Clip device

Abstract

This clip device includes: a clip having a first arm and a second arm that can open and close in the opening / closing direction; a holder that can house at least a part of the clip and extends in the longitudinal direction along the longitudinal axis; and a restriction part that restricts the movement of the clip. The first arm and the second arm can transition to an insertion mode, in which the arms are closed so as to be insertable into a channel of an endoscope. The first arm includes: a first arm body extending in the longitudinal direction in the insertion mode; and a first protruding claw provided at the distal end part of the first arm body and extending toward the closing side of the first arm in the opening / closing direction. The second arm includes: a second arm body extending in the longitudinal direction in the insertion mode; and a second protruding claw provided at the distal end of the second arm body and extending toward the closing side of the second arm in the opening / closing direction. In the insertion mode, the restriction part is a member extending to the opening side of the first arm in the opening / closing direction beyond an imaginary line connecting the distal end of the second protruding claw and the distal end part of the first arm body.

Description

Clip device

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

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

[0003] Patent Document 1 describes a clip device for treating biological tissues. The clip device described in Patent Document 1 is provided with clip arms, and the clip device is configured to be able to be inserted through the 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 tool insertion channel of an endoscope, the tip of the clip arm may touch the treatment tool insertion channel, which may reduce the insertion property of the clip device.

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

[0007] To solve the above problems, this invention proposes the following means. A clip device according to a first aspect of the present invention comprises a clip having a first arm and a second arm that can be opened and closed in the opening and closing direction, a holder that can house at least a part of the clip and extends longitudinally along the longitudinal axis, and a restricting part that restricts the movement of the clip, wherein the first arm and the second arm are transitionable to an insertion configuration that is closed so as to be inserted into a channel of an endoscope, and the first arm comprises a first arm body that extends longitudinally in the insertion configuration, and a part provided at the tip of the first arm body, A clip device having a first protruding claw extending toward the closed side of the first arm in the opening and closing direction, the second arm having a second arm body extending in the longitudinal direction in the insertion configuration, and a second protruding claw provided at the tip of the second arm body and extending toward the closed side of the second arm in the opening and closing direction, and in the insertion configuration, the restricting portion is a member that extends beyond the imaginary line connecting the tip of the second protruding claw and the tip of the first arm body to the open side of the first arm in the opening and closing direction.

[0008] The clip device of the present invention offers excellent insertion into the instrument insertion channel of an endoscope, allowing the user to begin treatment of biological tissue as quickly as possible.

[0009] This is a side view showing the clip device. This is a perspective view showing the clip introduction device. This is a perspective view showing the clip unit. This is a perspective view showing the clip unit with the retaining tube visible. This is a side view showing the clip in a closed state. This is a front view showing the clip in a closed state. This is a side view showing the first arm, viewed from the inside. This is a side view showing the first arm, viewed from the outside. This is a longitudinal cross-sectional view of the retaining member. This is a perspective view of the retaining tube. This is a perspective view of the retaining tube viewed from the base end. This is a perspective view of the connecting member. This is a perspective view showing the cartridge containing the clip unit. This is a diagram illustrating the operation of loading the clip unit. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This is a diagram illustrating how to load the clip unit into the clip introduction device using the cartridge. This diagram illustrates how to load the clip unit into the clip introduction device using the cartridge. This diagram shows the clip unit loaded into the clip introduction device. This diagram shows the clip unit introduced into the body. This diagram shows the clip unit with a pair of arms closed. This diagram shows the clip unit with the clip locked. This diagram shows the clip unit with the clip separated. This diagram shows the first and second anchors puncturing the mucosa. This diagram shows the first and second mucosa being pulled together. This is a side view of the clip device, showing the regulating part in contact with the instrument insertion channel of the endoscope. This is a side view of the clip device, showing the regulating part moving the first arm away from the inner wall of the instrument insertion channel of the endoscope. This is a side view of the clip according to Modification 1. This is a front view of the clip. This is a view of the first arm according to Modification 1 from the inside. This is a view of the first arm from the outside. This is a side view of the clip according to Modification 2.This is a front view showing the clip. This is a view of the first arm according to Modification 2, seen from the inside. This is a view of the first arm from the outside. This is a side view showing the clip according to Modification 3. This is a front view showing the clip. This is a view of the first arm according to Modification 3, seen from the inside. This is a view of the first arm from the outside. This is a side view showing the clip device according to the second embodiment. This is a side view showing the clip according to the second embodiment in a closed state. This is a side view showing the clip according to the second embodiment in an open state. This is a front view showing the clip. This is a view of the first arm according to the second embodiment, seen from the inside. This is a view of the first arm from the outside. This is a side view showing a modified version of the clip, showing the closed state. This is a side view showing a modified version of the clip, showing the open state. This is a side view showing the clip device according to the third embodiment. This is a cross-sectional view showing the clip according to the third embodiment in a closed state. This is a cross-sectional view showing the clip according to the open state. This is a front view showing the clip. This is a view of the first arm according to the third embodiment, seen from the inside. This is a view of the first arm from the outside. This is a side view showing a modified version of the regulating part. This is a side view showing the clip device according to the fourth embodiment. This is a side view showing the clip according to the fourth embodiment. This is a front view showing the clip.

[0010] The clip device of the embodiment will be described below with reference to the drawings. In the following description, components having the same or similar function will be denoted by the same reference numerals. Duplication of these components may be omitted.

[0011] (First Embodiment) [Clip Device 300] A clip device 300 according to the first embodiment of the present invention will be described with reference to Figures 1 to 41.

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

[0013] [Clip Introduction Device 200] Figure 2 is a perspective view showing the clip introduction device 200. As shown in Figure 2, the clip introduction device (applicator) 200 comprises a sheath 220, an operating wire 230, and an operating unit 240. The clip introduction device 200 is inserted, for example, into the instrument insertion channel (channel) N of an endoscope and used in combination with the endoscope (see Figures 28 and 29). Therefore, the sheath 220 is formed to be sufficiently longer than the length of the instrument insertion channel N of the endoscope. The sheath 220 is flexible and bends to match the curvature of the insertion section of the endoscope.

[0014] As shown in Figure 2, the sheath 220 comprises a tip 221, a tip-side coil 222, and a prong-side coil 224, and is formed as an elongated tubular shape overall. The tip-side coil 222 is located at the tip end of the sheath 220. The tip 221 is located at the tip end of the tip-side coil 222.

[0015] As shown in Figure 2, the operating wire (power transmission section) 230 includes an arrowhead hook (connecting section) 231 connected to the clip unit 1 and a wire 232 that operates the arrowhead hook 231.

[0016] As shown in Figure 2, the arrowhead hook 231 comprises 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 from a metal material such as stainless steel.

[0017] The wire 232 is inserted into the sheath 220 so as to be able to move back and forth. The tip of the wire 232 is fixed to the base end of the wire connector 231b, for example, by welding.

[0018] As shown in Figure 2, the operating unit 240 comprises an operating unit body 241, a slider 242, and a thumb ring 248. The operating unit body 241, slider 242, and thumb ring 248 are injection molded from, for example, a resin material. The operating unit body 241 includes a slit portion 241a and a rotating grip 241b at its tip. The slit portion 241a supports the slider 242 so that it can move forward and backward.

[0019] The slider 242 is mounted so as to be able to move back and forth in the longitudinal direction of the operating unit body 241, and the base end of the wire 232 is attached to it. As the slider 242 moves back and forth along the operating unit body 241, the wire 232 moves back and forth relative to the sheath 220, and the arrowhead hook 231 moves back and forth.

[0020] The thumb ring 248 is attached to the base end of the operating unit body 241 so as to be rotatable around the longitudinal axis of the operating unit body 241.

[0021] [Clip Unit 1] Figure 3 is a perspective view showing the clip unit 1. Figure 4 is a perspective view showing the clip unit 1 with the retaining tube 3A visible through it. As shown in Figure 3, the clip unit 1 comprises a clip 2, a retaining member (holder) 3, and a connecting member 4.

[0022] In the following explanation, the clip 2 side of the clip unit 1 in the longitudinal direction A will be referred to as the tip side (distal side) A1 of the clip unit 1, and the connecting member 4 side will be referred to as the base side (proximal side) A2 of the clip unit 1. Furthermore, the direction perpendicular to the longitudinal direction A will be referred to as the "first direction B" or "left-right direction B". Also, the direction perpendicular to both the longitudinal direction A and the first direction B will be referred to as the "second direction C" or "up-down direction C".

[0023] Figure 5 is a side view showing the clip 2 in the closed state. Figure 6 is a front view showing the clip 2 in the closed state. The clip 2 is formed by bending a metal plate in the middle. The clip 2 has a pair of arms 21 that can open and close toward the tip side A1, and a base end 28 that connects the pair of arms 21. An engaging portion 25 is provided on the base end 28. The base end side A2 of the clip 2 is inserted into the internal space 38 of the retaining member 3.

[0024] Figure 7 is a side view of the first arm 211, as seen from the inside. Figure 8 is a side view of the first arm 211, as seen from the outside. The pair of arms 21 has a first arm 211 and a second arm 212 that can open and close in the opening and closing direction H. The pair of arms 21 can transition between an open state and a 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] Of the opening and closing directions H, the direction in which one arm moves towards the other arm is defined as the "closed side H1". Of the opening and closing directions H, the direction in which one arm moves away from the other arm is defined as the "opening side H2". The direction in which the pair of arms 21 face each other is defined as the "inside", and the opposite side of the inside is defined as the "outside".

[0026] The first arm 211 includes a first anchor (first protruding claw) 21a, a first claw 21c, and a first arm body 21d. The first arm 211 does not necessarily have to have the first anchor 21a. In that case, the first claw 21c can be defined as the first protruding claw.

[0027] The second arm 212 has a second anchor (second protruding claw) 22a, a second claw 22c, and a second arm body 22d. The second arm 212 does not necessarily have a second anchor 22a. In that case, the second claw 22c can be defined as the second protruding claw. Since the second arm 212 has a shape similar to the first arm 211, only the differences will be described below.

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

[0029] The first claw 21c is provided at the tip (tip portion) 21s of the first arm body 21d and extends toward the closed side H1 in the opening / closing direction H. The first claw 21c extends toward the closed side H1 from the first anchor 21a in the opening / closing direction H. The first claw 21c is formed, for example, by hollowing out.

[0030] The first anchor 21a is provided at the tip 21s of the first arm body 21d and extends toward the closed side H1 in the opening / closing direction H. The first anchor 21a is positioned 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 roughly right-angled triangular shape when viewed from the longitudinal direction L. The first anchor 21a extends inward in the width direction W, so that the tip 21p is less likely to come into contact with the endoscope's instrument insertion channel N.

[0031] The first anchor 21a is positioned on the opening side H2 in the opening / closing direction H compared to the first claw 21c. The first claw 21c and the first anchor 21a extend from the same part (tip 21s) when viewed from the width direction W. However, the first claw 21c and the first anchor 21a do not necessarily extend from the same part when viewed from the width direction W. It is sufficient that at least the tip 21p of the first anchor 21a is positioned on the opening side H2 in the opening / closing direction H compared to the first claw 21c. The first anchor 21a is formed, for example, by bending the tip of the first arm 211.

[0032] When clip 2 is in the open position, it is desirable that the tip 21p of the first anchor 21a is positioned further forward A1 than the tip 21r of the first claw 21c. This is because when clip 2 in the open position is approached from the front against tissue, the tip 21p of the first anchor 21a makes contact with the tissue first.

[0033] When clip 2 is in the closed position, the first claw 21c and the second claw 22c overlap when viewed from the longitudinal direction L, and the first claw 21c is positioned further towards the tip A1 than the second claw 22c.

[0034] The first anchor 21a is positioned on one side W1 in the width direction W. The second anchor 22a is positioned on the other side W2 in the width direction W. When the clip 2 is in the closed position, the first anchor 21a and the second anchor 22a are not overlapping but spaced apart when viewed from the longitudinal direction L, and are positioned rotationally symmetric with respect to the central axis O2 in the longitudinal direction A of the clip 2.

[0035] The first arm body 21d has a flat gripping portion 21f and a first sliding portion (curved portion) 21e. The second arm body 22d has a flat gripping portion 22f and a second sliding portion (curved portion) 22e.

[0036] The first sliding portion 21e is the part that elastically deforms when the first arm 211 is pulled into the retaining member 3. The tip of the first sliding portion 21e is connected to the first arm body 21d. The base end of the first sliding portion 21e is connected to the base end portion 28.

[0037] As shown in Figure 4, the engaging portion 25 is a member that can engage with the fastening member 32 of the retaining member 3. The tip side A1 of the engaging portion 25 is formed as an obtuse slope with respect to the longitudinal direction A, and the base side A2 is formed as an acute slope with respect to the longitudinal direction A.

[0038] 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 to open and close toward the tip side A1. The base end 28 is bent into a U-shape and is connected to the 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.

[0039] The base end 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 28. When the base end 28 is connected to the connecting member 4, the opening and closing direction H of the pair of arms 21 is approximately the same as the left-right direction B.

[0040] FIG. 9 is a cross-sectional view of the pressing member 3 in the longitudinal direction A. The pressing member (tubular member) 3 is a circular tubular member capable of storing at least a part of the clip 2. The pressing member 3 has an internal space 38 in which the clip 2 advances and retreats in the longitudinal direction A. The pressing member 3 can fix the clip 2 drawn 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.

[0041] FIG. 10 is a perspective view of the pressing tube 3A. As shown in FIG. 10, the pressing tube (second tubular member) 3A has a pressing tube body 30 formed in a cylindrical shape, a protruding and retracting wing 31, and a tightening member 32.

[0042] The pressing tube body 30 is formed by injection molding a thermoplastic resin having appropriate elasticity, such as PPA (polyphthalamide), PA (polyamide), PEEK (polyetheretherketone), LCP (liquid crystal polymer), which is softer than the clip 2. Note that the pressing tube body 30 may be formed of metal instead of the thermoplastic resin.

[0043] FIG. 11 is a perspective view of the pressing tube 3A viewed from the base end side A2. An engaging concave portion 30r that engages with an engaging convex portion 43p of a connecting member 4 described later is formed in the base end opening 3d of the pressing tube body 30. The engaging concave portions 30r are provided on both sides with the central axis O1 interposed therebetween.

[0044] The protruding and retracting wing 31 is a pair of convex portions that protrude and retract with respect to the outer peripheral surface 30a of the pressing tube body 30. The protruding and retracting wings 31 are provided on both sides with the central axis O1 interposed therebetween. The protruding and retracting wing 31 has a protruding state protruding outward in the radial direction R with respect to the outer peripheral surface 30a as a basic posture. The protruding and retracting wing 31 enters a retracted state in which it retracts with respect to the outer peripheral surface 30a by receiving a force from the outside in the radial direction R inward. When the above force is released, the protruding and retracting wing 31 returns from the retracted state to the protruding state.

[0045] The fastening member 32 is a ring-shaped member provided in the internal space 38 of the pressing tube 3A. The fastening member 32 is formed of metal. Note that the fastening member 32 only needs to be formed to be harder than the pressing tube main body 30, and may be formed of, for example, a thermoplastic resin instead of metal.

[0046] The pressing pipe (first tubular member) 3B is a cylindrical member made of metal. The pressing pipe 3B is press-fitted into the tip of the pressing tube 3A. The pressing tube 3A and the pressing pipe 3B may be connected by heat welding, adhesion or screwing.

[0047] FIG. 12 is a perspective view of the connecting member 4. The connecting member 4 is detachably connected to the base end portion 28 of the clip 2. Further, the connecting member 4 is detachably connected to the arrowhead hook 231 inserted through the sheath 220. That is, 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 connecting the tip connecting portion 41 and the base end connecting portion 42.

[0048] As shown in FIG. 12, the tip connecting portion 41 has a hook 41f at the tip, a breaking portion 41b provided on the base end side A2 of the hook 41f, and a tip expansion portion 41e. The tip connecting portion 41 can pass through the internal space 38 of the pressing member 3 in a state of being connected to the clip 2.

[0049] The hook 41f is a hook extending in the vertical direction C perpendicular to the central axis O1, and is formed in a substantially cylindrical rod shape. The hook 41f extends from the "lower side" to the "upper side" in the vertical direction C. The base end portion 28 of the clip 2 is hooked on the hook 41f from above.

[0050] The breaking portion 41b breaks when a breaking force is applied to the hook 41f due to tensile force as the base end portion 28 is pulled toward the base end side A2. The breaking portion 41b only needs to have a mechanism to release the connection between the base end portion 28 of the clip 2 and the hook 41f of the connecting member 4. For example, the breaking portion 41b may be a mechanism that releases the connection between the base end portion 28 and the hook 41f by deforming (plastic deformation or elastic deformation) without breaking.

[0051] The base end connecting portion 42 is an engaging portion to which the arrowhead hook 231 of the clip introduction device 200 is engaged (connected). As shown in Figure 12, the base end connecting portion 42 has a connecting portion body 43 and a connecting arm 44.

[0052] The connecting portion body 43 is provided at the base end of the rod-shaped portion 45. The connecting portion body 43 has an engaging projection 43p that protrudes in the vertical direction C. When the engaging projection 43p engages with the engaging recess 30r provided at the base end opening of the retaining member 3, the relative rotation of the retaining member 3 and the connecting member 4 in the circumferential direction with respect to the longitudinal direction A is restricted.

[0053] 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 vertical direction C relative to the connecting body 43 and can be opened and closed relative to the connecting body 43. The connecting arm 44 has a notch 44m formed therein for gripping and housing the engaging portion 231a of the arrowhead hook 231. The notch 44m is shaped to be in close contact with the outer circumferential surface of the engaging portion 231a of the arrowhead hook 231. When the connecting arm 44 is in the open state, it can connect to the arrowhead hook 231 of the clip introduction device 200, and when it is in the closed state, it can maintain the connection with the arrowhead hook 231 of the clip introduction device 200.

[0054] The rod-shaped portion 45 is a substantially rod-shaped member extending in the longitudinal direction A. The rod-shaped portion 45 is provided between the tip connecting portion 41 and the base connecting portion 42, and connects the tip connecting portion 41 and the base connecting portion 42. The rod-shaped portion 45 can be inserted through the internal space 38 of the retaining member 3.

[0055] [Cartridge 5] Figure 13 is a perspective view showing a cartridge 5 containing the clip unit 1. The system comprising the clip unit 1 and a cartridge 5 capable of housing the clip unit 1 is defined as the cartridge system 100. The cartridge system 100 is a support system for easily loading the clip unit 1 into the clip introduction device 200.

[0056] Cartridge 5 is a case that houses the clip unit 1. Cartridge 5 is approximately 10 to 20 mm wide, 50 mm long, and 5 mm thick, and is sized to be easy to hold in the hand.

[0057] Cartridge 5 is manufactured by injection molding using a resin material that has appropriate hardness and is transparent, such as ABS, PC, PP, PS, acrylic, or cycloolefin polymer. Because cartridge 5 is formed using a transparent resin material, it is easy for the user to determine whether or not the clip unit 1 is inside.

[0058] As shown in Figure 13, of the two directions 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". Furthermore, in the cartridge 5 that houses the clip unit 1, the side with the pair of arms 21 is defined as the tip side Z1 of the cartridge 5, and the side with the connecting member 4 is defined as the base end side Z2 of the cartridge 5.

[0059] As shown in Figure 13, the cartridge 5 has a cartridge body 70 formed in a roughly rectangular box shape and a storage area 7S formed inside the cartridge body 70.

[0060] The cartridge body 70 has a storage area 7S in which the clip unit 1 is stored so as to be movable in the longitudinal direction (advancing / retracting direction) Z. The storage area 7S has a first area 71, a folding area 73, and a sheath insertion area 74. As shown in Figure 13, the first area 71, the folding area 73, and the sheath insertion area 74 are arranged in the longitudinal direction Z of the cartridge 5 from the tip to the base.

[0061] The cartridge body 70 has an insertion opening 67 into which the sheath 220 can be inserted. The opening surface of the insertion opening 67 is formed substantially perpendicular to the longitudinal direction Z. The insertion opening 67 is formed on the side surface of the base end Z2 of the cartridge body 70. The insertion opening 67 is in communication with the sheath insertion area 74.

[0062] 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 is in communication with the folding region 73.

[0063] The folding region 73 is the region that holds the retractable wing 31 in a retracted state. A reduced diameter portion 73c (see Figure 15) is formed in the folding region 73. 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 when the clip unit 1 is stored in the cartridge 5.

[0064] The sheath insertion region 74 is the region into which the tip of the sheath 220, after passing through the insertion port 67, is inserted. The sheath insertion region 74 is located on the base end side Z2 of the folding region 73 and communicates with the folding region 73. At the point where the sheath insertion region 74 connects to the folding region 73, the length in the left-right direction X of the sheath insertion region 74 is longer than the length in the left-right direction X of the folding region 73.

[0065] [Restricting part 8] As shown in Figure 1, the clip device 300 has a restricting part 8. The restricting part 8 is a member that restricts the movement of the clip 2. When the restricting part 8 hits the inner wall of the endoscope's instrument insertion channel N in insertion configuration Pi, the restricting part 8 is a member that moves the arm 21 away from the point where the restricting part 8 hits.

[0066] The insertion configuration Pi, as shown in Figure 1, is a configuration in which the first arm 211 and the second arm 212 are closed, allowing insertion into the endoscope's instrument insertion channel (channel) N (see Figures 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 Figure 24), but the insertion configuration Pi is a state in which the clip 2 is not locked. When the first arm 211 and the second arm 212 are in the insertion configuration Pi, the longitudinal direction L is approximately the same as the longitudinal direction A.

[0067] The restricting portion 8 is provided on the clip 2. In this embodiment, the restricting portion 8 is provided on the arm 21, as shown in Figure 1. The member on which the restricting portion 8 is provided is not limited. The restricting portion 8 is a member that extends inward from the outer circumference of the retaining member 3. Because the restricting portion 8 extends inward from the outer circumference of the retaining member 3, the clip 2 can be inserted easily. The shape of the restricting portion 8 is not limited. The restricting portion 8 may extend outward from the outer circumference of the retaining member 3.

[0068] In this embodiment, the restricting portion 8, as shown in Figure 5, has a first restricting portion 81 and a second restricting portion 82. The first restricting portion 81 is a member that moves the first arm 211 away from the point where the first restricting portion 81 makes contact when the first restricting portion 81 makes contact with the inner wall of the endoscope's instrument insertion channel N in insertion configuration Pi. The second restricting portion 82 is a member that moves the second arm 212 away from the point where the second restricting portion 82 makes contact when the second restricting portion 82 makes contact with the inner wall of the endoscope's instrument insertion channel N in insertion configuration Pi.

[0069] The first restricting portion 81 is a member that extends from the first virtual line (virtual line) T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi. The first virtual line T1 is the line connecting the tip 22p of the second anchor (second protruding claw) 22a and the first arm body 21d in the insertion configuration Pi. Specifically, the first virtual line T1 is the line connecting the tip 22p of the second anchor (second protruding claw) 22a and the tip 21s of the first arm body 21d in the insertion configuration Pi. Alternatively, the first virtual line T1 may be the line connecting the tip 21p of the first anchor (first protruding claw) 21a and the tip 21s of the first arm body 21d in the insertion configuration Pi.

[0070] In this embodiment, the first restricting portion 81 is provided on the first arm 211 and is a protrusion that projects outward on the open side H2 of the first arm 211 in the opening and closing direction H. Specifically, the first restricting portion 81 is provided on the first anchor (first protruding claw) 21a. The first restricting portion 81 is provided on the first anchor 21a at a position away from the proximal end of the first anchor 21a from the tip 21p. Therefore, the first restricting portion 81 does not prevent the first anchor 21a from puncturing the mucosa.

[0071] The first restricting portion 81 is a curved member that protrudes from the opening side H2 of the first arm 211 in the opening / closing direction H when viewed from the width direction W. The first restricting portion 81 is formed in a substantially semicircular shape when viewed from the width direction W. The shape of the first restricting portion 81 is not limited.

[0072] The first restricting portion 81 is formed by the extrusion of the first anchor 21a. Therefore, when the first anchor 21a is viewed from the inside, the position where the first restricting portion 81 is provided is recessed. The configuration of the first restricting portion 81 is not limited. For example, the first restricting portion 81 may be provided separately from the first arm 211.

[0073] The second restricting portion 82 is a member that extends from the second virtual line T2 to the open side H2 of the second arm 212 in the opening / closing direction H in the insertion configuration Pi. The second virtual line T2 is the line connecting the tip 21p of the first anchor (first protruding claw) 21a and the second arm body 22d in the insertion configuration Pi. Specifically, the second virtual line T2 is the line connecting the tip 21p of the first anchor (first protruding claw) 21a and the tip 22s of the second arm body 22d in the insertion configuration Pi. Alternatively, the second virtual line T2 may be the line connecting the tip 22p of the second anchor (second protruding claw) 22a and the tip 22s of the second arm body 22d in the insertion configuration Pi.

[0074] In this embodiment, the second restricting portion 82 is provided on the second arm 212 and is a protrusion that projects outwards on the open side H2 of the second arm 212 in the opening and closing direction H. Specifically, the second restricting portion 82 is provided on the second anchor (second protruding claw) 22a. The second restricting portion 82 is provided on the second anchor 22a at a position away from the proximal end of the second anchor 22a from the tip 22p. Therefore, the second restricting portion 82 does not prevent the second anchor 22a from puncturing the mucosa.

[0075] The second restricting portion 82 is a curved member that protrudes from the opening side H2 of the second arm 212 in the opening / closing direction H when viewed from the width direction W. The second restricting portion 82 is formed in a substantially semicircular shape when viewed from the width direction W. The shape of the second restricting portion 82 is not limited.

[0076] The second restricting portion 82 is formed by the extrusion of the second anchor 22a. Therefore, when the second anchor 22a is viewed from the inside, the position where the second restricting portion 82 is provided is recessed. The configuration of the second restricting portion 82 is not limited. For example, the second restricting portion 82 may be provided separately from the second arm 212.

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

[0078] The user inserts the sheath 220 from the insertion port 67 into the sheath insertion area 74.

[0079] Figure 15 shows a clip unit 1 connected to a clip introduction device 200. The user advances the slider 242 relative to the operating unit body 241 of the operating unit 240, thereby advancing the operating wire 230 relative to the sheath 220, and pushing the connecting member 4 with the arrowhead hook 231 to advance the clip unit 1 until it contacts the cartridge 5.

[0080] Figure 16 shows a clip unit 1 connected to a clip introduction device 200. The user connects the engaging portion 231a of the arrowhead hook 231 to the connecting arm 44 of the connecting member 4 by further advancing the arrowhead hook 231.

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

[0082] The user pulls the clip unit 1 further towards the base end Z2. As shown in Figure 18, the base end of the protruding wing 31 comes into contact with the tip of the sheath 220.

[0083] As shown in Figure 19, the user further pulls the operating wire 230. The clip 2, pulled from the base end Z2, is drawn into the internal space of the retaining tube 3A and into the sheath 220. This completes the loading of the clip unit 1 into the clip introduction device 200. At this point, the clip 2 is not completely retracted into the sheath 220. As shown in Figure 19, the clip 2 is loaded with its protrusion from the tip of the sheath 220.

[0084] The user further pulls the operating wire 230, as shown in Figure 20. The clip 2 is pulled out of the cartridge 5 with the clip 2 protruding from the end of the sheath 220.

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

[0086] Figure 21 shows a clip unit 1 loaded into a clip introduction device 200. The clip unit 1 is loaded into the clip introduction device 200 using a cartridge 5. The connecting member 4 of the clip unit 1 loaded into the clip introduction device 200 is connected to an arrowhead hook 231 that passes through the sheath 220. The retractable wing 31 is positioned 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 pressed against the inner circumferential surface of the retaining member 3 and are in a closed state. The engaging portion 25 is located at the tip A1 of the clamping member 32, and the pair of arms 21 are not locked in the closed state.

[0088] Figure 22 shows the clip unit 1 introduced into the body. The user introduces the clip unit 1, loaded in the sheath 220, into the body via the instrument insertion channel N of the endoscope. Next, the user advances the arrowhead hook 231 by moving the slider 242 forward along the operating unit body 241.

[0089] As the tip A1 of the pair of arms 21 extends from the retaining member 3, the clip 2 returns to the open state while moving relative to the retaining member 3, using the self-expanding force of the pair of arms 21 as a restoring force. Even when the pair of arms 21 have returned to the open state and protrude the most from the retaining member 3, the engaging portion 25 is positioned within the internal space 38 of the retaining member 3.

[0090] Figure 23 shows the clip unit 1 with a pair of arms 21 closed. The user retracts the arrowhead hook 231 by moving the slider 242 backward 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 A2, pushing the tip opening 3a of the retaining member 3 toward the base end A2. The protruding wing 31 engages with the sheath 220 and is therefore not retracted into the sheath 220. As a result, the clip 2, pulled by the connecting member 4, is retracted into the retaining member 3.

[0091] The connecting member 4 pulls the base end 28 of the clip 2 toward the base end A2 of the pressing member 3, causing the pair of arms 21 to be pulled toward the pressing member 3, and the pair of arms 21 to gradually close. When the pulling force on the base end 28 is released in this state, the self-expanding force of the pair of arms 21 acts as a restoring force, and the clip 2 returns to the open state while moving toward the tip end A1. The user can return the pair of arms 21 to the open state and re-grasp the tissue.

[0092] Figure 24 shows the clip unit 1 with the clip 2 locked. As the base end 28 is further pulled toward the base end A2 of the retaining member 3, the engaging portion 25 is pulled toward the base end A2 from the tightening member 32. Since the base end A2 of the engaging portion 25 is formed on an obtuse angle, the engaging portion 25 is easily pulled toward the base end A2 from the tightening member 32. On the other hand, since the tip end A1 of the engaging portion 25 is formed on an acute angle, when the engaging portion 25 is pulled toward the base end A2 from the tightening member 32, the engaging portion 25 and the tightening member 32 engage. As a result, the clip 2 is restricted from moving toward the tip end A1 relative to the retaining member 3, and the pair of arms 21 are locked in the closed position. Once the pair of arms 21 are locked in the closed position, they cannot return to the open position.

[0093] Figure 25 shows the clip unit 1 with the clip 2 separated. The user then pulls the clip 2 further. A breaking force is applied to the hook 41f due to the tensile force, and the breaking portion 41b breaks. The breaking strength of the breaking portion 41b is lower than the breaking strength of the connecting portion body 43. Therefore, the breaking portion 41b breaks, not the connecting portion body 43.

[0094] The user reloads the clip unit 1 into the clip introduction device 200 using cartridge 5.

[0095] The user moves the endoscope and sheath 220 to bring the clip 2 of the clip unit 1 closer to the defect D, which is the treatment area. In the following description, the peripheral mucosa surrounding the defect D, which is positioned opposite the defect D on either side, will be referred to as the "first mucosa M1" and the "second mucosa M2".

[0096] Figure 26 shows 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 / closing direction H, but are positioned toward the open side H2 in the opening / closing direction H than the first claw 21c and the second claw 22c. Therefore, when the open clip 2 is positioned facing the mucosa, the first anchor 21a and the second anchor 22a are positioned to be easily inserted into the mucosa.

[0097] Figure 27 shows the first mucosa M1 and the second mucosa M2 being pulled together. The user can pull together the first mucosa M1 and the second mucosa M2 by pulling together the first arm 211, which has the first anchor 21a punctured into the first mucosa M1, and the second arm 212, which has the second anchor 22a punctured into the second mucosa M2.

[0098] [Operation of the Regulating Unit 8] Next, the operation of the regulating unit 8 will be explained with reference to Figures 28 and 29.

[0099] Figure 28 is a side view of the clip device 300, showing the regulating portion 8 in contact with the instrument insertion channel N of the endoscope. In insertion configuration Pi, the clip device 300 can be inserted into the instrument insertion channel N of the endoscope. At this time, the clip device 300 advances in the longitudinal direction A from the proximal end A2 to the distal end A1.

[0100] Because the instrument insertion channel N of the endoscope is curved, the clip device 300 may come into contact with the instrument insertion channel N of the endoscope. At this time, since the first regulating portion 81 extends from the first virtual line T1 to the open side H2 of the first arm 211 in the opening / closing direction H, it is possible to prevent the tip 21p of the first anchor 21a from coming into contact with the instrument insertion channel N of the endoscope. When the tip side of the first arm 211 comes into contact with the instrument insertion channel N of the endoscope, the first regulating portion 81 comes into contact with the instrument insertion channel N of the endoscope, as shown in Figure 28. Because it is possible to prevent the tip 21p of the first anchor 21a from coming into contact with the instrument insertion channel N of the endoscope, the insertion of the clip device 300 is improved.

[0101] Figure 29 is a side view of the clip device 300, showing how the first restricting portion 81 moves the first arm 211 away from the inner wall of the endoscope's instrument insertion channel N. When the first restricting portion 81 comes into contact with the inner wall of the endoscope's instrument insertion channel N, the first restricting portion 81 moves the first arm 211 away from the point of contact, as shown in Figure 29. Therefore, even if the first restricting portion 81 comes into contact with the inner wall of the endoscope's instrument insertion channel N, the clip device 300 can be inserted easily.

[0102] When the clip device 300 comes into contact with the endoscope's instrument insertion channel N, the second restricting portion 82 extends from the second virtual line T2 to the open side H2 of the second arm 212 in the opening / closing direction H, thus preventing the tip 22p of the second anchor 22a from coming into contact with the endoscope's instrument insertion channel N. When the tip side of the second arm 212 comes into contact with the endoscope's instrument insertion channel N, the second restricting portion 82 comes into contact with the endoscope's instrument insertion channel N. Because the tip 22p of the second anchor 22a from coming into contact with the endoscope's instrument insertion channel N is prevented, the clip device 300 has good insertion performance.

[0103] The second restricting portion 82 moves the second arm 212 away from the point of contact with the inner wall of the endoscope's instrument insertion channel N when the second restricting portion 82 contacts the inner wall of the instrument insertion channel N of the endoscope. Therefore, even if the second restricting portion 82 comes into contact with the inner wall of the endoscope's instrument insertion channel N, the insertion of the clip device 300 remains smooth.

[0104] According to the clip device 300 of this embodiment, because it has a restricting portion 8, the tip of the arm 21 can be prevented from contacting the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion properties. Because the clip device 300 has good insertion properties, the user can begin treating biological tissue as quickly as possible.

[0105] According to the clip device 300 of this embodiment, because it has a first restricting portion 81, the tip of the first arm 211 can be prevented from contacting the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion performance.

[0106] According to the clip device 300 of this embodiment, because it has a second restricting portion 82, the tip of the second arm 212 can be prevented from contacting the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion performance.

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

[0108] Figure 30 is a side view showing clip 2B. Figure 31 is a front view showing clip 2B. Figure 32 is an inside view of the first arm 211 according to Modification 1. Figure 33 is an outside view of the first arm 211 according to Modification 1.

[0109] Clip 2B is a modified version of Clip 2. As shown in Figure 30, in the insertion configuration Pi, Clip 2B is provided such that the first claw 21c and the second claw 22c overlap when viewed from the longitudinal direction A. The first claw 21c and the second claw 22c are offset in the longitudinal direction A in the insertion configuration Pi. The second claw 22c is provided at the base end A2 of the first claw 21c 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 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 2B. The shape of the first claw 21c and the second claw 22c is not limited.

[0111] [Restricting part 8B] As shown in Figure 30, the clip 2B has a restricting part 8B. The restricting part 8B is a member that restricts the movement of the clip 2B, similar to the restricting part 8. Unlike the restricting part 8, the restricting part 8B is provided on the first arm body 21d and the second arm body 22d. The restricting part 8B has a first restricting part 81B and a second restricting part 82B.

[0112] The first restricting portion 81B is provided on the first arm body 21d. Similar to the first restricting portion 81, the first restricting portion 81B is a protrusion that projects outward on the open side H2 of the first arm 211 in the opening / closing direction H. Similar to the first restricting portion 81, the first restricting portion 81B is a member that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi. The first restricting portion 81B is formed, for example, by hollowing out the first arm body 21d.

[0113] The second restricting portion 82B is provided on the second arm body 22d. Similar to the second restricting portion 82, the second restricting portion 82B is a protrusion that projects outward on the open side H2 of the second arm 212 in the opening / closing direction H. Similar to the second restricting portion 82, the second restricting portion 82B is a member that extends from the second imaginary line T2 to the open side H2 of the second arm 212 in the opening / closing direction H in the insertion configuration Pi. The second restricting portion 82B is formed, for example, by hollowing out the second arm body 22d.

[0114] Because the restricting portion 8B is provided, in insertion configuration Pi, it is possible to prevent the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion properties.

[0115] (Modification 2) [Clip 2C] Next, referring to Figures 34 to 37, we will describe Clip 2C of Modification 2.

[0116] Figure 34 is a side view showing clip 2C. Figure 35 is a front view showing clip 2C. Figure 36 is an inside view of the first arm 211 according to Modification 2. Figure 37 is an outside view of the first arm 211 according to Modification 2.

[0117] Clip 2C is a modified version of Clip 2.

[0118] In clip 2C, as shown in Figure 35, in insertion configuration Pi, two first anchors 21a are formed spaced apart in the width direction W. In clip 2C, the first claw 21c is formed between the pair of first anchors 21a in the width direction W. A gap is formed between the pair of first anchors 21a and the first claw 21c in the width direction W. The pair of first anchors 21a and the first claw 21c are formed, for example, by bending the tip of the first arm 211. The second anchor 22a and the second claw 22c have a shape similar to the first anchors 21a and the first claw 21c.

[0119] [Restricting part 8C] As shown in Figure 34, the clip 2C has a restricting part 8C. The restricting part 8C is a member that restricts the movement of the clip 2C, similar to the restricting part 8. Unlike the restricting part 8, the restricting part 8C is provided on the first arm body 21d and the second arm body 22d. The restricting part 8C has a first restricting part 81C and a second restricting part 82C. The second restricting part 82C has a shape similar to the first restricting part 81C.

[0120] The first restricting portion 81C is provided on the first arm body 21d. Similar to the first restricting portion 81, the first restricting portion 81C is a protrusion that projects outward on the open side H2 of the first arm 211 in the opening / closing direction H. Similar to the first restricting portion 81, the first restricting portion 81C is a member that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi. The first restricting portion 81C is formed, for example, by extruding the first arm body 21d.

[0121] As shown in Figure 35, two first restricting portions 81C are provided spaced apart in the width direction W. The pair of first restricting portions 81C are formed at both ends of the first arm body 21d in the width direction W. Therefore, the first restricting portions 81C have a large contact area with the inner wall of the endoscope's instrument insertion channel N, making it easier to prevent the tip of the first arm 211 from coming into contact with the inner wall of the endoscope's instrument insertion channel N. Note that the pair of first restricting portions 81C do not have to be formed at both ends. For example, the pair of first restricting portions 81C may be formed spaced apart in the width direction W, with the center of the first arm body 21d in between.

[0122] Because the restricting portion 8C is provided, in insertion configuration Pi, it is possible to prevent the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion properties.

[0123] (Modification 3) [Clip 2D] Next, with reference to Figures 38 to 41, Clip 2D of Modification 3 will be described.

[0124] Figure 38 is a side view showing clip 2D. Figure 39 is a front view showing clip 2D. Figure 40 is an inside view of the first arm 211 according to Modification 3. Figure 41 is an outside view of the first arm 211 according to Modification 3.

[0125] Clip 2D is a variation of Clip 2.

[0126] In clip 2D, as shown in Figure 39, in insertion configuration Pi, two first claws 21c are formed spaced apart in the width direction W. In clip 2D, the first anchor 21a is formed between the pair of first claws 21c in the width direction W. A gap is formed between the pair of first claws 21c and the first anchor 21a in the width direction W. The pair of first claws 21c and the first anchor 21a are formed, for example, by bending the tip of the first arm 211. The second claw 22c and the second anchor 22a have a shape similar to the first claws 21c and the first anchor 21a.

[0127] [Restricting part 8D] As shown in Figure 38, the clip 2D has a restricting part 8D. The restricting part 8D is a member that restricts the movement of the clip 2D, similar to the restricting part 8. Unlike the restricting part 8, the restricting part 8D is provided on the first arm body 21d and the second arm body 22d. The restricting part 8D has a first restricting part 81D and a second restricting part 82D. The second restricting part 82D has a shape similar to the first restricting part 81D.

[0128] The first restricting portion 81D is provided on the first arm body 21d. Similar to the first restricting portion 81, the first restricting portion 81D is a protrusion that projects outward on the open side H2 of the first arm 211 in the opening / closing direction H. Similar to the first restricting portion 81, the first restricting portion 81D is a member that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi. The first restricting portion 81D is formed, for example, by bending the first arm body 21d.

[0129] As shown in Figure 39, the first restricting portion 81D is a curved member that protrudes from the opening side H2 of the first arm 211 in the opening / closing direction H when viewed from the longitudinal direction L. The first restricting portion 81D is formed in a substantially semicircular shape when viewed from the longitudinal direction L. The shape of the first restricting portion 81D is not limited.

[0130] Because the restricting portion 8D is provided, in insertion configuration Pi, it is possible to prevent the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N. Therefore, the clip device 300 has good insertion properties.

[0131] Although the first embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design changes and the like are also included within the scope of the gist of the present invention. Furthermore, the components shown in the above embodiment and the modifications shown below can be combined as appropriate.

[0132] (Second Embodiment) [Clip Device 300E] The clip device 300E according to the second embodiment of the present invention will be described with reference to Figures 42 to 49. The clip device 300E according to the second embodiment has a different clip configuration compared to the clip device 300 of the first embodiment. In the following description, components that are common to those already described will be denoted by the same reference numerals and redundant descriptions will be omitted.

[0133] Figure 42 is a side view showing the clip device 300E. The clip device 300E comprises a clip introduction device (applicator) 200 and a clip unit 1E. The clip unit 1E is loaded into the clip introduction device 200, similar to the clip unit 1. The clip unit 1E is housed in the cartridge 5, similar to the clip unit 1.

[0134] The clip unit 1E comprises a clip 2E, a retaining member 3, and a connecting member 4. The retaining member 3 and the connecting member 4 have the same configuration as the clip unit 1. However, the configuration of the retaining member 3 and the connecting member 4 is not limited.

[0135] [Clip 2E] Figure 43 is a side view showing clip 2E in the closed position. Figure 44 is a side view showing clip 2E in the open position. Figure 45 is a front view showing clip 2E. Figure 46 is a view of the first arm 211 according to the second embodiment, seen from the inside. Figure 47 is a view of the first arm 211 according to the second embodiment, seen from the outside.

[0136] Clip 2E, like Clip 2, is formed by bending a metal plate in the middle and has an openable and closable first arm 211 and a second arm 212.

[0137] The first arm 211, like the clip 2, has a first anchor 21a and a first claw 21c. The first arm 211 according to the second embodiment further has a third claw 21g. The third claw 21g, like the first claw 21c, 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.

[0138] The first anchor 21a, the first claw 21c, and the third claw 21g are formed side by side in the width direction W. The first anchor 21a is formed between the first claw 21c and the third claw 21g in the width direction W. A gap is formed between the first anchor 21a and the first claw 21c in the width direction W. A gap is formed between the first anchor 21a and the third claw 21g in the width direction W. The first anchor 21a, the first claw 21c, and the third claw 21g are formed, for example, by bending the tip of the first arm 211.

[0139] The third claw 21g is a member that extends from the second virtual line T2 to the open side H2 of the second arm 212 in the opening / closing direction H in the insertion configuration Pi, and is a member that restricts the movement of the clip 2E. In other words, the third claw 21g is the second restricting portion 82E.

[0140] The second arm 212 has a shape similar to the first arm 211. The second arm 212 has a fourth claw 22g instead of a third claw 21g.

[0141] The fourth claw 22g is a member that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi, and is a member that restricts the movement of the clip 2E. In other words, the fourth claw 22g is the first restricting portion 81E.

[0142] Figure 48 is a side view showing a modified example of clip 2E, illustrating the closed state. Figure 49 is a side view showing a modified example of clip 2E, illustrating the open state. As shown in Figures 48 and 49, the first claw 21c and the second claw 22c may not be formed on clip 2E. When using clip 2E, the mucous membrane can be grasped using the third claw 21g and the fourth claw 22g. In this embodiment, the third claw 21g and the fourth claw 22g are designated as the restricting portion 8E, but the first claw 21c and the second claw 22c may be formed to function as the restricting portion 8E.

[0143] [Restricting part 8E] As shown in Figure 43, the clip 2E has a restricting part 8E. The restricting part 8E is a member that restricts the movement of the clip 2E, similar to the restricting part 8. Unlike the restricting part 8, the restricting part 8E is provided on the first arm body 21d and the second arm body 22d. The restricting part 8E has a first restricting part 81E and a second restricting part 82E. The second restricting part 82E has a shape similar to the first restricting part 81E.

[0144] Unlike the first restricting portion 81, the first restricting portion 81E is provided on the second arm 212. Specifically, it is provided on the second arm body 22d. Similar to the first restricting portion 81, the first restricting portion 81E is a protrusion that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi. In other words, the first restricting portion 81E is the fourth claw 22g.

[0145] The first regulating portion 81E has a tip 81Es that curves toward the proximal end. The tip 81Es of the first regulating portion 81E is wide and chamfered. Therefore, even if the tip 81Es of the first regulating portion 81E comes into contact with the inner surface of the endoscope's instrument insertion channel N, it will not get caught.

[0146] Unlike the second restricting portion 82, the second restricting portion 82E is provided on the first arm 211. Specifically, it is provided on the first arm body 21d. Similar to the second restricting portion 82, the second restricting portion 82E is a protrusion that extends from the second imaginary line T2 to the open side H2 of the second arm 212 in the opening / closing direction H in the insertion configuration Pi. In other words, the second restricting portion 82E is the third claw 21g.

[0147] According to the clip device 300E of this embodiment, since a restricting portion 8E is provided, it is possible to prevent the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N in the insertion configuration Pi. Therefore, the clip device 300E has good insertion properties.

[0148] Although a second embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design changes and the like are also included within the scope of the gist of the present invention. Furthermore, the components shown in the above-described embodiment and the following modifications can be combined as appropriate.

[0149] (Third Embodiment) [Clip Device 300F] The clip device 300F according to the third embodiment of the present invention will be described with reference to Figures 50 to 56. The clip device 300F according to the third embodiment has a different clip configuration compared to the clip device 300 of the first embodiment. In the following description, components that are common to those already described will be denoted by the same reference numerals and redundant descriptions will be omitted.

[0150] Figure 50 is a side view showing the clip device 300F. The clip device 300F comprises a clip introduction device (applicator) 200 and a clip unit 1F. The clip unit 1F is loaded into the clip introduction device 200, similar to the clip unit 1. The clip unit 1F is housed in the cartridge 5, similar to the clip unit 1.

[0151] The clip unit 1F comprises a clip 2F, a retaining member 3, and a connecting member 4. The retaining member 3 and the connecting member 4 have the same configuration as the clip unit 1. However, the configuration of the retaining member 3 and the connecting member 4 is not limited.

[0152] [Clip 2F] Figure 51 is a cross-sectional view showing clip 2F in a closed state. Figure 52 is a cross-sectional view showing clip 2F in an open state. Figure 53 is a front view showing clip 2E. Figure 54 is a view of the first arm 211 according to the third embodiment, seen from the inside. Figure 55 is a view of the first arm 211 according to the third embodiment, seen from the outside.

[0153] Clip 2F, like Clip 2, is formed by bending a metal plate in the middle and has an openable and closable first arm 211 and a second arm 212. The second arm 212 has a shape similar to the first arm 211.

[0154] The first arm 211, like the clip 2, has a first anchor 21a and a first claw 21c. The first anchor 21a and the first claw 21c are formed, for example, by hollowing out the first arm 211.

[0155] [Restricting part 8F] As shown in Figure 51, the clip 2F has a restricting part 8F. The restricting part 8F is a member that restricts the movement of the clip 2F, similar to the restricting part 8. Unlike the restricting part 8, the restricting part 8F is provided on the first arm body 21d and the second arm body 22d and is a member that extends in the longitudinal direction A in the insertion configuration Pi. The restricting part 8F has a first restricting part 81F and a second restricting part 82F. The second restricting part 82F has a shape similar to the first restricting part 81F.

[0156] The first restricting portion 81F is provided on the first arm 211. Specifically, the first restricting portion 81F is provided on the first arm body 21d. In the insertion configuration Pi, the first restricting portion 81F is a member that extends in the longitudinal direction A. Similar to the first restricting portion 81, the first restricting portion 81F is a protrusion that extends from the first imaginary line T1 to the open side H2 of the first arm 211 in the opening / closing direction H in the insertion configuration Pi.

[0157] The first restricting portion 81F has a tip 81Fs that curves toward the base end. The tip 81Fs of the first restricting portion 81F is wide and chamfered. The first restricting portion 81F is formed, for example, by bending the tip of the first arm 211. Therefore, even if the tip 81Fs of the first restricting portion 81F comes into contact with the inner surface of the endoscope's instrument insertion channel N, it will not get caught.

[0158] The first restricting portion 81F extends from the first anchor 21a toward the tip A1. Therefore, the first restricting portion 81F can prevent the tip 21p of the first anchor 21a from contacting the inner wall of the endoscope's instrument insertion channel N. Furthermore, the first restricting portion 81F is provided so as to cover the first anchor 21a. Therefore, the first restricting portion 81F can prevent contact with the entrance (forceps channel) of the endoscope's instrument insertion channel N.

[0159] The second restricting portion 82F is provided on the second arm 212. Specifically, the second restricting portion 82F is provided on the second arm body 22d. In the insertion configuration Pi, the second restricting portion 82F is a member that extends in the longitudinal direction A. Similar to the second restricting portion 82, the second restricting portion 82F is a protrusion that extends from the second imaginary line T2 to the open side H2 of the second arm 212 in the opening / closing direction H in the insertion configuration Pi.

[0160] Figure 56 is a side view showing a modified example of the restricting section 8F. Multiple restricting sections 8F may be provided. As illustrated in Figure 56, two first restricting sections 81F may be provided spaced apart in the width direction W. The pair of first restricting sections 81F are formed at both ends of the first arm body 21d in the width direction W. Therefore, the first restricting sections 81F have a large contact area with the inner wall of the endoscope's instrument insertion channel N, making it easier to prevent contact between the tip of the first arm 211 and the inner wall of the endoscope's instrument insertion channel N.

[0161] The first restricting portion 81F may extend from the tip 21p of the first anchor 21a to the base end A2, as illustrated in Figure 56. That is, the tip of the first restricting portion 81F may be formed on the base end A2 side of the tip 21p of the first anchor 21a. In that case, it is possible to prevent the restricting portion 8F from interfering with clipping.

[0162] In this embodiment, the clip device 300F is provided with a restricting portion 8F, which prevents the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N in insertion configuration Pi. Therefore, the clip device 300F offers good insertion performance.

[0163] Although a third embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design changes and the like are also included within the scope of the gist of the present invention. Furthermore, the components shown in the above-described embodiment and the following modifications can be combined as appropriate.

[0164] (Fourth Embodiment) [Clip Device 300G] The clip device 300G according to the fourth embodiment of the present invention will be described with reference to Figures 57 to 59. The clip device 300G according to the fourth embodiment has a different clip configuration compared to the clip device 300 of the first embodiment. In the following description, components that are common to those already described will be denoted by the same reference numerals and redundant descriptions will be omitted.

[0165] Figure 57 is a side view showing the clip device 300G. The clip device 300G comprises a clip introduction device (applicator) 200 and a clip unit 1G. The clip unit 1G is loaded into the clip introduction device 200, similar to the clip unit 1. The clip unit 1G is housed in the cartridge 5, similar to the clip unit 1.

[0166] The clip unit 1G comprises a clip 2G, a retaining member 3, and a connecting member 4. The retaining member 3 and the connecting member 4 have the same configuration as the clip unit 1. However, the configuration of the retaining member 3 and the connecting member 4 is not limited.

[0167] [Clip 2G] Figure 58 is a side view showing clip 2G. Figure 59 is a front view showing clip 2G.

[0168] Clip 2G, like Clip 2, is formed by bending a metal plate in the middle and has an openable and closable first arm 211 and a second arm 212. The second arm 212 has a shape similar to the first arm 211.

[0169] The first arm 211, like the clip 2, has a first anchor 21a and a first claw 21c. The first anchor 21a and the first claw 21c are formed at the tip 21s of the first arm body 21d.

[0170] The first arm 211 has a shape in which its tip bulges outwards on the opening side H2 in the opening / closing direction H. When viewed from the width direction W, there is a convex portion between the first arm body 21d and the first anchor 21a. Therefore, when the tip of the arm 21 contacts the inner wall of the endoscope's instrument insertion channel N in the opening / closing direction H, the convex portion makes contact first, preventing the tip of the arm 21 from contacting the inner wall of the endoscope's instrument insertion channel N.

[0171] The first arm 211 has a shape in which its tip bulges in the width direction W. When viewed from the longitudinal direction L, the space between the first arm body 21d and the first anchor 21a is a convex portion. Therefore, when the tip of the arm 21 comes into contact with the inner wall of the endoscope's instrument insertion channel N in the width direction W, the convex portion makes contact first, preventing the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N.

[0172] The second arm 212 has a shape in which its tip bulges outwards on the opening side H2 in the opening / closing direction H. When viewed from the width direction W, there is a convex portion between the second arm body 22d and the second anchor 22a. Therefore, when the tip of the arm 21 contacts the inner wall of the endoscope's instrument insertion channel N in the opening / closing direction H, the convex portion makes contact first, preventing the tip of the arm 21 from contacting the inner wall of the endoscope's instrument insertion channel N.

[0173] The second arm 212 has a shape in which its tip bulges in the width direction W. When viewed from the longitudinal direction L, the space between the second arm body 22d and the second anchor 22a is a convex portion. Therefore, when the tip of the arm 21 comes into contact with the inner wall of the endoscope's instrument insertion channel N in the width direction W, the convex portion makes contact first, preventing the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N.

[0174] The protrusions formed on the first arm 211 and the second arm 212 are members that restrict the movement of the clip 2G. That is, the protrusions formed on the first arm 211 and the second arm 212 are restricting portions 8G. The restricting portion 8G formed on the first arm 211 is referred to as the first restricting portion 81G, and the restricting portion 8G formed on the second arm 212 is referred to as the second restricting portion 82G.

[0175] In the first restricting section 81G, the end portion 81Ga of one side W1 in the width direction W (second direction C) protrudes the most from the first arm 211 in the width direction W. In the first restricting section 81G, the end portion 81Gb of the other side W2 in the width direction W (second direction C) protrudes the most from the first arm 211 in the width direction W2.

[0176] In the second restricting section 82G, the end portion 82Ga of one side W1 in the width direction W (second direction C) protrudes the most from the second arm 212 in the width direction W. In the second restricting section 82G, the end portion 82Gb of the other side W2 in the width direction W (second direction C) protrudes the most from the second arm 212 in the width direction W2.

[0177] In other words, the restricting portion 8G has the portion of the clip 2G that protrudes the most in the width direction W (second direction C). In the insertion configuration Pi, the restricting portion 8G is the portion of the clip 2G with the largest outer diameter in the first direction B (opening / closing direction H) and the second direction C (width direction W).

[0178] According to the clip device 300G of this embodiment, since a restricting portion 8G is provided, it is possible to prevent the tip of the arm 21 from coming into contact with the inner wall of the endoscope's instrument insertion channel N in the insertion configuration Pi. Therefore, the clip device 300G has good insertion properties.

[0179] Although a fourth embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design changes and the like are also included within the scope of the gist of the present invention. Furthermore, the components shown in the above-described embodiment and the following modifications can be combined as appropriate.

[0180] 300 Clip device 200 Clip introduction device (applicator) 220 Sheath 221 Tip 222 Tip-side coil 224 Handle-side coil 230 Wire 231 Arrowhead hook 232 Wire 240 Operating part 241 Operating part 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 body 21f Gripping part 21e First sliding part 212 Second arm 22a Second anchor 22c Second claw 22d Second arm body 22f Gripping part 22e Second sliding part 25 Engaging part 28 Base end 3 Retaining member (holder) 3A Retaining tube 3B Pipe 30 Retaining tube body 31 Retractable wing 32 Fastening member 38 Internal space 4 Connecting member 41 Tip connecting part 42 Base connecting part 43 Connecting part body 44 Connecting arm 45 Rod-shaped part 100 Cartridge system 5 Cartridge 67 Insertion opening 70 Cartridge body 7S Storage area 71 First area 73 Folding area 74 Sheath insertion area 8 Restricting part 81 First restricting part 82 Second restricting part Pi Insertion configuration T1 First virtual line (virtual line) T2 Second virtual line

Claims

1. A clip device comprising: a clip having a first arm and a second arm that can be opened and closed in the opening and closing direction; a holder that can house at least a portion of the clip and extends longitudinally along the longitudinal axis; and a restricting part that restricts the movement of the clip, wherein the first arm and the second arm are transitionable to an insertion configuration that is closed so as to be inserted into a channel of an endoscope, the first arm having a first arm body that extends longitudinally in the insertion configuration, and a first protruding claw provided at the tip of the first arm body and extending toward the closed side of the first arm in the opening and closing direction, the second arm having a second arm body that extends longitudinally in the insertion configuration, and a second protruding claw provided at the tip of the second arm body and extending toward the closed side of the second arm in the opening and closing direction, and in the insertion configuration, the restricting part is a member that extends beyond a virtual line connecting the tip of the second protruding claw and the tip of the first arm body to the open side of the first arm in the opening and closing direction.

2. The clip device according to claim 1, wherein the first arm is provided at the tip of the first arm body and has a first claw that extends toward the closed side of the first arm from the first protruding claw in the opening and closing direction.

3. The clip device according to claim 1, wherein, in the insertion configuration, when the restricting portion contacts the inner wall of the channel of the endoscope, the restricting portion moves the first arm away from the point of contact with the restricting portion.

4. The clip device according to claim 1, wherein the restricting portion extends inward from the outer circumference of the holder in the insertion configuration.

5. The clip device according to claim 1, wherein the restricting portion is provided on the first arm and is a convex portion that protrudes on the opening side of the first arm in the opening and closing direction.

6. The clip device according to claim 5, wherein the restricting portion is provided on the first protruding claw and is a convex portion that protrudes on the opening side of the first arm in the opening and closing direction.

7. The clip device according to claim 5, wherein the restricting portion is provided on the first arm body.

8. The clip device according to claim 5, wherein the restricting portion is provided in multiple locations on the first arm.

9. The clip device according to claim 8, wherein the restricting portion is provided at both ends of the first arm body in the width direction intersecting the longitudinal direction and the opening / closing direction in the insertion configuration.

10. The clip device according to claim 1, wherein the restricting portion, when viewed from the width direction intersecting the longitudinal direction and the opening / closing direction in the insertion configuration, is curved in the opening / closing direction, protruding towards the opening side of the first arm.

11. The clip device according to claim 1, wherein the restricting portion, when viewed from the longitudinal direction in the insertion configuration, is curved and protrudes toward the opening side of the first arm in the opening and closing direction.

12. The clip device according to claim 1, wherein the restricting portion is provided on the second arm and, in the insertion configuration, is a protrusion that extends beyond the imaginary line to the open side of the first arm in the opening / closing direction.

13. The clip device according to claim 12, wherein the restricting portion is provided on the second arm body.

14. The clip device according to claim 12, wherein the second arm is provided at the tip of the second arm body and has a second claw that extends toward the closed side of the second arm from the second protruding claw in the opening and closing direction, and the restricting portion is provided on the second claw.

15. The clip device according to claim 1, wherein the restricting portion extends in the longitudinal direction in the insertion configuration.

16. The clip device according to claim 15, wherein the restricting portion is provided on the first arm.

17. The clip device according to claim 16, wherein the regulating portion has a tip that curves toward the closing side.

18. The clip device according to claim 15, wherein a plurality of restricting portions are provided spaced apart in the width direction intersecting the longitudinal direction and the opening / closing direction in the insertion configuration.

19. The clip device according to claim 1, which is used in connection with an applicator.

20. The clip device according to claim 19, wherein the applicator is housed in a cartridge and can be loaded into the applicator by inserting the applicator into the cartridge.

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