Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Reexamination Certificate
2001-10-11
2004-11-09
Reip, David O. (Department: 3731)
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
C606S157000, C606S142000
Reexamination Certificate
active
06814742
ABSTRACT:
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is based upon and claims the benefit of priority from the prior Japanese Patent Applications No. 2000-244402, filed Oct. 16, 2000; and No. 2001-244402, filed Aug. 10, 2001, the entire contents of both of which are incorporated herein by reference.
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to a physiological tissue clipping apparatus, clipping method and clip unit mounting method for inserting an endoscope into a cavity endoscopically, for example, and clipping a physiological tissue.
2. Description of the Related Art
As a physiological tissue clipping apparatus, there is known a mechanism disclosed in Japanese Patent Application KOKAI Publication No. 8-19548, for example. This clipping apparatus is composed of a clip unit
10
and a clip manipulating device
106
, as shown in FIG.
28
A and FIG.
28
B. The clip unit
101
causes a link member
103
to be engaged with a clip
102
, and further, engages a clip tightening ring
104
. A link member
103
is composed of a plate material, and an engagement hole
103
b
is provided to be linked with a hook section
112
of the clip manipulating device
106
.
The clip manipulating device
106
composed of an insert section
106
a and a frontal manipulating section
106
b
. The insert section
106
a
is composed of an introducing tube
107
, a manipulating tube
109
routed into the introducing tube
107
, and a manipulating wire
110
routed into the manipulating tube
109
. The hook section
112
having a pin
111
to be linked with a link member
103
is provided at the manipulating wire
110
. The frontal manipulating section
106
b
is composed of: a tube joint
114
fixed frontally of the introducing tube
107
; a manipulating section main body
115
for manipulating the manipulating tube
109
to be advanced or retracted; and a slider section
116
for manipulating the manipulating wire
110
to be advanced or retracted.
Therefore, the clip unit
101
is mounted on the clip manipulating device
106
, and is introduced into a cavity in accordance with the following procedures.
(1) The manipulating section main body
115
is pushed against a tip end side, and the manipulating tube
109
is protruded from the introducing tube
107
.
(2) The slider section
116
is pushed against a tip end side, and the hook section
103
a is protruded from the manipulating tube
109
.
(3) The pin
111
is engaged through the engagement hole
103
b
while the engagement hole
103
b
of the link member
103
of the clip unit
101
is aligned with the pin
111
of the hook section
112
of the clip manipulating device
106
.
(4) The slider section
116
is pulled toward a proximal end side, and the tightening ring
104
of the clip unit
101
is engaged with a tip end of the manipulating tube
109
.
(5) The manipulating section main body
115
is pulled to the proximal end side, and the clip unit
101
is stored in the introducing tube
107
.
(6) The clip unit is introduced into a cavity via an endoscope.
Next, the clip unit
101
is ligated in accordance with the following procedures.
(1) The manipulating section main body
115
is pushed to the tip end side, and the clip unit
101
is protruded from the inside of the introducing tube
107
.
(2) The slider section
116
is slightly pulled toward the proximal end side, and the clip
102
is placed in an expanded state.
(3) The slider section
116
is pulled toward the proximal end side, the tightening ring
104
is engaged with the clip
102
, and the clip
102
is ligated.
In addition, as a configuration of the introducing tube and the manipulating wire, for example, an endoscope treatment tool disclosed in Japanese Patent Application KOKAI Publication No. 2-239855 is known. Structurally, this endoscope treatment tool comprises: an external sheath tube; a manipulating wire retractably inserted into this external sheath tube to be advanced and retracted by manipulation from the frontal side; a treatment section mounted on this manipulating wire, the treatment section being capable of manipulating the treatment tool at the tip end side of the external sheath tube by advancement and retraction of such manipulating wire and being configured by an elastic wire; an extension section wire expanding at least one end of this elastic wire, the extension section wire being introduced into the external sheath tube; and a plurality of bent sections forming either of this extension section wire and the above manipulating wire to be bent in the external sheath tube and securely mounting it to another one.
Therefore, when this endoscope treatment tool advances and retracts a manipulating wire by manipulating a manipulating section, and actuates a treatment section, slackness is reduced in the external sheath tube of the manipulating wire or extension section wire. Therefore, a loss of a manipulating quantity of the manipulating section is very small, and the treatment section at the tip end of the external sheath tube can be reliably manipulated.
In addition, as a configuration of the introducing tube and the manipulating wire, an endoscope injector disclosed in Japanese Utility Model Application KOKAI Publication No. 5-91686 is known. This endoscope injector is such that a manipulating section and a puncture section are linked with each other via a double tube composed of an internal sheath tube and an external sheath tube. A protrusion quantity restricting member for stabilizing a projection quantity of an injection needle provided at a tip end of the internal sheath tube is provided at a tip end of the external sheath tube, and a side face of a stopper and a side face of a protrusion quantity restricting member are slid each other, whereby the movement quantity of the injector needle is restricted.
Further, a configuration of the manipulating section, an endoscope injector disclosed in Japanese Utility Model Application KOKAI Publication No. 62-78901 is known. This injector comprises: an injection tube having flexibility; a tubular tip end needle mounted on a tip end of this injection tube; a flexible external sheath tube having the tip end needle and the injection tube slidably routed; an injection pipe connected to a proximal end of the injection tube at the frontal inside of this external sheath tube; and a fixing mechanism for, when the tip end needle provided at the tip end part of the external sheath tube protrudes from the tip end of the external sheath tube, and is restricted in abutment against the stopper, compressing this injection tube to be fixed to the external sheath tube.
However, in the clipping apparatus disclosed in Japanese Patent Application KOKAI Publication No. 8-19548, a tube joint
114
for advancing and retracting an introducing tube
107
, a manipulating section main body
115
for advancing and retracting a manipulating tube
109
, and a slider section
116
for advancing and retracting the manipulating wire
110
are provided at frontally of a manipulating section
106
b.
Therefore, over six steps between (1) and (2), it is required to manipulate the tube joint
114
, manipulating section main body
115
, and manipulating wire
110
to be advanced and retracted, which complicates manipulation.
In addition, the following steps are required to mount the clip unit
101
on the hook section
112
:
(1) the link member
103
of the clip unit
101
is held in a horizontal direction relevant to a cutout provided at the hook section
112
;
(2) the pin
111
provided at the hook section
112
is engaged with the engagement hole
113
b
provided at the link section
113
while they are aligned with each other so that the pin
111
is engaged with the engagement hole
103
b
. Thus, two steps of (1) orientation and (2) alignment must be carried out at the same time, making it difficult to carry out a mounting work.
In order to ligate the clip unit
101
, the clip
102
is held to the maximally opened state, making it necessary to ligate a target site in this state. However, if manipulation is incor
Kimura Koh
Shiro Chika
Suzuki Takayuki
Watanabe Hiroyoshi
Olympus Corporation
Pantuck Bradford C
Reip David O.
Scully Scott Murphy & Presser
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