Clip device

Abstract

This clip device comprises: a clip having a first arm and a second arm that can be opened and closed in an opening / closing direction; a tubular member capable of storing at least a portion of the clip and extending in a longitudinal direction along the longitudinal axis; and a stopper capable of regulating movement of the first arm with respect to the second arm. In an insertion mode in which the first arm and the second arm are closed and are able to pass through a channel of an endoscope, the first arm and the second arm extend from the tubular member toward the tip side in the longitudinal direction, and when the first arm is subjected to an external force, the stopper regulates the movement of the first arm with respect to the second arm.

Description

Clip Device

[0001] The present invention relates to a clip device.

[0002] In endoscopic treatment, medical instruments such as clip devices are used to treat biological tissue. These medical instruments are introduced to the treatment site by an applicator (introduction device) that can be inserted through the treatment tool insertion channel of the endoscope.

[0003] Patent Document 1 describes a clip device for treating biological tissue. The clip device described in Patent Document 1 is provided with a first clip arm and a second clip arm, and is configured to be insertable through a treatment tool insertion channel of an endoscope.

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

[0005] However, when the clip device is inserted into the treatment instrument insertion channel of the endoscope, the clip arms may come into contact with the treatment instrument insertion channel, causing the positions of the two clip arms to become misaligned, which may reduce the insertability of the clip device.

[0006] In view of the above circumstances, an object of the present invention is to provide a clip device that has good insertability when inserted into a treatment tool insertion channel or the like of an endoscope.

[0007] In order to solve the above problems, the present invention proposes the following means: A clip device according to a first aspect of the present invention includes: a clip having a first arm and a second arm that can be opened and closed in an opening and closing direction, a tubular member that can store at least a portion of the clip and that extends in a longitudinal direction along a longitudinal axis, and a stopper that can restrict movement of the first arm relative to the second arm, wherein in an insertion configuration in which the first arm and the second arm can be inserted through a closed channel of an endoscope, the first arm and the second arm extend from the tubular member toward a distal end in the longitudinal direction, and the stopper restricts movement of the first arm relative to the second arm when the first arm is subjected to an external force.

[0008] The clip device of the present invention has good insertability when inserted into a treatment tool insertion channel of an endoscope, etc., and allows the user to begin treatment of living tissue as soon as possible.

[0009] 1 is a side view showing a clip device; a perspective view showing a clip introducing apparatus; a perspective view showing a clip unit; a perspective view showing the clip unit with the pressure tube seen through; a side view showing the clip in a closed state; a front view showing the clip in a closed state; a side view showing the first arm as seen from the inside; a side view showing the second arm as seen from the inside; a cross-sectional view of the pressure member in the longitudinal direction A; a perspective view of the pressure tube; a perspective view of the pressure tube as seen from the base end side; a perspective view of a connecting member; a perspective view showing a cartridge storing the clip unit; a view showing an operation for loading the clip unit; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge; a view explaining a method for loading the clip unit into the clip introducing apparatus using the cartridge. 1. A diagram explaining a method of loading the clip unit into the clip introduction device using the cartridge. A diagram illustrating the clip unit loaded into the clip introduction device. A diagram illustrating the clip unit introduced into a body. A diagram illustrating the clip unit with a pair of arms closed. A diagram illustrating the clip unit with the clip locked. A diagram illustrating the clip unit with the clip separated. A diagram illustrating a first anchor and a second anchor that have punctured a mucous membrane. A diagram illustrating a first mucous membrane and a second mucous membrane that have been pulled together. A side view of the clip device, showing the first arm receiving force from a treatment tool insertion channel of an endoscope. A side view of the clip device, showing the first arm receiving force from a treatment tool insertion channel of an endoscope. A side view of a clip according to a first modification. A front view of the clip. A view of the first arm according to a first modification from the inside. A view of the second arm according to a first modification from the inside. A diagram illustrating a modification of a third claw.10 is a side view of a clip according to Modification 2. FIG. 11 is a view of a first arm according to Modification 3 as viewed from the inside. FIG. 12 is a view of a second arm according to Modification 3 as viewed from the inside. FIG. 13 is a side view of a clip according to Modification 4. FIG. 14 is a front view of the clip. FIG. 15 is a view of a first arm according to Modification 4 as viewed from the inside. FIG. 16 is a view of a second arm according to Modification 4 as viewed from the inside. FIG. 17 is a side view of a clip according to Modification 5. FIG. 18 is a front view of the clip. FIG. 19 is a view of a first arm according to Modification 5 as viewed from the inside. FIG. 19 is a view of a second arm according to Modification 5 as viewed from the inside. FIG. 19 is a side view of a clip according to Modification 6. FIG. 19 is a front view of the clip. FIG. 19 is a view of a first arm according to Modification 6 as viewed from the inside. FIG. 19 is a view of a second arm according to Modification 6 as viewed from the inside. FIG. 19 is a side view of a clip device according to a second embodiment. FIG. 19 is a front view of the clip. FIG. 19 is a view of a first arm according to Modification 2 as viewed from the inside. FIG. 19 is a view of a second arm according to Modification 2 ... 10 is a front view of the clip. FIG. 11 is a view of a first arm according to Modification 8 as viewed from the inside. FIG. 12 is a view of a second arm according to Modification 8 as viewed from the inside. FIG. 13 is a side view of a clip according to Modification 9. FIG. 14 is a front view of the clip. FIG. 15 is a view of a first arm according to Modification 9 as viewed from the inside. FIG. 16 is a view of a second arm according to Modification 9 as viewed from the inside. FIG. 17 is a view of a second arm according to Modification 10 as viewed from the inside. FIG. 18 is a side view of a clip according to Modification 11. FIG. 19 is a front view of the clip. FIG. 19 is a view of a first arm according to Modification 11 as viewed from the inside. FIG. 19 is a view of a second arm according to Modification 11 as viewed from the inside.

[0010] Hereinafter, clip devices according to embodiments will be described with reference to the accompanying drawings. In the following description, components having the same or similar functions will be designated by the same reference numerals. Duplicate descriptions of those components may be omitted.

[0011] First Embodiment [Clip Device 300] A clip device 300 according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 49. FIG.

[0012] 1 is a side view showing a clip device 300. The clip device 300 includes a clip introducing device (applicator) 200 and a clip unit 1. The clip unit 1 is loaded into the clip introducing device 200.

[0013] [Clip Introducing Device 200] Fig. 2 is a perspective view showing the clip introducing device 200. As shown in Fig. 2, the clip introducing device (applicator) 200 includes a sheath 220, an operating wire 230, and an operating section 240. The clip introducing device 200 is inserted, for example, into a treatment tool insertion channel (channel) N of an endoscope and used in combination with the endoscope (see Figs. 28 and 29). For this reason, the sheath 220 is formed to be sufficiently longer than the length of the treatment tool insertion channel N of the endoscope. The sheath 220 is flexible and bends in accordance with the curvature of the insertion section of the endoscope.

[0014] 2, 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.

[0015] As shown in FIG. 2, 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 .

[0016] 2, 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.

[0017] 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.

[0018] 2, 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.

[0019] 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.

[0020] 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 .

[0021] [Clip unit 1] Fig. 3 is a perspective view showing the clip unit 1. Fig. 4 is a perspective view showing the clip unit 1, showing a state in which the pressing tube 3A is transparent. As shown in Fig. 3, the clip unit 1 includes a clip 2, a pressing member 3, and a connecting member 4.

[0022] 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 "first direction B" or "left-right direction B." Furthermore, the direction perpendicular to the longitudinal direction A and the first direction B is referred to as the "second direction C" or "up-down direction C."

[0023] Fig. 5 is a side view showing the clip 2 in a closed state. Fig. 6 is a front view showing the clip 2 in a closed state. The clip 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.

[0024] Fig. 7 is a side view showing the first arm 211, as seen from the inside. Fig. 8 is a side view showing the second arm 212, as seen from the inside. The pair of arms 21 has a first arm 211 and a second arm 212 that can be opened and closed in the opening and closing direction H. The pair of arms 21 can transition between an open configuration (open state) and a closed configuration (closed state). The first arm 211 and the second arm 212 are arranged on both sides of the central axis O1 in the longitudinal direction A of the clip unit 1. Note that the clip 2 may have three or more arms.

[0025] 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."

[0026] The first arm 211 has a first anchor 21a, a first claw 21c, and a first arm body 21d.

[0027] The second arm 212 has a second anchor 22 a, a second claw 22 c, and a second arm body 22 d. The second arm 212 has a similar shape to the first arm 211, so only the differences will be described below.

[0028] First arm body 21d is formed in a flat plate shape extending in longitudinal direction L. First arm body 21d is a portion that mainly grasps tissue. A direction perpendicular to longitudinal direction L and opening / closing direction H is defined as a "width direction W."

[0029] 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.

[0030] The first claw 21c is provided at the tip 21s of the first arm body 21d and extends toward the closing side H1 in the opening / closing direction H.

[0031] 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 a substantially right-angled triangular shape when viewed from the longitudinal direction L. The first anchor 21a extends inward in the width direction W, making it less likely that the tip 21p will come into contact with the treatment instrument insertion channel N of the endoscope.

[0032] The first anchor 21a is disposed closer to the opening side H2 in the opening / closing direction H than the first claw 21c. The first claw 21c and the first anchor 21a extend from the same portion (tip 21s) as viewed in the width direction W. The first claw 21c and the first anchor 21a do not have to extend from the same portion as viewed in 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.

[0033] 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.

[0034] When the clip 2 is in the closed state, the first claw 21c and the second claw 22c overlap when viewed from the longitudinal direction L, and the first claw 21c is positioned on the tip side A1 of the second claw 22c.

[0035] 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 do not overlap but are spaced apart as viewed from the longitudinal direction L, and are disposed rotationally symmetrical with respect to the central axis O2 in the longitudinal direction A of the clip 2.

[0036] The first arm body 21d has a flat plate-shaped gripping portion 21f and a first sliding portion (curved portion) 21e. The second arm body 22d has a flat plate-shaped gripping portion 22f and a second sliding portion (curved portion) 22e.

[0037] 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.

[0038] 4, 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.

[0039] 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.

[0040] 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.

[0041] 9 is a cross-sectional view of the pressing member 3 in the longitudinal direction A. The pressing member (tubular member) 3 is a cylindrical member capable of storing at least a portion of the clip 2. The pressing member 3 has an internal space 38 through which the clip 2 advances and retreats in the longitudinal direction A. The pressing member 3 can fix the clip 2 retracted into the internal space 38 in a closed state. As shown in FIG. 5, the pressing member 3 has a pressing tube 3A provided on the base end side A2 and a pressing pipe 3B provided on the tip end side A1.

[0042] 10 is a perspective view of the pressure tube 3A. As shown in FIG. 10, the pressure tube (second tubular member) 3A has a cylindrical pressure tube main body 30, protruding and retracting wings 31, and a tightening member 32.

[0043] 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.

[0044] 11 is a perspective view of the pressing tube 3A as seen from the base end side A2. An engaging recess 30r that engages with an engaging protrusion 43p of the connecting member 4 (described later) 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.

[0045] 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.

[0046] 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.

[0047] 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.

[0048] 12 is a perspective view of the connecting member 4. The connecting member 4 is detachably connected to the base 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. As shown in FIG. 12 , the connecting member 4 includes a tip connecting portion 41 provided at the tip, a base end connecting portion 42 provided at the base end, and a rod-shaped portion 45 that connects the tip connecting portion 41 and the base end connecting portion 42.

[0049] 12, the tip connecting portion 41 has a hook 41f at its tip, a breaking portion 41b provided on the base end side A2 of the hook 41f, and a tip expanding portion 41e. The tip connecting portion 41 can be inserted through the internal space 38 of the pressing member 3 when connected to the clip 2.

[0050] 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.

[0051] 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.

[0052] 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, as shown in FIG.

[0053] The connecting portion main body 43 is provided at the base end of the rod-shaped portion 45. The connecting portion main body 43 is formed with an engaging protrusion 43p that protrudes in the vertical direction C. 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.

[0054] 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.

[0055] 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.

[0056] 13 is a perspective view showing the cartridge 5 storing the clip unit 1. A system having the clip unit 1 and the cartridge 5 capable of accommodating the clip unit 1 is referred to as a cartridge system 100. The cartridge system 100 is a support system for easily loading the clip unit 1 into the clip introduction device 200.

[0057] The cartridge 5 is a case that stores the clip unit 1. The cartridge 5 is about 10 mm to 20 mm wide, about 50 mm long, and about 5 mm thick, and is formed to a size that is easy to hold in the hand.

[0058] The cartridge 5 is manufactured by injection molding from a transparent resin material that has an appropriate hardness, such as ABS, PC, PP, PS, acrylic, cycloolefin polymer, etc. The cartridge 5 is formed using a transparent resin material, making it easy for the user to determine whether or not the clip unit 1 is present inside.

[0059] 13 , of two directions that are perpendicular to the longitudinal direction Z of the cartridge 5 and perpendicular to each other, one is defined as the “left-right direction X” and the other as the “height direction Y.” In addition, in the cartridge 5 that stores the clip unit 1, the pair of arms 21 side is defined as the tip side Z1 of the cartridge 5, and the connecting member 4 side is defined as the base side Z2 of the cartridge 5.

[0060] As shown in FIG. 13, the cartridge 5 has a cartridge body 70 formed in a substantially rectangular box shape, and a storage area 7S formed inside the cartridge body 70.

[0061] The cartridge body 70 is formed with a storage area 7S in which the clip unit 1 is stored so as to be movable in the longitudinal direction (advance / retract direction) Z. The storage area 7S has a first area 71, a folding area 73, and a sheath insertion area 74. As shown in Fig. 13 , the first area 71, the folding area 73, and the sheath insertion area 74 are arranged from the tip to the base end in the longitudinal direction Z of the cartridge 5.

[0062] The cartridge body 70 is formed with an insertion opening 67 through which the sheath 220 can be inserted. The insertion opening 67 has an opening surface that is formed substantially perpendicular to the longitudinal direction Z. The insertion opening 67 is formed on the side surface of the cartridge body 70 on the base end side Z2. The insertion opening 67 communicates with the sheath insertion region 74.

[0063] The first region 71 is an internal space in which the clip unit 1 is stored so as to be movable in the longitudinal direction Z. The first region 71 communicates with the folding region 73.

[0064] The folding region 73 is a region that holds the protruding / retracting wing 31 in a retracted state. A reduced diameter portion 73c (see FIG. 15) is formed in the folding region 73. When the clip unit 1 is stored in the cartridge 5, the reduced diameter portion 73c can hold the connecting arm 44 of the connecting member 4 in a state that prevents the connecting arm 44 from spreading.

[0065] The sheath insertion region 74 is a region into which the distal end of the sheath 220 is inserted after passing through the insertion port 67. The sheath insertion region 74 is located on the proximal end side Z2 of the folding region 73 and communicates with the folding region 73. At the portion where the sheath insertion region 74 is connected to the folding region 73, the length of the sheath insertion region 74 in the left-right direction X is longer than the length of the folding region 73 in the left-right direction X.

[0066] [Stopper 8] As shown in Fig. 1 , the clip device 300 has a stopper 8. The stopper 8 is a member that can restrict movement of the first arm 211 relative to the second arm 212 when the first arm 211 receives an external force in the insertion configuration Pi. In this embodiment, the stopper 8 restricts movement of the first arm 211 relative to the second arm 212 in the longitudinal direction A and the opening / closing direction H. The direction in which the stopper 8 restricts movement is not limited. The stopper 8 can also restrict movement of the second arm 212 relative to the first arm 211.

[0067] The insertion configuration Pi is a configuration in which the first arm 211 and the second arm 212 can be inserted through the treatment tool insertion channel (channel) N of the closed endoscope, as shown in Fig. 1 (see Figs. 28 and 29). The insertion configuration Pi is included in the closed configuration. The closed configuration also includes a configuration in which the clip 2 is locked (see Fig. 24), but the insertion configuration Pi is a state in which the clip 2 is unlocked. When the first arm 211 and the second arm 212 are in the insertion configuration Pi, the longitudinal direction L substantially coincides with the longitudinal direction A.

[0068] The stopper 8 is provided on the clip 2. In this embodiment, the stopper 8 is provided on the first arm 211 and the second arm 212, as shown in Fig. 1 . Note that there are no limitations on the member on which the stopper 8 is provided. For example, the stopper 8 may be provided on at least one of the first arm 211 and the second arm 212.

[0069] In this embodiment, as shown in Fig. 5, the stopper 8 has a first engagement portion 81 and a second engagement portion 82. The first engagement portion 81 is a member provided on the first arm 211. The second engagement portion 82 is a member provided on the second arm 212. The first engagement portion 81 and the second engagement portion 82 are engageable with each other in the insertion configuration Pi. The shape of the stopper 8 is not limited.

[0070] The first engagement portion 81 is provided on the first arm body 21d and extends toward the closing side H1 in the opening and closing direction H. As shown in FIG. 5 , the first engagement portion 81 extends from the first arm body 21d toward the second arm body 22d in the insertion configuration Pi, and is engageable with the second engagement portion 82.

[0071] The first engagement portion 81 has a first engagement portion main body 81a and a protrusion 81b. The first engagement portion main body 81a has a plate-like shape with the second direction C as its plate thickness direction. The first engagement portion main body 81a is provided on the first arm main body 21d and extends toward the closed side H1 in the opening and closing direction H. In the insertion configuration Pi, the first engagement portion 81 extends from the first arm main body 21d toward the second arm main body 22d. The first engagement portion main body 81a is formed, for example, by bending the end of the first arm 211 in the second direction C.

[0072] The convex portion 81b is formed on the first engagement portion main body 81a and is a member that can engage with the concave portion 82b of the second engagement portion 82 in the insertion configuration Pi. The convex portion 81b protrudes from the first engagement portion main body 81a toward the closed side H1 in the opening and closing direction H, and protrudes toward the second arm main body 22d in the insertion configuration Pi. The convex portion 81b is formed in a substantially triangular shape when viewed from the second direction C. The shape of the convex portion 81b is not limited.

[0073] The second engagement portion 82 is provided on the second arm body 22d and extends toward the closing side H1 in the opening and closing direction H. As shown in FIG. 5 , the second engagement portion 82 extends from the second arm body 22d toward the first arm body 21d in the insertion configuration Pi, and is engageable with the first engagement portion 81.

[0074] The second engagement portion 82 has a second engagement portion main body 82a and a recess 82b. The second engagement portion main body 82a has a plate-like shape with the second direction C as its plate thickness direction. The second engagement portion main body 82a is provided on the second arm main body 22d and extends toward the closed side H1 in the opening and closing direction H. In the insertion configuration Pi, the second engagement portion 82 extends from the second arm main body 22d toward the first arm main body 21d. The second engagement portion main body 82a is formed, for example, by bending the end of the second arm 212 in the second direction C.

[0075] The recess 82b is formed in the second engagement portion main body 82a and is a member that can engage with the protrusion 81b of the first engagement portion 81 in the insertion configuration Pi. The recess 82b is recessed from the second engagement portion main body 82a toward the open side H2 in the opening / closing direction H, and is recessed in a direction away from the first arm main body 21d in the insertion configuration Pi. The recess 82b is formed in a substantially triangular shape when viewed from the second direction C. The shape of the recess 82b is not limited. For example, if the first engagement portion 81 has a concave shape, the second engagement portion 82 may have a convex shape.

[0076] In this embodiment, as shown in Fig. 7, two first engagement portions 81 are provided spaced apart in the second direction C. When two first engagement portions 81 are provided, two second engagement portions 82 are provided spaced apart in the second direction C, as shown in Fig. 8. There is no limit to the number of first engagement portions 81 and second engagement portions 82 that can be provided. By providing a plurality of first engagement portions 81 and second engagement portions 82, the movement of the first arm 211 is further restricted.

[0077] [Method of Loading Clip Unit 1] Next, the operation of the cartridge system 100 will be described with reference to Figures 14 to 20. Figure 14 is a diagram showing the operation of loading the clip unit 1. Figures 15 to 20 are diagrams explaining a method of loading the clip unit 1 into the clip introducer device 200 using the cartridge 5.

[0078] The user inserts the sheath 220 into the sheath insertion region 74 through the insertion port 67 .

[0079] 15 is a diagram showing the clip unit 1 connected to the clip introduction device 200. The user advances the slider 242 relative to the operation unit body 241 of the operation unit 240, and advances the operation wire 230 relative to the sheath 220, thereby pushing the connecting member 4 with the arrowhead hook 231 and advancing the clip unit 1 until it comes into contact with the cartridge 5.

[0080] 16 is a diagram showing the clip unit 1 connected to the clip introduction device 200. The user further advances the arrowhead hook 231 to connect the engaging portion 231a of the arrowhead hook 231 with the connecting arm 44 of the connecting member 4.

[0081] 17, the user pulls the operating wire 230. The clip 2 of the clip unit 1 is pulled toward the base end side Z2 by the connecting member 4 connected to the arrowhead hook 231.

[0082] The user further pulls the clip unit 1 toward the proximal end side Z2. As shown in FIG.

[0083] The user further pulls the operating wire 230, as shown in Fig. 19. The clip 2 pulled toward the proximal end Z2 is pulled into the internal space of the pressure tube 3A and into the sheath 220. This completes the loading of the clip unit 1 into the clip introduction device 200. At this time, the clip 2 is not completely pulled into the sheath 220. As shown in Fig. 19, the clip 2 is loaded in a state where it protrudes from the distal end of the sheath 220.

[0084] 20, the user further pulls the operating wire 230. The clip 2 is pulled out from the cartridge 5 in a state where it protrudes from the distal end of the sheath 220.

[0085] [Operation and Function of Clip Unit 1] Next, the operation and function of the clip unit 1 will be described with reference to FIGS. 21 to 27. FIG.

[0086] 21 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 5. 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 disposed at the tip of the sheath 220. The clip 2 protrudes from the tip of the sheath 220.

[0087] The pair of arms 21 of the loaded clip unit 1 are in a closed state, being pressed against the inner circumferential surface of the sheath 220. The engaging portion 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.

[0088] 22 is a diagram showing the clip unit 1 introduced into the body. The user introduces the clip unit 1 loaded into the sheath 220 into the body via the treatment tool insertion channel N of the endoscope. Next, the user advances the slider 242 along the operation portion main body 241, thereby advancing the arrowhead hook 231.

[0089] When the distal end side A1 of the pair of arms 21 comes 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 side A1 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.

[0090] 23 is a diagram showing the clip unit 1 with the pair of arms 21 closed. The user 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 pressing member 3 toward the base end side A2. The protruding and retracting wings 31 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 pulled into the pressing member 3.

[0091] When the connecting member 4 pulls the base end 28 of the clip 2 toward the base end side A2 of the presser member 3, the pair of arms 21 are pulled into the presser 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 user can return the pair of arms 21 to the open state to re-grasp the tissue.

[0092] 24 is a diagram showing 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 A2 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 is locked in the closed state. Once the pair of arms 21 is locked in the closed state, the pair of arms 21 cannot return to the open state.

[0093] 25 is a diagram showing the clip unit 1 from which the clip 2 has been separated. The user further pulls the clip 2. A breaking force is applied to the hook 41f by pulling, and the breaking portion 41b breaks. 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.

[0094] The user uses the cartridge 5 to reload a new clip unit 1 into the clip introducer device 200 .

[0095] The user 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."

[0096] 26 is a diagram showing the first anchor 21a and the second anchor 22a puncturing the mucosa. The user 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 closed side H1 in the opening and closing direction H, but are positioned closer to the open 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.

[0097] 27 is a diagram showing the first mucosa M1 and the second mucosa M2 being pulled together. The user can pull together 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.

[0098] [Function of Stopper 8] Next, the function of the stopper 8 will be described with reference to FIGS. 28 and 29. FIG.

[0099] 28 is a side view showing the clip device 300, illustrating the state in which the first arm 211 receives force from the treatment tool insertion channel N of the endoscope. In the insertion configuration Pi, the clip device 300 can be inserted through the treatment tool insertion channel N of the endoscope. At this time, the clip device 300 advances in the longitudinal direction A from the base end side A2 to the tip end side A1.

[0100] Because the treatment tool insertion channel N of the endoscope is curved, the clip device 300 may come into contact with the treatment tool insertion channel N of the endoscope. For example, as shown in Fig. 28 , the first arm 211 may come into contact with the treatment tool insertion channel N of the endoscope. When the first arm 211 comes into contact with the treatment tool insertion channel N of the endoscope, for example, as shown in Fig. 28 , the first arm 211 may be subjected to an external force in the longitudinal direction A.

[0101] When the first arm 211 receives an external force, the first arm 211 attempts to move relative to the second arm 212. For example, as shown in Fig. 28 , the first arm 211 attempts to move toward the base end side A2 relative to the second arm 212. At this time, the stopper 8 restricts the first arm 211 from moving relative to the second arm 212. In the present embodiment, the convex portion 81b of the first engagement portion 81 engages with the concave portion 82b of the second engagement portion 82, thereby restricting the movement in the longitudinal direction A.

[0102] 29 is a side view showing the clip device 300, illustrating the state in which the first arm 211 receives force from the treatment tool insertion channel N of the endoscope. When the clip device 300 is inserted through the treatment tool insertion channel N of the endoscope, for example, as shown in FIG. 29 , the first arm 211 may receive an external force in the opening / closing direction H.

[0103] When the first arm 211 receives an external force, the first arm 211 attempts to move relative to the second arm 212. For example, as shown in Fig. 28 , the first arm 211 attempts to move toward the closing side H1 relative to the second arm 212. At this time, the stopper 8 restricts the movement of the first arm 211 relative to the second arm 212. In this embodiment, the convex portion 81b of the first engagement portion 81 engages with the concave portion 82b of the second engagement portion 82, thereby restricting the movement toward the closing side H1 in the opening / closing direction H.

[0104] According to the clip device 300 of this embodiment, the stopper 8 is provided, and therefore movement of the first arm 211 relative to the second arm 212 can be suppressed. Even when the clip device 300 is inserted through the treatment tool insertion channel N of the endoscope, movement of the first arm 211 relative to the second arm 212 is suppressed, and therefore the clip device 300 has good insertability. Because the clip device has good insertability, the user can begin treatment of the living tissue as soon as possible.

[0105] According to the clip device 300 of this embodiment, since it has the first engaging portion 81 and the second engaging portion 82, it is possible to restrict movement of the first arm 211 relative to the second arm 212 in the opening / closing direction H. Therefore, the clip device 300 has good insertability.

[0106] According to the clip device 300 of the present embodiment, since the clip device 300 has the convex portion 81b and the concave portion 82b, it is possible to restrict the movement of the first arm 211 relative to the second arm 212 in the longitudinal direction A. Therefore, the clip device 300 has good insertability.

[0107] (Modification 1) [Clip 2B] Next, a clip 2B of modification 1 will be described with reference to Figs. 30 to 33 .

[0108] Fig. 30 is a side view showing clip 2B. Fig. 31 is a front view showing clip 2B. Fig. 32 is a view of first arm 211 according to Modification 1 as seen from the inside. Fig. 33 is a view of second arm 212 according to Modification 1 as seen from the inside.

[0109] Clip 2B is a modified example of clip 2. As shown in FIG. 30 , in clip 2B, in the insertion configuration Pi, the first claw 21c and the second claw 22c are arranged to overlap when viewed from the longitudinal direction A. The first claw 21c and the second claw 22c are arranged to be offset in the longitudinal direction A when in the insertion configuration Pi. The second claw 22c is arranged closer to the base end side A2 than the first claw 21c when in the insertion configuration Pi. Therefore, when the first arm 211 and the second arm 212 are closed, the first claw 21c and the second claw 22c do not come into contact with each other in the opening / closing direction H, and the first claw 21c and the second claw 22c overlap when viewed from the longitudinal direction A.

[0110] The first claw 21c and the second claw 22c are formed by bending the tip of the clip 2. The shapes of the first claw 21c and the second claw 22c are not limited.

[0111] The clip 2B has a third claw 21g. The third claw 21g is located on the first arm body 21d closer to the base end A2 than the first claw 21c and extends toward the closed side H1 in the opening and closing direction H. The third claw 21g is located closer to the base end A2 than the second claw 22c in the insertion configuration Pi. In the insertion configuration Pi, the first claw 21c, the second claw 22c, and the third claw 21g are arranged in this order from the tip end A1. The third claw 21g is formed, for example, by hollowing out the first arm 211.

[0112] The shape of the third claw 21g is not limited, and may be formed on the side of the first arm body 21d, for example, as shown in Fig. 34. Specifically, the third claw 21g is formed by hollowing out and bending the end of the first arm body 21d in the second direction C. In this case, the third claw 21g has a notch shape.

[0113] The third claw 21g restricts the movement of the first arm 211 relative to the second arm 212. That is, the third claw 21g is a stopper 8B. The clip 2B is provided with a stopper 8B instead of the stopper 8.

[0114] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8B restricts movement of the first arm 211 relative to the second arm 212 in the longitudinal direction A. When the first arm 211 receives an external force toward the distal end side A1, the stopper 8B abuts against the second claw 22c, thereby restricting movement of the first arm 211 relative to the second arm 212. Furthermore, when the first arm 211 receives an external force toward the proximal end side A2, the first claw 21c abuts against the second claw 22c, thereby restricting movement of the first arm 211 relative to the second arm 212.

[0115] The stopper 8B is larger than the first claw 21c and the second claw 22c in the opening / closing direction H. When the first arm 211 receives an external force in the inserted configuration Pi, the stopper 8B restricts the first arm 211 from moving toward the closing side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closing side H1, the stopper 8B abuts against the second arm 212, thereby restricting the first arm 211 from moving toward the second arm 212.

[0116] (Modification 2) [Clip 2C] Next, a clip 2C of modification 2 will be described with reference to FIG.

[0117] 35 is a side view showing a clip 2C. The clip 2C is a modified version of the clip 2B. In the clip 2C, the shape of a stopper 8C is different from that of the stopper 8B.

[0118] The length of stopper 8C in the opening / closing direction H is smaller than the length of stopper 8B in the opening / closing direction H. In the insertion configuration Pi, stopper 8C only needs to overlap at least a portion with second claw 22c as viewed from the longitudinal direction A. The overlapping portion as viewed from the longitudinal direction A makes it possible to restrict movement of first arm 211 relative to second arm 212.

[0119] The stopper 8C is easy to form because it has a small length in the opening and closing direction H. Therefore, the clip 2C is a member that is easy to form and has good insertability.

[0120] (Modification 3) [Clip 2D] Next, a clip 2D according to modification 3 will be described with reference to Figs. 36 and 37 .

[0121] Fig. 36 is a view from the inside of a first arm 211 according to Modification 3. Fig. 37 is a view from the inside of a second arm 212 according to Modification 3. Clip 2D is a modification of clip 2B.

[0122] In clip 2D, the shapes of the first anchor 21a and the second anchor 22a are different from those of clip 2B. The first anchor 21a is formed at approximately the center of the first arm body 21d in the second direction C. The second anchor 22a is formed at approximately the center of the second arm body 22d in the second direction C. The shapes of the first anchor 21a and the second anchor 22a are not limited.

[0123] In clip 2D, the shapes of first claw 21c and second claw 22c are different from those of clip 2B. First claw 21c is formed by hollowing out first arm body 21d. Therefore, an opening is formed in first arm body 21d. Second claw 22c is formed by hollowing out second arm body 22d. Therefore, an opening is formed in second arm body 22d.

[0124] In clip 2D, first claw 21 c and second claw 22 c are formed by hollowing out, which makes it easy to form first anchor 21 a and second anchor 22 a on tip side A1 of first arm body 21 d and second arm body 22 d, and to change the shapes of first anchor 21 a and second anchor 22 a.

[0125] (Modification 4) [Clip 2E] Next, a clip 2E of modification 4 will be described with reference to Figs. 38 to 41 .

[0126] Fig. 38 is a side view showing clip 2E. Fig. 39 is a front view showing clip 2E. Fig. 40 is a view of a first arm 211E according to Modification 4 seen from the inside. Fig. 41 is a view of a second arm 212E according to Modification 4 seen from the inside. Clip 2E is a modification of clip 2B.

[0127] The clip 2E is formed by bending a metal plate at the center, similar to the clip 2B, and has a first arm 211E and a second arm 212E that can be opened and closed.

[0128] The first arm 211E has a first anchor 21Ea, a first claw 21Ec, a first arm body 21d, and a third claw 21Eg. The first arm 211E differs from the first arm 211 in the arrangement of the first anchor 21Ea, the first claw 21Ec, and the third claw 21Eg.

[0129] The first anchor 21Ea is formed at the tip 21s of the first arm body 21d. The first anchor 21Ea is formed approximately in the center in the second direction C. Like the first anchor 21a, the tip 21Ep of the first anchor 21Ea is formed in a sharp tapered shape. The first anchor 21Ea is formed, for example, by bending the tip 21s of the first arm body 21d.

[0130] The first claw 21Ec is formed on the tip 21s of the first arm body 21d. The first claw 21Ec is formed alongside the first anchor 21Ea in the second direction C. Like the first claw 21c, the first claw 21Ec extends from the first arm body 21d toward the closing side H1 in the opening / closing direction H. The first claw 21Ec is formed, for example, by bending the tip 21s of the first arm body 21d.

[0131] The third claw 21Eg is formed at the tip 21s of the first arm body 21d. The third claw 21Eg is formed closer to the base end side A2 than the first claw 21Ec. The third claw 21Eg is formed alongside the first anchor 21Ea in the second direction C. The first anchor 21Ea is formed between the first claw 21Ec and the third claw 21Eg in the second direction C. Like the third claw 21g, the third claw 21Eg extends from the first arm body 21d toward the closing side H1 in the opening / closing direction H. The third claw 21Eg is formed, for example, by bending the tip 21s of the first arm body 21d.

[0132] The second arm 212E has a second anchor 22Ea, a second claw 22Ec, a second arm body 22d, and a fourth claw 22Eg. The second arm 212E differs from the second arm 212 in the arrangement of the second anchor 22Ea and the second claw 22Ec. Unlike the second arm 212, the second arm 212E has a fourth claw 22Eg. The fourth claw 22Eg is a member that restricts movement of the first arm 211E relative to the second arm 212E.

[0133] The second anchor 22Ea is formed at the tip 22s of the second arm body 22d. The second anchor 22Ea is formed approximately in the center in the second direction C. The second anchor 22Ea is formed at a position overlapping with the first anchor 21Ea in the opening / closing direction H. Like the second anchor 22a, the tip 22Ep of the second anchor 22Ea is formed in a sharp tapered shape. The second anchor 22Ea is formed, for example, by bending the tip 22s of the second arm body 22d.

[0134] The second claw 22Ec is formed at the tip 22s of the second arm body 22d. The second claw 22Ec is formed alongside the second anchor 22Ea in the second direction C. The second claw 22Ec is formed at a position overlapping with the third claw 21Eg in the longitudinal direction A. Like the second claw 22c, the second claw 22Ec extends from the second arm body 22d toward the closing side H1 in the opening / closing direction H. The second claw 22Ec is formed, for example, by bending the tip 22s of the second arm body 22d.

[0135] The fourth claw 22Eg is formed at the tip 22s of the second arm main body 22d. The fourth claw 22Eg is formed closer to the base end side A2 than the second claw 22Ec. The fourth claw 22Eg is formed alongside the second anchor 22Ea in the second direction C. The second anchor 22Ea is formed between the second claw 22Ec and the fourth claw 22Eg in the second direction C. The fourth claw 22Eg is formed at a position overlapping with the first claw 21Ec in the longitudinal direction A. The fourth claw 22Eg extends from the second arm main body 22d toward the closing side H1 in the opening / closing direction H. The fourth claw 22Eg is formed, for example, by bending the tip 22s of the second arm main body 22d.

[0136] The third claw 21Eg restricts the first arm 211E from moving relative to the second arm 212E. The fourth claw 22Eg also restricts the first arm 211E from moving relative to the second arm 212E. In other words, the third claw 21Eg and the fourth claw 22Eg are stoppers 8E. In the clip 2E, the stopper 8E is provided instead of the stopper 8B.

[0137] When the first arm 211E receives an external force in the insertion configuration Pi, the stopper 8E restricts movement of the first arm 211E relative to the second arm 212E in the longitudinal direction A. When the first arm 211E receives an external force toward the distal end side A1, the third claw 21Eg abuts against the second claw 22Ec, restricting movement of the first arm 211E relative to the second arm 212E. Furthermore, when the first arm 211E receives an external force toward the proximal end side A2, the fourth claw 22Eg abuts against the first claw 21Ec, restricting movement of the first arm 211E relative to the second arm 212E.

[0138] The third claw 21Eg and the fourth claw 22Eg are larger than the first claw 21Ec and the second claw 22Ec in the opening / closing direction H. When the first arm 211E receives an external force in the inserted configuration Pi, the stopper 8E restricts the first arm 211E from moving toward the closed side H1 relative to the second arm 212E in the opening / closing direction H. When the first arm 211E receives an external force toward the closed side H1, the third claw 21Eg and the fourth claw 22Eg abut against the second arm 212E, restricting the first arm 211E from moving relative to the second arm 212E.

[0139] In addition, in the insertion form Pi, it is sufficient that the third claw 21Eg at least partially overlaps with the second claw 22Ec when viewed from the longitudinal direction A. The existence of the overlapping portion when viewed from the longitudinal direction A makes it possible to restrict movement of the first arm 211E relative to the second arm 212E.

[0140] In addition, in the insertion form Pi, it is sufficient that the fourth claw 22Eg at least partially overlaps with the first claw 21Ec when viewed from the longitudinal direction A. The overlapping portion when viewed from the longitudinal direction A makes it possible to restrict movement of the first arm 211E relative to the second arm 212E.

[0141] (Modification 5) [Clip 2F] Next, a clip 2F of modification 5 will be described with reference to Figs. 42 to 45 .

[0142] Fig. 42 is a side view showing clip 2F. Fig. 43 is a front view showing clip 2F. Fig. 44 is a view of a first arm 211 according to Modification 5 seen from the inside. Fig. 45 is a view of a second arm 212 according to Modification 5 seen from the inside. Clip 2F is a modification of clip 2.

[0143] The first arm 211 has a first anchor 21a and a first claw 21c, similar to the clip 2. The first anchor 21a and the first claw 21c are formed at the tip 21s of the first arm body 21d, similar to the clip 2. The first anchor 21a is formed alongside the first claw 21c in the second direction C, similar to the clip 2. The first anchor 21a and the first claw 21c are formed, for example, by bending the tip 21s of the first arm body 21d.

[0144] The second arm 212 has a second anchor 22a and a second claw 22c, similar to the clip 2. The second anchor 22a and the second claw 22c are formed at the tip 22s of the second arm body 22d, similar to the clip 2. The second anchor 22a is formed alongside the second claw 22c in the second direction C, similar to the clip 2. The second anchor 22a and the second claw 22c are formed, for example, by bending the tip 22s of the second arm body 22d.

[0145] The first claw 21c and the second claw 22c are formed in a position where they overlap in the longitudinal direction A. The first claw 21c and the second claw 22c are formed in a position where they at least partially overlap in the opening / closing direction H. That is, the tips of the first claw 21c and the second claw 22c abut in the closed state.

[0146] The clip 2F is provided with a stopper 8F instead of the stopper 8. The stopper 8F restricts the movement of the first arm 211 relative to the second arm 212. Note that the direction in which the stopper 8F restricts the movement is not limited.

[0147] The stopper 8F is a restricting member 81F that can engage with the first arm 211 and the second arm 212 in the insertion configuration Pi. The restricting member 81F is a member that can be separated from the first arm 211 and the second arm 212. It is sufficient that the restricting member 81F can be separated from at least one of the first arm 211 and the second arm 212.

[0148] The restricting member 81F is an elastically deformable member made of a biodegradable material. When the clip 2F transitions from the closed state to the open state, the restricting member 81F separates from the first arm 211 and the second arm 212 and is left in the body.

[0149] The restricting member 81F is formed, for example, in a substantially H-shape when viewed from the second direction C. The restricting member 81F has a restricting member main body 81Fa, a first locking portion 81Fb, and a second locking portion 81Fc. The restricting member main body 81Fa is a plate-shaped member whose thickness direction is the opening / closing direction H. The first locking portion 81Fb is a plate-shaped member extending from the tip end side A1 of the restricting member main body 81Fa in the opening / closing direction H. The second locking portion 81Fc is a plate-shaped member extending from the base end side A2 of the restricting member main body 81Fa in the opening / closing direction H.

[0150] In the insertion configuration Pi, the restricting member 81F is sandwiched between the first claw 21c and the second claw 22c. Specifically, the restricting member main body 81Fa is sandwiched between the tip 21r of the first claw 21c and the tip 22r of the second claw 22c in the opening / closing direction H. At this time, the first claw 21c and the second claw 22c are sandwiched between the first locking portion 81Fb and the second locking portion 81Fc in the longitudinal direction A.

[0151] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8F restricts movement of the first arm 211 relative to the second arm 212 in the longitudinal direction A. When the first arm 211 receives an external force toward the distal end side A1, the first locking portion 81Fb abuts against the first claw 21c while the second locking portion 81Fc abuts against the second claw 22c, thereby restricting movement of the first arm 211 relative to the second arm 212. Furthermore, when the first arm 211 receives an external force toward the proximal end side A2, the second locking portion 81Fc abuts against the first claw 21c while the first locking portion 81Fb abuts against the second claw 22c, thereby restricting movement of the first arm 211 relative to the second arm 212.

[0152] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8F restricts the first arm 211 from moving toward the closed side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closed side H1, the tips of the first claw 21 c and the second claw 22 c abut against the restricting member main body 81Fa, thereby restricting the first arm 211 from moving toward the second arm 212.

[0153] (Modification 6) [Clip 2G] Next, a clip 2G of modification 6 will be described with reference to Figs. 46 to 49 .

[0154] Fig. 46 is a side view showing clip 2G. Fig. 47 is a front view showing clip 2G. Fig. 48 is a view of a first arm 211 according to Modification 6 as seen from the inside. Fig. 49 is a view of a second arm 212 according to Modification 6 as seen from the inside. Clip 2G is a modification of clip 2F.

[0155] Similar to the clip 2F, the first arm 211 has a first anchor 21a and a first claw 21c. Similar to the clip 2F, the first anchor 21a and the first claw 21c are provided at the tip 21s of the first arm main body 21d. The first anchor 21a is formed approximately in the center in the second direction C. Two first claws 21c are provided spaced apart in the second direction C. The first anchor 21a is formed alongside the pair of first claws 21c in the second direction C. The first anchor 21a is formed between the pair of first claws 21c in the second direction C. The first anchor 21a and the pair of first claws 21c are formed, for example, by bending the tip 21s of the first arm main body 21d.

[0156] The second arm 212 has a second anchor 22a and a second claw 22c, similar to the clip 2F. The second anchor 22a and the second claw 22c are provided at the tip 22s of the second arm main body 22d, similar to the clip 2F. The second anchor 22a is formed approximately in the center in the second direction C. Two second claws 22c are provided spaced apart in the second direction C. The second anchor 22a is formed alongside the pair of second claws 22c in the second direction C. The second anchor 22a is formed between the pair of second claws 22c in the second direction C. The second anchor 22a and the pair of second claws 22c are formed, for example, by bending the tip 22s of the second arm main body 22d.

[0157] The first anchor 21a and the second anchor 22a are formed in a position where they overlap in the longitudinal direction A. The first anchor 21a and the second anchor 22a are formed in a position where they at least partially overlap in the opening / closing direction H. That is, the tips of the first anchor 21a and the second anchor 22a abut against each other in the closed state.

[0158] The clip 2G is provided with a stopper 8G. The stopper 8G restricts the movement of the first arm 211 relative to the second arm 212. Note that the direction in which the stopper 8G restricts the movement is not limited.

[0159] The stopper 8G is a restricting member 81F, similar to the stopper 8F. The stopper 8G is a member that can engage with the first arm 211 and the second arm 212 in the insertion configuration Pi. The restricting member 81F is a member that can be separated from the first arm 211 and the second arm 212 in the open state.

[0160] In the insertion configuration Pi, the restricting member 81F is sandwiched between the first anchor 21a and the second anchor 22a. Specifically, the restricting member main body 81Fa is sandwiched between the tip 21p of the first anchor 21a and the tip 22p of the second anchor 22a in the opening / closing direction H. At this time, the first anchor 21a and the second anchor 22a are sandwiched between the first locking portion 81Fb and the second locking portion 81Fc in the longitudinal direction A.

[0161] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8G restricts movement of the first arm 211 relative to the second arm 212 in the longitudinal direction A. When the first arm 211 receives an external force toward the distal side A1, the first locking portion 81Fb abuts against the first anchor 21a while the second locking portion 81Fc abuts against the second anchor 22a, thereby restricting movement of the first arm 211 relative to the second arm 212. Furthermore, when the first arm 211 receives an external force toward the proximal side A2, the second locking portion 81Fc abuts against the first anchor 21a while the first locking portion 81Fb abuts against the second anchor 22a, thereby restricting movement of the first arm 211 relative to the second arm 212.

[0162] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8G restricts the first arm 211 from moving toward the closed side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closed side H1, the tips of the first anchor 21 a and the second anchor 22 a abut against the restricting member main body 81Fa, thereby restricting the first arm 211 from moving relative to the second arm 212.

[0163] 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 following modified examples can be appropriately combined to form a configuration.

[0164] Second Embodiment [Clip Device 300H] A clip device 300H according to a second embodiment of the present invention will be described with reference to Figs. 50 to 71. The clip device 300H according to the second embodiment differs from the clip device 300 of the first embodiment in the configuration of the clips, etc. In the following description, components that are common to those already described will be assigned the same reference numerals, and redundant description will be omitted.

[0165] 50 is a side view showing a clip device 300H. The clip device 300H includes a clip introducer (applicator) 200 and a clip unit 1H. The clip unit 1H is loaded into the clip introducer 200, similar to the clip unit 1. The clip unit 1H is housed in a cartridge 5, similar to the clip unit 1.

[0166] The clip unit 1H includes a clip 2H, a pressing member 3, and a connecting member 4. The pressing member 3 and the connecting member 4 have the same configuration as those of the clip unit 1. However, the configurations of the pressing member 3 and the connecting member 4 are not limited.

[0167] [Clip 2H] Fig. 51 is a side view showing clip 2H. Fig. 52 is a front view showing clip 2H. Fig. 53 is a view of a first arm 211 according to the second embodiment as seen from the inside. Fig. 54 is a view of a second arm 212 according to the second embodiment as seen from the inside.

[0168] The clip 2H is formed by bending a metal plate material at the center, similar to the clip 2. The clip 2H, similar to the clip 2, has a first arm 211 and a second arm 212 that can be opened and closed.

[0169] Similar to the clip 2, the first arm 211 has a first anchor 21a, a first claw 21c, and a first arm body 21d. Similar to the clip 2, the first anchor 21a and the first claw 21c are provided at 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 anchor 21a extends further toward the open side H2 in the opening and closing direction H than the first claw 21c. The first anchor 21a and the first claw 21c are formed, for example, by bending the tip 21s of the first arm body 21d.

[0170] Similar to the clip 2, the second arm 212 has a second anchor 22a, a second claw 22c, and a second arm body 22d. Similar to the clip 2, the second anchor 22a and the second claw 22c are provided at a tip 22s of the second arm body 22d and extend toward the closing side H1 in the opening and closing direction H. The second anchor 22a extends further toward the opening side H2 in the opening and closing direction H than the second claw 22c. The second anchor 22a and the second claw 22c are formed, for example, by bending the tip 22s of the second arm body 22d.

[0171] [Stopper 8H] As shown in Fig. 51 , the clip 2H is provided with a stopper 8H. Similar to the stopper 8, the stopper 8H is a member that restricts movement of the first arm 211 relative to the second arm 212 when the first arm 211 receives an external force in the insertion configuration Pi. In this embodiment, the stopper 8H restricts movement of the first arm 211 relative to the second arm 212 toward the closed side H1 in the opening / closing direction H. The direction in which the stopper 8H restricts movement is not limited. The stopper 8H can also restrict movement of the second arm 212 relative to the first arm 211.

[0172] The stopper 8H is provided on the first arm 211 and the second arm 212. The stopper 8H has a first engagement portion 81H and a second engagement portion 82H. The first engagement portion 81H and the second engagement portion 82H are members that define the minimum closing width of the clip 2H. The first engagement portion 81H is a member provided on the first arm 211. The second engagement portion 82H is a member provided on the second arm 212. The first engagement portion 81H and the second engagement portion 82H are engageable with each other in the insertion configuration Pi.

[0173] The first engagement portion 81H is provided on the first arm body 21d and extends toward the closed side H1 in the opening / closing direction H. In the insertion configuration Pi, the first engagement portion 81H extends from the first arm body 21d toward the second arm body 22d and is engageable with the second engagement portion 82H. A tip 81Hs of the first engagement portion 81H is formed to have a width in the longitudinal direction A in the insertion configuration Pi. Therefore, the first engagement portion 81H is engageable with the second engagement portion 82H even when the first arm 211 moves in the longitudinal direction A.

[0174] The second engagement portion 82H is provided on the second arm body 22d and extends toward the closing side H1 in the opening / closing direction H. As shown in FIG. 5 , the second engagement portion 82H extends from the second arm body 22d toward the first arm body 21d in the insertion configuration Pi and is engageable with the first engagement portion 81H. A tip 82Hs of the second engagement portion 82H is formed to have a width in the longitudinal direction A in the insertion configuration Pi. Therefore, the second engagement portion 82H is engageable with the first engagement portion 81H even when the second arm 212 moves in the longitudinal direction A.

[0175] The first engaging portion 81H and the second engaging portion 82H are provided in pairs spaced apart from each other in the second direction C. By providing a plurality of first engaging portions 81H and a plurality of second engaging portions 82, the movement of the first arm 211 is further restricted.

[0176] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8H restricts the first arm 211 from moving toward the closed side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closed side H1, the tip 81Hs of the first engagement portion 81H abuts against the tip 82Hs of the second engagement portion 82H, thereby restricting the first arm 211 from moving relative to the second arm 212.

[0177] (Modification 7) [Clip 2I] Next, a clip 2I of modification 7 will be described with reference to Figs. 55 to 58 .

[0178] Fig. 55 is a side view showing a clip 2I. Fig. 56 is a front view showing a clip 2I. Fig. 57 is a view of a first arm 211 according to Modification 7 as seen from the inside. Fig. 58 is a view of a second arm 212 according to Modification 7 as seen from the inside.

[0179] The clip 2I is a modified version of the clip 2H. In the clip 2I, the configuration of the stopper 8I is different from that of the stopper 8H.

[0180] The clip 2I is provided with a stopper 8I. Similar to the stopper 8H, the stopper 8I is a member that restricts the movement of the first arm 211 relative to the second arm 212 when the first arm 211 receives an external force in the insertion configuration Pi. The stopper 8I restricts the movement of the first arm 211 relative to the second arm 212 toward the closed side H1 in the opening / closing direction H.

[0181] The stopper 8I is provided on the first arm 211 and the second arm 212. The stopper 8I has a first stop plate 81I and a second stop plate 82I. The first stop plate 81I and the second stop plate 82I are members that determine the minimum closing width of the clip 2I. The first stop plate 81I is a member provided on the first arm 211. The second stop plate 82I is a member provided on the second arm 212. The first stop plate 81I and the second stop plate 82I can abut against each other in the insertion configuration Pi.

[0182] The first stop plate 81I is provided on the first claw 21c and is a plate-shaped member whose thickness direction is the opening / closing direction H. In the insertion form Pi, the first stop plate 81I extends in the longitudinal direction A from the tip 21s of the first claw 21c. The first stop plate 81I can abut against the second stop plate 82I in the insertion form Pi. The first stop plate 81I is formed to have widths in the longitudinal direction A and the second direction C in the insertion form Pi. Therefore, the first stop plate 81I can abut against the second stop plate 82I even when the first arm 211 moves in the longitudinal direction A and the second direction C.

[0183] The second stop plate 82I is provided on the second claw 22c and is a plate-shaped member whose thickness direction is in the opening / closing direction H. In the insertion form Pi, the second stop plate 82I extends in the longitudinal direction A from the tip 22s of the second claw 22c. The second stop plate 82I can abut against the first stop plate 81I in the insertion form Pi. The second stop plate 82I is formed to have widths in the longitudinal direction A and the second direction C in the insertion form Pi. Therefore, the second stop plate 82I can abut against the first stop plate 81I even when the second arm 212 moves in the longitudinal direction A and the second direction C.

[0184] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8I restricts the first arm 211 from moving toward the closed side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closed side H1, the first restricting plate 81I abuts against the second restricting plate 82I, and therefore, the movement of the first arm 211 relative to the second arm 212 is restricted.

[0185] (Modification 8) [Clip 2J] Next, a clip 2J of modification 8 will be described with reference to Figs. 59 to 62.

[0186] Fig. 59 is a side view showing a clip 2J. Fig. 60 is a front view showing a clip 2J. Fig. 61 is a view of a first arm 211 according to Modification 8 as seen from the inside. Fig. 62 is a view of a second arm 212 according to Modification 8 as seen from the inside.

[0187] The clip 2J is a modified version of the clip 2H. In the clip 2J, the configuration of the stopper 8J is different from that of the stopper 8H.

[0188] The clip 2J is provided with a stopper 8J. Similar to the stopper 8H, the stopper 8J is a member that restricts the movement of the first arm 211 relative to the second arm 212 when the first arm 211 receives an external force in the insertion configuration Pi. The stopper 8J restricts the movement of the first arm 211 relative to the second arm 212 in the opening / closing direction H and the second direction C.

[0189] The stopper 8J is provided on the first arm 211 and the second arm 212. The stopper 8J has a first engagement portion 81J and a second engagement portion 82J. The first engagement portion 81J and the second engagement portion 82J ​​are members that define the minimum closed width of the clip 2J. The first engagement portion 81J is a member provided on the first arm 211. The second engagement portion 82J ​​is a member provided on the second arm 212. The first engagement portion 81J and the second engagement portion 82J ​​are engageable with each other in the insertion configuration Pi.

[0190] The first engagement portion 81J is a convex portion that protrudes from the tip 21r of the first claw 21c toward the closed side H1 in the opening and closing direction H. In the insertion form Pi, the first engagement portion 81J extends from the first claw 21c toward the second claw 22c. The first engagement portion 81J is formed in a substantially triangular shape when viewed from the longitudinal direction A. The shape of the first engagement portion 81J is not limited.

[0191] The second engagement portion 82J ​​is a recess that is recessed from the tip 22r of the second claw 22c toward the closed side H1 in the opening and closing direction H. In the insertion configuration Pi, the second engagement portion 82J ​​extends from the second claw 22c toward the first claw 21c. The second engagement portion 82J ​​is formed in a substantially triangular shape when viewed from the longitudinal direction A. The shape of the second engagement portion 82J ​​is not limited. For example, if the first engagement portion 81J has a concave shape, the second engagement portion 82J ​​may have a convex shape.

[0192] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8J restricts the first arm 211 from moving toward the closed side H1 relative to the second arm 212 in the opening / closing direction H. When the first arm 211 receives an external force toward the closed side H1, the tip 81Js of the first engagement portion 81J abuts against the tip 82Js of the second engagement portion 82H, thereby restricting the first arm 211 from moving relative to the second arm 212.

[0193] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8J restricts the first arm 211 from moving relative to the second arm 212 in the second direction C. When the first arm 211 receives an external force in the second direction C, the convex portion of the first engagement portion 81J abuts on the concave portion of the second engagement portion 82J, thereby restricting the first arm 211 from moving relative to the second arm 212.

[0194] (Modification 9) [Clip 2K] Next, a clip 2K of modification 9 will be described with reference to Figs. 63 to 66 .

[0195] Fig. 63 is a side view showing clip 2K. Fig. 64 is a front view showing clip 2K. Fig. 65 is a view of a first arm 211 according to Modification 9 as seen from the inside. Fig. 66 is a view of a second arm 212 according to Modification 9 as seen from the inside. Clip 2K is a modification of clip 2H.

[0196] The clip 2K is formed by bending a metal plate material at the center, similar to the clip 2H, and has a first arm 211K and a second arm 212K that can be opened and closed.

[0197] The first arm 211K has a first anchor 21Ka, a first claw 21Kc, and a first arm body 21d. The first arm 211K is different from the first arm 211 in the configurations of the first anchor 21Ka and the first claw 21Kc.

[0198] The first anchor 21Ka is formed at the tip 21s of the first arm body 21d. The first anchor 21Ka is formed approximately in the center in the second direction C. Like the first anchor 21a, the first anchor 21Ka has a tip 21Kp formed in a sharp tapered shape. The first anchor 21Ka is formed, for example, by bending the tip 21s of the first arm body 21d.

[0199] The first claws 21Kc are formed on the tip 21s of the first arm body 21d. Two first claws 21Kc are provided spaced apart in the second direction C. The pair of first claws 21Kc are formed side by side with the first anchor 21Ka in the second direction C. The first anchor 21Ka is formed between the pair of first claws 21Kc in the second direction C. Like the first claws 21c, the first claws 21Kc extend from the first arm body 21d toward the closing side H1 in the opening / closing direction H. The first claws 21Kc are formed, for example, by bending the tip 21s of the first arm body 21d.

[0200] The second arm 212K has a second anchor 22Ka, a second claw 22Kc, and a second arm body 22d. The second arm 212K differs from the second arm 212 in the arrangement of the second anchor 22Ka and the second claw 22Kc.

[0201] The second anchor 22Ka is formed at the tip 22s of the second arm main body 22d. The second anchor 22Ka is formed in approximately the center in the second direction C. The second anchor 22Ka is formed at a position overlapping with the first anchor 21Ka in the opening / closing direction H. Two second anchors 22Ka are provided side by side in the second direction C. The pair of second anchors 22Ka sandwich the first anchor 21Ka in the insertion configuration Pi. Specifically, in the insertion configuration Pi, the tips 22Kp of the pair of second anchors 22Ka sandwich the tip 21Kp of the first anchor 21Ka. The second anchor 22Ea is formed, for example, by bending the tip 22s of the second arm main body 22d.

[0202] The second anchor 22Ka restricts the first arm 211K from moving relative to the second arm 212K. That is, the second anchor 22Ka is a stopper 8K. In the clip 2K, the stopper 8K is provided instead of the stopper 8H.

[0203] The second claws 22Kc are formed on the tip 22s of the second arm main body 22d. Two second claws 22Kc are provided spaced apart in the second direction C. The pair of second claws 22Kc are formed side by side with the second anchor 22Ka in the second direction C. The second anchor 22Ka is formed between the pair of second claws 22Kc in the second direction C. The second claws 22Kc are formed at positions overlapping with the first claws 21Kc in the opening / closing direction H. Like the second claws 22c, the second claws 22Kc extend from the second arm main body 22d toward the closing side H1 in the opening / closing direction H. The second claws 22Kc are formed, for example, by bending the tip 22s of the second arm main body 22d.

[0204] When the first arm 211K receives an external force in the insertion configuration Pi, the stopper 8K restricts the first arm 211K from moving toward the closed side H1 relative to the second arm 212K in the opening and closing direction H. When the first arm 211K receives an external force toward the closed side H1, the tip 22Kp of the second anchor 22Ka abuts against the tip 21Kp of the first anchor 21Ka, thereby restricting the first arm 211K from moving relative to the second arm 212K.

[0205] When the first arm 211K receives an external force in the insertion configuration Pi, the stopper 8K restricts the first arm 211K from moving relative to the second arm 212K in the second direction C. When the first arm 211K receives an external force in the second direction C, the tip 22Kp of the second anchor 22Ka abuts against the tip 21Kp of the first anchor 21Ka, thereby restricting the first arm 211K from moving relative to the second arm 212K.

[0206] (Modification 10) [Clip 2L] Next, with reference to FIG. 67, a clip 2L of modification 10 will be described.

[0207] 67 is a view of the second arm 212L in Modification 10 as viewed from the inside. The clip 2L is a modification of the clip 2K.

[0208] In the clip 2L, the shape of the second claw 22Lc is different from that of the second claw 22Kc. The second claw 22Lc is formed by hollowing out the second arm body 22d. Therefore, an opening is formed in the second arm body 22d.

[0209] In the clip 2L, the second claw 22Lc is formed by hollowing out, which makes it easy to form the second anchor 22a on the tip side A1 of the second arm body 22d and to change the shapes of the first anchor 21Ka and the second anchor 22Ka.

[0210] (Modification 11) [Clip 2M] Next, clip 2M of modification 11 will be described with reference to Fig. 68 to Fig. 71. Fig. 68 is a side view showing clip 2M. Fig. 69 is a front view showing clip 2M. Fig. 70 is a view of first arm 211 according to modification 11 as seen from the inside. Fig. 71 is a view of second arm 212 according to modification 11 as seen from the inside. Clip 2M is a modification of clip 2H.

[0211] The clip 2M is provided with a stopper 8M instead of the stopper 8H. The stopper 8M restricts the movement of the first arm 211 relative to the second arm 212. Note that the direction in which the stopper 8M restricts the movement is not limited.

[0212] The stopper 8M is a restricting member 81M that can engage with the first arm 211 and the second arm 212 in the insertion configuration Pi. The restricting member 81M is a member that can be separated from the first arm 211 and the second arm 212 in the open state. The restricting member 81M is an elastically deformable member that is made of a biodegradable material.

[0213] In the insertion configuration Pi, the restricting member 81M is sandwiched between the first arm 211 and the second arm 212. Specifically, the restricting member 81M is sandwiched between the first arm body 21d and the second arm body 22d in the opening / closing direction H. The restricting member 81M is a member that defines the minimum closing width of the clip 2M. The restricting member 81M is formed in the shape of, for example, a substantially rectangular parallelepiped.

[0214] When the first arm 211 receives an external force in the insertion configuration Pi, the stopper 8M restricts the first arm 211 from moving to the closed side H1 relative to the second arm 212 in the opening and closing direction H. When the first arm 211 receives an external force on the closed side H1 in the opening and closing direction H, the restricting member 81M abuts against the first arm main body 21 d and the second arm main body 22 d, thereby restricting the first arm 211 from moving relative to the second arm 212.

[0215] 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.

[0216] 300 Clip device 200 Clip introduction device (applicator) 220 Sheath 221 Distal tip 222 Distal coil 224 Proximal coil 230 Wire 231 Arrowhead hook 232 Wire 240 Operation unit 241 Operation unit main body 242 Slider 248 Thumb ring 1 Clip unit 2 Clip 21 Arm 211 First arm 21a First anchor 21c First claw 21d First arm main body 21f Grip portion 21e First sliding portion 212 Second arm 22a Second anchor 22c Second claw 22d Second arm main body 22f Grip portion 22e Second sliding portion 25 Engagement portion 28 Base end portion 3 Pressing member 3A Pressing tube 3B Pipe 30 Pressing tube main body 31 Protruding / retracting wing 32 Fastening member 38 Internal space 4 Connecting member 41 Tip connecting portion 42 Base connecting portion 43 Connecting portion main body 44 Connecting arm 45 Rod-shaped portion 100 Cartridge system 5 Cartridge 67 Insertion port 70 Cartridge main body 7S Storage region 71 First region 73 Folding region 74 Sheath insertion region 8 Stopper 81 First engaging portion 82 Second engaging portion

Claims

a clip having a first arm and a second arm that can be opened and closed in an opening and closing direction; a tubular member extending longitudinally along a longitudinal axis, capable of housing at least a portion of the clip; a stopper capable of restricting movement of the first arm relative to the second arm; Equipped with In an insertion mode in which the first arm and the second arm can be inserted through a channel of a closed endoscope, the first arm and the second arm extend from the tubular member toward a distal end in the longitudinal direction, the stopper restricts movement of the first arm relative to the second arm when the first arm receives an external force. Clip device. 　 the stopper restricts movement of the first arm relative to the second arm in the longitudinal direction when the first arm receives an external force in the inserted state. The clip device of claim 1 . 　 the stopper restricts the first arm from moving toward the closing side relative to the second arm in the opening and closing direction when the first arm receives an external force in the inserted state. The clip device of claim 1 . 　 the stopper restricts movement of the first arm relative to the second arm in the longitudinal direction and a width direction intersecting the opening / closing direction when the first arm receives an external force in the inserted state. The clip device of claim 1 . 　 The first arm a first arm body extending in the longitudinal direction in the inserted state; a first claw provided at a tip of the first arm body and extending toward a closing side in the opening and closing direction; a first anchor provided at a tip of the first arm body and extending further toward the opening side in the opening / closing direction than the first claw; The clip device of claim 1 . 　 the first arm has a gripping portion and an elastically deformable curved portion, the bending portion is elastically deformed by receiving an external force from the tubular member. The clip device of claim 1 . 　 the stopper restricts movement of the first arm relative to the second arm when the bending portion is elastically deformed and bent in the insertion state. The clip device of claim 6. 　 the stopper is provided on at least one of the first arm and the second arm; The clip device of claim 1 . 　 The stopper is a first engagement portion provided on the first arm; a second engaging portion provided on the second arm and engageable with the first engaging portion in the inserted state; The clip device of claim 1 . 　 the first engagement portion has a protrusion that protrudes toward the closing side in the opening and closing direction, The second engagement portion has a recess that is recessed on the opening side in the opening and closing direction. The clip device of claim 9. 　 the first engaging portion and the second engaging portion restrict the first arm from moving toward a closing side relative to the second arm in the opening and closing direction when the first arm receives an external force in the inserted state. The clip device of claim 9. 　 the first engaging portion and the second engaging portion restrict movement of the first arm relative to the second arm in the longitudinal direction when the first arm receives an external force in the inserted state. The clip device of claim 9. 　 The first arm a first arm body extending in the longitudinal direction in the inserted state; a first claw provided at a tip of the first arm body and extending toward a closing side in the opening and closing direction; a third claw that is provided on the first arm body closer to a base end than the first claw and extends toward a closing side in the opening and closing direction, The second arm is a second arm body extending in the longitudinal direction in the inserted state; a second claw provided at a tip of the second arm body and extending toward the closing side in the opening and closing direction, The stopper is the third claw. The clip device of claim 1 . 　 The first arm a first arm body extending in the longitudinal direction in the inserted state; a first claw provided at a tip of the first arm body and extending toward a closing side in the opening and closing direction, The second arm is a second arm body extending in the longitudinal direction in the inserted state; a second claw provided at a tip of the second arm body and extending toward the closing side in the opening and closing direction, the stopper is a restricting member engageable with the first arm and the second arm in the inserted state, the regulating member is a member that can be separated from at least one of the first arm and the second arm. The clip device of claim 1 . 　 the restricting member restricts the first arm from moving toward a closing side relative to the second arm in the opening and closing direction when the first arm receives an external force in the inserted state. The clip device of claim 14. 　 the restricting member restricts movement of the first arm relative to the second arm in the longitudinal direction when the first arm receives an external force in the inserted state. The clip device of claim 14. 　 The first arm a first arm body extending in the longitudinal direction in the inserted state; a first claw provided at a tip of the first arm body and extending toward a closing side in the opening and closing direction, The second arm is a second arm body extending in the longitudinal direction in the inserted state; a second claw provided at a tip of the second arm body and extending toward the closing side in the opening and closing direction, The stopper is a first engagement portion provided on the first claw; a second engaging portion provided on the second claw and capable of engaging with the first engaging portion in the inserted state; The clip device of claim 1 . 　 the first engagement portion is a convex portion that protrudes from a tip of the first claw toward the closing side in the opening and closing direction, the second engagement portion is a recess that is recessed from a tip of the second claw toward the opening side in the opening / closing direction, the first engaging portion and the second engaging portion restrict movement of the first arm relative to the second arm in the longitudinal direction and a width direction intersecting the opening / closing direction when the first arm receives an external force in the inserted state.

18. The clip device of claim 17. 　 It is loaded into an applicator and used. The clip device of claim 1 . 　 It is housed in a cartridge The applicator is inserted into the cartridge, and the cartridge can be loaded into the applicator.

20. The clip device of claim 19.

Images