ENDOSCOPE CLIP SYSTEM AND METHOD FOR MANUFACTURING SAME

Abstract

An endoscope clip system (1) including a medical treatment clip (10) which grips a target object, and a linear object (20) which has a distal end and a proximal end, extends along a longitudinal axis and causes the medical treatment clip (10) to move along said longitudinal axis, wherein: the linear object (20) comprises a clip coupling part (21) which couples the medical treatment clip (10) to the distal side of said linear object (20); the medical treatment clip (10) has a longitudinal direction, an opening / closing direction of the medical treatment clip (10) and a width direction of the medical treatment clip (10); the medical treatment clip (10) has a first arm part (11a) and a second arm part (12a) which are arranged facing one another and grip the target object, and a first base part (11b) and a second base part (12b) which are arranged facing one another and are on the proximal side of the first arm part (11a) and the second arm part (12a); the medical treatment clip (10) is configured so as to be coupled to the clip coupling part (21) by the first base part (11b) and the second base part (12b); the medical treatment clip (10) has a connection part (13) which connects the first base part (11b) and the second base part (12b), on a first end side in the width direction; and the medical treatment clip (10) and the clip coupling part (21) are coupled by inserting the clip coupling part (21), from a second end side in the width direction of the medical treatment clip (10), between the first base part (11b) and the second base part (12b) of the medical treatment clip (10).

Description

[Technical field]

[0001] The present invention relates to an endoscopic clip system used for purposes such as hemostasis in surgery or treatment using an endoscope, and a method for manufacturing an endoscopic clip system. [Background technology]

[0002] Treatments using endoscopes, such as endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), can sometimes cause bleeding during the procedure. In such cases, the clipping method involves using an endoscopic treatment tool with a clip attached to place a clip at the bleeding site and applying pressure to stop the bleeding.

[0003] For example, Patent Document 1 describes a clip having a main body having a pair of arms and a fastening member that is inserted on the main body and can fasten and close the arms, a fastening receiver is formed on each arm, and the outer circumferential shape of the fastening receiver on at least one arm is formed into a curved surface that is convex in the opposite direction to the other arm. Patent Document 2 describes a ligation device for biological tissue that includes a clip having an arm that grasps biological tissue, a fastening member that closes the arms, a connecting member that engages with the clip, and an engaging portion that restricts the movement of the connecting member relative to the fastening member. Patent Document 3 describes an endoscopic clip device in which a clip is connected to an operation motion transmission member that is arranged in a flexible sheath and can be moved forward and backward, and the clip is held in a closed state by pulling the operation motion transmission member from the operating portion side connected to the flexible sheath, and a water supply channel that penetrates the axial direction is formed over the entire length in the operation motion transmission member, and both ends of the water supply channel are opened straight in the axial direction. Patent Document 4 describes an endoscopic clip device in which a clip and a clip closing ring that maintains the arms in a closed state are positioned near the tip of the sheath, and a friction surface that prevents the base end connecting portion of the clip from slipping out of the clip closing ring is provided at the contact surface between the base end connecting portion of the clip and the clip closing ring. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2011-78592 A [Patent Document 2] JP 2009-11852 A [Patent Document 3] JP 2004-254887 A [Patent Document 4] JP 2002-360585 A Summary of the Invention [Problem to be solved by the invention]

[0005] In conventional endoscopic clip systems such as those disclosed in Patent Documents 1 to 4, the clip connector of the endoscopic treatment tool is inserted into the opening at the proximal end of the clip toward the distal side, and the clip is attached to the clip connector. In addition, some conventional endoscopic clip systems have a directionality at the proximal end of the clip and the distal end of the clip connector to prevent the clip from rotating relative to the clip connector. Therefore, in conventional endoscopic clip systems, when attaching a clip to the clip connector, it is necessary to insert the clip connector into the opening at the proximal end of the clip while checking the directions of the clip and the clip connector, and it may take time to attach the clip. In clinical settings, since a quick treatment is required for bleeding, there is a demand for reliable attachment of the clip to the endoscopic clip system.

[0006] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an endoscope clip system that allows easy attachment of a medical clip, and a manufacturing method thereof. [Means for solving the problem]

[0007] The endoscopic clip system that has been able to solve the above problems includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip along the longitudinal axis, the linear object having a clip connecting portion that connects the medical clip to the surgical instrument side, the medical clip having a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip, the medical clip being disposed opposite each other and including a first arm portion and a second arm portion that grasp the object. and a first base and a second base arranged opposite each other and located proximal to the first arm and second arm, the medical clip is configured to be connected to the clip connecting portion at the first base and the second base, the medical clip has a connecting portion at a first end side in the width direction that connects the first base and the second base, and the medical clip and the clip connecting portion are connected by fitting the clip connecting portion between the first base and the second base of the medical clip from the second end side in the width direction of the medical clip.

[0008] It is preferable that, at the proximal end of the medical clip of the medical clip system of the present invention, the arithmetic mean roughness Ra based on JIS B0601 of the inner surface of the medical clip is greater than the arithmetic mean roughness Ra based on JIS B0601 of the outer surface of the medical clip.

[0009] In the endoscopic clip system of the present invention, it is preferable that the medical clip does not require any force to position the clip connecting portion from the second end side of the medical clip in the width direction between the first base and the second base of the medical clip.

[0010] In the clip system for an endoscope of the present invention, a protrusion is preferably provided on an inner surface of the medical clip, on a second end side in the width direction of the medical clip.

[0011] In the clip system for an endoscope of the present invention, at least one of the first base portion and the second base portion and the clip connecting portion preferably include an engaging portion that engages the clip connecting portion with the medical clip.

[0012] In the clip system for an endoscope of the present invention, the connection portion is preferably disposed proximally relative to the midpoint of the longitudinal length of the medical clip.

[0013] In the clip system for an endoscope of the present invention, the distal end of the clip connecting portion is preferably located distal to the proximal end of the connecting portion.

[0014] In the endoscopic clip system of the present invention, the medical clip further has a cylindrical fastening ring arranged on the outside of the first base and the second base, and the fastening ring is movable longitudinally on the medical clip, and when the medical clip is not gripping an object, the fastening ring is arranged at the distal end of its range of motion, and the clip connecting portion is moved proximally, it is preferable that the force required for the clip connecting portion to detach from the medical clip is 20 N or more.

[0015] In the endoscopic clip system of the present invention, it is preferable that the linear object further has a pushing tool capable of moving in the longitudinal direction, and that the distal end of the pushing tool is configured to contact the proximal end of the fastening ring and move the fastening ring distally.

[0016] In the clip system for an endoscope of the present invention, it is preferable that the clip connecting portion has a contact portion that contacts the proximal end of the medical clip.

[0017] In the endoscopic clip system of the present invention, the medical clip further has a first claw portion at the proximal end of the first base extending toward the second base, and a second claw portion at the proximal end of the second base extending toward the first base, and it is preferable that the first claw portion and the second claw portion have a notch that follows the outer periphery of the linear object.

[0018] In the endoscopic clip system of the present invention, it is preferable that the clip connecting portion has a groove portion that is concave in the circumferential direction of the clip connecting portion, and that the distal wall surface of the groove contacts the distal side surface of the proximal end of the medical clip, and that the proximal wall surface of the groove contacts the proximal side surface of the proximal end of the medical clip.

[0019] The manufacturing method of the endoscopic clip system that can solve the above problem includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip along the longitudinal axis, the linear object having a clip connecting portion that connects the medical clips, the medical clip having a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip, the medical clip has first and second arms arranged opposite each other and grasping the object, and first and second bases arranged opposite each other and located proximal to the first and second arms, the medical clip is configured to connect to the clip connecting portion at the first and second bases, a first end side of the medical clip in the width direction has a connecting portion that connects the first and second bases, and the manufacturing method includes a step of fitting the clip connecting portion between the first and second bases of the medical clip from the second end side of the medical clip in the width direction. Effect of the Invention

[0020] According to the endoscopic clip system of the present invention, the medical clip has a first base and a second base, and a connecting portion is provided at a first end side in the width direction of the medical clip, and the medical clip can be attached to the clip connecting portion by fitting the clip connecting portion between the first base and the second base of the medical clip from the second end side in the width direction of the medical clip, and the medical clip can be attached more easily than with conventional endoscopic clip systems. Also, according to the manufacturing method of the endoscopic clip system of the present invention, the medical clip has a connecting portion at the first end side in the width direction of the medical clip, and includes a step of fitting the clip connecting portion between the first base and the second base from the second end side in the width direction of the medical clip, and therefore the medical clip can be attached to the clip connecting portion more easily than with conventional endoscopic clip systems. [Brief description of the drawings]

[0021] [Figure 1] 1 illustrates a plan view of the distal side of an endoscopic clip system in one embodiment of the present invention. [Diagram 2] 2 is a cross-sectional view of the clip system for an endoscope shown in FIG. 1 along line II-II. [Diagram 3] 2 shows a plan view of the distal side of the linear object of the endoscopic clip system shown in FIG. 1. [Figure 4] 2 is a plan view of a medical clip of the clip system for an endoscope shown in FIG. 1, without showing a fastening ring. [Diagram 5] 5 shows a VV cross-sectional view of the medical clip shown in FIG. 4. [Figure 6] 13 illustrates a cross-sectional view of a proximal end of a medical clip of an endoscopic clip system in accordance with another embodiment of the present invention. [Figure 7] 13 is a plan view of a medical clip without a fastening ring according to another embodiment of the present invention; FIG. [Figure 8] 13 is a plan view of the distal side of a linear object of an endoscopic clip system in accordance with another embodiment of the present invention. FIG. [Figure 9] 13 is a plan view of the distal side of a linear object of a clip system for an endoscope in yet another embodiment of the present invention. FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0022] The present invention will be described in more detail below based on the following embodiments, but the present invention is not limited to the following embodiments, and can be modified as long as it meets the purpose described above and below, and all of these modifications are included in the technical scope of the present invention. In addition, hatching and component symbols may be omitted in each drawing for convenience, but in such cases, the specification and other drawings should be referred to. In addition, the dimensions of various components in the drawings may differ from the actual dimensions because priority is given to helping understand the features of the present invention.

[0023] FIG. 1 is a plan view of the distal side of a clip system 1 for an endoscope in one embodiment of the present invention, and FIG. 2 is a cross-sectional view perpendicular to the longitudinal direction of the clip system 1 for an endoscope.

[0024] 1 and 2, the endoscopic clip system 1 of the present invention includes a medical clip 10 that grips an object, and a linear object 20 that has a distal end and a proximal end, extends in the longitudinal direction, and moves the medical clip 10 along its longitudinal axis. After gripping the target site inside the body, the medical clip 10 is separated from the linear object 20 at the connecting portion, and the linear object 20 is removed from the body.

[0025] In the present invention, the proximal side refers to the hand side of the user in the extending direction of the linear object 20, and the distal side refers to the opposite side of the proximal side, i.e., the side to be treated. The extending direction of the linear object 20 is called the longitudinal direction. The longitudinal direction can be rephrased as the direction of approach and distance of the linear object 20. The radial direction refers to the radial direction of the circumscribing circle of the cross-sectional shape of the linear object 20 in the longitudinal direction, the inward direction in the radial direction refers to the direction toward the axial center of the circumscribing circle of the cross-sectional shape of the linear object 20, and the outward direction in the radial direction refers to the direction toward the opposite side to the inward direction. In addition, in Figures 1, 3, and 4, the right side of the figure is the proximal side, and the left side of the figure is the distal side.

[0026] The medical clip 10 is attached to a linear object 20 of an endoscopic clip system 1 in an endoscopic procedure such as ESD or EMR, and is used for stopping bleeding, suturing a lesion, or the like.

[0027] Examples of materials constituting the medical clip 10 include stainless steels such as SUS301, SUS303, SUS304, and SUS631, Ni-Ti alloys, and the like. Among these, it is preferable that the material constituting the medical clip 10 is stainless steel. By using stainless steel as the material constituting the medical clip 10, the medical clip 10 becomes highly elastic, and the biocompatibility of the medical clip 10 can be improved.

[0028] The linear object 20 has a longitudinal direction. That is, the linear object 20 extends along the longitudinal axis. The linear object 20 may be tubular having an inner cavity extending along the longitudinal axis, but is preferably solid. By making the linear object 20 solid, the rigidity of the linear object 20 can be increased without increasing the outer diameter of the linear object 20. As a result, the insertability of the endoscopic clip system 1 can be improved. The linear object 20 may be a solid wire, or a twisted wire in which single wires are twisted together. If the linear object 20 is a solid wire, it is easy to manufacture. If the linear object 20 is a twisted wire, the strength of the linear object 20 can be increased, so that the operation on the hand side is easily transmitted to the distal end including the medical clip 10 and the clip connecting portion 21. The cross-sectional shape of the wire constituting the linear object 20 may be, for example, a circular shape, an elliptical shape, a polygonal shape, or a shape that is a combination of these.

[0029] Examples of materials constituting the linear object 20 include metals such as stainless steels, such as SUS301, SUS303, SUS304, and SUS631, and carbon steel, and synthetic resin fibers, such as polyamide resins, such as nylon, polyolefin resins, such as PP and PE, polyester resins, such as PET, aromatic polyether ketone resins, such as PEEK, polyimide resins, and fluororesins, such as PTFE, PFA, and ETFE. Among these, the material constituting the linear object 20 is preferably stainless steel. By using stainless steel as the material constituting the linear object 20, it is possible to improve biocompatibility while providing the strength required for the endoscopic clip system 1.

[0030] Although not shown, the linear object 20 may have a coating layer on the surface. By having the linear object 20 have a coating layer, it is possible to reduce friction on the surface of the linear object 20 and increase the sliding property, and to increase the strength of the linear object 20. Examples of the coating layer include fluororesins such as PTFE, PFA, ETFE, and tetrafluoroethylene-hexafluoropropylene copolymer (FEP).

[0031] The coating layer can be formed on the linear object 20 by, for example, coating the linear object 20 with a material for forming the coating layer, and methods such as a dipping method, a spraying method, a fluidized bed method, and a kneader coater method can be used.

[0032] The longitudinal length of the linear object 20 can be appropriately selected in consideration of the distance from the forceps port of the endoscope to the treatment target site, and can be, for example, 1000 mm or more and 3000 mm or less. By providing a handle on the proximal side of the linear object 20, the medical clip 10 and the linear object 20 can be easily operated.

[0033] The outer diameter of the linear object 20 is preferably 100 μm or more, more preferably 200 μm or more, and even more preferably 300 μm or more. By setting the lower limit of the outer diameter of the linear object 20 within the above range, the rigidity of the linear object 20 can be increased. Furthermore, the outer diameter of the linear object 20 is preferably 900 μm or less, more preferably 800 μm or less, and even more preferably 700 μm or less. By setting the upper limit of the outer diameter of the linear object 20 within the above range, the linear object 20 can be made thinner, and the insertability of the endoscopic clip system 1 can be improved.

[0034] The outer diameter of the linear object 20 may be the same or different over the entire length. For example, the proximal portion of the linear object 20 may be thickened for reinforcement. As a method for reinforcing the linear object 20, for example, a tubular part may be disposed on the outer surface of the linear object 20.

[0035] Fig. 3 is a plan view of the distal side of the linear object 20 of the endoscopic clip system 1. As shown in Fig. 3, the linear object 20 has a clip connecting portion 21 for connecting the medical clip 10 to the distal side. The medical clip 10 can be attached to the linear object 20 by connecting the medical clip 10 to the clip connecting portion 21. In other words, the linear object 20 has a distal end and a proximal end, extends along a longitudinal axis, and moves the medical clip 10 along the longitudinal axis.

[0036] The clip connecting part 21 is provided on the linear object 20. For the operation of the medical clip 10, the clip connecting part 21 is provided on the distal side of the linear object 20, and is preferably provided on the distal end of the linear object 20. The linear object 20 preferably has a portion, as the clip connecting part 21, whose outer diameter increases toward the distal side. The clip connecting part 21 may be a part of the linear object 20, or may be configured by attaching a separate part (hereinafter, sometimes referred to as a "clip connecting part") for connecting the medical clip 10 to the linear object 20. The clip connecting part 21 may be disposed, for example, on the distal end of the linear object 20.

[0037] When the clip connecting portion 21 is a clip connecting part attached to the linear object 20, the material of the clip connecting part may be, for example, a metal such as stainless steel or carbon steel, a polyamide resin such as nylon, a polyolefin resin such as PP or PE, a polyester resin such as PET, an aromatic polyetherketone resin such as PEEK, a polyimide resin, or a synthetic resin such as fluororesin such as PTFE, PFA, or ETFE. Among them, the material of the clip connecting part is preferably the same as the material of the linear object 20. By using the same material of the clip connecting part as the material of the linear object 20, the connection between the clip connecting part and the linear object 20 can be made strong, so that the clip connecting part is less likely to come off from the linear object 20. As a result, the durability of the endoscopic clip system 1 can be increased.

[0038] When the clip connecting portion 21 is a clip connecting part, the method of fixing the clip connecting part to the linear object 20 can be, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser, silver solder, or heat, or adhesion using an adhesive or tape. Among these, it is preferable that the clip connecting part is fixed to the linear object 20 by welding. Fixing the clip connecting part to the linear object 20 by welding can increase the bonding strength between the clip connecting part and the linear object 20.

[0039] FIG. 4 is a plan view of the medical clip 10, and FIG. 5 is a cross-sectional view perpendicular to the longitudinal direction of the medical clip 10. As shown in FIG. 4 and FIG. 5, the medical clip 10 has a first part 11 and a second part 12 arranged opposite each other. The first part 11 has a first arm 11a on the distal side and a first base 11b located proximal to the first arm 11a. Similarly, the second part 12 has a second arm 12a on the distal side and a second base 12b located proximal to the second arm 12a. For example, as shown in FIG. 4, the distal side of the midpoint P1 of the longitudinal length of the medical clip 10 can be the arm, and the proximal side can be the base. The medical clip 10 has a longitudinal direction, an opening / closing direction of the medical clip 10, and a width direction of the medical clip 10. The medical clip 10 is configured to connect to the clip connecting part 21 on the proximal side in the longitudinal direction of the medical clip 10, and to grasp an object on the distal side in the longitudinal direction. A connecting part 13 that connects the first base part 11b and the second base part 12b is disposed on the first end side in the width direction of the medical clip 10, and the medical clip 10 and the clip connecting part 21 are connected by fitting the clip connecting part 21 between the first base part 11b and the second base part 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10.

[0040] In the conventional endoscopic clip system, as described above, the proximal end of the medical clip has an opening through which the clip connector is inserted, and the medical clip is attached to the clip connector by inserting the clip connector into this opening toward the distal side while checking the orientation of the medical clip and the clip connector. The opening at the proximal end of the medical clip is opened in the longitudinal direction, and is therefore very small in size. Since the opening of the medical clip is small, if the position of the clip connector is misaligned when inserting it into the opening, it becomes difficult to insert the clip connector into the opening. Therefore, accurate positioning of the opening and the clip connector of the medical clip is required. In a clip system that has a restriction on the connection direction between the medical clip and the clip connector, if the orientation of the medical clip and the clip connector is not correct, the medical clip cannot be attached to the clip connector, or the medical clip is easily detached from the clip connector.

[0041] On the other hand, in the endoscopic clip system 1 of the present invention, the medical clip 10 has a first part 11 and a second part 12, and the connecting part 13 is disposed on the first end side of the medical clip 10 in the width direction, and the medical clip 10 can be attached to the clip connecting part 21 by fitting the clip connecting part 21 between the first base part 11b and the second base part 12b of the medical clip 10 from the second end side of the medical clip 10 in the width direction. In other words, since the medical clip 10 is not connected from the longitudinal direction of the conventional medical clip 10 but is approached from a direction perpendicular to the longitudinal direction, the endoscopic clip system 1 of the present invention can attach the medical clip 10 more easily than the conventional endoscopic clip system. Since the cross-sectional area of ​​the outer shape of the medical clip 10 in the direction perpendicular to the longitudinal direction is larger than the cross-sectional area of ​​the outer shape of the medical clip 10 in the longitudinal direction, the opening can be made larger in size according to the present invention. In addition, when attaching the medical clip 10, there is no need to check the orientation of the medical clip 10 and the clip connecting portion 21, and the medical clip 10 can be attached to the clip connecting portion 21 by fitting the clip connecting portion 21 between the first base portion 11b and the second base portion 12b of the medical clip 10 from a direction perpendicular to the longitudinal direction of the medical clip 10, which has a larger opening area than the opening at the proximal end of the medical clip 10. Therefore, the endoscopic clip system 1 of the present invention can attach the medical clip 10 more easily than the conventional endoscopic clip system. In FIG. 4, the left-right direction of the paper corresponds to the longitudinal direction, the up-down direction of the paper corresponds to the opening and closing direction of the medical clip 10, and the front-back direction of the paper corresponds to the width direction of the medical clip 10. In three-dimensional coordinates, when the x-axis direction is the longitudinal direction, the y-axis direction can be the opening and closing direction, and the z-axis direction can be the width direction. The medical clip 10 is configured to be connected to the clip connecting portion 21 of the linear object 20 on the proximal side in the longitudinal direction thereof, and to grip an object on the distal side in the longitudinal direction thereof.

[0042] It is preferable that the force required to fit the clip connector 21 between the first base 11b and the second base 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10 is 0.05 N or more. By setting the lower limit of the force required to fit the clip connector 21 between the first base 11b and the second base 12b from the second end side within the above range, it is possible to reliably confirm whether the medical clip 10 is attached to the clip connector 21 by the tactile feeling when the clip connector 21 is pressed into the medical clip 10 and fitted. Therefore, it is possible to prevent the medical clip 10 from being unintentionally removed when the endoscopic clip system 1 is used for treatment in a state in which the medical clip 10 is not sufficiently attached to the clip connector 21. The upper limit of the force required to fit the clip connector 21 between the first base 11b and the second base 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10 is not particularly limited, but can be, for example, 10 N or less. In addition, except when the force required to fit clip connecting portion 21 between the first base 11b and the second base 12b of medical clip 10 from the second end side of the width direction of medical clip 10 is not generated, a sense of resistance is generated when fitting, so that the attachment of clip connecting portion 21 to medical clip 10 can be recognized by touch.

[0043] FIG. 6 shows a cross-sectional view of the proximal end of the medical clip 10 of the endoscopic clip system 1 in another embodiment of the present invention. Specifically, it shows a cross-sectional view perpendicular to the longitudinal direction of the endoscopic clip system 1 at a portion where the connecting portion 13 of the medical clip 10 is arranged. As shown in FIG. 6, the medical clip 10 may have a protrusion 60 on the inner surface of the medical clip 10 at the second end side in the width direction of the medical clip 10. The protrusion 60 can be a soft protrusion-like object provided at one or both ends of the first base 11b or the second base 12b at the second end side, which is the opposite side to the first end side where the connecting portion 13 is located. When the clip connecting portion 21 is fitted between the first base 11b and the second base 12b of the medical clip 10, the clip connecting portion 21 touches the protrusion 60, generating a sense of resistance, and this tactile sensation allows the user to reliably recognize whether the medical clip 10 is attached to the clip connecting portion 21. Furthermore, by providing the protrusion 60, it is possible to prevent the clip connecting portion 21 from moving toward the second end side and becoming detached from the medical clip 10.

[0044] The protrusion 60 may serve as a guide for guiding the clip connecting portion 21 from the second end side to the first end side of the medical clip 10. For example, the shape of the protrusion 60 may be a right triangle with one end side as the base in a cross section perpendicular to the longitudinal axis of the medical clip 10, and the clip connecting portion 21 may be fitted between the first part 11 and the second part 12 along the hypotenuse.

[0045] The medical clip 10 may be configured such that no force is generated when the clip connecting portion 21 is fitted between the first base portion 11b and the second base portion 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10. In the embodiment of the present invention, the fact that no force is required to place the clip connecting portion 21 between the first base portion 11b and the second base portion 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10 includes that the force required to place the clip connecting portion 21 between the first base portion 11b and the second base portion 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10 is less than 0.05 N. In this case, in order to connect the medical clip 10 and the clip connecting portion 21, it is preferable to provide engagement portions 71, 72, and 73 on the first base portion 11b or the second base portion 12b of the medical clip 10 and the clip connecting portion 21.

[0046] FIG. 7 shows a plan view of the medical clip 10 without the fastening ring 30 of the endoscopic clip system 1 according to another embodiment of the present invention, FIG. 8 shows a plan view of an example of the distal end of the linear object 20, and FIG. 9 shows another plan view of the distal end of the linear object 20. As shown in FIG. 7, at least one of the first base portion 11b and the second base portion 12b and the clip connector portion 21 preferably includes engagement portions 71, 72, and 73 for engaging the clip connector portion 21 with the medical clip 10. The engagement portions 71, 72, and 73 may be, for example, interlocking grooves, irregularities, etc. The engagement portions 71, 72, and 73 may be a combination of a large diameter portion and a small diameter portion provided on the medical clip 10 and the clip connector portion 21. The large diameter portion on the distal side comes into contact with the small diameter portion, whereby the two engage with each other, and the connection between the medical clip 10 and the clip connector portion 21 can be strengthened. Incidentally, even in a mode in which a force is generated when the medical clip 10 and the clip connecting portion 21 are engaged with each other, the engaging portions 71, 72, and 73 can be provided.

[0047] Examples of the embodiment of the engaging portions 71, 72, and 73 include the following. As shown in FIG. 7, a groove may be provided as the engaging portion 71 in one or both of the first base portion 11b and the second base portion 12b of the medical clip 10, and as shown in FIG. 8 and FIG. 9, the clip connecting portion 21 may be provided with convex portions as the engaging portions 72 and 73 that engage with the groove of the engaging portion 71 of the medical clip 10. When the cross section perpendicular to the longitudinal direction of the clip connecting portion 21 is circular, the engaging portions 72 and 73 may be provided as convex portions that engage with the groove of the engaging portion 71 of the medical clip 10 over a part or the entire circumference of the clip connecting portion 21. When the cross section perpendicular to the longitudinal direction of the clip connecting portion 21 is rectangular, the engaging portions 72 and 73 may be provided as convex portions that engage with the groove of the engaging portion 71 of the medical clip 10 over a part or the entire circumference of the clip connecting portion 21.

[0048] The medical clip 10 may be formed, for example, by bending a single metal plate including the first portion 11, the second portion 12, and the connecting portion 13, or may be formed by joining a part including the first portion 11, a part including the second portion 12, and a part including the connecting portion 13. In particular, the medical clip 10 is preferably formed by bending a single metal plate including the first portion 11, the second portion 12, and the connecting portion 13. By forming the medical clip 10 from a single metal plate, there is less variation in the product during the manufacture of the medical clip 10, and the manufacturing efficiency of the medical clip 10 can be improved.

[0049] When the medical clip 10 is formed by joining together a part including the first part 11, a part including the second part 12, and a part including the connecting part 13, the part including the connecting part 13 and the part including the first part 11 and the part including the second part 12 can be joined by, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser, silver solder, or heat, or adhesion using an adhesive or tape. Among these, the method for joining the part including the connecting part 13 to the part including the first part 11 and the part including the second part 12 is preferably welding. By joining the parts by welding, the joining strength of the parts can be increased.

[0050] The length from the distal end 13d of the connecting part 13 to the proximal end 13p of the connecting part 13 is preferably greater than at least one of the width of the proximal end of the first part 11 and the width of the proximal end of the second part 12. Since the length from the distal end 13d of the connecting part 13 to the proximal end 13p is greater than at least one of the width of the proximal end of the first part 11 and the width of the proximal end of the second part 12, the connecting part 13 can easily prevent the distance between the first part 11 and the second part 12 from changing, and for example, when the clip connecting part 21 is fitted between the first part 11 and the second part 12, the distance between the first part 11 and the second part 12 can be prevented from widening, causing the clip connecting part 21 to come off the medical clip 10.

[0051] 4, the connecting portion 13 is preferably disposed proximal to the midpoint P1 of the longitudinal length of the medical clip 10. By disposing the connecting portion 13 proximal to the midpoint P1 of the longitudinal length of the medical clip 10, the clip connecting portion 21 can be easily fitted to the medical clip 10 and is less likely to come off, thereby improving the ease of handling of the endoscopic clip system 1.

[0052] It is more preferable that the connection part 13 is disposed proximal to the midpoint P1 of the longitudinal length of the medical clip 10 and distal to the proximal end of the medical clip 10. By disposing the connection part 13 proximal to the midpoint P1 of the longitudinal length of the medical clip 10 and distal to the proximal end of the medical clip 10, the medical clip 10 is less likely to be deformed or damaged due to being widely opened.

[0053] At the proximal end of the medical clip 10, the arithmetic mean roughness Ra based on JIS B0601 of the inner surface of the medical clip 10 is preferably greater than the arithmetic mean roughness Ra based on JIS B0601 of the outer surface of the medical clip 10. By making the arithmetic mean roughness Ra of the inner surface at the proximal end of the medical clip 10 greater than the arithmetic mean roughness Ra of the outer surface, it is possible to increase the frictional force between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21. As a result, the medical clip 10 is less likely to rotate in the circumferential direction relative to the clip connecting part 21, making the endoscopic clip system 1 easier to handle.

[0054] 1, when the medical clip 10 and the clip connecting part 21 are connected, the distal end 21d of the clip connecting part 21 is preferably disposed distal to the proximal end 13p of the connecting part 13. By disposing the distal end 21d of the clip connecting part 21 distal to the proximal end 13p of the connecting part 13, the contact area between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 can be made sufficient. Therefore, during treatment using the endoscopic clip system 1 after the medical clip 10 is attached to the clip connecting part 21, it is possible to prevent the medical clip 10 from unintentionally falling off the clip connecting part 21.

[0055] The distal end 21d of the clip connecting part 21 is disposed distal to the proximal end 13p of the connecting part 13, and more preferably, the proximal end of the clip connecting part 21 is disposed proximal to the proximal end 13p of the connecting part 13. In addition to the distal end 21d of the clip connecting part 21 being disposed distal to the proximal end 13p of the connecting part 13, the proximal end of the clip connecting part 21 is disposed proximal to the proximal end 13p of the connecting part 13, so that a larger area can be secured where the inner surface of the medical clip 10 is in contact with the outer surface of the clip connecting part 21. As a result, the frictional force generated between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 can be increased, making it possible to make the medical clip 10 less likely to fall off the clip connecting part 21.

[0056] 1, the endoscopic clip 10 further includes a cylindrical fastening ring 30 disposed outside the first base 11b and the second base 12b, that is, on the outer periphery of the medical clip 10, and the fastening ring 30 is movable in the longitudinal direction on the medical clip 10. When the medical clip 10 is not gripping an object, the fastening ring 30 is disposed at the most distal position of its movable range, and the clip connector 21 is moved proximally. The force required for the clip connector 21 to be detached from the medical clip 10 when the clip connector 21 is moved proximally is preferably 20 N or more. Since the force required for the clip connector 21 to be detached from the medical clip 10 when the clip connector 21 is moved proximally is 20 N or more, it is necessary to apply a certain amount of force to detach the medical clip 10 from the clip connector 21, and therefore the medical clip 10 is prevented from being unintentionally detached during use of the endoscopic clip system 1, and treatment can be performed smoothly.

[0057] When the fastening ring 30 is placed at the most distal position of the range of motion of the fastening ring 30 and the clip connector 21 is moved proximally while the medical clip 10 is not gripping an object, the force required for the clip connector 21 to be detached from the medical clip 10 can be appropriately set depending on the application of the medical clip 10, etc. It is preferable that the force required for the clip connector 21 to be detached from the medical clip 10 is set to be greater than the force required to move the fastening ring 30. This setting is for preventing the medical clip 10 from being detached from the clip connector 21 when the fastening ring 30 is moved. For example, it is preferable that the force required for the clip connector 21 to be detached from the medical clip 10 is 20 N or more. By setting the lower limit of the force required for the clip connector 21 to be detached from the medical clip 10 when the clip connector 21 is moved proximally within the above range, the medical clip 10 is less likely to be unintentionally detached from the clip connector 21, and time loss such as reattaching the medical clip 10 to the clip connector 21 during treatment using the endoscopic clip system 1 is less likely to occur. In addition, when the medical clip 10 is not gripping an object and the fastening ring 30 is placed at the most distal position of the range of motion of the fastening ring 30 and the clip connector 21 is moved proximally, if the force required for the clip connector 21 to be detached from the medical clip 10 is too small, the medical clip 10 will easily detach from the clip connector 21, which is not preferable. In addition, if this force is too large, it will be difficult to separate the medical clip 10 and the clip connector 21. By appropriately setting the force required for the clip connecting portion 21 to detach from the medical clip 10 when the clip connecting portion 21 is moved proximally, it becomes easier to detach the medical clip 10 from the clip connecting portion 21 after the medical clip 10 has grasped the bleeding area, etc., and treatment using the endoscopic clip system 1 can be performed smoothly.

[0058] The material of the fastening ring 30 may be the same as that of the medical clip 10, and examples of such materials include stainless steels such as SUS301, SUS303, SUS304, and SUS631, and metals such as Ni-Ti alloys. Of these, the material of the fastening ring 30 preferably contains stainless steel. By including stainless steel in the material of the fastening ring 30, the fastening ring 30 can be made highly elastic. Therefore, the fastening ring 30 can easily press the medical clip 10 from the outside, making it easy to close the medical clip 10.

[0059] As shown in FIG. 1, the linear object 20 further has a pusher 40 capable of moving in the longitudinal direction, and the distal end 40d of the pusher 40 is preferably configured to contact the proximal end 30p of the fastening ring 30 to move the fastening ring 30 distally. By the linear object 20 having the pusher 40, it becomes easy to move the fastening ring 30 distally, and it becomes easy to close the medical clip 10 and grasp the target object. The pusher 40 is preferably operated by an operating handle disposed on the proximal side of the linear object 20. When the pusher 40 is operated by the operating handle, the linear object 20 and the pusher 40 are preferably integrated via the operating handle.

[0060] The pushing tool 40 is preferably tubular, with the linear object 20 disposed in the inner cavity of the pushing tool 40. By disposing the linear object 20 in the inner cavity of the pushing tool 40, the pushing tool 40 can be moved along the linear object 20, making it easier to move the pushing tool 40 in the longitudinal direction. The pushing tool 40 pushes the fastening ring 30 to move it from the proximal side to the distal side of the medical clip 10. For this reason, the distal end of the pushing tool 40 is preferably tubular with a cross-sectional size that is the same as or similar to that of the fastening ring 30.

[0061] Examples of the material of the pressing tool 40 include stainless steel such as SUS304 and SUS316, metals such as platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni-Ti alloy, and Co-Cr alloy, polyamide resins such as nylon, polyolefin resins such as polyethylene and polypropylene, polyester resins such as polyethylene terephthalate (PET), aromatic polyether ketone resins such as polyether ether ketone (PEEK), polyimide resins, and synthetic resins such as polytetrafluoroethylene (PTFE), tetrafluoroethylene-perfluoroalkyl vinyl ether copolymer (PFA), and ethylene-tetrafluoroethylene copolymer (ETFE), etc. Among these, the material of the pressing tool 40 is preferably a metal, and more preferably contains stainless steel. Since the material of the pusher 40 is metal, the pusher 40 is less likely to be crushed when the distal end 40d of the pusher 40 comes into contact with the proximal end 30p of the fastening ring 30, and the force applied to the pusher 40 is sufficiently transmitted to the fastening ring 30, making it easier to move the fastening ring 30 distally.

[0062] Although not shown, the distal end of the pushing tool 40 is preferably a coil. By forming the distal end of the pushing tool 40 as a coil, the distal end of the pushing tool 40 is easily bent. Therefore, even if the distal end of the endoscopic clip system 1 is curved when the medical clip 10 is gripped on an object, the fastening ring 30 can be easily moved distally by the pushing tool 40.

[0063] 1 and 3, the clip connecting part 21 preferably has a contact part 22 that contacts the proximal end 10p of the medical clip 10. By having the clip connecting part 21 have the contact part 22, the contact part 22 contacts the proximal end 10p of the medical clip 10, thereby preventing longitudinal movement of the linear object 20, and making it difficult for the medical clip 10 to come off the clip connecting part 21 in an unintended situation.

[0064] 4 and 5, the medical clip 10 further has a first claw portion 51 extending toward the second base portion 12b at the proximal end of the first base portion 11b, and a second claw portion 52 extending toward the first base portion 11b at the proximal end of the second base portion 12b, and as shown in Fig. 2, the first claw portion 51 and the second claw portion 52 preferably have a notch 53 along the outer periphery of the linear object 20. Since the medical clip 10 has the first claw portion 51 and the second claw portion 52, it has an effect of preventing the linear object 20 from moving proximally relative to the medical clip 10 and preventing the medical clip 10 from unintentionally coming off the linear object 20. Furthermore, since the first claw portion 51 and the second claw portion 52 have a notch 53 that follows the outer circumference of the linear object 20, when attaching the medical clip 10 to the linear object 20, even if the medical clip 10 has the first claw portion 51 and the second claw portion 52 at the proximal ends of the first base portion 11b and the second base portion 12b, the linear object 20 passes through the notch 53, making it easy to attach the medical clip 10 to the linear object 20.

[0065] When the gripping of the object by the medical clip 10 is completed and the medical clip 10 is to be removed from the linear object 20 to place the medical clip 10, it is preferable that the clip connecting part 21 pushes the first claw part 51 and the second claw part 52 from the distal side toward the proximal side to deform them, so that the clip connecting part 21 passes through the notch 53, and the clip connecting part 21 moves to the proximal side to remove the medical clip 10 from the linear object 20. The clip connecting part 21 deforms the first claw part 51 and the second claw part 52 to pass through the notch 53, and removes the medical clip 10 from the linear object 20. As a result, the clip connecting part 21 does not move to the proximal side unless a force greater than the deformation of the first claw part 51 and the second claw part 52 is applied to the clip connecting part 21, and therefore it is possible to prevent the medical clip 10 from being unintentionally removed from the linear object 20.

[0066] The first claw portion 51 may be formed by bending the proximal end of the first portion 11, or may be formed by joining a part constituting the first claw portion 51 (hereinafter, sometimes referred to as a "first claw part") to the proximal end of the first portion 11. Similarly, the second claw portion 52 may be formed by bending the proximal end of the second portion 12, or may be formed by joining a part constituting the second claw portion 52 (hereinafter, sometimes referred to as a "second claw part") to the proximal end of the second portion 12. Among them, it is preferable that the first claw portion 51 is formed by bending the proximal end of the first portion 11, and the second claw portion 52 is formed by bending the proximal end of the second portion 12. Since the first claw portion 51 is formed by bending the proximal end of the first part 11 and the second claw portion 52 is formed by bending the proximal end of the second part 12, the first claw portion 51 is prevented from coming off the first part 11 and the second claw portion 52 is prevented from coming off the second part 12. Even if a load is applied to the first claw portion 51 and the second claw portion 52 when attaching the medical clip 10 to the clip connecting part 21 or removing the medical clip 10 from the clip connecting part 21, the first claw portion 51 and the second claw portion 52 of the medical clip 10 are less likely to be damaged.

[0067] When the first claw 51 is formed by joining the first claw part to the first base 11b, and the second claw 52 is formed by joining the second claw part to the second base 12b, the first claw part and the second claw part can be joined to the first base 11b and the second base 12b by, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser or heat, or adhesion using an adhesive or tape. Among them, the method of joining the first claw part and the second claw part to the first base 11b and the second base 12b is preferably welding. By joining each part by welding, it is possible to increase the joining strength of the first claw part to the first base 11b and the joining strength of the second claw part to the second base 12b.

[0068] 1 and 3, the clip connecting part 21 has a groove part 23 that is recessed in the circumferential direction of the clip connecting part 21, and it is preferable that a distal side wall surface 24d of the groove part 23 contacts the distal side surface of the proximal end of the medical clip 10, and a proximal side wall surface 24p of the groove part 23 contacts the proximal side surface of the proximal end of the medical clip 10. Since the distal side wall surface 24d of the groove part 23 contacts the distal side surface of the proximal end of the medical clip 10 and the proximal side wall surface 24p of the groove part 23 contacts the proximal side surface of the proximal end of the medical clip 10, the proximal end of the medical clip 10 is fitted into the groove part 23 of the clip connecting part 21, so that the medical clip 10 is firmly fixed to the clip connecting part 21, and the medical clip 10 is less likely to fall off unintentionally when the endoscopic clip system 1 is used.

[0069] The depth of groove 23 is preferably greater than the thickness of first claw 51 and second claw 52. The depth of groove 23 indicates the size of groove 23 in the radial direction of clip connecting part 21, the thickness of first claw 51 indicates the size of first claw 51 in the longitudinal direction, and the thickness of second claw 52 indicates the size of second claw 52 in the longitudinal direction. Since groove 23 is deeper than the thickness of first claw 51 and second claw 52, ​​clip connecting part 21 can be easily fitted into medical clip 10 from the second end side of medical clip 10 in the width direction, and medical clip 10 can be easily attached to clip connecting part 21.

[0070] Although not shown, the endoscopic clip system 1 preferably has a handle connected to a proximal end of the linear object 20. The handle is a member that is gripped by a user when operating the endoscopic clip system 1. By having the handle, the endoscopic clip system 1 can be easily operated.

[0071] The manufacturing method of the clip system for endoscope 1 of the present invention includes a medical clip 10 that grasps an object, and a linear object 20 having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip 10 along the longitudinal axis, the linear object 20 having a clip connecting portion 21 that connects the medical clip 10 to the distal side, the medical clip 10 having a longitudinal direction, an opening and closing direction of the medical clip 10, and a width direction of the medical clip 10, the medical clip 10 being disposed opposite each other and having a first arm portion 11a and a second arm portion 12 that grasp the object. a and a first base 11b and a second base 12b disposed opposite each other and located proximal to the first arm 11a and the second arm 12a, the medical clip 10 is configured to be connected to a clip connecting portion 21 at the first base 11b and the second base 12b, the medical clip 10 has a connecting portion 13 connecting the first base 11b and the second base 12b at a first end side in the width direction of the medical clip 10, and includes a step of fitting the clip connecting portion 21 between the first base 11b and the second base 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10. Note that in the following description of the manufacturing method of the endoscopic clip system 1, the description of the parts that overlap with the description of the above-mentioned endoscopic clip system 1 will be omitted.

[0072] The manufacturing method of the clip system 1 for endoscopes includes a step of fitting the clip connecting part 21 between the first base part 11b and the second base part 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10. By pushing the clip connecting part 21 between the first base part 11b and the second base part 12b of the medical clip 10 from the second end side in the width direction of the medical clip 10, the medical clip 10 can be easily attached to the clip connecting part 21.

[0073] As described above, the clip system for an endoscope of the present invention includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip along the longitudinal axis, the linear object having a clip connecting portion that connects the medical clip to the distal side, the medical clip having a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip, the medical clip being disposed opposite each other and including a first arm portion and a second arm portion that grasp the object. The medical clip has a first portion and a second portion disposed opposite each other and located proximal to the first arm and the second arm, the medical clip is configured to be connected to the clip connecting portion at the first base and the second base, the medical clip has a connecting portion connecting the first base and the second base at a first end side in the width direction, and the medical clip and the clip connecting portion are connected by fitting the clip connecting portion between the first base and the second base of the medical clip from the second end side in the width direction of the medical clip. The medical clip has a first portion and a second portion, and a connecting portion is disposed at the first end side in the width direction of the medical clip, and the medical clip can be attached to the clip connecting portion by fitting the clip connecting portion between the first base and the second base of the medical clip from the second end side in the width direction of the medical clip, making it easier to attach the medical clip than conventional endoscopic clip systems.

[0074] In addition, a manufacturing method of a clip system for an endoscope of the present invention includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip along the longitudinal axis, the linear object having a clip connecting portion that connects the medical clip to the distal side, the medical clip having a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip, the medical clip being disposed opposite each other, and having first and second arms that grasp the object. and a first base and a second base disposed opposite each other and located proximal to the first arm and the second arm, the medical clip is configured to be connected to the clip connecting part on the proximal side in the longitudinal direction of the medical clip and to grasp an object on the distal side in the longitudinal direction, the medical clip has a connecting part connecting the first base and the second base on a first end side in the width direction, and includes a step of fitting the clip connecting part between the first base and the second base of the medical clip from the second end side in the width direction of the medical clip. By arranging the connecting part on the first end side in the width direction of the medical clip and including a step of pushing the clip connecting part between the first base and the second base from the second end side in the width direction of the medical clip, the medical clip can be more easily attached to the clip connecting part than in conventional endoscopic clip systems.

[0075] This application claims the benefit of priority based on Japanese Patent Application No. 2019-208964, filed on November 19, 2019. The entire contents of the specification of Japanese Patent Application No. 2019-208964, filed on November 19, 2019, are incorporated by reference into this application. [Explanation of symbols]

[0076] 1: Endoscopic clip system 10: Medical clips 10p: Proximal end of medical clip 11: Part 1 11a: 1st arm 11b: 1st base 12: Part 2 12a: 2nd arm 12b:Second base 13: Connection 13d: Distal end of connection 13p: Proximal end of the connection 20: Linear object 21: Clip connection part 21d: Distal end of clip connection 22: Contact part 23: Groove 24d: Distal wall of groove 24p: Proximal wall of the groove 30: Fastening ring 30p: Proximal end of fastening ring 40: Pressing tool 40d: Distal end of pusher 51: 1st claw part 52:Second claw part 53:Notch 60: Protrusion 71: Engagement part 72: Engagement part 73: Engagement part P1: Midpoint of the longitudinal length of the medical clip

Claims

1. A medical clip for gripping an object; a wire having a distal end and a proximal end, extending along a longitudinal axis, for moving the medical clip along the longitudinal axis; the linear object has a clip connecting portion for connecting the medical clip to a distal side thereof, the medical clip has a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip; The medical clip has a first arm and a second arm arranged opposite each other and configured to grip the object, and a first base and a second base arranged opposite each other and located proximal to the first arm and the second arm, the medical clip is configured to couple to the clip connector at the first base and the second base; the medical clip has a connection portion at a first end side in a width direction, the connection portion connecting the first base portion and the second base portion, a protrusion is provided on an inner surface of the medical clip and on a proximal end of the medical clip at a second end side in a width direction of the medical clip; An endoscopic clip system in which the medical clip and the clip connecting portion are connected by fitting the clip connecting portion between the first base portion and the second base portion of the medical clip from the second end side in the width direction of the medical clip.

2. 2. The clip system for an endoscope according to claim 1, wherein the medical clip has an inner surface having an arithmetic mean roughness Ra based on JIS B0601 that is greater than an outer surface of the medical clip having an arithmetic mean roughness Ra based on JIS B0601 at a proximal end of the medical clip.

3. The clip system for an endoscope according to claim 1 or 2, wherein at least one of the first base portion and the second base portion and the clip connecting portion are provided with an engaging portion that engages the clip connecting portion with the medical clip.

4. The clip system for an endoscope according to any one of claims 1 to 3, wherein the connection portion is disposed proximally relative to a midpoint of the longitudinal length of the medical clip.

5. The clip system for an endoscope according to any one of claims 1 to 4, wherein a distal end of the clip connecting portion is disposed distally of a proximal end of the connecting portion.

6. The medical clip further includes a cylindrical fastening ring disposed outside the first base portion and the second base portion, the fastening ring is longitudinally movable on the medical clip; The clip system for an endoscope according to any one of claims 1 to 5, wherein when the fastening ring is positioned at the distal end of its range of motion and the clip connecting portion is moved proximally while the medical clip is not gripping an object, a force required for the clip connecting portion to detach from the medical clip is 20 N or more.

7. The linear object further has a pusher that is movable in a longitudinal direction, The clip system for an endoscope according to claim 6 , wherein a distal end of the pusher is configured to contact a proximal end of the fastening ring to move the fastening ring distally.

8. The clip system for an endoscope according to any one of claims 1 to 7, wherein the clip connecting portion has a contact portion that contacts a proximal end of the medical clip.

9. The medical clip further includes a first claw portion at a proximal end of the first base portion and extending toward the second base portion, a second prong portion at a proximal end of the second base portion extending toward the first base portion; The clip system for an endoscope according to any one of claims 1 to 8, wherein the first claw portion and the second claw portion have a notch along an outer periphery of the linear object.

10. The clip connecting portion has a groove portion that is recessed in a circumferential direction of the clip connecting portion, a distal wall surface of the groove contacts a distal side surface of a proximal end of the medical clip; The clip system for an endoscope according to any one of claims 1 to 9, wherein the proximal wall surface of the groove is in contact with the proximal side surface of the proximal end of the medical clip.

11. A medical clip for gripping an object; a wire having a distal end and a proximal end, extending along a longitudinal axis, for moving the medical clip along the longitudinal axis; the linear object has a clip connecting portion for connecting the medical clip to a distal side thereof, the medical clip has a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip; The medical clip has a first arm and a second arm arranged opposite each other and configured to grip the object, and a first base and a second base arranged opposite each other and located proximal to the first arm and the second arm, the medical clip is configured to couple to the clip connector at the first base and the second base; a connecting portion that connects the first base portion and the second base portion to a first end side in a width direction of the medical clip; a protrusion is provided on an inner surface of the medical clip and on a proximal end of the medical clip at a second end side in a width direction of the medical clip; A manufacturing method for an endoscopic clip system, comprising a step of fitting the clip connecting portion between the first base portion and the second base portion of the medical clip from a second end side in the width direction of the medical clip.

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