Patent Publication Number: US-2009228023-A1

Title: Clipping device

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates to an endoscopic clipping device used to effect stopping of bleeding, closing of a puncture, etc. in a living body or the like. 
     In an endoscopic clipping device, a clip is caused to protrude from a distal end of an endoscope inserted into a living body, and a portion to be ligated, such as a bleeding portion or a portion from which a lesioned tissue has been removed is pinched by the clip, thereby stopping the bleeding or closing the puncture. A conventional clipping device has a clip whose distal end is open, and a clamping part for closing the clip to effect fastening, with the clip being closed by causing the clamping part to advance with respect to the open clip. 
     For example, JP 2002-272751 A discloses a construction in which a clip clamping ring is attached to a rear end portion of a clip and in which the clip is pulled with respect to the clip clamping ring to thereby draw the clip into the clip clamping ring, thereby closing a pinching portion at the distal end portion of the clip and grasping living tissues. In the clip clamping ring of JP 2002-272751 A, when the clip is pushed out of an introducing tube (sheath), the clip clamping ring is pushed out together with the clip. This clip clamping ring has two blades that can protrude and retract. When a distal end tip attached to the distal end of the introducing tube is passed by, the blades protrude, and if the clip is pulled thereafter, the clip clamping ring does not retract into the introducing tube. When the clip is pulled in this state, the clip is clamped by the clip clamping ring. After that, the clip clamping ring is allowed to stay in the living body cavity together with the clip. 
     JP 2006-187391 A discloses a construction in which a clamping ring is fitted onto a rear side portion of a clip and in which the clip is pulled with respect to this clamping ring, whereby the clamping ring is moved to a front side portion of the clip, thereby closing the clip. The clamping ring of JP 2006-187391 A is a truncated-cone-shaped component whose outer diameter increases from the front end toward the rear end. The outer diameter of the rear end of the same is larger than the inner diameter of a tubular front tip mounted to the front end of a sheath. A front side portion of the front tip has an axial slit, and can undergo elastic deformation so as to enlarge the inner diameter. Thus, the clamping ring, which can be pushed out from the front tip toward the front end, cannot be brought back to the former position once it has been pushed out. At the time of clipping, the clamping ring is pushed out of the front tip, and is prevented from retreating by the front tip. In this state, a manipulating wire is pulled to draw the clip into the sheath, thereby effecting clipping. 
     The clip of JP 2002-272751 A is made of a thin metal strip, and the clip clamping ring is made of a resin, metal, or the like. However, when the clip clamping ring is made of a resin, it may be impossible to obtain a clamping force strong enough to maintain the grasping force of the clip depending upon the size and hardness of the living tissues to be grasped. When the clip clamping ring is made of metal, it is impossible to endow the blade portions with sufficient elasticity, and hence there is a fear of the blades not spreading properly when the front tip is passed by. 
     In the construction disclosed in JP 2006-187391 A, it is necessary to separately provide, at the front end of the sheath, the front tip of a tapered configuration having a slit, i.e., a separate member of a special configuration. Further, this front tip requires attachment/detachment each time the clip is put into the sheath. JP 2006-187391 A gives no description regarding the material of the clip and the clamping ring. It should be noted, however, that when the clamping ring is made of a resin or the like, it may be impossible to obtain a claming force strong enough to maintain the grasping force of the clip depending upon the size and hardness of the living tissues to be grasped. 
     SUMMARY OF THE INVENTION 
     It is an object of the present invention to solve the above-mentioned problems in the related art and to provide a clipping device including a clamping ring realizing both the function of preventing the clip from retreating into the sheath at the time of clipping manipulation and a strong clamping force of the clip, and making it possible to perform clipping and clip loading through easy manipulation. 
     A clipping device according to a first aspect of the invention comprises: 
     a clip loaded into a forward end portion of a sheath; 
     a manipulating wire connected to a rear end of the clip and used to pull the clip; and 
     a retention ring fitted onto the clip and fitted into the sheath so as to be capable of advancing and retreating, 
     wherein the retention ring includes: 
     a resin retaining portion which has, at the same position in a clip pulling direction and at positions circumferentially spaced apart from each other, two or more skirt portions which, when being situated inside the sheath, are closed inwardly by being pressed by an inner wall of the sheath and which, when being situated outside of a forward end of the sheath, are opened in a width larger than an inner diameter of the sheath to prevent retreat into the sheath, and 
     a metal clamping portion arranged on a forward end side of the retaining portion and, when being situated on a forward end side of the clip, abutting the clip to clamp the clip. 
     A clipping device of a magazine type according to a second aspect of the invention comprises: 
     a plurality of clips loaded into a forward end portion of a sheath while being engaged with other clips longitudinally connected together; 
     at least one connection ring fitted into the sheath so as to be capable of advancing and retreating and covering an engagement portion of the clips to maintain the clips in a connected state; and 
     a manipulating wire connected to a rearmost clip and adapted to pull a clip row formed of the plurality of clips, 
     wherein the connection ring includes: 
     a resin retaining portion which has, at the same position in a clip pulling direction and at positions circumferentially spaced apart from each other, two or more skirt portions which, when being situated inside the sheath, are closed inwardly by being pressed by an inner wall of the sheath and which, when being situated outside of a forward end of the sheath, are opened in a width larger than an inner diameter of the sheath to prevent retreat into the sheath, and 
     a metal clamping portion arranged on a forward end side of the retaining portion and, when being situated on a forward end side of the clip, abutting the clip to clamp the clip. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       In the accompanying drawings: 
         FIGS. 1A and 1B  are side sectional view and a front sectional view, respectively, illustrating a clipping device according to Embodiment 1 of the present invention; 
         FIG. 2  is a perspective view of a clip used in Embodiment 1; 
         FIGS. 3A through 3C  are a front view, a front sectional view, and a bottom view of a connection ring used in Embodiment 1; 
         FIGS. 4A and 4B  are partial sectional views illustrating how the clip is connected and retained by the connection ring; 
         FIGS. 5A and 5B  are a partial plan sectional view and a partial front sectional view schematically illustrating the construction of a manipulating portion; 
         FIGS. 6A through 6E  are sectional views illustrating stepwise the state of the clipping device according to Embodiment 1 during clipping manipulation; 
         FIGS. 7A and 7B  are a front view and a front sectional view of a connection clip package, and  FIG. 7   c  is a sectional view thereof taken along a plane orthogonal to the axis of a case thereof; 
         FIG. 8  is a partial enlarged view of  FIG. 7B ; 
         FIGS. 9A through 9C  are partial sectional views illustrating stepwise how clip member loading manipulation is performed from the connection clip package to the sheath; 
         FIG. 10  is a perspective view of a connecting portion between a connecting member and a manipulating wire; 
         FIG. 11  is a sectional view of a connection ring used in Embodiment 2; 
         FIGS. 12A through 12D  are partial sectional views of a clipping device according to Embodiment 2; 
         FIGS. 13A through 13C  are a front view, a front sectional view, and a bottom view of a connection ring used in Embodiment 3; 
         FIGS. 14A and 14B  are a front view and a front sectional view of a connection clip package according to Embodiment 4, and  FIG. 14C  is a sectional view thereof taken along a plane orthogonal to the axis of the case thereof; 
         FIGS. 15A through 15C  are partial sectional views illustrating stepwise how clip member loading manipulation is performed in Embodiment 5; 
         FIGS. 16 and 17  are a perspective view and a sectional view of a manipulating portion used in Embodiment 6; 
         FIG. 18  is a perspective view of the manipulating portion according to Embodiment 6 with a slider guide removed therefrom; 
         FIG. 19A  is a perspective view of a guide portion of the slider guide; 
         FIG. 19B  is a schematic developed view of the slider guide; 
         FIG. 20  is a perspective view of a rotating position regulating member; and 
         FIG. 21  is a schematic developed view of the slider guide illustrating how clipping manipulation is performed in Embodiment 6. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     In the following, preferred embodiments of the clipping device of the present invention are described with reference to the accompanying drawings. 
     Embodiment 1 
       FIGS. 1A and 1B  are sectional views of a clipping device  10  according to Embodiment 1 of the present invention, and  FIG. 1B  is a diagram as seen from an angle differing from  FIG. 1A  by 90 degrees. 
     The clipping device  10  is a magazine type clipping device in which clips can be used in succession and which has a plurality of clips  12  ( 12 A,  12 B,  12 C,  12 D, and  12 E), a dummy clip  18  connected to the rearmost clip  12 D, a manipulating wire  20  connected to the dummy clip via a connecting member  19 , and connection rings  14  ( 14 A,  14 B,  14 C,  14 D, and  14 E) covering the engagement portions of the adjacent clips  12  to maintain the clips  12  in the connected state, with those components being fitted into a sheath  16 .  FIGS. 1A and 1B  illustrate an initial state immediately before the start of clipping manipulation by the foremost clip  12 . 
     One clip  12  and one connection ring  14  corresponding to the clip  12  form one endoscopic bleeding stop clip member, and the clipping device  10  includes a plurality of such bleeding stop clip members loaded into the interior of the distal end portion of the elongated sheath  16 . The terminal end of the successive bleeding stop members is engaged with the dummy clip  18 , and the manipulating wire  20  extends to the proximal end of the sheath  16  to be connected to a manipulating portion described below. When the manipulating wire  20  is drawn out by a predetermined length from the manipulating portion, and the dummy clip  18  is moved in one direction by the predetermined length, the series of clips  12  move by the same amount, and the foremost clip  12  is clamped by the connection ring  14  retaining the same, whereby clipping for stopping bleeding, marking, etc. is effected by the foremost clip  12 . When the clipping by the foremost clip  12  has been completed, the sheath  16  is pulled toward the manipulating portion side by a predetermined length, whereby the next clip  12  is placed in a usable state (standby state), thus making it possible to perform clipping successively. 
     While in  FIGS. 1A and 1B  the foremost clip  12 A protrudes from the distal end of the sheath  16 , when loading the clips  12 , etc. into the sheath  16 , setting is effected such that the foremost clip  12 A is completely accommodated within the sheath  16  as illustrated in  FIG. 6A . Further, while in  FIGS. 1A and 1B  the number of clips  12  is five, that is, the clipping device is of a five-shooter type, it is possible for the clips  12  to be provided in any number not less than two. 
       FIG. 2  is a perspective view of the clip  12 . The clip  12  is a closed clip having a turned portion  24  turned by 180 degrees with respect to claw portions  22 . That is, in forming the clip  12 , a single elongated plate is bent by 180 degrees to form a closed end, and then both ends thereof are caused to cross each other. Further, the end portions are bent so as to be opposed to each other, thereby forming the claw portions  22  to two open ends. On the open-end side of the crossing portion  26 , there exist arm portions  28 , and, on the closed-end portion thereof, there exists the turned portion  24 . At the central portion of each arm portion  28 , there is formed a partially widened projection  30 . The clip  12  may be formed of a metal with biocompatibility. For example, it is possible to use SUS 631, which is a spring stainless steel. 
     In the clip  12 , the forward end portion (a clamping portion  40  described below) of the connection ring  14  fitted onto the crossing portion  26  moves by a predetermined amount toward the claw portions  22  while pressurizing the arm portions  28 , whereby the arm portions  28  and the claw portions  22  are closed, with the claw portions  22  exerting a predetermined fit-engagement force. 
     To reliably grasp an object, the claw portions  22  are formed as V-shaped male type and female type ones. Further, as illustrated in  FIG. 2 , the arm portions  28  of the clips  12  gradually increase in width from the crossing portion  26  toward the projections  30 . 
     The projections  30  have a width larger than that of the portions of the distal end side opening and the proximal end side opening of the connection ring  14  abutted by the projections  30 . Thus, while the portions of the clip  12  other than the projections  30  can enter the interior of the connection ring  14 , the projections  30  cannot enter the interior either from the distal end side or the proximal end side of the connection ring  14 . 
     It is only necessary for the projections  30  to be wide enough to prevent intrusion into the interior of the connection ring  14 . However, as described below, the distal end side end portions of the protrusions  30  (upper end portions as seen in  FIG. 2 ) abut the proximal end of the connection ring  14  retaining the arm portions  28  of the clip  12 , and serve to place the connection ring  14  in position with respect to the clip  12 , and hence it is desirable for the distal end side end portions of the projections  30  to be substantially perpendicular with respect to the axial direction of the clip  12 , making it possible to reliably secure the portions held in contact with the proximal end of the connection ring  14 . 
     When, for example, performing stamping on a strip plate constituting the material of the clip  12 , the projections  30  are provided beforehand, and the plate obtained by stamping is worked as described above, thereby forming the projections  30 . The plate thickness at the projections  30  may be different from the thickness of the other portions of the arm portions  28 . Further, it is also possible to fold the end portions in the width direction (horizontal direction) thereof inwardly in the diverging direction of the clip  12 . In this case, it is possible to enhance the strength of the projections  30 . 
     The positions of the projections  30  of the arm portions  28  are determined as follows. 
     Regarding the second clip  12  onward, the distal end side portions of the projections  30  having a width not allowing them to enter the connection ring  14  (hereinafter referred to as upper end portions) are situated so as to abut the proximal end of the connection ring  14  retaining the arm portions  28  of each clip  12  when the clipping device is placed in the state as illustrated in  FIGS. 1A and 1B , that is, in the initial state immediately before the start of the clipping manipulation by the foremost clip  12 A, in which the plurality of clips  12  have been connected together and loaded into the sheath  16 . 
     In the clipping device  10 , to cause the foremost clip  12  to protrude from the sheath  16 , the sheath  16  is retracted with respect to the clips  12 . At this time, due to the frictional force between the sheath  16  and the connection rings  14  fitted into the sheath  16 , there is exerted on the connection rings  14  a force that would cause them to retreat with respect to the clips  12  together with the sheath  16 . However, by keeping the upper end portions of the projections  30  of the clips  12  in contact with the proximal ends of the connection rings  14 , the connection rings  14  are prevented from moving even when retracting the sheath  16 , making it possible to maintain the clips  12  and the connection rings  14  in the initial positional relationship. 
     The proximal end side portions of the projections  30  having a width not allowing them to enter the connection rings  14  are at the movement positions at the distal ends of the connection rings  14  or slightly on the distal end side thereof to obtain a pre-set fit-engagement force at the claw portions  22  of the clips  12  through the movement of the connection rings  14  at the time of clamping of the clips  12  by the connection rings  14 . 
     The distal ends of the connection rings  14  (i.e., clamping portions  40  thereof) move to the positions where they abut the projections  30  of the clips  12  or to positions immediately below the same, whereby the clips  12  can exert a predetermined fit-engagement force, e.g., the maximum fit-engagement force, at the claw portions  22 . 
     Further, by providing the clip  12  with the projections  30 , it is possible to prevent the connection rings  14  from moving toward the distal end side by an amount larger than the predetermined amount and to avoid excessive clamping of the clip  12  and, conversely, loosening of the clamping of the clip  12 . 
     As illustrated in  FIGS. 1A and 1B , the claw portions  22  of the second clip  12 B are engaged with the turned portion  24  of the first clip  12 A and retained by the connection ring  14 A in a closed state, whereby the first clip  12 A and the second clip  12 B are connected together. As illustrated in  FIG. 1A , the claw portions  22  of the second clip  12 B are engaged with the turned portion  24  of the first clip  12 A in a direction orthogonal thereto, with the first clip  12 A and the second clip  12 B being differing in orientation by 90 degrees. Similarly, the clips  12 C,  12 D, and  12 E are connected together, with their orientations alternately differing by 90 degrees. 
     Each ring  14  is fitted into the sheath  16  so as to be capable of advancing and retreating while covering the engagement portion between two clips  12  and maintaining their connected state. That is, the outer diameter of the connection rings  14  is substantially the same as the inner diameter of the sheath  16  so that they can smoothly advance and retreat within the sheath  16  as the clips  12  move.  FIGS. 3A through 3C  schematically illustrate the construction of each connection ring  14 .  FIG. 3A  is a front view of the connection ring  14 ,  FIG. 3B  is a sectional view thereof, and  FIG. 3C  is a bottom view thereof. 
     The connection ring  14  includes a clamping portion  40  and a retaining portion  42 . In the connection ring  14 , the clamping portion  40  formed of metal is fixed to the forward end of the retaining portion  42  formed of resin, and the two members form an integral structure. The retaining portion  42  formed of resin serves to maintain the connected state and to retain the clip within the connection ring, and the clamping portion  40  formed of metal serves to clamp the clip. It is also possible for the connection ring  14  to be formed by a single member if it can provide the functions of both the clamping portion  40  and the retaining portion  42 . 
     The clamping portion  40  is a cylindrical (ring-like) metal component mounted to the forward end side of the connection ring  14 , and has a hole whose inner diameter is larger than the width of the portion of the clip  12  in the vicinity of the crossing portion  26  and smaller than the width of the projections  30 . Thus, while the clamping portion  40  can move in the vicinity of the crossing portion  26  of the clip  12  it retains, it cannot be detached to the forward end side beyond the projections  30 . That is, the projections  30  function as a stopper determining the movement limit of the connection ring  14  advancing with respect to the clip  12 . 
     The clamping portion  40  is set at a predetermined position in the vicinity of the crossing portion  26  of the clip  12 . The clamping portion  40  moves from its initial position, i.e., from the crossing portion  26  toward the projections  30 , with the arm portions  28  of the clip  12  increasing in width, whereby it closes the arm portions  28  of the diverging clip  12  to effect fixation and clamping. As the material of the clamping portion  40 , there is used a metal with biocompatibility, for example, a stainless steel SUS  304 . By forming the clamping portion  40  of metal, it is possible to exert on the metal clip  12  a frictional force, which serves as the clamping force. 
     The retaining portion  42  is a schematically cylindrical (ring-like) component formed by resin molding. The retaining portion  42  has a first region  32  retaining the preceding clip  12  and a second region  34  which is a connection retaining region retaining the next clip  12  while connected to the preceding clip. 
     The first region  32  has a large circular hole capable of accommodating the turned portion  24  of the clip  12  and larger than the hole of the clamping portion  40 . On the outer surface of the forward end portion of the first region  32 , there is formed a stepped portion onto which the clamping portion  40  is to be fitted, and the clamping portion  40  and the retaining portion  42  are fit-engaged with each other through close fit such that they are not detached from each other while loaded in the sheath  16  and during clipping manipulation. Further, the first region  32  has skirt portions  38  each diverging while inclined in a skirt-like fashion with respect to the axis of the connection ring  14  main body. 
     The forward end side, that is, the upper, base portion of the skirt portion  38  as seen in  FIGS. 3A and 3B  is connected to the main body of the retaining portion  42 , whereas the lower, diverging portion thereof is partially separated from the main body to be radially diverged or closed. Two skirt portions  38  are formed so as to be separated from each other by 180 degrees at the same position in the pulling direction for the clip  12 , that is, in the vertical direction in  FIGS. 3A and 3B . 
     When left as they are, that is, when in a state in which no external force is being imparted thereto, the skirt portions  38  are diverged in a skirt-like fashion as illustrated in  FIG. 3A . At this time, the interior of the first region  32  of the retaining portion  42  forms a columnar space as illustrated in  FIG. 3B . When loading the connection rings  14  into the sheath  16 , the following takes place: in the case, for example, of the second connection ring  14 B illustrated in  FIG. 1B , the skirt portions  38  are pushed in to enter the internal space, and the inner peripheral side portions of the skirt portions  38  pressurize the side surface (edge portion) of the turned portion  24  of the clip  12 B retained by the first region  32 , thus retaining the clip  12 B such that it does not move in the rotating direction and the advancing/retreating direction within the connection ring  14 B. It is also possible for the skirt portions  38  to pressurize and retain the clip retained by the second region  34 , that is, the succeeding clip. 
     As in the case of the first connection ring  14 A illustrated in  FIG. 1A , the skirt portions  38  extend beyond the forward end of the sheath  16 , and are opened due to their own elasticity, releasing the retention of the clip  12 A and becoming wider than the inner diameter of the sheath  16  to prevent the connection ring  14 A from retracting into the sheath  16 . In this state, the manipulating wire  20  is pulled, and the clip  12 A retreats, whereby the connection ring  14 A advances relative to the clip  12 A to clamp the clip  12 A. 
     Thus, it is necessary for the skirt portions  38  to have elasticity so that they can be closed inwardly within the sheath  16  and widen in a skirt-like fashion when they get out of the forward end of the sheath  16  and released from the external force. At the same time, it is also necessary for the skirt portions  38  to exhibit rigidity enabling them to retain the clip  12  within the sheath  16  and to withstand the repulsive force of the clamping force of the clip  12  at the forward end of the sheath  16 . 
     From the above viewpoints, as the material of the retaining portion  42 , there is used a material exhibiting biocompatibility and providing the requisite elasticity and rigidity for the skirt portions  38 . As for their configuration, it is determined so as to satisfy the requirements in terms of elasticity and rigidity for the skirt portions  38 . As the material of the retaining portion  42 , it is possible to use, for example, polyphenylsulfone (PPSU). From the viewpoint of ease of production, it is desirable for the retaining portion  42  to be formed as an integral molding. 
     The second region  34  is provided on the proximal end side of the first region  32 . The succeeding clip  12  engaged with the clip  12  retained by the first region  32  is retained in a state in which the claw portions  22  thereof are closed while holding the closed end (tail portion) of the turned portion  24  of the preceding clip  12  therebetween. 
     The length of the second region  34  is substantially equal to the movement length required for the clamping portion  40  set at the initial position with respect to the clip  12  to move until the clamping of the clip  12  is completed. That is, while the clip  12  retreats relative to the connection ring  14  to be clamped, the second region  34  of the connection ring  14  maintains the connection between the two clips  12  retained therein, allowing the pulling force of the rear clip  12  to be transmitted to the front clip  12 , and when the clamping has been completed, the engagement portion of the two clips  12  is detached from the second region  34 , thereby canceling the connection between the clips  12 . 
     As illustrated in  FIG. 3C , the second region  34  has a hole  43  having the same inner diameter as the proximal end side portion of the first region  32 , and further, two grooves (recesses)  43   a  opposed to each other are formed. The grooves  43   a  can accommodate the arm portions  28  of the clip  12  retained in the second region  34 , with the claw portions  22  being closed. 
     The grooves  43   a  are provided at two positions in the direction in which the claw portions  22  of the clip  12  retained in the second region  34  are opened and closed (horizontal direction in  FIGS. 3B and 3C ). The plate surfaces of the arm portions  28  of the clip  12  retained in the second region  34  abut the inner walls of the grooves  43   a.  The width (opening width) of the grooves  43   a  is slightly larger than the maximum width of the arm portions  28  of the clip  12 , and the distance from the wall surface of one groove  43   a  to the wall surface of the other groove  43   a  is substantially equal to the sum total of the lengths of the two claw portions  22  of the clip  12  (length in the diverging direction). The width of the grooves  43   a  is smaller than the width of the projections  30  formed on the arm portions  28 . Thus, the projections  30  of the clip  12  retained in the second region  34  cannot enter the grooves  43   a.    
     The distance between the wall surfaces of the two grooves  43   a  is such that the engagement between the turned portion  24  of the preceding clip  12  and the claw portions  22  of the next clip  12  is not canceled, and the distance is smaller than the sum total of the lengths of the two claw portions  22  and the width of the portion of the turned portion  24  engaged with the claw portions  22 . 
     For example, the claw portions  22  of the clip  12  retained in the second region  34  may slightly overlap each other, or the connection of the clip with the preceding clip  12  may be maintained, with a slight gap being left between the claw portions  22 . 
     The engagement portion between the two clips  12  is retained in the portion of the second region  34  close to the boundary between the second region  34  and the first region  32 . Inside the sheath  16 , the turned portion  24  of the preceding clip  12  (e.g., the clip  12 B in the connection ring  14 B illustrated in  FIG. 1B ) is retained by the closed skirt portions  38  in the first region  32 , and hence the advancing/retreating movement and rotating movement of the clip is restrained. The next clip  12  (e.g., the clip  12 C in the connection ring  14 B illustrated in  FIG. 1B ) engaged with the preceding clip  12  is retained in an orientation differing by 90 degrees from the preceding clip by the grooves  43   a  of the second region  34 , whereby rotating movement of the clip is restrained, and the clip is engaged with the preceding clip restrained in advancing/retreating movement, thereby restraining the advancing/retreating movement thereof. That is, the engagement portion between the front and rear clips is retained by the connection ring  14  with very little play. 
     As illustrated in  FIGS. 1A and 1B , the claw portions  22  of the second clip  12 B are engaged with the turned portion  24  of the first clip  12 A, and the engagement portion is retained by the connection ring  14 A. The claw portions  22  of the second clip  12 B are retained in the closed state by the inner wall of the connection ring  14 A (second region  34  thereof). As a result, the connection of the first clip  12 A and the second clip  12 B is maintained. Similarly, the connection of the second clip  12 B and the third clip  12 C is maintained by the connection ring  14 B, the connection of the third clip  12 C and the fourth clip  12 D is maintained by the connection ring  14 C, the connection of the fourth clip  12 D and the fifth clip  12 E is maintained by the connection ring  14 D, and the connection of the fifth clip  12 E and the dummy clip  18  is maintained by the connection ring  14 E. 
     The rearmost clip  12 E is engaged with the dummy clip  18 , which is not used for clipping. At its forward end portion, the dummy clip  18  has a resilient portion of a configuration similar to that of the open end side half as from the crossing portion of the clip  12 . The resilient portion is engaged with the turned portion of the clip  12 E, with the claw portions thereof being closed, and releases the clip  12 E when the claw portions are opened. At the proximal end portion of the dummy clip  18 , there exits the connecting member  19 , to which the manipulating wire  20  is connected. 
     The sheath  16  is formed, for example, of a flexible coil sheath formed through intimate winding of metal wire. The inner diameter of the sheath  16  is one allowing canceling of the engagement between the turned portion  24  of the preceding clip  12  and the claw portions  22  of the next clip  12 . That is, the inner diameter of the sheath  16  is larger than the sum total of the lengths of the two claw portions  22  and the width of the turned portion  24  engaged with the claw portions  22 . 
     Here, the construction of each clip  12  and each connection ring  14  and the operation of each portion are described in detail taking the connection ring  14 A and the clips  12 A and  12 B retained thereby as an example.  FIGS. 4A and 4B  are sectional views illustrating stepwise the condition of the clips  12 A and  12 B and the connection ring  14 A during the clipping manipulation of the foremost clip  12 A.  FIG. 4A  corresponds to an enlarged view of the distal end portion of the clipping device of  FIG. 1A . In  FIG. 4A , the connection ring  14 B retaining the clip  12 B is omitted. Further, the operation described below also applies to the other, succeeding clips  12  and connection rings  14 . 
     In the state illustrated in  FIG. 4A , the connection ring  14 A is fitted onto the clip  12 A and the clip  12 B such that the clamping portion  40  thereof is at a predetermined initial position on the clip  12 A. This initial position is in the vicinity of the crossing portion  26  of the clip  12 A. The clamping portion  40  does not clamp the clip  12 A, and the arm portions  28  of the clip  12 A are diverged to the maximum. 
     The turned portion  24  of the clip  12 A is accommodated in the first region  32  of the connection ring  14 A, and the arm portions  28  of the clip  12 B is retained in the second region  34  of the connection ring  14 A, with the claw portions  22  being closed with the tail portion of the clip  12 A therebetween. The forward end of the clip  12 B substantially coincides with the upper end of the second region  34  of the connection ring  14 A, and the upper ends of the projections  30  of the clip  12 B abut the lower end of the connection ring  14 A. Thus, the length L 1  as measured from the forward end of the clip  12 B to the upper ends of the projections  30  is substantially equal to the length of the second region  34  of the connection ring  14 A. 
     In the state in which, as in the case of the second connection ring onward, i.e., the connection rings  14 B through  14 D, of  FIGS. 1A and 1B  are accommodated in the sheath  16 , and the skirt portions  38  are closed to retain the clips  12 B through  12 D in the first regions  32 , there is hardly any vertical play in the engagement portions between the front and rear clips  12 . Also in  FIG. 4A , such a state is substantially maintained. 
     When the tail portion of the clip  12 A and the forward end of the clip  12 B are engaged with each other with no play, and the upper ends of the projections  30  of the clip  12 B abut the lower end of the connection ring  14 A, the clamping portion  40  is brought to a predetermined initial position on the clip  12 A. That is, the projections  30  of the clip  12  also serve to determine the initial position of the clamping portion  40 . 
     In the state of  FIG. 4A , the length L 2  as measured from the lower ends of the projections  30  of the clip  12 A to the forward end of the connection ring  14  (clamping portion  40  thereof) is substantially equal to the above-mentioned length L 1 . The lengths L 1  and L 2  are equal to the movement amount of the connection ring  14 A with respect to the clip  12 A to clamp the clip  12 A, and are substantially equal to the pulling amount of the manipulating wire  20  (see  FIGS. 1A and 1B ) causing the clip  12 A, etc. to retreat relative to the connection ring  14 A, etc. 
     When, in the state of  FIG. 4A , the manipulating wire  20  is pulled by the predetermined amount L 2 , the clip  12 A moves by the length L 2  with respect to the connection ring  14 A, and, as illustrated in  FIG. 4B , the lower ends of the projections  30  of the clip  12 A are brought to the position where they abut the forward end of the connection ring  14 A or a position immediately above the same. 
     When the connection ring  14 A is brought to a position immediately below the projections  30 , the clip  12 A exerts a predetermined fit-engagement force at the claw portions  22 , e.g., the maximum fit-engagement force thereof, whereby the clamping of the clip  12 A by the clamping portion  40  of the connection ring  14  is completed. 
     By pulling the manipulating wire  20  by the length L 2 , the clip  12 B also moves by the same amount as the clip  12 A. That is, the clip  12 B moves by the length L 1  of the second region  34 , which is substantially equal to the above-mentioned length L 2 , and the forward end of the clip  12 B leaves the proximal end of the connection ring  14 A, with the engagement portion between the clip  12 A and the clip  12 B being detached from the second region  34  of the connection ring  14 A. 
     In this way, in the initial state, the clamping portion  40  of the connection ring  14 A is set at a fixed initial position of the preceding clip  12 A, that is, at a position at the distance L 2  from the lower ends of the projections  30  of the clip  12 A. By pulling the manipulating wire  20  each time by the fixed pulling amount (stroke) L 2 , and by moving the clamping portion  40  to the lower ends of the projections  30  of the clip  12 A, the clamping of the clips  12  can be completed. 
     As described above, in the clipping device  10 , the sheath  16  is caused to retreat with respect to the clip  12 A in order to bring the device from the state in which the foremost clip  12 A is completely accommodated in the sheath  16  (state of  FIG. 6A  described below) to the state in which the foremost clip  12 A protrudes from the forward end of the sheath  16  as illustrated in  FIG. 4A . If, at this time, the connection ring  14 A is allowed to move together with the sheath  16 , the position of the connection ring  14 A is deviated to the proximal end side with respect to the clip  12 A, and the distance from the lower ends of the projections  30  of the clip  12 A to the forward end of the connection ring  14 A becomes larger than L 2 . Then, if the manipulating wire  20  is pulled by the predetermined amount L 2 , the connection ring  14 A does not reach the predetermined position on the clip  12 A, that is, the lower end of the projections  30 , making it impossible to complete the clamping of the clip  12 A. 
     The front and rear clips  12 A and  12 B are retained by the connection ring  14 A in a state in which there is no play in the engagement portion. As a result, by pulling the manipulating wire  20  each time by a fixed pulling amount (stroke) L 2 =L 1 , it is possible to effect the clamping of the clip  12 A and the canceling of the connection between the front and rear clips  12 A and  12 B. 
     However, if, when causing the sheath  16  to retreat with respect to the clip  12 A, the connection ring  14 A moves together with the sheath  16 , and further, if the clip  12 A retained by the skirt portions  38  of the connection ring  14 A also moves together with the connection ring  14 A, play is generated in the engagement portion of the clips  12 A and  12 B. Then, if the clip  12 B moves toward the proximal end side through pulling of the manipulating wire  20 , the clip  12 A does not move by the amount corresponding to the play generated, and hence, if the manipulating wire  20  is pulled by the predetermined pulling amount L 2 , it is impossible to effect the clamping of the clip  12 A and the canceling of the connection. 
     In contrast, in the clipping device  10 , the projections  30  of the clip  12 B are held in contact with the proximal end of the connection ring  14 A, and movement of the connection ring  14 A when pulling down the sheath  16  is prevented, whereby it is possible to maintain the mutual positional relationship between the connection ring  14 A, the clip  12 A, and the clip  12 B. Thus, it is possible to always maintain a fixed pulling amount (stroke) for the manipulating wire  20 , making it possible to perform a stable, high precision manipulation. 
     Further, due to the projections  30  of the clip  12 B, the mutual positional relationship between the clips  12 A and  12 B and the connection ring  14 A is maintained, whereby it is possible to cause the clip  12 A to protrude by a fixed protruding amount from the connection ring  14 A in the initial state immediately before the start of the clipping manipulation, making it possible to obtain a predetermined diverging amount for the claw portions  22  of the clip  12 A. 
     In another form, instead of providing the clip  12  with the projections  30 , a step may be provided between the first region  32  and the second region  34  in the connection ring  14 , and the forward end of the lower clip  12  (bent portions at the forward ends of the arm portions  28 ) is caused to abut the step portion, thereby preventing rearward movement of the connection ring  14  with respect to the clip  12 . For example, at the forward end position of the clip  12 B retained by the connection ring  14 A, the inner diameter of the first region  32  may be made smaller than the inner diameter of the second region  34 , making it impossible for the forward end of the clip  12 B retained in the second region  34  to enter the first region  32 . 
     However, in a case in which the connection ring  14  is a very small component whose outer diameter is, for example, 2 mm or less, it is difficult to provide a large step therein, and to provide a sufficient contact portion to be held in contact with the forward end of the clip  12 . In such a case, it is more effective to provide the projections  30  on the clip  12 . 
     The proximal ends of the manipulating wire  20  and the sheath  16  are attached to the manipulating portion.  FIGS. 5A and 5B  schematically illustrate an example of the construction of the manipulating portion. In  FIGS. 5A and 5B , the left-hand side is the forward end side connected to the clipping device  10 , and the right-hand side is the rear end side (or the proximal end side). A manipulating portion  50  includes a wire manipulating handle  52  constituting a manipulating portion main body, and a sheath manipulating handle  54  serving as a grasping portion for grasping the proximal end portion of the sheath, with the sheath manipulating handle  54  being slidable with respect to the wire manipulating handle  52 . 
     The wire manipulating handle  52  includes a cylindrical case  58 , a positioning pipe  56  fixed coaxially to the forward end of the case  58 , and a lever  60  and a spring  62  retained inside the case  58 . 
     The lever  60  is retained inside the case  58  so as to be movable in the longitudinal direction (axial direction of the wire manipulating handle  52 ). A rear end part of the lever  60  appears through a window  59  provided at the central portion of the case  58 , and the operator can hook his finger onto the rear end part of the lever  60  to pull the lever  60  toward the rear end side. The spring  62  is attached to the rear end of the lever  60 . The spring  62  is compressed by pulling the lever  60  rearwards, and when the pulling force on the lever  60  is released, the spring  62  forwardly pushes back the lever  60  by repulsive force. As a result, the lever  60  is restored to the former position (home position). 
     The rearward movement limit for the lever  60  is determined by the window  59 . That is, the position where the surface  60 a of the lever  60  onto which the finger is hooked coincides with the rear end of the window  59  is the movement limit for the lever  60 . It is also possible to provide a regulating plate at the rear of the lever  60 , and to determine the rearward movement limit for the lever  60  through abutment of the rear end of the lever  60  against the regulating plate. 
     A regulating plate  61  is provided in front of the lever  60  to determine the home position of the lever  60 . The lever  60  is urged by the spring  62  and moves forwards until it abuts the regulating plate  61  to return to the home position. 
     In this way, the lever  60  can move longitudinally by a fixed amount between the home position and the rearward movement limit. 
     While in  FIG. 5A  the spring  62  is formed of a coil spring, this should not be construed restrictively. It is only necessary for the spring  62  to be capable of forwardly urging the lever  60 . Thus, it is also possible to use a plate spring or some other elastic member. 
     Fixed to the forward end of the lever  60  is the manipulating wire  20  for pulling the clips  12 . The manipulating wire  20  extends through the sheath manipulating handle  54  and the positioning pipe  56  to reach the lever  60 . 
     When the operator inserts his finger into the window  59  and pulls the lever  60  to move the lever  60  backwards, the manipulating wire  20  attached to the forward end of the lever  60  also moves, and the forward end of the manipulating wire  20  moves backwards. When the pulling force applied to the lever  60  is canceled and the lever  60  is restored to the former position, the manipulating wire  20  also moves, with its forward end returning to the former position. 
     The pulling amount of the manipulating wire  20  in the clipping manipulation is a very small amount, e.g., 3.1 mm. Thus, in order to give a reliable operational feel at the manipulating portion  50 , a pulling amount magnifying mechanism for the manipulating wire  20  may be provided between the pulling amount of the manipulating wire  20  and the manipulating amount of the lever  60 , making the movement amount of the lever  60  a predetermined number of times the movement amount of the manipulating wire  20 . 
     The positioning pipe  56  is a hollow pipe-like member through which the manipulating wire  20  passes. The inner diameter of the positioning pipe  56  is larger than the outer diameter of the sheath  16 , making it possible to insert the sheath  16  into the positioning pipe  56 . As illustrated in  FIG. 5B , a plurality of notches  66  are formed in the upper surface of the positioning pipe  56  at predetermined axial intervals L. The forward end portion of the positioning pipe  56  is inserted into the sheath manipulating handle  54 , and a detachment prevention ring  64  is attached to the forward end portion thereof. 
     As illustrated in  FIG. 5A , at the center of the detachment prevention ring  64 , there is formed a hole slightly larger than the outer diameter of the sheath  16 . The detachment prevention ring  64  retains the sheath  16  so as to allow the sheath  16  move in the axial direction. 
     The sheath manipulating handle  54  has a cylindrical case  68 , a support block  70 , and a sheath retaining ring  72 . 
     The support block  70  is arranged at the rear end of the sheath manipulating handle  54 , and slidably supports the positioning pipe  56  inserted into the sheath manipulating handle  54 . Further, as illustrated in  FIG. 5B , the forward end side surface of the support block  70  abuts the detachment prevention ring  64  attached to the forward end of the positioning pipe  56 , preventing the positioning pipe  56  from being detached from the sheath manipulating handle  54 . 
     The sheath retaining ring  72  is provided at the forward end of the case  68  on the axis of the sheath manipulating handle  54 , and fixedly retains the outer periphery of the sheath  16  inserted into the sheath manipulating handle  54 . Thus, when the sheath manipulating handle  54  moves, the sheath  16  moves together with the same. 
     The sheath manipulating handle  54  further has a button  74  protruding out of the case  68  and a claw  76  provided inside the case  68  and interlocked with the movement of the button  74 . The claw  76  is urged so as to be pressed against the positioning pipe  56 , and is caught by the notches  66  of the positioning pipe  56 , thereby effecting positioning on the sheath manipulating handle  54  with respect to the wire manipulating handle  52  and stopping the movement thereof. 
     When the button  74  is depressed, the claw  76  is raised above the notches  66 , enabling the wire manipulating handle  52  to move with respect to the sheath manipulating handle  54 . When the hand is released from the button  74  and the sheath manipulating handle  54  is moved with respect to the wire manipulating handle  52 , its movement is stopped when the claw  76  is caught by the next notch  66 . Thus, assuming that the interval L of the notches  66  is one stroke, the one sheath manipulating handle  54  and the sheath  16  can move by the stroke length L. The magnitude of L is, for example, 15.5 mm. 
     When the sheath  16  moves with the movement of the sheath manipulating handle  54 , the proximal end side end portion of the sheath  16  advances through the hole of the detachment prevention ring  64  to enter the interior of the positioning pipe  56 . 
     Next, the operation of the magazine type clipping device  10  is described.  FIGS. 6A through 6E  are partial sectional views illustrating stepwise the condition of the clipping device  10  during clipping manipulation. 
     First, as illustrated in  FIG. 6A , after five bleeding stop clip units (hereinafter simply referred to as clipping units) formed of the clips  12 A through  12 E and the connection rings  14 A through  14 E have been loaded into the sheath  16 , the sheath  16  is inserted into the forceps channel of an endoscope. As illustrated in  FIG. 6A , in this example, the forward end of the clip  12 A is substantially matched with the forward end of the sheath  16 . 
     The foremost clip  12 A is retained in the closed state by the inner wall of the sheath  16 . Each of the connection rings  14 A through  14 E is fitted such that the clamping portion  40  thereof is situated in the vicinity of the crossing portion  26  of each of the clips  12 A through  12 E. At this time, the upper ends of the projections  30  of the clips  12 B through  12 E are respectively situated directly below the connection rings  14 A through  14 D. 
     When the forward end of the sheath  16  reaches the forward end of the insert portion of the endoscope inserted into the living body, and protrudes from the forward end of the endoscope, in the manipulating portion  50  illustrated in  FIGS. 5A and 5B , the sheath manipulating handle  54  is pulled such that the claw  76  of the sheath manipulating handle  54  moves by the length L from the first notch  66  to the second notch  66 . Since the sheath  16  is fixed to the sheath manipulating handle  54 , the sheath  16  retreats by the same amount L as the movement amount L of the sheath manipulating handle  54 . Through this manipulation, solely the sheath  16  is drawn to the manipulating portion side, with the manipulating wire  20  remaining stationary. 
     When the sheath  16  is pulled by the predetermined amount L, which corresponds to the distance between the first notch  66  and the second notch  66 , the forward end of the sheath  16  is lowered to a position where the skirt portions  38  of the foremost connection ring  14 A are opened, and the claw portions  22  of the clip  12 A protruding from the sheath  16  are diverged by the urging force, whereby the state as illustrated in  FIG. 6B  is attained. As a result, it is possible to use the first clip  12 A. In  FIG. 6B , the skirt portions  38  of the connection ring  14 A are not illustrated because they are perpendicular to the plane of the drawing. 
     The connecting portion between the clip  12 A and the clip  12 B is situated directly below the skirt portions  38  of the connection ring  14 A, and hence, in the state as illustrated in  FIG. 6B , the forward end of the clip  12 B substantially coincides with the forward end of the sheath  16 . 
     When the sheath  16  is drawn, there is exerted a frictional force between the sheath  16  and the connection rings  14 A through  14 E fitted into the sheath  16 . However, between the connection rings  14 A through  14 E and the clips  12 A through  12 E, there are exerted the pressurizing force of the clips  12  due to the inner side portions of the closed skirt portions  38 , and the pressurizing force applied to the inner wall surfaces of the connection rings  14  (second regions  34  thereof, see  FIG. 3B ) due to the resilient force of the claw portions  22  of the succeeding clips  12  inclined to open. Further, the projections  30  of the clips  12 B through  12 E abut the proximal ends of the connection rings  14 A through  14 D, and cannot enter the holes  43  of the connection rings  14  (see  FIG. 3B ). Thus, even if the sheath  16  is drawn, the connection rings  14 A through  14 E make no unnecessary movement. Thus, the connection rings  14 A through  14 E can maintain the state in which they respectively retain the clips  12 A through  12 E. 
     Next, the clipping device  10  in the state of  FIG. 6B  is moved to press the claw portions  22  of the diverged clip  12 A against the portion to be subjected to clipping, and the lever  60  of the manipulating portion  50  (see  FIGS. 5A and 5B ) is pulled, whereby the manipulating wire  20  is pulled by a predetermined amount. By pulling the manipulating wire  20 , the clips  12 A through  12 E engaged sequentially starting from the dummy clip  18  are pulled all together. 
     At this time, in the state of  FIGS. 6B and 6C , the skirt portions  38  of the connection ring  14 A protruding from the sheath  16  are open, and the pressurizing retention of the clip  12 A by the skirt portions  38  is released. Further, the skirt portions  38  of the connection ring  14 E are open at the forward end of the sheath  16 , whereby the connection ring  14 A is prevented from retreating into the sheath  16 . Thus, as illustrated in  FIG. 6C , the foremost clip  12 A retreats relative to the connection ring  14 A. The forward end of the connection ring  14 A, that is, the clamping portion  40 , is pushed down to a position directly below the projections  30  of the clip  12 A, whereby the clamping of the clip  12 A by the connection ring  14 A is completed. 
     At the same time, the engagement portion between the clip  12 A and the next clip  12 B leaves the rear end of the connection ring  14 A. When the engagement portion between the clip  12 A and the clip  12 B is detached from the connection ring  14 A, the arm portions  28  are diverged by the resilient force of the clip  12 B until they abut the inner wall of the sheath  16 , and the claw portions  22  are opened until their interval becomes larger than the width of the turned portion  24  of the clip  12 A, thereby canceling the connection between the clip  12 A and the clip  12 B. As a result, the clip  12 A and the connection ring  14 A can be detached from the sheath  16 , and the clipping by the clip  12 A and the connection ring  14 A is completed. 
     On the other hand, the succeeding clips  12 B through  12 E are retained by the connection rings  14 B through  14 E whose skirt portions  38  are closed so as not to move in the rotating direction and the advancing/retreating direction with respect to the connection rings  14 B through  14 E. Further, the claw portions  22  are pressed against the inner walls of the second regions  34  (see  FIG. 3B ) of the connection rings  14 B through  14 E by the expanding force (urging force) of the claw portions  22  of the clips  12 C through  12 E engaged with the clips  12 B through  12 E and the claw portions of the dummy clip  18 , with the result that the frictional force between the clips  12 B through  12 E and the connection rings  14 B through  14 E is enhanced. Thus, the connection rings  14 B through  14 E move with the movement of the clips  14 B trough  14 E. 
     That is, the clips and the connection rings other than the foremost clip  12 A and the connection ring  14 A retaining the same, i.e., the clips  12 B through  12 E and the connection rings  14 B through  14 E advance and retreat integrally with respect to the sheath  16 , and the connected state of the clips  14 B through  14 E and the dummy clip  18  is maintained by the connection rings  14 B through  14 E. 
     The manipulating wire  20  is constructed so as to be capable of being pulled by a fixed amount from the initial state. This fixed amount is an amount equal to the length of the second regions  34  of the connection rings  14  or an amount slightly larger than that, and at the same time, it is an amount equal to the length from the lower ends of the projections  30  of each clip  12  to the forward end of the connection ring  14  retaining that clip  12 , or an amount slightly smaller than that. In the manipulating portion  50  of  FIG. 5A , this fixed amount is determined by the length as measured from the home position of the lever  60  to the movement limit at the rear. 
     After it has been pulled by the fixed amount, the manipulating wire  20  is soon restored by that fixed amount due to the spring  62  urging the lever  60  of the manipulating portion  50 . When the pulling force of the lever  60  is canceled at the manipulating portion  50 , the lever  60  is restored to the former position, and the manipulating wire  20  pulled from the state illustrated in  FIG. 6B  to the state illustrated in  FIG. 6C  is thereby restored to the former position, whereby the state as illustrated in  FIG. 6D  is attained. That is, as in the case of  FIG. 6B , the forward end of the second clip  12 B is restored to the position where it substantially coincides with the forward end of the sheath  16 . 
     Next, in order to place the second clip  12 B in the usable state, the sheath  16  is pulled by the predetermined one stroke, that is, by the length L. In the manipulating portion  50  of  FIG. 5A , the sheath manipulating handle  54  is moved by the length L from the second notch  66  to the third notch  66 . As a result, the forward end of the sheath  16  is lowered to the position where the skirt portions  38  of the next connection ring  14 B are opened, and the claw portions  22  of the clip  12 B protruding from the sheath  16  are diverged, whereby the state as illustrated in  FIG. 6E  is attained. 
     The length L, which corresponds to one stroke by which the sheath  16  is pulled, is substantially equal to the distance between the forward ends of the two front and rear clips  12  loaded into the sheath  16 , that is, a loading interval of the clips  12  in the sheath  16 . The length L, which corresponds to one stroke by which the sheath  16  is pulled, is determined by the length between the notches  66  of the manipulating portion  50 . 
     After that, as in the case of the clip  12 A described above, the claw portions of the clip  12 B are pressed against the portion to be subjected to clipping, and the manipulating wire  20  is pulled by a predetermined amount. As a result, the clamping of the clip  12 B by the connection ring  14 B is completed, and, at the same time, the connection between the clip  12 B and clip  12 C is canceled, whereby the clipping by the clip  12   b  is completed. 
     As described above, in the clipping device  10  of Embodiment 1, due to the connection ring  14  formed integrally by the metal clamping portion  40  and the resin retaining portion  42 , it is possible, with a single component, to prevent the sheath  16  from retreating, and to secure the strong clamping force of the clip  12 , that is, the requisite frictional force for clamping, while securing the requisite elasticity and rigidity for the skirt portions  38  retaining the clip  12 . 
     Further, the clip  12  is maintained in the connected state by the connection ring  14 , and hence the connection state of the clip  12  is reliably maintained. In addition, the connection portion of the clip  12  is covered with the connection ring  14 , and hence there is no fear of the inner wall of the sheath  16  being flawed by a corner portion of the connecting portion of the clip  12  at the time of clipping manipulation or the like, and, when inserting the sheath  16  into the endoscope, there is very little possibility of twisting or torsion being generated in the clip  12  at the connection portion. 
     Further, in the clipping device  10  of Embodiment 1, the retaining portion  42  of the connection ring  14  is formed of resin, and hence the friction between the connection ring  14  and the inner wall of the sheath  16  is small, and it is possible to smoothly perform the manipulation of causing the clip  12  to advance and retreat by the manipulating wire  20  and the manipulation of pulling the sheath  16 , with there being no fear of the inner wall of the sheath  16  being flawed. It is desirable for the outer diameter of the clamping portion  40  to be equal to or slightly smaller than the outer diameter of the retaining portion  42 . 
     The sheath  16  loaded with the clips  12  has to pass a curved portion in the endoscope when being inserted into the endoscope inserted into the living body. In this regard, the retaining portion  42  is formed of resin, and hence it is superior in flexibility, and can be bent while retaining the connecting portion of the clips  12 . 
     In the state in which the clips are set in the sheath  16 , the skirt portions  38  of the retaining portions  42  of the connection rings  14  retain the clips  12  through pressurization, and hence it is possible to retain the connecting portions of the clips  12  in a fixed state, and there is very little play in the connecting portions. Thus, the advancing/retreating movement at the time of manipulation by the manipulating wire  20  is stabilized, and the error in the movement amount is small, making it possible to effect movement with high precision. 
     By pulling the dummy clip  18  and the plurality of clips  12  connected thereto by a predetermined length in one direction by the manipulating wire  20 , it is possible to effect the clamping of the foremost clip  12  by the clamping portion  40  of the connection ring  14  and the canceling of the connection with the next clip  12 , and hence it is possible to perform the clipping by the foremost clip  12 . Further, by pulling the sheath  16  toward the manipulating portion side by the predetermined length L, the next clip  12  becomes usable, thus making it possible to continue clipping. 
     While in the above-mentioned example the clips  12  are connected together with their orientations alternately changed by 90 degrees, this should not be construed restrictively, and the inner configuration of the connection clip can be selected according to the configuration of the engagement portion. For example, it is also possible to adopt a clip of a configuration in which twisting is effected by 90 degrees at the portion between the claw portions  22  and the turned portion  24 , connecting together the consecutive clips in the same orientation. Further, by using a closed clip with a turned portion, it is advantageously possible to impart a resilient force pressurizing the turned portion and diverging the arm portions. The present invention, however, is also applicable to a construction adopting an open clip (U-shaped clip) with no turned portion. 
     Next, a package for the clips  12  used in the clipping device  10  is described. 
       FIGS. 7A through 7C  illustrate a connection clip package  80 . In the connection clip package  80 , a predetermined number of clip units (clips  12  with the connection rings  14  fitted thereto) to be used in the above-mentioned magazine type clipping device  10  are previously connected together and accommodated in the same manner as when they are loaded into the sheath  16 , thus forming a package.  FIG. 7A  is a front view,  FIG. 7B  is a sectional view, and  FIG. 7C  is a sectional view taken along a plane orthogonal to the axis of the case. In the following, the left-hand side in  FIGS. 7A and 7B  is referred to as the forward end, and the right-hand side thereof as the rear end. 
     As illustrated in  FIG. 7A , the connection clip package  80  includes a case  82 , a top cap  84 , and a bottom cap  86 . 
     The case  82  is of a cylindrical configuration, and accommodates therein the clip units including the clips  12  and the connection rings  14 . As illustrated in  FIGS. 7A and 7C , the case  82  is formed by combining two case components  82   a  and  82   b  which are semi-cylindrical and substantially of the same configuration. The top cap  84  is fitted onto the forward ends of the two case components  82   a  and  82   b,  and the bottom cap  86  is fitted onto the rear ends thereof, maintaining the case  82  in the closed state. 
     It is desirable for the case  82  to be transparent or translucent so that its interior can be seen. Further, from the viewpoint of impact resistance, ease of handling, and ease of molding, it is desirable for the case to be formed of a resin that is not deteriorated in the fluctuation range of the ambient temperature (e.g., 5° C. to 38° C.). While in this embodiment the case  82  is formed in a cylindrical configuration, the outer configuration of the case  82  is not restricted to a columnar one, and it may also be of a prism-like configuration. 
     The connection clip package  80  accommodates medical clips, and hence it is necessary to maintain the interior of the case  82  in a hermetically sealed condition. For this purpose, in the case  82 , the outer surfaces of the case components  82   a  and  82   b  are covered with a cover  88  made of a transparent resin, thus securing the airtightness of the interior of the case  82 . Alternatively, it is also possible to form the case components  82   a  and  82   b  of the case  82  of an elastic material, and to keep the mating surfaces of the case components  82   a  and  82   b  pressed against each other by the top cap  84  and the bottom cap  86 , thereby securing the airtightness. It is also possible to provide packing between the case components  82   a  and  82   b  to secure the requisite airtightness. 
     There are no particular limitations regarding the top cap  84  and the bottom cap  86  as long as they can hermetically seal the case components  82   a  and  82   b,  and they may be formed of rubber or resin. The bottom cap  86  is detachable. When loading the clip units in the case  82  into the sheath, the bottom cap  86  is removed, and the clip units therein are drawn out while in the connected state. It does not matter whether the top cap  84  is detachable or not. Further, it is also possible to form the forward end portion by the case  82 , without providing any top cap  84 . 
     As illustrated in  FIG. 7B , there is formed in the case  82  a hole whose inner diameter is slightly larger than the outer diameter of the connection rings  14  and substantially equal to the inner diameter of the sheath into which the clip units are loaded, with the hole extending through the entire case  82 . The five clips  12 A through  12 E connected together and the dummy clip  18  and the five connection rings  14 A through  14 E covering the connecting portions thereof are accommodated in the hole. The forward end of the foremost clip  12 A is protected by the portion protruding from the top cap  84  into the case  82 . The connecting member  19  at the rear end of the dummy-clip  18  connected to the rearmost clip  12 E is retained by the bottom cap  86 . 
     At the rear end portion of the case  82 , there is formed a sheath fit-engagement portion  98  into which the sheath can be inserted. The sheath fit-engagement portion  98  has a diameter substantially equal to the outer diameter of the sheath into which the clips  12 A through  12 E and the connection rings  14 A through  14 E are loaded. The diameter of the sheath fit-engagement portion  98  is larger than the diameter of a straight portion  90  of the hole of the case  82  by approximately the thickness of the sheath, and hence there is a corresponding step at the forward end of the sheath fit-engagement portion  98 . When loading the clip units in the case  82  into the sheath, the sheath is inserted up to the forward end of the sheath fit-engagement portion  98 . 
     The forward end of the sheath fit-engagement portion  98  is substantially at the same position as the forward end of the dummy clip  18  accommodated in the case  82 , that is, substantially at the same position as the rear end of the rearmost clip  12 E, and it is situated directly below the skirt portions  38  of the connection ring  14 E. 
       FIG. 8  is a partial enlarged view of  FIG. 7B . As illustrated in  FIG. 8 , in the inner surface of the case  82 , there are formed, at the positions where the connection rings  14 A through  14 E are accommodated, recesses  96  corresponding to the configuration of the skirt portions  38 . Each recess  96  is formed by a first inclined portion  92  expanding radially outwards from the straight portion  90  at substantially the same angle of the inclination of the skirt portions  38  in the natural state so as to be substantially in conformity with the expansion of the skirt portions  38 , and a second inclined portion  94  radially narrowed from the expanded end portion (rear end) of the first inclined portion  92 . 
     As described above, the clips  12 A through  12 E are connected together, with their orientations alternately changed by 90 degrees, and, in correspondence therewith, the connection rings  14 A through  14 E are fitted onto the clips  12 A through  12 E with their orientations alternately changed by 90 degrees. Thus, the positions of the recesses  96  of the case  82  are also deviated from each other by 90 degrees in the circumferential direction at positions corresponding to the connection rings  14 A through  14 E. As illustrated in  FIG. 7B , two upper and lower recesses  96  are provided for each recess  96  corresponding to the skirt portions  38  of each of the connection rings  14 A,  14 C, and  14 E. Two recesses are formed in a direction perpendicular to the plane of  FIG. 7B  for each recess  96  corresponding to the skirt portions  38  of each of the connection rings  14 B and  14 D. 
     It is also possible for the recesses  96  to be formed over the entire periphery at the positions corresponding to the skirt portions  38  in the longitudinal direction (the horizontal direction as seen in the drawing). 
     Due to the first inclined portions  92  of the recesses  96 , the connection rings  14 A through  14 E are accommodated in the case  82  with their skirt portions  38  being in the diverged state without receiving any external force. Thus, it is possible to prevent the elasticity of the skirt portions  38  from deteriorating while stored in the case  82 , thus making it possible to maintain the performance of the connection rings  14 A through  14 E. 
     When the clips  12 A through  12 E and the connection rings  14 A through  14 E are drawn out of the case  82 , the skirt portions  38  open in the recesses  96  are gradually closed while guided by the second inclined portions  94 , and hence they are not turned up when they leave the recesses  96 , and can move within the case  82  while accommodated in the straight portion  90 . 
     The clip units are accommodated in the case  82  as follows. 
     First, the clips  12 A through  12 E are successively connected together. In connecting the clips  12 A through  12 E, the turned portion  24  of one clip  12  is engaged with the claw portions  22  of the next clip  12 , and the engagement portion is set at a predetermined position on the connection ring  14 . The last clip  12 E is connected to the dummy clip  18  in a similar manner. 
     The connection clips previously connected together and assembled in the state in which they are to be loaded into the sheath  16  are accommodated in one case component  82   a  of the case  82 . After that, the other case component  82   b  is put on the case component  82   a,  and the top cap  84  and the bottom cap  86  are fitted, whereby the connection clip package  80  is obtained. 
     Next, a method of loading the clip units into the sheath  16  from the connection clip package  80  is described with reference to  FIGS. 9A through 9C . 
     Prior to the loading of new clip units, the dummy clip  18  that has been engaged with the rearmost clip  12 E already used is removed from the manipulating wire  20 . 
     When, in the clipping device  10  described above, all the clips  12  have been used, the forward end of the dummy clip  18  substantially coincides with the forward end of the sheath  16 . In the manipulating portion  50 , the claw  76  of the sheath manipulating handle  54  is on the sixth notch  66  after the five clips have been used. When, in this state, the sheath manipulating handle  54  is further pulled toward the wire manipulating handle  52  side, the sheath  16  is caused to retreat, and the dummy clip  18  protrudes from the forward end of the sheath  16 , making it possible to detach the dummy clip  18  from the manipulating wire  20 . 
     When, with the dummy clip  18  being removed, the sheath manipulating handle  54  is restored to the former position, that is, the position where the claw is on the sixth notch  66 , the forward end of the manipulating wire  20  is retracted from the forward end of the sheath  16  by a length K as illustrated in  FIG. 9A . 
     On the other hand, in the case  82 , the length in the depth direction of the sheath fit-engagement portion  98  is determined such that the length as measured from the position where the forward end of the manipulating wire  20  connected to the connecting member  19  is situated to the forward end of the sheath fit-engagement portion  98  is K. In this way, the positional relationship between the sheath  16  before fit-engagement with the case  82  and the manipulating wire  20  is maintained also after the sheath  16  and the case  82  have been fit-engaged with each other, and hence, when the sheath  16  is fit-engaged, it is possible to prevent any surplus force such as the tensile force due to manipulating wire  20  from being applied to the clips  12 A through  12 E in the case  82 . 
     First, as illustrated in  FIG. 9A , when loading the clip units, the bottom cap  86  of the connection clip package  80  is removed, and the manipulating wire  20  protruding from the forward end of the sheath  16  is connected to the connecting member  19  at the rear end of the dummy clip  18  in the case  82 . 
     As illustrated in  FIG. 10 , the connecting member  19  at the rear end of the dummy clip  18  has a connection ring  19   a  and a cover  19   b.  At the time of connection with the manipulating wire  20 , the connection ring  19   a  is drawn out of the cover  19   b,  and is connected to the manipulating wire  20 , and then the connecting portion thereof is covered with the cover  19   b.    
     A hook-like member  20   a  is attached to the forward end of the manipulating wire  20 . The hook-like member  20   a  of the manipulating wire  20  is hooked onto the connection ring  19   a  of the connecting member  19  to connect the dummy clip  18  and the manipulating wire  20  to each other. 
     The connecting portion of the hook-like member  20   a  and the connection ring  19   a  is protected against detachment by being covered with the cover  19   b.    
     When the manipulating wire  20  is connected to the dummy clip  18  in the case  82 , the operator holds the sheath  16  and the case  82 , and inserts the end portion of the sheath  16  into the sheath fit-engagement portion  98  of the case  82 . Then, the sheath manipulating handle  54  of the manipulating portion  50  (see  FIGS. 5A and 5B ) is caused to advance with respect to the wire manipulating handle  52 , whereby the sheath  16  is caused to advance with respect to the manipulating wire  20 , and the sheath  16  is inserted up to the forward end of the sheath fit-engagement portion  98 . 
     In order to connect the manipulating wire  20  to the dummy clip  18 , the sheath manipulating handle  54  that has been drawn to the wire manipulating handle  52  side, is restored to the former position, that is, the position where it is engaged with the sixth notch  66 , whereby, as illustrated in  FIG. 9B , it is possible to insert the sheath up to the forward end of the sheath fit-engagement portion  98  to fit-engage it with the case  82 . 
     It is also possible to adopt some other construction as long as the connecting member  19  (rear end portion of the dummy clip  18 ) and the forward end of the manipulating wire  20  are detachable with respect to each other and no detachment occurs as a result of the advancement/retreating movement of the manipulating wire  20 . 
     In order to enhance the fit-engagement force exerted between the sheath  16  and the case  82  to prevent detachment of the sheath  16  and the case  82  from each other during clip loading manipulation, a minute protrusion may be imparted to one or both of the outer surface of the sheath  16  and the surface of the sheath fit-engagement portion  98 . Due to the provision of such a minute protrusion, the fit-engagement portion can be placed in a lightly press-fitted state. Further, it is possible to enhance the frictional force to reliably maintain the fit-engagement state. 
     In the state in which the sheath  16  has been fit-engaged with the sheath fit-engagement portion  98  of the case  82 , the inner diameter of the straight portion  90  of the case  82  and the inner diameter of the sheath  16  are substantially equal to each other. 
     Next, as illustrated in  FIGS. 9B and 9C , solely the sheath  16  is moved toward the forward end side by a length M, with the manipulating wire  20  remaining at the same position, and, with that, the case  82  is moved toward the forward end side by the length M. Through the movement of the sheath  16  and the case  82 , the clips  12 A through  12 E and the connection rings  14 A through  14 E in the case  82  are successively loaded into the sheath  16  starting with the rear end side. 
     The movement of the sheath  16  is effected by moving the sheath manipulating handle  54  of the manipulating portion  50  to the forward end side with respect to the wire manipulating handle  52 . In the manipulating portion  50  of  FIGS. 5A and 5B , the sheath manipulating handle  54  is caused to slide forwards at one time by the length M with respect to the wire manipulating handle  52  from the state in which the hook  76  is engaged with the sixth notch  66  as from the front side to the position where it is engaged with the first notch  66 . The length M is equal to the sum total of the five intervals L between the notches  66 . 
     That is, the movement length M of the sheath  16  at the time of clip loading is equal to a length obtained by multiplying the loading interval L of the clips  12  of the sheath  16 , that is, the amount L by which the sheath  16  is caused to retreat each time one clip  12  is used, by the number of clips  12  connected together for use in the clipping device  10 . 
     As described above, in the manipulating portion  50 , the use of the connection clips is started from the state in which the claw  76  is hooked onto the first notch  66  as from the front side, and, each time one clip  12  is used, the sheath manipulating handle  54  is caused to slide to the next notch  66  on the rear side, whereby the sheath  16  is caused to retreat, and the clipping device is placed in the state in which the next clip  12  can be used. This operation is repeated the number of times corresponding to the number of clips  12  loaded (which is five in this example), and, in the state in which all the clips  12  have been used, the sheath manipulating handle  54  moves to the sixth notch  66  to approach the wire manipulating handle  52  side. Thus, the forward end of the manipulating wire  20  has advanced toward the forward end of the sheath  16 . 
     At the time of loading of new connection clips, the manipulating wire  20  and the clip row of the connection clip package  80  are connected together with all the clips  12  having been used, the sheath  16  is restored forward by the amount it has moved at the time of use, that is, L multiplied by 5=M, whereby it is possible to load a new clip row in the same condition as the former clip row. That is, the forward end of the foremost clip  12  of the newly loaded clip row is placed at a position substantially coinciding with the forward end of the sheath  16 . 
     When moving the sheath  16  toward the forward end of the connection clip package  80  through manipulation of the manipulating portion  50 , it is desirable to move the sheath  16  and the case  82  while pressing the portion in the vicinity of the forward end of the sheath fit-engagement portion  98  indicated by the arrow in  FIGS. 9B and 9C . When the sheath  16  and the case  82  move with respect to the clips  12  connected to the manipulating wire  20  and the connection rings  14 , a pulling force is exerted on the clip row formed of the clips  12 A through  12 E and the dummy clip  18  connected together. However, by moving the sheath  16  and the case  82  while pressing the portion in the vicinity of the forward end of the sheath fit-engagement portion  98 , it is possible to suppress the pulling force applied to the clips  12 A through  12 E to a low level, thus making it possible to prevent troubles such as deviation of the interval of the clips  12 , detachment of the connecting portion from the connection rings  14 , and deformation of the clips  12 . 
     Further, as illustrated in  FIG. 9B , the forward end of the sheath fit-engagement portion  98  is directly below the-recess  96  (see  FIG. 8 ) accommodating the skirt portions  38  of the connection ring  14 E, and hence, by pressing this portion in the vicinity of the forward end, it is possible to smoothly close the skirt portions  38  staying in this recess  96  or passing this recess  96 . 
     In the case  82 , the skirt portions  38  of the connection rings  14 A through  14 E are accommodated in the recesses  96  in the open state. However, when the case  82  moves toward the forward end, the skirt portions  38  are closed while guided by the second inclined portions  94  of the recesses  96 , and accommodated in the straight portion  90  to be drawn into the sheath  16  as they are. The skirt portions  38  of the connection rings  14 A through  14 C pass the other recesses  96  on the rear end side. However, if, in this process, the skirt portions  38  thereof are once opened at the first inclined portions  92 , they are closed again at the second inclined portions  94 , and are guided to the straight portion  90 . 
     The inner walls of the second regions  34  (see  FIG. 3B ) on the rear side of the connection rings  14 A through  14 E are pressurized by the urging force with which the claw portions  22  of the succeeding clips  12 B through  12 E and the dummy clip  18  are inclined to be diverged. Thus, in the case  82 , the connected state of the clips, and the positional relationship between the clips  12 A through  12 E and the connection rings  14 A through  14 E are maintained. 
     Further, when loading the clips into the sheath  16 , the skirt portions  38  move from the recesses  96  to the straight portion  90  to be thereby closed, whereby the clips  12 A through  12 E in the connection rings  14 A through  14 E are pressurized by the inner side portions of the skirt portions  38 , and the connection rings  14 A through  14 E maintain the clips  12 A through  12 E and the dummy clip  18  in the connected state. Thus, at the time of loading of the clips into the sheath  16 , it is possible to prevent disengagement of the clips  12 A through  12 E and the dummy clip  18  and deviation in their positional relationship with the connection rings  14 A through  14 E. 
     As a result of the movement of the sheath  16  by the length M, the forward end of the sheath  16  moves to the position where it accommodates the forward end of the foremost clip  12 A, whereby the loading of the clips into the sheath  16  is completed. At the time of completion of the loading, in the manipulating portion  50  (see  FIGS. 5A and 5B ), the sheath manipulating handle  54  moves toward the forward end, and the claw  76  is hooked onto the first notch  66 . 
     In this way, the connection clip package  80  allows distribution and storage in the state in which the clips are connected together. Further, it allows loading of the clips into the sheath  16  by a simple manipulation while maintaining the connected state. Thus, the operational burden on the operator is small, and the loading of the clips can be effected easily in a short time. 
     Further, solely by performing the above-mentioned loading manipulation, the newly loaded clips can be placed at predetermined positions in the sheath  16 . Thus, there is no need to perform fine adjustment on, for example, the amount by which the clip  12  protrudes from the sheath  16  during clipping manipulation, thus facilitating the clipping manipulation. 
     While in Embodiment 1 described above the dummy clip  18  and the manipulating wire  20  are detachably connected via the connecting portion  19 , this should not be construed restrictively, and it is also possible to fixedly connect the manipulating wire  20  to the dummy clip  18 . 
     Embodiment 2 
     Next, Embodiment 2 of the present invention is described. While the clipping device of Embodiment 1 described above is of the magazine type, the clipping device of Embodiment 2 is of a single-loader type.  FIG. 11  illustrates a retaining ring  48  used in the clipping device of Embodiment 2. 
     The retaining ring  48  includes a clamping portion  40  similar to the clamping portion  40  of the connection ring  14  used in Embodiment 1, and a retaining portion  44  formed by shortening the retaining portion  42  and substantially formed solely of the first region  32 . The construction and operation of the clamping portion  40  are the same as those of the clamping portion  40  of the connection ring  14  of Embodiment 1, and the construction and operation of the retaining portion  44  are the same as those of the first region  32  of the retaining portion  42  of the connection ring  14  of Embodiment 1. 
       FIGS. 12A through 12D  illustrate a clipping device  46  according to Embodiment 2.  FIGS. 12B and 12D  are views as seen from an angle differing by 90 degrees from  FIGS. 12A and 12C , respectively. 
     The clipping device has one clip  12 , a retaining ring  48  retaining the clip  12 , a hook  49  engaged with the clip  12 , and the manipulating wire  20  connected to the hook  49 . Those components are fitted into the sheath  16 . 
     As illustrated in  FIGS. 12C and 12D , a bleeding stop clip unit including the clip  12  and the retaining ring  48  is loaded into the forward end portion of the sheath  16 . The loading of the bleeding stop clip unit is conducted, for example, as follows: the retaining ring  48  is previously fitted onto the clip  12 , and the hook  49  is engaged with the turned portion  24  of the clip  12 ; the hook  49  is attached to the forward end of the manipulating wire  20  protruding from the forward end of the sheath  16 , and then the sheath  16  is caused to advance relative to the manipulating wire  20  to accommodate the clip  12  in the sheath  16 . 
     When solely the sheath  16  is pulled by a predetermined amount toward the manipulating portion with the manipulating wire  20  remaining as it is, the forward end of the sheath  16  is lowered to a position where the skirt portions  38  of the retaining ring  48  are opened, and the claw portions  22  of the clip  12  are diverged to attain the state as illustrated in  FIGS. 12A and 12B . When, in this state, the manipulating wire  20  is pulled, the clip  12  retreats with respect to the sheath  16  and the retaining ring  48  that has become incapable of retreating due to the skirt portions  38  opened, and the clamping portion  40  of the retaining ring  48  is forced into the forward end portion of the clip  12 , whereby the clamping of the clip  12  by the retaining ring  48  is completed. At the same time, the engagement portion of the clip  12  and the hook  49  leaves the rear end of the retaining ring  48 , and the engagement of the clip  12  and the hook  49  is canceled, whereby the clipping by the clip  12  is completed. 
     The hook  49  may be formed so as to undergo plastic deformation upon a fixed level of pulling force. After clamping the clip  12  by the retaining ring  48 , the manipulating wire  20  is further pulled to apply a force larger than the above-mentioned fixed level of pulling force, whereby the hook  49  is deformed, and its engagement with the clip  12  is canceled. 
     After performing clipping one time, the sheath  16  is drawn out of the endoscope, and the next bleeding stop unit is attached to the forward end of the manipulating wire, whereby it is possible to perform next clipping. 
     Embodiment 3 
     Instead of the connection rings  14  of the clipping devices  10  of Embodiment 1, it is possible to use a connection ring  114  as illustrated in  FIGS. 13A through 13C . 
     The connection ring  114  is of the same construction as the connection ring  14  of Embodiment 1 except that two slits  46  are formed in a second region  134  of a retaining portion  142 . That is, the connection ring  114  includes the metal clamping portion  40  and the resin retaining portion  142 , and the retaining portion  142  has a first region  32  and a second region  134 , with the second region  134  having the slits  46  cut from the proximal end thereof at positions opposed to each other. 
     The slits  46  are formed at two positions deviated from the skirt portions  38  by 90 degrees so as to be shallower than the upper end of the second region  134 . In other words, the slits  46  are provided at positions deviated by 90 degrees from the direction in which the clips  12  retained by the second region  134  are diverged. 
     Due to the provision of the slits  46 , the connection ring  114  is improved in terms of flexibility, and the clipping device  100  can pass a curved portion of small curvature. Further, due to the provision of the slits  46 , the hem (proximal end portion) of the connection ring  114  is partially turned up, and hence, when the front and rear clips  12  are connected together prior to the loading of the clips  12  into the sheath  16 , the connection is advantageously facilitated through the turning of the hem of the connection ring  114 . 
     The slits  46  are situated so as to be shallower than the skirt portions  38 , whereby a substantial reduction in the strength of the connection ring  114  is prevented. Further, the depth of the slits  46  is shallower than the position of the rear end of the clip  12  retained in the first region  32 , that is, shallower than the engagement position of the clips  12 , and hence, also in the connection clip unit prior to the loading into the sheath  16 , it is possible to maintain the retention of the clip  12  in the second region  134  of the connection ring  114 . 
     Embodiment 4 
     A connection clip package  100  according to Embodiment 4 is described with reference to  FIGS. 14A through 14C . The connection clip package  100  has a case  102  that is of a double structure formed of an inner cylinder  104  and an outer cylinder  106 . A top cap  84  fitted onto the forward end of the inner cylinder  104  and the outer cylinder  106  and a bottom cap  86  fitted onto the rear end thereof are similar the top cap  84  and the bottom cap  86  of the connection clip package  80  described above. 
     The inner cylinder  104  is a cylindrical member formed of an elastic material. The configuration of the hole of the inner cylinder  104  is the same as the configuration of the hole of the case  82  of the connection clip package  80  described above. The straight portion  90  has recesses  96  formed at a position corresponding to the skirt portions  38  of the connection rings  14 A through  14 E. Formed at the rear end portion of the inner cylinder  104  is the sheath fit-engagement portion  98  whose diameter is slightly larger than that of the straight portion  90  and substantially equal to the outer diameter of the sheath  16 . 
     The outer cylinder  106  is a cylindrical member covering the inner cylinder  104 . The outer cylinder  106  exhibits elasticity and has a plurality of bar members  108  arranged parallel to the axial direction thereof. As illustrated in  FIG. 14C , four bar members  108  are arranged at an interval of 90 degrees. The bar members  108  are arranged in correspondence with the positions of the skirt portions  38  of the connection rings  14 A through  14 E, that is, the positions of the recesses  96  of the inner cylinder  104 . 
     The top cap  84  and the bottom cap  86  are fitted to both ends of the bar members  108 , whereby the radial position of the case  102  is fixed. The bar members  108  support the case  102  during distribution and storage so that the case  102  (inner cylinder  104  and outer cylinder  106 ) formed of an elastic material may not be bent or crushed under an external force, thus protecting the clip units therein against deformation and breakage. 
     When the bottom cap  86  are pressurized with the bottom cap  86  being removed, the bar members  108  presses the case  102  as a whole in the axial direction to reduce in diameter thereof. 
     When loading the clips of the connection clip package  100  into the sheath  16 , the bottom cap  86  is removed as in the case of the connection clip package  80  of Embodiment 1, and the manipulating wire  20  is connected to the connecting member  19  at the rear end of the dummy clip  18 . Then, the forward end of the sheath  16  is inserted into the interior of the case  102  to be fit-engaged with the sheath fit-engagement portion  98 , and the manipulating wire  50  is manipulated to move the sheath  16  and the case  102  toward the forward end with respect to the manipulating wire  20  while pressing the sheath fit-engagement portion  98  by the operator&#39;s hand. 
     Here, by pressing the four bar members  108 , the case  102  as a whole is pressurized in the axial direction from four directions. As a result, the case  102  formed of an elastic material is crushed, and the interval between the opposing recesses  96  is reduced, whereby the interval between the opposing recesses  96  is reduced, and the skirt portion  38  accommodated in the recesses  96  are closed. When, in this state, the sheath  16  and the case  102  are caused to advance, the skirt portions  38  can be more smoothly closed, making it possible to load the clips  12 A through  12 E and the connection rings  14 A through  14 E smoothly into the sheath  16 . 
     It is also possible to press the bar members  108  with the top cap  84  also being removed. In this case, the case  102  is pressurized substantially uniformly in the axial direction. Further, of the four bar members  108 , it is also possible for the two opposing ones to be pressed alternately. 
     In another method, when high elasticity is imparted to the inner cylinder  104  and the outer cylinder  106 , and the case  102  is deformed to a sufficient degree by pressing the bar members  108 , thereby closing the skirt portions  38  of the connection rings  14 A through  14 E, and when the sheath  16  can be inserted into the inner cylinder  104 , the sheath  16  may be caused to enter the gap between the inner cylinder  104  and the clips  12 A through  12 E and the connection rings  14 A through  14 E, with the case  102  being pressed by the bar members  108 , thereby loading the clips into the sheath  16 . 
     In this case, there is no need to provide the second inclined portions  94  to the recesses  96 . For example, the rear ends of the first inclined portions  92  may be formed as surfaces substantially perpendicular to the axial direction like the skirt portions  38 . 
     Also in the connection clip package  100 , distribution and storage are possible with the clips being connected together. Further, it is possible to load the clips into the sheath  16  while maintaining the connected state. 
     Embodiment 5 
     Next, a connection clip package  110  according to Embodiment 5 is described with reference to  FIGS. 15A through 15C . The connection clip package  110  is of the same construction as the connection clip package  80  except that its sheath fit-engagement portion  102  is formed up to a position shallower than that of the sheath fit-engagement portion  98  of the connection clip package  80  of Embodiment 1. In the connection clip package  110 , the same components as those of the connection clip package  80  are indicated by the same reference numerals, and a detailed description thereof is omitted. 
     In the case  82  of the connection clip package  110 , the sheath fit-engagement portion  102  is provided to extend to a position on the rear side of the forward end of the accommodated dummy clip  18  and in the vicinity of the terminal end of the resilient member. 
     A method of loading clip units into the sheath  16  from the connection clip package  110  is described with reference to  FIGS. 15A through 15C . 
     First, as illustrated in  FIG. 15A , the bottom cap  86  of the connection clip package  110  is removed, and the manipulating wire  20  protruding from the forward end of the sheath  16  is connected to the connecting member  19  at the rear end of the dummy clip  18  in the case  82 . 
     The manipulating wire  20  can be caused to protrude from the sheath  16  through manipulation of the manipulating portion  50  illustrated in  FIGS. 5A and 5B . That is, in the clipping device of  FIGS. 1A and 1B , after all the clips  12  have been used, the sheath manipulating handle  54  of the manipulating portion  50  illustrated in  FIGS. 5A and 5B  is moved to the wire manipulating handle  52  side. For example, the claw  76  of the sheath manipulating handle  54  is engaged with the rearmost notch  66 . In this state, there is a predetermined interval between the wire manipulating handle  52  and the sheath manipulating handle  54 , and, by pulling the sheath manipulating handle  54  by this interval, the sheath  16  is drawn with respect to the manipulating wire  20 , whereby it is possible to cause the manipulating wire  20  to protrude from the forward end of the sheath  16 . It is also possible to provide the positioning pipe  56  with a notch at a position corresponding to the position where the wire manipulating wire  20  is caused to protrude. 
     The dummy clip  18  that has been engaged with the rearmost portion of the clip  12  already used is previously removed, with the manipulating wire  20  protruding from the sheath  16 . 
     As illustrated in  FIG. 15B , when the manipulating wire  20  has been connected to the dummy clip  18  in the case  82 , the sheath  16  is inserted up to the forward end of the sheath fit-engagement portion  102  to be fit-engaged with the case  82 . By causing the sheath manipulating handle  54  of the manipulating portion  50  to advance with respect to the wire manipulating handle  52 , it is possible to cause the sheath  16  to advance with respect to the manipulating wire  20 . 
     With the sheath  16  having been inserted up to the forward end of the sheath fit-engagement portion  102 , the positional relationship between the sheath  16  and the manipulating wire  20  is such that the sheath  16  has retreated by a length N, with the condition in which all the clips  12  have been used being a reference. In the manipulating portion  50 , the sheath manipulating handle  54  has further moved to the wire manipulating handle  52  side by the length N from the position where the claw is hooked onto the sixth notch  66 . 
     Next, as illustrated in  FIGS. 15B and 15C , in this state, solely the sheath  16  is moved to the forward end side, with the manipulating wire  20  remaining as it is, and, with that, the case  82  is moved to the forward end side. The movement of the sheath  16  is effected by moving the sheath manipulating handle  54  of the manipulating portion  50  to the forward end side with respect to the wire manipulating handle  52 . In the manipulating portion  50  of  FIGS. 5A and 5B , the sheath manipulating handle  54  is caused to slide at one time with respect to the wire manipulating handle  52  by a length M+N to the position where the first notch  66  is engaged with the claw  76  from the state in which the claw  76  has been retracted by the length N from the sixth notch  66  as from the front side. 
     At this time, as in the case of the connection clip package  80  described above, it is desirable to move the sheath  16  and the case  82  while pressing the portion in the vicinity of the sheath fit-engagement portion  102  indicated by the arrow in  FIGS. 15B and 15C . As a result of the movement of the sheath  16  and the case  82 , the clips  12 A through  12 E and the connection rings  14 A through  14 E in the case  82  are sequentially loaded into the sheath  16  starting from the rear end side. 
     As a result of the movement of the sheath  16  by the length M+N, the forward end of the sheath  16  moves to the position where it accommodates the forward end of the foremost clip  12 A, whereby the loading of the clips into the sheath  16  is completed. At the time of completion of the loading, in the manipulating portion  50 , the sheath manipulating handle  54  moves toward the forward end, and the claw  76  is hooked onto the first notch  66 . 
     While in the examples described above the loading is effected with positioning being effected such that the forward end of the foremost clip  12 A substantially coincides with the forward end of the sheath  16 , it is also possible for the foremost clip  12 A to be set at a position retracted from the forward end of the sheath  16  by a predetermined amount. In this case, the distance between the first notch  66  and the second notch  66  of the manipulating portion  50  is changed to the length L′ from the forward end of the sheath  16  to the forward end of the second clip  12 B loaded into the sheath  16 . 
     Embodiment 6 
     Next, Embodiment 6 of the present invention is described. 
     While in the embodiments described above the clipping device is placed in the state in which the next clip  12  can be used (standby state) by pulling the sheath  16  to the manipulating portion side, in Embodiment 6, the state in which the next clip  12  can be used is attained by pushing out the manipulating wire  20  to the forward end side. 
     Here, to be described by way of example is a clipping device in which three clips  12  are loaded for three successive clipping manipulations. 
       FIGS. 16 and 17  illustrate the construction of a manipulating portion  182  for use in the clipping device of Embodiment 6. The manipulating portion  182  includes the sheath  16 , the manipulating wire  20 , the connecting member  19  at the forward end of the manipulating wire  20 , and a handle portion  184 . The handle portion  184  has a handle main body  152 , a slider  154 , a slider guide  156 , a rotating position regulating member  158 , an urging spring  160 , and a finger hook member  162 . 
       FIG. 18  is a schematic perspective view of the handle main body  152  with the slider guide  156  removed therefrom. The handle main body  152  is a stepped cylindrical member having three cylinder portions differing in outer diameter, and is formed, from the proximal end side, by a large diameter portion  152   a,  a medium diameter portion  152   b,  and a small diameter portion  152   c.    
     The handle main body  152  has a through-hole  152   d  of a fixed diameter extending through the large diameter portion  152   a,  the medium diameter portion  152   b,  and the small diameter portion  152   c.  The finger hook member  162  is fixed to the proximal end side end portion of the large diameter portion  152   a  by being fixedly fitted into the through-hole  152   d.  The finger hook member  162  is provided for the doctor to hook his thumb onto it when manipulating the slider  154  described below, and has a ring-like portion. 
     The medium diameter portion  152   b  of the handle main body  152  has an engagement groove  168  which is an elongated through-hole extending in the central axis direction of the through-hole  152   d.  A substantially cylindrical slider guide  156  described below is rotatably inserted into the medium diameter portion  152   b.    
     In the following description, the center axis direction of the cylinder forming the handle main body  152  is referred to as the “axial direction,” and the circumferential direction around this axial direction is referred to as the “peripheral direction.” 
     In the handle main body  152 , the sheath  16  is fixed to the forward end of the foremost, small diameter portion  152   c  so as to communicate with the through-hole  152   d  of the handle main body  152 . The manipulating wire  20  is passed through the sheath  16 , and protrudes from the proximal end portion of the sheath  16 , thereby being passed through the small diameter portion  152   c  and the medium diameter portion  152   b  of the handle main body  152  to be connected to the slider  154 . 
     Thus, the sheath  16  is not caused to advance or retreat as in the case of the clipping device  10  illustrated in  FIGS. 1A and 1B . 
     The slider  154  is a substantially cylindrical member which is arranged in the outer periphery of the handle main body  152  so as to pass through the handle main body  152  (and the slider guide  156  described below) and which is movable in the axial direction of the handle main body  152 . 
     The slider  154  has outwardly protruding disc-like flange portions at two positions, that is, the proximal end portion of the cylinder and some midpoint in the axial direction thereof. The operator can hook his finger onto the flange portions and easily move the slider  154  in the axial direction. In an example, the operator inserts his thumb into the ring of the finger hook member  162 , and moves the slider  154  in the axial direction while holding the slider  154  between the flange portions between the index finger and the middle finger. 
     Further, the slider  154  has a slider pin  170  mounted so as to protrude toward the central axis of the handle main body  152 . The slider pin  170  passes through the engagement groove  168  to reach the center line of the through-hole  152   d  of the handle main body  152 . Fixed in position in the vicinity of the lower end portion of this slider pin (center line side of the through-hole  152   d ) is the manipulating wire  20  passed through the smaller diameter portion  152   c  and the medium diameter portion  152   b  of the handle main body  152 . 
     As described above, the slider  154  is movable in the axial direction of the handle main body  152 . By moving the slider  154 , it is possible to cause the manipulating wire  20  inserted into the sheath  16  to advance and retreat (move to the forward end and the proximal end). Through advancement and retreat of the manipulating wire  20  by the slider  154 , the clip row at the forward end of the sheath  16  is caused to advance and retreat to place the clipping device in the state in which the next clip  12  can be used. 
     The position where the proximal end portion of the engagement groove  168  and the slider pin  170  abut each other is the home position (HP) for the slider  154 . By moving the slider  154  to the forward end side by a predetermined amount, the manipulating wire  20  is fed toward the forward end side to place the clipping device in the standby state for clipping. By restoring the slider  154  to the HP side from the standby state, the manipulating wire  20  is pulled back, thus effecting clipping and the canceling of the connection between the preceding clip  12  and the succeeding clip  12 . 
     Further, also when loading the clip row into the sheath  16 , the slider  154  is moved to the forward end side by a predetermined amount and, in this state, the dummy clip  18  and the manipulating wire  20  are connected together, and the slider  154  is moved to HP, thereby loading the clip row into the sheath  16 . 
       FIG. 19A  is a schematic perspective view of a slider guide  156 . The slider guide  156  is a substantially cylindrical member for regulating the movement amount in the axial direction of the slider  154 , that is, the advancing/retreating amount of the manipulating wire  20  in the longitudinal direction of the sheath  16 . The slider guide  156  is supported on the outer peripheral surface of the handle main body  152  so as to be rotatable in the peripheral direction and movable in the axial direction. 
     The slider guide  156  includes a joint portion  156   a,  a grasping portion  156   b,  and a guide portion  156   c  which are arranged from the forward end side toward the proximal end side and all of which are substantially cylindrical. The slider guide  156  is formed as an integral unit constituting a single cylinder. 
     The joint portion  156   a  has an inner diameter substantially equal to the outer diameter of the smaller diameter portion  152   c  of the handle main body  152 , and its convex forward end portion is inserted into a joint portion  158   a  formed on a rotating position regulating member  158  for regulating the rotating position of the slider guide  156  described below. The joint portion  156   a  has four protrusions  157   a  and four recesses  157   b  between the protrusions  157   a,  which are formed in a sawtooth-like fashion. The protrusions  157   a  and the recesses  157   b  are engaged with protrusions  159   a  and recesses  159   b  formed on the joint portion  158   a  of the rotating position regulating member  158 . 
     The grasping portion  156   b  is a portion for grasping to allow the operator to rotate the slider guide  156  to effect clipping as described below. 
     The guide portion  156   c  has an inner diameter substantially equal to the outer diameter of the medium diameter portion  152   b  of the handle main body  152 , and an outer diameter substantially equal to the inner diameter of the slider  154  and the outer diameter of the large diameter portion  152   a  of the handle main body  152 . Thus, the slider  154  is guided by the large diameter portion  152   a  of the handle main body  152  and the outer periphery of the guide portion  156   c  to move in the axial direction. 
       FIG. 19B  is a developed view of the guide portion  156   c.  The guide portion  156   c  has axially extending guide grooves  166 A through  166 D for guiding the slider  154  (slider pin  170 ). The guide portion  156   c  has four guide grooves to conform to a clipping device capable of performing clipping three times with the three clips  12  being loaded and without drawing the sheath  16  out of the living body. 
     In an example, the guide groove  166 A corresponds to the loading of the clip row, the guide groove  166 B corresponds to the first clipping, the guide groove  166 C corresponds to the second clipping, and the guide groove  166 D corresponds to the third clipping, with the guide grooves being formed at a circumferential interval of 90 degrees. In the present invention, the number of clips allowing loading (repeating) is not restricted to three, and the guide portion  156   c  of the slider guide  156  has (n+1) guide grooves  166 , which corresponds to the number n of clips  12  that can be loaded into the clipping device and one guide groove for clip row loading. 
     The slider grooves  166 A through  166 D guide the movement of the slider  154  (slider pin  170 ) together with the engagement groove  168  of the handle main body  12 , and, further, regulate the movement amount of the slider  154 . By axially reciprocating the slider  154  from HP, there are conducted clipping manipulation and the loading of the clip row (row formed of three clips  12  and the dummy clip  18  connected together by the connection rings  14 ) into the sheath  16 . Further, it is possible to conduct clipping three times without drawing the sheath  16  out of the living body. 
     The movement amount of the slider  154  differs according to whether the loading of the clip row is conducted and the number of times that clipping has been conducted. In correspondence with this, as illustrated in  FIG. 19B , the slider guide  156  has four guide grooves  166 A through  166 D differing in axial length formed in the guide portion  156   c.  Thus, the lengths of the guide grooves are lengths through which the slider  154  moves at the time of loading of the clip row and in correspondence with the number of times that clipping is performed. 
     More specifically, at the time of loading of the clip row, it is necessary for the connecting member  19  to protrude from the sheath  16 . Further, in the state in which the slider  154  has been restored to HP, it is necessary for the entire region of the clip row to be accommodated in the sheath  16 . Thus, as illustrated in  FIG. 19B , the guide groove  166 A corresponding to the loading of the clip row is formed in a predetermined length which corresponds to maximum movement amount of the slider  154 . 
     Clipping is performed successively starting with the foremost clip  12 . As described below, the HP for the clipping manipulation is the same independently of the number of times that clipping is performed. Thus, the requisite movement amount by which the slider moves from HP toward the forward end in order to place the clipping device in the state in which the next clipping is possible, that is, the state in which the arm portions  28  of the clip  12  and the skirt portions  38  of the connection ring  14  protrude from the forward end of the sheath  16 , increases gradually as clipping is performed the first, second and third time. 
     Thus, as illustrated in  FIG. 19B , the guide groove  166 B corresponding to the first clipping (clip  12 A) is formed in a predetermined length leading to the minimum movement amount of the slider  154 . Further, the guide groove  166 C corresponding to the second clipping (clip  12 B) is formed in a predetermined length leading to the second least movement amount of the slider  154 . The guide groove  166 C corresponding to the third clipping (clip  12 C) is formed in a predetermined length leading to the third least movement amount of the slider  154 . 
     The slider guide  156  is rotated according to the manipulation such as the loading of the clip row and clipping, with each guide groove coinciding with the engagement groove  168  of the handle main body  152 . That is, the slider guide  156  is rotated such that the guide groove  166 A is matched with the engagement groove  168  at the time of loading of the clip row, that the guide groove  166 B is matched with the same at the time of the first clipping (clip  12 A), that the guide groove  166 C is matched with the same at the time of the second clipping (clip  12 B), and that the guide groove  166  is matched with the same at the time of the third clipping (clip  12 C). 
     The four protrusions  157   a  formed at the forward end of the joint portion  156   a  are of the same configuration, and the four protrusions  157   a  are of a sawtooth-like configuration, that is, one tooth surface of each of them is gently tapered, and the other tooth surface thereof exhibits a substantially perpendicular step, thus forming a protrusion of a triangular sectional configuration. The intervals between the adjacent protrusions  157   a  constitute the recesses  157   b.  The protrusions  157   a  and the recesses  157   b  are engaged with the protrusions  159   a  and the recesses  159   b  formed on the joint portion  158   a  of the rotating position regulating member  158 . 
     The rotating position regulating member  158  is a member arranged on the most proximal side of the handle portion  184 , and is a cylindrical member having a cylindrical region and a substantially semi-spherical region, with a through-hole being formed at the center thereof. The rotating position regulating member  158  is fixed to the handle main body  152  by passing the small diameter portion  152   c  of the handle main body  152  through the through-hole, with the cylindrical region being oriented to the forward end side. 
     Further, as illustrated in  FIG. 20 , the rotating position regulating member  158  has a recessed joint portion  158   a  at the proximal end thereof. As described above, the convex joint portion  156   a  at the forward end of the slider guide  156  is rotatably inserted into the recessed joint portion  158   a.    
     Like the convex joint portion  156   a  at the forward end of the slider guide  156 , the joint portion  158   a  has four protrusions  159   a  of the same configuration which protrude toward the proximal end and which are arranged at equal circumferential intervals, with each of them having two tooth surfaces differing in inclined angle with respect to the abutment surface. The protrusions  159   a  are formed in a sawtooth-like configuration. That is, one tooth surface of each of them is gently tapered, and the other tooth surface thereof forms a substantially perpendicular, stepped portion, thus forming a protrusion of a triangular sectional configuration. The intervals between the adjacent protrusions  159   a  are the recesses  159   b,  which are also four in number. 
     The protrusions  157   a  of the joint portion  156   a  of the slider guide  156  and the recesses  159   b  of the joint portion  158   a  of the rotating position regulating member  158  are engaged with each other, and the recesses  157   b  of the joint portion  156   a  of the slider guide  156  and the protrusions  159   a  of the joint portion  158   a  of the rotating position regulating member  158  are engaged with each other. That is, positioning is effected on the slider guide  156  by the rotating position regulating member  158  at intervals of 90 degrees in the rotating direction. 
     The guide grooves  166 A through  166 D of the slider guide  156  are formed such that, when the protrusions and recesses of the joint portion  158   a  of the rotating position regulating member  158  and the joint portion  156   a  of the slider guide  156  are engaged with each other, the guide grooves  166 A through  166 D overlap the engagement grooves  168  of the handle main body  152  in the circumferential direction. That is, the rotation of the slider guide  156  is regulated so as to be stopped by the rotating position regulating member  158  at the position where the guide grooves  166  and the engagement grooves  168  of the handle main body  152  overlap each other. 
     Each of the protrusions is configured such that one tooth surface has tapered inclined angle and that the other tooth surface is substantially perpendicular, and hence the rotating direction of the slider guide  156  is regulated to one direction. The tooth surfaces of the protrusions are formed such that the guide groove  166 A, the guide groove  166 B, the guide groove  166 C, and the guide groove  166 D overlap the engagement groove  168  in that order as the slider guide rotates. 
     Further, an urging spring  160  is arranged between the step portion between the medium diameter portion  152   a  and the small diameter portion  152   c  of the handle main body  152  (i.e., the forward end surface of the medium diameter portion  152   b  formed by this step portion) and the proximal end surface of the joint portion  156   a  of the slider guide  156 . 
     The urging spring is a compression spring arranged so as to be wound around the small diameter portion  152   c  of the handle main body  152 . The urging spring exerts an urging force so as to separate the forward end surface of the medium diameter portion  152   b  and the proximal end surface of the joint portion  156   a  from each other. That is, the urging spring  160  keeps the slider guide  156  pressed against the rotating position regulating member  158 . 
     Thus, due to the action of the urging spring  160 , the slider guide  156  is prevented from being inadvertently rotated. 
     Further, the slider guide  156  is rotated in a predetermined direction, whereby, due to the protrusions and recesses of the joint portion  158   a  of the rotating position regulating member  158  and the joint portion  156   a  of the slider guide  156 , the slider guide  156  moves, according to the rotation, toward the proximal end along the tapered portions of the protrusions and recesses of the slider guide  156  against the urging force of the urging spring  160 . At the point in time when it is detached from the tapered portions of the protrusions and recesses (the point in time when the protrusions and recesses exhibit substantially perpendicular tooth surfaces), the slider guide  156  moves toward the forward end due to the urging force of the urging spring  160  to be pressed against the rotating position regulating member  158 . 
     As described above, at the position where the protrusions and recesses of the joint portion  158   a  of the rotating position regulating member  158  and the joint portion  156   a  of the slider guide  156  are engaged with each other, the engagement groove  168  and the guide grooves  166  are matched with each other in the circumferential direction. Thus, by rotating the slider guide  156 , the operator can match the engagement groove  168  with the guide grooves  166  easily and correctly according to the number of times that clipping is performed, etc. 
     The axial length of the slider guide  156  is set such that, in the state in which it is pressed against the rotating position regulating member  158 , there exists, between the step portion between the medium diameter portion  152   a  and the large diameter portion  152   a  of the handle main body  152  (i.e., the forward end surface of the large diameter portion  152   a  formed by this step portion) and the proximal end portion, a gap corresponding to the amount of movement toward the proximal end, etc. due to the protrusions and recesses of the joint portion  158   a  of the rotating position regulating member  158  and the joint portion  156   a  of the slider guide  156  at the time of rotation. 
     With the engagement groove  168  of the handle main body  152  and each guide groove  166  of the slider guide being matched with each other, the slider  154  is moved from HP (position where the proximal end portion of the engagement groove  168  and the slider pin  170  abut each other) to the position where the slider pin abuts the forward end portion of the guide groove  166 , and is then returned to HP again, whereby clipping is effected by the clip  12 . 
     In the following, with reference to  FIG. 21 , which is a developed view of the slider guide  156 , an example of the clipping manipulation conducted three times by the clipping device is described. 
     First, the slider guide  156  is rotated as needed to match the guide groove  166 A with the engagement groove  168  of the handle main body  152 , and the slider  154  is moved in the axial direction to HP where the slider pin  170  abuts the forward end surface of the engagement groove  168 . That is, the slider pin  170  of the slider  154  is moved to a position P 1  illustrated in  FIG. 21 . 
     At this time, the forward end of the manipulating wire  20  is retracted into the sheath  16 . This state is the initial state of the clipping by the clipping device. 
     In the present invention, instead of causing the forward end surface of the engagement groove  168  and the slider pin  170  to abut each other, it is also possible to cause the main body of the slider  154  and the forward end surface of the engagement groove  168  to each other, thereby regulating the movement amount in the axial direction of the slider  154 . 
     Next, the slider  154  is moved to the position where it abuts the forward end portion of the guide groove  166 A, that is, the slider pin  170  is moved to a maximum protruding position P 2 . As a result, the forward end of the manipulating wire  20  protrudes by a predetermined amount from the forward end of the sheath  16 . 
     In this state, the connecting member  19  of the dummy clip  18  is attached to the forward end of the manipulating wire  20 . As a result, a clip row formed of the three clips  12  and the dummy clip  18  connected together by the connection rings  14  is connected to the manipulating wire  20 . 
     Next, the slider pin  170  is restored to a position P 3  illustrated in  FIG. 21 , that is, to HP. Through this manipulation, the clip row is accommodated in the sheath  16 . As a result, the loading of the clip row formed of the clips  12  connected together into the manipulating portion  182  is completed. 
     After that, the sheath  16  is inserted into the port of the forceps of the endoscope or the like inserted into the living body. Then, the forward end of the sheath  16  is caused to reach the forward end of the insert portion of the endoscope, and is then caused to protrude from the forward end of the endoscope. Further, through manipulation of the insert portion or the angle portion of the endoscope, the forward end of the sheath  16  is moved to the target position. 
     When the requisite manipulation has been completed, the slider guide  156  is rotated by 90 degrees to match the guide groove  166 B with the engagement groove  168 . As a result, the position of the slider pin  170  is moved to a position P 4  in  FIG. 21 , that is, HP, which corresponds to the guide groove  166 B. 
     Next, the slider  154  is moved to the position where it abuts the forward end portion of the guide groove  166 B, that is, to a maximum protruding position P 5  in  FIG. 21 . Through this extrusion of the slider  154 , that is, the extrusion of the manipulating wire  20 , the clip row is moved in the direction of the forward end, and the foremost clip  12 A and the first region  32  of the connection ring  14 A protrude from the forward end of the sheath  16 . As a result, the arm portions  28  of the clip  12 A are opened, and further, the skirt portions  38  of the connection ring  14 A are opened. 
     It should be noted that there is dimensional variation or the like due to a production error in the clips  12  and the connection rings  14 . Further, in the clipping device inserted into the endoscope, there may be a case in which the protruding amount of the manipulating wire  20  decreases due to a difference between the inner and outer periphery, etc. attributable to bending, curving, etc. of the manipulating wire  20  and the sheath  16 . Thus, the forward end of the guide groove  166 B is at the maximum protruding position P 5  where the clip  12 A is not detached from the sheath  16 , and where the skirt portions  38  of the connection ring  14 A are reliably opened independently of a production error in the clips  12 , etc. or the condition of the sheath  16 . 
     Thus, normally, in the state in which the slider pin  170  has been pushed forward to the maximum protruding position P 5 , the skirt portions  38  of the connection ring  14 A are situated in front of the forward end portion of the sheath  16 , and the skirt portions  38  and the sheath  16  are spaced apart from each other. 
     This also applies to the forward end portion of the guide groove  166 C corresponding to the second clipping by the clip  12 B, and to the forward end portion of the guide groove  166 D corresponding to the third clipping by the clip  12 C. 
     Next, while watching, for example, the display of the endoscope, the operator restores the slider pin  170  to the HP side, and restores the clip row to the sheath  16  to the standard protruding position P 5 ′ where the skirt portions  38  of the connection ring  14 A abut the forward end portion of the sheath  16 . As a result, the preparation for the first clipping (clipping by the first clip  12 ) is completed. 
     After that, the endoscope is operated to press the claw portions  22  of the diverged clip  12 A against the portion of the living body to be subjected to clipping, and, in this state, the slider pin  170  is moved to the proximal side to be restored to HP, that is, the position P 7 . 
     Through this movement of the slider pin  170 , the foremost clip  12 A is drawn into the connection ring  14 A, and the arm portions  28 , which have been open, are closed by the clamping ring  40 , with the claw portions  22  being closed to effect clipping on the living body. When the slider pin  170  moves from the standard protruding position P 5 ′ to the clipping completion position P 6 , the portions of the arm portions  28  directly below the projections  30  are drawn into the connection ring  14 A, whereby the clipping is completed. 
     Simultaneously with the completion of the clipping, the proximal end portion of the foremost clip  12 A (proximal end portion of turned portion  24 ) and the claw portions  22  of the second clip  12 B are discharged from the proximal end portion of the connection ring  14 A. As a result, the arm portions  28  of the second clip  12 B, which have been closed by the second region  34  of the connection ring  14 A, are opened up to the inner diameter of the sheath  16 , and the engagement between the turned portion  24  of the preceding clip  12 A and the claw portions of the next clip  12 B is released, whereby the clip  12 A and the connection ring  14 A are separated from the clip row, thereby attaining the state in which the clip  12 A and the connection ring  14 A can be discharge from the sheath  16 . 
     Further, in the state in which the slider pin  170  has been restored to the position P 7 , the clip row separated from the clip  12 A and the connection ring  14 A is drawn into the sheath  16 . 
     As is apparent from the above description, the distance between the maximum protruding position P 5  (P 9 , P 13 ) and the standard protruding position P 5 ′ (P 9 ′, P 13 ′) serves as a buffer for absorbing a production error in the components, a difference between the inner and outer periphery of the sheath  16 , etc. Thus, by once pushing out the slider pin  170  to the maximum protruding position P 5 , it is possible to reliably open the arm portions  28  and the skirt portions  38  to perform clipping independently of the production error in the clips  12  or the condition of the sheath  16  in the living body. 
     In a preferable manipulation, the slider pin  170  is pushed out to the maximum protruding position P 5 , and then returned to the standard protruding position P 5 ′. After that, the claw portions  22  are brought into contact with the living body to effect clipping (restoration of the slider  54  to P 7 , which is HP), whereby it is possible to more reliably prevent detachment, etc. of the clip  12  attributable to excessive protrusion from the sheath  16 . Further, it is possible to press the reliably retained clip  12  firmly against the living body to be subjected to clipping. 
     When, at the maximum protruding position, the foremost clip  12  is firmly retained, and there is no (or very little) risk of detachment, the slider pin  170  may be pulled back at a stroke from the maximum protruding position to HP to effect clipping and the releasing of the connection of the clip row. 
     It is also desirable to generate a small impact (i.e., so-called click feel) by well-known means such as a protrusion and a recess engaged with each other or an urged spherical body and a recess engaged therewith at the point in time when the slider pin  170  passes the clipping completion position P 6  (P 10 , P 14 ), thus enabling the operator performing the clipping to be aware of the completion of the clipping. 
     When the slider pin  170  has been restored to the position P 7 , which is HP, to complete the first clipping (clipping by the first clip  12 A), the slider guide  156  is rotated by 90 degrees as illustrated in  FIG. 12  (H) to match the guide groove  166 C with the engagement groove  168 . As a result, the position of the slider pin  170  moves to HP, which corresponds to the guide groove  166 C, as indicated at P 8  in  FIG. 21 . 
     Next, the slider pin  170  is moved to the maximum protruding position P 9  where the slider pin  170  abuts the forward end portion of the guide groove  166 C. Through this manipulation, the second clip  12 B and the first region  32  of the connection ring  14 B protrude from the forward end of the sheath  16 , with the arm portions  28  and the skirt portions  38  opening. Further, by pulling the slider pin  170  back to the standard protruding position P 9 ′ where the skirt portions  38  abut the forward end of the sheath  16 , the clipping device is placed in the state in which the clipping device is ready for the second clipping (by the clip  12 B). 
     When the clipping device has become ready for clipping, the claw portions  22  of the diverged clip  12 B are pressed against the portion which is to be subjected to clipping, and the slider pin  170  is moved to the proximal side to be pulled back to HP, that is, the position P 11 . 
     As a result, through the movement of the slider pin  170  from the standard protruding position P 9 ′ to the clipping completion position P 10 , the clipping by the second clip  12  is completed, and the second clip  12 B and the next clip  12 C (one on the most proximal side) are separated from each other, whereby a state is attained in which the clip  12 B and the connection ring  14 B can be discharged from the sheath  16 . 
     In the state in which the slider pin  170  has been restored to the position P 11 , which is HP, the clip row separated from the clip  12 B and the connection ring  14 B is in the state in which the clip row has been drawn into the sheath  16 . 
     When the second clipping is completed, the slider guide  156  is then rotated by 90 degrees to match the guide groove  166 D with the engagement groove  168 . As a result, the position of the slider pin  170  moves to HP, which corresponds to the guide groove  166 D, indicated as the position P 12  in  FIG. 21 . 
     Next, the slider pin  170  is moved to the maximum protruding position P 13  where the slider pin  170  abuts the forward end portion of the guide groove  166 D. Through this manipulation, the third clip  12 C and the connection ring  14 B protrude from the forward end of the sheath  16 , with the arm portions  28  and the skirt portions  38  opening. Further, by pulling the slider pin  170  back to the standard protruding position P 13 ′, the clipping device is placed in the state in which the clipping device is ready for the third clipping. 
     When the clipping device has become ready for clipping, the claw portions  22  of the diverged clip  12 C are pressed against the portion which is to be subjected to clipping, and the slider pin  170  is moved to the proximal side to be pulled back to HP, that is, the position P 15 . 
     As a result, clipping is performed in the same manner as described above, and the clipping by the third clip  12 C is completed through the movement of the slider pin  170  from the standard protruding position P 13 ′ to the clipping completion position P 14 , and, further, the third clip  12 C and the dummy clip  18  are separated from each other, whereby the state is attained in which the clip  12 C and the connection ring  14 C can be discharged from the sheath  16 . 
     In the state in which the slider pin  170  has been restored to the position P 15 , which is HP, the dummy clip  18  separated from all the clips is in the state in which the dummy clip  18  has been drawn into the sheath  16 . 
     When the clipping by the three clips  12  has been completed, the slider guide  156  is rotated by 90 degrees to match the guide groove  166 A with the engagement groove  168 . As a result, the position of the slider pin  170  is restored again to HP, which corresponds to the guide groove  166 A as indicated by the position P 1  in  FIG. 21 . After that, the sheath  16  is pulled out of the endoscope. 
     After the sheath  16  has been pulled out, the slider pin  170  is pushed out to the position P 2  where the slider pin  170  abuts the forward end portion of the guide groove  166 A, and the dummy clip  18  and the connecting member  19  are caused to protrude from the forward end of the sheath  16 , thereby removing the dummy clip  18  and the connecting member  19  from the forward end of the manipulating wire  20 . 
     As described above, it is possible to perform clipping a plurality of times without pulling out the sheath. Further, solely through the rotation of the slider guide  156  and the reciprocating movement of the slider  154 , the clip row is moved in the axial direction (longitudinal direction of the sheath  16 ) by a proper amount according to the number of times that clipping is performed (first time, second time . . . ) to place the clipping device in the state in which the clipping device is ready for clipping, making it possible to perform clipping and the separation of the clips connected together. That is, it is possible to perform accurate clipping through easy manipulation. 
     The clipping device and the method of loading the connected clips of the embodiments of the present invention described in detail above should not be construed restrictively. It goes without saying that various improvements and variations are possible without departing from the gist of the present invention. The clipping device of the present invention is applicable not only to a soft endoscope but also to a hard endoscope. 
     According to the above-mentioned embodiments of the present invention, there are disclosed the technical ideas as set forth in the following items: 
     (Item 1) 
     A magazine type clipping device comprising: 
     a plurality of clips loaded into a forward end portion of a sheath while being engaged with preceding and succeeding clips; 
     a connection ring fitted into the sheath so as to be capable of advancing and retreating and adapted to cover an engagement portion of the clips to maintain the clips in a connected state; and 
     a manipulating wire connected to a rearmost clip and adapted to pull a clip row formed of the plurality of clips, wherein each of the clips has, at a position where each of the clips abuts a proximal end of the connection ring retaining a forward end portion thereof, a protrusion which has a width larger than an opening of a proximal end portion of the connection ring and which prevents intrusion into the connection ring in an initial state immediately before start of a clipping manipulation by s foremost clip. 
     (Item 2) 
     A magazine type clipping device according to Item 1, wherein the connection ring has, at its forward end portion, a clamping portion which abuts the clip by moving from a central portion toward a forward end of the clip to thereby clamp the clip so as to close claw portions thereof, and 
     wherein, in the initial state, a distance between a proximal end portion of the protrusion of the clip and a forward end of the clamping portion of the connection ring retaining a rear end portion of the clip is larger than a movement amount of the connection ring from the initial state to completion of the clip by the clamping portion. 
     (Item 3) 
     A magazine type clipping device according to Item 1 or 2, wherein the foremost clip is pulled by the manipulating wire with respect to the connection ring and an engagement port-ion by means of which the foremost clip is engaged with the succeeding clip is detached from the connection ring, whereby connection with the succeeding clip is canceled. 
     (Item 4) 
     A magazine type clipping device according to any one of Items 1 through 3, wherein, after the foremost clip has been used for clipping, the sheath moves to a position where next clip protrudes, whereby the next clip becomes usable. 
     (Item 5) 
     A magazine type clipping device according to any one of Items 1 through 4, wherein the connection ring includes a retaining portion made of a resin and adapted to maintain the clips in the connected state, and the above-mentioned clamping portion made of metal and provided at a forward end side of the retaining portion. 
     (Item 6) 
     A magazine type clipping device according to any one of Items 1 through 5, wherein, inside the sheath, the connection ring is pressed by a sheath inner wall to be inwardly closed, with at least one of the clips connected within the connection ring being pressed and retained, and the connection ring has, at the same position in a clip pulling direction and at two or more circumferential positions, skirt portions which are opened in a width larger than a sheath inner diameter after passing of a forward end of the sheath to prevent retreat into the sheath. 
     (Item 7) 
     A magazine type clipping device according to any one of Items 1 through 6, wherein the plurality of clips are connected together with orientations thereof being changed alternately by 90 degrees. 
     (Item 8) 
     A connection clip package comprising: 
     a cylindrical case; 
     a detachable lower cap attached to a rear end of the case; and 
     a plurality of clips consecutively engaged with each other in a row and a plurality of connection rings covering engagement portions between the clips to maintain the clips in a connected state, the clips and the connection rings being accommodated in the case, 
     wherein the connection rings have skirt portions which, in a natural state in which no external force is imparted, are diverged in a skirt-like fashion to protrude in a radial direction of the connection rings and which are closed inwardly when being pressed in the radial direction, and 
     wherein the case has, in a portion in which the clips and the connection rings are accommodated, an inner diameter slightly larger than an outer diameter of the connection rings, and has, at positions which correspond to the skirt portions of the accommodated connection rings, first inclined portions adapted to radially diverge in conformity with expansion of the skirt portions in the natural state. 
     (Item 9) 
     A connection clip package according to Item 8, wherein the case has second inclined portions radially narrowed from diverging end portions of the first inclined portions. 
     (Item 10) 
     A connection clip package according to Item 8 or 9, wherein, when being radially pressed to be inwardly closed, the skirt portions of each connection ring press at least one of the clips connected within the connection ring to retain the same. 
     (Item 11) 
     A connection clip package according to any one of Items 8 through 10, wherein the case has, at the rear end thereof, a fit-engagement portion to be fit-engaged with a sheath into which the clips and the connection rings are loaded. 
     (Item 12) 
     A method of loading a sheath with the clips and the connection rings of a connection clip package according to Item 11, the method comprising: 
     connecting a forward end of a manipulating wire for pulling a clip row provided in the sheath and formed of the plurality of clips to a connecting member attached to a rearmost clip in the case; 
     fit-engaging the sheath with the fit-engagement portion of the case; and 
     accommodating all of the clips and the connection rings into the sheath while moving the case toward a forward end by moving the sheath toward the forward end. 
     (Item 13) 
     A magazine type clipping device comprising: 
     a connection clip package including a case accommodating a plurality of clips connected together through engagement of a rear end of a preceding clip with a forward end of a succeeding clip and a connecting member connected to a rearmost clip; 
     a sheath into which the plurality of clips are loaded; 
     a manipulating wire which is provided in the sheath and whose forward end is detachably connected to the connecting member to pull a clip row formed by the plurality of clips; and 
     a manipulating portion having a grasping portion grasping a proximal end portion of the sheath and a slide mechanism causing the grasping portion to slide longitudinally with respect to a main body connected to the manipulating wire, 
     wherein a fit-engagement portion to be fit-engaged with a forward end of the sheath is formed at a rear end portion of the case of the connection clip package, and 
     wherein the grasping portion of the manipulating portion slides forwards by a predetermined first length with respect to the main body from a state in which the forward end of the sheath is fit-engaged with the fit-engagement portion and in which the forward end of the manipulating wire is connected to the connecting member in the connection clip package, whereby the forward end of the sheath moves from a rear end of the connection clip package to a forward end of the plurality of clips, thereby loading the plurality of clips of the connection clip package into the sheath. 
     (Item 14) 
     A magazine type clipping device according to Item 13, wherein, in a state in which the plurality of clips have been loaded into the sheath, the grasping portion of the manipulating portion slides backwards with respect to the main body by a second length which is a unit length equal to a clip loading interval for the sheath, whereby the forward end of the sheath retreats by the second length with respect to the clip, and a foremost clip protrudes by a fixed length from the forward end of the sheath to become usable. 
     (Item 15) 
     A magazine type clipping device according to Item 14, wherein the first length is equal to a length obtained by multiplying the second length by the number of the plurality of clips. 
     (Item 16) 
     A magazine type clipping device according to any one of Items 13 through 15, wherein the fit-engagement portion is formed to extend from the rear end of the case of the connection clip package to a rear end of the rearmost clip accommodated in the connection clip package. 
     (Item 17) 
     A magazine type clipping device according to any one of Items 13 through 16, wherein the manipulating wire is connected to a lever mounted to the main body of the manipulating portion and capable of reciprocating through a fixed length, and the lever reciprocates, whereby the manipulating wire reciprocates in a longitudinal direction, thereby clamping the foremost clip. 
     (Item 18) 
     A magazine type clipping device according to any one of Items 13 through 17, wherein fitted onto a connecting portion between the clips is a connection ring fitted into the sheath so as to be capable of advancing and retreating and covering an engagement portion of the clips to maintain the clips in a connected state. 
     (Item 19) 
     A method of loading a plurality of clips into a sheath from a connection clip package accommodating the plurality of clips arranged in a row in a cylindrical case with consecutive clips being engaged with each other, 
     wherein the sheath is fit-engaged with a fit-engagement portion provided at a rear end portion of the case, with a forward end of a manipulating wire for pulling a clip row formed of the plurality of clips provided in the sheath being connected to a connecting member attached to a rearmost clip in the case, and 
     wherein, by moving the sheath toward a forward end, all of the clips and connection rings are accommodated in the sheath while moving the case toward the forward end.