Clipping device

Abstract

To provide a clip device whose number of components is reduced, which is inexpensive, and is easily made disposable.SOLUTION: The clip device includes: a sheath 12 composed of one pipe body; a drive wire 13 inserted in the sheath 12; an operation unit 16 which is provided at a proximal end of the sheath 12 and slides the drive wire 13 with respect to the sheath 12; and a clip 20 removably coupled to a distal end of the drive wire 13 and composed of an elastic body that can be housed in the sheath 12. By receiving an external force from the clip 20 and elastically deforming, the clip 20 is allowed to go from inside the sheath 12 to the distal end side and an elastic engaging part 33 which engages a fastening ring 29 gone through to the distal end side from inside the sheath 12, slides the fastening ring 29 to the distal end side, and closes the clip 20 is provided at an opening on the distal end side of the sheath 12.SELECTED DRAWING: Figure 7

Description

[Technical Field]

[0001] The present invention relates to a medical clipping device that is used with an endoscope to perform hemostasis, marking, suturing, etc. on internal tissue. [Background technology]

[0002] Medical clipping devices are used when performing endoscopic procedures such as hemostasis of bleeding sites and suturing of defects in internal tissue. This type of clipping device generally includes a sheath that is passed through an endoscope and a clip attached to the distal end of the sheath. After the distal end of the sheath is guided to the vicinity of the site to be treated, the internal tissue is grasped with the clip by operating an operating portion attached to the proximal end of the sheath outside the body, and the clip is placed inside the body while maintaining this state.

[0003] A known conventional clip device is one that has a sheath with a double-tube structure in which an inner sheath is inserted into an outer sheath, a drive wire is inserted into the inner sheath, and a clip made of an elastic material is detachably connected to the tip of the drive wire via a connecting hook (for example, Patent Document 1, etc.).

[0004] The clip device described in Patent Document 1 has a clip whose base end is connected to a connecting hook connected to the tip of a drive wire, and the clip is housed in a closed state within an outer sheath. When the outer sheath is retracted proximally relative to the inner sheath and drive wire from this state, the clip is released from the constraint of the outer sheath and opens. When the inner sheath is then pushed distally relative to the drive wire, the clamping ring fitted around the clip is pushed by the inner sheath and slides distally, closing the clip and enabling it to grasp internal tissue. When the inner sheath is then retracted proximally relative to the drive wire, the connecting hook opens, releasing the connection with the clip. The sheaths and drive wire are then retracted, leaving the clip in place within the body. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Publication No. 2016-123805 Summary of the Invention [Problem to be solved by the invention]

[0006] In recent years, medical instruments have become increasingly disposable to improve hygiene and eliminate the need for complicated cleaning, and this demand is also increasing for clip devices. One factor that makes disposable devices possible is cost reduction through a reduction in the number of parts, but with the conventional clip devices described above, the double-tube sheath in particular increases costs, making it difficult to make them disposable.

[0007] The present invention has been made in view of the above circumstances, and has as its object to provide a clipping device that has a reduced number of parts, is inexpensive, and can be easily made disposable. [Means for solving the problem]

[0008] a clip body configured to open at its distal end by its own elasticity when pulled out from the distal end of the sheath and to close by being constrained by the sheath when housed in the sheath; and a fastening member slidably provided at least partially between the proximal and distal ends of the clip body and to close the clip body by sliding toward the distal end. The clip device according to the present invention is characterized in that it comprises a sheath consisting of a single tubular body, a drive wire inserted into the sheath, an operating unit provided at the proximal end of the sheath and configured to slide the drive wire relative to the sheath along the axial direction of the sheath, and a clip made of an elastic material that is detachably connected to the distal end of the drive wire and can be housed in the sheath. The clip has a fastening member slidably provided at least partially between the proximal and distal ends of the clip body and to close the clip body by sliding toward the distal end. The clip is characterized in that an elastic engaging portion is provided at an opening on the distal end of the sheath, which elastically deforms when subjected to an external force from the clip, thereby allowing the clip to pull out from within the sheath toward the distal end, and which can engage with the fastening member that has pulled out from within the sheath toward the distal end and slide the fastening member toward the distal end.

[0009] The sheath of the present invention has a distal end at the tip end placed inside the body and a proximal end at the base end placed outside the body. The distal end and proximal end described accompanying each component of the present invention refer to the end portions corresponding to the distal end, i.e., the tip side, and the proximal end, i.e., the base side, of the sheath, respectively.

[0010] Due to the above-mentioned configuration, the clip device of the present invention does not have a double-tube structure sheath and is composed of a single sheath, so the sheath configuration is simpler than conventional sheaths and the number of parts can be reduced, resulting in lower costs and making the device disposable.

[0011] In addition, the clip device of the present invention is characterized in that the elastic engagement portion is formed in a cylindrical shape with a plurality of elastic pieces that elastically deform when subjected to external force from the clip, allowing the clip to pass through its interior.

[0012] With this configuration, the clip device according to the present invention can simplify the configuration of the elastic engagement portion, thereby promoting cost reduction and disposability. Furthermore, the clip is restricted from slipping out of the sheath while being surrounded by the tubular elastic engagement portion, and when the clip slides relative to the sheath and passes through the interior of the elastic engagement portion, the multiple elastic pieces elastically deform, causing the clip to slip out of the sheath. This prevents the clip housed in the sheath from accidentally passing through the elastic engagement portion and slipping out of the sheath, ensuring safety when used inside the body.

[0013] In addition, the clip device according to the present invention is characterized in that the elastic engaging portion is formed in a conical shape whose diameter decreases toward the distal end side.

[0014] With this configuration, the clip device according to the present invention can be easily inserted into an endoscope, and the distal end provided with the elastic engagement portion can be positioned with high precision at the site to be treated inside the body.

[0015] The clip device according to the present invention is characterized in that the elastic piece is configured so that the tip surface on the distal end side thereof abuts against and engages with the proximal end of the fastening member.

[0016] With this configuration, the clip device of the present invention can configure the portion of the elastic engagement portion that engages with the fastening member of the clip using the tip surface of the elastic piece, thereby simplifying the configuration of the elastic engagement portion and further promoting disposability as a result of reduced costs.

[0017] The clip device according to the present invention may be configured so that the elastic engagement portion is integrally formed with the sheath.

[0018] According to this configuration, the clip device of the present invention further reduces the number of parts, which further promotes disposability as a result of lower costs. [Effects of the Invention]

[0019] According to the present invention, it is possible to provide a clip device that has a reduced number of parts, is inexpensive, and is easily made disposable. [Brief explanation of the drawings]

[0020] [Figure 1] 1 is a side view showing a clip device according to an embodiment of the present invention. [Figure 2] FIG. 2 is a cross-sectional view taken along line II-II of FIG. [Figure 3] 1A and 1B are perspective views of a clip constituting a clip device according to one embodiment of the present invention, in which FIG. 1A shows a state in which the legs are spread apart, and FIG. 1B shows a state in which the legs are closed. [Figure 4] 1 is a side view showing a portion of a connecting hook and a driving wire that constitute a clip device according to one embodiment of the present invention. FIG. [Figure 5] 1 is a perspective view showing a gate member constituting a clip device according to an embodiment of the present invention. FIG. [Figure 6] 1A and 1B are diagrams showing a gate member constituting a clip device according to one embodiment of the present invention, in which FIG. 1A is a side view and FIG. 1B is a front view. [Figure 7] 1A and 1B are perspective views illustrating the function of a clip constituting a clip device according to one embodiment of the present invention, in which (a) shows the clip stored in a sheath, (b) shows the clip with its legs open, and (c) shows the clip with its legs closed outside the sheath. [Figure 8] 5A to 5D are cross-sectional views showing the action of a clip in a clip device according to one embodiment of the present invention in a stepwise manner. [Figure 9] 10 is a cross-sectional view showing a modified example in which the sheath and the gate member are integrally molded in the clip device according to one embodiment of the present invention. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0021] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0022] (Embodiment) First, the configuration of one embodiment will be described.

[0023] As shown in Figures 1 and 2, the clip device 1 of this embodiment comprises a sheath 12 consisting of a single tubular body, a drive wire 13 inserted into the sheath 12, an operating unit 16 provided at the proximal end (the upper end in Figure 1) of the sheath 12 and sliding the drive wire 13 along the axial direction of the sheath 12 relative to the sheath 12, and a connecting hook 11.

[0024] The clip device 1 according to this embodiment also includes a clip 20 shown in Fig. 3. The clip 20 is detachably connected to the distal end (the lower end in Fig. 1) of the drive wire 13 via a connecting hook 11, and can be housed together with the connecting hook 11 in the sheath 12.

[0025] The clip device 1 according to this embodiment is used by inserting the sheath 12 through an endoscope (not shown) and inserting it into the body together with the endoscope. The tip end of the sheath 12 that is placed inside the body when in use is called the distal end, and the base end that is placed outside the body is called the proximal end. In the following description, the distal end and proximal end refer to the ends of the sheath 12 that correspond to the distal end and proximal end.

[0026] The sheath 12 according to this embodiment is configured as a flexible hollow tubular body. The sheath 12 is configured as, for example, a wire tube. The wire tube is a hollow stranded wire formed by helically twisting a plurality of wires (cables) made of a metal such as stainless steel to form a hollow space. The sheath 12 may also be configured by molding a flexible resin (for example, a polyamide resin or a polyamide-based elastomer) into a tubular body.

[0027] As shown in FIG. 1, the opening on the distal end side of the sheath 12 is provided with a gate member 30 having an elastic engagement portion 33, which will be described later.

[0028] The driving wire 13 according to this embodiment is made of a flexible wire, such as a wire rope made of a stranded wire formed by helically twisting multiple wires (cables) made of a metal such as stainless steel. The driving wire 13 may be a wire tube like the sheath 12, or may be a single wire.

[0029] The connecting hook 11 according to this embodiment has a pair of arms 11a made of elastic material arranged in a substantially V-shape toward its tip, as shown in Fig. 4. The connecting hook 11 can be in two states, an open leg state and a closed leg state, in cooperation with the sheath 12.

[0030] Claws 11b are formed at the tip of each arm 11a of the connecting hook 11 by bending them inward to face each other. The connecting hook 11 grips a connecting plate 22 of a clip body 21 constituting a clip 20 (described later) and engages with each claw 11b, thereby detachably connecting the clip 20 and the driving wire 13.

[0031] The connecting hook 11 has, at its base end, a U-shaped portion 11c formed in a substantially U-shape and continuing from the base end of each arm portion 11a.

[0032] Each arm portion 11a including the claw portion 11b and the U-shaped portion 11c are formed by appropriately bending and plastically deforming a single elongated plate made of an elastic body. Although not particularly limited, the thickness of the plate constituting the connecting hook 11 is approximately 0.20 to 0.24 mm, and the width is approximately 0.6 mm. For example, stainless steel is used as the plate material.

[0033] A hook-side annular portion 11d is provided at the base end of the U-shaped portion 11c of the connecting hook 11. The hook-side annular portion 11d is fixed integrally to the connecting hook 11 by fixing a pair of open ends of a U-shaped member to the outer surfaces of the base end of the U-shaped portion 11c. The hook-side annular portion 11d is fixed to the U-shaped portion 11c by means of, for example, laser welding, adhesive bonding, or the like.

[0034] As shown in Fig. 4, a wire-side annular portion 19 is provided at the distal end (the end on the left side in Fig. 4) of the drive wire 13. The wire-side annular portion 19 is fixed integrally to the drive wire 13 by sandwiching the distal end of the drive wire 13 between a pair of open ends of a U-shaped member and joining the inner surfaces of the open ends to the side surfaces of the drive wire 13. The wire-side annular portion 19 is fixed to the drive wire 13 by means of, for example, laser welding, adhesive bonding, or the like.

[0035] The U-shaped members constituting the hook side annular portion 11d and the wire side annular portion 19 may be made of a plate material similar to that constituting the connecting hook 11, but bent appropriately. Stainless steel, for example, may be used as the material for the U-shaped members constituting the annular portions 11d and 19. The semicircular arc portions of the annular portions 11d and 19 have an outer diameter of, for example, about 1.0 to 1.2 mm and an inner diameter of, for example, about 0.8 to 1.0 mm, and their cross-sectional shapes may be, for example, rectangular, circular, or semicircular.

[0036] Hook side annular portion 11d and wire side annular portion 19 are connected to each other in a chain shape, whereby connecting hook 11 is attached so as to be able to swing relative to the distal end of drive wire 13. By allowing connecting hook 11 to swing relative to the distal end of drive wire 13, this portion within sheath 12 is prevented from becoming rigid, and sheath 12 can be smoothly passed through the curved portion of the endoscope inserted into the digestive tract.

[0037] 1 , the operating unit 16 according to this embodiment has a cylindrical slider portion 17 and a base portion 18 inserted into the slider portion 17 from the proximal end side so as to be relatively slidable and rotatable about its axis. A reinforcing coil 15 is fixed to the distal end of the slider portion 17 so as to extend coaxially. The proximal end of the sheath 12 is inserted into the reinforcing coil 15 and is fixed integrally with this reinforcing coil 15. In other words, the sheath 12 is integrated with the slider portion 17 via the reinforcing coil 15.

[0038] The slider portion 17 is slidably supported on the distal end of the base portion 18. The proximal end of the drive wire 13 is fixed to the base portion 18 inside the slider portion 17. Therefore, the drive wire 13 is integral with the base portion 18 and is slidable relative to the slider portion 17.

[0039] A pair of flanges 17a spaced apart in the sliding direction are formed at the proximal end of the slider portion 17, and the circumferential groove 17b between these flanges 17a can be held between the index finger and middle finger, for example.

[0040] Furthermore, ring portion 18a is supported rotatably about an axis at the proximal end of base portion 18. As described above, by inserting the thumb into ring portion 18a while holding circumferential groove portion 17b of slider portion 17 between the index finger and middle finger, the operation of sliding slider portion 17 relative to base portion 18 can be smoothly performed with one hand. Furthermore, when ring portion 18a is rotated, drive wire 13 rotates integrally therewith, and thereby clip 20, which will be described later, can also rotate integrally with drive wire 13.

[0041] Next, the clip 20 will be described with reference to FIG.

[0042] As shown in Figure 3, the clip 20 has a clip body 21 and a clamping ring 29. The clamping ring 29 constitutes the fastening member of the present invention. The clamping ring 29 is provided slidably relative to an arm plate portion 23 (described later) of the clip body 21. The clip 20 is configured so that when the clamping ring 29 slides toward the proximal end, the clip body 21 opens as shown in Figure 3(a), and when the clamping ring 29 moves toward the distal end, the clip body 21 closes as shown in Figure 3(b).

[0043] The clip body 21 has a connecting plate portion 22 bent into a substantially U-shape. A pair of arm plate portions 23 are integrally formed on both ends of the connecting plate portion 22, and are arranged to open in a substantially V-shape toward the tip. The connecting plate portion 22 is formed on the proximal end side of the arm plate portion 23.

[0044] A claw 24 is integrally formed at the distal end of each arm plate 23. The claws 24 are bent inwardly to face each other at the tip of the arm plate 23. A concave notch 24a is formed in the center of the tip edge of each claw 24.

[0045] The connecting plate 22, the pair of arm plate portions 23, and the pair of claw portions 24 that make up the clip body 21 are formed by bending and plastically deforming a single thin, elongated plate made of an elastic body. Although not particularly limited, the thickness of the plate that makes up the clip body 21 is preferably 0.10 to 0.30 mm. For example, stainless steel is used as the plate material.

[0046] Each arm plate 23 has a base end 23a and a gripping portion 23b formed contiguous with the base end 23a on the distal end side. The claw portions 24 are formed at the tip of each gripping portion 23b. The arm plates 23 are curved so that they move away from each other toward the gripping portion 23b side. The base end 23a has a uniform width, but the gripping portion 23b is formed in an elongated trapezoidal shape that widens toward the distal end where the claw portions 24 are formed. In addition, a through hole 23c is formed in the gripping portion 23b to reduce the weight of the clip body 21.

[0047] The U-shaped connecting plate 22 has wide portions 22a at both ends on its distal end side. The width of the base end 23a of each arm plate 23 is slightly smaller than the width of the wide portion 22a and the grip portion 23b of the connecting plate 22. Due to this shape, as shown in FIG. 3(b), a pair of locking steps 25a are formed on both widthwise ends of the edge of the wide portion 22a of the connecting plate 22 on the distal end side (the side of the base end 23a of the arm plate 23). Furthermore, as shown in FIG. 3(a), a pair of locking steps 25b are formed on both widthwise ends of the edge of the grip portion 23b on the proximal end side (the side of the base end 23a of the arm plate 23).

[0048] As shown in FIG. 3(a), the base end 23a of each arm plate 23 has a ring locking portion 26 formed with a large width at the end on the gripping portion 23b side.

[0049] The tightening ring 29 is made of a substantially cylindrical member and is attached to the base end 23a of each arm plate 23 of the clip body 21 so as to be slidable along the direction in which the base end 23a extends. The tightening ring 29 may also be made of a coil spring formed by winding a wire rod into a coil shape.

[0050] The clamping ring 29 has an internal space through which the base end 23a of the arm plate portion 23 is inserted, and is fitted onto the base end 23a so as to slide between the wide portion 22a of the connecting plate portion 22 and the grip portion 23b.

[0051] 3(a), when the clamping ring 29 is slid toward the connecting plate portion 22, which is the proximal end side, the clamping ring 29 comes into contact with the locking steps 25a and stops, and further sliding toward the proximal end side is restricted. At this time, the arm plate portions 23 of the clip body 21 are separated from each other by their own elasticity, and are in an open leg state.

[0052] 3(b), when the clamping ring 29 is slid toward the gripping portion 23b, which is the distal end, against the elasticity of each arm plate 23, the clamping ring 29 comes into contact with each locking step 25b and stops, restricting further sliding toward the distal end. As the clamping ring 29 is slid toward the gripping portion 23b, the arm plates 23 are pressed toward each other by the clamping ring 29 and elastically deformed, and when the clamping ring 29 comes into contact with each locking step 25b, the clip body 21 is completely closed. When the clip body 21 is closed in this manner, the claws 24 overlap each other.

[0053] The clip 20 is configured so that when the clamping ring 29 abuts against each locking step 25b and the clip body 21 is in a closed position, each ring locking portion 26 is press-fit into the clamping ring 29. This causes the clamping ring 29 to be locked onto each ring locking portion 26, and the closed position of the clip body 21 is maintained.

[0054] The clip 20 is connected to the connecting hook 11 within the sheath 12 by inserting the claws 11b of the closing connecting hook 11 into the connecting plate 22 of the clip body 21. When the connecting hook 11 is pulled toward the proximal end of the clip 20 in this connected state within the sheath 12, the claws 11b ride up onto the connecting plate 22, slightly opening the arms 11a, and the connecting hook 11 disengages from the clip 20, allowing the connection to be released.

[0055] Next, the gate member 30 provided at the opening at the distal end of the sheath 12 will be described.

[0056] 5 and 6 show gate member 30. Gate member 30 according to this embodiment is elastically deformed when subjected to an external force from clip 20, thereby allowing clip 20 to slip out of sheath 12 toward the distal end, and has elastic engagement portion 33 that can engage with fastening ring 29 that has slipped out of sheath 12 toward the distal end, thereby sliding fastening ring 29 toward the distal end.

[0057] The elastic engagement portion 33 according to this embodiment has four elastic pieces 33b that are elastically deformed when subjected to an external force from the clip 20. The elastic engagement portion 33 is formed into a cylindrical shape by the elastic pieces 33b so that the clip 20 can pass through the inside thereof.

[0058] The gate member 30 is made of a member formed in an entirely cylindrical shape, and has a fixing portion 31, an intermediate cylindrical portion 32, and an elastic engagement portion 33 from the proximal end side to the distal end side.

[0059] The fixing portion 31 of the gate member 30 is a portion that is fixed to the opening on the distal end side of the sheath 12. As shown in Fig. 7, the end of the gate member 30 on the distal end side of the sheath 12 is inserted into the fixing portion 31, and the gate member 30 is fixed to the opening on the distal end side of the sheath 12. Fixing the fixing portion 31 to the sheath 12 is performed by, for example, bonding with an adhesive.

[0060] The intermediate cylindrical portion 32 is formed to have an outer diameter slightly smaller than that of the fixed portion 31. The elastic engagement portion 33 is formed in a conical shape that continues from the intermediate cylindrical portion 32 and decreases in diameter toward the distal end. Therefore, the opening diameter of the elastic engagement portion 33 on the distal end side is smaller than the inner diameter of the sheath 12.

[0061] The elastic engagement portion 33 is formed with a plurality of slits 33a extending in the axial direction of the gate member 30. Each slit 33a is formed so as to penetrate into a part of the intermediate cylindrical portion 32. In this embodiment, the slits 33a are formed at four locations that divide the circumference equally, but the number of slits 33a formed may be arbitrary. The elastic engagement portion 33 is divided into four elastic pieces 33b between the slits 33a by forming the four slits 33a. In other words, the elastic engagement portion 33 has four elastic pieces 33b whose cross section is formed in a substantially quarter-circular arc shape. The number of elastic pieces 33b, i.e., the number of slits 33a formed, may be arbitrary, as described above.

[0062] The outer diameter of the tip surface of the elastic engagement portion 33, i.e., the annular tip surface formed by the tip surfaces 33c of each elastic piece 33b, is set to be approximately the same as the outer diameter of the tightening ring 29. This allows the tip surface 33c of each elastic piece 33b to come into contact with the annular end surface 29c on the proximal end side of the tightening ring 29 (see FIG. 8(d)).

[0063] 5 and 6(a), the elastic engagement portion 33 maintains its conical shape and is in a closed state when the elastic pieces 33b are not subjected to external force. As shown in FIGS. 8(a) to 8(d), when the clip 20 housed in the sheath 12 slides toward the distal end of the sheath 12 and enters the elastic engagement portion 33, the gripping portions 23b of the arm plate portions 23 of the clip body 21 and the tightening ring 29 push the elastic pieces 33b radially open, allowing the clip 20 to come out of the sheath 12 to the outside on the distal end side. After the clip 20 comes out of the sheath 12, the clip body 21 elastically returns to its original position, allowing the clip 20 to fully open.

[0064] When the clip 20 including the tightening ring 29 is released distally from the gate member 30 and the clip body 21 is opened, the drive wire 13 is retracted proximally relative to the sheath 12, and the sheath 12 is slid relatively distally. This causes the distal end surfaces 33c of the elastic pieces 33b of the closed elastic engagement portion 33 to abut against the proximal end surfaces 29c of the tightening ring 29, and the tightening ring 29 is pushed and slid distally along the base ends 23a of the clip body 21 by the elastic engagement portions 33. The tightening ring 29 slides distally until it abuts against the locking steps 25b and is locked by the ring locking portions 26. This causes the clip body 21 to close.

[0065] The clip 20, which is connected to the drive wire 13 via the connecting hook 11, can be positioned at one of three positions by sliding the drive wire 13 toward the proximal end or distal end with respect to the sheath 12 using the operation unit 16: a stored position where it is stored within the sheath 12; an open position where the clip body 21 is released from the gate member 30 toward the distal end and opened; and a clip position where the clip body 21 is closed by the tightening ring 29. Figures 7(a), (b), and (c) show the clip 20 positioned in the stored position, open position, and clip position, respectively.

[0066] The operating portion 16 is equipped with a click mechanism (not shown) that can accurately position the clip 20 at the above three positions. The click mechanism can be configured, for example, by a combination of grooves formed in three axially spaced locations on the base portion 18 and spring members provided on the slider portion 17 that elastically engage with these grooves.

[0067] The fixed portion 31, intermediate cylindrical portion 32, and elastic engagement portion 33 that constitute the gate member 30 are molded as a single unit. The gate member 30 is made of a material that allows each elastic piece 33b of the elastic engagement portion 33 to be pushed open and elastically deformed when it receives an external force from the clip 20 passing through it, and metal such as stainless steel is preferred, for example. Alternatively, resin can also be used.

[0068] Next, a method of using the clipping device 1 according to the present embodiment to clip the internal tissue of the treatment target will be described.

[0069] First, the clip 20 is connected to the connecting hook 11, and the clip 20 and the connecting hook 11 are stored inside the distal end side of the sheath 12. To do this, for example, the elastic engagement portion 33 of the gate member 30 is held open by a jig (not shown), and the sheath 12 is slid toward the proximal end relative to the drive wire 13 by the operating portion 16, causing the connecting hook 11 to protrude from the gate member 30 toward the distal end side and open. The clip 20 is also prepared in the open state as shown in FIG. 3(a).

[0070] From this state, the sheath 12 is slid distally relative to the drive wire 13 to retract the drive wire 13 into the sheath 12, and the connecting hook 11 is housed in the gate member 30, thereby closing the legs. At this time, the clip 20 in the closed state is placed in a position where the connecting hook 11 can clamp the connecting plate portion 22 of the clip body 21, and the drive wire 13 is further retracted into the sheath 12. As a result, the connecting hook 11 closes, and each claw portion 11b enters the connecting plate portion 22 of the clip body 21, and the clip 20 is connected to the connecting hook 11 as shown in FIG. 8.

[0071] Next, the drive wire 13 is further retracted toward the proximal end, and the clip 20 is stored in the storage position, which is the end portion on the distal end side within the sheath 12.

[0072] Next, the jig is removed from the gate member 30, and the elastic engagement portion 33 is returned to the closed state. Figures 7(a) and 8(a) show this state.

[0073] Next, the distal end of the sheath 12 is guided and positioned near the tissue to be treated inside the body via an endoscope (not shown). From this state, the sheath 12 is slid toward the proximal end relative to the drive wire 13 by the operation unit 16, and the clip 20 is positioned in the open position. At this time, as shown in Figures 8(b) and 8(c), the elastic engagement portion 33 of the gate member 30 is pushed open by the clip 20, and the clip 20 opens and comes out of the gate member 30 to the outside on the distal end side, and the clip 20 including the tightening ring 29 is positioned in the open position.

[0074] Next, the open clip 20 is positioned so that the area of ​​the internal tissue to be treated is positioned between the claws 24 at the tip of each gripping portion 23b of the clip 20. At this time, the ring portion 18a of the operating portion 16 is used to rotate the clip 20 around its axis via the driving wire 13, if necessary.

[0075] Next, the sheath 12 is slid toward the distal end relative to the drive wire 13 by the operating unit 16, and the clip 20 is positioned at the clip position. At this time, as shown in Figures 8(c) and 8(d), the tip surfaces 33c of the elastic pieces 33b of the gate member 30 come into contact with the proximal end surface 29c of the fastening ring 29, and the fastening ring 29 is further pushed toward the distal end by the elastic engaging portions 33 and slides until it comes into contact with the fastening step portion 25b. As a result, the fastening ring 29 is locked by the ring locking portion 26, the clip body 21 is completely closed, and the internal tissue is grasped by the pair of claws 24.

[0076] Next, the drive wire 13 is slid toward the proximal end relative to the sheath 12 and pulled back. This pulls the connecting hook 11 toward the proximal end, disengaging the claws 11b from the connecting plate 22 of the clip body 21, and the connecting hook 11 is released from the clip 20. At this time, the clip body 21 is pressed toward the distal end via the tightening ring 29 by the sheath 12, which recoils toward the distal end. Therefore, the stress generated when the connecting hook 11 is pulled is not transmitted to the clip body 21, and there is no risk of the clip body 21 being pulled toward the proximal end together with the connecting hook 11. Therefore, the connecting hook 11 can be removed from the clip body 21 without damaging the internal tissue grasped by the claws 24.

[0077] Instead of releasing the connection between the two by pulling the connecting hook 11 toward the proximal end relative to the clip 20 and releasing it, the sheath 12 may be slid toward the proximal end relative to the drive wire 13, causing the connecting hook 11 to protrude from within the sheath 12 toward the distal end, and each arm portion 11a may be elastically returned to its original position to open the legs, thereby releasing the connection.

[0078] Thereafter, the entire operation unit 16 is moved toward the proximal end side relative to the endoscope, the sheath 12 and the drive wire 13 are retracted, and the clip 20 gripping the internal tissue is placed inside the body. This completes clipping of the internal tissue by the clip device 1.

[0079] The operation of the clip device 1 according to the present embodiment will be described below.

[0080] The clip device 1 according to this embodiment does not have a sheath with a double-tube structure, but is composed of a single sheath 12. This simplifies the sheath configuration compared to conventional sheaths, reducing the number of parts, and as a result, making it possible to achieve disposable devices at lower costs.

[0081] In addition, in this embodiment, the elastic engagement portion 33 of the gate member 30 is formed in a cylindrical shape with multiple elastic pieces 33b that elastically deform when subjected to external force from the clip 20, allowing the clip 20 to pass through its interior.

[0082] With this configuration, the clip device 1 according to this embodiment can have a simple configuration for the elastic engagement portion 33, which can promote disposability due to lower cost.

[0083] Furthermore, clip 20 is restricted from slipping out of sheath 12 while surrounded by cylindrical, closed elastic engagement portion 33, and when clip 20 slides relative to sheath 12 and passes through the inside of elastic engagement portion 33, four elastic pieces 33b are elastically deformed, causing clip 20 to slip out of sheath 12. Therefore, clip 20 stored in sheath 12 can be prevented from accidentally passing through elastic engagement portion 33 and slipping out of sheath 12, thereby ensuring safety when used inside the body.

[0084] Furthermore, in the clip device 1 according to this embodiment, the elastic engagement portion 33 of the gate member 30 is formed in a conical shape that decreases in diameter toward the distal end. This configuration makes it easier to insert the clip device 1 according to this embodiment into an endoscope, and also allows the distal end provided with the elastic engagement portion 33 to be positioned with high precision at the site to be treated inside the body.

[0085] Furthermore, in this embodiment, the four elastic pieces 33b constituting the elastic engagement portion 33 are configured so that the tip surfaces 33c on the distal end sides thereof abut and engage with the end surface 29c on the proximal end of the tightening ring 29. This simplifies the configuration of the elastic engagement portion 33, further promoting disposability along with cost reduction.

[0086] (Example of change) In the clip device 1 of the above-described embodiment, the gate member 30 including the elastic engagement portion 33 is a separate member from the sheath 12, but the gate member 30 may be integrally formed with the sheath 12.

[0087] FIG. 9 shows one example of this. In this case, the sheath 12 is made of flexible resin as described above, and the shape of the gate member 30 including the elastic engagement portion 33 is integrally molded at the tip of the sheath 12, thereby forming the gate member 30 integrally with the sheath 12.

[0088] When the sheath 12 and the gate member 30 are integrally molded in this way, the number of parts can be further reduced, which further promotes disposability along with cost reduction. [Industrial Applicability]

[0089] The present invention is useful as a medical clip device that can be made disposable. [Explanation of symbols]

[0090] 1 Clipping device 12 Sheath 13 Drive wire 16 Control section 20 clips 21 Clip body 29 Tightening ring (fastening member) 30 Gate material 33 Elastic engagement portion 33b Elastic piece 33c Tip surface of elastic piece

Claims

1. 1. A clip device comprising: a sheath consisting of a single tubular body; a drive wire inserted into the sheath; an operation unit provided at a proximal end of the sheath and configured to slide the drive wire relative to the sheath along an axial direction of the sheath; a clip made of an elastic material that is detachably connected to the distal end of the drive wire and that can be housed within the sheath; The clip has a clip body that is configured so that when it is pulled out from the distal end of the sheath, its distal end side opens due to its own elasticity, and when it is housed in the sheath, it is constrained by the sheath and closed; and a fastening member that is slidably provided at least partially between the proximal end and the distal end of the clip body and slides toward the distal end side to close the clip body, an elastic engaging portion is provided at an opening on the distal end side of the sheath, the elastic engaging portion being elastically deformed by an external force from the clip to allow the clip to come out from within the sheath toward the distal end, and engaging with the fastening member that has come out from within the sheath toward the distal end side to slide the fastening member toward the distal end; The clip device includes only one clip, The operating portion is provided with a click mechanism for positioning the clip device at three positions: a storage position in which the clip is stored within the sheath; an open position in which the clip body is released from the elastic engagement portion toward the distal end and opens; and a clip position in which the clip body is closed by the fastening member.

2. The clip device according to claim 1, characterized in that the elastic engagement portion is formed in a cylindrical shape with a plurality of elastic pieces that elastically deform when subjected to external force from the clip, allowing the clip to pass through its interior.

3. 3. The clip device according to claim 2, wherein the elastic engaging portion is formed in a conical shape whose diameter decreases toward the distal end.

4. 4. The clip device according to claim 2, wherein the elastic piece is configured so that a tip surface on the distal end side thereof abuts against and engages with the proximal end of the fastening member.

5. 5. The clip device according to claim 1, wherein the elastic engagement portion is molded integrally with the sheath.

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