Surgical clip
Patent Information
- Application Number
- EP2023800377
- Authority / Receiving Office
- EP · EP
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2023-10-30
- Publication Date
- 2026-09-09
AI Technical Summary
Existing surgical clips used for endoscopic treatment of gastrointestinal bleeding often cause unnecessary damage to healthy tissue due to their design, which includes spikes or tips that penetrate the tissue for anchoring.
A surgical clip with a ring-shaped geometry featuring two sections of gripping with rounded or wave-shaped clamping edges, and elastic deformable hinge sections, which allows for tissue compression without penetration, thereby reducing the risk of tissue damage.
The surgical clip effectively clamps tissue without penetrating it, reducing the risk of tissue damage and providing a reliable connection between tissue areas, such as the gastric wall, while minimizing harm to healthy tissue.
Smart Images
Figure EP2023080259_08052025_PF_FP_ABST
Abstract
Description
[0001] Surgical clip
[0002] Description
[0003] Technical area
[0004] The present disclosure relates to a surgical clip for the endoscopic treatment of gastrointestinal bleeding, comprising a closed ring having two gripping portions, each having a base portion and a plurality of gripping teeth, which are designed to staple tissue, for example a stomach wall or a colon or the like, or to close chronic or acute wall lesions of a human or animal body.
[0005] Background of the Revelation
[0006] When inserting medical devices into a body orifice, in particular into a patient's hollow organ, endoscopic implantation procedures can be carried out in a known manner, which pose little risk to the patient. For example, it is known to attach medical devices to the hollow organ starting from the inside of the hollow organ. Here, tissue clamps or clips are inserted into the hollow organ, preferably with the aid of an endoscope or a similar advancement device, and positioned at predetermined points or positions on the inside of the organ. For this purpose, the respective clip is brought towards the organ tissue and elastic hinges of the clip are used to snap the clip into place and thus to attach the clip to the organ tissue. This clip then holds or clamps a fold of tissue between its gripping teeth, which can optionally have spikes, whereby the spikes cut into or drill into the tissue.and preferably penetrate it.
[0007] Surgical (tissue) clips that can be attached to a patient's organ tissue wall via an endoscopic procedure are already known from the prior art. For example, EP 2 449 983 B1 discloses a clip that is placed spread-eagle on an endoscope head and inserted into the patient. Once in the correct position, the clip is then pushed forward by the endoscope head, causing the clip to snap together and clamp the organ tissue between its gripping teeth. The described clip has a plurality of pointed spike geometries, or spikes, that pierce the clamped tissue to further anchor the clip. Additional spikes, or points, arranged laterally, also serve to grasp a larger volume of tissue, exert greater clamping forces, and pierce more tissue for improved anchoring.
[0008] However, the pressure exerted by the laterally positioned spikes or points on the tissue has proven to be partially detrimental. In particular, it has been found that the laterally positioned spikes or points unnecessarily damage or stress healthy tissue by penetrating it at this point. Thin and fresh tissue in particular has been unnecessarily damaged or stressed.
[0009] Summary of the present disclosure
[0010] Therefore, the present disclosure is based on the object of avoiding or at least mitigating the disadvantages described above and, in particular, of providing a surgical (tissue) clip that automatically applies the necessary clamping force for reliably tacking together tissue, for example, two areas of the stomach wall, without unnecessarily damaging healthy tissue, and thus handles the tissue more sensitively overall. In particular, it is an objective of the present disclosure to provide a surgical clip with suitable clamping properties that reduces the risk of unnecessary tissue damage.
[0011] As a possibly independent further object of the present disclosure, the risk of injury to the mucous membrane through the use of such a tissue clip, particularly when inserting the tissue clip into a hollow organ of a patient, is to be reduced by appropriate manufacturing processes. The present disclosure primarily relates to a surgical clip according to the features of claim 1.
[0012] The disclosure accordingly relates to a surgical (tissue) clip comprising a closed ring / circular sheet having a first gripping portion and a second gripping portion, each having a base portion and a plurality of gripping teeth located between two circumferential ends / edge portions of each gripping portion and extending substantially parallel to one another and away from the respective base portion, and two elastically deformable hinge portions / hinge arcs arranged adjacent to the circumferential ends of the gripping portions, wherein the hinge portions have a curvature extending toward the inside of the ring, such that the hinge portions and the circumferential ends of the gripping portions at least partially face one another, thereby forming a gap between them.The circumferential ends of at least one of the gripping sections, preferably both gripping sections, have a plurality of rounded or round crushing teeth / compression teeth which extend towards the hinge sections, so that the space between the hinge sections and the circumferential ends of the gripping sections has a wave geometry or is formed in a wave shape for (additional) compression of tissue.
[0013] In other words, the surgical clip according to the disclosure has an annular geometry comprising two gripping sections with a plurality of gripping teeth. The gripping teeth of both gripping sections are arranged such that they face one another. The edges of both gripping sections, which extend alongside the gripping teeth, have a plurality of rounded projections which, when arranged side by side, form a wave-like geometry. These wave-like projections point towards an arched hinge section with a curve which connects the two gripping sections to one another. Advantageously, a surgical clip designed in this way enables the clamping of tissue between the corresponding gripping teeth as well as between the laterally arranged, rounded crushing teeth and the arched hinge section.This allows a larger volume of tissue to be captured, resulting in improved anchoring of the clip to the organ wall. Furthermore, the rounded shape of the crushing teeth ensures that healthy, especially thin and delicate, tissue is not unnecessarily penetrated or punctured, thus minimizing the risk of tissue injury. Advantageously, the crushing teeth only compress or squeeze the tissue without penetrating it.
[0014] The present disclosure is therefore based on the finding that the laterally arranged teeth, which are referred to as crushing teeth according to the disclosure, are intended merely to clamp or pinch tissue. In other words, the laterally arranged crushing teeth are not designed to pierce tissue. According to the disclosure, this advantageously applies to both young and old tissue, and to both thin and thick tissue. The disclosure thus utilizes the advantages of the lateral crushing teeth, namely capturing a larger volume of tissue and exerting large clamping forces, while simultaneously avoiding the disadvantages mentioned above.In other words, the disclosure thus provides lateral (crushing) teeth that form rounded and wave-shaped clamping edges, wherein the gap to the adjacent hinge sections is selected to be so small that the lateral (crushing) teeth, together with the hinge sections, can exert a suitable clamping force on the clamped tissue. The provision of the rounded or wave-shaped clamping edges or the wave geometry / shape thus preferably implies that the course or lateral contour of the (crushing) teeth (in the plan view of the crushing teeth) does not have a point or kink, but is rounded or rounded or runs in a rounded manner over its entire lateral contour.
[0015] Advantageous embodiments are claimed in the subclaims and / or explained below. In a preferred aspect of the present disclosure, the plurality of rounded or rounded squeezing teeth are arranged at the circumferential ends in such a way that an indentation or notch is formed between each two of the squeezing teeth of the respective gripping section, thereby forming the wave geometry or wave shape of the lined-up or juxtaposed squeezing teeth.
[0016] In a further preferred embodiment of the disclosure, the two circumferential ends of the first gripping portion each have at least two of the squeezing teeth and / or the two circumferential ends of the second gripping portion each have at least one of the squeezing teeth.
[0017] In other words, the circumferential ends of both gripping sections preferably have rounded projections in the form of crimping teeth, which are arranged at the respective circumferential ends in such a way that the adjacent crimping teeth merge seamlessly into one another, in particular via an indentation arranged between the corresponding crimping teeth. This means that the wave geometry is created by an alternating arrangement of at least one rounded projection and at least one, in particular rounded, indentation, which merge seamlessly into one another. Such an arrangement of the crimping teeth enables reliable and risk-free compression of additional tissue during the placement process of the surgical clip. It should be noted that the indentation can theoretically also be pointed or have a kink.
[0018] Further preferably, a circumferential end of the first gripping section is arranged so close to a circumferential end of the second gripping section that the wave shape or wave geometry is also continued in the transition region between the two gripping sections. Thus, a crimping tooth of the first gripping section and an adjacent or adjacent crimping tooth of the second gripping section are preferably designed and coordinated with one another in such a way that they form or continue the wave shape or wave geometry. In a further advantageous aspect of the disclosure, the circumferential ends of both gripping sections (considered as a whole) extend completely or almost completely over the length or the circumference of the curved hinge sections.This means that the hinge sections of the surgical clip extend almost entirely along the opposite circumferential ends of the gripping sections, so that the crimping teeth arranged at the circumferential ends and the wave geometry formed by them also extend almost entirely along the circumference of the hinge sections, creating the largest possible intermediate section that applies a clamping force between the circumferential ends of the gripping sections and the hinge sections. This advantageously allows even more tissue structure to be clamped, thereby increasing the stability of the clip's anchorage.
[0019] In a further preferred embodiment of the disclosure, the first gripping portion has four gripping teeth and the second gripping portion has five gripping teeth.
[0020] In a further preferred aspect of the disclosure, the gripping teeth each have additional prongs or spikes at their ends for anchoring in the tissue, which are designed as an extension of the ends.
[0021] In other words, additional spikes or prongs or spikes can be formed on the gripping teeth, extending from the ends of the gripping teeth. These spikes can serve to additionally penetrate or pierce the tissue clamped by the gripping teeth, in particular from both sides, in order to ensure an improved hold of the clip on the tissue. This can be particularly advantageous with thick tissue. According to the present disclosure, the gripping teeth can thus optionally have spikes or prongs or spikes or not. However, the crushing teeth on the sides preferably do not have such spikes or prongs or spikes. In a preferred embodiment of the disclosure, the crushing teeth therefore do not have spikes or angular sections or points.This ensures that tissue is not unnecessarily injured by the lateral crushing teeth, but is only reversibly compressed or squeezed by the crushing teeth, which leads to a reduction in the risks of the endoscopic procedure.
[0022] In a further preferred embodiment of the disclosure, the elastically deformable hinge sections have rounded crimping teeth which are designed to form the wave geometry or wave shape complementary to the crimping teeth of the circumferential ends of the gripping sections.
[0023] In other words, the hinge sections arranged opposite the circumferential ends of the gripping sections can have further rounded hinge-section-side crimping teeth that are complementary to the wave geometry of the circumferential ends. In particular, the crimping teeth of the hinge sections are arranged opposite the indentations formed between two of the crimping teeth at the circumferential ends. This advantageously reinforces or expands the wave geometry or wave shape of the spaces between the circumferential ends and the hinge sections, which enables an increased clamping effect of the crimping teeth or leads to an increased clamping force of the crimping teeth. When designing the hinge-section-side crimping teeth, it should be taken into account that the clamping force of the hinge sections is only insignificantly reduced.
[0024] In a further preferred aspect of the disclosure, running edges or end edges or tooth edges of the gripping teeth and / or the crushing teeth are rounded for improved insertion of the surgical clip into a body opening of a patient.
[0025] In other words, the end edges of the gripping teeth and / or the crushing teeth preferably have radii or additional edge roundings, which can prevent scratches on the tissue, particularly on the mucosa of a hollow organ, during the insertion of the endoscope and the clip placement process. In other words, the end edges preferably no longer have edges in the literal sense, but rather curves or radii. Providing such radii or additional edge roundings on the crushing teeth can advantageously also lead to a gentler or more sensitive clamping of tissue between the crushing teeth and the hinge sections.
[0026] The edge roundings of the end edges of the gripping teeth and / or the crushing teeth are preferably produced by blasting the clip, in particular the teeth of the clip, with particles, in particular with spheres, preferably made of ceramic, and a concomitant rounding of the tooth edges of the teeth at their tooth tips (if spikes or points are provided on the gripping teeth) or at their tooth ends. The corresponding manufacturing process will be described in detail later.
[0027] The rounded tooth edges of the gripping teeth and / or the crushing teeth preferably have a rounding radius of 0.05 mm to 0.40 mm, preferably of 0.10 mm to 0.30 mm and particularly preferably of 0.10 mm to 0.20 mm.
[0028] In a further preferred aspect of the disclosure, the clip is curved such that the gripping sections have a substantially arcuate curvature extending along the gripping teeth. Due to this curvature of the clip across the gripping teeth, the gripping teeth are preferably arranged in a shark-mouth shape.
[0029] In a further advantageous embodiment of the disclosure, at least one of the base sections of the gripping sections has a through opening substantially halfway between the circumferential ends.
[0030] In a further preferred aspect of the disclosure, the through-opening forms a separate connection eyelet to which a medical device can be or is anchored. In a further preferred aspect of the disclosure, the gripping teeth of the gripping sections are designed and arranged such that the gripping teeth of each of the gripping sections alternately face each other when the surgical clip is closed.
[0031] In a further aspect of the disclosure, the surgical clip is made in one piece from an elastic, in particular spring-elastic, sheet material.
[0032] The disclosure further relates to a system according to claim 15, i.e. a system for applying a surgical clip as described above to a location in a body cavity of a patient in order to compress body tissue, comprising an endoscope cap on which the surgical clip is arranged, and an application device which is provided and configured to apply the surgical clip to the body tissue.
[0033] The application device preferably has at least one trigger thread via which a clip application can be triggered by a user.
[0034] The application device preferably further comprises a pull-off ring, wherein the pull-off ring is arranged on the endoscope cap, and the surgical clip is arranged on the pull-off ring, wherein the application device is designed such that the pull-off ring and with it the surgical clip can be displaced by actuating the release thread in order to eject the surgical clip from the endoscope cap and apply it to the body tissue.
[0035] Preferably, the system further comprises an endoscope, at the distal end of which the endoscope cap is arranged.
[0036] The disclosure further relates, according to an aspect which may be claimed independently, to a method for producing a surgical clip, comprising at least one step: irradiating the clip, in particular teeth of the clip, with particles, in particular with spheres, preferably made of ceramic, and concomitantly rounding off tooth edges of the teeth at their tooth tip or at their tooth end.
[0037] The surgical clip can be configured as described above, but does not necessarily have to have the lateral crushing teeth disclosed. Thus, the teeth mentioned can be understood as merely gripping teeth or, alternatively, as both gripping teeth and crushing teeth, if present.
[0038] In other words, the blasting process according to the disclosure, in particular the shot peening process, can ensure that the edges of the teeth, in particular the gripping teeth and / or the crushing teeth, have curves or radii or are rounded, thus minimizing the risk of injury, particularly to the mucosa or mucous membrane, when inserting the endoscope or surgical clip into the patient. This prevents unwanted scratching or catching of the gripping teeth on the organ walls.
[0039] The rounded tooth edges preferably have a rounding radius of 0.05 mm to 0.40 mm, preferably of 0.10 mm to 0.30 mm, particularly preferably of 0.10 mm to 0.20 mm.
[0040] According to an advantageous aspect, the (ceramic) particles, in particular the (ceramic) spheres, have a diameter of 100 pm to 1180 pm, preferably of 300 pm to 425 pm.
[0041] The ceramic particles, in particular the ceramic spheres, can contain ZrO2 and / or SiO2 and / or AlO2.
[0042] The irradiation can be carried out with an intensity of 0.10 mmA to 0.20 mmA, preferably with an intensity of 0.16 mmA to 0.17 mmA.
[0043] Blasting can be carried out at a pressure of 5 bar to 7 bar, preferably at a pressure of approximately 6 bar. Irradiation is particularly preferably carried out with a coverage factor of 1.5 x 198%. The factor is preferably between 1 and 3, in particular 1.5, and the (blasting media) coverage is at least 93%, preferably 98%.
[0044] The method for manufacturing the surgical clip may further include: punching, etching, or lasering a basic geometry from a (spring) steel sheet or another suitable metal, e.g., nitinol or a superelastic material; in particular, the gripping teeth (as well as the crushing teeth) are created in the same step; irradiating the gripping teeth (and the crushing teeth) with (ceramic) particles; and curving the basic geometry to create the hinge sections and the gripping sections. Alternatively, the gripping teeth (as well as the crushing teeth) can be created in an additional step, e.g., by laser cutting.
[0045] Furthermore, according to an aspect which may be claimed independently, the present disclosure relates to a surgical clip comprising a closed ring having a first gripping portion and a second gripping portion, each having a base portion and a plurality of gripping teeth which lie between two circumferential ends of each of the gripping portions and extend substantially parallel to one another and away from the respective base portion, and two elastically deformable hinge portions which are arranged next to the circumferential ends of the gripping portions, wherein the hinge portions have a curvature extending towards the inside of the ring, such that the hinge portions and the circumferential ends of the gripping portions at least partially face one another, whereby a gap is formed between them. The (end) edges orThe edges of the gripping teeth are rounded to improve the insertion of the surgical clip into a patient's body opening.
[0046] The rounded tooth edges preferably have a rounding radius of 0.05 mm to 0.25 mm, preferably 0.1 mm to 0.2 mm. The surgical clip according to this aspect is preferably manufactured using the method described above.
[0047] The disclosure is explained in more detail below using advantageous embodiments and with reference to the accompanying figures. They show:
[0048] Fig. 1 is an exemplary top perspective view of a surgical clip according to a first preferred embodiment of the present disclosure;
[0049] Fig. 2 is an exemplary side perspective view of the surgical clip according to the first preferred embodiment of the present disclosure;
[0050] Fig. 3 is an exemplary isometric view of the surgical clip according to a second preferred embodiment of the present disclosure;
[0051] Fig. 4 is an enlarged top perspective view of a space between peripheral ends of the gripping portions and a hinge portion of the surgical clip in the second preferred embodiment of the present disclosure;
[0052] Fig. 5 is an exemplary perspective view of a gripping tooth of the surgical clip in a preferred embodiment of the present disclosure;
[0053] Fig. 6 is a first exemplary perspective side view of the surgical clip according to a third preferred embodiment of the present disclosure in an unfolded and mounted state on an endoscope attachment;
[0054] Fig. 7 shows a second exemplary perspective side view of the surgical clip according to the third preferred embodiment of the present disclosure in an unfolded and mounted state on an endoscope attachment; Fig. 8 shows a third exemplary perspective side view of the surgical clip according to the third preferred embodiment of the present disclosure in an unfolded and mounted state on an endoscope attachment;
[0055] Fig. 9 is a flowchart of a method of manufacturing the surgical clip according to a preferred embodiment of the present disclosure.
[0056] The figures are merely schematic in nature and serve solely to facilitate understanding of the present disclosure. It should be noted that the features of the individual embodiments may be interchanged and may occur in a specific combination.
[0057] Detailed description of preferred embodiments
[0058] The present disclosure is described below using advantageous embodiments with reference to Figures 1 to 9. Figures 1 and 2 show views of a surgical clip according to a first preferred embodiment. Figures 3 and 4 show exemplary views of the surgical clip according to a second preferred embodiment. Figure 5 further shows a view of a gripping tooth of the surgical clip according to a preferred embodiment. Figures 6 to 8 show views of the attached surgical clip according to a third embodiment, and Figure 9 shows a flow diagram of a manufacturing method of the surgical clip according to the disclosure.
[0059] Figures 1 and 2 show an exemplary perspective top view and a perspective side view of a surgical clip 2 in a closed state according to a first preferred embodiment of the present disclosure. The surgical clip 2 is formed in one piece in the form of a closed ring, which has a first gripping section 4 with a base section 5 and a second gripping section 6 with a base section 7. The two gripping sections 4, 6 are each connected via two elastically deformable, arcuate hinge sections 8. The hinge sections 8 each have a curvature / arch that extends towards the inside of the closed ring. Both gripping sections 4, 6 have a plurality of gripping teeth 10 that extend parallel from the respective base sections 5, 7 and in the direction of the opposite base section 5, 7 and taper to a point.Furthermore, the surgical clip 2 is formed with a curvature along the lined-up gripping teeth 10. According to this first preferred embodiment, the gripping teeth 10 each have an additional spike 11, which is formed as an extension of the respective gripping tooth 10. In this preferred embodiment, the first gripping section 4 has four gripping teeth 10 and the second gripping section 6 has five gripping teeth 10, which complementarily interlock in a shark-like manner. The base section 5 of the first gripping section 4 has a circumferential end 12 on each of its lateral edges, and the base section 7 of the second gripping section 6 has a circumferential end 14 on each of its lateral edges.The circumferential ends 12 of the base section 5 each have two rounded crimping teeth 16, 17, which extend toward the hinge sections 8, whereas the circumferential ends 14 of the base section 7 each have three rounded crimping teeth 18, 19, 20, which also extend toward the hinge sections 8. The crimping teeth 16, 17, 18, 19, 20 are arranged such that gaps are created between them and the hinge sections 8, which, due to the rounded crimping teeth 16, 17, 18, 19, 20 and the indentations located therebetween, have a wave shape, at least on one side. The crimping teeth 16, 17, 18, 19, 20 almost completely cover the arc / circumference of the opposing hinge sections 8. In addition, a through hole 22 is arranged centrally between the circumferential ends 12 on the base section 5.
[0060] Figure 3 is an exemplary isometric view of the surgical clip 2 according to a second preferred embodiment of the present disclosure. The surgical clip 2 in this likewise preferred second embodiment is almost identical to the surgical clip 2 of the first embodiment described in Figures 1 and 2. The differences are that the surgical clip 2 of the second embodiment does not have spikes 11 on the gripping teeth 10. In addition, the spaces between the circumferential ends 12, 14 of the base sections 5, 7 and the hinge sections 8 are differently designed, the shape of which is described in more detail in the following figure description of Figure 4.
[0061] Figure 4 shows an enlarged perspective top view of a gap between the circumferential ends 12, 14 of the base sections 5, 7 and a hinge section 8 of the surgical clip 2 in the second preferred embodiment of the present disclosure. The surgical clip 2 in this second embodiment also has the two crimping teeth 16, 17 at the circumferential ends 12 of the base section 5. However, the circumferential ends 14 of the base section 7 each have only one crimping tooth 20, which flows seamlessly over a rounded indentation / notch into the outermost gripping teeth 10 of the second gripping section 6. These two outermost gripping teeth 10 do not run parallel to the remaining gripping teeth 10, but are also inclined toward the arcuate hinge section 8, similar to the crimping tooth 20.These two outer gripping teeth 10 thus simultaneously form, so to speak, another lateral squeezing tooth. Furthermore, the hinge sections 8 also have two additional rounded squeezing teeth 24, which extend to the circumferential ends 12, 14 and are arranged complementarily (at a certain distance) to the indentations of the wave-shaped squeezing teeth 16, 17, 20 arranged opposite them.
[0062] Figure 5 is an exemplary perspective view of a gripping tooth 10 of the surgical clip 2 in a preferred embodiment of the present disclosure. Clearly visible in this view is the rounded tooth edge 25 of the illustrated gripping tooth 10. Thus, in this preferred embodiment, the gripping teeth 10 have radii to reduce the risk of injury caused by the clip 2, in particular scratching or scraping of the mucous membrane of the hollow organ. The rounding radius R here is approximately 0.1 mm to 0.2 mm.
[0063] Figures 6 to 8 show exemplary perspective side views of the surgical clip 2 according to a third preferred embodiment of the present disclosure in an unfolded / spread and mounted state on an endoscope cap or on an endoscope attachment 26. Figure 6 shows a side view of the first gripping section 4, on which the through-hole 22 is arranged, and Figure 7 shows a side view of the second gripping section 6 of the mounted surgical clip 2. Figure 8 shows a side view of a hinge section 8 of the mounted spread surgical clip 2. In this open or spread state, the surgical clip 2 sits on the endoscope cap or the endoscope attachment 26 in such a way that the basic shape of the closed ring of the clip 2, consisting of the two gripping sections 4, 6 and the two hinge sections 8, encloses the circumference of the endoscope attachment 26. The gripping teeth 10 andthe ends of the gripping sections 4, 6 in the axial direction of the endoscope attachment 26 (upward in this view). Likewise, the hinge sections 8 of the surgical clip 2 are curved even more sharply due to the spreading / opening of the gripping sections 4, 6. In this attached state of the clip 2, the hinge sections 8 and their curvature / arch also point in the axial direction, toward the upper end or upper opening of the endoscope attachment 26. Furthermore, a pull-off ring or attachment ring 28 is provided between the endoscope attachment 26 and the surgical clip 2. A clip application can be carried out by a user pulling on the provided release thread 30, wherein the pulling on the release thread 30 causes the pull-off ring or attachment ring 28 to be displaced together with the surgical clip 2, until the surgical clip 2 is ejected from the endoscope cap or endoscope attachment 26 and applied to the body tissue.This third embodiment of the surgical clip 2 has the same structure as the first embodiment of the clip 2 described above, except that the gripping teeth 10 do not have spikes 10.
[0064] Figure 9 is a flowchart of a manufacturing method for the surgical clip 2 according to a preferred embodiment of the present disclosure. The manufacturing method for the surgical clip 2 includes the steps: punching or etching or lasering S1 of a basic geometry from a (spring) steel sheet, including the creation of the gripping teeth 10 and / or the crushing teeth 16, 17, 18, 19, 20; irradiating S2 the gripping teeth 10 and / or the crushing teeth 16, 17, 18, 19, 20 with (ceramic) particles, in particular at a pressure of 6 bar and an intensity of 0.16 to 0.17 mmA, in order to round off the tooth edges of the gripping teeth 10 and / or the crushing teeth 16, 17, 18, 19, 20; Arching S3 of the basic geometry to create the hinge sections 8 and the gripping sections 4, 6.
[0065] 2 surgical clips
[0066] 4, 6 first, second gripping section
[0067] 5, 7 Basic section
[0068] 8 Hinge section
[0069] 10 gripping teeth
[0070] 11 Spike
[0071] 12, 14 circumferential ends
[0072] 16, 17, 18, 19, 20 crushing teeth
[0073] 22 through hole
[0074] 24 hinge section side crushing tooth
[0075] 25 rounded tooth edge
[0076] 26 Endoscope attachment
[0077] 28 attachment ring
[0078] 30 release thread
[0079] 51 step punching or etching or lasering
[0080] 52 Step Irradiation
[0081] 53 Step Arching
Claims
Claims 1 . A surgical clip (2) comprising a closed ring having a first gripping portion (4) and a second gripping portion (6), each having a base portion (5, 7) and a plurality of gripping teeth (10) located between two circumferential ends (12, 14) of each of the gripping portions (4, 6) and extending substantially parallel to one another and away from the respective base portion (5, 7), and two elastically deformable hinge portions (8) arranged adjacent to the circumferential ends (12, 14) of the gripping portions (4, 6), wherein the hinge portions (8) have a curvature extending towards the inside of the ring, so that the hinge portions (8) and the circumferential ends (12, 14) of the gripping portions (4, 6) at least partially face one another, thereby forming a gap between them, characterized in that the circumferential ends (12, 14) at least one of the gripping sections (4, 6),preferably both gripping sections (4, 6), have a plurality of rounded or round crushing teeth (16, 17, 18, 19, 20) which extend towards the hinge sections (8), so that the space between the hinge sections (8) and the peripheral ends (12, 14) of the gripping sections (4, 6) has a wave geometry or is formed in a wave shape for compressing tissue.
2. Surgical clip (2) according to claim 1, characterized in that the plurality of rounded or round crushing teeth (16, 17, 18, 19, 20) are arranged on the circumferential ends (12, 14) in such a way that an indentation is formed between each two of the crushing teeth (16, 17, 18, 19, 20) of the respective gripping section (4, 6), whereby the wave geometry or the wave shape of the lined-up crushing teeth (16, 17, 18, 19, 20) is formed.
3. Surgical clip (2) according to claim 1 or 2, characterized in that the two circumferential ends (12) of the first gripping section (4) each have two of the crushing teeth (16, 17) and / or the two circumferential ends (14) of the second gripping section (6) each have at least one of the crushing teeth (18, 19, 20).
4. Surgical clip (2) according to one of the preceding claims, characterized in that the circumferential ends (12, 14) of both gripping sections (4, 6) extend completely or almost completely over a circumference of the curved hinge sections (8).
5. Surgical clip (2) according to one of the preceding claims, characterized in that the first gripping section (4) has at least four gripping teeth (10) and the second gripping section (6) have at least five gripping teeth (10).
6. Surgical clip (2) according to one of the preceding claims, characterized in that the gripping teeth (10) each have additional prongs or spikes (11) at their tips for anchoring in the tissue, which are designed as an extension of the tips.
7. Surgical clip (2) according to one of the preceding claims, characterized in that the crushing teeth (16, 17, 18, 19, 20) do not have spikes (11 ) or have angular sections or points.
8. Surgical clip (2) according to one of the preceding claims, characterized in that the elastically deformable hinge sections (8) have rounded hinge-section-side crimping teeth (24) which are designed to form the wave geometry or wave shape complementary to the crimping teeth (16, 17, 18, 19, 20) of the circumferential ends (12, 14) of the gripping sections (4, 6).
9. Surgical clip (2) according to one of the preceding claims, characterized in that tooth edges (25) of the gripping teeth (10) and / or the crushing teeth (16, 17, 18, 19, 20) are rounded for improved insertion of the surgical clip (2) into a body opening of a patient.
10. Surgical clip (2) according to claim 9, characterized in that the edge roundings of the tooth edges (25) of the gripping teeth (10) and / or the crushing teeth (16, 17, 18, 19, 20) are produced by irradiating the surgical clips (2), in particular the gripping teeth (10) and / or the crushing teeth (16, 17, 18, 19, 20) of the surgical clip (2), with particles, in particular with balls, preferably made of ceramic, and a concomitant rounding of the tooth edges (25) of the gripping teeth (10) and / or the crushing teeth (16, 17, 18, 19, 20) at their tooth tip or at their tooth end.
11. Surgical clip (2) according to claim 9 or 10, characterized in that the rounded tooth edges (25) of the gripping teeth (10) and / or the crushing teeth (16, 17, 18, 19, 20) have a rounding radius of 0.05 mm to 0.40 mm, preferably of 0.10 mm to 0.30 mm and particularly preferably of 0.10 mm to 0.20 mm.
12. Surgical clip (2) according to one of the preceding claims, characterized in that the surgical clip (2) is curved such that the gripping sections (4, 6) have a substantially arcuate curvature which extends along the gripping teeth (10).
13. Surgical clip (2) according to one of the preceding claims, characterized in that the gripping teeth (10) of the gripping sections (4, 6) are designed and arranged such that the gripping teeth (10) of each of the gripping sections (4, 6) are alternately or alternately opposite one another in a closed state of the surgical clip (2).
14. Surgical clip (2) according to one of the preceding claims, characterized in that the surgical clip (2) is made in one piece from an elastic sheet material.
15. A system for applying a surgical clip (2) according to any one of the preceding claims 1 to 14 at a location in a body cavity of a patient to compress body tissue, comprising: an endoscope cap (26) on which the surgical clip (2) is arranged; and an application device (28, 30) which is provided and arranged to apply the surgical clip (2) to the body tissue.