JP2008200190A - Clip applier and clip piece - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a clip applier the shaft diameter of which is reduced without impairing its conventional clip applier functions, and a clip piece applicable to this clip applier. <P>SOLUTION: The shaft is reduced in diameter by keeping the spring that has conventionally been arranged within the shaft for energizing the trigger rearranged into the handle. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a clip applier and a clip piece that are used when a tissue is sutured and ligated in an endoscopic operation.

  In recent years, in the field of surgery, instead of conventional laparotomy and thoracotomy, endoscopic surgery with less invasiveness is performed because of the advantages of reducing the burden on the patient and early recovery after surgery. It has become to. In this endoscopic surgery, a clip piece is used to hold a suture when a living tissue is sutured or ligated (see, for example, Non-Patent Document 1). And this clip piece is attached to a suture using the apparatus called a clip applier (for example, refer patent document 1 and nonpatent literature 2).

  FIG. 26 to FIG. 28 show an example of a clip applier conventionally used. The conventional clip applier 30 is roughly composed of a shaft portion 31 and a handle portion 37. As shown in FIG. 27, the shaft portion 100 includes an arm shaft 32 disposed on the outermost side, a jaw 33 fixed inside the arm shaft 32, an arm shaft 32, and the jaw 33. And a guide shaft 34 provided to be movable in the longitudinal direction. In addition, the handle portion 37 includes a trigger 38 that is connected to the guide shaft 34 via the rod 35 and moves the guide shaft 33. Then, by pulling the trigger 38, the guide shaft 34 moves to the distal end side, and the jaw 33 is squeezed and closed by the guide shaft 34 along with this movement. Further, a coil spring 36 is provided inside the guide shaft 34 to bias the trigger and return the moved guide shaft 120 to its original position.

FIGS. 29 to 31 show an example of a clip piece used in combination with a conventional clip applier. The clip piece 40 has two leg portions 41 and 42 and a hinge portion 43 that connects these base portions to each other. And the convex part 45 is formed in the outer surface of the two leg parts 41 and 42, respectively, and the latch part 44 is formed in the front-end | tip of one leg part 41. As shown in FIG.
A method of attaching the conventional clip piece 40 to the suture will be described with reference to FIGS. 28 to 31. First, as shown in FIG. 28, the convex portion 45 of the clip piece 20 is attached to the jaw 33 of the clip applier 30. The clip piece 40 is loaded into the jaw 33 by being locked in the locking recess 33a. Then, when the suture is placed inside the clip piece 40 in the open state as shown in FIGS. 29 and 30, and then the trigger 38 of the clip applier 30 is operated, the jaw 33 is closed and the clip piece is moved to FIG. Clipping is performed by squashing as shown.

The outer diameter of the shaft portion of the conventional clip applier is generally formed to be about 11 mm. On the other hand, the outer diameter of the shaft portion of the endoscope apparatus other than the clip applier such as forceps is formed to be about 5.0 mm. The shaft portion of the clip applier is larger in diameter than the shaft portion of other endoscope devices. The coil spring for biasing the trigger is disposed inside the shaft portion as shown in FIG. It is because it has been.
Thus, since the outer diameter of the shaft portion of the clip applier and the shaft portion of the other endoscope apparatus is different, the forceps are applied to the treatment section according to the outer diameter of the shaft section of the endoscope apparatus. It is necessary to provide an incision for inserting the clip applier into the abdominal cavity and an incision for inserting the clip applier into the abdominal cavity, and to prepare a trocar suitable for each size. This not only complicates the procedure, but also increases the number of incisions on the patient's side. Furthermore, the clip applier, whose outer diameter of the shaft portion is larger than that of other endoscope apparatuses, is increased in weight, and there is a problem in terms of operability.

  Such problems of the conventional clip applier are considered to be solved by making the outer diameter of the shaft portion equal to the outer diameter of other endoscope apparatuses. In other words, if the outer diameter of the shaft portion of the clip applier can be made equal to the outer diameter of the shaft portion of another endoscopic device, the incision can be shared with other endoscopic devices. This should not only reduce the number of incisions, but also reduce the weight and improve operability.

  On the other hand, as shown in FIG. 30, the conventional clip piece described above has a width of approximately 5 mm in an open state. For this reason, even if the manufacture of a clip applier in which the outer diameter of the shaft portion is reduced to about 5.0 mm can be realized, as shown in FIG. 32, the clip piece 40 is at least 4 mm wide. It is necessary to crush. Then, as shown in FIG. 33, the conventional clip piece 40 is almost closed just by being loaded, and the suture cannot be placed between the two legs 41 and 42. .

  In spite of the above problems, a clip applier having a reduced diameter shaft portion and a clip piece corresponding to the clip applier have not yet been provided at present.

JP-A-5-200039 Japan Patent Office General Affairs Department Technical Research Section Technology Trends Group, “Absorbable Clip (Polymer)”, [online], March 26, 2004, Japan Patent Office, Internet <http://www.jpo.go.jp/shiryou /s_sonota/hyoujyun_gijyutsu/operation_tools/page120.htm> Japan Patent Office General Affairs Department Technology Research Section Technology Trends Group, “Single Clip Applier”, [online], March 26, 2004, Japan Patent Office, Internet <http://www.jpo.go.jp/shiryou/s_sonota /hyoujyun_gijyutsu/operation_tools/page127.htm>

  Therefore, in order to solve the above problem, the present invention provides a clip applier in which the diameter of the shaft portion is reduced without impairing the function of a conventional clip applier, and a clip piece applicable to the clip applier. Is an issue.

  In order to solve the above-mentioned problem, the means adopted by the invention described in claim 1 is a clip applier having an elongated rod-like shaft portion inserted into a body cavity and a handle portion connected to the shaft portion. The shaft portion includes an arm shaft, a guide shaft that is disposed inside the arm shaft so as to be movable in a longitudinal direction, and a guide portion that is exposed from the arm shaft is formed at a tip, and the guide shaft A pair of jaws that are fixed to the inside of the guide shaft and extend from a receiving portion that is stored inside the guide shaft and are exposed from the guide portion are formed between the pair of jaws and the receiving portion. And a jaw shaft formed with a tapered portion that is slidably contacted with the guide portion, and the handle portion rotates to the handle body. And a trigger that is connected to the proximal end of the guide shaft and moves the guide shaft in the distal direction, and the guide shaft moves in the proximal direction when the trigger is released. And a spring for biasing the trigger.

  The main feature of the clip applier according to claim 1 is that the guide shaft moved in the distal direction by the trigger to bring the jaw into a closed state is retracted in the proximal direction and returned to the original position. The diameter of the shaft portion is reduced by reviewing the position of the spring. That is, in the conventional clip applier, the spring disposed in the shaft portion is disposed in the handle portion, thereby enabling the diameter of the shaft portion to be reduced.

Further, the means adopted by the invention described in claim 2 is the clip applier according to claim 1, wherein the outer diameter of the arm shaft is 3.0 mm or more and 6.0 mm or less.
The outer diameter of the shaft portion of an endoscopic device such as forceps is generally 3.0 mm to 6.0 mm. For this reason, by setting the outer diameter of the shaft portion to the same thickness as other endoscope devices, it becomes possible to share the trocar used when inserting the shaft portion into the incision and the body cavity. .

According to a third aspect of the present invention, the jaw shaft is fixed by a pin member inserted into the jaw shaft, the arm shaft, and the guide shaft, and the pin member of the guide shaft is inserted. 3. The clip applier according to claim 1, wherein a long hole that prevents the pin member from interfering when the guide shaft is moved is formed in the portion to be moved.
If you try to fix the jaw shaft and arm shaft by inserting a fixing pin through the shaft part, the guide shaft that must be movable in the longitudinal direction to close and open and close the jaw is also fixed at the same time. End up. Therefore, in order to avoid contact with the fixed pin along the moving direction and by the length of the moving in the portion where the fixed pin is inserted in the guide shaft so that the movement in the longitudinal direction is not restricted by the fixed pin. A long hole is provided. This makes it possible to achieve both contradictory effects of fixing the jaw shaft inside the arm shaft and moving the guard shaft.

Further, according to a fourth aspect of the present invention, there is provided the means according to the present invention, wherein the pair of jaws are formed with locking projections for locking the clip pieces on the mutually facing surfaces. Item 4. The clip applier according to any one of Items 1 to 3.
As described above, the conventional clip applier jaw is provided with a locking recess for locking the clip piece, while the clip piece is formed with a locking projection for locking to the locking recess of the jaw. Had been. However, when the outer diameter of the clip applier shaft portion is reduced to a small diameter, for example, 5 mm, in the conventional clip piece, the width including the engaging convex portion exceeds the range of the open length of the pair of jaws. It will end up. Therefore, by disposing the locking recesses and locking projections provided on the jaw and clip piece of the conventional clip applier in reverse, that is, providing the locking projections on the jaw side, the clip By providing the locking recess on the piece side, the width of the clip piece can be kept short. As a result, application to a clip applier having a reduced diameter shaft portion is possible.

  Further, according to the fifth aspect of the present invention, the pair of jaws is formed with side walls for preventing the clip pieces gripped by the pair of jaws from falling on both sides or one side. The clip applier according to any one of claims 1 to 4, wherein the clip applier is provided.

  The clip piece is loaded between the pair of jaws by locking with the locking projections formed on the pair of jaws. At this time, since the plane and bottom surface of the clip piece are exposed, there is a risk of dropping from the plane direction or the bottom surface direction. Therefore, by providing side walls on both sides or one side in the lateral direction of the pair of jaws, movement in the direction is restricted and the clip piece is prevented from falling off.

Further, according to a sixth aspect of the present invention, the clip portion according to any one of claims 1 to 5, wherein the shaft portion is rotatably attached to the handle portion. Pliers.
By disposing the shaft portion in the handle portion so as to be rotatable, the direction in which the jaws are opened and closed can be freely changed.

  Further, the means adopted by the invention described in claim 7 is a clip piece applied to the clip applier according to claims 1 to 6, comprising two leg portions and the two leg portions. A hinge portion that connects the base ends and has flexibility so as to be able to close between the two legs, and the tip of one leg of the two legs Is formed with a latch portion for locking the tip of the other leg portion, and on the outer surface of the two leg portions, respectively, is a locking convex portion formed on the jaw of the clip applier. A clip piece, wherein a recessed portion to be locked is formed.

  In the conventional clip piece, the convex part for latching the jaw of a clip applier was formed in the outer surface of the leg part. For this reason, this convex part made the width | variety of the suturing clip long. Therefore, in the present invention, the width of the suturing clip 100 is reduced by replacing the conventional convex portion with the concave portion. Then, by shortening the width of the suturing clip 100 in this manner, application to a clip applier having a reduced shaft diameter becomes possible.

  According to the clip applier described in claim 1, the spring for biasing the trigger for moving the guide shaft in the longitudinal direction is disposed in the handle portion, so that the shaft applier is more than the conventional clip applier. It becomes possible to set the outer diameter to a small diameter. As a result, the entire clip applier can be lightened, and not only the operability is improved, but also the incision can be shared with that of other endoscope devices when inserted into a body cavity. Therefore, it is not necessary to provide a dedicated incision, so that the surgical operation can be simplified and the burden on the viewer can be reduced.

  According to the clip applier described in claim 2, by setting the outer diameter of the shaft portion to 3.0 mm or more and 6.0 mm or less and setting it to be equal to the outer diameter of the shaft portion of another endoscope apparatus, It becomes possible to share a trocar used for insertion into other endoscope devices such as forceps.

  According to the clip applier described in claim 3, in addition to the effect of the clip applier described in claim 1 or 2, the jaw shaft is fixed by the pin member that passes through the jaw shaft, the arm shaft, and the guide shaft. In addition, by forming a long hole in the portion where the pin member of the guide shaft is inserted so that the pin member does not interfere when the guide shaft moves, the jaw shaft can be moved without hindering the movement of the guide shaft. Can be fixed to the arm shaft.

  According to the clip applier described in claim 4, in addition to the effect of the clip applier described in any one of claims 1 to 3, the clip pieces are respectively locked on the opposing surface sides of the pair of jaws. Even if the shaft part is reduced in diameter, a clip piece with a reduced width and length is formed by forming a locking recess corresponding to the locking protrusion of the pair of jaws. It becomes possible to do.

  According to the clip applier described in claim 5, in addition to the effect of the clip applier described in any one of claims 1 to 4, the clip piece is prevented from falling off on both sides or one side of the pair of jaws. By forming the side wall for this purpose, the clip piece can be reliably loaded.

  According to the clip applier described in claim 6, in addition to the effect of the clip applier described in any one of claims 1 to 5, the shaft portion is disposed so as to be rotatable with respect to the handle portion. The direction in which the jaw opens and closes can be freely adjusted according to the treatment site, and the operability can be further improved.

  According to the clip piece described in claim 7, since the concave portion for locking the jaw is formed, the width and length can be shortened compared to the conventional clip piece, so the shaft diameter is small. It can be set as the clip piece applicable to the clip applier of Claim 1 to 6 made into.

  Embodiments of the present invention will be described below with reference to the drawings.

First, an embodiment of a clip applier according to the present invention will be described with reference to FIGS.
FIG. 1 shows a clip applier 10 according to the present embodiment. The clip applier 10 is roughly composed of a shaft portion 100 and a handle portion 200.

  FIG. 2 shows an enlarged plan view of the shaft portion 100 as seen from the direction of the arrow in FIG. 3 and 4 show a view of the shaft portion 100 seen from the AA cross section in FIG. 1, and FIG. 5 shows a view of the shaft portion 100 seen from the BB cross section in FIG. It is shown. The shaft portion 100 is a portion that is formed in an elongated rod shape and is inserted into a body cavity. For this reason, the material of the shaft portion 100 is formed from a material having sufficient toughness and rigidity, and surface treatment is performed to ensure corrosion resistance and chemical resistance. As shown in FIGS. 3 to 5, the shaft portion 100 includes an arm shaft 110, a guide shaft 120, and a jaw shaft 130.

  FIG. 6 shows a view of the arm shaft 110 constituting the shaft portion 100 as seen from the AA cross section in FIG. 1. The arm shaft 110 is formed in an elongated cylindrical shape having an outer diameter of 5.0 mm and an inner diameter of 4.0 mm, and is a member disposed on the outermost side of the shaft portion 100. The arm shaft 110 is provided with a pin hole 111 through which a pin 140 for fixing a jaw shaft 130 (described later) in the arm shaft 110 is inserted, and a first cleaning hole 112 for injecting a cleaning liquid therein. ing.

  7 shows a view of the guide shaft 120 constituting the shaft portion 100 as seen from the AA cross section in FIG. 1, and FIG. 8 shows the guide shaft 120 in the BB cross section in FIG. The figure seen from is shown. The guide shaft 120 is a member that controls the opening / closing operation of a pair of jaws 131 and 131 described later. The guide shaft 120 is formed in an elongated cylindrical shape having an outer diameter of 3.8 mm and an inner diameter of 3.0 mm. It is arranged to be movable along the direction. And the guide shaft 120 is connected with the trigger 220 provided in the handle part 200 mentioned later through the rod 150 connected to the base end 120b. On the other hand, a guide portion 121 is formed at the tip 120 a of the guide shaft 120 so as to be exposed from the arm shaft 110 without being housed inside the arm shaft 110. The guide portion 121 is set to have an outer diameter of 5.0 mm and an inner diameter of 3.2 mm, and is formed to be thicker than a portion housed in the arm shaft 110. A long hole 122 is formed in the guide shaft 120. This long hole 122 is provided so that the movement in the longitudinal direction of the guide shaft 120 is not hindered by the pin 140 inserted to fix the jaw shaft from the pin hole 111 of the arm shaft 110. . Further, the guide shaft 120 is provided with a second cleaning hole 123 communicating with the first cleaning hole 112 provided in the arm shaft 110.

  9 shows a side view of the jaw shaft 130 constituting the shaft portion 100, and FIG. 10 shows a plan view of the jaw shaft 130. As shown in FIG. The jaw shaft 130 is a member that is loaded with a clip piece and fires, and is disposed inside the guide shaft 120 and is fixed to the arm shaft 110 by a pin 140 at the same time. The jaw shaft 130 includes a pair of jaws 131 and 131 exposed from the guide portion 121 of the guide shaft 120, a storage portion 134 that is stored in the guide shaft 120, and a space between the pair of jaws 131 and 131 and the storage portion 134. And a tapered portion 136 formed on the substrate.

  As shown in FIG. 10, the pair of jaws 131 and 131 are formed in such a manner that the jaw shaft 130 is divided into two forks from the tip, and has an appropriate length so that it can be opened and closed. . Further, the width of the pair of jaws 131 and 131 (a-a portion in FIG. 9) is set to 4.0 mm, which is the same as the inner diameter of the arm shaft 110.

  FIG. 11 shows an enlarged view of the pair of jaws 131 and 131 as seen from the CC cross section in FIG. 9, and FIG. 12 shows an enlarged view of the inner surfaces of the pair of jaws 131 facing each other. It is shown. As shown in FIGS. 11 and 12, a locking projection 132 having a substantially semicircular cross section for locking the clip piece is formed at the tip of the surface where the pair of jaws 131, 131 face each other. . Further, FIG. 13 shows a view of the pair of jaws 131, 131 as seen from the EE cross section in FIG. As shown in FIG. 11 to FIG. 13, when the pair of jaws 131, 131 are closed on one side surface orthogonal to the locking projections 132 of the pair of jaws 131, 131, Side walls 133 for closing the periphery are provided to face each other. The side wall 133 can prevent the clip piece from dropping the jaw 131 from the lateral direction.

  The receiving portion 134 has an outer diameter set to 2.8 mm and is stored inside the guide shaft 120. A pin hole 135 is formed in the accommodated portion 134. By inserting the pin 140 through the pin hole 135 and the pin hole formed in the arm shaft 110, the jaw shaft 130 is moved to the arm shaft 110. Fixed to.

  The tapered portion 136 is formed between the pair of jaws 131 and 131 and the accommodated portion 134. The tapered portion 136 is a portion in which the guide portion 121 is slidably contacted when the guide shaft 120 is moved. The tapered portion 136 has a tapered outer diameter as it goes from the jaw 131 side toward the accommodated portion 134 side. The width of the thickest portion of the tapered portion 136 (portion bb in FIG. 9) is set to 4.0 mm, which is the same as the width of the jaw 131 and the outer diameter of the guide shaft 120, and the width of the narrowest portion ( The portion cc in FIG. 9 is set to 2.8 mm, which is the same as the accommodated portion.

FIG. 14 is a schematic diagram showing the internal structure of the handle portion 200. The handle portion 200 is roughly composed of a handle body 210 that functions as a handle for a clip applier, and a trigger 220 for performing a moving operation of the guide shaft 120.
The shaft portion 100 is rotatably attached to the handle body 210 via a bush 230. In addition, a trigger 220 is attached to the handle main body 210 by a shaft member 221 so as to be rotatable. Since the trigger 220 is rotated around the shaft member 221, when the trigger 220 is pulled toward the handle main body 210 (in the direction of arrow X shown in FIG. 14), the portion above the shaft member 221 of the trigger 220 is It is moved to the shaft part 100 side (arrow Y direction in FIG. 14). At the upper end of the trigger 220, a locking portion 222 that locks with the end 151 of the rod 150 extending from the guide shaft 120 is formed. The end 151 of the rod 150 is formed in a substantially spherical shape. As a result, the shaft portion 100 can be rotated 360 ° with respect to the handle portion 200, and the rod 150 can be pushed out horizontally even when the trigger 220 is pulled.

  The shaft portion 100 is attached to the handle portion 200 via the fixed bush 230. The fixed bush 230 is fixed to the handle main body 210, and the trigger urged to the handle main body side (in the direction of the arrow X in FIG. 14) is placed between the fixed bush 230 and the trigger 220 at the original position. A coil spring 240 is disposed for returning to the position. By disposing the coil spring 240 inside the handle portion, the structure of the shaft portion is simplified and it is possible to create a small diameter. A push 250 that houses one end of the coil spring 240 is disposed between the coil spring 240 and the trigger 220. The fixing bush 230 is covered with a holder 260, and when the inside of the shaft portion 100 is cleaned between the holder 260 and the fixing bush 230, the cleaning liquid flows into the handle portion 200 side. A disc 270 that functions as a seal for prevention is provided. Further, a knob 280 that is fixed to the arm shaft 110 of the shaft portion 100 and performs the rotation operation of the shaft portion 100 is disposed so as to cover the holder 270.

  Next, a series of operations from when the clip piece 20 is loaded to the clip applier 10 until the firing is performed will be described. The detailed configuration of the clip piece 20 will be described in detail in Example 2 below. First, as shown in FIG. 3, the clip piece 20 is loaded between the pair of jaws 131. At this time, the locking recess formed in the clip piece 20 is locked to the locking projection 132 of the jaw 131. Next, when the trigger 220 is pulled in the direction of arrow X shown in FIG. 14, the rod 150 connected to the trigger 220 is pushed out in the direction of arrow Y [shown in FIG. Then, as shown in FIG. 4, the guide shaft 120 connected to the rod 150 moves to the jaw 131 side via the rod 150. At this time, the guide portion of the guide shaft 120 is in sliding contact with the tapered portion 136 of the jaw shaft 130, and the pair of jaws 131 and 131 are squeezed and closed. As a result, the clip piece 20 loaded between the pair of jaws 131 and 131 is crushed and clipped. When the pulling operation of the trigger 220 is stopped, the trigger 220 is biased by the coil spring 240, and the trigger 220, the rod 150, and the guide shaft 120 are automatically returned to the initial positions. At this time, the pair of jaws 131 and 131 are opened, and the clip piece 20 is detached from between the pair of jaws 131 and 131 to complete the fire.

  According to the clip applier 10 according to the present embodiment, the coil spring 240 that biases the trigger 220 that moves the guide shaft 120 in the longitudinal direction is disposed inside the handle portion 200, so The diameter can be set to 5.0 mm, which is the same as the outer diameter of the shaft portion of another endoscope apparatus. As a result, the entire clip applier 10 can be lightened, and not only the operability is improved, but also the incision and the trocar are shared with those of other endoscope apparatuses when inserted into the body cavity. Therefore, it is not necessary to provide a dedicated incision, so that the operation can be simplified and the burden on the viewer can be reduced.

It should be noted that the clip applier described in this example is merely a preferred embodiment of the present invention, and the technical scope of the present invention is not limited to the present example itself, and It can change suitably in the range provided with a structure. For example, in the above embodiment, the side walls 133 provided on the pair of jaws 131 are alternately provided on one side surface of the pair of jaws. However, as shown in FIG. 131 may be provided on both side surfaces of 131. Further, depending on the clip piece to be used, the shape of the locking projection 132 may be a protrusion as shown in FIG. 16 or a rib as shown in FIG.
Furthermore, the shape, arrangement, etc. of the spring, which is the main feature of the present invention, are not limited to the form shown in the embodiment. For example, a torsion spring is disposed between the trigger and the handle, and the spring is rotated. Any device that functions to return the trigger to its original position may be used.

  Next, the Example of the clip piece 20 corresponding to the clip applier which concerns on this invention is described based on figures. 18 and 19 show a clip piece 20 according to the present embodiment. The clip piece 20 is made of polydioxanone, which is a hydrolyzable synthetic polymer, so that it does not remain as a foreign object even when it is placed in the body. The clip piece 20 has two leg portions 21 and 22 and a hinge portion 23 connecting them. With. And as shown in FIG. 19, the width length of the clip piece 20 is formed in about 4 mm.

  The two leg portions 21 and 22 are connected by a hinge portion 23 so that they can be opened and closed freely. The hinge portion 23 is formed integrally with the two leg portions 21 and 22, but is formed thinner than the two leg portions 21 and 22 and has flexibility.

  Of the two leg portions 21 and 22, one leg portion 21 is formed with a latch portion 24 having a tip portion bent in a substantially U-shape. When the space between the two leg portions 21 and 22 is closed, the leading end of the other leg portion 22 is locked to the latch portion 24. That is, when the space between the two leg portions 21 and 22 is closed, the tip of the other leg portion 22 is locked to the latch portion 24 formed on the one leg portion 21, so that both It is blocked and clipped.

  Further, locking recesses 25 are respectively formed on the outer surfaces of the two leg portions 21 and 22. The locking recess 25 is a portion where the jaw 131 of the clip applier 10 described in the first embodiment is locked.

  FIG. 20 shows a state where the clip piece 20 is loaded on the jaw 131 of the clip applier 10 of the first embodiment. As shown in FIG. 20, the clip piece 20 includes a pair of jaws 131, with a locking projection 132 of the jaw 131 locked to a locking recess 25 formed on each of the two legs 21 and 22. 131 is loaded. At this time, the space between the two leg portions 21 and 22 of the clip piece 20 is sufficiently open. FIG. 21 shows a state where the clip piece 20 is clipped by the clip applier 10. As shown in FIG. 21, when the pair of jaws 131, 131 are closed between the two leg portions 21, 22 of the clip piece 20, the latch portion 140 of one leg portion 110. Thus, the tip of the other leg 120 is locked to complete clipping.

  According to the clip piece according to the present embodiment, when the clip applier is loaded into the jaw of the clip applier, the portion to be locked with the jaw is formed as the locking recess 150, so that the width and length of the conventional clip piece is increased. Can be shortened. As a result, when the shaft portion according to the present invention is applied to a clip applier in which the diameter is reduced, the jaw 220 can be loaded with the space between the two leg portions 21 and 21 sufficiently open. .

  In addition, the clip piece 20 described in the present embodiment is merely a preferred embodiment of the clip piece according to the present invention, and the technical scope of the present invention is not limited to the present embodiment itself. These can be appropriately changed within the scope of the configuration of the present invention. For example, the clip piece 20 may be made of a hydrolyzable material other than polydioxanone, and if it can be removed using a remover even after attachment, a metal such as titanium that does not cause rejection in the living body. Or acetal resin or other resins.

  In addition, the shape of the concave portion 25 is not limited to the form of the present embodiment, and for example, as shown in FIG. 22, the leg portion 21 may be shaped so as to be bent from the latch portion 24 side. Further, in the case where the locking projection 132 formed on the jaw 131 of the clip applier 10 is formed in a rib shape or a protrusion shape, it is formed in a slit shape as shown in FIGS. You may form, or you may form combining a slit and a hole as shown in FIG.

It is a side view of a clip applier. It is the top view to which the shaft part of the clip applier was expanded. It is the schematic diagram which looked at the shaft part from the AA cross section of FIG. It is the schematic diagram which looked at the shaft part from the AA cross section of FIG. It is the schematic diagram which looked at the shaft part from the BB cross section of FIG. It is the schematic diagram which looked at the arm shaft from the AA cross section of FIG. It is the schematic diagram which looked at the guide shaft from the AA cross section of FIG. It is the schematic diagram which looked at the guide shaft from the BB cross section of FIG. It is a side view of a jaw shaft. It is a top view of a jaw shaft. It is CC sectional drawing in FIG. 9 of a jaw shaft. It is a figure showing the inner surface of Joe. It is DD sectional drawing in FIG. 10 of a jaw shaft. It is a schematic diagram showing the internal structure of a handle part. It is a front view which shows other embodiment of a pair of jaw. It is a perspective view which shows other embodiment of a pair of jaw. It is a perspective view which shows other embodiment of a pair of jaw. It is a perspective view of a clip piece. It is a top view of a clip piece. It is a figure explaining the state by which the clip piece was loaded in the jaw of a clip applier. It is a figure explaining the state which clipped the clip piece loaded into the jaw of the clip applier. It is a perspective view which shows other embodiment of a clip piece. It is a perspective view which shows other embodiment of a clip piece. It is a perspective view which shows other embodiment of a clip piece. It is a perspective view which shows other embodiment of a clip piece. It is a side view of the conventional clip applier. It is a schematic diagram explaining the internal structure of the shaft part of the conventional clip applier. It is an expansion perspective view which shows the state by which the conventional clip piece was loaded into the conventional clip applier. It is a perspective view of the conventional clip piece. It is a top view of the conventional clip piece in an open state. It is a top view of the conventional clip piece in a clipping state. It is the schematic diagram which assumed the state when the conventional clip piece was loaded in the clip applier by which the outer diameter of the shaft part was set to 5 mm. It is the conventional clip piece, Comprising: The top view which assumed the state when loaded in the clip applier by which the outer diameter of the shaft part was set to 5 mm

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Clip applier 100 Shaft part 110 Arm shaft 120 Guide shaft 121 Guide part 130 Jaw shaft 131 Jaw 132 Locking convex part 133 Side wall 134 Stored part 136 Taper part 140 Pin member 200 Handle part 210 Handle main body 220 Trigger 240 Coil spring 20 Clip pieces 21, 22 Leg 23 Hinge 24 Latch 25 Locking recess

Claims (7)

An elongated rod-like shaft portion inserted into the body cavity;
A clip applier having a handle portion coupled to the shaft portion,
The shaft portion is
An arm shaft,
A guide shaft that is arranged inside the arm shaft so as to be movable in the longitudinal direction, and a guide portion that is exposed from the arm shaft is formed at the tip;
A pair of jaws that are fixed to the inside of the guide shaft and extend from a receiving portion that is stored inside the guide shaft and are exposed from the guide portion are formed, and the pair of jaws and the receiving portion And a jaw shaft formed with a taper portion that is disposed between and a sliding contact with the guide portion,
The handle portion is
The handle body,
A trigger rotatably disposed on the handle body and connected to a proximal end of the guide shaft to move the guide shaft in a distal direction;
A clip applier comprising a spring that biases the trigger so that the guide shaft moves in the proximal direction when the trigger is released. The clip applier according to claim 1, wherein an outer diameter of the arm shaft is 3.0 mm or more and 6.0 mm or less. The jaw shaft is fixed by a pin member inserted through the jaw shaft, the arm shaft, and the guide shaft,
The long hole which prevents the said pin member from interfering when moving the said guide shaft is formed in the part through which the said pin member of the said guide shaft penetrates. Clip applier. The clip applier according to any one of claims 1 to 3, wherein a locking projection for locking the clip piece is formed on each of the opposing surfaces of the pair of jaws. The side wall for preventing dropout of the clip piece gripped by the pair of jaws is formed on both sides or one side of the pair of jaws. Clip applier. The clip applier according to any one of claims 1 to 5, wherein the shaft portion is rotatably attached to the handle portion. A clip piece applied to the clip applier according to claim 1,
Two legs,
A hinge portion that connects the base ends of the two leg portions and has a flexibility so that the space between the two leg portions can be closed;
A latch portion is formed at the tip of one of the two legs, and the tip of the other leg is locked. A clip piece having a concave portion to be engaged with an engaging convex portion formed on a jaw of a clip applier.

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