JPH07155333A - Ligator for phlebeurysm - Google Patents

Abstract

PURPOSE:To provide a ligator for the phlebeurysm which gives a less pain on a patient and is good in operability for a doctor as well. CONSTITUTION:A second tube 22 is inserted into a first tube 21 inserted into the pincer hole of an endoscope and a wire 23 is passed through the inside of this second tube. A tubular member 25 for holding by ligature is so disposed that a ligature ring 26 ligates the phlebeurysm by pulling the wire outward of the patient after the phlebeurysm is sucked through the pincer hole. Further, the ligature ring is provided with a recessed part 33 for holding by ligature in order to hold the ligature state and the tubular member 25 for holding by ligature is provided with a projecting part 27 engaging with this recessed part 33 for holding by ligature. Further, the ligature ring 26 is provided with a notch 34 for disconnection in order to tear off the ligature ring 26.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a varicose vein ligator for use in endoscopic sclerotherapy for varicose veins.

[0002]

2. Description of the Related Art For example, the following is known as a sclerosing treatment device for performing sclerosing treatment using an endoscope for esophageal varices. As shown in FIGS. 10 and 11, the sclerosing treatment device includes an inner cylinder 2 that is set on an outer peripheral surface of an O-ring-shaped rubber annular ring 1 with its inner diameter expanded, and the inner cylinder 2 described above. A friction fit adapter 3 having an inner diameter slightly larger than the outer diameter of the cylinder 2 and a trip wire 4 connected to the inner cylinder 2 are provided. 10 and 11, the inner cylinder 2 and the friction fit adapter 3 are shown as transparent so that the operation of the curing treatment device can be easily understood. Such a sclerosing treatment device is attached to the distal end portion of the endoscope 5. That is, one end of the friction fit adapter 3 is inserted into the tip of the endoscope. In addition, the trip wire 4 is inserted through the forceps hole of the endoscope.
Of the trip wire 4 is connected to the inner cylinder 2 in which the annular ring 1 is set. Then, the inner cylinder 2 is pulled into the friction fit adapter 3 to such an extent that the ring 1 set in the inner cylinder 2 does not come off. In such a state, the distal end of the endoscope is advanced into the body up to the affected part, and the varicose vein is sucked into the inner cylinder 2 by the suction device via the endoscope as shown in FIG. With the varicose vein sucked into the inner cylinder 2 in this manner, the trip wire 4 is pulled, and the inner cylinder 2 is further pulled into the friction fit adapter 3 to set a circle set on the outer peripheral surface of the inner cylinder 2. After the ring 1 comes into contact with the friction fit adapter 3, the ring 1 is detached from the outer peripheral surface of the inner cylinder 2 by the friction fit adapter 3, and the root of the varicose vein that has been sucked is bound as shown in FIG. The varicose vein thus bound is necrosed and discharged together with the annulus 1 to the outside of the body.

[0003]

As is clear from the above description of the operation, in the above-mentioned sclerosing treatment device, only one annular ring 1 can be set in the inner cylinder 2. In the treatment of varicose veins, there are multiple sites to be treated, so once the ligation of one varicose vein is completed, the endoscope is once removed from the body, and the friction fit adapter 3 and the inner tube are again attached to the distal end of the endoscope. It is necessary to repeat the operation of wearing the second item and the like and inserting the endoscope again into the body. Generally, to treat varicose veins, it is necessary to repeat the above operation 4 to 12 times on average,
In order to facilitate such multiple insertions of the endoscope into and out of the body, the patient needs to be pre-inserted with a rather thick overtube. This is very painful for the patient to be treated, and also has poor operability for doctors and the like. The present invention has been made to solve such a problem, and an object of the present invention is to provide a varicose vein ligator that causes less pain to a patient and is easy to operate for a doctor or the like.

[0004]

SUMMARY OF THE INVENTION The present invention is an endoscope having a forceps hole and connecting a suction device, wherein a suction operation through the forceps hole by the suction device causes a varicose vein inside the tip of the endoscope. In a varicose vein ligating device that is inserted into the forceps hole of an endoscope that sucks in, a first tube that is inserted into the forceps hole and has an opening at one end located at the distal end of the endoscope, and a tube axis as described above. A second tube is inserted into the first tube along the axial direction of the first tube, and a ligating portion and a non-ligating portion are respectively provided from one end to the other end, and each ligating portion is ligated and held. A ring formed by joining the one end and the other end of two string-like bodies each having a notch for cutting at the boundary between each of the ligated part and the non-ligated part And, in the state where the ring is crushed into an elongated shape, the first It has a thickness to be drawn into the tube and is arranged so as to surround a varicose vein that spreads in a circular shape when pushed from the inside of the endoscope tip to the outside of the endoscope tip and is sucked into the inside of the endoscope tip. And a connecting member to be connected to the other end of the ligature wheel, which is inserted into and out of the endoscope through the second tube. A ligation wheel operating wire for performing an operation, a ligation retaining tubular member through which the non-ligation portion of the ligation wheel operating wire and the ligation wheel can penetrate, and the ligation wheel operating wire to which the ligation wheel is connected is It is placed inside the patient's body from the opening of the second tube located at the distal end of the endoscope in a penetrating state, and can be inserted into the first tube but cannot be inserted into the second tube. The wire for operating the ligature wheel has When the ligature wheel is retracted, it is engaged with the ligature holding notch of the ligature wheel to inhibit the movement of the ligature part of the ligature wheel and to hold the ligature state of the varicose vein by the ligature part of the ligature wheel. And a tubular member for holding a ligature having a locking member, wherein the non-ligating portion of the ligating wheel is further connected by the ligating wheel operating wire in a state where the notch for ligating holding and the locking member are engaged with each other. It is characterized in that the ligation part and the non-ligation part are separated by the notch for cutting of the ligation wheel by being pulled, and the ligation holding member including the ligation part is left in the patient's body.

[0005]

With this configuration, the ligature ring penetrates through the first tube inserted into the forceps hole of the endoscope and is guided to the affected area. Therefore, the endoscope itself is ligated for each ligation procedure. It will not be taken in or out of the patient's body.

The joining at the other end of the string-shaped body includes not only the case where the other ends are joined in advance but also the case where the respective separated other ends are indirectly joined. Further, the circular shape in a state where the ligature ring is expanded is a concept including not only a perfect circle but also, for example, an ellipse.

[0007]

DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the varicose vein ligating device of the present invention will be described below with reference to the drawings. As shown in FIGS. 8 and 7, the varicose vein ligator 20 in the present embodiment has a forceps hole 10 penetrating along the axial direction, and a suction device (not shown) provided outside the patient's body and the forceps hole 10 described above. It is applied to an endoscope 11 of a type capable of sucking a tissue inside a patient through the forceps hole 10 by connecting with. That is, the varicose vein ligator 20 is inserted into the forceps hole 10 from the forceps hole inlet on the endoscope 11 outside the patient's body, and sends out a ligature ring, which will be described later, from the forceps hole outlet at the endoscope tip 11a, for example, the esophagus. The varicose veins are ligated.

The varicose vein ligator 20 in this embodiment is
As shown in FIG. 1, the first tube 21 and the second tube 2
2. A wire 23 corresponding to the ligature wheel operating wire according to the claims, a ligature holding tubular member 25, a ligature wheel 26, and the like are provided. Further, the endoscope 11 to which the varicose vein ligating apparatus 20 of the present embodiment is applied has a forceps hole 10 with a diameter dimension of 2.7 mm. 1 to 9, the same components are designated by the same reference numerals. The first tube 21 is a tube made of Teflon having an outer diameter dimension of 2.4 mm and an inner diameter dimension of 1.8 mm, and is arranged so that the axial direction of the forceps hole 10 is along the axial direction of the first tube 21. The endoscope 11 outside the patient's body is inserted from the operating side of the endoscope 11 to the endoscope tip portion 11a inside the patient's body.

The outer diameter of the second tube 22 is 1.6 m.
m, an inner diameter of 1.2 mm, is a metal spiral tube in which a metal material is spirally wound on the outer peripheral surface, and the first tube 21 is axially aligned with the second tube 22 in the axial direction. One tube 21 is inserted from the operation side of the endoscope 11 to the endoscope tip portion 11a. The second tube 22 can freely move in the first tube 21 in the axial direction.

The wire 23 is made of stainless steel and has a diameter of 0.4 mm. The wire 23 extends along the axial direction of the second tube 22 from the operation side of the endoscope 11 to the endoscope tip portion 11a.
Is inserted in the direction. Further, a ligature wheel connecting member 24 made of stainless steel for connecting the ligature wheel 26 and the wire 23 is attached to the tip portion of the wire 23 in the direction of the endoscope tip portion 11a. The ligature wheel connecting member 24 has a diameter dimension of 0.7 mm, and is connected to the ligature wheel 26 by crimping one end thereof, for example, a ligature wheel connecting member 24a.
And a wire-side connecting member 24b whose one end is fixed to the tip of the wire 23. Incidentally, the ligation wheel side connecting member 24
The other end of a and the other end of the wire side connecting member 24b are detachably connected by, for example, a screw or a fitting method.

The ligature holding tubular member 25 is a tubular member made of stainless steel having an outer diameter of 1.6 mm, an inner diameter of 1.4 mm and a length of about 8 mm. In this embodiment, one end in the axial direction is used. The portion 25a is provided with a small diameter portion having an outer diameter dimension of 1.1 mm. The formation of the small diameter portion is optional. In addition, at a position somewhat from the other end 25b from the axial center of the ligation holding tubular member 25, the ligation holding tubular member 25 continuously extends toward the center of the tube along the entire inner circumferential surface of the ligation holding tubular member 25. A protruding portion 27 having a protruding U-shaped cross section is formed. The convex portion 27 corresponds to the locking member described in the claims. The inner diameter of the ligature holding tubular member 25 in the portion where the protrusion 27 is formed is about 0.9 mm, and the ligature wheel connecting member 24 can pass through this portion. Further, because of the dimensions of the first tube 21, the second tube 22 and the ligation holding tubular member 25 described above, the ligation holding tubular member 25 can be inserted into the tube of the first tube 21, but the second tube 22. Cannot enter into the pipe. In the present embodiment, the convex portion 27 is formed over the entire circumference of the inner peripheral surface of the ligation holding tubular member 25, but it may be provided in a certain range or only in a predetermined portion. Further, although the ligation holding tubular member 25 is tubular in the present embodiment, the present invention is not limited to this.

As shown in FIG. 8, the ligature wheel 26 has two string-like members 28 and 29, which have the same shape, at one end 26a.
And a substantially circular silicon rubber ring joined at the other end 26b. Each of the string-like members 28 and 29 has a semicircular cross section, and the semicircular semicircular surface 31 is arranged on the outer diameter side of the ligature wheel 26 as shown in FIG. The semicircular flat surface 32 is arranged on the inner diameter side of 26. Therefore, the string-like bodies 28 and 29 forming the ligature wheel 26 shown in FIG. 8 are aligned at the center line 30 of the ligature wheel 26 to form a substantially perfect circle.

Further, on the outer diameter side of the ligature wheel 26, a semicircular ligature holding recess 33 is formed in each of the string-like bodies 28 and 29.
And a V-shaped notch 34 for separation is formed. The ligature holding recess 33 is formed at an angle position of 47 degrees from the center line 30 in the clockwise direction and the counterclockwise direction with respect to the center point of the ligation wheel 26, and the notch 34 for cutting is used in the center line 30. Is formed at an angle position of 67 degrees in the clockwise direction and the counterclockwise direction. The thickness C of the ligature holding concave portion 33 and the closest portion of the cords 28, 29 to the flat surface 32 is 0.25 mm, and the thickness dimension C at the closest portion of the notch 34 for cutting and the flat surface 32 is. The thickness dimension D is 0.1 mm to 0.15 mm. Such a ligature holding concave portion 33 has the above-mentioned ligature holding tubular member 25.
Ligature ring 2 that ligates a varicose vein by engaging the convex portion 27 of the
6 acts so that the ligated state can be maintained. Further, the cutting notch 34 acts so that the ligation wheel 26 is torn at the cutting notch 34 portion in a state where the ligature holding concave portion 33 and the convex portion 27 are engaged with each other.

In each of the string-like members 28, 29, a section 35 from the one end 26a to the notch 34 for cutting corresponds to the ligation part described in the claims, and the notch 34 for cutting and the other end 2 are provided.
The section 36 up to 6b corresponds to the unligated portion described in the claims.

Further, each of the cord-like members 28, 29 has a semicircular diameter gradually decreasing from the one end 26a to the other end 26b. That is, in each of the string-like bodies 28 and 29, the radius dimension from the one end portion 26a to each ligature holding recess 33 is 0.8 mm, and the radius dimension from the ligature holding recess 33 to the cutting notch 34 is 0. 0.6 mm, and the radius dimension from the notch 34 for cutting to the other end 26b is 0.4 mm. In addition, the inner diameter of the ligature ring 26 is 17.0 m regardless of the change in the radius.
Since the outer diameter of the ligature device 26 is constant, the outer diameter of the ligature device 26 is 18.6 mm from the one end 26a to each of the ligature holding recesses 33 due to the change in the above-mentioned radial dimension. 18.2 mm up to the notch 34,
The distance from the cutting notch 34 to the other end 26b is 17.8 mm.

Further, the vicinity of the one end portion 26a and the other end portion 26b of the ligation wheel 26 is not circular but V-shaped.
The reason for having such a shape is that the ligature wheel 2 is used as described later.
6 is inserted into the first tube 21 so that the string-like bodies 28 and 29 are aligned with the center line 30. At that time, the first tube 21 near the one end portion 26a and the other end portion 26b is connected to the first tube 21. This is for proper insertion.

As a material for the ligation wheel 26, a synthetic resin material such as polyester or polyethylene, or a metal material such as stainless steel may be used. Also, the string-like body 2
The numbers 8 and 29 are not limited to those having a semicircular cross section as described above. Further, the above-mentioned dimensional values and angle values in each part of the ligation wheel 26 are not limited to those described above. Furthermore, although the string-like bodies 28 and 29 have the same shape in the present embodiment, the present invention is not limited to this, and may have different shapes. In this case, the ligature holding concave portion 33 and the ligature holding tubular member 2
It is necessary to appropriately design the arrangement of the convex portions 27 so that the convex portions 27 of No. 5 are properly engaged. further,
In the present embodiment, the other end portion 26b of the ligation wheel 26 is joined, but the present invention is not limited to this, and it may not be joined. In this case, the other end portions 26b of the string-like bodies 28, 29 are connected by the ligature wheel side connecting member 24a of the ligature wheel connecting member 24 described above. Furthermore, the notch 34 for separation is not limited to the V-shaped one described above, and may be any shape having a concept of reducing the thickness of the string-like bodies 28, 29. Further, the ligating wheel 26 is not limited to the circular shape in the expanded state.

The ligature ring 26 thus constructed is shown in FIG.
As shown in FIG. 1, one end 25a of the ligation holding tubular member 25
The other end portion 26b of the ligation wheel 26 is connected to the ligation wheel side connection member 24a of the ligation wheel connection member 24 that penetrates from the direction of the other end portion 25b.

The operation of the varicose vein ligating device thus configured will be described below. The first tube 21 is inserted into the forceps hole 10 of the endoscope 11. Next, the ligature ring 26 connected to the ligature ring connecting member 24 penetrating the second tube 22 and the ligature holding tubular member 25 arranged inside the patient body of the second tube is connected to the ligature ring 26 constituting each ligature ring 26. Body 28,
By aligning 29 with the center line 30, the elongated tube is inserted into the first tube 21. Following the ligature wheel 26, the ligature holding tubular member 25 and the ligature wheel connecting member 24 are inserted into the first tube 21. And the second tube 22
Is inserted into the first tube 21, the end 22a inside the patient body of the second tube 22 is ligated and held by the tubular member 25.
The second tube 22 and the wire 23 are inserted into the first tube 21 by contacting one end 25a of the ligature ring 26, the ligature holding tubular member 25, and the ligature ring connecting member 24.
As shown in FIG. 2, the second tube 22 is pushed to the distal end of the first tube 21, that is, the distal end 11a near the affected part of the endoscope 11 inside the patient. Further, the second tube 22 and the wire 23 are connected to the first tube 21.
By inserting the ligature ring 26 into the first tube 21, in other words, the endoscope 1 as shown in FIG. 3 or FIG.
1 is pushed out into the patient's body from the distal end 11a of the ligature ring 2
6 spreads in a substantially circular shape as shown by the restoring force of itself.

The doctor performs an operation such as rotating the wire 23 in the circumferential direction while observing the inside of the patient with the endoscope 11, and as a result, as shown in FIG.
6 is arranged so as to surround the varicose vein 12 to be treated. Then, the opening 11 of the distal end portion 11a of the endoscope 11
Apply b to the varicose vein 12. Next, the doctor drives the suction device to suck the varicose vein 12 through the forceps hole 10, whereby the varicose vein 12 is sucked into the distal end portion 11a of the endoscope 11. Therefore, the varicose vein 12 is in a state in which the inside of the ring of the ligation ring 26 is raised as shown in FIG. 6. In such a state, immediately after the suction is stopped, the doctor
After fixing so as not to move in the axial direction, the wire 23 is pulled toward the outside of the patient's body. In addition, when the second tube 22 is fixed, the distal end portion 22a of the inside of the patient body has a ligation holding tubular member 2
The insertion length of the second tube 22 into the first tube 21 is adjusted so that the second tube 22 is located at a position entering the first tube 21 from the distal end portion 11a of the endoscope 11 by the axial length of 5. Is preferred.

By pulling the wire 23, the wire 23
The ligature ring 26 is brought together with the ligature holding tubular member 25 to the distal end portion 21a inside the patient body of the first tube 21 via the ligature ring connecting member 24 connected to the ligature holding tubular member 25, and the wire 23 is pulled. 25 is the first tube 2
One end 2 of the tubular member 25 for holding the ligature
5a and the patient's body inside tip part 22a of the 2nd tube 22 contact | abut. As described above, the second tube 22 is prohibited from moving in the axial direction.
Even if is pulled, the ligation holding tubular member 25 is prohibited from moving outside the patient's body. Therefore, by further pulling the wire 23, the ligation wheel 26 is gradually pulled from the non-ligation portion 36 of the ligation wheel 26 toward the ligation portion 35 into the ligation holding tubular member 25. Although there may be some resistance when the ligature wheel 26 passes through the convex portion 27 of the ligature holding tubular member 25, in the present embodiment, since the ligature wheel 26 is made of silicone rubber, the ligature wheel 26 is The expansion and contraction does not cause problems such as impassability. Further, the non-ligated portion 36 passes through the ligature holding tubular member 25 and is drawn into the second tube 22.

In this way, the diameter of the ligature ring 26 is gradually reduced, and the varicose vein 12 is ligated. Then, the ligature holding concave portion 33 of the ligature ring 26 is provided with the ligature holding tubular member 2
When the convex portion 27 of No. 5 is pulled in, the ligature holding concave portion 33 and the convex portion 27 engage with each other as shown in FIG. By engaging in this way, the ligation of the varicose vein 12 is completed, and even if the wire 23 is subsequently pulled, the ligation portion 3 of the ligation wheel 26 is
Both the movement of the patient 5 toward the outside of the body and the movement of the inside of the patient are prohibited. Therefore, the ligature ring 26 holds the varicose vein 12 in the ligated state by the ligature holding tubular member 25. When the ligature holding concave portion 33 and the convex portion 27 are engaged, the inner diameter dimension E of the ligature wheel 26 shown in FIG. 4 is about 2.5 mm.

After the above engagement is performed, the wire 23 is further
Since the movement of the ligation portion 35 is prohibited by pulling the ligature outside the patient's body, the non-ligation portion 36 is pulled, and a tensile force acts on the notch 34 for cutting to cause the notch 34 for cutting. The ligature ring 26 is torn off. And the first
The first tube 2 is pulled by pulling the tube 21 toward the outside of the patient or inserting the second tube 22 toward the inside of the patient.
The ligation part 35 and the ligation holding tubular member 25 are sent out from 1 to the patient body, and the ligation part 35 and the ligation holding tubular member 25 are left in the patient body as shown in FIG. The ligated varicose vein 12 is then necrotized and discharged together with the ligation portion 35 and the ligation holding tubular member 25 out of the patient's body.

In this way, the procedure for ligating one varicose vein is completed, and the doctor inserts the second tube 22 and the wire 23 into the endoscope 1.
Extract from 1 to outside the patient's body. Then, after removing the ligation wheel side connecting member 24a having the unligated portion 36 left from the ligation wheel connecting member 24, the wire side connecting member 24b is passed through the new ligature holding tubular member 25, and the new ligature wheel 26 is set. Ligating wheel side connecting member 24a and wire side connecting member 24
Connect with b. The attachment of the new ligature wheel 26 is completed by the above operation, and the ligature wheel 26 is again attached by the procedure described above.
1 to the tip portion 11a. Then, the varicose vein is ligated again. After that, these operations are repeated until the treatment is completed for all varicose veins.

As described above, according to the varicose vein ligating apparatus of this embodiment, the endoscope 11 is used for each ligation procedure.
The ligation ring 26 and the like may be put in and taken out in the first tube 21 inserted in the forceps hole 10 of the above, and it is not necessary to put the endoscope 11 itself in and out of the patient. Therefore, it is no longer necessary to insert the overtube into the patient, which has been conventionally required for moving the endoscope itself into and out of the patient's body, and the patient's pain can be alleviated. Also, the forceps hole 1
The ligature ring 26 and the like may be taken in and out in the first tube 21 inserted in 0, and in the case of replacement with a new ligature ring and the like, the ligature wheel side connecting member 24a is removed from the ligature wheel connecting member 24 and the new ligature wheel 26 is replaced. Since a new ligature ring 26 can be mounted by connecting the ligature ring side connecting member 24a and the wire side connecting member 24b that have been set, it is possible to provide a varicose vein ligator that is easy to operate even for a doctor or the like. it can. Further, in the varicose vein ligator of the present embodiment, since the ligation is performed together with the mucous membrane around the varicose vein, the blood vessel is not damaged. Further, by changing the size of the ligature ring, varicose veins of various sizes can be dealt with by the same ligator.

The varicose vein ligator of this embodiment can be used not only for varicose veins in the esophagus but also for sclerotherapy for varicose veins in the stomach, for example.

[0027]

As described in detail above, according to the present invention, since the ligature ring penetrates the first tube inserted into the forceps hole of the endoscope and is guided to the affected area, each ligation procedure is performed. The endoscope itself will no longer be inserted into or removed from the patient's body. Therefore, it suffices to insert the endoscope into the patient's body, and it is not necessary to insert a thick overtube into the patient for facilitating the entrance and exit of the endoscope multiple times. Therefore, the varicose vein ligating device of the present invention can alleviate the pain of the patient, and the operability of the doctor can be improved by inserting and removing the ligature ring and the like through the forceps hole.

[Brief description of drawings]

FIG. 1 is a view showing an embodiment of the varicose vein ligating device of the present invention.

FIG. 2 is a cross-sectional view showing a state in which the ligature ring and the like of the varicose vein ligating device shown in FIG. 1 are inserted up to the distal end of the endoscope.

FIG. 3 is a cross-sectional view showing a state in which the ligature ring and the like shown in FIG. 2 are further moved and the ligature ring is advanced into the patient's body.

FIG. 4 is a cross-sectional view showing a ligated state of a ligation ring of the varicose vein ligating device shown in FIG. 1.

5 is a view showing a ligation ring and a ligation-holding tubular member left in the patient after performing a ligation operation for a varicose vein with the varicose vein ligating device shown in FIG. 1. FIG.

FIG. 6 is a diagram showing a state in which the varicose vein ligator shown in FIG. 1 is attached to an endoscope to perform a varicose vein ligation operation.

7 is a cross-sectional view taken along the line AA shown in FIG.

8 is a plan view showing a ligature ring of the varicose vein ligating device shown in FIG. 1. FIG.

9 is a cross-sectional view taken along the line BB shown in FIG.

FIG. 10 is a perspective view showing a ligating operation in a conventional varicose vein ligating device.

FIG. 11 is a perspective view showing a ligating operation in a conventional varicose vein ligating device.

[Explanation of symbols]

21 ... 1st tube, 22 ... 2nd tube, 23 ... Wire, 24 ... Ligation ring connection member, 25 ... Ligation holding tubular member, 26 ... Ligation ring, 26a ... One end part, 26b ... Other end part,
27 ... Convex part, 28 ... String-like body, 29 ... String-like body, 33 ...
Ligature holding recess, 34 ... notch for cutting, 35 ... ligating portion, 3
6 ... Non-ligated part.

Claims (3)

[Claims] 1. An endoscope having a forceps hole and connecting a suction device, wherein the suction device sucks a varicose vein into the distal end of the endoscope by a suction operation through the forceps hole. In a varicose vein ligator that is inserted into a forceps hole, a first tube that is inserted into the forceps hole and has an opening at one end located at the distal end of the endoscope, and a tube axis extending along the axial direction of the first tube. In addition, a second tube inserted into the first tube and a ligating portion and a non-ligating portion are provided from one end portion to the other end portion, and each ligating portion has a ligature holding concave portion. It is a ring formed by joining the one end and the other end of two string-like bodies each having a notch for cutting at the boundary between the ligated portion and the non-ligated portion, and the ring has an elongated shape. Pulled into the first tube in the collapsed state A ligation ring having a thickness and arranged so as to surround a varicose vein that spreads in a circular shape when pushed from the inside of the endoscope tip to the outside of the endoscope tip and is sucked into the endoscope tip. A ligature wheel having a connecting member connected to the other end portion of the ligature wheel at a distal end portion thereof, and inserting / removing the ligature wheel with respect to the endoscope distal end portion through the second tube. An operation wire rod, a ligation holding tubular member through which the non-ligation portion of the ligation wheel operation wire and the ligation wheel can penetrate, and in a state where the ligation wheel operation wire material connected to the ligation wheel penetrates. It has a tube diameter that is arranged inside the patient's body from the opening of the second tube located at the distal end of the endoscope and that can be inserted into the first tube but cannot be inserted into the second tube. Then
Further, when the ligature wheel is pulled in by the ligature wheel operating wire, it is engaged with the ligature holding notch of the ligature wheel to prohibit the movement of the ligature part of the ligature wheel and varicose vein by the ligature part of the ligature wheel. A tubular member for holding a ligature, which has a convex locking member for holding the ligated state, and is ligated by the ligature wheel operating wire in a state where the notch for holding the ligature and the locking member are engaged with each other. By further pulling the non-ligated portion of the ring, the ligated portion and the non-ligated portion are separated by the notch for cutting of the ligated ring, and the ligature holding member including the ligated portion is left in the patient's body. A ligation device for varicose veins, comprising: 2. The thickness dimension of the ligature portion of the ligature wheel is
The varicose vein ligating device according to claim 1, wherein the ligature device has a thickness larger than that of the non-ligating portion. 3. The varicose vein ligator according to claim 1, wherein the ligature ring is made of a synthetic resin material or a rubber material.