JP5224278B2

JP5224278B2 - Grip device with anchor for endoscope

Info

Publication number: JP5224278B2
Application number: JP2008168126A
Authority: JP
Inventors: 寿光小林; 邦利池田; 直幸内藤; 晃義松原
Original assignee: Hoya Corp; National Cancer Center Japan
Current assignee: Hoya Corp; National Cancer Center Japan
Priority date: 2008-06-27
Filing date: 2008-06-27
Publication date: 2013-07-03
Anticipated expiration: 2028-06-27
Also published as: JP2010005151A

Description

本発明は、患者の体内の配置した磁気アンカーを体外に配置した磁力発生装置の磁力によって移動させる磁気アンカー遠隔誘導システムにおいて利用可能な内視鏡用アンカー付把持装置に関する。 The present invention relates to a gripping device with an anchor for an endoscope that can be used in a magnetic anchor remote guidance system that moves a magnetic anchor arranged in a patient's body by the magnetic force of a magnetic force generating device arranged outside the body.

特許文献１には、磁気アンカー、把持部材（クリップ）、クリップ受容管、及びループワイヤ（牽引分離部材）からなるアンカー付把持装置が開示してある。
このアンカー付把持装置は、磁気アンカーから延びる連結ひもとループワイヤを把持部材に接続し、把持部材をクリップ受容管の内部に収納することにより、磁気アンカー、把持部材（クリップ）、クリップ受容管、及びループワイヤを一体化したものである。アンカー付把持装置は、そのループワイヤに内視鏡の処置具挿通路の先端開口部（挿入部の先端面に設けた孔）から突出させた操作ワイヤ（牽引部材）の先端部に固定したフック部を掛け、操作ワイヤをその基端側に引いてフック部とアンカー付把持装置の一部を処置具挿通路内に位置させることにより、処置具挿通路の先端開口部に装着する。
内視鏡を用いてアンカー付把持装置を患者の体内に配置した後に、上記操作ワイヤを引き操作すると、把持部材が一旦開いた後に再度閉じて患部を把持する。そして、患者の外部に配置した磁力発生装置の磁力によって磁気アンカーを移動させると、磁気アンカーに引っ張られた把持部材によって患部が持ち上げられる。このようにして患部を持ち上げると、処置具によって患部を簡単に切除できる。
特開２００４−３５７８１４号公報 Patent Document 1 discloses a gripping device with an anchor including a magnetic anchor, a gripping member (clip), a clip receiving tube, and a loop wire (traction pulling member).
This gripping device with an anchor connects a connecting string and a loop wire extending from a magnetic anchor to a gripping member, and the gripping member is accommodated inside the clip receiving tube, whereby a magnetic anchor, a gripping member (clip), a clip receiving tube, In addition, the loop wire is integrated. The holding device with an anchor is a hook fixed to a distal end portion of an operation wire (traction member) protruding from a distal end opening portion (a hole provided in a distal end surface of the insertion portion) of a treatment instrument insertion path of an endoscope to the loop wire The hook is attached to the distal end opening of the treatment instrument insertion path by pulling the operation wire toward the proximal end thereof and positioning the hook part and a part of the anchored gripping device in the treatment instrument insertion path.
After the gripping device with an anchor is placed in the patient's body using an endoscope, when the operation wire is pulled, the gripping member is once opened and then closed again to grip the affected part. Then, when the magnetic anchor is moved by the magnetic force of the magnetic force generation device arranged outside the patient, the affected part is lifted by the gripping member pulled by the magnetic anchor. When the affected part is lifted in this way, the affected part can be easily excised with the treatment tool.
JP 2004-357814 A

アンカー付把持装置と操作ワイヤを接続する際はループワイヤにフック部を掛ける必要がある。
しかし、ループワイヤは可撓性を有する柔軟な部材ゆえその形状は安定せず、しかもクリップ受容管に対して相対移動可能である。そのため、ループワイヤにフック部を掛ける作業は容易でなく、術者の負担が大きかった。 When connecting the gripping device with an anchor and the operation wire, it is necessary to hang a hook portion on the loop wire.
However, since the loop wire is a flexible member having flexibility, the shape of the loop wire is not stable, and the loop wire is movable relative to the clip receiving tube. Therefore, it is not easy to hang the hook portion on the loop wire, and the burden on the operator is large.

本発明は、把持部材及び磁気アンカーを内視鏡の内部に通したフック部材と簡単に接続できる内視鏡用アンカー付把持装置を提供することを目的とする。 An object of the present invention is to provide an endoscope-equipped anchoring device that can be easily connected to a hook member in which a grasping member and a magnetic anchor are passed through an endoscope.

本発明の内視鏡用アンカー付把持装置は、開閉可能であり、閉じたときに対象物内部の対象部位を把持する把持部材と、該把持部材に柔軟な連結部材を介して連結した、上記対象物外部に配設した磁力発生装置が発生する磁力に吸引される磁気アンカーと、牽引部材の先端部に固定したフック部材に接続し、かつ上記把持部材に接続する接続部を備える、外力が掛からないときは形状を保持する弾性材料からなる牽引分離部材と、上記把持部材及び牽引分離部材の一部を内部に収納する収納筒部材と、を備え、上記牽引分離部材が、上記牽引部材から所定の保持解除荷重以上の荷重を受けないときは、上記収納筒部材に接触することにより該牽引分離部材が上記収納筒部材に対して該収納筒部材の軸線方向に相対移動するのを規制し、かつ、該保持解除荷重以上の荷重を受けたときは、該牽引分離部材が上記軸線方向に相対移動するのを許容する保持部を備え、上記牽引分離部材の上記接続部は、上記牽引部材に上記保持解除荷重より大きい所定の分離荷重以上の荷重が掛かったときに、上記把持部材との接続を解除することを特徴としている。 The gripping device with an anchor for an endoscope of the present invention is openable and closable, and is connected to a gripping member that grips a target portion inside a target object when closed, and the gripping member via a flexible connecting member. An external force comprising a magnetic anchor attracted by a magnetic force generated by a magnetic force generating device disposed outside the object, and a connecting portion connected to the hook member fixed to the distal end portion of the traction member and connected to the gripping member. A traction separation member made of an elastic material that retains its shape when not hanging, and a storage cylinder member that accommodates a part of the gripping member and the traction separation member therein, and the traction separation member is separated from the traction member. When not receiving a load equal to or greater than a predetermined holding release load, the traction separating member is prevented from moving relative to the storage cylinder member in the axial direction of the storage cylinder member by contacting the storage cylinder member. ,And, A holding portion that allows the traction separation member to move relative to the axial direction when receiving a load that is greater than a holding release load, and the connection portion of the traction separation member is released to the traction member. When a load greater than a predetermined separation load greater than the load is applied, the connection with the gripping member is released.

上記接続部が、互いに接離可能で、上記牽引部材に上記分離荷重以上の荷重が掛からないときは互いに接触することにより上記把持部材が上記牽引分離部材から分離するのを規制し、かつ、上記牽引部材に上記分離荷重以上の荷重が掛かったときは互いに離間して、上記把持部材が上記牽引分離部材から分離するのを許容する一対の接続片からなるものとしてもよい。
さらにこの場合は、上記牽引分離部材を金属製または樹脂製とし、上記一対の接続片どうしを、上記牽引部材に上記分離荷重以上の荷重が掛かったときに破断するレーザ溶接、スポット溶接または接着剤により結合してもよい。 When the connecting portions are separable from each other and the traction member is not subjected to a load greater than the separation load, the gripping members are prevented from separating from the traction separation member by contacting each other, and When a load equal to or greater than the separation load is applied to the traction member, the traction member may be separated from each other and may be composed of a pair of connection pieces that allow the gripping member to be separated from the traction separation member.
Further, in this case, the traction separation member is made of metal or resin, and the pair of connecting pieces are laser-welded, spot-welded, or adhesive that breaks when the traction member is loaded with a load greater than the separation load. May be combined.

また、上記牽引分離部材を金属製または樹脂製とし、上記接続部に、周辺部に比べて機械的強度が弱い脆弱部を形成してもよい。 In addition, the pulling / separating member may be made of metal or resin, and a fragile portion having a lower mechanical strength than the peripheral portion may be formed in the connecting portion.

上記保持部が、上記収納筒部材の長手方向の一方の端面に当接する第１接触部と、上記収納筒部材の長手方向の他方の端面に当接する第２接触部と、を具備してもよい。
この場合は、上記収納筒部材に係止孔または係止凹部を形成し、上記保持部が、上記牽引分離部材に形成した、上記係止孔または係止凹部に係合する係止突起であり、該係止突起は、上記牽引部材に所定の保持解除荷重以上の荷重が掛からないときは上記係止孔または係止凹部との係合状態を保持し、該保持解除荷重以上の荷重が掛かったときは該係止孔または係止凹部から脱出するのが好ましい。 The holding portion, be provided with a first contact portion abutting against the one end face of the longitudinal direction of the housing tubular member, a second contact portion which abuts on the other longitudinal end face of the housing tubular member, the Good.
In this case, a locking hole or a locking recess is formed in the storage cylinder member, and the holding portion is a locking protrusion that is formed in the traction separation member and engages with the locking hole or the locking recess. The locking protrusion holds the engagement state with the locking hole or the locking recess when a load equal to or greater than a predetermined holding release load is not applied to the pulling member, and the load exceeding the holding release load is applied. It is preferable to escape from the locking hole or the locking recess.

上記牽引分離部材が、上記接続部を有する薄肉部と、該薄肉部より肉厚であり、かつ上記牽引部材に接続する厚肉部と、を備えていてもよい。
この場合は、上記薄肉部と上記厚肉部を、別部材として成形した後に一体化してもよい。 The traction separation member may include a thin portion having the connection portion and a thick portion that is thicker than the thin portion and is connected to the traction member.
In this case, the thin portion and the thick portion may be integrated after being formed as separate members.

本発明の牽引分離部材は弾性変形可能であるものの、外力が掛からないときは形状を保持しかつ収納筒部材に対して相対移動しないので、牽引部材の先端部に固定したフック部材を掛けるのが容易である。そのため、牽引分離部材と牽引部材の取り付け時間を短くすることができ、術者の負担を軽減できる。 Although the traction separating member of the present invention can be elastically deformed, it retains its shape when no external force is applied and does not move relative to the storage cylinder member. Easy. Therefore, the time for attaching the traction separating member and the traction member can be shortened, and the burden on the operator can be reduced.

以下、本発明の第１の実施形態を、図１から図２０を参照しながら詳しく説明する。
本実施形態のアンカー付把持装置１０Ａは、内視鏡５０の内部に挿入した操作装置６０を介して病変部Ｘに取り付けられるものであり、かつ患者Ａの体外に配置した磁気アンカー誘導装置７０の磁力によって吸引制御されるものである。 Hereinafter, a first embodiment of the present invention will be described in detail with reference to FIGS.
The gripping device with an anchor 10A of the present embodiment is attached to a lesioned part X via an operating device 60 inserted into the endoscope 50, and is a magnetic anchor guiding device 70 disposed outside the body of the patient A. The attraction is controlled by magnetic force.

まず、図１から図７を参照して、磁気アンカー１１（連結ひも１５）、把持部材１８、牽引分離部材２８及び収納筒部材３８からなるアンカー付把持装置１０Ａの構成について説明する。
強磁性体（例えば、純鉄、鉄合金のほか、プラチナマグネット、希土類磁石、テルビウム・ディスプロシウム・鉄合金などの磁石）からなりかつ略三角錐形状をなす磁気アンカー１１は、その端部に突部１２を有しており、突部１２の端面に形成した凹部内に固定した固定部１３には、柔軟性を有しかつ全体として環状をなす連結ひも１５が接続してある。連結ひも１５としては、例えば、手術用縫合糸、釣糸、金属製ワイヤを利用可能である。
図６等に示すように、金属等の弾性材料からなる把持部材１８は一対の開閉片１９を具備している。一対の開閉片１９は共に、略平行な基端部２０と、基端部２０に連なる中間部２１と、中間部２１に連なる先端把持部２２と、を具備している。中間部２１における基端部２０に連なる部分は第１傾斜部（第１接触部）２４となっており、先端把持部２２における中間部２１に連なる部分は第２傾斜部２５となっている。さらに、両先端把持部２２の先端には互いに対向する把持爪２６が設けてある。なお、把持部材１８を３枚以上の開閉片１９からなるものすることも可能である。 First, with reference to FIG. 1 to FIG. 7, the configuration of the anchoring gripping device 10 A including the magnetic anchor 11 (connection string 15), the gripping member 18, the traction separating member 28, and the storage cylinder member 38 will be described.
A magnetic anchor 11 made of a ferromagnetic material (eg, pure iron, iron alloy, platinum magnet, rare earth magnet, terbium, dysprosium, iron alloy, etc.) and having a substantially triangular pyramid shape is formed at its end. A connecting string 15 that is flexible and has a ring shape as a whole is connected to a fixed portion 13 that has a protruding portion 12 and is fixed in a recess formed on the end face of the protruding portion 12. As the connecting string 15, for example, a surgical suture, a fishing line, or a metal wire can be used.
As shown in FIG. 6 and the like, the gripping member 18 made of an elastic material such as metal has a pair of opening / closing pieces 19. Each of the pair of opening / closing pieces 19 includes a base end portion 20 that is substantially parallel, an intermediate portion 21 that is continuous with the base end portion 20, and a tip gripping portion 22 that is continuous with the intermediate portion 21. A portion of the intermediate portion 21 connected to the base end portion 20 is a first inclined portion (first contact portion) 24, and a portion of the distal end gripping portion 22 connected to the intermediate portion 21 is a second inclined portion 25. Further, gripping claws 26 that are opposed to each other are provided at the distal ends of both distal gripping portions 22. The gripping member 18 may be composed of three or more open / close pieces 19.

弾性材料である金属からなる牽引分離部材２８は、互いに近づく方向に傾斜する一対の傾斜当接部（第２接触部）２９を有するループ部３０と、一対の傾斜当接部２９から略平行に延び、かつ側面視における幅がループ部３０より広幅（図３参照）である一対の中間広幅部３１と、一対の中間広幅部３１から略平行に延びかつループ部３０と略同幅（図３参照）である一対の先端部３２と、を具備している。一対の先端部３２の先端には互いに対向する接続片（接続部）３３と接続片（接続部）３４がそれぞれ設けてある。図４に示すように、接続片３３の端面は正面視で直線をなす平面であるが、接続片３４の端面は正面視略円弧状をなす湾曲面である。接続片３３と接続片３４は牽引分離部材２８自身の弾性力によって互いの端面同士が点接触している。なお、図５に示すように、一方の先端部３２の接続片（接続部）３６のループ部３０との対向端面を正面視略三角形状に加工してもよい。
収納筒部材３８は連結ひも１５、把持部材１８及び牽引分離部材２８の一部を収納するための部材であり、図１等に示すように両端が開口する略円筒形をなしている。収納筒部材３８は大径部３９と小径部４０を具備している。大径部３９側の開口縁部はテーパ面４１となっており、大径部３９と小径部４０に跨る一本のスリット４２が設けてある。さらに、収納筒部材３８の内部孔４３の内径はその全長にわたって一定である。この収納筒部材３８は、例えばステンレスやプラスチックや超弾性合金により成形することができる。 The pulling / separating member 28 made of a metal that is an elastic material includes a loop portion 30 having a pair of inclined contact portions (second contact portions) 29 inclined in a direction approaching each other, and the pair of inclined contact portions 29 substantially in parallel. A pair of intermediate wide portions 31 extending in a side view and wider than the loop portion 30 (see FIG. 3), and extending substantially parallel to the pair of intermediate wide portions 31 and substantially the same width as the loop portion 30 (see FIG. 3). And a pair of tip portions 32 which are reference). A connecting piece (connecting portion) 33 and a connecting piece (connecting portion) 34 facing each other are provided at the tips of the pair of tip portions 32. As shown in FIG. 4, the end surface of the connection piece 33 is a flat surface that forms a straight line when viewed from the front, but the end surface of the connection piece 34 is a curved surface that forms a substantially arc shape when viewed from the front. The connecting piece 33 and the connecting piece 34 are in point contact with each other due to the elastic force of the traction separating member 28 itself. In addition, as shown in FIG. 5, you may process the opposing end surface with the loop part 30 of the connection piece (connection part) 36 of the one front-end | tip part 32 in a substantially triangular shape in front view.
The storage cylinder member 38 is a member for storing a part of the connecting string 15, the gripping member 18, and the traction separating member 28, and has a substantially cylindrical shape with both ends opened as shown in FIG. The storage cylinder member 38 includes a large diameter portion 39 and a small diameter portion 40. The opening edge on the large diameter portion 39 side is a tapered surface 41, and a single slit 42 is provided across the large diameter portion 39 and the small diameter portion 40. Further, the inner diameter of the inner hole 43 of the storage cylinder member 38 is constant over its entire length. The storage cylinder member 38 can be formed of, for example, stainless steel, plastic, or a superelastic alloy.

磁気アンカー１１（連結ひも１５）、把持部材１８、牽引分離部材２８及び収納筒部材３８は次の手順により組み立てる。
まず、図２に示す状態にある牽引分離部材２８の接続片３３と接続片３４を牽引分離部材２８自身の弾性力に抗して引き離し、接続片３３と接続片３４の間に形成された隙間を通して把持部材１８における一対の基端部２０どうしの連結部を牽引分離部材２８の内部に通す。そして、接続片３３と接続片３４同士を接触（点接触）させて、両者の接触部をレーザ溶接、スポット溶接または接着剤により結合する。さらに、離間状態にある一対の先端部３２の中間部（図２参照）を互いに近づく方向に塑性変形させることにより、当該部分を互いに接触するくびれ部３５とする（図１参照）。先端部３２にくびれ部３５を形成すると、把持部材１８の基端部２０がくびれ部３５よりループ部３０側に移動するのを規制できる。
次に、連結ひも１５の一部を収納筒部材３８のスリット４２を利用して収納筒部材３８の内部に挿入し、大径部３９の開口部を通して収納筒部材３８の外部に引き出す。そして、連結ひも１５の当該引き出した部分（ループ状の部分）に把持部材１８の一方の開閉片１９に通し、このループ状部分を把持部材１８における一対の基端部２０どうしの連結部に掛ける（図１参照）。
続いて、収納筒部材３８の小径部４０側の端面開口部から紐あるいは先端にフック部を備える硬質部材からなる棒を挿入し、紐あるいはフック部を収納筒部材３８の大径部３９側の開口部から突出させる。そして、この紐あるいはフック部を牽引分離部材２８のループ部３０に引っ掛け、紐あるいは棒を小径部４０側の端面側に引っ張る。すると、牽引分離部材２８のループ部３０が幅を狭める方向に弾性変形しながら内部孔４３の内部に引き込まれる。図１に示すようにループ部３０が小径部４０側の端面開口部から脱出するまで紐あるいは棒を引っ張れば、磁気アンカー１１（連結ひも１５）、把持部材１８、牽引分離部材２８及び収納筒部材３８の組み付け作業（アンカー付把持装置１０Ａの構成作業）が完了する。このとき、図１に示すように、一対の傾斜当接部２９が収納筒部材３８の小径部４０側の開口部に接触すると共に把持部材１８の一対の第１傾斜部２４が収納筒部材３８のテーパ面４１に接触し、さらに図７に示すように一対の中間広幅部３１が内部孔４３に接触するので、収納筒部材３８に対して把持部材１８及び牽引分離部材２８が図１の位置に保持される。 The magnetic anchor 11 (connection string 15), the gripping member 18, the traction separating member 28, and the storage cylinder member 38 are assembled by the following procedure.
First, the connection piece 33 and the connection piece 34 of the traction separation member 28 in the state shown in FIG. 2 are separated against the elastic force of the traction separation member 28 itself, and a gap formed between the connection piece 33 and the connection piece 34. The connecting portion between the pair of base end portions 20 in the gripping member 18 is passed through the inside of the traction separating member 28. And the connection piece 33 and the connection piece 34 are contacted (point contact), and both contact parts are couple | bonded by laser welding, spot welding, or an adhesive agent. Furthermore, by plastically deforming an intermediate portion (see FIG. 2) of the pair of tip portions 32 in a separated state in a direction approaching each other, the portion is made a constricted portion 35 that contacts each other (see FIG. 1). When the constricted portion 35 is formed at the distal end portion 32, the movement of the proximal end portion 20 of the gripping member 18 toward the loop portion 30 side from the constricted portion 35 can be restricted.
Next, a part of the connecting string 15 is inserted into the storage cylinder member 38 by using the slit 42 of the storage cylinder member 38, and pulled out to the outside of the storage cylinder member 38 through the opening of the large diameter portion 39. Then, one open / close piece 19 of the gripping member 18 is passed through the drawn-out portion (loop-shaped portion) of the connecting cord 15, and this loop-shaped portion is hung on the connecting portion between the pair of base end portions 20 of the gripping member 18. (See FIG. 1).
Subsequently, a string or a rod made of a hard member having a hook portion at the tip is inserted from the end surface opening on the small diameter portion 40 side of the storage cylinder member 38, and the string or hook portion is inserted on the large diameter portion 39 side of the storage cylinder member 38. Project from the opening. Then, the string or hook part is hooked on the loop part 30 of the traction separating member 28, and the string or bar is pulled to the end face side on the small diameter part 40 side. Then, the loop portion 30 of the traction separating member 28 is drawn into the inner hole 43 while being elastically deformed in the direction of narrowing the width. As shown in FIG. 1, if a string or a rod is pulled until the loop part 30 escapes from the end face opening on the small diameter part 40 side, the magnetic anchor 11 (connection string 15), the gripping member 18, the traction separating member 28, and the storage cylinder member 38 assembly work (configuration work of the anchoring gripping device 10A) is completed. At this time, as shown in FIG. 1, the pair of inclined contact portions 29 come into contact with the opening on the small diameter portion 40 side of the storage cylinder member 38, and the pair of first inclination portions 24 of the gripping member 18 corresponds to the storage cylinder member 38. 1 and the pair of intermediate wide portions 31 are in contact with the inner hole 43 as shown in FIG. 7, so that the gripping member 18 and the traction separating member 28 are located at the position shown in FIG. Retained.

アンカー付把持装置１０Ａが図１及び図６に示す状態にあるとき、把持部材１８は一対の開閉片１９の把持爪２６が互いに接触する全閉状態となる。
この状態からループ部３０を小径部４０から離れる方向に所定の大きさである保持解除荷重以上の力で引くと、図８に示すように牽引分離部材２８が塑性変形し、牽引分離部材２８の幅が収納筒部材３８の内部孔４３及び規制管６３の小径部６５の内周面の内径より短くなる。さらに、把持部材１８の一対の第１傾斜部２４がテーパ面４１に接触しながら互いに近づく方向に弾性変形し、一対の中間部２１が内部孔４３内に収納される。すると、一対の中間部２１が内部孔４３の周面に接触することにより互いに近づく方向に弾性変形するので、この動きに連動して一対の把持部材１８が開き、把持部材１８は図８に示す全開状態となる。
この状態からループ部３０をさらに引くと、図９に示すように牽引分離部材２８の塑性変形がさらに進行して牽引分離部材２８の幅がさらに狭くなり、かつ、把持部材１８の一対の第２傾斜部２５が収納筒部材３８の内部に引き込まれる。第２傾斜部２５が内部孔４３に接触することにより互いに近づく方向に弾性変形すると、図９に示すように一対の把持爪２６が互いに接近するので、把持部材１８は再度全閉状態となる。 When the anchored gripping device 10A is in the state shown in FIGS. 1 and 6, the gripping member 18 is in a fully closed state in which the gripping claws 26 of the pair of opening and closing pieces 19 are in contact with each other.
When the loop portion 30 is pulled in this direction away from the small diameter portion 40 with a force equal to or larger than the holding release load having a predetermined size, the traction separating member 28 is plastically deformed as shown in FIG. The width is shorter than the inner diameter of the inner hole 43 of the storage cylinder member 38 and the inner peripheral surface of the small diameter portion 65 of the restriction tube 63. Further, the pair of first inclined portions 24 of the gripping member 18 are elastically deformed in a direction approaching each other while contacting the tapered surface 41, and the pair of intermediate portions 21 are accommodated in the inner hole 43. Then, since the pair of intermediate portions 21 come into contact with the peripheral surface of the inner hole 43 and elastically deform in a direction approaching each other, the pair of gripping members 18 opens in conjunction with this movement, and the gripping members 18 are shown in FIG. Fully open.
When the loop portion 30 is further pulled from this state, as shown in FIG. 9, the plastic deformation of the traction separation member 28 further proceeds, the width of the traction separation member 28 is further reduced, and the pair of second members of the gripping member 18 The inclined portion 25 is drawn into the storage cylinder member 38. When the second inclined portion 25 comes into contact with the inner hole 43 and elastically deforms in a direction approaching each other, the pair of gripping claws 26 approach each other as shown in FIG. 9, and the gripping member 18 is again fully closed.

図１０は、アンカー付把持装置１０Ａを装着可能な内視鏡５０を示している。
内視鏡５０は、術者が把持する操作部５１と、操作部５１から延びる挿入部５２と、操作部５１から挿入部５２と反対側に向かって延び、端部にプロセッサ（光源装置兼画像処理装置。図示略）に接続するためのコネクタ部５４を有するユニバーサルチューブ５３と、を具備している。挿入部５２の先端面５５には、エア及び洗浄水を送るための送気送水ノズルと、切除部及びその周辺を照らすための照明レンズと、切除部及びその周辺を観察するとともに、直後に挿入部５２の内部に配設した対物レンズと撮像素子が配置された観察窓と、処置具挿通路５６の出口開口５７（図１１、図１４から図１９参照）が設けてある。処置具挿通路５６の基端側開口部は、操作部５１に突設した処置具挿通用突部５８の端面に形成してある。 FIG. 10 shows an endoscope 50 to which the anchoring gripping device 10A can be attached.
The endoscope 50 includes an operation unit 51 held by an operator, an insertion unit 52 extending from the operation unit 51, an extension from the operation unit 51 toward the opposite side of the insertion unit 52, and a processor (light source device / image) at the end. And a universal tube 53 having a connector portion 54 for connection to a processing apparatus (not shown). In the distal end surface 55 of the insertion portion 52, an air / water supply nozzle for sending air and washing water, an illumination lens for illuminating the excision portion and its periphery, and the observation portion and its periphery are observed and inserted immediately thereafter. An observation window in which an objective lens and an image sensor are disposed inside the portion 52 and an outlet opening 57 (see FIGS. 11 and 14 to 19) of the treatment instrument insertion path 56 are provided. The proximal end side opening of the treatment instrument insertion passage 56 is formed on the end surface of the treatment instrument insertion protrusion 58 that protrudes from the operation section 51.

図１１等に示した操作装置６０は、内視鏡５０の処置具挿通用突部５８から処置具挿通路５６の内部に挿入するものであり、挿入管６１、挿入コイル６２、規制管６３及び操作ワイヤ（牽引部材）６９を具備している。
挿入管６１は可撓性を有する筒状部材であり、挿入コイル６２は挿入管６１の内部に相対移動可能に挿入してある。規制管６３は前部をなす大径部６４と、後部をなしかつ挿入コイル６２の先端部に嵌合固定される小径部６５と、を備えている。大径部６４の外径は挿入管６１の内径より小さく、かつ、挿入コイル６２の外径とほぼ同一に設定してある。さらに、大径部６４の内径は小径部６５の内径及び収納筒部材３８の小径部４０の外径より大きく設定してあり、大径部６４の内周面と小径部６５の内周面の接続部には環状段部６６が形成してある。
挿入コイル６２の内側には、先端にフック部材６８を固定した操作ワイヤ６９を相対移動可能に配設してある。
挿入管６１、挿入コイル６２及び操作ワイヤ６９の各基端部は、図示を省略した基端側操作部によって互いに軸方向に相対移動可能として結合してある。 11 or the like is inserted into the treatment instrument insertion passage 56 from the treatment instrument insertion protrusion 58 of the endoscope 50, and includes an insertion tube 61, an insertion coil 62, a restriction tube 63, and An operation wire (traction member) 69 is provided.
The insertion tube 61 is a flexible cylindrical member, and the insertion coil 62 is inserted into the insertion tube 61 so as to be relatively movable. The restriction tube 63 includes a large-diameter portion 64 that forms the front portion, and a small-diameter portion 65 that forms the rear portion and is fitted and fixed to the distal end portion of the insertion coil 62. The outer diameter of the large diameter portion 64 is set smaller than the inner diameter of the insertion tube 61 and substantially the same as the outer diameter of the insertion coil 62. Further, the inner diameter of the large-diameter portion 64 is set to be larger than the inner diameter of the small-diameter portion 65 and the outer diameter of the small-diameter portion 40 of the storage cylinder member 38, and the inner peripheral surface of the large-diameter portion 64 and the inner peripheral surface of the small-diameter portion 65 are set. An annular step 66 is formed at the connecting portion.
Inside the insertion coil 62, an operation wire 69 having a hook member 68 fixed to the tip is disposed so as to be relatively movable.
The base end portions of the insertion tube 61, the insertion coil 62, and the operation wire 69 are coupled to each other so as to be relatively movable in the axial direction by a base end side operation portion (not shown).

次に、図１２及び図１３を用いて、患者Ａの体外において磁気アンカー１１を吸引制御する磁気アンカー誘導装置７０の構成について説明する。
患者Ａを載せるベッド７１の両側部には、一対のＸＹステージ７２が配設してある。この一対のＸＹステージ７２は、床面上をベッド７１の長手方向に沿って同期しながら直線的にスライド（往復移動）するものであり、両ＸＹステージ７２の該長手方向の位置は常に一致する。さらに、ベッド７１の上方には、ベッド７１の長手方向と直交する平面内において互いに平行をなす、正面視略逆Ｕ字形の二つのレール７４、レール７５からなるフレーム／レール７３が配設してあり、このフレーム／レール７３の両端部は、左右のＸＹステージ７２にそれぞれ固定してある。内側のレール７４には、アンカー付把持装置１０Ａの磁気アンカー１１を患者Ａの体外において吸引制御する（磁気アンカー１１に磁力を及ぼす）磁気誘導部材（磁力発生装置）７６が摺動自在に装着してある。磁気誘導部材７６は、その基体７８に鉄心にコイルを巻いた構造の電磁石７７を固定したものであり、電磁石７７は常に患者Ａ側を向いている（図１２参照）。 Next, the configuration of the magnetic anchor guidance device 70 that controls the magnetic anchor 11 outside the body of the patient A will be described with reference to FIGS. 12 and 13.
A pair of XY stages 72 are disposed on both sides of the bed 71 on which the patient A is placed. The pair of XY stages 72 slide linearly (reciprocate) on the floor surface in synchronization with the longitudinal direction of the bed 71, and the longitudinal positions of the XY stages 72 always coincide. . Further, above the bed 71, there is disposed a frame / rail 73 composed of two rails 74 and rails 75 which are substantially U-shaped in front view and are parallel to each other in a plane orthogonal to the longitudinal direction of the bed 71. The both ends of the frame / rail 73 are fixed to the left and right XY stages 72, respectively. A magnetic induction member (magnetic force generator) 76 that controls the magnetic anchor 11 of the grasping apparatus 10A with an anchor outside the body of the patient A (which exerts a magnetic force on the magnetic anchor 11) is slidably attached to the inner rail 74. It is. The magnetic induction member 76 is obtained by fixing an electromagnet 77 having a structure in which a coil is wound around an iron core around a base 78, and the electromagnet 77 is always facing the patient A side (see FIG. 12).

フレーム／レール７３の外側のレール７５には、フレーム／レール７３全体の重量バランスを保つためのカウンターウェイト７９が摺動自在に装着してある。カウンターウェイト７９は、磁気誘導部材７６の位置に応じて、その位置を変更する。例えば、磁気誘導部材７６が患者Ａの正面側に位置するときは、カウンターウェイト７９は患者Ａの背面側に位置し、磁気誘導部材７６が患者Ａの背面側に位置するときは、カウンターウェイト７９は患者Ａの正面側に位置する。
そして、以上説明したＸＹステージ７２、フレーム／レール７３及び磁気誘導部材７６が磁気アンカー誘導装置７０の構成要素である。 A counterweight 79 for maintaining the weight balance of the entire frame / rail 73 is slidably mounted on the rail 75 outside the frame / rail 73. The counter weight 79 changes its position according to the position of the magnetic induction member 76. For example, when the magnetic guide member 76 is located on the front side of the patient A, the counterweight 79 is located on the back side of the patient A, and when the magnetic guide member 76 is located on the back side of the patient A, the counterweight 79 is placed. Is located in front of patient A.
The XY stage 72, the frame / rail 73, and the magnetic induction member 76 described above are components of the magnetic anchor induction device 70.

次に、患者Ａの病変部Ｘの切除要領について説明する。
切除術の実施に先立っては、まず、図１２及び図１３に示すように、局所麻酔を施した患者Ａをベッド７１上に横たわらせる。このとき、磁気誘導部材７６をフレーム／レール７３に沿って切除術開始時位置に移動させる（図１２及び図１３参照）。
次いで、あらかじめ図示を省略した可撓性を有するオーバーチューブを内視鏡５０の挿入部５２の手元側に装着した状態で、アンカー付把持装置１０Ａ及び操作装置６０が装着されていない状態の内視鏡５０を患者Ａの口から挿入し、挿入部５２の先端部を病変部Ｘに近接させる（図示略）。このようにして内視鏡５０の挿入部５２の先端を臓器Ｂ内に挿入すると、挿入部５２の先端面５５に設けた上記観察窓から得られた臓器Ｂ内の観察像が、上記プロセッサに接続したテレビモニタ（図示略）に写し出される。この状態で、上記オーバーチューブを挿入部５２に沿って患者Ａの口から所定位置まで挿入する。
次いで内視鏡５０の処置具挿通用突部５８から、先端部に注射針を具備するチューブ状の処置具（図示略）を挿入し、その注射針を挿入部５２の出口開口５７から突出させて、注射針を病変部Ｘの周辺から臓器壁の粘膜下層Ｂ１に挿入して生理食塩水を注入し、病変部Ｘを固有筋層Ｂ２から浮き上がらせておく（図１６から図１９参照）。 Next, the procedure for excision of the lesion X of the patient A will be described.
Prior to performing the resection, first, as shown in FIGS. 12 and 13, the patient A subjected to local anesthesia is laid on the bed 71. At this time, the magnetic guide member 76 is moved along the frame / rail 73 to the position at the start of resection (see FIGS. 12 and 13).
Next, the endoscope in a state in which the flexible overtube (not shown) is attached to the proximal side of the insertion portion 52 of the endoscope 50 and the grasping device with anchor 10A and the operation device 60 are not attached. The mirror 50 is inserted from the mouth of the patient A, and the distal end portion of the insertion portion 52 is brought close to the lesioned portion X (not shown). When the distal end of the insertion portion 52 of the endoscope 50 is inserted into the organ B in this way, an observation image in the organ B obtained from the observation window provided on the distal end surface 55 of the insertion portion 52 is transferred to the processor. The image is displayed on a connected TV monitor (not shown). In this state, the overtube is inserted along the insertion portion 52 from the mouth of the patient A to a predetermined position.
Next, a tube-like treatment instrument (not shown) having an injection needle is inserted into the distal end portion from the treatment instrument insertion protrusion 58 of the endoscope 50, and the injection needle protrudes from the outlet opening 57 of the insertion portion 52. Then, the injection needle is inserted from the periphery of the lesion X into the submucosa B1 of the organ wall and physiological saline is injected, and the lesion X is lifted from the proper muscle layer B2 (see FIGS. 16 to 19).

次に、患者Ａの体内から内視鏡５０を取り出し、患者Ａの体外において内視鏡５０にアンカー付把持装置１０Ａと操作装置６０を次の手順で取り付ける。
まず、内視鏡５０の処置具挿通路５６に操作装置６０を挿通し、挿入管６１の先端部を挿入部５２の出口開口５７から外部に僅かに突出させ、さらに規制管６３の先端部を挿入管６１の先端部から僅かに突出させる（図１１参照）。次いで、上記基端側操作部を操作することにより操作ワイヤ６９の先端部に固着したフック部材６８を規制管６３の前方に突出させる（図１１参照）。
次いで、フック部材６８の直前にアンカー付把持装置１０Ａの牽引分離部材２８のループ部３０を位置させ、フック部材６８をループ部３０に引っ掛ける。そして、上記基端側操作部を操作することによりフック部材６８を操作ワイヤ６９の基端側に引っ張り、フック部材６８によって収納筒部材３８の小径部４０を環状段部６６に当接するまで大径部６４の内部に引き込む（図１４参照）。このようにして規制管６３の内部に小径部４０を収納しても、収納筒部材３８のスリット４２の前端部は規制管６３の大径部６４より前方に位置するので（図１４等参照）、連結ひも１５はスリット４２の前端部から外部へ引き出すことができる。
続いて、上記基端側操作部を操作することにより挿入管６１を前方に押し出すと、図１５に示すように把持部材１８及び収納筒部材３８が挿入管６１の内部に収納され、かつ磁気アンカー１１の突部１２が挿入管６１の先端部に嵌合する。
そして、最後に上記状態を保持したまま基端側操作部を操作することにより挿入管６１、挿入コイル６２及び操作ワイヤ６９を基端側に引くと、図１５に示すように磁気アンカー１１が処置具挿通路５６の出口開口５７に嵌合するので、アンカー付把持装置１０Ａ及び操作装置６０が内視鏡５０と一体になる。 Next, the endoscope 50 is taken out from the body of the patient A, and the holding device with anchor 10A and the operation device 60 are attached to the endoscope 50 outside the body of the patient A in the following procedure.
First, the operating device 60 is inserted into the treatment instrument insertion passage 56 of the endoscope 50, the distal end portion of the insertion tube 61 is slightly protruded from the outlet opening 57 of the insertion portion 52, and the distal end portion of the restriction tube 63 is further extended. It protrudes slightly from the tip of the insertion tube 61 (see FIG. 11). Next, by operating the proximal end side operation portion, the hook member 68 fixed to the distal end portion of the operation wire 69 is projected forward of the restriction tube 63 (see FIG. 11).
Next, the loop portion 30 of the pulling / separating member 28 of the anchoring gripping apparatus 10 A is positioned immediately before the hook member 68, and the hook member 68 is hooked on the loop portion 30. Then, the hook member 68 is pulled toward the proximal end side of the operation wire 69 by operating the proximal end side operation portion, and the large diameter is maintained until the small diameter portion 40 of the storage cylinder member 38 is brought into contact with the annular step portion 66 by the hook member 68. It pulls in the part 64 (refer FIG. 14). Even if the small-diameter portion 40 is housed inside the regulation tube 63 in this way, the front end portion of the slit 42 of the housing cylinder member 38 is located in front of the large-diameter portion 64 of the regulation tube 63 (see FIG. 14 and the like). The connecting cord 15 can be pulled out from the front end of the slit 42 to the outside.
Subsequently, when the insertion tube 61 is pushed forward by operating the proximal end side operation portion, the gripping member 18 and the storage cylinder member 38 are stored in the insertion tube 61 as shown in FIG. 11 projections 12 are fitted to the distal end of the insertion tube 61.
When the insertion tube 61, the insertion coil 62, and the operation wire 69 are pulled toward the proximal end by finally operating the proximal end operation portion while maintaining the above state, the magnetic anchor 11 is treated as shown in FIG. Since it fits into the outlet opening 57 of the instrument insertion passage 56, the anchored gripping device 10 A and the operation device 60 are integrated with the endoscope 50.

次いで、アンカー付把持装置１０Ａ及び操作装置６０と一体となった内視鏡５０の挿入部５２を上記オーバーチューブ内に挿入し、挿入部５２の先端部及びアンカー付把持装置１０Ａを臓器Ｂ内に挿入する。そして、挿入部５２の先端部を病変部Ｘに近接させた後にアンカー付把持装置１０Ａ及び操作装置６０を前方に移動させて、内視鏡５０から離間させる。さらに、挿入コイル６２と操作ワイヤ６９を操作することによって規制管６３と共に収納筒部材３８を挿入管６１に対して前方へ相対移動させると、この動作にともなって把持部材１８が収納筒部材３８と一緒に前方に移動するので、把持部材１８の先端（把持爪２６）が磁気アンカー１１の突部１２の後端面に当接する。収納筒部材３８をさらに前方に移動させると、挿入管６１の先端部に嵌合している磁気アンカー１１が把持部材１８（把持爪２６）によって前方に押し出され（挿入管６１から外れ）、かつ収納筒部材３８が挿入管６１の前方に突出する（図１６参照）。 Next, the insertion portion 52 of the endoscope 50 integrated with the anchoring grasping device 10A and the operation device 60 is inserted into the overtube, and the distal end portion of the insertion portion 52 and the anchoring grasping device 10A are inserted into the organ B. insert. Then, after the distal end portion of the insertion portion 52 is brought close to the lesioned portion X, the anchored gripping device 10 A and the operation device 60 are moved forward and separated from the endoscope 50. Further, when the storage tube member 38 is moved relative to the insertion tube 61 together with the restriction tube 63 by operating the insertion coil 62 and the operation wire 69, the gripping member 18 and the storage tube member 38 are moved along with this operation. Since they move forward together, the tip of the gripping member 18 (the gripping claw 26) comes into contact with the rear end surface of the protrusion 12 of the magnetic anchor 11. When the storage cylinder member 38 is moved further forward, the magnetic anchor 11 fitted to the distal end portion of the insertion tube 61 is pushed forward (disengaged from the insertion tube 61) by the gripping member 18 (gripping claw 26), and The storage cylinder member 38 projects forward of the insertion tube 61 (see FIG. 16).

次いで、上記保持解除荷重以上の力で操作ワイヤ６９を基端側に引っ張ると、牽引分離部材２８及び把持部材１８が収納筒部材３８に対して後方に相対移動するので、図８に示すように把持部材１８の一対の開閉片１９が全開状態になる。
次いで、挿入コイル６２、規制管６３及び操作ワイヤ６９を一体的に前方に移動させることにより全開状態となった把持部材１８を病変部Ｘ側に近づけて、把持部材１８の把持爪２６が所望の位置に来たところで、操作ワイヤ６９を挿入コイル６２及び規制管６３に対して相対的に後方に移動させる。すると、図９及び図１７に示すように把持部材１８が全閉状態となるので、把持部材１８の一対の把持爪２６が病変部Ｘを把持する（図１７参照）。
この状態で、操作ワイヤ６９を上記保持解除荷重より大きい所定の分離荷重以上の強い力で後方に引くと、牽引分離部材２８の接続片３３と接続片３４を接合しているレーザ溶接、スポット溶接または接着剤が破断し、かつ接続片３３及び接続片３４が塑性変形するので、図１８に示すように接続片３３と接続片３４が分離する。そのため、接続片３３と接続片３４の間に形成された隙間から把持部材１８が前方に脱出し、磁気アンカー１１、連結ひも１５、把持部材１８及び収納筒部材３８が操作装置６０から完全に分離する（図１９参照）。 Next, when the operation wire 69 is pulled toward the proximal end with a force equal to or greater than the holding release load, the traction separation member 28 and the gripping member 18 move rearward relative to the storage cylinder member 38, so as shown in FIG. The pair of opening / closing pieces 19 of the gripping member 18 are fully opened.
Next, the gripping member 18 that has been fully opened by moving the insertion coil 62, the restriction tube 63, and the operation wire 69 together is moved closer to the lesioned part X side, and the gripping claw 26 of the gripping member 18 has a desired gripping claw 26. When the position is reached, the operation wire 69 is moved backward relative to the insertion coil 62 and the restriction tube 63. Then, as shown in FIGS. 9 and 17, since the gripping member 18 is fully closed, the pair of gripping claws 26 of the gripping member 18 grips the lesion X (see FIG. 17).
In this state, when the operation wire 69 is pulled backward with a strong force equal to or greater than a predetermined separation load larger than the holding release load, laser welding or spot welding for joining the connection piece 33 and the connection piece 34 of the traction separation member 28 is performed. Alternatively, since the adhesive breaks and the connecting piece 33 and the connecting piece 34 are plastically deformed, the connecting piece 33 and the connecting piece 34 are separated as shown in FIG. Therefore, the gripping member 18 escapes forward from the gap formed between the connection piece 33 and the connection piece 34, and the magnetic anchor 11, the connecting string 15, the gripping member 18, and the storage cylinder member 38 are completely separated from the operation device 60. (See FIG. 19).

続いて、磁気誘導部材７６の発生磁界を強めることによって、磁気アンカー１１を磁気誘導部材７６の発生磁界（磁力）によって図２０の上側に吸引すると、連結ひも１５全体が緊張して把持部材１８が磁力方向（図２０の上方）に移動し、把持部材１８に掴まれている病変部Ｘも同方向に十分な距離だけ確実に引っ張られる。
このように、病変部Ｘを所望方向に所望距離だけ引っ張ると、病変部Ｘと正常組織との境界部に、十分な大きさの切除部分が形成されるので、挿入管６１、挿入コイル６２、及び操作ワイヤ６９を内視鏡５０の処置具挿通路５６から取り出し、処置具挿通路５６を利用して高周波メス８０などの切開具を臓器Ｂ内に挿入し、高周波メス８０の先端部８１で病変部Ｘを粘膜とともに切除する（図示略）。 Subsequently, by strengthening the magnetic field generated by the magnetic induction member 76, when the magnetic anchor 11 is attracted to the upper side of FIG. 20 by the magnetic field (magnetic force) generated by the magnetic induction member 76, the entire connecting string 15 is tensioned and the gripping member 18 is moved. The lesioned part X that moves in the direction of magnetic force (upward in FIG. 20) and is gripped by the gripping member 18 is also reliably pulled by a sufficient distance in the same direction.
Thus, when the lesioned part X is pulled in a desired direction by a desired distance, a sufficiently large excision part is formed at the boundary between the lesioned part X and the normal tissue, so that the insertion tube 61, the insertion coil 62, Then, the operation wire 69 is taken out from the treatment instrument insertion path 56 of the endoscope 50, and an incision instrument such as a high frequency knife 80 is inserted into the organ B using the treatment instrument insertion path 56, and the distal end portion 81 of the high frequency knife 80 is used. The lesion X is excised together with the mucous membrane (not shown).

以上のようにして病変部Ｘの切除作業を終えると、正常組織から切り離された病変部Ｘは把持部材１８に把持されたままの状態となるので、病変部Ｘが紛失することが防止される。切除した病変部Ｘを回収するには、内視鏡５０の処置具挿通路５６に図示を省略した把持鉗子を挿入し、この把持鉗子によりアンカー付把持装置１０Ａ（例えば連結ひも１５）を把持し、そのままの状態で内視鏡５０を体内から抜き去り、病変部Ｘをアンカー付把持装置１０Ａとともに体外に取り出す。そしてその後に、切除した部分の縫合、消毒などの処置を行う。 When the excision work of the lesioned part X is completed as described above, the lesioned part X separated from the normal tissue remains in the state of being gripped by the gripping member 18, so that the lesioned part X is prevented from being lost. . In order to collect the excised lesion X, a grasping forceps (not shown) is inserted into the treatment instrument insertion path 56 of the endoscope 50, and the grasping device 10A with anchor (for example, the connecting string 15) is grasped by the grasping forceps. In this state, the endoscope 50 is removed from the body, and the lesioned part X is taken out of the body together with the anchored grasping device 10A. After that, treatments such as suturing and disinfection of the excised part are performed.

以上説明したように、本実施形態の牽引分離部材２８は弾性変形可能であるものの外力が掛からないときは形状を保持し、しかも収納筒部材３８に対して相対移動しない。しかも、ループ部３０は中間広幅部３１に比べて狭幅なので広幅の場合に比べてフック部材６８を掛け易いので、術者はフック部材６８を牽引分離部材２８のループ部３０に簡単に引っ掛けることができる。
また、牽引分離部材２８の接続片３３と接続片３４を単に接触させるのではなく、レーザ溶接、スポット溶接または接着剤によって接合しているので、牽引分離部材２８に上記分離荷重以上の荷重が掛かる前に接続片３３と接続片３４が不意に分離してしまうのを確実に防止できる。
さらに、操作ワイヤ６９を所定の大きさ以上の力で引くだけで磁気アンカー１１、連結ひも１５、把持部材１８及び収納筒部材３８を操作装置６０から確実に分離できる。特に、接続片３３と接続片３４を中間広幅部３１より狭幅で機械的強度が弱い部分としているので、牽引分離部材２８に上記分離荷重以上の荷重が掛かると接続片３３と接続片３４が大きく塑性変形して接続片３３と接続片３４の間には大きな隙間が形成されるので、把持部材１８は牽引分離部材２８から確実に脱出できる。
従って、術者はアンカー付把持装置１０Ａ、内視鏡５０、操作装置６０及び磁気アンカー誘導装置７０を用いた内視鏡術を円滑に行うことが可能である。 As described above, the pulling / separating member 28 of the present embodiment can be elastically deformed, but retains its shape when no external force is applied, and does not move relative to the storage cylinder member 38. In addition, since the loop portion 30 is narrower than the intermediate wide portion 31, the hook member 68 can be easily hung compared to the wide case, so that the operator can easily hook the hook member 68 on the loop portion 30 of the traction separating member 28. Can do.
Further, since the connecting piece 33 and the connecting piece 34 of the traction separating member 28 are not simply brought into contact with each other, but are joined by laser welding, spot welding or an adhesive, a load greater than the separation load is applied to the traction separating member 28. It is possible to reliably prevent the connection piece 33 and the connection piece 34 from being unexpectedly separated before.
Furthermore, the magnetic anchor 11, the connecting cord 15, the gripping member 18, and the storage cylinder member 38 can be reliably separated from the operating device 60 simply by pulling the operation wire 69 with a force of a predetermined size or more. In particular, since the connecting piece 33 and the connecting piece 34 are narrower than the intermediate wide portion 31 and have a weak mechanical strength, the connecting piece 33 and the connecting piece 34 are connected to each other when the traction separation member 28 is subjected to a load greater than the separation load. A large gap is formed between the connecting piece 33 and the connecting piece 34 due to the great plastic deformation, so that the gripping member 18 can reliably escape from the traction separating member 28.
Therefore, the surgeon can smoothly perform endoscopy using the anchored gripping device 10A, the endoscope 50, the operation device 60, and the magnetic anchor guiding device 70.

次に、本発明の第２の実施形態について、図２１から図２７を参照しながら説明する。
なお、第１の実施形態と同じ部材には同じ符号を付すに止めて、その詳細な説明は省略する。
本実施形態のアンカー付把持装置１０Ｂの牽引分離部材９０は金属製であり、厚肉部９１と薄肉部９５の二部材から構成してある。
厚肉部９１は、牽引分離部材２８のループ部３０と略同じ形状であるループ部９２と、中間広幅部３１に相当する一対の中間広幅部９３とを備えている。一方、薄肉部９５は、先端部３２に相当する一対の先端部９６と、一対の先端部９６の先端同士を接続する接続部９７とからなるものであり、図２３に示すように接続部９７には三角形状をなす一対の切欠９８が設けてある。一対の先端部９６は、対応する厚肉部９１の外側面にそれぞれ溶接（例えばスポット溶接）してある。図２１から明らかなように、薄肉部９５は厚肉部９１よりも薄肉であり、その機械的強度は厚肉部９１より小さい。
把持部材１８と牽引分離部材９０を接続するには、まず把持部材１８の先端把持部２２の幅方向と先端部９６の長手方向が一致するように牽引分離部材９０に対する把持部材１８の向きを調整した後に、一方の開閉片１９を一対の先端部９６の間に挿入し、一対の基端部２０の連結部が一対の先端部９６の間に位置した後に牽引分離部材９０に対する把持部材１８の向きを変えて、図２４、図２６及び図２７に示すように平面視で把持部材１８と牽引分離部材９０を同一直線上に位置させる。さらに、互いに離間した状態にある一対の先端部９６の中間部を互いに近づく方向に塑性変形させることにより、当該部分を互いに接触するくびれ部９９とする（図２６参照）。
このようにして一体化した把持部材１８と牽引分離部材９０は第１の実施形態と同じ手順により収納筒部材３８に収納する。すると牽引分離部材９０の一対の傾斜当接部２９が収納筒部材３８の小径部４０側の開口部に接触し、把持部材１８の一対の第１傾斜部２４が収納筒部材３８のテーパ面４１に接触し、さらに図２５に示すように一対の中間広幅部９３が内部孔４３に接触するので、収納筒部材３８に対して把持部材１８及び牽引分離部材９０が図２４に示す位置に保持される。 Next, a second embodiment of the present invention will be described with reference to FIGS.
The same members as those in the first embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
The pulling / separating member 90 of the anchoring gripping apparatus 10 B according to the present embodiment is made of metal, and is composed of two members, a thick portion 91 and a thin portion 95.
The thick portion 91 includes a loop portion 92 having substantially the same shape as the loop portion 30 of the traction separating member 28 and a pair of intermediate wide portions 93 corresponding to the intermediate wide portion 31. On the other hand, the thin-walled portion 95 includes a pair of tip portions 96 corresponding to the tip portion 32 and a connection portion 97 that connects the tips of the pair of tip portions 96, and as shown in FIG. Is provided with a pair of notches 98 having a triangular shape. A pair of front-end | tip parts 96 are welded to the outer surface of the corresponding thick part 91, respectively (for example, spot welding). As is clear from FIG. 21, the thin portion 95 is thinner than the thick portion 91, and its mechanical strength is smaller than that of the thick portion 91.
To connect the gripping member 18 and the traction separation member 90, first, the orientation of the gripping member 18 with respect to the traction separation member 90 is adjusted so that the width direction of the tip gripping portion 22 of the gripping member 18 and the longitudinal direction of the tip portion 96 coincide. After that, one opening / closing piece 19 is inserted between the pair of distal end portions 96, and after the connecting portion of the pair of proximal end portions 20 is positioned between the pair of distal end portions 96, The direction is changed, and the gripping member 18 and the traction separating member 90 are positioned on the same straight line in a plan view as shown in FIGS. Further, the intermediate portions of the pair of tip portions 96 that are separated from each other are plastically deformed in a direction approaching each other, thereby forming the constricted portions 99 that contact each other (see FIG. 26).
The gripping member 18 and the pulling / separating member 90 integrated in this way are housed in the housing cylinder member 38 by the same procedure as in the first embodiment. Then, the pair of inclined contact portions 29 of the traction separating member 90 comes into contact with the opening on the small diameter portion 40 side of the storage cylinder member 38, and the pair of first inclination portions 24 of the gripping member 18 is the tapered surface 41 of the storage cylinder member 38. Further, as shown in FIG. 25, the pair of intermediate wide portions 93 come into contact with the inner hole 43, so that the gripping member 18 and the traction separating member 90 are held at the positions shown in FIG. The

アンカー付把持装置１０Ｂは図２６に示すように、第１の実施形態とほぼ同じ要領により内視鏡５０の挿入部５２に装着される。さらに、図２７に示すように、把持部材１８が病変部Ｘを把持した状態で操作ワイヤ６９を後方に引くと牽引分離部材９０の接続部９７、特に２つの切欠９８の間に位置する幅が狭くなっている部分（脆弱部）に応力が集中する。そのため、操作ワイヤ６９に掛かった荷重が所定の分離荷重以上となったときに接続部９７の上記脆弱部が破断する。そのため、破断により出来た隙間から把持部材１８の一対の基端部２０の連結部が前方に脱出し、磁気アンカー１１、連結ひも１５、把持部材１８及び収納筒部材３８が操作装置６０から完全に分離する。
このように本実施形態では、牽引分離部材９０の先端部を溶接等により固定する必要がないので、把持部材１８と牽引分離部材９０の接続作業が容易である。
しかも、薄肉部９５は厚肉部９１よりも機械的強度が弱いため、牽引分離部材９０に分離荷重以上の荷重が掛かったときには、破断により分離した２つの接続部９７は大きく変形する。そのため、分離した２つの接続部９７の間に大きな隙間が形成されるため、把持部材１８は牽引分離部材９０から確実に脱出できる。 As shown in FIG. 26, the anchored gripping device 10B is attached to the insertion portion 52 of the endoscope 50 in substantially the same manner as in the first embodiment. Further, as shown in FIG. 27, when the operation wire 69 is pulled backward with the gripping member 18 gripping the lesioned part X, the width located between the connection part 97 of the traction separating member 90, particularly between the two notches 98, is increased. Stress concentrates on the narrow part (fragile part). For this reason, when the load applied to the operation wire 69 exceeds a predetermined separation load, the fragile portion of the connection portion 97 is broken. Therefore, the connecting portion of the pair of base end portions 20 of the gripping member 18 escapes forward from the gap created by the breakage, and the magnetic anchor 11, the connecting string 15, the gripping member 18, and the storage cylinder member 38 are completely removed from the operating device 60. To separate.
Thus, in this embodiment, since it is not necessary to fix the front-end | tip part of the traction separation member 90 by welding etc., the connection operation | work of the holding member 18 and the traction separation member 90 is easy.
Moreover, since the thin-walled portion 95 has a mechanical strength weaker than that of the thick-walled portion 91, the two connecting portions 97 separated by breakage are greatly deformed when a load greater than the separation load is applied to the traction separation member 90. Therefore, a large gap is formed between the two separated connection portions 97, so that the gripping member 18 can reliably escape from the traction separation member 90.

次に、本発明の第３の実施形態について、図２８から図３０を参照しながら説明する。
なお、従前の実施形態と同じ部材には同じ符号を付すに止めて、その詳細な説明は省略する。
本実施形態のアンカー付把持装置１０Ｃの牽引分離部材１００は金属製であり、その基本構造は第１の実施形態の牽引分離部材２８と同じである。しかし、一方の中間広幅部３１に相当する部分を、ループ部３０と先端部３２にそれぞれ連なる一対の中間広幅部１０１と、一対の中間広幅部１０１を接続する中間狭幅部１０２とから形成した点が異なる。中間狭幅部１０２はループ部３０及び先端部３２と同幅であり、かつその中間部には側方に向かって突出する係止突起１０３が形成してある。図示するように、収納筒部材３８におけるスリット４２と反対側の側面には側面視方形の係止孔１０４が穿設してある。
牽引分離部材１００を収納筒部材３８に収納すると、係止突起１０３が係止孔１０４に嵌合し、係止突起１０３の前後一対の傾斜面が係止孔１０４の前後の縁部に接触する。これによって、収納筒部材３８に対する牽引分離部材１００の回転を規制できる。さらに、一対の傾斜当接部２９が収納筒部材３８の小径部４０側の開口部に接触し、かつ図３０に示すように中間広幅部３１及び中間広幅部１０１が内部孔４３に接触する。そのため、牽引分離部材１００に所定の保持解除荷重以上の荷重が掛からない場合は、収納筒部材３８に対して牽引分離部材１００（及び把持部材１８）を図２８及び図２９の位置に確実に保持できる。その他の作用効果は従前の実施形態と同様である。
なお、係止孔１０４の形状は方形でなくともよく、例えば図３１に示すように円形として実施することも可能である。また、係止孔１０４の代わりに有底の係止凹部を形成してもよい。 Next, a third embodiment of the present invention will be described with reference to FIGS.
It should be noted that the same members as those of the previous embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
The pulling / separating member 100 of the anchoring gripping apparatus 10C of this embodiment is made of metal, and the basic structure thereof is the same as that of the pulling / separating member 28 of the first embodiment. However, a portion corresponding to one intermediate wide portion 31 is formed by a pair of intermediate wide portions 101 that are respectively connected to the loop portion 30 and the tip portion 32, and an intermediate narrow portion 102 that connects the pair of intermediate wide portions 101. The point is different. The intermediate narrow portion 102 has the same width as the loop portion 30 and the tip portion 32, and a locking projection 103 that protrudes sideways is formed in the intermediate portion. As shown in the drawing, a locking hole 104 having a square shape in side view is formed on the side surface of the storage cylinder member 38 opposite to the slit 42.
When the pulling separation member 100 is stored in the storage cylinder member 38, the locking protrusion 103 is fitted into the locking hole 104, and the pair of front and rear inclined surfaces of the locking protrusion 103 contacts the front and rear edges of the locking hole 104. . Thereby, rotation of the traction separation member 100 with respect to the storage cylinder member 38 can be restricted. Further, the pair of inclined contact portions 29 are in contact with the opening on the small diameter portion 40 side of the storage cylinder member 38, and the intermediate wide portion 31 and the intermediate wide portion 101 are in contact with the inner hole 43 as shown in FIG. Therefore, when the load beyond the predetermined holding release load is not applied to the traction separation member 100, the traction separation member 100 (and the gripping member 18) is securely held at the position shown in FIGS. it can. Other functions and effects are the same as in the previous embodiment.
Note that the shape of the locking hole 104 does not have to be square, and for example, as shown in FIG. Further, instead of the locking hole 104, a bottomed locking recess may be formed.

最後に、本発明の第４の実施形態について、図３２から図３４を参照しながら説明する。
なお、従前の実施形態と同じ部材には同じ符号を付すに止めて、その詳細な説明は省略する。
本実施形態のアンカー付把持装置１０Ｄの牽引分離部材１１０は金属製であり、第３の実施形態の牽引分離部材１００に類似した形状である。即ち、本実施形態の牽引分離部材１１０は一対の中間広幅部１０１と中間狭幅部１０２からなる中間部を一対具備している。さらに、収納筒部材３８には一対の係止孔１０４が穿設してある（一方の係止孔１０４はスリット４２と同じ位置に形成してある）。
そのため牽引分離部材１１０を収納筒部材３８に収納すると、一対の係止突起１０３が対応する係止孔１０４にそれぞれ嵌合し、各係止突起１０３の前後一対の傾斜面が対応する係止孔１０４の前後の縁部に接触する。さらに、図３４に示すように各中間広幅部１０１が内部孔４３に接触する。そのため、牽引分離部材１００に所定の保持解除荷重以上の荷重が掛からない場合は、収納筒部材３８に対して牽引分離部材１１０（及び把持部材１８）を図３２及び図３３の位置に保持できる。その他の作用効果は従前の実施形態と同様である。
なお、第３の実施形態と同様に係止孔１０４の形状は方形でなくともよく、また有底の係止凹部として実施してもよい。 Finally, a fourth embodiment of the present invention will be described with reference to FIGS.
It should be noted that the same members as those of the previous embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
The pulling / separating member 110 of the holding device with anchor 10D of the present embodiment is made of metal and has a shape similar to that of the pulling / separating member 100 of the third embodiment. That is, the traction separation member 110 of the present embodiment includes a pair of intermediate portions including a pair of intermediate wide portions 101 and intermediate narrow portions 102. Further, a pair of locking holes 104 are formed in the storage cylinder member 38 (one locking hole 104 is formed at the same position as the slit 42).
Therefore, when the traction separation member 110 is stored in the storage cylinder member 38, the pair of locking projections 103 are fitted into the corresponding locking holes 104, and the pair of front and rear inclined surfaces of the locking projections 103 correspond to the corresponding locking holes. Contact the front and rear edges of 104. Further, as shown in FIG. 34, each intermediate wide portion 101 contacts the inner hole 43. Therefore, when a load equal to or greater than a predetermined holding release load is not applied to the traction separation member 100, the traction separation member 110 (and the gripping member 18) can be held at the position shown in FIGS. Other functions and effects are the same as in the previous embodiment.
Note that, as in the third embodiment, the shape of the locking hole 104 may not be rectangular, and may be implemented as a bottomed locking recess.

以上、本発明について上記各実施形態を利用して説明したが、本発明は様々な変更を施しながら実施可能である。
例えば、牽引分離部材２８、９０、１００、１１０を弾性材料である樹脂により成形してもよい。
また、牽引分離部材２８、１００、１１０の２つのくびれ部３５や牽引分離部材９０の２つのくびれ部９９を、スポット溶接等によって互いに固定してもよい。
さらに、牽引分離部材２８、１００、１１０の弾性力が大きい場合は、接続片３３と接続片３４（接続片３６）をレーザ溶接、スポット溶接、接着剤等により固定しなくてもよい。このように構成すると、分離荷重以上の荷重が掛からないとき、接続片３３と接続片３４（接続片３６）は牽引分離部材２８、１００、１１０の弾性力によって互いに接触した状態に保持される。 As mentioned above, although this invention was demonstrated using said each embodiment, this invention can be implemented, giving various changes.
For example, the traction separation members 28, 90, 100, and 110 may be formed of a resin that is an elastic material.
Further, the two constricted portions 35 of the traction separating members 28, 100, and 110 and the two constricted portions 99 of the traction separating member 90 may be fixed to each other by spot welding or the like.
Furthermore, when the elastic force of the traction separation members 28, 100, and 110 is large, the connection piece 33 and the connection piece 34 (connection piece 36) may not be fixed by laser welding, spot welding, an adhesive, or the like. If comprised in this way, when the load more than a separation load is not applied, the connection piece 33 and the connection piece 34 (connection piece 36) are hold | maintained in the state mutually contacted by the elastic force of the traction separation members 28,100,110.

本発明の一実施形態のアンカー付把持装置の縦断面図である。It is a longitudinal cross-sectional view of the holding apparatus with an anchor of one Embodiment of this invention. くびれ部を形成する前の牽引分離部材の平面図である。It is a top view of the traction separation member before forming a constriction part. くびれ部を形成する前の牽引分離部材の側面図である。It is a side view of the traction separation member before forming a constriction part. 牽引分離部材の正面図である。It is a front view of a traction separation member. 変形例の牽引分離部材の正面図である。It is a front view of the traction separation member of a modification. 磁気アンカーを省略して示す図１のVI−VI矢線に沿う断面図である。It is sectional drawing which follows the VI-VI arrow line of FIG. 1 which abbreviate | omits and shows a magnetic anchor. 図６のVII−VII矢線に沿う断面図である。It is sectional drawing which follows the VII-VII arrow line of FIG. 把持部材が全開状態にあるときの図６と同様の断面図である。It is sectional drawing similar to FIG. 6 when a holding member exists in a full open state. 把持部材が全閉状態になったときの図６と同様の断面図である。It is sectional drawing similar to FIG. 6 when a holding member will be in a fully closed state. 内視鏡の全体図である。1 is an overall view of an endoscope. 挿入部の先端から、挿入管、挿入コイル、及びフック部材が突出した状態を示す、内視鏡先端部の拡大縦断側面図である。It is an expansion vertical side view of the endoscope front-end | tip part which shows the state which the insertion tube, the insertion coil, and the hook member protruded from the front-end | tip of an insertion part. 磁気アンカー誘導装置を患者の頭部側から見た図である。It is the figure which looked at the magnetic anchor guidance device from the patient's head side. 磁気アンカー誘導装置の側面図である。It is a side view of a magnetic anchor guidance device. アンカー付把持装置を操作装置に接続した状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which connected the holding apparatus with an anchor to the operating device. アンカー付把持装置の内視鏡の挿入部への装着が完了したときの挿入部、アンカー付把持装置及び操作装置の拡大縦断側面図である。It is an enlarged vertical side view of the insertion portion, the anchoring gripping device, and the operating device when the attachment of the gripping device with anchor to the insertion portion of the endoscope is completed. 臓器内において、把持部材及び磁気アンカーを挿入管から外部に押し出し、かつ把持部材を開いた状態を示す、挿入部、アンカー付把持装置及び操作装置の拡大縦断側面図である。FIG. 4 is an enlarged longitudinal side view of the insertion portion, the anchored gripping device, and the operating device showing a state in which the gripping member and the magnetic anchor are pushed out from the insertion tube and opened in the organ. 把持部材が患部を把持したときの挿入部、アンカー付把持装置及び操作装置の拡大縦断側面図である。It is an enlarged vertical side view of an insertion part, an anchored gripping device, and an operating device when a gripping member grips an affected part. 牽引分離部材の接続片が分離したときの挿入部、アンカー付把持装置及び操作装置の拡大縦断側面図である。It is an expansion vertical side view of an insertion part, a holding device with an anchor, and an operating device when a connecting piece of a pulling separation member separates. アンカー付把持装置が内視鏡から完全に切り離されたときの挿入部、アンカー付把持装置及び操作装置の拡大縦断側面図である。It is an enlarged vertical side view of the insertion portion, the anchoring gripping device, and the operating device when the anchoring gripping device is completely separated from the endoscope. 把持部材が病変部を把持した状態で磁気アンカー誘導装置を用いて病変部を移動させている状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which has moved the lesioned part using the magnetic anchor guidance apparatus in the state where the holding member was holding the lesioned part. 第２の実施形態の牽引分離部材のくびれ部を変形させる前の平面図である。It is a top view before changing the constriction part of the traction separation member of a 2nd embodiment. くびれ部を変形させる前の牽引分離部材の側面図である。It is a side view of the traction separation member before changing a constriction part. 牽引分離部材の正面図である。It is a front view of a traction separation member. 把持部材、牽引分離部材及び収納筒部材の図６と同様の断面図である。It is sectional drawing similar to FIG. 6 of a holding member, a traction separation member, and a storage cylinder member. 図２４のXXV−XXV矢線に沿う断面図である。It is sectional drawing which follows the XXV-XXV arrow line of FIG. 図１５と同様の拡大縦断側面図である。It is an enlarged vertical side view similar to FIG. 図１８と同様の拡大縦断側面図である。It is an enlarged vertical side view similar to FIG. 第３の実施形態のアンカー付把持装置の図１と同様の縦断面図である。It is the longitudinal cross-sectional view similar to FIG. 1 of the holding apparatus with an anchor of 3rd Embodiment. 図２８のXXIX−XXIX矢線に沿う断面図である。It is sectional drawing which follows the XXIX-XXIX arrow line of FIG. 図２９のXXX−XXX矢線に沿う断面図である。It is sectional drawing which follows the XXX-XXX arrow line of FIG. 第３の実施形態の変形例のアンカー付把持装置の図２９と同様の断面図である。It is sectional drawing similar to FIG. 29 of the holding apparatus with an anchor of the modification of 3rd Embodiment. 第４の実施形態のアンカー付把持装置の図１と同様の縦断面図である。It is the longitudinal cross-sectional view similar to FIG. 1 of the holding apparatus with an anchor of 4th Embodiment. 図３２のXXXIII−XXXIII矢線に沿う断面図である。It is sectional drawing which follows the XXXIII-XXXIII arrow line of FIG. 図３３のXXXIV−XXXIV矢線に沿う断面図である。It is sectional drawing which follows the XXXIV-XXXIV arrow line of FIG.

符号の説明Explanation of symbols

１０Ａ１０Ｂ１０Ｃ１０Ｄアンカー付把持装置
１１磁気アンカー
１２突部
１３固定部
１５連結ひも（連結部材）
１８把持部材
１９開閉片
２０基端部
２１中間部
２２先端把持部
２４第１傾斜部（第１接触部）（保持部）
２５第２傾斜部
２６把持爪
２８牽引分離部材
２９傾斜当接部（第２接触部）（保持部）
３０ループ部
３１中間広幅部
３２先端部
３３３４接続片（接続部）
３５くびれ部
３６接続片（接続部）
３８収納筒部材
３９大径部
４０小径部
４１テーパ面
４２スリット
４３内部孔
５０内視鏡
５１操作部
５２挿入部
５３ユニバーサルチューブ
５４コネクタ部
５５先端面
５６処置具挿通路
５７出口開口
５８処置具挿通用突部
６０操作装置
６１挿入管
６２挿入コイル
６３規制管
６４大径部
６５小径部
６６環状段部
６８フック部材
６９操作ワイヤ（牽引部材）
７０磁気アンカー誘導装置
７１ベッド
７２ＸＹステージ
７３フレーム／レール（一平面内動機構）
７４７５レール
７６磁気誘導部材（磁力発生装置）
７７電磁石
７８基体
７９カウンターウェイト
８０高周波メス
８１先端部
９０牽引分離部材
９１厚肉部
９２ループ部
９３中間広幅部
９５薄肉部
９６先端部
９７接続部
９８切欠
９９くびれ部
１００牽引分離部材
１０１中間広幅部
１０２中間狭幅部
１０３係止突起（保持部）
１０４係止孔
１１０牽引分離部材
Ａ患者（対象物）
Ａ１頭部
Ｂ臓器
Ｂ１粘膜下層
Ｂ２固有筋層
Ｘ病変部（対象部位） 10A 10B 10C 10D Holding device 11 with anchor 11 Magnetic anchor 12 Protruding portion 13 Fixing portion 15 Connection string (connection member)
18 Grasping member 19 Opening / closing piece 20 Base end portion 21 Intermediate portion 22 Tip gripping portion 24 First inclined portion (first contact portion) (holding portion)
25 2nd inclination part 26 grasping claw 28 traction separation member 29 inclination contact part (2nd contact part) (holding part)
30 loop part 31 middle wide part 32 tip part 33 34 connection piece (connection part)
35 Constriction part 36 Connection piece (connection part)
38 Storage cylinder member 39 Large diameter part 40 Small diameter part 41 Tapered surface 42 Slit 43 Internal hole 50 Endoscope 51 Operation part 52 Insertion part 53 Universal tube 54 Connector part 55 End face 56 Treatment instrument insertion path 57 Exit opening 58 Treatment instrument insertion Common protrusion 60 Operation device 61 Insertion tube 62 Insertion coil 63 Restriction tube 64 Large diameter portion 65 Small diameter portion 66 Annular step portion 68 Hook member 69 Operation wire (traction member)
70 Magnetic Anchor Guidance Device 71 Bed 72 XY Stage 73 Frame / Rail (One-plane In-plane Movement Mechanism)
74 75 rail 76 magnetic induction member (magnetic force generator)
77 Electromagnet 78 Base 79 Counterweight 80 High-frequency knife 81 Tip 90 Pulling separation member 91 Thick part 92 Loop part 93 Middle wide part 95 Thin part 96 Tip 97 Connection part 98 Notch 99 Constriction part 100 Traction separation member 101 Middle wide part 102 Middle narrow width portion 103 Locking protrusion (holding portion)
104 Locking hole 110 Traction separation member A Patient (object)
A1 head B organ B1 submucosa B2 proper muscle layer X lesion (target site)

Claims

開閉可能であり、閉じたときに対象物内部の対象部位を把持する把持部材と、
該把持部材に柔軟な連結部材を介して連結した、上記対象物外部に配設した磁力発生装置が発生する磁力に吸引される磁気アンカーと、
牽引部材の先端部に固定したフック部材に接続し、かつ上記把持部材に接続する接続部を備える、外力が掛からないときは形状を保持する弾性材料からなる牽引分離部材と、
上記把持部材及び牽引分離部材の一部を内部に収納する収納筒部材と、
を備え、
上記牽引分離部材が、上記牽引部材から所定の保持解除荷重以上の荷重を受けないときは、上記収納筒部材に接触することにより該牽引分離部材が上記収納筒部材に対して該収納筒部材の軸線方向に相対移動するのを規制し、かつ、該保持解除荷重以上の荷重を受けたときは、該牽引分離部材が上記軸線方向に相対移動するのを許容する保持部を備え、
上記牽引分離部材の上記接続部は、上記牽引部材に上記保持解除荷重より大きい所定の分離荷重以上の荷重が掛かったときに、上記把持部材との接続を解除することを特徴とする内視鏡用アンカー付把持装置。 A gripping member that is openable and closable and grips a target part inside the target when closed;
A magnetic anchor that is connected to the gripping member via a flexible connecting member and is attracted by a magnetic force generated by a magnetic force generating device disposed outside the object;
A traction separating member made of an elastic material that is connected to a hook member fixed to the tip end portion of the traction member and has a connection portion connected to the gripping member, and that retains its shape when no external force is applied;
A storage cylinder member for storing a part of the gripping member and the pulling separation member inside;
With
When the traction separation member does not receive a load greater than a predetermined holding release load from the traction member, the traction separation member comes into contact with the storage cylinder member so that the traction separation member is in contact with the storage cylinder member. A holding portion that restricts relative movement in the axial direction and that allows the traction separating member to move in the axial direction when receiving a load that is greater than the holding release load;
The endoscope, wherein the connecting portion of the traction separating member releases the connection with the gripping member when a load greater than a predetermined separation load larger than the holding release load is applied to the traction member. Gripping device with anchor.

請求項１記載の内視鏡用アンカー付把持装置において、
上記接続部が、互いに接離可能で、上記牽引部材に上記分離荷重以上の荷重が掛からないときは互いに接触することにより上記把持部材が上記牽引分離部材から分離するのを規制し、かつ、上記牽引部材に上記分離荷重以上の荷重が掛かったときは互いに離間して、上記把持部材が上記牽引分離部材から分離するのを許容する一対の接続片からなる内視鏡用アンカー付把持装置。 The grasping device with an anchor for an endoscope according to claim 1,
When the connecting portions are separable from each other and the traction member is not subjected to a load greater than the separation load, the gripping members are prevented from separating from the traction separation member by contacting each other, and A gripping device with an anchor for an endoscope comprising a pair of connection pieces that are separated from each other when the pulling member is subjected to a load equal to or greater than the separation load and allows the gripping member to be separated from the pulling separation member.

請求項２記載の内視鏡用アンカー付把持装置において、
上記牽引分離部材が金属製または樹脂製であり、
上記一対の接続片どうしを、上記牽引部材に上記分離荷重以上の荷重が掛かったときに破断するレーザ溶接、スポット溶接または接着剤により結合した内視鏡用アンカー付把持装置。 In the grasping apparatus with an anchor for endoscopes according to claim 2,
The traction separation member is made of metal or resin,
A gripping device with an anchor for an endoscope in which the pair of connection pieces are joined by laser welding, spot welding or an adhesive that breaks when the pulling member is loaded with a load greater than the separation load.

請求項１記載の内視鏡用アンカー付把持装置において、
上記牽引分離部材が金属製または樹脂製であり、
上記接続部に、周辺部に比べて機械的強度が弱い脆弱部を形成した内視鏡用アンカー付把持装置。 The grasping device with an anchor for an endoscope according to claim 1,
The traction separation member is made of metal or resin,
A gripping device with an anchor for an endoscope, in which a weakened portion having a weaker mechanical strength than a peripheral portion is formed in the connecting portion.

請求項１から４のいずれか１項記載の内視鏡用アンカー付把持装置において、
上記保持部が、
上記収納筒部材の長手方向の一方の端面に当接する第１接触部と、
上記収納筒部材の長手方向の他方の端面に当接する第２接触部と、を具備する内視鏡用アンカー付把持装置。 In the grasping apparatus with an anchor for endoscopes according to any one of claims 1 to 4,
The holding part is
A first contact portion in contact with one end face in the longitudinal direction of the storage cylinder member ;
A grasping device with an anchor for an endoscope, comprising: a second contact portion that abuts against the other end surface in the longitudinal direction of the storage cylinder member .

請求項５記載の内視鏡用アンカー付把持装置において、
上記収納筒部材に係止孔または係止凹部を形成し、
上記保持部が、上記牽引分離部材に形成した、上記係止孔または係止凹部に係合する係止突起であり、
該係止突起は、上記牽引部材に所定の保持解除荷重以上の荷重が掛からないときは上記係止孔または係止凹部との係合状態を保持し、該保持解除荷重以上の荷重が掛かったときは該係止孔または係止凹部から脱出する内視鏡用アンカー付把持装置。 The endoscope anchoring gripping device according to claim 5,
Forming a locking hole or a locking recess in the storage cylinder member;
The holding portion is a locking protrusion formed on the traction separation member and engaging with the locking hole or the locking recess,
When the load above the predetermined hold release load is not applied to the pulling member, the lock projection holds the engagement state with the lock hole or the lock recess, and the load above the hold release load is applied. Sometimes a gripping device with an anchor for an endoscope that escapes from the locking hole or the locking recess.

請求項１から６のいずれか１項記載の内視鏡用アンカー付把持装置において、
上記牽引分離部材が、
上記接続部を有する薄肉部と、
該薄肉部より肉厚であり、かつ上記牽引部材に接続する厚肉部と、
を備える内視鏡用アンカー付把持装置。 The grasping device with an anchor for an endoscope according to any one of claims 1 to 6,
The traction separation member is
A thin portion having the connecting portion;
A thicker part that is thicker than the thin part and connected to the traction member;
A gripping device with an anchor for an endoscope.

請求項７記載の内視鏡用アンカー付把持装置において、
上記薄肉部と上記厚肉部は、別部材として成形した後に一体化したものである内視鏡用アンカー付把持装置。 The endoscope anchor-holding device according to claim 7,
The gripping device with an anchor for an endoscope, wherein the thin portion and the thick portion are integrated after being molded as separate members.