CN100464716C - Clip and clipping instrument for biological tissues - Google Patents

Abstract

A clipping instrument for biological tissues equipped with an outer tube which can be inserted into a biological cavity, an operating member freely passed through the outer tube, an operating wire freely passed though the operating member, a self-opening holder which can be opened and closed by the action of the operating member attached to the edge of the operating wire, and a self-opening clop having a clipping member for clopping a biological tissue which is attached to the edge of the holder in a detachable manner by opening/closing the holder. Using this clopping instrument, a lesion site can be surely clipped over a long period of time in ligating a breeding site in a biological tissue, stitching a laceration, making in excision of a mucosal tissue and so on with an endoscope.

Description

The gripping mechanism of bio-tissue

Technical field

The clamp that the endoscope of the labelling when the present invention relates to a kind of conduct and carrying out the ligation of the bleeding part of bio-tissue, the stitching of splitting wound and mucosal tissue excision by endoscope etc. uses with handling implement and the gripping mechanism of bio-tissue.

Background technology

, be used in the clamp that handling implement uses as endoscope, in a lot of cases, be used as by endoscope ligation bleeding part or sew up and split wound or labelling during as mucosa resection uses etc.At the real gripping mechanism of opening the disclosed bio-tissue of clear 62-170010 communique of JP as shown in figure 35, by the clamp with the clamp 801 that opens habit, closed clamp leading section fastening with ring 802, can install on the operation tinsel of linking up with removably that connecting plate 803 constitutes at not shown front end.The gripping mechanism 800 of this bio-tissue is when the bio-tissue of clamping focus etc., connecting plate 803 is installed on the hook, and the fore-end of opening of clamp 801 is put into focus portion by endoscope, be positioned at the operation tinsel of control member inner chamber by tension, clamp is fastening to be moved with the mode in the ring 802 clamp 801 to draw in, thus closed the and clamping focus of peristome.And, because its front peristome clamping focus of clamp 801 usefulness, so fastening with encircling the active force that has been subjected on 802 to the base end side direction of clamp 801 at clamp.But, in case organism has been carried out ligation, need keep the clamp position about a few days to 1 week usually, if come off at once, just must carry out ligation with clamp once more.This processing once more is very painful to the patient.

In addition, connecting plate 803 is fastening more outstanding with ring 802 than clamp, for preventing not have under the closed fully state clamp 801 come off from hook at clamp 801, be filled with gelationus fixative 804 with ring in 802 in that clamp is fastening, but the fastening inner chamber with ring 802 of less clamp is filled, not only on making, having any problem, when further clamping bio-tissue, having the fastening problem of peeling off of clamp that is filled into simultaneously with the fixative 804 that encircles 802 inner chambers.

In the clear 50-75797 communique of TOHKEMY, disclose: control intravital tissue with clamp and keep somewhere the tissue clamp device of this clamp through endoscope.Because this gripping mechanism directly is loaded into clamp on the hook that is arranged on the operation front end of wire,, there is its using method complicated problems all around so when keeping somewhere clamp,, gripping mechanism is moved in order to unload clamp from hook.

Open in the flat 2-6011 communique in fact at JP, disclose the gripping mechanism 900 that solves above-mentioned shortcoming as shown in figure 36.Hook 902, an end that this gripping mechanism 900 is provided with in the front end setting of operation tinsel 901 have the mating holes 904 that cooperates with the latching 906 of hook 902, and have at the other end and to be connected with clamp and by elongating the connecting elements 903 of deformable not shown hook, for clamp 905 is retained in the bio-tissue, when making connecting plate 903 move at one's side side by operation tinsel 901, the hook of connecting plate 904 is elongated, thereby removes the mated condition of clamp 905 and connecting plate 903.

According to this gripping mechanism 900, improved the complicated operations that clamp is unloaded from hook, but be engaged on the operation tinsel 901 because clamp is kept somewhere back connecting plate 903,, have the discarded problem that becomes the connecting plate 903 of useless part so must after taking out endoscope, remove connecting plate 903.In addition, because connecting plate 903 is less,, exist to cause attracting bad problem so can be attracted by the attraction mouth of endoscope once in a while.In addition, the real described gripping mechanism of flat 2-6011 communique of opening of clear 50-75797 communique of TOHKEMY and JP, when gripping mechanism loads clamp, because hook is a single armed, thus all exist balance poor, the problem that clamp easily comes off from hook.

On the other hand, real opening the gripping mechanism that has used the ratchet mechanism that constitutes by the card claw stop of ratchet with by the card claw stop is disclosed in the flat 1-77703 communique.This gripping mechanism is to be formed carefullyyer than the card claw stop by the spacing of card claw stop, perhaps dispose 2 groups of card claw stops at least and blocked claw stop, under the prerequisite of the spacing that does not change pawl, the device that a mobile side's phase place diminishes whole moving interval, this device is by the tinsel of stretching stationary clamp, make clamp open up into maximum and open foot, close clamp, discharge clamp thereby destroy connecting plate at last by further stretched wire.

According to this gripping mechanism, the amount of movement of control member can carry out trickle operation by ratchet mechanism, but because of the operation of carrying out the installation of clamp and opening foot by ratchet mechanism, so for clamp is stopped on the good position of plan exactly, the operator must be while seeing that clamp carries out position adjustment operation, exists the problem of complicated operation.

In addition, drive disclosed gripping mechanism 900 in the flat 2-6011 communique in fact, because the compounding practice of the little mating holes 904 of the latching 906 of hook and connecting plate 903 is to carry out at dim Endoscopy, so it is difficult to load clamp 905 at JP.In addition because in the state that latching 906 is coupled to mating holes 904 operating grip, so the situation that latching 906 comes off takes place when operating grip sometimes.And then, must control with clamp focus than multiple-case in carry out operation rapidly than difficult.

In addition, the endoscope clamp package body that can deposit endoscope usefulness clamp between base material and base material is disclosed in TOHKEMY 2000-335631 communique.By this endoscope package body, in package body, carry out sterilization treatment in advance, can make the sterilization operation become easy.; use the clamp package body when gripping mechanism loads clamp from this endoscope; in order to make hands directly not contact clamp; above this package body, hold clamp with clamp package body half open state at endoscope with a hands; under the state of holding handle and 2 members of control member with the another hands, the latching of hook is suspended to the little mating holes of connecting plate.Therefore this action need is skilled and complicated.

Summary of the invention

Therefore, the object of the present invention is to provide endoscope handling implement clamp, in it can be when carrying out the excision of the ligation of the bleeding part of bio-tissue, the stitching of splitting wound and mucosal tissue by endoscope the labelling etc., clamping focus reliably for a long time.In addition, another object of the present invention is to provide the gripping mechanism of bio-tissue, and the situation of opening that it does not need to observe clamp does not need to carry out trickle position adjustment.In addition, another purpose of the present invention is to provide the gripping mechanism of bio-tissue, and it does not need complicated operations at the loading of clamp, when unloading.

That is, the invention provides a kind of gripping mechanism of bio-tissue, it is characterized in that, this gripping mechanism possesses: clamp, and it has two wrists and clamping ring, and wherein this two wrist has opening property automatically, and this clamping ring is used for the clamping part of closed this two wrists front end; Outer bobbin, it can be inserted in the body cavity of organism; Control member, it can be advanced and retreat freely to insert and lead in the above-mentioned outer bobbin; The operation tinsel, it can be advanced and retreat freely to insert and lead in the aforesaid operations member; The member of controlling with opening property automatically, the advance and retreat of its this control member by being attached to this operation front end of wire are carried out switch, this gripping mechanism is controlled member by this and is kept above-mentioned clamp, this gripping mechanism also possesses the handle of control aforesaid operations member, and possess: Handle axis, whole advance and retreat of itself and above-mentioned handle and front end possess first cam part; The position holding mechanism of tubular, it has cam path at the circumferential edges of front opening when inner peripheral surface has axially extended mating groove; The shut-down mechanism of tubular when it is positioned at the front of this position holding mechanism, has from front to axially extended rib midway at inner peripheral surface; Rotary body, it cooperates with first cam part of Handle axis in this position holding mechanism He in this shut-down mechanism, and becomes whole moving axially with Handle axis; Spring, it is resisted advancing of handle and gives and elastic force.

In addition, the invention provides a kind of gripping mechanism of bio-tissue, it is characterized in that, this gripping mechanism possesses: clamp, and it has two wrists and clamping ring, and wherein this two wrist has opening property automatically, and this clamping ring is used for the clamping part of closed this two wrists front end; Outer bobbin, it can be inserted in the body cavity of organism; Control member, it can be advanced and retreat freely to insert and lead in the above-mentioned outer bobbin; The operation tinsel, it can be advanced and retreat freely to insert and lead in the aforesaid operations member; The member of controlling with opening property automatically, the advance and retreat of its this control member by being attached to this operation front end of wire are carried out switch, this gripping mechanism is controlled member by this and is kept above-mentioned clamp, this gripping mechanism also has the clamp frame, this clamp frame has the approximate cross recess more than 1, this approximate cross recess by with the front end of above-mentioned clamp downwards and the clamp accommodating groove of taking at the state of submerging and the guide-track groove of keeping straight on by the center of this accommodating groove constitute.

Description of drawings

Fig. 1 is the axonometric chart of the clamp of present embodiment;

Fig. 2 is the figure of closure state of the clamp of presentation graphs 1;

Fig. 3 is the profile of user mode of the clamp of presentation graphs 1;

Fig. 4 is the axonometric chart of a part of front of the gripping mechanism of this routine bio-tissue of expression;

Fig. 5 is the figure that the state of clamp has been loaded in expression;

Fig. 6 be expression closed the figure of state of clamp;

Fig. 7 is the figure that the state of closed clamp has been pulled down in expression;

Fig. 8 is the profile of front of gripping mechanism that has omitted the description of clamp;

Fig. 9 is the longitudinal sectional drawing of Fig. 6;

Figure 10 is the figure of variation of the gripping mechanism of this routine bio-tissue of expression;

Figure 11 is the axonometric chart of a part of gripping mechanism of the bio-tissue of expression second embodiment;

Figure 12 is the profile of a part of the gripping mechanism of this routine bio-tissue of expression;

Figure 13 is the exploded view of the gripping mechanism of this routine bio-tissue;

Figure 14 is the enlarged drawing that has omitted the part of rod member;

Figure 15 is an operation enlarged drawing wiry;

Figure 16 is the operation figure wiry that sees Figure 15 from above;

Figure 17 (A) is the figure of the contact relation of expression control member and slip short tube, (B) is the figure that sees along the A-A line of (A);

Figure 18 (B) is the front view as the part of the Handle axis of the member of formation of gripping mechanism of this example of expression, (A) is the left view of (B);

Figure 19 (B) is the front view as the rotary body of the member of formation of gripping mechanism of this example of expression, (A) is the left view of (B), (C) is the right view of (B);

Figure 20 (B) is the front view as the position holding mechanism of the member of formation of gripping mechanism of this example, (A) is the left view of (B);

Figure 21 (B) is the front view as the shut-down mechanism of the member of formation of gripping mechanism of this example, (A) is the left view of (B);

Figure 22 is the longitudinal sectional drawing of each operation sequence of this routine gripping mechanism of explanation;

Figure 23 is the figure of the action of explanation rotary body;

Figure 24 is the axonometric chart of gripping mechanism of the bio-tissue of the 3rd embodiment;

Figure 25 is the front view of loading tool that is loaded into the gripping mechanism of this routine bio-tissue;

Figure 26 is the axonometric chart of clamp retaining member;

Figure 27 is the profile of clamp retaining member;

Figure 28 is the figure of using method of the gripping mechanism of this routine bio-tissue of explanation;

Figure 29 is the figure that expression keeps the state of clamp;

Figure 30 is the figure that expression is accommodated in clamp the state of outer bobbin;

Figure 31 be expression from control member unload the lower front end closure the figure of state of clamp;

Figure 32 is the axonometric chart of other clamp retaining member;

Figure 33 and Figure 34 are the profiles of the using method of other clamp retaining member of explanation;

Figure 35 is the profile of the part of gripping mechanism in the past;

Figure 36 is the axonometric chart of the part of other gripping mechanism in the past.

The specific embodiment

In the gripping mechanism (being designated hereinafter simply as " gripping mechanism ") and clamp of bio-tissue of the present invention, so-called front is meant the bio-tissue side in user mode, and so-called base end side is meant the opposition side with bio-tissue.With reference to Fig. 1～Fig. 3 the clamp of embodiment of the present invention is described.As shown in Figures 1 and 2, this routine clamp 10 comprises and makes elongated metallic leaf spring and the clamp body 1 that obtain and the clamping ring 2 of tubular crooked at central part.Clamp body 1 comprises, at the clamping part 3,3 of front end clamping bio-tissue with show the base end part 4 of コ word shape section roughly and have two wrists 11,11 of opening property automatically from base end part 4 extended front ends.Freely be inserted into the inner chamber of aftermentioned control member in order to advance and retreat, the width dimensions w that constitutes the metallic leaf spring of clamp body is limited.

Clamp body 1 has first recess 5 and have second recess 6,6 between first recess 5 and clamp leading section at base end part 4 respectively, and clamping ring 2 is loaded into first recess 5.As at the position that is provided with of first recess 5 of base end part, be preferably placed at and have the front end of controlling member 8 and can hang over space in the コ word shape section portion 41 roughly, not make the position of the openings get smaller of the clamp front end that is in open configuration again.In addition, as the position that is provided with of second recess 6, so long as between first recess 5 and clamp leading section and make clamping part 3, the 3 lucky position contacting of clamp front end, just there is no particular limitation.In this example, by front plate width of cloth section is set and differs from 69 and differ from 69 by section base end side made recess, during from the " loaded " position slide displacement of first recess 5, can be loaded in second recess 6 by external force reliably at clamping ring 2 at second recess 6.Though the concavity of second recess 6 of clamp body is compared greatly with first recess 5, is more satisfactory from the angle that can finish the loading of clamping ring 2 reliably.In addition, when the leading section that the clamping part 3,3 of clamp front end makes two wrists is crooked to the inside, at its contact surface jog is set, this point sees it is ideal from the viewpoint of clamping bio-tissue reliably.

Clamp 10 usually as shown in Figure 1, the clamping part 3 of front end is being opened, and under this state, is mounted with clamping ring 2 on first recess 5 of base end part 4.Be loaded into the clamping ring 2 of first recess 5,,, in addition, need only non-migration and just the opening amplitude of clamping part 3 is diminished to front so short of external force effect just can not move forward and backward naturally because the inner chamber of clamping ring 2 partly is stuck in recessed part.As the material of clamp, select for example rustless steel, titanium etc. for use.In addition, the length of the wrist of clamp is though have no particular limits preferred 2.0～6.0mm, preferred especially 3.0～5.0mm.When length was in above-mentioned scope, the controlling property of clamp was superior especially.

Below, the method with clamp 10 clamping bio-tissues is described.At first, be attached to gripping mechanism operation tinsel 7 front ends a pair of arm shape with opening property automatically control the inboard of roughly コ word shape section portion 41 that member 8 hangs over the base end part 4 of clamp 1.Then, when pulling is in the inner chamber of control member 9 and the operation tinsel 7 that can move forward and backward, controls member 8 and be pulled into the inner chamber of control member 9 and the front end 91 that clamping ring 2 is run into control member 9.And then, by pull operation tinsel 7, two wrists 11 of clamp body slowly are pulled into the inner chamber of clamping ring 2 from the base end part side of clamp, when being pulled into the position of second recess 6, section differs from 69 and contacts with clamping ring 2, clamping ring 2 is stopped, and the clamping part 3,3 of the front end of clamp body 1 contacts, and becomes the state (Fig. 2) of not shown clamping bio-tissue.Then, when to the rightabout of drawing in operation tinsel 7, when promptly forwards promoting, have automatically the member 8 of controlling of opening property and automatically deviate from from the base end part 4 of clamp.On the other hand, be in the clamp body 1 of closure state, because clamping ring 2 is fixed on the negative area of second recess 6 reliably, it doesn't matter for the size of clamp body 1 and the bio-tissue of answering clamping, can clamp reliably, so can not come off at once, but the state of long term maintenance clamping bio-tissue.

As the material of clamp body 1, the preferably metal of rustless steel that in the stomach of secretion digestive enzyme etc., can not be corroded in body cavity, especially and titanium alloy etc., the perhaps plastics of ABS resin, hard vinyl chloride resin, polyamide and polyethylene etc.In addition, from when the clamping bio-tissue, to closure state, need keep the viewpoint of its closure state to set out for a long time, preferred whippy material from the state of the clamping part 3 of opening the clamp front end.In addition, as the material of clamping ring 2, restriction especially, but because and clamp body 1 use jointly, so can enumerate the material identical with clamp body 1.Specifically, preferably select the metal of the plastics of fluororesin, polyamide, silicones etc. or rustless steel, titanium alloy etc. for use.

According to the clamp 10 of present embodiment, the bio-tissue of clamping focus that can be reliably and with long-term etc.

With reference to Fig. 4～Figure 10 the gripping mechanism of the bio-tissue of first embodiment of the present invention is described.The gripping mechanism 20 of the described bio-tissue of present embodiment possesses: outer bobbin 21, and it can be inserted in the body cavity of organism; Control member 22, it can be advanced and retreat freely to insert and lead in the outer bobbin 21; Operation tinsel 23, it can be advanced and retreat freely to insert and lead in the control member 22; Control member 24, its be attached to the operation tinsel 23 front end, carry out switch and have opening property automatically by the advance and retreat of this control member; Automatically the clamp 10a of opening property, the clamping part that it can be loaded in the front end of controlling member 24 with freely loading and unloading and have the clamping bio-tissue by this switch of controlling member.In addition, the base end part of operation tinsel 23 is connected with not shown handle.

In the gripping mechanism 20 of bio-tissue, the material of control member 22 though have no particular limits, can be enumerated the thermoplastic resin and the thin-wall metal coil of polyether-ether-ketone, polyamide, polyimides etc.Thermoplastic resin from can with the reliable in action of operating grip be delivered to front the aspect be ideal.Though the thin-wall metal coil is ideal by the crooked or generation gap that stretches from bendability and rigidity this point.Though the external diameter of control member 22 has no particular limits, preferred 1.7～2.7mm, preferred especially 1.9～2.3mm.

Operation tinsel 23 will be controlled member 24 when being fixed on front end, have the big slightly and section of having of diameter than tinsel main body and differ from 26 connecting portion 25.In addition, from the front end of control member 22 is the isolated position of stroke of control member to base end side, setting up operation tinsel main body at the inwall of control member 22 can insert logical and differ from 26 blocks that contact 27 with section, when preventing control member 22 excessive outstanding, also prevent to enter to the excessive of control member 22 of controlling member 24.The material of operation tinsel 23, though have no particular limits, preferred its whole or part has flexual material.Particularly, can enumerate the resin fibre such as metal wire, polyamide, polyester, ultra-high molecular weight polyethylene of rustless steel, carbon steel etc.

Outer bobbin 21 is long chi shape pliability members of hollow.Though the internal diameter of outer bobbin 21 has no particular limits, preferred 1.8～2.8mm, preferred especially 2.0～2.4mm.When internal diameter was in above-mentioned scope, operability was superior especially.In addition, though the length of outer bobbin 21 have no particular limits, preferred 1,500～3,000mm, preferred especially 1,600～2,300mm.If length is in above-mentioned scope, the operability in endoscope is just superior especially.The material of outer bobbin 21 though have no particular limits, can be enumerated for example fluororesin of politef (PTFE), tetrachloroethylene-hexafluoropropene copolymer resins (FEP) etc.

In the gripping mechanism 20 of bio-tissue, as clamp 10a, though so long as possessing as shown in Figure 4 has two wrist 11a of opening property automatically and is used for the words of clamping ring 12 of the clamping part 15 of closed two wrist 11a, just have no particular limits, but preferred Fig. 1 and clamp 10 shown in Figure 2.

According to said structure, the method to the gripping mechanism 20 loading clamp 10a of above-mentioned bio-tissue is described.For example,, will operate tinsel 23 and be fixed on operating grip, and by the pull operation handle control member 22 be shifted at the axis direction of operation tinsel 23 and controlled member 24 sides at the state of Fig. 4.Thus, the member 24 of controlling that is made of a pair of wrist contacts with the inner peripheral surface of control member 22 on one side, on one side closed slowly because entering base end side.And the front end hook 28 of control member 22 is closed, and the base end part 14 of clip applying forceps 10a is kept clamp 10a.And then by the pull operation handle, clamping ring 12 comes to the front end of control member 22, and then, clamping ring 12 differs from 13 for intermediary section with two wrists that are in clamp 10a and contacts, clamping part 15,15 closures (Fig. 6, Fig. 9) of clamp.From this state, by control member 22 is turned back to original position, control member 24 and give prominence to from control member 22, according to controlling the opening property automatically that member 24 has, a pair of wrist becomes the state of opening, thereby can unload clamp 10a under closure state.

According to the gripping mechanism 20 of bio-tissue,, do not need complicated operations at the loading of clamp or in unloading.In addition, with controlling member 24 when keeping clamp 10a, even how many control members 22 has move, control the inner chamber that member 24 also is incorporated in control member 22, and because front end hook 28 overlaps, clamp 10a is not easy to fall.In addition,, the gap of 28 of front end hooks how much opens, because the width of the plate that is コ word shape section 41 of the base end part 4 of clamp 10a is arranged, so clamp 10a can not fall from controlling member 24 yet even having.

In the gripping mechanism 20 of bio-tissue, as the shape of controlling member 24, be not limited to above-mentioned slightly V-shape, for example, also can be the 24a of summary U word shape as shown in figure 10.By making the wrist flexion of controlling member 24a, along with change of shape, can disperse to be added in the load of connecting portion 25, improve spring performance, and then, compare with linearity, also can make leading section earlier closed.Crooked shape can consider that the characteristic of spring adopts shape arbitrarily when two wrist switch motions.

In addition, operational approach as control member 22 and operation tinsel 23, be not limited to said method, for example can enumerate fixing operation tinsel 23 and make the method that control member 22 moves and make operation tinsel 23 and the control member 22 common methods that move.

Gripping mechanism 20 according to bio-tissue, because at the loading of clamp, unload and do not need complicated operations in the inferior process, so very useful as the gripping mechanism of the bio-tissue of the labelling that is used in the zone usefulness that the ligation of clearly carrying out the bleeding part of bio-tissue, excision etc. handle etc.

Then, the gripping mechanism at the bio-tissue of second embodiment describes with reference to Figure 11～Figure 23.Figure 12 has omitted the description of the slip cylindrical body 211 of Figure 11.In the gripping mechanism 30 of this routine bio-tissue, indicate identical symbol at the structural element identical, and omitted its explanation with the gripping mechanism 20 of the bio-tissue of first embodiment, be primarily aimed at different points and describe.Promptly, in the gripping mechanism 30 of bio-tissue, the points different with the gripping mechanism 20 of bio-tissue are, also have the control operation member handle 51, be provided with make handle 51 progressive make simultaneously first pressing mechanism that advancing of handle 51 stop, temporarily keep the stop position of handle 51 maintaining body, make second pressing mechanism, handle 51 that advancing of handle stopped automatically turn back to first the gigback of position before being pressed into.That is, gripping mechanism 30 possesses: outer bobbin 21; And the slip cylindrical body 211 of hollow, it is connected in front with outer tube pipe 21, has flange connector 213 at base end side; Apparatus main body portion 61, it possesses the main chamber that the front end sidepiece cooperates with the inner chamber of slip cylindrical body 211; Shut-down mechanism 63, it is loaded in the main chamber of apparatus main body portion 61 with stationary state, and is positioned at front; Position holding mechanism 64, it is loaded in base end side and main chamber that shut-down mechanism 63 contacts with stationary state; Handle 51, it is inserted in the apparatus main body portion 61 from base end side; Rod member 71, a termination of its base end side contacts the inside of the substrate 651 of rotary body 65, and the other end is outstanding from the front of apparatus main body portion 61.

Handle 51 comprises the Handle axis 512 that cyclic handle part 511 is connected with handle part 511 with an end, the other end possesses coronal first cam part 514 of king.Handle part 511 is operator operations dominated by hand, has the insertable space of finger of operator.First cam part 514 is the circular protrusions with 6 triangular shape projections that form paddy portion on the end face of cylinder element every 60 degree.First cam part 514 cooperates with 3 card uppermost leaf sheets 653 of the rotary body 65 that moves in shut-down mechanism 63 and in the position holding mechanism 64 and the thrust and the revolving force of handle is added to rotary body 65.In addition, the connecting portion different place of form on every side that has cyclic handle part 511 and Handle axis 512 in the accompanying drawing mapping.

Position holding mechanism 64 is to be fixed in the main chamber of apparatus main body portion 61 615 cylinder element, it determines the reception position of rotary body 65 in preoperative state, by first push operation, the guiding 65 progressive whiles of rotary body, rotary body is induced to second starting position that is pressed into.Alongst be formed with 3 mating grooves 641 of 3 tabular vane members 653 that cooperate rotary body 65 at inner peripheral surface 644.In addition, set up the cam path 642 of the notch part 645 that possesses 6 sawtooth section shapes at the circumferential edges of front opening.When the front end of the vane member 653 of rotary body loads when touching the inclined-plane of notch part 645 by elasticity, cam path 642 is given and the rotations of maximum 60 degree.The inclined-plane of notch part 645 is seen in the counterclockwise direction downward-slopingly from front and is formed.

Shut-down mechanism 63 is cylinder elements that contact is fixed in the front of position holding mechanism 64 in the main chamber of apparatus main body portion 61, when the helical body 65 that enters being stopped, by entering of second push operation guiding rotary body 65 by first push operation.Shut-down mechanism 63 has at inner peripheral surface and extends to axial 3 ribs 631 of (Figure 22, the length of symbol m) midway from front.3 ribs 631 with 120 degree serve as at interval and a rib from front, be formed on the positions that are rotated counterclockwise 50 degree with respect to vertical axle.In addition, under the state of shut-down mechanism 63 in the main chamber that is arranged at apparatus main body portion 61, front opening touches the wall of main chamber.Therefore, rotary body 65 can't be outstanding from shut-down mechanism 63 forward end directions.The length 1 of shut-down mechanism 63 is forward strokes of rotary body 65.

Rotary body 65 cooperates with first cam part 514 of Handle axis front end, makes in position holding mechanism 64 and the shut-down mechanism 63 and advances, retreats or rotate, and comes rod member 71 is transmitted operating physical force.It is the substrate 651 that spacing is positioned at front with 120 degree that rotary body 65 has notch part 654, and in the tabular vane member of setting up with 120 degree spacings between notch part 654 when direction of principal axis extends on the substrate 651 653, an end of its base end side is second cam part 654 of pointed section shape.In addition, the mating holes 655 that has the leading section 731 that cooperates rod member 71 in the inside of substrate 651 central authorities.

Rod member 71 possesses: operation tinsel 23, and it is set up at front end and controls member 24, cardinal extremity is fixed on fixedly ring portion 73; Control member 22, the chamber is inserted logical operation tinsel 23, is had thin tuning portion 741 in substrate-side within it; Slip short tube 75 forms window portion 751 on base end side and tube-shaped tube outer peripheral face that thin tuning portion 741 contacts.The base end part 751 of slip short tube 75 cooperates with the mating holes 655 of substrate 651 the insides of rotary body.Fixing ring portion 73 main chamber's front a little of being fixed on ratio device main part 61 is not with the operation interlock of handle.In the window portion 751 of slip short tube 75, can the free chimeric slippingly fixedly ring portion 73 that operation tinsel 23 is arranged.Control member 22 advances via the elasticity loading of slip short tube 75 antagonistic springs 74 by advance (the advancing of handle 51) of rotary body 65, and interlock retreats therewith when the elasticity loading rotary body 65 by spring 74 retreats.In addition, operation tinsel 23 can be advanced and retreat and freely is inserted in the control member 22, the slippage in the window portion 751 of slip short tube 75 of the connecting portion 733 of base end side, so not with operation (action of the control member 22) interlock of handle 51.

Have in the inside of apparatus main body portion 61 from front come in and go out in turn control member 22 front opening 616, take in the chamber 614 of spring 74, fixedly the fixedly ring portion 73 of rod member fixed part 617, take in shut-down mechanism 63 and position holding mechanism 64 main chamber 615, insert the insertion mouth 616 of the front end of Handle axis.Apparatus main body portion 61 cylindrical body from base end side begin to set up first flange part 611, second flange part 612 improves operability.

Slip cylindrical body 211 is members of the advance and retreat of operation hollow outer bobbin 21, is the tubular article that is embedded into apparatus main body portion 61 leading sections.The front hollow outer bobbin 21 interior with being inserted into body cavity of organism is connected, and possesses the holding flange 213 with the protuberance (not shown) that cooperates with the recess 613 of apparatus main body portion at base end side.Set up the cooperation cancel system 214 that cooperates of removing slip cylindrical body 211 and apparatus main body portion 61 at holding flange 213.Control member 22 is inserted into outer bobbin 21.And, be loaded into the slip cylindrical body 211 of apparatus main body portion 61, remove with apparatus main body portion 61 between the state that cooperates under, if the push operation of the handle 51 or the cylindrical body 211 of sliding, then outer bobbin 21 just advances with respect to control member 22.Thus, the two wrist closures of clamp 10a under the state of closed clamp 10a, can temporaryly be accommodated in the outer bobbin 21.Thus, when outer bobbin 21 is inserted into endoscope, because clamp 10a is incorporated in the outer bobbin 21, so do not damage the pliers hole of endoscope.

Below, mainly the operational approach of the gripping mechanism 30 of second embodiment is carried out following explanation with reference to Figure 22 and Figure 23.The operational approach of gripping mechanism 30 comprises first push operation, keeps operation, second push operation and returns operation.In first push operation, when being pressed into handle 51, first cam part 514 of handle front end and second cam part 654 of rotary body 65 contact (Figure 22 (a) and Figure 23 (a)).At this moment, the shape top, mountain of the mutual cam part of first cam part 514 and second cam part 654 is disposing with misplacing a little.Therefore, 515 one side, top of the mountain shape of first cam part 514 of handle front end contact with the inclined plane of the mountain shape of second cam part 654 of rotary body, Yi Bian advance.And rotary body 65 63 moves in shut-down mechanism from position holding mechanism 64.In the time of in rotary body 65 enters shut-down mechanism 63, first cam part 514 and second cam part 654 mesh fully, and rotary body 65 is rotated counterclockwise 30 degree (rotation for the first time) from initial position.In this state, because be the relation that the substrate 651 of rotary body contacts with the rib 631 of shut-down mechanism 63, so 65 shift motion n of rotary body run into the end face of rib 631 and stop (Figure 22 (b) and Figure 23 (b)).By first push operation, advance with the control member 22 of the rod member 71 of the mobile interlock of rotary body 65, to control member 24 and be pulled in the control member 22, closure is controlled the front end of member 24, keeps clamp 10a (Fig. 5) controlling member 24.

In keeping operation, after first push operation,, utilize the bounce rotary body 65 of spring 74 to retreat when when handle 51 is taken away hands, second cam part of rotary body 65 and the cam path of position holding mechanism 642 cooperate.At this moment, the front end of second cam part of rotary body 65 is rotated counterclockwise 60 degree (rotation for the second time) and stops (Figure 22 (c) and Figure 23 (c)) in the paddy portion of cam path 642 from initial position along the inclined plane of jagged cam path 642.Thus, can keep open clamp 10a is remained on the state of controlling member 24 front ends.In addition, because the aperture of clamp 10a is certain, so do not need to do lever operated position adjustment by trickle.

In second push operation, when when hold mode is pressed handle, first cam part 514 of Handle axis and second cam part of rotary body cooperate, and then rotary body 65 revolves from initial position and turn 90 degrees (rotation for the third time).Under this state, the notch part 654 of rotary body 65 and the rib 631 of shut-down mechanism 63 are in the position relation of cooperation.Under this state, be pressed into handle 51, rotary body 65 advances to the front end (Figure 22 (d) and Figure 23 (d)) of shut-down mechanism 63.By second push operation,, close the clamping part 15 (Fig. 6) of clamp 10a with the control member 22 of the rod member 71 of the mobile interlock of rotary body 65 forward stroke m again.

In returning operation, after second push operation, when when handle 51 is taken away hands, utilize the rebound effect of spring 74, control member 22 returns, interlock therewith, remove the cooperation of the rib 631 of rotary body 65, vane member 653 and shut-down mechanism 63, the front end of rotary body 65 is run into spiral helicine cam path 642, and then along its inclined plane, portion stops in paddy, is rotated counterclockwise 120 degree (the 4th rotation) from initial position.In this state, become the position that the groove 641 of the vane member 653 of rotary body 65 and position holding mechanism 64 cooperates.Therefore, rotary body 65 automatically returns to initial position.By returning operation, because control member 22 turns back to original position, the front end of controlling member of opening property opens so have automatically, and clamp 10a comes off from controlling member 24.On the other hand, the front end closure of clamp 10a finishes the loading to the clamp 10a of bio-tissue.

In the gripping mechanism 30 of second embodiment, operational approach is seen fixing operation tinsel 23 and method that control member 22 is moved with being not limited to above-mentioned such relative property.For example the direction of the position by making spring, rotary body, shut-down mechanism, position holding mechanism is opposite, also can the fixing operation member and the operation tinsel is moved.In addition, by changing the shape of rotary body, shut-down mechanism, position holding mechanism, also can carry out multistagely stopping, the position keeps.

Gripping mechanism 30 according to second embodiment, when carrying out through the ligation of the bleeding part of the bio-tissue of endoscope or excision etc., do not need to observe the open situation of clamp with endoscope, lever operatedly do not carry out the position adjustment because do not need to do, so can seek to shorten the processing time by trickle.In addition, by indicate the stop position that determines displacement at handle, the front end that can make endoscope handle tool measure in accordance with regulations into.

Below, with reference to Figure 24～Figure 31 the gripping mechanism of the 3rd embodiment is described.In the gripping mechanism 40 of the 3rd embodiment, the structural element identical with the gripping mechanism 30 of second embodiment indicates identical symbol and omitted its explanation, is primarily aimed at difference and describes.That is, the difference of gripping mechanism 40 and gripping mechanism 30 is that near the outer peripheral face of the apparatus main body portion 61 second flange 612 has been set up clamp retaining member 90.Clamp retaining member 90 is packets 91, has 3 by with the front end of clamp 10 and the roughly cross recess 94 that constitutes of the clamp accommodating groove of taking at the state of submerging 92 and the center by accommodating groove 92 and the guide-track groove 93 of keeping straight on downwards in the right angle orientation of accommodating groove 92.In addition, be formed with the mating groove 94 that cooperates with loading appliance 80 in the inside of packet 91.End by closed mating groove 94 is as wall, thus location easily.That is, when the tabular hooking sheet 81 of loading appliance cooperates with mating groove 94 fully, make clamp retaining member 90 roughly be in the central authorities of apparatus main body portion 61.

The well width of clamp accommodating groove 92 is bigger slightly and wide slightly to face width from deep than the plate wide cut of two wrists 11.The degree of depth of clamp accommodating groove 92 is degree of depth of degree that can visible slightly base end part under the state of taking in clamp 10, and in addition, the slot length of clamp accommodating groove 92 is slightly littler at the open width of naturalness than clamp 10.Thus, when clamp 10 is accommodated in accommodating groove 92 because make two wrists a little closure enter like that, so can stably take in.Though the shape of guide-track groove 93 has no particular limits, in this example, by making the groove that plan view is arrowhead form, the front end hook 28 of controlling member 24 guides to the roughly コ word shape portion 41 of the base end part of clamp easily.Preferred guide-track groove 93 usefulness luminous paints are painted, so that also can discern guide-track groove 93 in darker Endoscopy.As the quantity of the clamp accommodating groove 92 that is formed on structure 91, except above-mentioned 3, it can be 1, more than 2 or 4.The material of clamp retaining member 90, though have no particular limits, when using material transparent, it is good whether being contained this point from external energy observation clamp 10.Material transparent can be chosen the resin material of acrylonitrile butadiene styrene resin (ABS resin), polyethylene, polystyrene, Merlon, allyl resin etc.In addition, clamp retaining member 90, the state clamp 10 being accommodated in accommodating groove 92 is incorporated in not shown sterilizing bag, never needs to carry out sterilization treatment at every turn, and the first-class this respect of operability is ideal.

Loading appliance 80 is the adapters that are used for installing in the cylindrical body of apparatus main body portion 61 clamp retaining member 90.Loading appliance 80 is made of ring portion 82 that is loaded into apparatus main body portion 61 and the tabular hooking sheet 81 that has the flange part 82 of the ring portion of being attached to 82 tops and cooperate with the mating groove 94 of clamp retaining member 90.

Below, come the hemostatic method to describe with reference to Figure 28～Figure 31 to using gripping mechanism 40.In Figure 28, the flange 213 of slip cylindrical body 211 omits to be described.At first, clamp 10 is being accommodated under the state of accommodating groove 92, is taking out clamp retaining member 90, be fixed on apparatus main body portion 61 from sterilizing bag.Take on one side the fore-end of outer bobbin 21 with hands, on one side will control member 24 front end shift onto on the guide-track groove 93 of clamp retaining member 90.At this moment, because hands can not directly contact clamp 10, so do not worry polluting.

Below, when being pressed into handle 51 and carrying out first push operation, control member 22 advances, and is attached to the front end closure of controlling member 24 of operation tinsel 23 front ends, keeps the base end part 4 (Figure 28, Figure 29) of clamp 10.This operation is as long as hold handle 51 with one, and it is just passable to hold outer bobbin 21 with another, but shirtsleeve operation.In addition, be pressed into guide-track groove 93 such shirtsleeve operations by the front end that will control member 24 and just can controlling installation clamp 10 on the member 24.In addition, set up the ring portion 29 that contacts with clamping ring 2 in the front of control member 22.The external diameter of the external diameter of ring portion 29 and clamping ring 2 can advance by coming in to make clamping ring 2 before the control member 22 much at one.

Under this state, the cooperation of decontrol main part 61 and slip cylindrical body 211 is moved handle 51 to base end side.Thus, control member 22 relative outer bobbins 21 are pulled to base end side, and clamp 10 temporarily is accommodated in the outer bobbin 21 (Figure 30) with the state of closed front end.At this state, with outer bobbin 21 by in the not shown endoscope, with endoscope integral body be inserted into biological intravital bleeding part near.And, Yi Bian confirm endoscope, Yi Bian make outer bobbin 21 overhanging from the front end of endoscope.Then, when handle 51 was pressed into front, because control member 22 advances with respect to outer bobbin 21, so clamp 10 is overhanging from outer bobbin 21, and front end was in open state.Then, the open clamp 10 of front end is pushed into the purpose position.And when further being pressed into handle 51 and carrying out second push operation, control member 22 advances, and shifts the clamping ring 2 of clamp onto front.Thus, clamping ring 2 cooperates the purpose position of closed front end and clamping organism with second recess 6 of clamp 10.Because the clamping ring 2 that is pushed out by control member 22 cooperates with second recess 6, so can keep the state of jaws close.Behind the closed clamp 10, when when handle 51 is taken away hands, by gigback, handle 51 is got back to original position.At this moment,, open, the clamp 10 of closure can be unloaded (Figure 31) from controlling member 24 so control member 24 because control member 22 also retreats.And, clamp 10 is kept somewhere in vivo, will control member 24 and in body, take out simultaneously with endoscope.When the position controlled with clamp 10 is downright bad, the coming off and in body, discharge of clamp 10 natures.

Below, with reference to Figure 32～Figure 34 the variation of clamp retaining member 90 is described.In clamp retaining member 90a, the structural element identical with clamp retaining member 90 indicates identical symbol and omitted its explanation, is primarily aimed at different points and describes.That is, in clamp retaining member 90a, with clamp retaining member 90 different points be: do 1 roughly cross recess; Kept straight in guide-track groove 93a the center by accommodating groove of making and descend to towards the center, make in the degree of depth of guide-track groove central part be in the state of taking in clamp 10 clamping ring 2 above and this control the degree of depth of base end part that member rides over the roughly コ word shape of this clamp that is contained; Also have, be not outer peripheral face loading, and make other member with gripping mechanism towards apparatus main body portion 61.As the form of guide-track groove 93, be above-mentioned arrowhead form, the rectangular shape except being chosen at plan view, also have fan shape etc.

Then, the method that taking-up is accommodated in the clamp 10 of clamp retaining member 90a describes.In addition, Figure 33 is the profile of Figure 32, and Figure 34 is illustrated in the figure that controls member 24 closure states among Figure 33.The front end of controlling member 24 is shifted onto on the guide-track groove 93a of the clamp retaining member 90a that loads clamp 10.Under this state, shift to clamp retaining member 90a side by making control member 22, keep the state (Figure 34) that keeps clamp 10 by retaining member 24.Then, clamp 10 is unloaded from clamp retaining member 90a, finish loading to the gripping mechanism of clamp 10.

Gripping mechanism 40 according to the 3rd embodiment, except play with the same operation of the gripping mechanism 30 of second embodiment, hold handle 51 with one, hold outer bobbin 21 with another, be pressed into guide-track groove 93 this shirtsleeve operations with the front end that will control member 24 and just clamp 10 can be installed to and control on the member 24.Therefore, though the operator who is unaccustomed to this operation also can be simply and efficient carry out the clamp loading operation than the highland.

Utilizability on the industry

Clamp of the present invention and gripping mechanism carry out going out of bio-tissue as being used in by introscope The handling implement of the mark the when ligation at blood position, the stitching of splitting wound and mucosal tissue excise etc. has very much With.

Claims (9)

1. the gripping mechanism of a bio-tissue is characterized in that, this gripping mechanism possesses: clamp, and it has two wrists and clamping ring, and wherein this two wrist has opening property automatically, and this clamping ring is used for the clamping part of closed this two wrists front end; Outer bobbin, it can be inserted in the body cavity of organism; Control member, it can be advanced and retreat freely to insert and lead in the above-mentioned outer bobbin; The operation tinsel, it can be advanced and retreat freely to insert and lead in the aforesaid operations member; The member of controlling with opening property automatically, the advance and retreat of its this control member by being attached to this operation front end of wire are carried out switch,

This gripping mechanism is controlled member by this and is kept above-mentioned clamp,

This gripping mechanism also possesses the handle of control aforesaid operations member, and possesses: Handle axis, and it is advanced and retreat and front end possesses first cam part with above-mentioned handle is whole; The position holding mechanism of tubular, it has cam path at the circumferential edges of front opening when inner peripheral surface has axially extended mating groove; The shut-down mechanism of tubular when it is positioned at the front of this position holding mechanism, has from front to axially extended rib midway at inner peripheral surface; Rotary body, it cooperates with first cam part of Handle axis in this position holding mechanism He in this shut-down mechanism, and becomes whole moving axially with Handle axis; Spring, it is resisted advancing of handle and gives and elastic force.

2. the gripping mechanism of bio-tissue as claimed in claim 1 is characterized in that, is used for by endoscope clamping bio-tissue.

3. the gripping mechanism of bio-tissue as claimed in claim 1 is characterized in that, the material of above-mentioned clamping ring is fluororesin, polyamide or silicones.

4. the gripping mechanism of bio-tissue as claimed in claim 1 is characterized in that, the material of above-mentioned clamping ring is rustless steel or titanium alloy.

5. the gripping mechanism of bio-tissue as claimed in claim 1, it is characterized in that, above-mentioned rotary body has at circumferential edges and has the substrate of notch part with equidistant angle, and an end of the tabular vane member of setting up with equidistant angle between this notch part in the axially extended while on this substrate is second cam part of pointed section shape.

6. the gripping mechanism of bio-tissue as claimed in claim 1 is characterized in that, the aforesaid operations member is the member of making of thermoplastic resin.

7. the gripping mechanism of a bio-tissue is characterized in that, this gripping mechanism possesses: clamp, and it has two wrists and clamping ring, and wherein this two wrist has opening property automatically, and this clamping ring is used for the clamping part of closed this two wrists front end; Outer bobbin, it can be inserted in the body cavity of organism; Control member, it can be advanced and retreat freely to insert and lead in the above-mentioned outer bobbin; The operation tinsel, it can be advanced and retreat freely to insert and lead in the aforesaid operations member; The member of controlling with opening property automatically, the advance and retreat of its this control member by being attached to this operation front end of wire are carried out switch,

This gripping mechanism is controlled member by this and is kept above-mentioned clamp,

This gripping mechanism also has the clamp frame, and this clamp frame has the approximate cross recess more than 1, this approximate cross recess by with the front end of above-mentioned clamp downwards and the clamp accommodating groove of taking at the state of submerging and the guide-track groove of keeping straight on by the center of this accommodating groove constitute.

8. the gripping mechanism of bio-tissue as claimed in claim 7, it is characterized in that, keeping straight on and descend to towards this center in the center of above-mentioned guide-track groove by this accommodating groove, is that this controls the degree of depth of base end part that member rides over the roughly コ word shape of this clamp that is contained in the degree of depth of the central part of this guide-track groove.

9. the gripping mechanism of bio-tissue as claimed in claim 7 is characterized in that, above-mentioned clamp frame is attached to apparatus main body.

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