Implant placement device, coupling support, and endoscopic treatment tool

• US 20120029278A1
• Filed: 05/25/2011
• Published: 02/02/2012
• Est. Priority Date: 11/09/2009
• Status: Active Grant

• Current Assignee: Olympus Corporation
• Original Assignee: Olympus Medical Systems Corporation (Olympus Corporation)
• Inventors: SATO, Masatoshi, TAKAHASHI, Shinji, HASHIMOTO, Tatsutoshi, MURAKAMI, Kazushi
• Granted Patent: US 9,895,142 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/00133 Drive units for endoscopic tools inserted through or with the endoscope
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/0645 being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0649 Coils or spirals

Abstract

An implant placement device includes a sheath; a long-axis member having an opening on a distal end side, movable along an axis, and a lumen communicating with the opening; a stylet movable in the axis and provided within the lumen to be turnable around the axis; an operating part on a proximal end side of the stylet to turn the stylet around the axis; a guide part on the proximal end side of the sheath to guide the operating part in a predetermined direction, thereby moving the sheath in the axis with respect to the stylet and turning a distal end portion of the stylet around the axis; and a coupling portion formed at the distal end of the stylet, detachably coupled with an implant, and moving in the axis and turning around the axis along with the stylet and the implant according to an operation of the operating part.

Claims

1. An implant placement device comprising:

a sheath having a longitudinal axis;

a long-axis member having an opening formed on a distal end side thereof, movable along the longitudinal axis, and provided with a lumen communicating with the opening;

a stylet being movable in the longitudinal axis within the lumen, and provided within the lumen so as to be turnable around the longitudinal axis;

an operating part provided on a proximal end side of the stylet in order to turn the stylet around the longitudinal axis;

a guide part provided on the proximal end side of the sheath to guide a movement of the operating part in a predetermined direction, thereby moving the sheath in the longitudinal axis with respect to the stylet and turning a distal end portion of the stylet around the longitudinal axis; and

a coupling portion formed at the distal end of the stylet, detachably coupled with an implant to be placed within a body tissue, and moving in the longitudinal axis and turning around the longitudinal axis along with the stylet and the implant according to an operation of the operating part.

2. The implant placement device according to claim 1,

wherein the long-axis member is a tubular member having a coil-spring-shaped implant to be placed in a body tissue arranged in a stretched state therein, and capable of being inserted into the body tissue, and

wherein the sheath rotates integrally with the tubular member around an axis of the tubular member in a state where the tubular member is inserted therethrough.

3. The plant placement device according to claim 2, wherein

the stylet is arranged inside the tubular member closer to the proximal end side than the implant in an insertion direction of the tubular member, and is coupled to the end of the implant.

4. The plant placement device according to claim 3,

wherein the stylet, the tubular member, and the sheath rotate integrally around the axis of the tubular member.

5. The plant placement device according to claim 2,

wherein a multilayer coil wound around the outer peripheral surface of the tubular member in a circumferential direction and fixed thereto is provided between the tubular member and the sheath.

6. The plant placement device according to claim 2,

wherein at least a portion of the tubular member is formed from a multilayer coil sheath.

7. The plant placement device according to claim 2,

wherein at least of a portion of the tubular member is formed from a material having superelasticity.

8. The implant placement device according to claim 2,

wherein at least a portion of the tubular member is formed from resin.

9. The plant placement device according to claim 3,

wherein the stylet is formed from a material having superelasticity.

10. The plant placement device according to claim 1, being an implant placement device used after being inserted to an insertion part of an endoscope,

wherein the long-axis member is a tubular member having a coil-spring-shaped implant arranged in a stretched state therein, and capable of being inserted into a body tissue,

wherein the tubular member is inserted through an inside of the sheath,

wherein the implant placement device further includes a stylet arranged inside the tubular member closer to the proximal end side than the coil in an insertion direction of the tubular member, and a sheath operating part moving at least the sheath to the distal end side in the insertion direction into the insertion part in an axial direction of the tubular member with respect to the endoscope, and moving at least the sheath to the proximal end side in the insertion direction with respect to the endoscope after the movement, and

wherein the operating part is capable of operating the tubular member, the stylet, and the sheath.

11. The plant placement device according to claim 10,

wherein the sheath operating part moves the sheath and the stylet relative to each other in the axial direction of the sheath when the sheath is moved to the proximal end side in the insertion direction.

12. The plant placement device according to claim 10,

wherein a movement distance by which the sheath is moved to the proximal end side by the sheath operating part is set to be shorter than a length equivalent to one round of the coil of the implant.

13. The plant placement device according to claim 10,

wherein the distance by which the sheath protrudes from the distal end of the insertion part of the endoscope when the sheath is moved to the proximal end side in the insertion direction by the sheath operating part is greater than the size of the external diameter of the coil of the implant.

14. The plant placement device according to claim 10,

wherein the sheath operating part moves the stylet along with the sheath when moving the sheath to the distal end side in the insertion direction.

15. The plant placement device according to claim 14,

wherein the sheath operating part moves the tubular member and the stylet along with the sheath.

16. The plant placement device according to claim 10,

wherein the sheath operating part has a stopper that fixes the axial relative positions of the sheath and the sheath operating part at a predetermined movement distance when the sheath is moved to the distal end side in the insertion direction.

17. The plant placement device according to claim 10,

wherein the sheath operating part has a stopper that fixes the axial and circumferential relative positions of the sheath and the sheath operating part at a predetermined movement distance when the sheath is moved to the proximal end side in the insertion direction.

18. The plant placement device according to claim 10,

wherein the stylet is coupled to the end of the coil,

wherein the sheath is rotatable integrally with the tubular member around the axis of the tubular member,

wherein the operating part has an operating body coupled to the sheath operating part,

wherein the implant placement device further includes a cam tube arranged coaxially with the central axis of the sheath operating part inside the sheath operating part, and coupled to the sheath such that the advance and retreat operation of the sheath operating part in a direction of the central axis interlocks with the sheath, and a tilt cam formed at a portion of an outer wall portion of the cam tube and engaging with the operating body, and

wherein the tilt cam moves in the direction of the central axis of the cam tube relative to the operating body, and turns the sheath operating part around an axis relative to the operating body.

19. The plant placement device according to claim 18,

wherein when the stylet is seen toward the distal end side from the proximal end side in a delivery direction in which the implant is delivered from the tubular member, the stylet rotates around an axis of the stylet inside the tubular member in a direction opposite to a winding direction of the coiled form of the portion of the implant hooked to the body tissue.

20. An endoscopic treatment tool comprising the implant placement device according to claim 1 and used in combination with an endoscope,

wherein the long-axis member is a tubular member capable of being inserted into a body tissue,

wherein the tubular member is inserted through the inside of the sheath,

wherein the operating part has an operating body that is coupled to the tubular member and the sheath, respectively, and operates at least any of the tubular member and the sheath,

wherein the operating body is provided with a tubular member slider that advances and retreats the tubular member in an axial direction of the tubular member with respect to an operating body,

wherein a slide stopper that is capable of moving relative to the operating body in the axial direction of the tubular member and capable of being fixed to the operating body, and regulates an advance and retreat of the tubular member slider when fixed to the operating body is provided on the distal end side of the tubular member slider in an insertion direction of the tubular member, and

wherein the endoscopic treatment tool further includes a coupling member that couples the tubular member slider and the slider stopper together when the tubular member slider has come into contact with the slider stopper, and suppresses a movement of the tubular member slider at least in an advance and retreat direction with respect to the slider stopper.

21. The endoscopic treatment tool according to claim 20,

wherein a fixing member is provided to allows for selection of a state where an axial positions of the tubular member and the tubular member slider are fixed and a state where the axial positions are not fixed.

22. The endoscopic treatment tool according to claim 21, further comprising:

a pull-back mechanism that pulls back the tubular member to the inside of the sheath after being moved such that the tubular member protrudes from the sheath,

wherein the pull-back mechanism moves the tubular member relative to the sheath in the axial direction of the sheath until the distal end of the tubular member is pulled back to the inside of the sheath to the inside of the sheath.

23. A coupling support capable of being inserted to an operating part of an endoscope, and coupling a forceps channel of the endoscope with the implant placement device or endoscopic treatment tool according to any one of claims 1 to 22, the coupling support comprising:

a first engaging portion that engages with the external surface of the operating part;

a second engaging portion that engages with the external surface of the implant placement device; and

a coupling portion that couples together the first engaging portion and the second engaging portion in a positional relationship in which the direction of the central axis of a port of the forceps channel on the side of the operating part of the endoscope coincides with a direction in which the sheath extends from the implant placement device.