Patent Publication Number: US-2020275823-A1

Title: Clip apparatus for endoscope

Description:
TECHNICAL FIELD 
     The present disclosure relates to a clip apparatus for an endoscope, and more particularly, to a clip apparatus for an endoscope having a simple driving part and enabling accurate and easy clip ligation and separation. 
     BACKGROUND ART 
     A clip apparatus for an endoscope is an endoscope medical device used to ligate and suture biological tissues, and may be used to ligate through a clip or suture a perforated site in all situations related to the bleeding of body tissues such as arterial rupture due to an ulcer of stomach and colon. To this end, it is important to fix the clip to an accurate position. 
     Hereinafter, a conventional clip apparatus  1  for an endoscope will be described with reference to  FIGS. 1 to 4 . 
     As illustrated in  FIG. 1 , the conventional clip apparatus  1  for the endoscope is schematically composed of an outer sheath  10 , an inner sheath  20  which is disposed inside the outer sheath  10 , a wire  30  which is disposed inside the inner sheath  20 , a connection hook  40 , a base part  50 , a slider part  60 , and an outer support  70 . 
     The slider part  60  includes a base outer cylinder  62  and a slider  64 , the outer support  70  is slidably supported on the outside of the base outer cylinder  62 , and one end of the wire  30  is connected and fixed to the slider  64 . 
     One end of the outer sheath  10  is connected and fixed to the outer support  70  to be slid integrally, the base part  50  is provided with a fixed base  52  and a rotating base  54  which is rotatably supported thereby, and one end of the inner sheath  20  is connected and fixed to the center of the fixed base  52 . 
     The rotating base  54  is a means which regulates the position of the slider part  60 , and has a regulated position which regulates the slider part and an unregulated position which does not regulate the slider part. This will be described in detail below. 
     The connection hook  40  which is fixed to the front end of the wire  30  takes two states of an opened state and a closed state by cooperation with the inner sheath  20  so that the clip is coupled. 
     Next, a process of operating the conventional clip apparatus  1  for the endoscope will be described with reference to  FIGS. 2 to 4 . 
     The positions of the slider part  60  and the outer support  70  are determined by a plate spring and a positioning groove. A plate spring  65  is accommodated inside the slider  64 , and the positioning thereof is performed as the plate spring  65  is elastically locked to any one of positioning grooves  53   a ,  53   b ,  53   c  which are formed in the base part  50 . In addition, a plate spring  75  is also accommodated inside the outer support  70 , and the positioning thereof is performed as the plate spring  75  is elastically locked to positioning groove  63   a  or  63   b  which is formed in the base outer cylinder  62 . 
     First, as a preparing state for coupling the clip illustrated in  FIG. 2 , the plating spring  65  of the slider becomes locked to the positioning groove  53   a , the plating spring  75  of the outer support becomes locked to the positioning groove  63   a , and the connection hook  40  becomes opened by protruding from the inner sheath  20 . 
     Next, as a step for coupling the clip illustrated in  FIG. 3 , first, the rotating base  54  is rotated clockwise with respect to the fixed base  52  to set it to a regulated position. At the regulated position, the outer shape of the rotating base  54  does not overlap with a part of the outer shape of the base  52  and a part thereof protrudes, such that when the slider part  60  is pushed into the base part  50  side, the slider part  60  is slidable with respect to the fixed base  52 , but is not slidable with respect to the rotating base  54 . Accordingly, when the clip is disposed on the connection hook  40  so as to be gripped and the slider part  60  is slid to the base part  50  side, the sliding of the slider part  60  is forcibly stopped in contact with the rotating base  54 , the plate spring  65  of the slider is locked to the positioning groove  53   b . As a result, the wire  30  connected to the slider and the connection hook  40  fixed to the front end of the wire are buried into the inner sheath  20 , and the connection hook  40  is closed, thereby coupling the clip. At this time, the clip protrudes from the front end of the inner sheath  20 . 
     Next, although not illustrated in the drawings, by sliding the outer support  70  to the clip side in order to insert the clip apparatus into the body so that the plate spring  75  of the outer support is locked to the positioning groove  63   b , it is possible to integrally slide forward the outer sheath  10  which is connected to the outer support  70 . Accordingly, from the inner sheath  20  to the clip may be buried inside the outer sheath  10 , and after the clip enters the body, the outer support  70  is slid again to the slider part  60  side so that the plate spring  75  of the outer support is locked to the positioning groove  63   a.    
     After entering the body as described above, the clip is disposed at a suitable position for ligating the clip. When the position of the clip is completely adjusted, the rotating base  54  is rotated counterclockwise with respect to the fixed base  52  to set it to the non-regulated position. At the non-regulated position, the outer shape of the rotating base  54  and the outer shape of the fixed base  52  overlap with each other to form the same shape, such that when the slider part  60  is pushed to the base part  50  side, the slider part  60  is slidable with respect to the rotating base  54  as well as the fixed base  52 . 
     In addition, when the slider part  60  is slid to the base part  50  side, as illustrated in  FIG. 4 , the slider part  60  is slid to the rotating base  54  as well as the fixed base  52 , such that the plate spring  65  of the slider is locked to the positioning groove  53   c . As a result, the wire  30  which is connected to the slider is additionally drawn into the inner sheath  20  and the clip is also buried into the inner sheath  20 . Accordingly, similarly to the closed state of the connection hook, the clip is also in the closed state, thereby ligating the clip. 
     Finally, when the ligation of the clip is completed, as illustrated in  FIG. 2 , the slider part  60  is slid to the distal end side of the base part  50 , that is, in the opened state of the connection hook  40  and the operation is terminated by opening and separating the grip of the clip by the connection hook  40 . 
     As may be seen in the above process, in order to couple, separate, or ligate the conventional clip, a method is used, in which the conventional clip apparatus is driven by sliding the slider part and the wire connected thereto or the outer support and the outer sheath connected thereto so that the plate spring is locked to the suitable positioning groove. 
     However, there are problems in that not only the configuration of the conventional clip apparatus is complicated because the conventional clip apparatus includes the plurality of plate springs and positioning grooves, but also the operation process thereof is very cumbersome because the conventional clip apparatus has the rotating base, in addition to the fixed base, to rotate them in the proper direction according to the operation process. In addition, there are problems in that, in order to separate the clip, the slider part is needed to be slid back to the distal end side of the base part, it is cumbersome to separate the clip because the clip is separated through the separate opening of the connection hook, and it is not possible to attempt to open and close the clip several times in order to ligate the clip to an accurate position because it is difficult to repeatedly open and close the clip. 
     DETAILED DESCRIPTION OF THE INVENTION 
     Technical Problem 
     The present disclosure is intended to solve the above problems, and an object of the present disclosure is to provide a clip apparatus for an endoscope having a simple driving part and enabling accurate and easy clip ligation and separation. 
     Technical Solution 
     An embodiment of the present disclosure for achieving the object provides a clip apparatus for an endoscope including a handle part which is formed with a moving hole, a handle slider which is installed to be slidable on the handle part through the moving hole, an inner sheath which is connected rotatably to the inside of the handle part and extend to the outside of the handle part, a wire which is connected to the handle slider and disposed inside the inner sheath, an outer sheath which is disposed to surround the inner sheath, an outer handle which is coupled to the outer sheath to move the outer sheath along the longitudinal direction of the inner sheath, and a clip coupling part which is connected to one end of the wire and configured to couple a clip. 
     In addition, the clip apparatus for the endoscope may further include a stopper which is provided detachably between the handle part and the outer handle. 
     The stopper may have a detachable part which may be spread and contracted to surround the outer sheath at both sides thereof. 
     The clip coupling part may include a connection part connected to one end of the wire and a bending part configured to detachably couple the clip. 
     The bending part may be composed of a pair of coupling arm parts which extend to face each other, and one coupling arm part may be bent to contact the other coupling arm part. 
     The connection part may include an insertion hole into which the wire may be inserted. 
     In addition, the clip apparatus for an endoscope may further include a clip which is coupled to the clip coupling part, and the clip may include a pair of clip arm parts which extend in a spreading configuration to be openable and closable, gripping parts which are formed to protrude from the ends of the pair of clip arm parts to the inside of the pair of clip arm parts and are placed opposite to each other to be engaged with each other, and a tightening ring which adjusts the opening and closing of the pair of clip arm parts. 
     The pair of clip arm parts may be each formed with a protrusion part, and as the tightening ring is press-fitted into the protrusion part, the clip may be gripped. 
     The tightening ring may adjust the opening and closing of the clip while moving on the pair of clip arm parts and until the tightening ring is press-fitted into the protrusion part. 
     The inner width of the tightening ring at a location where the pair of clip arm parts is disposed may be formed to be greater than the width of a portion where the tightening ring moves on the pair of clip arm parts, and may be formed to be equal to or smaller than the width of the protrusion part. 
     The pair of clip arm parts may be formed of an elastic body to have a spreading property. 
     An outer diameter (L1) of the tightening ring may be formed to be greater than an inner diameter (L2) of the inner sheath. 
     When the handle slider is slid to the handle part side, the tightening ring may be press-fitted into the protrusion part by being pushed and moved to the protrusion part side by the inner sheath. 
     When the tightening ring is press-fitted into the protrusion part and then the handle slider is slid to the handle part side, the bending part may be unfolded and the clip may be separated. 
     A space part where the outer sheath may be disposed may be formed between the handle part and the inner sheath. 
     In addition, the clip apparatus for the endoscope may further include a spring which is disposed within the moving hole to surround the wire. 
     When the spring is not compressed, the clip coupling part may be positioned inside the inner sheath. 
     A handle ring may be formed at one end of the handle part, and a handle part may be formed on the outer surface of the handle slider along the circumferential direction. 
     The sliding movement of the handle slider may be limited within a length of the moving hole of the handle part. 
     In addition, the present disclosure provides a clip including a pair of clip arm parts which extends in the form spread to be openable and closable, gripping parts which are formed to protrude from the ends of the pair of clip arm parts to the insides opposite to each other to be engaged with each other, a protrusion part which is formed on each of the pair of clip arm parts, and a tightening ring which adjusts the opening and closing of the pair of clip arm parts, and the gripping parts may be engaged with each other to be gripped as the tightening ring is press-fitted into the protrusion part. 
     Advantageous Effects 
     According to the clip apparatus of the present disclosure, by driving, with one handle slider, the wire connected thereto, the clip may be ligated and separated, such that the structure of the driving part is simple and the operation thereof is easy. 
     In addition, since the wire may also be rotated based on the rotation of the handle part, the clip which is connected to the wire may be rotated, thereby easily determining the direction of the clip, and other structures are not affected by the rotation. 
     In addition, since the opening and closing of the clip may be repeatedly performed until the clip is completed ligated, that is, until the tightening ring is press-fitted into the protrusion part, the opening and closing of the clip may be attempted several times to ligate the clip to the accurate position. 
     In addition, the clip apparatus of the present disclosure enters the target point inside the body and then removes the stopper so that the outer handle and the outer sheath connected thereto are pushed back to prevent the clip from being opened when the clip apparatus enters the body, thereby making the clip apparatus easily and safely enter the body. 
     In addition, the clip coupling part is not exposed to the outside of the inner sheath because the spring is included, thereby preventing the clip from being separated by the side load when the clip apparatus enters, and the spring is compressed to push the handle slider after the clip apparatus enters, thereby correcting the opening angle of the clip to be wider. 
     The effects of the present disclosure are not limited to the above-described effects, but should be understood to include all the effects inferable from the configurations of the disclosure described in the detailed description or claims of the present disclosure. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a front diagram illustrating a conventional clip apparatus for an endoscope. 
         FIG. 2  is an enlarged cross-sectional diagram of a portion A of  FIG. 1 . 
         FIG. 3  is a cross-sectional diagram illustrating another state of  FIG. 2 . 
         FIG. 4  is a cross-sectional diagram illustrating still another state of  FIG. 2 . 
         FIG. 5  is a front diagram illustrating a clip apparatus for an endoscope according to an embodiment of the present disclosure. 
         FIG. 6  is a partial cross-sectional diagram of  FIG. 5 . 
         FIG. 7  is a front diagram illustrating a state of the clip apparatus for an endoscope illustrated in  FIG. 5 . 
         FIG. 8  is a perspective diagram in which a part of  FIG. 5  is separated. 
         FIG. 9  is a cross-sectional diagram of a portion A of  FIG. 7 . 
         FIG. 10  is a front diagram illustrating a state of the clip apparatus for an endoscope illustrated in  FIG. 5 . 
         FIG. 11  is a perspective diagram separately illustrating a clip coupling part and a clip in  FIG. 9 . 
         FIGS. 12 and 13  are side diagrams illustrating before and after coupling the clip coupling part and the clip of  FIG. 11 . 
         FIG. 14  is a diagram illustrating a state where the clip is separated in  FIG. 10 . 
         FIG. 15  is a front diagram illustrating a clip apparatus for an endoscope according to another embodiment of the present disclosure. 
     
    
    
     BEST MODE 
     Hereinafter, a preferred embodiment of a clip apparatus for an endoscope according to the present disclosure will be described with reference to  FIGS. 5 to 15 . 
     In addition, terms to be described later are terms defined in consideration of functions in the present disclosure, which may vary according to intentions or customs of users or operators, and the following embodiments do not limit the scope of the present disclosure but are merely illustrative of the components recited in the claims of the present disclosure. 
     In order to clearly describe the present disclosure, parts irrelevant to the description are omitted, and the same or like components are denoted by the same reference numerals throughout the specification. Throughout the specification, when a part is said to “include” a component, it means that it may further include other components rather than excluding the other components unless otherwise stated. 
       FIG. 5  is a front diagram illustrating a clip apparatus for an endoscope according to an embodiment of the present,  FIG. 6  is a partial cross-sectional diagram of  FIG. 5 ,  FIG. 7  is a front diagram illustrating a state of the clip apparatus for an endoscope illustrated in  FIG. 5 ,  FIG. 8  is a perspective diagram in which a part of  FIG. 5  is separated,  FIG. 9  is a cross-sectional diagram of a portion A of  FIG. 7 ,  FIG. 10  is a front diagram illustrating a state of the clip apparatus for an endoscope illustrated in  FIG. 5 ,  FIG. 11  is a perspective diagram separately illustrating a clip coupling part and a clip in  FIG. 9 ,  FIGS. 12 and 13  are side diagrams illustrating before and after coupling the clip coupling part and the clip of  FIG. 11 ,  FIG. 14  is a diagram illustrating a state where the clip is separated in  FIG. 10 , and  FIG. 15  is a front diagram illustrating a clip apparatus for an endoscope according to another embodiment of the present disclosure. 
     First, a structure of the clip apparatus for an endoscope according to an embodiment of the present disclosure will be described with reference to  FIGS. 5 to 10 . 
     The clip apparatus for an endoscope according to an embodiment of the present disclosure may be configured to largely include a clip part, a sheath part which may operate the clip part by the relative movement, a driving part which is connected to the sheath part to drive the movement of the sheath part. 
     Specifically, in the present embodiment, the driving part may be configured to include a handle part  100 , a handle slider  200 , and an outer handle  600 , and the sheath part may be configured to include an inner sheath  300 , a wire  400 , and an outer sheath  500 , and the clip part may include a clip coupling part  700  and a clip  800  which is detachably coupled to the clip coupling part  700 . 
     The handle part  100  forms the body of the clip apparatus and is formed of an elongated cylindrical rod in the present embodiment. 
     A part of the handle part  100  may be formed with a moving hole  120  along the longitudinal direction, and the handle slider  200  to be described later may be provided to be slidable on the handle part  100  through the moving hole  120 . 
     A handle ring  102  may be formed at one end of the handle part  100 . Accordingly, a user may easily fix the clip apparatus according to the present disclosure by inserting his/her finger into the handle ring  102 . 
     At this time, a friction groove may also be formed on the partial outer surface of the handle part  100  to prevent the handle slider  200  from being moved relatively with respect to the handle part  100  by a weak force. 
     The handle slider  200  is installed to be slidable on the handle part  100  through the moving hole  120 . Specifically, the handle slider  200  may be fitted to penetrate the moving hole  120  and may be formed of a cylindrical column like the handle part  100 . 
     The handle slider  200  may be formed in two separable structures to be fitted to penetrate both sides of the moving hole  120  of the handle part, and may be assembled when the clip apparatus is assembled. 
     A handle part  202  may be formed on the outer surface of the handle slider  200  in the circumferential direction. In the present embodiment, the handle part  202  may be formed of a groove which is formed on the outer circumferential surface of the handle slider  200  in the circumferential direction, thereby easily gripping the handle part  202  by hand. That is, the thumb may be fitted into the handle ring  102  and the handle part  202  may be gripped with the index finger and the middle finger, thereby easily moving the handle slider  200  back and forth with respect to the handle part  100 . 
     Hereinafter, by defining, based on  FIG. 5 , the left, that is, the side where the handle part  100  is formed as the rear and the right, that is, the side where the clip  800  is coupled as the front, pushing the handle slider  200  into the clip  800  side will be described as forward movement, and the pulling the handle slider  200  to the handle ring  102  side will be described as backward movement. 
     At this time, the inside of the handle slider  200  may be formed with a coupling groove  220  configured to couple the wire  400  to be described later, and in the present embodiment, the coupling groove  220  is formed in a combination of a Z shape and a straight shape. The coupling structure of the wire  400  will be described in detail below. 
     In addition, the handle slider  200  is slidable within the moving hole  120  of the handle part, and the sliding movement thereof may be limited within the length of the moving hole  120 . 
     That is, the handle slider  200  may move as forward as possible as illustrated in  FIG. 5 , and move as backward as possible as illustrated in  FIG. 10 . This will be described in detail in the operation process of the clip apparatus according to the present disclosure. 
     The inner sheath  300  is rotatably connected to the inside of the handle part  100  and is formed to extend to the outside of the handle part  100 . 
     Specifically, as illustrated in  FIG. 8 , the inner sheath  300  is connected to the inside of the handle part  100  and the sliding movement is not possible forward or backward, but is connected to have a gap with the inner surface of the handle part  100  through an inner sheath ring  310  and is relatively rotatable with respect to the handle part  100 . 
     The inner sheath  300  may be formed in a hollow long tubular shape having flexibility, and is formed of a coil tube in the present embodiment. In addition, an inner pipe tip  320  made of a rigid material may also be formed at the end of the inner sheath  300 . Accordingly, as will be described in detail later, the inner pipe tip  320  may easily push a tightening ring  860  of the clip  800 . 
     The outer sheath  500  is disposed to surround the inner sheath  300 , and the outer sheath  500  is slidable along the longitudinal direction from the outside of the inner sheath  300 . The outer sheath  500  may be formed in a hollow long tube shape having flexibility. 
     Specifically, a space part  340  in which the outer sheath  500  may be disposed may be formed between the handle part  100  and the inner sheath  300 . Accordingly, one end portion of the outer sheath  500  may be moved within the space part  340 . At this time, the end of the outer sheath  500  is preferably formed to be movable within the range of the space part  340 . 
     To this end, the end of the outer sheath  500  may be formed with a locking part which is locked to the inside of the handle part  100  to prevent the outer sheath  500  from being separated to the outside. 
     In addition, the outer sheath  500  may be coupled to the outer handle  600  configured to move the outer sheath  500  along the longitudinal direction of the inner sheath  300 . 
     In the present embodiment, the outer handle  600  is formed of a cylindrical rod which is coupled to surround a part of the outer sheath  500 , and as described in detail below, may be coupled to a position which is spaced a certain length apart from the end of the outer sheath  500  in order to form a portion where a stopper  900  is detached, that is, to form one end portion of the outer sheath  500  for movement in the space part  340 . 
     Specifically, the outer handle  600  is preferably coupled to be spaced apart from the end of the outer sheath  500  by a length at which the outer sheath  500  may be disposed within the space part  340 . That is, as illustrated in  FIG. 7 , when the outer handle  600  contacts the handle part  100 , one end portion of the outer sheath  500  may be disposed within the space part  340 . 
     As described above, as the outer sheath  500  moves forward or backward through the outer handle  600 , the clip  800  may be disposed within the outer sheath  500  or exposed to the outside of the outer sheath  500 , thereby facilitating the entry of the clip apparatus. This will be described in detail in the operation process of the clip apparatus according to the present disclosure. 
     In addition, an outer pipe tip made of a rigid material may also be formed at the end of the outer sheath  500 . Accordingly, the outer pipe tip may help the clip apparatus to easily enter upon entry. 
     The wire  400  is connected to the handle slider  200  and disposed inside the inner sheath  300 . 
     Accordingly, the wire  400  may move forward and backward integrally with the handle slider  200 , and the wire  400  is also rotated integrally as the handle part  100  and the handle slider  200  rotate. 
     As described above, the wire  400  may also rotate together based on the rotation of the handle part  100 , and accordingly, the direction of the clip may be easily determined by the rotation of the clip  800  which is connected to the wire  400 , and other structures are not affected by the rotation. 
     The wire  400  is composed of a wire having flexibility, is disposed to penetrate the inside of the inner sheath  300 , and is slidable inside the inner sheath  300 . To this end, the wire  400  is preferably formed longer in length than the inner sheath  300 . 
     In the present embodiment, the wire  400  is coupled to the coupling groove  220  of the handle slider  200 , as illustrated in  FIG. 6 , and formed to extend to the outside of the handle part  100  with being disposed inside the inner sheath  300  by penetrating the handle part  100 . Specifically, the wire  400  may be fixed by being locked to the Z-shaped portion of the coupling groove  220 . 
     In addition, since the wire  400  has a flexible property, a sus pipe may be further provided to surround the wire  400  to reinforce the straightness thereof. Specifically, the sus pipe may be formed to surround one end portion of the rear side of the wire  400 , that is, one end portion of the portion of the wire  400  which is coupled to the coupling groove  220  of the handle slider, and formed to have a length of about 8 to 12 cm. 
     In addition, the clip apparatus may further include the stopper  900  which is detachably provided between the handle part  100  and the outer handle  600 . 
     The stopper  900  is provided between the handle part  100  and the outer handle  600  so that the outer handle  600  and the outer sheath  500  connected thereto are not moved backward, when the clip apparatus according to the present disclosure enters a target point inside the body through an endoscope. Accordingly, when the clip apparatus enters the body, the outer handle  600  and the outer sheath  500  connected thereto are pushed back so that the clip  800  which is disposed inside the outer sheath  500  is not exposed to the outside, thereby enabling safer and easier entry. 
     The stopper  900  may be removed after the clip apparatus according to the present disclosure enters the target point inside the body. This will be described in detail in the operation process of the clip apparatus according to the present disclosure. 
     The stopper  900  is formed to have a detachable part which may be spread and contracted to surround the outer sheath  500  at both sides thereof, and in the present embodiment, the stopper  900  is formed of a structure in which four detachable parts  920 , which surround one side of the outer sheath  500  alternately at both sides of the outer sheath  500 , are connected to one, as illustrated in  FIG. 5 . 
     Next, the clip coupling part  700  configured to couple the clip  800  is connected to one end of the wire  400 . 
     The clip coupling part  700  may include a connection part  720  which is connected to one end of the wire  400  and a bending part  740  configured to detachably couple the clip  800 . 
     The bending part  740  is composed of a pair of coupling arm parts  742  extending to face each other, and one coupling arm part  742   a  may be bent to contact the other coupling arm part  742   b . That is, as illustrated in  FIGS. 12 and 13 , the bending part  740  is composed of the pair of coupling arm parts  742  extending to face each other, and in the present embodiment, the one coupling arm part  742   a  is formed longer in length than the other coupling arm part  742   b.    
     Accordingly, the one coupling arm part  742   a  may be bent toward the inside facing the other coupling arm part  742   b  to couple one end portion of the clip  800  as illustrated in  FIG. 13 , and the one coupling arm part  742   a  may have a flexible property to be bendable, and at the same time, have a constant strength, thereby keeping the clip  800  coupled. 
     As described above, the clip  800  may be coupled as the one coupling arm part  742   a  is bent to contact the other coupling arm part  742   b , and at this time, the other coupling arm part  742   b  may be made of a rigid material. 
     In addition, as illustrated in  FIG. 9 , the connection part  720  may include an insertion hole  722  into which the wire  400  may be inserted. Accordingly, the wire  400  may be fixed by the welding with being inserted into the insertion hole  722 . 
     As described above, when the clip  800  is coupled by the bending of the bending part  740  and then a tensile force is applied to the bending part  740 , that is, when, as described later, a force of pulling the wire  400 , connected to the handle slider  200 , backward is applied to the bending part  740  by moving the handle slider  200  backward in a state where the clip  800  is ligated to the lesion site, the bending part  740  is unfolded in the original state and the coupled state of the clip  800  is released as illustrated in  FIG. 12 , such that as illustrated in  FIG. 14 , the clip  800  may be separated from the clip coupling part  700 . This will be described in detail in the operation process of the clip apparatus according to the present disclosure. 
     Next, describing the clip  800  in detail with reference to  FIGS. 9 and 11 , the clip  800  is connected to one end portion of the wire  400  through the clip coupling part  700 . Specifically, the clip  800  may include a pair of clip arm parts  820  which extends in the form which is spread to be openable and closable, gripping parts  840  which are formed to protrudes from the ends of the pair of clip arm parts  820  to the insides opposite to each other to be engaged with each other, and the tightening ring  860  which adjusts the opening and closing of the pair of clip arm parts  820 . 
     A protrusion part  822  is formed on each of the pair of clip arm parts  820 , and the clip  800  may be gripped as the tightening ring  860  is forcibly press-fitted into the protrusion part  822 . 
     The pair of clip arm parts  820  is formed side by side in a substantially U shape and then extend while being spread to both sides thereof to be openable and closable, and are generally formed of a metal plate having elasticity. As described above, the pair of clip arm parts  820  may be formed of an elastic body and may have a spreading property when no external physical force is applied thereto. 
     At this time, each of the arm parts  820  may also be formed with a hole to allow tissues to escape when the tissues are excessively picked up. By forming the hole as described above, even when the tissues are excessively picked up, it is possible to prevent the case where the clip is not ligated well or the clip is spread again. 
     The protrusion part  822  is formed on each of the pair of clip arm parts  820 , and in the present embodiment, the protrusion parts  822  are formed side by side in a U shape at each of the clip arm parts  820 , and then partially spread to both sides thereof. 
     The tightening ring  860  is disposed to be movable forward and backward on the pair of clip arm parts  820  until being press-fitted into the protrusion part  822 , and may be made of metal. Accordingly, until the tightening ring  860  is press-fitted into the protrusion part  822 , the tightening ring  860  may adjust the opening and closing of the clip  800  while moving on the pair of clip arm parts  820 , and the opening and closing of the clip  800  may be repeatedly performed, thereby attempting to the opening and closing of the clip  800  several times in order to ligate the clip  800  to the accurate position. 
     When the tightening ring  860  is located at the rear with respect to the pair of clip arm parts  820 , the pair of clip arm parts  820  are opened, and when the tightening ring  860  is located at the front with respect to the pair of clip arm parts  820 , the pair of clip arm parts  820  are closed. 
     At this time, referring to  FIG. 11 , the inner width at the position where the pair of clip arm parts  820  are disposed in the tightening ring  860  is preferably formed to be greater than the width of a portion where the tightening ring  860  moves in the pair of clip arm parts  820 , and equal to or smaller than the width of the protrusion part  822 . 
     That is, the inner width at each position where the pair of clip arm parts  820  are disposed side by side inside the tightening ring  860  may be formed greater than the U-shaped portion where the tightening ring  860  moves in the pair of clip arm parts  820 , thereby easily performing the forward and backward movements of the tightening ring  860 , and may be formed to be equal to or smaller than the width of the protrusion part  822  to be forcibly press-fitted, thereby enabling the ligation of the clip  800 . 
     The clip arm part  820  from the protrusion part  822  to the gripping part  840  may be formed to have the width greater than the protrusion part  822  to prevent the tightening ring  860  press-fitted into the protrusion part  822  from being separated forward. 
     In addition, as illustrated in  FIG. 9 , an outer diameter (L1) of the tightening ring  860  is formed greater than an inner diameter (L2) of the inner sheath  300 . Accordingly, when the handle slider  200  is moved backward and the wire  400  connected thereto is pulled backward, the tightening ring  860  does not enter the inner sheath  300  but is pushed by the inner sheath  300 , thereby moving forward from the clip  800 . 
     The gripping parts  840  are formed to protrude from the ends of the pair of clip arm parts  820  to the insides opposite to each other to be engaged with each other, and are engaged with each other until the pair of clip arm parts  820  are closed. At this time, it is preferable that one gripping part is formed with a portion of protruding in a certain shape, and the other gripping part is formed with a portion which includes a groove having a certain shape corresponding thereto, so that the gripping parts are engaged with each other. 
     Next, a clip apparatus for an endoscope according to another embodiment of the present disclosure will be described with reference to  FIG. 15 . 
     The clip apparatus for an endoscope according to another embodiment of the present disclosure has the same structure as the clip apparatus for an endoscope described above, but further includes a spring  420  which is disposed within the moving hole  120  to surround the wire  400 . 
     The present embodiment is particularly applicable to the case where the clip apparatus according to the present disclosure is used in the procedure through a windingly twisted path rather than straight, such as the oral cavity and anus of the body. 
     As described above, since the sheath part of the clip apparatus according to the present disclosure is also twisted when the procedure is performed along the windingly complicated path and the wire  400  is wound around the inside of the inner sheath  300  in a wider radius than when the procedure is performed through a straight section, the wire  400  may be pulled backward and the clip  800  coupled thereto may also be pulled backward, thereby reducing the opening angle. 
     In order to compensate for this, the wire  400  may be applied longer in preparation for the case where the sheath part according to the present disclosure is looped. That is, in the aforementioned embodiment, as illustrated in  FIG. 5 , when the handle slider  200  is disposed at the maximum forward position, the clip coupling part  700  is formed to be positioned inside the inner sheath  300 , but in the present embodiment, when the handle slider  200  is disposed at the maximum forward position, the clip coupling part  700  may be formed to be exposed to the outside of the inner sheath  300 . 
     At this time, although the wire  400  is formed lengthily, the spring  420  may be further included as in the present embodiment in order to prevent the clip coupling part  700  from being exposed to the outside of the inner sheath  300 . 
     That is, the spring  420  maintains the handle slider  200  not to be disposed at the maximum forward position when no force is applied thereto, and as a result, the clip coupling part  700  is positioned inside the inner sheath  300  when the spring  420  is not compressed. 
     Thereafter, when the clip  800  approaches the lesion site for the procedure, the narrowed opening angle of the clip  800  may be corrected by pushing the handle slider  200  to the maximum forward position while compressing the spring  420 . 
     Accordingly, even when the wire  400  is formed lengthily in preparation for the procedure through the winding path, the clip coupling part  700  may be prevented from being exposed to the outside of the inner sheath  300 , thereby preventing the clip  800  from being separated by the side load when the clip apparatus enters, and after the clip apparatus enters, the opening angle of the clip may be corrected to be widened by compressing the spring  420  and pushing the handle slider  200 . 
     Next, a process will be described, in which the clip apparatus for an endoscope according to an embodiment of the present disclosure is operated to stop the bleeding of or suture the biological tissues. 
     First, the state for entering the clip apparatus for an endoscope according to the present disclosure into the body will be described with reference to  FIGS. 5 and 6 . 
     This is a state where both the handle slider  200  and the outer handle  600  are moved to the maximum forward position. Accordingly, the wire  400  which is connected to the handle slider  200  is also positioned as forward as possible, and at this time, the clip coupling part  700  is disposed inside the inner sheath  300  and the pair of clip arm parts  820  of the clip are opened. 
     In addition, the outer sheath  500  which is connected to the outer handle  600  is also positioned as forward as possible to all surround from the inner sheath  300  to the clip  800 . At this time, the clip  800  is in the opened state but becomes spread because the clip  800  is not ligated by the outer sheath  500 . As will be described later, when the outer sheath  500  is moved backward again, the clip  800  returns to the opened state. 
     In addition, since the stopper  900  is provided between the handle part  100  and the outer handle  600 , the outer handle  600  and the outer sheath  500  connected thereto are not pushed backward, and accordingly, the clip  800  is not exposed to the outside, and accordingly, the clip apparatus according to the present disclosure may more safely and easily enter the body. 
     Next, a state where the clip  800  is exposed to the outside of the outer sheath  500  after the clip apparatus enters the body will be described with reference to  FIG. 7 . 
     When the clip apparatus completely enters the body as described above, the position of the clip  800  is needed to be properly adjusted to ligate the clip  800  to the lesion site inside the body. To this end, the clip  800  is needed to be exposed to the outside of the outer sheath  500 , and the outer sheath  500  is needed to be moved backward. 
     To this end, the stopper  900  may be removed and the outer handle  600  and the outer sheath  500  connected thereto may be pulled and moved backward, and accordingly, the clip  800  is opened while coming out to the outside of the outer sheath  500 . 
     Accordingly, in such a state, the pair of clip arm parts  820  are positioned at a target position, and the direction of the clip  800  which is connected through the wire  400  may also be properly adjusted by rotating the handle part  100 . 
     That is, by gripping the outer handle  600  and integrally rotating the handle part  100  and the handle slider  200 , the wire  400 , the clip coupling part  700 , and the clip  800  which are connected to the handle slider  200  may be rotated. 
     Next, the state where the clip  800  is ligated will be described with reference to  FIG. 10 . 
     As described above, when the position of the clip  800  is completely adjusted, the clip  800  may be ligated by pulling the handle slider  200  backward. 
     Specifically, when the handle slider  200  is pulled backward, the wire  400  and the clip coupling part  700  which are connected thereto are also pulled backward. At this time, since the outer diameter of the tightening ring  860  of the clip is greater than the inner diameter of the inner sheath  300  and the tightening ring  860  may not enter the inner sheath  300 , only the pair of clip arm parts  820  which are coupled by the bending part  740  of the clip coupling part  700  are pulled backward, and accordingly, the tightening ring  860  moves forward on the pair of clip arm parts  820 , thereby making the clip  800  closed. 
     Until the tightening ring  860  is forcibly press-fitted into the protrusion part  822  of the pair of clip arm parts  820 , the tightening ring  860  may adjust the opening and closing of the clip  800  while moving the handle slider  200  forward or backward. 
     In order to ligate the clip  800 , when an operator feels the feeling which is locked to the handle slider  200 , that is, when the operator feels that the tightening ring  860  is locked to the protrusion part  822 , the tightening ring  860  is forcibly press-fitted into the protrusion part  822  by applying a force to and pulling the handle slider  200 , and the clip  800  is ligated. 
     Lastly, as illustrated in  FIG. 10 , when the clip  800  is ligated and then the handle slider  200  is pulled as backward as possible by applying a force thereto, the clip  800  is ligated and fixed to the lesion site, such that only the wire  400  and the clip coupling part  700  are moved backward and a tensile force is generated in the bending part  740  of the clip coupling part. 
     Accordingly, the one coupling arm part  742   a  which has been bent to couple the clip  800  is unfolded and the clip  800  may be separated as illustrated in  FIG. 14 . Finally, the clip apparatus for an endoscope escapes to the outside with the clip  800  positioned as it is. 
     According to the clip apparatus for an endoscope according to the present disclosure, by driving, with one handle slider, the wire connected thereto, the clip may be ligated and separated, such that not only the structure of the driving part is simple but also the operation thereof is easy. 
     The present disclosure is not limited to the aforementioned specific embodiments and descriptions, and various modifications may be made by those skilled in the art without departing from the subject matter of the present disclosure as claimed in the claims, and such modifications fall within the protection scope of the present disclosure. 
     INDUSTRIAL APPLICABILITY 
     The present disclosure relates to a clip apparatus for an endoscope, and more particularly, to a clip apparatus for an endoscope having a simple driving part, and enabling the accurate and easy clip ligation and separation.