Detachable over-the-scope clip

Abstract

The clip includes first and second jaws, first and second hinges, and a connecting portion. Each jaw extends along a curve from a first end to a second end. The first hinge connects the first ends and the second hinge connects the second ends such that the jaws are movable between an open configuration in which the jaws are separated from each other and a closed configuration in which the jaws are drawn toward each other to grasp tissue therebetween. The first hinge and / or the second hinge are biased to draw the clip toward the closed configuration. The connecting portion connects each end of the hinge to a corresponding one of the first end and the second end. The connecting portion includes an engaging portion configured to be engaged through a through-the-scope device upon deployment to remove the clip from the tissue to which it is clipped.

Description

[Technical Field]

[0001] The present disclosure relates to endoscopic devices, and more particularly to endoscopic clipping devices for treating tissue along the digestive tract. [Background technology]

[0002] Physicians are increasingly performing aggressive interventional and therapeutic endoscopic gastrointestinal (GI) procedures, which may increase the risk of perforating the wall of the GI tract or require closure of the wall as part of these procedures. Such procedures may include, for example, removal of large lesions, tunneling beneath the mucosal layer of the GI tract to treat submucosal problems, full-thickness tissue removal, treatment of problems in other organs by passing devices inserted through the GI tract into the body, and endoscopic treatment / repair of postoperative problems (e.g., postoperative leaks, surgical staple line breaks, and anastomotic leaks). Currently, tissue can be treated via endoscopic closure devices such as through-the-scope clips or over-the-scope clips. Over-the-scope clips can be particularly useful for achieving closure of larger tissue defects. These endoscopic closure devices can save hospitals money and provide benefits to patients.

[0003] However, in some cases, it may be unavoidable for a physician to remove a previously deployed over-the-scope clip. An improperly placed clip may, for example, cause bleeding and perforation or disturb / trauma adjacent tissue or organs. Methods currently exist for removing deployed over-the-scope clips, but these generally involve cutting the clip in half using a lead, an endoscopic mucosal resection (EMR) device, or an endoscopic submucosal dissection (ESD) device. Additionally, in some cases, if the clip extends away from the tissue, grasping forceps may be used to pull the clip away from the tissue so that the clip is accessible.

[0004] However, cutting and removing clips is tedious and time-consuming. After placement and / or deployment of a clip, removing the clip generally requires removing the endoscope from the body and attaching an accessory configured for clip removal, such as a retrieval cap, conductive cutter, etc., to the endoscope. When cutting a clip (e.g., using a conductive cutter) to release it from the clipped tissue, the user must remove the conductive cutter from the working channel of the endoscope after cutting the clip and then insert a grasping tool through the working channel to grasp the cut clip and retract the cut portion of the clip into the retrieval cap for removal from the body. It should be noted that the cut fragments of the clip generally must be removed from the body one at a time, such that the grasping tool and a first portion of the clip must be removed from the body, and then the grasping tool must be reinserted through the working channel to remove the second portion of the cut clip. This removal system, associated with EMR and ESD, almost always transmits a voltage through the clip to the clipped tissue, potentially damaging the target tissue (the tissue the user wishes to clip) and / or healthy tissue surrounding the target tissue. As will be appreciated by those skilled in the art, the gripping force does not conduct any current, but the process of pulling or detaching the clip from the clipped tissue may cause severe bleeding / perforation, etc. Summary of the Invention

[0005] The present disclosure relates to an over-the-scope clip including a first jaw and a second jaw, each extending along a curve from a first end to a second end. The clip also includes a first hinge connecting a first end of the first jaw to a first end of the second jaw and a second hinge connecting a second end of the first jaw to a second end of the second jaw such that the first and second jaws are movable between an open configuration in which the first and second jaws are separated from each other and a closed configuration in which the first and second jaws are drawn toward each other to grasp tissue therebetween. At least one of the first hinge and the second hinge is biased to draw the clip toward the closed configuration.

[0006] Additionally, the clip includes a connecting portion connecting an end of each of the first and second hinges to a corresponding one of the first and second ends of each of the first and second jaws, and the connecting portion includes an engaging portion configured to be engaged via a through-the-scope device for removing the clip from tissue to which the clip is clipped upon deployment.

[0007] In one embodiment, the engagement portion includes a first notch that aligns with a corresponding one of the first and second jaws and extends along a portion of the outer edge of the coupling portion. In one embodiment, the engagement portion includes a second notch that aligns with a corresponding one of the first hinge and the second hinge and extends along a portion of the outer edge of the linking portion.

[0008] In one embodiment, the first notch and the second notch are configured as aligned slots. In one embodiment, the engagement portion is a protrusion extending from an outer surface of the coupling portion, the protrusion including an enlarged head coupled to the outer surface via a stem.

[0009] In one embodiment, the stem extends substantially perpendicular to the outer surface. In one embodiment, the stem includes an L-shaped bend. In one embodiment, the engagement portion includes an opening that extends through a corresponding one of the coupling portions.

[0010] In one embodiment, the first hinge and the second hinge each include a curve extending toward and between the first jaw and the second jaw. In one embodiment, the first jaw and the second jaw each include a plurality of teeth configured to grasp tissue received therebetween.

[0011] Additionally, the present disclosure relates to an over-the-scope clip including a first jaw and a second jaw. A first end of the first jaw is coupled to a first end of the second jaw via a first hinge, and a second end of the first jaw is coupled to a second end of the second jaw via a second hinge, such that the first jaw and the second jaw are movable between an open configuration in which the first jaw and the second jaw are separated from each other and a closed configuration in which the first and second jaws are drawn together to grasp tissue therebetween. At least one of the first hinge and the second hinge is biased to draw the clip into the closed configuration. The clip also includes a first engagement portion extending from an edge of the first jaw facing away from the second jaw and a second engagement portion extending from an edge of the second jaw facing away from the first jaw.

[0012] In one embodiment, each of the first and second engaging portions includes a protrusion including an enlarged head that couples to an edge of the corresponding one of the first and second jaws via a stem.

[0013] In one embodiment, each of the first and second jaws extends along a curve that corresponds to the surface of the end cap of the endoscope to which the clip is attached. In one embodiment, the first hinge and the second hinge each include a curve extending toward and between the first jaw and the second jaw.

[0014] In one embodiment, the first jaw and the second jaw each include a plurality of teeth configured to grasp tissue received therebetween. Additionally, the present disclosure relates to a method for removing a deployed over-the-scope from a body, the method including: inserting a snare device through a working channel of a deployed endoscope with a clip therethrough clipped onto tissue; and winding a wire of the snare device across two or more engagement portions of a first jaw and a second jaw of the clip such that the wire of the snare device engages with one or more engagement portions, the clip including a first hinge connecting a first end of the first jaw to a first end of the second jaw and a second hinge connecting a second end of the first jaw to a second end of the second jaw, the ends of the first hinge and the second hinge connecting the first and second hinges via a connecting portion including the engagement portion. the first and second jaws of the endoscope; tightening the wire to draw the two or more engaging portions toward each other, thereby compressing one of the first and second hinges and moving the clip from a closed configuration in which the first and second jaws are moved toward each other to clip tissue therebetween, to a closed configuration in which the first and second jaws are moved away from each other to release the tissue grasped therebetween; pulling the clip proximally away from the released tissue relative to the distal end of the endoscope; and removing the clip from the body simultaneously with the endoscope.

[0015] In one embodiment, each of the engagement portions includes a first notch that aligns with a corresponding one of the first and second jaws and extends along a portion of the outer edge of the connecting portion, and a second notch that aligns with a corresponding one of the first and second hinges and extends along a portion of the outer edge of the connecting portion.

[0016] In one embodiment, the wire is wrapped around four links. In one embodiment, the wire is wound across the engagement of two diagonally positioned connecting portions, a first connecting portion at a first end of the first jaw and a second connecting portion at a second end of the second jaw.

[0017] In one embodiment, the wire is wrapped across the engagement of two opposing first connecting portions at a first end of the first jaw and an opposing first connecting portion at a second end of the second jaw. [Brief explanation of the drawings]

[0018] [Figure 1] 1 illustrates a perspective view of a clip according to an exemplary embodiment of the present disclosure; [Figure 2] 2 shows a perspective view of the clip according to FIG. 1 clipped onto tissue; [Figure 3] 2 shows a perspective view of the clip of FIG. 1 engaged through a loop of a snare device in accordance with an exemplary method of the present disclosure. [Figure 4] 2 shows a perspective view of the clip according to FIG. 1 moved from a closed configuration towards an open configuration by tightening of the loop of the snare device to release tissue gripped by the clip. [Figure 5] 2 shows a perspective view of the clip according to FIG. 1 moved away from the released tissue; [Figure 6] 1, in which the engagement portion of the clip is wrapped with a snare device according to another exemplary method. [Figure 7] 1, in which the engagement portion of the clip is wrapped with a snare device according to another exemplary method. [Figure 8] 1, in which the engagement portion of the clip is wrapped with a snare device according to yet another exemplary method. [Figure 9] 10 shows a perspective view of a clip according to another exemplary embodiment of the present disclosure; [Figure 10]10 shows a perspective view of a clip according to yet another exemplary embodiment of the present disclosure; [Figure 11] 10 shows a perspective view of a clip according to another exemplary embodiment of the present disclosure; [Figure 12] 10 shows a perspective view of a clip according to yet another exemplary embodiment of the present disclosure; DETAILED DESCRIPTION OF THE INVENTION

[0019] The present disclosure can be further understood with reference to the following description and the accompanying drawings, in which like elements are referred to with the same reference numerals. The present disclosure relates to an endoscopic clipping system, and more particularly, to an over-the-scope clipping system including a clip configured to be detached after deployment / placement on tissue. Exemplary embodiments of the present disclosure describe an over-the-scope clip that includes features that allow engagement via a through-the-scope device, such as a snare or grasping forceps. The engagement portion is configured to be engaged via the through-the-scope device to reopen a deployed clip and safely remove it from the body without requiring prior procedures (e.g., cutting the clip) or adjustment of the endoscope through which the clip was deployed.

[0020] 1-8 , clipping system 100 includes an over-the-scope clip 102 including multiple engagement portions 104 configured to facilitate removal of clip 102 after the clip has been deployed (clipped onto tissue). Specifically, engagement portions 104 are configured to be engaged via a through-the-scope device, such as a snare device 106, such that applying tension to loop 108 of snare device 106 and, therefore, to engagement portions of clip 102, moves clip 102 to reopen (i.e., moves clip 102 from a closed configuration in which opposing jaws 110 of clip 102 contact and / or approximate each other to grasp tissue therebetween to an open configuration in which jaws 110 move away from each other) and release the previously clipped tissue. Clip 102 can then be removed from the patient's body without the need for any cutting of clip 102 and / or any resection or dissection of tissue.

[0021] The clip 102 includes a pair of jaws 110 coupled to each other via a hinge 112 such that the clip is movable between an open configuration in which the jaws 110 are separated from each other and a closed configuration in which the jaws 110 are moved toward each other to grasp tissue therebetween, as shown in FIG. 1 . In the exemplary embodiment, each of the jaws 110 extends along a curve from a first end 114 to a second end 116. The curvature of the jaws 110, in this embodiment, corresponds to the curvature of the exterior surface of an end cap or other structure on which the clip 102 is mounted for deployment from an endoscope or other delivery device. The first ends 114 of the jaws 110 are coupled to each other via a first one of the hinges 112, and the second ends 114 of the jaws 110 are coupled to each other via a second one of the hinges 112.

[0022] In the exemplary embodiment, each of the multiple hinges 112 is a living hinge that, when the jaws 110 are in the closed configuration, extends along a substantially C-shaped curve from a corresponding end of a first of the jaws 110 toward a distal face of the jaw 110 and arcs back toward the corresponding end of the other jaw 110. In this embodiment, the hinges 112 are spring-biased to bias the jaws 110 toward the closed configuration. It will be understood by those skilled in the art that the hinges 112 and / or jaws 110 of the clip 102 may be formed from any of a variety of materials, so long as the hinges 112 bias the jaws 110 toward the closed configuration, as described above, and the bias is strong enough to maintain the clip 102 in the closed configuration clipped onto the target tissue after the clip 102 is ultimately deployed, as described in more detail below. In one embodiment, portions of clip 102 (eg, hinge 112) are formed from a shape memory alloy, such as, for example, Nitinol, to provide and / or add a bias toward the closed configuration.

[0023] In the exemplary embodiment, each end 120 of hinge 112 is coupled to a first end 114 and a second end 116 of a corresponding one of jaws 110 via a coupling portion 118. Hinges 112 are coupled to jaws 110 via coupling portions 118 such that there are four coupling portions 118 (118a, 118b, 118c, 118d), one at a corresponding one of first and second ends 114, 116 of each of jaws 110. In other words, as shown in FIG. 2 , first coupling portion 118a couples first end 114 of first jaw 110a to first hinge 112a, and second coupling portion 118b couples first end 114 of second jaw 110b to first hinge 112a. The third connecting portion 118c connects the second end 116 of the first jaw 110a to the second hinge 112b, and the fourth connecting portion 118d connects the second end 116 of the second jaw 112b to the second hinge 112b.

[0024] According to an exemplary embodiment, at least two of the connecting portions 118 include an engagement portion 104 configured to engage, for example, the loop 108 of the snare device 106, thereby allowing the loop 108 to apply tension to the connecting portion 104 without slipping off the engaging portion 104 (i.e., tension can be applied to the engaging portion to open the clip 102, as described below). If only two connecting portions 118 include an engagement portion 104, the two connecting portions 118 must include a connecting portion 118 of each of the jaws 110. However, it will be understood by those skilled in the art that in another embodiment, each of the connecting portions 118 (i.e., all four connecting portions 118) may include an engagement portion 104. However, in yet another exemplary embodiment, only one of the connecting portions 118 may include the engagement portion 104.

[0025] According to an exemplary embodiment, each engagement portion 104 includes a pair of notches (i.e., a first notch 122 and a second notch 124) along opposite sides of connecting portion 118. A first of the plurality of first notches 122 is formed along outer edge 123 of connecting portion 118 on a side that coincides with a surface of first jaw 110 opposite the tissue-grasping surface of first jaw 110, and a second of the plurality of second notches 124 is formed along outer edge 123 of connecting portion 118 on a side of connecting portion 118 that faces hinge 112. In an embodiment, first notch 122 and second notch 124 are configured as slots and are substantially aligned with one another such that a portion of loop 108 drawn into first notch 122 moves toward second notch 124 as it moves deeper into first notch 122. The pair of first and second notches 122, 124 are sized, shaped, and configured to receive and engage a portion of the loop 108 of the snare device 106 therein. Although the exemplary embodiment shows and describes the connecting portion 118 as including the pair of first and second notches 122, 124, in alternative embodiments, one or more of the connecting portions 118 may include a single notch (e.g., first notch 122) that matches a corresponding one in the jaws 110.

[0026] Additionally, each of the jaws 110 may, in some embodiments, include gripping portions 126, such as teeth, that extend along each of the jaws 110 and toward each other to grasp tissue received between the jaws 110 when the clip 102 is in the closed configuration.

[0027] It will be understood by those skilled in the art that although the clip 102 is biased toward the closed configuration, the clip 102 is maintained in an open configuration for insertion into a target area within the body. For example, the clip 102 may be expanded into the open configuration and positioned on an end cap, e.g., mounted on the distal end of an endoscope, such that the end cap holds the clip 102 in the open configuration until the clip 102 is deployed.

[0028] For example, in the exemplary embodiment, clip 102 is opened and slid over the end cap so that each of jaws 110 extends over an opposing portion of the end cap, with the outer surface of the end cap holding clip 102 in the open configuration. Clip 102 may be mounted on an end cap that is attached to a delivery device, such as an endoscope, and inserted into a target area adjacent the tissue to be clipped (e.g., by advancing the endoscope through a body lumen accessed via a natural body orifice). The target tissue is then drawn into the end cap and clip 102 (e.g., by applying suction to the end cap through the working channel of the endoscope) so that the tissue within the end cap is received between jaws 110. Clip 102 is then moved distally away from the end cap using any known deployment mechanism, so that as clip 102 moves distally away from the end cap, the bias of hinge 112 causes clip 102 to close and grasp the tissue drawn within the end cap.

[0029] As will also be understood by those skilled in the art, clip 102 may be moved distally away from the end cap toward a closed clipping configuration via any of several control mechanisms. For example, in one embodiment, clip 102 may be releasably coupled to one or more control elements that pull clip 102 proximally and prevent clip 102 from moving distally from the cap. The distal ends of the control elements may be releasably coupled to jaws 110, for example, via keyhole openings 111 extending through jaws 110. Once a user (e.g., a physician) of system 100 determines that the desired portion of tissue has been drawn into the end cap, the user may release tension along these control elements, allowing the jaws of the clip to begin closing over the tapered surface of the end cap such that the biasing of hinge 112 and closing of jaws 110 pulls clip 102 distally away from the end cap, clipping the tissue received therein.

[0030] Once the clip 102 is clipped onto tissue, the clip 102 may be finally deployed by releasing the clip 102 from the control element (as shown in FIG. 2 ), as will be understood by those skilled in the art. While the clip 102 has been described as being allowed to slide distally away from the end cap, in another embodiment, a control element releasably coupled to the clip 102 may be moved distally relative to the end cap to push the clip from the end cap (e.g., by applying a distally directed force to the control element such that the post stiffness of the control element pushes the clip 102 distally away from the end cap). While the exemplary embodiment shows and describes a keyhole opening 111, it will also be understood by those skilled in the art that the control element may be releasably coupled to the clip 102 via any of several releasable linkages, so long as the control element can be released therefrom upon clipping the clip 102 onto tissue.

[0031] According to an exemplary method of utilizing the system 100, once it is determined that the clip 102 should be removed, for example, due to incorrect placement, the snare device 106 may be inserted through the working channel of the endoscope. As will be appreciated by those skilled in the art, the snare device 106 may be inserted into the target area without first having to remove the endoscope and / or adjust the endoscope in any way. According to one exemplary embodiment, once the snare device 106 is inserted into the target area, the loop 108 of the snare device 106 is wrapped around the connecting portions 118 of the clip 102, as shown in FIG. 3, such that the loop 108 is received within the first notch 122 of each of the connecting portions 118. The loop 108 may then be tightened, as shown in FIG. 4, compressing each of the hinges 112, such that the connecting portions 118 of the jaws 110 are moved toward each other, moving the clip 102 from the closed configuration to the open configuration.

[0032] As the jaws 110 move away from each other toward the open configuration, the grasped tissue is released, allowing the user to pull the snare device 106 away from the tissue, with the clip 102 still held via the loop 108, as shown in FIG. 5. After the clip 102 has been moved away from the released tissue, the tension on the loop 108 may be released slightly to allow the clip 102 to return to the closed configuration. The clip 102 may then be pulled proximally relative to the distal end of the endoscope, so that the endoscope may be withdrawn from the body to remove the clip 102 from the body.

[0033] According to another exemplary method of use of the system 100, a user may remove a deployed clip by wrapping the loop 108 of the snare device 106 around two of the connecting portions. In one embodiment, as shown in FIG. 6 , the loop 108 is positioned on two diagonally positioned connecting portions 118 (118a, 118c). For example, the loop 108 may be positioned such that the loop 108 extends across the first connecting portion 118a at the first end 114 of the first jaw 110 and the third connecting portion 118c at the second end 116 of the second jaw 110. The loop 108 may be received in a pair of a first notch 122 and a second notch 124 on each of the first connecting portion 118a and the second connecting portion 118b.

[0034] Next, the loop 108 is tightened to draw the two connecting portions 118 toward each other, moving the jaws 110 away from each other from the closed configuration to the open configuration. Thus, the grasped tissue is released, allowing the clip 102 to be removed from the body with the endoscope, as described above. It will be understood by those skilled in the art that because the clip 102 does not need to be cut, and therefore does not include sharp edges, the clip 102 may be removed from the body with the endoscope without causing damage to any surrounding tissue.

[0035] 7, the loop 108 of the snare device 106 is positioned across opposing linkage portions (118a, 118b). For example, the loop 108 may be positioned such that the loop 108 extends across the first linkage portion 118a at the first end 114 of the first jaw 110 and the second linkage portion 118b at the first end 114 of the second jaw 110. The loop 108 is received within a first notch 122 of each of the first and second linkage portions 118a, 118b, such that when the loop 108 is tightened, the first and second linkage portions 118a, 118b are drawn toward each other, compressing the hinge 112 extending therebetween, and the jaws 110 are separated from each other to release the grasped tissue. As described above, the clip 102 can then be removed from the body with the endoscope.

[0036] According to yet another exemplary method, as shown in FIG. 8 , the loop 108 of the snare device 106 may be wrapped around one of the connecting portions 118 such that the loop 108 is received within the first notch 122 and the second notch 124. The loop 108 may be tightened to allow the snare device 106 to grasp the clip 102. Thus, pulling the snare device 106 proximally correspondingly pulls the clip 102 proximally against the tissue, separating the clip 102 from the tissue. Those skilled in the art will appreciate that this method may be particularly useful when the clip 102 is superficially clipped onto the tissue. Once the clip 102 is separated from the tissue (e.g., tearing a portion of the tissue), the clip 102 may be removed from the body as described above.

[0037] Although the engaging portion 104 of the clip 102 is described and illustrated as including a first notch 122 and a second notch 124 along its connecting portion 118, it will be understood by those skilled in the art that the engaging portion 104 may include any of a number of different structural features, so long as the engaging portion 104 is configured to be grasped, gripped, or otherwise engaged, for example, via a through-the-scope device such as a snare device or grasping forceps, which can facilitate removal of the clip 102.

[0038] 9 , for example, clip 202 may be substantially similar to clip 102 described above, including a pair of opposing jaws 210 coupled to one another via a hinge 212 such that the jaws 210 are movable relative to one another between an open configuration in which the jaws 210 are separated from one another and a closed configuration in which the jaws 210 move toward one another to grasp tissue. Similar to clip 102, hinge 212 is coupled to jaws 210 via a coupling portion 218 that includes an engagement portion 204 that can be engaged via a through-the-scope device, such as, for example, a snare device or grasping forceps, to remove clip 202 from the body. However, rather than a notch, engagement portion 204 in this embodiment includes a protrusion 230 extending from an outer surface 228 of clip 202 (i.e., the surface of clip 202 that faces away from the end cap when clip 202 is mounted on the end cap of an endoscope).

[0039] The protrusion 230, in this embodiment, is configured as a pin including a stem 234 extending from the outer surface to an enlarged head 232 at its free end. The enlarged head 232 may take on any of a variety of shapes and configurations, so long as the enlarged head 232 facilitates wrapping, grasping, or other engagement using a through-the-scope device, such as a snare device or grasping forceps, such that sufficient tension may be applied to open the clip 202. In the exemplary embodiment, the stem 234 extends substantially perpendicular to the outer surface 228.

[0040] According to an exemplary method of using the clip 202, the loop of the snare device described above is manipulated to engage the stem 234 of one or more of the protrusions 230 using any of the exemplary methods described above with respect to the system 100. For example, if the snare device is used to wrap around two or more protrusions 230, tightening the loop compresses at least one of the hinges 212, moving the clip 202 from a closed configuration to an open configuration and releasing the grasped tissue. Those skilled in the art will appreciate that the enlarged head 232 facilitates engagement of the stem 234 with the loop by preventing the loop from slipping off the stem 234 when tension is applied to the loop. In another example where the snare device is used to wrap around one of the protrusions 230, the loop of the snare device is tightened around the wrapped protrusion such that tension applied to the snare device applies to the clip 202, opening the clip 202 and pulling it away from the clipped tissue.

[0041] According to another exemplary method of using clip 202, grasping forceps can be used to grasp one or more protrusions 230 and remove deployed clip 202 in a manner substantially similar to that described above with respect to the use of a snare device. In one embodiment, the grasping forceps may be used to grasp two protrusions of jaws 210 (i.e., one jaw of the forceps grasps a protrusion at the end of a hinge coupled to a first of jaws 210, and the other jaw of the forceps engages a protrusion at the other end of the same hinge (i.e., at the end of the same hinge attached to the other jaw 210). Drawing the jaws of the forceps together then draws the protrusions toward each other, moving clip 202 from a closed configuration to an open configuration.

[0042] As described above with respect to system 100, forceps may be used to grasp two protrusions directly opposite each other (e.g., at first end 214 of jaws 210) or diagonally opposite each other (e.g., one protrusion 230 at first end 214 of one of jaws 210 and one protrusion at the second end of the second of jaws 210). In another embodiment, grasping forceps may be used to grasp a single protrusion 230 and pull clip 202 away from the clipped tissue.

[0043] 10 , a clip 302 according to another exemplary embodiment is substantially similar to clip 202 and includes jaws 310 coupled to one another via a connecting portion 318 that includes engaging portions 304, each of which may be configured as a protrusion 330 extending from an outer surface 328 of clip 302. Similar to protrusions 230, protrusions 330 include an enlarged head 332 coupled to outer surface 328 via a stem 334. However, stem 334 is bent and / or curved such that protrusions 330 extend in a proximal direction, e.g., in a direction away from tissue grasped by clip 302, in a substantially L-shaped configuration.

[0044] Once deployed / positioned, clip 302 may be removed from the clipped tissue in a manner substantially similar to clip 202, using any of the methods described above with respect to system 100 and clip 202. Specifically, any of a variety of through-the-scope devices, such as, for example, a snare device or grasping forceps, may be utilized to grasp and / or engage one or more of protrusions 330 to open, release, and remove clip 302 from the tissue, as described above.

[0045] 11 , a clip 402 according to another exemplary embodiment is substantially similar to the clips described above and includes jaws 410 movable via hinges 220 connected to jaws 412 at connecting portions 418 between an open configuration in which the jaws 410 are separated from one another and a biased closed configuration in which the jaws 410 are moved toward one another. However, in this embodiment, rather than a protrusion or notch, each connecting portion 418 includes an opening 430 extending through from an inner surface 429 of the clip 402 (i.e., the surface of the clip 402 that faces toward the end cap when the clip 402 is mounted on the end cap of an endoscope) to an outer surface 428 (i.e., the surface of the clip 402 that faces away from the end cap when the clip 402 is mounted on the end cap). Those skilled in the art will appreciate that opening 430 may take any of a variety of configurations, so long as opening 430 is configured to facilitate grasping of connecting portion 418, for example, via grasping forceps, and to move clip 402 from the closed configuration toward the open configuration in the manner described above.

[0046] Upon deployment / placement, clip 402 may be removed from the body using, for example, grasping forceps as described above. Specifically, grasping forceps may be used to grasp one or more of openings 430 and pull clip 402 from the clipped tissue or to draw opposing linking portions 418 (e.g., diagonally positioned or directly opposite) toward one another to move clip 402 from the closed configuration to the open configuration, as described above.

[0047] 12 , clip 502 may be substantially similar to the clips described above, including jaws 510 connected to one another via hinges 512 such that the jaws 510 are movable relative to one another between an open configuration in which the jaws 510 are separated from one another and a closed configuration in which the jaws 510 are moved toward one another. Clip 502 also includes engagement portions 504 through which the deployed / deployed clip 502 may be removed from the body using, for example, a snare device and / or grasping forceps. Each of the engagement portions 504 of clip 5023 is not positioned along connecting portion 518 connecting hinge 512 to jaws 510, but rather extends from the end of a corresponding one of jaws 510 opposite the tissue-grasping end of each of jaws 510 (i.e., opposite the surface of jaw 510 between which tissue is grasped).

[0048] In the illustrative embodiment, each of the engagement portions 504 includes a protrusion 530 extending from an edge 536 of the jaw 510 that faces away from the other one of the jaws 510, for example. Specifically, each protrusion 530 extends from the edge 536 of the corresponding one of the jaws 510 in a direction extending away from the other jaw 510, such that the protrusion 530 extends away from the grasped tissue and is thereby exposed to facilitate grasping via a grasping forceps or other device. Similar to the protrusions 230, 330 described above with respect to the clips 202, 302, respectively, the protrusion 530 includes an enlarged head 532 (or other engagement structure) coupled to the edge 536 via a stem 534. As described above with respect to the clips 202 and 302, the protrusion 530 facilitates removal of the clip 502 utilizing a through-the-scope device, such as a snare device or grasping forceps, using any of the removal methods described above.

[0049] It will be apparent to those skilled in the art that various modifications can be made in the present disclosure without departing from the scope of the disclosure. Furthermore, those skilled in the art will understand that the features of any of the various embodiments can be combined in any manner not inconsistent with the description and / or functionality of the embodiments.

Claims

1. a first jaw and a second jaw, each of the first jaw and the second jaw extending along a curve from a first end to a second end; a first hinge connecting the first end of the first jaw and the first end of the second jaw, and a second hinge connecting the second end of the first jaw and the second end of the second jaw, such that the first jaw and the second jaw are movable between an open configuration in which the first jaw and the second jaw are separated from each other and a closed configuration in which the first jaw and the second jaw are drawn toward each other to grasp tissue therebetween, wherein at least one of the first hinge and the second hinge is biased to draw a clip toward the closed configuration; a connecting portion connecting an end of each of the first and second hinges to a corresponding one of the first end and the second end of each of the first and second jaws, the connecting portion including an engaging portion configured to be engaged through a through-the-scope device to remove the clip from clipped tissue when the clip is deployed.

2. The clip of claim 1 , wherein the engagement portion includes a first notch extending along a portion of an outer edge of the connecting portion in alignment with a corresponding one of the first jaw and the second jaw.

3. The clip of claim 2 , wherein the engagement portion includes a second notch extending along a portion of the outer edge of the connecting portion in alignment with a corresponding one of the first hinge and the second hinge.

4. The clip of claim 3 , wherein the first notch and the second notch are configured as aligned slots.

5. The clip according to any one of claims 1 to 4, wherein the engagement portion is a protrusion extending from an outer surface of the connecting portion, the protrusion including an enlarged head connected to the outer surface via a stem.

6. The clip of claim 5 , wherein the stem extends substantially perpendicular to the outer surface.

7. The clip of claim 5 , wherein the stem includes an L-shaped bend.

8. The clip of any one of claims 1 to 7, wherein the engagement portion includes an opening that extends through the corresponding one of the connecting portions.

9. 9. The clip of claim 1, wherein each of the first hinge and the second hinge includes a curve extending toward and between the first jaw and the second jaw.

10. 10. The clip of claim 1, wherein the first jaw and the second jaw each include a plurality of teeth configured to grasp tissue received between the first jaw and the second jaw.

11. a first jaw and a second jaw, wherein a first end of the first jaw is coupled to a first end of the second jaw via a first hinge and a second end of the first jaw is coupled to a second end of the second jaw via a second hinge so that the first jaw and the second jaw are movable between an open configuration in which the first jaw and the second jaw are separated from each other and a closed configuration in which the first jaw and the second jaw are drawn together to grasp tissue therebetween, and at least one of the first hinge and the second hinge is biased to draw a clip toward the closed configuration; an over-the-scope clip comprising: a first engagement portion extending from an edge of the first jaw facing away from the second jaw; and a second engagement portion extending from an edge of the second jaw facing away from the first jaw.

12. 12. The clip of claim 11, wherein each of the first and second engaging portions includes a protrusion including an enlarged head that connects to the edge of the corresponding one of the first and second jaws via a stem.

13. 13. The clip of claim 11, wherein each of the first jaw and the second jaw extends along a curve that corresponds to a surface of an end cap of an endoscope to which the clip is attached.

14. The clip of any one of claims 11 to 13, wherein each of the first hinge and the second hinge includes a curve extending toward and between the first jaw and the second jaw.

15. 15. The clip of claim 11, wherein the first jaw and the second jaw each include a plurality of teeth configured to grasp tissue received between the first jaw and the second jaw.

Images