Clip System

Abstract

To provide a clip system in which the operation of loading a clip unit into an applicator using a cartridge system after a pack is opened is reduced.SOLUTION: A clip system includes a cartridge system in which a clip unit is accommodated, an applicator in which the clip unit can be loaded, and a pack in which the cartridge system and the applicator are packaged together.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] This application claims the benefit of U.S. Provisional Application No. 63 / 493,100, filed March 30, 2023, which is incorporated herein by reference in its entirety. [Background technology]

[0002] In endoscopic treatment, clip units are used to ligate the excision site after treatment to stop bleeding, etc. The clip unit includes a clip that clamps the excision site, etc., and a pressure tube that houses the clip and locks it in a closed state. The clip unit is introduced to the treatment site by an applicator (introduction device) that can be inserted through the channel of the endoscope.

[0003] Patent Document 1 describes a cartridge system that allows a clip unit to be reloaded into an applicator. A user can use the cartridge system to reload the clip unit. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] US Patent Application Publication No. 2007 / 0112359 Summary of the Invention [Problem to be solved by the invention]

[0005] However, the cartridge system that stores the reloadable clip unit and the applicator are packaged in separate packs. Therefore, the user must open the applicator and the cartridge system, connect the applicator and the cartridge system, and load the clip unit into the applicator using the cartridge system. There is a need for a clip system that eliminates the need to load the clip unit into the applicator using the cartridge system after opening the pack, and enables the clip unit loaded into the applicator to be used as soon as possible.

[0006] In view of the above circumstances, an object of the present invention is to provide a clip system that requires less work to load a clip unit into an applicator using a cartridge system after opening a pack. [Means for solving the problem]

[0007] In order to solve the above problems, the present invention proposes the following means. A clip system according to a first aspect of the present invention includes a cartridge system containing a clip unit, and the clip unit Connect with a possible applicator; a fixing means for fixing the cartridge system and the applicator; The cartridge system and the applicator of Both packaging do Pack and The cartridge system and the applicator are packaged in the pack while being fixed by the fixing means, and when the clip unit is connected to the applicator, the cartridge is configured to be detachable from the applicator. [Effects of the Invention]

[0008] The clip system of the present invention requires less work to load the clip unit into the applicator using the cartridge system after opening the pack, and the clip unit loaded into the applicator can be used as soon as possible. [Brief explanation of the drawings]

[0009] [Figure 1] 1 is a diagram showing a clip system according to a first embodiment. FIG. [Figure 2]FIG. 10 is a diagram showing another aspect of the clip system. [Figure 3] FIG. 2 is a perspective view of a clip introducing device of the clip system. [Figure 4] FIG. 2 is a perspective view of a clip unit of a cartridge system in the clip system. [Figure 5] FIG. 10 is a perspective view of the clip unit with the pressing tube shown in transparency. [Figure 6] FIG. 2 is a perspective view of a cartridge of the clip unit. [Figure 7] FIG. [Figure 8] FIG. [Figure 9] FIG. 2 is a view showing a compression part of the cartridge. [Figure 10] FIG. [Figure 11] FIG. 2 is a view showing a sheath connection portion of the cartridge. [Figure 12] FIG. [Figure 13] FIG. 2 is a perspective view of a regulating member of the cartridge. [Figure 14] FIG. 2 is a perspective view of the restricting member held by a pair of arms. [Figure 15] FIG. [Figure 16] FIG. 10 is a plan view of the restricting member gripped in the first region. [Figure 17] FIG. 1 shows an opened sterilization pack. [Figure 18] FIG. 1 shows a clip introducing device held by a user. [Figure 19] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 20] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 21]10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 22] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 23] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 24] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 25] 10A to 10C are diagrams illustrating a method of loading the clip unit into the clip introduction device using the cartridge. [Figure 26] 10A and 10B show the cartridge with the sheath of the clip introduction device being withdrawn. [Figure 27] 10A and 10B show the cartridge with the sheath of the clip introduction device being withdrawn. [Figure 28] FIG. 10 shows the clip unit introduced into the body. [Figure 29] FIG. 10 is a view showing the clip unit with the pair of arms closed. [Figure 30] FIG. 10 is a view showing the clip unit with the clip locked. [Figure 31] FIG. 10 is a view showing the clip unit with the clip separated. [Figure 32] FIG. 10 is a view showing the clip unit after breaking. [Figure 33] FIG. 10 is a diagram showing a modified example of the compressing unit. [Figure 34] FIG. 10 is a diagram showing another modified example of the compressing unit. [Figure 35] FIG. 10 is a diagram showing a cartridge system according to a second embodiment. [Figure 36] 10 is a diagram showing a case housed in an outer case in the cartridge system. FIG. [Figure 37] FIG. 37 is a view of the cartridge shown in FIG. 36 as seen from the base end side. [Figure 38]FIG. 10 is a view showing the case being separated from the outer case. [Figure 39] FIG. 39 is a view of the cartridge shown in FIG. 38 as seen from the base end side. [Figure 40] FIG. 10 shows the same case with the sheath removed. [Figure 41] 10A to 10C are diagrams illustrating the procedure for withdrawing the sheath. [Figure 42] 10A to 10C are diagrams illustrating the procedure for withdrawing the sheath. [Figure 43] 10A to 10C are diagrams illustrating the procedure for withdrawing the sheath. [Figure 44] FIG. 10 is a diagram showing a cartridge system according to a third embodiment. [Figure 45] FIG. 2 is a diagram showing the cartridge as viewed from one side in the width direction. [Figure 46] FIG. 10 is a view showing the cartridge as seen from the other side in the width direction. [Figure 47] FIG. 10 is a view showing the cartridge with a sheath inserted into the sheath insertion path. [Figure 48] FIG. 10 is a diagram showing a case in which the sheath is pulled out. [Figure 49] FIG. 10 shows the case with the sheath being withdrawn. [Figure 50] FIG. 10 shows the case with the sheath being withdrawn. [Figure 51] 10A and 10B are diagrams showing modified examples of the case connecting portion; [Figure 52] 52 is a view showing the connecting portion of the case as seen from the arrow in FIG. 51. FIG. [Figure 53] 52 is a view showing the connecting portion of the case as seen from the arrow in FIG. 51. FIG. [Figure 54] FIG. 10 is a diagram showing a modified example of the sheath insertion path. [Figure 55] FIG. 10 is a diagram showing another modified example of the sheath insertion path. [Figure 56] FIG. 10 is a diagram showing another modified example of the sheath insertion path. [Figure 57] 10A and 10B are diagrams showing modified examples of the case connecting portion. [Figure 58]10A and 10B are diagrams showing the modified example of the case connecting portion. [Figure 59] 10A and 10B are diagrams showing the modified example of the case connecting portion. [Figure 60] 10A and 10B are diagrams showing another modified example of the case connecting portion. [Figure 61] FIG. 10 is a diagram showing a modified example of the sheath. [Figure 62] 10 is a view showing the modified example of the case connecting portion into which the modified example of the sheath is inserted. FIG. [Figure 63] FIG. 10 is a diagram showing a modified example of the compressing unit. [Figure 64] FIG. 10 is a diagram showing the same modified example of the compressing unit. [Figure 65] FIG. 10 is a diagram showing the same modified example of the compressing unit. [Figure 66] FIG. 10 is a diagram showing the same modified example of the compressing unit. [Figure 67] FIG. 10 is a diagram showing the same modified example of the compressing unit. [Figure 68] FIG. 10 is a diagram showing a cartridge system according to a fourth embodiment. [Figure 69] FIG. 10 shows a cartridge with a locking mechanism attached to a compression part. [Figure 70] 10A and 10B are diagrams illustrating a method for fixing the sheath so that it does not come off the cartridge. [Figure 71] FIG. [Figure 72] FIG. [Figure 73] FIG. [Figure 74] FIG. 10 is a diagram showing a modified example of the compressing unit. [Figure 75] 10A to 10C are diagrams illustrating a method for separating the locking mechanism from the case. [Figure 76] FIG. [Figure 77] 10A and 10B are diagrams illustrating a method for removing the cartridge from the sheath. [Figure 78] FIG. [Figure 79] 10A and 10B are diagrams showing a modified example of the locking mechanism. [Figure 80] 10A and 10B are diagrams showing the same modified example of the locking mechanism. [Figure 81] 10A and 10B are diagrams showing another modified example of the locking mechanism. [Figure 82] 10A and 10B are diagrams showing the same modified example of the locking mechanism. DETAILED DESCRIPTION OF THE INVENTION

[0010] (First embodiment) A first embodiment of the present invention will be described with reference to FIGS.

[0011] FIG. 1 is a diagram showing a clip system 500 according to this embodiment. The clip system 500 includes a cartridge system 100, a clip introducer (applicator) 200, and a sterilization pack 400. The cartridge system 100 and the clip introducer 200 are packaged together in the sterilization pack 400. The cartridge system 100 is packaged in the sterilization pack 400 in a state where it is connected to the clip introducer 200. Specifically, the cartridge system 100 is connected to the clip introducer 200 in a state where a clip unit 1 can be loaded into the clip introducer 200.

[0012] FIG. 2 illustrates another embodiment of a clip system 500. As shown in FIG. The cartridge system 100 may be packaged in a sterile pack 400 without being connected to the clip introducer device 200 .

[0013] The cartridge system 100 includes a clip unit 1 and a cartridge 5 that houses the clip unit 1. The cartridge system 100 is a support system for easily loading the clip unit 1 into a clip introducer 200. The clip introducer 200 and the clip unit 1 loaded into the clip introducer 200 are also referred to as a clip device 300 (see FIG. 28).

[0014] [Clip introduction device 200] FIG. 3 is a perspective view of clip introduction device 200. As shown in FIG. The clip introduction device (applicator) 200 includes a sheath 220, an operating wire 230, and an operating section 240. The clip introduction device 200 is inserted, for example, into a treatment tool insertion channel of an endoscope and used in combination with the endoscope. For this reason, the sheath 220 is formed to be sufficiently longer than the length of the treatment tool insertion channel of the endoscope. The sheath 220 is flexible and bends in accordance with the curvature of the insertion section of the endoscope.

[0015] The sheath 220 includes a distal tip 221, a distal coil 222, and a proximal coil 224, and is formed into an elongated tubular shape as a whole. The distal coil 222 is disposed on the distal end side of the sheath 220. The distal tip 221 is disposed at the distal end of the distal coil 222.

[0016] As shown in FIG. 3, the operating wire (power transmission unit) 230 includes an arrowhead hook portion (connection portion) 231 connected to the clip unit 1, and a wire 232 that operates the arrowhead hook portion 231.

[0017] The arrowhead hook portion 231 includes a substantially conical engaging portion 231a that engages with the clip unit 1, and a wire connecting portion 231b provided at the base end of the engaging portion 231a. The arrowhead hook portion 231 is formed of a metal material such as stainless steel.

[0018] The wire 232 is inserted so as to be able to move forward and backward relative to the sheath 220. The distal end of the wire 232 is fixed to the proximal end of the wire connecting portion 231b by, for example, welding.

[0019] 3, the operation unit 240 includes an operation unit main body 241, a slider 242, and a thumb ring 248. The operation unit main body 241, the slider 242, and the thumb ring 248 are injection molded from, for example, a resin material. The operation unit main body 241 includes a slit portion 241a and a rotating grip 241b on the tip side. The slit portion 241a supports the slider 242 so that it can move forward and backward.

[0020] The slider 242 is attached so as to be movable forward and backward in the longitudinal axis direction of the operation portion main body 241, and has the base end of the wire 232 attached thereto. When the slider 242 moves forward and backward along the operation portion main body 241, the wire 232 moves forward and backward relative to the sheath 220, and the arrowhead hook portion 231 moves forward and backward.

[0021] The thumb ring 248 is attached to the base end of the operation portion main body 241 so as to be rotatable around the longitudinal axis of the operation portion main body 241 .

[0022] [Clip Unit 1] Fig. 4 is a perspective view of the clip unit 1 of the cartridge system 100. Fig. 5 is a perspective view of the clip unit 1 with the pressing tube 3 shown in a see-through manner. The clip unit 1 includes a clip 2, the pressing tube 3 as a fastening member, and a connecting member 4. In the following description, the clip 2 side of the clip unit 1 in the longitudinal direction A will be referred to as the tip side (distal side) A1 of the clip unit, and the connecting member 4 side will be referred to as the base side (proximal side) A2 of the clip unit 1.

[0023] The clip 2 is formed by bending a metal plate material such as a leaf spring material made of stainless steel at the center. The clip 2 has a pair of arms 21 that can be opened and closed, and a connecting portion 22 that connects the pair of arms 21.

[0024] The pair of arms 21 includes a first arm 211 and a second arm 212. The first arm 211 and the second arm 212 are disposed symmetrically with respect to a central axis O1 in the longitudinal direction A of the clip unit 1. Tissue gripping portions 23 facing each other are formed at the tips of the pair of arms 21. The tissue gripping portions 23 are formed by bending the tips of the pair of arms 21 inward.

[0025] Engagement portions 24 that protrude in a direction perpendicular to the central axis O1 are formed at the base ends of the pair of arms 21. The tissue grasping portion 23 side of the engagement portion 24 is formed as an acutely inclined surface, and the connecting portion 22 side of the engagement portion 24 is formed as an obtusely inclined surface.

[0026] The connecting portion 22 is bent into a U-shape and is connected to the connecting member 4. The connecting portion 22 is biased so that the pair of arms 21 are in an open state. Therefore, the pair of arms 21 of the clip 2 have a self-expanding force in the opening / closing direction P.

[0027] The holding tube 3 has a cylindrical holding tube main body 30 and protruding / recessed wings 31. The holding tube main body 30 is formed by injection molding a highly rigid resin material. The holding tube main body 30 may also be formed from a metal instead of a highly rigid resin material. The protruding / recessed wings 31 are formed by injection molding a material softer than the clip 2, such as a highly rigid resin material with appropriate elasticity, such as PPA (polyphthalamide) or PA (polyamide).

[0028] The protruding and retracting wings 31 are a pair of protruding and retracting projections relative to the outer peripheral surface 30a of the retaining tube main body 30. The protruding and retracting wings 31 are provided on both sides of the central axis O1. The protruding and retracting wings 31 have a basic position in which they protrude radially outward relative to the outer peripheral surface 30a. When the protruding and retracting wings 31 receive a force directed from the outside to the inside in the radial direction, they enter a retracted state in which they retract relative to the outer peripheral surface 30a. When the force is released, the protruding and retracting wings 31 return from the retracted state to the protruding state.

[0029] The connecting member 4 is connected to the connecting portion 22 of the clip 2. The connecting member 4 is also connected to the arrowhead hook portion 231 that passes through the sheath 220. In other words, the connecting member 4 connects the clip 2 and the arrowhead hook portion 231. The connecting member 4 includes an insertion portion 41 that is inserted into the internal space of the pressing tube 3, and a connecting portion 42 that is provided at the base end of the insertion portion 41.

[0030] The insertion portion 41 is an engaging portion that engages (connects) with the connecting portion 22 of the clip 2. The insertion portion 41 has a hook 41f provided on the tip side A1 and a breaking portion 41b provided on the base end side A2 of the hook 41f. The hook 41f extends in a direction perpendicular to the central axis O1 and is formed in a substantially cylindrical rod shape. The connecting portion 22 of the clip 2 is hooked onto the hook 41f.

[0031] The breaking portion 41b breaks when the connecting portion 22 is pulled toward the base end side A2, and a breaking force of, for example, 20 N to 90 N is applied to the hook 41f. Note that the breaking portion 41b may have a mechanism for releasing the connection between the connecting portion 22 of the clip 2 and the hook 41f of the connecting member 4. For example, the breaking portion 41b may have a mechanism for releasing the connection between the connecting portion 22 and the hook 41f by deforming (plastic deformation or elastic deformation) without breaking.

[0032] The connecting portion is an engaging portion that is engaged (connected) with the arrowhead hook portion 231 of the clip introduction device 200. The connecting portion has a connecting portion main body 43 and a connecting arm .

[0033] The connecting arm 44 is provided at the base end of the connecting body 43 and is bifurcated. The connecting arm 44 is elastically deformable relative to the connecting body 43 and can open and close relative to the connecting body 43. A notch 44m that grips and stores the engaging portion 231a of the arrowhead hook portion 231 is formed between the connecting arms 44. The notch 44m is formed in a shape that fits closely to the outer peripheral surface of the engaging portion 231a of the arrowhead hook portion 231.

[0034] [Cartridge 5] 6 and 7 are perspective views of the cartridge 5. FIG. The cartridge 5 has a case 6 and a restricting member 7. The cartridge 5 is about 10 to 20 mm wide, about 50 mm long, and about 5 mm thick, and is formed to a size that is easy to hold in the hand.

[0035] Of the two directions that are perpendicular to the longitudinal direction L of the cartridge 5 and perpendicular to each other, one is referred to as the "width direction W" and the other as the "height direction H." Furthermore, a plane that is horizontal to the longitudinal direction L and the width direction W is referred to as the "horizontal plane HP." A plane that is horizontal to the longitudinal direction L and the height direction H is referred to as the "vertical plane VP." Furthermore, in the cartridge 5 that stores the clip unit 1, the side of the pair of arms 21 is referred to as the tip side of the cartridge 5, and the side of the connecting member 4 is referred to as the base side of the cartridge 5.

[0036] The case 6 has a case main body 60, a compression portion (fixing means) 65, and a sheath connection portion 66. The case 6 is manufactured by injection molding from a transparent resin material that has an appropriate hardness, such as ABS, PC, PP, PS, acrylic, or cycloolefin polymer. Because the case 6 is made of a transparent resin material, the user can easily determine whether or not the clip unit 1 is present inside.

[0037] The case body 60 is formed in a rectangular box shape. The length of the case body 60 in the width direction W is longer than the length of the case body 60 in the height direction H. A pair of protrusions 60p protruding on both sides in the height direction H is provided at the base end of the case body 60.

[0038] FIG. 8 is a cross-sectional view of the cartridge 5. The case body 60 is formed with a storage area 6S in which the clip unit 1 is stored so as to be movable in the longitudinal direction L. The storage area 6S has a first area 61, a second area 62, a folding area 63, and a sheath insertion area 64. As shown in Fig. 8, the first area 61, the second area 62, the folding area 63, and the sheath insertion area 64 are arranged from the distal end to the proximal end in the longitudinal direction L of the case 6. The first area 61, the second area 62, the folding area 63, and the sheath insertion area 64 form an internal space formed symmetrically with respect to a vertical plane VP including a central axis O2 in the longitudinal direction L of the storage area 6S.

[0039] 8, the clip unit 1 is stored in the storage area 6S with the central axis O1 of the clip unit 1 aligned with the longitudinal direction L of the case 6. The clip unit 1 is stored in the storage area 6S with the opening / closing direction P of the pair of arms 21 aligned with the width direction W of the case 6.

[0040] The first area 61 is an internal space in which the clip unit 1 is stored so as to be movable in the longitudinal direction L. The first area 61 communicates with the second area 62.

[0041] The second region 62 is an internal space in which the clip unit 1 is stored so as to be movable in the longitudinal direction L. The length of the second region 62 in the longitudinal direction L is shorter than the length of the first region 61 in the longitudinal direction L. The second region 62 is in communication with the folded region 63.

[0042] 8, the length W1 of the first region 61 in the width direction W is smaller than the opening width W3 (see FIG. 23) of the pair of arms 21 in the open state. Also, the length W2 of the second region 62 in the width direction W (see FIG. 23) is larger than the opening width W3 of the pair of arms 21 in the open state.

[0043] The folded region 63 has an enlarged diameter portion 63a, a tapered portion 63b, and a reduced diameter portion 63c, which are arranged from the distal end to the proximal end.

[0044] The expanded diameter portion 63a is an area that allows the connecting arm 44 of the connecting member 4 to elastically expand (open and close). When the arrowhead hook portion 231 of the clip introduction device 200 and the connecting member 4 of the clip unit 1 engage with each other, the expanded diameter portion 63a allows the connecting arm 44 of the connecting member 4 to open and close in a direction perpendicular to the central axis O1.

[0045] The tapered portion 63b is provided on the base end side of the expanded diameter portion 63a and is formed in a tapered shape. The diameter of the tapered portion 63b expands from the base end side toward the tip end side. Therefore, when the pressing tube 3 is slid from the tip end side toward the base end side, the protruding and retracting wings 31 of the pressing tube 3 are housed inside the pressing tube main body 30.

[0046] The reduced diameter portion 63c is an area that holds the retractable wing 31 in a retracted state. When the clip unit 1 is stored in the cartridge 5, the reduced diameter portion 63c can hold the connecting arm 44 of the connecting member 4 in a state that prevents the connecting arm 44 from spreading.

[0047] When the pressing tube 3 is slid along the tapered portion 63b from the distal end toward the proximal end, the protruding and retracting wings 31 of the pressing tube 3 are housed inside the pressing tube 3. Therefore, the reduced diameter portion 63c, which is smoothly connected to the tapered portion 63b, can hold the protruding and retracting wings 31 of the pressing tube 3 in a housed state.

[0048] The sheath insertion region 64 is a region into which the distal end of the sheath 220 that has passed through the sheath connection portion 66 is inserted. The sheath insertion region 64 is located on the proximal end side of the folding region 63 and communicates with the folding region 63. At the portion where the sheath insertion region 64 and the folding region 63 are connected, the length in the width direction W of the sheath insertion region 64 is longer than the length in the width direction W of the folding region 63. The sheath insertion region 64 is formed with a sheath abutment portion 68 against which the distal tip 221 of the advanced sheath 220 can abut.

[0049] 9 and 10 are diagrams showing the compression unit 65. FIG. The compression portion (fixing means) 65 is a member provided at the base end of the case body 60. The compression portion 65 has a first compression portion 651 and a second compression portion 652. The first compression portion 651 and the second compression portion 652 are provided opposite each other in the height direction H with the sheath connection portion 66 interposed therebetween.

[0050] The first compressing portion 651 has a first connecting portion 651a, a first sheath compressing portion 651b, and a first retaining wing 651c. The first connecting portion 651a connects the case body 60 and the first sheath compressing portion 651b. The first sheath compressing portion 651b is a portion that compresses the sheath 220. The first retaining wing 651c is a blade-shaped member that extends from the first sheath compressing portion 651b toward the tip side.

[0051] The second compressing portion 652 has a second connecting portion 652a, a second sheath compressing portion 652b, and a second retaining wing 652c. The second connecting portion 652a connects the case body 60 and the second sheath compressing portion 652b. The second sheath compressing portion 652b is a portion that compresses the sheath 220. The second retaining wing 652c is a blade-shaped member that extends from the second sheath compressing portion 652b toward the tip side.

[0052] In the following description, the first connecting portion 651a and the second connecting portion 652a are also referred to as "(a pair of) connecting portions 65a." The first sheath compressing portion 651b and the second sheath compressing portion 652b are also referred to as "(a pair of) sheath compressing portions 65b." Furthermore, the first holding wing 651c and the second holding wing 652c are also referred to as "(a pair of) holding wings 65c."

[0053] The sheath connecting portion 66 is an insertion groove into which the sheath 220 can be inserted. The sheath connecting portion 66 is an arc-shaped groove formed on the inner surfaces of the connecting portion 65a and the sheath compressing portion 65b. The sheath connecting portion 66 communicates with the sheath insertion region 64 in the storage region 6S. The sheath 220 is inserted through a sheath insertion port 67 provided at the proximal end of the sheath connecting portion 66, enters the sheath insertion region 64 via the sheath connecting portion 66, and abuts against a sheath abutment portion 68 of the sheath insertion region 64.

[0054] 10, by moving the pair of retaining wings 65c in a direction approaching the central axis O2, the pair of retaining wings 65c move the pair of sheath compressing portions 65b in a direction away from the central axis O2 (i.e., in a direction away from the sheath 220) using the pair of protrusions 60p as fulcrums, thereby widening the sheath insertion opening 67. As a result, the sheath 220 becomes insertable into and removable from the sheath connecting portion 66.

[0055] 11 and 12 are diagrams showing the sheath connection portion 66. FIG. The height H1 of the internal space of the sheath connecting portion 66 is smaller than the outer diameter H2 of the sheath 220. Therefore, when the sheath 220 is inserted into the sheath connecting portion 66, the sheath 220 is sandwiched between the pair of sheath compressing portions 65b and will not come off the sheath connecting portion 66 unless an external force is applied to the pair of retaining wings 65c. In other words, the sheath 220 inserted into the cartridge 5 maintains its connection with the cartridge 5 and will not come off the cartridge 5 unless an external force is applied to the compressing portions (fixing means) 65b.

[0056] FIG. 13 is a perspective view of the restricting member 7. As shown in FIG. The restricting member 7 is movably stored in the first area 61 and the second area 62 together with the clip unit 1. The restricting member 7 is formed, for example, from the same resin as the case 6. The restricting member 7 does not have to be formed from a transparent resin like the case 6.

[0057] 13, the restricting member 7 is formed in a shape symmetrical with respect to a vertical plane VP including the central axis O3. The restricting member 7 has a tip portion 71, a protruding portion 72, a tapered portion 73, and a pressing portion 74. The tip portion 71, the protruding portion 72, the tapered portion 73, and the pressing portion 74 are arranged from the tip to the base end along the central axis O3 of the restricting member 7.

[0058] FIG. 14 is a perspective view of the restricting member 7 held by the pair of arms 21. As shown in FIG. The restricting member 7 is gripped by the clip 2 with the central axis O3 substantially aligned with the central axis O1 of the clip unit 1. As shown in Fig. 8, the clip unit 1 is stored in the storage area 6S with the clip 2 gripping the restricting member 7. At this time, it is desirable that the central axis O1, the central axis O2, and the central axis O3 are aligned.

[0059] The tip portion 71 is provided to protrude from the protruding portion 72 toward the tip side. The tip of the tip portion 71 is located further forward than the tissue gripping portion 23 of the clip 2 that grips the restricting member 7. Therefore, the tip portion 71 prevents the tissue gripping portion 23 of the clip 2 from coming into contact with the case body 60. In addition, the tip of the tip portion 71 is formed on a plane perpendicular to the central axis O3.

[0060] The protruding portion 72 is a member that protrudes in a direction perpendicular to the central axis O3 (hereinafter referred to as the "protruding direction P"). The protruding portion 72 is provided on both sides of the central axis O3. The protruding portion 72 is grasped by the first arm 211 and the second arm 212. The opening / closing direction P of the pair of arms 21 that grasp the protruding portion 72 substantially coincides with the protruding direction P of the protruding portion 72. The curvature of the outer peripheral surface of the protruding portion 72 is smaller than the curvature of the inner peripheral surface of the tissue grasping portion 23. Therefore, the pair of arms 21 can grasp the protruding portion 72 securely.

[0061] The tapered portion 73 is a member formed in a tapered shape. The tapered portions 73 are provided on both sides of the central axis O3. The length of the tapered portion 73 in the protruding direction P is shorter than that of the protruding portion 72. The length of the tapered portion 73 in the protruding direction P becomes shorter from the tip side to the base end side.

[0062] The retaining portion 74 is a plate-like member that regulates the minimum approach distance between the clip 2 and the retaining tube 3. The retaining portion 74 is provided on the base end side of the tapered portion 73. The retaining portion 74 engages with the edge of the distal opening 3a and therefore cannot enter the internal space of the retaining tube 3 from the distal opening 3a. Therefore, even if the clip 2 is pulled in a direction approaching the retaining tube 3, the retaining portion 74 engages with the edge of the distal opening 3a, thereby regulating the minimum approach distance between the clip 2 and the retaining tube 3.

[0063] 13, the regulating member 7 is sandwiched between auxiliary members 75 in the height direction H. The auxiliary members 75 adjust the position of the regulating member 7 in the height direction H so that the regulating member 7 is held by the pair of arms 21. If it is not necessary to adjust the position of the regulating member 7 in the height direction, the auxiliary members 75 are not necessary.

[0064] FIG. 15 is a plan view of the restricting member 7. As shown in FIG. The portion of the protruding portion 72 that protrudes most from the central axis O3 in the protruding direction P is defined as the maximum protruding point 72b. A length W4 between the maximum protruding points 72b is slightly shorter than the length W1 in the width direction W of the first region 61. The length from the maximum protruding point 72b to the base end of the pressing portion 74 in the direction of the central axis O3 is defined as L2.

[0065] FIG. 16 is a plan view of the restricting member 7 gripped in the first region 61. As shown in FIG. The restricting member 7 is stored in the first region 61 while being gripped by the pair of arms 21. The length W1 of the first region 61 in the width direction W is smaller than the opening width W3 of the pair of arms 21 in the open state. Therefore, the pair of arms 21 grip the restricting member 7 when they are closed from the open state. The opening width of the pair of arms 21 is approximately the length W1 of the first region 61 in the width direction W. The pair of arms 21 abut against the case main body 60 in the opening / closing direction P. The length in the direction of the central axis O3 from a contact point 72c between the pair of arms 21 and the case main body 60 to the base end of the pressing portion 74 is defined as L1.

[0066] It is desirable that the length L1 in the direction of the central axis O3 from the contact point 72c to the base end of the pressing portion 74 be equal to or greater than the length L2 in the direction of the central axis O3 from the maximum protruding point 72b to the base end of the pressing portion 74. This is because, when the clip 2 is pulled toward the base end, the clip 2 reliably engages with the restricting member 7 and is pulled toward the base end.

[0067] 15 and 16, the length W4 between the maximum protruding points 72b is slightly smaller than the length W1 in the width direction W of the first region 61. Therefore, the restricting member 7 is maintained in a state where it is gripped by the pair of arms 21 in the first region 61.

[0068] The length L3 (see FIG. 16) from the contact point 72c to the tip of the protruding / retracting wing 31 in the direction of the central axes O1, O3 is equal to or greater than the distance L4 (see FIG. 8) from the tip of the second region 62 to the base end of the tapered portion 63b.

[0069] [How to load Clip Unit 1] Next, the operation of the clip system 500 will be described with reference to Figures 17 to 27. Note that in Figures 17 to 27, illustration of gloves worn by a user on the hands is omitted.

[0070] FIG. 17 shows the sterilization pack 400 after it has been opened. The user opens the sterilization pack 400 and removes the cartridge system 100 and the clip introducer 200 from the sterilization pack 400. The cartridge system 100 is connected to the clip introducer 200.

[0071] As shown in FIG. 2, when the cartridge system 100 is not connected to the clip introducing device 200, the user widens the sheath insertion opening 67 as shown in FIG. 10 and inserts the sheath 220 of the clip introducing device 200 into the sheath connection portion 66.

[0072] FIG. 18 shows clip introducer device 200 being held by a user. For example, the user holds the operating portion 240 of the clip introduction device 200 with the right hand and the sheath 220 with the left hand. The cartridge system 100 is attached to the sheath 220 so that it will not come off from the sheath 220. Therefore, the user does not need to hold the cartridge system 100.

[0073] 19 to 25 are views illustrating a method for loading the clip unit 1 into the clip introducer 200 using the cartridge 5. As shown in Fig. 19, the sheath 220 is inserted into the sheath connecting portion 66, and the distal tip 221 of the sheath 220 abuts against the sheath abutting portion 68. If the distal tip 221 of the sheath 220 is not abutting against the sheath abutting portion 68, the user pushes the sheath 220 toward the distal end to abut the distal tip 221 against the sheath abutting portion 68.

[0074] 20 , the user operates the operating portion 240 to advance the operating wire 230 relative to the sheath 220, thereby advancing the arrowhead hook portion 231. The arrowhead hook portion 231 is connected to the connecting member 4 of the clip unit 1.

[0075] It should be noted that if the arrowhead hook portion 231 is connected to the connecting member 4 of the clip unit 1 in advance, the user does not need to carry out the procedure of moving the arrowhead hook portion 231 forward.

[0076] As shown in Figure 21, the user pulls the operating wire 230. The clip 2 of the clip unit 1 is pulled toward the base end by the connecting member 4 connected to the arrowhead hook portion 231. The hook 41f of the connecting member 4 pulls the connecting portion 22 of the clip 2 without breaking. The restricting member 7 moves through the first area 61 of the storage area 6S while in contact with the pair of arms 21. The pair of arms 21, which have a self-expanding force, engage with the edge of the distal opening 3a of the pressing tube 3, so that the pressing tube 3 is pulled toward the base end together with the clip 2.

[0077] The pair of arms 21 abut against the case body 60 in the first region 61 in the opening / closing direction P. The frictional force generated by the abutment between the pair of arms 21 and the case body 60 can suitably prevent the clip 2 from being pulled into the internal space of the pressing tube 3 and being locked in the closed state by the pressing tube 3.

[0078] When the clip 2 is pulled toward the base end, the pressing portion 74 of the regulating member 7 engages with the edge of the distal opening 3a of the pressing tube 3, thereby restricting the minimum approach distance between the clip 2 and the pressing tube 3. When the operating wire 230 is pulled, the pressing portion 74 comes into contact with the pair of arms 21 and abuts against the pressing tube 3, restricting the relative movement of the regulating member 7 with respect to the pressing tube 3. This also makes it possible to preferably prevent the clip 2, which is pulled toward the base end by the connecting member 4, from being drawn into the internal space of the pressing tube 3 and being locked in the closed state by the pressing tube 3.

[0079] The user pulls the clip unit 1 further toward the proximal end. As shown in FIG. 22 , the pressing tube 3 passes through the folded region 63. The pressing tube 3 slides along the reduced diameter portion 63c from the distal end toward the proximal end, and the protruding and retracting wings 31 of the pressing tube 3 are housed inside the pressing tube main body 30. The pressing tube 3, with the protruding and retracting wings 31 housed inside the pressing tube main body 30, is drawn into the sheath 220.

[0080] 22, the length L3 from the contact point 72c to the tip of the protruding / retracting wing 31 in the direction of the central axes O1, O3 is equal to or greater than the distance L4 from the tip of the second region 62 to the base end of the tapered portion 63b. Therefore, when the protruding / retracting wing 31 of the pressing tube 3 is housed inside the pressing tube 3, the contact point 72c between the pair of arms 21 and the case body 60 is located in the first region 61. In other words, until the protruding / retracting wing 31 is housed inside the pressing tube 3, the pair of arms 21 grip the restricting member 7 and are not drawn into the internal space of the pressing tube 3.

[0081] 23 , the user further pulls the operation wire 230 to pull the restriction member 7 to the second region 62. The length W2 of the second region 62 in the width direction W is greater than the open width W3 of the pair of arms 21 in the open state. Therefore, the restriction member 7 is not gripped by the pair of arms 21 in the second region 62.

[0082] 24, the user further pulls the operating wire 230. The clip 2 separates from the restricting member 7 and is pulled toward the base end. The restricting member 7 has a tapered portion 73 formed on the base end side of the protruding portion 72 that was gripped by the pair of arms 21. Therefore, when the restricting member 7 is pulled toward the base end, the pair of arms 21 are less likely to get caught on the restricting member 7.

[0083] The user further pulls the operating wire 230 as shown in Figure 25. Because the pair of arms 21 do not grip the restricting member 7, the minimum approach distance between the clip 2 and the presser tube 3 is not restricted. The clip 2 pulled toward the proximal end is drawn into the internal space of the presser tube 3 and into the sheath 220. The clip 2 may also be drawn into the sheath 220 without being drawn into the internal space of the presser tube 3. This completes the loading of the clip unit 1 into the clip introducer 200.

[0084] 26 and 27 show the cartridge 5 with the sheath 220 being withdrawn. The user grasps the pair of retaining wings 65c and moves them in a direction approaching the central axis O2, thereby widening the sheath insertion opening 67 and pulling out the sheath 220 from the sheath connecting portion 66.

[0085] [Clip unit 1 operation and function] Next, the operation and function of the clip unit 1 will be described with reference to FIGS.

[0086] The connecting member 4 of the loaded clip unit 1 is connected to the arrowhead hook portion 231 that passes through the inside of the sheath 220. The protruding and retracting wings 31 are pressed against the inner peripheral surface of the sheath 220 and are in a retracted state.

[0087] The pair of arms 21 of the loaded clip unit 1 are in a closed state, being pressed against the inner circumferential surface of the sheath 220. The engaging portion 24 is located closer to the distal end than the proximal end opening 3b, and the pair of arms 21 are not locked in the closed state.

[0088] FIG. 28 is a diagram showing the clip unit 1 introduced into the body. The user introduces the clip unit 1 loaded into the sheath 220 into the body via the channel of the endoscope. Next, the user advances the arrowhead hook portion 231 by advancing the slider 242 along the operation portion main body 241. The user advances the clip unit 1 until the protruding / retracting wings 31 emerge from the sheath 220. By emerging from the sheath 220, the protruding / retracting wings 31 return from the retracted state to the protruding state, which is the basic position.

[0089] When the distal ends of the pair of arms 21 come out of the sheath 220, the self-expanding force of the pair of arms 21 serves as a restoring force, and the clip 2 returns to the open state while moving toward the distal end relative to the presser tube 3. Even when the pair of arms 21 return to the open state and protrude most from the presser tube 3, the engaging portion 24 is positioned within the internal region of the presser tube 3.

[0090] FIG. 29 is a diagram showing the clip unit 1 with the pair of arms 21 closed. The user retracts the arrowhead hook portion 231 by retracting the slider 242 along the operating unit main body 241. The connecting member 4 connected to the arrowhead hook portion 231 pulls the clip 2. The pair of arms 21, which have a self-expanding force, are pulled toward the base end, thereby pushing the distal opening 3a of the pressing tube toward the base end. The protruding and retracting wings 31, which are in the protruding state, are engaged with the sheath 220 and are therefore not retracted into the sheath 220. Therefore, the clip 2 pulled by the connecting member 4 is retracted into the pressing tube 3.

[0091] When the connecting member 4 pulls the connecting portion 22 of the clip 2 toward the base end of the pressure tube 3, the pair of arms 21 are pulled into the pressure tube 3 and gradually close. When the pulling force of the connecting portion 22 is released in this state, the clip 2 returns to the open state while moving toward the tip end, using the self-expanding force of the pair of arms 21 as a restoring force. The user can return the pair of arms 21 to the open state to re-grasp the tissue.

[0092] FIG. 30 shows the clip unit 1 with the clip 2 locked. As the connecting portion 22 is further pulled toward the base end of the pressing tube 3, the engaging portion 24 is retracted toward the base end from the base end opening 3b. Because the connecting portion 22 side of the engaging portion 24 is formed as an obtuse-angled slope, the engaging portion 24 can be easily retracted to the base end from the base end opening 3b. On the other hand, because the tissue gripping portion 23 side of the engaging portion 24 is formed as an acute-angled slope, when the engaging portion 24 is retracted to the base end from the base end opening 3b, the engaging portion 24 engages with the base end opening 3b. As a result, the movement of the clip 2 toward the tip end relative to the pressing tube 3 is restricted, and the pair of arms 21 is locked in the closed state. Once the pair of arms 21 is locked in the closed state, the pair of arms 21 cannot return to the open state.

[0093] FIG. 31 is a diagram showing the clip unit 1 from which the clip 2 has been separated. The user further pulls the clip 2. A tensile breaking force of, for example, 20 to 90 Newtons (N) is applied to the hook 41f, causing the breaking portion 41b to break. The breaking strength of the breaking portion 41b is lower than the breaking strength of the connecting portion main body 43. Therefore, the breaking portion 41b, not the connecting portion main body 43, breaks.

[0094] FIG. 32 is a view showing the clip unit 1 after it has been broken. The user retracts the sheath 220, and leaves the clip 2 in the body with the tissue ligated.

[0095] According to the clip system 500 of this embodiment, the cartridge system 100 and the applicator 200 are housed in the same sterilization pack 400, and the cartridge system 100 is attached to the applicator 200 in advance. Therefore, the work of loading the clip unit 1 into the applicator 200 using the cartridge system 100 after opening the sterilization pack is reduced, and the user can use the clip unit 1 loaded into the applicator 200 as soon as possible.

[0096] Although the first embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0097] (Variation 1-1) FIG. 33 is a diagram showing a compression section 65A1 which is a modified example of the compression section 65. As shown in FIG. The compressing portion 65A1 has a rubber band 65s wound around a pair of sheath compressing portions 65b. The compressing portion 65A1 can more reliably prevent the sheath 220 inserted into the sheath connecting portion 66 from slipping out.

[0098] (Variation 1-2) FIG. 34 is a diagram showing a compression section 65A2 which is a modified example of the compression section 65. As shown in FIG. The compressing portion 65A2 has a metal plate 65t that presses down on the pair of sheath compressing portions 65b in the height direction H. The metal plate 65t and the pair of retaining wings 65c have a structure similar to that of a double clip. The user can reduce the force with which the metal plate 65t presses down on the pair of sheath compressing portions 65b by grasping the pair of retaining wings 65c and moving them in a direction that brings them closer to the central axis O2. The compressing portion 65A2 can more reliably prevent the sheath 220 inserted into the sheath connecting portion 66 from coming out.

[0099] Second Embodiment A second embodiment of the present invention will be described with reference to Figures 35 to 43. In the following description, components common to those already described will be assigned the same reference numerals and duplicated description will be omitted.

[0100] FIG. 35 is a diagram showing a cartridge system 100B according to the second embodiment. Similar to the cartridge system 100 of the first embodiment, the cartridge system 100B is packaged as a clip system 500 together with a clip introduction device (applicator) 200 in a sterilization pack 400. The cartridge system 100B has a clip unit 1 and a cartridge 5B that houses the clip unit 1.

[0101] The cartridge 5B has a case (inner case) 6B, a restricting member 7, and an outer case (fixing means) 8. The cartridge 5B accommodates the clip unit 1.

[0102] The case (inner case) 6B stores the clip unit 1 together with the restricting member 7, similar to the case 6 of the first embodiment. The case 6B can be housed in the outer case 8. The case 6B has a case main body 60, a compressing portion 65B, and a sheath connecting portion 66.

[0103] Compressing portion 65B is a plate-like member provided at the base end of case body 60. Compressing portion 65B has a first compressing portion 651B and a second compressing portion 652B. First compressing portion 651B and second compressing portion 652B are provided opposite each other in the height direction H with sheath connecting portion 66 interposed therebetween.

[0104] The compression portion 65B has a connecting portion 65a that connects to the case body 60. The connecting portion 65a connects the first compression portion 651B and the second compression portion 652B separately to the case body 60. The connecting portion 65a is bent so that the first compression portion 651B and the second compression portion 652B are spaced apart from each other. Therefore, a gap 65G is formed between the first compression portion 651B and the second compression portion 652B. The first compression portion 651B and the second compression portion 652B are spaced apart more from each other on the base end side than on the tip end side.

[0105] The compressing portion 65B is provided with a pair of protrusions 65p that protrude to both sides in the height direction H. The pair of protrusions 65p are provided on both sides of the sheath insertion opening 67.

[0106] The outer case (fixing means) 8 is a case capable of housing the case 6B. The case 6B is inserted and removed through an insertion opening 80 formed on the base end side of the outer case 8. The insertion opening 80 of the outer case 8 is formed with a pair of recesses 80r that engage with a pair of protrusions 65p of the housed case 6B.

[0107] FIG. 36 shows the case 6B housed in the outer case 8. As shown in FIG. The case 6B with the sheath 220 inserted into the sheath connecting portion 66 can be housed in the outer case 8. When the case 6B is housed in the outer case 8, the pair of protrusions 65p engage with the pair of recesses 80r, and the pair of recesses 80r move the compressing portion 65B including the pair of protrusions 65p in a direction approaching the central axis O2. Note that the pair of protrusions 65p and the pair of recesses 80r do not have to be provided as long as the outer case 8 moves the compressing portion 65B in a direction approaching the central axis O2 when the case 6B is housed in the outer case 8.

[0108] FIG. 37 is a view of the cartridge 5B shown in FIG. 36 as seen from the base end side. When the case 6B is housed in the outer case 8, the sheath 220 is sandwiched between the compression portion 65B and does not come off from the sheath connection portion 66. In other words, when the case 6B is housed in the outer case (fixing means) 8, the sheath 220 inserted into the cartridge 5B maintains its connection with the cartridge 5B and does not come off from the cartridge 5B.

[0109] With the sheath 220 inserted into the case body 60 of the cartridge 5B, the clip unit 1 is loaded into the clip introduction device 200 in the same manner as in the first embodiment.

[0110] FIG. 38 shows the case 6B being separated from the outer case 8. As shown in FIG. When the sheath 220 moves in a direction away from the cartridge 5B, the compression portion 65B that has been sandwiching the sheath 220 moves together with the sheath 220. As a result, the case 6B is pulled out from the outer case 8, and the case 6B and the outer case 8 are separated.

[0111] FIG. 39 is a view of the cartridge 5B shown in FIG. 38 as seen from the base end side. When the case 6B and the outer case 8 are separated, the elastic force of the compressed portion 65B causes the compressed portion 65B to move in a direction away from the central axis O2, widening the sheath insertion opening 67. As a result, the sheath 220 becomes insertable into and removable from the sheath connecting portion 66.

[0112] FIG. 40 shows the case 6B with the sheath 220 removed. When the sheath 220 moves further in the direction away from the cartridge 5B, the sheath 220 comes out of the sheath connecting portion 66.

[0113] 41 to 43 are diagrams illustrating the procedure for withdrawing the sheath 220. FIG. The user can separate the case 6B from the outer case 8 and pull out the sheath 220 from the case 6B simply by pulling out the sheath 220 from the cartridge 5B.

[0114] According to the clip system 500 of this embodiment, the cartridge system 100B and the applicator 200 are housed in the same sterilization pack 400, and the cartridge system 100B is attached in advance to the applicator 200. Therefore, the work of loading the clip unit 1 into the applicator 200 using the cartridge system 100B after opening the sterilization pack is reduced, and the user can use the clip unit 1 loaded into the applicator 200 as soon as possible.

[0115] Although the second embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0116] (Variation 2-1) In the above embodiment, the outer case 8 is a case that can contain the entire case 6B. However, the shape of the outer case is not limited to this. The outer case may be any case that can contain at least the compression portion 65B and maintain the connection between the sheath 220 and the cartridge 5B.

[0117] (Third embodiment) A third embodiment of the present invention will be described with reference to Figures 44 to 50. In the following description, components common to those already described will be assigned the same reference numerals and duplicated description will be omitted.

[0118] FIG. 44 is a diagram showing a cartridge system 100C according to the third embodiment. Similar to the cartridge system 100 of the first embodiment, the cartridge system 100C is packaged as a clip system 500 together with a clip introduction device (applicator) 200 in a sterilization pack 400. The cartridge system 100C has a clip unit 1 and a cartridge 5C that houses the clip unit 1.

[0119] The cartridge 5C has a case 6C and a restricting member 7. The cartridge 5C accommodates the clip unit 1.

[0120] The case 6C stores the clip unit 1 together with the restricting member 7, similar to the case 6 of the first embodiment. The case 6C has a case main body 60 and a case connecting portion (fixing means) 81.

[0121] The case connecting part 81 connects the sheath 220 to the case main body 60. The case connecting part 81 is formed in a substantially box shape and supports the case main body 60 so that the sheath insertion region 64 of the case main body 60 communicates with the internal space 8s. The case connecting part 81 has a case movable part 82 in the internal space 8s.

[0122] The case movable part 82 is movably provided in the internal space 8s of the case connecting part 81. The case movable part 82 has a first movable piece 83, a second movable piece 84, and a third movable piece 85.

[0123] FIG. 45 is a view showing the cartridge 5C as seen from one side in the width direction W. FIG. The first movable piece 83 has a first passage 83a that passes through the first movable piece 83. The first movable piece 83 is connected to the second movable piece 84. The first movable piece 83 has a first stopper 83p that protrudes on one side in the width direction W. The first stopper 83p engages with a first slit 81a that is formed on one side of the case connecting portion 81 in the width direction W and extends in the longitudinal direction L. The first movable piece 83 is movable in the longitudinal direction L along the first slit 81a. The first slit 81a is a slit that is closed on both ends in the longitudinal direction L, and the first stopper 83p cannot come out of the first slit 81a.

[0124] The second movable piece 84 has a second passage 84a that passes through the second movable piece 84. The second movable piece 84 is connected to the first movable piece 83 and the third movable piece 85.

[0125] FIG. 46 is a view showing the cartridge 5C as seen from the other side in the width direction W. FIG. The third movable piece 85 has a third passage 85a penetrating the third movable piece 85. The third movable piece 85 is connected to the second movable piece 84. The third movable piece 85 has a third stopper 85p protruding to the other side in the width direction W. The third stopper 85p engages with a third slit 81b extending in the longitudinal direction L and formed on the other side of the case connecting portion 81 in the width direction W. The third movable piece 85 is movable in the longitudinal direction L along the third slit 81b. The base end of the first slit 81a in the longitudinal direction L coincides with the base end of the case connecting portion 81 and is open on the base end side. Therefore, the third stopper 85p can be removed from the third slit 81b and pulled out to the outside of the case connecting portion 81.

[0126] The first path 83a, the second path 84a, and the third path 85a form a path (hereinafter also referred to as a "sheath connection portion 86") through which the sheath 220 can be inserted.

[0127] 44, when the first movable piece 83 moves to the distal end side, the first path 83a communicates with the sheath insertion region 64. When the first movable piece 83 moves to the distal end side, the second movable piece 84 and the third movable piece 85 also move to the distal end side. At this time, the sheath connection portion 86 (the first path 83a, the second path 84a, and the third path 85a) forms a curved, approximately S-shaped path.

[0128] 47 is a diagram showing a cartridge 5C in which a sheath 220 is inserted into a sheath connecting portion 86. When the case movable portion 82 is disposed on the distal end side of the case connecting portion 81, the sheath connecting portion 86 (first path 83a, second path 84a, and third path 85a) forms a curved, approximately S-shaped path. In other words, when the case movable portion 82 is disposed on the distal end side of the case connecting portion (fixing means) 81, the sheath 220 inserted into the cartridge 5C maintains its connection with the cartridge 5C and does not come off from the cartridge 5C.

[0129] With the sheath 220 inserted into the case body 60 of the cartridge 5C, the clip unit 1 is loaded into the clip introduction device 200 in the same manner as in the first embodiment.

[0130] 48 to 50 show the case 6C from which the sheath 220 is withdrawn. When the sheath 220 moves in a direction away from the cartridge 5C, the case movable part 82 moves toward the base end together with the sheath 220. The first movable piece 83 moves toward the base end along the first slit 81a. The third movable piece 85 moves toward the base end along the third slit 81b. Until the third stopper 85p is released from the third slit 81b and pulled out, the sheath connecting part 86 (first path 83a, second path 84a, and third path 85a) maintains its bent, approximately S-shape, and the sheath 220 does not come out of the cartridge 5C.

[0131] When the sheath 220 further moves in a direction away from the cartridge 5C, the third movable piece 85 comes out of the third slit 81b. As a result, as shown in Figure 50, the sheath connection portion 86 (the first path 83a, the second path 84a, and the third path 85a) becomes linear.

[0132] The user can straighten the sheath connecting portion 86 and pull out the sheath 220 from the case 6C simply by pulling out the sheath 220 from the cartridge 5C.

[0133] According to the clip system 500 of this embodiment, the cartridge system 100C and the applicator 200 are housed in the same sterilization pack 400, and the cartridge system 100C is attached in advance to the applicator 200. Therefore, the work of loading the clip unit 1 into the applicator 200 using the cartridge system 100C after opening the sterilization pack is reduced, allowing the user to use the clip unit 1 loaded into the applicator 200 as soon as possible.

[0134] Although the third embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0135] (Variation 3-1) 51 is a diagram showing a case connecting part 81A, which is a modified example of the case connecting part 81. The case connecting part 81A has a sheath connecting part 86A through which a sheath is inserted. A tube 86t is fitted into the sheath connecting part 86A. The sheath connecting part 86A communicates with the sheath insertion region 64 at a distal end opening 86a. The sheath connecting part 86A has a bending part 86b that bends with respect to the longitudinal direction L (sheath insertion direction).

[0136] 52 and 53 are views showing the case connecting portion 81A as viewed from the arrow V1 in Fig. 51. As shown in Fig. 52, the sheath connecting portion 86A at the bending portion 86b is narrower than the proximal end opening 86c, etc. As shown in Fig. 53, due to friction between the surface of the sheath 220 and the surface of the tube 86t, the sheath 220 inserted into the sheath connecting portion 86A maintains its connection with the cartridge 5C and does not come off the sheath connecting portion 86A unless an external force of a predetermined magnitude or greater is applied.

[0137] 54 to 56 are diagrams showing modified examples of the sheath connecting part 86A. The sheath connecting part 86A may have multiple bent parts 86b. By having two or more bent parts 86b that bend in different directions, the sheath connecting part 86A can more firmly hold the sheath 220 so that it does not slip out. Note that the tube 86t does not need to be fitted into the sheath connecting part 86A as long as it can sufficiently hold the sheath 220.

[0138] (Variation 3-2) 57 to 59 are views showing a case connecting part 81B that is a modified example of the case connecting part 81. The case connecting part 81B has a cylindrical elastic body 81e, and the internal space of the elastic body 81e is the sheath connecting part 86B. The outer diameter of the sheath 220 inserted into the sheath connecting part 86B from the proximal end opening 86c is larger than the inner diameter of the sheath connecting part 86B. As shown in FIG. 59, due to the restoring elastic force of the elastic body 81e of the case connecting part 81B, the sheath 220 inserted into the sheath connecting part 86B maintains its connection with the cartridge 5C and does not come off from the sheath connecting part 86B unless an external force equal to or greater than a predetermined value is applied.

[0139] (Variation 3-3) 60 is a diagram showing a case connecting part 81C which is a modified example of case connecting part 81. Case connecting part 81C has a cylindrical elastic body 81e and a rotating body 81r which moves elastic body 81e back and forth in longitudinal direction L (sheath insertion direction). The internal space of elastic body 81e and rotating body 81r is a sheath connecting part 86C.

[0140] 61 is a diagram showing a sheath 220A which is a modified example of the sheath 220. The sheath 220A has an expanded diameter section 220e at its distal end which has a larger outer diameter than the section from the distal end toward the proximal end. A step 220s is formed at the proximal end of the expanded diameter section 220e.

[0141] Figure 62 is a diagram showing the case connecting portion 81C into which the sheath 220A is inserted. When the sheath 220A abuts against the sheath abutment portion 68, the step 220s is located closer to the distal end than the elastic body 81e. As shown in Figure 62, when the rotator 81r is rotated and moved forward, the elastic body 81e is compressed in the longitudinal direction L, reducing the inner diameter of the internal space and coming into close contact with the sheath 220A. Because the step 220s is caught by the elastic body 81e, the sheath 220 inserted into the sheath connecting portion 86C remains connected to the cartridge 5C and will not come off the sheath connecting portion 86C unless an external force of a predetermined magnitude or greater is applied.

[0142] (Variation 3-4) 63 to 67 are diagrams showing a compression unit 65C which is a modified example of the compression unit 65B. The compressing portion 65C is a plate-shaped member provided at the base end of the case body 60. The compressing portion 65C has a first compressing portion 651C, a second compressing portion 652C, and an elastic ring 653. The first compressing portion 651C and the second compressing portion 652C are provided opposite each other in the height direction H, sandwiching the sheath connecting portion 66 therebetween. The elastic ring 653 is provided to bring the first compressing portion 651C and the second compressing portion 652C closer to each other. Therefore, the height H1 of the internal space of the sheath connecting portion 66 is smaller than the outer diameter H2 of the sheath 220. Therefore, as shown in FIGS. 66 and 67 , when the sheath 220 is inserted into the sheath connecting portion 66, the sheath 220 is sandwiched between the first compressing portion 651C and the second compressing portion 652C and does not come off the sheath connecting portion 66. That is, unless an external force of a predetermined magnitude or greater is applied, the sheath 220 inserted into the sheath connecting portion 66 of the compressing portion 65C maintains its connection with the cartridge 5C and does not come off from the sheath connecting portion 66 of the compressing portion 65C. It is desirable that the height H3 of the compressing portion 65C in the height direction H (opening / closing direction) with which the elastic ring 653 contacts is greater than the length W6 of the compressing portion 65C in the width direction W with which the elastic ring 653 contacts.

[0143] (Fourth embodiment) A fourth embodiment of the present invention will be described with reference to Figures 68 to 78. In the following description, components common to those already described will be assigned the same reference numerals and duplicated description will be omitted.

[0144] 68 is a diagram showing a cartridge system 100D according to the fourth embodiment. Similar to the cartridge system 100 of the first embodiment, the cartridge system 100D is packaged as a clip system 500 together with a clip introduction device (applicator) 200 in a sterilization pack 400. The cartridge system 100D has a clip unit 1 and a cartridge 5D that houses the clip unit 1.

[0145] The cartridge 5D has a case 6D, a restricting member 7, and a locking mechanism 9. The cartridge 5D houses the clip unit 1 therein.

[0146] Similar to the case 6 of the first embodiment, the case 6D stores the clip unit 1 together with the restricting member 7. The case 6D has a case main body 60, a compressing portion 65D, a sheath connecting portion 66, and a locking mechanism supporting portion 69.

[0147] Compressing portion 65D is a plate-like member provided at the base end of case body 60. Compressing portion 65D has a first compressing portion 651D and a second compressing portion 652D. First compressing portion 651D and second compressing portion 652D are provided opposite each other in the height direction H with sheath connecting portion 66 interposed therebetween.

[0148] The compression portion 65D has a connecting portion 65a that connects to the case body 60. The connecting portion 65a connects the first compression portion 651D and the second compression portion 652D separately to the case body 60. The connecting portion 65a is bent so that the first compression portion 651D and the second compression portion 652D are spaced apart from each other. Therefore, a gap 65G is formed between the first compression portion 651D and the second compression portion 652D. The first compression portion 651D and the second compression portion 652D are spaced apart further from each other at the base end than at the tip end.

[0149] The locking mechanism support part 69 is provided on one side (lower side) of the second compressing part 652D in the height direction H. The locking mechanism support part 69 supports the locking mechanism 9 attached to the compressing part 65D.

[0150] The locking mechanism (fixing means) 9 has a main body 90, a claw 91, and a knob (first knob) 92. The main body 90 is formed in a generally plate shape. The main body 90 is supported by the locking mechanism support portion 69. The claw 91 is provided at the base end of the main body 90 and protrudes to the other side (upper side) in the height direction H. Two claws 91 are provided on both sides in the width direction W. The knob 92 is a convex portion that protrudes from the main body 90 to one side (lower side) in the height direction H.

[0151] 69 is a diagram showing a cartridge 5D in which the locking mechanism 9 is attached to the compressing portion 65D. When the locking mechanism 9 is attached to the compressing portion 65D, the claws 91 clamp the first compressing portion 651D and the second compressing portion 652D together, maintaining a predetermined distance between the first compressing portion 651D and the second compressing portion 652D.

[0152] 70 to 73 are views illustrating a method for fixing the sheath 220 so that it does not come off from the cartridge 5D. As shown in FIG. 70, the user inserts the sheath 220 into the sheath connection portion 66 of a compressing portion 65D to which the locking mechanism 9 is not attached. Next, as shown in FIG. 71, the user sandwiches the first compressing portion 651D and the second compressing portion 652D and brings them closer together. Next, as shown in FIG. 72, the user slides the locking mechanism 9 toward the distal end, and hooks the claws 91 onto the first compressing portion 651D and the second compressing portion 652D as shown in FIG. 73. When the locking mechanism (fixing means) 9 is attached to the compressing portion 65D, the sheath 220 inserted into the cartridge 5D remains connected to the cartridge 5D and does not come off from the cartridge 5D.

[0153] With the sheath 220 inserted into the case body 60 of the cartridge 5D, the clip unit 1 is loaded into the clip introduction device 200 in the same manner as in the first embodiment.

[0154] FIG. 74 is a diagram showing a compression unit 65E which is a modified example of the compression unit 65D. The compressing portion 65E has a knob (second knob) 65f that protrudes from the first compressing portion 651D to the other side (upward) in the height direction H. The knob 92 of the locking mechanism 9 has a slope facing the tip side in the longitudinal direction L. On the other hand, the knob 65f of the compressing portion 65E has a slope facing the base end side in the longitudinal direction L.

[0155] 75 and 76 are diagrams illustrating a method for separating the locking mechanism 9 from the case 6D. As shown in Fig. 75, the user can easily separate the locking mechanism 9 from the case 6D by grasping the knobs 65f and 92 with their fingers and sliding them in the direction of the arrow shown in Fig. 76. When the locking mechanism 9 is separated from the case 6D, the sheath insertion port 67 widens, and the sheath 220 can be inserted into or removed from the sheath connecting portion 66.

[0156] 77 and 78 are views illustrating a method for removing the cartridge 5D from the sheath 220. After loading the clip unit 1 into the applicator 200, when holding the cartridge 5D, by hooking the index finger and thumb on the knob 65f and the knob 92, respectively, as shown in FIG. 77 and simultaneously moving in the direction of the arrow as shown in FIG. 78, the cartridge 5D can be removed from the sheath 220 at almost the same time as holding the cartridge 5D.

[0157] According to the clip system 500 of this embodiment, the cartridge system 100D and the applicator 200 are housed in the same sterilization pack 400, and the cartridge system 100D is attached in advance to the applicator 200. Therefore, the work of loading the clip unit 1 into the applicator 200 using the cartridge system 100D after opening the sterilization pack is reduced, allowing the user to use the clip unit 1 loaded into the applicator 200 as soon as possible.

[0158] Although the fourth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0159] (Variation 4-1) 79 and 80 are views showing a locking mechanism 9A which is a modified example of the locking mechanism 9. The locking mechanism 9A has a main body 90, a claw 91A, and a knob 92. The claw 91A is provided at the base end of the main body 90 and protrudes to the other side (upper side) in the height direction H. One claw 91 is provided in the center in the width direction W. The claw 91A has an insertion / removal hole 94 through which the sheath 220 can be inserted.

[0160] (Variation 4-2) 81 and 82 are views showing a locking mechanism 9B that is a modified example of the locking mechanism 9. The locking mechanism 9B has a main body 90, a claw 91B, and a knob 92. Two claws 91B are provided on both sides in the width direction W. The two claws 91B are provided in positions that sandwich the first compressing portion 651D and the second compressing portion 652D from the outside in the width direction W. [Industrial Applicability]

[0161] The present invention can be applied to a cartridge or the like that stores a clip unit. [Explanation of symbols]

[0162] 500 Clip System 300 Clip Device 400 sterile packs 200 Clip introduction device (applicator) 220,220A sheath 230 Operating wire (power transmission part) 231 Arrowhead hook part (connection part) 240 Operation section 100, 100B, 100C, 100D Cartridge System 1 Clip unit 2 clips 3. Presser Tube 4 Connecting members 5, 5B, 5C, 5D cartridges 6,6C,6D Case 6B case (inner case) 60 Case body 6S storage area 61 First area 62 Second area 63 Folded Region 64 Sheath insertion area 65, 65A1, 65A2, 65B, 65C, 65D, 65E Compression part (fixing means) 651, 651B, 651C, 651D First pressing section 652, 652B, 652C, 652D Second Compression Section 653 Elastic Ring 65a (pair) connecting part 65b (pair) sheath compression parts 65c (pair) retaining wings 65f knob (second knob) 65G spacing 65p convex part 65s rubber band 65t metal plate 66 Sheath connection 67 Sheath insertion port 68 Sheath contact part 69 Locking mechanism support part 81, 81A, 81B, 81C Case connection part (fixing means) 82 Case moving parts 83 First moving piece 84 Second moving piece 85 Third moving piece 86, 86A, 86B, 86C sheath connection part 86b Bend part 7 Regulatory elements 8 Outer case (fixing means) 80 Insertion port 8s interior space 9, 9A, 9B Locking mechanism (fixing means) 90 Main body 91, 91A, 91B Claws 92 Knob (First Knob) 94 Insertion / extraction hole

Claims

1. a cartridge system containing a clip unit; an applicator connectable to the clip unit; a fixing means for fixing the cartridge system and the applicator; a pack that packages the cartridge system and the applicator together; Equipped with the cartridge system and the applicator are packaged in the pack while being fixed by the fixing means; The cartridge system is configured to be detachable from the applicator when the clip unit is connected to the applicator. Clip system.

2. The fixing means is capable of fixing the cartridge system and the applicator together when the clip unit and the applicator are separated from each other. The clip system of claim 1 .

3. The clip unit is configured to be able to transition from a state separated from the applicator to a state connected to the applicator when the cartridge system and the applicator are fixed by the fixing means. The clip system of claim 2 .

4. The applicator has a wire connectable to the clip unit and a sheath through which the wire is inserted, the fixing means fixes the cartridge system and the sheath together when the wire and the clip unit are separated from each other. The clip system of claim 2 .

5. The fixing means releases the fixation between the cartridge system and the applicator when subjected to an external force. The clip system of claim 1 .

6. The fixing means maintains the fixation between the cartridge system and the applicator unless an external force is applied. The clip system of claim 1 .

7. the cartridge system has a sheath connection portion into which a sheath of the applicator is inserted; The fixing means is a compression portion that clamps the sheath connection portion. The clip system of claim 1 .

8. The fixing means has a locking mechanism that clamps and fixes the compressing portion. The clip system of claim 7.

9. A loading method for loading a clip unit into an applicator using a cartridge containing the clip unit, comprising: unpacking the cartridge and the applicator from the pack in a state where the clip unit and the applicator are separated and fixed so as to maintain connection between the cartridge and the applicator; connecting the clip unit to the applicator; releasing the fixation between the cartridge and the applicator; Loading method.

10. The cartridge and the applicator are released from their fixed state by manually widening a compressed portion that sandwiches a sheath connection portion into which the sheath of the applicator is inserted.

10. The method of claim 9.

11. the sheath of the applicator is pulled out from a sheath connection portion into which the sheath is inserted, thereby releasing the fixation between the cartridge and the applicator; 10. The method of claim 9.

12. the fixation between the cartridge and the applicator is released by removing a locking mechanism that clamps and fixes a compression part that clamps a sheath connection part into which the sheath of the applicator is inserted; 10. The method of claim 9.

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