Electrocautery hemostatic clip

Abstract

A device for treating tissue includes a tube that extends longitudinally from a proximal end to a distal end and includes a passage extending therethrough. The tube is releasably coupled to a proximal portion of the device, and a proximal end of the clamping arm is slidably received within the passage of the tube such that the clamping arm is movable between an open configuration and a closed configuration. A core member is connected to the clamping arm, and the core member includes a proximal portion and a distal portion that are releasably connected to each other such that when the core member is subjected to a predetermined load, the proximal portion and the distal portion separate from each other. A conductive control member is connected to the core member, and a proximal end of the connecting member is connected to a power source that transmits an electric current to the clamping arm.

Description

[0001] This application is a divisional application of patent application No. 201680070447.3.

[0002] Priority Claim

[0003] This application claims the benefit of priority of U.S. Provisional Patent Application No. 62 / 262,729, filed on Dec. 3, 2015, the content of which is incorporated herein by reference. BACKGROUND OF THE INVENTION

[0004] There is an increasing willingness among physicians to perform more aggressive invasive and therapeutic endoscopic procedures, including, for example, removing larger lesions (such as cancerous masses), tunneling under the mucosal layer of the gastrointestinal (GI) tract to treat submucosal problems, full-thickness tissue resection, inserting a device through the GI tract and then penetrating a GI organ to treat the peripheral tissue of the GI tract, endoscopic treatment and / or repair of postoperative problems (such as postoperative leakage, breakdown of surgical sutures, and anastomotic leakage). These procedures may increase the risk of perforating or damaging the GI tract wall, or may require procedures including closing the GI tract wall during the operation. Closing with an endoscope can reduce costs and reduce the trauma and inconvenience associated with these procedures. However, existing tissue closing devices may be insufficient to close certain tissue defects. SUMMARY OF THE INVENTION

[0005] The present invention relates to a device for treating tissue, including a tube longitudinally extending from a proximal end to a distal end. The tube includes a channel extending through the tube, and the tube is releasably coupled to a proximal portion of the device. The proximal ends of the clamping arms are slidably received in the channel of the tube, such that the clamping arms can move between an open configuration and a closed configuration. In the open configuration, the distal ends of the clamping arms extend distally and separate from each other beyond the distal end of the tube. In the closed configuration, the clamping arms are restricted by the inner surface of the tube, such that the distal ends of the clamping arms are pulled closer to each other. A core member coupled to the clamping arms includes a proximal portion and a distal portion, and the proximal portion and the distal portion are releasably connected to each other. Thus, when the core member is subjected to a predetermined load, the proximal portion and the distal portion separate from each other. A conductive control member connected to the core member has a proximal end connected to a power source for transmitting current to the clamping arms.

[0006] In one embodiment, the proximal portion of the device includes a flexible member and a bushing located at the distal end of the flexible member.

[0007] In one embodiment, the flexible member and the bushing are separated from each other by a non-conductive member, thereby protecting the flexible member from the influence of current.

[0008] In one embodiment, the proximal portion and the distal portion of the core member are connected to each other by a disconnectable coupling member.

[0009] In one embodiment, the tube is one of insulated and made of a non-conductive material.

[0010] In one embodiment, the tube is made of a conductive material.

[0011] In one embodiment, a portion of the control member is insulated to protect the proximal portion of the device.

[0012] In one embodiment, a portion of the clamping arm is insulated to provide current to a desired portion of the clamping arm.

[0013] In one embodiment, the proximal portion of the core member includes a limiting tab for engaging the proximal end of the clamping arm, and the distal portion includes an alignment protrusion for connecting to corresponding notches extending laterally through each clamping arm.

[0014] In one embodiment, the distal ends of the clamping arms include sharp teeth extending laterally towards each other for cauterizing tissue clamped between the clamping arms when electrical energy is received through the clamping arms.

[0015] In one embodiment, when electrical energy is received by the clamping arms, the inner surfaces of the clamping arms are configured to coagulate tissue.

[0016] The present invention also relates to a clamping device including a proximal portion having a flexible member and a bushing, the flexible member longitudinally extending from a proximal end to a distal end, and the bushing connected to the distal end of the flexible member. A distal portion releasably coupled to the proximal portion such that the distal portion can be deployed from the clamping device. The distal portion includes a tube releasably coupled to the bushing, the tube longitudinally extending from a proximal end to a distal end and including a channel extending through the tube. Clamping arms extend from a proximal end slidably received in the channel of the tube such that the clamping arms can move between an open configuration and a closed configuration, in the open configuration the distal ends of the clamping arms extend distally and are separated from each other beyond the distal end of the tube, and in the closed configuration the clamping arms are restricted by the inner surface of the tube such that the distal ends of the clamping arms are pulled towards each other. A core member coupled to the proximal ends of the clamping arms, the core member including a proximal portion and a distal portion connected to each other by a disconnectable connector, the disconnectable connector designed to fail when subjected to a predetermined load. A conductive control line connected to the core member, the proximal end of the connector being connected to a power source for transmitting current to the clamping arms.

[0017] In one embodiment, the device further includes an insulating bushing extending over a portion of the control line.

[0018] In one embodiment, the distal ends of the clamping arms include sharp teeth extending laterally towards each other.

[0019] In one embodiment, a portion of the clamping arm is insulated.

[0020] The present invention also relates to a method of treating a target tissue, the method comprising inserting a distal portion of a clamping device into a target area within a living body, the distal portion including a tube and clamping arms that are slidably received within the tube and are movable between an open configuration and a closed configuration. In the open configuration, the distal ends of the clamping arms are separated from each other, and in the closed configuration, the distal ends of the clamping arms are drawn closer to each other. The distal portion is releasably coupled to a proximal portion of the device so that the distal portion can be deployed from the clamping device, positioning the clamping arms in contact with the target tissue, and transmitting electrical energy to the clamping arms through an electrical conductor connected to one of the tube and the clamping arms to thereby treat the target tissue.

[0021] In one embodiment, the step of positioning the clamping arms in contact with the target tissue includes moving the clamping arms toward the open configuration so that the inner surfaces of the clamping arms are in contact with the target tissue to thereby coagulate the target tissue.

[0022] In one embodiment, the step of positioning the clamping arms in contact with the target tissue includes clamping the target tissue between sharp teeth located on the distal ends of the clamping arms to thereby cauterize the target tissue.

[0023] In one embodiment, the method further includes clamping a target portion of the tissue by positioning the target portion of the tissue between the distal ends of the clamping arms in the open configuration, and pulling the clamping arms toward the closed configuration to thereby clamp the target portion of the tissue.

[0024] In one embodiment, the method further includes locking the clamping arms in the closed configuration and deploying the distal portion from the proximal portion of the device. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 is a longitudinal cross-sectional view showing a device according to an exemplary embodiment of the present invention;

[0026] Figure 2 is a longitudinal cross-sectional view showing a device according to an alternative embodiment of the present invention;

[0027] Figure 3 is a longitudinal side view showing a device according to another exemplary embodiment of the present invention;

[0028] Figure 4 is a longitudinal cross-sectional view showing Figure 3 a device;

[0029] Figure 5 is a partial perspective isometric view showing a device according to another alternative embodiment of the present invention; and

[0030] Figure 6 is a longitudinal cross-sectional view showing Figure 5 a device. DETAILED DESCRIPTION

[0031] The present invention can be further understood with reference to the following description and drawings, in which like elements are denoted by like reference numerals. The present invention relates to an endoscopic clamping device for treating tissue perforations, defects, and / or bleeding. In particular, example embodiments of the present invention describe a hemostatic clip having clamping and coagulation functions. A portion of the clamping device is insulated or made of non-conductive material to achieve the desired coagulation effect. It should be noted that as used herein, the terms "proximal" and "distal" are intended to indicate the direction of the device toward (proximal) and away from (distal) the user.

[0032] As Figure 1 shown, the device 100 according to an example embodiment of the present invention includes a distal portion 102 that can be inserted into a living body through a working channel of, for example, an endoscope to reach a target tissue awaiting treatment. The device has sufficient flexibility to allow passage through tortuous paths within the body - for example, through a natural body cavity accessed through a natural body orifice by insertion through the working channel of an endoscope. The distal portion 102 includes a pair of clamping arms 104 that are slidably received within a longitudinal channel 122 of a tube 106. The clamping arms 104 are movable between an open configuration in which the distal ends 108 of the clamping arms 104 are separated from each other to receive the target tissue therein and a closed configuration in which the distal ends 108 of the clamping arms 104 move toward each other to clamp the target tissue therebetween. The distal portion 102 is releasably coupled to a proximal portion 110 of the device 100, the proximal portion 110 including a handle (not shown) that remains outside the body and is accessible to the user when the distal portion 102 is deployed. The clamping arms 104 are movable between the open and closed configurations by a control member 112 that extends into the tube 106. The proximal end of the control member is connected to an actuator of the handle. In the present embodiment, the distal end 114 of the control member 112 is coupled to the proximal end 116 of the clamping arms 104. The proximal end of the control member 112 is also coupled to an energy source that supplies an electric current to the clamping arms 104 through the control member 112 to supply energy to the target tissue, as will be described in further detail below.

[0033] The proximal portion 110 of the device 100 includes a flexible member 118 that connects the tube 106 to the handle. The flexible member 118 is made, for example, using a coil or any other suitable flexible structure, which facilitates the insertion of the distal portion 102 of the device 100 through the tortuous paths of a living body. The tube 106 is connected to the flexible member 118 through a bushing 120, and the bushing 120 is releasably coupled to the tube 106. The control member 112 extends through the flexible member 118, the bushing 120, and the tube 106 and is connected to the clamping arm 104. The flexible member 118 and the bushing 120 are electrically insulated and / or made of non-conductive materials to protect the user, surrounding instruments, and non-target tissues from their effects. Insulation can be applied using powder coating, heat shrink tubing, or by using non-conductive components such as plastics and / or ceramics. The insulating material can include acetal (POM), epoxy resin, FEP, polyamide, PVDF, phenolic resin, PFA, polycarbonate, polysulfone, PVC, polyphenylene sulfide, polyetherimide, silicone resin, polyetheretherketone (PEEK), polytetrafluoroethylene (PTFE), and polyethylene. The thickness of the insulator can be between 0.0005 inches (0.0127 mm) and 0.020 inches (0.508 mm), and more specifically, between 0.002 inches (0.0508 mm) and 0.006 inches (0.1524 mm).

[0034] The bushing 120 longitudinally extends from a proximal end 124 connected to the distal end 126 of the flexible member 118 to a distal end 128 of the bushing releasably coupled to the tube 106. In one example, the bushing 120 includes at least one opening 130 that extends laterally through the bushing 120 for receiving a corresponding connection tab 132 of the tube 106. However, the bushing 120 can include multiple openings, and in a particular embodiment, the bushing 120 includes a pair of radially opposed openings. Similar to the tube 106 and the flexible member 118, the bushing 120 can be insulated and / or formed of non-conductive materials to prevent the surrounding portion from being affected by the current passing through the control member 112 that passes through the bushing 120. In another embodiment, the length of the control member 112 passes through the flexible member 117 and the bushing 120, and the control member 112 can be insulated and / or covered by a sheath 158 to prevent current from being transmitted from the control member 112 to the surrounding portion of the device 100. The insulating member and / or the sheath 158 covering the control member 112 provides additional protection for the surrounding portion of the clamping device. In this embodiment, the flexible member 118 and the bushing 120 do not need to be insulated / non-conductive.

[0035] The tube 106 includes a plurality of connecting tabs 132 corresponding to pairs of openings 130 in the bushing 120. The tube 106 extends longitudinally from a proximal end 134 to a distal end 136 and includes a passage 122 extending longitudinally therethrough. The connecting tabs 132 extend radially inwardly from the proximal end 134 such that when the tabs 132 are received in a corresponding opening 130 of the bushing 120, the tube 106 and the bushing 120 are coupled to each other. The tube 106 also includes a pair of windows 138 that extend transversely through the tube 106 along a proximal portion of the tube 106. As will be described in further detail below, the size, shape, and configuration of the pair of windows 138 are adapted to receive locking members 140 on the proximal ends 116 of the clamping arms 104. Although the device 100 is shown coupling the bushing 120 and the tube 106 via the openings 130 and the connecting tabs 132, the bushing 120 and the tube 106 may be coupled to each other in any of a variety of ways so long as the bushing 120 and the tube 106 are releasably coupled to each other and the bushing 120 and the tube 106 may be released when the distal portion 102 of the device 100 is deployed.

[0036] The clamping arms 104 of the present embodiment are connected to the control member 112 by a core member 142 that includes a proximal portion 144 and a distal portion 146 that are releasably connected to each other such that the proximal portion 144 and the distal portion 146 will separate from each other when subjected to a predetermined load. In one embodiment, the releasable connection is a disconnectable connector 148 designed to separate or break when subjected to a predetermined load. The disconnectable connector is formed by welding or other suitable connection so long as the connection remains in place until subjected to a predetermined load and the connection fails when the load is applied. The core member 142 is formed of a conductive material such that current passing through the control member 112 passes through the core member 142 to the clamping arms 104. The distal end 114 of the control member 112 is connected to the proximal portion 144, for example, by an enlarged distal end 114 received in a cavity 154 of corresponding size and shape located within the proximal portion 144. Thus, when the control member 112 moves longitudinally relative to the tube 106, the core member 142 and, concomitantly, the clamping arms 104 move correspondingly relative to the tube 106.

[0037] The proximal portion 144 of the present embodiment includes a pair of tabs 150 positioned on opposite sides of the proximal portion 144 for engaging the proximal ends 116 of the clamping arms 104. The distal portion 146 includes alignment protrusions 152, each alignment protrusion 152 being longitudinally aligned with a corresponding one of the tabs 150, and the alignment protrusions 152 engage notches that extend transversely through a portion of the clamping arms 104 and are of corresponding size and shape. The alignment protrusions 152 cause the clamping arms 104 to remain aligned with each other. Although the core member 142 is described and shown as a single element having portions connected to each other via a detachable connection 148, the clamping arms 104 may be connected and aligned with each other via other mechanisms. For example, as will be understood by those skilled in the art, the core member 142 may be single or may consist of two or more separate elements connected to each other in various ways by separable joints.

[0038] The clamping arms 104 are biased toward the open configuration, so that when the clamping arms 104 are moved distally past the distal end 136 of the tube 106, the distal ends 108 of the clamping arms 104 separate from each other to the open configuration. When the clamping arms 104 are pulled proximally into the tube 106, the clamping arms 104 move toward the closed configuration by contacting the inner surface of the tube 106, and the tube 106 holds the clamping arms 104 in the closed position. As described above, the clamping arms 104 are moved between the open and closed configurations by the control member 112. The clamping arms 104 are made of a conductive material, so that current passing through the control member 112 passes through the clamping arms 104 to reach the target tissue in contact with the clamping arms 104. The configuration of the clamping arms 104 and the tube 106 is such that the pulling distance required to pull the clamping arms 104 toward the closed configuration ensures that the conductive portions of the control member 112, the core member 142, and the clamping arms 104 are never pulled into the conductive portion of the flexible member 118.

[0039] The features of the jaw 104 with a small current emission area (such as a sharp edge) can be used as a cauterizing edge or a cutting edge. For example, the sharp teeth 109 located on the distal end 108 of the jaw 104 extend laterally towards each other. Thus, when tissue is clamped between the sharp teeth 109, the sharp teeth 109 can be used to cauterize the tissue they contact. The features with a large current emission area such as a smooth surface can be used for coagulation. For example, when the inner surface 156 along the length of the jaw 104 (such as the surface of the jaw 104 facing each other when the jaws 104 are pulled together) is pressed against the tissue, it can be used to provide a coagulation function. In another example, the jaws 104 move towards a closed configuration, so that the sharp teeth 109 at the distal end 108 are joined together to form a smooth distal edge. This smooth distal edge is used to coagulate a small area of the tissue. In yet another example, in the closed configuration, the distal surface of the jaw 104 can be pressed against the target tissue to coagulate the tissue. Different regions of the jaw 104 provide different functions to the tissue when pressed against the tissue. In this way, the geometry and material construction of the tip can change the current density acting on the tissue. A large area such as the inner or outer surface of the jaw 104 provides a lower current density effect for coagulation. Smaller, sharper regions, such as the tip of the jaw 104 or the sharp teeth 109, provide a higher current density effect for cutting. Although the exemplary embodiments show and describe that all of the jaws 104 are conductive, a portion of the jaws 104 can also be made insulating, and only the desired portion can be conductive. For example, it is desired that only the distal end of the jaw 104 is conductive.

[0040] As described above, the device 100 is used to cauterize / cut, coagulate, and / or shear the target tissue, treating the target area as needed or necessary. The cauterizing and coagulation functions are powered and controlled by turning on or off the power supply connected to the proximal end of the control member 112. When it is desired to cauterize or coagulate the tissue, the power supply is energized so that current is transmitted to the jaws 104. Once the desired cauterizing and / or coagulation function is achieved, or when it is desired to utilize the clamping aspect of the device 100, the power supply is de-energized so that the jaws 104 are positioned on the target tissue and clamp the target tissue without further applying energy to the excised tissue. Once the target tissue has been positioned between the jaws 104, the jaws 104 can move towards the closed configuration so that the distal portion 102 of the device 100 is deployed on the target tissue, which will be described in more detail below.

[0041] According to an exemplary method, the distal portion 102 of the device 100 is inserted through a working channel of, for example, an endoscope into a target area within a living body. The distal portion 102 is inserted through the working channel in a closed configuration. However, once the distal portion 102 reaches the target area, the control member 112 is moved distally relative to the tube 106 to move the jaw arms 104 to an open configuration. The jaw arms 104 can move between the open and closed configurations to grip and / or contact tissue in a manner that achieves the desired effect. For example, the distal ends 108 of the jaw arms 104 can be positioned near the tissue area to be cut in the open configuration to provide a cutting function. The jaw arms 104 are pulled towards the closed configuration, so that a portion of the target area desired to be cut is gripped between the sharp edges of the teeth 109 at the distal ends 108 of the jaw arms 104. The power supply is energized so that an electric current through the control member 112 passes through the jaw arms 104 to the distal ends 108 to cauterize / cut the gripped tissue. It is also desirable to provide coagulation of a portion of the tissue in the target area. In one example, the jaw arms 104 are positioned in the open configuration across a portion of the tissue to be treated such that the inner surfaces 156 contact the tissue to be treated. The jaw arms 104 are moved slightly towards the closed configuration to increase the area of contact with the tissue. In another example, the jaw arms 104 can form a smooth distal edge in the closed configuration to coagulate the tissue. The smooth distal edge is used to coagulate more target portions of the tissue. When the power supply is activated, an electric current passes through the jaw arms 104 to coagulate the tissue contacted by the jaw arms 104. The above procedures can be repeated until the desired cauterization and / or coagulation effect is achieved.

[0042] After the desired cauterization and / or coagulation is completed, or when it is desired to utilize the gripping aspect of the device 100, the power supply can be disconnected and the jaw arms 104 are positioned around a portion of the tissue to be gripped. Once a portion of the tissue to be gripped is positioned between the jaw arms 104, the jaw arms 104 are moved towards the closed configuration, so that the tissue is gripped between the jaw arms 104. The jaw arms 104 move between the open and closed configurations until the desired portion of the tissue is gripped. In a particular embodiment, in the closed configuration, by further pulling the control member 112 proximally until the proximal end 160 of the core member 142 moves proximally against the connecting tab 132 of the tube 106, the distal portion 102 of the device 100 is deployed with the jaw arms 104. The proximal force against the tab 132 forces the tab 132 to disengage from the opening 130 of the bushing 120, releasing the tube 106 from the bushing 120. Further proximal movement of the control member 112 separates the core member 142 such that the proximal ends 116 of the jaw arms 104 are released and engaged with the window 138, thereby locking the jaw arms 104 in the closed configuration. The proximal portion 144 of the core member 142 is pulled proximally out of the tube 106, thereby separating the distal portion 102 of the device 100 from the proximal portion and deploying the device within the body.

[0043] The above-described deployment procedure is an example of how to deploy the distal portion of the device 100. The distal portion 102 can be deployed in a variety of different ways, depending on the configuration of the core member 142 and / or the manner of connection between the bushing 120 and the tube 106, as long as the deployment procedure can release the tube 106 from the bushing 120 and simultaneously lock the clamping arms 104 in the closed configuration.

[0044] According to an alternative embodiment, as Figure 2 shown, the device 100' is substantially similar to the above-described device 100, including a distal portion 102' having clamping arms 104' that are slidably received within a tube 106'. The distal portion 102' is moved between an open configuration and a closed configuration by a control member 112'. The method of using the device 100' is substantially the same as that of the device 100. However, the tube 106' is not insulated and / or formed of a non-conductive material, but rather is formed of a conductive material such that electrical energy can pass through. For example, electrical energy is transmitted to the tube 106' through the control member 112' via the core member 142' and / or the clamping arms 104' that contact the tube 106' substantially as described above with respect to the device 100.

[0045] Similar to the device 100, the distal portion 102' is releasably coupled to a flexible member 118' of the proximal portion 110' of the device 100' by a bushing 120'. However, the proximal portion 110' also includes a non-conductive separator 162' positioned between the bushing 120' and the flexible member 118' to further protect the flexible member 118' from the effects of electric current. Substantially similar to the above-described device 100, the flexible member 118' can be protected from the effects of electric current by insulating a portion of the control line 112' extending within the flexible member 118' and / or covering a portion of the control line 112' with a non-conductive sheath 158'.

[0046] As Figures 3 to 4 shown, the device 200 according to an exemplary embodiment is substantially similar to the device 100 described above, including a pair of clamping arms 204 that are slidable within a tube 206 between an open configuration and a closed configuration. However, instead of transmitting electric current to the clamping arms 204 through a control member 212, cauterization and / or coagulation via the clamping arms 204 is activated by an inductive or capacitive coupling. Specifically, a conductive coil 264 extends around the outer surface of the tube 206. The conductive coil 264 can be connected to a power source at the proximal end of the device 200 such that when powered, the conductive coil 264 generates an electric field that transmits electrical energy to the clamping arms 204, enabling the clamping arms 204 to cauterize tissue and / or coagulate tissue in a manner substantially similar to the device 100 described above. Since the clamping arms 204 are activated using the conductive coil 264, the control member 212 is insulated and / or formed of a non-conductive material.

[0047] As Figures 5 to 6As shown, the device 200' according to an alternative embodiment is substantially similar to the device 200. However, instead of having a conductive coil around the outer surface of the tube 206', the device 200' has a conductive coil 264' extending around the inner surface of the tube 206'. The conductive coil 264' generates an electric field for activating the clamping arm 204' slidably received within the tube 206'. In another embodiment (not shown), the conductive coil may be embedded within the wall of the tube 206'.

[0048] The method of using the devices 200, 200' is substantially similar to that of the device 100. In particular, the clamping arms 204, 204' can be used for disinfection, coagulation, and / or tissue clamping as described above.

[0049] Changes may be made to the structure and method of the present invention without departing from the spirit and scope thereof. Accordingly, the present invention is intended to cover modifications and variations of the present invention that would be apparent to one of ordinary skill in the art.

Claims

1. A device for treating tissue, comprising: a tube extending longitudinally from a proximal end towards a distal end, the tube including a passage extending through the tube, the tube being releasably coupled to a proximal portion of the device; clip arms, a proximal end of the clip arms being slidably received in the passage of the tube such that the clip arms are movable between an open configuration and a closed configuration, in the open configuration, distal ends of the clip arms extend distally and beyond a distal end of the tube and are separated from each other, and in the closed configuration, the clip arms are restricted by an inner surface of the tube such that the distal ends of the clip arms are pulled towards each other; a conductive coil coupled to a power source at a proximal end of the device such that when powered, the conductive coil generates an electric field that transmits electrical energy to the clip arms; the conductive coil extends around an outer surface of at least a portion of the tube or around an inner surface of the tube or the conductive coil is embedded within a wall of the tube, the conductive coil forming an inductive coupling with the clip arms to transmit electrical energy to the clip arms, thereby cauterizing tissue in contact with the clip arms and / or coagulating the tissue; a core member coupled to the clip arms, the core member including a proximal portion and a distal portion, the proximal portion and the distal portion being releasably connected to each other such that when the core member is subjected to a predetermined load, the proximal portion and the distal portion are separated from each other; a control member connected to the core member, a distal end of the control member being coupled to the core member, and a proximal end of the control member being connected to an actuator on a handle that moves the core member proximally and distally relative to the tube such that the clip arms are movable between the open configuration and the closed configuration, wherein the control member is electrically insulated from the clip arms or is formed of a non-conductive material, and when the control member moves longitudinally relative to the tube, the core member and the associated clip arms move correspondingly relative to the tube; wherein a first clip arm of the clip arms includes a first clip arm insulating portion and a first clip arm conductive portion, wherein the first clip arm conductive portion includes a small current emission region configured to cauterize tissue when electrical energy is supplied thereto; and a large current emission region configured to coagulate tissue when electrical energy is supplied thereto.

2. The device according to claim 1, wherein the proximal portion of the device includes a flexible member and a bushing located at a distal end of the flexible member.

3. The device according to claim 1, wherein the proximal portion and the distal portion of the core member are connected to each other by a disconnectable connector.

4. The device according to claim 1, wherein multiple portions of the control member are insulated to protect the proximal portion of the device.

5. The device according to claim 1, wherein the proximal portion of the core member includes a limiting tab for engaging a proximal end of the clip arms, and the distal portion includes an alignment protrusion for engaging corresponding notches extending transversely through each clip arm.

6. The device according to claim 1, wherein the distal ends of the clip arms include sharp teeth that extend transversely towards each other to cauterize tissue clamped between the clip arms when the clip arms receive electrical energy.

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