U.S. patent application number 11/416215 was filed with the patent office on 2006-09-07 for endoscopic ligation tool and endoscope.
This patent application is currently assigned to Olympus Corporation. Invention is credited to Kiyotaka Matsuno, Takayuki Suzuki.
Application Number | 20060200176 11/416215 |
Document ID | / |
Family ID | 34567079 |
Filed Date | 2006-09-07 |
United States Patent
Application |
20060200176 |
Kind Code |
A1 |
Matsuno; Kiyotaka ; et
al. |
September 7, 2006 |
Endoscopic ligation tool and endoscope
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.
Inventors: |
Matsuno; Kiyotaka;
(Sagamihara-shi, JP) ; Suzuki; Takayuki;
(Yokohama-shi, JP) |
Correspondence
Address: |
OSTROLENK FABER GERB & SOFFEN
1180 AVENUE OF THE AMERICAS
NEW YORK
NY
100368403
US
|
Assignee: |
Olympus Corporation
|
Family ID: |
34567079 |
Appl. No.: |
11/416215 |
Filed: |
May 1, 2006 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
PCT/JP04/16688 |
Nov 4, 2004 |
|
|
|
11416215 |
May 1, 2006 |
|
|
|
Current U.S.
Class: |
606/140 |
Current CPC
Class: |
A61B 1/00101 20130101;
A61B 1/015 20130101; A61B 2017/12018 20130101; A61B 2017/00296
20130101; A61B 1/00087 20130101; A61B 2017/306 20130101; A61B
17/12013 20130101; A61B 1/00089 20130101 |
Class at
Publication: |
606/140 |
International
Class: |
A61B 17/10 20060101
A61B017/10 |
Foreign Application Data
Date |
Code |
Application Number |
Nov 5, 2003 |
JP |
2003-375526 |
Claims
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.
Description
TECHNICAL FIELD
[0001] 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.
[0002] 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
[0003] 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.
[0004] 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.
[0005] 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.
[0006] 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.
[0007] 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
[0008] The present invention employs the following means in order
to resolve the above-described problems.
[0009] The endoscopic ligation tool according to the present
invention is an endoscopic ligation tool for ligating an internal
body tissue, provided with:
[0010] 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;
[0011] 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
[0012] 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,
[0013] 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.
[0014] 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.
[0015] 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.
[0016] 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.
[0017] In addition, the endoscopic ligation tool according to the
present invention is an endoscopic ligation tool for ligating an
internal body tissue, provided with:
[0018] 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;
[0019] 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
[0020] 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,
[0021] 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.
[0022] 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.
[0023] 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.
[0024] 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.
[0025] 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.
[0026] 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.
[0027] 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.
[0028] 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.
[0029] 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.
[0030] 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.
[0031] 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.
[0032] 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.
[0033] 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.
[0034] 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.
[0035] 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.
[0036] 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.
[0037] 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.
[0038] 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.
[0039] 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.
[0040] 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.
[0041] 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
[0042] FIG. 1 is a cross-sectional view showing the endoscopic
ligation tool according to the first embodiment of the present
invention.
[0043] 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.
[0044] 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.
[0045] 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.
[0046] 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.
[0047] 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.
[0048] FIG. 7 is a cross-sectional view showing the endoscopic
ligation tool according to a second embodiment of the present
invention.
[0049] FIG. 8 is a cross-sectional view showing the endoscopic
ligation tool according to another embodiment of the present
invention.
[0050] FIG. 9 is a cross-sectional view showing the endoscopic
ligation tool according to another embodiment of the present
invention.
[0051] 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
[0052] 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.
[0053] 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
3a of the outer cylinder member 3.
[0054] 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.
[0055] 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 8a of the inserted part 8 of the endoscope 7 in which the
channel 11 shown in FIG. 2 is formed.
[0056] The inner cylinder member 5 is designed such that the front
end 5a thereof is disposed projecting out in the forward direction
from the outer cylinder member 3, a floor part 5b is provided to
the base end side thereof, and a communicating hole 5c is formed to
the floor part 5b for communicating between the inside and the
outside of the inner cylinder member 5.
[0057] This inner cylinder member 5 is designed such that the
distance between the floor part 5b and the front end 8a of the
inserted part 8 is designed to be greater than the distance between
the front end 5a of the inner cylinder member 5 and the front end
3a of the outer cylinder member 3, so that the inner cylinder
member 5 can be attached to the outer cylinder member 3.
[0058] Note that the front end 5a of the inner cylinder member 5 is
formed into a round shape in order to increase adherence with the
internal body tissue 2.
[0059] 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 3a side, and a convex part
(anti-disconnect mechanism) 5d is provided to the outer periphery
of the floor part 5b 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.
[0060] 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.
[0061] 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.
[0062] 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.
[0063] 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.
[0064] First, the inner cylinder member 5 is inserted into the
outer cylinder main body 3A so that the floor part 5b is the base
end side of the outer cylinder member 3, causing engagement between
the concave part 3C and the convex part 5d. Next, the front end 5a
of the inner cylinder member 5 is made to project out from the
front end 3a 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.
[0065] Next, the endoscopic ligation tool 1 is attached by covering
the outer peripheral surface of the front end 8a 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 5a of the inner cylinder member 5
comes into contact with the surface of the internal body tissue
2.
[0066] 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 5b, the front end 8a of
the inserted part 8, and the outer cylinder member 3, are formed as
shown in FIG. 3.
[0067] 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.
[0068] The front end 5a 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 5c 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 5a of the inner cylinder member 5, is
pushed forward by the front end 3a 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.
[0069] 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.
[0070] 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 5d, the inner cylinder
member 5 becomes housed inside the outer cylinder member 3.
[0071] 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 5a 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.
[0072] 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 5d, 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.
[0073] 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.
[0074] 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.
[0075] The point of difference between the second embodiment and
the first embodiment is that a floor part 5b, having a
communicating hole 5c 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 18b
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.
[0076] Next, the method for operating the endoscopic ligation tool
17 and endoscope 7, and the actions and effects thereof, will be
explained.
[0077] 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 18b. At
this point, the surface of the internal body tissue 2 can generate
force via the convexly-shaped part 18b 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 18a of the inner cylinder member 18.
[0078] 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.
[0079] 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.
[0080] 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.
[0081] 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 5d, but also to provide a sealing agent for increasing
the sliding friction between the inner cylinder member 5 and the
outer cylinder member 3.
[0082] 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.
[0083] 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
5b or convexly-shaped part 18b.
[0084] In this case, the front end 21a 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 21a of the inner cylinder member
21, so that the O-ring 6 can be disconnected from the front end 21a
of the inner cylinder member 21.
[0085] 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.
[0086] 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.
[0087] 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.
[0088] 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
[0089] 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.
[0090] 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.
* * * * *