US20060200176A1 - Endoscopic ligation tool and endoscope - Google Patents

Endoscopic ligation tool and endoscope Download PDF

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Publication number
US20060200176A1
US20060200176A1 US11/416,215 US41621506A US2006200176A1 US 20060200176 A1 US20060200176 A1 US 20060200176A1 US 41621506 A US41621506 A US 41621506A US 2006200176 A1 US2006200176 A1 US 2006200176A1
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United States
Prior art keywords
cylinder member
inner cylinder
outer cylinder
body tissue
internal body
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Abandoned
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US11/416,215
Inventor
Kiyotaka Matsuno
Takayuki Suzuki
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Olympus Corp
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Olympus Corp
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Assigned to OLYMPUS CORPORATION reassignment OLYMPUS CORPORATION ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MATSUNO, KIYOTAKA, SUZUKI, TAKAYUKI
Publication of US20060200176A1 publication Critical patent/US20060200176A1/en
Priority to US14/084,138 priority Critical patent/US8992548B2/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B17/12013Implements 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00089Hoods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00101Insertion part of the endoscope body characterised by distal tip features the distal tip features being detachable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/012Instruments 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
    • A61B1/015Control of fluid supply or evacuation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00087Tools
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A61B2017/12018Elastic band ligators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30Surgical pincettes without pivotal connections
    • A61B2017/306Surgical pincettes without pivotal connections holding by means of suction

Definitions

  • 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.
  • 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.
  • 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.
  • 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.
  • the endoscopic ligation tool according to the first reference Japanese Patent No. 2958219
  • 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.
  • the endoscopic ligation tool according to the second reference U.S. Pat. No. 4,735,194
  • 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.
  • the devices disclosed in the second and third references are also problematic in that the assembly operations therefore are complicated.
  • 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;
  • 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;
  • the inner cylinder member 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.
  • 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.
  • an internal body tissue such 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 member can be carried out through a suction operation performed via the channel.
  • 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.
  • other procedure instruments such as an injection syringe, etc., can be inserted into the channel, even during the ligation operation.
  • 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;
  • 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;
  • the inner cylinder member 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.
  • the inner cylinder member can 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 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.
  • an internal body tissue such 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 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.
  • 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.
  • 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.
  • the internal body tissue 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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 endoscopic ligation tool 1 is an endoscopic ligation tool for ligating an esophageal varix or other such internal body tissue 2 (see FIG. 3 ).
  • this endoscopic ligation tool is 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 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
  • an O-ring (ligating band member) 6 which is annual in shape and can freely extend and contract, that is attached to the
  • the endoscope 7 is 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 13 is provided to the base end of the channel 11 for inserting procedure instruments into the channel 11 .
  • the outer cylinder member 3 is 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 5 is 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 5 is 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 5 is formed into a round shape in order to increase adherence with the internal body tissue 2 .
  • a concave part (anti-disconnect mechanism) 3 C 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 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 C is 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 like is 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 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 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 A can 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 5 is 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 5 is 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 3 is 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 1 is 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 7 is 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 5 and 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 A is then depressed.
  • the vacuum pump of the suction device 12 is 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 5 is 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 c becomes blocked by the internal body tissue 2 , so that a sealed state is created in the second region 16 .
  • a region of negative pressure is then created in this second region 16 .
  • the O-ring 6 which 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 6 is disconnected from the inner cylinder member 5 , ligating the varix or other such internal body tissue 2 .
  • the suction pump 10 A When 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 8 is first removed to the outside of the body.
  • an O-ring 6 can 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 1 can be provided. The same operation as described above is then carried out again.
  • this endoscopic ligation tool 1 and endoscope 7 it 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 5 are 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 b having 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 b that 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 17 is 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 2 is 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 2 can 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 20 capable 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 21 is 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 pressure increases, 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 3 pushes 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 7 was employed as the suction source.
  • a syringe 23 that 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 22 extends 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 tool is 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 member By 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 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.
  • 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.

Abstract

An endoscopic ligation tool for ligating an internal body tissue such as an esophageal varix, including: an outer cylinder member formed in the shape of a cylinder; an inner cylinder member formed in the shape of a cylinder, which is capable of sliding movement within the outer cylinder member; and an O-ring (ligation band member) which is annular in shape and freely extends and contracts.

Description

    TECHNICAL FIELD
  • 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.
  • BACKGROUND ART
  • 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.
  • DISCLOSURE OF THE INVENTION
  • 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.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • 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.
  • BEST MODE FOR CARRYING OUT THE INVENTION
  • 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 tissue 2 (see FIG. 3). As shown in FIG. 1, this endoscopic ligation tool is 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.
  • As shown in FIG. 2, the endoscope 7 is 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 13 is provided to the base end of the channel 11 for inserting procedure instruments into the channel 11.
  • As shown in FIG. 1, the outer cylinder member 3 is provided with an outer cylinder main body 3A which is formed of a transparent hard resin, and an attaching part 3B that is connected to the base end of the outer cylinder main body 3A 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 5 is 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 5 is 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.
  • Note that the front end 5 a of the inner cylinder member 5 is formed into a round shape in order to increase adherence with the internal 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 cylinder main body 3A 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 3C in a manner to enable sliding in the axial direction. The length of this concave part 3C is 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 like is 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 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 the inner cylinder member 5 and the internal body tissue 2 are made to adhere and the suction button 10A 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.
  • Note that this suction button 10A can be designed to be depressed in two stages. Namely, it is acceptable to provide a suction button 10A 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.
  • Next, the method for operating the endoscopic ligation tool 1 and the endoscope 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 cylinder main body 3A so that the floor part 5 b is the base end side of the outer cylinder member 3, causing engagement between the concave part 3C and the convex part 5 d. Next, the front end 5 a of the inner cylinder member 5 is 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. As a result, the positioning of the inner cylinder member 5 in the outer cylinder member 3 is 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.
  • Next, the endoscopic ligation tool 1 is 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 3B. The inserted part 8 of the endoscope 7 is 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.
  • At this point, a sealed first region 15 enclosed by the internal body tissue 2 and the inner cylinder member 5, and 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 10A is then depressed. The vacuum pump of the suction device 12 is 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 5 is then sealed by the internal body tissue 2, and the internal body tissue 2 is further drawn up into the inner cylinder member 5. Next, as shown in FIG. 4, the communicating hole 5 c becomes blocked by the internal body tissue 2, so that a sealed state is created in the second region 16. A region of negative pressure is then created in this second region 16. In this case, the O-ring 6, which 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.
  • As shown in FIG. 6, the O-ring 6 is disconnected from the inner cylinder member 5, ligating the varix or other such internal body tissue 2.
  • When the suction pump 10A 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 3C and the convex part 5 d, the inner cylinder member 5 becomes housed inside the outer 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 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. Alternatively, a new endoscopic 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 and endoscope 7, it 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 3C 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.
  • Further, since both the outer cylinder member 3 and the inner cylinder member 5 are 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.
  • 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 5 b, having 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. In contrast, a convexly-shaped part 18 b that 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.
  • Next, the method for operating the endoscopic ligation tool 17 and endoscope 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 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. In this case, the surface of the suctioned internal body tissue 2 is 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. At this point, the surface of the internal body tissue 2 can 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.
  • 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 engaging groove 20, capable of engaging the O-ring 6, in the outer peripheral surface of the inner cylinder member 5.
  • In this case, it is possible to prevent the O-ring 6 from disconnecting from the inner 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 the outer cylinder member 3 by means of the concave part 3C and the convex part 5 d, but also to provide a sealing agent for increasing the sliding friction between the inner cylinder member 5 and the outer cylinder member 3.
  • In this case, it is possible to prevent the inner cylinder member 5 from disconnecting from the outer cylinder member 3 by increasing the frictional resistance between the inner cylinder member 5 and the outer cylinder member 3.
  • In addition, as shown in FIG. 9, it is also acceptable to provide an inner cylinder member 21 in which there is no floor part 5 b or convexly-shaped part 18 b.
  • In this case, the front end 21 a of the inner cylinder member 21 is brought into contact with and suctions the internal body tissue, so that the internal body tissue is drawn up inside inner cylinder member 21. When suctioning is further continued in this state, the suctioning pressure increases, 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 3 pushes 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.
  • In the preceding embodiment, the suction device 12 of the endoscope 7 was employed as the suction source. However, it is also acceptable to provide a syringe 23 that has a tube 22, insertable into the channel 11, connected at its end, for the suction source, as shown in FIG. 10.
  • In this case, the front end of the tube 22 extends 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. As a result, it is possible to prevent the flow of air into the branched tube 25 during the ligation operation, and to carry out the operation using syringe 23 with accuracy.
  • The endoscopic ligation tool is attached to the front end of the inserted part 8 of the endoscope 7 and the internal body tissue 2 is suctioned. By then pushing the inner cylinder member into the internal 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.
  • INDUSTRIAL APPLICABILITY
  • 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 in claim 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 in claim 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 to claim 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 to claim 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 to claim 1, wherein said outer cylinder member and said inner cylinder member are both formed of a transparent member.
8. An endoscopic ligation tool, according to claim 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 to claim 1, wherein provided to the front end of said inserted part.
10. An endoscope as set forth in claim 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.
US11/416,215 2003-11-05 2006-05-01 Endoscopic ligation tool and endoscope Abandoned US20060200176A1 (en)

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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
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JP7234608B2 (en) * 2017-12-28 2023-03-08 住友ベークライト株式会社 Instrument for colonic diverticulum ligation and colonic diverticulum ligation system
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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
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
WO2016049145A1 (en) * 2014-09-23 2016-03-31 Scott Miller Optical coupler for optical imaging visualization device
US11428922B2 (en) 2014-09-23 2022-08-30 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
US11782257B2 (en) 2014-09-23 2023-10-10 Scott Miller Optical imaging device
US10989912B2 (en) 2014-09-23 2021-04-27 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
US10548467B2 (en) 2015-06-02 2020-02-04 GI Scientific, LLC Conductive optical element
US11666208B2 (en) 2015-06-02 2023-06-06 GI Scientific, LLC Conductive optical element
US11019984B2 (en) 2015-07-21 2021-06-01 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
US10856724B2 (en) 2015-07-21 2020-12-08 GI Scientific, LLC Endoscope accessory with angularly adjustable exit portal
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
US20210145265A1 (en) * 2018-07-06 2021-05-20 Hoya Corporation Endoscope
US11759096B2 (en) * 2018-07-06 2023-09-19 Hoya Corporation Endoscope

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US8992548B2 (en) 2015-03-31
CN1874730B (en) 2011-10-19
US20140088615A1 (en) 2014-03-27
JP2005137477A (en) 2005-06-02
JP4373186B2 (en) 2009-11-25
WO2005044112A1 (en) 2005-05-19
KR100808743B1 (en) 2008-02-29
EP1683493A4 (en) 2010-05-26
EP1683493B1 (en) 2013-05-22
KR20060132584A (en) 2006-12-21
EP1683493A1 (en) 2006-07-26
CN1874730A (en) 2006-12-06

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