Medical Clip System

Abstract

To provide a medical clip system that can prevent a ring from coming off a clip when attaching the clip to a linear object.SOLUTION: A medical clip system 1 includes a medical clip 10 having a first part 11 and a second part 12 opposed to each other for gripping a living body tissue, a ring 30, and a linear object 20 having a connection part 22 connected to the medical clip 10. The medical clip 10 includes a bridge 13 for connecting a first base part 11b and a second base part 12b on a first end side in a width direction z. The first base part 11b and the second base part 12b are not connected to each other except through the bridge 13. In an axial direction x, the bridge 13 is disposed on a tip 10a side rather than a base end 10b, and on a base end 10b side rather than a first arm part 11a and a second arm part 12a. The ring 30 includes an abutment part 31 that abuts against the bridge 13.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a medical clip system used for treatments such as hemostasis in endoscopic surgery. [Background technology]

[0002] Endoscopic procedures such as endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) can sometimes result in bleeding during the procedure. One method for stopping such bleeding or bleeding from lesions in body cavities such as the digestive tract is the clipping method, which uses an endoscopic treatment tool equipped with a medical clip to place the medical clip at the bleeding site and apply pressure to stop the bleeding.

[0003] In the clipping method, a clip system with a medical clip attached to the distal end of a linear object is inserted into the forceps channel through the forceps port of an endoscope, and the medical clip is then transported to the treatment site. Multiple medical clips are often used in a single procedure, and a new clip must be attached to the clip system each time clipping with one clip is completed. Therefore, clip cartridges have been proposed as a connecting aid to efficiently attach clips (e.g., Patent Documents 1 to 5). [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Publication No. 2017-217206 [Patent Document 2] Japanese Patent Application Publication No. 2017-148182 [Patent Document 3] Japanese Patent Application Laid-Open No. 2009-11769 [Patent Document 4] International Publication No. 2017 / 94455 [Patent Document 5] International Publication No. 2018 / 123137 Summary of the Invention [Problem to be solved by the invention]

[0005] A clip cartridge contains a clip and a ring that fastens the clip, but with the conventional clip cartridge described above, the ring can fall off during handling of the clip cartridge, causing the clip without the ring to be attached to a linear object and transported to the area to be treated.

[0006] SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide a medical clip system in which the ring does not fall off the clip when the clip is attached to a linear object. [Means for solving the problem]

[0007] One embodiment of the medical clip system of the present invention that can solve the above problems is a medical clip system having a medical clip that has a first part and a second part facing each other and grasps biological tissue, a ring having an inner cavity into which the medical clip is inserted, and a linear object having a connecting part that is connected to the medical clip, wherein the medical clip has a base end and a tip end, and has an opening / closing direction, an axial direction from the base end to the tip end, and a width direction perpendicular to the opening / closing direction and the axial direction, and the first part is a first arm part that grasps the biological tissue and is located closer to the base end than the first arm part. The medical clip has a first base portion, and the second portion has a second arm portion that grasps the biological tissue and a second base portion that is located closer to the base end than the second arm portion. The medical clip has a first end side and a second end side in the width direction, and has a bridge on the first end side that connects the first base portion and the second base portion. The first base portion and the second base portion are not connected except via the bridge. In the axial direction, the bridge is located closer to the tip end than the base end and closer to the base end than the first arm portion and the second arm portion. The ring has an abutment portion that abuts the bridge.

[0008] In the above medical clip system, the medical clip has a bridge connecting the first base and the second base at the first end in the width direction, and the ring has an abutment portion that abuts against the bridge, so that the medical clip can be attached to a linear object without the ring falling off the medical clip. This prevents the clip from being delivered to the treatment site and being unable to ligate due to the absence of the ring. Furthermore, in the above medical clip system, the first base and the second base are connected only via the bridge, and the bridge is located axially closer to the distal end than the proximal end, so that the connecting portion of the linear object can be easily connected between the first base and the second base, improving the efficiency of connection between the medical clip and the linear object.

[0009] The contact portion is preferably provided at the end of the ring on the tip side.

[0010] Alternatively, the abutment portion may be provided on the end portion of the ring on the proximal side, thereby preventing the ring from coming off the clip while ensuring that the connection between the medical clip and the linear object is not hindered by the ring.

[0011] The axial length of the ring is preferably shorter than the axial length from the base end of the medical clip to the distal end of the bridge.

[0012] It is preferable that the medical clip and the linear object are connected by fitting the connecting portion between the first base portion and the second base portion from the second end side in the width direction.

[0013] When the medical clip and the linear object are connected, it is preferable that the distal end of the connecting portion is located further distal than the proximal end of the bridge in the axial direction.

[0014] The connecting portion preferably has a contact portion that contacts the base end of the medical clip.

[0015] Preferably, the medical clip further has a first claw portion protruding from a base end of the first base toward the second base, and a second claw portion protruding from a base end of the second base toward the first base. In this case, it is preferable that the first claw portion and the second claw portion have a notch along the outer periphery of the linear object. [Effects of the Invention]

[0016] According to the above medical clip system, the medical clip can be attached to a linear object without the ring falling off the medical clip. This prevents the clip from being delivered to the treatment site and preventing ligation due to the absence of the ring. Furthermore, the connecting portion of the linear object can be easily connected between the first base and the second base, improving the efficiency of connecting the medical clip to the linear object. [Brief explanation of the drawings]

[0017] [Figure 1] 1 illustrates a plan view of a medical clip system according to an embodiment of the present invention. [Figure 2] 2 shows a cross-sectional view of the medical clip system shown in FIG. 1 along line II-II. [Figure 3] 1 illustrates a plan view of a medical clip system when a medical clip and a linear object are connected in one embodiment of the present invention. [Figure 4] 4 shows a cross-sectional view of the medical clip system shown in FIG. 1 taken along line IV-IV. [Figure 5] 1 illustrates a perspective view of a ring according to an embodiment of the present invention. [Figure 6] 10 shows a perspective view of a ring according to another embodiment of the present invention. [Figure 7] 10 illustrates a plan view of a medical clip system according to another embodiment of the present invention. [Figure 8] 8 shows a cross-sectional view taken along the line VIII-VIII in FIG. 7. [Figure 9]10 is a plan view of a medical clip system when a medical clip and a linear object are connected in accordance with yet another embodiment of the present invention. FIG. [Figure 10] 10 shows a cross-sectional view taken along the line XX of the medical clip system shown in FIG. 9. [Figure 11] 10 shows a plan view of the distal side of the linear object shown in FIG. 9. DETAILED DESCRIPTION OF THE INVENTION

[0018] The present invention will be described below based on the embodiments, but the present invention is not limited to the following embodiments, and can be implemented with appropriate modifications within the scope of the above and below-described purposes, and all such modifications are included within the technical scope of the present invention. In addition, hatching and component symbols may be omitted in each drawing for convenience. In such cases, reference should be made to the specification or other drawings. The dimensions of various components in the drawings may differ from actual dimensions, as priority is given to helping understand the features of the present invention.

[0019] An embodiment of the medical clip system of the present invention will be described with reference to FIGS. 1 to 8. However, the present invention is not limited to the embodiment shown in the drawings. FIG. 1 is a plan view of a medical clip system 1 according to one embodiment of the present invention, illustrating a state in which the medical clip 10 and the linear object 20 are not connected. In FIG. 1, the inner tube 25 and a portion of the linear object 20 are disposed within the outer tube 26, and are therefore indicated by dotted lines. FIG. 2 is a cross-sectional view taken along the line II-II in FIG. 1, i.e., a cross-sectional view perpendicular to the axial direction x at a location where the bridge 13 is disposed on the medical clip 10. FIG. 3 is a plan view of the medical clip system 1 according to one embodiment of the present invention, when the medical clip 10 and the linear object 20 are connected. FIG. 4 is a cross-sectional view taken along the line IV-IV in FIG. 1, i.e., a cross-sectional view of the medical clip 10 in the axial direction x. FIGS. 5 and 6 are perspective views of a ring 30 according to different embodiments of the present invention. Fig. 7 shows a plan view of a medical clip system 1 according to another embodiment of the present invention, illustrating a state in which the medical clip 10 and the linear object 20 are not connected. Fig. 8 shows a cross-sectional view taken along line VIII-VIII in Fig. 7, i.e., a cross-sectional view of the medical clip 10 in the axial direction x. In Figs. 3 and 8, the bridge 13, the inner cylinder 25, and a portion of the linear object 20 are shown with dotted lines because they are disposed below other components. In Figs. 4 and 7, the first portion 11 (first base portion 11b) does not exist on the cross-section, but is shown with dotted lines as a component that exists when the cross-section is viewed in the direction of the arrow.

[0020] As shown in Figure 1, a medical clip system 1 according to an embodiment of the present invention comprises a medical clip 10 having a first part 11 and a second part 12 facing each other and configured to grasp biological tissue, a ring 30 having an inner cavity into which the medical clip 10 is inserted, and a linear object 20 having a connecting part 22 connected to the medical clip 10.

[0021] The medical clip 10 has a clip base end 10b and a clip tip end 10a, an opening / closing direction y, an axial direction x from the clip base end 10b to the clip tip end 10a, and a width direction z perpendicular to the opening / closing direction y and the axial direction x. In this specification, members and parts other than the medical clip 10 will also be described as having the same axial direction x, opening / closing direction y, and width direction z as the medical clip 10. In addition, the side of the clip tip end 10a in the axial direction x may be described as the distal side, and the opposite side as the proximal side. In FIG. 1, the left side of the figure is the distal side, and the right side of the figure is the proximal side. The proximal side is the extension direction of the linear object 20, i.e., the side closer to the user in the axial direction x, and the distal side is the opposite side of the proximal side, i.e., the side closer to the patient.

[0022] In this specification, the medical clip system 1 may be simply referred to as the clip system 1, and the medical clip 10 may be simply referred to as the clip 10. The base end 10b of the medical clip 10 may also be referred to as the clip base end 10b, and the tip 10a of the medical clip 10 may also be referred to as the clip tip end 10a.

[0023] When connecting a linear object 20 to a medical clip 10, the linear object 20 is positioned so that the connecting portion 22 of the linear object 20 is on the distal side, thereby allowing the connecting portion 22 of the linear object 20 to be connected to the base end 10B (hereinafter also referred to as the clip base end 10B) of the medical clip 10. Here, the clip base end 10B refers to the portion including the clip base end 10b. The medical clip system 1, in which the medical clip 10 is connected to the distal side of the linear object 20, is passed through the forceps channel of an endoscope, and the medical clip 10 is transported to the site to be treated, whereby clipping using the clip 10 can be performed inside the patient's body.

[0024] The linear object 20 is a member extending in the axial direction x and can be composed of one or more members. The linear object 20 may be solid or hollow with an inner lumen extending along the axial direction x, but is preferably solid. The solid shape of the linear object 20 increases the rigidity of the linear object 20 without increasing the outer diameter of the linear object 20. As a result, the insertion ability of the medical clip system 1 can be improved. The linear object 20 may be a solid wire or a twisted wire formed by twisting together single wires. If the linear object 20 is a solid wire, manufacturing is easier. If the linear object 20 is a twisted wire, the strength of the linear object 20 can be increased, making it easier to transmit a proximal operation to the distal portion of the medical clip system 1, including the medical clip 10 and the connecting portion 22. The cross-sectional shape of the linear object 20 can be, for example, a circle, an ellipse, a polygon, or a combination thereof.

[0025] Examples of materials constituting the linear object 20 include metals such as stainless steels such as SUS301, SUS303, SUS304, and SUS631, and carbon steel; polyamide resins such as nylon; polyolefin resins such as PP and PE; polyester resins such as PET, and aromatic polyether ketone resins such as PEEK; polyimide resins; and synthetic resin fibers such as fluororesins such as PTFE, PFA, and ETFE. Among these, stainless steel is preferred as the material constituting the linear object 20. By making the linear object 20 out of stainless steel, the strength of the linear object 20 can be ensured while improving biocompatibility.

[0026] Although not shown, the linear object 20 may have a coating layer on its surface. Examples of the coating layer include fluororesins such as PTFE, PFA, ETFE, and tetrafluoroethylene-hexafluoropropylene copolymer (FEP). By having the coating layer on the linear object 20, it is possible to reduce friction on the surface of the linear object 20, thereby increasing the slidability and increasing the strength of the linear object 20.

[0027] The method for forming a coating layer on the linear object 20 may be any method that allows the material forming the coating layer to cover the surface of the linear object 20, and for example, a dipping method, a spraying method, a fluidized bed method, a kneader coater method, etc. may be used.

[0028] The length of the linear object 20 in the axial direction x can be selected appropriately taking into consideration the distance from the forceps port of the endoscope to the treatment target area, and can be, for example, 1000 mm or more and 3000 mm or less.

[0029] The outer diameter of the linear object 20 is preferably 100 μm or more, more preferably 200 μm or more, and even more preferably 300 μm or more. When the lower limit of the outer diameter of the linear object 20 is within the above range, the rigidity of the linear object 20 can be increased. Furthermore, the outer diameter of the linear object 20 is preferably 900 μm or less, more preferably 800 μm or less, and even more preferably 700 μm or less. When the upper limit of the outer diameter of the linear object 20 is within the above range, the insertability of the clip system 1 can be improved.

[0030] The outer diameter of the linear object 20 may be the same or may vary over the entire length in the axial direction x. For example, the proximal portion of the linear object 20 may be thickened for reinforcement. Examples of methods for reinforcing the linear object 20 include disposing a tubular part on the outer surface of the linear object 20.

[0031] As shown in FIG. 1 , the linear object 20 has a connecting portion 22 on the distal side that connects to the medical clip 10. The medical clip 10 can be attached to the linear object 20 by connecting the medical clip 10 to the connecting portion 22. The linear object 20 preferably has a configuration in which the outer diameter of the connecting portion 22 is larger than the outer diameter of the portion other than the connecting portion 22. This stabilizes the connection between the connecting portion 22 and the medical clip 10. The connecting portion 22 may be formed integrally with the linear object 20, or the linear object 20 may be composed of a linear object main body 21 and the connecting portion 22 which is a separate member, and the connecting portion 22 may be attached to the distal side of the linear object main body 21.

[0032] The shape of the connecting portion 22 is not particularly limited as long as it can be connected to the clip base end 10B, but the cross-sectional shape of the connecting portion 22 perpendicular to the axial direction x can be, for example, circular, elliptical, polygonal, or a combination of these.

[0033] When the connecting portion 22 is attached to the linear object main body 21 as a separate member, the above description of the material constituting the linear object 20 can be referred to for the materials constituting the linear object main body 21 and the connecting portion 22. Even when the connecting portion 22 is attached to the linear object main body 21 as a separate member, it is preferable that the material of the connecting portion 22 is the same as the material of the linear object main body 21. By making the material of the connecting portion 22 the same as the material of the linear object main body 21, the connection between the connecting portion 22 and the linear object main body 21 can be strengthened, making it difficult for the connecting portion 22 to come off the linear object main body 21. As a result, the durability of the medical clip system 1 can be improved.

[0034] When the connecting portion 22 is a separate member, the connecting portion 22 and the linear object main body 21 can be fixed to each other by, for example, mechanical fixing such as screws, crimping, fitting, press-fitting, etc.; fusion; welding; adhesion using adhesives, tape, etc. Among these, it is preferable that the connecting portion 22 is fixed to the linear object main body 21 by welding. This can increase the bonding strength between the connecting portion 22 and the linear object main body 21.

[0035] As shown in FIG. 1 , it is preferable that at least a portion of the linear object 20 is disposed within the inner tube 25. That is, it is preferable that the medical clip system 1 further includes an inner tube 25, and that the linear object 20 is disposed within the lumen of the inner tube 25. With the clip 10 connected to the linear object 20, the opening and closing of the clip 10 can be adjusted by moving the linear object 20 proximally or distally in the axial direction x of the inner tube 25. For example, when the linear object 20 is moved proximally relative to the inner tube 25, the proximal end of the ring 30 comes into contact with the distal end of the inner tube 25, and the clip 10 can be closed by moving the ring 30 toward the clip tip 10a.

[0036] It is preferable that the inner tube 25 has both flexibility to bend along the shape of the inside of the body cavity and rigidity to reliably reach the treatment target site. The inner tube 25 can be composed of a coil body made of metal or synthetic resin, a cylindrical body in which multiple short cylindrical joint pieces are connected in the axial direction to enable rotation, a cylindrical body made of synthetic resin, or a combination of these. For the types of metals and synthetic resins, please refer to the above explanation of the material that makes up the linear object 20.

[0037] The medical clip system 1 may further include an outer tube 26. In this case, the inner tube 25 is disposed in the inner cavity of the outer tube 26. It is preferable that the clip 10 be configured to be freely inserted and removed from the outer tube 26 when connected to the linear object 20. By storing the clip 10 within the outer tube 26, the clip 10 can be prevented from being exposed. This prevents the clip 10 from damaging the forceps channel or internal tissue other than the lesion while transporting the clip 10 to the treatment site. During treatment, the clip 10 and the ring 30 are exposed from the outer tube 26.

[0038] It is desirable that the outer cylinder 26 has flexibility and rigidity similar to the inner cylinder 25. The outer cylinder 26 can be composed of a cylindrical body made of synthetic resin, a coil body made of metal or synthetic resin, a cylindrical body in which multiple short cylindrical joint links are connected in the axial direction to enable rotation, or a combination of these. Among these, a cylindrical body made of synthetic resin is preferably used for the outer cylinder 26. For the types of synthetic resin, refer to the above explanation of the material making up the linear object 20. The outer cylinder 26 may be composed of a transparent or translucent material to make it easier to check the positional relationship between the outer cylinder 26 and the inner cylinder 25.

[0039] The first portion 11 of the medical clip 10 has a first arm 11a that grasps biological tissue and a first base portion 11b that is located closer to the clip base end 10b than the first arm 11a, and the second portion 12 of the medical clip 10 has a second arm 12a that grasps biological tissue and a second base portion 12b that is located closer to the clip base end 10b than the second arm 12a. For example, as shown in Fig. 1, the arm portion can be located on the clip tip end 10a side of a midpoint M of the length in the axial direction x of the medical clip 10, and the base portion can be located on the clip base end 10b side of the midpoint M.

[0040] In the natural state of the clip 10, the first arm 11a and the second arm 12a are preferably configured so that the distance between the first arm 11a and the second arm 12a in the opening / closing direction y increases from the clip base end 10b toward the clip tip 10a, making it easier for the first arm 11a and the second arm 12a to grasp biological tissue.

[0041] Examples of materials that can be used to form the first and second parts 11 and 12 of the medical clip 10 include Ni-Ti alloys and stainless steels such as SUS301, SUS303, SUS304, and SUS601. Among these, stainless steel is preferred as the material that forms the medical clip 10. If the medical clip 10 is made of stainless steel, the medical clip 10 will have high elasticity and the biocompatibility of the medical clip 10 can be improved.

[0042] 1 and 2, the medical clip 10 has a first end side and a second end side in the width direction z, and has a bridge 13 on the first end side connecting the first base portion 11b and the second base portion 12b. The bridge 13 is located closer to the clip distal end 10a than the clip proximal end 10b and closer to the clip proximal end 10b than the first arm portion 11a and the second arm portion 12a. The bridge 13 being located closer to the clip distal end 10a than the clip proximal end 10b means that the first portion 11 and the second portion 12, which are formed as a continuous member, are not bent at the clip proximal end 10b to form two arms, but rather the first portion 11 and the second portion 12, which are independent of each other, are connected by the bridge 13 on the clip distal end 10a side of the clip proximal end 10b. Furthermore, because the bridge 13 is located closer to the clip base end 10b than the first arm 11a and the second arm 12a, the bridge 13 can directly connect the first base 11b and the second base 12b. This allows the bridge 13 to be configured so that it does not interfere with the first arm 11a and the second arm 12a grasping biological tissue. Furthermore, the first base 11b and the second base 12b are not connected except via the bridge 13. That is, the first portion 11 and the second portion 12 are not connected except via the bridge 13, and a gap is formed between the first portion 11 and the second portion 12 at the clip base end 10b. An example of a bridge 13 that enables such a configuration includes a bridge-like configuration that directly connects the first base 11b and the second base 12b, as shown in FIG. 2. Preferably, the second end, which is opposite the first end where the bridge 13 is provided in the width direction z, is open.

[0043] 3, because bridge 13 has the above-described configuration, when connecting portion 22 to clip base end 10B, i.e., between first base portion 11b and second base portion 2b, connecting portion 22 and bridge 13 can come into contact, making it possible to easily and stably connect connecting portion 22 to clip 10. Furthermore, because a gap is formed between first portion 11 and second portion 12 at clip base end 10b, connecting portion 22 to clip base end 10B is easy.

[0044] The medical clip 10 may be formed, for example, by bending a single metal plate including the first portion 11, the second portion 12, and the bridge 13. Alternatively, the medical clip 10 may be formed by joining a component including the first portion 11, a component including the second portion 12, and a component including the bridge 13. In particular, the medical clip 10 is preferably formed by bending a single metal plate including the first portion 11, the second portion 12, and the bridge 13. By forming the medical clip 10 from a single metal plate, variation in quality of the product is reduced during the manufacture of the medical clip 10, and manufacturing efficiency can be improved.

[0045] When the medical clip 10 is formed by joining together a component including the first portion 11, a component including the second portion 12, and a component including the bridge 13, the above description of the materials constituting the first portion 11 and the second portion 12 can be referenced for the material constituting the component including the bridge 13. The material constituting the component including the bridge 13 may be the same as or different from the materials constituting the component including the first portion 11 and the component including the second portion 12, but is preferably the same. The component including the bridge 13 can be joined to the component including the first portion 11 and the component including the second portion 12 by, for example, mechanical fastening such as screws, crimping, fitting, or press-fitting; fusion; welding; or bonding using adhesives or tapes. Among these, welding is preferred as the method for joining the component including the bridge 13 to the component including the first portion 11 and the component including the second portion 12. This increases the joining strength of each component.

[0046] The medical clip 10 has a space S between the first base portion 11b and the second base portion 12b that receives the connecting portion 22 of the linear object 20. Hereinafter, the space S that receives the connecting portion 22 may be referred to as the receiving space S. The receiving space S can be said to be a space defined by the first base portion 11b, the second base portion 12b, and the bridge 13.

[0047] When the connecting portion 22 is received in the receiving space S, the connecting portion 22 is fitted into the clip base end 10B, and the clip 10 and the linear object 20 can be connected. Conversely, when the connecting portion 22 moves out of the receiving space S and is detached from the clip base end 10B, the connection between the clip 10 and the linear object 20 can be released. At this time, the connecting portion 22 may be moved proximally by pulling the linear object 20 proximally, and the connecting portion 22 may be removed from the receiving section S.

[0048] When the medical clip 10 is not gripping biological tissue, the ring 30 is positioned at the distal end of its range of motion, and the connecting portion 22 is moved proximally. The force required to detach the connecting portion 22 from the clip proximal end 10B can be appropriately set depending on the application of the clip 10, but is preferably 20 N or greater. This prevents the clip 10 from unintentionally detaching from the connecting portion 22 during use of the clip system 1, thereby allowing for smooth treatment. Furthermore, if this force is too large, it becomes difficult to detach the clip 10 from the connecting portion 22, which is undesirable. The upper limit of this force may be, for example, 50 N. In this way, with the medical clip system 1, it is possible to appropriately set the force required for the connecting portion 22 to detach from the clip base end 10B when the connecting portion 22 is moved proximally, making it easier to release the connection between the clip 10 and the connecting portion 22 after the clip 10 has grasped the target area, such as a bleeding site, and allowing treatment using the medical clip system 1 to be carried out smoothly.

[0049] In the axial direction x, the length from the end 13b of the bridge 13 on the clip base end 10b side (hereinafter also referred to as the bridge base end 13b) to the end 13a of the bridge 13 on the clip tip end 10a side (hereinafter also referred to as the bridge tip 13a) is preferably greater than at least one of the lengths of the first base portion 11b in the width direction z and the second base portion 12b in the width direction z. This stabilizes the connection between the first base portion 11b and the second base portion 12b by the bridge 13, making it less likely that the distance between the first base portion 11b and the second base portion 12b will change in the opening / closing direction y. As a result, the receiving space S can be prevented from becoming too wide, and for example, a problem can be prevented in which the connecting portion 22 comes off the clip 10 when fitting the connecting portion 22 into the clip base end 10B.

[0050] As shown in FIGS. 1 to 8 , the medical clip system 1 has a ring 30 having an inner cavity into which the medical clip 10 is inserted. When the clip 10 and the linear object 20 are connected before use, the ring 30 is preferably disposed outside the first base portion 11b and the second base portion 12b of the clip 10. The ring 30 is movable in the axial direction x relative to the clip 10 with the clip 10 disposed in the inner cavity. Before the clip 10 grasps biological tissue, the ring 30 is positioned closer to the clip base end 10b than the first arm portion 11a and the second arm portion 12a of the clip 10. When the ring 30 moves toward the clip distal end 10a in the axial direction x so that the first arm portion 11a and the second arm portion 12a are disposed in the inner cavity, the first arm portion 11a and the second arm portion 12a move in the closing direction in the opening / closing direction y, and the biological tissue is grasped between the first arm portion 11a and the second arm portion 12a.

[0051] As shown in FIGS. 4 to 6 , the ring 30 has an abutment portion 31 that abuts against the bridge 13. Preferably, the abutment portion 31 abuts against the bridge tip 13a. This restricts the ring 30 from moving toward the clip base end 10b in the axial direction x relative to the bridge 13 when the clip 10, with the ring 30 disposed outside the first base portion 11b and the second base portion 12b, is set in a clip cartridge to connect the clip 10 and the linear object 20 before use. This prevents the ring 30 from slipping off toward the clip base end 10b. Furthermore, the first arm 11a and the second arm 12a are preferably configured such that the distance between the first arm 11a and the second arm 12a in the opening / closing direction y increases from the clip base end 10b toward the clip tip 10a in the axial direction x. This prevents the ring 30 from slipping off toward the clip tip 10a. In this way, the medical clip system 1 can prevent the ring 30 from falling off the clip 10, and therefore the clip 10 can be connected to the linear object 20 while being placed in the lumen of the ring 30. This can prevent the problem of the clip 10 being unable to perform ligation because the ring 30 is missing even after the clip 10 has been delivered to the treatment site.

[0052] As shown in FIGS. 4 and 5 , the abutment portion 31 may be, for example, a protrusion provided on a part of the end of the ring 30 in the axial direction x toward the inside of the ring 30. The angle θ formed on the inner cavity side of the ring 30 between the central axis C of the ring 30 and a line L connecting the end of the protrusion on the boundary side with the ring 30 to the innermost end may be 90°. That is, the protrusion may protrude at a right angle toward the inside of the ring 30. Alternatively, the angle θ formed by the line L connecting the end of the protrusion on the boundary side with the ring 30 to the innermost end and the central axis C of the ring 30 may be inclined within ±5° from 90°, within ±10° from 90°, within ±20° from 90°, or within ±45° from 90°. By providing the abutment portion 31 as a protrusion at a part of the end of the ring 30 in the axial direction x at an angle θ within the above range, the abutment portion 31 can prevent the ring 30 from moving toward the clip base end 10b in the axial direction x relative to the bridge 13.

[0053] 6, the contact portion 31 may be, for example, a beam portion provided at a part of the end portion of the ring 30 in the axial direction x and spanning the opposing end portion of the ring 30. When the contact portion 31 is a beam portion, the contact portion 31 can restrict the ring 30 from moving toward the clip base end 10b in the axial direction x relative to the bridge 13.

[0054] The abutment portion 31 may be formed integrally with the ring 30, or may be formed by joining a component constituting the abutment portion 31 (hereinafter sometimes referred to as an "abutment portion component") to the ring 30. In particular, it is preferable that the abutment portion 31 be formed integrally with the ring 30. This makes it possible to prevent the abutment portion 31 from coming off the ring 30 even when an external force is applied to the ring 30.

[0055] When the abutment portion 31 is formed by joining an abutment portion part to the ring 30, the material constituting the abutment portion part can be determined by referring to the following description of the material constituting the ring 30. The abutment portion 31 can be joined to the ring 30 by, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting; fusion; welding; or bonding using an adhesive, tape, or the like. Among these, it is preferable that the abutment portion part be joined to the ring 30 by welding, which can increase the joining strength.

[0056] The inner diameter of the ring 30 is preferably smaller than the outer diameter of the inner tube 25. As a result, by moving the linear object 20 proximally relative to the inner tube 25, the proximal end of the ring 30 comes into contact with the distal end of the inner tube 25, causing the ring 30 to move toward the clip tip 10a, thereby closing the clip 10. In addition, the outer diameter of the ring 30 is preferably smaller than the inner diameter of the outer tube 26. As a result, the clip 10 and the ring 30 can be accommodated in the inner cavity of the outer tube 26.

[0057] It is preferable that the force required to move the ring 30 in the axial direction x be set smaller than the force required to release the connecting portion 22 from the clip 10. This makes it possible to prevent the connection between the clip 10 and the connecting portion 22 from being unintentionally released when the ring 30 is moved in the axial direction x.

[0058] The cross-sectional shape of the ring 30 perpendicular to the axial direction x is not particularly limited, and may be, for example, a circle, an oval, a polygon, etc. Alternatively, the cross-sectional shape of the ring 30 perpendicular to the axial direction x may be a C-shape with a notch, or the ring 30 itself may be a coil formed by spirally winding a wire.

[0059] The ring 30 may be made of the same material as the medical clip 10, such as a metal, such as a Ni-Ti alloy, or stainless steel, such as SUS301, SUS303, SUS304, or SUS631. Of these, the material of the ring 30 preferably includes stainless steel.

[0060] 1, 3, and 4, the contact portion 31 is preferably provided at the end of the ring 30 on the clip tip 10a side (hereinafter, also referred to as the ring tip.) If the contact portion 31 is provided at the ring tip, the ring 30 can be easily moved in the axial direction x while preventing the ring 30 from slipping off toward the clip base end 10b side.

[0061] 7 and 8, the abutting portion 31 may be provided at the end of the ring 30 on the clip base end 10b side (hereinafter, also referred to as the ring base end). If the abutting portion 31 is provided at the ring base end, the abutting portion 31 provided at the ring base end can abut against the bridge tip 13a, so that the bridge 13 can be exposed from the ring 30. This allows the receiving space S defined by the first base portion 11b, the second base portion 12b, and the bridge 13 to be exposed from the ring 30, so that the connecting portion 22 can be easily fitted into the receiving space S, facilitating the connection between the clip 10 and the linear object 20.

[0062] The length of the ring 30 in the axial direction x is preferably shorter than the length in the axial direction x from the base end 10b of the medical clip 10 to the end 13a on the tip 10a side of the connecting portion 13. With this configuration, the ring 30 is less likely to obstruct the receiving space S, and the clip 10 and the linear object 20 can be easily connected.

[0063] Preferably, the medical clip 10 and the linear object 20 are connected by fitting the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z. With this connecting method, the connecting portion 22 fitted from the second end side in the width direction z can be received by the bridge 13 provided at the first end portion in the width direction z, and the clip 10 and the linear object 20 can be easily and stably connected. Furthermore, unlike conventional clip systems, it is not necessary to move the linear object 20 from the clip base end 10b side in the axial direction x to insert the connecting portion 22 into the clip base end 10B, which improves connecting efficiency and prevents poor connection.

[0064] The force required to fit the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z of the clip 10 is preferably 0.05 N or more. By setting the lower limit of the force required to fit the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z within the above range, it is possible to confirm whether the clip 10 and the connecting portion 22 are connected by the feel when the connecting portion 22 is pressed into the clip 10 to fit it. This prevents the clip 10 from being accidentally detached in an unintended situation when the medical clip system 1 is used for treatment when the clip 10 and the connecting portion 22 are not properly connected. The upper limit of the force required to fit the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z of the clip 10 can be, for example, 10 N or less.

[0065] Alternatively, the medical clip 10 may be configured such that no force is required when fitting the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z of the clip 10. Here, "no force required" includes a force of less than 0.05 N required to fit the connecting portion 22 between the first base portion 11b and the second base portion 12b from the second end side in the width direction z of the clip 10. Even in such a configuration, the medical clip system 1 has a predetermined bridge 13, and therefore it is possible to confirm that the clip 10 and the connecting portion 22 are connected by the contact between the connecting portion 22 and the bridge 13.

[0066] 3, when the medical clip 10 and the linear object 20 are connected, it is preferable that, in the axial direction x, the end of the connecting portion 22 on the clip tip 10a side, i.e., the distal end 22a, is located closer to the clip tip 10a side than the end 13b on the clip base end 10b side of the bridge 13. By connecting the clip 10 and the linear object 20 in this manner, the connecting portion 22 of the linear object 20 can be supported by the bridge 13, and the clip 10 and the linear object 20 can be connected more easily and stably.

[0067] When the medical clip 10 and the linear object 20 are connected, it is more preferable that the distal end 22a of the connecting portion 22 is located closer to the clip tip 10a than the bridge base end 13b in the axial direction x, and the proximal end 22b of the connecting portion 22 is located closer to the clip base end 10b than the bridge base end 13b. This increases the contact area between the bridge 13 and the connecting portion 22, increasing the frictional force generated between the bridge 13 and the connecting portion 22, and making it possible to more easily and stably connect the clip 10 and the linear object 20.

[0068] A medical clip system 1 according to another embodiment of the present invention will be described with reference to Figs. 9 to 11. Fig. 9 shows a plan view of the medical clip system 1 according to another embodiment of the present invention, in which a medical clip 10 and a linear object 20 are connected. In Fig. 9, the bridge 13, the inner cylinder 25, and a portion of the linear object 20 are shown by dotted lines because they are disposed below other components. Fig. 10 shows a cross-sectional view of the medical clip system 1 shown in Fig. 9, taken along line XX, and shows a cross-sectional view of the first claw portion 110 and the second claw portion 120 provided at the clip base end 10b. Fig. 11 shows a plan view of the distal side of the linear object 20 shown in Fig. 9.

[0069] 9 and 11, the connecting portion 22 of the linear object 20 preferably has a contact portion 23 that contacts the base end 10b of the medical clip 10. The contact portion 23 contacts the clip base end 10b, thereby preventing movement of the linear object 20 in the axial direction x and preventing the connection between the clip 10 and the connecting portion 22 from being released in an unintended situation.

[0070] As shown in FIG. 9 , the medical clip 10 preferably further includes a first claw 110 protruding from the base end of the first base 11b toward the second base 12b, and a second claw 120 protruding from the base end of the second base 12b toward the first base 11b. Even when the clip 10 includes the first claw 110 and the second claw 120, the first claw 110 and the second claw 120 do not abut each other, and the first portion 11 and the second portion 12 are not connected except via the bridge 13. That is, a gap is formed between the first claw 110 and the second claw 120. Due to this gap, even when the clip 10 includes the first claw 110 and the second claw 120, the clip 10 and the linear object 20 can be easily connected by the linear object 20 passing through the gap.

[0071] The clip 10 has the first claw portion 110 and the second claw portion 120, which prevents the linear object 20 from moving proximally relative to the clip 10. Furthermore, the first claw portion 110 and the second claw portion 120 can restrain the connecting portion 22, which makes it easy to maintain a stable connected state between the linear object 20 and the clip 10.

[0072] When the medical clip 10 has completed grasping the biological tissue and the clip 10 is to be removed from the linear object 20 to place it in place, it is preferable that the connecting portion 22 pushes the first claw portion 110 and the second claw portion 120 from the distal side toward the proximal side to deform them, and then moves the connecting portion 22 proximally so that the connecting portion 22 passes through the gap between the first claw portion 110 and the second claw portion 120 to remove the clip 10 from the linear object 20. With this configuration, the connecting portion 22 will not come off the clip 10 unless it is moved proximally with a force greater than or equal to the force that deforms the first claw portion 110 and the second claw portion 120, and therefore unintentional removal of the clip 10 from the linear object 20 can be prevented.

[0073] The first claw portion 110 may be formed by bending the proximal end portion of the first base portion 11b, or may be formed by joining a component constituting the first claw portion 110 (hereinafter, sometimes referred to as a "first claw portion component") to the proximal end portion of the first base portion 11b. Similarly, the second claw portion 120 may be formed by bending the proximal end portion of the second base portion 12b, or may be formed by joining a component constituting the second claw portion 120 (hereinafter, sometimes referred to as a "second claw portion component") to the proximal end portion of the second base portion 12b. In particular, it is preferable that the first claw portion 110 is formed by bending the proximal end portion of the first base portion 11b, and the second claw portion 120 is formed by bending the proximal end portion of the second base portion 12b. By forming them in this manner, it is possible to prevent the first claw portion 110 from coming off the first base portion 11b and the second claw portion 120 from coming off the second base portion 12b, and even if a load is applied to the first claw portion 110 and the second claw portion 120 when connecting or disconnecting the clip 10 and the linear object 20, the first claw portion 110 and the second claw portion 120 are less likely to be damaged.

[0074] When the first claw portion 110 is formed by joining a first claw part to the first base portion 11b, and the second claw portion 120 is formed by joining a second claw part to the second base portion 21b, the first claw part and the second claw part can be joined to the first base portion 11b and the second base portion 12b, respectively, by, for example, mechanical fastening using a connecting member such as a screw, crimping, fitting, or press-fitting; fusion; welding; or adhesion using an adhesive, tape, or the like. Among these, it is preferable that the first claw part and the second claw part are joined to the first base portion 11b and the second base portion 12b, respectively, by welding. This increases the joining strength.

[0075] 10 , the first claw portion 110 and the second claw portion 120 preferably have notches 111, 121 that follow the outer periphery of the linear object 20. The notches 111, 121 may be provided along the outer periphery of the linear object 20, or may be provided along the outer periphery of the connecting portion 22. This makes it possible to prevent excessive play from occurring between the first claw portion 110 and the second claw portion 120 and the linear object 20 when the linear object 20 is placed in the gap between the first claw portion 110 and the second claw portion 120 when connecting the clip 10 and the linear object 20, making it easier to restrain the linear object 20 with the first claw portion 110 and the second claw portion 120.

[0076] 11 , the connecting portion 22 has a groove portion 24 that is concave in the circumferential direction of the connecting portion 22, and it is preferable that a distal side surface 24a of the groove portion 24 contacts the distal side surfaces of the first claw portion 110 and the second claw portion 120, and a proximal side surface 24b of the groove portion 24 contacts the proximal side surfaces of the first claw portion 110 and the second claw portion 120. With this configuration, the proximal end of the clip 10 is fitted into the groove portion 24 of the connecting portion 22, so that the clip 10 and the connecting portion 22 are reliably connected, and unintentional release of the connection between the clip 10 and the linear object 20 is less likely to occur.

[0077] The length of groove 24 in the axial direction x is preferably longer than the thickness of first claw 110 and second claw 120 in the axial direction x, and is preferably no more than twice the thickness of first claw 110 and second claw 120 in the axial direction x. This makes it easier to fit connecting portion 22 between first base 11b and second base 12b from the second end side in the width direction z, facilitating connection between linear object 20 and clip 10.

[0078] In a state in which the clip 10 and the linear object 20 are connected, the connecting portion 22 may be located distal to the clip base end 10b as shown in Fig. 3, or a part of the connecting portion 22 may be located distal to the clip base end 10b, and the remaining part may be located proximal to the clip base end 10b as shown in Fig. 9. In this case, the connecting portion 22 may have a groove 24, and a part of the groove 24 proximal to the proximal side surface 24b may be located proximal to the proximal side surfaces of the first claw portion 110 and the second claw portion 120.

[0079] Although not shown, the medical clip system 1 preferably has a handle connected to the proximal end of the linear member 20. The handle is a member that a user holds when activating the medical clip system 1. Providing the medical clip system 1 with a handle makes it easier to operate the medical clip system. [Explanation of symbols]

[0080] 1: Medical Clip System 10: Medical clips 10a: Clip tip 10b: Clip base end 10B: Clip base end 11: Part 1 11a: 1st arm 11b: 1st base 12: Part 2 12a: 2nd arm 12b:Second base 13: Bridge 13a: Bridge tip 13b: Bridge base 20: Linear object 21: Linear object body 22:Connection part 22a: Distal end of the connection 22b: Proximal end of the connection 23: Contact part 24: Groove 24a: Distal side of the groove 24b: Proximal side of the groove 25: Inner cylinder 26: Outer cylinder 30: Ring 31: Contact part 110: 1st claw part 120:Second claw part 111, 121: Notch C: Center axis of the ring L: A straight line connecting both ends of the contact part θ: The angle between the line L and the central axis C M: Midpoint of the axial length of the medical clip S: Receiving section x: Axial direction y: Open / close direction z: Width direction

Claims

1. A medical clip system comprising: a medical clip having a first part and a second part opposed to each other and configured to grip biological tissue; a ring having an inner cavity into which the medical clip is inserted; and a linear object having a connecting part that is connected to the medical clip, the medical clip has a base end and a tip end, an opening / closing direction, an axial direction from the base end to the tip end, and a width direction perpendicular to the opening / closing direction and the axial direction, the first section has a first arm section that grasps the biological tissue and a first base section that is located closer to the base end than the first arm section, and the second section has a second arm section that grasps the biological tissue and a second base section that is located closer to the base end than the second arm section, the medical clip has a first end side and a second end side in the width direction, and a bridge on the first end side that connects the first base portion and the second base portion, the first base portion and the second base portion are not connected except via the bridge, In the axial direction, the bridge is disposed closer to the tip side than the base end and closer to the base end than the first arm portion and the second arm portion, the ring has an abutment portion that abuts against the bridge, A medical clip system, wherein the abutment portion is provided at the end portion on the base end side of the ring.

2. The medical clip system according to claim 1 , wherein the axial length of the ring is shorter than the axial length from the base end of the medical clip to the distal end of the bridge.

3. 3. The medical clip system according to claim 1, wherein the medical clip and the linear object are connected by fitting the connecting portion between the first base portion and the second base portion from the second end side in the width direction.

4. A medical clip system according to any one of claims 1 to 3, wherein when the medical clip and the linear object are connected, in the axial direction, the tip end of the connecting portion is located closer to the tip than the base end of the bridge.

5. 5. The medical clip system according to claim 1, wherein the connecting portion has a contact portion that contacts the base end of the medical clip.

6. A medical clip system according to any one of claims 1 to 5, wherein the medical clip further has a first claw portion protruding from the base end of the first base toward the second base, and a second claw portion protruding from the base end of the second base toward the first base.

7. The medical clip system according to claim 6 , wherein the first claw portion and the second claw portion have a notch along the outer periphery of the linear object.

8. A medical clip system as described in claims 1 to 7, wherein the abutment portion is a protrusion toward the inside of the ring at the base end portion of the ring in the axial direction, and when viewed from the opening and closing direction, the base end portion of the ring is connected to the abutment portion on the side where the bridge exists relative to the central axis of the ring, and the base end portion of the ring is not connected to the abutment portion on the side opposite to the side where the bridge exists relative to the central axis.

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