JP2010069292A - Clip package - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To reliably fasten a clip unit to an operating wire by accurately positioning a fastening member at a predetermined position. <P>SOLUTION: A slider 84 is assembled in a loading device 82. A coupling clip unit 13 including a clip and a fastening member 48 connected to each other is fed into a skirt closing channel 99 of the loading device 82. A introduction preventive claw 52 is formed at the fastening member 48. A step 131 is formed at the rear end of the skirt-closing channel 99. When a clip case 81 is pulled out, the introduction preventive claw 52 is put in the open state and locked on the step 131, so that the fastening member 48 is prevented from being introduced to the inside of the skirt-closing channel 99. When the slider 84 is pushed in, a front hook 58 and a rear hook 59 arranged on the operating wire 12 are pressed in a direction perpendicular with the axial direction of the connecting clip unit, so that the front hook 58 and the rear hook 59 are connected to the fastening member 48. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a clip package including a clip unit that is loaded on an operation handle that can continuously perform hemostasis, wound closure, and the like in a living body, and a loading jig that loads the clip unit on the operation handle.

  The clip treatment tool (operation handle) is inserted into the living body through the forceps channel of the endoscope, the clip protrudes from the tip, and the affected part such as the bleeding part or the site where the diseased tissue has been removed is sandwiched between the clips to stop hemostasis or wounds. Used for clip treatment for obstruction. 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.

  When loading the clip unit, first, the hook is exposed from the sheath, and then entered into the case through the opening formed in 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 is 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.

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

  The clip package of the present invention includes a clip unit having a clip to be loaded into a sheath of a treatment instrument, and a connecting portion provided at the rear of the clip and connected to a hook at a distal end of an operation wire inserted through the sheath, A case that accommodates a clip unit and that can be pulled out from the top of the clip unit; a case connection portion to which the case is connected; and the clip that is pulled out from the case when the clip unit is loaded into the sheath A clip package having a loading jig having a passage through which the unit is fed from the head, and the clip unit has a radially outer side perpendicular to the axial direction of the clip unit when pulled out from the case. A claw projecting toward the claw is provided, and the loading jig is engaged with the claw. And the characterized in that the engagement portion for regulating the entry into the passage of the connecting portion is provided.

  It is preferable that the engaging portion is provided in the vicinity of a rear end portion of the passage, is formed by a step with the inner wall of the passage, and is an abutting surface that abuts on the claw. Further, it is preferable that the base end of the claw is fixed to the connecting portion, and the open end swings with the base end as a fulcrum by elasticity to protrude and engage with the engaging portion. Furthermore, it is preferable that the claw is formed integrally with the connecting portion.

  It is preferable that a convex portion is formed on the peripheral surface of the claw to reduce frictional resistance generated between the clip unit and a sliding contact surface that is in sliding contact with the claw. Furthermore, it is a connection auxiliary member for assisting the connection operation of the connection part and the hook, and at least one of the connection part and the hook overlapped with the connection part in the axial direction of the clip unit is the other. It is preferable to include a connection assisting member that pushes one into the other to complete the connection. Moreover, it is preferable that the said connection part is positioned in the connection position which receives the press from the said connection auxiliary member by engagement with the said nail | claw and the said engaging part.

  According to the present invention, the clip unit is fed from the case, and the connecting member is pressed in the axial direction so as to be positioned at the connecting position, and the hook provided at the distal end of the operation wire is along the pressing direction orthogonal to the axial direction. Since the pressing is performed, the connecting member or the operating wire can be accurately positioned at a predetermined connecting position, and the clip unit and the operating wire can be easily and reliably connected.

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 bottom side perspective view of a connecting member. 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 sectional drawing of a connection clip package. It is a disassembled perspective view of a connection clip package. It is an exploded perspective view of a connection clip unit, and a perspective view of a clip case and a clip retracting 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 clip case to the loading jig, and extracted the case from the loading jig. FIG. 10 is a cross-sectional view showing a state in which the pull-in prevention claw of the connecting member is in an open state and is locked to a step of the loading jig when the clip case is pulled out. 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. It is a perspective view of the connection clip package of 2nd Embodiment. It is sectional drawing of the connection clip package of 2nd Embodiment. It is a disassembled perspective view of the connection clip package of 2nd Embodiment. It is a perspective view of a connection clip unit, a clip case of a 2nd embodiment, and a clip drawing member. It is a disassembled perspective view of the loading jig of 2nd Embodiment. It is a perspective view which shows the structure of the convex part for sliders of 2nd Embodiment. It is a perspective view of the slider of 2nd Embodiment. It is sectional drawing which shows insertion of the hook with respect to the engaging part by the slider of 2nd Embodiment. It is sectional drawing which shows the connection state of the engaging part and hook by the slider of 2nd Embodiment. It is sectional drawing which shows the state which pulled the connection clip unit from the clip case to the loading jig with the connection clip package of 2nd Embodiment, 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 with the connection clip package of 2nd Embodiment, 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 with the connection clip package of 2nd Embodiment, and pulled in the connection clip unit in the sheath from the loading jig.

  As shown in FIG. 1, a repetitive operation handle (hereinafter referred to as operation handle) 10 includes a cylindrical sheath 11, an operation wire 12 inserted into the sheath 11, and an operation wire loaded in the sheath 11. And a handle main body 14 used for pulling operation of the sheath 11 and the operation wire 12.

  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 connection ring 20 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 configured by bending an elongated metal plate, and includes a pair of arm portions 47a and 47a that are opened when no external force is applied. Similar to the clip 19, claw portions 47b and 47b and convex portions 47c and 47c are provided at the tips and intermediate portions of the respective arm portions 47a and 47a. The dummy clip 47 can be formed of the same material as the clip 19.

The dummy clip 47 is rotated so that the opening / closing direction of the arms 47a, 47a is shifted by 90 ° from the opening / closing direction of the rearmost clip 19C and is inserted into the hole 31a of the connecting ring 20C, and the claw portions 47b, 47b are Engage with the turn part 26 of the clip 19C. The connecting ring 20 </ b> C maintains the connected state by suppressing the claw portions 47 b and 47 b from being displaced to the open state.
.

  As shown in FIGS. 5 and 6, the connecting member 48 is a cylindrical body formed of the same material as the holding portion 31 of the connecting ring 20, for example. A cutout holding portion 49 that holds the dummy clip 47 is provided on the distal end side of the connecting member 48. A connecting portion 50 for connecting to the operation wire 12 is provided on the rear end side of the connecting member 48.

  The connecting portion 50 includes a pair of elastic arms 53 and 53 that are elastic in the radial direction of the connecting member 48, and clamping portions 54 and 54 that are provided at the distal ends of the elastic arms 53 and 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 is integrally provided with a positioning portion 51 and a pull-in preventing claw 52. The positioning unit 51 positions the connecting member 48 in the axial direction when the connecting member 48 and the operation wire 12 are connected by a clip package 80 (see FIG. 8) described later. The pull-in preventing claw 52 prevents the coupling member 48 from being excessively pulled into the loading jig 82 when the coupling clip unit 13 is pulled from the clip case 81 of the clip package 80 into the loading jig 82. The positioning part 51 and the pull-in preventing claw 52 are arranged approximately in the middle between the holding part 49 and the connecting 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. When the external force is not applied, the connecting member 48 is opened by its own elasticity, that is, when the open end protrudes with the base end 52a as a fulcrum and is pushed from the outside. It enters a closed state so as to enter inside.

  The pull-in preventing claw 52 is larger in width than the skirt portion 38 of the connecting ring 20. This is because the skirt opening 114 (see FIG. 11) in which the pull-in preventing claw 52 accommodates the skirt portion 38 when the connecting clip unit 13 is loaded into the sheath 11 using a clip package 80 (see FIG. 8) described later. This is to prevent entering.

  In FIG. 6, a convex portion 52 b protruding in the radial direction is provided on the outer peripheral surface of the pull-in preventing claw 52. The convex portion 52 b has the pull-in preventing claw 52 so that the edge 52 c on the distal end side of the pull-in preventing claw 52 is not caught by the distal end of the sheath 11 when the connecting member 48 is loaded from the rear end side to the distal end of the sheath 11. close. Further, when the connecting member 48 is in the sheath 11, the convex portion 52 b slides on the inner wall surface of the sheath 11 to reduce the frictional resistance.

  The sheath 11 is, for example, a flexible coil sheath in which a metal wire is tightly wound. 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 handle main body 14 includes a sheath operation portion 63 that pulls the sheath 11 and the operation wire 12, and a wire operation portion 62. The sheath operation part 63 has a substantially cylindrical shape, and the rear end of the sheath 11 is fixed to the tip. The sheath operating portion 63 is slidably mounted on the outside of a pipe 64 provided at the tip of the wire operating portion 62. By sliding along the pipe 64 toward the wire operating portion 62, the sheath 11 is operated by the operating 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 unit 62 has a substantially cylindrical shape and includes a through window 65 with a slidable operation lever 66 built therein. The operation wire 12 passes through the inside of the sheath operation portion 63 and is engaged with the operation lever 66 at the rear end. 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 operation handle 10 will be briefly described. As shown in FIG. 7A, 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 operating portion 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. 7B, 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 operation handle 10 is moved to press the claw portions 23 and 23 of the clip 19A in the open state against the affected part. When the operation lever 66 of the wire operation unit 62 is pulled in this state, the operation wire 12 is pulled by a predetermined amount, and all the clips 19A to 19C that are sequentially engaged from the connecting clip body 18 are pulled uniformly. .

  As shown in FIG. 7C, 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. 7D, 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). Accordingly, 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. Therefore, 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 handle main body 14 is operated, and the second and third hemostatic clip bodies 17B and 17C can be clipped.

  Next, the connection clip package 80 will be described. As shown in FIGS. 8 to 10, the connection clip package 80 includes a cylindrical clip case 81 that houses the connection clip unit 13, and a rectangular loading jig 82 into which the tip of the clip case 81 is inserted. Yes. The loading jig 82 includes a clip retracting member 83 for pulling the coupling clip unit 13 from the clip 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 clip case 81 is provided with a clip accommodating portion 87 which is a cylindrical space on the inner side. The outer diameter of the clip 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 clip case 81. When the connection clip unit 13 is accommodated in the clip case 81, the above-described pull-in preventing claw 52 of the connection member 48 is in a closed state.

  As shown in FIG. 11, the clip 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. Thereby, the fall of the restoring force (elastic force) to the opening direction of the skirt part 38 by storing in the clip case 81 in the state where the skirt part 38 was pushed by the closing direction can be prevented. A recess may be provided instead of the opening.

  At the tip of the lower case 110, a notch 116 for preventing claw having an opening width larger than the width dimension of the pull-in preventing claw 52 of the connecting member 48 is provided along the axial direction. The pull-in preventing claw 52 protrudes out of the clip receiving portion 87 from the cut-out claw 116 when the connecting clip unit 13 is pulled into the loading jig 82 from the clip case 81, and the connecting clip unit 13 is loaded into the loading jig 82. To prevent it from being pulled too much into.

  When the connecting clip unit 13 is pulled from the clip case 81 into the loading jig 82, the pull-in preventing claw 52 passes over the skirt opening 114, but the pull-in preventing claw 52 is more than the skirt opening 114. Since the width dimension is large, the skirt opening 114 does not enter. Further, the leading end 52c of the pull-in preventing claw 52 does not come into contact with the inner surface of the clip accommodating portion 87 due to the effect of the convex portion 52b, and therefore is not caught by the skirt opening 114.

  At the lower part of the lower case 110, a ridge-shaped positioning part 117 arranged along the axial direction of the clip case 81 is provided. An elastic piece 117 a that is elastic in a direction orthogonal to the axial direction of the clip 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 clip case 81 is formed of, for example, a transparent plastic so that the connection clip unit 13 accommodated in the clip accommodating portion 87 can be seen from the outside of the clip 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 clip 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 clip case 81 and having an open upper portion 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 clip 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 clip case 81 is extracted from the case insertion groove 91 and the case insertion hole 92, and the sheath 11 is inserted instead. The upper part of the clip case 81 or the sheath 11 inserted into the case insertion groove 91 is partially exposed. Therefore, the clip 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 clip case 81, and the outer diameter when the hook 57 is viewed from the side. The opening area is larger than the dimension. 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 accommodating portion 87, and the inner diameter surface thereof is connected to the inner diameter surface of the clip case 81 and the sheath 11 inserted into the case insertion hole 92. 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.

  At the boundary between the case insertion hole 92 and the skirt closing passage 99 and in the vicinity of the entrance / exit of the skirt closing passage 99, an abutment surface 100 that is a step corresponding to the thickness of the sheath 11 or the clip case 81 is provided. . The skirt closing passage 99 and the inner diameter surface of the sheath 11 or the clip case 81 are connected by the end of the sheath 11 or the clip case 81 being abutted against the abutting surface 100. Thereby, the connecting clip unit 13 can be loaded from the loading jig 82 to the sheath 11 while maintaining the closed state of the skirt portion 38.

  The abutting surface 100 also functions as an engaging portion that engages with the pull-in preventing claw 52 that protrudes out of the clip housing portion 87 from the notch 116 for preventing claw of the clip case 81 (see FIG. 19A). . As a result, the connecting member 48 can be prevented from being excessively drawn into the skirt closing passage 99.

  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 a clip engaging portion 104 (see also FIG. 11) 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 clip engaging portion 104 is inserted into the clip housing 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 clip case 81. The insertion portion 103 is inserted into the skirt closing passage 99, and the pulling portion 102 protrudes out of the loading jig 82 through a pulling hole (see reference numeral 151 in FIG. 18) formed at the end of the skirt closing passage 99. . When the pulling portion 102 is pulled with respect to the loading jig 82, the leading clip 19 </ b> A is pulled by the clip engaging portion 104 and pulled into the skirt closing passage 99 from the clip accommodating portion 87. .

  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 clip 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 FIG. 18) located on the opposite side of the insertion groove 91. As shown in FIG. 11, the slit 103a is provided in the edge part by the side of the clip engaging part 104 of the insertion part 103 so that a side surface may be penetrated. On the upper and lower sides of the slit 103a, check protrusions 103b extending from the pulling portion 102 toward the clip 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 clip 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 clip engaging portion 104 is accommodated in the clip accommodating portion 87 of the clip 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 clip 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 FIG. 18) protruding in the left-right direction from the skirt closing passage 99, it is displaced to the open state by its own elasticity, and the engagement with the clip engaging portion 104 is released. . Thereby, the connecting clip unit 13 is stopped in the skirt closing passage 99 so that the connecting 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.

  When the clip 19A is disengaged from the clip engaging portion 104 and the connecting clip unit 13 is stopped as described above, the connecting member 48 of the connecting clip body 18 is directly pulled by the pulling portion 102. Since it is pulled through the clips 19A to 19C and the dummy clip 47, even if the clip 19A is pulled to an appropriate position, it can follow a little later than the clip 19A due to friction or slippage. is there. 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 clip 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 clip engagement portion 104 may be formed separately and connected in the loading jig 82.

  The stop position of the connecting clip unit 13 in the loading jig 82 varies depending on the timing at which the engagement between the leading clip 19A and the clip engaging portion 104 is released. Further, the timing at which the engagement between the clip 19A and the clip engagement portion 104 is released includes the engagement state between the clip 19A and the clip engagement portion 104, the posture of the clip 19A in the skirt closing passage 99, and the clip retracting member. There is a possibility of change depending on the traction speed of 83 or the like. In the present invention, even when the stop position of the connecting member 48 is shifted, the contact surface 56 of the connecting member 48 can be pressed by a positioning surface 170 of the slider 84 described later, and the connecting member 48 can be moved to an appropriate position. .

  If the clip 19 </ b> A and the clip engaging portion 104 are not properly released in the release groove 148, the connecting member 48 is drawn into the skirt closing passage 99, and the hook of the operation wire 12 is connected to the connecting member 48. 57 cannot be connected. In the present invention, as described above, the pull-in preventing claw 52 abuts against the abutting surface 100 which is the entrance portion of the skirt closing passage 99, so that the connecting member 48 is not excessively drawn into the skirt closing passage 99.

  As shown in FIG. 12, 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 clip case 81 is inserted into the case recess 122 when the clip case 81 is inserted into the case insertion groove 91 and the case insertion hole 92 from the axial direction. Are provided along the axial direction. The positioning portion 117 and the positioning groove 125 position the insertion posture of the clip 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. The fact that the clip case 81 has been inserted to the back of the case insertion hole 92 can be known from the click feeling when the click protrusion 117b engages 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 clip 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 connecting clip unit 13 is fed into the loading jig 82 and pulled out from the clip case 81, the step 131 is engaged with the pull-in preventing claw 52 when the pull-in preventing claw 52 released from the external force is opened. It functions as an engaging part. By engaging the step 131 with the pull-in preventing claw 52, 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. Accordingly, the connecting member 48 is positioned at an appropriate connecting position where the hook 57 receives the pressure from the slider 84 and the connecting member 48 and the hook 57 are engaged.

  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. 13). 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 that allows the arms 25 and 25 of the leading clip 19 </ b> A to open to the extent that the engagement with the clip engaging 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 connection 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 loading jig 82 is made of, for example, transparent plastic so that the connecting clip unit 13, the clip 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. 14, the slider 84 includes 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.

  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.

  First recesses 159 and 159 and second recesses 160 and 160 having the same inner diameter as the outer diameter of the sheath 11 and the clip 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 portion connecting the base ends of the lower piece 155 and the upper piece 156 of the slider 84, and slide further. Stop.

  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 clip 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). Since the click grooves 165 and 166 engage with the click protrusion 164, the stop position of the slider 84 with respect to the lower jig 120, that is, the loading jig 82 can be accurately positioned, and the click feeling when engaged. Thus, the stop position of the slider 84 can be known.

  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. 15A, 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 square column part 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. 15B, when the slider 84 is pushed into the slider passage 107 from the initial position, the protruding 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 abutting surface 56 and thus the connecting member 48 are pressed in the feed direction. As a result, the connecting member 48 is fed to a connecting position where it is connected to the hook 57. 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. 15C, 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.

  By pressing the slider 84, the pressing surface 172 generates a pressing force while sliding on the hook 57. In the present invention, while the engaging force between the connecting member 48 and the hook 57 is small, first, the connecting member 48 and the hook 57 slide by being pushed by a gentle slope (first slope 172a) having a small horizontal component acting in the sliding direction. Misalignment in the direction is prevented from occurring. Then, when the engagement between the two has progressed and a resistance force against the horizontal component force has been generated, pushing is performed by a steep slope (second slope 172b) in which the ratio of the pushing amount to the slide amount is higher than that of the first slope 172a. Thus, the connection between the connecting member 48 and the hook 57 is completed.

  When the operation wire 12 and the hook 57 are pushed into the connecting portion 50 at once, the position of the operation wire 12 or the connecting 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. 16A, 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 clip case 81 is pulled out from the loading jig 82, the connecting 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 connecting auxiliary opening 136a and Since the lower part is received, the position of the connecting part 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, a method for loading the connection clip unit 13 from the connection clip package 80 to the sheath 11 will be described with reference to FIGS.

  First, as shown in FIG. 8, the clip 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 clip engagement portion 104 follows this and moves to the skirt closing passage 99. The connecting clip unit 13 is pulled by the clip engaging portion 104 and pulled into the skirt closing passage 99 from the clip accommodating portion 87.

  As shown in FIG. 18A, the connection clip unit 13 drawn into the skirt closing passage 99 is closed by pushing the skirt portions 38 of the connection rings 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 clip 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.

  Further, when the clip 19A and the clip engaging portion 104 are not properly released in the release groove 148, the pull-in preventing claw 52 is provided with a notch for preventing claw in the clip case 81 as shown in FIG. 116 protrudes out of the clip accommodating portion 87 from 116 and engages the abutting surface 100. Thus, the connecting member 48 is stopped at a position corresponding to the connecting opening 95 without being excessively drawn into the skirt closing passage 99.

  As shown in FIGS. 18B and 19B, the clip case 81 is extracted from the case insertion hole 92 in the axial direction. When the clip case 81 is extracted, a part of the connection member 48 of the connection clip body 18 is exposed from the case insertion hole 92. The connecting 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 unit 63 with respect to the wire operation unit 62. As shown in FIG. 20A, the sheath 11, the operation wire 12 and the hook 57 are located from above the loading jig 82 with respect to the case insertion groove 91, the wire slit 96 and the connection opening 95 (see FIG. 10). Inserted. 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. 15 and 16, the first inclined surface 172a and the second inclined surface 172b of the pressing surface 172 are connected to the front hook while suppressing the rattling of the slider 84 to prevent idling. 58 and the rear hook 59 are pressed downward. At this time, the positioning surface 170 presses the contact surface 56 to position the connecting member 48. At the same time, the wire pressing portion 173 enters the gap between the front hook 58 and the rear hook 59 to press the operation wire 12 downward, and further positions the hook 57 in the axial direction. As shown in FIG. 20 (B), the front hook 58 pressed by the slider 84 is reliably inserted between the elastic arms 53 and 53 by suppressing the rattling and positioning in this way. 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. 21A, the sheath 11 is advanced with respect to the operation wire 12, the sheath 11 is inserted into the case insertion hole 92, and the tip comes into contact with the abutting surface 100. At that time, as shown in FIG. 19B, the connecting member 48 is inserted into the sheath 11, and the pull-in preventing claw 52 is closed by the sheath 11. Next, the operation wire 12 is pulled with respect to the sheath 11. For example, the operation wire 12 can be moved largely with respect to the sheath 11 by pulling the wire operation unit 62 with respect to the sheath operation unit 63.

  As shown in FIG. 21B, 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 portion 63 is engaged with the first notch 69 of the wire operating portion 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 connection member 48 and the hook 57 are engaged by the sliding operation of the slider 84, and therefore the operation is easy. Further, since the hooks 57 are gradually pressed by the slide 84 and engaged with the connecting member 48, it is possible to prevent the positions of the engaging member 48 and the hook 57 being engaged from being shifted. Since the pushing amount of the hook by the slider 84 gradually increases according to the inclination angles of the first inclined surface 172a and the second inclined surface 172b of the pressing surface 172, stable operation is possible without depending on the technique of the operator. Further, since the upper piece 156 of the slider 84 is urged downward by the urging portions 146 and 147 to suppress the rattling, the slider 84 can be prevented from swinging. 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.

  Moreover, since the positioning surface 170 presses the contact surface 56 and moves the connecting member 48 along the axial direction, the connecting member 48 can be adjusted to an appropriate position. Further, it is possible to prevent the connecting member 48 from being excessively drawn into the skirt closing passage 99 by the engagement between the drawing-in preventing claw 52 and the abutting surface 100.

  In the above embodiment, the hooks 57 are pressed by the slider 84 and engaged with the connecting member 48, but the connecting member 48 may be pressed by the slider 84 and connected to the hook 57. Further, the present invention can also be applied to a configuration in which the connection member and the hook are connected without providing a connection auxiliary member such as the slider 84.

  Furthermore, in the above-described embodiment, a configuration including a connecting portion including a dummy clip 47 to be engaged with the rear end of the clip 19 and a connecting member 48 that holds the dummy clip 47 is illustrated. For example, the present invention can also be applied to a configuration including a connecting portion that directly engages the rear end of the clip without using a dummy clip.

  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 by pushing from both sides of the loading jig or the clip case. It is good also as a structure pressed toward the other.

  In the above embodiment, the clip case 81 has a cylindrical shape and the loading jig 82 has a plate shape. However, the shape is not limited thereto. 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.

  Furthermore, in the above embodiment, the claw for preventing the loading jig from being pulled into the passage is formed integrally with the connecting member. However, the present invention is not limited to this, and any one of the components constituting the clip unit is used. A claw similar to the pull-in prevention claw 52 of the above embodiment may be provided.

  In the above-described embodiment, the configuration using the slider having the upper and lower pieces that bifurcate from the operation portion and face in the vertical direction is shown, but the present invention is not limited to this, and the present invention described below The second embodiment exemplifies a configuration using a slider having a pressing piece formed in a single plate shape from the operation unit. 22-24 show the connection clip package using this slider.

  As shown in FIGS. 22 to 24, the connection clip package 180 includes a clip case 181 in which the connection clip unit 13 is accommodated, and a loading jig 182 in which the clip case 181 is inserted. The loading jig 182 securely engages the clip retracting member 183 that pulls the connecting clip unit 13 from the clip case 181 into the loading jig 182, and the connecting clip unit 13 and the clip retracting member 183 in the clip case 181. A pair of brackets 184 and 184 (see FIGS. 23 and 25) for this purpose and a slider 185 (pushing member) used for connecting the operation wire 12 and the connecting clip body 18 are incorporated. In addition, the connection clip unit 13 accommodated in the clip case 181 is the same as that of the said embodiment.

  The clip case 181 is provided with a clip accommodating portion 187 that is a cylindrical space inside. The clip case 181 has a substantially rectangular tube shape at the top and a semi-cylindrical shape at the bottom, the outer diameter of the lower portion is substantially the same as the outer diameter of the sheath 11, and the vertical height is the outer diameter of the sheath 11. Formed larger. The clip housing portion 187 has a circular cross-sectional shape, and the inner diameter thereof is substantially the same as the inner diameter of the sheath 11. In the clip accommodating portion 187, the connecting clip unit 13 is accommodated such that the leading clip 19A is disposed on the tip end side of the clip case 181.

  As shown in FIG. 25, the clip case 181 is formed by joining a semi-cylindrical lower case 211 and a rectangular tube-shaped upper case 212 to each other. The lower case 211 and the upper case 212 are provided with semicircular receiving recesses 211a and 212a, respectively, which become circular clip receiving portions 187 when they are joined. The clip accommodating portion 187 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 front end side of the clip housing portion 187 is a delivery port that feeds the connecting clip unit 13 out of the clip housing portion 187 from the head side.

  A pressing portion 213 is integrally provided at the upper portion and the rear end portion of the upper case 212. The pressing portion 213 includes a pressing surface 213 a formed in a curved surface that is concave downward so that the upper surface matches the shape of the finger, and a base end portion 213 b that is fixed to the upper surface of the upper case 212 along the axial direction. . In addition, a plurality of anti-slip protrusions 213c are provided on the pressing surface 213a.

  The clip case 181 is formed of, for example, a transparent plastic so that the connection clip unit 13 accommodated in the clip accommodating portion 187 can be visually recognized from the outside of the clip case 181. For joining the lower case 211 and the upper case 212, for example, adhesion using an adhesive, welding using ultrasonic waves, engagement by an engaging claw, or the like can be used. Alternatively, a transparent plastic film may be wound around the outer periphery in a state where the lower case 211 and the upper case 212 are combined.

  The connecting clip unit 13 is accommodated in the clip accommodating portion 187 so 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 housing portion 187 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 211 and the upper case 212 are formed with skirt openings 214 for accommodating the connecting rings 20A and 20C with the skirt portions 38 opened. Further, the joints of the lower case 211 and the upper case 212 are respectively formed with notches 215 serving as skirt openings for accommodating the skirt portions 38 of the connecting ring 20B when they are joined. Thereby, the fall of the restoring force (elastic force) to the opening direction of the skirt part 38 by storing in the state where the skirt part 38 was pushed in the closing direction within the clip case 181 can be prevented. A recess may be provided instead of the opening.

  The lower case 211 is provided with ribs 216 and 216 and a positioning key 217. The ribs 216 and 216 and the positioning key 217 are formed integrally with the lower case 211.

  The ribs 216 and 216 protrude from the front end of the lower case 211 at a predetermined interval and from the rear end to both sides, and extend along a horizontal direction perpendicular to the axial direction and the vertical direction of the clip case 181. Is formed. The ribs 216 and 216 are arranged so that the upper surface is continuous with the joint of the lower case 211 and the upper case 212. That is, when the lower case 211 and the upper case 212 are joined, the ribs 216 and 216 are positioned below the center of the clip case 181. The positioning key 217 is located at the lower part of the lower case, and has a leaf spring 217 a disposed along the axial direction of the clip case 181 at the lower end thereof. The leaf spring 217 a has a base end on the rear end side of the clip case 181 and an open end on the tip end side, and is elastic in a direction orthogonal to the axial direction of the clip case 181. A semi-cylindrical click protrusion 217b is provided on the tip side surface of the leaf spring 217a.

  At the tip of the lower case 211, a notch 218 for preventing claw having an opening width larger than the width dimension of the pull-in preventing claw 52 of the connecting member 48 is provided along the axial direction. The pull-in preventing claw 52 protrudes out of the clip receiving portion 187 from the cut-out for preventing claw 218 when the connecting clip unit 13 is pulled into the loading jig 182 from the clip case 181, and the connecting clip unit 13 is inserted into the loading jig 182. To prevent it from being pulled too much into.

  When the connecting clip unit 13 is pulled from the clip case 181 into the loading jig 182, the pull-in preventing claw 52 passes over the skirt opening 214, but the pull-in preventing claw 52 is more than the skirt opening 214. Since the width dimension is large, it does not enter the skirt opening 214. Further, the leading end 52c of the pull-in preventing claw 52 does not come into contact with the inner surface of the clip accommodating portion 187 due to the effect of the convex portion 52b, so that it is not caught in the skirt opening 214.

  22 to 24, a recess 190 that is recessed in the height direction is formed on one end side in the longitudinal direction of the loading jig 182. A case insertion groove 191 to which the clip case 181 or the sheath 11 is attached is formed in the recess 190.

  The case insertion groove 191 has an inner diameter slightly larger than the outer diameter of the lower part of the clip case 181, and an opening 191 a that exposes the clip case 181 or the sheath 11 inserted therein from the upper surface of the loading jig 182 is formed. Has been. Through this opening 191a, the clip case 181 or the sheath 11 can be pressed from above with a thumb, for example, and the loading jig 182 is supported from below with another finger, whereby the clip case 181 or the sheath 11 and the loading jig are supported. 182 can be gripped together.

  Position restricting grooves 192 and 192 and a positioning key groove 193 are formed inside the case insertion groove 191. The clip case 181 is inserted into the case insertion groove 191, and the ribs 216, 216 and the positioning key 217 are engaged with the position regulating grooves 192, 192 and the positioning key groove 193. When the connecting clip unit 13 is loaded from the loading jig 182 to the sheath 11, the clip case 181 is removed from the case insertion groove 191 and the sheath 11 is inserted instead.

  A connection opening 195 and a wire slit 196 are provided on the upper surface of the loading jig 182 adjacent to the recess 190. The connection opening 195 is an opening for inserting the hook 57 of the operation wire 12 into the loading jig 182 from the direction orthogonal to the insertion direction of the clip case 181, and the outer diameter dimension when the hook 57 is viewed from the side. Larger opening area. The wire slit 196 is formed so as to connect the case insertion groove 191 and the connection opening 195, and has a width dimension in which the operation wire 12 can be inserted. When the sheath 11 is inserted into the case insertion groove 191, the operation wire 12 and the hook 57 are simultaneously inserted into the wire slit 196 and the connection opening 195 and are pulled into the loading jig 182. To the connecting member 48 (see FIGS. 31 to 33).

  A skirt closing passage 197, which is a cylindrical space, is provided in the loading jig 182 at the back of the case insertion groove 191. The skirt closing passage 197 has the same inner diameter as that of the sheath 11 and the clip accommodating portion 187 and is formed so as to align the position of the center axis with the clip case 181 inserted into the case insertion groove 191. The clip case 181 inserted into the insertion groove 191 and the inner diameter surface of the sheath 11 are connected. The skirt closing passage 197 closes each skirt portion 38 of the connecting clip unit 13 drawn from the clip accommodating portion 187 by pushing the inner diameter surface.

  At the boundary between the case insertion groove 191 and the skirt closing passage 197 and in the vicinity of the entrance / exit of the skirt closing passage 197, an abutting surface 198 which is a step corresponding to the thickness of the sheath 11 or the clip case 181 is provided. . The skirt closing passage 197 and the inner diameter surface of the sheath 11 or the clip case 181 are connected by the front end of the sheath 11 or the clip case 181 being abutted against the abutting surface 198. Thereby, the connection clip unit 13 can be loaded from the loading jig 182 to the sheath 11 while maintaining the closed state of the skirt portion 38.

  The skirt closing passage 197 is formed with a cutout 199 (see FIGS. 26 and 27) cut out from the abutting surface 198 along the axial direction. The notch 199 engages with a pull-in preventing claw 52 that protrudes out of the clip housing portion 187 from the notch 218 for preventing claw of the clip case 181. The front end of the notch 199 serves as an abutting surface, and the front end of the pull-in preventing claw 52 engaged with the notch 199 contacts the abutting surface. This can prevent the connecting member 48 from being excessively drawn into the skirt closing passage 197.

  The clip retracting member 183 includes a substantially elliptical traction portion 201 protruding outward from the other end side in the longitudinal direction of the loading jig 182, an insertion portion 202 provided with the traction portion 201 at one end, and an insertion portion 202. And a clip engaging portion 203 (see also FIG. 25) provided at the other end. The insertion part 202 is a rod-like body having a length penetrating the skirt closing passage 197 and is inserted into the skirt closing passage 197. The clip engaging portion 203 is inserted into the clip accommodating portion 187 and is engaged with the leading clip 19A.

  The insertion portion 202 is inserted into the skirt closing passage 197, and the pulling portion 201 is attached to the outside of the loading jig 182 through a pulling hole (see reference numeral 204 in FIGS. 31 to 33) formed at the end of the skirt closing passage 197. Protruding. When the pulling portion 201 is pulled with respect to the loading jig 182, the connecting clip unit 13 pulls the top clip 19 </ b> A by the clip engaging portion 203 and is pulled into the skirt closing passage 197 from the clip accommodating portion 187. .

  As shown in FIG. 25, check protrusions 202 a that extend from the pulling portion 201 toward the clip engaging portion 203 are provided above and below the insertion portion 202. The check protrusion 202 a jumps out of the loading jig 182 from the pulling hole 204 when the insertion portion 202 is elastically deformed. The check protrusion 202a locks the insertion portion 202 so that the insertion portion 202 does not return to the skirt closing passage 197 again.

  The clip engagement portion 203 includes a substantially prismatic engagement piece 203 a and a retaining portion 203 b positioned between the front end portion of the engagement piece 203 a and the rear end portion of the insertion portion 202. The engagement piece 203a has engagement holes 203c and 203c with which the claw portions 23 and 23 are engaged. The retaining portion 203 b is formed to have an outer diameter that matches the inner diameter of the clip housing portion 187, and restricts the clip 19 </ b> A from being released to the front of the clip engaging portion 203.

  The brackets 184 and 184 are a pair of semi-cylindrical plates having an outer diameter matching the inner diameter of the clip housing portion 187 and an inner diameter matching the outer diameter of the engagement piece 203a. Along the closing direction of the clip 19A to be joined, the clip 19A is sandwiched from both sides so as to face each other. These brackets 184 and 184 are made of, for example, a SUS metal plate.

  The clip engaging portion 203 is accommodated in the clip accommodating portion 187 of the clip case 181 together with the brackets 184 and 184 and the connecting clip unit 13. The leading clip 19A is pushed by the clip accommodating portion 187 via the brackets 184 and 184 to be closed, and engages the claw portions 23 and 23 with the engagement holes 203c and 203c. When the pulling portion 201 is pulled with respect to the loading jig 182, the insertion portion 202 moves in the skirt closing passage 197 and the clip engaging portion 203 moves from the clip accommodating portion 187 into the skirt closing passage 197.

  The connecting clip unit 13 is pulled by the clip engaging portion 203 and pulled into the skirt closing passage 197. In the vicinity of the pulling hole 204 of the skirt closing passage 197, a release groove 205 (see FIGS. 31 to 33) protruding in the left-right direction is formed. The release groove 205 has a width dimension in which the arms 25 and 25 of the leading clip 19 </ b> A can be opened to the extent that the engagement with the clip engaging portion 203 of the clip retracting member 183 is released. . The release groove 205 is arranged so that the leading clip 19 </ b> A reaches the release groove 205 when the connection portion 50 of the connection clip body 18 reaches a position facing the connection opening 195.

  When the pulling part 201 is pulled with respect to the loading jig 182, the insertion part 202 moves in the skirt closing passage 197. By pulling the pulling portion 201, the brackets 184 and 184 move together with the clip engaging portion 203. As a result, the clip engaging portion 203, the clip 19 </ b> A, and the bracket 184 move from the clip accommodating portion 187 into the skirt closing passage 197.

  When the leading clip 19 </ b> A reaches the release groove 205, it is displaced to the open state by its own elasticity, and the engagement with the clip engagement portion 203 is released. At this time, the bracket 184 is disengaged from the clip 19A and the clip engaging portion 203 by pressing from the clip 19A displaced to the open state. The bracket 184 removed from the clip 19 </ b> A and the clip engaging portion 203 is left in the release groove 205. The connecting clip unit 13 pulled in this way is stopped at the rear of the skirt closing passage 197 so that the connecting portion 50 of the connecting clip body 18 is positioned in the slider passage 200 within the skirt closing passage 197.

  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 205. The skirt portions 38, 38 of the connecting ring 20A are not opened.

  The pulling part 201, the insertion part 202, and the clip engaging part 203 constituting the clip retracting member 183 are integrally formed of, for example, plastic having appropriate elasticity. Note that the insertion portion 202 and the clip engagement portion 203 may be formed separately and connected within the loading jig 182.

  In the present embodiment, even when the stop position of the connecting portion 50 is shifted, the contact surface 56 of the connecting member 48 is pressed by a positioning surface 257 of the slider 185 described later, and the connecting member 48 is moved to an appropriate position. be able to. In the present embodiment, as described above, the pull-in preventing claw 52 engages with the notch 199 (see FIG. 26) and abuts against the abutting surface of the front end thereof, so that the connecting member 48 is in the skirt closing passage 197. It will not be overdrawn.

  The slider 185 is slidably inserted into the slider passage 200 opened from one side surface of the loading jig 182. The slider 185 is pushed into the slider passage 200 when the connecting clip body 18 drawn into the loading jig 182 and the hook 57 inserted from the connecting opening 195 are connected.

  The slider passage 200 has a rectangular shape with a cross section having a width substantially equal to the width dimension of the slider 185, and is provided so as to be cut out along the short direction of the loading jig 182, that is, the direction perpendicular to the case insertion groove 191. ing.

  As shown in FIGS. 24 and 26, the loading jig 182 is formed by joining a plate-like lower jig 220 and an upper jig 221 formed in a semicircular shape in the front and rear. The loading jig 182 is formed of, for example, a transparent plastic so that the connecting clip unit 13, the clip case 181, the clip retracting member 183, the slider 185, and the like can be seen from the outside. For joining the lower jig 220 and the upper jig 221, for example, adhesion using an adhesive, welding using ultrasonic waves, engagement by an engaging claw, or the like can be used.

  On the upper surface 220a of the lower jig 220, there is formed a semicircular case concave portion 222 that forms a case insertion groove 191 when the upper jig 221 is joined. The upper surface 220a of the lower jig 220 is formed with position restricting recesses 223 and 223 that are continuous from both sides of the case recess 222 and are recessed by one step from the upper surface 220a. The position restricting recesses 223 and 223 extend along the axial direction from the front end to the rear end of the case recess 222. The position regulating recesses 223 and 223 form the position regulating grooves 192 and 192 together with the lower surface 221a of the upper jig 221 when joined to the upper jig 221. Engaging the ribs 216 and 216 of the clip case 181 and the position restricting grooves 192 and 192 restricts the vertical movement of the clip case 181 inserted into the case inserting groove 191.

  A positioning keyway 193 is provided in the case recess 222. The positioning key groove 193 is formed along the axial direction of the clip case 181. When the clip case 181 is inserted into the case insertion groove 191 from the axial direction, the positioning key groove 193 is fitted with the positioning key 217 provided in the clip case 181. Thus, the rotation of the clip case 181 around the axis is restricted.

  The case insertion groove 191 including the position restricting grooves 192 and 192 and the positioning key groove 193 has a cross-sectional shape that matches the outer shape of the clip case 181, and this cross-sectional shape of the skirt closing passage 197 from the rear end side of the loading jig 182. Since it continues along the axial direction to the vicinity, the clip case 181 is detachably attached to the loading jig 182.

  A side surface of the positioning key groove 193 is provided with a click hole (not shown) having a substantially U-shaped cross section. The click hole is arranged at a position corresponding to the click protrusion 217b provided in the positioning key 217, and constitutes a click mechanism together with the click protrusion 217b. When the positioning key 217 is inserted to a predetermined position in the positioning key groove 193, the click protrusion 217b enters the click hole and is engaged. Thereby, the position of the clip case 181 is restricted in the axial direction, and the detachment of the clip case 181 from the loading jig 182 is prevented.

  A semicircular skirt closing recess 228 that forms a skirt closing passage 197 when joined to the upper jig 221 is formed in the back of the case recess 222. On the front end side in the longitudinal direction of the lower jig 220, a rectangular release recess 229 that extends from the skirt closing recess 228 in the left-right direction is formed. A rectangular notch 230 into which the insertion portion 202 of the clip retracting member 183 is inserted is formed at the front end of the release recess 229.

  At the boundary between the case recess 222 and the skirt closing recess 228, that is, at the rear end of the skirt closing recess 228, a step 231 is formed that is one step in the radial direction with respect to the inner wall of the skirt closing recess 228. The step 231 constitutes the abutting surface 198 described above.

  As shown in FIGS. 26 and 27, with respect to the step 231, the case recess 222 and the skirt closing recess 228 are sandwiched between the front and rear in the axial direction, and on the left and right of the upper surface 220 a of the lower jig 220. Protrusions 233 and 234 for sliders that are convex are formed. The slider convex portions 233 and 234 project into a substantially rectangular shape having a width substantially equal to the width dimension of the slider 185, and form the slider passage 200 together with the slider concave portion 244 described later when joined to the upper jig 221. .

  The slider convex portion 234 extends at both ends in the width direction of the slider passage 200 to one end portion of the lower jig 220 where the entrance of the slider passage 200 is formed. A slider notch 237 is formed at the center in the width direction of the slider protrusion 234 by cutting out from the end of the lower jig 220 toward the case recess 222 and the skirt closing recess 228. The inner surface in the sliding direction of the slider notch 237 serves as a stopper when the slider 185 is pushed into the slider passage 200.

  The slider convex portions 233 and 234 are formed so that the upper surfaces 233a and 234a on both sides of the case concave portion 222 are stepped higher than the upper surfaces 233b and 234b on both sides of the skirt closing concave portion 228 with the step 231 as a boundary. The upper surfaces 233 a and 234 a are formed so that the upper surfaces 233 a and 234 a are higher than the upper end of the sheath 11 when the sheath 11 is inserted into the case insertion groove 191.

  For this reason, even if the sheath 11 is inserted into the case insertion groove 191, the upper end of the sheath 11 protrudes above the upper surfaces 233a and 234a and does not enter the slider passage 200. Therefore, when the sheath 11 is inserted into the case insertion groove 191, the slider 185 can move along the upper surfaces 233 a and 234 a without the slider 185 and the upper end of the sheath 11 contacting each other. On the other hand, when the clip case 181 is inserted into the case insertion groove 191, the upper and lower dimensions of the clip case 181 are larger than the sheath 11, so that the upper end of the clip case 181 protrudes upward from the upper surfaces 233 a and 234 a. Enter. Therefore, even if the slider 185 is pushed from the initial position toward the skirt closing passage 197, the slider 185 and the clip case 181 come into contact with each other and the slider 185 cannot be pushed. That is, while the clip case 181 is inserted into the case insertion groove 191, the movement of the slider 185 is restricted by the clip case 181.

  The upper surfaces 233b and 234b are formed so that their axial positions correspond to the stop position of the connecting member 48 when the connecting clip unit 13 is drawn into the skirt closing passage 197. Further, the upper surfaces 233b and 234b are formed so that the height thereof is substantially the same as the height of the connecting member 48 (see FIG. 29). For this reason, since the upper end of the connecting member 48 protrudes above the upper surfaces 233b and 234b and does not enter the slider passage 200, the slider 185 and the connecting member 48 do not interfere when the slider 185 moves.

  In addition, on the inner side surfaces of the slider convex portions 233 and 234 (the surfaces on both sides of the skirt closing concave portion 228), the position restricting concave portions 223 and 223 that engage with the ribs 216 and 216 of the clip case 181; , 192 are not formed. Therefore, when the clip case 181 is inserted into the case insertion groove 191, the position of the clip case 181 in the axial direction is positioned at a position where the ribs 216 and 216 come into contact with the rear end surfaces of the slider convex portions 233 and 234. However, since the ribs 216 and 216 are formed at a predetermined interval from the tip of the clip case 181 (see FIG. 25), the tip of the clip case 181 protrudes to the position where it abuts against the abutting surface 198. It is inserted between the parts 233 and 234.

  On the lower surface 221 a of the upper jig 221, a case notch 239 that forms a case insertion groove 191 together with the case recess 222 is formed at a position facing the case recess 222 of the lower jig 220. Further, a skirt closing recess 241 that forms a skirt closing passage 197 together with the skirt closing recess 228 of the lower jig 220 is formed on the lower surface 221a. Further, a release recess 242 and a notch 243 are formed on the lower surface 221a at positions opposite to the release recess 229 and the notch 230 of the lower jig 220, respectively. Configure.

  Between the case notch 239 and the skirt closing recess 241, a slider recess 244 that forms the slider passage 200 is formed. A connection opening 195 and a wire slit 196 are formed in the approximate center of the slider recess 244 so as to be continuous with the case notch 239.

  The slider concave portion 244 is formed in a rectangular shape having a width dimension matched to the slider convex portion 233. When the lower jig 220 and the upper jig 221 are joined, the slider convex portion 233 is fitted into the slider concave portion 244. The gap between the slider concave portion 244 and the slider convex portion 233 becomes the slider passage 200.

  When the hook 57 and the connecting member 48 are connected by the slider 185, the slider recess 244 abuts against the upper surface of the slider 185 and biases the slider 185 toward the pressing direction of the hook 57. , 247 are formed. The urging portions 246 and 247 are arranged at positions symmetrical with respect to the case notch 239 and the skirt closing recess 241, that is, the case insertion groove 191 and the skirt closing passage 197. The urging portions 246 and 247 include leaf springs 246a and 247a extending from the widthwise end portion of the upper jig 221 toward the center, and projecting portions 246b and 247b projecting downward from the tips of the leaf springs 246a and 247a. Each is composed.

  Since the rear end of the skirt closing recess 241 is interrupted at the front end of the slider recess 244, there is no upper half of the skirt closing passage 197 in the range of the slider passage 200, and it faces the connection opening 195 and the wire slit 196. Have been released.

  As shown in FIG. 28, the slider 185 includes an operation unit 250 used for a push operation into the slider passage 200 and a single plate-shaped push piece 251 extending from the operation unit 250 in the sliding direction. Are integrally molded. The pushing piece 251 is inserted into the slider passage 200, is biased by the biasing portions 246 and 247 of the upper jig 221, and sandwiches the connecting member 48 and the hook 57 together with the lower jig 220 of the loading jig 182.

  On the upper surface of the pushing piece 251, a concave portion 252 (see FIG. 24) for accommodating the protruding portion 247 b of the urging portion 247 is formed. The recess 252 retracts the upper surface of the pushing piece 251 from the protrusion 247b when the slider 185 is in the initial position. When the slider 185 is in the initial position, the protruding portion 246b of the other urging portion 246 is located on the back side of the distal end portion of the pushing piece 251. Therefore, when the slider 185 is in the initial position, the protrusions 246b and 247b do not come into contact with the pushing piece 251 and are not urged by the leaf springs 246a and 247a. An opening may be provided instead of the recess.

  In accordance with the shape of the upper surfaces 233a, 234a, 233b, and 234b of the slider convex portions 233 and 234 described above, the pushing piece 251 has a lower bottom surface 251a on the case insertion groove 191 side than a bottom surface 251b on the skirt closing passage 197 side. It is formed one step higher. In addition, a fitting convex portion 253 that projects downward from the bottom surface 251b is provided in a portion close to the operation portion 250. The fitting convex portion 253 is fitted into the notch 237 of the slider passage 200. The front end surface in the sliding direction of the fitting convex portion 253 abuts against the abutting surface formed at the back of the notch 237 and prevents the slider 185 from being excessively pushed.

  The pressing piece 251 of the slider 185 is formed with a pressing surface 254 that is inclined from the front end side in the sliding direction toward the bottom surface 251b. The pressing surface 254 is formed such that when the slider 185 is pressed, the pressing amount for pressing the hook 57 in the skirt closing passage 197 in the pressing direction gradually increases, and the connecting clip body is pressed by the pressing by the pressing surface 254. The hook 57 is connected to the 18 connecting members 48. Further, the pressing surface 254 is supported from behind by the urging portions 246 and 247 of the upper jig 221, that is, the inner wall of the slider passage 200. When the slider 185 is pushed in, the urging portions 246 and 247 abut against the upper surface of the pushing piece 251 to urge the pressing surface 254 toward the pressing direction in which the hook 57 is pushed. A recess 255 having an inner diameter substantially the same as the inner diameter of the sheath 11 is formed on the bottom surface 251b. The recess 255 closes the upper part of the skirt closing recess 228 and constitutes a part of the skirt closing passage 197 when the slider 185 is in the coupling position.

  A notch 256 that makes the width of the pushing piece 251 about ¼ is formed at the front end of the pushing piece 251 in the sliding direction. The notch 256 is formed so as to correspond to the position of the connection opening 195 when the slider 185 is in the initial position. Thereby, the hook 57 can be coupled to the coupling member 48 from the lateral direction (above the loading jig 182).

  The pushing piece 251 is provided with a positioning surface 257 on the opposite side of the notch 256. The positioning surface 257 is an inclined surface that is inclined so that the width of the pushing piece 251 increases from the front to the rear in the sliding direction of the slider 185. The positioning surface 257 contacts and presses the contact surface 56 of the connecting member 48 described above when the slider 185 is pushed into the connecting position on the back side of the slider passage 200, thereby pressing the connecting member 48 along the axial direction. Push in. Thereby, the connecting member 48 is positioned in the axial direction.

  An elastic piece 258 that is elastic in the width direction of the slider 185 is formed on the side surface of the pushing piece 251 opposite to the positioning surface 257. An engaging protrusion 259 that protrudes in the width direction of the slider 185 is provided at the tip of the elastic piece 258. When the slider 185 is in the initial position, the engagement protrusion 259 engages with a click groove 260 (see also FIG. 26) provided in the slider recess 244 of the upper jig 221, and the slider 185 slides to the coupling position. When engaged, it engages with the click groove 261 (see also FIG. 26). The engagement between the click groove 260 and the engagement protrusion 259 prevents the slider 185 from being detached from the slider passage 200. On the other hand, the connection position of the slider 185 can be positioned by the engagement of the click groove 261 and the engagement protrusion 259, and the connection position of the slider 185 can be known from the click feeling at the time of engagement.

  As shown in FIG. 29A, the hook 57 inserted from the lateral direction (above the loading jig 182) into the connection opening 195 has a corner portion of the square column portion 58a of the front hook 58, and the connection opening 195. And inserted between the elastic arms 53 and 53 of the connecting member 48.

  As shown in FIG. 29B, when the slider 185 is pushed into the slider passage 200, the pressing surface 254 comes into contact with the front hook 58 and the rear hook 59 and gradually presses them downward.

  As shown in FIG. 30A, when the slider 185 is further pushed in, the front hook 58 rotates so that the outer peripheral surface of the quadrangular prism portion 58a is along the pressing surface 254, and elastically deforms the elastic arms 53 and 53. In between. Then, as shown in FIG. 30B, the front hook 58 is completely inserted between the elastic arms 53, 53, and the operation wire 12 also pushes the holding portions 54, 54 apart and is sandwiched between them. It is. Further, the rear hook 59 abuts against the rear end surfaces of the holding portions 54 and 54.

  In the assembly work of the connection clip package 180 including the operation of accommodating the connection clip unit 13 in the clip case 181, first, the clips 19 </ b> A to 19 </ b> C, the connection rings 20 </ b> A to 20 </ b> C, the dummy clip 47, and the connection member 48 on the lower case 211. Concatenate.

  After the connection is completed, the connection clip unit 13 is stored in the lower case 211 such that each skirt portion 38 is inserted into the skirt opening 214 and the notch 215 (see FIG. 25). The clip engaging portion 203 of the clip retracting member 183 is also accommodated in the lower case 211, and together with the brackets 184 and 184, the arm portions 25 and 25 of the leading clip 19A are closed, and the claw portions 23 and 23 are engaged with the engaging holes 203c and 203c. Engage with. Thereafter, the upper case 212 is placed on the lower case 211 and joined together to form the clip case 181.

  The clip case 181 in which the connection clip unit 13 is accommodated is set on the lower jig 220 together with the clip retracting member 183 and the brackets 184 and 184 engaged with the connection clip unit 13. The clip case 181 is set on the case recess 222 and the clip retracting member 183 is set on the skirt closing recess 228 (see FIG. 24). At this time, the ribs 216 and 216 are engaged with the position regulating recesses 223 and 223. In this state, when the upper jig 221 is put on the lower jig 220 and the clip case 181 and the clip retracting member 183 are attached to the loading jig 182, the assembly work of the connected clip package 180 is completed. .

  With reference to FIGS. 22, 23, and 31 to 33, a method of loading the connection clip unit 13 from the connection clip package 180 to the sheath 11 will be described. First, before the connection clip unit 13 is loaded, in the connection clip package 180 in an unused state, as shown in FIG. 23, the clip case 181 is engaged to a position where it abuts against the abutting surface 198. . Further, the positioning key 217 is engaged with the positioning key groove 193, and the click protrusion 217b is engaged with the click hole.

  Next, as shown in FIG. 22, the clip case 181 is pressed with the thumb or thumb ball, and the loading jig 182 is sandwiched from below with the other fingers, and the clip case is used using the recess 190. 181 and the loading jig 182 are held together, and the pulling unit 201 is pulled from the loading jig 182. The insertion portion 202 is pulled out from the loading jig 182, and the clip engagement portion 203 follows this and moves to the skirt closing passage 197. The connecting clip unit 13 is pulled by the clip engaging portion 203 and pulled from the clip accommodating portion 187 to the skirt closing passage 197. The clip case 181 is restricted from moving upward, that is, toward the opening 191 a with respect to the loading jig 182 by the engagement between the ribs 216 and 216 and the position restriction grooves 192 and 192.

  As shown in FIG. 31A, the connection clip unit 13 drawn into the skirt closing passage 197 is closed by pushing the skirt portions 38 of the connection rings 20 against the inner wall of the skirt closing passage 197. When the first clip 19A reaches the release groove 205, the arms 25 and 25 of the clip 19A are released, and the bracket 184 is disengaged from the clip 14A and the clip engaging portion 203 due to the displacement of the clip 19A. , 23 and the clip engaging portion 203 are released. The connecting clip unit 13 stops at a predetermined position in the skirt closing passage 197. In this stop position, the connecting member 48 of the connecting clip body 18 reaches a position corresponding to the connecting opening 195. The clip retracting member 183 is pulled until the check protrusion 202a protrudes out of the loading jig 182.

  Further, when the clip 19A and the clip engagement portion 203 are not properly released in the release groove 205, the pull-in prevention claw 52 protrudes from the clip claw notch 218 of the clip case 181 to the outside of the clip housing portion 187. , Engage with the notch 199 (see FIGS. 26 and 27). Accordingly, the connecting member 48 is stopped at a position corresponding to the connecting opening 195 without being excessively drawn into the skirt closing passage 197.

  As shown in FIG. 31B, the clip case 181 is pulled out from the case insertion groove 191 in the axial direction. When the clip case 181 is extracted, the connecting portion 50 of the connecting member 48 faces the connecting opening 195 through the slider passage 200.

  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 unit 63 with respect to the wire operation unit 62. As shown in FIG. 32A, the sheath 11, the operation wire 12, and the hook 57 are inserted from above the loading jig 182 into the case insertion groove 191, the connection opening 195, and the wire slit 196. After insertion of the sheath 11 or the like, the sheath 11 and the loading jig 182 are held together using the recess 190. 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 185 is pushed into the slider passage 200, the pressing surface 254 presses the front hook 58 and the rear hook 59 downward. As shown in FIG. 32B, the front hook 58 pressed by the slider 185 is inserted between the elastic arms 53 and 53. 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. At this time, the concave portion 255 of the slider 185 closes the upper portion of the skirt closing concave portion 241 to constitute a part of the skirt closing passage 197 (the state shown in FIG. 30B).

  As shown in FIG. 33A, the sheath 11 is advanced with respect to the operation wire 12, the sheath 11 is inserted to the back of the case insertion groove 191, and the tip abuts against the abutting surface 198. At that time, the connecting member 48 is inserted into the sheath 11, and the pull-in preventing claw 52 is closed by the sheath 11. Next, the operation wire 12 is pulled with respect to the sheath 11. For example, the operation wire 12 can be moved largely with respect to the sheath 11 by pulling the wire operation unit 62 with respect to the sheath operation unit 63.

  As shown in FIG. 33 (B), 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 197 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 portion 63 is engaged with the first notch 69 of the wire operating portion 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 182.

  As described above, since the positioning surface 257 of the slider 185 presses the contact surface 56 and moves the connecting member 48 along the axial direction as in the first embodiment, the connecting member 48 is adjusted to an appropriate position. can do. Further, the engagement of the pull-in preventing claw 52 and the notch 199 can prevent the connecting member 48 from being excessively pulled into the skirt closing passage 197. Further, since the slider 185 having the pushing piece 251 formed in a single plate shape is used instead of the shape having the upper and lower pieces branched in a bifurcated shape, the slider 185 and the loading jig 182 can be easily formed. Cost reduction can be achieved. In particular, when forming the lower jig 220 and the upper jig 221 of the loading jig 182, it is necessary to provide a connection piece 136 for connecting the slider passage as in the lower jig 120 (see FIG. 12) of the first embodiment. This eliminates the need for a complicated mold such as a nesting structure and improves manufacturing suitability.

  In the second embodiment, the hook 57 is pressed by the slider 185 and engaged with the connecting member 48. However, the connecting member 48 may be pressed by the slider 185 and connected to the hook 57. In both the first and second embodiments, a loading jig is used separately from the clip case, and the connecting clip unit is transferred from the clip housing portion of the clip case to the skirt closing passage of the loading jig and then loaded. In the example, the connecting member and the hook are connected by the slider provided on the tool. In this case, the storage unit in the claims of the present invention corresponds to a loading jig, and the storage portion corresponds to a skirt closing passage of the loading jig. However, the connection between the connection member and the hook may be completed by the connection auxiliary member in a state where the connection clip unit is accommodated in the clip case without using the loading jig. In this case, the housing unit in the claims of the present invention corresponds to a clip case, and the housing portion corresponds to a clip housing portion of the clip case.

  According to the second embodiment of the present invention described above, the following configuration can be obtained.

[Appendix 1]
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 is capable of pulling 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 clip package comprising a housing unit having
The connection auxiliary member is a single plate-shaped pushing member provided slidably in a direction orthogonal to the axial direction of the clip unit;
It is a pressing surface formed on the pushing member, and when the pushing member slides,
It is a slider having the connecting portion and a pressing surface that completes the connection of the two by pressing one of the hooks overlapping the connecting portion toward the other in the axial direction of the clip unit. Clip package.
[Appendix 2]
The clip package according to claim 1, wherein the pressing surface is inclined with respect to the sliding direction, and the amount of pressing to push one of the hook and the connecting portion in the pressing direction is gradually increased by sliding.
[Appendix 3]
The storage unit is formed with a slider passage through which the slider is inserted and slidably disposed, and the pressing surface is supported by an inner wall of the slider passage from behind. The described clip package.
[Appendix 4]
A biasing means is provided in the slider passage for biasing the pressing surface in the pressing pressure direction while the pressing surface presses at least one of the connecting portion and the hook by sliding the slider. The clip package according to appendix 3, wherein
[Appendix 5]
The biasing means is a leaf spring that is formed integrally with the inner wall of the slider passage and is provided with a protruding portion that protrudes toward the peripheral surface of the slider at an open end, and the protruding portion is in contact with the peripheral surface The clip package according to appendix 4, wherein the pressing surface is urged by pressing the pressing surface.
[Appendix 6]
6. The clip package according to claim 5, wherein a concave portion or an opening is formed on the peripheral surface of the slider to retract the peripheral surface from the protrusion when the slider is in an initial position.
[Appendix 7]
7. The attachment according to any one of appendices 3 to 6, wherein the slider is formed with an engagement protrusion that engages with an inner wall of the slider passage to prevent the slider from coming off from the slider passage. Clip package.

  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.

DESCRIPTION OF SYMBOLS 10 Operation handle 11 Sheath 12 Operation wire 13 Connection clip unit 14 Handle body 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, 180 Link clip package 81, 181 Clip case 82, 182 Loading jig 83, 183 Clip retracting member 84, 185 Slider 87, 187 Clip housing part 91, 191 Case insertion groove 92 Case insertion hole 95, 195 Connection opening 96 , 196 Slit for wire 99, 197 Skirt closing passage 102, 201 Traction part 103, 202 Insertion part 104, 203 Engagement part 146, 147, 246, 247 Energizing part 148, 205 Release groove 170, 2 57 Positioning surface 172, 253 Pressing surface

Claims (7)

A clip unit having a clip loaded on the sheath of the treatment instrument, and a connecting portion provided at the rear of the clip and connected to a hook at the tip of an operation wire inserted through the sheath;
A case that accommodates the clip unit and can be pulled out from the top of the clip unit;
Clip comprising: a case connecting portion to which the case is connected; and a loading jig having a passage through which the clip unit pulled out from the case is fed from the top when the clip unit is loaded into the sheath Package,
The clip unit is provided with a claw that protrudes outward in the radial direction perpendicular to the axial direction of the clip unit when pulled out from the case.
The clip package according to claim 1, wherein the loading jig is provided with an engaging portion that engages with the claw to restrict entry of the connecting portion into the passage.   The said engaging part is provided in the back end part vicinity of the said channel | path, is formed of the level | step difference with the inner wall of the said channel | path, and is an abutting surface contact | abutted with the said nail | claw. Clip package.   The base end of the claw is fixed to the connecting portion, and the claw protrudes and engages with the engaging portion when the open end swings around the base end by elasticity. The clip package according to 1 or 2.   The clip package according to claim 3, wherein the claw is formed integrally with the connecting portion.   The convex part for reducing the frictional resistance which arises in the peripheral surface of the said nail | claw between the sliding contact surface which contacts the said nail | claw when the said clip unit moves is formed. The clip package according to 3 or 4.   It is a connection auxiliary member for assisting the connection operation of the connection part and the hook, and at least one of the connection part and the hook overlapped with the connection part in the axial direction of the clip unit faces the other. The clip package according to any one of claims 1 to 5, further comprising a connection auxiliary member that presses one of them into the other to complete the connection.   The coupling part is positioned at a coupling position where the coupling part and the hook are coupled by receiving a pressure from the coupling auxiliary member by engagement of the claw and the engagement part. Item 6. The clip package according to item 6.

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