Feeder and ligation device

Abstract

A feeder that mounts an indwelling device capable of being indwelled in a subject has a connector that connects to the indwelling device in a releasable manner, a power transmission member that is connected to the connector for moving the connector, and an auxiliary member that is disposed at a position where the connector is contacted by the power transmission member as the power transmission member is pulled. The auxiliary member deforms the connector by contacting the connector to release the connection of the connector to the indwelling device, and an opening through which the connector can pass is formed after the connection is released as the power transmission member is further pulled.

Description

TECHNICAL FIELD

[0001] The present application relates to a supply device, more particularly a supply device that mounts a ligation device that ligates a tissue, and a ligation apparatus that includes the supply device. BACKGROUND

[0002] As a treatment using an endoscope, a ligation using a ligation device such as a clip unit is known. The clip unit includes a pair of arms. When the pair of arms is pulled by a predetermined amount in a state where the pair of arms is holding a tissue, the pair of arms is locked in a state where the tissue is strongly tightened.

[0003] The clip unit is introduced into the body in a state where it is mounted to the supply device. Since the clip unit is left in the body in a state where a tissue is ligated, it is necessary to separate the supply device from the clip unit after the pair of arms is locked.

[0004] Several modes of releasing the connection of the supply device and the clip unit are known. For example, there are a mode of breaking a connector that connects the supply device and the clip unit, a mode of deforming the connector without breaking it to release the connection, a mode of rotating the connector to release the connection (see, for example, Patent Literature 1), and the like.

[0005] The connection release by deformation is superior to the connection release by breaking in that it does not generate a fragment. The connection release by deformation is superior to the connection release by rotation in that it can release the connection by only a pulling operation of an operation transmission member connected to the connector.

[0006] Prior art documents

[0007] Patent documents

[0008] Patent Literature 1: Japanese Patent No. 5750620 SUMMARY

[0009] PROBLEMS TO BE SOLVED BY THE INVENTION

[0010] The operator closes the pair of arms to tighten the target tissue, and confirms the ligation to be sufficient while confirming the holding position and the like. In a case where the ligation is judged to be insufficient, the pair of arms is opened to release the tightening of the target tissue, and the ligation operation is performed again. Also, in a case where the ligation is judged to be sufficient, the arms are locked. At this time, by setting the operation force (locking force) required to lock the arms of the clip unit to be significantly larger than the force required to ligate the target tissue, the operator can recognize the difference in the forces, and can perform the operation without erroneously locking the arms.

[0011] The amount of operation force (locking force) required to lock the arm of the clip unit varies depending on the reaction force received by the object tissue from the arm. If the object tissue is hard, the locking force becomes large.

[0012] In the case where the connection release by deformation is applied to the clip unit, if the connection is released before the locking is completed, the tissue cannot be ligated. Thus, the operation force (release force) required for the connection release is generally set to be larger than the locking force. Further, from the viewpoint of ensuring the above-described difference, the locking force is sometimes set to be larger. Here, if the release force is set based on the locking force in the case where the arm grips the tissue of average hardness, there is a possibility that the connection is released although the locking is not completed in the case where the tissue of higher hardness is gripped. If the release force is set based on the locking force in the case where the arm grips the tissue of higher hardness, such a possibility is eliminated, but the release force becomes very large, and there is a possibility that the operation is difficult.

[0013] Further, there is a problem of the operation feeling. After the connection is released by deformation, if the operation force is not changed or increased, the operator cannot recognize the state of the connection release. As a result, the operation becomes complicated, such as the operation is unnecessarily continued.

[0014] In view of the above, an object of the present application is to provide a supply device capable of reliably ligating a tissue of higher hardness using a lodging device and capable of easily detecting the state of the connection release.

[0015] Solution for solving the problem

[0016] The first aspect of the present application is a supply device to which a lodging device for lodging in a subject is attached.

[0017] The supply device has a connector connected to the lodging device in a detachable manner, a power transmission member connected to the connector for moving the connector, and an auxiliary member disposed at a position where the connector is contacted by the power transmission member when the power transmission member is pulled.

[0018] The auxiliary member deforms the connector by contacting the connector to release the connection between the connector and the lodging device, and forms an opening through which the connector can pass after the connection is released because the power transmission member is further pulled.

[0019] The second aspect of the present application is a ligation device including the supply device of the first aspect and the lodging device for lodging in a subject.

[0020] The third aspect of the present application is a method for releasing connection of an indwelling device of a ligation device, the ligation device having: a connector connected to an indwelling device that can be indwelled in a subject in a manner that the connection can be released; a power transmission member connected to the connector for moving the connector; and an auxiliary member disposed at a position where the auxiliary member comes into contact with the connector as the power transmission member is pulled.

[0021] In the method, the power transmission member is pulled to bring the connector into contact with the auxiliary member. Further, the connector is deformed by pulling the power transmission member to separate the connector from the indwelling device. Further, an opening through which the connector can pass is formed in the auxiliary member by pulling the power transmission member to move the connector to a position on the proximal side of the auxiliary member.

[0022] Effects of the Invention

[0023] According to the present application, a relatively hard tissue can be reliably ligated using the indwelling device, and the release of the connection can be easily detected. BRIEF DESCRIPTION OF DRAWINGS

[0024] Figure 1 is a whole structure diagram of the ligation device of the first embodiment of the present application.

[0025] Figure 2 is a diagram showing a clamp unit of the ligation device.

[0026] Figure 3 is a cross-sectional view of the clamp unit.

[0027] Figure 4 is a cross-sectional view of the clamp unit showing a cross section in a different direction from Figure 3

[0028] Figure 5 is an enlarged cross-sectional view of a clamp mounting portion of the ligation device.

[0029] Figure 6 is a diagram showing one process of the release of connection of an arm and a hook in the ligation device.

[0030] Figure 7 is a diagram showing one process of the release of connection of an arm and a hook.

[0031] Figure 8 is a diagram showing one process of the release of connection of an arm and a hook.

[0032] Figure 9 is a diagram showing one process of the release of connection of an arm and a hook.

[0033] Figure 10 ​is a partial enlarged view of the feeder of the second embodiment of the present application.

[0034] Figure 11 is an external view of the catheter of the feeder.

[0035] Figure 12 is a view showing a modification of the catheter. DETAILED DESCRIPTION

[0036] REFERENCE Figures 1-9 The first embodiment of the present application will be described.

[0037] Figure 1 is a view showing the external appearance of a ligation device 1 as a medical device of the present embodiment. The ligation device 1 includes a clip unit (indwelling device) 10 to be indwelled in a body and a feeder 50 for operating the clip unit 10. The clip unit 10 is attached to the front end (distal end) of the feeder 50.

[0038] Figure 2 is a view showing the external appearance of the clip unit 10. Figure 3 is a sectional view of the clip unit 10. As shown in Figure 2 , the clip unit 10 includes an arm portion 20 and a press tube 30 in which a part of the arm portion 20 is housed.

[0039] The arm portion 20 has a pair of arms of a first arm 21 and a second arm 22. The first arm 21 and the second arm 22 have claws 21a and 22a, respectively, at the front end portions thereof. As shown in Figure 3 , at the base end portion 20a of the arm portion 20, the first arm 21 is connected to the second arm 22. The base end portion 20a is formed in the shape of a letter U.

[0040] The arm portion 20 is formed of an alloy, a metal. As the material of the arm portion 20, stainless steel, cobalt-chromium alloy, nickel-titanium alloy, and the like can be exemplified.

[0041] The first arm 21 and the second arm 22 are spread apart in an initial state shown in Figure 2 . When the first arm 21 and the second arm 22 approach each other from the initial state, an action force to restore to the initial state is generated by the action of the elasticity of the material.

[0042] The press tube 30 is a cylindrical member formed of a metal, a resin, or the like. As shown in Figure 3 , the base end portion 20a of the arm portion 20 is housed in the press tube 30. The front end portion of the arm portion 20 protrudes from the front end opening 30a of the press tube. The base end opening 30b of the press tube 30 is smaller than the front end opening 30a.

[0043] Figure 4 is a view showing the inside of the press tube 30 from a different direction from Figure 3 . As shown in Figure 4As shown, a locking part 23 is provided in the middle of each arm of the arm portion 20. At the locking part 23, the width dimension of each arm 21, 22 increases (in the width direction of the locking part 23). Figure 4 Only the first arm 21 is visible in the image. Each locking part 23 can pass through the base opening 30b by approaching the first arm 21 and the second arm 22. If the first arm 21 and the second arm 22 move away after passing through the base opening 30b, the locking part 23 cannot pass through the base opening 30b. As a result, the arm 20 is locked in a closed state.

[0044] A helical spring 31 is disposed inside the pressure tube 30. The front end of the helical spring 31 can contact the rear surface of the first arm 21 and the rear surface of the second arm 22. The rear end of the helical spring 31 can contact the rear end face 32 of the pressure tube having a base end opening 30b.

[0045] The basic structure of the arm 20 and the pressure tube 30 described above is well known, for example, as disclosed in PCT International Publication 2014 / 181676.

[0046] like Figure 1 As shown, the feeder 50 includes an elongated insertion part 51, a wire (power transmission member) 52 passing through the insertion part 51, and an operation part 60 connected to the insertion part 51.

[0047] As the insertion part 51, for example, a sheath formed of a coil can be used.

[0048] The operation unit 60 has a main body 61 connected to the insertion unit 51 and a slider 62 mounted on the main body 61 in a manner that allows it to slide relative to the main body 61.

[0049] As the thread 52, for example, a twisted thread formed of metal wire can be used. The base end of the thread 52 is connected to the slider 62. When the slider 62 is moved relative to the main body 61, the thread 52 can move forward and backward within the insertion portion 51.

[0050] Figure 5 This is an enlarged sectional view of the front end of the feeder 50 on which the clamp unit 10 is mounted.

[0051] The front end of the online 52 is fixed with a hook (connector) 70 that engages with the clamping unit 10. For example... Figure 5 As shown, the front end of the line 52 enters the pressure tube 30, and the hook 70 engages with the base end 20a of the arm 20. The hook 70 is slightly smaller than the inner diameter of the coil spring 31, and can move within the coil spring 31 without interfering with it.

[0052] The hook 70 has a rear portion 71 that connects to the line 52 and a front portion 72 that engages with the base end portion 20a.

[0053] The rear portion 71 is shaped like a spindle, gradually narrowing towards both ends in the front-rear direction, and has a bottomed hole 71a opening at the rear end. The front end of the line 52 enters the hole 71a. The line 52 and the hook 70 are connected, for example, by brazing. In this embodiment, the hook 70 and the line 52 are connected in a coaxial manner.

[0054] The front portion 72 has a pair of engaging arms 73 and 74. Engaging arms 73 and 74 are inserted into the arm portion 20 from a direction orthogonal to the opening and closing direction of the arm portion 20. Engaging arm 73 has a claw portion 75 that contacts the arm portion 20 and a plate-like portion 76 connecting the claw portion 75 and the rear portion 71. Engaging arm 74, like engaging arm 73, has a claw portion 77 and a plate-like portion 78, and has the same shape as engaging arm 73. Engaging arms 73 and 74 are positioned symmetrically with respect to the central axis X1 of the hook 70.

[0055] like Figure 5 As shown, a rigid conduit (auxiliary member) 55 is installed at the front end of the insertion part 51. The inner diameter of the front end region of the conduit 55 is larger than the outer diameter of the pressure tube 30, allowing the pressure tube 30 to enter. The conduit 55 has a tapered section 55a whose inner diameter gradually decreases towards the base end, and the inner diameter of the small-diameter section 55b closer to the base end than the tapered section 55a is approximately the same as the minimum inner diameter of the tapered section 55a. The rear part 71 of the hook 70 has a smaller overall dimension than the inner diameter of the small-diameter section 55b, and the maximum overall dimension of the front part 72 defined by the claws 75 and 77 is larger than the inner diameter of the small-diameter section 55b.

[0056] The smaller diameter portion 55b is thinner than the reduced diameter portion 55a. In this embodiment, the insertion portion 51 and the conduit 55 are joined at the reduced diameter portion 55a by welding or the like. Therefore, a gap exists between the smaller diameter portion 55b and the insertion portion 51. A stop (not shown) is installed on the line 52. The shape and size of the stop are set so that it cannot enter the conduit; therefore, when the stop contacts the rear end of the conduit, the line cannot advance further.

[0057] The operation of the ligation device 1 configured as described above will be explained. The ligation device 1 is inserted into the body through the endoscope channel. When inserting the ligation device 1 into the endoscope, the user retracts the slider 62 by a predetermined amount, inserting it in a closed but unlocked state with the arm 20 closed. Alternatively, the endoscope can be inserted with the clamp unit 10 with the arm 20 closed and the front end of the insertion part 51 housed in a separately prepared outer sheath.

[0058] When the ligation device 1 protrudes from the channel opening at the tip of the endoscope to reduce the force pulling the sliding member, or when the outer sheath retracts, the arm 20 advances relative to the pressure tube 30 under the action of its own elastic restoring force and the elastic restoring force of the coil spring 31. As a result, the pair of arms 21, 22 are in an open position. When the stop contacts the rear end of the catheter 55, the arm 20 cannot advance relative to the pressure tube 30, so the arm 20 does not detach from the pressure tube 30 and remains in an open position.

[0059] When the user moves the slider 62 backward relative to the main body 61, the traction line 52 causes the arm 20 to move backward relative to the pressure tube 30, resulting in a closed state for the pair of arms 21 and 22. The user ligates the tissue by positioning the tissue between the pair of arms 21 and 22, thus closing the pair of arms 21 and 22. Before performing the locking operation described later, the pair of arms 21 and 22 can be moved forward relative to the main body 61 to change from the closed state back to the open state. Therefore, in the ligation device 1, the tissue can be re-grasped by operating the clamp unit 10 using the line 52 before performing the locking operation.

[0060] like Figure 5 As shown, a limiting portion 58 with an inner diameter slightly larger than the outer diameter of the hook 70 is provided within the conduit 55. The limiting portion 58 prevents unexpected disengagement of the connection between the base end 20a and the hook 70. To disengage the base end 20a from the hook 70, the engaging arms 73 and 74 need to be separated by a certain distance, but there is no space within the limiting portion 58 for the engaging arms 73 and 74 to be sufficiently far apart. As a result, the engagement between the hook 70 and the base end 20a is not disengaged until the engaging arms 73 and 74 pass through the limiting portion 58, thus maintaining the engagement properly.

[0061] If it is determined that the tissue located between the pair of arms 21 and 22 can be ligated, the user performs a locking operation to fix the arm 20 in a closed position. During the locking operation, the user moves the slider 62 further back relative to the main body 61 beyond the range that can be re-grasped. As the slider 62 moves back, the thread 52 is pulled, and the pair of arms 21 and 22, maintaining the state of clamping the tissue, become approximately parallel and enter into the pressure tube 30. Furthermore, the locking parts 23 provided on the pair of arms 21 and 22 move closer to each other, so that they are positioned to pass through the base opening 30b of the pressure tube 30.

[0062] The pair of locking parts 23 that have moved out of the pressure tube 30 through the base opening 30b move away again when the force on the self-line 52 weakens, resulting in a positional relationship where they cannot pass through the base opening 30b. As a result, the arm 20 is prevented from protruding from the pressure tube 30 by the pair of locking parts 23 abutting against the edge of the base opening 30b, and the arm 20 is locked and maintains a closed shape.

[0063] During the locking operation, the base end portion 20a and the hook 70 are moved outside the tube 30 through the base end opening 30b, and the engagement state of the base end portion 20a and the hook 70 is properly maintained by the restriction portion 58.

[0064] When the user further retracts the slide 62 after the arm portion 20 is locked, the engagement of the base end portion 20a and the hook 70 is released, and the clip unit 10 is separated from the feeder 50. Hereinafter, the operation of the hook 70 at the time of the connection release will be described in detail.

[0065] When the slide 62 is retracted after the arm portion 20 is locked, the wire 52 is pulled. As a result, as shown in FIG. 16, the rear end portions of the claw portions 75, 77 come into contact with the inner surface of the reduced diameter portion 55a. When the wire 52 is pulled, the rear end portions of the claw portions 75, 77 move along the inner surface of the reduced diameter portion 55a and enter the small diameter portion 55b. Figure 6

[0066] As the rear side of the claw portions enters the small diameter portion 55b, the claw portions 75, 77 rotate about the connection portions with the plate-shaped portions, respectively. As a result, as shown in FIG. 18, the front end sides of the claw portions 75, 77 move in directions away from each other and are separated from the base end portion 20a of the arm portion. In this way, the connection of the hook 70 and the arm portion 20 is released. Figure 7

[0067] When the wire 52 is further pulled after the connection is released, the front end portion of the plate-shaped portion 76 and the front end portion of the plate-shaped portion 78 approach each other, and the claw portions 75, 77 further enter the small diameter portion 55b.

[0068] Since the small diameter portion 55b is thin and has a gap between the small diameter portion 55b and the insertion portion 51, the small diameter portion 55b deforms toward the inner surface of the insertion portion 51 by receiving the force at the time of entry of the front portion 72 of the hook 70. As a result, as shown in FIG. 20, the small diameter portion 55b deforms in a manner that the inner diameter increases and the front portion 72 passes therethrough. Thus, the opening Op through which the hook 70 can pass is formed in the small diameter portion 55b. The inner diameter of the opening Op is larger than the inner diameter of the small diameter portion 55b before the deformation. Figure 8 When the user further retracts the slide 62, the hook 70 passes through the opening Op and moves to a position on the hand side of the tube 55 from the base end opening of the tube 55. When the hook 70 is separated from the tube 55, no external force against the pulling of the wire 52 acts on the hook 70, and thus the force required to retract the slide 62 is greatly reduced, and the operation of the slide 62 becomes light. Thus, the user can easily recognize the state in which the clip unit 10 is separated from the feeder 50.

[0069]

[0070] ​​​The series of operations ends when the user pulls out the endoscope and the feeder 50 to the outside of the body. As explained above, according to the ligature device 1 of the present embodiment, in view of the dimensional relationship of the restriction portion 58 and the claw portions 75, 77, even in the case of ligaturing a relatively hard tissue, the condition in which the coupling of the clip unit 10 and the feeder 50 is released before the arms of the clip unit 10 are locked can be prevented.

[0071] Further, only by pressing the rear end portions of the claw portions 75, 77 against the reduced diameter portion 55a of the catheter 55, the claw portions are spread to release the coupling of the clip unit 10 and the feeder 50. Thus, the user can release the coupling by continuing the retraction of the slide 62, and can make the force required at this time smaller than that required when the arms are locked. Also, by deforming the small diameter portion 55b so that the inner diameter increases, the hook 70 after the coupling is released can be detached from the catheter 55 through the opening Op formed in the small diameter portion. As a result, as explained above, the operation of the slide 62 is significantly lightened, and the user can easily recognize the condition in which the clip unit 10 is separated from the feeder 50.

[0072] According to the above-described effects, in the ligature device 1, the reliable retention of the clip unit 10 in the state of gripping a relatively hard tissue and the ease of operation can be both satisfied.

[0073] Figure 9 The relationship between the amount of pulling of the line 52 and the force generated is shown. When the line is pulled by operating the slide 62 after the arms grip the tissue, in the region Rl before the entire arms are drawn into the pressure tube, the force N gradually increases under the action of the reaction force received from the gripped tissue.

[0074] Next, in the region R2 before the base end portions of the arms reach the base end opening of the pressure tube, the force N gradually decreases because the arms and the inner surface of the pressure tube are substantially parallel.

[0075] Next, in the region R3 before the arms are locked, the force N increases again because the arms need to be deformed to pass the locking portions 23 over the base end opening. At the time of completion of the locking, the force N temporarily decreases.

[0076] Next, in the region R4 before the connection of the arm portion and the hook is released, the force N increases again. If the maximum force value N2 of the region R4 is below the maximum force value Nl of the region R3 in terms of mechanics, the connection of the arm portion and the hook before locking is released, and there is a possibility that the tissue cannot be ligated. However, in the present embodiment, in view of the dimensional relationship of the restriction portion 58 and the claw portions 75, 77, the connection release is physically suppressed, and the claw portions are opened by pressing the rear end portions of the claw portions 75, 77 against the reduced diameter portion 55a of the catheter 55, so that the maximum force value N2 is set to be below the maximum force value Nl, and the condition that the connection of the arm portion and the hook before locking is released is prevented not only depending on the stiffness of the claw portions.

[0077] Next, in the region R5 before the claw portions 75, 77 enter the small diameter portion 55b, the force N gradually increases, but since the small diameter portion 55b is easily deformed to form the opening Op, the maximum force value of the region R5 does not exceed the maximum force value Nl. In the region R6 after the claw portions 75, 77 are detached from the catheter 55, since the force N rapidly decreases, the user can easily recognize the condition that the connection of the arm portion and the hook is released, that is, the condition that the clip unit is separated from the feeder.

[0078] Reference Signs List Figures 10-12 A second embodiment of the present application will be described. In the following description, the same reference signs are attached to structures common to the already described structures, and repeated description is omitted.

[0079] Figure 10 is a view showing the periphery of the catheter 550 of the feeder 150 of the present embodiment. The catheter 550 is composed of two members, a first member 551 having the restriction portion 58 and the reduced diameter portion 55a, and a second member 552 having the small diameter portion 550b.

[0080] Figure 11 is an external appearance view of the catheter 550. The second member 552 is a cylindrical shape, and its outer peripheral surface is divided by a slit 552a extending in parallel with the axis of itself. Thus, the second member 552 has a cross-sectional shape of a letter C, and the opposite outer peripheral surfaces thereof can approach and depart from each other with the slit 552a interposed therebetween.

[0081] The front portion of the second member 552 is engaged with the rear portion of the first member 551 from the outside, and thus the first member 551 and the second member 552 are integrated.

[0082] In the feeder 150 of the present embodiment, when the front portion 72 of the hook 70 enters the small diameter portion 550b, the front portion 72 pushes the second member 552 from the inside. As a result, the outer peripheral surface of the second member 552 opposite through the slit 552a is distanced. When the distance of the distanced becomes a predetermined value or more, the engagement of the first member 551 and the second member 552 is released, and the second member 552 is separated from the first member 551.

[0083] As a result, an opening larger than the inner diameter of the small diameter portion 550b is formed at the rear end of the first member 551, and the hook is smoothly released from the catheter 550.

[0084] The feeder 150 of the present embodiment, like the feeder 50 of the first embodiment, can take into account both reliable placement of the clip unit in a state of gripping a relatively hard tissue and ease of operation.

[0085] In the present embodiment, the first member and the second member can be formed of the same material or different materials. In the case where the second member is a material that is easily deformed compared to the first member or the like, the thickness of the second member can be the same as or more than the thickness of the first member.

[0086] Further, the first member shape and the second member shape can be formed by one member 553, and the slit 552a can be extended to the outer peripheral surface of the first member, as in the modification shown in FIG. 17. Figure 12

[0087] The slit can not be linear as long as it divides the outer peripheral surface of the small diameter portion.

[0088] The second member can not necessarily be separated from the first member when the front portion of the hook passes through the inside of the small diameter portion. In this case, an opening of a size that the front portion 72 can pass through is formed in the second member by being pushed away.

[0089] The above describes each embodiment of the present application, but the scope of the present application is not limited to the above-described embodiments, and various modifications or deletions can be made to each component within the scope of the gist of the present application.

[0090] In the present application, the restriction member and the catheter are not essential. For example, a restriction portion can be provided in a part of the catheter, and a reduced diameter portion or a small diameter portion can be formed by molding the front end portion of the sheath constituting the insertion portion.

[0091] In the case of using a catheter, an opening can be formed by cutting a part of the catheter or the like. The cross-sectional shape of the lumen of the small diameter portion is not limited to a circular shape, and can be a polygonal shape such as a square shape.

[0092] ​The indwelling device of the present application is not limited to the clamp unit described above. For example, it can also be a snare wire capable of being indwelled in the body in a ligature state as described in Japanese Patent No. 4981157.

[0093] The power transmission member of the present application is not limited to the wire described above. For example, in the case of applying the present application to a treatment instrument used under a laparoscope or the like, the power transmission member can also be a hard rod.

[0094] The auxiliary member of the present application can also not have a small-diameter portion. In this case, the base end portion of the reduced-diameter portion is deformed by the connector by pulling the power transmission member, thereby forming an opening in the auxiliary member.

[0095] Industrial applicability

[0096] The present application can be applied to a feeder used for installing an indwelling device.

[0097] Explanation of reference numerals

[0098] 1, ligature device; 10, clamp unit (indwelling device); 20, arm portion; 21, first arm; 22, second arm; 50, feeder; 51, insertion portion; 52, wire (power transmission member); 55, catheter (auxiliary member); 55a, reduced-diameter portion; 55b, 550b, small-diameter portion; 70, hook (connector); 75, 77, claw portion; 552a, slit.

Claims

1. A ligature device, wherein the ligature device comprises: a clamp unit having an arm portion capable of opening and closing; a connector linked to the clamp unit in a releasable manner; a wire connected to the connector and configured to operate the clamp unit; and a catheter having an opening through which the wire passes, in a first state in which the connector and the clamp unit are linked together, an inner diameter of the opening is smaller than a dimension in a radial direction of the connector, in a second state in which the connector is not linked to the clamp unit, the inner diameter of the opening is larger than the dimension in the radial direction of the connector, the catheter has a reduced diameter portion in which the inner diameter is reduced toward a base end side, and a small diameter portion connected to the base end side of the reduced diameter portion, the inner diameter of the opening is the inner diameter of the small diameter portion, the connector has a claw for linking to the clamp unit, the dimension in the radial direction of the connector is the dimension in the radial direction of the claw.

2. The ligature device according to claim 1, wherein the catheter is configured to deform from a state in which the inner diameter of the opening is smaller than the dimension in the radial direction of the connector to a state in which the inner diameter of the opening is larger than the dimension in the radial direction of the connector in the second state.

3. The ligature device according to claim 1, wherein with respect to the catheter, in the first state, the connector can be in contact with the reduced diameter portion, and the inner diameter of the small diameter portion is smaller than the dimension in the radial direction of the connector.

4. The ligature device according to claim 1, wherein the small diameter portion is configured to be more easily deformed than the reduced diameter portion.

5. The ligature device according to claim 1, wherein the connector has a plate-shaped portion extending along a length axis of the wire, and the claw extending from the plate-shaped portion toward a front end side, the claw having a rear end portion extending toward a base end side.

6. The ligature device according to claim 5, wherein the catheter has a reduced diameter portion in which the inner diameter is reduced toward a base end side, and a small diameter portion connected to the base end side of the reduced diameter portion, by pulling the wire, the rear end portion enters into the small diameter portion from the contact with the reduced diameter portion, thereby releasing the linking of the connector to the clamp unit.

7. The ligature device according to claim 1, wherein the clamp unit further has a press tube through which the arm portion passes, an inner diameter of a front end side region of the catheter is larger than an outer diameter of the press tube.

8. The ligature device according to claim 2, wherein the catheter has a reduced diameter portion in which the inner diameter is reduced toward a base end side, the reduced diameter portion has a slit extending in a direction of an axis thereof, the ligature device is configured such that the connector entering into the base end of the reduced diameter portion causes the outer peripheral surface of the base end opposite across the slit to be distanced, thereby the opening can be deformed.

9. A ligature device, wherein the ligature device comprises: an arm portion configured to be capable of opening and closing; an auxiliary member through which at least a portion of the arm portion passes; and an opening provided to the auxiliary member, the ligature device is configured such that in a case where the arm portion is disposed at a first position, the opening has a first diameter, the opening is capable of expanding in diameter to a second diameter larger than the first diameter when the arm portion is disposed at a second position closer to the opening than the first position, the auxiliary member has a reduced diameter portion in which the inner diameter is reduced toward the base end side and a small diameter portion connected to the base end side of the reduced diameter portion, the inner diameter of the opening is the inner diameter of the small diameter portion.

10. The ligature according to claim 9, wherein the ligature further includes a feeder connected to the arm portion in a releasable manner, the arm portion and the feeder are connected together when the arm portion is disposed at the first position, the arm portion and the feeder are released from connection when the arm portion is disposed at the second position.

11. The ligature according to claim 10, wherein the feeder has a connector connected to the arm portion in a releasable manner, the connector is disposed at a position closer to the front end side than the opening when the arm portion is disposed at the first position, at least a portion of the connector penetrates the opening when the arm portion is disposed at the second position.

12. The ligature according to claim 11, wherein the auxiliary member has a reduced diameter portion in which the inner diameter is reduced toward the base end side and a small diameter portion connected to the base end side of the reduced diameter portion, the connector has a plate-shaped portion extending along a length axis of the connector and a claw extending from the plate-shaped portion toward the front end side, the claw having a rear end portion extending toward the base end side, the rear end portion enters the small diameter portion by pulling a wire connected to the connector, so that the connector is released from connection with the arm portion.

13. The ligature according to claim 12, wherein the small diameter portion is configured to be more easily deformed than the reduced diameter portion.

14. A ligature having a connector connected to an indwelling device capable of being indwelled in a subject in a releasable manner, a power transmission member connected to the connector, and an auxiliary member having an opening through which the power transmission member penetrates, wherein the auxiliary member has a reduced diameter portion in which the inner diameter is reduced toward the base end side and a small diameter portion connected to the base end side of the reduced diameter portion, the inner diameter of the opening is the inner diameter of the small diameter portion, the connector has a claw for connection with the indwelling device, the dimension of the connector in the radial direction is the dimension of the claw in the radial direction, the connector is brought into contact with the auxiliary member by pulling the power transmission member, the connector is deformed by bringing the connector into contact with the auxiliary member, so that the connector is separated from the indwelling device, the inner diameter of the opening of the auxiliary member is expanded from a first diameter smaller than the outer diameter of the connector to a second diameter larger than the outer diameter of the connector by pulling the power transmission member.

15. The ligature according to claim 14, wherein the connector is deformed by pulling the power transmission member with a first force, so that the connector is separated from the indwelling device, the connector is deformed by pulling the power transmission member with a second force larger than the first force, so that the connector is separated from the auxiliary member. The power transmission member is pulled with a second force smaller than the first force, thereby moving the connector through the opening to a position on the base end side than the auxiliary member.

16. The ligation device according to claim 14, wherein The auxiliary member has a reduced diameter portion in which the inner diameter is reduced toward the base end side, and a small diameter portion connected to the base end side of the reduced diameter portion, The connector is deformed by bringing the connector into contact with the reduced diameter portion, thereby separating the connector from the indwelling device, The inner diameter of the small diameter portion is expanded from a first diameter smaller than the outer diameter of the connector to a second diameter larger than the outer diameter of the connector by pulling the power transmission member.

17. The ligation device according to claim 16, wherein The connector has a plate-shaped portion extending along the length axis of the power transmission member, and a claw extending from the plate-shaped portion toward the front end side, the claw having a rear end portion extending toward the base end side, The connector is deformed by bringing the rear end portion into contact with the reduced diameter portion, thereby separating the connector from the indwelling device.

18. The ligation device according to claim 17, wherein The indwelling device is a clamp unit having an arm portion capable of opening and closing, and a pressure tube through which the arm portion penetrates, The inner diameter of the front end side region of the auxiliary member is larger than the outer diameter of the pressure tube.

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