KR102036055B1 - An Applier for a Medical Clip - Google Patents

Abstract

The present invention relates to a medical clip applier, and more particularly, to a medical clip applier to allow the medical clip to reliably ligation of the surgical site. A clip applier having a clip jaw unit (10), comprising: a pair of engaging members (12a, 12b) coupled to an induction rod (16); Clip fixing members 11a and 11b formed integrally with the coupling members 12a and 12b and extending at different angles from the pair of coupling members 12a and 12b; And clip fixing guide portions 111a and 111b on opposite surfaces of the clip fixing members 11a and 11b, and the lower surfaces of the ends of the clip fixing members 11a and 11b may be in contact with each other along the extending direction. It becomes a flat structure that can be.

Description

Medical Applied Clips {An Applier for a Medical Clip}

The present invention relates to a medical clip applier, and more particularly, to a medical clip applier to allow the medical clip to reliably ligation of the surgical site.

Medical clips may be used for gripping or excision of human organs extending in the longitudinal direction, such as blood vessels or caecum, during surgical procedures inside the human body. Clips are used, for example, to grasp, ligation or hemostatic the cecum or blood vessels during appendectomy. Such medical clips may be made of, for example, elastic metal or polymer materials. Multiple clips may be placed in turn on the applier for ligation of parts of the body, such as blood vessels or parts of the caecum, during surgery. And before use of the clip, the applier may be sterilized or sterilized or left for a long time. When the applier is in such a state, physical properties such as elasticity of the clip disposed therein may be changed, thereby causing the clip to be detached in the process of being transferred to and used in the jaw unit disposed at the end of the applier. In addition, since a plurality of clips are continuously disposed in the supply tube of the applier, the clips placed at the rear may change physical properties with time. Therefore, there is a need for a clip applier that maintains the physical properties of the clip before use and can be used stably in the surgical procedure.

US Pat. No. US 7,316,696 B2 is a polymer having first and second curved legs that are joined at the ends by a flexible hinge region and moveable from an open position to a closed position to grip blood vessels between the curved inner facing surfaces. Disclosed is a surgical clip of material.

US Pat. No. 7,052,504 B1 discloses a surgical clip applier consisting of a drive device, a pair of opposing jaws and an extension assembly disposed therebetween. The prior art is operated by the drive device to continuously move the clip through the extension assembly such that the clip drive device disposed in the extension assembly is coupled to the jaw, the clip control part is disposed at the end of the extension assembly, the clip control part Includes a first, second and third clip control surface, the first clip control surface contacting the first end of the clip to cause the clip to rotate about the first end, and the second and third control assertions Disclosed is a self-feeding surgical clip applier that receives an end of a clip before the clip is moved to engage.

US 2014/0052157 A1 shows a handle portion; A body extending from the handle portion; Disclosed is a device for application of a surgical clip for body tissue consisting of a plurality of surgical clips disposed within the body and a jaw unit installed adjacent to an end of the body.

The medical clip may be stored in a plurality of clip appliers disposed inside the induction rod, and may be used for ligation of blood vessels by being guided to the clip jaw unit in turn during the surgical procedure. The clip jaw unit needs to be made of a structure that does not damage the periphery of the ligation site while preventing the detachment of the clip during the ligation process. However, the prior art or the known art does not disclose a clip applier having such a structure.

The present invention is to solve the problems of the prior art has the following object.

Prior Art 1: US 7,316,696 B2 (Teleflex Medical Incorporated, released Jan 08, 2008) Ligating Clip with Integral Interlocking Latch Mechanism Prior Art 2: US 7,052,504 B1 (Teleflex Medical Incorporated, published May 20, 2004) Automated-feed Surgical Clip Applier and Related Methods Prior Art 3: US 2014/0052157 A1 (Covidien LP, released February 20, 2014) Endoscopic Surgical Clip Applier

SUMMARY OF THE INVENTION An object of the present invention is to provide a medical clip applicator capable of damaging a human part while preventing the detachment of a clip during the ligation process.

According to a preferred embodiment of the present invention, a clip applier having a clip jaw unit, comprising: a pair of engaging members coupled to the induction rod; A clip fixing member integrally formed with the coupling member and extending at different angles from the pair of coupling members; And a clip fixing guide portion on opposite surfaces of the clip fixing member, wherein the lower surface of the end portion of the clip fixing member is in a planar structure which can be in contact with each other along the extending direction.

According to another suitable embodiment of the present invention, the two end portions of the clip fixing guide portion to which the clip contacts and the front end portion of the clip fixing unit contacting the boundary points of the different branches of the clip are horizontally formed in the extending direction of the guide rod. It is asymmetrical with respect to the baseline.

According to another suitable embodiment of the present invention, it further includes a clip guide disposed inside the guide rod, wherein the clip guide discharges the clip fixed to the clip fixing guide portion by the elastic unit.

The medical clip applier according to the present invention has a structure for preventing the clip used for ligation from being separated from the clip jaw unit. The applier according to the present invention allows the surgical procedure to be safely carried out by preventing contact with the human body in the ligation process of the clip jaw unit. This also makes the use of the clip appliers convenient.

1 shows an embodiment of a clip jaw unit forming a clip applier according to the invention.
FIG. 2 illustrates an embodiment of the geometry of the clip jaw unit of FIG. 1.
3 shows another embodiment of a clip jaw unit according to the invention.
4 illustrates an embodiment of a clip guide forming a clip applier according to the present invention.
Figure 5 illustrates an embodiment of the operation of the clip applier according to the present invention.

Hereinafter, the present invention will be described in detail with reference to the embodiments set forth in the accompanying drawings, but the embodiments are provided for clarity of understanding and the present invention is not limited thereto. In the following description, components having the same reference numerals in different drawings have similar functions, and thus are not repeatedly described unless necessary for understanding of the invention, and well-known components are briefly described or omitted. It should not be understood to be excluded from the embodiment of.

1 shows an embodiment of a clip jaw unit forming a clip applier according to the invention.

Referring to FIG. 1, a clip applier having a clip jaw unit 10 includes a pair of engagement members 12a and 12b coupled to the guide rod 16; Clip fixing members 11a and 11b formed integrally with the coupling members 12a and 12b and extending at different angles from the pair of coupling members 12a and 12b; And clip fixing guide portions 111a and 111b on opposite surfaces of the clip fixing members 11a and 11b, and the lower surfaces of the ends of the clip fixing members 11a and 11b may be in contact with each other along the extending direction. It becomes a flat structure that can be.

The clip applier may be applied to a medical clip of various standards, for example, the clip applier may be applied to a medical clip consisting of two branch branches to be held at an angle to fix the clip. The medical clip may be used for ligation of blood vessels or tissues during open surgery or laparoscopic surgery and may be made of a polymer material or a metal material such as titanium. The clips applied to the clip appliers can have various sizes made of any material. In addition, a plurality of clips disposed in the clip applier may be used for ligation of organs or blood vessels inside the human body for ligation in turn. The plurality of clips C stored in the induction rod 16 may be fixed to the clip jaw unit 10 in turn by the operation of the clip fixing unit 13. The clip C can then be used for ligation of the hemostatic or cut portions around the blood vessel or similar surgical site while engaging with each other by the operation of the clip jaw unit 10.

The induction rod 16 may be hollow in the shape of a cylinder, the clip jaw unit 10 may be coupled to one end of the induction rod 16, and the operation handle (see FIG. 5) to the other end thereof. The clips C may be fed through the operating handles and arranged in a row inside the guide rod 16. It can be fixed to the clip jaw unit 10 in turn for ligation in the surgical procedure.

The pair of coupling members 12a and 12b may be arranged to face each other, and one end may be coupled to a clip guide (see FIG. 4) disposed inside the guide rod 16. Each of the pair of coupling members 12a and 12b has one end coupled to the pair of coupling members 12a and 12b so that the clip C is moved forward and the end is coupled to the guide rod 16. It can happen. The other ends of the pair of coupling members 12a and 12b need to have a structure capable of stably fixing the clip. From the ends of each of the pair of engaging members 12a and 12b, the clip fixing members 11a and 11b can be integrally extended with the engaging members 12a and 12b, and the clip C is connected to the clip fixing members 11a and 12b. 11b).

In a state where the clip C is fixed to the clip fixing members 11a and 11b, the clip fixing members 11a and 11b may extend to have different inclination angles from the coupling members 12a and 12b. For example, while the clip C is fixed to the clip fixing members 11a and 11b, the clip fixing members 11a and 11b may extend at a smaller angle than the coupling members 12a and 12b. In detail, each of the clip fixing members 11a and 11b may have a linear bar shape having a rectangular cross section, and may have a constant cross-sectional area along the extending direction. And the clip fixing member (11a, 11b) can be integrally extended from the end of the clip engaging member (11a, 11b), the cross-sectional area is reduced in the extending direction along the extension direction and then the cross-sectional area at the end is increased again, The bottom face may be horizontal or shaped similarly. By this structure, the clip C can be stably fixed to the clip fixing members 11a and 11b. In addition, the outer surface of each of the clip fixing members 11a and 11b may be formed into a curved surface, whereby the quadrant shape of the cross section in the vertical direction of the end portions of the clip fixing members 11a and 11b may be formed. Damage to the surgical site in the ligation process can be prevented by the structures of the end portions of the respective clip fixing members 11a and 11b.

Each of the clip fixing members 11a and 11b may be made of a tunnel structure in which faces facing each other are open, and a clip fixing guide for receiving the clip C inside the respective clip fixing members 11a and 11b. Portions 111a and 111b may be formed. The clip fixing guide portions 111a and 111b may be in the shape of grooves formed along the extending direction inside the respective clip fixing members 11a and 11b, and the clip C may be used to fix the clip fixing members 11a and 11b. According to this, the guide clip C can be stably fixed while being stably moved. The clip fixing guide portions 111a and 111b are formed on the side walls 112a and 112b or the clip by making the clip fixing guide portions 111a and 111b into grooves on the opposite surfaces of the clip fixing members 11a and 11b. It may be a shape protruding from the bottom surface or the ceiling surface of the fixing members (11a, 11b). Such a protruding structure stably guides the clip C and at the same time makes the clip fixing members 11a and 11b structurally stable.

The clip C may be entirely V-shaped, and both ends of the clip C may be fixed to the ends of the respective clip fixing guide portions 111a and 111b. And the center of the clip (C) can be fixed by the clip fixing unit (13). In this state, by the operation of the operation handle described above, the clip fixing members 11a and 11b are moved in a direction facing each other so that the end portions of the clip C opened for ligation may be engaged with each other.

The clip fixing unit 13 may be fixed to the position defined by the clip stopper 15 disposed on the operation frame 14 to limit the movement of the clip fixing unit 13. A plurality of clips C may be stored inside the guide rod 16, and each clip C may in turn be fixed to the clip jaw unit 10. And by the operation of the clip jaw unit 10, each clip (C) can be used for ligation, and when the last clip (C) that was stored is used for ligation, the end marker (EL) is clip clip unit (10) It can be discharged to, it can be confirmed that there is no clip (C) stored in the guide rod 10, the end marker (EL) can be stored in the interior of the guide rod 16 in advance.

The clip C is fixed to the clip fixing members 11a and 11b, and then the open ends of the clips C are moved while the coupling members 12a and 12b and the clip fixing members 11a and 11b face each other. These can interlock with each other. As such, the clip fixing members 11a and 11b are moved in the fixing process or the ligation process of the clip C, and it is necessary to prevent the human body from being damaged by the movement of the clip jaw unit 10 in the fixing or ligation process. And a structure suitable for this.

Hereinafter, embodiments of such a structure will be described.

FIG. 2 illustrates an embodiment of the geometry of the clip jaw unit of FIG. 1.

2, the front end of the clip fixing unit 13 in contact with the two end portions of the clip fixing guide portions 111a and 111b to which the clip C is contacted and the boundary points of the different branches of the clip C. The portion is asymmetrical with respect to the horizontal reference line RL formed in the extending direction of the induction rod 16.

In FIG. 2, the line indicated by the geometry is formed based on the portion where the clip contacts the clip jaw unit, and the horizontal reference line RL corresponds to the reference line formed based on the extension direction of the guide rod 16. The extending direction of the clip fixing guide portions 111a and 111b may have a small inclination angle with respect to the extending direction of the engaging members 12a and 12b, and each of the finishing portions 113a and 113b extends downward in a curved shape. Afterwards it may be inclined inwardly. Different branches of the clip may be moved along the moving lines ML1 and ML2, respectively, and fixed to the clip fixing guide portions 111a and 111b for ligation.

For ligation, the clip needs to be stably fixed in the process of waiting for the clip in the clip jaw unit or during the ligation process. Clips fixed inside the clip jaw unit can be fixed in the 1, 2 and 3 fixing positions C1, C2, C3. The 1, 2 and 3 fixing positions C1, C2 and C3 correspond to the end of the clip fixing unit and the end of the clip fixing guide portion, respectively. As the clip is fixed by the three fixing positions C1, C2, and C3, the lines connecting the three fixing positions may have an asymmetrical structure based on the horizontal reference line RL. Specifically, the straight line connecting the 2 fixed positions C2 at the 1 fixed position C1 may have a greater length than the straight line connecting the 3 fixed positions C3 at the 1 fixed position C1. Alternatively, the straight line connecting the 2 fixed positions C2 and the 3 fixed positions C3 may be inclined outward with respect to the vertical reference line VR. By this geometric fixing structure, the clip can be stably fixed to the clip jaw unit.

The clip fixed to the clip jaw unit can be used for ligation and the pair of engagement members 12a, 12b can be moved to a position facing each other for ligation. In the ligation process, the closing portions 113a and 113b are moved in the facing directions, respectively, and in this process, the surrounding tissue of the surgical site needs to be prevented from being damaged. To this end, the outer circumferential surfaces of the finishing portions 113a and 113b may be curved, and specifically, may be quadrant shapes, respectively. In this way, the movement range of the clip jaw unit can be minimized in the ligation process.

Hereinafter, an embodiment of the clip jaw unit for such a structure will be described.

3 shows another embodiment of a clip jaw unit according to the invention.

Referring to FIG. 3A, the clip jaw unit may include two sub jaw units 10a and 10b, and the clip may be stably fixed by the sub jaw units 10a and 10b. As described above, the first and second sub jaw units 10a and 10b include one and two coupling members 12a and 12b extending facing each other; Clip fixing members 11a and 11b formed integrally with the first and second coupling members 12a and 12b and extending from ends of the first and second coupling members 12a and 12b; And one and two fastening portions 31a and 31b which extend from the other ends of the first and second coupling members 12a and 12b and which engage the guide rods described above.

The inner part of the one finishing portion 113a forming the end of the first clip fixing member 11a may be planar or inclined planar as described above. In addition, the two finishing portions 113b forming the ends of the two clip fixing members 11b may have two branch branches, but are not limited thereto and may be made of an appropriate structure capable of fixing one end of the clip. . In addition, one or two guide grooves 32a and 32b may be formed in the inner surfaces of the first and second clip fixing members 11a and 11b to guide the movement of the clip and fix the ends of the clips. And the 1 and 2 clip fixing guide portions 111a and 111b projecting outward from the ceiling surfaces of the 1 and 2 clip fixing members 11a and 11b described above by the formation of the 1 and 2 guide grooves 32a and 32b. Can be formed. Specifically, the first and second guide grooves 32a and 32b are 1/4 to 1/1 of the width corresponding to the width of the clip and the height of the sidewalls 112a and 112b of the 1 and 2 clip fixing members 11a. It can have And it may have an extension length such that the end of the clip fixed from the end of the first and second coupling members 12a and 12b does not leave the finishing portions 113a and 113b.

The first and second fastening portions 31a and 31b may extend to end portions of the first and second coupling members 12a and 12b and may be integrally formed with the first and second coupling members 12a and 12b. In addition, the fastening holes 311 may be formed at the front end portions of the first and second fastening portions 31a and 31b so as to be inclined in different directions from the first and second coupling members 12a and 12b. The clip jaw unit may be coupled to the guide rod by the fastening holes 311, and the 1 and 2 clip fixing guides 111a and 111b may be fitted to each other about the fastening holes 311 by being inclined in different directions. Can be bitten. The first and second fastening portions 31a and 31b may be received into the guide rod and may be connected to the clip guide and operated.

4 illustrates an embodiment of a clip guide forming a clip applier according to the present invention.

Referring to FIG. 4, the guide rod 42 may be a hollow cylinder shape as a whole, and the clip guide 41 may be accommodated inside the guide rod 42. The clip guide 41 may be made of a structure extending in a box shape, and a plurality of clips may be continuously disposed therein. The shooting member 45 may be disposed inside the clip guide 41, and one end of the shooting member 45 may be connected with the clip fixing unit described above. The shooting member 45 may be connected to the movement adjusting unit 44 at the other end thereof, and the operation wheel 43 may be disposed at the connection portion of the movement adjusting member 44 and the shooting member 45.

The clip guide 41 may be composed of a pair of guide walls 411 and 412 facing each other, and the pair of guide walls 411 and 412 are connected to each other by a clip fixing surface and have a channel having an overall rectangular cross section or It may be tunnel shaped. The ends of each of the guide walls 411 and 412 may be an isosceles triangular structure, a pair of presses that contact the back of the clip at the ends of the clip fixing surfaces facing each other to allow the clip to be fixed to the clip jaw unit. The protrusions 413 and 414 may be formed in an inclined structure.

The movement control unit 44 includes an adjustment member 443; One elastic unit 441 coupled to the adjustment member 443; It may be composed of two elastic units 442 disposed inside the one elastic unit 441. The first and second elastic units 441 and 442 can be guided while the movement of the shooting member 45 in one direction and the other direction is restricted. The shooting member 45 may be connected to the handle module through the movement control unit 44.

Figure 5 illustrates an embodiment of the operation of the clip applier according to the present invention.

Referring to FIG. 5, the clip applier includes a clip jaw unit 10 to which a clip 50 is fixed; An induction rod 42 in which a plurality of clips 50 are stored while the clip jaw unit 10 is coupled; An actuation wheel 43 coupled to one end of the induction rod 42; And an operating handle 46 coupled to the operating wheel 43.

The actuation handle 46 includes a handle body 461; A handle 463 coupled to the handle body 461; And a trigger 462 for inducing movement and ligation of the clip 50. The trigger 462 can be actuated in two stages, for example, the clip 50 is fixed to the clip jaw unit in one stage of operation and then ligated by the clip 50 by two stages of operation. It can work in a way. The actuation handle 46 can be actuated in a variety of ways and is not limited to the embodiments shown.

Clips 50 having various structures may be applied to the clip applier according to the present invention, and the clip 50 shown on the right side of FIG. 5 may be applied to the clip applier according to the present invention.

Referring to the right side of FIG. 5, the clip 50 includes one extension body 51 extending in one direction; Two extension bodies 52 which are connected to the first extension body 51 in a bent shape and extend while forming a predetermined angle; An extension through hole 521 formed at a bent connection portion between the first extension body 51 and the second extension body 52; An insertion fixing protrusion 54 which is formed at the end of the first extension body 51 and extends in a shape perpendicular to the extension direction of the first extension body 51; 2 is formed in a ring shape at the end of the extension body 52, the fixing hook 55 for inserting fixing projections 54 are inserted and fixed; And one and two balanced fixing portions 541 and 551 formed in the one and two extension bodies 51 and 52. Additionally, the clip 50 may include one fixed plane protrusion 56 and two fixed plane protrusions 57 formed on the inner surfaces of the first extension body 51 and the second extension body 52 facing each other.

The clip 50 may be made of synthetic resin or metal material, but is not limited thereto, and may be made of various materials having elasticity. The first extension body 51 and the second extension body 52 may have a rectangular cross section and extend in a curved shape with a large radius of curvature, and the first extension body 51 and the second extension body 52 may be V-shaped as a whole. Or it may be an integral structure having a U-shape. Extension through hole made in the shape of C along the extension direction so as to extend to the 1 extension body 51 and the 2 extension body 52 respectively at the boundary surface or the bent portion of the 1 extension body 51 and the 2 extension body 52. 521 reduces the overall weight of the clip 50 and at the same time allows the 1st extension body 51 and the 2nd extension body 52 to be bent in an easily adjacent direction or away from the boundary portion.

Insertion fixing protrusion 54 may be formed at the end of the first extension body 51, it may be made of a structure to form a sharp end portion while extending the lower portion of the first extension body 51 inclined. The fixing hook 55, which is made of a structure in which the insertion fixing protrusion 54 is received and fixed, becomes inverted C shape and forms a sharp end portion, and the inner surface is in contact with the outer surface of the insertion fixing protrusion 54. Can be made.

The first balance fixing part 541 may have a function of being fixed at a predetermined position while preventing left and right shaking of the insertion fixing protrusion 54 fixed by the fixing hook 55. The two balance fixing portions 551 may have a structure that prevents deformation of the clip 50, and the first and second extension bodies 51 and 52 are secured in the ligation process while the clip 50 is stably fixed to the jaw unit. Make sure that it is located in a stable position. The first balanced fixing portion 551 may be in a cylindrical shape extending in a direction perpendicular to the extending direction of the two extending bodies 52, and may be disposed adjacent to the fixing hook 55. In addition, the balance fixing parts 541 and 551 may have a function in which a part of the first and second extension bodies 51 and 52 protrudes to the outer surfaces thereof so that the clip 50 can be easily separated from the jaw unit.

The inner surface of the first extension body 51 may be planar, and are disposed to face the inner surface of the two extension bodies 52, and the two inner surfaces may be in contact with each other in the ligation process. 1 fixed plane projections 56 formed on the inner surface of the first extension body 51 may each be a projection of a square pillar shape, the inner surface may be disposed on both sides with respect to the center line that is divided into two equally in the longitudinal direction. Each part may be disposed at regular intervals. And the 1 fixed plane projections 56 disposed at different parts may be staggered from each other, and the gap between the 1 fixed plane projections 56 disposed adjacent to each other in the longitudinal direction is the cross-sectional area of the 1 fixed plane projection 56. It may be equal to or greater than the cross-sectional area of the one fixed plane projection 56. The two fixed plane protrusions 57 arranged on the inner surface of the second elongated body 52 may be formed in the same or similar manner as the one fixed plane protrusion 56, and the two fixed plane protrusions 57 may be the one fixed plane protrusions. It may be formed at a position corresponding to between 56. The ligation is stably achieved by the arrangement structure of the 1 and 2 fixed plane protrusions 56 and 57.

The clip 50 may be a hemo clip for ligation of blood vessels, but is not limited thereto, and may be applied to ligation of various sites, and may be made of various structures using various materials.

The medical clip applier according to the present invention has a structure for preventing the clip used for ligation from being separated from the clip jaw unit. The applier according to the present invention allows the surgical procedure to be safely carried out by preventing contact with the human body in the ligation process of the clip jaw unit. This also makes the use of the clip appliers convenient.

Although the present invention has been described in detail above with reference to the presented embodiments, those skilled in the art may make various modifications and modifications without departing from the technical spirit of the present invention with reference to the presented embodiments. . The invention is not limited by the invention as such variations and modifications but only by the claims appended hereto.

10: Clip jaw unit 10a, 10b: 1, 2 sub jaw unit
11a, 11b: 1, 2 clip fixing member 12a, 12b: 1, 2 coupling member
13: clip fixing unit 14: operating frame
15: Clip Stopper 16: Induction Rod
31a, 31b: 1, 2 fastening part 32a, 32b: 1, 2 guide groove
41: Clip guide 42: Induction rod
43: operating wheel 44: travel adjustment unit
45: shooting member 46: operating handle
50: Clip 51, 52: 1, 2 extension body
54: insertion fixing projection 55: fixing hook
56, 57: 1, 2 fixed plane projection
111a, 111b: 1, 2 clip fixing guide section
112a, 112b: sidewalls 113a, 113b: 1, 2 finish
311: fastening hole 411, 412: induction wall
413, 414: Pressing protrusions 441, 442: 1, 2 elastic units
443: adjusting member 461: handle body
462: trigger 463: the handle
521: extension through hole 541, 551: 1, 2 balance fixing part
C: clips C1, C2, C3: 1, 2, 3 fixed position
EL: end marker ML1, ML2: moving line
RL: horizontal baseline VR: vertical baseline

Claims (3)

In the clip applier having the clip jaw unit 10,
A pair of coupling members 12a and 12b coupled to the induction rod 16;
Clip fixing members 11a and 11b formed integrally with the coupling members 12a and 12b and extending at different angles from the pair of coupling members 12a and 12b; And
It includes the clip fixing guide portion (111a, 111b) on the surface facing each other of the clip fixing member (11a, 11b),
The lower surface of the end of the clip fixing member (11a, 11b) is a planar structure that can be in contact with each other along the extending direction,
The front end of the clip fixing unit 13 in contact with the two end portions of the clip fixing guide portions 111a and 111b to which the clip C is contacted and the different branches of the clip C are guide rods 16. Asymmetrical structure based on the horizontal reference line RL formed in the extension direction of
The clip fixing guide portions 111a and 111b have a groove shape formed along the extending direction inside the respective clip fixing members 11a and 11b, and the side walls 112a and 112b or the clip fixing members 11a and 11b. The clip applier which becomes a shape which protrudes from the bottom surface or the ceiling surface of). delete The method of claim 1, further comprising a clip guide 41 disposed inside the guide rod 16, the clip guide 41 to the clip fixing guide portions (111a, 111b) by the elastic units (441, 442) Clip applier, characterized in that for discharging the fixed clip (C).

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