Clip unit

Abstract

This clip unit comprises a clip that has a first arm and a second arm capable of opening / closing in an opening / closing direction. The first arm has a first arm body extending in the longitudinal direction along a longitudinal axis, a first claw provided to the leading end of the first arm body and extending toward the closing side in the opening / closing direction, and a first anchor provided to the first claw or the leading end of the first arm body and extending toward the closing side in the opening / closing direction. At least the leading end of the first anchor is disposed closer to the opening side in the opening / closing direction in relation to the first claw. A gap is formed between the first claw and the first anchor and in the width direction perpendicularly to the longitudinal direction and the opening / closing direction.

Description

Clip Unit

[0001] This application claims the benefit of U.S. Provisional Application No. 63 / 508,588, filed June 16, 2023, and U.S. Provisional Application No. 63 / 590,939, filed October 17, 2023, the entire contents of which are incorporated herein by reference.

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

[0003] Patent Document 1 describes a treatment tool that punctures biological tissue. The treatment tool described in Patent Document 1 can be left in the body while punctured into biological tissue.

[0004] US Patent Application Publication No. 2022 / 0378431

[0005] However, the treatment tool described in Patent Document 1 is not necessarily the optimum treatment tool for performing treatments such as suturing a resected portion or a defective portion of tissue.

[0006] In view of the above circumstances, an object of the present invention is to provide a clip unit that is optimal for the procedure of suturing biological tissue.

[0007] In order to solve the above problems, the present invention proposes the following means: A clip unit according to a first aspect of the present invention includes a clip having a first arm and a second arm that are openable and closable in an opening and closing direction, and a tubular member that can store at least a portion of the clip, wherein the first arm includes a first arm body extending in a longitudinal direction along a longitudinal axis, a first claw provided at a tip of the first arm body and extending toward a closing side in the opening and closing direction, and a first anchor provided at the tip of the first arm body or the first claw and extending toward the closing side in the opening and closing direction, wherein at least the tip of the first anchor is positioned closer to the opening side in the opening and closing direction than the first claw, and a gap is formed between the first claw and the first anchor in a width direction perpendicular to the longitudinal direction and the opening and closing direction.

[0008] The clip unit of the present invention can be suitably used for, for example, suturing a cut or defect portion.

[0009] 1 is a perspective view of a clip introduction apparatus in a clip device according to a first embodiment. FIG. 2 is a perspective view of a clip unit of the clip device. FIG. 3 is a perspective view of the clip unit with the presser member displayed in a see-through manner. FIG. 4 is a view of the clip in an open configuration. FIG. 5 is a view of the clip in a closed configuration. FIG. 6 is a view of the clip in a closed configuration as viewed longitudinally. FIG. 7 is a longitudinal cross-sectional view of the presser member. FIG. 8 is a perspective view of a presser tube of the presser member. FIG. 9 is a perspective view of the presser tube as viewed from the base end side. FIG. 10 is a perspective view of a fastening member of the presser tube. FIG. 11 is a perspective view of a connecting member of the clip unit. FIG. 12 is a view of the clip unit loaded in the clip introduction apparatus. FIG. 13 is a view of the clip unit introduced into a body. FIG. 14 is a view of a first anchor and a second anchor puncturing a mucous membrane. FIG. 15 is a view of the first mucous membrane and the second mucous membrane being drawn together. FIG. 16 is a view of the first anchor puncturing the first mucous membrane. FIG. 17 is a view of the first mucous membrane being drawn against the second mucous membrane. FIG. 18 is a view of the clip unit with the clip closed. FIG. 19 is a view of the clip unit with the clip locked. FIG. 19 is a view of the clip unit with the clip locked. FIG. 19 is a view of the clip unit with the clip separated. FIG. 19 is a view of the clip unit with the clip separated. 1 is a diagram showing a clip in an open configuration in a clip unit according to a second embodiment. FIG. 2 is a diagram showing the clip in a closed configuration. FIG. 3 is a diagram showing the clip in a closed configuration as viewed from the longitudinal direction. FIG. 4 is a diagram showing a clip in an open configuration in a clip unit according to a third embodiment. FIG. 5 is a diagram showing the clip in a closed configuration. FIG. 6 is a diagram showing the clip in a closed configuration as viewed from the longitudinal direction. FIG. 7 is a diagram showing a modified first anchor and a modified second anchor of the clip. FIG. 8 is a diagram showing another modified first anchor and another modified second anchor of the clip. FIG. 9 is a diagram showing another modified first anchor and another modified second anchor of the clip. FIG. 10 is a diagram showing a clip in an open configuration in a clip unit according to a fourth embodiment. FIG. 11 is a diagram showing the clip in a closed configuration. FIG. 12 is a diagram showing the clip in a closed configuration as viewed from the longitudinal direction. FIG. 13 is a diagram showing a clip in an open configuration in a clip unit according to a fifth embodiment. FIG. 14 is a diagram showing the clip in a closed configuration.10A and 10B are views showing the clip in a closed configuration as viewed from the longitudinal direction; FIG. 11A shows modified first and second anchors of the clip; FIG. 11B shows modified first and second anchors of the clip; FIG. 11C shows another modified first anchor and another modified second anchor; FIG. 11D shows another modified first anchor and another modified second anchor; FIG. 11E shows another modified first anchor and another modified second anchor; FIG. 11F shows a clip in an open configuration in a clip unit according to a sixth embodiment; FIG. 11F shows the clip in a closed configuration; FIG. 11F shows the clip in a closed configuration as viewed from the longitudinal direction; FIG. 11F shows a clip in an open configuration in a clip unit according to a seventh embodiment; FIG. 11F shows the clip in a closed configuration; FIG. 11F shows the clip in a closed configuration as viewed from the longitudinal direction; FIG. 11F shows modified first and second anchors of the clip; FIG. 11F shows another modified first anchor and second anchor of the clip; FIG. 11F shows a clip in an open configuration in a clip unit according to an eighth embodiment; FIG. 11F shows the clip in a closed configuration; FIG. 11F shows the clip in a closed configuration as viewed from the longitudinal direction; FIG. 11C shows the clip in a closed configuration as viewed from the longitudinal direction; FIG. 11D shows the clip in an open configuration in a clip unit according to a ninth embodiment; FIG. 11F shows the clip in a closed configuration; FIG. 11F shows the clip in a closed configuration as viewed from the longitudinal direction. 13A and 13B are diagrams illustrating a method for manufacturing the first arm of the first embodiment;

[0010] First Embodiment A clip device 300 according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 23. FIG.

[0011] [Clip Device 300] The clip device (clip system) 300 includes a clip introduction device (applicator) 200 and a clip unit 1. The clip unit 1 is loaded into the clip introduction device 200.

[0012] [Clip Introducing Device 200] Fig. 1 is a perspective view of the clip introducing device 200. The clip introducing device (applicator) 200 includes a sheath 220, a manipulation wire 230, and a manipulation section 240. The clip introducing device 200 is inserted, for example, into a treatment tool insertion channel of an endoscope and used in combination with the endoscope. For this reason, the sheath 220 is formed to be sufficiently longer than the length of the treatment tool insertion channel of the endoscope. The sheath 220 is flexible and bends in accordance with the curvature of the insertion section of the endoscope.

[0013] The sheath 220 is formed in an elongated tubular shape as a whole and includes a distal tip 221, a distal coil 222, and a proximal coil 224. The distal coil 222 is disposed on the distal end side of the sheath 220. The distal tip 221 is disposed at the distal end of the distal coil 222.

[0014] As shown in FIG. 1, the operating wire (power transmission unit) 230 includes an arrowhead hook (connection unit) 231 connected to the clip unit 1 and a wire 232 for operating the arrowhead hook 231 .

[0015] The arrowhead hook 231 includes a substantially conical engaging portion 231a that engages with the clip unit 1, and a wire connecting portion 231b provided at the base end of the engaging portion 231a. The arrowhead hook 231 is formed of a metal material such as stainless steel.

[0016] The wire 232 is inserted so as to be able to move forward and backward relative to the sheath 220. The distal end of the wire 232 is fixed to the proximal end of the wire connecting portion 231b by, for example, welding.

[0017] 1, the operation unit 240 includes an operation unit main body 241, a slider 242, and a thumb ring 248. The operation unit main body 241, the slider 242, and the thumb ring 248 are injection molded from, for example, a resin material. The operation unit main body 241 includes a slit portion 241a and a rotating grip 241b on the tip side. The slit portion 241a supports the slider 242 so that it can move forward and backward.

[0018] The slider 242 is attached to the operation portion main body 241 so as to be movable forward and backward in the longitudinal axis direction, and has the base end of the wire 232 attached thereto. When the slider 242 moves forward and backward along the operation portion main body 241, the wire 232 moves forward and backward relative to the sheath 220, and the arrowhead hook 231 moves forward and backward.

[0019] The thumb ring 248 is attached to the base end of the operation portion body 241 so as to be rotatable around the longitudinal axis of the operation portion body 241 .

[0020] [Clip unit 1] Fig. 2 is a perspective view of the clip unit 1. Fig. 3 is a perspective view of the clip unit 1 with the pressing member 3 shown in a see-through manner. The clip unit 1 includes a clip 2, the pressing member 3, and a connecting member 4.

[0021] In the following description, the clip 2 side in the longitudinal direction A of the clip unit 1 is referred to as the tip side (distal side) A1 of the clip unit 1, and the connecting member 4 side is referred to as the base side (proximal side) A2 of the clip unit 1. Furthermore, the direction perpendicular to the longitudinal direction A is referred to as the "left-right direction B," and the direction perpendicular to the longitudinal direction A and the left-right direction B is referred to as the "up-down direction C."

[0022] 4 is a diagram showing the clip 2 in an open configuration. The clip (clip arm) 2 is formed by bending a metal plate at the center. The clip 2 has a pair of arms 21 that can open and close toward the distal end side A1, and a proximal end 28 that connects the pair of arms 21. An engaging portion 25 is provided at the proximal end 28. The proximal end side A2 of the clip 2 is inserted into the internal space 38 of the pressing member 3.

[0023] The pair of arms 21 includes a first arm 211 and a second arm 212 that can be opened and closed in an opening and closing direction H. The first arm 211 and the second arm 212 are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1. Note that the clip 2 may have three or more arms.

[0024] In the opening / closing direction H, the direction in which one arm approaches the other arm is referred to as the "closing side H1." In the opening / closing direction H, the direction in which one arm moves away from the other arm is referred to as the "opening side H2." The direction in which the pair of arms 21 face each other is referred to as the "inside," and the side opposite the inside is referred to as the "outside."

[0025] The first arm 211 has a first anchor 21a, a first claw 21c, a first arm body 21d, and a first sliding portion 21e.

[0026] The second arm 212 has a second anchor 22 a, a second claw 22 c, a second arm body 22 d, and a second sliding portion 22 e. Since the second arm 212 has a similar shape to the first arm 211, only the differences will be described below.

[0027] 5 is a diagram showing the clip 2 in the closed configuration. The first arm body 21d is formed in a flat plate shape extending in the longitudinal direction L. The first arm body 21d is the portion that mainly grasps tissue. When the clip 2 is in the closed configuration, the longitudinal direction L substantially coincides with the longitudinal direction A. The direction perpendicular to the longitudinal direction L and the opening / closing direction H is defined as the "width direction W."

[0028] 6 is a diagram showing the clip 2 in the closed state as viewed from the longitudinal direction L. The first claw 21c and the first anchor 21a are spaced apart in the width direction W. A gap G is formed between the first claw 21c and the first anchor 21a in the width direction W. Therefore, the first anchor 21a can easily puncture the mucous membrane.

[0029] First claw 21c is provided at tip 21s of first arm body 21d and extends toward closing side H1 in opening / closing direction H. First claw 21c is disposed in the center in width direction W. Tip 21r of first claw 21c is formed with an uneven surface, making it easy to grasp the mucous membrane.

[0030] The first anchor 21a is provided at the tip 21s of the first arm body 21d and extends toward the closed side H1 in the opening and closing direction H. The first anchor 21a is disposed on one side W1 in the width direction W. The tip 21p of the first anchor 21a is formed in a sharp, tapered shape, making it easy to puncture the mucosa. The first anchor 21a is formed in the shape of a right triangle when viewed from the longitudinal direction L. The first anchor 21a extends toward the inside in the width direction W, making it less likely that the tip 21p will come into contact with the channel of the endoscope.

[0031] The first anchor 21a is disposed closer to the opening side H2 in the opening / closing direction H than the first claw 21c. As shown in FIG. 4 , the first claw 21c and the first anchor 21a extend from the same portion (tip 21s) when viewed from the width direction W. Note that the first claw 21c and the first anchor 21a do not have to extend from the same portion when viewed from the width direction W. It is sufficient that at least the tip 21p of the first anchor 21a is disposed closer to the opening side H2 in the opening / closing direction H than the first claw 21c.

[0032] 6, the length of the first anchor 21a in the opening / closing direction H is shorter than the length of the first claw 21c in the opening / closing direction H. The length of the first anchor 21a in the width direction W is shorter than the length of the first claw 21c in the width direction W.

[0033] The first angle β formed between the first anchor 21a and the first arm body 21d is larger than the second angle α formed between the first claw 21c and the first arm body 21d. For example, the first angle β is desirably equal to or greater than 90 degrees and equal to or less than 135 degrees. This is because when the clip 2 in the open configuration approaches tissue from the front, the tip 21p of the first anchor 21a is likely to come into contact with the tissue.

[0034] When the clip 2 is in the open configuration, the tip 21p of the first anchor 21a is desirably positioned on the tip side A1 relative to the tip 21r of the first claw 21c. This is because when the clip 2 in the open configuration approaches tissue from the front, the tip 21p of the first anchor 21a comes into contact with the tissue first.

[0035] 6, when the clip 2 is in the closed state, the first claw 21c and the second claw 22c overlap each other when viewed from the longitudinal direction L, and the first claw 21c is positioned closer to the distal end side A1 than the second claw 22c. The second claw 22c may have a notch to prevent interference with the first claw 21c.

[0036] 6 , the first anchor 21a is disposed on one side W1 in the width direction W. The second anchor 22a is disposed on the other side W2 in the width direction W. When the clip 2 is in the closed configuration, the first anchor 21a and the second anchor 22a are not overlapping but are spaced apart as viewed in the longitudinal direction L, and are disposed rotationally symmetrical about the central axis O2 in the longitudinal direction A of the clip 2. When the clip 2 is in the closed configuration, the first anchor 21a and the second anchor 22a are disposed in overlapping positions in the opening / closing direction H, and can puncture the mucosa without interfering with each other.

[0037] As shown in FIG. 5, when the clip 2 is in the closed state, the tip 21p of the first anchor 21a and the tip 22p of the second anchor 22a are positioned at offset positions in the longitudinal direction A, making it easier to puncture the mucous membrane.

[0038] The first arm 211 and the second arm 212 are formed to have an asymmetric shape with respect to the central axis O2. As shown in Fig. 5, the length L1 of the first arm main body 21d in the longitudinal direction L is longer than the length L2 of the second arm main body 22d in the longitudinal direction L.

[0039] The first sliding portion 21e is a portion that elastically deforms when the first arm 211 is retracted into the pressing member 3. The tip of the first sliding portion 21e is connected to the first arm main body 21d. The base end of the first sliding portion 21e is connected to the base end portion 28.

[0040] The engaging portion 25 is a member that can engage with the fastening member 32 of the pressing member 3. The tip side A1 of the engaging portion 25 is formed as a slope that forms an obtuse angle with respect to the longitudinal direction A, and the base side A2 is formed as a slope that forms an acute angle with respect to the longitudinal direction A.

[0041] The base end 28 connects the first arm 211 and the second arm 212. The first arm 211 and the second arm 212 connected by the base end 28 are provided so as to be able to open and close toward the tip side A1. The base end 28 is bent into a U-shape and is connected to a hook 41f of the connecting member 4. The base end 28 is biased so that the pair of arms 21 are in an open state. Therefore, the pair of arms 21 of the clip 2 have a self-expanding force in the opening and closing direction H.

[0042] 3, the base end portion 28 and the hook 41f of the connecting member 4 are connected by inserting the hook 41f of the connecting member 4 into the U-shaped base end portion 28. When the base end portion 28 is connected to the connecting member 4, the opening / closing direction H of the pair of arms 21 substantially coincides with the left-right direction B.

[0043] 7 is a cross-sectional view of the holding member 3 in the longitudinal direction A. The holding member (tubular member, holder) 3 is a tubular member capable of storing at least a portion of the clip 2. The holding member 3 has an internal space 38 through which the clip 2 advances and retreats in the longitudinal direction A. The holding member 3 can fix the clip 2 in a closed state after it has been retracted into the internal space 38. The holding member 3 has a holding tube 3A provided on the base end side A2 and a holding pipe 3B provided on the tip end side A1.

[0044] 8 is a perspective view of the pressure tube 3 A. The pressure tube (second tubular member) 3 A has a pressure tube main body 30 formed in a cylindrical shape, protruding and retracting wings 31, and a tightening member 32.

[0045] The holding tube body 30 is formed by injection molding a material softer than the clip 2, such as a thermoplastic resin having appropriate elasticity, such as PPA (polyphthalamide), PA (polyamide), PEEK (polyether ether ketone), or LCP (liquid crystal polymer). The holding tube body 30 may also be formed from a metal instead of a thermoplastic resin.

[0046] 9 is a perspective view of the pressing tube 3A as seen from the base end side A2. An engaging recess 30r that engages with the engaging protrusion 43p of the connecting member 4 is formed in the base end opening 3d of the pressing tube main body 30. The engaging recess 30r is provided on both sides of the central axis O1.

[0047] The protruding and retracting wings 31 are a pair of protruding and retracting projections relative to the outer peripheral surface 30a of the retaining tube main body 30. The protruding and retracting wings 31 are provided on both sides of the central axis O1. The protruding and retracting wings 31 have a basic position in which they protrude outward in the radial direction R relative to the outer peripheral surface 30a. When the protruding and retracting wings 31 receive a force from the outside toward the inside in the radial direction R, they enter a retracted state in which they retract into the outer peripheral surface 30a. When the force is released, the protruding and retracting wings 31 return from the retracted state to the protruding state.

[0048] The clamping member 32 is a ring-shaped member provided in the internal space 38 of the presser tube 3A. The clamping member 32 is made of metal. Note that the clamping member 32 only needs to be formed to be harder than the presser tube main body 30, and may be formed of, for example, a thermoplastic resin instead of metal.

[0049] The clamping member 32 is disposed so that its central axis coincides with the central axis O1. The clamping member 32 is disposed on the base end side A2 relative to the protruding / recessed wing 31. The clamping member 32 is incorporated into the holding tube main body 30 by, for example, insert molding. The clamping member 32 is disposed in a position that protrudes inward in the radial direction R from the inner circumferential surface of the holding tube main body 30.

[0050] 10 is a perspective view of the fastening member 32. The fastening member 32 has a tapered surface 32t formed on the base end side A2, the inner diameter of which decreases from the base end side A2 toward the tip end side A1. Because the fastening member 32 has the tapered surface 32t, the connecting member 4 can be easily inserted into the fastening member 32 from the base end side A2.

[0051] The pressure pipe (first tubular member) 3B is a cylindrical member made of metal. The pressure pipe 3B is press-fitted into the tip of the pressure pipe 3A. The pressure pipe 3A and the pressure pipe 3B may be connected by heat welding, adhesive bonding, or screw fastening.

[0052] 11 is a perspective view of the connecting member 4. The connecting member 4 is detachably connected to the proximal end 28 of the clip 2. The connecting member 4 is also detachably connected to the arrowhead hook 231 that passes through the sheath 220. In other words, the connecting member 4 connects the clip 2 and the arrowhead hook 231. The connecting member 4 includes a distal connecting portion 41 provided at the distal end, a proximal connecting portion 42 provided at the proximal end, and a rod-shaped portion 45 that connects the distal connecting portion 41 and the proximal connecting portion 42.

[0053] The tip connecting portion 41 has a hook 41 f at its tip, a breaking portion 41 b provided on the base end side A2 of the hook 41 f, a tip expanding portion 41 e, and a first protrusion 41 w. The tip connecting portion 41 can be inserted through the internal space 38 of the pressing member 3 when connected to the clip 2.

[0054] The hook 41f is a hook that extends in the vertical direction C perpendicular to the central axis O1 and is formed in a generally cylindrical rod shape. The hook 41f extends from the "lower side" to the "upper side" in the vertical direction C. The base end 28 of the clip 2 is hooked from above onto the hook 41f.

[0055] The breaking portion 41b breaks when a breaking force is applied to the hook 41f by pulling the base end 28 toward the base end side A2. The breaking portion 41b may have a mechanism for releasing the connection between the base end 28 of the clip 2 and the hook 41f of the connecting member 4. For example, the breaking portion 41b may have a mechanism for releasing the connection between the base end 28 and the hook 41f by deforming (plastic deformation or elastic deformation) without breaking.

[0056] The distal end expansion portion 41e is a member provided on the hook 41f and protruding toward the distal end side A1. The distal end expansion portion 41e has a tapered shape that narrows toward the distal end side A1 in both the vertical direction C and the horizontal direction B.

[0057] The first protrusion 41w is a member provided on the hook 41f and protruding in the left-right direction B. The first protrusion 41w is a pair of wing-shaped protrusions extending on both sides in the left-right direction B at the upper end of the hook 41f, which extends upward in the up-down direction C. The first protrusion 41w has a shape symmetrical with respect to the central axis O1.

[0058] The proximal end connecting portion 42 is an engaging portion that is engaged (connected) with the arrowhead hook 231 of the clip introduction device 200. The proximal end connecting portion 42 has a connecting portion main body 43 and a connecting arm 44.

[0059] The connecting portion main body 43 is provided at the base end of the rod-shaped portion 45. An engaging protrusion 43p that protrudes in the vertical direction is formed on the connecting portion main body 43. The engaging protrusion 43p engages with an engaging recess 30r provided in the base end opening of the pressing member 3, thereby restricting relative rotation between the pressing member 3 and the connecting member 4 in the circumferential direction with respect to the longitudinal direction A.

[0060] The connecting arm (a pair of legs) 44 is provided at the base end of the connecting body 43 and is bifurcated. The connecting arm 44 is elastically deformable in the up-down direction C relative to the connecting body 43 and can open and close relative to the connecting body 43. The connecting arm 44 is formed with a notch 44m that grips and stores the engaging portion 231a of the arrowhead hook 231. The notch 44m is formed in a shape that fits closely to the outer peripheral surface of the engaging portion 231a of the arrowhead hook 231. The connecting arm 44 can be connected to the arrowhead hook 231 of the clip introduction device 200 when in the open state, and can maintain its connection to the arrowhead hook 231 of the clip introduction device 200 when in the closed state.

[0061] The rod-shaped portion 45 is a generally rod-shaped member extending in the longitudinal direction A. The rod-shaped portion 45 is provided between the distal end connecting portion 41 and the proximal end connecting portion 42, and connects the distal end connecting portion 41 and the proximal end connecting portion 42. The rod-shaped portion 45 can be inserted through the internal space 38 of the pressing member 3.

[0062] [Operation and Function of Clip Unit 1] Next, the operation and function of the clip unit 1 will be described with reference to FIGS. 12 to 23. FIG.

[0063] 12 is a diagram showing the clip unit 1 loaded into the clip introducer device 200. The clip unit 1 is loaded into the clip introducer device 200 using a cartridge or the like. The connecting member 4 of the clip unit 1 loaded into the clip introducer device 200 is connected to an arrowhead hook 231 that passes through the inside of the sheath 220. The protruding and retracting wings 31 are pressed against the inner circumferential surface of the sheath 220 and are in a retracted state.

[0064] The pair of arms 21 of the loaded clip unit 1 are in a closed state, being pressed against the inner circumferential surface of the sheath 220. The engaging portion 25 is located on the distal side A1 of the fastening member 32, and the pair of arms 21 are not locked in the closed state.

[0065] 13 is a diagram showing the clip unit 1 introduced into the body. The surgeon introduces the clip unit 1 loaded into the sheath 220 into the body via the channel of the endoscope. Next, the surgeon advances the slider 242 along the operation unit main body 241 to advance the arrowhead hook 231. The surgeon advances the clip unit 1 until the protruding / retracting wings 31 emerge from the sheath 220. By emerging from the sheath 220, the protruding / retracting wings 31 return from the retracted state to the protruding state, which is the basic position.

[0066] When the distal ends of the pair of arms 21 come out of the sheath 220, the self-expanding force of the pair of arms 21 serves as a restoring force, and the clip 2 returns to the open state while moving toward the distal end relative to the pressing member 3. Even when the pair of arms 21 return to the open state and protrude most from the pressing member 3, the engaging portion 25 is disposed in the internal space 38 of the pressing member 3.

[0067] The surgeon moves the endoscope and sheath 220 to bring the clip 2 of the clip unit 1 closer to the treatment area, which is the defect D. In the following description, the mucous membranes at the periphery surrounding the defect D and positioned opposite each other across the defect D will be referred to as the "first mucosa M1" and the "second mucosa M2."

[0068] 14 is a diagram showing the first anchor 21a and the second anchor 22a puncturing the mucosa. When the defect D is small, the surgeon punctures the first mucosa M1 with the first anchor 21a and the second mucosa M2 with the second anchor 22a. The first anchor 21a and the second anchor 22a extend toward the closing side H1 in the opening and closing direction H, but are positioned closer to the opening side H2 in the opening and closing direction H than the first claw 21c and the second claw 22c. Therefore, when the clip 2 in the open configuration is positioned directly in front of the mucosa, the first anchor 21a and the second anchor 22a are positioned so that they can easily puncture the mucosa.

[0069] 15 is a diagram showing the retracted first mucosa M1 and second mucosa M2. The surgeon can retract the first mucosa M1 and second mucosa M2 by retracting the first arm 211, which is punctured into the first mucosa M1 by the first anchor 21a, and the second arm 212, which is punctured into the second mucosa M2 by the second anchor 22a.

[0070] 16 is a diagram showing the first anchor 21a puncturing the first mucosa M1. When the defect D is large, the surgeon first punctures the first mucosa M1 with the first anchor 21a. For the reasons described above, the first anchor 21a is positioned at a position that makes it easy to puncture the mucosa.

[0071] 17 is a diagram showing the first mucosa M1 being pulled toward the second mucosa M2. The surgeon pulls the first mucosa M1, which has been punctured with the first anchor 21a, toward the second mucosa M2. Because the first mucosa M1 is firmly punctured by the first anchor 21a, the surgeon can easily pull the first mucosa M1 toward the second mucosa M2.

[0072] The surgeon punctures the second mucosa M2 with the second anchor 22a. For the reasons described above, the first anchor 21a is placed at a position that makes it easy to puncture the mucosa.

[0073] 18 and 19 show the clip unit 1 with the pair of arms 21 closed. The surgeon retracts the arrowhead hook 231 by retracting the slider 242 along the operating unit body 241. The connecting member 4 connected to the arrowhead hook 231 pulls the clip 2. The pair of arms 21, which have a self-expanding force, are pulled toward the base end side A2, thereby pushing the distal opening 3a of the holding member 3 toward the base end side A2. The protruding and retracting wings 31, which are in the protruding state, engage with the sheath 220 and are therefore not retracted into the sheath 220. Therefore, the clip 2 pulled by the connecting member 4 is retracted into the holding member 3.

[0074] The first mucosa M1 and the second mucosa M2 swell and are firmly pressed and grasped by the first claw 21c and the second claw 22c.

[0075] When the connecting member 4 pulls the base end 28 of the clip 2 toward the base end side A2 of the pressing member 3, the pair of arms 21 are pulled into the pressing member 3 and gradually close. When the pulling force on the base end 28 is released in this state, the clip 2 returns to the open state while moving toward the tip end side A1, using the self-expanding force of the pair of arms 21 as a restoring force. The surgeon can return the pair of arms 21 to the open state and re-grasp the tissue.

[0076] 20 and 21 show the clip unit 1 in which the clip 2 is locked. When the proximal end 28 is further pulled toward the proximal side A2 of the presser member 3, the engaging portion 25 is retracted toward the proximal side A2 from the fastening member 32. Because the proximal side A2 of the engaging portion 25 is formed as an obtuse-angled slope, the engaging portion 25 is easily retracted toward the proximal side from the fastening member 32. Meanwhile, because the distal side A1 of the engaging portion 25 is formed as an acute-angled slope, when the engaging portion 25 is retracted toward the proximal side A2 from the fastening member 32, the engaging portion 25 engages with the fastening member 32. As a result, movement of the clip 2 toward the distal side A1 relative to the presser member 3 is restricted, and the pair of arms 21 are locked in the closed state. Once the pair of arms 21 are locked in the closed state, they cannot return to the open state.

[0077] 22 and 23 are diagrams showing the clip unit 1 from which the clip 2 has been separated. The surgeon further pulls the clip 2. A breaking force is applied to the hook 41f by pulling, causing the breaking portion 41b to break. The breaking strength of the breaking portion 41b is lower than the breaking strength of the connecting portion main body 43. Therefore, the breaking portion 41b breaks, not the connecting portion main body 43. The surgeon retracts the sheath 220, and leaves the clip 2 and the presser member 3 in the body, with the first mucosa M1 and the second mucosa M2 ligated.

[0078] The surgeon reloads a new clip unit 1 into the clip introduction device 200 using a cartridge or the like.

[0079] The clip unit 1 of this embodiment can suitably perform a procedure for suturing the defect D. Even if the defect D is large, the mucosa punctured by the first anchor 21 a and the second anchor 22 a can be pulled in and then compressed and grasped by the first claw 21 c and the second claw 22 c.

[0080] Although the first embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0081] Second Embodiment A clip unit 1B according to a second embodiment of the present invention will be described with reference to Fig. 24 to Fig. 26. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0082] The clip unit 1B includes a clip 2B, a pressing member 3, and a connecting member 4. The clip unit 1B is loaded into a clip introduction device 200.

[0083] Figure 24 shows a clip 2B in an open configuration. Figure 25 shows a clip 2B in a closed configuration. The clip (clip arms) 2B is formed by bending a metal plate at the center. The clip 2B has a pair of arms 21B that can be opened and closed toward the distal end side A1, and a base end 28 that connects the pair of arms 21B.

[0084] The pair of arms 21B includes a first arm 211B and a second arm 212B that can be opened and closed in an opening and closing direction H. The first arm 211B and the second arm 212B are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1B.

[0085] The first arm 211B has a first anchor 21a, a first auxiliary anchor 21b, a first claw 21c, a first arm body 21d, and a first sliding portion 21e.

[0086] The second arm 212B has a second anchor 22 a, a second auxiliary anchor 22 b, a second claw 22 c, a second arm body 22 d, and a second sliding portion 22 e. Since the second arm 212B has a similar shape to the first arm 211B, only the differences will be described below.

[0087] 26 is a diagram showing clip 2B in the closed state as viewed from the longitudinal direction L. First claw 21c and first auxiliary anchor 21b are spaced apart in the width direction W. A gap G is formed between first claw 21c and first auxiliary anchor 21b in the width direction W. Therefore, first auxiliary anchor 21b can easily puncture the mucosa.

[0088] 26 , the first anchor 21a is disposed on one side W1 in the width direction W. The first auxiliary anchor 21b is disposed on the other side W2 in the width direction W. The first anchor 21a and the first auxiliary anchor 21b are provided on both sides in the width direction W, with the first claw 21c in between. The first anchor 21a and the first auxiliary anchor 21b are disposed symmetrically with respect to a central plane S. Here, the central plane S is a plane that extends along the longitudinal direction L and the opening / closing direction H and passes through the central axis O2.

[0089] The first auxiliary anchor 21b is positioned on the opening side H2 in the opening / closing direction H relative to the first claw 21c.

[0090] When the clip 2B is in the closed state, the first claw 21c and the second claw 22c overlap when viewed from the longitudinal direction L, and the second claw 22c is positioned closer to the tip side than the first claw 21c.

[0091] The clip unit 1B of this embodiment can suitably perform the procedure of suturing the defect D. The clip unit 1B can suitably puncture the mucosa by the first auxiliary anchor 21b in addition to the first anchor 21a.

[0092] Although the second embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0093] Third Embodiment A clip unit 1C according to a third embodiment of the present invention will be described with reference to Figures 27 to 29. In the following description, components that are common to those already described will be assigned the same reference numerals, and duplicate descriptions will be omitted.

[0094] The clip unit 1C includes a clip 2C, a pressing member 3, and a connecting member 4. The clip unit 1C is loaded into a clip introduction device 200.

[0095] Fig. 27 shows a clip 2C in an open configuration. Fig. 28 shows a clip 2C in a closed configuration. The clip (clip arms) 2C is formed by bending a metal plate at the center. The clip 2C has a pair of arms 21C that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21C.

[0096] The pair of arms 21C includes a first arm 211C and a second arm 212C that can be opened and closed in the opening and closing direction H. The first arm 211C and the second arm 212C are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1C.

[0097] The first arm 211C includes a first anchor 21Ca, a first claw 21Cc, a first arm body 21d, and a first sliding portion 21e. The first claw 21Cc includes a first upper claw 21Cu and a first lower claw 21Cf.

[0098] The second arm 212C has a second anchor 22Ca, a second claw 22Cc, a second arm body 22d, and a second sliding portion 22e. The second claw 22Cc has a second upper claw 22Cu and a second lower claw 22Cf. The second arm 212C has a similar shape to the first arm 211C, so only the differences will be described below.

[0099] 29 is a diagram showing the clip 2C in the closed form as viewed from the longitudinal direction L. The first upper claw 21Cu and the first anchor 21Ca are spaced apart in the width direction W. A gap G is formed between the first upper claw 21Cu and the first anchor 21Ca in the width direction W. The first lower claw 21Cf and the first anchor 21Ca are spaced apart in the width direction W. A gap G is formed between the first lower claw 21Cf and the first anchor 21Ca in the width direction W. Therefore, the first anchor 21Ca can easily puncture the mucosa.

[0100] The first claws 21Cc (first upper claw 21Cu and first lower claw 21Cf) are provided on the tip 21s of the first arm body 21d and extend toward the closed side H1 in the opening and closing direction H. The first claws 21Cc (first upper claw 21Cu and first lower claw 21Cf) are arranged on both sides of the first anchor 21Ca in the width direction W.

[0101] First anchor 21Ca is provided at tip 21s of first arm body 21d and extends toward closed side H1 in opening / closing direction H. First anchor 21Ca is disposed at the center in width direction W. Tip 21p of first anchor 21Ca is formed in a sharp tapered shape to easily puncture the mucous membrane. First anchor 21Ca is formed in an isosceles triangle shape when viewed from the longitudinal direction L.

[0102] The first anchor 21Ca is positioned on the opening side H2 in the opening / closing direction H relative to the first claws 21Cc (the first upper claw 21Cu and the first lower claw 21Cf).

[0103] When clip 2C is in the closed configuration, first anchor 21Ca and second anchor 22Ca overlap when viewed from the longitudinal direction L. First anchor 21Ca and second anchor 22Ca are arranged to overlap at positions where they overlap in the opening / closing direction H, making it easy to puncture the mucosa.

[0104] The clip unit 1C of this embodiment can suitably perform a procedure to suture the defect D. Because the first anchor 21Ca and the second anchor 22Ca are located at the center in the width direction W, the first anchor 21Ca and the second anchor 22Ca can easily puncture the mucosa regardless of the angle of the clip 2C.

[0105] Although the third embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0106] 30 is a diagram showing a first anchor 21Ca(1), which is a modified example of the first anchor 21Ca, and a second anchor 22Ca(1), which is a modified example of the second anchor 22Ca. When the clip 2C is in the closed configuration, the first anchor 21Ca(1) and the second anchor 22Ca(1) do not overlap when viewed from the longitudinal direction L, but are arranged to overlap in an overlapping position in the opening and closing direction H. The first anchor 21Ca(1) and the second anchor 22Ca(1) are longer in the opening and closing direction H than the first anchor 21Ca and the second anchor 22Ca, and are therefore more likely to puncture the mucosa.

[0107] 31 is a diagram showing a first anchor 21Ca(2), which is a modified example of the first anchor 21Ca, and a second anchor 22Ca(2), which is a modified example of the second anchor 22Ca. When the clip 2C is in the closed configuration, the first anchor 21Ca(2) and the second anchor 22Ca(2) do not overlap when viewed from the longitudinal direction L, but are arranged in an overlapping position in the opening and closing direction H. The first anchor 21Ca(2) and the second anchor 22Ca(2) are formed in the shape of a right triangle when viewed from the longitudinal direction L. Therefore, the overlapping length H2 between the first anchor 21Ca(2) and the second anchor 22Ca(2) in the opening and closing direction H is longer than the overlapping length H1 between the first anchor 21Ca(1) and the second anchor 22Ca(1) in the opening and closing direction H.

[0108] 32 is a diagram showing a first anchor 21Ca(3) that is a modified example of the first anchor 21Ca and a second anchor 22Ca(3) that is a modified example of the second anchor 22Ca. When viewed from the longitudinal direction L, the tip of the first anchor 21Ca(3) and the first lower claw 21Cf overlap. When viewed from the longitudinal direction L, the tip of the second anchor 22Ca(3) and the second upper claw 22Cu overlap.

[0109] (Fourth embodiment) A clip unit 1D according to a fourth embodiment of the present invention will be described with reference to Figures 33 to 35. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0110] The clip unit 1D includes a clip 2D, a pressing member 3, and a connecting member 4. The clip unit 1D is loaded into a clip introduction device 200.

[0111] Figure 33 shows a clip 2D in an open configuration. Figure 34 shows a clip 2D in a closed configuration. The clip (clip arms) 2D is formed by bending a metal plate at the center. The clip 2D has a pair of arms 21D that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21D.

[0112] The pair of arms 21D includes a first arm 211D and a second arm 212D that can be opened and closed in an opening and closing direction H. The first arm 211D and the second arm 212D are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1D.

[0113] The first arm 211D has a first anchor 21Da, a first claw 21Dc, a first arm body 21d, and a first sliding portion 21e.

[0114] The second arm 212D has a second anchor 22Da, a second claw 22Dc, a second arm body 22d, and a second sliding portion 22e. The second arm 212D has a similar shape to the first arm 211D, and therefore only the differences will be described below.

[0115] 35 is a diagram showing the clip 2D in the closed form as viewed from the longitudinal direction L. The first claw 21Dc and the first anchor 21Da are spaced apart in the width direction W. A gap G is formed between the first claw 21Dc and the first anchor 21Da in the width direction W. Therefore, the first anchor 21Da can easily puncture the mucous membrane.

[0116] The first anchor 21Da is disposed on the opening side H2 in the opening / closing direction H relative to the first claw 21Dc.

[0117] When clip 2D is in the closed configuration, first anchor 21Da and second anchor 22Da are spaced apart and do not overlap when viewed in the longitudinal direction L, and are arranged rotationally symmetrical about central axis O2. First anchor 21Da and second anchor 22Da are arranged so as not to overlap in the opening and closing direction H. A gap GH is formed between first anchor 21Da and second anchor 22Da in the opening and closing direction H. Therefore, first anchor 21Da and second anchor 22Da are shorter than those in other embodiments, and can puncture the mucosa without bending.

[0118] The clip unit 1D of this embodiment can suitably perform a procedure for suturing the defect D. Even if the defect D is large, the mucosa punctured by the first anchor 21 a and the second anchor 22 a can be pulled in and then compressed and grasped by the first claw 21 c and the second claw 22 c.

[0119] Although the fourth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0120] Fifth Embodiment A clip unit 1E according to a fifth embodiment of the present invention will be described with reference to Figures 36 to 38. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0121] The clip unit 1E includes a clip 2E, a pressing member 3, and a connecting member 4. The clip unit 1E is loaded into a clip introduction device 200.

[0122] Figure 36 shows a clip 2E in an open configuration. Figure 37 shows a clip 2E in a closed configuration. The clip (clip arms) 2E is formed by bending a metal plate at the center. The clip 2E has a pair of arms 21E that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21E.

[0123] The pair of arms 21E includes a first arm 211E and a second arm 212E that can be opened and closed in the opening and closing direction H. The first arm 211E and the second arm 212E are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1E.

[0124] The first arm 211E includes a first anchor 21Ea, a first claw 21Ec, a first arm body 21d, and a first sliding portion 21e. The first anchor 21Ea includes a first inner anchor 21Ei and a first outer anchor 21Eo.

[0125] The second arm 212E has a second anchor 22Ea, a second claw 22Ec, a second arm body 22d, and a second sliding portion 22e. The second anchor 22Ea has a second inner anchor 22Ei and a second outer anchor 22Eo. The second arm 212E has a similar shape to the first arm 211E, so only the differences will be described below.

[0126] 38 is a diagram showing the clip 2E in the closed state as viewed from the longitudinal direction L. The first claw 21Ec and the first anchor 21Ea are spaced apart in the width direction W. A gap G is formed between the first claw 21Ec and the first anchor 21Ea in the width direction W. Therefore, the first anchor 21Ea can easily puncture the mucous membrane.

[0127] The first claw 21Ec is provided at the tip 21s of the first arm body 21d, and extends toward the closing side H1 in the opening and closing direction H. The first claw 21Ec is disposed in the center in the width direction W.

[0128] The first anchor 21Ea (first inner anchor 21Ei and first outer anchor 21Eo) is provided at the tip 21s of the first arm body 21d, and extends toward the closed side H1 in the opening and closing direction H. The first anchor 21Ea (first inner anchor 21Ei and first outer anchor 21Eo) is arranged on one side W1 in the width direction W. The first inner anchor 21Ei and the first outer anchor 21Eo are arranged in the width direction W. The tip of the first inner anchor 21Ei is formed in a sharp, tapered shape, making it easy to puncture the mucosa. The tip of the first outer anchor 21Eo is formed in a sharp, tapered shape, making it easy to puncture the mucosa.

[0129] The first anchor 21Ea (the first inner anchor 21Ei and the first outer anchor 21Eo) is positioned on the opening side H2 in the opening / closing direction H relative to the first claw 21Ec.

[0130] The clip unit 1E of this embodiment can suitably perform a procedure for suturing the defect D. The first arm 211E and the second arm 212E each have a plurality of anchors, which makes it easy to puncture the mucosa.

[0131] Although the fifth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0132] 39 and 40 are diagrams showing a first anchor 21Ea(1), which is a modified example of the first anchor 21Ea, and a second anchor 22Ea(1), which is a modified example of the second anchor 22Ea. The first inner anchor 21Ei and the first outer anchor 21Eo of the first anchor 21Ea(1) form different angles with the longitudinal direction L. Because the first inner anchor 21Ei and the first outer anchor 21Eo make contact with the mucous membrane at different angles, the mucous membrane can be easily punctured regardless of the angle of the clip 2E relative to the mucous membrane.

[0133] 41 and 42 are diagrams showing a first anchor 21Ea(2), which is a modified example of the first anchor 21Ea, and a second anchor 22Ea(2), which is a modified example of the second anchor 22Ea. The first inner anchor 21Ei and the first outer anchor 21Eo of the first anchor 21Ea(2) differ in angle with the opening and closing direction H in addition to the longitudinal direction L. Because the first inner anchor 21Ei and the first outer anchor 21Eo have different angles at which they come into contact with the mucous membrane, they can easily puncture the mucous membrane regardless of the angle of the clip 2E relative to the mucous membrane.

[0134] Sixth Embodiment A clip unit 1F according to a sixth embodiment of the present invention will be described with reference to Figures 43 to 45. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0135] The clip unit 1F includes a clip 2F, a pressing member 3, and a connecting member 4. The clip unit 1F is loaded into a clip introduction device 200.

[0136] Figure 43 shows a clip 2F in an open configuration. Figure 44 shows a clip 2F in a closed configuration. The clip (clip arms) 2F is formed by bending a metal plate at the center. The clip 2F has a pair of arms 21F that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21F.

[0137] The pair of arms 21F includes a first arm 211F and a second arm 212F that can be opened and closed in the opening and closing direction H. The first arm 211F and the second arm 212F are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1F.

[0138] The first arm 211F has a first anchor 21Fa, a first claw 21Fc, a first arm body 21d, and a first sliding portion 21e.

[0139] The second arm 212F has a second anchor 22Fa, a second claw 22Fc, a second arm body 22d, and a second sliding portion 22e. The second arm 212F has a similar shape to the first arm 211F, and therefore, only the differences will be described below.

[0140] 45 is a diagram showing the clip 2F in the closed configuration as viewed from the longitudinal direction L. The first claw 21Fc and the first anchor 21Fa are spaced apart in the width direction W. A gap G is formed between the first claw 21Fc and the first anchor 21Fa in the width direction W. Therefore, the first anchor 21Fa can easily puncture the mucosa.

[0141] First anchor 21Fa is positioned closer to the open side H2 in the opening / closing direction H than first claw 21Fc. First claw 21Fc and first anchor 21Fa extend from different portions when viewed in the width direction W, as shown in FIG. 44 . First anchor 21Fa extends from first connecting portion 21v. First claw 21Fc extends from second connecting portion 21w. First connecting portion 21v is located closer to the tip end in the longitudinal direction L than second connecting portion 21w.

[0142] The clip unit 1F of the present embodiment can suitably perform a procedure for suturing the defect D. Because the first claw 21Fc and the first anchor 21Fa are disposed at positions separated from each other in the longitudinal direction L, the first claw 21Fc does not get in the way when the first anchor 21Fa punctures the mucosa.

[0143] Although the sixth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0144] Seventh Embodiment A clip unit 1G according to a seventh embodiment of the present invention will be described with reference to Figures 46 to 48. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0145] The clip unit 1G includes a clip 2G, a pressing member 3, and a connecting member 4. The clip unit 1G is loaded into a clip introduction device 200.

[0146] Figure 46 shows a clip 2G in an open configuration. Figure 47 shows a clip 2G in a closed configuration. The clip (clip arms) 2G is formed by bending a metal plate at the center. The clip 2G has a pair of arms 21G that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21G.

[0147] The pair of arms 21G includes a first arm 211G and a second arm 212G that can be opened and closed in the opening and closing direction H. The first arm 211G and the second arm 212G are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1G.

[0148] The first arm 211G has a first anchor 21Ga, a first claw 21c, a first arm body 21d, and a first sliding portion 21e.

[0149] The second arm 212G has a second anchor 22Ga, a second claw 22c, a second arm body 22d, and a second sliding portion 22e. The second arm 212G has a similar shape to the first arm 211G, and therefore only the differences will be described below.

[0150] 48 is a diagram showing a clip 2G in a closed configuration as viewed from the longitudinal direction L. The first anchor 21Ga is provided at the tip 21s of the first arm body 21d and extends toward the closed side H1 in the opening and closing direction H. The first anchor 21Ga is disposed on one side W1 in the width direction W. The tip of the first anchor 21Ga is formed into a sharp, tapered shape to easily puncture the mucosa. The first anchor 21Ga is formed into a right-angled triangle as viewed from the longitudinal direction L, and is thinner toward the tip.

[0151] The first anchor 21Ga is disposed on the opening side H2 in the opening / closing direction H relative to the first claw 21c.

[0152] The clip unit 1G of this embodiment can suitably perform a procedure for suturing the defect D. The first anchor 21Ga is thinner toward the tip, and can easily puncture the mucosa.

[0153] Although the seventh embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be configured by appropriately combining them.

[0154] 49 and 50 are diagrams showing a first anchor 21Ga(1), which is a modified example of first anchor 21Ga, and a second anchor 22Ga(1), which is a modified example of second anchor 22Ga. The tip of first anchor 21Ga(1) is not formed in a sharp tapered shape, but is thinner toward the tip, making it easier to puncture the mucosa.

[0155] Eighth Embodiment A clip unit 1H according to an eighth embodiment of the present invention will be described with reference to Figures 51 to 53. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0156] The clip unit 1H includes a clip 2H, a pressing member 3, and a connecting member 4. The clip unit 1H is loaded into a clip introduction device 200.

[0157] Figure 51 shows a clip 2H in an open configuration. Figure 52 shows a clip 2H in a closed configuration. The clip (clip arms) 2H is formed by bending a metal plate at the center. The clip 2H has a pair of arms 21H that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21H.

[0158] The pair of arms 21H includes a first arm 211H and a second arm 212H that can be opened and closed in the opening and closing direction H. The first arm 211H and the second arm 212H are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1H.

[0159] The first arm 211H has a first anchor 21Ha, a first claw 21c, a first arm body 21d, and a first sliding portion 21e.

[0160] The second arm 212H has a second anchor 22Ha, a second claw 22c, a second arm body 22d, and a second sliding portion 22e. The second arm 212H has a similar shape to the first arm 211H, and therefore, only the differences will be described below.

[0161] 53 is a diagram showing clip 2H in the closed configuration as viewed from the longitudinal direction L. First anchor 21Ha is provided on first claw 21c and extends toward closed side H1 in the opening and closing direction H. First anchor 21Ha and second anchor 22Ha are formed in symmetrical shapes with respect to the opposing surface where first arm 211H and second arm 212H face each other.

[0162] The first anchor 21Ha is disposed on the opening side H2 in the opening / closing direction H relative to the first claw 21c.

[0163] The clip unit 1H of this embodiment can suitably perform a procedure to suture the defect D. Because the first anchor 21Ha is positioned close to the mucosa, it can easily pierce the mucosa even if the first anchor 21Ha is short. Because the first anchor 21Ha is short, it can easily puncture the mucosa without bending.

[0164] Although the eighth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above-described embodiment and the modified examples shown below can be configured by appropriately combining them.

[0165] Ninth Embodiment A clip unit 1I according to a ninth embodiment of the present invention will be described with reference to Figures 54 to 58. In the following description, components that are common to those already described will be assigned the same reference numerals, and duplicate descriptions will be omitted.

[0166] The clip unit 1I includes a clip 2I, a pressing member 3, and a connecting member 4. The clip unit 1I is loaded into a clip introduction device 200.

[0167] Figure 54 shows a clip 2I in an open configuration. Figure 55 shows a clip 2I in a closed configuration. The clip (clip arms) 2I is formed by bending a metal plate at the center. The clip 2I has a pair of arms 21I that can be opened and closed toward the distal end side A1, and a base end portion 28 that connects the pair of arms 21I.

[0168] The pair of arms 21I includes a first arm 211I and a second arm 212I that can be opened and closed in the opening and closing direction H. The first arm 211I and the second arm 212I are arranged on either side of a central axis O1 in the longitudinal direction A of the clip unit 1I.

[0169] The first arm 211I has a first anchor 21a, a first claw 21c, a first fin portion 21k, a first arm body 21d, and a first sliding portion 21e.

[0170] The second arm 212I has a second anchor 22 a, a second claw 22 c, a second fin portion 22 k, a second arm body 22 d, and a second sliding portion 22 e. Since the second arm 212I has a similar shape to the first arm 211I, only the differences will be described below.

[0171] 56 is a diagram showing the clip 2I in the closed state as viewed from the longitudinal direction L. The first fin portion 21k is a fin-shaped member that connects the first anchor 21a and the first claw 21c. At least a portion of the gap G in the width direction W that is formed between the first claw 21c and the first anchor 21Fa is filled by the first fin portion 21k.

[0172] 57 is a diagram showing a manufacturing method of the first arm 211 of the first embodiment. The manufacturing method of the first arm 211 includes a step of punching a metal plate P with a press to form the gap G, a step of forming the first anchor 21 a by primary bending, and a step of forming the first claw 21 c by secondary bending.

[0173] 58 is a diagram showing a manufacturing method of the first arm 211I of the ninth embodiment. The manufacturing method of the first arm 211I includes a step of forming the first anchor 21a by performing a primary bending process on the metal plate material P, and a step of forming the first claw 21c by performing a secondary bending process. The manufacturing method of the first arm 211I does not require the punching process of forming the gap G. The first fin portion 21k is formed in the step of performing a bending process on the metal plate material P in which the gap G is not formed.

[0174] The clip unit 1I of this embodiment can suitably perform a procedure for suturing the defect D. The manufacturing method of the clip 2I does not require a punching step for forming the gap G. The first anchor 21 a, the first claw 21 c, and the first fin portion 21 k can be easily formed by bending.

[0175] Although the ninth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and the modified examples shown below can be appropriately combined to form a configuration.

[0176] The present invention can be applied to a clip unit or the like.

[0177] 300 Clip device 200 Clip introduction device (applicator) 220 Sheath 221 Distal tip 222 Distal coil 224 Proximal coil 230 Operation wire (power transmission unit) 231 Arrowhead hook (connection unit) 232 Wire 240 Operation unit 1, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I Clip unit 2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 2I Clip (clip arm) 21, 21B, 21C, 21D, 21E, 21F, 21G, 21H, 21I Pair of arms 211, 211B, 211C, 211D, 211E, 211F, 211G, 211H, 211I First arm 212, 212B, 212C, 212D, 212E, 212F, 212G, 212H, 212I Second arm 25 Engagement portion 28 Base end portion 3 Holding member (tubular member) 3A Holding tube (second tubular member) 3B Holding pipe (first tubular member) 30 Holding tube main body 31 Protruding and retracting wing 32 Fastening member 38 Internal space 4 Connecting member 41 Tip connecting portion 41b Breaking portion 42 Base end connecting portion 43 Connecting portion main body 43p Engaging protrusion 44 Connecting arm (pair of legs) 44e Insertion port 44m Notch portion 44s Base end surface 45 Rod-shaped portion A Longitudinal direction A1 Tip side (distal side) A2 Base end side (proximal side) B Left-right direction C Up-down direction L Longitudinal direction H Opening / closing direction W Width direction

Claims

1. A clip unit comprising: a clip having a first arm and a second arm which can be opened and closed in an opening and closing direction; and a tubular member capable of storing at least a portion of the clip, wherein the first arm has: a first arm body extending in a longitudinal direction along a longitudinal axis; a first claw provided at a tip of the first arm body and extending toward the closing side in the opening and closing direction; and a first anchor provided at the tip of the first arm body or on the first claw and extending toward the closing side in the opening and closing direction, wherein at least the tip of the first anchor is positioned on the opening side in the opening and closing direction relative to the first claw, and a gap is formed between the first claw and the first anchor in the width direction perpendicular to the longitudinal direction and the opening and closing direction.

2. The clip unit according to claim 1, wherein the length of the first anchor in the width direction is shorter than the length of the first claw in the width direction.

3. A clip unit according to claim 1, wherein the tip of the first anchor is positioned distal to the tip of the first claw.

4. The clip unit according to claim 1, wherein a first angle formed between said first anchor and said first arm body is greater than a second angle formed between said first claw and said first arm body.

5. The clip unit according to claim 4, wherein the first angle is greater than or equal to 90 degrees and less than or equal to 135 degrees.

6. A clip unit as described in claim 1, wherein the first arm has a first auxiliary anchor, and the first anchor and the first auxiliary anchor are provided on either side of the first claw in the width direction.

7. A clip unit as described in claim 1, wherein the first claw has a first upper claw and a first lower claw, the first upper claw and the first lower claw being provided on either side of the first anchor in the width direction.

8. A clip unit as described in claim 1, wherein the first anchor has a first inner anchor and a second outer anchor, and the first inner anchor and the second outer anchor are arranged in the width direction.

9. A clip unit as described in claim 1, wherein a first connection portion connecting the first anchor and the first arm body is located on the tip side in the longitudinal direction of a second connection portion connecting the first claw and the first arm body.

10. The clip unit according to claim 1, wherein the first anchor is thinner toward the tip.

11. The clip unit according to claim 1, wherein the first anchor is provided on the first claw.

12. The clip unit according to claim 1, further comprising a first fin portion that fills at least a portion of the gap formed between the first claw and the first anchor.

13. A clip unit as described in claim 1, wherein the second arm has a second arm body extending in a longitudinal direction along a longitudinal axis, a second claw provided at a tip of the second arm body and extending toward the closing side in the opening and closing direction, and a second anchor provided at the tip of the second arm body or the second claw and extending toward the closing side in the opening and closing direction, at least the tip of the second anchor is positioned on the opening side in the opening and closing direction relative to the first claw, and the second claw and the second anchor are spaced apart in the width direction perpendicular to the longitudinal direction and the opening and closing direction.

14. The clip unit according to claim 13, wherein the length of the first arm body in the longitudinal direction is longer than the length of the second arm body in the longitudinal direction.

15. The clip unit according to claim 13, wherein when the first arm and the second arm are in a closed configuration, the first anchor and the second anchor are positioned apart from each other when viewed in the longitudinal direction.

16. A clip unit as described in claim 15, wherein when the first arm and the second arm are in a closed configuration, the first anchor and the second anchor are arranged to overlap in a position where they overlap in the opening and closing direction when viewed from the longitudinal direction.

17. The clip unit according to claim 13, wherein when the first arm and the second arm are in a closed configuration, the first claw and the second claw are arranged to overlap each other when viewed in the longitudinal direction.

18. A clip unit as described in claim 13, wherein, when the first arm and the second arm are in a closed configuration, the first claw and the second claw are positioned centrally in the width direction, the first anchor is positioned on one side in the width direction, and the second anchor is positioned on the other side in the width direction.

19. The clip unit according to claim 13, wherein when the first arm and the second arm are in a closed configuration, the first anchor and the second anchor are arranged to overlap when viewed in the longitudinal direction.

20. The clip unit according to claim 13, wherein when the first arm and the second arm are in a closed configuration, a gap is formed between the first anchor and the second anchor in the opening and closing direction.

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