11b) is the first part according to the present invention, and a part on the base end part side of the arm plate part 12 (base end part 12b) is the present invention. The first part and the second part are arranged so that one end side (connecting plate part 13 side) thereof is close to each other and the other end side (gripping part 11c side) is separated from each other. Has been.

  One end (base end) of the base end portion (first portion) 11b of the arm plate portion 11 is one end (base end) of the base end portion (second portion) 12b of the arm plate portion 12 at one end of the connecting plate portion 13. ) Are integrally connected to the other end of the connecting plate portion 13, respectively.

  Claw portions 11a and 12a are integrally formed at the distal ends of the arm plate portions 11 and 12, respectively. The claw portions 11a and 12a are formed by being bent toward the inner side (that is, the closing direction) at the tips of the arm plate portions 11 and 12. Each nail | claw part 11a, 12a has a notch part (not shown) recessed in the intermediate part of the front-end | tip.

  The connecting plate portion 13, the pair of arm plate portions 11 and 12, and the pair of claw portions 11 a and 12 a that constitute the endoscope clip 1 are formed by bending a single plate material. Although the board thickness of the board | plate material which comprises the clip 1 for endoscopes is not specifically limited, Preferably it is 0.10-0.30 mm. As the plate material, a plate material having elasticity is preferable, for example, stainless steel is used.

  The arm plate portions 11 and 12 have base end portions 11b and 12b and gripping portions 11c and 12c, respectively. Protruding portions and wide portions are provided as locking portions for preventing further sliding of the ring 14 toward the gripping portions 11c and 12c on the boundary portions 11d and 12d between the base end portions 11b and 12b and the gripping portions 11c and 12c. May be. The tightening ring 14 is composed of a substantially cylindrical ring member. However, the tightening ring 14 may be configured by a spring formed by winding a wire in a coil shape.

  The fastening ring 14 is inserted into the guide hole inside thereof, and the connecting plate portion 13 is inserted therethrough, and moves in the axial direction between the outer periphery of the connecting plate portion 13 and the outer periphery of the base end portions 11b and 12b of the arm plate portions 11 and 12. (Sliding) is mounted (externally fitted). When the fastening ring 14 is slid from the position (release position) externally fitted to the connecting plate part 13 to the position (holding position) externally fitted to the base end parts 11b and 12b of the arm plate parts 11 and 12, The base end portions 11b and 12b of the pair of arm plate portions 11 and 12 are drawn into the inside (guide hole) of the tightening ring 14, and the arm plate portions 11 and 12 are closed, that is, the arm plate portions 11 and 12 are respectively connected. It is designed to be close to each other.

  As shown in FIG. 1, when the tightening ring 14 is disposed rearward (connecting plate portion 13), the arm plate portions 11 and 12 are opened (opened) by their own elasticity. If necessary, as shown in FIG. 2, the arm plate portions 11 and 12 are gradually closed by moving (sliding) the tightening ring 14 to a position closer to the front, and the base end portions 11b and 12b are reached. By moving, the arm plate portions 11 and 12 can be closed (closed).

  Such an endoscope clip 1 is attached to the distal end of a catheter tube (clip device) that is passed through a treatment instrument guide tube of an endoscope, and is guided to a body tissue to be treated such as hemostasis. By the operation from the operation part provided at the proximal end of the catheter tube, the body tissue (mucosa) is grasped and removed from the catheter tube and left in the body.

  After achieving the purpose of treatment such as hemostasis, when releasing the clip of the body tissue by the clip placed in the body and taking the clip out of the body, the body tissue holding member holding release device according to this embodiment ( Clip remover) is used. Hereinafter, the holding release device will be described with reference to FIGS.

  As shown in FIGS. 3 to 6, the holding release device 2 includes a guide member 21, a sheath (tube) 22, an operation wire 23, an extrusion member 24, a base side lock member 25, and a sheath side lock member 26. An operation unit having a lock mechanism, a base portion 27 and a slider portion 28 is roughly provided.

  The sheath 22 is made of a flexible hollow tube, and a simple flexible tube made of resin or the like may be used, but in this embodiment, a coil tube is used. As the coil tube, a flat wire coil tube formed by spirally winding a long flat plate made of metal (stainless steel) or the like can be used. However, a round wire coil tube or an inner flat coil tube may be used. Note that a wire tube may be used as the sheath 22. The wire tube is a tube made of a hollow stranded wire formed by twisting a plurality of wires (cables) made of, for example, metal (stainless steel) in a spiral shape so as to be hollow.

  Such a coil tube (or wire tube) is used as the sheath 22 when the holding release device 2 is ultrasonically cleaned using a cleaning liquid, so that the cleaning liquid sufficiently penetrates the inside of the tube both inside and outside. This is so that it can be washed well.

  The drive wire 23 is made of a flexible wire, and a wire rope is used in this embodiment. The wire rope is a rope made of a stranded wire formed by twisting a plurality of wires (cables) made of, for example, metal (stainless steel) or the like. However, the drive wire 23 may be a single wire.

  A push member 24 is integrally fixed to the tip (distal end) of the drive wire 23. The pushing member 24 is a substantially cylindrical member, and the outer diameter of the pushing member 24 is set to a value slightly smaller than the inner diameter of the sheath 22. By sliding the drive wire 23 in the sheath 22, the sheath 22 The distal end of the sheath 22 can be moved (slided) so as to be housed in the sheath 22 and to protrude from the distal end of the sheath 22. As the extruding member 24, a metal such as stainless steel can be used. For example, the pushing member 24 is formed in an annular shape so that a metal flat plate has an inner diameter substantially equal to or slightly smaller than the outer diameter of the driving wire 23, and the tip end portion of the driving wire 23 is formed into the annular member. It can be fixed to the drive wire 24 by being inserted or press-fitted inside and welded to each other.

  The guide member 21 is a substantially halved cylindrical member having an inner wall 21a, a side opening 21b, a locking claw 21c, and a notch 21d. The guide member 21 serves as a notch 21d for forming a locking claw 21c at the center of the closed end surface of the cylindrical member whose one end in the axial direction is closed and the other end is opened. A circular hole is formed, and the cylindrical member is assumed to have a first surface and a second surface passing through the central axis, respectively, and the first surface and the second surface are at a predetermined angle θ. It is a member shaped like a rectangular side opening 21b by cutting so as to intersect.

  In the present embodiment, the predetermined angle θ is set to an angle smaller than 180 ° as shown in FIGS. 5 and 6, but may be set to an angle larger than 180 °. , 180 ° (that is, half-cylindrical) may be set. The dimension (width) in the short direction of the side opening 21b of the guide member 21 is set to a value larger than the outer diameter of the ring 14 of the clip 1, and the dimension in the longitudinal direction of the side opening 21b is the base of the clip 1. It is set to a value larger than the total length of the end portions 11b, 12b and the connecting plate portion 13.

  The inner diameter of the circular hole formed in the central portion of the closed end surface of the cylindrical member and serving as the notch 21d for forming the locking claw 21c is larger than the outer diameter of the ring 14 of the clip 1. Is also set to a slightly smaller value. The inner diameter of the guide member 21 is substantially the same as the inner diameter of the sheath 22, and the guide member 21 is fixed to the distal end portion of the sheath 22 so that the inner wall 21 a continues to the inner surface of the distal end portion of the sheath 22 without a step. Yes. As the guide member 21, a member made of metal such as stainless steel can be used. The guide member 21 can be fixed to the sheath 22 by, for example, welding.

  The inner wall 21a of the guide member 21 guides the movement of the push-out member 24 in the direction along the central axis of the sheath 22 when the push-out member 24 is pushed out from the distal end of the sheath 22, and the pair of arm plate portions 11 The base end portions 11b and 12b including the connecting plate portion 13 and the ring 14 of the clip 1 in a state in which the ring 14 is externally fitted to the base end portions 11b and 12b (holding state) of the base plate 11b and the base end portions 11b and 12b of the base end portions 11b and 12b ) To guide the movement in the direction along the central axis while being accommodated inside.

  When the base end portions 11b and 12b of the clip 1 in the holding state and the connecting plate portion 13 are accommodated in the guide member 21, a portion (boundary portion) slightly on the tip side of the ring 14 of the arm plate portions 11 and 12 11d, 12d or the vicinity thereof pass through the cut portion 21d.

  The proximal end (base end portion) of the sheath 22 through which the drive wire 23 is inserted has a base portion via a luer lock mechanism having a base side lock member 25 having a male screw portion and a sheath side lock member 26 having a female screw portion. 27 is connected and fixed to the distal end of 27.

  The sheath side lock member 26 is rotatably attached to the proximal end of the sheath 22. Although not shown in the figure, the sheath side lock member 26 has a through hole at the center thereof, a female screw portion is formed on the proximal end side of the through hole, and an annular receiving member on the back side of the female screw portion. A surface is formed. Further, a convex annular flange portion is integrally formed at the proximal end of the sheath 22 so as to protrude to the periphery, and the vicinity of the proximal end of the sheath 22 is formed in a through hole of the sheath side lock member 26. The surface of the distal end side of the flange portion is arranged so as to face the receiving surface so as to be able to rotate and slide.

  Although not shown in the figure, the base side locking member 25 has a through hole at the center thereof, and the distal end of the base portion 27 is arranged with the male screw portion protruding toward the distal end side. It is fixed at the end. The proximal end of the sheath 22 is detachably attached to the base portion 27 by screwing the female screw portion of the sheath side lock member 26 with the male screw portion of the base side lock member 25.

  A slider portion 28 is slidably attached to the base portion 27, and the proximal end of the drive wire 23 passes through the respective through holes of the sheath side lock member 26 and the base side lock member 25, and the slider portion. 28, and is detachably fixed to the slider portion 28 via a lock screw 29.

  By sliding the slider portion 28 toward the distal end side with respect to the base portion 27, the pushing member 24 provided at the distal end of the drive wire 23 is pushed out from the distal end of the sheath 22, and the inner wall of the guide member 21 is pushed. It moves to the distal end side along 21a. On the contrary, by sliding the slider portion 28 toward the proximal end side with respect to the base portion 27, the pushing member 24 provided at the distal end of the drive wire 23 approaches the inner wall 21 a of the guide member 21. It moves to the distal end side and is received in the distal end of the sheath 22.

  Next, a method for using the above-described holding release device 2 will be described. 7 and 8, the clip 1 is slid from the release position where the ring 14 is positioned on the connecting plate portion 13, and is set to the holding position where it is positioned at the base end portions 11 b and 12 b of the pair of arm plate portions 11 and 12. In this state, the body tissue (mucosa) B is held (gripped) by the gripping portions 11c and 12c of the pair of arm plate portions 11 and 12, and is placed in the body.

  First, the sheath 22 of the holding release device 2 is inserted through the treatment instrument guide tube of the endoscope, and the guide member 21 is positioned in the vicinity of the clip 1 to be released from holding (gripping) placed in the living body. Let Next, the slider portion 28 is slid toward the proximal end side with respect to the base portion 27 of the holding release device 2, and the pushing member 24 provided at the distal end of the drive wire 23 is retracted from the guide member 21. The sheath 22 is accommodated in the distal end. In this state, as shown in FIGS. 7 and 8, the base portion 27 and the slider portion 28 are integrally rotated so that the side opening 21 b of the guide member 21 is directed in the direction of the clip 1. The attitude of the guide member 21 is adjusted.

  After that, as shown by a one-dot chain line arrow in FIGS. 7 and 8, the pair of arm members 11, 12 including the connecting plate portion 13 and the ring 14 of the clip 1 inside the side opening 21 b of the guide member 21. The base end portions 11b and 12b of the pair of arm members 11 and 12 and the gripping portion are accommodated in the notch 21d of the locking claw 21c at the distal end of the guide member 21 so that the base end portions 11a and 12a are accommodated. The guide member 21 is brought close to each other so that the vicinity of the boundary portions 11d and 12d (see FIG. 1) with 11c and 12c passes.

  9 and 10, the base end portions 11 b and 12 b including the connecting plate portion 13 and the ring 14 of the clip 1 are accommodated along the inner wall 21 a of the guide member 21. The end surface on the distal end side faces the inner surface of the locking claw 21c.

  Next, the slider portion 28 is slid to the distal end side with respect to the base portion 27 of the holding release device 2, and the pushing member 24 provided at the distal end of the drive wire 23 is guided from the distal end of the sheath 22 to the guide member. It protrudes into 21. As a result, as shown in FIGS. 11 and 12, the base end portion of the connecting plate portion 13 of the clip 1 is in a state where the ring 14 of the clip 1 is locked to the locking claw 21 c of the guide member 21. The proximal end portions 11b and 12b are pushed out from the ring 14 by being pushed by the pushing member 24, and the pair of arm plate portions 11 and 12 are opened in a substantially C shape by their own elasticity to hold the body tissue B ( (Gripping) is released.

  The clip 1 released from holding (gripping) is taken out of the body through the treatment instrument guide tube of the endoscope together with the holding release device 2.

  According to the embodiment described above, the connecting plate portion 13 (connecting portion) of the clip 1 placed in the body and the base end portion 11b (first portion) and the base end portion 12b (second portion) on which the ring 14 is externally fitted. Is inserted into the guide member 21 through the side opening 21b and along the inner wall 21a of the guide member 21, and a part of the end of the ring 14 on the distal end side is a locking claw 21c ( When the pusher member 24 is operated so as to be pushed out from the distal end of the sheath 22 while being housed so as to be locked by the claw portion), the pusher member 24 is guided by the inner wall 21a of the guide member 21 and It moves in the direction along the central axis and presses the base end portion of the connecting plate portion 13. At this time, since a part of the end portion on the distal end side of the ring 14 is locked by the inner surface of the locking claw 21c, it moves relative to the ring 14 so that the base end portions 11b and 12b are pushed out. When the ring 14 reaches the connecting plate portion 13, the pair of arm plate portions 11 and 12 are opened, and the holding (gripping) of the body tissue B by the grasping portions 11c and 12c is released.

  In this way, the base plate portions 11b and 12b including the connecting plate portion 13 and the ring 14 of the clip 1 are accommodated and arranged along the inner wall 21a of the guide member 21, and the push member 24 is simply pushed out. Since the holding (gripping) of the body tissue B by the clip 1 can be released, the operation is very simple.

  In addition, the base end portions 11b and 12b on which the connecting plate portion 13 and the ring 14 of the clip 1 are externally fitted and the pushing member 24 are guided by the inner wall 21a of the guide member 21, so that they are arranged in an appropriate positional relationship with each other. In addition, the clip 1 can be slid (extruded) with respect to the ring 14 while maintaining the proper posture even when the push-out member 21 is pushed out. It is possible to reduce the occurrence of troubles such as stagnation, and to perform the release work quickly.

  Furthermore, since the number of movable parts is small (a mechanism for opening and closing the ring holding arm as in the prior art is not necessary and only one sheath is required), the configuration is simple, and the device is small and small in diameter. And cost reduction.

  In the above-described embodiment, the object to be held and released by the holding and releasing device is arranged in a substantially C shape so as to open toward the distal end portion thereof, and a first portion (base) is provided on each base end side. A pair of arm plate portions 11 and 12 including the end portion 11b) and the second portion (base end portion 12b) are used as holding portions, and a part B of the body tissue is grasped by the pair of arm plate portions 11 and 12. The endoscope clip (medical clip) 1 is described as an example, but the present invention is not limited to this, and the first portion arranged so that one end side thereof is close to each other and the other end side is separated from each other, and A holding part having a second part, a connecting part for connecting the one end of the first part and the one end of the second part, a release position fitted on the connecting part, and the first part The part and the second part are drawn into the inside, and the first part and the second part It can be widely applied to body tissue holding member and a slidably disposed a ring member between the fitted on the holding position to the position.

  For example, as shown in FIG. 13, an element including a first part (base end part on one end side) 31a at one end and a second part (base end part on the other end side) 31b at the other end. The ligation loop 31 having a substantially looped line is provided as a holding portion (ligation portion) for holding (ligating) the body tissue, and one end of the first portion 31a (one end of the ligation loop 31) and the second portion 31b. Connecting line part 33 formed in a substantially U-shape that connects one end of the ligation loop 31 (the other end of the ligation loop 31), a release position fitted to the connecting line part 33, the first part 31a, and the second part. A ring 32 slidably arranged between the holding positions fitted to the first portion 31a and the second portion 31b by pulling 31b to the inside thereof, and the diameter of the ligation loop 31 is reduced. As a result, it is possible to maintain an endoscopic (medical) snare that ligates part of the body tissue. It is possible to apply the present invention to (ligating) release device.

  The embodiment described above is described for facilitating the understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the above-described embodiment is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

DESCRIPTION OF SYMBOLS 1 ... Endoscope clip 11, 12 ... Arm board part 11b, 12b ... Base end part (1st site | part, 2nd site | part)
13 ... Connecting plate part (connecting part)
DESCRIPTION OF SYMBOLS 14 ... Tightening ring 2 ... Holding release device 21 ... Guide member 21a ... Inner wall 21b ... Side opening part 21c ... Locking claw 21d ... Notch part 22 ... Sheath 23 ... Drive wire 24 ... Extrusion member 25 ... Base side lock member 26 ... Sheath side lock member 27 ... Base (operation part)
28 ... Slider section (operation section)
DESCRIPTION OF SYMBOLS 29 ... Lock screw 3 ... Endoscope snare 31 ... Ligation loop 31a ... Base end part (1st site | part)
31b ... Base end (second part)
32 ... Tightening ring 33 ... Connection line part (connection part)
B ... Body tissue

Claims (4)

A holding part having a first part and a second part arranged so that one end sides thereof are close to each other and the other end side is separated;
A connecting portion that connects the one end of the first part and the one end of the second part;
Slide between the release position that is externally fitted to the connecting portion and the holding position that is externally fitted to the first part and the second part by pulling the first part and the second part into the inside. A body tissue holding member holding release device comprising a ring arranged in a possible manner, and operating the ring of the body tissue holding member placed in the body with the ring set in the holding position from outside the body A holding release device that slides from the holding position to the release position,
A tubular sheath;
A drive wire slidably inserted into the sheath;
A pusher member integrally secured to the distal end of the drive wire;
An operating portion provided at a proximal end of the sheath and sliding the drive wire within the sheath;
The pushing member pushed out from the distal end of the sheath guides the movement of the pushing member in the direction along the center axis of the sheath, and the first portion and the second portion to which the connecting portion and the ring are externally fitted are guided. An inner wall that guides movement in the direction along the central axis in a state where the portion is accommodated from the side to the inside, and a locking claw that locks a part of the end portion on the holding portion side of the ring in this state A holding release device for a body tissue holding member, comprising: a guide member having a distal end portion thereof, and a proximal end portion thereof integrally fixed to a distal end of the sheath.   The guide member is formed of a substantially half-cylindrical half-cylindrical member, and the locking claw is attached to a substantially semi-disc-like member integrally provided so as to close the tip end portion of the half-cylindrical member. 2. The body tissue holding member releasing device according to claim 1, wherein a substantially semicircular cut portion having an inner diameter slightly smaller than the outer diameter is formed. The body tissue holding member is
A pair of arm plate portions, which are arranged in a substantially C shape so as to open toward the distal end portion and include the first portion and the second portion on the base end side, are used as the holding portions. The in-vivo tissue holding member release device according to claim 1, wherein the in-vivo tissue holding member is a clip for an endoscope that holds a part of the in-vivo tissue with the pair of arm plate portions. The body tissue holding member is
An endoscope that has, as the holding portion, a ligation loop in which a wire including the first part at one end and the second part at the other end is formed into a substantially loop shape, and ligates a part of the body tissue. The in-vivo tissue holding member retention release device according to claim 1, which is a snare for use.

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