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JP6930758B2 - Hooks and medical snares - Google Patents

Hooks and medical snares Download PDF

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JP6930758B2
JP6930758B2 JP2019503869A JP2019503869A JP6930758B2 JP 6930758 B2 JP6930758 B2 JP 6930758B2 JP 2019503869 A JP2019503869 A JP 2019503869A JP 2019503869 A JP2019503869 A JP 2019503869A JP 6930758 B2 JP6930758 B2 JP 6930758B2
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篤史 山田
篤史 山田
徹 谷
徹 谷
茂廣 森川
茂廣 森川
仲　成幸
成幸 仲
哲久 新田
哲久 新田
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods
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    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor

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Description

本発明は、引っ掛け具とその引っ掛け具が用いられた医療用スネアに関し、詳しくは、対象物を引っ掛けるループ形成部材のループの大きさや向きを変化させることが可能な引っ掛け具及び医療用スネアに関するものである。 The present invention relates to a hook and a medical snare to which the hook is used, and more particularly to a hook and a medical snare capable of changing the size and direction of a loop of a loop forming member for hooking an object. Is.

体腔内のポリープを切除するためや異物を除去するための医療用スネアとして、例えば特許文献１に記載のものが提案されている。特許文献１に記載のスネアは、内視鏡装置の細長の体腔挿入部に挿通されて使用されるものであり、可撓性を有する筒部材と、筒部材の内孔に挿入される操作ワイヤと、筒部材の内孔に挿入され筒部材の先端から出没させるスネアループとを備えている。スネアループは操作ワイヤの先端に接続されており、操作ワイヤを筒部材の内孔に沿って摺動させることでスネアループが筒部材の先端から出没する。スネアループは、筒部材から突出させるとループ状に膨らんだ状態となり、筒部材の内部に引き込むと、略直線状に窄まった状態となる。 As a medical snare for excising a polyp in a body cavity or removing a foreign substance, for example, the one described in Patent Document 1 has been proposed. The snare described in Patent Document 1 is used by being inserted into an elongated body cavity insertion portion of an endoscope device, and is used by inserting a flexible tubular member and an operation wire inserted into an inner hole of the tubular member. And a snare loop that is inserted into the inner hole of the tubular member and appears and disappears from the tip of the tubular member. The snare loop is connected to the tip of the operation wire, and by sliding the operation wire along the inner hole of the tubular member, the snare loop appears and disappears from the tip of the tubular member. When the snare loop is projected from the tubular member, it expands in a loop shape, and when it is pulled into the tubular member, it becomes a substantially linearly narrowed state.

特許文献１に記載のスネアを用いて体腔内のポリープを除去するには、まず、スネアループを筒部材の内孔に引き込んだ状態とし、筒部材を先端側から内視鏡装置の体腔挿入部に挿通する。そして、内視鏡装置の体腔挿入部を体内に挿入し、内視鏡装置の先端部に設けられた撮像素子による画像を見ながら内視鏡装置の先端部をポリープの近傍まで移動させる。ポリープの近傍への到達後、内視鏡装置の先端部からスネアの筒部材をポリープに向けて伸ばし、筒部材からスネアループを突出させてスネアループを所望の大きさに膨らんだ状態とする。そして、スネアループをポリープに引っ掛けて筒部材に引き込んでポリープを締め付け、最終的にポリープを体組織から切断する。 In order to remove the polyp in the body cavity using the snare described in Patent Document 1, first, the snare loop is pulled into the inner hole of the tubular member, and the tubular member is inserted from the tip side into the body cavity of the endoscope device. Insert into. Then, the body cavity insertion portion of the endoscope device is inserted into the body, and the tip portion of the endoscope device is moved to the vicinity of the polyp while observing an image by an image pickup device provided at the tip portion of the endoscope device. After reaching the vicinity of the polyp, the tubular member of the snare is extended from the tip of the endoscopic device toward the polyp, and the snare loop is projected from the tubular member so that the snare loop is inflated to a desired size. Then, the snare loop is hooked on the polyp and pulled into the tubular member to tighten the polyp, and finally the polyp is cut from the body tissue.

特開２０１１−５０４６号公報Japanese Unexamined Patent Publication No. 2011-5046

特許文献１に記載の医療用スネアにおいては、スネアループが突出する方向は筒部材の長さ方向すなわち内視鏡装置の体腔挿入部の長さ方向であり、他の方向に突出させることはできない。このため、ポリープが例えば撮像素子による画像の右側位置に認められる場合には、内視鏡装置の体腔挿入部の先端部を右側に変位させることでスネアループを右側に向かせる必要がある。一方で、撮像素子は内視鏡装置の体腔挿入部の先端に固定されているので、内視鏡装置の体腔挿入部を右側へ変位させると、撮像素子も右側へ動き、撮像素子の視野が移動してしまうため、スネアループをポリープに引っ掛ける操作が行いにくいという問題があった。 In the medical snare described in Patent Document 1, the direction in which the snare loop protrudes is the length direction of the tubular member, that is, the length direction of the body cavity insertion portion of the endoscopic device, and cannot be projected in any other direction. .. Therefore, when a polyp is recognized, for example, at a position on the right side of an image taken by an image sensor, it is necessary to direct the snare loop to the right side by displacing the tip of the body cavity insertion portion of the endoscope device to the right side. On the other hand, since the image sensor is fixed to the tip of the body cavity insertion part of the endoscope device, when the body cavity insertion part of the endoscope device is displaced to the right, the image sensor also moves to the right and the field of view of the image sensor is expanded. Since it moves, there is a problem that it is difficult to hook the snare loop on the polyp.

また、図１６（Ａ）に示すように、スネアループ１がポリープ２の斜め上方向に位置する場合には、スネアループ１を斜め下方向へ伸ばしてポリープ２の奥側からスネアループ１を引っ掛けると、スネアループ１によりポリープ２を確実に捉え、引き込みやすい。しかし、特許文献１に記載の医療用スネアでは、スネアループ１が内視鏡装置３から突出する方向を変えることができない。このため、スネアループ１を内視鏡装置３及び筒部材４の長さ方向に突出させ（図１６（Ｂ））、スネアループ１の先端に設けられた針を体組織５の壁面に押し付けてスネアループ１の先端を固定し、筒部材４を体組織５側へ撓ませている（図１６（Ｃ））。このようにしてスネアループ１をポリープ２の手前側より引っ掛けるが、この操作では、ポリープ２の手前側からスネアループ１を引っ掛けることになり、スネアループ１を引き込むとポリープ２がスネアループにおさまりにくく、捉えにくかった。また、操作性が悪かった。 Further, as shown in FIG. 16A, when the snare loop 1 is located diagonally upward of the polyp 2, the snare loop 1 is extended diagonally downward and the snare loop 1 is hooked from the back side of the polyp 2. Then, the snare loop 1 reliably catches the polyp 2 and makes it easy to pull in. However, in the medical snare described in Patent Document 1, the direction in which the snare loop 1 protrudes from the endoscope device 3 cannot be changed. Therefore, the snare loop 1 is projected in the length direction of the endoscope device 3 and the tubular member 4 (FIG. 16B), and the needle provided at the tip of the snare loop 1 is pressed against the wall surface of the body tissue 5. The tip of the snare loop 1 is fixed, and the tubular member 4 is bent toward the body tissue 5 (FIG. 16 (C)). In this way, the snare loop 1 is hooked from the front side of the polyp 2, but in this operation, the snare loop 1 is hooked from the front side of the polyp 2, and when the snare loop 1 is pulled in, the polyp 2 is hard to fit in the snare loop. It was hard to catch. In addition, the operability was poor.

本発明は前記問題に鑑みてなされたものであり、ループの形状や向きを容易に変化させることができることで、操作性に優れた引っ掛け具及び医療用スネアを提供することを課題としている。 The present invention has been made in view of the above problems, and it is an object of the present invention to provide a hooking tool and a medical snare having excellent operability by being able to easily change the shape and orientation of the loop.

前記課題を解決するための本発明の引っ掛け具は、貫通する内孔を有する筒部材と、
前記筒部材の前記内孔に挿通されるループ形成部材とを備え、
前記ループ形成部材は、先端同士が繋がった第１、第２の片を有しており、前記第１、第２の各片の基端は、それぞれ前記筒部材の長さ方向に移動可能とされ、
前記第１、第２の各片の基端の双方を前記筒部材の長さ方向の一方側に移動させることで、前記第１、第２の各片の先端側を前記筒部材の先端から突出させて、当該突出した第１、第２の各片の先端側によって、前記筒部材の先端の位置から延びるループを形成でき、
前記第１の片の基端と第２の片の基端とのうち、一方を他方に対して前記筒部材の長さ方向に相対的に移動させることで、前記第１の片と前記第２の片とが向き合う方向に、前記ループの向きを変えることができ、
前記第１、第２の各片の基端の双方を前記筒部材の長さ方向の他方側に移動させることで、前記第１、第２の各片の先端側を記筒部材の内孔に引き込むことが可能である。The hooking tool of the present invention for solving the above-mentioned problems includes a tubular member having an inner hole through which the hook is provided.
A loop forming member inserted into the inner hole of the tubular member is provided.
The loop forming member has first and second pieces in which the tips are connected to each other, and the base ends of the first and second pieces can be moved in the length direction of the tubular member, respectively. Being done
By moving both the base ends of the first and second pieces to one side in the length direction of the tubular member, the tip end side of each of the first and second pieces can be moved from the tip end of the tubular member. By projecting, the tip side of each of the projecting first and second pieces can form a loop extending from the position of the tip of the tubular member.
By moving one of the base end of the first piece and the base end of the second piece relative to the other in the length direction of the tubular member, the first piece and the first piece are moved. The direction of the loop can be changed in the direction in which the pieces of 2 face each other.
By moving both the base ends of the first and second pieces to the other side in the length direction of the tubular member, the tip end side of each of the first and second pieces is made into an inner hole of the tubular member. It is possible to pull in.

好ましくは、前記第１、第２の片は、互いに向き合う方向への可撓性が互いに向き合う方向以外の方向への可撓性よりも大きい。 Preferably, the first and second pieces have greater flexibility in the direction facing each other than flexibility in directions other than the direction facing each other.

好ましくは、前記ループ形成部材は、前記第１、第２の各片の長さ方向と直交する方向の断面形状において、前記互いに向き合う方向に沿う外形寸法が、前記互いに向き合う方向と直交する方向に沿う外形寸法より小さい形状である。 Preferably, the loop forming member has a cross-sectional shape in a direction orthogonal to the length direction of each of the first and second pieces, in a direction in which the external dimensions along the direction facing each other are orthogonal to the direction facing each other. The shape is smaller than the outer dimensions along the line.

また、前記ループ形成部材は、前記第１、第２の各片が別個の線材よりなり、各線材の先端部が接合されていてもよい。或いは、前記ループ形成部材は、１本の線材が折り曲げられたものであってもよい。 Further, in the loop forming member, the first and second pieces may be made of separate wire rods, and the tip portions of the wire rods may be joined to each other. Alternatively, the loop forming member may be one in which one wire rod is bent.

好ましくは、前記第１の片の基端を前記第１の片の軸回りに回動させることや、前記第２の片の基端を前記第２の片の軸回りに回動させることが可能とされることで、前記ループの向きを、前記第１の片と前記第２の片とが向き合う方向と直交する方向や、前記筒部材の周方向に変えることができる。 Preferably, the base end of the first piece can be rotated around the axis of the first piece, or the base end of the second piece can be rotated around the axis of the second piece. When enabled, the direction of the loop can be changed to a direction orthogonal to the direction in which the first piece and the second piece face each other, or a circumferential direction of the tubular member.

好ましくは、前記第１の片や前記第２の片は、トルクコイルから構成されている。さらに好ましくは、前記第１の片や前記第２の片は、外層のトルクコイルの内面が内層のトルクコイルの外面に密着し、且つ、外層のトルクコイルの巻方向と内層のトルクコイルの巻方向とが逆である多条多層コイルから構成されている。 Preferably, the first piece and the second piece are made of a torque coil. More preferably, in the first piece and the second piece, the inner surface of the torque coil in the outer layer is in close contact with the outer surface of the torque coil in the inner layer, and the winding direction of the torque coil in the outer layer and the winding of the torque coil in the inner layer are formed. It is composed of a multi-row multi-layer coil whose direction is opposite to that of the coil.

また好ましくは、本発明の引っ掛け具は、径方向に変形可能である中空のガイド部と、前記ガイド部内に長さ方向に沿って移動自在に挿入される可動片とを有する屈曲・伸展装置をさらに備え、
前記可動片は、前記ガイド部の長さ方向に沿って延び、互いに向き合う方向へ可撓性を有する第１、第２の帯状の可撓片と、前記第１、第２の可撓片の先端同士をつなぐ接続片とを含み、前記接続片及び前記ガイド部の端面に前記筒部材を通すための貫通孔が形成されている。Further, preferably, the hooking tool of the present invention is a bending / extending device having a hollow guide portion that is deformable in the radial direction and a movable piece that is movably inserted into the guide portion along the length direction. Further prepare
The movable piece extends along the length direction of the guide portion and has flexibility in the direction facing each other, and the first and second strip-shaped flexible pieces and the first and second flexible pieces. A through hole for passing the tubular member is formed in the connection piece and the end surface of the guide portion, including a connection piece that connects the tips to each other.

また本発明の医療用スネアは、前記引っ掛け具と、
前記引っ掛け具の第１の片の基端部に連繋される第１の操作部と、前記引っ掛け具の第２の片の基端部に連繋される第２の操作部とを備える。Further, the medical snare of the present invention includes the hook and the hook.
It includes a first operating portion connected to the base end portion of the first piece of the hooking tool and a second operating portion connected to the base end portion of the second piece of the hooking tool.

好ましくは、本発明の医療用スネアは、前記第１、第２の各操作部を前記筒部材の長さ方向に沿って摺動自由に支持する操作本体部をさらに備える。 Preferably, the medical snare of the present invention further includes an operation main body portion that freely slidably supports the first and second operation portions along the length direction of the tubular member.

本発明の引っ掛け具及び医療用スネアによれば、ループの形状や向きを変化させることができることで、操作性に優れる。 According to the hook and the medical snare of the present invention, the shape and orientation of the loop can be changed, so that the operability is excellent.

本発明の一実施形態に係る医療用スネアの全体構成を示す斜視図である。It is a perspective view which shows the whole structure of the medical snare which concerns on one Embodiment of this invention. ループが形成された状態の医療用スネアの断面図である。It is sectional drawing of the medical snare in a state where a loop is formed. ループ形成部材が筒部材に引き込まれた状態の医療用スネアの断面図である。It is sectional drawing of the medical snare in a state where a loop forming member is pulled into a tubular member. （Ａ）は図２のＡ−Ａ線に沿う断面図であり、（Ｂ）は第１の片の断面にＸ軸、Ｙ軸を重ねた図、（Ｃ）は第２の片の断面にＸ軸、Ｙ軸を重ねた図である。(A) is a cross-sectional view taken along the line AA of FIG. 2, (B) is a view in which the X-axis and the Y-axis are superimposed on the cross-section of the first piece, and (C) is a cross-sectional view of the second piece. It is the figure which overlapped the X-axis and Y-axis. 筒部材及び第１、第２の片の変形例を示す断面図である。It is sectional drawing which shows the modification of the tubular member and the 1st and 2nd pieces. ループ形成部材の向き及び形状の変化を説明するための原理説明図であり、（Ａ）は第１の片の基端を筒部材の長さ方向の一方側に移動させた状態の図、（Ｂ）は第１の片の基端を筒部材の長さ方向の他方側に移動させた状態の図である。It is a principle explanatory view for demonstrating the change of the direction and shape of a loop forming member, and FIG. B) is a diagram showing a state in which the base end of the first piece is moved to the other side in the length direction of the tubular member. 他の実施形態のループ形成部材の向きの変化を説明するための原理説明図であり、（Ａ）は第１、第２の片の基端が揃っている状態の図、（Ｂ）、（Ｃ）、（Ｄ）は第１の片の基端を筒部材の長さ方向の一方側に摺動させた状態の図である。It is a principle explanatory view for demonstrating the change of the direction of the loop forming member of another embodiment, (A) is the figure of the state which the base ends of the 1st and 2nd pieces are aligned, (B), ( C) and (D) are views in a state where the base end of the first piece is slid to one side in the length direction of the tubular member. 本発明の他の実施形態に係る引っ掛け具においてループ形成部材の向きの変化を説明するための原理説明図であり、（Ａ）は引っ掛け具の断面図、（Ｂ）は引っ掛け具の側面図である。It is a principle explanatory view for demonstrating the change of the direction of the loop forming member in the hooking tool which concerns on another Embodiment of this invention, (A) is the sectional view of the hooking tool, (B) is the side view of the hooking tool. be. 本発明の他の実施形態に係る引っ掛け具においてループ形成部材の向きの変化を説明するための原理説明図であり、（Ａ）は引っ掛け具の断面図、（Ｂ）は引っ掛け具の側面図である。It is a principle explanatory view for demonstrating the change of the direction of the loop forming member in the hooking tool which concerns on another Embodiment of this invention, (A) is the sectional view of the hooking tool, (B) is the side view of the hooking tool. be. 本発明の他の実施形態に係る引っ掛け具においてループ形成部材の向きの変化を説明するための原理説明図であり、（Ａ）は引っ掛け具の断面図、（Ｂ）は引っ掛け具の平面図である。It is a principle explanatory view for demonstrating the change of the direction of the loop forming member in the hooking tool which concerns on another Embodiment of this invention, (A) is the sectional view of the hooking tool, (B) is the plan view of the hooking tool. be. 本発明の他の実施形態に係る引っ掛け具においてループ形成部材の向きの変化を説明するための原理説明図であり、（Ａ）は引っ掛け具の断面図、（Ｂ）は引っ掛け具の平面図である。It is a principle explanatory view for demonstrating the change of the direction of the loop forming member in the hooking tool which concerns on another Embodiment of this invention, (A) is the sectional view of the hooking tool, (B) is the plan view of the hooking tool. be. 本発明の他の実施形態に係る引っ掛け具を示す図であり、（Ａ）は引っ掛け具の断面図、（Ｂ）は第１の片及び第２の片を示す平面図である。It is a figure which shows the hooking tool which concerns on other embodiment of this invention, (A) is the sectional view of the hooking tool, (B) is the top view which shows the 1st piece and 2nd piece. 屈曲・伸展装置が付加された引っ掛け具を示す斜視図である。It is a perspective view which shows the hooking tool which added the bending / extending device. 屈曲・伸展装置の方向の変化を説明するための原理説明図であり、（Ａ）は第１の可撓片の基端が第２の可撓片の基端よりも長さ方向の基端側としたときの図、（Ｂ）は先端側としたときの図である。It is a principle explanatory view for demonstrating the change of the direction of a bending-extending device, and (A) is the base end of the 1st flexible piece in the length direction from the base end of a 2nd flexible piece. The figure when it is set to the side, (B) is the figure when it is set to the tip side. 筒部材を撓ませた状態を示す説明図である。It is explanatory drawing which shows the state which the tubular member was bent. 従来技術のスネアを用いたポリープの除去プロセスを模式的に示す説明図である。It is explanatory drawing which shows typically the process of removing a polyp using the snare of the prior art.

本発明の実施形態を図面を参照して説明する。
図１〜図６は本発明の引っ掛け具１０が用いられた医療用スネア２０の一実施形態を示す。医療用スネア２０は、内視鏡装置（図示せず）の体腔挿入部に挿通されるものである。なお、本発明の引っ掛け具１０は、手術の妨げとなる臓器を圧排、牽引して術野を確保するためのレトラクターとして用いることや、血管内に存在する除去対象物（例えばカテーテルの破片）を除去するスネアとしても使用できる。また、医療用途であっても、必ずしも内視鏡装置に付加されて用いられるものに限定されるものではない。Embodiments of the present invention will be described with reference to the drawings.
1 to 6 show an embodiment of the medical snare 20 in which the hook 10 of the present invention is used. The medical snare 20 is inserted through a body cavity insertion portion of an endoscopic device (not shown). The hook 10 of the present invention can be used as a retractor for excluding and pulling an organ that interferes with surgery to secure a surgical field, or an object to be removed (for example, a fragment of a catheter) existing in a blood vessel. Can also be used as a snare to remove. Further, even for medical applications, it is not necessarily limited to those used by being added to an endoscope device.

医療用スネア２０は、引っ掛け具１０と、操作本体部２１と、操作本体部２１に個別に摺動自由に支持される第１、第２の操作部２２、２３とを備えている。 The medical snare 20 includes a hook 10, an operation main body 21, and first and second operation units 22 and 23 that are individually slidably supported by the operation main body 21.

図１、図２に示すように、引っ掛け具１０は、貫通する内孔１１ａを有する筒部材１１と、筒部材１１の内孔１１ａに挿通されるループ形成部材１２とからなる。 As shown in FIGS. 1 and 2, the hooking tool 10 includes a tubular member 11 having an inner hole 11a that penetrates the hook, and a loop forming member 12 that is inserted into the inner hole 11a of the tubular member 11.

筒部材１１は、内孔１１ａの長さ方向に直交する方向の断面形状が円形である（すなわち、筒部材１１は円筒体である）。筒部材１１は、例えばβチタンやニッケルチタンなどの弾性を有する金属あるいは合金や、樹脂製の材料、ゴムなどで形成されており、径方向への可撓性を有している。内孔１１ａの先端の開口部や、内孔１１ａの後端の開口部には、それぞれ、支持部材１１ｂが設けられる（図２）。 The tubular member 11 has a circular cross-sectional shape in a direction orthogonal to the length direction of the inner hole 11a (that is, the tubular member 11 is a cylindrical body). The tubular member 11 is made of an elastic metal or alloy such as β titanium or nickel titanium, a resin material, rubber, or the like, and has flexibility in the radial direction. A support member 11b is provided at the opening at the tip of the inner hole 11a and at the rear end of the inner hole 11a, respectively (FIG. 2).

ループ形成部材１２は、ワイヤである第１片１３及び第２片１４を有している。第１の片１３や第２の片１４は、例えばニッケルチタン（ニチノール）やベータチタンなどの超弾性金属材料からなり、可撓性を有している。第１片１３の先端部と第２片１４の先端部とは繋がっており、当該繋がった第１片１３及び第２片１４の先端部によって、ループ形成部材１２の先端部１２ａが構成される。第１の片１３や第２の片１４は、筒部材１１の内孔１１ａに挿通されて、筒部材１１の支持部材１１ｂに摺動自由に支持される。第１の片１３の基端側や、第２の片１４の基端側は、筒部材１１の内孔１１ａから延び出される。なお、支持部材１１ｂは、必ずしも必要ではなく、省略されてもよい。 The loop forming member 12 has a first piece 13 and a second piece 14 which are wires. The first piece 13 and the second piece 14 are made of a superelastic metal material such as nickel titanium (nitinol) or beta titanium and have flexibility. The tip of the first piece 13 and the tip of the second piece 14 are connected, and the tip of the first piece 13 and the second piece 14 connected to each other form the tip 12a of the loop forming member 12. .. The first piece 13 and the second piece 14 are inserted into the inner hole 11a of the tubular member 11 and are slidably supported by the support member 11b of the tubular member 11. The base end side of the first piece 13 and the base end side of the second piece 14 extend from the inner hole 11a of the tubular member 11. The support member 11b is not always necessary and may be omitted.

本実施形態では、第１、第２の各片１３，１４が別個の線材よりなり、第１片１３を構成する線材の先端部と、第２片１４を構成する線材の先端部とが接合されていることで、ループ形成部材１２が形成されている。ループ形成部材１２の先端部１２ａには針１２ｂが取り付けられており、当該針１２ｂによって第１、第２の各片１３、１４の先端部同士が接合されている。針１２ｂは、ループ形成部材１２の先端をポリープ近傍の体組織の壁面に固定するためのものであり、この針１２ｂを用いることで、ポリープにループ形成部材１２が引っ掛けやすくなる。 In the present embodiment, the first and second pieces 13 and 14 are made of separate wire rods, and the tip portion of the wire rod constituting the first piece 13 and the tip portion of the wire rod constituting the second piece 14 are joined. As a result, the loop forming member 12 is formed. A needle 12b is attached to the tip portion 12a of the loop forming member 12, and the tip portions of the first and second pieces 13 and 14 are joined to each other by the needle 12b. The needle 12b is for fixing the tip of the loop forming member 12 to the wall surface of the body tissue near the polyp, and by using this needle 12b, the loop forming member 12 can be easily hooked on the polyp.

なお、針１２ｂを省略して、第１、第２の各片１３、１４の先端部を直接接合してもよい。 The needle 12b may be omitted, and the tips of the first and second pieces 13 and 14 may be directly joined.

また、ループ形成部材１２は、１本の線材が折り曲げられたものであってもよい。この場合、ループ形成部材１２は、線材の折り曲げ位置によって先端部１２ａが構成されたものとなる。そして当該先端部１２ａと一方の基端１３ｂとの間の線材の範囲によって第１の片１３が構成され、上記先端部１２ａと他方の基端１３ｂとの間の線材の範囲によって第２の片１３が構成される。 Further, the loop forming member 12 may be one in which one wire rod is bent. In this case, the loop forming member 12 has a tip portion 12a formed by the bending position of the wire rod. The first piece 13 is formed by the range of the wire rod between the tip portion 12a and one base end 13b, and the second piece is formed by the range of the wire rod between the tip portion 12a and the other base end 13b. 13 is configured.

操作本体部２１は、筒状を呈しており、操作本体部２１の内径は、筒部材１１の外径と同等とされる。操作本体部２１は、その先端が筒部材１１の基端に連結されて、筒部材１１の長さ方向に延びるものとされる。操作本体部２１の内部には、第１の片１３の基端側や第２の片１４の基端側が挿入される。第１の操作部２２は、第１の片１３の基端１３ｂに連繋され、第２の操作部２３は、第２の片１４の基端１４ｂに連繋される。 The operation main body 21 has a tubular shape, and the inner diameter of the operation main body 21 is the same as the outer diameter of the tubular member 11. The tip of the operation main body 21 is connected to the base end of the tubular member 11 and extends in the length direction of the tubular member 11. The base end side of the first piece 13 and the base end side of the second piece 14 are inserted into the operation main body 21. The first operating unit 22 is connected to the base end 13b of the first piece 13, and the second operating unit 23 is connected to the base end 14b of the second piece 14.

操作本体部２１の側壁には、摺動溝Ｍが形成される。摺動溝Ｍは、筒部材１１の長さ方向Ｚに延びるものであり、第１、第２の操作部２２、２３は、それぞれ、摺動溝Ｍに通されて、操作本体部２１の外側に延び出される。 A sliding groove M is formed on the side wall of the operation main body 21. The sliding groove M extends in the length direction Z of the tubular member 11, and the first and second operating portions 22 and 23 are passed through the sliding groove M, respectively, and are outside the operating main body portion 21. Is extended to.

ユーザは、第１、第２の操作部２２、２３を摺動溝Ｍに沿って筒部材１１の長さ方向Ｚの一方側（図２の左側）に摺動させることで、第１の片１３や第２の片１４の基端１３ｂ，１４ｂを、筒部材１１の長さ方向Ｚの一方側（図２の左側）に移動させることができる。また、ユーザは、第１、第２の操作部２２、２３を摺動溝Ｍに沿って筒部材１１の長さ方向Ｚの他方側（図２の右側）に摺動させることで、第１の片１３や第２の片１４の基端１３ｂ，１４ｂを、筒部材１１の長さ方向Ｚの他方側（図２の右側）に移動させることができる。なお、「第１の片１３や第２の片１４の基端１３ｂ，１４ｂを、筒部材１１の長さ方向Ｚの一方側に移動させる」とは、「基端１３ｂ，１４ｂを筒部材１１に近づけること」に相当し、「第１の片１３や第２の片１４の基端１３ｂ，１４ｂを、筒部材１１の長さ方向Ｚの他方側に移動させる」とは、「基端１３ｂ，１４ｂを筒部材１１から遠ざけること」に相当する。また図示の例では、第１の操作部２２が、第１の片１３の長さ方向と略直交する方向に延びる環状体とされ、第２の操作部２３が、第２の片１４の長さ方向と略直交する方向に延びる環状体とされているが、第１の操作部２２や第２の操作部２３の構造は、図示例に限定されない。すなわち、第１の操作部２２や第２の操作部２３の構造は、ユーザが把持することで、第１の片１３や第２の片１４を長さ方向Ｚに移動させることの可能な様々な構造とされ得る。 The user slides the first and second operating units 22 and 23 along the sliding groove M on one side (left side in FIG. 2) of the tubular member 11 in the length direction Z, so that the first piece The base ends 13b and 14b of the 13 and the second piece 14 can be moved to one side (left side in FIG. 2) of the tubular member 11 in the length direction Z. Further, the user slides the first and second operation units 22 and 23 along the sliding groove M to the other side (right side in FIG. 2) of the tubular member 11 in the length direction Z, thereby causing the first operation. The base ends 13b and 14b of the piece 13 and the second piece 14 can be moved to the other side (right side in FIG. 2) of the tubular member 11 in the length direction Z. In addition, "moving the base ends 13b and 14b of the first piece 13 and the second piece 14 to one side of the length direction Z of the tubular member 11" means "moving the base ends 13b and 14b to the tubular member 11". "Move the base ends 13b and 14b of the first piece 13 and the second piece 14 to the other side in the length direction Z of the tubular member 11" corresponds to "approaching to" means "base end 13b". , 14b away from the tubular member 11 ”. Further, in the illustrated example, the first operating portion 22 is an annular body extending in a direction substantially orthogonal to the length direction of the first piece 13, and the second operating portion 23 is the length of the second piece 14. Although it is an annular body extending in a direction substantially orthogonal to the vertical direction, the structures of the first operation unit 22 and the second operation unit 23 are not limited to the illustrated examples. That is, the structures of the first operation unit 22 and the second operation unit 23 are various in that the first piece 13 and the second piece 14 can be moved in the length direction Z by being grasped by the user. Structure.

そして本実施形態では、第１、第２の操作部２２，２３に対する操作で、第１の片１３や第２の片１４の基端１３ｂ，１４ｂの双方を筒部材１１の長さ方向Ｚの一方側に移動させることで、図２に示すように、第１、第２の各片１３、１４の先端側を筒部材１１の先端から突出させて、当該突出した第１、第２の各片１３、１４の先端側によって、筒部材１１の先端の位置から延びるループＰを形成することができる。 Then, in the present embodiment, both the base ends 13b and 14b of the first piece 13 and the second piece 14 are operated with respect to the first and second operation units 22 and 23 in the length direction Z of the tubular member 11. By moving it to one side, as shown in FIG. 2, the tip side of each of the first and second pieces 13 and 14 is projected from the tip of the tubular member 11, and each of the protruding first and second pieces is projected. The tip side of the pieces 13 and 14 can form a loop P extending from the position of the tip of the tubular member 11.

また本実施形態では、第１、第２の片１３、１４に形状記憶が施されていることで、筒部材１１から突出した第２の各片１３、１４の先端側は、膨らんで、幅が数センチメートル程度のループＰを形成するものとなる。つまり、第１、第２の各片１３、１４の先端側を筒部材１１から突出させると、第１、第２の各片１３、１４の先端側は、筒部材１１による外力が加えられないものとなるが、本実施形態の引っ掛け具１０では、第１、第２の各片１３、１４の先端側が、外力の解放に伴う弾性復帰によって膨らんで、幅が数センチメートル程度のループＰを形成するものとなるように、第１、第２の片１３、１４に形状記憶が施されている。なお上記の「膨らむ」とは、第１の片１３と第２の片１４とが向き合う方向Ｘにおいて、第１の片１３と第２の片１４との間の間隔が大きくなることを意味する。 Further, in the present embodiment, since the first and second pieces 13 and 14 are provided with shape memory, the tip side of each of the second pieces 13 and 14 protruding from the tubular member 11 is bulged and has a width. Will form a loop P of about several centimeters. That is, when the tip side of each of the first and second pieces 13 and 14 is projected from the tubular member 11, no external force is applied to the tip side of each of the first and second pieces 13 and 14 by the tubular member 11. However, in the hook 10 of the present embodiment, the tip side of each of the first and second pieces 13 and 14 swells due to the elastic return accompanying the release of the external force, and the loop P having a width of about several centimeters is formed. Shape memory is applied to the first and second pieces 13 and 14 so as to form. The above-mentioned "bulging" means that the distance between the first piece 13 and the second piece 14 becomes large in the direction X in which the first piece 13 and the second piece 14 face each other. ..

また本実施形態では、第１、第２の操作部２２，２３に対する操作で、第１、第２の各片１３、１４が筒部材１１の先端から突出する長さを変えることで、ループＰの形状を変化させることができる。つまり、第１、第２の操作部２２、２３を筒部材１１の長さ方向Ｚの一方側に摺動させて、第１、第２の各片１３、１４が筒部材１１の先端から突出する長さを大きくすれば、ループＰを大きくすることができる。また第１、第２の操作部２２、２３を筒部材１１の長さ方向Ｚの他方側に摺動させて、第１、第２の各片１３、１４が筒部材１１の先端から突出する長さを小さくすれば、ループＰを小さくすることができる。 Further, in the present embodiment, by operating the first and second operation units 22 and 23, the loop P is changed by changing the length of each of the first and second pieces 13 and 14 protruding from the tip of the tubular member 11. The shape of can be changed. That is, the first and second operating portions 22 and 23 are slid on one side of the tubular member 11 in the length direction Z, and the first and second pieces 13 and 14 project from the tip of the tubular member 11. The loop P can be increased by increasing the length of the loop P. Further, the first and second operating portions 22 and 23 are slid to the other side of the tubular member 11 in the length direction Z, and the first and second pieces 13 and 14 project from the tip of the tubular member 11. If the length is reduced, the loop P can be reduced.

さらに本実施形態では、第１、第２の操作部２２，２３に対する操作で、第１の片１３や第２の片１４の基端１３ｂ，１４ｂの双方を筒部材１１の長さ方向Ｚの他方側に移動させることで、図３に示すように、第１、第２の片１３、１４の先端側を筒部材１１の内孔に引き込むことが可能である。この際には、第１、第２の各片１３、１４の先端側に、筒部材１１による内向きの外力が加わることで、第１、第２の各片１３、１４の先端側は、互いに接近するように弾性変形して閉じた状態となる。 Further, in the present embodiment, by operating the first and second operating units 22 and 23, both the base ends 13b and 14b of the first piece 13 and the second piece 14 are placed in the length direction Z of the tubular member 11. By moving it to the other side, as shown in FIG. 3, it is possible to pull the tip end side of the first and second pieces 13 and 14 into the inner hole of the tubular member 11. At this time, an inward external force by the tubular member 11 is applied to the tip side of each of the first and second pieces 13 and 14, so that the tip side of each of the first and second pieces 13 and 14 is It elastically deforms so as to approach each other and becomes a closed state.

上記の弾性復帰や弾性変形が生じ得る第１、第２の片１３、１４の範囲を長くするために、第１、第２の片１３、１４の全長を超弾性金属材料から形成することが好ましいが、材料費を安価に抑える観点から、第１、第２の片１３、１４の先端側部分のみを超弾性金属材料で構成し、その他の基端側部分は超弾性金属材料以外の材料から構成してもよい。 In order to lengthen the range of the first and second pieces 13 and 14 where the elastic return and elastic deformation can occur, the entire length of the first and second pieces 13 and 14 can be formed from a superelastic metal material. However, from the viewpoint of keeping the material cost low, only the tip end side portion of the first and second pieces 13 and 14 is made of a superelastic metal material, and the other base end side portion is a material other than the superelastic metal material. It may be composed of.

第１、第２の各片１３、１４は、図４（Ａ）に示すように、長さ方向と直交する方向の断面形状が半円形であって、平坦な面１３ａ、１４ａを内側にして線対称に配置されている。第１、第２の各片１３、１４は互いに向き合う方向Ｘへの可撓性が、互いに向き合う方向以外の方向への可撓性よりも大きく、第１、第２の各片１３、１４の前記断面形状において、第１、第２の各片１３、１４が互いに向き合う方向Ｘに沿う外形寸法Ｌ２は、向き合う方向Ｘと直交する方向Ｙに沿う外形寸法Ｌ１より小さな形状に設定されている。すなわち、第１、第２の各片１３、１４の向き合う方向Ｘを横方向と定義し、方向Ｙを縦方向と定義した場合には、前記断面形状はいわゆる縦長形状となっている。このような断面形状においては、第１、第２の各片１３、１４は、Ｙ軸周りの断面二次モーメントがＸ軸周りの断面二次モーメントよりも小さく、方向Ｘに曲がりやすい。図４（Ｂ）、図４（Ｃ）は、第１、第２の各片１３、１４の前記断面にＸ軸、Ｙ軸を重ねた図である。図４（Ｂ）に示すＸ軸は、「Ｘ方向に延びて、第１の片１３の横断面の図心を通過する軸」に相当する。図４（Ｃ）に示すＸ軸は、、「Ｘ方向に延びて、第２の片１４の横断面の図心を通過する軸」に相当する。図４（Ｂ）に示すＹ軸は、「Ｙ方向に延びて、第１の片１３の横断面の図心を通過する軸」に相当する。図４（Ｃ）に示すＹ軸は、「Ｙ方向に延びて、第２の片１４の横断面の図心を通過する軸」に相当する。 As shown in FIG. 4A, each of the first and second pieces 13 and 14 has a semicircular cross-sectional shape in the direction orthogonal to the length direction, with the flat surfaces 13a and 14a inside. They are arranged line-symmetrically. The first and second pieces 13 and 14 have greater flexibility in the direction X facing each other than the flexibility in directions other than the directions facing each other, and the first and second pieces 13 and 14 have greater flexibility. In the cross-sectional shape, the outer dimension L2 along the direction X in which the first and second pieces 13 and 14 face each other is set to be smaller than the outer dimension L1 along the direction Y orthogonal to the facing direction X. That is, when the direction X in which the first and second pieces 13 and 14 face each other is defined as the horizontal direction and the direction Y is defined as the vertical direction, the cross-sectional shape is a so-called vertically long shape. In such a cross-sectional shape, each of the first and second pieces 13 and 14 has a geometrical moment of inertia about the Y-axis smaller than the moment of inertia of area around the X-axis, and tends to bend in the direction X. 4 (B) and 4 (C) are views in which the X-axis and the Y-axis are superimposed on the cross sections of the first and second pieces 13 and 14, respectively. The X-axis shown in FIG. 4 (B) corresponds to "an axis extending in the X direction and passing through the center of gravity of the cross section of the first piece 13." The X-axis shown in FIG. 4C corresponds to "an axis extending in the X direction and passing through the center of gravity of the cross section of the second piece 14". The Y-axis shown in FIG. 4 (B) corresponds to "an axis extending in the Y direction and passing through the center of gravity of the cross section of the first piece 13." The Y-axis shown in FIG. 4 (C) corresponds to "an axis extending in the Y direction and passing through the center of gravity of the cross section of the second piece 14".

なお、第１、第２の各片１３、１４の前記断面形状は、図４に示す半円形に限られない。例えば図５（Ａ）〜図５（Ｃ）に示すように、第１、第２の各片１３、１４の断面形状を、長方形、三角形、楕円形にすることで、第１、第２の各片１３、１４が互いに向き合う方向Ｘに沿う外形寸法Ｌ２を、向き合う方向Ｘと直交する方向Ｙに沿う外形寸法Ｌ１より小さくしてもよい。さらに、本実施形態では、第１、第２の各片１３、１４の前記断面形状において、平坦な面が向き合っているが、第１、第２の各片１３、１４の向き合う面を、曲面にしてもよい。また、第１、第２の各片１３、１４の各断面形状は、正方形や長方形や矩形以外の多角形（五角形や六角形など）や楕円や円を二等分した線対称の形状であってもよい。さらに、第１、第２の各片１３、１４の前記断面形状の大きさは、両方の片１３、１４が筒部材１１の内孔１１ａ内を移動可能であれば任意の大きさでよい。 The cross-sectional shape of each of the first and second pieces 13 and 14 is not limited to the semicircular shape shown in FIG. For example, as shown in FIGS. 5 (A) to 5 (C), by making the cross-sectional shapes of the first and second pieces 13 and 14 rectangular, triangular, and elliptical, the first and second pieces can be changed. The outer dimension L2 along the direction X in which the pieces 13 and 14 face each other may be smaller than the outer dimension L1 along the direction Y orthogonal to the facing direction X. Further, in the present embodiment, in the cross-sectional shape of the first and second pieces 13 and 14, the flat surfaces face each other, but the facing surfaces of the first and second pieces 13 and 14 are curved surfaces. It may be. The cross-sectional shapes of the first and second pieces 13 and 14 are squares, rectangles, polygons other than rectangles (pentagons, hexagons, etc.), and axisymmetric shapes obtained by bisecting ellipses and circles. You may. Further, the size of the cross-sectional shape of each of the first and second pieces 13 and 14 may be any size as long as both pieces 13 and 14 can move in the inner hole 11a of the tubular member 11.

また、筒部材１１の長さ方向に直交する方向の断面に現れる内孔１１ａの形状は円形に限られるものではなく、長方形、三角形、楕円形等、任意の形状であってもよい。
例えば、内孔１１ａの形状は、筒部材１１の内孔１１ａの内面と第１、第２の各片１３、１４の外面との間の間隔が一定になるような形状であってもよい。図５（Ｄ）においては、第１、第２の各片１３、１４を合わせた外形１５は略長方形であり、筒部材１１の内孔１１ａの形状は、第１、第２の各片１３、１４の外形１５に沿う略長方形である。図５（Ｅ）においては、第１、第２の各片１３、１４の外形１５が略正方形であり、筒部材１１の内孔１１ａの形状は、第１、第２の各片１３、１４の外形１５に沿う略正方形である。Further, the shape of the inner hole 11a appearing in the cross section in the direction orthogonal to the length direction of the tubular member 11 is not limited to a circle, and may be any shape such as a rectangle, a triangle, and an ellipse.
For example, the shape of the inner hole 11a may be such that the distance between the inner surface of the inner hole 11a of the tubular member 11 and the outer surfaces of the first and second pieces 13 and 14 is constant. In FIG. 5D, the outer shape 15 in which the first and second pieces 13 and 14 are combined is substantially rectangular, and the shape of the inner hole 11a of the tubular member 11 is the shape of the first and second pieces 13 respectively. , 14 is a substantially rectangular shape along the outer shape 15. In FIG. 5 (E), the outer shapes 15 of the first and second pieces 13 and 14 are substantially square, and the shape of the inner hole 11a of the tubular member 11 is the shape of the first and second pieces 13 and 14, respectively. It is a substantially square along the outer shape 15 of.

このように、筒部材１１の内孔１１ａの内面と第１、第２の各片１３、１４の外面との間の間隔を一定にすると、筒部材１１の内孔１１ａの内面と第１、第２の各片１３、１４の外面との間の空間に無駄が生じないため、両方の片１３、１４が筒部材１１の内孔１１ａ内を移動する際に、筒部材１１の内孔１１ａ内で第１、第２の各片１３、１４が振れてがたつくことがなく、安定して第１、第２の各片１３、１４を移動させることができる。また、筒部材１１の内孔１１ａの内面と第１、第２の各片１３、１４の外面との間の間隔が一定でない場合には、筒部材１１の内孔１１ａの内面と近い第１、第２の各片１３、１４の頂点や面が筒部材１１の内孔１１ａの内面に当たり易くなるが、前記間隔を一定とすることで、これを防ぐことができる。 In this way, if the distance between the inner surface of the inner hole 11a of the tubular member 11 and the outer surface of the first and second pieces 13 and 14 is constant, the inner surface of the inner hole 11a of the tubular member 11 and the first, first, Since there is no waste in the space between the outer surfaces of the second pieces 13 and 14, when both pieces 13 and 14 move in the inner hole 11a of the tubular member 11, the inner hole 11a of the tubular member 11 The first and second pieces 13 and 14 do not swing and rattle, and the first and second pieces 13 and 14 can be moved stably. Further, when the distance between the inner surface of the inner hole 11a of the tubular member 11 and the outer surface of the first and second pieces 13 and 14 is not constant, the first one close to the inner surface of the inner hole 11a of the tubular member 11. The vertices and surfaces of the second pieces 13 and 14 easily hit the inner surface of the inner hole 11a of the tubular member 11, but this can be prevented by keeping the interval constant.

また、第１、第２の各片１３、１４は、前記断面形状が異なっていてもよく、相似形であってもよい。また、第１、第２の各片１３、１４は、記憶されている形状が異なっていてもよく、例えば、第１の片１３の記憶する形状が直線状であり、第２の片１４の記憶する形状が曲線状であってもよい。さらに、第１、第２の各片１３、１４は構成される素材が異なっていてもよい。また、第１、第２の各片１３、１４の長さが異なっていてもよい。以上のようにすることで、ループＰの形状にバリエーションを持たせることが可能になり、治療部位に応じたカスタマイズが可能となる。 Further, the first and second pieces 13 and 14 may have different cross-sectional shapes or similar shapes. Further, the first and second pieces 13 and 14 may have different stored shapes. For example, the stored shape of the first piece 13 is linear, and the second piece 14 has a linear shape. The shape to be stored may be curved. Further, the materials of the first and second pieces 13 and 14 may be different from each other. Further, the lengths of the first and second pieces 13 and 14 may be different. By doing so, it is possible to give variation to the shape of the loop P, and it is possible to customize it according to the treatment site.

また本実施形態では、第１の片１３の基端１３ｂと第２の片１４の基端１４ｂとのうち、一方を他方に対して筒部材１１の長さ方向Ｚに相対的に移動させることで、第１、第２の各片１３、１４が向き合う方向Ｘに、ループＰの向きを変えることができる。以下、具体的に説明する。 Further, in the present embodiment, one of the base end 13b of the first piece 13 and the base end 14b of the second piece 14 is relatively moved with respect to the other in the length direction Z of the tubular member 11. Then, the direction of the loop P can be changed in the direction X in which the first and second pieces 13 and 14 face each other. Hereinafter, a specific description will be given.

図６（Ａ）、（Ｂ）は、ループ形成部材１２に形成されたループＰの向きを変化させるときの原理説明図である（図６（Ａ）、（Ｂ）では、操作本体部２１や第１、第２の操作部２２，２３の図示を省略している）。図６（Ａ）、図６（Ｂ）において、点線は第１、第２の各片１３、１４の基端１３ｂ、１４ｂが揃えられた状態でのループ形成部材１２のループＰの向きを示している。 6 (A) and 6 (B) are explanatory views of the principle when the direction of the loop P formed on the loop forming member 12 is changed (in FIGS. 6 (A) and 6 (B), the operation main body 21 and the operation main body 21 and The first and second operation units 22 and 23 are not shown). In FIGS. 6A and 6B, the dotted line indicates the direction of the loop P of the loop forming member 12 in a state where the base ends 13b and 14b of the first and second pieces 13 and 14 are aligned. ing.

図６（Ａ）の実線に示すように、第１の片１３の基端１３ｂを第２の片１４の基端１４ｂよりも筒部材１１の長さ方向Ｚの一方側に移動させた場合には、ループ形成部材１２のループＰは、第１、第２の各片１３、１４が向き合う方向Ｘの一方側（第２の片１４側）へ向きを変える。 As shown by the solid line in FIG. 6A, when the base end 13b of the first piece 13 is moved to one side of the length direction Z of the tubular member 11 from the base end 14b of the second piece 14. The loop P of the loop forming member 12 changes its direction to one side (second piece 14 side) of the direction X in which the first and second pieces 13 and 14 face each other.

図６（Ｂ）の実線に示すように、第１の片１３の基端１３ｂを第２の片１４の基端１４ｂよりも長さ方向Ｚの他方側に移動させた場合には、ループ形成部材１２のループＰは、第１、第２の各片１３、１４が向き合う方向Ｘの他方側（第１の片１３側）へ向きを変える。 As shown by the solid line in FIG. 6B, when the base end 13b of the first piece 13 is moved to the other side in the length direction Z from the base end 14b of the second piece 14, a loop is formed. The loop P of the member 12 changes its direction to the other side (first piece 13 side) of the direction X in which the first and second pieces 13 and 14 face each other.

このように、第１の片１３の基端１３ｂと第２の片１４の基端１４ｂとのうち、一方を他方に対して長さ方向Ｚに相対的に移動させることにより、ループ形成部材１２のループＰは、第１、第２の各片１３、１４が向き合う方向Ｘへ撓み、向きが変化する。撓む度合い、すなわち向きの変化の度合いは、一方の基端を他方の基端に対してどの程度移動させるかによって定まる。また、この撓みによりループ形成部材１２のループＰの形状が変化する。 In this way, the loop forming member 12 is formed by moving one of the base end 13b of the first piece 13 and the base end 14b of the second piece 14 relative to the other in the length direction Z. Loop P bends in the direction X in which the first and second pieces 13 and 14 face each other, and the direction changes. The degree of bending, that is, the degree of change in orientation, is determined by how much one base end is moved with respect to the other base end. Further, the shape of the loop P of the loop forming member 12 changes due to this bending.

図６（Ａ）においては、第２の片１４の基端１４ｂを定位置に止め、第１の片１３の基端１３ｂを筒部材１１の長さ方向Ｚの一方側に移動させているが、この状態は，第１の片１３の基端１３ｂを定位置に止め、第２の片１４の基端１４ｂを筒部材１１の長さ方向Ｚの他方側に移動させた状態と等価である。よって，第２の片１４の基端１４ｂを筒部材１１の長さ方向Ｚの他方側に移動させた場合であっても、図６（Ａ）と同様に、ループ形成部材１２のループＰは、方向Ｘの一方側（第２の片１４の側）へ向きを変える。また、図６（Ｂ）においては、第２の片１４の基端１４ｂを定位置に止め、第１の片１３の基端１３ｂを筒部材１１の長さ方向Ｚの他方側に移動させているが、この状態は，第１の片１３の基端１３ｂを定位置に止め、第２の片１４の基端１４ｂを筒部材１１の長さ方向Ｚの一方側に移動させた状態と等価である。よって，第２の片１４の基端１４ｂを筒部材１１の長さ方向Ｚの一方側に移動させた場合であっても、図６（Ｂ）と同様に、ループ形成部材１２のループＰは、方向Ｘの他方側（第１の片１３の側）へ向きを変える。 In FIG. 6A, the base end 14b of the second piece 14 is fixed at a fixed position, and the base end 13b of the first piece 13 is moved to one side of the tubular member 11 in the length direction Z. This state is equivalent to a state in which the base end 13b of the first piece 13 is stopped at a fixed position and the base end 14b of the second piece 14 is moved to the other side of the tubular member 11 in the length direction Z. .. Therefore, even when the base end 14b of the second piece 14 is moved to the other side of the tubular member 11 in the length direction Z, the loop P of the loop forming member 12 remains as in FIG. 6A. , Turn to one side of direction X (the side of the second piece 14). Further, in FIG. 6B, the base end 14b of the second piece 14 is stopped at a fixed position, and the base end 13b of the first piece 13 is moved to the other side of the tubular member 11 in the length direction Z. However, this state is equivalent to a state in which the base end 13b of the first piece 13 is stopped at a fixed position and the base end 14b of the second piece 14 is moved to one side of the tubular member 11 in the length direction Z. Is. Therefore, even when the base end 14b of the second piece 14 is moved to one side of the tubular member 11 in the length direction Z, the loop P of the loop forming member 12 remains as in FIG. 6B. , Turn to the other side of the direction X (the side of the first piece 13).

上記の構成の医療用スネア２０を用いて体腔内のポリープを除去するには、例えば、まず、ループ形成部材１２を筒部材１１の内部に引き込んだ状態で筒部材１１を先端側から内視鏡装置の体腔挿入部に挿通する。そして、内視鏡装置の体腔挿入部を体内に挿入し、内視鏡装置の先端部に設けられた撮像素子による画像を見ながら内視鏡装置の先端部をポリープの近傍まで移動させる。ポリープ近傍への到達後、医療用スネア２０の筒部材１１を内視鏡装置の先端から突出させる。次に、医療用スネア２０の第１、第２の操作部２２、２３の位置が揃った状態にした後、第１、第２の操作部２２、２３の操作で、第１、第２の各片１３、１４の基端１３ｂ，１４ｂを筒部材１１の長さ方向Ｚの一方側に移動させて、ループ形成部材１２を筒部材１１の先端から突出させ、ループＰを形成する。次に、第１、第２の操作部２２、２３を個別に操作して、ループ形成部材１２のループＰを所望の向きに撓ませ、ポリープに引っ掛ける。そして、第１、第２の各片１３、１４の基端１３ｂ，１４ｂを筒部材１１の長さ方向Ｚの他方側に移動させて、ループ形成部材１２を筒部材１１に引き込んでポリープを締め付け、最終的にポリープを体組織から切断する。 To remove the polyp in the body cavity using the medical snare 20 having the above configuration, for example, first, the tubular member 11 is retracted into the tubular member 11 and the tubular member 11 is inserted into the endoscope from the tip side. Insert through the body cavity insertion part of the device. Then, the body cavity insertion portion of the endoscope device is inserted into the body, and the tip portion of the endoscope device is moved to the vicinity of the polyp while observing an image by an image pickup device provided at the tip portion of the endoscope device. After reaching the vicinity of the polyp, the tubular member 11 of the medical snare 20 is projected from the tip of the endoscopic device. Next, after the positions of the first and second operation units 22 and 23 of the medical snare 20 are aligned, the first and second operation units 22 and 23 are operated to perform the first and second operations. The base ends 13b and 14b of the pieces 13 and 14 are moved to one side of the length direction Z of the tubular member 11, and the loop forming member 12 is projected from the tip of the tubular member 11 to form the loop P. Next, the first and second operating units 22 and 23 are individually operated to bend the loop P of the loop forming member 12 in a desired direction and hook it on the polyp. Then, the base ends 13b and 14b of the first and second pieces 13 and 14 are moved to the other side of the tubular member 11 in the length direction Z, and the loop forming member 12 is pulled into the tubular member 11 to tighten the polyp. Finally, the polyp is cut from the body tissue.

なおポリープを確実に切断すべく、第１、第２の各片１３、１４は導体とされてもよい。この場合、例えば第１、第２の各片１３、１４に図示しない高周波電源装置を電気的に接続し、ポリープの切除の際に第１、第２の各片１３、１４に高周波電流を流すことでポリープの根元を焼灼して体組織から切断する。 The first and second pieces 13 and 14 may be conductors in order to surely cut the polyp. In this case, for example, a high-frequency power supply device (not shown) is electrically connected to the first and second pieces 13 and 14, and a high-frequency current is passed through the first and second pieces 13 and 14 when cutting the polyp. This will cauterize the root of the polyp and cut it from the body tissue.

また上記実施形態に示した医療用スネア２０は、例えば、血管内に存在する除去対象物（例えばカテーテルの破片）を除去するためにも使用できる。以下、この用途における医療用スネア２０の操作方法の一例について説明する。 The medical snare 20 shown in the above embodiment can also be used, for example, to remove an object to be removed (for example, a fragment of a catheter) existing in a blood vessel. Hereinafter, an example of an operation method of the medical snare 20 in this application will be described.

まず、ループ形成部材１２を筒部材１１の内部に引き込んだ状態で、例えばＸ線透視装置のモニターで血管内部を見ながら、筒部材１１を血管内に挿入して、筒部材１１の先端部を除去対象物の近傍まで移動させる。筒部材１１の先端部が除去対象物の近傍に到達した後、第１、第２の操作部２２、２３の操作で、第１、第２の各片１３、１４の基端１３ｂ，１４ｂを筒部材１１の長さ方向Ｚの一方側に移動させて、ループ形成部材１２を筒部材１１の先端から突出させて、ループＰを形成する。次に、第１、第２の操作部２２、２３を個別に操作して、ループ形成部材１２のループＰを所望の向きに撓ませ、ループＰの内側に除去対象物が位置した状態にする。そして、第１、第２の操作部２２、２３の操作で、第１、第２の各片１３、１４の基端１３ｂ，１４ｂを筒部材１１の長さ方向Ｚの他方側に移動させて、ループＰを小さくすることで、ループＰに除去対象物が保持された状態にする。そして、筒部材１１を体外に引き出すことで、ループＰに保持された除去対象物を体外に取り出す。 First, in a state where the loop forming member 12 is pulled into the tubular member 11, the tubular member 11 is inserted into the blood vessel while looking at the inside of the blood vessel, for example, with a monitor of an X-ray fluoroscope, and the tip of the tubular member 11 is inserted. Move to the vicinity of the object to be removed. After the tip of the tubular member 11 reaches the vicinity of the object to be removed, the base ends 13b and 14b of the first and second pieces 13 and 14 are operated by the operations of the first and second operation units 22 and 23. The loop forming member 12 is projected from the tip of the tubular member 11 by moving the tubular member 11 to one side in the length direction Z to form the loop P. Next, the first and second operating units 22 and 23 are individually operated to bend the loop P of the loop forming member 12 in a desired direction so that the object to be removed is positioned inside the loop P. .. Then, by operating the first and second operation units 22 and 23, the base ends 13b and 14b of the first and second pieces 13 and 14 are moved to the other side of the tubular member 11 in the length direction Z. By making the loop P smaller, the object to be removed is held in the loop P. Then, by pulling out the tubular member 11, the object to be removed held by the loop P is taken out of the body.

以上説明した実施形態によれば、第１、第２の各片１３、１４の基端の双方を筒部材１１の長さ方向の一方側に移動させることで、第１、第２の各片１３、１４の先端側を筒部材１１の先端から突出させて、当該第１、第２の各片１３、１４の先端側によって、筒部材１１の先端の位置から延びるループＰを形成できる。 According to the embodiment described above, by moving both the base ends of the first and second pieces 13 and 14 to one side in the length direction of the tubular member 11, each of the first and second pieces The tip side of 13 and 14 can be projected from the tip of the tubular member 11, and the tip side of each of the first and second pieces 13 and 14 can form a loop P extending from the position of the tip of the tubular member 11.

そして、第１の片１３の基端１３ｂと第２の片１４の基端１４ｂとのうち、一方を他方に対して筒部材１１の長さ方向Ｚに相対的に移動させる簡易な操作によって、第１の片１３と第２の片１４とが向き合う方向Ｘに、ループＰの向きを変えることができる。。また、第１の片１３の基端１３ｂと第２の片１４の基端１４ｂとを長さ方向Ｚに移動させる簡易な操作で、第１、第２の各片１３、１４が筒部材１１の先端から突出する長さを変えることで、ループＰの形状を変化させることができる。
以上のことから、本実施形態の引っ掛け具１０及び医療用スネア２０は、ループＰの向きや形状を容易に変化させることができるので、操作性に優れる。したがって、様々な大きさのポリープを切除することや、様々な大きさの除去対象物を体外に除去することが可能である。Then, by a simple operation of moving one of the base end 13b of the first piece 13 and the base end 14b of the second piece 14 relative to the other in the length direction Z of the tubular member 11. The direction of the loop P can be changed in the direction X in which the first piece 13 and the second piece 14 face each other. .. Further, by a simple operation of moving the base end 13b of the first piece 13 and the base end 14b of the second piece 14 in the length direction Z, each of the first and second pieces 13 and 14 is a tubular member 11. The shape of the loop P can be changed by changing the length protruding from the tip of the loop P.
From the above, the hook 10 and the medical snare 20 of the present embodiment are excellent in operability because the direction and shape of the loop P can be easily changed. Therefore, it is possible to excise polyps of various sizes and to remove objects of various sizes outside the body.

また本実施形態によれば、ループ形成部材１２のループＰは向き合う方向Ｘにその他の方向よりも大きな可撓性を有しており、各基端を移動させることで向き合う方向Ｘへ撓む。このため、各片１３、１４の基端１３ｂ、１４ｂを移動させる際にループＰは他の向きに向いたり変形したりすることがなく、ループ形成部材１２の形状や向きを安定して変化させることができる。また、変形方向が安定するため、操作性も向上する。 Further, according to the present embodiment, the loop P of the loop forming member 12 has greater flexibility in the facing direction X than in the other directions, and bends in the facing direction X by moving each base end. Therefore, when the base ends 13b and 14b of the pieces 13 and 14 are moved, the loop P does not face or deform in another direction, and the shape and orientation of the loop forming member 12 are stably changed. be able to. In addition, since the deformation direction is stable, operability is also improved.

また本実施形態では、各片１３、１４の断面形状をいわゆる縦長形状とし、一方の片の基端と他方の片の基端とを個別に移動可能とするだけの簡単な構成であるため、部品点数を増やさずに操作性を向上させることができる。 Further, in the present embodiment, the cross-sectional shape of each of the pieces 13 and 14 is a so-called vertically long shape, and the base end of one piece and the base end of the other piece can be moved individually. Operability can be improved without increasing the number of parts.

なお上記実施形態では、第１、第２の各片１３、１４の先端側を筒部材１１から突出させた際に、第１、第２の各片１３、１４の先端側が弾性復帰するように第１、第２の各片１３、１４に形状記憶が施されていたが、第１、第２の各片１３、１４は、外力が加えられていないときに閉じた状態となるように形状記憶が施されていてもよい（閉じた状態とは、第１の片１３と第２の片１４とが向き合う方向において、第１の片１３と第２の片１４とが接近した状態を意味する）。図７（Ａ）〜図７（Ｄ）は、このような場合において、ループＰの形状及び向きを変化させるときの原理説明図である（図７（Ａ）〜図７（Ｄ）では、操作本体部２１や第１、第２の操作部２２，２３の図示を省略している）。 In the above embodiment, when the tip ends of the first and second pieces 13 and 14 are projected from the tubular member 11, the tip ends of the first and second pieces 13 and 14 are elastically restored. Shape memory was applied to the first and second pieces 13 and 14, but the first and second pieces 13 and 14 are shaped so as to be in a closed state when no external force is applied. Memory may be applied (the closed state means a state in which the first piece 13 and the second piece 14 are close to each other in the direction in which the first piece 13 and the second piece 14 face each other. do). 7 (A) to 7 (D) are explanatory views of the principle when the shape and orientation of the loop P are changed in such a case (in FIGS. 7 (A) to 7 (D), the operation is performed. The main body 21 and the first and second operation units 22 and 23 are not shown).

図７（Ａ）に示すように、第１、第２の各片１３、１４の基端１３ｂ、１４ｂを揃えて筒部材１１からループ形成部材１２を突出させた状態では、ループ形成部材１２によって形成されるループＰは、これを構成する第１、第２の各片１３、１４が接近していることで、幅の狭いものとなっている。第１の片１３の基端１３ｂを第２の片１４の基端１４ｂよりも先端側に移動させると、図７（Ｂ）に示すように、ループＰは、第２の片１４の側に撓んで向きを変えるとともに、ループＰの幅（ループＰを構成する第１の片１３と第２の片１４との間の幅）が大きくなり始める。さらに、図７（Ｃ）、図７（Ｄ）に示すように、第１の片１３の基端１３ｂを第２の片１４の基端１４ｂよりもさらに先端側に移動させることで、撓みが大きくなるとともに、ループＰが大きくなる。 同様に、第２の片１４の基端１４ｂを第１の片１３の基端１３ｂよりも先端側に移動させる場合は、ループ形成部材１２によって形成されるループＰは、第１の片１３の側に撓んで向きを変える。 As shown in FIG. 7A, in a state where the base ends 13b and 14b of the first and second pieces 13 and 14 are aligned and the loop forming member 12 is projected from the tubular member 11, the loop forming member 12 is used. The loop P formed is narrow in width because the first and second pieces 13 and 14 constituting the loop P are close to each other. When the base end 13b of the first piece 13 is moved to the tip side of the base end 14b of the second piece 14, the loop P is moved to the side of the second piece 14 as shown in FIG. 7 (B). As it bends and changes direction, the width of the loop P (the width between the first piece 13 and the second piece 14 constituting the loop P) begins to increase. Further, as shown in FIGS. 7 (C) and 7 (D), by moving the base end 13b of the first piece 13 further to the tip side than the base end 14b of the second piece 14, the bending is caused. As the size increases, the loop P increases. Similarly, when the base end 14b of the second piece 14 is moved closer to the tip side than the base end 13b of the first piece 13, the loop P formed by the loop forming member 12 is the first piece 13. Bend to the side and turn.

また上記実施形態に示した医療用スネア２０は、第１、第２の操作部２２、２３を操作本体部２１の摺動溝Ｍに沿って摺動させることで、第１、第２の片１３、１４の基端１３ｂ，１４ｂが移動するものであったが、例えば、第１、第２の片１３、１４の基端１３ｂ，１４ｂを操作本体部２１の外側に延び出して、第１の片１３の基端１３ｂに第１の操作部２２を連結し、第２の片１４の基端１４ｂに第２の操作部２３を連結することで、第１、第２の操作部２２、２３が摺動溝Ｍを通過しないものとしてもよい。また或いは、操作本体部２１を省略し、筒部材１１の外側に延び出た第１、第２の片１３、１４の基端１３ｂ，１４ｂに第１、第２の操作部２２、２３を連結してもよい。以上のようにすれば、第１、第２の操作部２２、２３の操作によって、第１、第２の片１３、１４の基端１３ｂ，１４ｂを筒部材１１の長さ方向Ｚに移動させることだけでなく、第１の片１３の基端１３ｂを、第１の片１３の軸回りに回動させることや、第２の片１４の基端１４ｂを、第２の片１４の軸回りに回動させることも可能となる。図８〜図１１は、このような場合における第１、第２の片１３、１４の動きを示している。 Further, in the medical snare 20 shown in the above embodiment, the first and second operation portions 22 and 23 are slid along the sliding groove M of the operation main body portion 21 to form the first and second pieces. The base ends 13b and 14b of 13 and 14 were to be moved. For example, the base ends 13b and 14b of the first and second pieces 13 and 14 were extended to the outside of the operation main body portion 21 to extend the first one. By connecting the first operation unit 22 to the base end 13b of the piece 13 and connecting the second operation unit 23 to the base end 14b of the second piece 14, the first and second operation units 22, 23 may not pass through the sliding groove M. Alternatively, the operation main body 21 is omitted, and the first and second operation units 22 and 23 are connected to the base ends 13b and 14b of the first and second pieces 13 and 14 extending to the outside of the tubular member 11. You may. According to the above, the base ends 13b and 14b of the first and second pieces 13 and 14 are moved in the length direction Z of the tubular member 11 by the operation of the first and second operation units 22 and 23. Not only that, the base end 13b of the first piece 13 is rotated around the axis of the first piece 13, and the base end 14b of the second piece 14 is rotated around the axis of the second piece 14. It is also possible to rotate it to. 8 to 11 show the movements of the first and second pieces 13 and 14 in such a case.

上述のように第１、第２の片１３、１４の基端１３ｂ，１４ｂを回動可能にする場合には、第１、第２の各片１３、１４は、筒部材１１に軸回動自由に支持される構成とされる。筒部材１１の内孔１１ａは、第１、第２の各片１３、１４の基端１３ｂ、１４ｂがそれぞれ軸回動可能な大きさに設定される。 When the base ends 13b and 14b of the first and second pieces 13 and 14 are rotatable as described above, the first and second pieces 13 and 14 are axially rotated around the tubular member 11. It is configured to be freely supported. The inner hole 11a of the tubular member 11 is set to a size such that the base ends 13b and 14b of the first and second pieces 13 and 14, respectively, can rotate around the axis.

上記実施形態では、第１、第２の片１３、１４の基端１３ｂ，１４ｂが筒部材１１の長さ方向Ｚに移動可能であることで、ループＰの形状を変えることや、第１、第２の各片１３、１４が向き合う方向ＸにループＰの向きを変えることが可能であったが、上述のように第１、第２の各片１３、１４の基端１３ｂ，１４ｂを回動可能とすれば、ループＰの向きを方向Ｘと直交する方向Ｙに変えることや、ループＰの向きを筒部材１１の周方向に変えることも、さらに可能となる。 In the above embodiment, the base ends 13b and 14b of the first and second pieces 13 and 14 can be moved in the length direction Z of the tubular member 11, so that the shape of the loop P can be changed and the first and second pieces can be changed. It was possible to change the direction of the loop P in the direction X in which the second pieces 13 and 14 face each other, but as described above, the base ends 13b and 14b of the first and second pieces 13 and 14 are rotated. If it is movable, it is further possible to change the direction of the loop P to the direction Y orthogonal to the direction X and to change the direction of the loop P to the circumferential direction of the tubular member 11.

すなわち図８（Ａ）に示すように、第１、第２の各片１３、１４の基端１３ｂ、１４ｂを、第１、第２の各片１３、１４の上端が互いに近づく向き（矢印Ａの向き）に回動させると、第１、第２の各片１３、１４が矢印Ａの向きに捻られて、図８（Ｂ）に示すように、ループ形成部材１２に、上側（方向Ｙの一方側）への撓みが生じて、当該撓みは、第１、第２の各片１３、１４の先端に近づくにつれて大きなものとなる。これにより、ループＰは、上側（方向Ｙの一方側）に傾いたものものとなる。 That is, as shown in FIG. 8 (A), the base ends 13b and 14b of the first and second pieces 13 and 14 are oriented so that the upper ends of the first and second pieces 13 and 14 approach each other (arrow A). When rotated in the direction of (direction), the first and second pieces 13 and 14 are twisted in the direction of arrow A, and as shown in FIG. 8 (B), the loop forming member 12 is placed on the upper side (direction Y). Deflection to one side) occurs, and the deflection becomes larger as it approaches the tips of the first and second pieces 13 and 14, respectively. As a result, the loop P is tilted upward (one side in the direction Y).

また図９（Ａ）に示すように、第１、第２の各片１３、１４の基端１３ｂ、１４ｂを、第１、第２の各片１３、１４の下端が互いに近づく向き（矢印Ｂの向き）に回動させると、第１、第２の各片１３、１４が矢印Ｂの向きに捻られて、図９（Ｂ）示すように、ループ形成部材１２に下側（方向Ｙの他方側）への撓みが生じて、当該撓みは、第１、第２の各片１３、１４の先端に近づくにつれて大きなものとなる。これにより、ループＰは、下側（方向Ｙの他方側）に傾いたものとなる。 Further, as shown in FIG. 9A, the base ends 13b and 14b of the first and second pieces 13 and 14 are oriented so that the lower ends of the first and second pieces 13 and 14 approach each other (arrow B). When rotated in the direction of (B), the first and second pieces 13 and 14 are twisted in the direction of arrow B, and as shown in FIG. 9B, the loop forming member 12 is on the lower side (in the direction Y). Deflection to the other side) occurs, and the deflection becomes larger as it approaches the tips of the first and second pieces 13 and 14, respectively. As a result, the loop P is tilted downward (the other side in the direction Y).

なお図８、図９においては、第１、第２の各片１３、１４の基端１３ｂ、１４ｂを同じ位置に揃えた状態で、第１、第２の各片１３、１４の基端１３ｂ、１４ｂを回動させた場合を示しているが、第１、第２の各片１３、１４の基端１３ｂ、１４ｂの位置が筒部材１１の長さ方向Ｚにずれた状態で、基端１３ｂ、１４ｂを回動させてもよい。 In FIGS. 8 and 9, the base ends 13b of the first and second pieces 13 and 14 are aligned at the same positions as the base ends 13b and 14b of the first and second pieces 13 and 14, respectively. , 14b is shown, but the positions of the base ends 13b and 14b of the first and second pieces 13 and 14 are deviated in the length direction Z of the tubular member 11 and the base ends are displaced. 13b and 14b may be rotated.

図１０は、第２の片１４の基端１４ｂを固定しない状態で、第１の片１３の基端１３ｂを、第１の片１３の軸回りに回動させた場合の動きを示している。上記のように第１の片１３の基端１３ｂを回動させた場合には、第１の片１３の基端１３ｂに加えたトルクが、第１の片１３の長さ方向に伝達されることで、第１の片１３の全体が、第１の片１３の軸回りに回動するものとなる。そして、第１の片１３に加えたトルクが、先端部１２を経由して、第２の片１４に伝達されることで、第２の片１４は、第１の片１３の軸１３Ｊを中心とする周方向に移動するものとなる。そして上記の第１の片１３や第２の片１４の動きによって、ループＰの向きは、筒部材１１の周方向に変わる。 FIG. 10 shows the movement when the base end 13b of the first piece 13 is rotated around the axis of the first piece 13 without fixing the base end 14b of the second piece 14. .. When the base end 13b of the first piece 13 is rotated as described above, the torque applied to the base end 13b of the first piece 13 is transmitted in the length direction of the first piece 13. As a result, the entire first piece 13 rotates about the axis of the first piece 13. Then, the torque applied to the first piece 13 is transmitted to the second piece 14 via the tip portion 12, so that the second piece 14 is centered on the shaft 13J of the first piece 13. It will move in the circumferential direction. Then, the direction of the loop P changes in the circumferential direction of the tubular member 11 due to the movement of the first piece 13 and the second piece 14 described above.

図１１は、第１の片１３の基端１３ｂを固定しない状態で、第２の片１４の基端１４ｂを、第２の片１４の軸回りに回動させた場合の動きを示している。上記のように第２の片１４の基端１４ｂを回動させた場合には、第２の片１４の基端１４ｂに加えたトルクが、第２の片１４の長さ方向に伝達されることで、第２の片１４の全体が、第２の片１４の軸回りに回動するものとなる。そして、第２の片１４に加えたトルクが、先端部１２を経由して、第１の片１３に伝達されることで、第１の片１３は、第２の片１４の軸１４Ｊを中心とする周方向に移動するものとなる。そして上記の第１の片１３や第２の片１４の動きによって、ループＰの向きが、筒部材１１の周方向に変わる。 FIG. 11 shows the movement when the base end 14b of the second piece 14 is rotated around the axis of the second piece 14 without fixing the base end 13b of the first piece 13. .. When the base end 14b of the second piece 14 is rotated as described above, the torque applied to the base end 14b of the second piece 14 is transmitted in the length direction of the second piece 14. As a result, the entire second piece 14 rotates about the axis of the second piece 14. Then, the torque applied to the second piece 14 is transmitted to the first piece 13 via the tip portion 12, so that the first piece 13 is centered on the shaft 14J of the second piece 14. It will move in the circumferential direction. Then, the direction of the loop P changes in the circumferential direction of the tubular member 11 due to the movement of the first piece 13 and the second piece 14 described above.

以上のように図８〜図１１に示す形態（第１の片１３や第２の片１４の基端１３ｂ，１４ｂがそれぞれ筒部材１１の長さ方向Ｚに移動可能であることに加えて、第１、第２の片１３、１４の基端１３ｂ，１４ｂがそれぞれ回動可能な形態）によれば、上記実施形態と同様、ループＰの形状を変えることや、ループＰの向きを方向Ｘに変えることが可能であることに加え、ループＰの向きを方向Ｙに変えることや、ループＰの向きを筒部材１１の周方向に変えることも可能となる。したがって、ループＰの形状を所望の形状にしつつ、ループＰを様々な方向に向けることができる。このため、ループＰをポリープに引っ掛けることや、ループＰに除去対象物を保持させることを、より容易に実現できる。 As described above, in addition to the modes shown in FIGS. 8 to 11 (the base ends 13b and 14b of the first piece 13 and the second piece 14 can be moved in the length direction Z of the tubular member 11, respectively). According to the form in which the base ends 13b and 14b of the first and second pieces 13 and 14 are rotatable, respectively), the shape of the loop P can be changed and the direction X of the loop P can be changed as in the above embodiment. In addition to being able to change to, the direction of the loop P can be changed to the direction Y, and the direction of the loop P can be changed to the circumferential direction of the tubular member 11. Therefore, the loop P can be oriented in various directions while making the shape of the loop P a desired shape. Therefore, it is possible to more easily realize that the loop P is hooked on the polyp and that the loop P holds the object to be removed.

なお上述のように第１、第２の片１３、１４の基端１３ｂ，１４ｂを回動可能とする場合には、図１２に示すように、第１の片１３や第２の片１４を、螺旋状のトルクコイルＣから構成することが好ましい（（図１２（ａ）の断面図では、筒部材１１や第１の片１３や第２の片１４のハッチングを省略している）。このようにすれば、第１の片１３や第２の片１４が長い場合においても、第１の片１３や第２の片１４の基端１３ｂ，１４ｂに加えたトルクが、確実に先端部１２に伝達される。このため、ループＰの向きを方向Ｙに変えることや、ループＰの向きを筒部材１１の周方向に変えることを確実に実現できる（第１の片１３や第２の片１４をトルクコイルから構成する場合には、第１の片１３や第２の片１４が筒部材１１の内孔１１ａに挿通された状態で、第１の片１３や第２の片１４の螺旋は、筒部材１１の長さ方向Ｚに延びるものとされる）。 When the base ends 13b and 14b of the first and second pieces 13 and 14 are rotatable as described above, as shown in FIG. 12, the first piece 13 and the second piece 14 are used. , It is preferable that the torque coil C is formed (in the cross-sectional view of FIG. 12A, the hatching of the tubular member 11, the first piece 13 and the second piece 14 is omitted). By doing so, even when the first piece 13 and the second piece 14 are long, the torque applied to the base ends 13b and 14b of the first piece 13 and the second piece 14 is surely applied to the tip portion 12. Therefore, it is possible to surely change the direction of the loop P to the direction Y and the direction of the loop P to the circumferential direction of the tubular member 11 (first piece 13 or second piece). When the 14 is composed of a torque coil, the spiral of the first piece 13 and the second piece 14 with the first piece 13 and the second piece 14 inserted into the inner hole 11a of the tubular member 11. Is supposed to extend in the length direction Z of the tubular member 11).

なお第１の片１３や第２の片１４を、トルクコイルＣから構成する場合には、トルクコイルＣを折り曲げることで、ループ形成部材１２が形成され得る。この場合、トルクコイルＣの折り曲げ位置によって、ループ形成部材１２の先端部１２ａが構成される。そして先端部１２ａと一方の基端１３ｂの間のトルクコイルＣの範囲によって第１の片１３が構成され、上記先端部１２ａと他方の基端１３ｂとの間のトルクコイルＣの範囲によって、第２の片１３が構成される。 When the first piece 13 and the second piece 14 are composed of the torque coil C, the loop forming member 12 can be formed by bending the torque coil C. In this case, the tip portion 12a of the loop forming member 12 is formed by the bending position of the torque coil C. The first piece 13 is formed by the range of the torque coil C between the tip portion 12a and one base end 13b, and the first piece 13 is formed by the range of the torque coil C between the tip portion 12a and the other base end 13b. Piece 13 of 2 is configured.

また、第１、第２の各片１３，１４を別個のトルクコイルＣから構成してもよい。この場合には、第１片１３を構成するトルクコイルＣの先端部と、第２片１４を構成するトルクコイルＣの先端部とが接合されていることで、ループ形成部材１２が形成される。 Further, the first and second pieces 13 and 14 may be formed of separate torque coils C. In this case, the loop forming member 12 is formed by joining the tip of the torque coil C constituting the first piece 13 and the tip of the torque coil C forming the second piece 14. ..

また図１２では、３つのトルクコイルＣ１，Ｃ２，Ｃ３によって第１の片１３や第２の片１４を構成する例を示しているが、第１の片１３や第２の片１４を構成するトルクコイルＣの数は、１又は任意の複数とすることができる。 Further, although FIG. 12 shows an example in which the first piece 13 and the second piece 14 are formed by the three torque coils C1, C2 and C3, the first piece 13 and the second piece 14 are formed. The number of torque coils C may be one or any plurality.

なお図１２に示すように、第１の片１３や第２の片１４を、「外層のトルクコイルＣの内面が内層のトルクコイルＣの外面に密着し、且つ、外層のトルクコイルＣの巻方向と内層のトルクコイルＣの巻方向とが逆になっている多条多層コイル」から構成することで、第１の片１３や第２の片１４におけるトルク伝達性を向上させることができる（図１２の例では、最外層のトルクコイルＣ１の内面が中間層のトルクコイルＣ２の外面に密着し、トルクコイルＣ２の内面が最内層のトルクコイルＣ２の外面に密着し、トルクコイルの巻方向とが逆、トルクコイルＣ２の巻方向とトルクコイルＣ３の巻方向とが逆であることで、第１の片１３や第２の片１４におけるトルク伝達性を向上させることができる）。 As shown in FIG. 12, the first piece 13 and the second piece 14 are attached to "the inner surface of the outer layer torque coil C is in close contact with the outer surface of the inner layer torque coil C, and the outer layer torque coil C is wound. By configuring the "multi-row multi-layer coil in which the direction and the winding direction of the torque coil C in the inner layer are opposite", the torque transmission property in the first piece 13 and the second piece 14 can be improved ( In the example of FIG. 12, the inner surface of the outermost layer torque coil C1 is in close contact with the outer surface of the intermediate layer torque coil C2, the inner surface of the torque coil C2 is in close contact with the outer surface of the innermost layer torque coil C2, and the winding direction of the torque coil. On the contrary, the winding direction of the torque coil C2 and the winding direction of the torque coil C3 are opposite to each other, so that the torque transmission property in the first piece 13 and the second piece 14 can be improved).

図１３、図１４は、本発明の引っ掛け具１０のさらに他の実施形態を示す。
本実施形態は、上記した何れかの実施形態の引っ掛け具１０の構成を屈曲・伸展装置３０に組み付けて構成されたものである。なお、図１３、図１４においては、屈曲・伸展装置３０の先端側のみを図示しており、基端側の図示を省略している。
屈曲・伸展装置３０は、径方向に変形可能である中空筒状のガイド部３１と、ガイド部３１内に長さ方向に沿って移動自在に挿入される可動片３２とを備えている。
ガイド部３１は、弾性があり残留応力の小さな材料から形成されることが好ましい。このような材料として、復元力が大きい超弾性金属素材であるβチタンやニッケルチタン（ニチノール）やそれらの含む合金、ポリエーテルエーテルケトン（PEEK）などの樹脂製の材料や、ゴム等を使用できる。13 and 14 show still another embodiment of the hook 10 of the present invention.
This embodiment is configured by assembling the structure of the hook 10 of any of the above-described embodiments to the bending / extending device 30. In addition, in FIGS. 13 and 14, only the tip end side of the flexion / extension device 30 is shown, and the base end side is omitted.
The bending / extending device 30 includes a hollow tubular guide portion 31 that is deformable in the radial direction, and a movable piece 32 that is movably inserted into the guide portion 31 along the length direction.
The guide portion 31 is preferably formed of a material that is elastic and has a small residual stress. As such materials, resin materials such as β-titanium and nickel titanium (Nitinol), which are superelastic metal materials having a large restoring force, alloys containing them, polyetheretherketone (PEEK), and rubber can be used. ..

可動片３２は、前記ガイド部３１の長さ方向に沿って延び、互いに向き合う方向Ｔに可撓性を有する第１、第２の帯状の可撓片３３、３４と、第１、第２の可撓片３３、３４の先端３３ａ、３４ａ同士をつなぐ接続片３５とを含んでいる。 The movable piece 32 extends along the length direction of the guide portion 31, and has flexibility in the direction T facing each other, the first and second strip-shaped flexible pieces 33 and 34, and the first and second strips. It includes a connecting piece 35 that connects the tips 33a and 34a of the flexible pieces 33 and 34.

ガイド部３１の先端面３１ａ及び接続片３５には、前記した引っ掛け具１０の筒部材１１を通すための貫通孔３１ｂ、３５ａが形成されている。 Through holes 31b and 35a for passing the tubular member 11 of the hooking tool 10 are formed in the tip surface 31a and the connecting piece 35 of the guide portion 31.

第１、第２の可撓片３３、３４と接続片３５は、ガイド部３１よりも大きな剛性を有する材料から形成される。例えば、上述のようにガイド部３１がβチタンやニッケルチタンから形成される場合には、第１、第２の可撓片３３、３４は、ポリプロピレン、アクリル系材料、PEEK（ポリエーテルエーテルケトン）樹脂などを用いて、ガイド部３１よりも大きな剛性を有するように形成される。なお、第１、第２の可撓片３３、３４やガイド部３１の幾何パラメータ（第１、第２の可撓片３３、３４やガイド部３１の厚み、幅、或いは長さ）が調整されることで、第１、第２の可撓片３３、３４の剛性が、ガイド部３１の剛性よりも、大きくされてもよい。 The first and second flexible pieces 33 and 34 and the connecting piece 35 are formed of a material having a higher rigidity than the guide portion 31. For example, when the guide portion 31 is formed of β titanium or nickel titanium as described above, the first and second flexible pieces 33 and 34 are made of polypropylene, an acrylic material, or PEEK (polyetheretherketone). It is formed by using a resin or the like so as to have a rigidity larger than that of the guide portion 31. The geometric parameters of the first and second flexible pieces 33, 34 and the guide portion 31 (thickness, width, or length of the first and second flexible pieces 33, 34 and the guide portion 31) are adjusted. As a result, the rigidity of the first and second flexible pieces 33 and 34 may be made larger than the rigidity of the guide portion 31.

この屈曲・伸展装置３０では、図１４（Ａ）、図１４（Ｂ）に示すように、第１、第２の可撓片３３、３４の基端３３ｂ、３４ｂのうち、一方の基端を他方の基端に対して、ガイド部３１の長さ方向Ｓに相対的に摺動させることで、可動片３２には、第１、第２の可撓片３３、３４の接続片３５の位置を節点とする撓みが、第１、第２の可撓片３３、３４が向き合う方向Ｔに生じる。撓みが生じる原理は図６に示すループ形成部材１２の撓みの原理と同じであるため説明を省略する。
撓んだ可動片３２がガイド部３１の内面の一部又は全部に接することで、ガイド部３１にも上記向き合う方向Ｔへの撓みが生じる。ガイド部３１の撓みに応じて、ガイド部３１と可動片３２の内部に挿入された引っ掛け具１０の筒部材１１も撓む。In this bending / extending device 30, as shown in FIGS. 14 (A) and 14 (B), one of the base ends 33b and 34b of the first and second flexible pieces 33 and 34 is used. By sliding the guide portion 31 relative to the other base end in the length direction S of the guide portion 31, the movable piece 32 has the position of the connecting piece 35 of the first and second flexible pieces 33 and 34. Deflection with the above-mentioned node is generated in the direction T in which the first and second flexible pieces 33 and 34 face each other. Since the principle of bending is the same as the principle of bending of the loop forming member 12 shown in FIG. 6, the description thereof will be omitted.
When the bent movable piece 32 comes into contact with a part or all of the inner surface of the guide portion 31, the guide portion 31 also bends in the facing direction T. In response to the bending of the guide portion 31, the tubular member 11 of the hooking tool 10 inserted inside the guide portion 31 and the movable piece 32 also bends.

図１４（Ａ）においては、第１の可撓片３３の基端３３ｂを定位置に止め、第２の可撓片３４の基端３４ｂを第１の可撓片３３の基端３３ｂよりも長さ方向Ｓの先端側となるように摺動させており、第１、第２の可撓片３３、３４やガイド部３１はその先端部が向き合う方向Ｔの第１の可撓片３３の側に撓んでいる。これにより、筒部材１１も同じ側に撓む。なお、第２の可撓片３４の基端３４ｂを定位置に止め、第１の可撓片３３の基端３３ｂを第２の可撓片３４の基端３４ｂよりも長さ方向Ｓの基端側となるように摺動させても、図１４（Ａ）の場合と同様に、第１、第２の可撓片３３、３４やガイド部３１はその先端部が向き合う方向Ｔの第１の可撓片３３の側に撓む。
また、図１４（Ｂ）においては、第１の可撓片３３の基端３３ｂを定位置に止め、第２の可撓片３４の基端３４ｂを第１の可撓片３３の基端３３ｂよりも長さ方向Ｓの基端側となるように摺動させており、第１、第２の可撓片３３、３４やガイド部３１はその先端部が向き合う方向Ｔの第２の可撓片３４の側に撓んでいる。これにより、筒部材１１も同じ側に撓む。なお、第２の可撓片３４の基端３４ｂを定位置に止め、第１の可撓片３３の基端３３ｂを第２の可撓片３４の基端３４ｂよりも長さ方向Ｓの先端側となるように摺動させても、図１４（Ｂ）の場合と同様に、第１、第２の可撓片３３、３４やガイド部３１はその先端部が向き合う方向Ｔの第２の可撓片３４の側に撓む。
屈曲・伸展装置３０を伸展させる際には、摺動させた第１、第２の可撓片３３、３４の基端３３ｂ、３４ｂを摺動方向と逆方向に移動させ、基端３３ｂ、３４ｂの位置を揃える。これにより、撓んだ可動片３２が伸展しガイド部３１も可動片２に応じて伸展する。In FIG. 14A, the base end 33b of the first flexible piece 33 is fixed at a fixed position, and the base end 34b of the second flexible piece 34 is larger than the base end 33b of the first flexible piece 33. It is slid so as to be on the tip side in the length direction S, and the first and second flexible pieces 33, 34 and the guide portion 31 are the first flexible pieces 33 in the direction T in which the tip portions face each other. It is bent to the side. As a result, the tubular member 11 also bends to the same side. The base end 34b of the second flexible piece 34 is fixed at a fixed position, and the base end 33b of the first flexible piece 33 is a base in the length direction S from the base end 34b of the second flexible piece 34. Even if they are slid so as to be on the end side, the first and second flexible pieces 33 and 34 and the guide portion 31 are the first in the direction T in which the tip portions face each other, as in the case of FIG. 14 (A). Bends to the side of the flexible piece 33.
Further, in FIG. 14B, the base end 33b of the first flexible piece 33 is fixed at a fixed position, and the base end 34b of the second flexible piece 34 is the base end 33b of the first flexible piece 33. The first and second flexible pieces 33, 34 and the guide portion 31 are slid so as to be on the base end side in the length direction S, and the first and second flexible pieces 33, 34 and the guide portion 31 are second flexible in the direction T in which the tip portions face each other. It is bent to the side of the piece 34. As a result, the tubular member 11 also bends to the same side. The base end 34b of the second flexible piece 34 is fixed at a fixed position, and the base end 33b of the first flexible piece 33 is the tip end in the length direction S from the base end 34b of the second flexible piece 34. Even if they are slid so as to be on the side, the first and second flexible pieces 33 and 34 and the guide portion 31 are in the second direction T in which the tip portions face each other, as in the case of FIG. 14 (B). It bends to the side of the flexible piece 34.
When the bending / extending device 30 is extended, the base ends 33b and 34b of the slidable first and second flexible pieces 33 and 34 are moved in the direction opposite to the sliding direction, and the base ends 33b and 34b are moved. Align the positions of. As a result, the bent movable piece 32 extends, and the guide portion 31 also extends according to the movable piece 2.

また、可動片３２をガイド部３１の周方向Ｕに回転させる操作を行うことで、第１、第２の可撓片３３、３４が向き合う方向Ｔが回転する。これにより、ガイド部３１が撓む方向が変化し、筒部材１１の撓む方向も変化する。
その他の構成については、図１の実施形態と同様であるため、対応する部分に同一の符号を付すことで説明を省略する。Further, by performing an operation of rotating the movable piece 32 in the circumferential direction U of the guide portion 31, the direction T in which the first and second flexible pieces 33 and 34 face each other is rotated. As a result, the bending direction of the guide portion 31 changes, and the bending direction of the tubular member 11 also changes.
Since the other configurations are the same as those in the embodiment of FIG. 1, the description thereof will be omitted by assigning the same reference numerals to the corresponding portions.

上記の構成によれば、屈曲・伸展装置３０により引っ掛け具１０の筒部材１１を撓ませることができるので、内視鏡装置の体腔挿入部の先端から屈曲・伸展装置３０を有する引っ掛け具１０の筒部材１１を突出させ、筒部材１１を所望の方向に向けて撓ませることができる。この後、引っ掛け具１０の第１、第２の各片１３、１４の基端１３ｂ、１４ｂを摺動させてループ形成部材１２のループＰの向きや形状を変えることで、ループ形成部材１２の向きを所望の方向に制御できるので、ポリープ２にループ形成部材１２を引っ掛けやすくなる。図１５は、ポリープ２の奥側からポリープ２にループ形成部材１２を引っ掛けるために、屈曲・伸展装置３０により引っ掛け具１０の筒部材１１を斜め下方向に撓ませた状態を示す図である。 According to the above configuration, since the tubular member 11 of the hooking tool 10 can be bent by the bending / extending device 30, the hooking tool 10 having the bending / extending device 30 from the tip of the body cavity insertion portion of the endoscope device The tubular member 11 can be projected and the tubular member 11 can be bent in a desired direction. After that, the base ends 13b and 14b of the first and second pieces 13 and 14 of the hook 10 are slid to change the direction and shape of the loop P of the loop forming member 12, thereby changing the loop forming member 12. Since the orientation can be controlled in a desired direction, the loop forming member 12 can be easily hooked on the polyp 2. FIG. 15 is a diagram showing a state in which the tubular member 11 of the hooking tool 10 is bent diagonally downward by the bending / extending device 30 in order to hook the loop forming member 12 on the polyp 2 from the back side of the polyp 2.

以上、本発明の一実施形態について説明したが、本発明は上記実施形態に限定されるものではなく、本発明の趣旨を逸脱しない限りにおいて種々の変更が可能である。 Although one embodiment of the present invention has been described above, the present invention is not limited to the above embodiment, and various modifications can be made without departing from the spirit of the present invention.

１０ 引っ掛け具
１１ 筒部材
１１ａ 内孔
１１ｂ 支持部材
１２ ループ形成部材
１２ａ 先端部
１２ｂ 針
１３、１４ 第１、第２の片
１３ａ、１４ａ 互いに向き合う面
１３ｂ、１４ｂ 基端
１５ 外形
２０ 医療用スネア
２１ 操作本体部
２２、２３ 第１、第２の操作部
３０ 屈曲・伸展装置
３１ ガイド部
３１ａ 先端面
３１ｂ 貫通孔
３２ 可動片
３３、３４ 第１、第２の可撓片
３３ａ、３４ａ 第１、第２の可撓片の先端
３３ｂ、３４ｂ 第１、第２の可撓片の基端
３５ 接続片
３５ａ 貫通孔
Ｃ１，Ｃ２，Ｃ３ トルクコイル
Ｌ１ 第１、第２の各片の互いに向き合う方向と直交する方向に沿う外形寸法
Ｌ２ 第１、第２の各片の互いに向き合う方向に沿う外形寸法
Ｘ 第１、第２の片が向き合う方向
Ｙ 互いに向き合う方向と直交する方向
Ｚ 筒部材の長さ方向
Ｐ ループ
Ｓ ガイド部の長さ方向
Ｔ 第１、第２の可撓片が向き合う方向
Ｕ ガイド部の周方向10 Hooks 11 Cylinder member 11a Inner hole 11b Support member 12 Loop forming member 12a Tip 12b Needles 13, 14 First and second pieces 13a, 14a Faces facing each other 13b, 14b Base end 15 External shape 20 Medical snare 21 Operation Main bodies 22, 23 First and second operating parts 30 Bending / extending device 31 Guide part 31a Tip surface 31b Through hole 32 Movable pieces 33, 34 First and second flexible pieces 33a, 34a First and second Tip 33b, 34b of the flexible piece of the first and second flexible pieces 35 Connection piece 35a Through holes C1, C2, C3 Torque coil L1 External dimensions along the direction L2 External dimensions along the direction in which the first and second pieces face each other X Direction in which the first and second pieces face each other Y Direction orthogonal to the direction in which they face each other Z Long direction of the tubular member P loop S Length direction of the guide part T Direction in which the first and second flexible pieces face each other U Circumferential direction of the guide part

Claims (8)

貫通する内孔を有する筒部材と、
前記筒部材の前記内孔に挿通されるループ形成部材とを備え、
前記ループ形成部材は、先端同士が繋がった第１、第２の片を有しており、前記第１、第２の各片の基端は、それぞれ前記筒部材の長さ方向に移動可能とされ、
前記第１、第２の各片の基端の双方を前記筒部材の長さ方向の一方側に移動させることで、前記第１、第２の各片の先端側を前記筒部材の先端から突出させて、当該突出した第１、第２の各片の先端側によって、前記筒部材の先端の位置から延びるループを形成でき、
前記第１の片の基端と第２の片の基端とのうち、一方を他方に対して前記筒部材の長さ方向に相対的に移動させることで、前記第１の片と前記第２の片とが向き合う方向に、前記ループの向きを変えることができ、
前記第１、第２の各片の基端の双方を前記筒部材の長さ方向の他方側に移動させることで、前記第１、第２の各片の先端側を記筒部材の内孔に引き込むことが可能であり、
前記第１、第２の各片は、別個の線材よりなり、前記第１、第２の各片とは別個の針が前記ループ形成部材の先端部に取り付けられており、前記針によって前記第１、第２の各片の先端部同士が接合されており、且つ、前記第１の片や前記第２の片は、外層のトルクコイルの内面が内層のトルクコイルの外面に密着し、且つ、外層のトルクコイルの巻方向と内層のトルクコイルの巻方向とが逆である多条多層コイルから構成されている、引っ掛け具。 A tubular member with an inner hole that penetrates
A loop forming member inserted into the inner hole of the tubular member is provided.
The loop forming member has first and second pieces in which the tips are connected to each other, and the base ends of the first and second pieces can be moved in the length direction of the tubular member, respectively. Being done
By moving both the base ends of the first and second pieces to one side in the length direction of the tubular member, the tip end side of each of the first and second pieces can be moved from the tip end of the tubular member. By projecting, the tip side of each of the projecting first and second pieces can form a loop extending from the position of the tip of the tubular member.
By moving one of the base end of the first piece and the base end of the second piece relative to the other in the length direction of the tubular member, the first piece and the first piece are moved. The direction of the loop can be changed in the direction in which the pieces of 2 face each other.
By moving both the base ends of the first and second pieces to the other side in the length direction of the tubular member, the tip end side of each of the first and second pieces is made into an inner hole of the tubular member. It is possible to pull in and
Each of the first and second pieces is made of a separate wire rod, and a needle separate from each of the first and second pieces is attached to the tip of the loop forming member, and the needle causes the first. The tips of the first and second pieces are joined to each other, and in the first piece and the second piece, the inner surface of the torque coil in the outer layer is in close contact with the outer surface of the torque coil in the inner layer. A hooking tool composed of a multi-row multi-layer coil in which the winding direction of the torque coil in the outer layer and the winding direction of the torque coil in the inner layer are opposite. 前記第１、第２の各片に高周波電源装置が電気的に接続されて、前記第１、第２の各片に高周波電流を流すことが可能とされる請求項１に記載の引っ掛け具。 The hook according to claim 1, wherein a high-frequency power supply device is electrically connected to each of the first and second pieces so that a high-frequency current can flow through each of the first and second pieces. 前記第１、第２の片は、互いに向き合う方向への可撓性が互いに向き合う方向以外の方向への可撓性よりも大きい請求項１又は２に記載の引っ掛け具。 The hook according to claim 1 or 2, wherein the first and second pieces have greater flexibility in the direction facing each other than flexibility in a direction other than the direction facing each other. 前記ループ形成部材は、前記第１、第２の各片の長さ方向と直交する方向の断面形状において、前記互いに向き合う方向に沿う外形寸法が、前記互いに向き合う方向と直交する方向に沿う外形寸法より小さい形状である請求項１から３のいずれかに記載の引っ掛け具。 In the cross-sectional shape of the loop forming member in the direction orthogonal to the length direction of each of the first and second pieces, the outer dimensions along the directions facing each other are the outer dimensions along the direction orthogonal to the directions facing each other. The hook according to any one of claims 1 to 3, which has a smaller shape. 前記第１の片の基端を前記第１の片の軸回りに回動させることや、前記第２の片の基端を前記第２の片の軸回りに回動させることが可能とされることで、前記ループの向きを、前記第１の片と前記第２の片とが向き合う方向と直交する方向や、前記筒部材の周方向に変えることができる請求項１から４のいずれかに記載の引っ掛け具。 It is possible to rotate the base end of the first piece around the axis of the first piece and to rotate the base end of the second piece around the axis of the second piece. Thereby, any one of claims 1 to 4 can change the direction of the loop to a direction orthogonal to the direction in which the first piece and the second piece face each other or a circumferential direction of the tubular member. Hooks described in. 請求項１に記載の引っ掛け具と、
前記引っ掛け具の第１の片の基端部に連繋される第１の操作部と、前記引っ掛け具の第２の片の基端部に連繋される第２の操作部とを備える医療用スネア。 The hook according to claim 1 and
A medical snare including a first operating portion connected to a base end portion of a first piece of the hooking tool and a second operating portion connected to a base end portion of a second piece of the hooking tool. .. 前記第１、第２の各操作部を前記筒部材の長さ方向に沿って摺動自由に支持する操作本体部をさらに備える請求項６に記載の医療用スネア。 The medical snare according to claim 6 , further comprising an operation main body portion that freely slides and freely supports each of the first and second operation portions along the length direction of the tubular member. 請求項１に記載の引っ掛け具であって、
径方向に変形可能である中空のガイド部と、前記ガイド部内に長さ方向に沿って移動自在に挿入される可動片とを有する屈曲・伸展装置をさらに備え、
前記可動片は、前記ガイド部の長さ方向に沿って延び、互いに向き合う方向へ可撓性を有する第１、第２の帯状の可撓片と、前記第１、第２の可撓片の先端同士をつなぐ接続片とを含み、前記接続片及び前記ガイド部の端面に前記筒部材を通すための貫通孔が形成されている引っ掛け具。 The hook according to claim 1.
Further provided with a bending / extending device having a hollow guide portion that can be deformed in the radial direction and a movable piece that is movably inserted into the guide portion along the length direction.
The movable piece extends along the length direction of the guide portion and has flexibility in the direction facing each other, and the first and second strip-shaped flexible pieces and the first and second flexible pieces. A hooking tool including a connecting piece that connects the tips to each other and having a through hole formed in the end surface of the connecting piece and the guide portion for passing the tubular member.
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