JP2022102474A - Clip cartridge - Google Patents

Abstract

To provide a clip cartridge contributing to improve efficiency of clip fitting.SOLUTION: A clip cartridge 1 connects a medical clip 5 and a linear article 30 having a connection part 32 on a tip end side, and has a case 10, and a ring 2 and a clip 5 arranged inside the case 10. The case 10 has an insertion port 11 in which the connection part 32 is inserted, a first mounting surface 14 where the ring 2 is mounted, a second mounting surface 16 where the clip 5 is mounted, and an insertion passage 12 communicating with the insertion port 11. In a mounting state where the ring 2 is mounted on the first mounting surface 14 and the clip 5 is mounted on the second mounting surface 16, a lowest end of the clip 5 is positioned at a lower position than a lowest end of the ring 2. The case 10 has, on an inner surface thereof, an outer cylinder holding part 70 protruding inward in a radial direction v of the insertion passage 12. The outer cylinder holding part 70 is positioned on a side closer to the insertion port 11 than the first mounting surface 14.SELECTED DRAWING: Figure 6

Description

The present invention relates to a clip cartridge for connecting a medical clip and a linear object having a connecting portion on the distal end side.

In endoscopic treatment, a medical clip is used to pinch the tissue to be treated such as the affected area. The medical clip is attached to the tip of a linear object such as a wire and carried into the patient's body. A clip device with a linear object and a clip attached to the tip of the linear object is inserted into the forceps channel through the forceps opening of the endoscope, and the clip is transported to the tissue to be treated to convey the patient's tissue. Clip treatment is possible inside the body. Multiple clips are often used in one treatment, and it is necessary to attach a new clip to the clip device for each clipping operation. Therefore, a clip cartridge has been proposed as a connecting assisting tool in order to efficiently attach the clip (for example, Patent Documents 1 to 6).

International Publication No. 2020/121401 Japanese Unexamined Patent Publication No. 2017-217206 Japanese Unexamined Patent Publication No. 2017-148182 Japanese Unexamined Patent Publication No. 2009-11769 International Publication No. 2017/94455 International Publication No. 2018/1231337

In order to reduce the burden on the operator and the patient by shortening the procedure time, it is beneficial to provide a clip cartridge that can be attached more efficiently. Therefore, an object of the present invention is to provide a clip cartridge that contributes to the efficiency of clip attachment.

One embodiment of the clip cartridge of the present invention that has achieved the above object is a clip cartridge for connecting a medical clip and a linear object having a connecting portion on the tip side, and the clip case and the clip case. A ring that is placed inside the clip case and has a cavity into which the clip is inserted, and a clip that is placed inside the clip case and opens and closes by the ring, with the first and second arms facing each other. It has a clip having a tip that holds an object and a base end that is connected to a connecting portion of the linear object, and the clip case has a connecting portion of the linear object inserted on the outer surface thereof. The clip case has an insertion port, and the clip case communicates with the first mounting surface on which the ring is mounted, the second mounting surface on which the clip is mounted, and the insertion slot, and a linear object is formed inside the clip case. It has an insertion passage to be inserted, the first mounting surface is a surface on which the ring is placed so that the central axis of the ring is parallel to the extending direction of the insertion passage, and the second mounting surface is. It is a surface different from the first mounting surface, and in the clip case, the first mounting surface is located on the side farther from the insertion port than the insertion passage, and the second mounting surface is from the first mounting surface. Is located on the side far from the insertion slot, and in the mounted state where the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the lowermost end of the clip is the most of the ring. Located below the lower end, the clip case has an outer cylinder holder on its inner surface that projects inward in the radial direction of the insertion passage, with the outer cylinder holder being higher than the first mounting surface. The point is that it is located near the insertion slot. The outer cylinder holding portion narrows a part of the insertion port side from the first mounting surface in the clip case. A member inserted into the insertion passage, for example, a linear object or an outer cylinder in which a linear object is arranged in the lumen is likely to come into contact with the outer cylinder holding portion. The movement of the member inserted into the insertion passage can be restricted by the frictional force due to the contact of the outer cylinder holding portion. As a result, when the clip and the linear object are connected, the member inserted into the insertion passage is less likely to fall off from the clip case, so that the connection can be efficiently performed.

It is preferable that the linear object is arranged in the lumen of the outer cylinder, and the outer cylinder holding portion presses the outer surface of the outer cylinder. It is preferable that the outer cylinder holding portion is provided on the side closer to the first mounting surface than the insertion port. It is preferable that the outer cylinder holding portion is provided on the side close to the insertion port when the extended length of the insertion passage is divided into two equal parts. The outer cylinder holding portion preferably has a portion in which the height of the outer cylinder holding portion in the radial direction of the insertion passage increases toward the side closer to the first mounting surface.

It is preferable that the outer cylinder holding portion can be moved to the side opposite to the protruding direction. The clip case has a first case body having a second mounting surface and a second case body covering the first case body, and the outer cylinder holding portion may be on the inner surface of the first case body. preferable. The first case body is provided with an elastic piece extending in the first direction parallel to the extending direction of the insertion passage, and the elastic piece has a first end close to the insertion port in the first direction and a first. It has a second end on the opposite side to the end, the second end side of the elastic piece is fixed to the first case body, the first end side of the elastic piece can be elastically deformed with the second end side as a fulcrum, and the outer cylinder is held. It is preferable that the portion is provided on the first end side of the elastic piece.

In a mounted state in which the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, it is preferable that the tip of the outer cylinder holding portion is at a position higher than the lowermost end of the ring. .. In the mounted state where the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the tip of the outer cylinder holding portion is at a position higher than the lowermost end of the lumen of the ring. Is preferable. The linear object is arranged in the lumen of the outer cylinder, the outer cylinder holding portion can press the outer surface of the outer cylinder, and the clip case is inside the outer cylinder and the insertion passage. It is preferable to have a wall against which the distal end of the outer cylinder abuts between the first mounting surfaces.

According to the above clip cartridge, a member inserted into the insertion passage when the clip and the linear object are connected, for example, an outer cylinder in which the linear object or the linear object is arranged in the lumen is hard to fall off from the clip case. Therefore, the connection can be performed efficiently.

It is an exploded perspective view of the clip cartridge which concerns on one Embodiment of this invention. It is a top view of the clip cartridge shown in FIG. It is a schematic diagram which shows the cross section of a part of the clip cartridge shown in FIG. It is a side view of the clip which concerns on one Embodiment of this invention. It is a side view (partial sectional view) of the linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows an example of the connection method of a clip and a linear object which concerns on one Embodiment of this invention. It is a schematic diagram which shows the modification of the clip cartridge shown in FIG.

One embodiment of the clip cartridge of the present invention relates to a clip cartridge for connecting a medical clip and a linear object having a connecting portion on the distal end side. The clip cartridge is used when performing a procedure using a clip device under an endoscope. Specifically, by transporting the clip device to which the clip is attached to the tissue to be treated through the forceps channel of the endoscope, the operation with the clip can be performed in the patient's body.

The clip cartridge is a clip case, a ring arranged in the clip case and having a cavity into which the clip is inserted, and a clip arranged in the clip case and opened and closed by the ring, and the first one facing each other. It has a clip having an arm portion and a second arm portion, a tip holding an object, and a base end connected to a connecting portion of a linear object, and the clip case has a line on its outer surface. The clip case has an insertion slot into which the connecting portion of the object is inserted, and the clip case has a first mounting surface on which the ring is mounted, a second mounting surface on which the clip is mounted, and an insertion slot. The first mounting surface is a surface on which the ring is placed so that the central axis of the ring is parallel to the extending direction of the insertion passage. , The second mounting surface is a surface different from the first mounting surface, and the first mounting surface is located on the side farther from the insertion port than the insertion passage in the clip case, and the second mounting surface is located. Is located on the side farther from the insertion port than the first mounting surface, and in the mounted state where the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the clip is placed. The lowermost end of the ring is lower than the lowermost end of the ring, and the clip case has an outer cylinder holding part on its inner surface that protrudes inward in the radial direction of the insertion passage, and the outer cylinder holding part is The point is that it is located closer to the insertion slot than the first mounting surface. The outer cylinder holding portion narrows a part of the insertion port side from the first mounting surface in the clip case. A member inserted into the insertion passage, for example, a linear object or an outer cylinder in which a linear object is arranged in the lumen is likely to come into contact with the outer cylinder holding portion. The movement of the member inserted into the insertion passage can be restricted by the frictional force due to the contact of the outer cylinder holding portion. As a result, when the clip and the linear object are connected, the member inserted into the insertion passage is less likely to fall off from the clip case, so that the connection can be efficiently performed.

Hereinafter, the present invention will be described in more detail based on the following embodiments, but the present invention is not limited by the following embodiments as well as the present invention, and appropriate changes are made to the extent that it can meet the purposes of the preceding and the following. In addition, it is of course possible to carry out, and all of them are included in the technical scope of the present invention. In each drawing, hatching, member reference numerals, and the like may be omitted for convenience, but in such cases, the specification and other drawings shall be referred to. Further, the dimensions of the various members in the drawings may differ from the actual dimensions because the priority is given to contributing to the understanding of the features of the present invention.

The configuration of the clip cartridge, the clip device, and the clip system will be described with reference to FIGS. 1 to 13. FIG. 1 is an exploded perspective view of a clip cartridge according to an embodiment of the present invention. FIG. 2 is a plan view of the clip cartridge shown in FIG. FIG. 3 is a schematic view showing a cross section of a part of the clip cartridge shown in FIG. FIG. 4 is a side view of a clip according to an embodiment of the present invention. FIG. 5 is a side view (partial sectional view) of a linear object according to an embodiment of the present invention. 6 to 12 are schematic views showing an example of a method of connecting a clip and a linear object according to an embodiment of the present invention. FIG. 13 is a schematic view showing a modified example of the clip cartridge shown in FIG. In addition, in FIG. 1, it was shown that a plurality of connection pins 26J were provided in the second case body 26, and a plurality of holes 25K into which the connection pins 26J were inserted were provided in the first case body 25. In FIGS. 6 to 10 and 12, the connection pin 26J and the hole 25K are omitted.

The clip cartridge 1 includes a ring 2, a clip 5, and a clip case 10. In the following, the clip cartridge may be referred to as a cartridge, and the clip case may be referred to as a case. Before describing the cartridge 1 in detail, the clip device and the clip system will be described. The clip device includes at least a clip 5, a ring 2 and a linear object 30. As shown in FIG. 5, the linear object 30 is formed in a linear shape and has a tip 30A and a proximal end (not shown) in the longitudinal axis direction. The linear object 30 has a connecting portion 32 connected to the clip 5 on the tip 30A side thereof. The tip 30A side of the linear object 30 is inserted into the cartridge 1. The clip system includes at least a case 10; a clip device having a clip 5, a ring 2 and a linear object 30; Although the details will be described later, the clip 5 and the ring 2 are housed inside the case 10. For example, as shown in FIGS. 6 to 8, the tip 30A side of the linear object 30 of the clip device is inserted into the case 10, and the linear object 30 is passed through the lumen 4 of the ring 2 as shown in FIG. Later, as shown in FIGS. 10 to 11, the clip 5 can be attached to the connecting portion 32 of the linear object 30. By such an operation, the clip device can be used.

The linear object 30 can be composed of one or a plurality of members. The connecting portion 32 may be integrally formed with the linear object 30. As shown in FIG. 5, the linear object 30 may have a long linear object main body 31 and a connecting portion 32 attached to the tip end side of the linear object main body 31.

The linear object main body 31 may be solid or hollow. The linear object main body 31 may be a single wire or a stranded wire obtained by twisting the single wires. As the linear object main body 31, for example, a thread formed of a metal wire such as stainless steel or carbon steel or a synthetic resin such as a polyamide resin, a polyolefin resin, a polyester resin, a polyimide resin or a fluororesin can be used. The surface of the linear object main body 31 may be coated with a resin such as fluororesin.

The shape of the connecting portion 32 is not particularly limited as long as it can be connected to the base end 5B side of the clip 5. The connecting portion 32 has a spherical shape, an oval shape, a semicircular shape, a semicircular spherical shape, a teardrop shape, a polygonal shape, a cone shape, a frustum shape, a pillar shape, or a shape obtained by combining these. Can be done. The connecting portion 32 may have a larger outer diameter than the linear object main body 31. By connecting the connecting portion 32 to the connected portion 9 preferably provided on the base end 5B side of the clip 5, the clip 5 and the linear object 30 can be fixed. The form of connecting the clip 5 and the linear object 30 is not particularly limited, and the connected portion 9 of the clip 5 shown in FIG. 4 is sandwiched and connected by two connecting members arranged on the tip end side of the linear object 30. The first arm portion 6 and the second arm portion 7 on the base end 5B side of the clip 5 shown in FIG. 4 are parallel to each other, sandwiching the connecting portion 32 on the tip end side of the linear object 30. Examples include a form of connection. In the clip cartridge 1, for connecting the clip 5 and the linear object 30, a form in which the linear object 30 approaches from the width direction z of the clip 5 can be preferably used.

The connecting portion 32 may be made of a biocompatible material, for example, a metal such as stainless steel or carbon steel, or a synthetic resin such as a polyamide resin, a polyolefin resin, a polyester resin, a polyimide resin, or a fluororesin. can do.

It is preferable that at least a part of the linear object 30 is arranged in the inner cylinder 35. That is, it is preferable that the clip device further has an inner cylinder 35, and the linear object 30 is arranged in the lumen of the inner cylinder 35. When the clip 5 is connected to the linear object 30 and used, the opening degree of the clip 5 is adjusted by moving the linear object 30 to the proximal side or the distal side with respect to the longitudinal axis direction of the inner cylinder 35. be able to. For example, when the linear object 30 is moved proximal to the inner cylinder 35, the ring 2 and the inner cylinder 35 come into contact with each other, and the clip 5 is closed by moving the ring 2 to the tip 5A side of the clip 5. Can be done.

It is desirable that the inner cylinder 35 has both the flexibility to bend along the shape in the body cavity and the rigidity to surely reach the tissue to be treated. The inner cylinder 35 is a coil body made of metal or synthetic resin, a cylinder made of a plurality of short-cylindrical joint pieces connected in the axial direction to be rotatable, a cylinder made of synthetic resin, or a cylinder thereof. It can be composed of combinations.

The clip device may further have an outer cylinder 36. In that case, the inner cylinder 35 is arranged in the lumen 362 of the outer cylinder 36. It is preferable that the clip 5 is configured to be freely put in and taken out from the outer cylinder 36 in a state where the clip 5 is connected to the linear object 30. By storing the clip 5 in the outer cylinder 36, the clip 5 does not need to be exposed to the outside. Further, while the clip 5 is transported close to the target tissue, the clip 5 is housed in the outer cylinder 36 to prevent the clip 5 from damaging the internal tissue other than the forceps channel and the lesion.

It is desirable that the outer cylinder 36 has flexibility and rigidity similar to the inner cylinder 35. The outer cylinder 36 is a cylinder formed of synthetic resin, a coil body formed of metal or synthetic resin, a cylinder formed by connecting a plurality of short tubular joint pieces in the axial direction and making them rotatable, or these. It can be composed of a combination of. Above all, a tubular body made of synthetic resin is preferably used for the outer cylinder 36. In order to make it easy to confirm the positional relationship between the outer cylinder 36 and the inner cylinder 35, the outer cylinder 36 may be made of a transparent or translucent material.

The clip 5 is for medical use, and is used for sealing, countertraction, hemostasis, stitching, and marking of an object such as a lesion in an endoscopic procedure, for example. The clip 5 is arranged in the case 10 and is opened and closed by the ring 2. The clip 5 has a tip 5A that sandwiches the object and a base end 5B that is connected to the connecting portion 32 of the linear object 30. The clip 5 is configured so that the tip 5A side can be opened and closed by the ring 2 with the base end 5B side as a fulcrum.

As shown in FIG. 4, the clip 5 has a first arm portion 6 and a second arm portion 7 facing each other. The first arm portion 6 and the second arm portion 7 extend from the base end 5B to the tip end 5A, respectively. The first arm portion 6 and the second arm portion 7 have a portion extending so as to be separated from each other toward the tip 5A side. The first arm portion 6 and the second arm portion 7 are connected to each other on the proximal end 5B side. FIG. 4 shows a connection portion 8 between the first arm portion 6 and the second arm portion 7. The first side portion in the longitudinal direction of one elongated plate bent in a U-shape or a Y-shape may be the first arm portion 6, and the second side portion in the longitudinal direction may be the second arm portion 7. Further, one of the two elongated plates arranged so as to face each other may be the first arm portion 6, and the other may be the second arm portion 7. The opening / closing direction y is a direction perpendicular to the direction x, and is the direction of the arrow y shown in FIG. The opening / closing locus of the first arm portion 6 and the second arm portion 7 may include a directional component other than the directional y, such as an arc.

The clip 5 preferably has a direction x from the tip 5A toward the base end 5B and a width direction z perpendicular to the opening / closing direction y. As shown in FIG. 3, the clip 5 preferably has a first end 51C and a second end 51D in the width direction z.

It is preferable that the connected portion 9 is provided on the base end 5B side of the clip 5. The connected portion 9 is connected to the connecting portion 32 of the linear object 30. The structure of the connected portion 9 is not particularly limited, but for example, as shown in FIG. 4, the first arm portion 6 has a first claw 9A protruding toward the second arm portion 7 side on the base end 5B side thereof. The structure may be such that the second arm portion 7 has a second claw 9B protruding toward the first arm portion 6 side on the base end 5B side thereof. Since the first claw 9A and the second claw 9B are caught on the connecting portion 32, the linear object 30 is less likely to come off from the clip 5 after the clip 5 and the linear object 30 are connected. As another aspect of the connected portion 9, the tip end side of the linear object 30 is connected to the portion where the first arm portion 6 and the second arm portion 7 are parallel to each other on the base end 5B side of the clip 5 shown in FIG. Examples thereof include a mode in which the portions 32 are sandwiched and connected.

The drawing shows an example in which the first arm portion 6 and the second arm portion 7 of the clip 5 have a constant width from the tip 5A toward the proximal end 5B, but the direction from the distal end 5A toward the proximal end 5B. The width of the arm may differ depending on the position of x. By changing the width of the clip 5, the gripping force of the clip can be adjusted, and the vertical positions of the ring 2 and the clip 5 in the case 10 can be adjusted.

As shown in FIGS. 1 and 3, the ring 2 is arranged in the case 10 and has a lumen 4 into which the clip 5 is inserted. In the case 10, the ring 2 and the clip 5 are arranged apart from each other. When the linear object 30 is pulled out to the hand side after the clip 5 and the linear object 30 are connected, the ring 2 is arranged so as to surround the periphery of the clip 5. The outer diameter of the ring 2 is smaller than the inner diameter of the outer cylinder 36. As a result, the clip 5 and the ring 2 are housed in the outer cylinder 36.

The shape of the cross section perpendicular to the central axis 3 of the ring 2 is not particularly limited, but may be, for example, a circular shape, an oval shape, or a polygonal shape. The ring 2 may have a C-shaped cross section with a notch, or may have a coil shape formed by spirally winding a wire rod.

The clip 5 and the ring 2 are preferably made of a material having high elasticity and biocompatibility. The clip 5 and the ring 2 can be made of, for example, stainless steel such as SUS301, SUS303, SUS304, SUS631 or Ni—Ti alloy.

The case 10 houses the ring 2 and the clip 5 inside. The case 10 has an insertion port 11 on the outer surface thereof into which the connecting portion 32 of the linear object 30 is inserted, and the case 10 has a first mounting surface 14 on which the ring 2 is mounted and a clip. It has a second mounting surface 16 on which the 5 is mounted, and an insertion passage 12 that communicates with the insertion port 11 and into which the linear object 30 is inserted. The first mounting surface 14 is a surface on which the ring 2 is mounted so that the central axis 3 of the ring 2 is parallel to the extending direction u of the insertion passage 12, and the second mounting surface 16 is the first mounting surface. It is a surface different from the surface 14. In the case 10, the first mounting surface 14 is located on the side farther from the insertion port 11 than the insertion passage 12, and the second mounting surface 16 is on the side farther from the insertion port 11 than the first mounting surface 14. Is located in. In a mounted state in which the ring 2 is mounted on the first mounting surface 14 and the clip 5 is mounted on the second mounting surface 16, the lowermost end 5L of the clip 5 is lower than the lowermost end 2L of the ring 2. In position. The case 10 has an outer cylinder holding portion 70 projecting inward in the radial direction v of the insertion passage 12 on the inner surface thereof, and the outer cylinder holding portion 70 has an insertion port 11 rather than the first mounting surface 14. It is located on the side close to. The outer cylinder holding portion 70 narrows a part of the insertion port 11 side of the first mounting surface 14 in the case 10. A member inserted into the insertion passage 12, for example, an outer cylinder 36 in which the linear object 30 or the linear object 30 is arranged in the lumen 362 easily comes into contact with the outer cylinder holding portion 70. The movement of the member inserted into the insertion passage 12 can be restricted by the frictional force due to the contact of the outer cylinder holding portion 70. As a result, when the clip 5 and the linear object 30 are connected, the member inserted into the insertion passage 12 is less likely to fall off from the case 10, so that the connection can be efficiently performed.

A method of connecting the clip 5 and the linear object 30 using the cartridge 1 will be described. As shown in FIG. 3, the ring 2 is placed on the first mounting surface 14, and the clip 5 is placed on the second mounting surface 16. In this mounted state, as shown in FIG. 6, the tip 30A of the linear object 30 is inserted into the insertion passage 12 from the insertion port 11. Specifically, it is preferable to insert the outer cylinder 36 in which the linear object 30 is arranged in the lumen 362 into the insertion passage 12 from the insertion port 11. When the linear object 30 is inserted into the back side (arrow A side in FIGS. 6 to 8), the linear object 30 is placed on the first mounting surface 14 as shown in FIG. It is passed through the lumen 4 of the. When the linear object 30 is further inserted into the interior, the tip 30A of the linear object 30 reaches the position of the second mounting surface 16. Since the lowermost end 5L of the clip 5 is lower than the lowermost end 2L of the ring 2 in the above-mentioned placement state, the tip 30A of the linear object 30 reaches the position of the second mounting surface 16 as shown in FIG. At least a part of the linear object 30 is arranged at a position higher than the clip 5. By pushing the linear object 30 toward the clip 5 side (arrow B side in FIG. 9), one of the width direction z of the first arm portion 6 and the second arm portion 7 of the clip 5 as shown in FIGS. 10 to 11 A linear object 30 can be fitted between the first arm portion 6 and the second arm portion 7 from the side. According to the cartridge 1, when connecting the clip 5 and the linear object 30, the linear object 30 is moved in the direction from the base end 5B of the clip 5 toward the tip end 5A, and the connecting portion 32 is connected to the connected portion 9 of the clip 5. It is not necessary to perform the operation of inserting. This contributes to the suppression of the occurrence of poor connection between the clip 5 and the linear object 30 and the suppression of the deformation of the base end 5B side of the clip 5. It should be noted that one side in the width direction z is the side opposite to the side in contact with the second mounting surface 16, and is the second end 5D side in the drawing.

Although not shown, the case 10 has a first case body 25 having a second mounting surface 16 and a second case body 26 covering the first case body 25, and the second case body 26. May have a pressing portion that moves toward the first case body 25 and presses the linear object 30. By moving the pressing portion toward the first case body 25 in a state where the pressing portion is in contact with the linear object 30, the clip 5 can be attached to the linear object 30. When the second case body 26 is pressed from the outside, the pressing portion may come into contact with the linear object 30. A projecting portion projecting toward the first case body 25 side may be provided inside the second case body 26, and a pressing portion may be provided at the tip end portion of the projecting portion.

After connecting the clip 5 and the linear object 30 in the case 10, when the linear object 30 is pulled toward the hand side, the ring 2 is arranged so as to surround the periphery of the clip 5. Further, when the linear object 30 is pulled toward the hand side, the clip 5 and the ring 2 can be accommodated in the outer cylinder 36. By pulling the outer cylinder 36 and the linear object 30 toward the hand side, the clip device can be pulled out from the case 10 with the clip 5 and the ring 2 housed in the outer cylinder 36. At the time of treatment, the clip 5 and the ring 2 are exposed from the outer cylinder 36 and used.

As shown in FIG. 12, it is preferable that the clip 5 and the linear object 30 connected to each other can be pulled out from the case 10 via the insertion slot 11. Since it is not necessary to disassemble the case 10 when the clip 5 is removed from the case 10, the procedure can be performed immediately after the clip 5 is connected to the linear object 30.

The case 10 may have a container shape that can accommodate the ring 2 and the clip 5 inside. The outer shape of the case 10 may be, for example, a polyhedron. Examples of the polyhedron include a rectangular parallelepiped shape. FIG. 1 shows an example in which the outer shape of the case 10 is a flat rectangular parallelepiped shape. The case 10 can be composed of one or a plurality of members.

The case 10 preferably has a first case body 25 having a second mounting surface 16 and a second case body 26 covering the first case body 25. It is preferable that the case 10 has a wall 25A extending in the direction from the first case body 25 toward the second case body 26 so that the clip 5 does not fall off from the second mounting surface 16. As can be understood from FIGS. 1 and 3, the first case body 25 and the second case body 26 each have a concave-shaped portion, and the concave-shaped portions of these case bodies are arranged so as to face each other. Therefore, a clip accommodating portion 17 for accommodating the clip 5 may be formed. Further, the first case body 25 may be formed in a plate shape, and the second case body 26 may be formed in a reverse concave shape so as to cover the plate-shaped first case body 25. The first case body 25 may be formed in a concave shape, and the second case body 26 may be formed in a plate shape.

The insertion port 11 may be provided on any portion of the outer surface of the case 10 as long as it communicates with the insertion passage 12. When the case 10 has a rectangular parallelepiped shape having an upper surface portion 10A, a lower surface portion 10B, and four side surface portions 10C to 10F, the insertion port 11 can be provided in either the upper surface portion 10A or the four side surface portions 10C to 10F. The insertion slot 11 may correspond to the entrance of the insertion passage 12.

When the case 10 has a first case body 25 and a second case body 26 covering the first case body 25, the insertion port 11 has the first case body 25 and the first case body 26 as shown in FIG. It may be provided straddling the two case bodies 26. Further, the insertion port 11 may be provided in either the first case body 25 or the second case body 26. For example, the insertion port 11 may be provided in the second case body 26. This makes it easier to bring the linear object 30 closer to one side of the clip 5 in the width direction z when the linear object 30 is inserted into the case 10.

The insertion passage 12 is a passage into which the linear object 30 is inserted, and is formed so as to connect the insertion port 11 and the ring accommodating portion 15 having the first mounting surface 14. The insertion passage 12 is usually formed so as to extend straight from the insertion opening 11 to the ring accommodating portion 15. The insertion passage 12 may be inclined so as to be lowered toward the tip end side of the clip 5, for example. The extending direction u of the insertion passage 12 corresponds to the direction from the insertion opening 11 to the ring accommodating portion 15 having the first mounting surface 14. It is preferable that the insertion port 11 and the insertion passage 12 have a size that allows the outer cylinder 36 to be inserted.

The first mounting surface 14 is a surface having a portion in contact with at least a part of the ring 2. On the first mounting surface 14, the ring 2 is arranged so that the direction of the central axis 3 of the ring 2 is parallel to the extending direction u of the insertion passage 12. The extending direction u of the insertion passage 12 can be defined by, for example, the extending direction of the center of the longitudinal axis of the insertion passage 12. The fact that the direction of the central axis 3 of the ring 2 is parallel to the extending direction u of the insertion passage 12 includes the case where the direction of the central axis 3 of the ring 2 and the extending direction u of the insertion passage 12 are substantially parallel. Is done. For example, the direction of the central axis 3 of the ring 2 is inclined within ± 5 degrees with respect to the extending direction u of the insertion passage 12. When the cartridge 1 is viewed from the direction of the central axis 3 of the ring 2, the direction of the central axis 3 of the ring 2 and the extending direction of the center of the longitudinal axis of the insertion passage 12 do not have to overlap.

The first mounting surface 14 may be composed of a single surface or may be composed of a plurality of surfaces. The first mounting surface 14 may be composed of only a flat surface, may be composed of only a curved surface, or may be composed of a combination of a flat surface and a curved surface. The first mounting surface 14 may have a shape along the outer peripheral surface of the ring 2.

When the case 10 has a first case body 25 and a second case body 26 covering the first case body 25, the first case body 25 has a first mounting surface 14. It is preferable to have. The first mounting surface 14 may be a part of the inner surface of the first case body 25. For example, it may be a part of the surface of the convex portion 25B provided on the inner surface of the first case body 25 as shown in FIG. As another embodiment, even if the first case body 25 has a holding member (not shown) for holding the ring 2 inside the first case body 25, and a part of the surface of the holding member is the first mounting surface 14. good.

A clip accommodating portion 17 for accommodating clips is provided behind the first mounting surface 14. The clip accommodating portion 17 has a second mounting surface 16. The second mounting surface 16 is a surface having a portion in contact with at least a part of the clip 5. On the second mounting surface 16, the clip 5 is mounted with the first arm portion 6 and the second arm portion 7 of the clip 5 open. The clip 5 is arranged so that the base end 5B side of the clip 5 faces the insertion passage 12 side. The second mounting surface 16 may be in contact with the base end 5B of the clip 5, may be in contact with the tip 5A of the clip 5, or may be in contact with both the tip 5A and the base end 5B.

The second mounting surface 16 may be composed of a single surface or may be composed of a plurality of surfaces. The second mounting surface 16 may be composed of only a flat surface, may be composed of only a curved surface, or may be composed of a combination of a flat surface and a curved surface. The second mounting surface 16 may have a shape along the edge of the first arm portion 6 and the second arm portion 7 of the clip 5 in the width direction z.

With the clip 5 mounted, the second mounting surface 16 may be parallel to the horizontal plane so that the second mounting surface 16 becomes lower toward the tip 5A side or the base end 5B side of the clip 5. It may be tilted. The second mounting surface 16 may be parallel to the direction of the central axis 3 of the ring 2 or may be inclined with respect to the direction of the central axis 3 of the ring 2. The horizontal plane is a plane including the horizontal direction m perpendicular to the gravity direction n.

The second mounting surface 16 is a surface different from the first mounting surface 14. This indicates that the heights of the first mounting surface 14 and the second mounting surface 16 are different at least in a part in the mounted state. The first mounting surface 14 and the second mounting surface 16 may be different surfaces separated by a step or the like, and at least a part of the first mounting surface 14 and the second mounting surface have different heights. The surface 16 may be connected to form a continuous shape.

In the mounting state as shown in FIG. 3, the ring 2 is mounted on the first mounting surface 14, and at least a part of the ring 2 is in contact with the first mounting surface 14, and the second mounting surface is in contact with the first mounting surface 14. A clip 5 is placed on the 16 and at least a part of the clip 5 is in contact with the second mounting surface 16. The state in which either the ring 2 or the clip 5 is not in contact with the mounting surface is not included in the mounting state. When the case 10 has the first case body 25 and the second case body 26, the first case body 25 is placed below the second case body 26 in the vertical direction in order to bring it into the above-mentioned placement state. Just place it.

When the case 10 has a first case body 25 and a second case body 26 covering the first case body 25, the second mounting surface 16 is one of the inner surfaces of the first case body 25. It may be a department. As another embodiment, even if the first case body 25 has a support member (not shown) for supporting the clip 5 inside the first case body 25, and a part of the surface of the support member is the second mounting surface 16. good.

The outer cylinder holding portion 70 is provided on the inner surface of the case 10. The outer cylinder holding portion 70 projects inward in the radial direction v of the insertion passage 12. The outer cylinder holding portion 70 comes into contact with the member 39 inserted into the insertion passage 12. The member 39 inserted through the insertion passage 12 is, for example, a linear object 30 or an outer cylinder 36 in which the linear object 30 is arranged in the lumen 362 as shown in FIGS. 6 to 12, and is simply referred to below. It may be referred to as a member 39. Above all, it is preferable that the outer cylinder holding portion 70 comes into contact with the outer surface 361 which is the outer surface of the outer cylinder 36. When the case 10 is composed of two case bodies such as the first case body 25 and the second case body 26, the outer cylinder holding portion 70 provided on one case body protrudes toward the other case body. There is.

In FIGS. 1 to 3, the case 10 is provided with a single outer cylinder holding portion 70, but the case 10 may be provided with a plurality of outer cylinder holding portions 70. As shown in FIGS. 1 to 3, the outer cylinder holding portion 70 may be integrally formed with the case 10, or may be formed by arranging a component for forming the outer cylinder holding portion in the case 10. good.

The outer cylinder holding portion 70 is in point contact, line contact, or surface contact with the member 39, but surface contact is particularly preferable. It is preferable that the outer cylinder holding portion 70 comes into contact with only a part of the member 39 in the circumferential direction so as not to excessively restrict the movement of the member 39.

The outer cylinder holding portion 70 preferably presses the member 39. As a result, the frictional force of the outer cylinder holding portion 70 can be increased, so that the movement of the member 39 can be appropriately regulated.

It is preferable that the linear object 30 is arranged in the lumen 362 of the outer cylinder 36, and the outer cylinder holding portion 70 presses the outer surface 361 of the outer cylinder 36. As a result, the movement of the outer cylinder 36 can be appropriately regulated.

The outer cylinder 36 may be movable so that the tip of the outer cylinder 36 is located closer to the first mounting surface 14 than the outer cylinder holding portion 70. The outer cylinder holding portion 70 may press the outer surface 361 of the outer cylinder 36. The outer cylinder holding portion 70 does not have to come into contact with the opening end surface 37 at the tip of the outer cylinder 36. The outer cylinder 36 may be movable so that the tip of the outer cylinder 36 is located closer to the insertion port 11 than the first mounting surface 14.

The shape of the outer cylinder holding portion 70 is not particularly limited. The outer cylinder holding portion 70 has a spherical shape, an oval shape, a semicircular shape, a semicircular spherical shape, a teardrop shape, a polygonal shape, a cone shape, a frustum shape, a pillar shape, a tongue piece shape, and a brush shape. Alternatively, the shape may be a combination of these. In FIG. 1, the outer cylinder holding portion 70 has a triangular prism shape arranged so that the protruding height increases toward the inner side of the insertion passage 12. The outer cylinder holding portion 70 may be in the form of a lump. The outer cylinder holding portion 70 may be a polyhedron.

The shape of the outer cylinder holding portion 70 is not particularly limited, but it is preferable that the outer cylinder holding portion 70 extends in the extending direction of the insertion passage 12. This facilitates contact of the outer cylinder holding portion 70 with the member 39 over a wide range. The outer cylinder holding portion 70 may extend in the circumferential direction of the insertion passage 12. The outer cylinder holding portion 70 may extend spirally around the center of the longitudinal axis of the insertion passage 12. Further, the outer cylinder holding portion 70 may be a spiral portion protruding toward the insertion passage 12.

The outer cylinder holding portion 70 has a height direction corresponding to the radial direction v of the insertion passage 12, and a width direction perpendicular to the height direction and the extending direction of the insertion passage 12. The width of the outer cylinder holding portion 70 is preferably larger than the width in the direction perpendicular to the longitudinal direction of the member 39. As a result, the outer cylinder holding portion 70 can reliably push the member 39 such as the outer cylinder. Since the cross section of the outer cylinder 36 in the longitudinal direction is often circular, if the width of the outer cylinder holding portion 70 is larger than the width, the outer cylinder 36 is less likely to escape when pushed, and the outer cylinder is securely held. can do. By holding the outer cylinder, the movement of the member 39 can be restricted.

The height of the outer cylinder holding portion 70 is not particularly limited, but it is preferable that the tip 71 of the outer cylinder holding portion 70 is located near the center of the longitudinal axis of the insertion passage 12. The member 39 can be arranged in the insertion passage 12 to the extent that it does not fall off from the case 10 but can be moved. The height of the outer cylinder holding portion 70 is the height in the radial direction v of the insertion passage 12, and is the height in a state where the member 39 is not inserted into the case 10. If the height of the outer cylinder holding portion 70 is too high, it becomes difficult to insert the member 39, and if the height is too low, the outer cylinder cannot be held. The height of the outer cylinder holding portion 70 should be determined in consideration of the diameter of the outer cylinder used and the size of the insertion passage 12. The strength with which the outer cylinder holding portion 70 holds the outer cylinder 36 is such that the clip 5 includes the outer cylinder 36, the inner cylinder 35, and the linear object 30 when the clip 5 is on the upper side and only the cartridge 1 is held. It is preferable that the pliers do not fall off from the cartridge 1.

The height of the outer cylinder holding portion 70 may be constant. The height of the outer cylinder holding portion 70 may differ depending on the position of the insertion passage 12 in the extending direction. The height of the outer cylinder holding portion 70 may differ depending on the position of the insertion passage 12 in the circumferential direction.

As shown in FIG. 3, the outer cylinder holding portion 70 has a portion in which the height of the outer cylinder holding portion 70 in the radial direction v of the insertion passage 12 increases toward the side closer to the first mounting surface 14. Is preferable. This makes it easier to accept the member 39 into the insertion passage 12 even if the outer cylinder holding portion 70 is provided. Further, when the member 39 is inserted into the inner side of the insertion passage 12, the outer cylinder holding portion 70 gradually and strongly contacts the outer cylinder 36, so that the movement of the member 39 can be easily regulated.

The position of the outer cylinder holding portion 70 in the case 10 is not limited as long as it is provided closer to the insertion port 11 than the first mounting surface 14. The outer cylinder holding portion 70 may be provided in the insertion passage 12 or may be provided in the insertion port 11. As shown in FIG. 3, it is preferable that the outer cylinder holding portion 70 is provided on the side closer to the first mounting surface 14 than the insertion port 11. The movement of the member 39 can be restricted while facilitating the insertion of the member 39 into the insertion port 11.

The outer cylinder holding portion 70 is preferably provided on the side 12A close to the insertion port 11 when the extended length of the insertion passage 12 is divided into two equal parts. The outer cylinder holding portion 70 can restrict the movement of the member 39 at an early stage of insertion.

The outer cylinder holding portion 70 may be provided on the side 12B close to the first mounting surface 14 when the extended length of the insertion passage 12 is divided into two equal parts. The movement of the member 39 can be restricted by the outer cylinder holding portion 70 while facilitating the smooth insertion of the member 39 into the insertion passage 12.

When the outer cylinder holding portion 70 is provided in the insertion passage 12, it is preferable that the outer cylinder holding portion 70 has the smallest cross-sectional area in the direction perpendicular to the center of the longitudinal axis of the insertion passage 12. Thereby, the movement of the member 39 can be appropriately regulated.

When the case 10 has a first case body 25 having a second mounting surface 16 and a second case body 26 covering the first case body 25, as shown in FIG. 3, the outer cylinder holding portion It is preferable that the 70 is provided on the side of the first case body 25, and it is more preferable that the outer cylinder holding portion 70 is on the inner surface of the first case body 25. Since the member 39 is easily pressed against the second case body 26 side, the member 39 is easily arranged at a position higher than the clip 5.

When the case 10 has a first case body 25 having a second mounting surface 16 and a second case body 26 covering the first case body 25, as shown in FIG. 13, the outer cylinder holding portion The 70 may be provided on the side of the second case body 26, and the outer cylinder holding portion 70 may be provided on the inner surface of the second case body 26. Since the member 39 is easily pressed against the first case body 25 side, it becomes easy to insert the linear object 30 of the member 39 into the lumen 4 of the ring 2 preferably placed on the first mounting surface 14. ..

The outer cylinder holding portion 70 may be provided on the inner surface of the first case body 25 and the inner surface of the second case body 26, respectively.

The outer cylinder holding portion 70 may be movable in the protruding direction. This makes it easier for the member 39 to come into contact with the outer cylinder holding portion 70, so that the movement of the member 39 can be appropriately restricted.

As shown in FIGS. 7 to 10, it is preferable that the outer cylinder holding portion 70 can move in the direction opposite to the protruding direction. By moving the outer cylinder holding portion 70 to the side opposite to the protruding direction, that is, outward in the radial direction of the insertion passage, the frictional force acting between the member 39 and the outer cylinder holding portion 70 is made appropriate. Can be done.

The outer cylinder holding portion 70 may be movable in the protruding direction by pressing the case 10 from the outside. By pressing the case 10, the operator can adjust the degree of contact between the member 39 and the outer cylinder holding portion 70. When the pressing of the case 10 is released, the outer cylinder holding portion 70 may move to the side opposite to the protruding direction. If the outer cylinder holding portion 70 can be moved at the timing of the operator in this way, the movement of the member 39 can be appropriately regulated.

The outer cylinder holding portion 70 may be movable in the extending direction u of the insertion passage 12 in order to adjust the degree of contact between the member 39 and the outer cylinder holding portion 70. Further, the outer cylinder holding portion 70 may be movable in the circumferential direction of the insertion passage 12.

The case 10 has a first case body 25 having a second mounting surface 16 and a second case body 26 covering the first case body 25, and the outer cylinder holding portion 70 is inside the first case body 25. When it is on the surface, the first case body 25 is provided with an elastic piece 27 extending in the first direction parallel to the extending direction u of the insertion passage 12, and the elastic piece 27 is inserted in the first direction. It has a first end 27A near the mouth 11 and a second end 27B opposite to the first end 27A, and the second end 27B side of the elastic piece 27 is fixed to the first case body 25, and the first elastic piece 27 is the first. It is preferable that the end 27A side is elastically deformable with the second end 27B side as a fulcrum, and the outer cylinder holding portion 70 is provided on the first end 27A side of the elastic piece 27. By providing the outer cylinder holding portion 70 in the elastic piece 27 in this way, when the member 39 is inserted into the insertion passage 12, the outer cylinder holding portion 70 is always in contact with the member 39 due to the elastic deformation of the elastic piece 27. Can be configured.

The elastic piece 27 can be formed by cutting out a part of the second case body 26.

When the case 10 has the first case body 25 and the second case body 26, it extends to the second case body 26 in the first direction parallel to the extending direction u of the insertion passage 12 as shown in FIG. The elastic piece 27 may be provided.

Although not shown, the first end 27A of the elastic piece 27 may be fixed to the first case body 25, and the second end 27B of the elastic piece 27 may be elastically deformed with the first end 27A side as a fulcrum. Further, the elastic piece 27 may extend in the opening / closing direction y of the clip 5. In that case, it is preferable that one end of the elastic piece 27 is fixed to the first case body 25 and the other end is elastically deformed with one end as a fulcrum.

In FIG. 3, the outer cylinder holding portion 70 is provided on the same side as the second mounting surface 16. In a mounted state in which the ring 2 is mounted on the first mounting surface 14 and the clip 5 is mounted on the second mounting surface 16, the tip 71 of the outer cylinder holding portion 70 is from the lowermost end 2L of the ring 2. Is preferably in a high position. By setting the height of the outer cylinder holding portion 70 in this way, it becomes easier to bring the outer cylinder holding portion 70 into contact with the member 39.

As shown in FIG. 3, in a mounted state in which the ring 2 is mounted on the first mounting surface 14 and the clip 5 is mounted on the second mounting surface 16, the tip 71 of the outer cylinder holding portion 70 is placed. It is preferably located at a position higher than the lowermost end 4L of the lumen 4 of the ring 2. By setting the height of the outer cylinder holding portion 70 in this way, it becomes easier to bring the outer cylinder holding portion 70 into contact with the member 39.

In FIG. 13, the outer cylinder holding portion 70 is provided on the side opposite to the second mounting surface 16. In that case, in order to make it easier for the outer cylinder holding portion 70 to come into contact with the member 39, the ring 2 is placed on the first mounting surface 14, and the clip 5 is placed on the second mounting surface 16. In the state, the tip 71 of the outer cylinder holding portion 70 may be located at a position lower than the uppermost end 2M of the ring 2. Further, in the above-described state, the tip 71 of the outer cylinder holding portion 70 may be located at a position lower than the uppermost end 4M of the lumen 4 of the ring 2.

In a mounting state in which the ring 2 is mounted on the first mounting surface 14 and the clip 5 is mounted on the second mounting surface 16, the positional relationship between the clip 5 and the ring 2 is not particularly limited. For example, the entire clip 5 may be located lower than the lowermost end 2L of the ring 2, and at least a part of the clip 5 may be located higher than the lowermost end 2L of the ring 2. In the above-mentioned placement state, the lowermost end of the second mounting surface 16 may be at a position lower than the lowermost end of the first mounting surface 14. In the above-described state, the central axis 3 of the ring 2 may be located higher than the uppermost end of the base end 5B of the clip 5. In the above-mentioned placement state, the uppermost end of the clip 5 may be at a position lower than the lowermost end of the first mounting surface 14. In the above-mentioned mounting state, the uppermost end of the clip 5 is located higher than the lowermost end of the first mounting surface 14, and the uppermost end of the second mounting surface 16 is higher than the lowermost end of the first mounting surface 14. It may be in a low position. In the above-mentioned placement state, the lowermost end 2L of the ring 2 may be located higher than the uppermost end of the base end 5B of the clip 5. In the above-mentioned placement state, the lowermost end 2L of the ring 2 may be located higher than the uppermost end of the clip 5. In the above-mentioned placement state, the uppermost end of the clip 5 may be located higher than the lowermost end 4L of the lumen 4 of the ring 2. In the above-mentioned placement state, a part of the clip 5 may not be in contact with the second mounting surface 16. In the above-mentioned placement state, the extending direction u of the insertion passage 12 may be parallel to the horizontal plane, or the insertion passage 12 may be inclined so as to be lower toward the tip 5A side of the clip 5.

As shown in FIG. 11, when the linear object 30 is arranged in the lumen 362 of the outer cylinder 36 and the outer cylinder holding portion 70 can press the outer surface 361 of the outer cylinder 36. As shown in FIG. 1, the case 10 may have a wall 18 inside which the distal end of the outer cylinder 36 abuts between the insertion passage 12 and the first mounting surface 14. When the outer cylinder 36 abuts on the wall 18, the outer cylinder 36 does not have to reach the first mounting surface 14, and the outer cylinder 36 is less likely to come into contact with the ring 2. Therefore, it is possible to prevent the ring 2 from falling off from the first mounting surface 14 due to contact with the outer cylinder 36.

The wall 18 may be fixed to the first case body 25, or may be provided on a member different from the first case body 25 and the second case body 26.

The wall 18 may extend in the radial direction v of the insertion passage 12. The height of the wall 18 is not particularly limited, and may be smaller than the outer diameter of the outer cylinder 36, or may be smaller than half of the outer diameter of the outer cylinder 36.

The constituent materials of the case 10, the outer cylinder holding portion 70, and the wall 18 are not particularly limited, but from the viewpoint of facilitating precision processing, keeping the clip 5 and the ring 2 housed therein hygienic, and preventing damage to the clip 5. , Preferably composed of synthetic resin. It is preferable that at least one of the first case body 25 and the second case body 26 is made of a transparent or translucent material. It becomes easier for the operator to connect the clip 5 and the linear object 30 while visually checking.

1: Clip cartridge 2: Ring, 2L: Bottom end of ring 3: Central axis 4: Lumen 5: Clip, 5A: Tip, 5B: Base end, 5C: First end in width direction, 5D: Width direction 2nd end, 6: 1st arm, 7: 2nd arm, 8: Connection, 9: Connected part 10: Clip case, 11: Insertion port, 12: Insertion passage, 14: 1st mounting Surface, 16: 2nd mounting surface, 18: Wall, 25: 1st case body, 26: 2nd case body 27: Elastic piece, 27A: 1st end, 27B: 2nd end 30: Linear object, 31 : Linear body, 32: Connecting part, 35: Inner cylinder, 36: Outer cylinder, 361: Outer surface, 362: Lumen, 39: Member inserted into the insertion passage 70: Outer cylinder holding part, 71: Tip u: Extension direction of the insertion passage v: Radial direction of the insertion passage x: Direction from the tip to the base end y: Opening / closing direction z: Width direction

Claims (11)

A clip cartridge for connecting a medical clip and a linear object having a connecting portion on the tip side.
With a clip case,
A ring disposed in the clip case and having a lumen into which the clip is inserted,
A clip that is arranged in the clip case and opens and closes by the ring, has a first arm portion and a second arm portion facing each other, and has a tip that holds an object and the linear object. With a clip having a base end connected to the connecting portion,
The clip case has an insertion port on its outer surface into which the connecting portion of the linear object is inserted.
The clip case communicates with the first mounting surface on which the ring is mounted, the second mounting surface on which the clip is mounted, and the insertion slot, and the linear object is inserted into the clip case. Has an insertion passage and
The first mounting surface is a surface on which the ring is mounted so that the central axis of the ring is parallel to the extending direction of the insertion passage.
The second mounting surface is a surface different from the first mounting surface.
In the clip case, the first mounting surface is located on the side farther from the insertion port than the insertion passage, and the second mounting surface is farther from the insertion port than the first mounting surface. Located on the side,
In a mounting state in which the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the lowermost end of the clip is located at a position lower than the lowermost end of the ring. can be,
The clip case has an outer cylinder holding portion protruding inward in the radial direction of the insertion passage on the inner surface thereof, and the outer cylinder holding portion is closer to the insertion port than the first mounting surface. Clip cartridge located on the near side. The linear object is arranged in the lumen of the outer cylinder, and is arranged in the lumen of the outer cylinder.
The clip cartridge according to claim 1, wherein the outer cylinder holding portion presses the outer surface of the outer cylinder. The clip cartridge according to claim 1 or 2, wherein the outer cylinder holding portion is provided on a side closer to the first mounting surface than the insertion port. The clip cartridge according to claim 3, wherein the outer cylinder holding portion is provided on the side close to the insertion port when the extended length of the insertion passage is divided into two equal parts. The outer cylinder holding portion has a portion in which the height of the outer cylinder holding portion in the radial direction of the insertion passage increases toward the side closer to the first mounting surface, according to claims 1 to 4. The clip cartridge described in any one of the items. The clip cartridge according to any one of claims 1 to 5, wherein the outer cylinder holding portion can be moved to a side opposite to the protruding direction. The clip case has a first case body having the second mounting surface and a second case body covering the first case body.
The clip cartridge according to any one of claims 1 to 6, wherein the outer cylinder holding portion is on the inner surface of the first case body. The first case body is provided with an elastic piece extending in the first direction parallel to the extending direction of the insertion passage.
The elastic piece has a first end close to the insertion slot in the first direction and a second end opposite to the first end.
The second end side of the elastic piece is fixed to the first case body, and the first end side of the elastic piece can be elastically deformed with the second end side as a fulcrum.
The clip cartridge according to claim 7, wherein the outer cylinder holding portion is provided on the first end side of the elastic piece. In a mounting state in which the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the tip of the outer cylinder holding portion is closer to the lowermost end of the ring. The clip cartridge according to any one of claims 1 to 8 in a high position. In a mounting state in which the ring is mounted on the first mounting surface and the clip is mounted on the second mounting surface, the tip of the outer cylinder holding portion is the lumen of the ring. The clip cartridge according to any one of claims 1 to 9, which is located higher than the lowermost end. The line-shaped object is placed in the lumen of the outer cylinder, and is located in the lumen of the outer cylinder.
The outer cylinder holding portion can press the outer surface of the outer cylinder.
According to any one of claims 1 to 10, the clip case has a wall inside which the distal end of the outer cylinder abuts between the insertion passage and the first mounting surface. The clip cartridge described.

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