US20060200176A1 - Endoscopic ligation tool and endoscope - Google Patents
Endoscopic ligation tool and endoscopeDownload PDFInfo
- Publication number
- US20060200176A1 US20060200176A1US11/416,215US41621506AUS2006200176A1US 20060200176 A1US20060200176 A1US 20060200176A1US 41621506 AUS41621506 AUS 41621506AUS 2006200176 A1US2006200176 A1US 2006200176A1
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- Prior art keywords
- cylinder member
- inner cylinder
- outer cylinder
- body tissue
- internal body
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Links
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- 238000007789sealingMethods0.000claimsdescription5
- 208000000624Esophageal and Gastric VaricesDiseases0.000abstractdescription4
- 208000024170esophageal varicesDiseases0.000abstractdescription4
- 201000010120esophageal varixDiseases0.000abstractdescription4
- 238000000034methodMethods0.000description18
- 206010046996Varicose veinDiseases0.000description16
- 208000027185varicose diseaseDiseases0.000description16
- 239000003795chemical substances by applicationSubstances0.000description4
- 210000003238esophagusAnatomy0.000description4
- 238000002347injectionMethods0.000description4
- 239000007924injectionSubstances0.000description4
- 239000007788liquidSubstances0.000description4
- 230000000994depressogenic effectEffects0.000description3
- 238000002360preparation methodMethods0.000description3
- 238000007632sclerotherapyMethods0.000description3
- 210000002784stomachAnatomy0.000description3
- 230000000694effectsEffects0.000description2
- 230000003902lesionEffects0.000description2
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- 230000003247decreasing effectEffects0.000description1
- 230000000881depressing effectEffects0.000description1
- 238000003825pressingMethods0.000description1
- 239000003229sclerosing agentSubstances0.000description1
- 229910052710siliconInorganic materials0.000description1
- 239000010703siliconSubstances0.000description1
Images
Classifications
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
- A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
- A61B17/12013—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot for use in minimally invasive surgery, e.g. endoscopic surgery
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00089—Hoods
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00101—Insertion part of the endoscope body characterised by distal tip features the distal tip features being detachable
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/015—Control of fluid supply or evacuation
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00087—Tools
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
- A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
- A61B2017/12018—Elastic band ligators
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
- A61B2017/306—Surgical pincettes, i.e. surgical tweezers without pivotal connections holding by means of suction
Definitions
- the present inventionrelates to an endoscopic ligation tool and endoscope for ligating a varix that has formed in an internal body tissue, such as the esophagus or stomach.
- An esophageal varix ligation techniquemay be used alone or in combination with endoscopic sclerotherapy, in which a sclerosing agent is injected, as a method for treating a varix that has formed in the esophagus or stomach.
- suctionis employed to draw the varix toward a cylindrical endoscopic ligation tool attached to the end of the endoscope, and a pre-attached O-ring is released and suspended around the root of the varix.
- the varixis then mechanically ligated under the elastic force of the O-ring, and thereby obliterated.
- FIG. 1of the Specification of U.S. Pat. No. 4,735,194, or FIG. 2 of Published Japanese translation No. 2002-526194 of International Publication, for example, in which a O-ring is caught on a wire which is inserted into the channel of the endoscope, and the O-ring is then disconnected from the end of the cylindrically shaped member by pulling out the wire.
- the endoscopic ligation tool according to the first referenceJapanese Patent No. 2958219
- Japanese Patent No. 2958219is problematic in that it requires the attachment of a supply device and tube along the inserted part of the endoscope for supplying liquid to the endoscopic ligation tool, and the preparations for this are troublesome.
- the endoscopic ligation tool according to the second referenceU.S. Pat. No. 4,735,194
- third referencepublished Japanese translation No. 2002-526194 of International Publication
- it is necessary to pass the wire though the channelso that, in the case where concurrently performing endoscopic sclerotherapy, it is not possible to pass the necessary injection syringe, etc. through the channel.
- the devices disclosed in the second and third referencesare also problematic in that the assembly operations therefore are complicated.
- endoscopic ligation tools disclosed in the first and second reference documentsdo require removal of the endoscope from the body cavity after use, they do not require considerable preparation provided that just the O-ring, or just the inner cylinder with the attached O-ring, can be exchanged.
- the endoscopic ligation tool according to the third referenceis problematic, however, in that once all the O-rings have been used, it is necessary to start all the preparation operations over from the beginning.
- the present inventionwas conceived in view of the above-described circumstances, and has as its objective the provision of an endoscopic ligation tool and endoscope capable of ligating a internal body tissue that has a simple design that does not require a wire or a device for supplying a liquid, this endoscopic ligation tool and endoscope making the aforementioned procedure easier and less time consuming.
- the present inventionemploys the following means in order to resolve the above-described problems.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool for ligating an internal body tissue, provided with:
- an outer cylinder memberformed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
- an inner cylinder memberformed in the shape of a cylinder, which can project out from the front end of the outer cylinder member and which is capable of sliding movement within the outer cylinder member;
- a ligation band memberwhich is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of the inner cylinder member that projects out from the front end of the outer cylinder member;
- the inner cylinder memberwhen the front end of the inner cylinder member comes into contact with the internal body tissue, the inner cylinder member is moved relative to the outer cylinder member in the direction of the base end of the outer cylinder member, as a result of suction force when the internal body tissue is suctioned via the channel, and the ligation band member can be pushed out by the front end of the outer cylinder member and disconnected.
- This endoscopic ligation toolis provided with the above-described design, so that, when the outer cylinder member is attached to the front end of the inserted part of the endoscope, with the inner cylinder member fitted into the outer cylinder member, and the internal body tissue is suctioned, it is possible to seal the front end of the inner cylinder member with the internal body tissue through this suction force. As a result, the internal body tissue can be drawn inside the inner cylinder member.
- the pressure of the suctioning force on the internal body tissuein this case causes the internal body tissue that has been drawn inside the inner cylinder member to push the inner cylinder member into the outer cylinder member.
- the inner cylinder memberitself can be drawn into the outer cylinder member, and the front end of the outer cylinder member pushes the ligation band member relatively forward, so that the ligation band member can be disconnected from the front end of the inner cylinder member.
- an internal body tissuesuch as a varix, etc., can be ligated by the ligation band member.
- the operation of taking up an internal body tissue such as a varix or the like into the inner cylinder member and the operation of ligating the tissue by disconnecting the ligation band membercan be carried out through a suction operation performed via the channel.
- the attachment to the inserted part of the endoscopesimply requires fitting of the outer cylinder member, and therefore can be carried out extremely easily.
- other procedure instrumentssuch as an injection syringe, etc., can be inserted into the channel, even during the ligation operation.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool for ligating an internal body tissue, provided with:
- an outer cylinder memberformed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
- an inner cylinder memberformed in the shape of a cylinder, which can project out from the front end of the outer cylinder member and which is capable of sliding movement within the outer cylinder member;
- a ligation band memberwhich is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of the inner cylinder member that projects out from the front end of the outer cylinder member;
- the inner cylinder memberwhen the front end of the inner cylinder member comes into contact with the internal body tissue, the inner cylinder member is moved relative to the outer cylinder member in the direction of the base end side of the outer cylinder member, due to the pushing force of the inserted part on the internal body tissue, and the ligation band member can be pushed out by the front end of the outer cylinder member, and disconnected.
- This endoscopic ligation toolis provided with the above-described design.
- the inner cylinder membercan be drawn into the outer cylinder member by pushing the inner cylinder member into the internal body tissue.
- the front end of the outer cylinder memberpushes the ligation band member in the relatively forward direction, so that the ligation band member can be disconnected from the front end of the inner cylinder member.
- an internal body tissuesuch as a varix, etc., can be ligated using this ligation band member.
- the operation of taking up an internal body tissue such as a varix into the inner cylinder member and the operation of ligating the tissue by disconnecting the ligation band membercan be carried out continuously. Further, there is no need to provide a wire member or a device for supplying a liquid, so that other procedure instruments, such as an injection syringe, etc., can be inserted into the channel, even during the ligation operation.
- suctioning of the internal body tissuecan be accomplished by a different process than required for the disconnection of the ligation band member, making it possible to avoid unintentional disconnection of the ligation band member.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above in which a convexly-shaped part is provided projecting out in the radial direction from the inner peripheral surface of the base end side of the inner cylinder member.
- This endoscopic ligation toolis provided with the above-described design, so that when the internal body tissue is drawn into the inner cylinder member, the surface of the internal body tissue comes into contact with and pushes against the convexly-shaped part, and generates a force that pushes the inner cylinder member into the outer cylinder member, so that the inner cylinder member can be easily drawn into the outer cylinder member. Accordingly, the ligation band member is pushed out by the front end of the outer cylinder member, and can be pushed out from the front end of the inner cylinder member.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above, having a floor part in which a communicating hole is formed for connecting the inside with the outside.
- This endoscopic ligation toolis provided with the above design, so that when the internal body tissue is drawn into the inner cylinder member, the surface of the internal body tissue comes into contact with and pushes the floor part, and generates a force to push the inner cylinder member into the outer cylinder member, so that the inner cylinder member can be easily drawn into the outer cylinder member.
- the internal body tissuewhen the surface of the internal body tissue is suctioned to the point where it is stretched to the floor part, the internal body tissue seals the a communicating hole. As a result, a sealed region is formed between the floor part, the internal body tissue, the front end of the inserted part, and the inner surface of the outer cylinder member.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above, provided with an anti-disconnect mechanism for preventing the inner cylinder member from disconnecting from the outer cylinder member.
- the endoscopic ligation tool according to the present inventionis provided with the above design. As a result, it is possible to prevent the inner cylinder member from pulling out from the outer cylinder member and becoming lost.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above, in which a sealing agent for adjusting the sliding friction is disposed to the space between the inner cylinder member and the outer cylinder member.
- the endoscopic ligation tool according to the present inventionis provided with the above design.
- the frictional resistance between the inner cylinder member and the outer cylinder memberis reduced, making it possible to disconnect the ligation band member using suction pressure of a degree required to draw the internal body tissue into the inner cylinder member.
- a sealing agentto increase the frictional resistance, it is possible to prevent the disconnection of the inner cylinder member from the outer cylinder member.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above, in which the outer cylinder member and the inner cylinder member are both formed of a transparent member.
- the endoscopic ligation tool according to the present inventionis provided with the above design. As a result, it is possible to secure a wide line of vision, facilitate the approach to the lesion site, and carry out the ligation procedure with certainty.
- the endoscopic ligation tool according to the present inventionis an endoscopic ligation tool as described above in which an engaging groove in which the ligation band member can engage is formed to the outer peripheral surface of the inner cylinder member.
- the endoscopic ligation tool according to the present inventionis provided with the above design. As a result, it is possible to prevent the ligation band member from easily disconnecting from the inner cylinder member during times other than when performing the ligation operation.
- the endoscope according to the present inventionis provided with a pliable inserted part; a channel passing through the inserted part; a suction source that is connected to the base end of the channel and can suction the area outside the front end of the inserted part; and a endoscopic ligation tool according to the present invention provided to the front end of the inserted part.
- This endoscopeis provided with the above design.
- suctioningcan be carried out via the channel using the suction source, the inner cylinder member can be relatively moved in a direction such that it is taken up at the base end side of the outer cylinder member, the ligation band member can be pushed out by the front end of the outer cylinder member, and the ligation procedure using the ligation band member can be carried out.
- the endoscope according to the present inventionis an endoscope as described above, wherein the suction source is designed to provide a suction pressure such that, when the front end of the inner cylinder member and the internal body tissue are adhered together, the internal body tissue can be drawn up into the inner cylinder member, and relative movement of the inner cylinder member with respect to the outer cylinder member is made possible.
- This endoscopeis provided with the above design. As a result, it is possible to carry out the operation of drawing up a internal body tissue such as a varix or the like, into the inner cylinder member, and the operation of moving the inner cylinder member with respect to the outer cylinder member by manipulating the supply of suction pressure from the suction source, to enable ligation of the varix, etc.
- the present inventionenables the a internal body tissue to be ligated using a simple structure and method, and makes it possible to simplify the technique and reduce the time required for the ligation.
- FIG. 1is a cross-sectional view showing the endoscopic ligation tool according to the first embodiment of the present invention.
- FIG. 2is a side view including a partial cross-sectional view showing the endoscopic ligation tool according to the first embodiment of the present invention, and an endoscope equipped therewith.
- FIG. 3is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.
- FIG. 4is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.
- FIG. 5is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.
- FIG. 6is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.
- FIG. 7is a cross-sectional view showing the endoscopic ligation tool according to a second embodiment of the present invention.
- FIG. 8is a cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention.
- FIG. 9is a cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention.
- FIG. 10is a side view including a partial cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention, and an endoscope equipped therewith.
- the endoscopic ligation tool 1is an endoscopic ligation tool for ligating an esophageal varix or other such internal body tissue 2 (see FIG. 3 ).
- this endoscopic ligation toolis provided with an outer cylinder member 3 , which is formed in the shape of a cylinder; an inner cylinder member 5 which is disposed in a slidable manner within the cylindrically-shaped outer cylinder member 3 ; and an O-ring (ligating band member) 6 which is annual in shape and can freely extend and contract, that is attached to the outer peripheral surface of the inner cylinder member 5 at the area of the inner cylinder member 5 that projects out from the front end 3 a of the outer cylinder member 3 .
- an outer cylinder member 3which is formed in the shape of a cylinder
- an inner cylinder member 5which is disposed in a slidable manner within the cylindrically-shaped outer cylinder member 3
- an O-ring (ligating band member) 6which is annual in shape and can freely extend and contract, that is attached to the
- the endoscope 7is provided with a pliable inserted part 8 ; an endoscope operator 10 that is connected to the base end of the inserted part 8 ; a channel 11 which passes through the inserted part 8 ; and a suction device (suction source) 12 that is connected to the base end side of the channel 11 and is capable of suctioning the area outside the front end of the inserted part 8 .
- a forceps port 13is provided to the base end of the channel 11 for inserting procedure instruments into the channel 11 .
- the outer cylinder member 3is provided with an outer cylinder main body 3 A which is formed of a transparent hard resin, and an attaching part 3 B that is connected to the base end of the outer cylinder main body 3 A and is formed of a soft resin, and which can be attached to and released from the front end 8 a of the inserted part 8 of the endoscope 7 in which the channel 11 shown in FIG. 2 is formed.
- the inner cylinder member 5is designed such that the front end 5 a thereof is disposed projecting out in the forward direction from the outer cylinder member 3 , a floor part 5 b is provided to the base end side thereof, and a communicating hole 5 c is formed to the floor part 5 b for communicating between the inside and the outside of the inner cylinder member 5 .
- This inner cylinder member 5is designed such that the distance between the floor part 5 b and the front end 8 a of the inserted part 8 is designed to be greater than the distance between the front end 5 a of the inner cylinder member 5 and the front end 3 a of the outer cylinder member 3 , so that the inner cylinder member 5 can be attached to the outer cylinder member 3 .
- the front end 5 a of the inner cylinder member 5is formed into a round shape in order to increase adherence with the internal body tissue 2 .
- a concave part (anti-disconnect mechanism) 3 Cis formed to the inner peripheral surface of the outer cylinder member 3 extending in the axial direction from the base end of the outer cylinder main body 3 A to the front end 3 a side, and a convex part (anti-disconnect mechanism) 5 d is provided to the outer periphery of the floor part 5 b of the inner cylinder member 5 for engaging with the concave part 3 C in a manner to enable sliding in the axial direction.
- the length of this concave part 3 Cis sufficient to secure the relative moving distance between the inner cylinder member 5 and the outer cylinder member 3 that is necessary to enable disconnection of the O-ring 6 , but restrict movement in excess of this amount.
- a sealing agent such as silicon or the likeis coated in between the inner cylinder member 5 and the outer cylinder member 3 , so that the O-ring 6 can be disconnected using suction pressure of a degree needed to draw the internal body tissue 2 inside the inner cylinder member 5 by decreasing the sliding friction so that inner cylinder member 5 moves easily within the outer cylinder member 5 .
- a suction device 12is equipped with a vacuum pump as the suction source, and is designed to be able to provide a suctioning pressure such that, when the front end of the inner cylinder member 5 and the internal body tissue 2 are made to adhere and the suction button 10 A is pushed, the internal body tissue 2 is drawn into the inner cylinder member 5 and the inner cylinder member 5 is able to slide relatively with respect to the outer cylinder member 3 under the control of a controller which is not shown in the figures.
- this suction button 10 Acan be designed to be depressed in two stages. Namely, it is acceptable to provide a suction button 10 A in which, by depressing the button to the first stage, the internal body tissue 2 is drawn into the inner cylinder member 5 due to suctioning under a first suction pressure. If the button is then further depressed from this first stage, the inner cylinder member 5 is moved relative to the outer cylinder member 3 under the second suction pressure, and O-ring 6 can be disconnected.
- the inner cylinder member 5is inserted into the outer cylinder main body 3 A so that the floor part 5 b is the base end side of the outer cylinder member 3 , causing engagement between the concave part 3 C and the convex part 5 d.
- the front end 5 a of the inner cylinder member 5is made to project out from the front end 3 a of the outer cylinder member 3 , and the O-ring 6 is attached to the outer peripheral surface of the outwardly-projecting inner cylinder member 5 .
- the positioning of the inner cylinder member 5 in the outer cylinder member 3is determined as a result of the restriction of the distance that the inner cylinder member 5 can move with respect to the outer cylinder member 3 .
- the endoscopic ligation tool 1is attached by covering the outer peripheral surface of the front end 8 a of the inserted part 8 of the endoscope 7 by the attaching part 3 B.
- the inserted part 8 of the endoscope 7is then inserted in this state into the esophagus, and moved to the varix or other such internal body tissue 2 , so that the front end 5 a of the inner cylinder member 5 comes into contact with the surface of the internal body tissue 2 .
- a sealed first region 15 enclosed by the internal body tissue 2 and the inner cylinder member 5and a second region 16 enclosed by the floor part 5 b, the front end 8 a of the inserted part 8 , and the outer cylinder member 3 , are formed as shown in FIG. 3 .
- the suction button 10 Ais then depressed.
- the vacuum pump of the suction device 12is activated under the control of a controller, to create a negative pressure in the first region 15 via the channel 11 .
- the front end 5 a of the inner cylinder member 5is then sealed by the internal body tissue 2 , and the internal body tissue 2 is further drawn up into the inner cylinder member 5 .
- the communicating hole 5 cbecomes blocked by the internal body tissue 2 , so that a sealed state is created in the second region 16 .
- a region of negative pressureis then created in this second region 16 .
- the O-ring 6which is attached to the front end 5 a of the inner cylinder member 5 , is pushed forward by the front end 3 a of the outer cylinder member 3 accompanying the movement of the inner cylinder member 5 relative to the base end side of the outer cylinder member 3 , as shown in FIG. 5 .
- the O-ring 6is disconnected from the inner cylinder member 5 , ligating the varix or other such internal body tissue 2 .
- the suction pump 10 AWhen the suction pump 10 A is released, the internal body tissue 2 separates from the inner cylinder member 5 . However, since the distance that the inner cylinder member 5 can move is limited by the concave part 3 C and the convex part 5 d, the inner cylinder member 5 becomes housed inside the outer cylinder member 3 .
- the inserted part 8is first removed to the outside of the body.
- an O-ring 6can be attached to the front end 5 a of the inner cylinder member 5 by causing the inner cylinder 5 to project out from within the outer cylinder member 3 , or, the inner cylinder member 5 may be removed from the outer cylinder member 3 and a new inner cylinder member 5 with an attached O-ring 6 can be exchanged by applying pressure from the front end of the outer cylinder member 3 .
- a new endoscopic ligation tool 1can be provided. The same operation as described above is then carried out again.
- this endoscopic ligation tool 1 and endoscope 7it is possible to continuously carry out the operation of taking up a varix or other such internal body tissue 2 into the inner cylinder member 5 , and the operation of ligating the tissue with the O-ring 6 , using the suction force from the suction device 12 . Accordingly, the need to provide a wire member inside the channel 11 as in the conventional art is eliminated. As a result, other procedure instruments such as injection syringes, etc. can be passed through the channel 11 , making it possible to carry out endoscopic sclerotherapy in a continuous manner. In addition, by means of the concave part 3 C and the convex part 5 d, it is possible to prevent the inner cylinder member 5 from being pulled out from the outer cylinder member 3 and becoming lost following ligation with the O-ring 6 .
- both the outer cylinder member 3 and the inner cylinder member 5are transparent, it is possible to ensure a wide line of view, facilitating approach to the internal body tissue 2 that includes the lesion site. As a result, it is possible to carry out the ligation procedure with certainty.
- a floor part 5 bhaving a communicating hole 5 c formed in its base end, is provided to the inner cylinder member 5 of the endoscopic ligation tool 1 according to the first embodiment.
- a convexly-shaped part 18 bthat projects out in the radial direction from the inner peripheral surface of the inner cylinder member 18 of the endoscopic ligation tool 17 is provided in this second embodiment.
- this endoscopic ligation tool 17is attached to the front end of the inserted part 8 , and inserted inside a body cavity, after which it is employed to suction the internal body tissue 2 using the suction device 12 .
- the surface of the suctioned internal body tissue 2is drawn into the inner cylinder member 18 under the suctioning force of the suction device 12 , until the internal body tissue 2 comes into contact with the convexly-shaped part 18 b.
- the surface of the internal body tissue 2can generate force via the convexly-shaped part 18 b to push the inner cylinder member 18 inside the outer cylinder member 3 . Due to this force, the inner cylinder member 18 can be easily drawn inside the outer cylinder member 3 . Accordingly, the O-ring 6 is pushed out by the front end of the outer cylinder member 3 , and can be pushed out from the front end 18 a of the inner cylinder member 18 .
- an engaging groove 20capable of engaging the O-ring 6 , in the outer peripheral surface of the inner cylinder member 5 .
- the front end 21 a of the inner cylinder member 21is brought into contact with and suctions the internal body tissue, so that the internal body tissue is drawn up inside inner cylinder member 21 .
- the suctioning pressureincreases, and the inner cylinder member 21 itself can be drawn up inside the outer cylinder member 3 .
- the front end of the outer cylinder member 3pushes the O-ring 6 relatively toward the front end 21 a of the inner cylinder member 21 , so that the O-ring 6 can be disconnected from the front end 21 a of the inner cylinder member 21 .
- the suction device 12 of the endoscope 7was employed as the suction source.
- a syringe 23that has a tube 22 , insertable into the channel 11 , connected at its end, for the suction source, as shown in FIG. 10 .
- the front end of the tube 22extends from the position where the channel 11 and a branching tube 25 , which is connected to the suction device 12 , branch, to the front end side of the channel 11 .
- the endoscopic ligation toolis attached to the front end of the inserted part 8 of the endoscope 7 and the internal body tissue 2 is suctioned.
- the inner cylinder memberBy then pushing the inner cylinder member into the internal body tissue 2 , the inner cylinder member can be drawn into the outer cylinder member.
- the front end of the outer cylinder memberenters a state such that it is pushing the O-ring 6 in the forward direction relatively, so that the O-ring 6 can be disconnected from the front end of the inner cylinder member.
- the internal body tissue 2can be suctioned by means of an operation different from that used to disconnect the O-ring 6 , making it possible to prevent unintentional disconnection of the O-ring 6 .
- the prevent inventioncan be employed as an endoscopic ligation tool and endoscope for ligating a varix that has formed in an internal body tissue such as the esophagus or stomach.
- the present inventionmakes it possible to ligate an internal body tissue using a simple design and method, and enables the procedure to be made simpler and faster.
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Abstract
Description
- The present invention relates to an endoscopic ligation tool and endoscope for ligating a varix that has formed in an internal body tissue, such as the esophagus or stomach.
- Priority is claimed on Japanese Patent Application No. 2003-375526, filed Nov. 5, 2003, the content of which is incorporated herein by reference.
- An esophageal varix ligation technique may be used alone or in combination with endoscopic sclerotherapy, in which a sclerosing agent is injected, as a method for treating a varix that has formed in the esophagus or stomach. In this esophageal varix ligation technique, suction is employed to draw the varix toward a cylindrical endoscopic ligation tool attached to the end of the endoscope, and a pre-attached O-ring is released and suspended around the root of the varix. The varix is then mechanically ligated under the elastic force of the O-ring, and thereby obliterated. As an example of this endoscopic ligation tool, a device has been proposed in which an O-ring disposed to the front end of an inner cylinder is disconnected by means of injecting a liquid between the inner and outer cylinders, as disclosed in FIG. 1 of Japanese Patent Publication No. 2958219.
- A design has also been proposed as disclosed in FIG. 1 of the Specification of U.S. Pat. No. 4,735,194, or FIG. 2 of Published Japanese translation No. 2002-526194 of International Publication, for example, in which a O-ring is caught on a wire which is inserted into the channel of the endoscope, and the O-ring is then disconnected from the end of the cylindrically shaped member by pulling out the wire.
- However, the endoscopic ligation tool according to the first reference (Japanese Patent No. 2958219) is problematic in that it requires the attachment of a supply device and tube along the inserted part of the endoscope for supplying liquid to the endoscopic ligation tool, and the preparations for this are troublesome. Further, in both the endoscopic ligation tool according to the second reference (U.S. Pat. No. 4,735,194) and third reference (Published Japanese translation No. 2002-526194 of International Publication), it is necessary to pass the wire though the channel, so that, in the case where concurrently performing endoscopic sclerotherapy, it is not possible to pass the necessary injection syringe, etc. through the channel. In addition, the devices disclosed in the second and third references are also problematic in that the assembly operations therefore are complicated.
- In addition, while the endoscopic ligation tools disclosed in the first and second reference documents do require removal of the endoscope from the body cavity after use, they do not require considerable preparation provided that just the O-ring, or just the inner cylinder with the attached O-ring, can be exchanged. The endoscopic ligation tool according to the third reference is problematic, however, in that once all the O-rings have been used, it is necessary to start all the preparation operations over from the beginning.
- The present invention was conceived in view of the above-described circumstances, and has as its objective the provision of an endoscopic ligation tool and endoscope capable of ligating a internal body tissue that has a simple design that does not require a wire or a device for supplying a liquid, this endoscopic ligation tool and endoscope making the aforementioned procedure easier and less time consuming.
- The present invention employs the following means in order to resolve the above-described problems.
- The endoscopic ligation tool according to the present invention is an endoscopic ligation tool for ligating an internal body tissue, provided with:
- an outer cylinder member formed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
- an inner cylinder member formed in the shape of a cylinder, which can project out from the front end of the outer cylinder member and which is capable of sliding movement within the outer cylinder member; and
- a ligation band member which is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of the inner cylinder member that projects out from the front end of the outer cylinder member; wherein,
- when the front end of the inner cylinder member comes into contact with the internal body tissue, the inner cylinder member is moved relative to the outer cylinder member in the direction of the base end of the outer cylinder member, as a result of suction force when the internal body tissue is suctioned via the channel, and the ligation band member can be pushed out by the front end of the outer cylinder member and disconnected.
- This endoscopic ligation tool is provided with the above-described design, so that, when the outer cylinder member is attached to the front end of the inserted part of the endoscope, with the inner cylinder member fitted into the outer cylinder member, and the internal body tissue is suctioned, it is possible to seal the front end of the inner cylinder member with the internal body tissue through this suction force. As a result, the internal body tissue can be drawn inside the inner cylinder member. The pressure of the suctioning force on the internal body tissue in this case causes the internal body tissue that has been drawn inside the inner cylinder member to push the inner cylinder member into the outer cylinder member. As a result, the inner cylinder member itself can be drawn into the outer cylinder member, and the front end of the outer cylinder member pushes the ligation band member relatively forward, so that the ligation band member can be disconnected from the front end of the inner cylinder member. As a result, an internal body tissue such as a varix, etc., can be ligated by the ligation band member.
- Further, if suctioning is continued even after the front end of the inner cylinder member has been sealed with the internal body tissue, then the suction force increases, and the inner cylinder member itself can be drawn into the outer cylinder member, so that the ligation band member can be disconnected in the same manner as described above.
- Accordingly, the operation of taking up an internal body tissue such as a varix or the like into the inner cylinder member and the operation of ligating the tissue by disconnecting the ligation band member can be carried out through a suction operation performed via the channel. In this case, the attachment to the inserted part of the endoscope simply requires fitting of the outer cylinder member, and therefore can be carried out extremely easily. In addition, there is no need to provide a wire member inside the channel as in the conventional art. As a result, other procedure instruments, such as an injection syringe, etc., can be inserted into the channel, even during the ligation operation.
- In addition, the endoscopic ligation tool according to the present invention is an endoscopic ligation tool for ligating an internal body tissue, provided with:
- an outer cylinder member formed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
- an inner cylinder member formed in the shape of a cylinder, which can project out from the front end of the outer cylinder member and which is capable of sliding movement within the outer cylinder member; and
- a ligation band member which is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of the inner cylinder member that projects out from the front end of the outer cylinder member; wherein,
- when the front end of the inner cylinder member comes into contact with the internal body tissue, the inner cylinder member is moved relative to the outer cylinder member in the direction of the base end side of the outer cylinder member, due to the pushing force of the inserted part on the internal body tissue, and the ligation band member can be pushed out by the front end of the outer cylinder member, and disconnected.
- This endoscopic ligation tool is provided with the above-described design. As a result, by attaching the endoscopic ligation tool to the front end of the inserted part of the endoscope and suctioning the internal body tissue, the inner cylinder member can be drawn into the outer cylinder member by pushing the inner cylinder member into the internal body tissue. Accordingly, the front end of the outer cylinder member pushes the ligation band member in the relatively forward direction, so that the ligation band member can be disconnected from the front end of the inner cylinder member. As a result, an internal body tissue such as a varix, etc., can be ligated using this ligation band member.
- Accordingly, the operation of taking up an internal body tissue such as a varix into the inner cylinder member and the operation of ligating the tissue by disconnecting the ligation band member can be carried out continuously. Further, there is no need to provide a wire member or a device for supplying a liquid, so that other procedure instruments, such as an injection syringe, etc., can be inserted into the channel, even during the ligation operation.
- In addition, suctioning of the internal body tissue can be accomplished by a different process than required for the disconnection of the ligation band member, making it possible to avoid unintentional disconnection of the ligation band member.
- In addition, the endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above in which a convexly-shaped part is provided projecting out in the radial direction from the inner peripheral surface of the base end side of the inner cylinder member.
- This endoscopic ligation tool is provided with the above-described design, so that when the internal body tissue is drawn into the inner cylinder member, the surface of the internal body tissue comes into contact with and pushes against the convexly-shaped part, and generates a force that pushes the inner cylinder member into the outer cylinder member, so that the inner cylinder member can be easily drawn into the outer cylinder member. Accordingly, the ligation band member is pushed out by the front end of the outer cylinder member, and can be pushed out from the front end of the inner cylinder member.
- The endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above, having a floor part in which a communicating hole is formed for connecting the inside with the outside.
- This endoscopic ligation tool is provided with the above design, so that when the internal body tissue is drawn into the inner cylinder member, the surface of the internal body tissue comes into contact with and pushes the floor part, and generates a force to push the inner cylinder member into the outer cylinder member, so that the inner cylinder member can be easily drawn into the outer cylinder member. In addition, when the surface of the internal body tissue is suctioned to the point where it is stretched to the floor part, the internal body tissue seals the a communicating hole. As a result, a sealed region is formed between the floor part, the internal body tissue, the front end of the inserted part, and the inner surface of the outer cylinder member. In this case, if suctioning is continued further, negative pressure is formed in this region, so that the inner cylinder member can be even more easily drawn into the outer cylinder member. Accordingly, the ligation band member can be pushed out by the front end of the outer cylinder member, and pushed out from the front end of the inner cylinder member under any circumstances.
- The endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above, provided with an anti-disconnect mechanism for preventing the inner cylinder member from disconnecting from the outer cylinder member.
- The endoscopic ligation tool according to the present invention is provided with the above design. As a result, it is possible to prevent the inner cylinder member from pulling out from the outer cylinder member and becoming lost.
- The endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above, in which a sealing agent for adjusting the sliding friction is disposed to the space between the inner cylinder member and the outer cylinder member.
- The endoscopic ligation tool according to the present invention is provided with the above design. As a result, the frictional resistance between the inner cylinder member and the outer cylinder member is reduced, making it possible to disconnect the ligation band member using suction pressure of a degree required to draw the internal body tissue into the inner cylinder member. Conversely, by employing a sealing agent to increase the frictional resistance, it is possible to prevent the disconnection of the inner cylinder member from the outer cylinder member. In addition, it is also possible to increase air-tightness by filling the space between the inner cylinder member and the outer cylinder member.
- The endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above, in which the outer cylinder member and the inner cylinder member are both formed of a transparent member.
- The endoscopic ligation tool according to the present invention is provided with the above design. As a result, it is possible to secure a wide line of vision, facilitate the approach to the lesion site, and carry out the ligation procedure with certainty.
- In addition, the endoscopic ligation tool according to the present invention is an endoscopic ligation tool as described above in which an engaging groove in which the ligation band member can engage is formed to the outer peripheral surface of the inner cylinder member.
- The endoscopic ligation tool according to the present invention is provided with the above design. As a result, it is possible to prevent the ligation band member from easily disconnecting from the inner cylinder member during times other than when performing the ligation operation.
- The endoscope according to the present invention is provided with a pliable inserted part; a channel passing through the inserted part; a suction source that is connected to the base end of the channel and can suction the area outside the front end of the inserted part; and a endoscopic ligation tool according to the present invention provided to the front end of the inserted part.
- This endoscope is provided with the above design. As a result, suctioning can be carried out via the channel using the suction source, the inner cylinder member can be relatively moved in a direction such that it is taken up at the base end side of the outer cylinder member, the ligation band member can be pushed out by the front end of the outer cylinder member, and the ligation procedure using the ligation band member can be carried out.
- The endoscope according to the present invention is an endoscope as described above, wherein the suction source is designed to provide a suction pressure such that, when the front end of the inner cylinder member and the internal body tissue are adhered together, the internal body tissue can be drawn up into the inner cylinder member, and relative movement of the inner cylinder member with respect to the outer cylinder member is made possible.
- This endoscope is provided with the above design. As a result, it is possible to carry out the operation of drawing up a internal body tissue such as a varix or the like, into the inner cylinder member, and the operation of moving the inner cylinder member with respect to the outer cylinder member by manipulating the supply of suction pressure from the suction source, to enable ligation of the varix, etc.
- The present invention enables the a internal body tissue to be ligated using a simple structure and method, and makes it possible to simplify the technique and reduce the time required for the ligation.
FIG. 1 is a cross-sectional view showing the endoscopic ligation tool according to the first embodiment of the present invention.FIG. 2 is a side view including a partial cross-sectional view showing the endoscopic ligation tool according to the first embodiment of the present invention, and an endoscope equipped therewith.FIG. 3 is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.FIG. 4 is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.FIG. 5 is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.FIG. 6 is an explanatory view showing the arrangement for ligating an internal body tissue using the endoscopic ligation tool according to a first embodiment of the present invention.FIG. 7 is a cross-sectional view showing the endoscopic ligation tool according to a second embodiment of the present invention.FIG. 8 is a cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention.FIG. 9 is a cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention.FIG. 10 is a side view including a partial cross-sectional view showing the endoscopic ligation tool according to another embodiment of the present invention, and an endoscope equipped therewith.- The first embodiment of the present invention will now be explained with reference to
FIGS. 1 through 6 . Note, however, that the present invention is not limited to the following embodiments. For example, it is acceptable to suitably combine the compositional elements in these various embodiments. - The
endoscopic ligation tool 1 according to the present embodiment is an endoscopic ligation tool for ligating an esophageal varix or other such internal body tissue2 (seeFIG. 3 ). As shown inFIG. 1 , this endoscopic ligation tool is provided with anouter cylinder member 3, which is formed in the shape of a cylinder; aninner cylinder member 5 which is disposed in a slidable manner within the cylindrically-shapedouter cylinder member 3; and an O-ring (ligating band member)6 which is annual in shape and can freely extend and contract, that is attached to the outer peripheral surface of theinner cylinder member 5 at the area of theinner cylinder member 5 that projects out from thefront end 3aof theouter cylinder member 3. - As shown in
FIG. 2 , theendoscope 7 is provided with a pliable insertedpart 8; anendoscope operator 10 that is connected to the base end of the insertedpart 8; achannel 11 which passes through the insertedpart 8; and a suction device (suction source)12 that is connected to the base end side of thechannel 11 and is capable of suctioning the area outside the front end of the insertedpart 8. Aforceps port 13 is provided to the base end of thechannel 11 for inserting procedure instruments into thechannel 11. - As shown in
FIG. 1 , theouter cylinder member 3 is provided with an outer cylindermain body 3A which is formed of a transparent hard resin, and an attachingpart 3B that is connected to the base end of the outer cylindermain body 3A and is formed of a soft resin, and which can be attached to and released from thefront end 8aof the insertedpart 8 of theendoscope 7 in which thechannel 11 shown inFIG. 2 is formed. - The
inner cylinder member 5 is designed such that thefront end 5athereof is disposed projecting out in the forward direction from theouter cylinder member 3, afloor part 5bis provided to the base end side thereof, and a communicatinghole 5cis formed to thefloor part 5bfor communicating between the inside and the outside of theinner cylinder member 5. - This
inner cylinder member 5 is designed such that the distance between thefloor part 5band thefront end 8aof the insertedpart 8 is designed to be greater than the distance between thefront end 5aof theinner cylinder member 5 and thefront end 3aof theouter cylinder member 3, so that theinner cylinder member 5 can be attached to theouter cylinder member 3. - Note that the
front end 5aof theinner cylinder member 5 is formed into a round shape in order to increase adherence with theinternal body tissue 2. - A concave part (anti-disconnect mechanism)3C is formed to the inner peripheral surface of the
outer cylinder member 3 extending in the axial direction from the base end of the outer cylindermain body 3A to thefront end 3aside, and a convex part (anti-disconnect mechanism)5dis provided to the outer periphery of thefloor part 5bof theinner cylinder member 5 for engaging with theconcave part 3C in a manner to enable sliding in the axial direction. The length of thisconcave part 3C is sufficient to secure the relative moving distance between theinner cylinder member 5 and theouter cylinder member 3 that is necessary to enable disconnection of the O-ring 6, but restrict movement in excess of this amount. - A sealing agent such as silicon or the like is coated in between the
inner cylinder member 5 and theouter cylinder member 3, so that the O-ring 6 can be disconnected using suction pressure of a degree needed to draw theinternal body tissue 2 inside theinner cylinder member 5 by decreasing the sliding friction so thatinner cylinder member 5 moves easily within theouter cylinder member 5. - A
suction device 12 is equipped with a vacuum pump as the suction source, and is designed to be able to provide a suctioning pressure such that, when the front end of theinner cylinder member 5 and theinternal body tissue 2 are made to adhere and thesuction button 10A is pushed, theinternal body tissue 2 is drawn into theinner cylinder member 5 and theinner cylinder member 5 is able to slide relatively with respect to theouter cylinder member 3 under the control of a controller which is not shown in the figures. - Note that this
suction button 10A can be designed to be depressed in two stages. Namely, it is acceptable to provide asuction button 10A in which, by depressing the button to the first stage, theinternal body tissue 2 is drawn into theinner cylinder member 5 due to suctioning under a first suction pressure. If the button is then further depressed from this first stage, theinner cylinder member 5 is moved relative to theouter cylinder member 3 under the second suction pressure, and O-ring 6 can be disconnected. - Next, the method for operating the
endoscopic ligation tool 1 and theendoscope 7 according to this embodiment, and the actions and effects thereof, will be explained. - First, the
inner cylinder member 5 is inserted into the outer cylindermain body 3A so that thefloor part 5bis the base end side of theouter cylinder member 3, causing engagement between theconcave part 3C and theconvex part 5d.Next, thefront end 5aof theinner cylinder member 5 is made to project out from thefront end 3aof theouter cylinder member 3, and the O-ring 6 is attached to the outer peripheral surface of the outwardly-projectinginner cylinder member 5. As a result, the positioning of theinner cylinder member 5 in theouter cylinder member 3 is determined as a result of the restriction of the distance that theinner cylinder member 5 can move with respect to theouter cylinder member 3. - Next, the
endoscopic ligation tool 1 is attached by covering the outer peripheral surface of thefront end 8aof the insertedpart 8 of theendoscope 7 by the attachingpart 3B. The insertedpart 8 of theendoscope 7 is then inserted in this state into the esophagus, and moved to the varix or other suchinternal body tissue 2, so that thefront end 5aof theinner cylinder member 5 comes into contact with the surface of theinternal body tissue 2. - At this point, a sealed
first region 15 enclosed by theinternal body tissue 2 and theinner cylinder member 5, and asecond region 16 enclosed by thefloor part 5b,thefront end 8aof the insertedpart 8, and theouter cylinder member 3, are formed as shown inFIG. 3 . - The
suction button 10A is then depressed. The vacuum pump of thesuction device 12 is activated under the control of a controller, to create a negative pressure in thefirst region 15 via thechannel 11. - The
front end 5aof theinner cylinder member 5 is then sealed by theinternal body tissue 2, and theinternal body tissue 2 is further drawn up into theinner cylinder member 5. Next, as shown inFIG. 4 , the communicatinghole 5cbecomes blocked by theinternal body tissue 2, so that a sealed state is created in thesecond region 16. A region of negative pressure is then created in thissecond region 16. In this case, the O-ring 6, which is attached to thefront end 5aof theinner cylinder member 5, is pushed forward by thefront end 3aof theouter cylinder member 3 accompanying the movement of theinner cylinder member 5 relative to the base end side of theouter cylinder member 3, as shown inFIG. 5 . - As shown in
FIG. 6 , the O-ring 6 is disconnected from theinner cylinder member 5, ligating the varix or other suchinternal body tissue 2. - When the
suction pump 10A is released, theinternal body tissue 2 separates from theinner cylinder member 5. However, since the distance that theinner cylinder member 5 can move is limited by theconcave part 3C and theconvex part 5d,theinner cylinder member 5 becomes housed inside theouter cylinder member 3. - In the case where ligating another internal body tissue, the inserted
part 8 is first removed to the outside of the body. At this point, an O-ring 6 can be attached to thefront end 5aof theinner cylinder member 5 by causing theinner cylinder 5 to project out from within theouter cylinder member 3, or, theinner cylinder member 5 may be removed from theouter cylinder member 3 and a newinner cylinder member 5 with an attached O-ring 6 can be exchanged by applying pressure from the front end of theouter cylinder member 3. Alternatively, a newendoscopic ligation tool 1 can be provided. The same operation as described above is then carried out again. - As a result of this
endoscopic ligation tool 1 andendoscope 7, it is possible to continuously carry out the operation of taking up a varix or other suchinternal body tissue 2 into theinner cylinder member 5, and the operation of ligating the tissue with the O-ring 6, using the suction force from thesuction device 12. Accordingly, the need to provide a wire member inside thechannel 11 as in the conventional art is eliminated. As a result, other procedure instruments such as injection syringes, etc. can be passed through thechannel 11, making it possible to carry out endoscopic sclerotherapy in a continuous manner. In addition, by means of theconcave part 3C and theconvex part 5d,it is possible to prevent theinner cylinder member 5 from being pulled out from theouter cylinder member 3 and becoming lost following ligation with the O-ring 6. - Further, since both the
outer cylinder member 3 and theinner cylinder member 5 are transparent, it is possible to ensure a wide line of view, facilitating approach to theinternal body tissue 2 that includes the lesion site. As a result, it is possible to carry out the ligation procedure with certainty. - Next, a second embodiment of the present invention will be explained with reference to
FIG. 7 . Note that compositional elements that are equivalent to those of the first embodiment will be assigned the same numeric symbol and an explanation thereof will be omitted here. - The point of difference between the second embodiment and the first embodiment is that a
floor part 5b,having a communicatinghole 5cformed in its base end, is provided to theinner cylinder member 5 of theendoscopic ligation tool 1 according to the first embodiment. In contrast, a convexly-shapedpart 18bthat projects out in the radial direction from the inner peripheral surface of theinner cylinder member 18 of theendoscopic ligation tool 17 is provided in this second embodiment. - Next, the method for operating the
endoscopic ligation tool 17 andendoscope 7, and the actions and effects thereof, will be explained. - In the same manner as in the first embodiment, this
endoscopic ligation tool 17 is attached to the front end of the insertedpart 8, and inserted inside a body cavity, after which it is employed to suction theinternal body tissue 2 using thesuction device 12. In this case, the surface of the suctionedinternal body tissue 2 is drawn into theinner cylinder member 18 under the suctioning force of thesuction device 12, until theinternal body tissue 2 comes into contact with the convexly-shapedpart 18b.At this point, the surface of theinternal body tissue 2 can generate force via the convexly-shapedpart 18bto push theinner cylinder member 18 inside theouter cylinder member 3. Due to this force, theinner cylinder member 18 can be easily drawn inside theouter cylinder member 3. Accordingly, the O-ring 6 is pushed out by the front end of theouter cylinder member 3, and can be pushed out from thefront end 18aof theinner cylinder member 18. - Note that the scope of the present invention is not limited to the embodiments described above. Rather, various alternations may be added within a range that does not depart from the spirit of the invention.
- As shown in
FIG. 8 , for example, it is acceptable to form an engaginggroove 20, capable of engaging the O-ring 6, in the outer peripheral surface of theinner cylinder member 5. - In this case, it is possible to prevent the O-
ring 6 from disconnecting from theinner cylinder member 5 at times other than during the ligation operation, and to enable the ligation operation to be carried out in a stable state. - In addition, it is also acceptable to not only restrict the distance of movement between the
inner cylinder member 5 and theouter cylinder member 3 by means of theconcave part 3C and theconvex part 5d,but also to provide a sealing agent for increasing the sliding friction between theinner cylinder member 5 and theouter cylinder member 3. - In this case, it is possible to prevent the
inner cylinder member 5 from disconnecting from theouter cylinder member 3 by increasing the frictional resistance between theinner cylinder member 5 and theouter cylinder member 3. - In addition, as shown in
FIG. 9 , it is also acceptable to provide aninner cylinder member 21 in which there is nofloor part 5bor convexly-shapedpart 18b. - In this case, the
front end 21aof theinner cylinder member 21 is brought into contact with and suctions the internal body tissue, so that the internal body tissue is drawn up insideinner cylinder member 21. When suctioning is further continued in this state, the suctioning pressure increases, and theinner cylinder member 21 itself can be drawn up inside theouter cylinder member 3. The front end of theouter cylinder member 3 pushes the O-ring 6 relatively toward thefront end 21aof theinner cylinder member 21, so that the O-ring 6 can be disconnected from thefront end 21aof theinner cylinder member 21. - In the preceding embodiment, the
suction device 12 of theendoscope 7 was employed as the suction source. However, it is also acceptable to provide asyringe 23 that has atube 22, insertable into thechannel 11, connected at its end, for the suction source, as shown inFIG. 10 . - In this case, the front end of the
tube 22 extends from the position where thechannel 11 and a branchingtube 25, which is connected to thesuction device 12, branch, to the front end side of thechannel 11. As a result, it is possible to prevent the flow of air into the branchedtube 25 during the ligation operation, and to carry out theoperation using syringe 23 with accuracy. - The endoscopic ligation tool is attached to the front end of the inserted
part 8 of theendoscope 7 and theinternal body tissue 2 is suctioned. By then pushing the inner cylinder member into theinternal body tissue 2, the inner cylinder member can be drawn into the outer cylinder member. In this case, the front end of the outer cylinder member enters a state such that it is pushing the O-ring 6 in the forward direction relatively, so that the O-ring 6 can be disconnected from the front end of the inner cylinder member. As a result, it is possible to ligate a varix or other such internal body tissue with the O-ring 6. - In this case, the
internal body tissue 2 can be suctioned by means of an operation different from that used to disconnect the O-ring 6, making it possible to prevent unintentional disconnection of the O-ring 6. - The prevent invention can be employed as an endoscopic ligation tool and endoscope for ligating a varix that has formed in an internal body tissue such as the esophagus or stomach.
- The present invention makes it possible to ligate an internal body tissue using a simple design and method, and enables the procedure to be made simpler and faster.
Claims (10)
1. An endoscopic ligation tool for ligating an internal body tissue, comprising:
an outer cylinder member formed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
an inner cylinder member formed in the shape of a cylinder, which can project out from the front end of said outer cylinder member and which is capable of sliding movement within said outer cylinder member; and
a ligation band member which is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of said inner cylinder member that projects out from the front end of said outer cylinder member; wherein,
when the front end of said inner cylinder member comes into contact with said internal body tissue, said inner cylinder member is moved relative to said outer cylinder member in the direction of the base end of said outer cylinder member, as a result of suction force when said internal body tissue is suctioned via said channel, and said ligation band member can be pushed out by the front end of said outer cylinder member and disconnected.
2. An endoscopic ligation tool for ligating an internal body tissue, comprising:
an outer cylinder member formed in the shape of a cylinder, having a base end that can attach to and release from the front end of the inserted part of an endoscope in which a channel is formed;
an inner cylinder member formed in the shape of a cylinder, which can project out from the front end of said outer cylinder member and which is capable of sliding movement within said outer cylinder member; and
a ligation band member which is annular in shape and freely extends and contracts, that is attached to the outer peripheral surface of said inner cylinder member that projects out from the front end of said outer cylinder member; wherein,
when the front end of said inner cylinder member comes into contact with said internal body tissue, said inner cylinder member is moved relative to said outer cylinder member in the direction of the base end side of said outer cylinder member, due to the pushing force of said inserted part on said internal body tissue, and said ligation band member can be pushed out by the front end of said outer cylinder member, and disconnected.
3. An endoscopic ligation tool as set forth inclaim 1 , wherein a convexly-shaped part is provided projecting out in the radial direction from the inner peripheral surface of the base end side of said inner cylinder member.
4. An endoscopic ligation tool as set forth inclaim 1 , wherein a floor part, in which a communicating hole is formed for communicating the inside with the outside, is formed to the base end of said inner cylinder member.
5. An endoscopic ligation tool according toclaim 1 , wherein comprising an anti-disconnect mechanism for preventing said inner cylinder member from disconnecting from said outer cylinder member.
6. An endoscopic ligation tool according toclaim 1 , wherein a sealing agent for adjusting the sliding friction is disposed to the space between said inner cylinder member and said outer cylinder member.
7. An endoscopic ligation tool, according toclaim 1 , wherein said outer cylinder member and said inner cylinder member are both formed of a transparent member.
8. An endoscopic ligation tool, according toclaim 1 , wherein an engaging groove in which said ligation band member can engage is formed to the outer peripheral surface of said inner cylinder member.
9. An endoscope comprising:
a pliable inserted part;
a channel passing through said inserted part;
a suction source that is connected to the base end of said channel and can suction the area outside the front end of said inserted part; and
an endoscopic ligation tool according toclaim 1 , wherein provided to the front end of said inserted part.
10. An endoscope as set forth inclaim 9 , wherein said suction source is designed to provide a suction pressure such that, when the front end of said inner cylinder member and said internal body tissue are adhered together, said internal body tissue can be drawn up into said inner cylinder member, and relative movement of said inner cylinder member with respect to said outer cylinder member is made possible.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US14/084,138US8992548B2 (en) | 2003-11-05 | 2013-11-19 | Method for ligating an internal body tissue |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2003375526AJP4373186B2 (en) | 2003-11-05 | 2003-11-05 | Endoscope ligation tool and endoscope |
| JP2003-375526 | 2003-11-05 | ||
| PCT/JP2004/016688WO2005044112A1 (en) | 2003-11-05 | 2004-11-04 | Clipper for endoscope and endoscope |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/JP2004/016688ContinuationWO2005044112A1 (en) | 2003-11-05 | 2004-11-04 | Clipper for endoscope and endoscope |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US14/084,138ContinuationUS8992548B2 (en) | 2003-11-05 | 2013-11-19 | Method for ligating an internal body tissue |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| US20060200176A1true US20060200176A1 (en) | 2006-09-07 |
Family
ID=34567079
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US11/416,215AbandonedUS20060200176A1 (en) | 2003-11-05 | 2006-05-01 | Endoscopic ligation tool and endoscope |
| US14/084,138Expired - Fee RelatedUS8992548B2 (en) | 2003-11-05 | 2013-11-19 | Method for ligating an internal body tissue |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US14/084,138Expired - Fee RelatedUS8992548B2 (en) | 2003-11-05 | 2013-11-19 | Method for ligating an internal body tissue |
Country Status (6)
| Country | Link |
|---|---|
| US (2) | US20060200176A1 (en) |
| EP (1) | EP1683493B1 (en) |
| JP (1) | JP4373186B2 (en) |
| KR (1) | KR100808743B1 (en) |
| CN (1) | CN1874730B (en) |
| WO (1) | WO2005044112A1 (en) |
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| US20110077666A1 (en)* | 2009-09-30 | 2011-03-31 | Boston Scientific Scimed, Inc | Ligating band dispenser device |
| US20120209074A1 (en)* | 2011-02-16 | 2012-08-16 | James Sidney Titus | Optical coupler for an endoscope |
| US20130165959A1 (en)* | 2011-12-27 | 2013-06-27 | Paul Smith | Adjustable resection device and related methods of use |
| US20150105614A1 (en)* | 2013-10-15 | 2015-04-16 | Olympus Medical Systems Corp. | Method for endoscopic treatment |
| WO2016049145A1 (en)* | 2014-09-23 | 2016-03-31 | Scott Miller | Optical coupler for optical imaging visualization device |
| US20180271353A1 (en)* | 2014-01-28 | 2018-09-27 | Catholic University Industry-Academic Cooperation Foundation | Endoscope |
| US10548467B2 (en) | 2015-06-02 | 2020-02-04 | GI Scientific, LLC | Conductive optical element |
| US10856724B2 (en) | 2015-07-21 | 2020-12-08 | GI Scientific, LLC | Endoscope accessory with angularly adjustable exit portal |
| US20210145265A1 (en)* | 2018-07-06 | 2021-05-20 | Hoya Corporation | Endoscope |
| US12419642B1 (en)* | 2024-08-19 | 2025-09-23 | Labella Health Care Llc | Hemorrhoid bander and method of use thereof |
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| JP4922690B2 (en)* | 2006-07-24 | 2012-04-25 | オリンパスメディカルシステムズ株式会社 | Endoscope fluid supply device and endoscope |
| CN100525732C (en)* | 2006-11-03 | 2009-08-12 | 山东大学齐鲁医院 | Visible ring taking-off forceps |
| CN102755181A (en)* | 2011-04-26 | 2012-10-31 | 桦莱高分子工业股份有限公司 | Esophageal venous tumor ligature for endoscopy |
| CN102961170B (en)* | 2012-09-24 | 2015-03-18 | 杭州市余杭区第一人民医院 | Esophageal varices single-thread ligation system |
| WO2016134368A2 (en)* | 2015-02-20 | 2016-08-25 | Spacebander Corporation | Improved banding device for treating hemmorrhoids and reloading device |
| US10660644B2 (en)* | 2016-10-14 | 2020-05-26 | Logan Medical Devices, Inc. | Rectal band ligation device and method of operation thereof |
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| CN216365146U (en)* | 2018-06-05 | 2022-04-26 | 沙爱尔泽德克科技有限公司 | Endoscope assistance device and endoscope assistance kit |
| CN110584584B (en)* | 2019-10-12 | 2021-08-27 | 内蒙古医科大学附属医院 | Portable cystoscope is used in urological department inspection |
| CN115135286A (en)* | 2020-02-20 | 2022-09-30 | 奥林巴斯株式会社 | Stent delivery system, endoscope system and stent indwelling method |
| JP7630393B2 (en) | 2021-09-08 | 2025-02-17 | 朝日インテック株式会社 | Ligation Device |
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Cited By (32)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20110077666A1 (en)* | 2009-09-30 | 2011-03-31 | Boston Scientific Scimed, Inc | Ligating band dispenser device |
| US20120209074A1 (en)* | 2011-02-16 | 2012-08-16 | James Sidney Titus | Optical coupler for an endoscope |
| US8905921B2 (en)* | 2011-02-16 | 2014-12-09 | The General Hospital Corporation | Optical coupler for an endoscope |
| US20150065795A1 (en) | 2011-02-16 | 2015-03-05 | The General Hospital Corporation | Optical Coupler for an Endoscope |
| US10506918B2 (en) | 2011-02-16 | 2019-12-17 | The General Hospital Corporation | Optical coupler for an endoscope |
| US20130165959A1 (en)* | 2011-12-27 | 2013-06-27 | Paul Smith | Adjustable resection device and related methods of use |
| US9629647B2 (en)* | 2011-12-27 | 2017-04-25 | Boston Scientific Scimed, Inc. | Adjustable resection device and related methods of use |
| US20150105614A1 (en)* | 2013-10-15 | 2015-04-16 | Olympus Medical Systems Corp. | Method for endoscopic treatment |
| US20180271353A1 (en)* | 2014-01-28 | 2018-09-27 | Catholic University Industry-Academic Cooperation Foundation | Endoscope |
| US10989912B2 (en) | 2014-09-23 | 2021-04-27 | Scott Miller | Optical coupler for optical imaging visualization device |
| US10101574B2 (en) | 2014-09-23 | 2018-10-16 | Scott Miller | Optical coupler for optical imaging visualization device |
| US9459442B2 (en) | 2014-09-23 | 2016-10-04 | Scott Miller | Optical coupler for optical imaging visualization device |
| US10642020B2 (en) | 2014-09-23 | 2020-05-05 | Scott Miller | Optical coupler for optical imaging visualization device |
| US9709795B2 (en) | 2014-09-23 | 2017-07-18 | Scott Miller | Optical coupler for optical imaging visualization device |
| WO2016049145A1 (en)* | 2014-09-23 | 2016-03-31 | Scott Miller | Optical coupler for optical imaging visualization device |
| US12196945B2 (en) | 2014-09-23 | 2025-01-14 | Scott Miller | Optical imaging device |
| US11782257B2 (en) | 2014-09-23 | 2023-10-10 | Scott Miller | Optical imaging device |
| US11428922B2 (en) | 2014-09-23 | 2022-08-30 | Scott Miller | Optical coupler for optical imaging visualization device |
| US11666208B2 (en) | 2015-06-02 | 2023-06-06 | GI Scientific, LLC | Conductive optical element |
| US10548467B2 (en) | 2015-06-02 | 2020-02-04 | GI Scientific, LLC | Conductive optical element |
| US12245753B2 (en) | 2015-06-02 | 2025-03-11 | GI Scientific, LLC | Conductive optical element |
| US10856724B2 (en) | 2015-07-21 | 2020-12-08 | GI Scientific, LLC | Endoscope accessory with angularly adjustable exit portal |
| US11253137B2 (en) | 2015-07-21 | 2022-02-22 | GI Scientific, LLC | Endoscope accessory with locking elements |
| US11882999B2 (en) | 2015-07-21 | 2024-01-30 | GI Scientific, LLC | Coupler device for an endoscope |
| US11910999B2 (en) | 2015-07-21 | 2024-02-27 | GI Scientific, LLC | Endoscope accessory with locking elements |
| US12004712B2 (en) | 2015-07-21 | 2024-06-11 | GI Scientific, LLC | Medical device kit with endoscope accessory |
| US11019984B2 (en) | 2015-07-21 | 2021-06-01 | GI Scientific, LLC | Endoscope accessory with angularly adjustable exit portal |
| US12256893B2 (en) | 2015-07-21 | 2025-03-25 | GI Scientific, LLC | Endoscope accessory and medical device kit |
| US12414677B2 (en) | 2015-07-21 | 2025-09-16 | GI Scientific, LLC | Endoscope accessory with locking elements |
| US11759096B2 (en)* | 2018-07-06 | 2023-09-19 | Hoya Corporation | Endoscope |
| US20210145265A1 (en)* | 2018-07-06 | 2021-05-20 | Hoya Corporation | Endoscope |
| US12419642B1 (en)* | 2024-08-19 | 2025-09-23 | Labella Health Care Llc | Hemorrhoid bander and method of use thereof |
Also Published As
| Publication number | Publication date |
|---|---|
| KR100808743B1 (en) | 2008-02-29 |
| JP2005137477A (en) | 2005-06-02 |
| JP4373186B2 (en) | 2009-11-25 |
| WO2005044112A1 (en) | 2005-05-19 |
| EP1683493A1 (en) | 2006-07-26 |
| US8992548B2 (en) | 2015-03-31 |
| CN1874730A (en) | 2006-12-06 |
| US20140088615A1 (en) | 2014-03-27 |
| EP1683493B1 (en) | 2013-05-22 |
| KR20060132584A (en) | 2006-12-21 |
| EP1683493A4 (en) | 2010-05-26 |
| CN1874730B (en) | 2011-10-19 |
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| AS | Assignment | Owner name:OLYMPUS CORPORATION, JAPAN Free format text:ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MATSUNO, KIYOTAKA;SUZUKI, TAKAYUKI;REEL/FRAME:017832/0871 Effective date:20060411 | |
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