JP6937323B2 - Medical clip cartridge - Google Patents

Description

The present invention relates to a medical clip cartridge used when connecting a medical clip and a linear object such as a wire.

In endoscopic treatment, a medical clip is used to grip the tissue to be treated such as the affected area. The medical clip is attached to the distal side of a wire or other linear object and is carried into the patient's body. A clip device with a linear object and a clip attached to the distal side 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 so that the patient's body can be treated. A clip treatment is performed inside the body. A plurality of medical clips are often used during one treatment, and it is necessary to attach a new clip to the clip device for each clipping operation. However, since the size of the medical clip is very small, about 1 cm at the most, it is difficult to attach the clip by hand, and it is very difficult especially for an unskilled person or a person wearing sterilized gloves. Become. On the other hand, since the clip attachment work is performed during the treatment, it is desired that the clip attachment work be performed accurately and promptly. Therefore, in order to facilitate the work of attaching the clip to the linear object, a clip cartridge is used as a connecting aid.

For example, Patent Document 1 discloses that a clip unit is composed of a clip and a tightening ring, the clip unit is housed inside a clip cartridge, and a connecting portion of an operation wire is connected to a base end of the clip. In Patent Document 2, the clip unit includes a clip body and a tightening ring, and the hook is hooked by inserting the hook at the front end of the operation wire into the case from the state where the clip unit is preliminarily housed in the clip case. It is disclosed that a clip unit is attached to the. In Patent Document 3, the clip unit is composed of a clip, a connecting member, and a holding tube as a tightening member, the clip unit is housed in the clip unit storage portion of the clip case, and the arrowhead hook of the operation wire is stored in the connecting member of the clip unit. Is disclosed to combine. In Patent Document 4, in a clip case housed in a state where a plurality of clips and a connecting ring are connected, a connecting clip body holds a dummy clip that engages with a turn portion of the last clip and a dummy clip. It is disclosed that a hook composed of a connecting member and provided at the tip of an operation wire is connected to a connecting clip body.

Japanese Unexamined Patent Publication No. 2014-188345 Japanese Unexamined Patent Publication No. 2013-63107 Japanese Unexamined Patent Publication No. 2009-11852 Japanese Unexamined Patent Publication No. 2010-35808

By using the clip cartridges disclosed in Patent Documents 1 to 4, a connecting portion or a connecting hook attached to the distal side of a linear object such as a wire can be connected to the clip. However, in the case of a clip of a type in which the base end portion of the clip is expanded and connected to a linear object, a tightening ring is arranged at the base end portion of the clip body in the clip cartridge. That is, if the base end of the clip is arranged inside the tightening ring, the base end of the clip body is restricted by the inner diameter of the tightening ring and is difficult to open. It becomes difficult to connect to the base end of. In addition, since the size and shape of the connecting portion of the linear object connected to the base end of the clip body are also limited, the clip is clipped when the linear object is moved to the proximal side after the clip and the linear object are connected. May come off from the linear object.
The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a clip cartridge that makes it easy to connect a clip to a linear object having a connecting portion on the distal side.

The medical clip cartridge of the present invention that has achieved the above object is for connecting a medical clip to the connecting portion of a linear object having a connecting portion on the distal side, and is a linear object. The insertion port for inserting the clip, the insertion path extending from the insertion port toward the distal side, the clip body storage part that communicates with the distal side of the insertion path and stores the clip body, and the tightening that tightens the clip body to the insertion path. It has a ring accommodating portion for accommodating the attached ring, and the ring accommodating portion is provided with a contact portion for stopping the movement of the tightening ring in the extending direction of the insertion path, and is provided at the distal end of the tightening ring. The gist is that is located proximal to the proximal end of the clip body. Further, another medical clip cartridge of the present invention that has achieved the above object is for connecting a medical clip to the connecting portion of a linear object having a connecting portion on the distal side. , An insertion port for inserting a linear object, an insertion path extending from the insertion port toward the distal side, a clip body storage portion that communicates with the distal side of the insertion path and stores the clip body, and a clip in the insertion path. It has a ring storage part for storing a tightening ring for tightening the main body, and the ring storage part is provided with a contact part for stopping the movement of the tightening ring in the extending direction in the extending direction, and the ring storage part is provided. The point is that the distal end of the clip is located proximal to the proximal end of the clip body compartment.

In the clip cartridge of the present invention, the contact portion contacts the tightening ring to stop the movement of the tightening ring, so that the clip body and the tightening ring can be prevented from coming into contact with each other. Therefore, it is possible to prevent the tightening ring from moving to the distal side of the proximal end of the clip body and the base end portion of the clip body from entering the inside of the tightening ring, and the base end portion of the clip body is tightened. It is easy to open without being restricted by the inner diameter of the attached ring. Therefore, it becomes easy to connect the connecting portion of the linear object to the base end portion of the clip body.

The contact portion is preferably a protrusion that protrudes from the inner surface of the insertion path. The movement of the tightening ring can be stopped by the protrusion contacting the tightening ring.

The protrusion is preferably composed of a distal protrusion and a proximal protrusion, and a ring accommodating portion is preferably arranged between the distal protrusion and the proximal protrusion. Since the distal protrusion abuts on the surface of the tightening ring facing the clip body storage side, the tightening ring can be prevented from moving to the distal side of the insertion path. Further, since the proximal side protrusion comes into contact with the surface of the tightening ring facing the insertion port side, it is possible to prevent the tightening ring from moving to the proximal side of the insertion path.

In the radial direction of the insertion path, it is preferable that the distal protrusion protrudes inward from the proximal protrusion. This makes it difficult for the tightening ring to move to the distal side.

It is preferable that a plurality of distal protrusions are provided and only one proximal protrusion is provided. Since the linear object basically moves toward the distal side, the tightening ring follows the connecting part of the linear object to the distal side rather than the possibility of moving to the proximal side. It is more likely to move. Therefore, the movement of the tightening ring can be reliably stopped by providing a plurality of protrusions on the distal side.

The protrusions are preferably formed so as to be removable from the insertion path. If the protrusion is formed in this way, when the clip device is taken out from the clip cartridge after connecting the linear object to the clip, even if the clip device is caught by the protrusion, the clip can be removed by removing the protrusion. The device can be easily removed from the clip cartridge.

The clip cartridge has a clip cartridge body and a clip cartridge cover, and the clip cartridge body has a first groove for forming an insertion path and a second groove for forming a clip body storage portion, and clips the clip cartridge body. It is preferable that the ring storage portion and the clip body storage portion are formed by covering with the cartridge cover. When the clip cartridge is configured in this way, the clip cartridge can be easily manufactured, the clip can be set in the clip cartridge, and the clip device in which the linear object is connected to the clip can be easily taken out from the clip cartridge. Will be.

In order to simplify the configuration of the clip cartridge, it is preferable that the contact portion is provided on the first groove of the clip cartridge body or the surface of the clip cartridge cover facing the clip cartridge body.

The present invention is also a medical clip system for attaching a clip to a medical clip device, the clip cartridge, a clip body for picking an object, a clip having a tightening ring for tightening the clip body, and a distal clip. It has a linear object having a connecting portion on the side, and the clip body has a grip portion that grips the object on the distal side and a base end portion that connects to the connecting portion of the linear object on the proximal side. It also offers a clip system.

In the above clip system, it is preferable that the inner diameter of the tightening ring is larger than the maximum outer diameter of the connecting portion. By configuring the clip system in this way, when connecting the clip to the linear object, the connecting portion can smoothly pass through the lumen of the tightening ring.

In the clip system, the clip body is formed by arranging two gripping members facing each other; at the base end portion, at least one of the two gripping members, on the side facing the gripping member. A protruding engaging portion is provided; at the proximal end, the two gripping members are movable at least in a direction away from each other; the connecting portion may be coupled to the engaging portion of the clip body. preferable. By making the base end portion of the clip body open in this way, it becomes easy to connect the clip body and the linear object.

In the clip system, the engaging portion of one gripping member is the first claw protruding toward the other gripping member, and the engaging portion of the other gripping member projects toward the one gripping member. It is the second claw, and it is preferable that the following equations (1) and (2) are satisfied.
0 ≤ L ₁ / A ₁ ≤ 0.87 (1)
0 ≤ L ₂ / A ₁ ≤ 0.87 (2)
Here, L ₁ is the maximum length of the first claw in the opening / closing direction of the _{base end, L 2} is the maximum length of the second claw in the opening / closing direction of the _{base end, and A 1} is the maximum length of the second claw in the opening / closing direction of the base end. It is the maximum separation distance between the gripping members in the portion where the engaging portion of the base end portion is not provided in the opening / closing direction of the portion. By using the engaging portion as a claw in this way, the clip body and the linear object are firmly connected, so that the connecting portion is less likely to come off from the engaging portion.

In the clip system, it is preferable that the connecting portion is provided with an engaging receiving portion that engages with the engaging portion of the clip body. As a result, the clip and the linear object can be easily connected.

The clip system preferably satisfies the following equations (3) and (4).
A ₂ <R ₁ (3)
0.13 ≤ (A ₂ / R ₁ ) ≤ 0.50 (4)
Here, A ₂ is the minimum separation distance between the gripping members of the base end portion in the opening / closing direction of the base end portion in a state where the engaging portion and the engaging receiving portion are not engaged, and R ₁ is the engagement. The maximum outer diameter of the receiving part. As a result, the clip body and the linear object are firmly connected to each other, so that the connecting portion is less likely to come off from the engaging portion.

The clip system preferably satisfies the following equations (5) and (6).
L ₃ <R ₂ (5)
L ₄ > R ₂ (6)
Here, L ₃ is the maximum length of the base end portion in the opening / closing direction of the base end portion in a state where the engaging portion and the engagement receiving portion are not engaged, and L ₄ is the two base end portions. It is the maximum length of the base end portion in the opening / closing direction of the base end portion at the time of the maximum separation of the gripping members, and R ₂ is the inner diameter of the tightening ring. That is, when the engaging portion and the engaging receiving portion are not engaged, the base end portion passes through the tightening ring, and when the two gripping members are maximally separated, the base end portion does not pass through the tightening ring. _{By setting L 3} in this way, the tightening ring can close the grip portion of the clip body by moving the tightening ring from the base end portion to the grip portion side. _{Further, by setting L 4} as described above, the base end portion of the clip body opens wide beyond the inner diameter of the tightening ring, so that the connecting portion of the linear object can be easily connected to the base end portion of the clip body. Become.

Further, the clip system has an inner cylinder for arranging a linear object in the lumen, the inner diameter of the tightening ring is smaller than the outer diameter of the inner cylinder, and the outer diameter of the tightening ring is large. It is preferably larger than the inner diameter of the inner cylinder. As a result, the tightening ring and the inner cylinder body come into contact with each other, and the tightening ring moves to the distal side of the clip body, so that the grip portion of the clip body can be closed.

The present invention also provides a method of manufacturing a medical clip device using the clip cartridge. The method for manufacturing a clip device of the present invention includes a clip body for picking an object, a clip having a tightening ring for tightening the clip body, and a linear object having a connecting portion on the distal side, and the clip body has a clip body. Distal to the step of preparing a clip device having a gripping portion for gripping an object on the distal side and a proximal end portion connecting to a connecting portion of a linear object on the proximal side, and an insertion path of a clip cartridge. It is preferable to have a step of inserting a linear object having a connecting portion on the side and connecting the connecting portion to the clip body on the distal side of the distal end of the tightening ring.

Another method of manufacturing the clip device of the present invention includes a clip body for picking an object, a clip having a tightening ring for tightening the clip body, a linear object having a connecting portion on the distal side, and a linear object in the lumen. A clip having an inner cylinder for arranging an object, and a clip body having a grip portion for gripping an object on the distal side and a base end portion for connecting the connecting portion of a linear object on the proximal side. In the process of preparing the device, a linear object having a connecting part on the distal side is inserted into the insertion path of the clip cartridge, and the connecting part is connected to the clip body on the distal side of the distal end of the tightening ring. It is preferable to have a step of moving the connecting portion proximal to the inner cylinder and arranging the connecting portion in the lumen of the inner cylinder.

In the clip cartridge of the present invention, the contact portion contacts the tightening ring to stop the movement of the tightening ring, so that the clip body and the tightening ring can be prevented from coming into contact with each other. Therefore, it is possible to prevent the tightening ring from moving to the distal side of the proximal end of the clip body and the base end portion of the clip body from entering the inside of the tightening ring, and the base end portion of the clip body is tightened. It is easy to open without being restricted by the inner diameter of the attached ring. Therefore, it becomes easy to connect the connecting portion of the linear object to the base end portion of the clip body.

Represents a plan view of a clip cartridge. The plan view which removed the cover of the clip cartridge shown in FIG. 1 is shown. The clip cartridge and the clip device are shown, and the plan view showing the clip cartridge cover omitted is shown. Shows a side view of the clip body. An enlarged view of the base end portion of the clip body shown in FIG. 4 is shown. A perspective view of a connecting portion of a clip device is shown. A side view of a connecting portion of a clip device is shown. It represents a clip system and represents an enlarged plan view of the VIII portion shown in FIG. It represents a clip system and represents an enlarged plan view of the VIII portion shown in FIG. It represents a clip system and represents an enlarged plan view of the VIII portion shown in FIG. It represents a clip system and represents an enlarged plan view of the VIII portion shown in FIG. A perspective view of the proximal side including the contact portion of the clip cartridge is shown. A perspective view of the proximal side including the contact portion of the clip cartridge is shown. Represents a plan view of a clip cartridge. A perspective view of the proximal side including the contact portion of the clip cartridge is shown. A perspective view of the proximal side including the contact portion of the clip cartridge is shown. A perspective view of the proximal side including the contact portion of the clip cartridge is shown. A perspective view of the proximal side including the contact portion of the clip cartridge is shown.

The present invention relates to a medical clip cartridge for connecting a medical clip to the connecting portion of a linear object having a connecting portion on the distal side. The clip cartridge of the present invention is used to connect a clip to a linear object when performing a procedure using a clip device under an endoscope. By inserting the clip device to which the clip is attached into the forceps channel from the forceps opening of the endoscope and transporting the clip to the tissue to be treated, the operation with the clip can be performed in the patient's body. A clip device capable of using the clip cartridge of the present invention includes at least a clip and a linear object, and the linear object includes at least a connecting portion and a linear object main body.

Hereinafter, the present invention will be specifically described based on the following embodiments, but the present invention is not limited by the following embodiments as well as the present invention, and appropriate modifications are made to the extent that it can be adapted to the purpose of the above and the following. Of course, it is also possible to carry out the above, 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. In addition, the dimensions of various members in the drawings may differ from the actual dimensions because priority is given to contributing to the understanding of the features of the present invention.

1 to 3 show a plan view of the clip cartridge. FIG. 1 shows a clip cartridge with a cover attached, and FIG. 2 shows a state with the cover of the clip cartridge shown in FIG. 1 removed. Further, FIG. 3 shows a clip cartridge main body in a state where the clip is stored. When connecting a clip to a linear object using a clip cartridge, the clip body and the tightening ring are arranged in the cartridge, and then a cover is attached to the clip cartridge body for use.

Before explaining the clip cartridge in detail, a configuration example of the clip system will be described first with reference to FIGS. 3 to 7. FIG. 3 shows a state in which a linear object having a connecting portion on the distal side is inserted into the clip cartridge main body in a state where the clip is stored, FIG. 4 shows a side view of the clip main body, and FIG. 5 is a view. 4 shows an enlarged view of the base end portion of the clip body, FIG. 6 shows a perspective view of the connecting portion of the linear object, and FIG. 7 shows a side view showing a modified example of the connecting portion of the linear object. There is. As shown in FIG. 3, the clip system 20 includes a clip cartridge 1, a clip having a clip body 21 and a tightening ring 29, and a clip device 40 having a linear object 30 having a connecting portion 32 on the distal side. It is preferable to provide.

The clip device 40 is configured by connecting the proximal side of the clip body 21 to the distal side of the linear object 30. At this time, the tightening ring 29 is located on the distal side of the linear object 30. The tightening ring 29 may be placed on the linear object main body 31, or may overlap the linear object main body 31 on the proximal side when the connecting portion 32 is provided on the distal side. Although not shown, it is preferable that an operation unit for operating the linear object 30 is provided on the proximal side of the linear object 30. By operating the operation unit of the clip device 40 under the endoscope, the direction of the clip can be changed, the opening and closing of the clip can be controlled, and the object can be gripped by the clip. It is preferable to provide a connecting portion 32 on the distal side of the linear object main body 31 of the clip device 40 to form the linear object 30. By connecting the connecting portion 32 of the linear object 30 to the clip, the clip main body 21 can be attached to the distal side of the linear object 30. The linear object main body 31 and the connecting portion 32 may be separated and the connecting portion 32 may be attached to the distal side of the linear object main body 31, or the distal side of the linear object main body 31 may be the connecting portion 32. The proximal side of the clip device 40 or the linear object 30 refers to the direction toward the hand side of the device user with respect to the axial direction (extending direction) of the linear object 30, and is close to the distal side. Refers to the opposite direction of the position side (that is, the direction of the treatment target side).

Clips can be used to seal objects such as lesions in organs during endoscopic treatment, to grip and counter traction, and to stop bleeding, sew, and mark objects. It is a device for picking (clipping). The clip has a clip body 21 for picking an object and a tightening ring 29 for tightening the clip body 21. The clip body 21 is configured so that the distal side can be opened and closed by a tightening ring 29 with the proximal side as a fulcrum.

As shown in FIG. 4, the clip main body 21 has a grip portion 22 for gripping the object on the distal side and a base end portion 23 for connecting to the connecting portion 32 of the linear object 30 on the proximal side. The clip main body 21 is formed by arranging two gripping members 24 (24A, 24B) facing each other. In that case, it is preferable that at least one of the two gripping members 24 of the base end portion 23 is provided with an engaging portion 25 projecting toward the opposite gripping member 24. The connecting portion 32 is connected to the engaging portion 25 of the clip body 21. The two gripping members 24 are movable at the proximal end portion 23 in at least directions that are separated from each other (preferably, directions that are separated from each other and directions that are close to each other). By making the base end portion 23 of the clip main body 21 open, it becomes easy to connect the clip main body 21 and the linear object 30. In order to firmly connect the connecting portion 32, it is preferable that the two gripping members 24 are provided with the engaging portions 25, respectively.

The engaging portion 25 of the clip body 21 can be selected from various shapes as long as it can be connected to the connecting portion 32 of the linear object 30. The shape of the engaging portion 25 of the clip body 21 is a claw shape protruding toward the opposite gripping member 24, a plate shape, a hemispherical shape, a semi-elliptical spherical shape, a columnar shape, a prismatic shape, a conical shape, a pyramidal shape, or the like. It may be a convex portion of. The engaging portion 25 is preferably provided at any of the base end portions 23 shown in FIGS. 4 to 5. The engaging portion 25 can be selected in various shapes and positions, and among them, as shown in FIGS. 4 to 5, the claw 26 provided at the proximal end of the clip body 21 is preferable. In particular, the engaging portion 25 of one gripping member 24A is the first claw 26 protruding toward the other gripping member 24B, and the engaging portion 25 of the other gripping member 24B is on the one gripping member 24A side. It is preferable that the second claw 26 is protruding toward the surface. In that case, it is preferable to satisfy the following equations (1) and (2).
0 ≤ L ₁ / A ₁ ≤ 0.87 (1)
0 ≤ L ₂ / A ₁ ≤ 0.87 (2)
Here, L ₁ is the maximum length of the first claw 26 in the opening / closing direction of the base end portion 23, and L ₂ is the maximum length of the second claw 26 in the opening / closing direction of the base end portion 23. ₁ is the maximum separation distance between the gripping members 24 at the portion where the engaging portion 25 of the proximal end portion 23 is not provided in the opening / closing direction of the proximal end portion 23. By using the engaging portion 25 as the claw 26 in this way, the clip main body 21 and the linear object 30 are firmly connected, so that the connecting portion 32 is less likely to come off from the engaging portion 25.

The size and angle of the claw 26 can be appropriately selected according to the shape of the connecting portion 32. Further, in order to suppress friction caused by contact with the connecting portion 32, the engaging portion 25 may be hemispherical or semi-elliptical spherical. The separation distance of the gripping member 24 in the engaging portion 25 in the opening / closing direction of the base end portion 23 may be constant or may change in the long axis direction of the clip main body 21. For example, the separation distance of the gripping member 24 may be smaller toward the distal side. In that case, since the distance between the gripping members 24 is large on the proximal side, it is easy to insert the connecting portion 32 between the gripping members 24, while the distance between the gripping members 24 is small on the distal side. Therefore, the engaging portion 25 and the connecting portion 32 are firmly engaged.

The clip body 21 is formed, for example, by bending one metal plate into a U-shape or a V-shape. Further, the clip main body 21 may be formed by connecting two metal plates arranged so as to face each other.

As shown in FIGS. 4 to 5, in order to keep the separation distance of the gripping member 24 at the base end portion 23 of the clip body 21 constant, the base end portion 23 of one gripping member 24 (24A) and the other A reinforcing portion 27 may be provided to connect the base end portions 23 of the gripping member 24 (24B) to each other. The reinforcing portion 27 is preferably provided on the distal side of the proximal end portion 23 so as not to hinder the engagement between the clip body 21 and the connecting portion 32. The gripping members 24A and 24B may face each other at the base end portion 23 of the clip main body 21, and the separation distance of the gripping member 24 at the base end portion 23 in the opening / closing direction of the base end portion 23 of the clip main body 21 may be constant. Well, it may be changing. For example, it may be narrowed or widened toward the distal side of the proximal end 23. In FIG. 4, the clip main body 21 including the reinforcing portion 27 is formed of one metal plate, but a member different from the clip main body 21 may be provided as the reinforcing portion 27. The reinforcing portion 27 is preferably made of the same or different material as the gripping member 24, and its thickness may be the same as or different from that of the gripping member 24. When the reinforcing portion 27 is a member different from the clip main body 21, the reinforcing portion 27 is attached to the gripping member 24 by a method such as mechanical fixing with screws, caulking or the like, welding, adhesion or the like.

The clip is provided with a tightening ring 29 that surrounds the clip body 21 and tightens the clip body 21. By moving the tightening ring 29 from the proximal side to the distal side of the clip body 21 by bringing the inner cylinder 37 and the tightening ring 29, which will be described later, into contact with each other, the tightening ring 29 is moved from the clip body 21 to the clip body 21. It is configured to close the grip portion 22.

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

As shown in FIG. 6, the linear object 30 is formed in a linear shape and has a connecting portion 32 on the distal side thereof. Specifically, the linear object 30 has a linear object main body 31 and a connecting portion 32 provided on the distal side of the linear object main body 31. It is desirable that the linear object main body 31 has both the flexibility of bending along the shape in the body cavity and the rigidity of reliably reaching the tissue to be treated in a well-balanced manner. Examples of the linear object main body 31 include metal wire rods such as stainless steel and carbon steel, polyamide resin (for example, nylon), polyolefin resin (for example, polyethylene and polypropylene), polyester resin (for example, PET), and aromatic poly. A thread formed from a synthetic resin such as an ether ketone resin (for example, PEEK), a polyimide resin, and a fluororesin (for example, PTFE, PFA, ETFE) can be used. The yarn may be a monofilament yarn, a multifilament yarn, or a spun yarn.

The connecting portion 32 is preferably made of a biocompatible material. For example, like the clip body 21 and the tightening ring 29, the connecting portion 32 is made of stainless steel such as SUS301, SUS303, SUS304, SUS631 or Ni—Ti alloy. It is preferably composed of. In addition, polyamide resin (for example, nylon), polyolefin resin (for example, polyethylene or polypropylene), polyester resin (for example, PET), aromatic polyetherketone resin (for example, PEEK), polyimide resin, fluororesin (for example, PTFE, etc.) It may be composed of a synthetic resin such as PFA or ETFE).

It is preferable that the connecting portion 32 of the linear object 30 is provided with an engaging receiving portion 33 that engages with the engaging portion 25 of the clip body 21. As a result, the clip and the linear object 30 can be easily connected. The shape of the engaging receiving portion 33 is not particularly limited as long as it can engage with the engaging portion 25 of the clip main body 21, and it is preferable that the engaging receiving portion 33 has an outer diameter similar to that of the linear object main body 31, for example. The engagement receiving portion 33 is preferably, for example, a claw, a hook, a convex portion, a concave portion, a through hole, or a combination thereof in order to engage with the engaging portion 25 of the clip body 21. Above all, the engaging receiving portion 33 is preferably a through port 33A that engages with the engaging portion 25 of the clip main body 21. As a result, the clip body 21 and the linear object 30 can be easily connected, and the simple structure enhances productivity. In the embodiment shown in FIG. 6, the connecting portion 32 is provided with a through port 33A as the engaging receiving portion 33, and in the embodiment shown in FIG. 7, the connecting portion 32 is provided with the through opening 33A as the engaging receiving portion 33. A convex portion 33B on the distal side of the through hole 33A is provided. In FIG. 7, a mode without the through port 33A is also preferable as a mode of the connecting portion.

The length of the connecting portion 32 in the major axis direction may exceed the length of the insertion path 3 or may be shorter than the length of the insertion path 3. When the length of the connecting portion 32 in the major axis direction is shorter than that of the insertion path 3, the connecting portion 32 and the linear object main body 31 may be inserted into the insertion path 3 with the connecting portion 32 at the head.

The connecting portion 32 may have a flat portion 35 on the distal side as shown in FIG. If the flat portion 35 is formed on the distal side of the connecting portion 32, the flat portion 35 can be easily inserted into the portion of the base end portion 23 where the two gripping members 24 are arranged apart from each other. By engaging the engaging portion 25 and the connecting portion 32, the connecting portion 32 and the clip main body 21 can be easily connected. In the clip device 40 and the connecting portion 32 shown in FIGS. 3 and 6, a through port 33A is provided in the flat portion 35 of the connecting portion 32, and the base end portion 23 of the clip main body 21 is fitted into the through opening 33A. As a result, the connecting portion 32 can be connected to the clip main body 21.

Various combinations can be used for the engaging portion 25 of the clip body 21 and the connecting portion 32 of the linear object 30. For example, a claw is provided as the engaging portion 25, and a through hole is provided in the connecting portion 32 so that the claw provided on one side and the through hole on the other side mesh with each other, or claws are provided on both sides so that the claws mesh with each other. Can be connected.

As shown in FIG. 3, it is preferable that at least a part of the linear object 30 is arranged in the inner cylinder 37. That is, the clip system 20 preferably has an inner cylinder 37 for arranging the linear object 30 in the lumen. By configuring the clip system 20 in this way, when the clip main body 21 is connected to the linear object 30 and used, the linear object 30 is moved to the proximal side or the distal side with respect to the axial direction. , The opening degree of the grip portion 22 of the clip body 21 can be adjusted. For example, by moving the linear object 30 to the proximal side with respect to the inner cylinder 37, the tightening ring 29 and the inner cylinder 37 come into contact with each other, and the tightening ring 29 is moved to the distal side of the clip body 21. By moving, the grip portion 22 of the clip body 21 can be closed. Further, the connecting portion 32 of the linear object 30 can be freely inserted and removed from the inner cylinder 37. It is preferable that the inner diameter of the tightening ring 29 is larger than the maximum outer diameter of the connecting portion 32. By configuring the clip system 20 in this way, when the clip main body 21 is connected to the linear object 30, the connecting portion 32 can smoothly pass through the lumen of the tightening ring 29. Further, it is preferable that the inner diameter of the tightening ring 29 is smaller than the outer diameter of the inner cylinder 37, and the outer diameter of the tightening ring 29 is larger than the inner diameter of the inner cylinder 37. By configuring the clip system 20 in this way, the tightening ring 29 and the inner cylinder 37 come into contact with each other, and the tightening ring 29 moves to the distal side of the clip body 21, so that the grip portion of the clip body 21 is gripped. 22 can be closed.

It is desirable that the inner cylinder 37 has both the flexibility to bend along the shape in the body cavity and the rigidity to surely reach the tissue to be treated in a well-balanced manner. The inner tubular body 37 is formed of, for example, a tubular body formed of a coiled metal or synthetic resin, a tubular body formed by connecting a plurality of short tubular joint pieces in the axial direction and making them rotatable, and a synthetic resin. It can be composed of a tubular body.

Although not shown, the clip system 20 may further have an outer cylinder, in which case the inner cylinder 37 is arranged inside the outer cylinder. It is preferable that the outer cylinder body is formed so that the clip main body 21 can be freely taken in and out of the outer cylinder body in a state where the clip main body 21 is connected to the linear object 30. By configuring the clip system 20 in this way, the clip system 20 is inserted into the forceps channel from the forceps opening of the endoscope, and the clip body 21 is conveyed near the target tissue by the outer cylinder. , It is possible to prevent the clip body 21 from damaging the forceps channel in the endoscope, internal tissues other than the lesion, and the like.

It is desirable that the outer cylinder has both the flexibility to bend along the shape in the body cavity and the rigidity to surely reach the tissue to be treated in a well-balanced manner. For the outer cylinder, for example, a cylinder made of synthetic resin, a cylinder made of coiled metal or synthetic resin, and a plurality of short-cylindrical joint pieces are connected in the axial direction to be rotatable. It can be composed of a cylinder. As the outer cylinder, a cylinder made of synthetic resin is preferably used, and the outer cylinder is so that the user (operator) can visually confirm the positional relationship between the outer cylinder and the inner cylinder 37. The cylinder is preferably made of a transparent or translucent material.

The clip cartridge 1 is used to easily attach the clip to the clip system 20. As shown in FIGS. 1 to 3, the clip cartridge 1 has an insertion port 2 into which the linear object 30 is inserted, an insertion path 3 extending from the insertion port 2 toward the distal side, and a distal side of the insertion path 3. The clip main body storage portion 4 for accommodating the clip main body 21 and the ring storage portion 5 for accommodating the tightening ring 29 for tightening the clip main body 21 in the insertion path 3 are provided. A contact portion 6 for stopping the movement of the insertion path 3 of the attachment ring 29 in the extending direction is provided, and the distal end of the tightening ring 29 is arranged proximal to the proximal end of the clip body 21. ing.

Further, the other clip cartridge 1 of the present invention communicates with the insertion port 2 into which the linear object 30 is inserted, the insertion path 3 extending from the insertion port 2 toward the distal side, and the distal side of the insertion path 3. The ring storage unit 5 has a clip body storage unit 4 for storing the clip body 21, and a ring storage unit 5 for storing a tightening ring 29 for tightening the clip body 21 in the insertion path 3. The ring storage unit 5 has a tightening ring 29. A contact portion 6 for stopping the movement of the insertion path 3 in the extending direction is provided, and the distal end of the ring accommodating portion 5 is arranged proximal to the proximal end of the clip body accommodating portion 4. There is.

When using the clip cartridge 1, the clip main body 21 is arranged in the clip main body storage portion 4, the contact portion 6 is brought into contact with the tightening ring 29, and the tightening ring 29 is arranged in the ring storage portion 5. By inserting the linear object 30 into the insertion path 3 from the insertion port 2, the connecting portion 32 provided on the distal side of the linear object 30 can be appropriately connected to the clip main body 21. When using the clip cartridge 1, instead of arranging the clip in the cartridge, the clip cartridge 1 in which the clip main body 21 and the tightening ring 29 are housed in advance can be used. In the clip cartridge 1, the insertion port 2 side is referred to as the proximal side, and the side in which the clip body 21 is housed is referred to as the distal side.

The clip body storage unit 4 is a space for storing the clip body 21. The clip main body 21 is stored in the clip main body storage portion 4 with the grip portion 22 open. The clip main body storage portion 4 is formed in the clip cartridge 1 so that the base end portion 23 (proximal side of the clip main body 21) of the clip main body 21 is arranged toward the insertion path 3. The clip cartridge 1 of the present invention includes both a case in which the clip main body 21 is stored in the clip main body storage portion 4 and a case in which the clip main body 21 is not stored. The clip main body storage portion 4 may have a space for arranging the connecting portion 32 of the linear object 30 on the proximal side of the proximal end of the clip main body 21.

The clip body storage portion 4 may be provided with a protrusion 4A for stopping the movement of the clip body 21. For example, by bringing the reinforcing portion 27 of the clip main body 21 into contact with the protrusion 4A, the clip main body 21 becomes difficult to move to the distal side. The shape of the protrusion 4A may be, for example, a circular shape, an elliptical shape, a polygonal shape such as a rectangle or a triangle, or a combination thereof. In FIGS. 1 to 3, the protrusion 4A is formed in a circular shape on the distal side and an elongated rectangle extending from the center of the circle to the proximal side on the proximal side, but the shape of the protrusion is not particularly limited.

The insertion path 3 is a passage for inserting the linear object 30, and is formed so as to connect the insertion port 2 and the clip body storage portion 4. The insertion path 3 is usually formed so as to extend straight from the insertion port 2 to the clip body storage section 4, and the extension direction of the insertion path 3 is the direction from the insertion port 2 to the entrance of the clip body storage section 4. Correspondingly, the proximal side of the insertion path 3 in the extending direction is the insertion port 2 side of the insertion path 3, and the distal side is the clip body storage portion 4 side. The insertion port 2 corresponds to the entrance of the insertion path 3 and is formed on the outer surface of the clip cartridge 1.

The ring storage portion 5 is a space for storing the tightening ring 29 for tightening the clip main body 21, and is provided in the middle of the insertion path 3. 8 to 11 show the inside of the clip cartridge, and show an enlarged plan view of the VIII portion shown in FIG. In FIGS. 8 to 11, the tightening ring 29 is housed in the ring storage portion 5 in a state where the central axis in the radial direction is along the extending direction of the insertion path 3. The clip cartridge 1 of the present invention includes both the one in which the tightening ring 29 is stored in the ring storage portion 5 and the one in which the tightening ring 29 is not stored in the ring storage portion 5.

The ring accommodating portion 5 includes a contact portion 6 for stopping the movement of the insertion path 3 of the tightening ring 29 in the extending direction. Since the abutting portion 6 can come into contact with the tightening ring 29 to stop the movement of the tightening ring 29, the tightening ring 29 moves to the distal side of the proximal end of the clip body 21 and is tightened. It is possible to prevent the base end portion 23 of the clip main body 21 from entering the inside of the ring 29, and the base end portion 23 of the clip main body 21 can be easily opened without being restricted by the inner diameter of the tightening ring 29. Therefore, the connecting portion 32 of the linear object 30 can be easily connected to the base end portion 23 of the clip main body 21. Further, it is possible to prevent the tightening ring 29 from moving to the proximal side or the distal side of the insertion path 3 and falling off from the ring accommodating portion 5 or the clip cartridge 1. In the present invention, the clip body accommodating portion 4 is arranged distal to the ring accommodating portion 5, or the distal end of the tightening ring 29 is arranged proximal to the proximal end of the clip body 21. ..

The details of the operation of the clip cartridge 1 of the present invention will be described with reference to FIGS. 8 to 11. First, as shown in FIG. 8, a clip cartridge 1 in which the clip main body 21 is arranged in the clip main body storage portion 4 and the tightening ring 29 is arranged in the ring storage portion 5 is prepared. Next, a linear object 30 having a connecting portion 32 on the distal side is inserted from the insertion port 2 of the clip cartridge 1 into the insertion path 3. In FIG. 8, as in the embodiment shown in FIG. 7, the connecting portion 32 is provided with the through-hole 33A and the convex portion 33B on the distal side of the through-hole 33A as the engaging receiving portion 33. The shape of the engaging receiving portion 33 is not particularly limited. The convex portion 33B is formed so as to project toward the distal side and taper toward the distal side. The engagement receiving portion 33 may have a shape in which the through port 33A is not provided and only the convex portion 33B is formed. In that case, the engaging portion 25 of the clip body 21 can be engaged with the convex portion 33B.

As shown in FIG. 9, the linear object 30 is moved to the distal side, the tightening ring 29 is passed through the linear object 30, and then the engaging receiving portion 33 of the connecting portion 32 of the linear object 30 is clipped to the main body. It is connected to the base end portion 23 of 21. Specifically, when the convex portion 33B of the connecting portion 32 is inserted between the engaging portions 25 (claw 26) provided on the gripping member 24, the base end portion 23 of the clip body 21 faces the gripping member 24. Move in a direction away from each other. That is, the gap between the gripping members 24 is expanded by the connecting portion 32, and the base end portion 23 of the clip main body 21 opens in the opening / closing direction of the clip main body 21. At this time, the tightening ring 29 is pushed to the distal side by the linear object 30, but the distal end of the tightening ring 29 and the protrusion 7A, which is the contact portion 6 on the distal side, come into contact with each other and tighten. Inadvertent movement of the attached ring 29 can be suppressed. When the tightening ring 29 moves so as to include the engaging portion 25 of the clip body 21 inside the tightening ring 29, the minimum separation distance (engagement) between the gripping members of the base end portion 23 in the opening / closing direction of the base end portion 23. The minimum separation distance in the portion 25) is not sufficiently widened, and the engaging portion 25 cannot be connected to the connecting portion 32.

As shown in FIG. 10, when the linear object 30 is moved to the distal side, the gap of the gripping member 24 is further widened by the convex portion 33B.

As shown in FIG. 11, when the linear object 30 is further moved to the distal side, the engaging portion 25 (claw 26) gets over the portion having the maximum outer diameter of the convex portion 33B, and the claw 26 becomes the convex portion. It engages by engaging with the through hole 33A located proximal to 33B.

As described above, in the clip cartridge 1 of the present invention, the contact portion 6 comes into contact with the tightening ring 29 to stop the movement of the tightening ring 29, so that the distal end of the tightening ring 29 is close to the clip body 21. It can be placed on the position side. Therefore, it is possible to prevent the tightening ring 29 from moving to the distal side of the proximal end of the clip body 21 and surrounding the base end portion 23 of the clip body 21, and the base end portion 23 of the clip body 21 is tightened. It becomes easy to open without being restricted by the inner diameter of the attached ring 29. This makes it easier to connect the connecting portion 32 of the linear object 30 to the base end portion 23 of the clip main body 21.

In the clip cartridge 1, the base end portion 23 of the clip body 21 is not easily covered by the tightening ring 29. Therefore, for example, as shown in FIGS. 8 to 11, at least one of the two gripping members 24 is provided with an engaging portion 25 projecting toward the opposing gripping member 24, and the connecting portion 32. Is provided with an engaging receiving portion 33 that engages with the engaging portion 25 of the clip body 21, _{it is preferable that the following A 2} and R ₁ satisfy the following equation (3).
A ₂ <R ₁ (3)
Here, A ₂ is the minimum separation distance between the gripping members 24 of the base end portion 23 in the opening / closing direction of the base end portion 23 in a state where the engaging portion 25 and the engagement receiving portion 33 are not engaged. R ₁ is the maximum outer diameter of the engaging receiving portion 33. As a result, the clip body 21 and the linear object 30 are firmly connected to each other, so that the connecting portion 32 is less likely to come off from the engaging portion 25.

Further, it is more preferable that the above A ₂ and the above R ₁ satisfy the following equation (4).
0.13 ≤ (A ₂ / R ₁ ) ≤ 0.50 (4)
As a result, the clip body 21 and the linear object 30 are more firmly connected.

When the connecting portion 32 of the linear object 30 has the engaging receiving portion 33, the proximal end portion 23 in the opening / closing direction of the proximal end portion 23 at the time of the maximum separation of the two gripping members 24 of the proximal end portion 23. The maximum length L ₄ is preferably expressed by the following equation.
L ₄ = (L ₃ + R ₁ ) -A ₂
Here, L ₃ is the maximum length of the base end portion 23 in the opening / closing direction of the base end portion 23 in a state where the engaging portion 25 and the engaging receiving portion 33 are not engaged, and L ₃ > A ₂ Is. By configuring the base end portion 23 of the clip body 21 to open in this way, the clip body 21 and the linear object 30 are firmly connected even if the distal end portion of the linear object 30 has a relatively large size. be able to.

The clip system preferably satisfies the following equations (5) and (6).
L ₃ <R ₂ (5)
L ₄ > R ₂ (6)
Here, R ₂ is the inner diameter of the tightening ring 29. In such a clip system, in a state where the engaging portion 25 and the engaging receiving portion 33 are not engaged, the base end portion 23 passes through the tightening ring 29, and when the two gripping members 24 are maximally separated, the base end portion 23 Does not pass through the tightening ring 29. _{By setting L 3} in this way, the tightening ring 29 can close the grip portion 22 of the clip body 21 by moving the tightening ring 29 from the base end portion 23 to the grip portion 22 side. _{Further, by setting L 4} as described above, the base end portion 23 of the clip main body 21 opens wide beyond the inner diameter of the tightening ring 29, so that the connecting portion 32 of the linear object 30 is the base of the clip main body 21. It becomes easy to connect to the end portion 23.

The contact portion 6 is preferably a protrusion (for example, 7, 7A, 7B in the drawing) protruding from the inner surface of the insertion path 3. The protrusion is formed so as to project from the inner surface of the insertion path 3 into the space of the insertion path 3 rather than the peripheral portion thereof. The movement of the tightening ring 29 can be stopped by the protrusion contacting the tightening ring 29. The contact portion 6 that contacts the tightening ring 29 and stops the movement of the tightening ring 29 is a protrusion that protrudes from the inner surface of the insertion path 3, and a recess provided on the inner surface of the insertion path 3 that will be described later. It may be 8. When the tightening ring 29 is fitted and stored in the recess 8, the distal end of the tightening ring 29 and the wall surface of the recess can come into contact with each other to stop the movement of the tightening ring 29. The protrusions will be described with reference to FIGS. 12 to 14.

The height of the protrusion is not particularly limited as long as the connecting portion 32 of the linear object 30 is formed so as to pass through the insertion path 3 in the portion of the insertion path 3 where the protrusion is provided. It is preferable that the protrusion protrudes from the inner surface of the insertion path 3 at a height that does not reach the center (or the center of gravity) of the cross section of the insertion path 3.

As shown in FIGS. 12 to 14, the protrusion is composed of the distal protrusion 7A and the proximal protrusion 7B, and the ring is housed between the distal protrusion 7A and the proximal protrusion 7B. It is preferable that the portion 5 is arranged. Since the distal projection 7A comes into contact with the surface of the tightening ring 29 facing the clip body storage portion 4, the tightening ring 29 is prevented from moving to the distal side of the insertion path 3. Further, since the proximal side protrusion 7B comes into contact with the surface of the tightening ring 29 facing the insertion port 2 side, the tightening ring 29 is prevented from moving to the proximal side of the insertion path 3.

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

One or more distal protrusions 7A and proximal protrusions 7B can be provided, respectively. In this case, the number of distal projections 7A and proximal projections 7B may be the same or different. In FIGS. 12 to 14, two distal protrusions 7A and one proximal protrusion 7B are provided. As described above, it is preferable that a plurality of distal protrusions 7A are provided and only one proximal protrusion 7B is provided. When using the clip cartridge 1, the linear object 30 is inserted from the insertion port 2 toward the distal side, and after the base end portion 23 of the clip body 21 and the linear object 30 are connected, the clip cartridge cover 16 is used. The clip body 21 is removed from the clip cartridge 1 by removing (described later) and lifting the linear object 30 to the side to which the cover is attached. In this way, since the linear object 30 basically moves toward the distal side, the tightening ring 29 may move toward the proximal side rather than the connecting portion 32 of the linear object 30. It is more likely to follow and move to the distal side. Therefore, by providing a plurality of protrusions on the distal side, the movement of the tightening ring 29 can be reliably stopped.

The heights of the distal projections 7A and the proximal projections 7B may be the same or different. Above all, it is preferable that the distal side protrusion 7A protrudes inward from the proximal side protrusion 7B in the radial direction of the insertion path 3. This makes it difficult for the tightening ring 29 to move to the distal side. Here, the height of the protrusion is the length in the direction from the inner surface of the insertion path 3 toward the center (or the center of gravity) of the cross section of the insertion path 3. The inside of the insertion path 3 in the radial direction is a direction from the wall surface of the insertion path 3 toward the center.

When a plurality of distal protrusions 7A are provided in the cross section of the insertion path 3, one distal protrusion 7A and the other distal protrusion 7A have the center of the cross section of the insertion path 3 as the central axis. It may be arranged symmetrically. As a result, the tightening ring 29 is supported by the contact portion 6 in a well-balanced manner, so that even if the linear object 30 unintentionally contacts the tightening ring 29, the movement of the tightening ring 29 can be stopped. In addition, when a plurality of proximal side protrusions 7B are provided, they can be arranged in the same manner.

The height of the protrusion may be constant or variable in the extending direction of the insertion path 3. The protrusion may be formed with an inclined surface that rises toward the distal side or the proximal side. The inclined surface provided on the distal projection 7A is preferably a surface including the proximal end of the projection. As a result, a gap can be provided between the protrusion and the tightening ring 29 while bringing the protrusion and the tightening ring 29 into contact with each other, so that the tightening ring 29 can be easily arranged in the ring storage portion 5. In FIGS. 12 to 13, an inclined surface is provided on the distal projection 7A.

When a plurality of distal protrusions 7A are provided, it is preferable that the plurality of distal protrusions 7A are arranged symmetrically with respect to the center (center of gravity) of the insertion path 3. As a result, the connecting portion 32 of the linear object 30 is fitted into the distal projection portion 7A, and the connecting portion 32 is set at an appropriate angle and position with respect to the clip main body 21 housed in the clip main body storage portion 4. Will be placed. Therefore, the clip main body 21 and the linear object 30 can be reliably connected, and erroneous operation can be prevented.

The inclined surface of the protrusion may be formed so as to be inclined linearly, or may be formed so as to be inclined so as to be curved. The inclined surface is preferably formed so as to have an angle of 20 ° or more and 60 ° or less with respect to the extending direction of the insertion path 3, for example. A plurality of inclined surfaces may be provided for one protrusion, and can be appropriately changed according to the shape of the tightening ring 29 that abuts.

Further, in order to easily manufacture the clip cartridge 1, the protrusions may be formed in a stepped shape with respect to the inner surface of the insertion path 3.

The position of the protrusion in the extending direction of the insertion path 3 is not particularly limited, and may be, for example, proximal or distal to the center of the insertion path 3 in the extending direction. If the protrusion is provided on the proximal side of the center of the insertion path 3 in the extending direction, it becomes difficult for the tightening ring 29 to reach the clip body storage portion 4 even if it moves to the distal side. If the protrusion is provided on the distal side of the center of the insertion path 3 in the extending direction, the tightening ring 29 is less likely to fall off from the insertion port 2.

The clip cartridge 1 may be composed of one member or two or more members. The clip cartridge 1 is formed with an insertion path 3 and a clip body storage portion 4 inside, and the clip cartridge 1 may be composed of at least two or more members from the viewpoint of facilitating the formation of these. preferable. For example, the clip cartridge 1 may be composed of two members, a clip cartridge main body 15 and a clip cartridge cover 16. The clip cartridge main body 15 has a first groove for forming the insertion path 3 and a second groove for forming the clip main body storage portion 4, and the clip main body is stored by covering the clip cartridge main body 15 with the clip cartridge cover 16. A portion 4 and a ring storage portion 5 are formed, respectively. By covering the first groove for forming the insertion path 3 with the clip cartridge cover 16, the insertion port 2, the insertion path 3, the clip body storage portion 4, and the ring storage portion 5 may be formed. A groove for the mouth 2 may be separately formed in the clip cartridge main body 15. When the clip cartridge 1 is configured in this way, the clip cartridge 1 can be easily manufactured, and the clip device 40 in which the clip main body 21 is set in the clip cartridge 1 or the linear object 30 is connected to the clip main body 21 is provided. It can be easily taken out from the clip cartridge 1.

The clip cartridge cover 16 may cover a part of the clip cartridge main body 15, and is composed of, for example, a member that can slide with respect to the clip cartridge main body 15. The shape of the clip cartridge cover 16 is not particularly limited as long as it can cover the first groove for forming the insertion path 3 and the second groove for forming the storage portion of the clip cartridge main body 15. In FIGS. 1 and 2, the clip cartridge cover 16 is formed in a cylindrical shape, and the clip cartridge 1 is configured so as to surround the clip cartridge main body 15 with the extending direction of the insertion path 3 as an axis. The clip cartridge cover 16 may be formed in a plate shape and may be configured to be overlapped with the clip cartridge main body 15. The surface of the clip cartridge cover 16 facing the clip cartridge body 15 may be formed flat, and the first groove for forming the insertion path 3 and the second groove for forming the clip body storage portion 4 may be formed flat. It may also be formed on the cover 16.

The contact portion 6 may be provided in the first groove of the clip cartridge main body 15 as shown in FIGS. 12 to 13, and the surface of the clip cartridge cover 16 facing the clip cartridge main body 15 (not shown). It may be provided in. This makes it possible to simplify the configuration of the clip cartridge 1. Further, the contact portion 6 may be provided on a member separate from the clip cartridge main body 15 and the clip cartridge cover 16.

Although not shown, when the contact portion 6 is a protrusion protruding from the surface of the clip cartridge cover 16 facing the clip cartridge main body 15, one or more protrusions may be provided. The protrusion provided on the cover is configured in the same manner as the protrusion provided in the first groove of the clip cartridge main body 15. Further, the protrusion is provided on the surface of the clip cartridge cover 16 facing the clip cartridge body 15 so as to abut the outer peripheral surface of the tightening ring 29 with the clip cartridge cover 16 attached to the clip cartridge body 15. May be good. By pressing the outer peripheral surface of the tightening ring 29 with the protrusion, the movement of the tightening ring 29 in the extending direction of the insertion path 3 can be stopped.

As shown in FIG. 2, even if a protrusion 16A is provided on the surface of the clip cartridge cover 16 facing the clip cartridge body 15 as a protrusion of the contact portion 6 for stopping the movement of the clip body 21. good. The shape of the protrusion 16A may be, for example, a circular shape, an elliptical shape, a polygonal shape such as a rectangle or a triangle, or a combination thereof. In FIG. 2, the protrusion 16A is formed in a rectangular shape extending over the entire perspective direction of the clip body storage portion 4, but the shape of the protrusion 16A is not particularly limited.

The protrusion may be formed so as to be removable from the insertion path 3. For example, in FIG. 14, the distal projection 7A is formed on the regulating member 17 that regulates the insertion direction of the connecting portion 32, and the regulating member 17 is slidably formed upward. The removal of the protrusion means that the protrusion is removed from the inner surface of the insertion path 3 of the clip cartridge 1, and the protrusion or a member provided with the protrusion (for example, a regulating member 17) may be separated from the clip cartridge 1. , A protrusion or a member provided with the protrusion may be slidably arranged on the clip cartridge 1. If the protrusion is formed in this way, even if the clip device 40 is caught in the protrusion when the clip device 40 is taken out from the clip cartridge 1 after the linear object 30 is connected to the clip body 21, the protrusion is formed. The clip device 40 can be easily taken out from the clip cartridge 1 by removing the portion. Further, when the clip device 40 is taken out from the clip cartridge 1, the protrusion may be removed in advance. When the clip cartridge cover 16 is attached to the clip cartridge main body 15 shown in FIG. 14, the protrusion (distal protrusion 7A) on the regulation member 17 is configured to protrude from the inner surface of the insertion path 3. The movement of the regulating member 17 can be regulated by the clip cartridge cover 16.

When the linear object 30 is inserted into the insertion path 3, the projecting portion causes the linear object 30 to rotate axially when the connecting portion 32 of the linear object 30 comes into contact with the projecting portion, and the angle and position of the connecting portion 32. Etc. may be controlled. It is preferable that the protrusion can serve both the function of storing the tightening ring 29 and the function of rotating the shaft of the linear object 30, and can simplify the configuration of the clip cartridge 1.

An example in which the contact portion 6 is the recess 8 will be described with reference to FIGS. 15 to 16. FIG. 15 shows a state in which the tightening ring 29 is arranged on the clip cartridge 1, and FIG. 16 shows a state in which the tightening ring 29 is removed from the clip cartridge 1. The contact portion 6 may be a recess 8 provided on the inner surface of the insertion path 3. In this case, the tightening ring 29 is housed in the recess 8, and the tightening ring 29 comes into contact with the inner wall surface of the recess 8, so that the movement of the tightening ring 29 in the extending direction can be stopped.

In order to accommodate the tightening ring 29, the recess 8 is formed longer than the tightening ring 29 in the extending direction of the insertion path 3. The maximum depth D of the recess 8 (height toward the outer side in the radial direction of the tightening ring 29 with reference to the inner surface of the insertion path 3) is preferably larger than the wall thickness of the tightening ring 29. As a result, the movement of the tightening ring 29 can be reliably stopped.

As shown in FIGS. 6 to 7, a thick portion 36 having an outer diameter larger than the minimum outer diameter of the engaging portion 25 may be formed on the proximal side of the connecting portion 32. When the thick portion 36 is provided in the connecting portion 32, the maximum depth D of the recess 8 preferably satisfies the following formula.
D <(R _3- R ₄ )
Here, R ₃ is the outer diameter of the tightening ring 29, and R ₄ is the maximum outer diameter of the thick portion 36.
If the maximum depth D of the recess 8 is set within the above range, the thick portion 36 can pass through the inside of the tightening ring 29 even when the tightening ring 29 is fitted in the recess 8.

The maximum depth D of the recess 8 is preferably, for example, _{30% or less of the outer diameter R 3} of the tightening ring 29, more preferably 20% or less, still more preferably 15% or less. Yes, more preferably 3% or more, and even more preferably 5% or more.

The recess 8 may be one or may be provided in plurality. For example, when a plurality of recesses 8 are provided, they can be provided on the first groove of the clip cartridge main body 15 and the surface of the clip cartridge cover 16 facing the clip cartridge main body 15.

17 to 18 show a perspective view of the proximal side including the contact portion of the clip cartridge, FIG. 17 shows a state in which the tightening ring 29 is arranged on the clip cartridge 1, and FIG. 18 shows the state from the clip cartridge 1. The state where the tightening ring 29 is removed is shown. As shown in FIGS. 17 to 18, the contact portion 6 may include both a protrusion protruding from the inner surface of the insertion path 3 and a recess 8 provided on the inner surface of the insertion path 3. As a result, the movement of the tightening ring 29 in the extending direction of the insertion path 3 is further suppressed.

The constituent materials of the clip cartridge body 15, the clip cartridge cover 16, and the regulating member 17 are not particularly limited, but synthetic resin is used from the viewpoint of facilitating precision processing, keeping the clip stored in the clip hygienic, and preventing damage to the clip. It is preferably formed from. Further, the clip cartridge cover 16 is preferably formed of a transparent or translucent material so that the user (operator) can visually confirm the work of connecting the clip body 21 to the linear object 30. ..

If the clip cartridge 1 is used, the clip main body 21 can be connected to the linear object 30 to easily manufacture the clip device 40. For example, it has a clip body 21 for picking an object, a clip having a tightening ring 29 for tightening the clip body 21, and a linear object 30 having a connecting portion 32 on the distal side, and the clip body 21 is far away. A step of preparing a clip device 40 having a grip portion 22 for gripping an object on the position side and a base end portion 23 for connecting the connecting portion 32 of the linear object 30 on the proximal side, and an insertion path for the clip cartridge 1. By inserting a linear object 30 having a connecting portion 32 on the distal side into 3, and performing a step of connecting the connecting portion 32 to the clip body 21 on the distal side of the distal end of the tightening ring 29. , Clip device 40 can be manufactured.

Further, the clip device 40 having an inner cylinder 37 includes a clip body 21 for picking an object, a clip having a tightening ring 29 for tightening the clip body 21, and a linear object 30 having a connecting portion 32 on the distal side. The clip body 21 has a grip portion 22 for gripping an object on the distal side and a linear object 30 on the proximal side. The step of preparing the clip device 40 having the base end portion 23 to be connected to the portion 32, and the linear object 30 having the connecting portion 32 on the distal side is inserted into the insertion path 3 of the clip cartridge 1 and tightened. The step of connecting the connecting portion 32 to the clip main body 21 on the distal side of the distal end of the ring 29, and moving the connecting portion 32 to the proximal side with respect to the inner cylinder 37, inside the inner cylinder 37. It can be manufactured by performing the step of placing it in the cavity.

This application claims the benefit of priority under Japanese Patent Application No. 2016-256524 filed on December 28, 2016. The entire contents of the specification of Japanese Patent Application No. 2016-256524 filed on December 28, 2016 are incorporated herein by reference.

1: Clip cartridge 2: Insertion port 3: Insertion path 4: Clip body storage part 4A: Protrusion 5: Ring storage part 6: Contact part 7: Protrusion part 7A: Distal side protrusion 7B: Proximal side protrusion 8 : Recess 15: Clip cartridge body 16: Clip cartridge cover 16A: Protrusion 17: Regulatory member 20: Clip system 21: Clip body 22: Gripping part 23: Base end part 24, 24A, 24B: Gripping member 25: Engaging part 26 : Claw 27: Reinforcing part 29: Tightening ring 30: Linear object 31: Linear object Main body 32: Connecting part 33: Engagement receiving part 33A: Throughout 33B: Convex part 35: Flat part 36: Thick part 37: Inner cylinder 40: Clip device

Claims (17)

A medical clip cartridge for connecting a medical clip to the connecting portion of a linear object having a connecting portion on the distal side.
An insertion slot for inserting a linear object and
An insertion path extending distally from the insertion opening,
A clip body storage unit that communicates with the distal side of the insertion path and stores the clip body,
The insertion path has a ring storage portion for storing a tightening ring for tightening the clip body.
The ring accommodating portion includes a contact portion for stopping the movement of the tightening ring in the extending direction of the insertion path.
The contact portion is a protrusion protruding from the inner surface of the insertion path.
The protrusion is composed of a distal protrusion and a proximal protrusion.
The ring accommodating portion is arranged between the distal side protrusion and the proximal side protrusion.
A medical clip cartridge characterized in that the distal end of the tightening ring is located proximal to the proximal end of the clip body. A medical clip cartridge for connecting a medical clip to the connecting portion of a linear object having a connecting portion on the distal side.
An insertion slot for inserting a linear object and
An insertion path extending distally from the insertion opening,
A clip body storage unit that communicates with the distal side of the insertion path and stores the clip body,
The insertion path has a ring storage portion for storing a tightening ring for tightening the clip body.
The ring accommodating portion includes a contact portion for stopping the movement of the tightening ring in the extending direction of the insertion path.
The contact portion is a protrusion protruding from the inner surface of the insertion path.
The protrusion is composed of a distal protrusion and a proximal protrusion.
The ring accommodating portion is arranged between the distal side protrusion and the proximal side protrusion.
A medical clip cartridge characterized in that the distal end of the ring accommodating portion is arranged proximally to the proximal end of the clip body accommodating portion. The clip cartridge according to claim 1 or 2 , wherein the distal protrusion protrudes inward from the proximal protrusion in the radial direction of the insertion path. The clip cartridge according to any one of claims 1 to 3, wherein a plurality of the distal side protrusions are provided and only one of the proximal side protrusions is provided. The clip cartridge according to any one of claims 1 to 4 , wherein the protrusion is formed so as to be removable from the insertion path. The clip cartridge has a clip cartridge body and a clip cartridge cover.
The clip cartridge main body has a first groove for forming an insertion path and a second groove for forming a clip main body storage portion, and the clip cartridge main body is covered with the clip cartridge cover to form a ring storage portion. The clip cartridge according to any one of claims 1 to 5 , wherein the clip body storage portion is formed therein. The clip cartridge according to claim 6 , wherein the contact portion is provided on the first groove of the clip cartridge body or the surface of the clip cartridge cover facing the clip cartridge body. A medical clip system for attaching clips to a medical clip device.
The clip cartridge according to any one of claims 1 to 7 and the clip cartridge.
A clip body that picks up an object, a clip that has a tightening ring that tightens the clip body, and
It has a linear object with a connecting part on the distal side,
The clip body is a clip system having a grip portion for gripping an object on the distal side and a base end portion for connecting to the connecting portion of the linear object on the proximal side. The clip system according to claim 8 , wherein the inner diameter of the tightening ring is larger than the maximum outer diameter of the connecting portion. The clip body is formed by arranging two gripping members so as to face each other.
At least one of the two gripping members, which is the base end portion, is provided with an engaging portion protruding toward the opposite gripping member.
At the base end, the two gripping members can move at least in a direction away from each other.
The clip system according to claim 8 or 9 , wherein the connecting portion is connected to the engaging portion of the clip body. The engaging portion of one of the gripping members is a first claw projecting toward the other gripping member.
The engaging portion of the other gripping member is a second claw projecting toward the gripping member.
The clip system according to claim 10 , which satisfies the following equations (1) and (2).
0 ≤ L ₁ / A ₁ ≤ 0.87 (1)
0 ≤ L ₂ / A ₁ ≤ 0.87 (2)
Here, L ₁ is the maximum length of the first claw in the opening / closing direction of the base end portion, and L ₂ is the maximum length of the second claw in the opening / closing direction of the base end portion. A ₁ is the maximum separation distance between the gripping members at the portion of the base end portion where the engaging portion is not provided in the opening / closing direction of the base end portion. The clip system according to claim 10 or 11 , wherein the connecting portion is provided with an engaging receiving portion that engages with the engaging portion of the clip body. The clip system according to claim 12 , which satisfies the following equations (3) and (4).
A ₂ <R ₁ (3)
0.13 ≤ (A ₂ / R ₁ ) ≤ 0.50 (4)
Here, A ₂ is the minimum separation distance between the gripping members of the base end portion in the opening / closing direction of the base end portion in a state where the engaging portion and the engaging receiving portion are not engaged. R ₁ is the maximum outer diameter of the engaging receiving portion. The clip system according to claim 12 or 13 , which satisfies the following equations (5) and (6).
L ₃ <R ₂ (5)
L ₄ > R ₂ (6)
Here, L ₃ is the maximum length of the base end portion in the opening / closing direction of the base end portion in a state where the engaging portion and the engaging receiving portion are not engaged, and L ₄ is the base. It is the maximum length of the base end portion in the opening / closing direction of the base end portion at the time of the maximum separation of the two gripping members at the end portion, and R ₂ is the inner diameter of the tightening ring. Further, the clip system has an inner cylinder for arranging the linear object in the lumen.
The inner diameter of the tightening ring is smaller than the outer diameter of the inner cylinder.
The clip system according to claim 8 to 14 , wherein the outer diameter of the tightening ring is larger than the inner diameter of the inner cylinder. A method for manufacturing a medical clip device using the clip cartridge according to any one of claims 1 to 7.
A clip body that picks up an object, a clip that has a tightening ring that tightens the clip body, and
With a linear object having a connecting part on the distal side,
The clip body has a step of preparing a clip device having a grip portion for gripping an object on the distal side and a base end portion for connecting to the connecting portion of the linear object on the proximal side.
The linear object having the connecting portion on the distal side is inserted into the insertion path of the clip cartridge, and the connecting portion is connected to the clip body on the distal side of the distal end of the tightening ring. A method for manufacturing a clip device, which comprises a step of performing. A method for manufacturing a medical clip device using the clip cartridge according to any one of claims 1 to 7.
A clip body that picks up an object, a clip that has a tightening ring that tightens the clip body, and
A linear object with a connecting part on the distal side,
It has an inner cylinder for arranging the linear object in the lumen, and has.
The clip body has a step of preparing a clip device having a grip portion for gripping an object on the distal side and a base end portion for connecting to the connecting portion of the linear object on the proximal side.
The linear object having the connecting portion on the distal side is inserted into the insertion path of the clip cartridge, and the connecting portion is connected to the clip body on the distal side of the distal end of the tightening ring. And the process to do
A method for manufacturing a clip device, which comprises a step of moving the connecting portion proximal to the inner cylinder and arranging the connecting portion in the lumen of the inner cylinder.

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