JP7633941B2 - Endoscopic Clip System - Google Patents

Description

The present invention relates to an endoscopic clip system used for purposes such as hemostasis in surgery and treatment using an endoscope.

Treatments using endoscopes, such as endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), can sometimes cause bleeding during the procedure. One method of stopping bleeding in such cases is the clipping method, in which an endoscopic treatment tool with a clip attached is used to place a clip at the bleeding site and apply pressure to stop the bleeding.

For example, Patent Document 1 describes a medical treatment tool that includes a force transmission member having a distal end and a base end, and an end effector provided at the distal end of the force transmission member, and when a hook is pushed into the rear end of a clip, the rear end of the clip deforms and the hook engages with the clip. Patent Document 2 describes an endoscopic treatment tool system that includes a treatment tool having an introduction device having a tubular body, a wire, and a connection portion provided at the tip of the wire, a connecting member having an engagement portion at its base end that can engage with the connection portion, and a treatment tool main body provided at the tip of the connecting member, and includes a hook portion that includes a substantially conical engagement portion that hooks onto and engages with a clip unit and a wire connection portion provided at the base end of the engagement portion, and the cross section of the tip of the engagement portion is formed in a substantially circular shape, and the cross section of the base end is formed in a substantially rectangular shape. Patent Document 3 describes a clip device that includes a cylindrical body, a wire having a first engagement means at its tip that engages with the clip, and an operating part for operating the opening and closing of the clip, the clip includes a clip body having a base end and both arms and a fastening member, the base end is provided with a second engagement means, the fastening member moves toward the tip side to close the opened arms, and the tip side of the operating wire tip hook may be provided with a rotationally symmetric polygonal regulating part that regulates the rotation of the clip body when engaged with the clip base end claw. Patent Document 4 describes a clip device that includes a clip body, an operating tube that can appropriately select a holding position for holding the clip body and a detaching position for attaching and detaching the clip body, and a temperature regulating mechanism for regulating the temperature state of the clip body and opening and closing, and the clip body is insulated by applying a fluororesin coating to the outer surface except for the part that contacts the contacts.

JP 2010-5430 A International Publication No. 2006/062019 JP 2007-275542 A Japanese Patent Application Publication No. 57-156752

When bleeding occurs during a procedure such as ESD or EMR, it is necessary to stop the bleeding quickly. To do this, it is necessary to rotate the clip so that it is oriented appropriately with respect to the bleeding point, and to reliably grasp the bleeding point with the clip without being pushed back by the reaction force of the tissue at the bleeding point. However, with endoscopic clip systems such as those described in Patent Documents 1 to 4, the clip rotates relative to the linear object of the endoscopic clip system when grasping, making it difficult to orient it appropriately with respect to the bleeding point, or the clip is pushed back by the tissue at the bleeding point, making it difficult to grasp the bleeding point sufficiently, which can result in a long time being required to stop the bleeding.

The present invention has been made in consideration of the above circumstances, and its object is to provide an endoscopic clip system in which the medical clip is less likely to rotate relative to a linear object, and which can reliably grasp the object.

The endoscopic clip system that can solve the above problem includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis and moving the medical clip along its longitudinal axis, the medical clip having a first part and a second part arranged opposite each other, the linear object having a clip connecting part on the distal side that connects the medical clip, and a friction part between the inner surface of the medical clip and the outer surface of the clip connecting part.

In the clip system for endoscopes of the present invention, it is preferable that at least one of the first member, the second member and the clip connection portion is provided with a friction portion.

In the endoscopic clip system of the present invention, it is preferable that the first member, the second member and the clip connection portion are provided with friction portions.

In the clip system for endoscopes of the present invention, it is preferable that the first and second parts are in surface contact with the clip connecting portion at the friction portion.

In the endoscopic clip system of the present invention, it is preferable that the material of the friction portion includes an elastic material.

In the endoscopic clip system of the present invention, it is preferable that the material of the first and second parts is the same as the material constituting the friction part.

In the endoscopic clip system of the present invention, it is preferable that the material of the clip connection portion is the same as the material constituting the friction portion.

In the endoscopic clip system of the present invention, the friction portion is preferably located on the outer surface of the clip connecting portion and distal to the proximal end of the clip connecting portion.

In the clip system for endoscopes of the present invention, it is preferable that the friction portion includes a resin tube arranged outside the clip connection portion.

In the endoscopic clip system of the present invention, the medical clip has a longitudinal direction, an opening/closing direction of the medical clip, and a width direction of the medical clip, and the medical clip is configured to connect to the clip connecting portion on the proximal side of the longitudinal direction of the medical clip and to grasp an object on the distal side of the longitudinal direction, and a connecting portion connecting the first part and the second part is disposed on the first end side of the width direction of the medical clip, and it is preferable that the connecting portion is disposed proximal to the midpoint of the longitudinal length of the medical clip.

In the endoscopic clip system of the present invention, the medical clip further has a cylindrical fastening ring arranged on the outside of the first and second parts, and it is preferable that the fastening ring is movable longitudinally on the medical clip.

In the endoscopic clip system of the present invention, it is preferable that the linear object further has a pusher capable of moving in the longitudinal direction, and that the distal end of the pusher is configured to contact the proximal end of the fastening ring and move the fastening ring distally.

In the endoscopic clip system of the present invention, it is preferable that the clip connection portion has a contact portion that contacts the proximal end of the medical clip.

In the endoscopic clip system of the present invention, the medical clip further has a first claw portion at the proximal end of the first part extending toward the second part, and a second claw portion at the proximal end of the second part extending toward the first part, and it is preferable that the first claw portion and the second claw portion have a notch along the outer periphery of the linear object.

In the endoscopic clip system of the present invention, it is preferable that the clip connecting portion has a groove portion that is concave in the circumferential direction of the clip connecting portion, and that the distal wall surface of the groove portion contacts the distal side surface of the proximal end of the medical clip, and that the proximal wall surface of the groove portion contacts the proximal side surface of the proximal end of the medical clip.

According to the endoscopic clip system of the present invention, a friction portion is provided between the inner surface of the medical clip and the outer surface of the clip connection portion, which makes it difficult for the medical clip to rotate relative to the clip connection portion and also makes it difficult for the medical clip to move longitudinally relative to the clip connection portion, making it easier for the medical clip to securely grasp the object.

1 illustrates a plan view of the distal side of an endoscopic clip system according to one embodiment of the present invention. 2 is a cross-sectional view of the clip system for an endoscope shown in FIG. 1 along line II-II. 3 shows a cross-sectional view of the endoscopic clip system shown in FIG. 1 taken along line III-III. 2 shows a plan view of the distal side of the linear member of the endoscopic clip system shown in FIG. 1 . 2 is a plan view of a medical clip of the endoscopic clip system shown in FIG. 1 , without showing a fastening ring; 6 shows a cross-sectional view taken along line VI-VI of the medical clip shown in FIG. 5.

The present invention will be described in more detail below based on the following embodiments, but the present invention is not limited to the following embodiments and can of course be modified as appropriate within the scope of the above and below, all of which are included in the technical scope of the present invention. In addition, hatching and component symbols may be omitted in each drawing for convenience, but in such cases, reference should be made to the specification or other drawings. Furthermore, the dimensions of various components in the drawings may differ from the actual dimensions, as priority is given to contributing to an understanding of the features of the present invention.

Figure 1 is a plan view of the distal side of an endoscopic clip system 1 in one embodiment of the present invention, and Figures 2 and 3 are cross-sectional views perpendicular to the longitudinal direction of the endoscopic clip system 1.

1 to 3, the endoscopic clip system 1 of the present invention includes a medical clip 10 that grips an object, and a linear object 20 that has a distal end and a proximal end, extends along a longitudinal axis, and moves the medical clip 10 along the longitudinal axis. After gripping the target site inside the body, the medical clip 10 is separated from the linear object 20 at the connecting portion, and the linear object 20 is removed from the body.

In the present invention, the proximal side refers to the side of the user's hand in the extension direction of the linear object 20, and the distal side refers to the opposite side of the proximal side, i.e., the side to be treated. The extension direction of the linear object 20 is also referred to as the longitudinal direction. The longitudinal direction can be rephrased as the direction of approach to the linear object 20. The radial direction refers to the radial direction of the circumscribing circle of the cross-sectional shape of the linear object 20 in the longitudinal direction, the inward direction in the radial direction refers to the direction toward the axial center of the circumscribing circle of the cross-sectional shape of the linear object 20, and the outward direction in the radial direction refers to the direction toward the opposite side to the inward direction. In addition, in Figures 1, 4, and 5, the right side of the figure is the proximal side, and the left side of the figure is the distal side.

The medical clip 10 is attached to the linear object 20 of the endoscopic clip system 1 during endoscopic treatments such as ESD and EMR, and is used for stopping bleeding, suturing lesions, etc.

Examples of materials that make up the medical clip 10 include stainless steels such as SUS301, SUS303, SUS304, and SUS631, Ni-Ti alloys, and the like. Of these, it is preferable that the material that makes up the medical clip 10 is stainless steel. By using stainless steel as the material that makes up the medical clip 10, the medical clip 10 becomes highly elastic and the biocompatibility of the medical clip 10 can be improved.

The linear object 20 has a longitudinal direction. That is, the linear object 20 extends along the longitudinal axis. The linear object 20 may be tubular having an inner cavity extending along the longitudinal axis, but is preferably solid. By making the linear object 20 solid, the rigidity of the linear object 20 can be increased without excessively increasing the outer diameter of the linear object 20. As a result, the insertability of the endoscopic clip system 1 can be improved. The linear object 20 may be a single wire or a twisted wire in which single wires are twisted together. If the linear object 20 is a single wire, it is easy to manufacture. If the linear object 20 is a twisted wire, the strength of the linear object 20 can be increased, so that the operation on the hand side is easily transmitted to the distal end including the medical clip 10 and the clip connecting portion 21. The cross-sectional shape of the wire constituting the linear object 20 may be, for example, a circular shape, an elliptical shape, a polygonal shape, or a combination of these shapes.

Examples of materials constituting the linear object 20 include metals such as stainless steels such as SUS301, SUS303, SUS304, and SUS631, and carbon steel, as well as synthetic resin fibers such as polyamide resins such as nylon, polyolefin resins such as PP and PE, polyester resins such as PET, aromatic polyether ketone resins such as PEEK, polyimide resins, and fluororesins such as PTFE, PFA, and ETFE. Among these, it is preferable that the material constituting the linear object 20 is stainless steel. By using stainless steel as the material constituting the linear object 20, it is possible to improve biocompatibility while providing the strength required for the endoscopic clip system 1.

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

A method for forming a coating layer on the linear object 20 can be, for example, to coat the linear object 20 with a material for forming the coating layer, and methods such as a dipping method, a spraying method, a fluidized bed method, or a kneader coater method can be used.

The longitudinal length of the linear object 20 can be appropriately selected taking into consideration the distance from the forceps port of the endoscope to the area to be treated, and can be, for example, 1000 mm or more and 3000 mm or less. In addition, by providing a handle on the proximal side of the linear object 20, the medical clip 10 and the linear object 20 can be easily operated.

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

The outer diameter of the linear object 20 may be the same over its entire length or may vary. For example, the proximal portion of the linear object 20 may be made thicker for reinforcement. Methods for reinforcing the linear object 20 include, for example, placing a tubular part on the outer surface of the linear object 20.

Figure 4 is a plan view of the distal side of the linear object 20 of the endoscopic clip system 1. As shown in Figure 4, the linear object 20 has a clip connecting portion 21 that connects the medical clip 10 to the distal side. The medical clip 10 can be attached to the linear object 20 by connecting the medical clip 10 to the clip connecting portion 21. In other words, the linear object 20 has a distal end and a proximal end, extends along a longitudinal axis, and moves the medical clip 10 along the longitudinal axis.

The clip connecting part 21 is provided on the linear object 20. For the operation of the medical clip 10, the clip connecting part 21 is provided on the distal side of the linear object 20, and is preferably provided on the distal end of the linear object 20. The linear object 20 preferably has a portion having an outer diameter that increases toward the distal side as the clip connecting part 21. The clip connecting part 21 may be a part of the linear object 20, or may be configured by attaching a separate part (hereinafter sometimes referred to as a "clip connecting part") for connecting the medical clip 10 to the linear object 20. The clip connecting part 21 may be disposed, for example, on the distal end of the linear object 20.

When the clip connection part 21 is a clip connection part attached to the linear object 20, the material of the clip connection part may be, for example, a metal such as stainless steel or carbon steel, a polyamide resin such as nylon, a polyolefin resin such as PP or PE, a polyester resin such as PET, an aromatic polyether ketone resin such as PEEK, a polyimide resin, or a synthetic resin such as fluororesin such as PTFE, PFA, or ETFE. Among them, it is preferable that the material of the clip connection part is the same as the material of the linear object 20. By using the same material of the clip connection part as the material of the linear object 20, the connection between the clip connection part and the linear object 20 can be made strong, so that the clip connection part is less likely to come off from the linear object 20. As a result, the durability of the endoscopic clip system 1 can be increased.

When the clip connecting portion 21 is a clip connecting component, the method of fixing the clip connecting component to the linear object 20 can be, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser, silver solder, or heat, or adhesion using an adhesive or tape. Among these, it is preferable that the clip connecting component is fixed to the linear object 20 by welding. By fixing the clip connecting component to the linear object 20 by welding, the bonding strength between the clip connecting component and the linear object 20 can be increased.

Figure 5 is a plan view of the medical clip 10, and Figure 6 is a cross-sectional view perpendicular to the longitudinal direction of the medical clip 10. As shown in Figures 5 and 6, the medical clip 10 has a first part 11 and a second part 12 arranged opposite each other, and has a friction part 60 between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21. By providing the friction part 60 to the medical clip 10, the friction force generated between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 is increased, making it difficult for the medical clip 10 to rotate relative to the clip connecting part 21 and for the medical clip 10 to move along the longitudinal axis relative to the clip connecting part 21. This makes it easier for the medical clip 10 to grip an object.

The friction part 60 may be provided on the inner surface of the medical clip 10, or on the outer surface of the clip connecting part 21, or may be configured by disposing a separate part (hereinafter, sometimes referred to as a "friction part part") that constitutes the friction part 60 between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21. When the friction part 60 is provided on the inner surface of the medical clip 10 or the outer surface of the clip connecting part 21, for example, at least one of the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 is coated with a material that constitutes the friction part 60, at least one of the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 is covered with a resin tube and fixed to form the friction part 60, or at least one of the surfaces of the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 is roughened to increase the frictional force and form the friction part 60. When the friction portion 60 is constructed by arranging friction portion parts between the inner surface of the medical clip 10 and the outer surface of the clip connecting portion 21, for example, a resin sheet or a resin tube can be arranged between the inner surface of the medical clip 10 and the outer surface of the clip connecting portion 21.

The friction portion 60 is preferably disposed in at least one of the first portion 11, the second portion 12, and the clip connecting portion 21. In other words, at least one of the first portion 11, the second portion 12, and the clip connecting portion 21 is preferably provided with the friction portion 60. By providing at least one of the first portion 11, the second portion 12, and the clip connecting portion 21 with the friction portion 60, the friction force between at least one of the first portion 11 and the clip connecting portion 21 and between the second portion 12 and the clip connecting portion 21 can be increased, and the medical clip 10 becomes less likely to rotate and move along the longitudinal axis relative to the clip connecting portion 21.

It is also preferable that the friction portion 60 is disposed in the first part 11, the second part 12, and the clip connecting part 21. In other words, it is also preferable that the first part 11, the second part 12, and the clip connecting part 21 are provided with the friction portion 60. In other words, it is also preferable that the friction portion 60 is disposed in all of the first part 11, the second part 12, and the clip connecting part 21. By providing the friction portion 60 in the first part 11, the second part 12, and the clip connecting part 21, it is possible to increase both the friction force generated between the first part 11 and the clip connecting part 21 and the friction force generated between the second part 12 and the clip connecting part 21, and it is possible to make the medical clip 10 more difficult to rotate with respect to the clip connecting part 21 and to move along the longitudinal axis.

In addition, in the friction portion 60, it is preferable that the first part 11 and the second part 12 are in surface contact with the clip connecting part 21. By having the first part 11 and the second part 12 and the clip connecting part 21 in surface contact, the friction force between the medical clip 10 and the clip connecting part 21 can be further increased. The surface where the first part 11 and the second part 12 and the clip connecting part 21 contact may be a flat surface or a curved surface. In addition, there may be multiple surfaces where the first part 11 and the second part 12 and the clip connecting part 21 contact.

The material of the friction part 60 preferably contains an elastic body. Examples of the elastic body contained in the material of the friction part 60 include synthetic rubber such as natural rubber, urethane rubber, and silicone rubber, and polyamide elastomers such as polyether ester amide elastomer and polyamide ether elastomer. Among them, the elastic body contained in the material of the friction part 60 is preferably a polyamide elastomer, and more preferably a polyether block amide elastomer. When the elastic body contained in the material of the friction part 60 is a polyamide elastomer, the flexibility of the friction part 60 is increased, and the friction part 60 is easily fitted to the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21. Therefore, it is possible to increase the friction force between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21.

The material of the first part 11 and the second part 12 is preferably the same as the material constituting the friction part 60. By using the same material of the first part 11 and the second part 12 as the material constituting the friction part 60, the frictional force generated between the first part 11 and the second part 12 and the friction part 60 is increased, and the effect of preventing rotation and longitudinal movement of the medical clip 10 with respect to the clip connecting part 21 can be enhanced.

It is also preferable that the material of the clip connecting portion 21 is the same as the material constituting the friction portion 60. By using the same material for the clip connecting portion 21 as the material constituting the friction portion 60, the frictional force between the clip connecting portion 21 and the friction portion 60 can be increased, making it difficult for the medical clip 10 to rotate and move longitudinally relative to the clip connecting portion 21.

As shown in Figure 4, the friction portion 60 is disposed on the outer surface of the clip connecting portion 21, and is preferably disposed distal to the proximal end 21p of the clip connecting portion 21. By disposing the friction portion 60 on the outer surface of the clip connecting portion 21 and distal to the proximal end 21p of the clip connecting portion 21, when the medical clip 10 is connected to the clip connecting portion 21, the proximal end 21p of the clip connecting portion 21 and the medical clip 10 are likely to come into direct contact with each other, making it easier to reliably connect the medical clip 10 to the clip connecting portion 21.

The friction portion 60 is preferably disposed on the outer surface of the clip connecting portion 21, distal to the proximal end 21p of the clip connecting portion 21 and proximal to the distal end 21d of the clip connecting portion 21. By disposing the friction portion 60 distal to the proximal end 21p of the clip connecting portion 21 and proximal to the distal end 21d of the clip connecting portion 21, for example, when connecting the medical clip 10 to the clip connecting portion 21 by inserting the distal end 21d of the clip connecting portion 21 from the proximal end 10p of the medical clip 10, the distal end 21d of the clip connecting portion 21 does not have the friction portion 60, making it easier to connect to the medical clip 10, and making it possible to provide an endoscopic clip system 1 in which the medical clip 10 can be easily attached.

It is preferable that the friction portion 60 includes a resin tube disposed outside the clip connection portion 21. Since the friction portion 60 includes a resin tube, it is easy to provide the friction portion 60 and to make the thickness of the friction portion 60 uniform, which makes it possible to improve the manufacturing efficiency of the endoscopic clip system 1.

The resin tube constituting the friction portion 60 may be disposed outside the clip connecting portion 21, for example, on the outer peripheral surface of the clip connecting portion 21 or on the inner peripheral surface of the medical clip 10. In particular, it is preferable that the resin tube constituting the friction portion 60 is disposed on the outer peripheral surface of the clip connecting portion 21. By disposing the resin tube constituting the friction portion 60 on the outer peripheral surface of the clip connecting portion 21, it becomes easier to provide the friction portion 60 while ensuring sufficient frictional force generated between the inner surface of the medical clip 10 and the outer surface of the clip connecting portion 21, and the efficiency of manufacturing the endoscopic clip system 1 can be improved.

5 and 6, the medical clip 10 has a longitudinal direction, an opening/closing direction of the medical clip 10, and a width direction of the medical clip 10, and the medical clip 10 is configured to be connected to the clip connecting portion 21 on the proximal side of the longitudinal direction of the medical clip 10 and to grasp an object on the distal side of the longitudinal direction, and a connecting portion 13 that connects the first portion 11 and the second portion 12 is disposed on the first end side of the width direction of the medical clip 10, and the connecting portion 13 is preferably disposed on the proximal side of the midpoint P1 of the longitudinal length of the medical clip 10. By disposing the connecting portion 13 on the first end side of the width direction of the medical clip 10, the distance between the first portion 11 and the second portion 12 is less likely to change when an external force is applied to the medical clip 10, and the medical clip 10 is less likely to be unintentionally detached from the clip connecting portion 21. In addition, since the connecting portion 13 is disposed proximal to the midpoint P1 of the longitudinal length of the medical clip 10, the clip connecting portion 21 can be easily fitted to the medical clip 10 and difficult to come off, and the endoscopic clip system 1 can be easily handled. In FIG. 5, the left-right direction of the paper corresponds to the longitudinal direction, the up-down direction of the paper corresponds to the opening and closing direction of the medical clip 10, and the front-to-back direction of the paper corresponds to the width direction of the medical clip 10. In three-dimensional coordinates, when the x-axis direction is the longitudinal direction, the y-axis direction can be the opening and closing direction, and the z-axis direction can be the width direction. The medical clip 10 is configured to connect to the clip connecting portion 21 of the linear object 20 on the proximal side of the longitudinal direction and to grip an object on the distal side of the longitudinal direction.

The medical clip 10 may be formed, for example, by bending a single metal plate including the first portion 11, the second portion 12, and the connecting portion 13, or may be formed by joining a part including the first portion 11, a part including the second portion 12, and a part including the connecting portion 13. In particular, it is preferable that the medical clip 10 is formed by bending a single metal plate including the first portion 11, the second portion 12, and the connecting portion 13. By forming the medical clip 10 from a single metal plate, there is less variation in the product during the manufacture of the medical clip 10, and the manufacturing efficiency of the medical clip 10 can be improved.

When the medical clip 10 is formed by joining together a part including the first part 11, a part including the second part 12, and a part including the connecting part 13, the part including the connecting part 13 and the part including the first part 11 and the part including the second part 12 can be joined by, for example, mechanical fixation using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser, silver solder, or heat, or adhesion using an adhesive or tape. Among these, the part including the connecting part 13 and the part including the first part 11 and the part including the second part 12 are preferably joined by welding. By joining the parts by welding, the joining strength of the parts can be increased.

It is preferable that the length from the distal end 13d of the connecting portion 13 to the proximal end 13p of the connecting portion 13 is greater than at least one of the width of the proximal end of the first portion 11 and the width of the proximal end of the second portion 12. Since the length from the distal end 13d of the connecting portion 13 to the proximal end 13p is greater than at least one of the width of the proximal end of the first portion 11 and the width of the proximal end of the second portion 12, the connecting portion 13 can easily prevent the distance between the first portion 11 and the second portion 12 from changing, and for example, when the clip connecting portion 21 is fitted between the first portion 11 and the second portion 12, the distance between the first portion 11 and the second portion 12 can be prevented from widening, causing the clip connecting portion 21 to come off the medical clip 10.

It is more preferable that the connection portion 13 is located proximal to the midpoint P1 of the longitudinal length of the medical clip 10 and distal to the proximal end of the medical clip 10. By arranging the connection portion 13 proximal to the midpoint P1 of the longitudinal length of the medical clip 10 and distal to the proximal end of the medical clip 10, the medical clip 10 is less likely to be deformed or damaged due to being opened widely.

It is preferable that the distal end 21d of the clip connecting portion 21 is disposed distal to the proximal end 13p of the connecting portion 13. By disposing the distal end 21d of the clip connecting portion 21 distal to the proximal end 13p of the connecting portion 13, the contact area between the inner surface of the medical clip 10 and the outer surface of the clip connecting portion 21 can be made sufficient. Therefore, during treatment using the endoscopic clip system 1 after the medical clip 10 is attached to the clip connecting portion 21, it is possible to prevent the medical clip 10 from unintentionally falling off the clip connecting portion 21.

The distal end 21d of the clip connecting part 21 is disposed distally of the proximal end 13p of the connecting part 13, and more preferably, the proximal end 21p of the clip connecting part 21 is disposed proximally of the proximal end 13p of the connecting part 13. In addition to the distal end 21d of the clip connecting part 21 being disposed distally of the proximal end 13p of the connecting part 13, the proximal end 21p of the clip connecting part 21 is disposed proximally of the proximal end 13p of the connecting part 13, so that the area of contact between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 can be further increased. As a result, the frictional force generated between the inner surface of the medical clip 10 and the outer surface of the clip connecting part 21 can be increased, making it possible to make the medical clip 10 less likely to fall off the clip connecting part 21.

1, the endoscopic clip 10 further has a cylindrical fastening ring 30 disposed outside the first part 11 and the second part 12, i.e., on the outer periphery of the medical clip 10, and it is preferable that the fastening ring 30 is movable in the longitudinal direction on the medical clip 10. Since the endoscopic clip 10 has the fastening ring 30, the medical clip 10 is less likely to be pushed back by the object, and the object can be sufficiently grasped by closing the medical clip 10.

The material of the fastening ring 30 may be the same as that of the medical clip 10, for example, stainless steels such as SUS301, SUS303, SUS304, and SUS631, and metals such as Ni-Ti alloys. In particular, it is preferable that the material of the fastening ring 30 contains stainless steel. By containing stainless steel in the material of the fastening ring 30, a highly elastic fastening ring 30 can be obtained. Therefore, the fastening ring 30 can easily press the medical clip 10 from the outside, making it easier to close the medical clip 10.

As shown in FIG. 1, the linear object 20 further has a pusher 40 capable of moving in the longitudinal direction, and the distal end 40d of the pusher 40 is preferably configured to contact the proximal end 30p of the fastening ring 30 to move the fastening ring 30 distally. By having the pusher 40 on the linear object 20, it becomes easier to move the fastening ring 30 distally, and it also becomes easier to close the medical clip 10 and grasp the object. The pusher 40 is preferably operated by an operating handle disposed on the proximal side of the linear object 20. When the pusher 40 is operated by the operating handle, the linear object 20 and the pusher 40 are preferably integrated via the operating handle.

It is preferable that the pushing tool 40 is tubular and the linear object 20 is disposed in the inner cavity of the pushing tool 40. By disposing the linear object 20 in the inner cavity of the pushing tool 40, the pushing tool 40 can be moved along the linear object 20, making it easier to move the pushing tool 40 in the longitudinal direction. The pushing tool 40 pushes the fastening ring 30 to move it from the proximal side to the distal side of the medical clip 10. Therefore, it is preferable that the distal end of the pushing tool 40 is tubular with a cross-sectional size that is the same as or similar to that of the fastening ring 30.

Examples of materials for the pressing tool 40 include stainless steel such as SUS304 and SUS316, metals such as platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni-Ti alloys, and Co-Cr alloys, polyamide resins such as nylon, polyolefin resins such as polyethylene and polypropylene, polyester resins such as polyethylene terephthalate (PET), aromatic polyether ketone resins such as polyether ether ketone (PEEK), polyimide resins, and synthetic resins such as polytetrafluoroethylene (PTFE), tetrafluoroethylene-perfluoroalkyl vinyl ether copolymer (PFA), and ethylene-tetrafluoroethylene copolymer (ETFE). Among these, the material for the pressing tool 40 is preferably a metal, and more preferably contains stainless steel. Since the material of the pressing tool 40 is metal, the pressing tool 40 is less likely to be crushed when the distal end 40d of the pressing tool 40 comes into contact with the proximal end 30p of the fastening ring 30, and the force applied to the pressing tool 40 is sufficiently transmitted to the fastening ring 30, making it easier to move the fastening ring 30 distally.

Although not shown, the distal end of the pushing tool 40 is preferably a coil. By having the distal end of the pushing tool 40 be a coil, the distal end of the pushing tool 40 is easily bent. Therefore, even if the distal end of the endoscopic clip system 1 is curved when the medical clip 10 is gripped on an object, the fastening ring 30 can be easily moved distally by the pushing tool 40.

1 and 4, the clip connecting portion 21 preferably has a contact portion 22 that contacts the proximal end 10p of the medical clip 10. By having the clip connecting portion 21 have the contact portion 22, the contact portion 22 contacts the proximal end 10p of the medical clip 10, thereby preventing movement of the linear object 20 in a direction along the longitudinal axis, and making it difficult for the medical clip 10 to come off the clip connecting portion 21 in an unintended situation.

5 and 6, the medical clip 10 further has a first claw portion 51 extending toward the second portion 12 at the proximal end of the first portion 11, and a second claw portion 52 extending toward the first portion 11 at the proximal end of the second portion 12, and as shown in FIG. 2, the first claw portion 51 and the second claw portion 52 preferably have a notch 53 along the outer periphery of the linear object 20. The medical clip 10 has the first claw portion 51 and the second claw portion 52, which prevents the linear object 20 from moving proximally relative to the medical clip 10 and prevents the medical clip 10 from unintentionally coming off the linear object 20. Furthermore, since the first claw portion 51 and the second claw portion 52 have a notch 53 that follows the outer periphery of the linear object 20, when attaching the medical clip 10 to the linear object 20, even if the medical clip 10 has the first claw portion 51 and the second claw portion 52 at the proximal ends of the first part 11 and the second part 12, the linear object 20 passes through the notch 53, making it easy to attach the medical clip 10 to the linear object 20.

When the gripping of the object by the medical clip 10 is completed and the medical clip 10 is to be removed from the linear object 20 to retain the medical clip 10, it is preferable that the clip connecting part 21 pushes the first claw part 51 and the second claw part 52 from the distal side toward the proximal side to deform them, so that the clip connecting part 21 passes through the notch 53, and the clip connecting part 21 moves to the proximal side to remove the medical clip 10 from the linear object 20. The clip connecting part 21 deforms the first claw part 51 and the second claw part 52 to pass through the notch 53, and removes the medical clip 10 from the linear object 20. As a result, the clip connecting part 21 does not move to the proximal side unless a force greater than the deformation of the first claw part 51 and the second claw part 52 is applied to the clip connecting part 21, thereby preventing the medical clip 10 from being unintentionally removed from the linear object 20.

The first claw portion 51 may be formed by bending the proximal end of the first part 11, or may be formed by joining a part constituting the first claw portion 51 (hereinafter, sometimes referred to as the "first claw part") to the proximal end of the first part 11. Similarly, the second claw portion 52 may be formed by bending the proximal end of the second part 12, or may be formed by joining a part constituting the second claw portion 52 (hereinafter, sometimes referred to as the "second claw part") to the proximal end of the second part 12. Among them, it is preferable that the first claw portion 51 is formed by bending the proximal end of the first part 11, and the second claw portion 52 is formed by bending the proximal end of the second part 12. Since the first claw portion 51 is formed by bending the proximal end of the first part 11 and the second claw portion 52 is formed by bending the proximal end of the second part 12, the first claw portion 51 is prevented from coming off the first part 11 and the second claw portion 52 is prevented from coming off the second part 12. Even if a load is applied to the first claw portion 51 and the second claw portion 52 when attaching the medical clip 10 to the clip connecting part 21 or removing the medical clip 10 from the clip connecting part 21, the first claw portion 51 and the second claw portion 52 of the medical clip 10 are less likely to be damaged.

When the first claw portion 51 is formed by joining the first claw part to the first part 11 and the second claw portion 52 is formed by joining the second claw part to the second part 12, the first claw part and the second claw part can be joined to the first part 11 and the second part 12, respectively, by, for example, mechanical fixing using a connecting member such as a screw, crimping, fitting, or press-fitting, welding using a laser or heat, or adhesion using an adhesive or tape. Among them, the method of joining the first claw part and the second claw part to the first part 11 and the second part 12, respectively, is preferably welding. By joining each part by welding, it is possible to increase the joining strength of the first claw part to the first part 11 and the joining strength of the second claw part to the second part 12.

1 and 4, the clip connecting portion 21 has a groove portion 23 that is concave in the circumferential direction of the clip connecting portion 21, and the distal side wall surface 24d of the groove portion 23 is in contact with the distal side surface of the proximal end 10p of the medical clip 10, and the proximal side wall surface 24p of the groove portion 23 is preferably in contact with the proximal side surface of the proximal end 10p of the medical clip 10. Since the distal side wall surface 24d of the groove portion 23 is in contact with the distal side surface of the proximal end 10p of the medical clip 10 and the proximal side wall surface 24p of the groove portion 23 is in contact with the proximal side surface of the proximal end 10p of the medical clip 10, the proximal end of the medical clip 10 is fitted into the groove portion 23 of the clip connecting portion 21, so that the medical clip 10 is firmly fixed to the clip connecting portion 21, and the medical clip 10 is less likely to fall off unintentionally when the endoscopic clip system 1 is used.

It is preferable that the depth of the groove 23 is greater than the thickness of the first claw 51 and the second claw 52. The depth of the groove 23 indicates the size of the groove 23 in the radial direction of the clip connecting part 21, the thickness of the first claw 51 indicates the size of the first claw 51 in the longitudinal direction, and the thickness of the second claw 52 indicates the size of the second claw 52 in the longitudinal direction. Since the depth of the groove 23 is greater than the thickness of the first claw 51 and the second claw 52, it becomes easier to fit the clip connecting part 21 into the medical clip 10 from the second end side in the width direction of the medical clip 10, and the medical clip 10 can be easily attached to the clip connecting part 21.

Although not shown, it is preferable that the endoscopic clip system 1 has a handle connected to the proximal end of the linear object 20. The handle is a member that is gripped by the user when operating the endoscopic clip system 1. Having a handle in the endoscopic clip system 1 makes it easier to operate the endoscopic clip system 1.

As described above, the endoscopic clip system of the present invention includes a medical clip that grasps an object, and a linear object having a distal end and a proximal end, extending along a longitudinal axis, and moving the medical clip along the longitudinal axis, the medical clip having a first part and a second part arranged opposite each other, the linear object having a clip connecting part that connects the medical clip to the distal side, and a friction part between the inner surface of the medical clip and the outer surface of the clip connecting part. By providing a friction part between the inner surface of the medical clip and the outer surface of the clip connecting part, the friction force generated between the medical clip and the clip connecting part is increased, the medical clip is less likely to rotate relative to the clip connecting part, and the medical clip is less likely to move along the longitudinal axis relative to the clip connecting part, making it easier for the medical clip to grasp the object reliably.

This application claims the benefit of priority based on Japanese Patent Application No. 2019-208965, filed on November 19, 2019. The entire contents of the specification of Japanese Patent Application No. 2019-208965, filed on November 19, 2019, are incorporated by reference into this application.

1: endoscopic clip system 10: medical clip 10p: proximal end of medical clip 11: first part 12: second part 13: connection part 13d: distal end of connection part 13p: proximal end of connection part 20: linear object 21: clip connecting part 21d: distal end of clip connecting part 21p: proximal end of clip connecting part 22: contact part 23: groove part 24d: distal wall surface of groove part 24p: proximal wall surface of groove part 30: fastening ring 30p: proximal end of fastening ring 40: pushing tool 40d: distal end of pushing tool 51: first claw part 52: second claw part 53: notch 60: friction part P1: midpoint of longitudinal length of medical clip

Claims (13)

A medical clip for gripping an object;
a wire having a distal end and a proximal end, extending along a longitudinal axis, for moving the medical clip along the longitudinal axis;
The medical clip has a first portion and a second portion disposed opposite one another;
the linear object has a clip connecting portion for connecting the medical clip to a distal side thereof,
A friction portion is provided between an inner surface of the medical clip and an outer surface of the clip connecting portion,
The friction portion is disposed on an outer surface of the clip connecting portion and is disposed distal to a proximal end of the clip connecting portion,
A clip system for an endoscope , wherein the friction portion includes a resin tube arranged outside the clip connection portion . The clip connecting portion has a groove portion that is recessed in a circumferential direction of the clip connecting portion,
a distal wall surface of the groove contacts a distal side surface of a proximal end of the medical clip;
The clip system for an endoscope according to claim 1 , wherein the proximal wall surface of the groove is in contact with a proximal side surface of the proximal end of the medical clip. The clip system for an endoscope according to claim 1 or 2, wherein at least one of the first part, the second part and the clip connecting part is provided with the friction part. The clip system for an endoscope according to any one of claims 1 to 3, wherein the first part, the second part and the clip connecting part are provided with the friction part. The clip system for an endoscope according to any one of claims 1 to 4, wherein the first and second parts are in surface contact with the clip connecting part in the friction part. The clip system for an endoscope according to any one of claims 1 to 5, wherein the material of the friction portion includes an elastic body. The clip system for an endoscope according to any one of claims 1 to 5, wherein the material of the first part and the second part is the same as the material constituting the friction part. The clip system for endoscopes according to any one of claims 1 to 5, wherein the material of the clip connection part is the same as the material constituting the friction part. the medical clip has a longitudinal direction, an opening and closing direction of the medical clip, and a width direction of the medical clip;
The medical clip is configured to connect to the clip connecting portion of the linear object on a proximal side in a longitudinal direction of the medical clip and to grip the object on a distal side in the longitudinal direction,
A connection portion that connects the first portion and the second portion is disposed on a first end side in a width direction of the medical clip,
The clip system for an endoscope according to any one of claims 1 to 8 , wherein the connection portion is disposed proximally relative to a midpoint of the longitudinal length of the medical clip. The medical clip further includes a cylindrical fastening ring disposed outside the first and second portions,
The clip system for an endoscope according to any one of claims 1 to 9 , wherein the fastening ring is movable in a longitudinal direction on the medical clip. The linear object further has a pusher that is movable in a longitudinal direction,
The clip system for an endoscope according to claim 10 , wherein a distal end of the pusher is configured to contact a proximal end of the fastening ring to move the fastening ring distally. The clip system for an endoscope according to any one of claims 1 to 11 , wherein the clip connecting portion has a contact portion that contacts a proximal end of the medical clip. the medical clip further includes a first claw portion at a proximal end of the first portion and extending toward the second portion, and a second claw portion at a proximal end of the second portion and extending toward the first portion;
The clip system for an endoscope according to any one of claims 1 to 12 , wherein the first claw portion and the second claw portion have a notch along an outer periphery of the linear object.

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