NOVEL TECHNIQUE AND INSTRUMENTATION FOR LAPAROSCOPIC APPLICATION OF HEMOSTATIC CLIPS

A novel device for applying hemostatic clips in laparoscopic surgery i ncorporates a distal hook into a multiple-firing titanium clip applier . The hook may be used for blunt dissection of tissue, and to displace and control ducts and vessels during clip application. A single instr ument may be used to achieve hemostasis in areas that are difficult to reach, and past pointing problems encountered with straight on clip a ppliers are alleviated. Comparative testing of the holding force of th e curved clips used with this device versus the straight clips used in conventional multiple-clip appliers demonstrated a higher mean pull-o ff force of 0.473 Ibs versus 0.33 Ibs. Clinical application of the dev ice in laparoscopic procedures including cholecystectomy, vaginal hyst erectomy, Nissen fundoplication, vagotomy, varicocelectomy, and lympha denectomy show the utility of the hook clip applier.