CN109788955B

CN109788955B - Medical clamp box

Info

Publication number: CN109788955B
Application number: CN201780061899.XA
Authority: CN
Inventors: 前久保尚武
Original assignee: Kaneka Corp
Current assignee: Kaneka Corp
Priority date: 2016-12-28
Filing date: 2017-08-29
Publication date: 2021-08-17
Anticipated expiration: 2037-08-29
Also published as: JPWO2018123137A1; JP6937323B2; WO2018123137A1; CN109788955A

Abstract

The invention provides a clip box which can easily connect a clip and a linear object with a connection part at a far side. A medical clip box (1) for connecting a medical clip to a connection part (32) of a wire (30) having the connection part (32) on a distal side, the medical clip box (1) comprising: the clip comprises an insertion opening (2) into which a thread (30) is inserted, an insertion passage (3) extending from the insertion opening (2) toward the distal side, a clip body housing section (4) communicating with the distal side of the insertion passage (3) and housing a clip body (21), and a ring housing section (5) housing a fastening ring (29) of the clip body (21) in the insertion passage (3), wherein the ring housing section (5) comprises an abutment section (6) for preventing the fastening ring (29) from moving in the direction in which the insertion passage (3) extends, and the distal end of the fastening ring (29) is disposed at a position closer to the proximal side than the proximal end of the clip body (21). The distal end of the ring housing section (5) of the other medical clip case (1) is disposed closer to the proximal side than the proximal end of the clip body housing section (4).

Description

Medical clamp box

Technical Field

The present invention relates to a medical clip case used for connecting a medical clip and a linear object such as a thread.

Background

In the treatment using the endoscope, a medical clip can be used to hold a treatment target tissue such as an affected part. The medical clip is attached to the distal side of a linear object such as a wire, and is delivered into the body of a patient. A clamp device including a wire and a clamp attached to a distal side of the wire is inserted into a clamp channel from a clamp port of an endoscope, and the clamp is delivered to a tissue to be treated, whereby a clamp-based operation is performed in a body of a patient. A plurality of medical clips are often used in 1 operation, and each time each grasping operation is performed, a new clip needs to be attached to the clip device. However, since the size of the medical clip is at most about 1cm, which is very small, the clip is difficult to attach by a human, and particularly, it is very difficult for an unskilled person or a person wearing sterile gloves. On the other hand, since the clip attachment work is performed during surgery, it is desired to perform the clip attachment work accurately and quickly. Therefore, in order to facilitate the work of attaching the clip to the wire, a clip case is used as a connection auxiliary tool.

For example, patent document 1 discloses: the clamp unit is composed of a clamp and a fastening ring, the clamp unit is accommodated in the clamp box, and a connecting part of the operating wire is connected to the base end of the clamp. Patent document 2 discloses: the clamp unit includes a clamp body and a fastening ring, and the clamp unit is attached to a hook by inserting the hook at the front end of the operating wire into the clamp housing from a state where the clamp unit is housed in the clamp housing in advance. Patent document 3 discloses: the clamp unit is configured by a clamp, a coupling member, and a pressure tube as a fastening member, the clamp unit is housed in a clamp unit housing portion of the clamp housing, and an arrow hook of the operation wire is coupled to the coupling member of the clamp unit. Patent document 4 discloses: in a caliper housing that houses a plurality of calipers and a coupling ring in a state in which the plurality of calipers and the coupling ring are coupled, a coupling caliper body is configured by a dummy caliper that engages with a folded-back portion of the rearmost caliper and a coupling member that holds the dummy caliper, and a hook provided at the distal end of an operating wire is coupled to the coupling caliper body.

Patent document 1: japanese patent laid-open No. 2014-188345

Patent document 2: japanese patent laid-open publication No. 2013-63107

Patent document 3: japanese laid-open patent publication No. 2009-11852

Patent document 4: japanese laid-open patent application No. 2010-35808

By using the clip case disclosed in patent documents 1 to 4, a coupling portion or a coupling hook attached to a distal side of a linear object such as a wire can be coupled to the clip. However, in the case of a clamp in which the proximal end portion of the clamp is expanded to be connected to a wire, the fastening ring is disposed at the proximal end portion of the clamp body in the clamp box. In other words, if the proximal end portion of the clip is disposed inside the fastening ring, the proximal end portion of the clip body is restricted by the inner diameter of the fastening ring and is difficult to open, and therefore it is difficult to connect the string-connecting portion to the proximal end portion of the clip body. Further, since the size and shape of the connection portion of the wire connected to the proximal end portion of the clip body are also limited, the clip may fall off from the wire when the wire is moved to the proximal side after the clip is connected to the wire.

Disclosure of Invention

The present invention has been made in view of the above circumstances, and an object thereof is to provide a clip case that facilitates connection of a clip to a linear object having a connection portion on a distal side.

A medical clip cassette according to the present invention for coupling a medical clip to a coupling portion of a wire having a coupling portion on a distal side thereof, the medical clip cassette including: an insertion opening into which the thread-like object is inserted; an insertion passage extending from the insertion port toward the distal side; a clip body housing section that communicates with the distal side of the insertion passage and houses the clip body; and a ring housing section that houses a fastening ring that fastens the clip main body in the insertion path, wherein the ring housing section includes an abutting section that prevents the fastening ring from moving in the direction in which the insertion path extends, and wherein the distal end of the fastening ring is disposed at a position closer to the proximal side than the proximal end of the clip main body. Another medical clip cassette according to the present invention for coupling a medical clip to a coupling portion of a linear object having a coupling portion on a distal side thereof, the medical clip cassette including: an insertion opening into which the thread-like object is inserted; an insertion passage extending from the insertion port toward the distal side; a clip body housing section that communicates with the distal side of the insertion passage and houses the clip body; and a ring housing section that houses a fastening ring that fastens the clip main body in the insertion path, the ring housing section including an abutting section that prevents the fastening ring from moving in the extending direction of the insertion path, and a distal end of the ring housing section being disposed at a position closer to the proximal side than a proximal end of the clip main body housing section.

The clamp box of the invention prevents the clamp main body from contacting the fastening ring by preventing the abutting part from contacting the fastening ring to stop the movement of the fastening ring. Therefore, the proximal end of the clip body can be prevented from entering the inside of the fastening ring due to the fastening ring moving to a position farther than the proximal end of the clip body, and the proximal end of the clip body can be easily opened without being restricted by the inner diameter of the fastening ring. Therefore, the connection portion of the wire can be easily connected to the proximal end portion of the clip body.

The abutment portion is preferably a protrusion portion protruding from an inner surface of the insertion passage. The protrusion abuts against the fastening ring, whereby the movement of the fastening ring can be restrained.

The projection preferably includes a distal projection and a proximal projection, and a ring housing is disposed between the distal projection and the proximal projection. The distal-side protrusion abuts against a surface of the clamp ring facing the side of the clip body housing, and therefore, the clamp ring is prevented from moving toward the distal side of the insertion passage. Further, the proximal-side projection abuts against a surface facing the insertion port side of the clamp ring, thereby preventing the clamp ring from moving toward the proximal side of the insertion passage.

Preferably, the distal-side projection projects more inward in the radial direction of the insertion passage than the proximal-side projection. This makes it difficult for the tightening ring to move to the distal side.

Preferably, a plurality of distal projections are provided, and only one proximal projection is provided. Since the string basically moves to the distal side, the probability that the connection portion following the string moves to the distal side is higher than the probability that the fastening ring moves to the proximal side. Therefore, by providing a plurality of projections on the distal side, the movement of the fastening ring can be reliably restrained.

The protrusion is preferably formed to be detachable from the insertion path. When the protrusion is formed in this manner, even if the clamp device is hooked to the protrusion when the clamp device is taken out from the clamp box after the thread is connected to the clamp, the protrusion can be detached and the clamp device can be easily taken out from the clamp box.

The clamp box comprises a clamp box body and a clamp box cover, wherein the clamp box body comprises a1 st groove for forming an insertion passage and a 2 nd groove for forming a clamp body accommodating part, and the clamp box cover covers the clamp box body, so that the clamp box body is formed into a ring accommodating part and a clamp body accommodating part respectively. When the clip case is configured in this manner, the clip case can be easily manufactured, and a clip device for attaching a clip to the clip case and connecting a linear object to the clip can be easily taken out from the clip case.

In order to simplify the structure of the cassette, the contact portion is preferably provided in the 1 st groove of the cassette main body or in a surface of the cassette cover facing the cassette main body.

The present invention also provides a clip system for medical use for attaching a clip to a medical clip device, the clip system including: the above-mentioned clip box; a clamp having a clamp body for clamping an object and a fastening ring for fastening the clamp body; and a wire having a connection portion on a distal side, wherein the clamp body has a gripping portion for gripping the object on the distal side and a proximal end portion connected to the connection portion of the wire on a proximal side.

In the above-described clip system, it is preferable that the inner diameter of the fastening ring is larger than the maximum outer diameter of the coupling portion. By configuring the clamp system in this manner, the coupling portion can smoothly pass through the lumen of the fastening ring when the clamp is coupled to the thread.

In the above clip system, it is preferable that the clip body is formed by arranging 2 gripping members facing each other, an engaging portion protruding toward the facing gripping member is provided at a proximal end portion of at least one of the 2 gripping members, the 2 gripping members are movable at the proximal end portion in at least a direction away from each other, and the connecting portion is connected to the engaging portion of the clip body. By configuring such that the proximal end portion of the clip body is open, the clip body and the thread can be easily connected to each other.

In the above-described gripper system, it is preferable that the engaging portion of the one gripping member is a1 st claw protruding toward the other gripping member, and the engaging portion of the other gripping member is a 2 nd claw protruding toward the one gripping member, and the following expressions (1) and (2) are satisfied.

0≤L₁/A₁≤0.87 (1)

0≤L₂/A₁≤0.87 (2)

Where L1 is the maximum length of the 1 st jaw in the opening and closing direction of the base end portion, L2 is the maximum length of the 2 nd jaw in the opening and closing direction of the base end portion, and a1 is the maximum separation distance between the gripping members at the portion of the base end portion in the opening and closing direction of the base end portion where the engaging portion is not provided. Since the engagement portion is formed as a claw in this manner, the clip main body and the wire can be firmly coupled to each other, and therefore the coupling portion is less likely to fall off from the engagement portion.

In the above-described clip system, it is preferable that the coupling portion is provided with an engagement receiving portion that engages with the engagement portion of the clip main body. This makes it easy to connect the clamp and the thread.

The above-described clamp system preferably satisfies the following expressions (3) and (4).

A₂＜R₁ (3)

0.13≤(A₂/R₁)≤0.50 (4)

Wherein A is₂Is the minimum separation distance R between the gripping members at the base end in the opening and closing direction of the base end in the state where the engagement portion and the engagement receiving portion are not engaged₁Is the maximum outer diameter of the engagement receiving portion. Thus, the clip body and the wire can be firmly coupled, and therefore the coupling portion is less likely to fall off from the engagement portion.

The above-described clamp system preferably satisfies the following expressions (5) and (6).

L₃＜R₂ (5)

L₄＞R₂ (6)

Wherein L3 is the maximum length of the base end portion in the opening and closing direction of the base end portion in a state where the engagement portion and the engagement receiving portion are not engaged, L4 is the maximum length of the base end portion in the opening and closing direction of the base end portion in a state where 2 gripping members of the base end portion are maximally separated, and R2 is the inner diameter of the fastening ring. That is, in a state where the engagement portion and the engagement receiving portion are not engaged, the proximal end portion passes through the fastening ring, and when the 2 grip members are separated to the maximum, the proximal end portion does not pass through the fastening ring. By thus setting L₃Thereby moving the fastening ring from the base end portion to the holding portion side, thereby fasteningThe ring can close the grip of the clamp body. In addition, by setting L as described above₄Thus, the proximal end portion of the clip body is opened largely beyond the inner diameter of the fastening ring, and therefore, the connecting portion of the thread can be easily connected to the proximal end portion of the clip body.

Preferably, the clamping system includes an inner cylinder having a wire disposed in an inner cavity, and the tightening ring has an inner diameter smaller than an outer diameter of the inner cylinder and an outer diameter larger than the inner diameter of the inner cylinder. Thus, the tightening ring comes into contact with the inner cylinder, and the tightening ring moves toward the distal side of the clip main body, whereby the grip portion of the clip main body can be closed.

The present invention also provides a method of manufacturing a medical clip device using the above clip case. The method of manufacturing a clamp device according to the present invention preferably includes a step of preparing the clamp device; and a step of inserting a wire having a coupling portion on a distal side into an insertion path of the clip case, and coupling the coupling portion to the clip body at a position on the distal side of a distal end of the fastening ring, wherein the clip device includes: a clamp having a clamp body for clamping an object and a fastening ring for fastening the clamp body; and a wire having a connection portion on a distal side, wherein the clamp body has a grip portion for gripping the object on the distal side and a proximal end portion connected to the connection portion of the wire on a proximal side.

Another method for manufacturing a clamp apparatus according to the present invention preferably includes a step of preparing the clamp apparatus; inserting a wire having a coupling portion at a distal end into an insertion passage of the clip case, and coupling the coupling portion to the clip body at a position further toward the distal end than the distal end of the fastening ring; and a step of moving the coupling portion to a proximal side with respect to the inner cylinder to dispose the coupling portion in the inner cavity of the inner cylinder, wherein the clamp device includes: a clamp having a clamp body for clamping an object and a fastening ring for fastening the clamp body; a wire having a connection portion on a distal side; and an inner cylinder in which a wire is disposed in the inner cavity, wherein the clamp body has a gripping portion for gripping the object on the distal side and a proximal end portion connected to the wire connection portion on the proximal side.

Drawings

Fig. 1 shows a plan view of the clamp box.

Fig. 2 is a plan view of the housing of the caliper housing shown in fig. 1.

Fig. 3 shows the clamp box and the clamp device, and shows a plan view of the cover from which the clamp box is omitted.

Figure 4 shows a side view of the clamp body.

Fig. 5 is an enlarged view of the proximal end portion of the clip body shown in fig. 4.

Fig. 6 is a perspective view of a coupling portion of the clamp device.

Fig. 7 is a side view of the coupling portion of the clamp device.

Fig. 8 shows the clamping system and shows a top view with the section VIII shown in fig. 3 enlarged.

Fig. 9 shows the clamping system and shows a top view with the section VIII shown in fig. 3 enlarged.

Fig. 10 shows the clamping system and shows a top view with the section VIII shown in fig. 3 enlarged.

Fig. 11 shows the clamping system and shows a top view with the section VIII shown in fig. 3 enlarged.

Fig. 12 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Fig. 13 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Fig. 14 shows a plan view of the cassette.

Fig. 15 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Fig. 16 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Fig. 17 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Fig. 18 is a perspective view of the proximal side including the abutting portion of the caliper housing.

Detailed Description

The present invention relates to a medical clip cartridge for coupling a medical clip to a coupling portion of a wire having the coupling portion on a distal side. The clip case of the present invention is used for connecting a clip to a wire when performing treatment using a clip device under an endoscope. The forceps device with the forceps attached thereto is inserted into the forceps channel from the forceps opening of the endoscope, and the forceps is delivered to the tissue to be treated, whereby the operation by the forceps can be performed in the body of the patient. The clamp device that can use the clamp case of the present invention includes at least a clamp and a wire, and the wire includes at least a connecting portion and a wire body.

The present invention will be specifically described below based on the following embodiments, but the present invention is not limited to the following embodiments, and can be carried out by appropriately changing the embodiments within a range not departing from the gist of the invention and the following description. Note that, in each drawing, hatching, component reference numerals, and the like may be omitted for convenience, and in such a case, the description and other drawings can be referred to. In addition, the dimensions of the various components in the drawings are preferred to facilitate understanding of the features of the present invention, and thus may differ from actual dimensions.

Fig. 1 to 3 show plan views of the clamp box. Fig. 1 shows the caliper cartridge in a state where the cover is attached, and fig. 2 shows a state where the cover of the caliper cartridge shown in fig. 1 is detached. Fig. 3 shows the clip case body in a state where the clips are stored. When the clip case is used to connect the clip to the linear object, the clip main body and the fastening ring are disposed in the case, and then the cover is attached to the clip case main body for use.

Before describing the clip case in detail, a configuration example of the clip system will be described first with reference to fig. 3 to 7. Fig. 3 shows a state in which a wire having a connection portion at a distal end side is inserted into a clip case body in a state in which a clip is stored, fig. 4 shows a side view of the clip body, fig. 5 shows an enlarged view of a proximal end portion of the clip body shown in fig. 4, fig. 6 shows a perspective view of the connection portion of the wire, and fig. 7 shows a side view of a modification of the connection portion of the wire. As shown in fig. 3, the clamp system 20 preferably includes: a clamp case 1; and a clamp device 40 including a clamp having a clamp body 21 and a tightening ring 29, and a wire 30 having a connection portion 32 on a distal side.

The clamp device 40 is configured by connecting the proximal side of the clamp body 21 to the distal side of the wire 30. At this time, the fastening ring 29 is located on the distal side of the thread 30. The tightening ring 29 may be positioned on the wire body 31, and in the case where the coupling portion 32 is provided on the distal side of the wire body 31, the tightening ring 29 may be overlapped with the proximal side of the wire body 31. Although not shown, an operation portion for operating the wire 30 is preferably provided on the proximal side of the wire 30. The direction of the clamp can be changed and the opening and closing of the clamp can be controlled by operating the operation unit of the clamp device 40 under the endoscope, and the object can be grasped by the clamp. Preferably, the suture 30 is formed by providing the connecting portion 32 on the distal side of the suture body 31 of the grasping device 40. By coupling the coupling portion 32 of the wire 30 to the clip, the clip body 21 can be attached to the distal side of the wire 30. The wire body 31 and the coupling portion 32 may be formed as separate bodies, and the coupling portion 32 may be attached to the distal side of the wire body 31, or the distal side of the wire body 31 may be the coupling portion 32. Furthermore, the proximal side of the clamping device 40 or the thread 30 refers to: the axial direction (extending direction) of the thread 30 is the direction of the proximal side of the device user, and the distal side is the opposite direction of the proximal side (i.e., the direction of the treatment target side).

The clip is an instrument for grasping (pinching) an object by grasping the object, such as a lesion of an organ, in order to seal the object under an endoscope, performing reverse traction (counter traction), stopping bleeding, reducing slit, and marking. The gripper has a gripper body 21 for gripping an object and a fastening ring 29 for fastening the gripper body 21. The clamp body 21 is configured to be openable and closable on the distal side by a tightening ring 29 with the proximal side as a fulcrum.

As shown in fig. 4, the clamp body 21 has a grip 22 for gripping an object on the distal side and a proximal end 23 connected to a connection portion 32 of a wire 30 on the proximal side. The clamp main body 21 is formed by arranging 2 grip members 24(24A, 24B) facing each other. In this case, it is preferable that an engaging portion 25 protruding toward the opposite gripping member 24 is provided on the base end portion 23 and at least one of the 2 gripping members 24. The coupling portion 32 is coupled to the engagement portion 25 of the caliper main body 21. The 2 grip members 24 are movable at the proximal end portion 23 at least in directions away from each other (preferably, in directions away from and toward each other). By configuring the proximal end portion 23 of the clamp body 21 to be open, the clamp body 21 and the thread 30 can be easily coupled. In order to be firmly coupled to the coupling portion 32, the 2 grip members 24 are preferably provided with engaging portions 25, respectively.

The engaging portion 25 of the clip main body 21 can be selected from various shapes as long as it can be connected to the connecting portion 32 of the wire 30. The engaging portion 25 of the gripper body 21 may have a claw-like, plate-like, hemispherical, semi-elliptical, cylindrical, prismatic, conical, or pyramidal shape protruding toward the opposed gripping member 24. The engaging portion 25 is preferably provided at any position of the proximal portion 23 shown in fig. 4 to 5. The engaging portion 25 can be selected from various shapes and positions, but is preferably a claw 26 provided at the proximal end of the caliper body 21, as shown in fig. 4 to 5. In particular, it is preferable that the engaging portion 25 of one gripping member 24A is the 1 st claw 26 protruding toward the other gripping member 24B, and the engaging portion 25 of the other gripping member 24B is the 2 nd claw 26 protruding toward the one gripping member 24A. In this case, the following expressions (1) and (2) are preferably satisfied.

0≤L₁/A₁≤0.87 (1)

0≤L₂/A₁≤0.87 (2)

Here, L₁The maximum length of the 1 st jaw 26 in the opening/closing direction of the base end 23, L₂The maximum length of the 2 nd jaw 26 in the opening/closing direction of the base end 23, A₁Is provided in the opening/closing direction of the proximal end portion 23 without the proximal end portion 23The maximum distance of separation between the gripping members 24 at the portion where the engaging portion 25 is disposed. Since the clamp body 21 and the wire 30 can be firmly coupled by forming the engaging portion 25 as the pawl 26 in this manner, the coupling portion 32 is less likely to fall off from the engaging portion 25.

The size and angle of the claw 26 can be appropriately selected according to the shape of the coupling portion 32. The engaging portion 25 may have a hemispherical or semi-ellipsoidal shape in order to suppress friction caused by contact with the connecting portion 32. The distance of separation of the gripping member 24 of the engaging portion 25 in the opening/closing direction of the proximal end portion 23 may be constant or may vary in the longitudinal direction of the clamp body 21. For example, the distance of separation of the gripping members 24 may be reduced toward the distal side. In this case, the distance separating the gripping members 24 is formed to be large on the proximal side, so that the coupling portion 32 can be easily inserted between the gripping members 24, while the distance separating the gripping members 24 is formed to be small on the distal side, so that the engaging portion 25 and the coupling portion 32 can be firmly engaged.

The clamp body 21 is formed by bending 1 metal plate into a U shape or a V shape, for example. The clamp body 21 may be formed by connecting 2 metal plates disposed to face each other.

As shown in fig. 4 to 5, in order to keep the distance of separation of the gripping members 24 at the proximal end portion 23 of the clamp body 21 constant, a reinforcing portion 27 may be provided that connects the proximal end portion 23 of one gripping member 24(24A) and the proximal end portion 23 of the other gripping member 24(24B) to each other. The reinforcement portion 27 is preferably provided on the distal side of the proximal end portion 23 so as not to hinder engagement between the clip main body 21 and the connection portion 32. The gripping

members

24A and 24B may be opposed to each other via the proximal end portion 23 of the clamp body 21, and the distance separating the gripping members 24 from the proximal end portion 23 of the clamp body 21 in the opening/closing direction may be constant or may be variable. For example, the proximal end portion 23 may be narrowed or widened toward the distal side. In fig. 4, the caliper main body 21 is formed of 1 metal plate including the reinforcement portion 27, but a member different from the caliper main body 21 may be provided as the reinforcement portion 27. The reinforcing portion 27 is preferably made of the same material as or a different material from the holding member 24, and may have the same thickness as or a different thickness from the holding member 24. When the reinforcing portion 27 is a member different from the clamp body 21, the reinforcing portion 27 is attached to the holding member 24 by mechanical fixing by a screw, caulking, or the like, welding, adhesion, or the like.

The clamp is provided with a fastening ring 29 that surrounds the periphery of the clamp body 21 and fastens the clamp body 21. The tightening ring 29 is moved from the proximal side to the distal side of the clip body 21 by bringing the inner cylindrical body 37, which will be described later, into contact with the tightening ring 29, for example, whereby the tightening ring 29 closes the grip portion 22 of the clip body 21.

The clip body 21 and the fastening ring 29 are preferably made of a material having high elasticity and biocompatibility. The clamp body 21 and the fastening ring 29 are preferably made of stainless steel such as SUS301, SUS303, SUS304, and SUS631, or Ni — Ti alloy.

As shown in fig. 6, the thread 30 is formed in a linear shape and has a connection portion 32 on the distal side thereof. Specifically, the wire 30 includes a wire body 31 and a connecting portion 32 provided on the distal side of the wire body 31. The wire body 31 preferably has both flexibility to bend along the shape in the body cavity and rigidity to reliably reach the tissue to be treated in a balanced manner. As the linear body 31, for example, a strand formed of a metal wire such as stainless steel or carbon steel, a synthetic resin such as polyamide resin (e.g., nylon), polyolefin resin (e.g., polyethylene or polypropylene), polyester resin (e.g., PET), aromatic polyether ketone resin (e.g., PEEK), polyimide resin, or fluororesin (e.g., PTFE, PFA, ETFE) can be used. The lines can be monofilament lines, multifilament lines or staple fibers.

The coupling portion 32 is preferably made of a biocompatible material, and is preferably made of stainless steel such as SUS301, SUS303, SUS304, and SUS631, or a Ni — Ti alloy, for example, as in the case of the clamp body 21 and the clamp ring 29. Further, the resin composition may be composed of synthetic resins such as polyamide resin (e.g., nylon), polyolefin resin (e.g., polyethylene, polypropylene), polyester resin (e.g., PET), aromatic polyether ketone resin (e.g., PEEK), polyimide resin, and fluorine resin (e.g., PTFE, PFA, ETFE).

The connection portion 32 of the thread 30 is preferably provided with an engagement receiving portion 33 that engages with the engagement portion 25 of the caliper body 21. This facilitates the connection between the clamp and the thread 30. The shape of the engagement receiving portion 33 is not particularly limited as long as it can engage with the engagement portion 25 of the clip main body 21, and it is preferable that the engagement receiving portion has an outer diameter similar to that of the wire main body 31, for example. The engagement receiving portion 33 is preferably a claw, a hook, a convex portion, a concave portion, a through opening, or a combination thereof, for example, in order to engage with the engagement portion 25 of the caliper body 21. In particular, the engagement receiving portion 33 is preferably a through hole 33A that engages with the engagement portion 25 of the caliper body 21. This facilitates the connection between the clamp body 21 and the wire 30, and improves productivity because of the simple structure. In the embodiment shown in fig. 6, the coupling portion 32 is provided with a through hole 33A as the engagement receiving portion 33, and in the embodiment shown in fig. 7, the coupling portion 32 is provided with a through hole 33A and a convex portion 33B on the distal side of the through hole 33A as the engagement receiving portion 33. In fig. 7, the embodiment without the through hole 33A is also a preferable embodiment of the coupling portion.

The length of the coupling portion 32 in the longitudinal direction may be longer than the length of the insertion path 3 or shorter than the insertion path 3. When the length of the coupling portion 32 in the longitudinal direction is shorter than the insertion path 3, the coupling portion 32 and the wire body 31 may be inserted into the insertion path 3 with the coupling portion 32 as the tip.

The coupling portion 32 may have a flat portion 35 on the distal side as shown in fig. 6. If the flat portion 35 is formed on the distal side of the coupling portion 32, the flat portion 35 can be easily inserted into the portion of the proximal end portion 23 where the 2 grasping members 24 are disposed apart, and the coupling portion 32 can be easily coupled by engaging the engaging portion 25 with each other. In the clamp device 40 and the coupling portion 32 shown in fig. 3 and 6, the flat portion 35 of the coupling portion 32 is provided with a through hole 33A, and the proximal end portion 23 of the clamp body 21 is fitted into the through hole 33A, whereby the coupling portion 32 can be coupled to the clamp body 21.

Various combinations can be used for the engaging portion 25 of the clip main body 21 and the connecting portion 32 of the wire 30. For example, the engagement portion 25 may be provided with a claw, the coupling portion 32 may be provided with a through hole, and the coupling may be performed by engaging one of the claws with the other through hole, or by providing both claws and engaging the claws with each other.

As shown in fig. 3, the wire 30 is preferably disposed at least partially within the inner barrel 37. That is, the clamping system 20 preferably has an inner barrel 37 within the lumen in which the wire 30 is disposed. By configuring the clamp system 20 in this manner, when the clamp body 21 is connected to the wire 30 and used, the opening degree of the grip portion 22 of the clamp body 21 can be adjusted by moving the wire 30 toward the proximal side or the distal side with respect to the axial direction. For example, when the thread 30 is moved to the proximal side with respect to the inner cylindrical body 37, the tightening ring 29 comes into contact with the inner cylindrical body 37, and the tightening ring 29 is moved to the distal side of the clip body 21, whereby the grip 22 of the clip body 21 can be closed. The connecting portion 32 of the thread 30 may be configured to be freely inserted into and removed from the inner cylinder 37. The inner diameter of the fastening ring 29 is preferably larger than the largest outer diameter of the coupling portion 32. By configuring the clamp system 20 in this manner, when the clamp body 21 is coupled to the wire 30, the coupling portion 32 can smoothly pass through the inner cavity of the fastening ring 29. Further, it is preferable that the inner diameter of the fastening ring 29 is smaller than the outer diameter of the inner cylinder 37, and the outer diameter of the fastening ring 29 is larger than the inner diameter of the inner cylinder 37. By configuring the clip system 20 in this manner, the fastening ring 29 comes into contact with the inner cylindrical body 37, and the fastening ring 29 moves to the distal side of the clip main body 21, whereby the grip 22 of the clip main body 21 can be closed.

The inner cylindrical body 37 preferably has both flexibility to bend along the shape in the body cavity and rigidity to reliably reach the tissue to be treated in a balanced manner. The inner cylinder 37 may be formed of, for example, a cylinder made of a spiral metal or a synthetic resin, a cylinder in which a plurality of short cylindrical joint blocks are coupled in the axial direction and are rotatable, or a cylinder made of a synthetic resin.

Although not shown, the clamp system 20 may further include an outer cylinder, and in this case, the inner cylinder 37 is disposed inside the outer cylinder. The outer cylinder is preferably formed so that the clamp body 21 can be inserted into and removed from the outer cylinder in a state where the clamp body 21 is coupled to the thread 30. By configuring the clip system 20 in this manner, the clip system 20 can be inserted into the clip channel from the jaw opening of the endoscope until the clip body 21 is sent to the vicinity of the target tissue, and the clip body 21 can be prevented from damaging the clip channel in the endoscope and the internal body tissue other than the lesion portion by the outer cylinder.

The outer cylinder preferably has both flexibility to bend along the shape in the body cavity and rigidity to reliably reach the tissue to be treated in a balanced manner. The outer cylinder may be composed of, for example, a cylinder made of synthetic resin, a cylinder made of spiral metal or synthetic resin, or a cylinder in which a plurality of short cylindrical joint blocks are coupled in the axial direction and are rotatable. Further, it is preferable that the outer cylinder be made of synthetic resin, and that the outer cylinder be made of transparent or translucent material so that the positional relationship between the outer cylinder and the inner cylinder 37 can be visually confirmed by a user (operator).

The clip case 1 can be used to facilitate the work of attaching the clip to the clip system 20. As shown in fig. 1 to 3, the caliper housing 1 includes: the clip includes an insertion port 2 into which a thread 30 is inserted, an insertion path 3 extending from the insertion port 2 toward a distal end side, a clip body housing portion 4 communicating with the distal end side of the insertion path 3 and housing a clip body 21, and a ring housing portion 5 housing a fastening ring 29 of the clip body 21 fastened to the insertion path 3, wherein the ring housing portion 5 includes an abutment portion 6 for preventing the fastening ring 29 from moving in an extending direction of the insertion path 3, and a distal end of the fastening ring 29 is disposed at a position closer to the proximal end side than the proximal end of the clip body 21.

Another clamp box 1 of the present invention includes: the clip includes an insertion port 2 into which a thread 30 is inserted, an insertion path 3 extending from the insertion port 2 toward a distal end side, a clip body housing portion 4 communicating with the distal end side of the insertion path 3 and housing a clip body 21, and a ring housing portion 5 housing a fastening ring 29 of the clip body 21 fastened to the insertion path 3, wherein the ring housing portion 5 includes an abutment portion 6 for preventing the fastening ring 29 from moving in an extending direction of the insertion path 3, and a distal end of the ring housing portion 5 is disposed at a position closer to the proximal end side than the proximal end of the clip body housing portion 4.

When the clip case 1 is used, the clip main body 21 is disposed in the clip main body housing portion 4, the fastening ring 29 is disposed in the ring housing portion 5 by bringing the abutment portion 6 into abutment with the fastening ring 29, and then the string 30 is inserted into the insertion path 3 from the insertion port 2, whereby the coupling portion 32 provided on the distal side of the string 30 can be appropriately coupled to the clip main body 21. When the clip case 1 is used, the clip case 1 in which the clip main body 21 and the fastening ring 29 are stored in advance can be used instead of disposing the clip in the case. In the clip case 1, the insertion port 2 side is referred to as a proximal side, and the side in which the clip main body 21 is housed is referred to as a distal side.

The clamp body housing portion 4 is a space for housing the clamp body 21. The clamp body 21 is stored in the clamp body storage 4 with the grip 22 opened. The clip body housing 4 is formed in the clip case 1 so that a proximal end portion 23 of the clip body 21 (proximal side of the clip body 21) is disposed toward the insertion path 3. The clip case 1 of the present invention includes any of a mode in which the clip body 21 is stored in the clip body storage portion 4 and a mode in which the clip body 21 is not stored in the clip body storage portion 4. Further, the clip body housing portion 4 may secure a space in which the coupling portion 32 of the wire 30 can be disposed at a position closer to the proximal end of the clip body 21.

The caliper main body housing 4 may be provided with a projection 4A for stopping the movement of the caliper main body 21. For example, the clip main body 21 is less likely to move to the distal side by bringing the projection 4A into contact with the reinforcement portion 27 of the clip main body 21. The shape of the projection 4A may be, for example, a polygon such as a circle, an ellipse, a rectangle, a triangle, or a combination thereof. In fig. 1 to 3, the distal side of the projection 4A is formed in a circular shape, and the proximal side is formed in an elongated rectangular shape extending from the center of the circle to the proximal side, but the shape of the projection is not particularly limited.

The insertion path 3 is a path through which the thread 30 is inserted, and is formed to connect the insertion port 2 and the clamp body housing portion 4. Normally, the insertion path 3 is formed to extend straight from the insertion port 2 to the clip body housing 4, the extending direction of the insertion path 3 corresponds to the direction from the insertion port 2 to the inlet of the clip body housing 4, the proximal side of the extending direction of the insertion path 3 is the insertion port 2 side of the insertion path 3, and the distal side is the clip body housing 4 side. The insertion opening 2 corresponds to an inlet of the insertion passage 3 and is formed on an outer surface of the gripper box 1.

The ring housing portion 5 is a space for housing the fastening ring 29 of the fastening clip body 21, and is provided in the middle of the insertion passage 3. Fig. 8 to 11 are plan views showing the inside of the caliper housing, with the portion VIII shown in fig. 3 enlarged. In fig. 8 to 11, the fastening ring 29 is housed in the ring housing portion 5 with its radial center axis along the extending direction of the insertion passage 3. The caliper housing 1 of the present invention includes any of a mode in which the fastening ring 29 is housed in the ring housing portion 5 and a mode in which the fastening ring 29 is not housed in the ring housing portion 5.

The ring housing portion 5 includes an abutting portion 6 for restraining the fastening ring 29 from moving in the extending direction of the insertion path 3. Since the abutment portion 6 is in contact with the fastening ring 29 and can stop the movement of the fastening ring 29, the proximal end portion 23 of the clip body 21 can be prevented from entering the inside of the fastening ring 29 by the fastening ring 29 moving to the distal side from the proximal end of the clip body 21, and the proximal end portion 23 of the clip body 21 can be easily opened without being restricted by the inner diameter of the fastening ring 29. Therefore, the connection portion 32 of the wire 30 is easily connected to the proximal end portion 23 of the clip main body 21. Further, the fastening ring 29 can be prevented from moving to the proximal side or the distal side of the insertion path 3 and coming off the ring housing 5 or the caliper housing 1. In the present invention, the clip body housing portion 4 is disposed on the distal side of the ring housing portion 5, and the distal end of the tightening ring 29 is disposed on the proximal side of the proximal end of the clip body 21.

The operation of the clip case 1 of the present invention will be described in detail with reference to fig. 8 to 11. First, as shown in fig. 8, the clip case 1 is prepared in which the clip body 21 is disposed in the clip body housing portion 4 and the fastening ring 29 is disposed in the ring housing portion 5. Next, the thread 30 having the connection portion 32 on the distal side is inserted into the insertion path 3 from the insertion port 2 of the clip case 1. In fig. 8, as in the case of the embodiment shown in fig. 7, the coupling portion 32 is provided with a through hole 33A and a convex portion 33B located on the distal side of the through hole 33A as the engagement receiving portion 33, but the shape of the engagement receiving portion 33 is not particularly limited. The convex portion 33B is formed to protrude toward the distal side and to have a shape tapered toward the distal side. The engagement receiving portion 33 may be formed only by the convex portion 33B without providing the through hole 33A. In this case, the engaging portion 25 of the caliper body 21 can be engaged with the convex portion 33B.

As shown in fig. 9, the thread 30 is moved to the distal side, the thread 30 is passed through the tightening ring 29, and then the engagement receiving portion 33 of the coupling portion 32 of the thread 30 is coupled to the proximal end portion 23 of the clip body 21. Specifically, when the convex portion 33B of the coupling portion 32 is inserted between the engaging portions 25 (claws 26) provided in the gripping members 24, the opposing gripping members 24 move in the direction away from each other in the proximal end portion 23 of the clamp body 21. That is, the base end portion 23 of the clamp body 21 is opened in the opening/closing direction of the clamp body 21 by expanding the gap of the gripping member 24 by the connecting portion 32. At this time, although the tightening ring 29 is pressed toward the distal side by the thread 30, the distal end of the tightening ring 29 comes into contact with the projection 7A as the abutment portion 6 on the distal side, and unintentional movement of the tightening ring 29 can be suppressed. When the fastening ring 29 is moved so as to include the engagement portion 25 of the clamp body 21 in the fastening ring 29, the minimum separation distance between the gripping members of the proximal portion 23 in the opening and closing direction of the proximal portion 23 (the minimum separation distance of the engagement portion 25) cannot be sufficiently extended, and the engagement portion 25 cannot be coupled to the coupling portion 32.

As shown in fig. 10, when the thread 30 is moved to the distal side, the gap of the holding member 24 is further expanded by the convex portion 33B.

As shown in fig. 11, when the thread 30 is further moved to the distal side, the engaging portion 25 (the claw 26) passes over the portion of the convex portion 33B having the maximum outer diameter, and the claw 26 engages with the through hole 33A located closer to the distal side than the convex portion 33B, whereby both are engaged.

As described above, in the clip case 1 of the present invention, the abutment portion 6 comes into contact with the fastening ring 29 to stop the movement of the fastening ring 29, so that the distal end of the fastening ring 29 can be disposed on the proximal side of the clip main body 21. Therefore, the tightening ring 29 can be prevented from moving to the distal side from the proximal end of the clip body 21 and surrounding the proximal end portion 23 of the clip body 21, and the proximal end portion 23 of the clip body 21 can be easily opened without being restricted by the inner diameter of the tightening ring 29. This facilitates the connection of the connection portion 32 of the wire 30 to the proximal end portion 23 of the clip main body 21.

In the clip case 1, the proximal end portion 23 of the clip main body 21 is hardly covered with the fastening ring 29. Therefore, for example, as shown in fig. 8 to 11, in the case where the engaging portion 25 protruding toward the opposed gripping member 24 is provided on at least one of the 2 gripping members 24, and the engaging receiving portion 33 engaging with the engaging portion 25 of the caliper body 21 is provided on the coupling portion 32, the following a is described₂And R₁Preferably, the following formula (3) is satisfied.

A₂＜R₁ (3)

Wherein A is₂The minimum distance R is the minimum distance between the gripping members 24 of the proximal end portion 23 in the opening/closing direction of the proximal end portion 23 in the state where the engagement portion 25 and the engagement receiving portion 33 are not engaged₁The maximum outer diameter of the engagement receiving portion 33. This can firmly connect the clip main body 21 and the thread 30, and therefore the connecting portion 32 is less likely to fall off from the engaging portion 25.

In addition, the above-mentioned A₂And the above-mentioned R₁More preferably, the following formula (4) is satisfied.

0.13≤(A₂/R₁)≤0.50 (4)

This enables the clamp body 21 and the thread 30 to be more firmly coupled.

When the connecting portion 32 of the wire 30 has the engagement receiving portion 33, the maximum length L of the base end portion 23 in the opening/closing direction of the base end portion 23 at the time of maximum separation of the 2 grasping members 24 of the base end portion 23₄Preferably, the compound is represented by the following formula.

L₄＝(L₃+R₁)－A₂

Wherein L is₃L is the maximum length of the base end part 23 in the opening and closing direction of the base end part 23 in the state where the engaging part 25 and the engaging receiving part 33 are not engaged with each other₃＞A₂. By thus configuring the base end portion 23 of the clamp body 21 to be open, even if it is openThe distal end of the wire 30 is relatively large in size, and the clamp body 21 and the wire 30 can be firmly connected to each other.

L₃＜R₂ (5)

L₄＞R₂ (6)

Wherein R is₂The inner diameter of the fastening ring 29. In such a clamp system, the proximal end portion 23 passes through the fastening ring 29 in a state where the engagement portion 25 is not engaged with the engagement receiving portion 33, and the proximal end portion 23 does not pass through the fastening ring 29 when the 2 grip members 24 are separated at the maximum. Providing such setting L₃As a result, the tightening ring 29 is moved from the base end portion 23 to the grip portion 22 side, and the tightening ring 29 can close the grip portion 22 of the clamp body 21. In addition, L is set as described above₄Accordingly, the proximal end portion 23 of the clip main body 21 is opened largely beyond the inner diameter of the fastening ring 29, and therefore, the connection portion 32 of the wire 30 is easily connected to the proximal end portion 23 of the clip main body 21.

The abutment portion 6 is preferably a protrusion (e.g., 7A, 7B in the drawings) protruding from the inner surface of the insertion passage 3. The protrusion is formed to protrude from the inner surface of the insertion path 3 toward the space of the insertion path 3 than the surrounding portion. The projection abuts against the fastening ring 29, whereby the movement of the fastening ring 29 can be restrained. The abutting portion 6 that comes into contact with the fastening ring 29 to restrain the movement of the fastening ring 29 may be a recess 8 provided in the inner surface of the insertion passage 3, which will be described later, in addition to a protrusion protruding from the inner surface of the insertion passage 3. When the fastening ring 29 is fitted into and housed in the recess 8, the distal end of the fastening ring 29 comes into contact with the wall surface of the recess, and the movement of the fastening ring 29 can be restrained. The protrusion will be described with reference to fig. 12 to 14.

The height of the protrusion is not particularly limited as long as the protrusion is formed so that the connection portion 32 of the wire 30 passes through the insertion passage 3 at a portion where the protrusion of the insertion passage 3 is provided, but the protrusion preferably protrudes from the inner surface of the insertion passage 3 so as not to reach the center (or the center of gravity) of the cross section of the insertion passage 3.

As shown in fig. 12 to 14, the projection preferably includes a distal projection 7A and a proximal projection 7B, and the ring housing 5 is disposed between the distal projection 7A and the proximal projection 7B. The distal-side protrusion 7A abuts against a surface of the fastening ring 29 facing the side of the clip body housing portion 4, and therefore, the fastening ring 29 is prevented from moving to the distal side of the insertion passage 3. Further, the proximal-side protrusion 7B abuts on a surface of the fastening ring 29 facing the insertion port 2 side, and therefore the fastening ring 29 is prevented from moving to the proximal side of the insertion passage 3.

The length of the protrusion in the width direction of the holding member 24 (vertical direction of the paper surface in fig. 12 to 13, and vertical direction of the paper surface in fig. 14) is not particularly limited, and may be longer than the outer diameter of the fastening ring 29 as shown in fig. 12, or shorter than the outer diameter of the fastening ring 29 as shown in fig. 13, for example. In order to reliably stop the movement of the fastening ring 29, it is preferable that the projection be longer than the maximum thickness of the fastening ring 29 in the width direction of the gripping member 24.

One or more distal-side projections 7A and one or more proximal-side projections 7B may be provided. In this case, the number of the distal projections 7A and the number of the proximal projections 7B may be the same or different. In each of fig. 12 to 14, 2 distal projections 7A are provided, and 1 proximal projection 7B is provided. In this way, it is preferable to provide a plurality of distal-side protrusions 7A and only one proximal-side protrusion 7B. When the clip case 1 is used, the wire 30 is inserted from the insertion port 2 toward the distal side, the proximal end portion 23 of the clip main body 21 is connected to the wire 30, and then the clip case cover 16 (described later) is removed, and the wire 30 is lifted up to the side to which the cover is attached, thereby removing the clip main body 21 from the clip case 1. Since the string 30 is basically moved toward the distal side in this way, the connecting portion 32 following the string 30 is more likely to move toward the distal side than the fastening ring 29 is likely to move toward the proximal side. Therefore, by providing a plurality of projections on the distal side, the movement of the fastening ring 29 can be reliably restrained.

The distal projections 7A and the proximal projections 7B may have the same or different heights. In particular, the distal-side projection 7A preferably projects inward from the proximal-side projection 7B in the radial direction of the insertion passage 3. This makes it difficult for the tightening ring 29 to move to the distal side. Here, the height of the protrusion means a length in a direction from the inner surface of the insertion passage 3 toward the center (or the center of gravity) of the cross section of the insertion passage 3. The radially inner side of the insertion passage 3 is a direction from the wall surface of the insertion passage 3 toward the center.

When a plurality of distal protrusions 7A are provided in the cross section of the insertion path 3, one distal protrusion 7A and the other distal protrusions 7A may be arranged in a rotationally symmetric configuration with the center of the cross section of the insertion path 3 as the central axis. Thus, the fastening ring 29 is uniformly supported by the abutting portion 6, and therefore, even if the thread 30 unintentionally comes into contact with the fastening ring 29, the movement of the fastening ring 29 can be restrained. The proximal protrusion 7B may be provided in a plurality of positions.

The height of the protrusion may be constant or may vary in the extending direction of the insertion path 3. The protrusion may have an inclined surface that increases toward the distal side or the proximal side. The inclined surface provided on the distal projecting portion 7A is preferably a surface including the proximal end of the projecting portion. This makes it possible to bring the projection into contact with the fastening ring 29 and provide a gap between the projection and the fastening ring 29, thereby facilitating the placement of the fastening ring 29 in the ring housing 5. In fig. 12 to 13, the distal-side projecting portion 7A is provided with an inclined surface.

When a plurality of distal-side protrusions 7A are provided, the plurality of distal-side protrusions 7A are preferably arranged in a rotationally symmetrical configuration with the center (center of gravity) of the insertion passage 3 as the center axis. Thereby, the coupling portion 32 of the wire 30 is fitted into the distal-side projecting portion 7A, and the coupling portion 32 is disposed at an appropriate angle and position with respect to the clip body 21 stored in the clip body storage portion 4. Therefore, the clamp body 21 and the wire 30 can be reliably connected, and erroneous operation can be prevented.

The inclined surface of the protrusion may be inclined linearly or may be inclined in a curved line. The inclined surface is preferably formed to have an angle of 20 ° or more and 60 ° or less with respect to the extending direction of the insertion passage 3, for example. The inclined surface may be provided in plural for one projection, and may be appropriately changed according to the shape of the tightening ring 29 to be brought into contact with.

In addition, in order to easily manufacture the clip case 1, the protrusion may be formed in a stepped shape with respect to the inner surface of the insertion passage 3.

The position of the projection in the extending direction of the insertion passage 3 is not particularly limited, and may be, for example, a position closer to the proximal side than the center in the extending direction of the insertion passage 3 or a position closer to the distal side. If the projection is provided at a position closer to the proximal side than the center in the extending direction of the insertion path 3, the projection hardly reaches the clip body housing 4 even if the tightening ring 29 moves to the distal side. If the protrusion is provided at a position farther than the center in the extending direction of the insertion passage 3, the fastening ring 29 is less likely to fall off from the insertion port 2.

The caliper housing 1 may be formed of 1 member, or 2 or more members. The clip case 1 has the insertion passage 3 and the clip body housing portion 4 formed therein, and from the viewpoint of facilitating the formation of the above-described structure, the clip case 1 is preferably formed of at least 2 or more members. For example, the cassette 1 may be composed of 2 members, i.e., the cassette main body 15 and the cassette cover 16. The gripper box body 15 has a1 st groove for forming the insertion passage 3 and a 2 nd groove for forming the gripper box body housing 4, and the gripper box body 4 and the ring housing 5 are formed by covering the gripper box body 15 with the gripper box cover 16. Further, the insertion port 2, the insertion path 3, the clamp body housing 4, and the ring housing 5 may be formed by covering the 1 st groove for forming the insertion path 3 with the clamp case cover 16, or the clamp case body 15 in which a groove for the insertion port 2 is separately formed may be provided. When the clip case 1 is configured in this manner, the clip case 1 can be easily manufactured, and the clip device 40 for attaching the clip body 21 to the clip case 1 and connecting the linear object 30 to the clip body 21 can be easily taken out from the clip case 1.

The cartridge cover 16 may cover a part of the cartridge body 15, and may be, for example, a member slidable with respect to the cartridge body 15. The shape of the cartridge cover 16 is not particularly limited as long as it can cover the 1 st groove for forming the insertion path 3 and the 2 nd groove for forming the housing portion of the cartridge body 15. In fig. 1 to 2, the caliper housing 1 is configured such that the caliper housing cover 16 is formed in a cylindrical shape and surrounds the caliper housing main body 15 with the extending direction of the insertion passage 3 as an axis. The cartridge cover 16 may be formed in a plate shape and may be overlapped with the cartridge body 15. The surface of the cartridge cover 16 facing the cartridge body 15 may be formed as a flat surface, and the 1 st groove for forming the insertion path 3 and the 2 nd groove for forming the cartridge body housing portion 4 may be formed in the cartridge cover 16.

As shown in fig. 12 to 13, the contact portion 6 may be provided in the 1 st groove of the cartridge main body 15, or may be provided on a surface (not shown) of the cartridge cover 16 facing the cartridge main body 15. This can simplify the structure of the caliper housing 1. The contact portion 6 may be provided on a member different from the cartridge main body 15 and the cartridge cover 16.

Although not shown, when the contact portion 6 is a projection portion projecting from a surface of the cartridge cover 16 facing the cartridge body 15, one or more projection portions may be provided. The projection provided on the cover is configured to be the same as the projection provided in the 1 st groove of the caliper housing main body 15. The projection may be provided on a surface of the cartridge cover 16 facing the cartridge body 15 so as to abut against the outer peripheral surface of the fastening ring 29 in a state where the cartridge cover 16 is attached to the cartridge body 15. Even if the outer peripheral surface of the fastening ring 29 is pressed by the protrusion, the fastening ring 29 can be prevented from moving in the extending direction of the insertion path 3.

As shown in fig. 2, a projection 16A may be provided on a surface of the cartridge cover 16 facing the cartridge body 15 as a projection of the contact portion 6 for stopping the movement of the cartridge body 21. The shape of the projection 16A may be, for example, a polygon such as a circle, an ellipse, a rectangle, a triangle, or a combination thereof. In fig. 2, the projection 16A is formed in a rectangular shape extending in the entire distal and proximal directions of the caliper body housing 4, but the shape of the projection 16A is not particularly limited.

The protrusion may be formed to be detachable from the insertion path 3. For example, in fig. 14, the distal-side projecting portion 7A is formed on a regulating member 17 that regulates the insertion direction of the coupling portion 32, and the regulating member 17 is formed so as to be slidable upward. The removal of the projection means that the projection is removed from the inner surface of the insertion passage 3 of the clip case 1, the projection or a member provided with the projection (for example, the regulating member 17) may be separated from the clip case 1, and the projection or the member provided with the projection may be slidably disposed in the clip case 1. If the protrusion is formed in this way, after the thread 30 is connected to the clip main body 21, when the clip device 40 is taken out from the clip case 1, even if the clip device 40 is hooked to the protrusion, the protrusion can be detached, and thus the clip device 40 can be easily taken out from the clip case 1. Further, when the clamp device 40 is taken out from the clamp case 1, the projection may be detached in advance. When the cartridge cover 16 is attached to the cartridge body 15 shown in fig. 14, the projection (distal projection 7A) on the regulating member 17 is configured to project from the inner surface of the insertion path 3, and thus the movement of the regulating member 17 can be regulated by the cartridge cover 16.

The protrusion may be formed by bringing the connection portion 32 of the wire 30 into contact with the protrusion when the wire 30 is inserted into the insertion passage 3, and the wire 30 may be rotated around the axis to control the angle, position, and the like of the connection portion 32. The protrusion is preferable because it can have both the function of accommodating the tightening ring 29 and the function of rotating the axis of the wire 30, and the structure of the clip case 1 can be simplified.

An example in which the abutting portion 6 is the recess portion 8 will be described with reference to fig. 15 to 16. Fig. 15 shows a state in which the fastening ring 29 is disposed in the caliper housing 1, and fig. 16 shows a state in which the fastening ring 29 is removed from the caliper housing 1. The abutting portion 6 may be a recess 8 provided on the inner surface of the insertion passage 3. In this case, the fastening ring 29 is housed in the recess 8, and the fastening ring 29 abuts against the inner wall surface of the recess 8, whereby the movement of the fastening ring 29 in the extending direction of the insertion path 3 can be restrained.

In order to receive the fastening ring 29, the recess 8 is formed longer than the fastening ring 29 in the extending direction of the insertion passage 3. The maximum depth D of the recess 8 (the height toward the radially outer side of the fastening ring 29 with respect to the inner surface of the insertion passage 3) is preferably larger than the wall thickness of the fastening ring 29. This can reliably stop the movement of the fastening ring 29.

As shown in fig. 6 to 7, a thick portion 36 having an outer diameter larger than the minimum outer diameter of the engaging portion 25 may be formed on the proximal side of the coupling portion 32. When the coupling portion 32 is provided with the thick-walled portion 36, the maximum depth D of the recess 8 preferably satisfies the following expression.

D＜(R₃－R₄)

Wherein R is₃To secure the outer diameter, R, of the ring 29₄The maximum outer diameter of the wall thickness portion 36.

When the maximum depth D of the recess 8 is set to the above range, the thick portion 36 can pass through the inside of the fastening ring 29 even in a state where the fastening ring 29 is fitted into the recess 8.

The maximum depth D of the recess 8 is preferably, for example, the outer diameter R of the fastening ring 29₃The size of (a) is 30% or less, more preferably 20% or less, further preferably 15% or less, and further preferably 3% or more, further preferably 5% or more.

One or more recesses 8 may be provided. For example, when a plurality of recesses 8 are provided, the recesses can be provided in the 1 st groove of the cassette main body 15 and the surface of the cassette cover 16 facing the cassette main body 15.

Fig. 17 to 18 are perspective views of the proximal side including the contact portion of the clip case, fig. 17 shows a state where the fastening ring 29 is disposed on the clip case 1, and fig. 18 shows a state where the fastening ring 29 is detached from the clip case 1. As shown in fig. 17 to 18, the contact portion 6 may include both a protrusion protruding from the inner surface of the insertion passage 3 and a recess 8 provided in the inner surface of the insertion passage 3. This can further prevent the fastening ring 29 from moving in the extending direction of the insertion path 3.

The materials of the caliper housing main body 15, the caliper housing cover 16, and the regulating member 17 are not particularly limited, but are preferably formed of a synthetic resin from the viewpoint of facilitating precision processing and preventing damage to the caliper while keeping the caliper stored therein sanitary. The forceps box cover 16 is preferably made of a transparent or translucent material so that a user (operator) can visually confirm the operation of connecting the forceps main bodies 21 to the wires 30.

By using the clip case 1, the clip body 21 and the thread 30 can be connected to each other, and the clip device 40 can be easily manufactured. For example, the clip device 40 can be manufactured by performing a step of preparing the clip device 40, and a step of inserting the string 30 having the coupling portion 32 on the distal side into the insertion path 3 of the clip case 1, and coupling the coupling portion 32 to the clip body 21 on the distal side from the distal end of the fastening ring 29, the clip device including: a clamp having a clamp body 21 for clamping an object and a fastening ring 29 for fastening the clamp body 21; and a wire 30 having a connection portion 32 on the distal side, and the clamp body 21 having a grip portion 22 for gripping the object on the distal side and a proximal end portion 23 connected to the connection portion 32 of the wire 30 on the proximal side.

The clip device 40 having the inner cylinder 37 is manufactured by performing a step of preparing the clip device 40, a step of inserting the thread 30 having the coupling portion 32 on the distal side into the insertion path 3 of the clip case 1 and coupling the coupling portion 32 to the clip main body 21 on the distal side from the distal end of the fastening ring 29, and a step of moving the coupling portion 32 to the proximal side with respect to the inner cylinder 37 and disposing the coupling portion 32 in the lumen of the inner cylinder 37, wherein the clip device 40 includes: a clamp having a clamp body 21 for clamping an object and a fastening ring 29 for fastening the clamp body 21; a wire 30 having a connection portion 32 on the distal side; and an inner cylinder 37 in which the wire 30 is arranged in the inner cavity, wherein the clamp body 21 has a grip portion 22 for gripping the object on the distal side and a proximal end portion 23 connected to the connection portion 32 of the wire 30 on the proximal side.

The present application claims priority from japanese patent application No. 2016-. The entire contents of the specification of Japanese patent application No. 2016-.

[ description of reference numerals ]

1 … clamp box; 2 … insertion opening; 3 … insertion into the passageway; 4 … clamp body receiving part; 4a … protrusions; 5 … ring receiving portion; 6 … abutment; 7 … protrusions; 7a … distal side projection; 7B … proximal protrusion; 8 … recess; 15 … clamp box body; 16 … clamp box cover; 16a … projection; 17 … a restricting member; 20 … clamp system; 21 … clamp body; 22 … a handle; 23 … base end portion; 24. 24A, 24B … holding members; 25 … snap-fit portion; 26 … claw; 27 … a reinforcement; 29 … fastening ring; 30 … a wire; 31 … wire body; 32 …, a joint; 33 … engagement receiving part; 33A … through hole; 33B … convex part; 35 … flat portion; 36 … thick wall portion; 37 … inner cylinder; 40 … clamp device.

Claims

1. A medical clip box for connecting a medical clip to a connection part of a wire having the connection part on a distal side,

the medical clip box is characterized by comprising:

an insertion opening into which the thread-like object is inserted;

an insertion passage extending from the insertion port toward a distal side;

a clip main body housing section that communicates with the distal side of the insertion passage and houses the clip main body; and

a ring housing section for housing a fastening ring for fastening the clip body to the insertion passage,

the ring housing portion includes an abutting portion for restraining the fastening ring from moving in an extending direction of the insertion path,

the distal end of the tightening ring is disposed closer to the proximal side than the proximal end of the clip body.

2. A medical clip box for connecting a medical clip to a connection part of a wire having the connection part on a distal side,

the medical clip box is characterized by comprising:

an insertion opening into which the thread-like object is inserted;

an insertion passage extending from the insertion port toward a distal side;

the distal end of the ring housing is disposed closer to the proximal end of the clip body housing.

3. The cassette claimed in claim 1 or 2,

the abutting portion is a protrusion portion protruding from an inner surface of the insertion passage.

4. The cassette of claim 3,

the protrusion is composed of a distal protrusion and a proximal protrusion,

the ring housing portion is disposed between the distal-side projection portion and the proximal-side projection portion.

5. The cassette of claim 4,

the distal-side projection projects more inward in the radial direction of the insertion passage than the proximal-side projection.

6. The cassette of claim 4 or 5,

the distal-side projecting portion is provided with a plurality of projecting portions, and the proximal-side projecting portion is provided with only one projecting portion.

7. The cassette of claim 3,

the protrusion portion is formed to be detachable from the insertion path.

8. The cassette claimed in claim 1 or 2,

the clamp box is provided with a clamp box main body and a clamp box cover,

the clip case body has a1 st groove for forming an insertion path and a 2 nd groove for forming a clip case housing portion, and the clip case cover covers the clip case body to form the ring housing portion and the clip case housing portion, respectively.

9. The cassette of claim 8,

the abutting portion is provided in the 1 st groove of the cassette main body or in a surface of the cassette cover opposed to the cassette main body.

10. A clip system for attaching a clip to a medical clip device,

the clamping system is characterized by comprising:

the caliper cartridge of any one of claims 1-9;

a clamp having a clamp body for clamping an object and a fastening ring for fastening the clamp body; and

a thread having a connection part at a distal side,

the clamp body has a gripping portion for gripping an object on a distal side and a proximal end portion connected to the connecting portion of the wire on a proximal side.

11. The clamping system of claim 10,

the inner diameter of the fastening ring is larger than the maximum outer diameter of the coupling portion.

12. The clamping system of claim 10 or 11,

the clamp body is formed by arranging 2 holding parts oppositely,

an engaging portion protruding toward the opposite gripping member is provided on at least one of the 2 gripping members at the proximal end portion,

at the base end portion, the 2 grip members are movable at least in directions away from each other,

the coupling portion is coupled to the engagement portion of the clamp body.

13. The clamping system of claim 12,

the engaging portion of one of the gripping members is a1 st claw protruding toward the other gripping member,

the engaging portion of the other of the gripping members is a 2 nd claw protruding toward the one of the gripping members,

and satisfies the following formulae (1) and (2),

0≤L₁/A₁≤0.87 (1)

0≤L₂/A₁≤0.87 (2)

wherein, L is₁L is the maximum length of the 1 st jaw in the opening and closing direction of the base end part₂Is the maximum length of the 2 nd jaw in the opening and closing direction of the base end part, A₁The maximum separation distance between the gripping members at a portion of the base end portion where the engaging portion is not provided in the opening/closing direction of the base end portion.

14. The clamping system of claim 12,

the coupling portion is provided with an engagement receiving portion that engages with the engagement portion of the caliper body.

15. The clamping system of claim 14,

satisfies the following expressions (3) and (4),

A₂＜R₁ (3)

0.13≤(A₂/R₁)≤0.50 (4)

wherein A is₂A minimum separation distance R between the gripping members of the proximal end portion in the opening/closing direction of the proximal end portion in a state where the engagement portion is not engaged with the engagement receiving portion₁The maximum outer diameter of the engagement receiving portion.

16. The clamping system of claim 14 or 15,

satisfies the following expressions (5) and (6),

L₃＜R₂ (5)

L₄＞R₂ (6)

wherein L is₃L is a maximum length of the base end portion in an opening/closing direction of the base end portion in a state where the engagement portion is not engaged with the engagement receiving portion₄R is the maximum length of the base end part in the opening and closing direction of the base end part when the 2 holding parts of the base end part are in the maximum separation state₂Is the inner diameter of the fastening ring.

17. The clamping system of claim 10 or 11,

the clamping system also has an inner barrel configured with the wire in an inner lumen,

the inner diameter of the fastening ring is smaller than the outer diameter of the inner cylinder,

the outer diameter of the fastening ring is larger than the inner diameter of the inner cylinder.

18. A method for manufacturing a medical clip device by using the clip case according to any one of claims 1 to 9,

the method for manufacturing the clamp device is characterized by comprising the following steps:

preparing a clamp device; and

inserting the wire having the coupling portion on a distal side into the insertion passage of the clip case, and coupling the coupling portion to the clip main body at a position on the distal side of a distal end of the fastening ring,

wherein the clamp device comprises:

a thread having a connection part at a distal side,

19. A method for manufacturing a medical clip device by using the clip case according to any one of claims 1 to 9,

a step of preparing a clamp device, wherein the clamp device comprises: a clamp having a clamp body for clamping an object and a fastening ring for fastening the clamp body; a wire having a connection portion on a distal side; and an inner cylinder in which the wire is arranged in an inner cavity, the clamp body having a grip portion for gripping an object on a distal side and a proximal end portion connected to a connection portion of the wire on a proximal side;

inserting the wire having the coupling portion on a distal side into the insertion passage of the clip case, and coupling the coupling portion to the clip main body at a position on the distal side of a distal end of the fastening ring; and

and a step of moving the connecting portion to a proximal side with respect to the inner cylinder to dispose the connecting portion in the inner cavity of the inner cylinder.