JP2010046275A - Clip package - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To surely couple a clip unit to an operating wire by accurately positioning a coupling member or the operating wire at a predetermined coupling position. <P>SOLUTION: A loading tool 82 incorporates a slider 84. A coupling clip unit formed by coupling a clip to a coupling member 48 is fed to the interior in the loading tool 82. The coupling member 48 is formed with a contact face 56. When the slider 84 is pushed toward the loading tool 82, the contact face 56 is pressed by a positioning face 170 of the slider 84 to position the coupling member 48 and a front hook 58 and a rear hook 59 provided to the operating wire 12 are pressed orthogonally to the axial direction of the coupling clip unit to couple the front hook 58 and the rear hook 59 to the coupling member 48. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a clip package including a clip unit loaded in a clip treatment instrument capable of continuously performing hemostasis and wound closure in a living body and the like, and a loading jig for loading the clip treatment instrument into the clip treatment instrument. About.

  The clip treatment tool is inserted into the living body through the forceps channel of the endoscope, the clip protrudes from the tip, the affected part such as the site where the bleeding part or the lesioned tissue has been removed is sandwiched between the clips, and hemostasis or wound closure is performed. Used for clip treatment. In Patent Document 1, a clip unit including a clip and a connecting member that engages with the rear end of the clip is used, and the clip unit is connected to an operation wire inserted through a sheath while being accommodated in a case. A method for loading a sheath into a sheath is described. A hook for connecting to the connecting member of the clip unit is provided at the tip of the operation wire.

To load the clip unit, first, with the hook exposed from the sheath, the clip unit is inserted into the case, the hook is brought into contact with the rear end of the connecting member, and the operation wire is moved along the axial direction. By moving, the hook is pushed into the connecting member for connection. Next, after the connection is completed, the operation wire is pulled, the clip unit is pulled out of the case, and pulled into the sheath. According to this, the clip unit can be loaded by a simple operation such as an axial advance / retreat operation of the operation wire.
JP 2002-191609 A

  In the clip treatment tool, since the hook is pushed into the connecting member by the operation of moving the operation wire in the axial direction, it is necessary to push the hook in a state where the connecting member and the hook are aligned in the radial direction. Since the operation wire is highly flexible, the hook at the tip is likely to be wobbling, and there is a concern that both positioning operations are troublesome. For example, if the hooks of the operation wire are advanced toward the connecting member and the two are approached, the connection is not performed if the radial positions of the two are shifted. The operation wire must be advanced again. Further, when the hook is pushed into the connecting member in a state where the radial positions of both are shifted, there is a concern that the engagement between the two becomes insufficient and poor connection occurs.

  Therefore, the present applicant has researched and developed a clip package having a loading jig for easily and reliably connecting the two. The loading jig is provided with a passage through which the clip unit once pulled out from the case is fed from the top, and a connection auxiliary member for assisting the connection operation between the connection member exposed from the passage and the hook. The auxiliary connecting member presses a hook that overlaps the connecting member in the axial direction, and pushes the hook into the connecting member to complete the connection.

  In the case of using such a loading jig, since the axial positioning of the connecting member is important in order to appropriately apply the pressing force of the connecting auxiliary member, a countermeasure is required.

  In the above-mentioned Patent Document 1, there is no description regarding such a loading jig, and of course, a measure for positioning the connecting member in the axial direction is not taken into consideration.

  SUMMARY OF THE INVENTION An object of the present invention is to provide a clip package capable of positioning a connecting portion of a clip unit at an appropriate position when connecting an operation wire of a sheath and the clip unit.

  The clip package of the present invention contains a clip unit that is connected to a hook provided on an operation wire inserted into the sheath of the treatment instrument and a connecting portion at the rear end and is loaded into the sheath, and the clip unit. An accommodating part capable of pulling out the clip unit from the rear end toward the sheath; a coupling auxiliary member for assisting a coupling operation between the coupling part exposed from the accommodating part and the hook; and the coupling part, And by connecting at least one of the hooks overlapped with the connection portion in the axial direction of the clip unit toward the other, a connection auxiliary member for completing the connection between the two, and the connection auxiliary member, A housing having a positioning portion that engages with the connecting portion and positions the connecting portion in the axial direction when pressed by a connecting auxiliary member. Characterized in that a knit.

  The connection assisting member is a slider that is slidable along a sliding direction orthogonal to the axial direction of the clip unit, and the slider is inclined with respect to the sliding direction, and slides to form the hook and the slider. It is preferable to have a pressing surface that gradually increases the pressing amount for pressing one of the connecting portions in the pressing direction. Moreover, it is preferable that the said positioning part is a positioning surface inclined so that the width | variety of an axial direction may spread toward the back from the front in a slide direction. Furthermore, the connecting portion has a substantially cylindrical shape, and has a contact surface that is provided by a step of the peripheral surface thereof and rises outward in the radial direction, and the contact surface and the positioning surface are engaged with each other. It is preferable to do.

  The pressing surface is provided with a wire pressing portion that contacts the wire portion of the operation wire provided with the hook and presses the wire portion when the pressing surface presses the hook. preferable. The hook includes a plurality of hook portions arranged at predetermined intervals in the axial direction, the wire pressing portion protrudes from the pressing surface in the pressing direction, and both side surfaces thereof are forward in the sliding direction. It is a wedge shape inclined so as to spread in the axial direction from the rear to the rear, enters between the hook portions from the front, and abuts on the hook portions on both side surfaces, whereby the axial direction of the hooks It is preferable to perform positioning. Furthermore, the storage unit is a loading jig used when loading the clip unit into the sheath, and the loading jig has a case connecting portion to which a case of the clip unit is connected, It is preferable that the accommodating portion is a passage through which the clip unit pulled out from the case is fed from the front immediately before being loaded into the sheath.

  According to the present invention, the positioning provided on the connection auxiliary member that completes the connection between the connecting portion and the hook that overlaps the connecting portion in the axial direction of the clip unit by pressing at least one of the hooks toward the other. Since the portion engages with the connecting portion and presses the connecting portion in the axial direction when pressed by the auxiliary connecting member, the connecting portion is accurately positioned at a predetermined connecting position, and the clip unit and the operation wire are It can be connected easily and reliably.

  As shown in FIG. 1, a repetitive clip treatment tool (hereinafter referred to as a “clip treatment tool”) 10 is loaded into a cylindrical sheath 11, an operation wire 12 inserted through the sheath 11, and the sheath 11. A connection clip unit 13 connected to the operation wire 12 and an operation unit 14 used for a pulling operation of the sheath 11 and the operation wire 12 are provided.

  As shown in FIG. 2, the connecting clip unit 13 includes a plurality of hemostatic clip bodies 17 (17A to 17C) connected in a row and a connecting clip body 18 connected to the last hemostatic clip body 17C. It is configured. The hemostatic clip body 17 includes a clip 19 (19A to 19C) and a cylindrical connection ring 20 (20A to 20C) attached to the outside of the clip 19.

  As shown in FIG. 3, the clip 19 is formed by bending a single elongated plate 180 degrees to form a closed end, crossing the two pieces, and bending the two open ends to oppose each other. Portions 23 and 23 are formed. The clip 19 has arm portions 25 and 25 on the open end side and a turn portion 26 on the closed end side, with a crossing portion 24 crossing the elongated plates as a boundary. Convex portions 27 and 27 that are partially wide are formed at the central portions of the arm portions 25 and 25.

  When the external force is not applied, the arm portions 25 and 25 are in an open state in which the claw portions 23 and 23 are separated, and when the arm portions 25 and 25 are elastically deformed so as to approach each other, the claw portions 23 and 23 mesh with each other. It will be in the closed state which pinches | interposes the affected part used as object. The nail | claw parts 23 and 23 are formed in the V-shaped male type and female type | mold in order to pinch | interpose an affected part reliably. The clip 19 can be made of a biocompatible metal, for example, SUS631 which is stainless steel for springs.

  The connecting ring 20, which is a cylindrical member, has a substantially cylindrical shape, and includes a metal fastening portion 30 disposed on the front end side and a plastic holding portion 31 disposed on the rear end side. The hemostatic clip body 17 is formed by inserting the clip 19 into the tightening hole 30 a formed in the tightening portion 30 from the turn portion 26 side and mounting the connecting ring 20 on the outside of the clip 19. The tightening portion 30 is set at an initial position covering the outer periphery of the intersecting portion 24, and the arm portions 25, 25 of the clip 19 are in an open state.

  When the clip 19 is pulled into the connecting ring 20, the tightening hole 30 a tightens the arm portions 25 and 25 and closes the claw portions 23 and 23. The claw portions 23 and 23 exhibit a predetermined meshing force when the arm portions 25 and 25 are tightened. Since the diameter of the fastening hole 30 a is smaller than the width of the convex portion 27 of the clip 19, the tip from the convex portion 27 of the clip 19 is not inserted into the connecting ring 20.

  As shown in FIG. 4, the holding portion 31 is formed with a holding hole 31a that is continuous with the tightening hole 30a. The turn part 26 inserted from the tightening hole 30a is accommodated in the holding hole 31a. Two skirt portions 38 are formed on the outer peripheral surface of the holding portion 31 symmetrically with respect to the central axis. The skirt portions 38, 38 are formed so as to expand in the radial direction from the front end side to the rear end side of the holding portion 31, and are opened by their own elasticity when external force is not applied, and are pressed from the outside. Sometimes it closes so as to enter the holding part 31.

  The connecting ring 20 is attached to the outside of the clip 19 so that the opening / closing direction of the claw portions 23, 23 and the opening / closing direction of the skirt portions 38, 38 are shifted by 90 °. When the connecting clip unit 13 is loaded into the sheath 11 and closed, the skirt portions 38 and 38 sandwich the turn portion 26 accommodated in the holding hole 31 a and integrate the connecting ring 20 with the clip 19.

  The plurality of hemostatic clip bodies 17 are connected in a row by engaging the claw portions 23 and 23 of the rear clip 19 with the turn portion 26 of the clip 19 disposed on the front side. The connection ring 20 covers the outside of the claw portions 23 and 23 of the rear clip 19 and maintains the connection of the clip 19 so that the claw portions 23 and 23 do not open. The projecting portion 27 of the clip 19 has a width that is greater than the diameter of the holding hole 31 a, and abuts against the rear end of the connecting ring 20 when disposed behind the connecting ring 20. Thereby, the movement of the connection ring 20 from the initial position described above to the rear end side of the connection clip unit 13 is restricted.

  Slits 44 a and 44 a are formed at two positions that are shifted from the skirt portions 38 and 38 in the circumferential direction by 90 ° in the rear end portion 44 of the connecting ring 20, that is, the rear portion of the skirt portion 38. The slits 44a and 44a are formed along the axial direction of the connecting ring 20, and the rear end portion 44 is elastically deformed so that the inner diameter thereof is expanded. The slit 44a improves the flexibility of the connecting ring 20 so that the connecting clip unit 13 is bent in accordance with the bending of the endoscope. Further, since the inner diameter of the rear end portion 44 is widened by the slit 44a, it is easy to engage the two clips 19 during assembly.

  A material that is biocompatible and satisfies the elasticity and rigidity required for the skirt portion 38 is used for the holding portion 31. For example, PPSU (polyphenylsulfone) is used as the material of the holding unit 31.

  As shown in FIG. 5, the connecting clip body 18 (connecting portion) includes a dummy clip 47 that engages with the turn portion 6 of the rearmost clip 19 </ b> C and a connecting member 48 that holds the dummy clip 47. Yes. The dummy clip 47 is formed by bending a metal thin plate, and has claw portions 47b and 47b that engage with the turn portion 26, and convex portions 47a and 47a that abut on the rear end of the connecting ring 20C. Yes. Like the clip 19, the claw portions 47b and 47b open by their own elasticity when no external force is applied, and close by being elastically deformed when pressed from the outside.

  For example, the connecting member 48 is a cylindrical body formed of the same material as the holding portion 31 of the connecting ring 20. A cutout holding portion 49 that holds the dummy clip 47 is provided on the distal end side of the connecting member 48. On the rear end side of the connecting member 48, an engaging portion 50 for connecting to the operation wire 12 is provided.

  The engaging part 50 has a pair of elastic arms 53, 53 that are made elastic in the radial direction of the connecting member 48, and clamping parts 54, 54 provided at the ends of the elastic arms 53, 53, respectively. . The gap between the pair of sandwiching portions 54, 54 is made thinner than the outer diameter of the operation wire 12. In addition, semi-circular grooves 54 a and 54 a having the same diameter as the outer diameter of the operation wire 12 are formed in the pair of sandwiching portions 54 and 54 along the central axis of the connecting member 48.

  The connecting member 48 includes a positioning portion 51 for positioning the connecting member 48 in the axial direction when the connecting clip unit 13 is fed into a loading jig 82 described later, and the connecting member 48 is pulled into the loading jig 82. The pull-in preventing claw 52 for preventing the pulling is integrally formed. The positioning part 51 and the pull-in preventing claw 52 are arranged approximately in the middle between the holding part 49 and the engaging part 50.

  The positioning portion 51 is located on the upper surface side of the elastic arms 53, 53, and has a flat surface 55 in which a part of the circumferential surface of the connecting member 48 is cut out flat, and a step between the circumferential surface and the flat surface 55. The contact surface 56 is provided and rises outward in the radial direction. The contact surface 56 is formed in a substantially triangular shape that protrudes from the front end side to the rear end side of the connecting member 48. The flat surface 55 is formed at a position that does not hinder the movement of a slider 84 described later, and the contact surface 56 is formed at a position that contacts a positioning surface 170 of the slider 84 described later.

  The pull-in preventing claw 52 is a claw whose base end is fixed to the connecting member 48 and protrudes radially outward from the circumferential surface of the connecting member 48 so as to spread from the rear end side to the front end side of the connecting member 48. And is open by its own elasticity when no external force is applied, that is, the open end protrudes by swinging with the base end as a fulcrum, and the inside of the connecting member 48 when pressed from the outside. Closed as if entering.

  In FIG. 1, a sheath 11 is a flexible coil sheath in which a metal wire is tightly wound, for example. The inner diameter of the sheath 11 is a dimension in which the engagement between the turn portion 26 of the previous clip 19 and the claws 23 and 23 of the next clip 19 is released. That is, the inner diameter of the sheath 11 is larger than the length obtained by adding the lengths of the two claw portions 23 and 23 and the width of the portion where the claw portions 23 and 23 of the turn portion 26 are engaged.

  The operation wire 12 is a metal wire formed of a metal having biocompatibility. As shown in FIG. 5, a hook 57 used for connection with the connection clip body 18 is provided at the distal end of the operation wire 12. The hook 57 includes a front hook 58 attached to the tip of the operation wire 12 and a rear hook 59.

  The front hook 58 has a square columnar part 58 a having a side with the same length as the gap between the elastic arms 53 and 53, and a quadrangular pyramid part 58 b that matches the gap between the elastic arms 53 and 53. Yes. The rear hook 59 has a cylindrical shape having an outer diameter that is larger than the outer diameter of the front hook 58 and slightly smaller than the outer diameter of the connecting member 48. The rear hook 59 is disposed behind the rear end of the front hook 58 by a predetermined distance. This predetermined distance is the same length as the axial length of the clamping part 54.

  The front hook 58 is fitted between the elastic arms 53 and 53 and comes into contact with a pair of holding portions 54 formed at the end of each elastic arm 53. The operation wire 12 between the front hook 58 and the columnar rear hook 59 is clamped by the clamping unit 54. The rear hook 59 abuts on the rear end of the holding portion 54. Accordingly, the pulling and rotation of the operation wire 12 can be transmitted to the connecting clip unit 13, and the connecting clip unit 13 can be pressed so as not to move together with the sheath 11 by the frictional force generated when the sheath 11 is pulled.

  As shown in FIG. 1, the operation unit 14 includes a sheath operation handle 63 that pulls the sheath 11 and the operation wire 12, and a wire operation handle 62. The sheath operation handle 63 has a substantially cylindrical shape, and the rear end of the sheath 11 is fixed to the tip. The sheath operation handle 63 is slidably attached to the outside of a pipe 64 provided at the tip of the wire operation handle 62. By sliding along the pipe 64 toward the wire operation handle 62, the sheath 11 is operated by the operation wire. 12 is pulled to the rear end side. Reference numeral 69 is a notch for allowing the operator to feel the amount of retraction when the sheath 11 is retreated with respect to the operation wire 12. The interval between the notches 69 is set corresponding to the retraction amount for pushing out the clips 19 of the connecting clip unit 13 from the sheath 11 one by one.

  The wire operation handle 62 has a substantially cylindrical shape and has a through window 65 with a slidable operation lever 66 built therein. The operation wire 12 passes through the sheath operation handle 63, and the rear end is locked to the operation lever 66. When the operation lever 66 is slid, the operation wire 12 is pulled with respect to the sheath 11 by an amount necessary for tightening the clip 19 by the connecting ring 20.

  Next, the operation of the clip treatment tool 10 will be briefly described. As shown in FIG. 6A, the connecting clip unit 13 is loaded in the sheath 11 so that the tip of the leading clip 19 </ b> A coincides with the tip of the sheath 11. The sheath 11 is inserted into a forceps channel of an endoscope inserted in the living body. The distal end of the sheath 11 protrudes from the forceps exit at the distal end of the endoscope and approaches the affected part.

  When the sheath operation handle 63 is pulled by a predetermined amount, the sheath 11 is retracted by a predetermined amount with respect to the operation wire 12. Since the operation wire 12 and the connection clip unit 13 are connected, the connection clip unit 13 moves forward with respect to the sheath 11 and, as shown in FIG. 6B, is connected to the leading clip 19A from the distal end of the sheath 11. The ring 20A is sent out.

  At this time, a force that moves to the rear end side together with the sheath 11 acts on the coupling rings 20 </ b> A to 20 </ b> C that are in contact with the inner wall surface of the sheath 11 due to a frictional force generated between the sheath 11 and the coupling rings 20 </ b> A to 20 </ b> C. However, the connecting rings 20A to 20C are integrated with the clips 19A to 19C by the closed skirt portions 38 and 38, and the convex portions 27 of the rear clips 19B and 19C and the convex portion 47a of the dummy clip 47 The movement to the rear end side is restricted by the above. For this reason, the connection rings 20A to 20C do not move backward, but move forward with respect to the sheath 11 together with the clips 19A to 19C.

  The clip 19A coming out of the sheath 11 opens the claw portions 23, 23 due to its own elasticity. As shown in FIG. 2 (A), the connecting ring 20A has a skirt portion 38, 38 that is larger than the inner diameter of the sheath 11. The connection ring 20 </ b> A is engaged so that the connection ring 20 </ b> A does not return into the sheath 11.

  The clip treatment tool 10 is moved, and the claws 23 and 23 of the clip 19A in the open state are pressed against the affected part. In this state, when the operation lever 66 of the wire operation handle 62 is pulled, the operation wire 12 is pulled by a predetermined amount, and all the clips 19 </ b> A to 19 </ b> C sequentially engaged from the connecting clip body 18 are pulled uniformly. .

  As shown in FIG. 6C, the clip 19A fed from the sheath 11 is released from the press and hold by the skirt portions 38, 38 because the skirt portions 38, 38 of the connecting ring 20A are open. Further, the connecting ring 20 </ b> A is prevented from retreating into the sheath 11 by the skirt portions 38, 38. Therefore, the leading clip 19A moves backward with respect to the connecting ring 20A when the operation wire 12 is pulled. When the tightening portion 30 is pushed to just below the convex portion 27 of the clip 19A, the tightening of the clip 19A by the connecting ring 20A is completed.

  Simultaneously with the completion of the fastening of the clip 19A, the engaging portion of the clip 19A and the next clip 19B comes out from the rear end of the connecting ring 20A. The arm portions 25, 25 of the clip 19B are expanded by their own elastic force until they hit the inner wall of the sheath 11, and the gap between the claw portions 23, 23 opens wider than the width of the turn portion 26 of the clip 19A. The connection with the clip 19B is released. As shown in FIG. 6D, when the distal end of the sheath 11 is separated from the affected part, the hemostatic clip body 17 </ b> A comes out from the distal end of the sheath 11.

  When the pulling operation of the operation lever 66 is stopped, the operation lever 66 returns to the original position by a biasing force of a spring (not shown). As a result, the operation wire 12 moves to the distal end side in the sheath 11 and the connecting clip body 18 and the clips 19B and 19C are pushed. As shown in FIG. The distal end moves to a position that substantially coincides with the distal end of the sheath 11. Thereafter, similarly to the first hemostatic clip body 17A, the operation unit 14 can be operated to perform the clip treatment with the second and third hemostatic clip bodies 17B and 17C.

  Next, the connection clip package 80 will be described. As shown in FIGS. 7 to 9, the connection clip package 80 includes a cylindrical case 81 that houses the connection clip unit 13, and a rectangular loading jig 82 into which the tip of the case 81 is inserted. The loading jig 82 includes a clip retracting member 83 that pulls the coupling clip unit 13 from the case 81 into the loading jig 82, and a slider 84 (coupling auxiliary member) used for coupling the operation wire 12 and the coupling clip body 18. And are incorporated.

  The case 81 is provided with a clip accommodating portion 87 that is a cylindrical space on the inner side. The outer diameter of the case 81 and the inner diameter of the clip housing portion 87 are substantially the same as the outer diameter and inner diameter of the sheath 11. In the clip accommodating portion 87, the connecting clip unit 13 is accommodated so that the leading clip 19A is arranged on the distal end side of the case 81.

  As shown in FIG. 10, the case 81 is formed by joining a semi-cylindrical lower case 110 and an upper case 111. The lower case 110 and the upper case 111 are respectively provided with semicircular receiving recesses 110a and 111a that become the clip receiving portion 87 when joined. The clip accommodating portion 87 is open on both the front end side where the leading clip 19A is accommodated and the rear end side where the connecting clip body 18 is accommodated. The opening on the distal end side of the clip accommodating portion 87 is a delivery port for sending the connecting clip unit 13 out of the clip accommodating portion 87 from the head side.

  The connecting clip unit 13 is accommodated in the clip accommodating portion 87 such that the claw portions 23 of the leading clip 19A open and close in the horizontal direction. The clip 19 </ b> A is pushed by the inner wall of the clip accommodating portion 87 and is in a closed state. As described above, the hemostatic clip bodies 17A to 17C are connected so that the opening and closing directions of the claw portions 23 and 23 are alternately rotated by 90 °, and the opening and closing directions of the claw portions 23 and 23 and the skirt portions 38 and 38 are also 90 °. It is off. Therefore, the connecting rings 20A and 20C open and close the skirt portion 38 in the vertical direction, and the connecting ring 20B opens and closes the skirt portion 38 in the left and right direction.

  The lower case 110 and the upper case 111 are formed with skirt openings 114 for accommodating the skirt portions 38 of the connecting rings 20A and 20C in an open state. Further, at the joint of the lower case 110 and the upper case 111, a notch 115 serving as a skirt opening for accommodating the skirt portion 38 of the connecting ring 20B is formed when the two are joined. Accordingly, it is possible to prevent a reduction in restoring force (elastic force) in the opening direction of the skirt portion 38 due to being stored in the case 81 while the skirt portion 38 is pushed in the closing direction. A recess may be provided instead of the opening.

  At the lower part of the lower case 110, a ridge-shaped positioning part 117 is provided along the axial direction of the case 81. An elastic piece 117 a that is elastic in a direction orthogonal to the axial direction of the case 81 is provided on the distal end side of the positioning portion 117. A click protrusion 117b is provided on the tip side surface of the elastic piece 117a.

  The case 81 is formed of, for example, a transparent plastic so that the connecting clip unit 13 accommodated in the clip accommodating portion 87 can be seen from the outside of the case 81. For joining the lower case 110 and the upper case 111, for example, bonding using an adhesive, welding using ultrasonic waves, engagement by an engaging claw, or the like can be used. Further, a transparent plastic film may be wound around the outer periphery in a state where the lower case 110 and the upper case 111 are combined.

  The loading jig 82 is a jig for closing the skirt portions 38 of the coupling clip unit 13 drawn from the case 81 and loading the coupling clip unit 13 into the sheath 11. A recess 90 that is recessed in the height direction is formed on one end side in the longitudinal direction of the loading jig 82. In the recess 90, a case insertion groove 91 having an inner diameter slightly larger than the outer diameter of the case 81 and having an open top is formed. A case insertion hole 92 having the same diameter is formed on the side surface in the recess 90 so as to be continuous with the case insertion groove 91.

  A case 81 is inserted into the case insertion groove 91 and the case insertion hole 92. When the connecting clip unit 13 is loaded from the loading jig 82 to the sheath 11, the case 81 is removed from the case insertion groove 91 and the case insertion hole 92, and the sheath 11 is inserted instead. Part of the upper portion of the case 81 or the sheath 11 inserted into the case insertion groove 91 is exposed. Therefore, the case 81 and the loading jig 82 or the sheath 11 and the loading jig 82 can be held together by gripping the inside of the recess 90.

  On the upper surface of the loading jig 82, a connection opening 95 and a wire slit 96 are provided adjacent to the recess 90. The connection opening 95 is an opening for inserting the hook 57 of the operation wire 12 into the loading jig 82 from the lateral direction perpendicular to the insertion direction of the case 81, and the outer diameter dimension when the hook 57 is viewed from the side. Larger opening area. The wire slit 96 is formed so as to connect the case insertion hole 92 and the connection opening 95, and has a width dimension in which the operation wire 12 can be inserted from the side. The operation wire 12 and the hook 57 are inserted into the wire slit 96 and the connection opening 95 at the same time when the sheath 11 is inserted into the case insertion groove 91, and are drawn into the loading jig 82. To the connecting member 48 (see FIG. 5).

  A skirt closing passage 99 that is a cylindrical space is provided in the loading jig 82 at the back of the case insertion hole 92. The skirt closing passage 99 has the same inner diameter as the sheath 11 and the clip housing portion 87, and the inner diameter surface thereof is connected to the case 81 inserted into the case insertion hole 92 and the inner diameter surface of the sheath 11. The skirt closing passage 99 closes each skirt portion 38 of the connecting clip unit 13 drawn from the clip accommodating portion 87 by pushing the inner diameter surface.

  The clip retracting member 83 includes a substantially elliptic traction portion 102 protruding outward from the other end side in the longitudinal direction of the loading jig 82, an insertion portion 103 provided with the traction portion 102 at one end, and an insertion portion 103. And an engaging portion 104 (see also FIG. 10) provided at the other end. The insertion portion 103 is a rod-like body having a length penetrating the skirt closing passage 99 and is inserted into the skirt closing passage 99. The engaging portion 104 is inserted into the clip accommodating portion 87 and is engaged with the leading clip 19A.

  The clip retracting member 83 is elastically deformed so as to crush the ring of the pulling portion 102 and is inserted into the case insertion hole 92 together with the case 81. The insertion portion 103 is inserted into the skirt closing passage 99, and the pulling portion 102 projects out of the loading jig 82 through a pulling hole (see reference numeral 151 in FIGS. 17 to 19) formed at the end of the skirt closing passage 99. Is done. When the pulling portion 102 is pulled with respect to the loading jig 82, the leading clip 19 </ b> A is pulled by the engaging portion 104, and the connecting clip unit 13 is drawn from the clip accommodating portion 87 into the skirt closing passage 99.

  The slider 84 is slidably inserted into a slider passage 107 provided so as to penetrate the side surface of the loading jig 82. The slider 84 is pushed into the slider passage 107 when the connecting clip body 18 drawn into the loading jig 82 and the hook 57 inserted from the connecting opening 95 are connected.

  The slider passage 107 is formed in a direction orthogonal to the case insertion groove 91. The slider passage 107 has a rectangular shape having a width substantially equal to the width dimension of the slider 84, and is provided so as to penetrate the short direction of the loading jig 82. The loading jig 82 is made of, for example, transparent plastic so that the connecting clip unit 13, the case 81, the clip retracting member 83, the slider 84, and the like can be seen from the outside.

  The insertion portion 103 of the clip retracting member 83 is inserted into a pulling hole 151 (see FIGS. 17 to 19) located on the opposite side of the insertion groove 91. As shown in FIG. 10, a slit 103a is provided at the end of the insertion portion 103 on the engaging portion 104 side so as to penetrate the side surface. Above and below the slit 103a, check protrusions 103b that extend from the pulling portion 102 toward the engaging portion 104 are provided. The check protrusion 103 b jumps out of the loading jig 82 from the pulling hole 151 when the insertion portion 103 is elastically deformed at the slit 103 a. The check protrusion 103b locks the insertion portion 103 so that the insertion portion 103 does not return to the skirt closing passage 99 again.

  The engaging portion 104 has a pair of guide pieces 104a and 104a that have the same outer diameter as the connection ring 20 and are arranged in the vertical direction. A rib 104b is integrally provided between the guide pieces 104a and 104a so as to keep the distance between the guide pieces 104a and 104a. Engagement pieces 104c and 104c protruding in the left-right direction are integrally formed on both side surfaces of the rib 104b at positions close to the insertion portion 103.

  The engaging portion 104 is accommodated in the clip accommodating portion 87 of the case 81 together with the connecting clip unit 13. The top clip 19A is pushed by the clip accommodating portion 87 to be in a closed state, and engages the claw portions 23 and 23 with the engagement pieces 104c and 104c. When the pulling portion 102 is pulled with respect to the loading jig 82, the insertion portion 103 moves in the skirt closing passage 99, and the engaging portion 104 moves from the clip accommodating portion 87 into the skirt closing passage 99.

  When the leading clip 19 </ b> A reaches the release groove 148 (see FIGS. 17 to 19), the leading clip 19 </ b> A is displaced by its own elasticity to release the engagement with the engaging portion 104. Thereby, the connecting clip unit 13 is stopped in the skirt closing passage 99 so that the engaging portion 50 of the connecting clip body 18 is positioned in the slider passage 107 in the case insertion hole 92.

  In addition, since the opening and closing direction of the claw portions 23 and 23 and the opening and closing direction of the skirt portions 38 and 38 are shifted by 90 °, the hemostatic clip body 17 has a leading end even when the leading clip 19A is in the release groove 148. The skirt portions 38, 38 of the connecting ring 20A are not opened.

  Further, as described above, when the clip 19A disengages from the engaging portion 104 and the connecting clip unit 13 stops, the connecting member 48 of the connecting clip body 18 is directly pulled by the pulling portion 102. Instead of being pulled through the clips 19A to 19C and the dummy clip 47, even if the clip 19A is pulled to an appropriate position, it may follow a little later than the clip 19A due to friction or slippage. . As a result, the connecting member 48 may be positioned rearward in the feed direction with respect to the appropriate position where the connecting member 48 is connected to the hook 57. The member 48 is pressed to an appropriate position.

  The pulling portion 102, the insertion portion 103, and the engaging portion 104 constituting the clip retracting member 83 are integrally formed of, for example, plastic having appropriate elasticity. Note that the insertion portion 103 and the engagement portion 104 may be formed separately and connected in the loading jig 82.

  As shown in FIG. 11, the loading jig 82 is formed by joining a plate-like lower jig 120 and an upper jig 121. On the upper surface 120 a of the lower jig 120, a semicircular case concave portion 122 that forms a case insertion groove 91 and a case insertion hole 92 when the upper jig 121 is joined is formed.

  A positioning groove 125 into which the positioning portion 117 provided on the lower surface of the case 81 is inserted when the case 81 is inserted into the case insertion groove 91 and the case insertion hole 92 from the axial direction is provided in the case recess 122. It is provided along the direction. The positioning portion 117 and the positioning groove 125 position the insertion posture of the case 81 with respect to the loading jig 82 so that the connecting clip unit 13 is set at a predetermined rotational position with respect to the loading jig 82. Note that the insertion of the case 81 to the back of the case insertion hole 92 can be known from the click feeling when the click protrusion 117b is engaged with the click groove in the positioning groove 125.

  A semicircular skirt closing recess 128 that forms a skirt closing passage 99 when joined to the upper jig 121 is formed in the back of the case recess 122. On the other end side in the longitudinal direction of the lower jig 120, a rectangular release recess 129 that extends from the skirt closing recess 128 in the left-right direction is formed. A rectangular cutout 130 into which the insertion portion 103 of the clip retracting member 83 is inserted is formed at the end of the skirt closing recess 128.

  At the boundary between the case recess 122 and the skirt closing recess 128, that is, at the rear end of the skirt closing recess 128, a step 131 is formed that is one step in the radial direction with respect to the inner wall of the skirt closing recess 128. The step 131 corresponds to the thickness of the sheath 11 or the case 81.

  The step 131 is an abutment surface that abuts against the pull-in preventing claw 52 that is in an open state. Therefore, when the connection clip unit 13 is sent to the loading jig 82 and pulled out from the case 81, the step 131 engages with the pull-in preventing claw 52 when the pull-in preventing claw 52 released from the external force is opened. Functions as a joint. The step 131 engages with the pull-in preventing claw 52, so that the connecting member 48 can be prevented from entering the skirt closing recess 128 side, that is, the skirt closing passage 99, and the connecting member 48 can be attached to the loading jig. 82 can be accurately positioned.

  A slider recess 133 is formed below the case recess 122. The slider recess 133 forms a slider passage 107 when joined to the upper jig 121, and guides the slider 84 in a direction orthogonal to the axial direction of the connecting clip unit 13. The slider recess 133 has a rectangular shape having a width substantially equal to the width dimension of the slider 84, and is provided so as to penetrate the short direction of the lower jig 120.

  A connection piece 136 made of a plate-like body connecting both sides of the slider recess 133 is provided at a substantially central portion of the slider recess 133. The connection piece 136 serves as a stopper when the slider 84 is pushed into the slider passage 107 while preventing the strength of the loading jig 82 from being lowered by the slider recess 133. The connection piece 136 is provided with a part of the case recess 122. In the case recess 122, a connection auxiliary opening 136 a is formed so as to be continuous with the slider recess 133.

  On the lower surface 121 a of the upper jig 121, as with the lower jig 120, a case notch 139 that forms the case insertion groove 91 and a semicircular case recess 140 that forms the case insertion hole 92 are formed. ing. Further, a skirt closing recess 141 that forms a skirt closing passage 99, a release recess 142, and a notch 143 having the same shape as the notch 130 are formed on the lower surface 121a. Furthermore, on the case recess 140, a slider recess 144 that forms the slider passage 107, a connection piece 145, and a connection auxiliary opening 145 a are formed. The connection auxiliary opening 145a faces the connection opening 95 (see FIG. 7).

  The slider recess 144 is formed with biasing portions 146 and 147 as biasing means for biasing the slider 84 to the hook 57 (see also FIG. 12). The urging portions 146 and 147 are arranged at positions symmetrical with respect to the case recess 140, that is, the case insertion hole 92. The urging portions 146 and 147 are formed from plate springs 146a and 147a extending from the widthwise end of the upper jig 121 toward the center, and projecting portions 146b and 147b protruding downward from the tips of the plate springs 146a and 147a. Each is composed.

  The release recess 129 and the release recess 142 form a release groove 148 (see FIGS. 17 to 19) projecting in the left-right direction of the skirt closing passage 99 when the lower jig 120 and the upper jig 121 are joined. . The release groove 148 has a width dimension in which the arms 25 and 25 of the leading clip 19A can be opened to the extent that the engagement with the engagement portion 104 of the clip retracting member 83 is released. The release groove 148 is arranged so that the leading clip 19A reaches the release groove 148 when the engaging portion 50 of the connection clip body 18 reaches the position facing the connection auxiliary opening 145a. Further, the notches 130 and 143 form a rectangular pulling hole 151 (see FIGS. 17 to 19) through which the insertion portion 103 of the clip retracting member 83 is inserted.

  The slider 84 is formed in a size that is loose enough to be slidable with respect to the slider passage 107. For example, the outer periphery of the lower piece 155 and the upper piece 156 is formed slightly smaller than the inner periphery of the slider recesses 133 and 144. Thus, the gap between the lower piece 155 and the upper piece 156 is formed to be slightly larger than the combined thickness of the connecting pieces 136 and 145.

  The loading jig 82 is made of, for example, transparent plastic so that the connecting clip unit 13, the case 81, the clip retracting member 83, the slider 84, and the like can be seen from the outside. For joining the lower jig 120 and the upper jig 121, for example, adhesion using an adhesive, welding using an ultrasonic wave, engagement by an engaging claw, or the like can be used.

  As shown in FIG. 13, the slider 84 has an operation portion 154 used for pushing into the slider passage 107, and a lower piece 155 and an upper piece 156 that are provided in a bifurcated shape from the operation portion 154 and face each other in the vertical direction. , Molded integrally with plastic. The lower piece 155 and the upper piece 156 are inserted into the slider concave portions 133 and 144 of the lower jig 120 and the upper jig 121, respectively, and sandwich the connection pieces 136 and 145 therebetween.

  First recesses 159 and 159 and second recesses 160 and 160 having the same inner diameter as the outer diameters of the sheath 11 and the case 81 are formed on the upper surface of the lower piece 155 and the lower surface of the upper piece 156, respectively. The slider 84 is slidable between an initial position where the first concave portions 159 and 159 on the distal end side match the case insertion hole 92 and a connection position where the second concave portions 160 and 160 match the case insertion hole 92. Yes. When the slider 84 slides to the coupling position, the connection pieces 136 and 145 of the loading jig 82 abut against the inner surface of the slider 84 and prevent further sliding.

  The first recesses 159 and 159 and the second recesses 160 and 160 face the connection auxiliary openings 136 a and 145 a of the loading jig 82 and constitute a part of the case insertion hole 92. When the case 81 or the sheath 11 is inserted into the case insertion hole 92, the first recesses 159 and 159 or the second recesses 160 and 160 are engaged with the outer peripheral surface thereof, so that sliding of the slider 84 is prohibited.

  An elastic piece 163 that is elastic in the width direction of the slider 84 is formed on the side surface on the front end side of the lower piece 155. A click protrusion 164 protruding in the width direction of the slider 84 is provided at the tip of the elastic piece 163. When the slider 84 is in the initial position, the click protrusion 164 engages with a click groove 165 (see FIG. 11) provided in the slider recess 133 of the lower jig 120, and the slider 84 slides to the coupling position. Sometimes it engages the click groove 166 (see FIG. 11). The stop position of the slider 84 can be known from the click feeling when the click grooves 165 and 166 engage with the click protrusion 164.

  The upper piece 156 of the slider 84 is formed with a notch 169 that reduces the width of the upper piece 156 by about half at the tip side. The notch 169 communicates between the connection opening 95 and the connection auxiliary opening 145a when the slider 84 is in the initial position. Thereby, the hook 57 can be connected to the connecting member 48 from the lateral direction.

  The upper piece 156 is provided with a positioning surface 170 on the opposite side of the notch 169. The positioning surface 170 is an inclined surface that inclines so that the axial width increases from the front to the rear in the sliding direction of the slider 84. When the slider 84 is pushed into the slider passage 107, the positioning surface 170 is brought into contact with the contact surface 56 (see FIG. 5) of the connecting member 48 to be engaged with the connecting member 48. Is pushed in along the axial direction. Thereby, the connecting member 48 is positioned in the axial direction.

  When the slider 84 is pushed into the slider passage 107, at least one lower end portion of the protrusions 146 b and 147 b described above comes into contact with the upper surface of the upper piece 156. The upper piece 156 whose protrusions 146b and 147b are in contact with the upper surface is pressed downward by receiving a biasing force from the leaf springs 146a and 147a.

  As described above, the slider 84 is formed so as to be loose enough to be slidable with respect to the slider passage 107, so that the slider 84 is rattled with respect to the slider passage 107, that is, left and right orthogonal to the pushing direction. Pitching (swinging) about the width direction or pitching up and down may occur, but by pushing the slider 84 into the slider passage 107, it receives a bias from the leaf springs 146a and 147a. Since the slider 84 is pressed downward, the slider 84 is prevented from rattling with respect to the slider passage 107. The slider 84 in which the rattling is suppressed can be pressed downward with the upper piece 156 abutting against the hook 57 reliably.

  On the upper surface of the upper piece 156, a recess 171 for accommodating the protruding portion 146b is formed. The concave portion 171 retracts the upper surface of the upper piece 156 from the protruding portion 146b when the slider 84 is in the initial position. When the slider 84 is in the initial position, the projecting portion 147b is located on the back side with respect to the tip portion of the upper piece 156. Therefore, when the slider 84 is in the initial position, the protrusions 146b and 147b do not come into contact with the upper piece 156 and are not urged by the leaf springs 146a and 147a.

  When the upper piece 156 is slid from the initial position to the connection position, the hook 57 in the case insertion hole 92 is pressed through the connection auxiliary opening 145a, and the hook 57 is attached to the connection member 48 of the connection clip body 18. A pressing surface 172 to be connected is provided. The pressing surface 172 has a first inclined surface 172a that gently descends from the notch 169 toward the second recess 160 in the direction in which the slider 84 is pushed in, and an angle steeper than the first inclined surface 172a, and the second inclined surface from the first inclined surface 172a. And a second slope 172b descending toward the recess 160.

  As described above, since the slider 84 is inserted into the slider passage 107 and the pressing surface 172 is supported by the inner wall of the slider passage 107 from behind, the reaction force when pressing the hook 57 with the pressing surface 172 is reduced. It is received by the slider passage 107. Thereby, the deformation | transformation and attitude | position change of the slider 84 can be prevented.

  In this way, the hook 57 is pressed against the pressing direction of the slider 84 by pressing the hook 57 with the pressing surface 172 that is inclined with respect to the pressing direction of the slider 84 and gradually increases the pressing amount of pressing the hook 57 in the pressing direction. The hook 57 can be pushed into the connecting member 48 at a short distance (pushing amount) relative to the sliding amount of the slider 84 while changing the pressing direction of the slider 57.

  By configuring the pressing surface 172 from the first inclined surface 172a and the second inclined surface 172b, the initial pressing of the slider 84 is hooked by the pressing of the first inclined surface 172a (slowly inclined surface) with a small pressing amount with respect to the sliding amount of the slider 84. 57 is pushed into the connecting member 48, and the engagement between the connecting member 48 and the hook 57 is advanced by this pushing, and then the hook 57 is pressed by the second slope 172 b (steep slope) having a larger pushing amount with respect to the sliding amount than the first slope 172 a. Can be pushed into the connecting member 48 at a stroke to complete the connection.

  Further, a wire pressing portion 173 that protrudes downward (pressing direction) from the first inclined surface 172a is provided on the lower surface of the upper piece 156. The wire pressing part 173 is formed in a wedge shape so that both side surfaces of the wire pressing part 173 spread in the axial direction of the operation wire 12 from the front to the rear in the insertion direction of the slider 84, and the slider 84 is moved from the initial position to the coupling position. When it moves, it enters between the front hook 58 and the rear hook 59. As a result, the wire pressing portion 173 abuts and presses the operation wire 12 positioned between the front hook 58 and the rear hook 59, so that stable connection can be achieved by pressing not only the hook 57 but also the operation wire 12. To do. Further, the wire pressing portion 173 can enter between the front hook 58 and the rear hook 58 and abut against each hook portion on both sides, thereby positioning the front hook 58 and the rear hook 59 in the axial direction. it can.

  When the lower piece 155 is inserted into the slider passage 107, the lower piece 155 is at a position facing the pressing surface 172 across the connecting member 48 and the hook 57, and a support portion that supports the connecting member 48 and the hook 57 that receives pressure from the pressing surface 172. Function as. As a result, the connecting member 48 and the hook 57 are not in a floating state, and can be stably connected.

  A method of connecting the connecting member 48 of the connecting clip unit 13 fed into the loading jig 82 and the hook 57 of the operation wire 12 will be described with reference to FIGS. As shown in FIG. 14 (A), when the slider 84 is in the initial position, the hook 57 inserted from the lateral direction into the connection opening 95 is connected to the corner of the rectangular column portion 58a of the front hook 58 by the connection auxiliary opening 145a. And inserted between the elastic arms 53 and 53 of the connecting member 48. When the slider 84 is in the initial position, the projecting portion 146b is in the recess 171 and the projecting portions 146b and 147b are not in contact with the upper piece 156. Therefore, the slider 84 is biased by the leaf springs 146a and 147a. Not. Further, as described above, since the slider 84 has a backlash relative to the slider passage 107, the upper piece 156 may float upward with respect to the connection piece 145. In FIG. This state is illustrated.

  As shown in FIG. 14B, when the slider 84 is pushed into the slider passage 107 from the initial position, the projecting portion 146b comes into contact with the rear end portion of the concave portion 171. When the slider 84 is further pushed in from the position where the protruding portion 146b hits the rear end of the concave portion 171, the protruding portion 146b gets over the concave portion 171 and comes into contact with the upper surface of the upper piece 156. When the protrusion 146b comes into contact with the upper surface of the upper piece 156, the upper piece 156 is biased downward by the elastic force of the leaf spring 146a. As a result, rattling of the slider 84 is suppressed, and the upper piece 156 can be prevented from floating upward.

  Further, when the slider 84 is pushed into the slider passage 107, the positioning surface 170 of the upper piece 156 contacts the contact surface 56 of the connecting member 48 as shown in FIG. Since the positioning surface 170 is an inclined surface that is inclined from the leading end side of the slider 84 in the insertion direction toward the feeding direction of the connecting clip unit 13, when the slider 84 is pushed into the slider passage 107, the positioning surface 170 is The connecting member 48 is pushed in along the axial direction by abutting and pressing against the contact surface 56 of the connecting member 48. As described above, when the pulling unit 102 is pulled and the connecting clip unit 13 is fed into the loading jig 82, the connecting member 48 is located behind the proper position for connecting to the hook 57 in the feed direction. However, when the contact surface 56 is pressed by the positioning surface 170, the connecting member 48 is sent to an appropriate position where the connecting member 48 is connected to the hook 57.

  As shown in FIG. 14C, when the slider 84 is pushed further into the slider passage 107, the upper piece 156 is urged downward by the elastic force received from the leaf spring 146a, and the first slope of the pressing surface 172 172a contacts the front hook 58 and the rear hook 59. At this time, since the upper piece 156 is urged downward and the backlash of the slider 84 is suppressed, the pressing surface 172 reliably contacts the front hook 58 and the rear hook 59 and gradually moves them downward. Press. If the slider 84 is loose and the upper piece 156 floats and passes through the connecting position, the pressing surface 172 does not sufficiently contact the front hook 58 and the rear hook 59, so that the hook 57 and Although the connection of the connection member 48 may not be completed, in this embodiment, the backlash of the slider 84 is suppressed by the urging force from the urging portion 146, so that the swinging state is prevented, that is, the pressing surface 172 is moved forward. The hook 58 and the rear hook 59 can be brought into contact with each other and reliably pushed in with a predetermined pushing amount.

  At this time, the wire pressing portion 173 enters between the front hook 58 and the rear hook 59 as shown in FIG. As a result, the operation wire 12 is pressed downward by the wire pressing portion 173. Further, since the wire pressing portion 173 contacts the front hook 58 and the rear hook 59 on both side surfaces, the hook 57 can be easily positioned in the axial direction. The front hook 58 rotates so that the outer peripheral surface of the quadrangular column portion 58a is along the first inclined surface 172a, elastically deforms the elastic arms 53, 53, and is pushed between them. Further, the operation wire 12 also spreads between the holding portions 54 and 54 and enters between them.

  When the operation wire 12 and the hook 57 are pushed into the engaging portion 50 at once, the position of the operation wire 12 or the connection member 48 may be shifted, and a connection error may occur. In the present invention, the hook 57 is pushed slowly by the first inclined surface 172a having a gentle inclination, so that a connection error is unlikely to occur.

  As shown in FIG. 15A, the second inclined surface 172b abruptly presses the front hook 58 and the rear hook 59 downward in accordance with the pushing operation of the slider 84. At this time, together with the protrusion 146b, the protrusion 147b also contacts the upper surface of the upper piece 156, and the upper piece 156 is biased downward by the elastic force of the leaf springs 146a, 147a. The pressure further increases. As a result, as shown in FIG. 5B, the front hook 58 is inserted between the elastic arms 53 and 53, and the operation wire 12 is sandwiched between the clamping portions 54 and 54. Further, the rear hook 59 abuts against the rear end surfaces of the holding portions 54 and 54.

  When the case 81 is pulled out from the loading jig 82, the engaging portion 50 of the connecting member 48 floats in the case insertion hole 92. However, the lower piece 155 of the slider 84 passes through the auxiliary connecting opening 136a and the engaging portion 50 is engaged. Therefore, the position of the engaging portion 50 is not shifted by the pressing of the pressing surface 172. Further, since the upper piece 156 and the lower piece 155 of the slider 84 are held by the loading jig 82, the upper piece 156 or the lower piece 155 is deformed by a reaction force when the hook 57 and the connecting member 48 are connected. I don't have to.

  Next, with reference to FIGS. 17-19, the method to load the connection clip unit 13 to the sheath 11 from the connection clip package 80 is demonstrated.

  First, as shown in FIG. 7, the case 81 and the loading jig 82 are held together using the concave portion 90, and the pulling portion 102 is pulled from the loading jig 82. The insertion portion 103 is pulled out from the loading jig 82, and the engaging portion 104 follows this and moves to the skirt closing passage 99. The connecting clip unit 13 is pulled by the engaging portion 104 and pulled into the skirt closing passage 99 from the clip accommodating portion 87.

  As shown in FIG. 17A, the connection clip unit 13 drawn into the skirt closing passage 99 is closed by pushing each skirt portion 38 of each connection ring 20 against the inner wall of the skirt closing passage 99. When the leading clip 19A reaches the release groove 148, the arms 25 and 25 of the clip 19A are released, and the engagement between the claw portions 23 and 23 and the engaging portion 104 is released. The connecting clip unit 13 stops at a predetermined position in the skirt closing passage 99. At this stop position, the connecting member 48 of the connecting clip body 18 reaches a position corresponding to the connecting opening 95. The clip retracting member 83 is pulled until the check protrusion 103b protrudes out of the loading jig 82.

  As shown in FIG. 17B, the case 81 is extracted from the case insertion hole 92 in the axial direction. When the case 81 is extracted, a part of the connecting member 48 of the connecting clip body 18 is exposed from the case insertion hole 92. The engaging portion 50 of the connecting member 48 faces the connecting opening 95 through the slider passage 107.

  From the distal end of the sheath 11, the operation wire 12 and the hook 57 protrude in advance by a pulling operation of the sheath operation handle 63 with respect to the wire operation handle 62. As shown in FIG. 18A, the sheath 11, the operation wire 12, and the hook 57 are inserted laterally from above the loading jig 82 into the case insertion groove 91, the wire slit 96, and the connection opening 95. Is done. After insertion of the sheath 11 or the like, the sheath 11 and the loading jig 82 are held together using the recess 90. The front hook 58 is inserted between the elastic arms 53, 53 at the corners of the square column part 58 a.

  When the slider 84 is pushed into the slider passage 107, as shown in FIGS. 14 and 15, the first inclined surface 172a and the second inclined surface 172b of the pressing surface 172 are hooked to the front hook while suppressing the backlash of the slider 84 to prevent idling. 58 and the rear hook 59 are pressed downward. Further, at this time, as shown in FIG. 16, the positioning surface 170 presses the contact surface 56 to position the connecting member 48 in the axial direction, and the wire pressing portion 173 is positioned in the gap between the front hook 58 and the rear hook 59. The operation wire 12 is pushed down and the hook 57 is positioned in the axial direction. By suppressing rattling and positioning in this manner, the front hook 58 pressed by the slider 84 is reliably inserted between the elastic arms 53 and 53 as shown in FIG. Further, the operation wire 12 is sandwiched between the sandwiching portions 54 and 54. The rear hook 59 comes into contact with the rear end surfaces of the holding portions 54 and 54.

  As shown in FIG. 19A, the entire clip treatment instrument 10 is pressed against the loading jig 82. As a result, the sheath 11 is pushed into the case insertion hole 92 and the inner diameter surface of the sheath 11 and the inner diameter surface of the skirt closing passage 99 are connected. Further, the connecting clip unit 13 pushed by the rear hook 59 advances in the skirt closing passage 99.

  Next, the operation wire 12 is pulled with respect to the sheath 11. For example, by pulling the wire operation handle 62 with respect to the sheath operation handle 63, the operation wire 12 can be moved largely with respect to the sheath 11.

  As shown in FIG. 19B, when the operation wire 12 is pulled, the connection clip unit 13 connected to the operation wire 12 is drawn together into the sheath 11 from the rear end side. Since the skirt closing passage 99 and the inner diameter surface of the sheath 11 are connected while the connecting clip unit 13 is being loaded, the connecting clip unit 13 can be moved while the skirt portion 38 is closed, and the resistance can be reduced. it can. Thereby, the connection clip unit 13 can be loaded into the sheath 11 without causing a positional shift between the clips 19A to 19C and the connection rings 20A to 20C.

  When the sheath operating handle 63 is engaged with the first notch 69 of the wire operating handle 62, the loading of the connecting clip unit 13 is completed. The sheath 11 loaded with the connecting clip unit 13 is removed from the loading jig 82.

  As described above, according to the connection clip package 80 of the present invention, the positioning surface 170 of the slider 84 contacts and presses against the contact surface 56, thereby pressing the connection member 48 along the axial direction. Therefore, the connecting member 48 and the operation wire 12 can be connected by accurately positioning the connecting member 48 in the axial direction. Further, since the wire pressing portion 173 enters the gap between the front hook 58 and the rear hook 59 and presses the operation wire 12 downward, the connection member 48 and the hook 57 can be more reliably connected. Alternatively, since the pressing surface 172 that presses the front hook 58 is constituted by the first inclined surface 172a and the second inclined surface 172b, it is possible to prevent the positions of the connecting member 48 and the hook 57 from being displaced by the pressing by the pressing surface 172. it can.

  In the above embodiment, the hook 57 receives the pressure from the slider 84 by the pushing operation of the slider 84 and is connected to the connecting member 48. However, the present invention is not limited to this, and the hook 57 is connected by the pushing operation of the slider 84. The present invention can also be applied to a configuration in which the member 48 is pressed and connected to the hook 57. Moreover, although the said embodiment illustrated the structure provided with the connection part which consists of the dummy clip 47 engaged with the rear end of the clip 19, and the connection member 48 holding this dummy clip 47, it is not restricted to this. For example, it is applicable also to the structure provided with the connection part directly engaged with the rear end of a clip, without passing through a dummy clip.

  In the above embodiment, the connecting clip unit 13 is fed from the clip case, and the loading jig 82 for connecting the connecting member 48 and the hook 57 by the pushing operation of the slider 84 is provided. Although the structure which loads the connection clip unit 13 is illustrated, this invention is not limited to this, The connection clip is directly connected to the sheath 11 from the clip case which accommodates the connection clip unit 13 without using the loading jig 82. The present invention can also be applied to a configuration of a clip package in which the unit 13 is loaded. In this case, the clip case allows the connecting clip unit 13 to be pulled out from the rear end, and the connecting member 48 and the hook 57 can be inserted in the axial direction of the connecting clip unit 13 and can be connected by pushing operation. A slider for connecting the member 48 and the hook 57 is provided. Moreover, in the said embodiment, although the skirt closing channel | path 99 is provided in the loading jig 82 as an accommodating part which accommodates the connection clip unit 13, in the case of the structure directly loaded to a sheath from a clip case, for example, Similar to the skirt closing passage 99 of the above-described embodiment, any structure may be used as long as the clip portion is provided with an accommodating portion for closing the skirt portion 38 in the clip case.

  Furthermore, the connection auxiliary member for connecting the connection member of the clip unit and the hook of the operation wire is not limited to the slider provided slidably with respect to the loading jig or the clip case, but the loading jig or the clip case. What is necessary is just a connection auxiliary member which presses and connects any one of the connection member 48 and the hook 57 which were inserted in to the other. Alternatively, in the above embodiment, the slider is pushed from one side of the loading jig. However, the present invention is not limited to this, and either the connecting member 48 or the hook 57 is pushed from both sides of the loading jig or the clip case. It is good also as a structure which presses one toward the other.

  In the above embodiment, the case 81 has a cylindrical shape and the loading jig 82 has a plate shape. However, the present invention is not limited to these shapes. Moreover, although the example of the connection clip package loaded in a continuous-type clip treatment tool was given in the above embodiment, the present invention can also be applied to a clip package loaded into a single-shot clip treatment tool.

  The clip package according to the present invention has been described in detail above. However, the present invention is not limited to the above-described embodiments, and various improvements and modifications may be made without departing from the spirit of the present invention. It is. Moreover, the clip treatment tool using the clip package of the present invention can be used for a rigid endoscope as well as a flexible endoscope.

It is a perspective view which shows an example of a repetitive clip treatment tool. It is sectional drawing of the sheath front end side of a repetitive clip treatment tool. It is a perspective view of a clip and a connection ring. It is sectional drawing of a connection ring. It is a perspective view which shows the connection state of the last hemostatic clip body, the clip body for connection, and an operation wire. It is a fragmentary sectional view which shows the stepped state in the clip treatment operation of a repetitive clip treatment tool. It is a perspective view of a connection clip package. It is a connection clip package field sectional view. It is a disassembled perspective view of a connection clip package. It is a connection clip unit exploded perspective view, and a perspective view of a case and a clip drawing member. It is a disassembled perspective view of a loading jig. It is a perspective view which shows the slider channel | path periphery of a loading jig. It is a perspective view of a slider. It is sectional drawing which shows the urging | biasing to the slider by an urging | biasing part, insertion of the hook with respect to an engaging part, and the connection state by the 1st slope of a slider. It is sectional drawing which shows the urging | biasing to the slider by an urging | biasing part, and the connection state of the engaging part and hook by the 2nd slope of a slider. It is sectional drawing which shows the state in which the connection member and the operation wire were positioned by the slider. It is sectional drawing which shows the state which pulled the connection clip unit from the case to the loading jig, and extracted the case from the loading jig. It is sectional drawing which shows the state which inserted the sheath etc. in the loading jig | tool and connected the connection clip unit and the operation wire. It is sectional drawing which shows the state which inserted the sheath in the loading jig | tool and pulled the connection clip unit in the sheath from the loading jig | tool.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Clip treatment tool 11 Sheath 12 Operation wire 13 Connection clip unit 14 Operation part 17 Hemostatic clip body 18 Connection clip body 19 Clip 20 Connection ring 23 Claw part 27 Projection part 38 Skirt part 47 Dummy clip 48 Connection member 56 Contact part 57 Hook 80 Link clip package 81 Case 82 Loading jig 83 Clip retraction member 84 Slider 87 Clip housing part 91 Case insertion groove 92 Case insertion hole 95 Connection opening 96 Wire slit 99 Skirt closing passage 102 Pulling part 103 Insertion part 104 Engagement Portions 146, 147 Energizing portion 148 Release groove 170 Positioning surface 172 Connection assisting portion 172a First slope 172b Second slope 172c Fitting portion

Claims (7)

A clip unit that is connected to a hook provided on an operation wire inserted into the sheath of the treatment instrument and a connecting portion at the rear end and is loaded into the sheath;
An accommodating portion that accommodates the clip unit and can draw the clip unit from the rear end toward the sheath, and a connection assisting member for assisting the coupling operation between the coupling portion exposed from the accommodating portion and the hook. A connection auxiliary member that completes the connection between the connection portion and the hook by overlapping at least one of the hooks that overlaps the connection portion in the axial direction of the clip unit, and the connection And a housing unit that includes a positioning portion that is provided on the auxiliary member and engages with the connecting portion to position the connecting portion in the axial direction when pressed by the connecting auxiliary member. Clip package to play.   The connection auxiliary member is a slider that is slidable along a slide direction orthogonal to the axial direction of the clip unit, and the slider is inclined with respect to the slide direction, and slides to form the hook and the connection portion. The clip package according to claim 1, further comprising a pressing surface in which a pressing amount for pressing one of the two in a pressing direction gradually increases.   The clip package according to claim 2, wherein the positioning portion is a positioning surface that is inclined so that the width in the axial direction is widened from the front to the rear in the sliding direction.   The connecting portion has a substantially cylindrical shape, has a contact surface that is provided at a step with the peripheral surface thereof and rises outward in the radial direction, and the contact surface and the positioning surface are engaged with each other. The clip package according to claim 3.   The pressing surface is provided with a wire pressing portion that contacts the wire portion of the operation wire provided with the hook and presses the wire portion when the pressing surface presses the hook. The clip package according to any one of claims 2 to 4, characterized in that: The hook is composed of a plurality of hook portions arranged at predetermined intervals in the axial direction,
The wire pressing portion has a wedge shape that protrudes from the pressing surface in the pressing direction and has both side surfaces inclined so as to spread in the axial direction from the front to the rear in the sliding direction. 6. The clip package according to claim 5, wherein the hook is positioned in the axial direction by entering in between and contacting each hook portion on both side surfaces. The storage unit is a loading jig used when loading the clip unit into the sheath.
The loading jig has a case connection portion to which a case of the clip unit is connected,
The clip package according to any one of claims 1 to 6, wherein the accommodating portion is a passage through which the clip unit pulled out from the case is fed from the front immediately before being loaded into the sheath.

Images